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America is confronting a difficult balancing act – how to open businesses and schools to accelerate economic improvement while, prior to vaccine availability, bringing down COVID-19 case counts to levels where people feel confident enough to fully participate in America’s economic and social life. Congress has a critical role to play in forging the way forward on these existential national challenges, but our window of opportunity is closing.
In April, United States of Care released a comprehensive set of federal recommendations informed, as always, by our Board and Founder’s Council, the private sector advisors serving on our Entrepreneurs Council, our work listening to people across the country and guided by public opinion research. Many of our proposals were included in the pandemic response legislation passed earlier this year.
United States of Care believes Congress must again come together to ensure all people living in our country are safe, including communities of color, people with disabilities and those with chronic diseases who have faced a disproportionate burden from this pandemic. As Congress debates the next federal response to help both people and state and local governments battle COVID-19. USofCare recommends three top priorities be addressed in the next relief package.
Support the Ongoing Robust Public Health Response
Government is the word we use for the things we do together. That is why it is only with significant support, resources and guidance from federal agencies that we will be able to bring case counts down to levels allowing us to safely resume normal activities. Wearing masks is a critical component of that work. Our reality, however, is that Congress is the only entity which can provide the resources necessary for our communities to work in unison to combat COVID-19.
- Congress should appropriate $75 billion for contact tracing, testing and isolation efforts across the country. As COVID-19 spikes in certain regions, state and local health departments are doing all they can to test and trace people who are positive and contact the individuals they may have been in close proximity to. Some experts have said the country needs 300,000 contact tracers and there have been calls for a contact tracing army. As regions spike, some places have failed to conduct contact tracing at all. Whether through shoe leather, technology or both, this tried and true public health strategy is inextricably linked to the employee and consumer confidence necessary to keep our economy open. Failure to execute these steps on the scale needed has resulted in the very surges we have been working so hard to prevent, erasing the sacrifices people, communities, and businesses have made. Contact tracing workers are also essential in connecting vulnerable populations to care, particularly if they are recruited from – and trusted by – the communities in which they work.
Supporting People and States
Individual households, as well as state and local governments, require ongoing support as the pandemic continues. As many people remain out of work, Congress should ensure continued unemployment assistance is available to meet basic needs. It is also critical for a person’s mental and physical health to have safe and stable housing; we must ensure people have ongoing protection from evictions and foreclosures during the pandemic.
- Congress should appropriate $500 billion in new state and local funding. State budgets have not been able to meet the demands of the pandemic as income, corporate and sales tax revenues have been decimated. States and localities have no other place to turn than the federal government to bridge the significant gaps in tax revenue they are experiencing. For example, research cited above indicates each percentage point increase in unemployment corresponds with a $45 billion loss to state budgets nationwide. Without an infusion of federal funds, basic services including public safety, fire, ambulance and education are at risk, exacerbating both unemployment and the reduction of the critical services people rely on to keep healthy and well.
- Establish new incentives for states to increase Medicaid eligibility. States could be incentivized to expand Medicaid by offering a 100 percent federal match for those enrolled in coverage through Medicaid expansion. The 100 percent match would be available to all states, regardless of whether they previously expanded Medicaid.
- Provide $38.5 billion to ensure continuation of critical mental health resources. Funding is required for direct payments to behavioral health providers to ensure they remain open, operational, and able to provide care during the COVID-19 pandemic. The need for mental health and substance abuse services is growing, yet behavioral health organizations are already laying off staff, cutting programs, and may need to cancel services or close clinics in the coming weeks. Without robust investment in behavioral health, these organizations will not be able to keep their doors open, leading many people to seek emergency services and further stressing hospital emergency departments.
Transforming Health Care For The Future
We need to build a reliable health care system adequately resourced to support front-line workers and our communities both now and after the pandemic. Congress should take this opportunity today to build a stronger health care system for the future.
- Build a health care workforce to tackle COVID-19 and future pandemics in all communities. We need both a public health workforce able to be quickly activated to respond during public health emergencies and also additional sustained capacity to meet diverse public health needs in different communities. Congress should establish a million-strong Health Care Ready Reserve similar to the reserve forces of the military branches. A health care reserve corps could be activated when extraordinary surges in health care workers are necessary. The Cultivating Opportunity and Response to the Pandemic Through Service (CORPS) Act which utilizes an AmeriCorps model and The Health Force and Resilience Force Act are two pieces of legislation designed to help take communities through and beyond the COVID-19 pandemic into the new normal. This innovative idea has the additional benefit of also providing jobs within people’s own communities in order to lay the groundwork for a stronger public health workforce. Community health workers, frontline public health professionals with established and trusted local relationships, should be included in the efforts to design and stand up these types of programs.
- Transform how our health care providers are paid by establishing a COVID-19 Health Care Resilience Program. Many providers and hospitals are suffering significant financial losses. In particular, primary care physicians on the front lines of initial COVID-19 response and diagnosis have experienced significant reductions in the number of patients coming into their offices. Congress can seize this moment by improving access and care now, keeping providers in business and reducing costs in the future all while accelerating the long necessary transition to Value Based Payment (VBP) arrangements. Upfront payments would immediately allow providers to invest in the resources they need to respond to COVID-19, including:
- Testing supplies (e.g., personal protective equipment) and staff for screening, testing, and contact tracing;
- Infrastructure to facilitate COVID-19 data sharing with public health authorities; and
- Telehealth and remote monitoring tools to support the implementation or expansion of home-based models of care.
These shifts will make providers, and the entire health care system, increasingly resilient when confronted by future public health crises.
Congress has a window of opportunity to address key needs for people. USofCare stands ready to work with both the House and the Senate and Members on each side of the aisle to put people over politics.
Hear what our Director of Policy, Federal Affairs and Partnerships – Andrew Schwab – has to say about these recommendations: