Biden signs $1.9T COVID-19 package that boosts ACA subsidies, rural hospital funding

White House
A major $1.9 trillion COVID-19 package was signed by President Joe Biden after the House passed an updated version. (uschools/iStock/Getty Images Plus/Getty Images)

President Biden signed into law a $1.9 trillion COVID-19 relief package that temporarily boosts Affordable Care Act (ACA) plan subsidies and includes $8.5 billion for rural hospitals.

The package is a mixed bag for providers, whose key priorities were excluded from the final text.

For instance, hospital groups had sought to add $35 billion to a provider relief fund to help stem losses caused by the virus. But the Senate version only included the $8.5 billion for rural providers.

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Providers also sought to extend a moratorium on a 2% cut to Medicare payments created under sequestration. The cuts were postponed at the start of the pandemic, but the moratorium ends at the end of March.

The Federation of American Hospitals (FAH) praised the package in a statement released after it passed the House earlier this week.

“The bill’s $8.5 billion allocation for rural providers will protect and support care for many of the nation’s most vulnerable patients, especially those who live in rural, underserved communities,” said FAH President and CEO Chip Kahn in a statement Wednesday. “Meanwhile, funding for vaccine distribution and testing included in the legislation takes direct aim at COVID-19’s grip on the nation.”

America’s Essential Hospitals, which represents safety net hospitals, also praised the package but stressed that hospitals need more help.

“They face persistent financial and resource challenges, and we will continue to work with Congress to secure appropriate and timely support for essential hospitals in future legislation,” said President and CEO Bruce Siegel, M.D., in a statement after the House passage.

The legislation also has several provisions that aim to increase insurance coverage. Chief among them is boosting income-based subsidies for ACA exchange plans for two years and increasing support for COBRA plans to ensure continuous coverage for the recently unemployed.

The Association for Community Affiliated Plans (ACAP), which represents safety net health plans, also applauded new incentives for states to expand Medicaid under the ACA and let states provide women with a year of continuous coverage in Medicaid and the Children’s Health Insurance Program after they give birth.

“This legislation will preserve crucial access to health care for working families,” said ACAP CEO Margaret Murray. “It gives states financial incentives to extend Medicaid to low-income, working adults, which includes many home health aides and others who work on the front lines.”