[Congressional Record Volume 167, Number 42 (Friday, March 5, 2021)]
[Senate]
[Pages S1370-S1372]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

  SA 1336. Mr. MORAN submitted an amendment intended to be proposed to 
amendment SA 891 proposed by Mr. Schumer (for himself, Mr. Wyden, Mrs. 
Murray, Mr. Brown, Mr. Peters, Mr. Cardin, Ms. Cantwell, Ms. Stabenow, 
Mr. Tester, Mr. Menendez, Mr. Schatz, Mr. Carper, Mr. Leahy, and Mr. 
Sanders) to the bill H.R. 1319, to provide for reconciliation pursuant 
to title II of S. Con. Res. 5; which was ordered to lie on the table; 
as follows:

        Strike section 2 and all that follows and insert the 
     following:

     SEC. 2. TABLE OF CONTENTS.

       The table of contents for this Act is as follows:

Sec. 2. Table of contents.

      TITLE I--COMMITTEE ON HEALTH, EDUCATION, LABOR, AND PENSIONS

                       Subtitle A--Public Health

Sec. 101. Funding for COVID-19 vaccine activities at the Centers for 
              Disease Control and Prevention.
Sec. 102. Funding for vaccine confidence activities.
Sec. 103. Funding for supply chain for COVID-19 vaccines, therapeutics, 
              and medical supplies.
Sec. 104. Funding for COVID-19 vaccine, therapeutic, and device 
              activities at the Food and Drug Administration.
Sec. 105. Reduced cost-sharing.

                          Subtitle B--Testing

Sec. 111. Funding for COVID-19 testing, contact tracing, and mitigation 
              activities.
Sec. 112. Funding for SARS-CoV-2 genomic sequencing and surveillance.
Sec. 113. Funding for global health.
Sec. 114. Funding for data modernization and forecasting center.

       TITLE II--COMMITTEE ON BANKING, HOUSING, AND URBAN AFFAIRS

Sec. 201. COVID-19 emergency medical supplies enhancement.

                    TITLE III--COMMITTEE ON FINANCE

Sec. 301. Funding for providers relating to COVID-19.

      TITLE I--COMMITTEE ON HEALTH, EDUCATION, LABOR, AND PENSIONS

                       Subtitle A--Public Health

     SEC. 101. FUNDING FOR COVID-19 VACCINE ACTIVITIES AT THE 
                   CENTERS FOR DISEASE CONTROL AND PREVENTION.

       (a) In General.--In addition to amounts otherwise 
     available, there is appropriated to the Secretary of Health 
     and Human Services (in this subtitle referred to as the 
     ``Secretary'') for fiscal year 2021, out of any money in the 
     Treasury not otherwise appropriated, $7,500,000,000, to 
     remain available until expended, to carry out activities to 
     plan, prepare for, promote, distribute, administer, monitor, 
     and track COVID-19 vaccines.
       (b) Use of Funds.--The Secretary, acting through the 
     Director of the Centers for Disease Control and Prevention, 
     and in consultation with other agencies, as applicable, 
     shall, in conducting activities referred to in subsection 
     (a)--
       (1) conduct activities to enhance, expand, and improve 
     nationwide COVID-19 vaccine distribution and administration, 
     including activities related to distribution of ancillary 
     medical products and supplies related to vaccines; and
       (2) provide technical assistance, guidance, and support to, 
     and award grants or cooperative agreements to, State, local, 
     Tribal, and territorial public health departments for 
     enhancement of COVID-19 vaccine distribution and 
     administration capabilities, including--
       (A) the distribution and administration of vaccines 
     licensed under section 351 of the Public Health Service Act 
     (42 U.S.C. 262) or authorized under section 564 of the 
     Federal Food, Drug, and Cosmetic Act (21 U.S.C. 360bbb-3) and 
     ancillary medical products and supplies related to vaccines;
       (B) the establishment and expansion, including staffing 
     support, of community vaccination centers, particularly in 
     underserved areas;
       (C) the deployment of mobile vaccination units, 
     particularly in underserved areas;
       (D) information technology, standards-based data, and 
     reporting enhancements, including improvements necessary to 
     support standards-based sharing of data related to vaccine 
     distribution and vaccinations and systems that enhance 
     vaccine safety, effectiveness, and uptake, particularly among 
     underserved populations;
       (E) facilities enhancements;
       (F) communication with the public regarding when, where, 
     and how to receive COVID-19 vaccines; and
       (G) transportation of individuals to facilitate 
     vaccinations, including at community vaccination centers and 
     mobile vaccination units, particularly for underserved 
     populations.
       (c) Supplemental Funding for State Vaccination Grants.--
       (1) Definitions.--In this subsection:
       (A) Base formula.--The term ``base formula'' means the 
     allocation formula that applied to the Public Health 
     Emergency Preparedness cooperative agreement in fiscal year 
     2020.
       (B) Alternative allocation.--The term ``alternative 
     allocation'' means an allocation to each State, territory, or 
     locality calculated using the percentage derived from the 
     allocation received by such State, territory, or locality of 
     the aggregate amount of fiscal year 2020 Public Health 
     Emergency Preparedness cooperative agreement awards under 
     section 319C-1 of the Public Health Service Act (42 U.S.C. 
     247d-3a).
       (2) Supplemental funding.--
       (A) In general.--Not later than 21 days after the date of 
     enactment of this Act, the Secretary shall use amounts 
     described in subsection (a) to provide supplemental funding 
     to any State, locality, or territory that received less of 
     the amounts that were appropriated under title III of 
     division M of Public Law 116-260 for vaccination grants to be 
     issued by the Centers for Disease Control and Prevention than 
     such State, locality, or territory would have received had 
     such amounts been allocated using the alternative allocation.
       (B) Amount.--The amount of supplemental funding provided 
     under this subsection shall be equal to the difference 
     between--
       (i) the amount the State, locality, or territory received, 
     or would receive, under the base formula; and
       (ii) the amount the State, locality, or territory would 
     receive under the alternative allocation.

     SEC. 102. FUNDING FOR VACCINE CONFIDENCE ACTIVITIES.

       In addition to amounts otherwise available, there is 
     appropriated to the Secretary for fiscal year 2021, out of 
     any money in the Treasury not otherwise appropriated, 
     $1,000,000,000, to remain available until expended, to carry 
     out activities, acting through the Director of the Centers 
     for Disease Control and Prevention--
       (1) to strengthen vaccine confidence in the United States, 
     including its territories and possessions;
       (2) to provide further information and education with 
     respect to vaccines licensed under section 351 of the Public 
     Health Service Act (42 U.S.C. 262) or authorized under 
     section 564 of the Federal Food, Drug, and Cosmetic Act (21 
     U.S.C. 360bbb-3); and
       (3) to improve rates of vaccination throughout the United 
     States, including its territories and possessions, including 
     through activities described in section 313 of the Public 
     Health Service Act, as amended by section 311 of division BB 
     of the Consolidated Appropriations Act, 2021 (Public Law 116-
     260).

     SEC. 103. FUNDING FOR SUPPLY CHAIN FOR COVID-19 VACCINES, 
                   THERAPEUTICS, AND MEDICAL SUPPLIES.

       In addition to amounts otherwise available, there is 
     appropriated to the Secretary for fiscal year 2021, out of 
     any money in the Treasury not otherwise appropriated, 
     $6,050,000,000, to remain available until expended, for 
     necessary expenses with respect to research, development, 
     manufacturing, production, and the purchase of vaccines, 
     therapeutics, and ancillary medical products and supplies to 
     prevent, prepare, or respond to--
       (1) SARS-CoV-2 or any viral variant mutating therefrom with 
     pandemic potential; and
       (2) COVID-19 or any disease with potential for creating a 
     pandemic.

     SEC. 104. FUNDING FOR COVID-19 VACCINE, THERAPEUTIC, AND 
                   DEVICE ACTIVITIES AT THE FOOD AND DRUG 
                   ADMINISTRATION.

        In addition to amounts otherwise available, there is 
     appropriated to the Secretary for fiscal year 2021, out of 
     any money in the Treasury not otherwise appropriated, 
     $500,000,000, to remain available until expended, to be used 
     for the evaluation of the continued performance, safety, and 
     effectiveness, including with respect to emerging COVID-19 
     variants, of vaccines, therapeutics, and diagnostics 
     approved, cleared, licensed, or authorized for use for the 
     treatment, prevention, or diagnosis of COVID-19; facilitation 
     of advanced continuous manufacturing activities related to 
     production of vaccines and related materials; facilitation 
     and conduct of inspections related to the manufacturing of 
     vaccines, therapeutics, and devices delayed or cancelled for 
     reasons related to COVID-19; review of devices authorized for 
     use for the treatment, prevention, or diagnosis of COVID-19; 
     and oversight of the supply chain and mitigation of shortages 
     of vaccines, therapeutics, and devices approved, cleared, 
     licensed, or authorized for use for the treatment, 
     prevention, or diagnosis of COVID-19 by the Food and Drug 
     Administration.

     SEC. 105. REDUCED COST-SHARING.

       (a) In General.--Section 1402 of the Patient Protection and 
     Affordable Care Act is amended by redesignating subsection 
     (f) as subsection (g) and by inserting after subsection (e) 
     the following new subsection:
       ``(f) Special Rule for Individuals Who Receive Unemployment 
     Compensation During 2021.--For purposes of this section, in 
     the case of an individual who has received, or has been 
     approved to receive, unemployment

[[Page S1371]]

     compensation for any week beginning during 2021, for the plan 
     year in which such week begins--
       ``(1) such individual shall be treated as meeting the 
     requirements of subsection (b)(2), and
       ``(2) for purposes of subsections (c) and (d), there shall 
     not be taken into account any household income of the 
     individual in excess of 133 percent of the poverty line for a 
     family of the size involved.''.
       (b) Effective Date.--The amendment made by this section 
     shall apply to plan years beginning after December 31, 2020.

                          Subtitle B--Testing

     SEC. 111. FUNDING FOR COVID-19 TESTING, CONTACT TRACING, AND 
                   MITIGATION ACTIVITIES.

       (a) In General.--In addition to amounts otherwise 
     available, there is appropriated to the Secretary of Health 
     and Human Services (in this subtitle referred to as the 
     ``Secretary'') for fiscal year 2021, out of any money in the 
     Treasury not otherwise appropriated, $47,800,000,000, to 
     remain available until expended, to carry out activities to 
     detect, diagnose, trace, and monitor SARS-CoV-2 and COVID-19 
     infections and related strategies to mitigate the spread of 
     COVID-19.
       (b) Use of Funds.--From amounts appropriated by subsection 
     (a), the Secretary shall--
       (1) implement a national, evidence-based strategy for 
     testing, contact tracing, surveillance, and mitigation with 
     respect to SARS-CoV-2 and COVID-19, including through 
     activities authorized under section 319(a) of the Public 
     Health Service Act;
       (2) provide technical assistance, guidance, and support, 
     and award grants or cooperative agreements to State, local, 
     and territorial public health departments for activities to 
     detect, diagnose, trace, and monitor SARS-CoV-2 and COVID-19 
     infections and related strategies and activities to mitigate 
     the spread of COVID-19;
       (3) support the development, manufacturing, procurement, 
     distribution, and administration of tests to detect or 
     diagnose SARS-CoV-2 and COVID-19, including through--
       (A) support for the development, manufacture, procurement, 
     and distribution of supplies necessary for administering 
     tests, such as personal protective equipment; and
       (B) support for the acquisition, construction, alteration, 
     or renovation of non-federally owned facilities for the 
     production of diagnostics and ancillary medical products and 
     supplies where the Secretary determines that such an 
     investment is necessary to ensure the production of 
     sufficient amounts of such supplies;
       (4) establish and expand Federal, State, local, and 
     territorial testing and contact tracing capabilities, 
     including--
       (A) through investments in laboratory capacity, such as--
       (i) academic and research laboratories, or other 
     laboratories that could be used for processing of COVID-19 
     testing;
       (ii) community-based testing sites and community-based 
     organizations; or
       (iii) mobile health units, particularly in medically 
     underserved areas; and
       (B) with respect to quarantine and isolation of contacts;
       (5) enhance information technology, data modernization, and 
     reporting, including improvements necessary to support 
     sharing of data related to public health capabilities;
       (6) award grants to, or enter into cooperative agreements 
     or contracts with, State, local, and territorial public 
     health departments to establish, expand, and sustain a public 
     health workforce; and
       (7) to cover administrative and program support costs 
     necessary to conduct activities related to subparagraph (a).

     SEC. 112. FUNDING FOR SARS-COV-2 GENOMIC SEQUENCING AND 
                   SURVEILLANCE.

       (a) In General.--In addition to amounts otherwise 
     available, there is appropriated to the Secretary for fiscal 
     year 2021 out of any money in the Treasury not otherwise 
     appropriated, $1,750,000,000, to remain available until 
     expended, to strengthen and expand activities and workforce 
     related to genomic sequencing, analytics, and disease 
     surveillance.
       (b) Use of Funds.--From amounts appropriated by subsection 
     (a), the Secretary, acting through the Director of the 
     Centers for Disease Control and Prevention, shall--
       (1) conduct, expand, and improve activities to sequence 
     genomes, identify mutations, and survey the circulation and 
     transmission of viruses and other organisms, including 
     strains of SARS-CoV-2;
       (2) award grants or cooperative agreements to State, local, 
     Tribal, or territorial public health departments or public 
     health laboratories--
       (A) to increase their capacity to sequence genomes of 
     circulating strains of viruses and other organisms, including 
     SARS-CoV-2;
       (B) to identify mutations in viruses and other organisms, 
     including SARS-CoV-2;
       (C) to use genomic sequencing to identify outbreaks and 
     clusters of diseases or infections, including COVID-19; and
       (D) to develop effective disease response strategies based 
     on genomic sequencing and surveillance data;
       (3) enhance and expand the informatics capabilities of the 
     public health workforce; and
       (4) award grants for the construction, alteration, or 
     renovation of facilities to improve genomic sequencing and 
     surveillance capabilities at the State and local level.

     SEC. 113. FUNDING FOR GLOBAL HEALTH.

       In addition to amounts otherwise available, there is 
     appropriated to the Secretary for fiscal year 2021, out of 
     any amounts in the Treasury not otherwise appropriated, 
     $750,000,000, to remain available until expended, for 
     activities to be conducted acting through the Director of the 
     Centers for Disease Control and Prevention to combat SARS-
     CoV- 2, COVID-19, and other emerging infectious disease 
     threats globally, including efforts related to global health 
     security, global disease detection and response, global 
     health protection, global immunization, and global 
     coordination on public health.

     SEC. 114. FUNDING FOR DATA MODERNIZATION AND FORECASTING 
                   CENTER.

       In addition to amounts otherwise available, there is 
     appropriated to the Secretary for fiscal year 2021, out of 
     any money in the Treasury not otherwise appropriated, 
     $500,000,000, to remain available until expended, for 
     activities to be conducted acting through the Director of the 
     Centers for Disease Control and Prevention to support public 
     health data surveillance and analytics infrastructure 
     modernization initiatives at the Centers for Disease Control 
     and Prevention, and establish, expand, and maintain efforts 
     to modernize the United States disease warning system to 
     forecast and track hotspots for COVID-19, its variants, and 
     emerging biological threats, including academic and workforce 
     support for analytics and informatics infrastructure and data 
     collection systems.

       TITLE II--COMMITTEE ON BANKING, HOUSING, AND URBAN AFFAIRS

     SEC. 201. COVID-19 EMERGENCY MEDICAL SUPPLIES ENHANCEMENT.

       (a) Supporting Enhanced Use of the Defense Production Act 
     of 1950.--In addition to funds otherwise available, there is 
     appropriated, for fiscal year 2021, out of any money in the 
     Treasury not otherwise appropriated, $10,000,000,000, 
     notwithstanding section 304(e) of the Defense Production Act 
     of 1950 (50 U.S.C. 4534(e)), to remain available until 
     September 30, 2025, to carry out titles I, III, and VII of 
     such Act in accordance with subsection (b).
       (b) Medical Supplies and Equipment.--
       (1) Testing, ppe, vaccines, and other materials.--Except as 
     provided in paragraph (2), amounts appropriated in subsection 
     (a) shall be used for the purchase, production (including the 
     construction, repair, and retrofitting of government-owned or 
     private facilities as necessary), or distribution of medical 
     supplies and equipment (including durable medical equipment) 
     related to combating the COVID-19 pandemic, including--
       (A) in vitro diagnostic products for the detection of SARS-
     CoV-2 or the diagnosis of the virus that causes COVID-19, and 
     the reagents and other materials necessary for producing, 
     conducting, or administering such products, and the 
     machinery, equipment, laboratory capacity, or other 
     technology necessary to produce such products;
       (B) face masks and personal protective equipment, including 
     face shields, nitrile gloves, N-95 filtering facepiece 
     respirators, and any other masks or equipment (including 
     durable medical equipment) needed to respond to the COVID-19 
     pandemic, and the materials, machinery, additional 
     manufacturing lines or facilities, or other technology 
     necessary to produce such equipment; and
       (C) drugs, devices, and biological products that are 
     approved, cleared, licensed, or authorized for use in 
     treating or preventing COVID-19 and symptoms related to 
     COVID-19, and any materials, manufacturing machinery, 
     additional manufacturing or fill-finish lines or facilities, 
     technology, or equipment (including durable medical 
     equipment) necessary to produce or use such drugs, biological 
     products, or devices (including syringes, vials, or other 
     supplies or equipment related to delivery, distribution, or 
     administration).
       (2) Responding to public health emergencies.--After 
     September 30, 2022, amounts appropriated in subsection (a) 
     may be used for any activity authorized by paragraph (1), or 
     any other activity necessary to meet critical public health 
     needs of the United States, with respect to any pathogen that 
     the President has determined has the potential for creating a 
     public health emergency.

                    TITLE III--COMMITTEE ON FINANCE

     SEC. 301. FUNDING FOR PROVIDERS RELATING TO COVID-19.

       Part A of title XI of the Social Security Act (42 U.S.C. 
     1301 et seq.) is amended by adding at the end the following:

     ``SEC. 1150C. FUNDING FOR PROVIDERS RELATING TO COVID-19.

       ``(a) Funding.--In addition to amounts otherwise available, 
     there is appropriated to the Secretary, for fiscal year 2021, 
     out of any monies in the Treasury not otherwise appropriated, 
     $8,500,000,000 for purposes of making payments to eligible 
     health care providers for health care related expenses and 
     lost revenues that are attributable to COVID-19. Amounts 
     appropriated under the preceding sentence shall remain 
     available until expended.
       ``(b) Special Rule Regarding Parent Organizations.--In the 
     case of any payment made under this section to an eligible 
     health care provider, but which is received by a parent 
     organization of such provider, such parent organization shall 
     allocate all of such payment to such provider.
       ``(c) Application Requirement.--To be eligible for a 
     payment under this section, an eligible health care provider 
     shall submit to

[[Page S1372]]

     the Secretary an application in such form and manner as the 
     Secretary shall prescribe. Such application shall contain the 
     following:
       ``(1) A statement justifying the need of the provider for 
     the payment, including documentation of the health care 
     related expenses attributable to COVID-19 and lost revenues 
     attributable to COVID-19.
       ``(2) The tax identification number of the provider.
       ``(3) Such assurances as the Secretary determines 
     appropriate that the eligible health care provider will 
     maintain and make available such documentation and submit 
     such reports (at such time, in such form, and containing such 
     information as the Secretary shall prescribe) as the 
     Secretary determines is necessary to ensure compliance with 
     any conditions imposed by the Secretary under this section.
       ``(4) Any other information determined appropriate by the 
     Secretary.
       ``(d) Limitation.--Payments made to an eligible health care 
     provider under this section may not be used to reimburse any 
     expense or loss that--
       ``(1) has been reimbursed from another source; or
       ``(2) another source is obligated to reimburse.
       ``(e) Application of Requirements, Rules, and Procedures.--
     The Secretary shall apply any requirements, rules, or 
     procedures as the Secretary deems appropriate for the 
     efficient execution of this section.
       ``(f) Definitions.--In this section:
       ``(1) Eligible health care provider.--The term `eligible 
     health care provider' means--
       ``(A) a provider of services (as defined in section 
     1861(u)) or a supplier (as defined in section 1861(d)) that--
       ``(i) is enrolled in the Medicare program under title XVIII 
     under section 1866(j), including temporarily enrolled during 
     the emergency period described in section 1135(g)(1)(B) for 
     such period;
       ``(ii) provides diagnoses, testing, or care for individuals 
     with possible or actual cases of COVID-19; and
       ``(iii) is located in a rural area or treated as located in 
     a rural area pursuant to section 1886(d)(8)(E); or
       ``(B) a provider or supplier that--
       ``(i) is enrolled with a State Medicaid plan under title 
     XIX (or a waiver of such plan) in accordance with subsections 
     (a)(77) and (kk) of section 1902 (including enrolled pursuant 
     to section 1902(a)(78) or section 1932(d)(6)) or enrolled 
     with a State child health plan under title XXI (or a waiver 
     of such plan) in accordance with subparagraph (G) of section 
     2107(e)(1) (including enrolled pursuant to subparagraph (D) 
     or (Q) of such section);
       ``(ii) provides diagnoses, testing, or care for individuals 
     with possible or actual cases of COVID-19; and
       ``(iii) is located in a rural area.
       ``(2) Health care related expenses attributable to covid-
     19.--The term `health care related expenses attributable to 
     COVID-19' means health care related expenses to prevent, 
     prepare for, and respond to COVID-19, including the building 
     or construction of a temporary structure, the leasing of a 
     property, the purchase of medical supplies and equipment, 
     including personal protective equipment and testing supplies, 
     providing for increased workforce and training, including 
     maintaining staff, obtaining additional staff, or both, the 
     operation of an emergency operation center, retrofitting a 
     facility, providing for surge capacity, and other expenses 
     determined appropriate by the Secretary.
       ``(3) Lost revenue attributable to covid-19.--The term 
     `lost revenue attributable to COVID-19' has the meaning given 
     that term in the Frequently Asked Questions guidance released 
     by the Department of Health and Human Services in June 2020, 
     including the difference between such provider's budgeted and 
     actual revenue if such budget had been established and 
     approved prior to March 27, 2020.
       ``(4) Payment.-- The term `payment' includes, as determined 
     appropriate by the Secretary, a pre-payment, a prospective 
     payment, a retrospective payment, or a payment through a 
     grant or other mechanism.
       ``(5) Rural area.--The term `rural area' means--
       ``(A) a rural area (as defined in section 1886(d)(2)(D)); 
     or
       ``(B) any other rural area (as defined by the 
     Secretary).''.
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