Senate HEALS Act vs. House HEROES Act

July 31, 2020

The Senate HEALS Act and the House HEROES Act emergency relief bills are now the basis for ongoing negotiations in Washington, please see the attached chart that compares the provisions of each bill.  

The GOP relief package that the Republicans are calling the HEALS Act is a $1 trillion package that omits many of the key priorities that Democrats included in the HEROES Act.  At present there are no proposal in the HEALS Act for state and local funding.   This is their opening position. 

Highlights of the HEALS Act proposals include:

–        Extension of Medicare telehealth waivers through the length of the public health emergency, or December 31, 2021, whichever is later. The bill calls for a full analysis of the impact of expanded telehealth allowances and provides Congress the opportunity to legislate before the flexibilities expire. It also maintains telehealth expansions specific to federally qualified health centers (FQHC) and rural health centers (RHC) for five years beyond the end of the PHE

–          $4.5 Billion Supplemental Appropriation to SAMHSA, including: 

  • Community Mental Health Services Block Grant – $2 billion, of which, no less than 50 percent of funds shall be directed to community mental health centers as defined by the Public Health Services Act. This broad definition encompasses organizations that provide any of the following services:
    • Outpatient services for children, the elderly, individuals with a serious mental illness or residents who have been discharged from inpatient treatment;
    • 24-hour emergency care services;
    • Day treatment, partial hospitalization or psychosocial rehabilitation services;
    • Treatment and services through child mental health programs, psychosocial rehabilitation programs, peer support programs, and mental health primary consumer-directed programs
  • Substance Abuse and Prevention Treatment Block Grant – $1.5 billion
  • Certified Community Behavioral Health Clinics – $600 million for expansion grants
  • Suicide Prevention Programs – $50 million
  • Project AWARE – $100 million to support mental health once children return to school
  • Emergency Grants to States – $250 million for flexible emergency grants to states

–        Public Health and Social Services Emergency Fund. $25 billion in new money for the Health Care Provider Relief Fund.

–        Liability Protections for Employers. The bill would create an exclusive federal cause of action for COVID-19 exposure lawsuits that runs retroactively from December 1, 2019 until October 1, 2024.  It would establish a safe harbor for businesses that undertake reasonable efforts to comply with public health and safety guidelines. In cases where defendants do not take such efforts, plaintiffs must demonstrate that the defendant’s gross negligence or willful misconduct caused the plaintiff’s infection.

–        Continuing Small Business Recovery and Paycheck Protection Program. The legislation would provide a second round of PPP loans for certain businesses that have already received a loan, setting aside $190 billion for business and nonprofits with at most 300 employees (down from the 500-employee threshold in the first round). To receive a second PPP loan, companies would have to demonstrate a 50 percent reduction in gross revenues over the same quarter last year.

The HEALS Act does not include an increase to the Medicaid FMAP as passed by the House’s HEROES Act back in May. The National Council continues its efforts to secure inclusion of an increase in federal matching dollars to state Medicaid programs as negotiations continue.

Small Business Relief. The legislation would provide a second round of PPP loans for certain businesses that have already received a loan, setting aside an additional $190 billion in funding. In order to receive a second PPP loan, companies would have to demonstrate a 50 percent reduction in gross revenues over the same quarter last year, and eligible businesses would include businesses with at most 300 employees (down from the 500 employees in the first round) or that meet one of the SBA’s revenue threshold. Borrowers would have more flexibility in using their loans, including for supplier payments, worker protection measures, cloud services, payroll software, and property damage arising from civil unrest. Additionally, eligibility would be expanded for 501(c)(6) non-lobbying organizations that have 50 or fewer employees with a covered loan no more than $500k.