On Tuesday, May 12, House Democrats released legislative text for an ambitious fourth stimulus bill, meant to address an economy and health care industry still reeling from the ongoing COVID-19 pandemic. The Health and Economic Recovery Omnibus Emergency Solutions (HEROES) Act allocates nearly $3 trillion in federal funding to support state and local governments and health care providers, and sets up a fund to provide for hazard pay for essential workers.

The proposal contains a number of ambitious health care provisions, many of which build on programs created in the CARES Act. The bill allocates another $100 billion in the Provider Relief Fund to provide for grants for hospitals and health care providers, and requires that HHS allocate funds based on lost revenue. It would also provide $75 billion for state and local governments to ramp up testing and tracing capabilities, and increase the federal matching rate for state Medicaid programs by 14%. It offers more flexibility for providers receiving loans through the Medicare advanced payment program, lowering the interest rate and extending time for repayment. The bill also eliminates cost-sharing requirements for COVID-19 treatment and an eventual vaccine, creates a special enrollment period in Medicare and on the Affordable Care Act exchanges, and provides for funding to subsidize COBRA premiums. Concerns about the medical supply chain are also addressed through enhanced reporting requirements.