The U.S. Response to Coronavirus: Summary of the Coronavirus Preparedness and Response Supplemental Appropriations Act, 2020
The Coronavirus Preparedness and Response Supplemental Appropriations Act, 2020 (P.L. 116-123), which passed with near unanimous support in both the House and Senate, was signed into law by the President on March 6, 2020. The bill provides $8.3 billion in emergency funding for federal agencies to respond to the coronavirus outbreak. Of the $8.3 billion, $6.7 billion (81%) is designated for the domestic response and $1.6 billion (19%) for the international response. Key highlights are below. Additional details on specified activities and expenditure period are provided in Table 1:
Domestic Efforts:
Of the $6.7 billion designated for the domestic response:
- The majority ($6.2 billion) is for the Department of Health and Human Services (HHS) including:
- $3.4 billion for the Office of the Secretary – Public Health and Social Services Emergency Fund (PHSSEF), which includes more than $2 billion for the Biomedical Advanced Research and Development Authority (BARDA) (for the research and development of vaccines, therapeutics, and diagnostics), $300 million in contingency funding for the purchase of vaccines, therapeutics, and diagnostics to be used if deemed necessary by the Secretary of HHS, and $100 million for the Health Resources and Services Administration (HRSA) for grants under the Health Center Program, which aims to improve health care to people who are geographically isolated and economically or medically vulnerable.
- $1.9 billion for the Centers for Disease Control and Prevention (CDC), which includes $950 million for state and local response efforts, of which $475 million must be allocated within 30 days of the enactment of the bill, and $300 million for the replenishment of the Infectious Diseases Rapid Response Reserve Fund, which supports U.S. efforts to respond to an infectious disease emergency.
- $836 million for the National Institute of Allergy and Infectious Diseases (NIAID), which conducts research on therapies, vaccines, diagnostics, and other health technologies, at the National Institutes of Health (NIH).
- $61 million for the Food and Drug Administration (FDA) for the development and review of vaccines, therapeutics, medical devices and countermeasures, address potential supply chain interruptions, and support enforcement of counterfeit products.
- $20 million is for the Small Business Administration (SBA) disaster loans program to support SBA’s administration of loan subsidies that will be made available to entities financially impacted as a result of the coronavirus.
- The bill also includes a waiver removing restrictions on Medicare providers allowing them to offer telehealth services to beneficiaries regardless of whether the beneficiary is in a rural community, at an estimated cost of $500 million.
It is possible that some of the domestic funding could be used for international efforts.
International Efforts:
Of the $1.6 billion designated for the international response:
- The majority, $986 million, is provided to the United States Agency for International Development (USAID) including funding provided through:
- $435 million for the Global Health Programs (GHP) account to support health systems responding to the coronavirus outbreak overseas.
- $300 million for the International Disaster Assistance (IDA) account to support humanitarian assistance needs resulting from the coronavirus outbreak.
- $250 million for the Economic Support Fund (ESF) account to support economic, security and stabilization efforts resulting from the coronavirus outbreak
- $1 million for the Office of the Inspector General (OIG) for oversight of coronavirus response activities.
- The State Department receives $264 million to support consular operations, emergency evacuations, and other needs at U.S. embassies.
- $300 million is provided to CDC to support global disease detection and emergency response efforts.
Expenditure Period:
The bill specified that funding could be disbursed over a multi-year period, although the periods vary by agency and account. For instance, Congress specified funding provided through the CDC “to remain available until September 30, 2022,” funding provided through the FDA “to remain available until expended,” and funding provided through NIAID “to remain available until September 30, 2024.”
Table 1: Coronavirus Supplemental Funding | |||
Agency/Department/Account | Total Funding | Expenditure Period | Description |
Domestic Response | |||
Department of Health and Human Services (HHS) | $6,197,000,000 | – | – |
Office of the Secretary Public Health and Social Services Emergency Fund |
$3,400,000,000 | “to remain available until September 30, 2024” | “to prevent, prepare for, and respond to coronavirus, domestically or internationally, including the development of necessary countermeasures and vaccines, prioritizing platform-based technologies with U.S.-based manufacturing capabilities, and the purchase of vaccines, therapeutics, diagnostics, necessary medical supplies, medical surge capacity, and related administrative activities” |
of which Public Health and Social Services Emergency Fund | $300,000,000 | “to remain available until September 30, 2024” | “for products purchased … including the purchase of vaccines, therapeutics, and diagnostics” |
of which Health Resources and Services Administration (HRSA) | $100,000,000 | – | ” to prevent, prepare for, and respond to coronavirus” for grants under the Health Centers Program |
Centers for Disease Control and Prevention* | $1,900,000,000 | “to remain available until September 30, 2022” | CDC-Wide activities and program support: “to prevent, prepare for, and respond to coronavirus, domestically or internationally” |
of which | $950,000,000 | – | “Not less than this amount shall be provided for grants to or cooperative agreements with States, localities, territories, tribes, tribal organizations, urban Indian health organizations, or health service providers to tribes, to carry out surveillance, epidemiology, laboratory capacity, infection control, mitigation, communications, and other preparedness and response activities” |
of which Infectious Diseases Rapid Response Reserve Fund (Reserve Fund) | $300,000,000 | – | ” to replenish the Infectious Diseases Rapid Response Reserve Fund, which supports immediate response activities during outbreaks” |
of which | $40,000,000 | – | “Not less than $40,000,000 of such funds shall be allocated to tribes, tribal organizations, urban Indian health organizations, or health service providers to tribes” |
National Institutes of Health (NIH) – National Institute of Allergy and Infectious Diseases (NIAID)* |
$836,000,000 | “remain available until September 30, 2024” | “to prevent, prepare for, and respond to coronavirus, domestically or internationally” |
of which National Institute of Environmental Health Sciences (NIEHS) | $10,000,000 | – | “for worker-based training to prevent and reduce exposure of hospital employees, emergency first responders, and other workers who are at risk of exposure to coronavirus through their work duties” |
Food and Drug Administration* | $61,000,000 | “to remain available until expended” | “to prevent, prepare for, and respond to coronavirus, domestically or international, including the development of necessary medical countermeasures and vaccines, advanced manufacturing for medical products, the monitoring of medical product supply chains, and related administrative activities.” |
Small Business Administration | $20,000,000 | – | – |
Disaster Loans Program Account | $20,000,000 | “to remain available until expended” | “to make economic injury disaster loans … in response to the coronavirus” |
Telehealth Services | $500,000,000 | Not specified | “to waive certain Medicare telehealth restrictions during the coronavirus public health emergency. These waivers would allow Medicare providers to furnish telehealth services to Medicare beneficiaries regardless of whether the beneficiary is in a rural community” |
Total Domestic Response | $6,717,000,000 | – | – |
International Response | |||
USAID | $986,000,000 | – | – |
Office of Inspector General | $1,000,000 | “to remain available until September 30, 2022” | Oversight activities |
Global Health Programs | $435,000,000 | “to remain available until September 30, 2022” | “to prevent, prepare for, and respond to coronavirus” |
of which Emergency Reserve Fund | $200,000,000 | “to remain available until September 30, 2022” | – |
International Disaster Assistance | $300,000,000 | “to remain available until expended” | “to prevent, prepare for, and respond to coronavirus” |
Economic Support Fund | $250,000,000 | “to remain available until September 30, 2022” | “to prevent, prepare for, and respond to coronavirus, including to address related economic, security, and stabilization requirements” |
Department of State | $264,000,000 | – | – |
Diplomatic & Consular Programs | $264,000,000 | “to remain available until September 30, 2022” | “to prevent, prepare for, and respond to coronavirus, including for maintaining consular operations, reimbursement of evacuation expenses, and emergency preparedness” |
Centers for Disease Control and Prevention | $300,000,000 | “to remain available until September 30, 2022” | “global disease detection and emergency response” |
Total International Response | $1,550,000,000 | – | – |
Total Coronavirus Funding | $8,267,000,000 | – | – |
NOTES: * Indicates funding that could be used both domestically and internationally SOURCES: KFF analysis of the “Coronavirus Preparedness and Response Supplemental Appropriations Act, 2020” (P.L. 116-123); House Appropriations H.R. 6074: Coronavirus Preparedness and Response Supplemental Appropriations Act, 2020 Title-By-Title Summary. |