The Biden Plan to Combat Coronavirus (COVID-19) and Prepare for Future Global Health Threats
THE BIDEN PLAN TO COMBAT CORONAVIRUS (COVID-19) AND PREPARE FOR FUTURE GLOBAL HEALTH THREATS
For more information on Joe’s leadership during the Coronavirus pandemic, please visit here.
For more information from the Centers for Disease Control and Prevention regarding the coronavirus, please visit here.
The American people deserve an urgent, robust, and professional response to the growing public health and economic crisis caused by the coronavirus (COVID-19) outbreak. That is why Joe Biden is outlining a plan to mount:
- A decisive public health response that ensures the wide availability of free testing; the elimination of all cost barriers to preventive care and treatment for COVID-19; the development of a vaccine; and the full deployment and operation of necessary supplies, personnel, and facilities.
- A decisive economic response that starts with emergency paid leave for all those affected by the outbreak and gives all necessary help to workers, families, and small businesses that are hit hard by this crisis. Make no mistake: this will require an immediate set of ambitious and progressive economic measures, and further decisive action to address the larger macro-economic shock from this outbreak.
Biden believes we must spend whatever it takes, without delay, to meet public health needs and deal with the mounting economic consequences. The federal government must act swiftly and aggressively to help protect and support our families, small businesses, first responders and caregivers essential to help us face this challenge, those who are most vulnerable to health and economic impacts, and our broader communities – not to blame others or bail out corporations.
Public health emergencies require disciplined, trustworthy leadership grounded in science. In a moment of crisis, leadership requires listening to experts and communicating credible information to the American public. We must move boldly, smartly, and swiftly. Biden knows how to mount an effective crisis response and elevate the voices of scientists, public health experts, and first responders. He helped lead the Obama-Biden Administration’s effective response to the 2009 H1N1 pandemic and the 2014 Ebola epidemic. Biden also helped lead the response to the greatest economic crisis since the Great Depression and ran point on implementation of the Recovery Act. He knows how to get relief out the door to families, as well as resources to state and local officials to deal with the challenges they are facing.
And, even as we respond to this crisis, we must prepare for the next one. As President, Biden will establish and manage a permanent, professional, sufficiently resourced public health and first responder system that protects the American people by scaling up biomedical research, deploying rapid testing capacity, ensuring robust nationwide disease surveillance, sustaining a first class public health and first responder workforce, establishing a flexible emergency budgeting authority, and mobilizing the world to ensure greater sustained preparedness for future pandemics.
Congress has taken a step forward by passing an initial bipartisan emergency plan to combat COVID-19. The Trump Administration must now heed the calls of House Speaker Nancy Pelosi and Senate Democratic Leader Chuck Schumer to put the health and safety of the American people first. Much more needs to be done, now, to bring our country together, respond to this emergency, and set the groundwork for bold, long-term reforms, including ensuring quality, affordable health care and a comprehensive paid leave program for every American.
Biden will be ready on Day One of his Administration to protect this country’s health and well-being. But he is not waiting until then to communicate his views on what must be done now to properly serve the American people. Biden believes the following steps must immediately be taken. If Trump does not take them, Biden will on Day One as President.
The Biden Plan calls for:
- Restoring trust, credibility, and common purpose.
- Mounting an effective national emergency response that saves lives, protects frontline workers, and minimizes the spread of COVID-19.
- Eliminating cost barriers for prevention of and care for COVID-19.
- Pursuing decisive economic measures to help hard-hit workers, families, and small businesses and to stabilize the American economy.
- Rallying the world to confront this crisis while laying the foundation for the future.
Biden understands that this is a dynamic situation. The steps proposed below are a start. As the crisis unfolds, Biden will build on this policy to address new challenges.
RESTORING TRUST, CREDIBILITY, AND COMMON PURPOSE
Stop the political theater and willful misinformation that has heightened confusion and discrimination. Biden believes we must immediately put scientists and public health leaders front and center in communication with the American people in order to provide regular guidance and deliver timely public health updates, including by immediately establishing daily, expert-led press briefings. This communication is essential to combating the dangerous epidemic of fear, chaos, and stigmatization that can overtake communities faster than the virus. Acts of racism and xenophobia against the Asian American and Pacific Islander community must not be tolerated.
Ensure that public health decisions are made by public health professionals and not politicians, and officials engaged in the response do not fear retribution or public disparagement for performing their jobs.
Immediately restore the White House National Security Council Directorate for Global Health Security and Biodefense, which was established by the Obama-Biden Administration and eliminated by the Trump Administration in 2018.
MOUNTING AN EFFECTIVE NATIONAL EMERGENCY RESPONSE THAT SAVES LIVES, PROTECTS FRONTLINE WORKERS, AND MINIMIZES THE SPREAD OF COVID-19
Make Testing Widely Available and Free
Ensure that every person who needs a test can get one – and that testing for those who need it is free. Individuals should also not have to pay anything out of their own pockets for the visit at which the test is ordered, regardless of their immigration status. The Centers for Disease Control and Prevention (CDC) must draw on advice from outside scientists to clarify the criteria for testing, including consideration of prioritizing first responders and health care workers so they can return to addressing the crisis.
Establish at least ten mobile testing sites and drive-through facilities per state to speed testing and protect health care workers. Starting in large cities and rapidly expanding beyond, the CDC must work with private labs and manufacturers to ensure adequate production capacity, quality control, training, and technical assistance. The number of tests must be in the millions, not the thousands.
Provide a daily public White House report on how many tests have been done by the CDC, state and local health authorities, and private laboratories.
Expand CDC sentinel surveillance programs and other surveillance programs so that we can offer tests not only only to those who ask but also to those who may not know to ask, especially vulnerable populations like nursing home patients and people with underlying medical conditions. This must be done in collaboration with private sector health care entities.
Task the Centers for Medicare and Medicaid Services to help establish a diagnosis code for COVID-19 on an emergency basis so that surveillance can be done using claims data.
Surge Capacity for Prevention, Response, and Treatment
Task all relevant federal agencies to take immediate action to ensure that America’s hospital capacity can meet the growing need, including by:
- Preparing to stand up multi-hundred-bed temporary hospitals in any city on short notice by deploying existing Federal Medical Stations in the strategic national stockpile and preemptively defining potential locations for their use as needed.
- Directing the U.S. Department of Defense (DOD) to prepare for potential deployment of military resources, both the active and reserve components, and work with governors to prepare for potential deployment of National Guard resources, to provide medical facility capacity, logistical support, and additional medical personnel if necessary. This includes activating the Medical Reserve Corps, which consists of nearly 200,000 volunteer health care professionals who stand ready to serve across America; training and deploying additional surge capacity, including U.S. Department of Veterans Affairs/DOD medical equipment and U.S. Department of Health and Human Services (HHS) Disaster Assistance Medical Teams; and directing and assisting existing hospitals to surge care for 20% more patients than current capacity through flexible staffing, use of telemedicine support, and delaying elective procedures.
- Instructing the CDC to establish real-time dashboards tracking (1) hospital admissions related to COVID-19, especially for ICUs and emergency departments, in concert with the American Hospital Association and large hospital chains, for which the HHS must ensure data is able to be shared, as needed; and (2) supply chain information – including availability, allocation, and shipping – for essential equipment and personal protective equipment, including in the various places where there may be federal reserves. The strategic national stockpile must be used to supplement any shortages that exist, especially for essential medical supplies, like oxygen, ventilators, and personal protective equipment.
- Ensuring that training, materials, and resources reach federally qualified health centers, rural health clinics, and safety-net hospitals, which are typically resource-poor and care disproportionately for vulnerable populations that will bear the brunt of COVID-19. This effort will lay the foundation for a deeper and more lasting public health infrastructure for accessible national health care for all.
Surge tele-emergency room, tele-ICU care, and telemedicine through a concerted, coordinated effort by health care providers to enable staff to manage additional patients and save beds for the very sick. Leverage existing efforts like Project ECHO to ensure health professionals have tele-mentoring and other training resources they need to make informed decisions.
Support older adults, vulnerable individuals, and people with disabilities. Ensure essential home- and community-based services continue and Centers for Medicare and Medicaid works to provide the waivers necessary for those who rely on medication to have a sufficient supply.
Protect health care workers, first responders, assisted living staff, and other frontline workers.
- Give all frontline workers high-quality and appropriate personal protective equipment – and enough of it and appropriate training to use it – so they don’t become infected. If our health care workers, first responders, and essential workers like transportation and food workers cannot function, we cannot protect and care for the public. The Biden Plan calls for issuing guidance to states and localities to ensure first responders and public health officials are prioritized to receive protective personal equipment and launching an education campaign to inform the general public about equipment that should be reserved for professionals.
- Direct the Occupational Safety and Health Administration (OSHA) to keep frontline workers safe by issuing an Emergency Temporary Standard that requires health care facilities to implement comprehensive infectious disease exposure control plans; increasing the number of OSHA investigators to improve oversight; and working closely with state occupational safety and health agencies and state and local governments, and the unions that represent their employees, to ensure comprehensive protections for frontline workers.
Ensure first responders, including local fire departments and Emergency Medical Services, can meet the staffing requirements needed to respond and are trained to recognize the symptoms of COVID-19.
Accelerate the Development of Treatment and Vaccines
Ensure the National Institutes of Health (NIH) and the Biomedical Advanced Research and Development Authority are swiftly accelerating the development of rapid diagnostic tests, therapeutics and medicines, and vaccines. NIH must be responsible for the clinical trial networks and work closely with the U.S. Food and Drug Administration (FDA) on trial approvals.
Ensure the FDA is working with the NIH to prioritize review and authorization for use of COVID-19 countermeasures and strengthen regulatory science at the FDA to make certain it has the needed resources to evaluate the safety and efficacy of new tools.
Provide Timely Information and Medical Advice and Guidance
Work with the CDC and HHS to ensure that health departments and health providers across the country give every person access to an advice line or interactive online advice so they can make an informed decision about whether to seek care or to stay at home. This will preserve the health care system for those who are sick and prevent people who may not need to see a provider from becoming needlessly exposed. Ensure all information provided to the public is accessible to people with disabilities, including through plain language materials and American sign language interpreters.
Instruct the CDC to provide clear, stepwise guidance and resources about both containment and mitigation for local school districts, health care facilities, higher education and school administrators, and the general public. Right now, there is little clarity for these groups about when to move toward social distancing measures, like cancelling school, mass gatherings, and travel and when to move to tele-work and distance learning models.
Ensure firefighters and other emergency responders are notified if they have been exposed to individuals infected with COVID-19.
Launching Urgent Public Health System Improvements for Now and the Future
Work with businesses to expand production of personal protective equipment, including masks and gloves, and additional products such as bleach and alcohol-based hand sanitizer. Incentivize greater supplier production of these critically important medically supplies, including committing, if necessary, to large scale volume purchasing and removing all relevant trade barriers to their acquisition.
Task the U.S. Department of Justice with combating price gouging for critical supplies.
Take steps in the aftermath of the crisis to produce American-sourced and manufactured pharmaceutical and medical supply products in order to reduce our dependence on foreign sources that are unreliable in times of crisis. The U.S. government should immediately work with the private sector to map critical health care supplies; identify their points of origin; examine the supply chain process; and create a strategic plan to build redundancies and domestic capacity. The goal is to develop the next generation of biomedical research and manufacturing excellence, bring back U.S. manufacturing of medical products we depend on, and ensure we are not vulnerable to supply chain disruptions, whether from another pandemic, or because of political or trade disputes.
Establish and fund a U.S. Public Health Service Reserve Corps to activate former Public Health Service Commissioned Corps officers to expand medical and public health capacity. By creating the Reserve Corps, we will have a larger team of health professionals to deploy across the nation to help train health care systems in detection and response, educate the public, provide direct patient care as needed, and support the public health infrastructure in communities that are often under-resourced and struggling.
Expand the Staffing for the Adequate Fire and Emergency Response (SAFER) Grant program so that fire departments – critical first responders in health emergencies—can increase staffing. As Vice President, Biden secured an expansion of the SAFER Act to keep more firefighters on the job during the Great Recession. He will expand the grants to build well-staffed, well-trained fire departments across the country.
Providing the Resources Necessary to Achieve These Outcomes
To implement this national emergency response, the Biden Plan calls for an immediate increase of federal resources to cover all necessary federal costs, as well as the creation of a State and Local Emergency Fund that gives state and local leaders the power to meet critical health and economic needs to combat this crisis. This Fund will be designed as follows:
Resources will be allocated according to a formula: 45% to state governments; 45% to local governments; and 10% reserved for special assistance for “hot-spots” of community spread.
Menus of Permissible Usages: Governors and mayors will be given significant flexibility to ensure that they can target their health and economic spending where it is most needed in their respective states and cities. Such usages include:
- Paying for medical supplies and expanding critical health infrastructure, including building new or renovating existing facilities, if necessary;
- Expanding hiring where needed including health care and emergency services workers, caregivers in nursing homes, drivers, childcare workers, substitute teachers, and others;
- Providing overtime reimbursements for health workers, first responders, and other essential workers.
The Fund will also be deployed to cushion the wider economic impact of the crisis, helping hard-hit families and communities, as described later in the fact sheet.
Bringing Our Country Together
Now is the time for empathy, decency, and unity. In times of crisis, Americans come together, and everyone steps up to meet our shared civic duty. We need that spirit now: volunteers standing ready to fill essential gaps, neighbors looking out for neighbors, business taking care of their workers, people contributing to frontline non-profit organizations, social media companies combating the spread of misinformation, universities and the private sector driving innovation in the search for new treatments and vaccines, and all of us following the guidance of health officials to take steps that reduce the spread of the virus. Biden believes this can’t just be a government response — it has to be a whole-of-society response.
ELIMINATING COST BARRIERS FOR PREVENTION OF AND CARE FOR COVID-19
The cost of preventive care, treatment, and a potential vaccine could be an insurmountable economic barrier for many Americans. If we fail to remove this barrier, we will be turning our backs on these Americans in a time of crisis, and putting all Americans at risk by discouraging people from getting necessary testing and treatment. The Biden Plan:
Ensures that every person, whether insured or uninsured, will not have to pay a dollar out-of-pocket for visits related to COVID-19 testing, treatment, preventative services, and any eventual vaccine. No co-payments, no deductibles, and no surprise medical billing. This will be achieved by:
- Amending the Public Health Service Act to immediately cover all testing, treatment, and preventive services that are necessary to address a Public Health Emergency for an infectious disease. Once triggered by the HHS Secretary in consultation with the CDC, all commercial plans in all markets will be immediately required to cover such services as COVID-19 testing and any eventual vaccine with no copayments and deductibles, including for the visits themselves.
- Amending the Social Security Act and other authorizing statutes to extend the same requirement to all public health programs. As such, there will be no co-pays for programs including but not limited to Medicare, Medicaid and CHIP, the Indian Health Service, the Dept. of Veterans Affairs, DoD’s TriCare program and the Federal Employees Health Benefit Plan.
- Fully funding and expanding authority for the National Disaster Medical System (NDMS) to reimburse health care providers for COVID-19-related treatment costs not directly covered by health insurance; this includes all copayments and deductibles for the insured as well as uncompensated care burdens incurred by uninsured and underinsured populations. Direct the HHS Secretary to direct NDMS, in collaboration with the Centers for Medicare and Medicaid Services for administrative and enforcement support, to directly reimburse health care providers for:
- All uncompensated care associated with the testing, treatment, and vaccines that are associated with COVID-19 for uninsured. This includes Americans in so-called “junk” health plans that are not regulated as compliant with the standards for individual market coverage under the Affordable Care Act.
- All copayments, deductibles and any cost-sharing for treatment for COVID-19 for insured. Providers will submit cost-sharing claims to NDMS that document private insurance contractual arrangement for co-payments. To ensure maximum provider participation and minimum billing abuses to consumers, current Medicare law’s “conditions of participation” and system-wide prohibitions against balance billing and surprise medical bills will apply. To guard against fraud and abuse by bad-apple health care providers, harsh civil and monetary penalties under the False Claims Act will apply.
Secures maximum Medicaid enrollment for currently eligible populations by explicitly authorizing federal matching dollars for presumptive eligibility, simplified application processes, and eligibility criteria. In past public health crises, such as Hurricane Katrina and 9/11, the federal government provided matching dollars for states to expedite enrollment for individuals who are eligible for Medicaid but not yet enrolled. This option must be specifically made available to states for the COVID-19 public health crisis. These policies are consistent with and complementary to the FMAP policy included in the federal economic assistance package below.
Reverses the Trump Administration public charge rule, which places new, burdensome restrictions on documented immigrants who receive public benefits and discourages all immigrants from seeking health care services for COVID-19.
Supports bipartisan efforts to delay the Medicaid Fiscal Accountability Regulation, which forces states to change how they finance their Medicaid programs and leads to major reductions in funding for critically important health care.
Provides explicit authority for the HHS Secretary to approve the commercial price of vaccines that are developed in conjunction with federally funded research. This ensures that the private, as well as the public sector, will not be subjected to vaccine prices that fail a “fair and reasonable” cost standard and, even if the vaccine is available free of charge, will protect the taxpayer from being gouged.
Ensures federal workers are able to access workers’ compensation and encourage states to do the same. Because it will be difficult for workers to prove that they were exposed to COVID-19 while on the job, the Biden Plan will ensure the Federal Employees’ Compensation Act program presumes they were exposed while on the job if their job put them in direct contact with infected individuals. And, he will encourage states to do the same.
PURSUING DECISIVE ECONOMIC MEASURES HARD-HIT WORKERS, FAMILIES, AND SMALL BUSINESSES AND TO STABILIZE THE AMERICAN ECONOMY
The Biden Plan will provide both financial support for those who are economically harmed by the fall-out of the crisis and help strengthen our economy as a whole. This includes taking immediate, bold measures to help Americans who are hurting economically right now. It means we will need bigger and broader measures to shore up economic demand to ensure we can protect jobs; keep credit flowing to our job creators, and have the economic firepower we need to weather this storm and get our people and economy back to full strength as soon as possible.
These immediate measures include both direct federal support and a renewable fund to state and local governments. Both the federal and state/local relief will be designed to be automatically extended upon certification by the federal government of a continuing health or economic threat, determined by clear health and economic criteria. This is critical to ensure that our political and legislative stalemates do not prevent additional rounds of funding from moving out swiftly when it is needed most.
Joe Biden believes we must do whatever it takes, spend whatever it takes, to deliver relief for our families and ensure the stability of our economy. This is an evolving crisis and the response will need to evolve, too, with additional steps to come so that we meet the growing economic shocks. We must prepare now to take further decisive action, including direct relief, that will be large in scale and focused on the broader health and stability of our economy.
The immediate economic measures in Biden’s plan consist of three parts, with additional measures to come as circumstances warrant, including further direct relief:
Providing Guaranteed Emergency Paid Sick Leave and Care-Giving Leave
As a nation, our goal must be to permanently provide the type of comprehensive 12 weeks of paid family and medical leave envisioned in the FAMILY Act sponsored by Senator Kristen Gillibrand and Representative Rosa DeLauro. We must also provide the type of coverage in the Healthy Families Act spearheaded by DeLauro and Senator Patty Murray, which will ensure workers receive seven days of paid sick leave for routine personal and family health needs, as well as time for survivors of domestic violence and sexual assault to seek services.
Providing widespread access to paid sick leave not only allows families to recover from sickness, but it also keeps sick workers and children away from the general population and helps slow the spread of disease. The Biden Plan calls for an emergency paid leave program that will ensure that all workers can take paid leave during the COVID-19 crisis. It calls for passage of the Healthy Families Act with the addition of an emergency plan that will require 14 days of paid leave for those who are sick, exposed, or subject to quaratines—while also ensuring that employers will not bear any additional costs for such additional leave in the midst of this crisis.
Types of Paid Leave that Must be Covered: Joe Biden’s emergency paid leave plan will be tailored to cover the various types of leave needed for our nation to get through this crisis. The paid leave plan will create a federal fund to cover 100% of weekly salaries or average weekly earnings capped at $1,400 a week—the weekly amount that corresponds with about $72,800 in annual earnings.
- Paid Leave for Sick Workers;
- Paid Leave for Workers Caring for Family Members or Other Loved Ones;
- Paid Leave for People Unable to Continue Work Because They Are At Increased Risk of Health Complications Due to COVID-19;
- Paid Leave and Child Care Assistance for Dealing with School Closings; and
- Paid Leave for Domestic Workers, Caregivers, Gig Economy Workers, and Independent Contractors.
Reimbursements to Employers: This emergency plan will provide reimbursement to employers or, when necessary, direct payment to workers for up to 14 days of paid sick leave or for the duration of mandatory quarantine or isolation. This will be in addition to existing paid leave provided by a business’s existing policies. No worker or contractor taking such leave during the crisis will impose any additional financial burden on a business. Businesses will be expected to support paid sick leave and seek reimbursement – or deduct against expected tax payments – to ensure workers are not discouraged from reporting symptoms of COVID-19. Direct payment will go to workers where needed due to their work arrangements.
Emergency Administration: Biden’s plan will provide all necessary funding to ensure such paid sick leave will be available immediately. One potential option for workers who require direct paid sick leave payments will be to staff up existing Social Security Administration offices to assist with distribution of the emergency paid leave fund. These offices exist throughout our nation and are the vehicle proposed by the FAMILY Act for a national paid leave plan – so this emergency legislation will also start building national infrastructure for a permanent and long-needed national paid leave benefit.
Federal Assistance to Hard-Hit Families
A Health Crisis Unemployment Initiative to Help all Workers Facing a Loss for Work Due to the COVID-19 Crisis. The reduction in demand for services such as hospitality, necessary closing of workplaces, and disruptions in supply chains will impact workers in all types of work arrangements. Just as the Obama-Biden Administration expanded regular unemployment insurance during the Great Recession, Joe Biden will again call for expanded Emergency Unemployment Compensation that will not only support workers facing extended spells of unemployment, but expand benefits and eligibility to address the nature of the job loss that will be impacted for the duration of the crisis. The Biden Plan calls for immediate expanded federal relief for impacted workers, that includes:
Ensuring Unemployment Benefits (UI) Are Available to Those Who Lose Jobs but Would Be Denied Benefits Due to Rules that Should Not Apply in a Major Health Crisis and Economic Downturn: The Biden Plan calls for expanded and broadened unemployment benefits that ensure our unemployment benefit policies are responsive to the depth and nature of this health and economic crisis. That means more support for state offices that will face far higher demand. It means waiving or relaxing work history, waiting and work search requirements that could prevent millions who might lose work due to no fault of their own from being left out in the cold. Current UI rules rightly require recipients to be actively looking for work. The nature of the COVID-19 crisis means, however, that many who lose their jobs will be prevented from looking for work due to public health rules related to containing community spread. The Biden Plan will ensure that workers who lose jobs but cannot meet search requirements due to this public health crisis are not denied benefits. This initiative can be combined with efforts to expand and reform our existing Disaster Unemployment Assistance program.
Employment Relief for Reduced Hours or Work-Sharing Arrangements: In addition to assistance for those who lose jobs, the Biden Plan will design unemployment insurance benefits to encourage expanded work-sharing arrangements for workers at businesses that are forced to cut back payroll due to lower economic demand, diminished travel, or cancelled orders. The Biden Plan will ensure that partial unemployment benefits are available to workers facing a significant reduction in hours so as to encourage employers to choose work-sharing over layoffs where possible. Such policies will build on those implemented by the Obama-Biden Administration during the Great Recession. The Biden Plan will require that this is implemented in a way that is consistent with existing collective bargaining agreements and that any employer with employees represented by a union create these arrangements in cooperation with the unions.
Provide Employment Relief for Domestic Workers, Caregivers, Gig Workers, or Independent Contractors who face Reduced Pay and Hours: Too often, our unemployment relief only helps those who are in more formal employer-employee relations. It leaves out too many of the hardest working, most hard-pressed Americans who drive cars, clean homes, and care for our younger and older loved ones. The Biden Plan will offer economic relief to all workers who can show hours have been cut back due to COVID-19 or to resulting economic impacts.
Expand Food Relief for Hard-Pressed Families and Children: The Biden Plan calls for a health crisis food initiative that addresses both the depth of potential economic hardship for families and the nature of this health crisis. Economic hardship caused by the crisis will stretch family budgets in ways that could reduce needed nutrition. Many students rely on free or discounted meals at schools, which may have to close. The Biden Plan health crisis food initiative will create a federal-state partnership – fully funded by the federal government – that will expand SNAP relief for the duration of the crisis, as well as broaden the type of food relief responses available to states – from supporting food banks across the nation to increased home delivery of food to a broad effort to replace lost school meals. It will adjust current policies that will harshly cut off or deny food benefits to workers unable to find work in this crisis. It will allow schools to submit waiver applications before they are impacted by the crisis, making it easier for them to get permission to provide food even when school is closed.
Increase Federal Medical Assistance Percentage (FMAP) for the state-administered Medicaid program: The Biden Plan calls for an increase in the share the federal government pays of Medicaid – the so-called FMAP. This is one of the fastest, most effective means to concurrently address the health and revenue burdens states face when confronting an economic crisis. The Biden Plan will increase the FMAP by at least 10 percent for all states during the crisis, with upward adjustments for states that are facing particularly high unemployment rates. It will also provide additional financial incentives for states that have not yet expanded their Medicaid program and will provide necessary additional support to Puerto Rico and other territories to ensure the health care needs of these populations are not neglected.
Establish a Temporary Small- and Medium-Sized Business Loan Facility: Many businesses that would otherwise thrive during normal economic times will face a severe shortfall in cash flow, potentially jeopardizing their ability to make payrolls, pay creditors, and keep their doors open. Working with the Small Business Association and Treasury Department, the Biden Plan proposes to establish a temporary small business loan program designed to address unanticipated shortfalls in revenue by offering interest-free loans to small- and medium-sized businesses around the country through the duration of the crisis. Biden’s plan includes both increased funding capacity for the Small Business Administration, in addition to a new program – modeled after the Obama-Biden State Small Business Credit Initiative–that provides funds to allow states to increase lending to small businesses. The Biden Plan also calls on the U.S. Treasury Department to coordinate with the Federal Reserve to monitor and consider policies to address severe credit and liquidity challenges related to the fall-out of COVID-19 and thus prevent small businesses and those in impacted industries from severe cutbacks, shutdowns, and layoffs.
Support for Child Care and Remote Student Learning: Potential school closings will create significant cost issues for parents seeking childcare and for schools and educators seeking to continue teaching remotely including online. The Biden Plan will expand assistance to federal child care centers and assistance to schools – particularly Title I schools — for those facing schools facing extra costs, including efforts to continue remote education or remote activities normally done after-school.
Relief or Forbearance of Federal Student Loans and Federally Backed Mortgages: Congress must immediately use new legislation or existing authority to provide assistance of forbearance to students and homeowners to provide financial relief until the worst of the economic fall-out of the crisis is over. As proposed below, there must also be a federal partnership with states and cities to provide rental relief during the crisis, so no one faces evictions due to impacts of the COVID-19 crisis.
Protecting union health funds. Union members have fought hard for their health insurance. Biden will commit to ensuring their Taft-Hartley health funds have the financial resources they need to continue despite the crisis.
A State and Local Emergency Fund
In addition to these federal initiatives, governors and mayors can access funds through the State and Local Emergency Fund to cushion the economic impacts in their communities. This Fund, as noted above, will also provide state and local leaders with resources and flexibility for responding to the immediate health crisis and economic fall-out in ways that best address the needs of their towns, cities, and states. The range of relief will include:
- Mortgage & Rental Relief for Impacted Workers: No one should face foreclosure or eviction because they are affected by the COVID-19 crisis. The State and Local Emergency Fund will allow mayors and governors to implement rental assistance, no-interest forbearance or mortgage payment relief for workers who have had to reduce their hours, have been laid off, or are otherwise earning less because of COVID-19.
- Employer Assistance for Job Maintenance: Funds could provide help for employers to keep workers on the job – or to do work-sharing with part-time relief to workers – when they are impacted by falls in economic demand or recession.
- Interest-Free Loans for Small Businesses: Governors and mayors will also be able to supplement their existing programs to assist local employers who are facing temporary economic distress due to supply-chain disruptions, declines in travel or economic demand due to continuing economic uncertainty related to the COVID-19. To supplement the federal loan program, state and local leaders can access these resources to help small businesses cope with a potential sharp cutback in economic activity.
- Needed Jobs: To both deal with additional needs due to COVID-19 or to address resulting declines in employment, the fund will be authorized to fund existing or new local and state jobs initiatives.
- Cash Assistance or Targeted Refundable Tax Relief: Where governors and mayors determine it is necessary to adequately address the full range of economic pain created by the COVID-19, the fund will authorize such leaders to directly draw on it to implement broader progressive cash or tax relief – that could include cash payments to working families, unpaid caregivers, seniors. those with disabilities, and children, or a child allowance. It could also be used to fund new legislation to expand State Earned Income Tax Credit relief.
More Will Be Needed
Biden understands that the crisis will have broader economic impacts that will no doubt require further action. The steps outlined above must be taken immediately and then Congress must move to understand the broader economic implications and act accordingly. And, any relief provided to states or industries must include conditions to support workers, including protecting their jobs.
Making the Economy More Resilient for Future Crises
Biden has released several plans to build a stronger, more inclusive middle class that will increase the resilience of all Americans in the face of a crisis. His plan to create a new public option is the quickest, most effective way to achieve universal health coverage. He will invest in infrastructure, like broadband, essential for mitigating the impact of future pandemics. And, he will encourage union organizing and defend collective bargaining. Unions can help negotiate for better safety and health protections, provide better training for personal protective equipment, protect against layoffs, and help ensure generous wages and benefits to help workers in a crisis. And, unions can provide a critical voice in handling crises, especially those that represent the many workers that are exposing themselves to hazards in order to keep Americans safe. Read Joe Biden’s labor plan here.
RALLY THE WORLD TO CONFRONT THIS CRISIS WHILE LAYING THE FOUNDATION FOR THE FUTURE
The only way to stop the threat from infectious diseases like COVID-19 is to detect them early and contain them effectively in communities around the world. Even as we take urgent steps to minimize the spread of COVID-19 at home, we must also help lead the response to this crisis globally. In doing so, we will lay the groundwork for sustained global health security leadership into the future.
Leading the Global Response to COVID-19
Direct the U.S. Agency for International Development (USAID), in coordination with the U.S. Department of State, DOD, HHS, and the CDC, to mobilize an international response that assists vulnerable nations in detecting, treating, and minimizing the spread of COVID-19, including deploying, when necessary, USAID Disaster Assistance Response Teams. Biden will empower the State Department to ensure the U.S. plays a major role in all global decisions about the outbreak and our experts have the access they need to COVID-19 hotspots. Staying on the sidelines or deferring to other nations ultimately makes us less safe and secure.
Call for the immediate creation of a Global Health Emergency Board to harmonize crisis response for vulnerable communities. The Board will convene leadership of the United States, our G7 partners, and other countries in support of the World Health Organization (WHO) to ensure a coordinated health and economic response globally, especially with respect to vulnerable countries. The Board will bring together scientific experts from the WHO and CDC, the Africa Centres for Disease Control and Prevention and other key CDCs, international financial institutions, and leading private sector and non-profit representatives to (1) offset the cost of bringing any eventual vaccines to developing countries, (2) harmonize economic measures with the emergency response globally, and (3) establish and ensure high standards for transparency and communication. In the future, the convening of the Board would be triggered by a public health emergency of international concern declaration by the WHO.
Protect America’s troops and deployed citizens, by bolstering CDC and DOD’s disease detection and protection programs overseas, planning for securing diplomatic and military assets and deployments in countries affected by COVID-19, and providing testing, care, and treatment and, if necessary, evacuation for military, public health service, foreign service, and deployed civil service personnel who become infected.
Advancing Global Health Security
Under the Obama-Biden Administration, the United States established the Global Health Security Agenda to mobilize the world against the threat of emerging infectious diseases. A Biden Administration will not only revitalize and elevate this Agenda after years of neglect under the Trump Administration, but also expand it to ensure it is suited to meet new challenges. Above all, we need to end the cycles of panic investment and neglect for our U.S. public health system and health systems around the world. They need to remain strong and ready to prevent, detect, and respond to pandemic threats whether caused by natural causes and climate change, bioterrorism, or laboratory accidents. Biden will:
Fully staff all federal agencies, task forces, and scientific and economic advisory groups focused on health security. This includes establishing an Assistant Secretary at the State Department to oversee an office of Global Health Security and Diplomacy, and engaging regional bureaus and embassies to improve health security readiness, governance, and global coordination.
Re-embrace international engagement, including prioritizing sustained funding for global health security – above and beyond emergency appropriations – to strengthen joint standing capacity for biosurveillance and health emergency response. Biden calls for the creation of a Permanent Facilitator within the Office of the United Nations Secretary-General for Response to High Consequence Biological Events, as recommended by experts, to facilitate crisis coordination among health, security, and humanitarian organizations. He also calls for fully resourcing the WHO, especially its Contingency Fund for Emergencies.
Support sustainable health security financing to urgently fill substantial gaps in global pandemic preparedness. The Biden Administration will build the global coalition necessary to fill urgent global gaps in pandemic preparedness, enhance accountability for those investments, and produce measurable results.
Build a global health security workforce for the 21st century. Biden will prioritize investing in and lifting barriers to the education of public health professionals, especially in less advantaged communities, including by strengthening the CDC’s Field Epidemiology Training Program and Field Epidemiology and Laboratory Program. We must support opportunities for global experts to train together so they are ready to deploy to assist the WHO and partner governments in responding to infectious disease threats, regardless of origin, including to insecure or unstable environments.
Fight climate change as a driver of health threats. The link between climate change and health security is well-documented and will create a growing threat to Americans. A Biden Administration will recommit the United States to the Paris Agreement on day one and lead an effort to get every major country to ramp up the ambition of their domestic climate targets. As President, Biden will fully integrate climate change into our foreign policy and global health security strategies, and prioritize efforts to mitigate disease and migration challenges caused by a warming planet. Read Biden’s full climate change plan here.