As negotiations in Washington continue over the prudent legislative response to the growing coronavirus pandemic, a team of public health leaders—with input from over 50 other experts in public health, health care, medicine, and law—has issued its own set of detailed policy recommendations to lawmakers for a comprehensive COVID-19 stimulus bill.
The framework lays out legislation that goes far beyond the payroll tax cut being floated in recent days. The suggestions detail a transformational set of emergency public health and financial measures that the experts say must be at the core of any effective and equitable government response to what is already a historic health crisis. In anticipation of political resistance to a proposal of this magnitude, the working group insists in one of the document’s guiding principles that “Protecting Americans’ health in this time of crisis should be a unifying effort; it should not be and cannot be divisive.” The groups’ recommendations were released earlier today in a piece appearing on Health Affairs Blog.
Among the framework’s chief recommendations are large-scale measures around boosting the country’s healthcare, testing, and containment capacities; requiring coverage of preventive and diagnostic services related to COVID-19 with no cost-sharing; protecting especially vulnerable populations; providing financial and logistical support to impacted workers and employers; expanding resources and assistance for frontline healthcare providers; facilitating the rapid development of a COVID-19 vaccine and treatment while restricting price-gouging; and investing in key public health infrastructure.
“What we are facing is a once-in-a-century public health challenge, and the response from our government absolutely has to reflect that,” said Dr. Howard Forman, a Yale University professor of public health, radiology, and management, who coordinated the working group’s effort. “The recommendations in this document—increasing health care capacity, covering patient costs, clearing the way for a fairly-priced vaccine, paying special attention to vulnerable groups, preparing for the profound impacts on workers and businesses, funding key research and public health institutions—are not precautionary measures. Rather, we believe these are the critical elements that any COVID-19 legislation must contain in order for our country to effectively battle this crisis, and then to come out on the other side better prepared to battle the next one.”
In support of its big picture proposals, the document goes into some detail about how lawmakers can use existing policy channels—such as state Medicaid expansion—to fulfill the experts’ directives and allocate the resources necessary for a robust coronavirus response. Collectively, the working group has extensive experience operating within the legislative contours of Medicare, Medicaid, the Affordable Care Act, and funding and legislation related to our public health infrastructure, and many of its suggestions involve wielding these programs to safeguard the health of the American public during the coronavirus pandemic.
“In terms of legislation, much of the infrastructure already exists to mount an aggressive effort against this virus and its far-reaching effects,” said Elizabeth Fowler, executive vice president for programs at the Commonwealth Fund and a member of the writing group. “It’s just a matter of pointing the right policies in the right direction.”
However, the recommendations also call for lawmakers to break new policy ground in a number of ways, especially in order to protect vulnerable populations. The experts warn about increased COVID-related risk to groups including the elderly, chronically ill, and homeless, as well as individuals who are undocumented, institutionalized, incarcerated, or food-insecure. During a public health crisis, the framework’s authors suggest, the government has an added responsibility to ensure accurate messaging, adequate nutrition, and quality health care for the most vulnerable Americans.
The authors of the COVID-19 stimulus framework are Howard Forman, professor of public health, radiology, and management at Yale University (founding member and lead of the group); Elizabeth Fowler, executive vice president for programs at the Commonwealth Fund; Megan Ranney, associate professor of emergency medicine and health services, policy, and practice at Brown University; Ruth J. Katz, vice president and the executive director of the Health, Medicine and Society (HMS) Program at the Aspen Institute; Sara Rosenbaum, Harold and Jane Hirsh Professor of Health Law and Policy and founding chair of the Department of Health Policy at the Milken Institute School of Public Health at George Washington University; Kavita Patel, vice president, Hopkins Medicine, at Johns Hopkins University; Timothy Stoltzfus Jost, emeritus professor at Washington and Lee University; Abbe Gluck, professor of law and faculty director of the Solomon Center for Health Law and Policy at Yale Law School and professor of medicine (general medicine) at Yale Medical School; Christen Linke Young, fellow, USC-Brookings Schaeffer Initiative for Health Policy, the Brookings Institution; as well as Yale Law School student Erica Turret, and Harvard Medical School students Suhas Gondi and Adam Beckman.