On March 18, 2020, the Families First Coronavirus Response Act was signed into law, marking the second major legislative initiative to address COVID-19 (the first was signed on March 6 and provided emergency funding relief for domestic and global efforts). The table below provides a summary of key provisions of the Families First Act, which addresses the domestic outbreak, including paid sick leave, insurance coverage of coronavirus testing, nutrition assistance, and unemployment benefits.

Table 1: Families First Coronavirus Response Act – Summary of Key Provisions
Department Key Provisions Fund/
Account
Funding Available Expenditure Period
TOTAL FUNDING

$3,471,000,000

plus additional funds*
DIVISION A—SECOND CORONAVIRUS PREPAREDNESS AND RESPONSE SUPPLEMENTAL APPROPRIATIONS ACT, 2020
Department of Agriculture

 

For an additional amount for the “Special Supplemental Nutrition Program for Women, Infants, and Children” (WIC). Food and Nutrition Service

$500,000,000

To remain available through Sept. 30, 2021
For an additional amount for the “Commodity Assistance Program” for The Emergency Food Assistance Program (TEFAP).

Of the funds available, the Secretary of Agriculture may use up to $100,000,000 for costs associated with the distribution of commodities.

Food and Nutrition Service

$400,000,000

To remain available through Sept. 30, 2021
For the Supplemental Nutrition Assistance Program (SNAP) during FY 2020.

During FY 2020, whenever a school is closed for at least 5 consecutive days during a public health emergency designation during which the school would otherwise be in session, each household containing at least 1 member who is an eligible child attending the school is eligible to receive assistance pursuant to a state agency plan approved by the Secretary of Agriculture. An “eligible child” means a child who, if not for the closure of the school attended by the child during a public health emergency designation and due to concerns about a COVID-19 outbreak, would receive free or reduced price school meals under the National School Lunch Act at the school.

During FY 2020, the Secretary of Agriculture may purchase commodities for emergency distribution in any area of the U.S. during a public health emergency designation.

A “public health emergency designation” here means the declaration of a public health emergency, based on an outbreak of SARS-CoV-2 or another coronavirus with pandemic potential, by the Secretary of Health and Human Services.

Food and Nutrition Service

Such amounts as are necessary

FY 2020
For the Secretary of Agriculture to provide grants to the Northern Mariana Islands, Puerto Rico, and American Samoa for nutrition assistance in response to a COVID–19 public health emergency. Food and Nutrition Service

$100,000,000

To remain available through Sept. 30, 2021
Department of Defense To carry out detection of SARS–CoV–2 or the diagnosis of the virus that causes COVID–19 and testing related visits. Defense Health Program (TRICARE)

$82,000,000

To remain available until Sept. 30, 2022
Department of Health and Human Services

 

For “Aging and Disability Services Programs” for nutrition services.

Of which, $160,000,000 is for Home-Delivered Nutrition Services, $80,000,000 is for Congregate Nutrition Services, and $10,000,000 is for Nutrition Services for Native Americans.

Administration for Community Living

$250,000,000

To remain available until Sept. 30, 2021
To carry out detection of SARS–CoV–2 or the diagnosis of the virus that causes COVID–19 and testing related visits. Indian Health Service

$64,000,000

To remain available until Sept. 30, 2022
For the “Public Health and Social Services Emergency Fund,” which supports the National Disaster Medical System, to pay the claims of providers for the detection of SARS–CoV–2 or the diagnosis of the virus that causes COVID–19 and testing related visits for the uninsured. Office of the Secretary

$1,000,000,000

To remain available until expended
Department of the Treasury For “Taxpayer Services” (amounts may be transferred and merged with Operations Support) for the purposes of carrying out this Act. Internal Revenue Service

$15,000,000

To remain available until Sept. 30, 2022
Department of Veterans Affairs (VA) To carry out detection of SARS–CoV–2 or the diagnosis of the virus that causes COVID–19 and testing related visits.

Of which, $30,000,000 is for “Medical Services” and $30,000,000 is for “Medical Community Care.”

Veterans Health Administration

$60,000,000

To remain available until Sept. 30, 2022
General Provisions Heads of Each Executive Agency Receiving Funding in This Act: Not later than 30 days after the date of enactment (3/18/20), each shall provide a report detailing the anticipated uses of all such funding to the House and Senate Committees on Appropriations, and that plan shall be updated and submitted to such Committees every 60 days until all funds are expended or expire.

States and Local Governments Receiving Funds or Assistance Pursuant to This Division: Shall ensure the respective State Emergency Operations Center receives regular and real-time reporting on aggregated data on testing and results from state and local public health departments, as determined by the Director of the Centers for Disease Control and Prevention (CDC), and that such data is transmitted to CDC.

DIVISION B—NUTRITION WAIVERS
Maintaining Essential Access to Lunch For Students (MEALS) Act

Allows the Secretary of Agriculture to grant a qualified waiver, which is allowed to increase federal costs, requested by states and eligible providers of requirements under certain federal laws for the purposes of providing meals and meal supplements under the federal school breakfast and lunch programs and related programs during school closure related to COVID-19.

COVID-19 Child Nutrition Response Act

Allows the Secretary of Agriculture to:

-establish a nationwide waiver for states for the purposes of providing meals and meal supplements under a qualified program, including the school lunch program, with appropriate safety measures with respect to COVID-19; this waiver shall apply automatically to any state that elects to be subject to the waiver without further application;

-grant a waiver to allow non-congregate feeding, permitting food to be served outside the school/care setting, under a child and adult food program with appropriate safety measures for COVID-19; and

-grant a waiver to adjust meal nutritional content under qualified programs if doing so is necessary due to COVID-19 related supply chain disruption with respect to foods served in such programs.

*A “qualified program” means the school lunch program, the school breakfast program, the child and adult care food program, and the summer food service program for children.

Permits Secretary of Agriculture to grant a request by a state agency to:

-waive the physical presence requirement under WIC during recertification and defer anthropometric and bloodwork requirements necessary to determine nutritional risk, and

-modify or waive any administrative requirements if the requirement cannot be met due to COVID–19.

Authority ends Sept. 30, 2020.

 

Supplemental Nutrition Assistance Program (SNAP) Waivers

Work and work training requirements are lifted for the SNAP program beginning April 2020 and for each subsequent month through the end of the month following the month when the COVID-19 public health emergency declaration by the Secretary of Health and Human Services is lifted. Beginning in the month following the month the declaration is lifted, state agencies offering a SNAP program shall disregard any period during which an individual received benefits under SNAP prior to such month.

In the event of a COVID-19 public health emergency declaration by the Secretary of Health and Human Services and a COVID-19 emergency or disaster declaration by a state, the Secretary of Agriculture:

-shall provide, at the request of a state agency, emergency allotments to SNAP households to address temporary food needs not greater than the applicable maximum monthly allotment for the household size, and

-may adjust issuance methods and application and reporting requirements to be consistent with what is practicable under actual conditions in affected areas.

DIVISION C—EMERGENCY FAMILY AND MEDICAL LEAVE EXPANSION ACT
Qualified need related to a public health emergency (reason) for leave: The employee is unable to work due to a need for leave to care for their child because the school or day care has been closed or the child care provider is unavailable due to a public health emergency.

Pay: Not less than two-thirds of the employee’s regular pay, up to $200/day and $10,000 over the benefit period. The first 10 days taken may be unpaid, but the employee may use other paid leave during that period, if available.

Duration of leave: 12 weeks, which includes job protection as required in the Family and Medical Leave Act (including amendments to it made by this Act with regard to job protection requirements for an employer who employs fewer than 25 employees). Benefits are not retroactive.

Eligible employees: Employees covered by Title I of FMLA (i.e., excludes most Federal employees, who are covered by Title II of FMLA). Employee must have worked for the employer for at least 30 days. Employees shall provide the employer with such notice of leave as is practicable. An employer of an employee who is a health care provider or emergency responder may elect to exclude such an employee.

Applicable employers: Private businesses with < 500 employees and all public employers (see below for exemptions).

Authority given to the Secretary of Labor: To exclude certain health care providers or emergency responders from the definition of eligible employees and to exempt small businesses with fewer than 50 employees if compliance with the requirements would jeopardize the viability of the business as a going concern.

A “public health emergency” here means an emergency with respect to COVID-19 declared by a federal, state, or local authority.

Effective not later than 15 days after enactment on March 18, 2020 (the Department of Labor has established it is effective April 1, 2020) and ending Dec. 31, 2020.
DIVISION D—EMERGENCY UNEMPLOYMENT INSURANCE STABILIZATION AND ACCESS ACT OF 2020
For FY 2020 emergency grants for states to provide and process uninsurance benefits.

Funds to states may be used for the administration of its unemployment compensation law, including ensuring adequate resources in periods of high demand.

50% of funding ($500 million) is for all states providing states follow certain notification and accessibility requirements related to unemployment compensation.

50% of funding ($500 million) is for states where unemployment compensation claims increased by at least 10% over the same quarter in the previous calendar year provided the state commits to maintaining and strengthening access to the unemployment compensation system and eases eligibility requirements and access to unemployment compensation, including waiving work search requirements and waiting period.

Provides for interest-free loans for states to assist with payment of unemployment compensation benefits through December 31, 2020.

Provides that the Secretary of Labor will give states technical assistance and guidance in establishing, implementing, and improving employer awareness of short-time compensation programs to help avert layoffs.

Provides 100% federal funding for extended benefits (rather than a 50% match) for states that experience a 10% or higher unemployment rate compared to the previous year, and comply with other beneficiary access requirements through December 31, 2020.

Distributed to the accounts of the States in the Unemployment Trust Fund using a ratio specified in existing law $1,000,000,000 FY 2020

 

 

 

 

 

DIVISION E—EMERGENCY PAID SICK LEAVE ACT
Qualified reasons for emergency paid sick time leave: An employee is unable to work or telework due to a need for leave because the employee is:

-subject to quarantine or isolation order,

-has been advised by a health care provider to self-quarantine due to coronavirus concerns, or

-is experiencing symptoms of coronavirus and seeking a medical diagnosis.

Pay: Employee’s regular pay, up to $511/day and $5,110 over the benefit period.

Other qualified reasons for paid sick time leave: An employee is unable to work or telework due to a need for leave because the employee is:

-caring for an individual who is subject to quarantine or isolation order or has been advised by a health care provider to self-quarantine due to coronavirus concerns;

-caring for their child if their school or day care has been closed, or the child care provider is unavailable, due to coronavirus precautions; or

-is experiencing “any other substantially similar condition specified by” the Secretary of Health and Human Services in consultation with the Secretaries of the Treasury and Labor.

Pay: Two-thirds of the employee’s regular pay, up to $200/day and $2,000 over the benefit period.

Duration and use of leave: An employee shall be entitled to paid sick time of 80 hours for full-time employees and an amount equal to the average number of hours such employee works over a 2-week period for part-time employees. Paid sick leave is available for immediate use and does not require a waiting period or accrual. Benefits are not retroactive. An employer may require that after the first workday or portion thereof an employee receives such leave, an employee follow reasonable notice procedures in order to continue receiving such paid sick time. An employer may not require an employee to use other paid leave provided by the employer to the employee before the employee uses the paid sick time provided under this section for the reasons above. Paid sick time shall not carry over from 1 year to the next. Employers may not require, as a condition of providing such paid sick time, that the employee involved search for or find a replacement employee to cover the hours during which the employee is using paid sick time.

Applicable employers: Private businesses with < 500 employees and all public employers. Employers shall post and keep posted a notice of these requirements. It is unlawful for any employer to discharge, discipline, or in any other manner discriminate against any employee who take such leave and has filed any complaint or instituted any proceeding under or related to this Act, or has testified or is about to testify in any such proceeding. The Act includes an enforcement mechanism for violations. See below for exemptions.

Authority given to the Secretary of Labor: To exclude certain health care providers or emergency responders from the definition of eligible employees and to exempt small businesses with fewer than 50 employees from the requirement to provide emergency paid sick leave to an employee who is caring for their child if the child’s school or day care is closed or child care provider is unavailable due to coronavirus precautions if compliance with the requirements would jeopardize the viability of the business as a going concern.

Effective not later than 15 days after enactment on March 18, 2020 (the Department of Labor has established it is effective April 1, 2020) and ending Dec. 31, 2020.

 

DIVISION F—HEALTH PROVISIONS
Testing Coverage

Private insurance, including group and individual plans, including grandfathered plans to cover the detection of SARS–CoV–2 or the diagnosis of the virus that causes COVID–19, provided the diagnostic has received Emergency Use Authorization (EUA) under Section 564 of the Federal Food, Drug, and Cosmetic Act (FD&C Act), and the associated visit in a range of settings without cost-sharing, without needing to meet deductible, without prior authorization or other utilization management (during the emergency period).

– Those in other types of non-compliant plans (such as short-term policies) are considered uninsured.

Medicare, including Traditional Medicare and Medicare Advantage plans, to cover the detection of SARS–CoV–2 or the diagnosis of the virus that causes COVID–19 and the associated visit in a range of settings without cost-sharing, without needing to meet deductible, without prior authorization or other utilization management (during the emergency period).

-Prior to this legislation, Traditional Medicare beneficiaries were already protected from cost-sharing/meeting a deductible for clinical diagnostic laboratory tests. Bill eliminates cost-sharing for the provider or outpatient visit for this population. Cost-sharing requirements for Medicare Advantage enrollees for Medicare-covered services varies by plan; bill eliminates cost sharing for testing and testing-related services for these enrollees.

Medicaid and CHIP to cover the detection of SARS–CoV–2 or the diagnosis of the virus that causes COVID–19, provided the diagnostic has received Emergency Use Authorization (EUA) under Section 564 of the Federal Food, Drug, and Cosmetic Act (FD&C Act), as a required benefit. Testing and testing-related services are covered without cost-sharing, during the emergency period.

-Also creates state option to cover SARS-CoV-2 or COVID-19 related testing and testing-related services (only) for uninsured individuals at a 100% federal match during the emergency period.

*Uninsured include those not otherwise Medicaid-eligible and not covered by group or individual private insurance or another federal health program.

-Provides states & territories with a temporary 6.2 percentage point increase in the regular federal matching rate for the emergency period (increase does not apply to ACA expansion adults).

*To receive, states need to meet certain requirements including:

-not implementing more restrictive eligibility standards or higher premiums than those in place as of January 1, 2020

-providing continuous eligibility for enrollees through the end of the month of the emergency period unless an individual asks to be disenrolled or ceases to be a state resident

-not charging cost sharing for SARS-CoV-2 or COVID-19 related testing services or treatments including vaccines, specialized equipment or therapies.

-Raises federal Medicaid allotments for territories.

TRICARE, Veteran’s Affairs, and health plans covering Federal Workers will not impose cost-sharing for the detection of SARS–CoV–2 or the diagnosis of the virus that causes COVID–19, provided the diagnostic has received Emergency Use Authorization (EUA) under Section 564 of the Federal Food, Drug, and Cosmetic Act (FD&C Act), and the associated visit, during the emergency period.

The Indian Health Service will not impose cost-sharing for those receiving health services through the Indian Health Service, including an Urban Indian Organization, for the detection of SARS–CoV–2 or the diagnosis of the virus that causes COVID–19,  provided the diagnostic has received Emergency Use Authorization (EUA) under Section 564 of the Federal Food, Drug, and Cosmetic Act (FD&C Act), or visits, including when provided outside of the Indian Health Service or tribal health care facility, during the emergency period.

Other

Personal respiratory protective devices are covered countermeasures under the PREP Act Declaration when used during COVID-19 outbreak and as such are granted protection from certain liabilities (protection ends October 1, 2024).

The “emergency period” here means the period during which there exists-

(A) an emergency or disaster declared by the President pursuant to the National Emergencies or the Robert T. Stafford Disaster Relief and Emergency Assistance Act; and

(B) a public health emergency declared by the Secretary of Health and Human Services.

DIVISION G—TAX CREDITS FOR PAID SICK AND PAID FAMILY AND MEDICAL LEAVE
Payroll tax credits for qualified sick leave wages and family leave paid by an employer shall be allowed in the amount of benefits paid (not to exceed the limits identified above for pay) over the permitted duration.

An individual tax credit for qualified sick leave and family leave for self-employed individuals in the amount of $200 a day (or $511 for emergency paid sick leave for own quarantine or seeking own medical diagnosis) or 67% (or 100% for emergency paid sick leave for own quarantine or seeking own medical diagnosis) of average daily pay for self-employed individuals over the permitted duration, whichever is less.

This credit shall not apply to the government of the U.S. or the government of any state.

Any wages required to be paid by reason of the Emergency Paid Sick Leave Act and the Emergency Family and Medical Leave Expansion Act (see above) shall not be considered wages for certain purposes.

There are hereby appropriated to Social Security, specifically the Federal Old-Age and Survivors Insurance Trust Fund and the Federal Disability Insurance Fund, amounts equal to the reduction in revenues to the Treasury by reason of this section (“Special Rule Related to Tax on Employers”). Amounts appropriated by the preceding sentence shall be transferred from the general fund at such times and in such manner as to replicate to the extent possible the transfers which would have occurred to such trust Fund or Account had this section not been enacted.

Effective on a date selected by the Secretary of the Treasury, which is within 15 days of enactment on March 18, 2020, and ending on Dec. 31, 2020
NOTES: * Additional as-yet unspecified amount of funding for Social Security and such amounts as necessary for SNAP.
SOURCE: KFF analysis of the Families First Coronavirus Response Act (P.L. 116-127).