Last week the U.S. House of Representatives passed the HEROES Act, a $3 trillion omnibus measure that addresses health care and economic needs related to the COVID-19 pandemic. The legislation is now in the Senate, where it is unlikely to pass in its current form.

The pandemic has made clear that the health and well-being of each of us depends on the health and wellbeing of all of us. While Congress has taken early steps to provide relief for individuals and businesses, the enacted measures have excluded millions of immigrants and their families. We are pleased that the HEROES Act takes a more inclusive approach to extending safety net protections to keep us all healthy during this public health crisis. It includes important provisions to ensure access to care for low- and middle-income people, support the health care safety net, and begin to address health inequities. Most importantly, it includes critical federal funding for Medicaid, which would protect health coverage for low-income residents at a time when states are facing massive revenue shortfalls.

Even with this positive development in the House, more work is needed to eliminate disparities in access to care. NoHLA, along with 30 partner organizations, has sent a letter to Washington’s congressional delegation urging them to take specific steps to ensure that all residents have equitable, affordable access to needed health care services. The HEROES Act includes several of our recommendations, but our letter identifies additional opportunities for Congress to address affordability for low-income Medicare enrollees, low- and ­­­­middle-income residents who purchase coverage through the Health Benefit Exchange, and immigrants who are uninsured and are ineligible for Apple Health (Medicaid).

As the action moves to the Senate, we encourage policymakers to consider these coverage gaps and the importance of ensuring that we all have access to affordable health care, now more than ever.

A section-by-section summary of the 1,800-page HEROES Act is available here, but highlights include the following:

 Medicaid & Medicare

• Increases federal Medicaid match by 14 percent for one year and increases federal payments for home- and community-based services by 10 percent.
• Allows states to cover COVID treatment and an eventual COVID vaccine for the uninsured through the new Medicaid eligibility pathway, and eliminates cost-sharing for COVID treatment and vaccines for Medicaid beneficiaries.
• Extends Medicaid eligibility to citizens of Freely-Associated States (COFA).
• Eliminates cost-sharing for COVID treatment for Medicare beneficiaries and creates a new special enrollment period for Medicare.

 Private Insurance

• Requires health plans to cover COVID treatment and waives cost-sharing, and makes free coverage of COVID testing retroactive.
• Disregards pandemic unemployment income for purposes of calculating marketplace premium subsidies.
• Covers COBRA premiums for workers who have been laid off or furloughed.

 Health Care Safety Net

• $7.6 billion for health centers to expand their capacity to provide testing, triage, and care for COVID and other services.
• $3 billion to increase behavioral health treatment and support.
• $2.1 billion for COVID-related health care needs for Native Americans.
• Codifies the Health Care Provider Relief Fund, allows providers to seek reimbursement for providing COVID treatment to uninsured people, and requires providers who receive reimbursements to agree not to balance bill insured patients or seek additional payment from uninsured patients.

 Racial Disparities

• Funds modernization of data collection related to health inequities, requires a report to Congress with disaggregated data, and requires a proposal of evidence-based response strategies to reduce disparities.

 Economic Support

• Allocates approximately $1 trillion for state, local, and tribal government coronavirus relief funds, including more than $11 billion for Washington State.
• Provides additional direct payments of $1,200 per family member and makes direct payments available to people who use a Taxpayer Identification Number instead of a Social Security Number.
• Allocates funding for SNAP, WIC, and other food assistance programs.

–Alexa Silver, NoHLA Consulting Attorney