The Families First Coronavirus Response Act (H.R. 6201) that passed the House in the early hours of March 14 has yet to reach the Senate as work continues to address technical corrections to the bill that staff characterize as significant changes. The universe of potential changes has not been publicly revealed, but the plan is to reach an agreement as soon as possible and have the revised measure re-approved by the House and sent to the Senate. The House is out of session and the intent is for the chamber to clear the revised bill by unanimous consent. House members have been advised that a 24-hour notice will be given if members are required to return before March 23.

The corrections negotiations are led by House Speaker Nancy Pelosi (D-CA) and Treasury Secretary Steven Mnuchin, who reached the deal to bring the initial bill to the floor early Saturday morning. Changes to the bill are also being negotiated with the input of Senate Majority Leader Mitch McConnell (R-KY), with the expectation that the Senate would try to approve the version the House sends over (as opposed to making further changes that would ping-pong the bill between chambers).

During a Saturday news conference with the President and others, Secretary Mnuchin first publicly raised the prospect that changes to the freshly passed bill would be required, saying: "I don't want people to be surprised. We will be doing a technical correction on Monday morning. Despite us working very hard, we had language agreed with the Speaker and with Kevin McCarthy. It didn't get into the final bill last night at 12:30. Kevin, the Speaker, and I agreed that they would vote on it and have an agreement. There'll be a technical correction. So, I don't want anybody to come back on Monday morning and be surprised by that."

Speaker Pelosi has said she envisions work on a "third emergency response package that will take further effective action that protects the health, economic security and well-being of the American people," but that it may be developed under a less urgent timetable. The additional economic security measures that will be considered in the future legislation are unclear but will soon be under development.

The base bill of the Families First Coronavirus Response Act would require insurers to fully cover coronavirus diagnostics and related services, provide affected individuals with paid sick and family leave and create tax credits for affected employers, expand food and nutrition services, allow for emergency state unemployment insurance grants, and increase Medicaid funding to states, among other things.

Highlights of the House-passed bill include:

• Food and nutrition: $500M additional support for the WIC program; $400M for the Commodity Assistance Program; $100M for eligible school children when schools are closed; $250M made available for home and other nutrition services for the aging and disabled; and waiving of statutory requirements for several food programs to allow for emergency provisions and added safety measures, including waiving federal work requirements.
• Funding for free testing: $82M for COVID-19 related diagnostics and related items and services for TRICARE and $642M for IHS, $60M for the VA, and $1B to pay claims of providers for reimbursement of such health services.
• Free testing requirements: Group health plans and health insurance issuers offering group or individual health insurance coverage, along with Medicare Advantage plans, TRICARE, and the VA, may not impose cost-sharing or prior authorization requirements for diagnostic laboratory tests for detection of SARS-COV-2 or diagnosis of COVID-19 or related items or services. Coverage and waving of cost-sharing is also required for these items and services under Medicare, Medicaid, CHIP, IHS, and for the civil service.
• Increase in Medicaid funding: Temporary increase in Medicaid Federal Medical Assistance Percentage (FMAP) of 6.2% if states meet certain requirements for coverage of COVID-19, an increase in Medicaid allotments for the territories for FY2020 and FY2021, and a state option to provide coverage for the detection of the virus for uninsured individuals with 100% FMAP for these purposes.
• Emergency family and medical leave: Creates an emergency family and medical leave program in response to the coronavirus. Private sector employers with fewer than 500 workers and government entities would have to provide as many as 12 weeks of job-protected leave to employees at an amount not less than two-thirds pay for leave due to compliance with a recommendation or order by a public official or health care provider, to care for a family member with coronavirus, or to care for a child whose school or place of care is closed more than five days due to a public emergency. The first 14 days could be unpaid, although a worker could choose to use other accrued leave. The Labor Department is authorized to issue regulations to exclude certain health care providers and exempt small businesses with fewer than 50 employees.
• Emergency paid sick leave: Private sector employers with fewer than 500 workers and government entities would have to provide paid sick leave of 80 hours for full-time employees and average hours for a two-week period for part-time employees due to coronavirus diagnosis, symptoms, or preventative care, or due to a recommendation or order by a public official or health care provider, to care for a family member with coronavirus, or to care for a child whose school or place of care is closed due to a public emergency. Workers would be paid the greater of their normal wage or local minimum wage or two-thirds pay for providing care to a family member. The provision expires at the end of the year.
• Tax credits for paid sick and family and medical leave: Payroll credit for required paid sick ($511 per day limit while the employee is caring for themselves and $200 per day limit for a family member or if a child's school is closed) and family leave ($200 per day limit or an aggregate of $10,000) for wages through the end of 2020. The language was expanded to include credits for self-employed individuals ($511 per day limit while is employee is caring for themselves and $200 if caring for a family member for sick leave and the lesser of $200 or their average daily self-employment income for family leave).
• Unemployment insurance: Provide as much as $1 billion for emergency transfers to states in fiscal 2020 to process and pay unemployment benefits. Individuals in states with rising unemployment can qualify for an additional 13 weeks (20 in some states) for unemployment benefits.
• Mask liability: The measure would make personal respiratory protective devices a covered countermeasure under the Public Readiness and Emergency Preparedness Act, which allows HHS to provide liability protections for certain emergency response products.
• Waives PAYGO: The bill waives statutory PAYGO requirements.

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