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1 [1] (February 18, 2022)

handle is hein.crs/govefhn0001 and id is 1 raw text is: Congressional Research Service Informing the legislative debate since 1914 0 February 18, 2022 Federal Support for Domestic COVID-19 Test Availability In January 2022, the White House launched several actions to boost the availability of Coronavirus Disease 2019 (COVID-19) tests to the general public, including the distribution of rapid antigen tests to individuals free of cost, enhanced testing initiatives in K-12 schools, and expansion of community testing options. This In Focus covers the federal funding sources, activities, and mechanisms that support domestic COVID-19 test availability as of the date of publication. As defined here, activities to support COVID-19 test availability include (1) the purchase, manufacture, and distribution of tests and related supplies, and (2) support for community and institution-based (e.g., school) testing programs. This In Focus does not address funding or financing for testing- related research and development, regulation, provider reimbursement, health service delivery, or health insurance. Appropriations The list below provides a general overview of major COVID-19 relief appropriations that support domestic COVID-19 test availability, but it is not exhaustive. The following Department of Health and Human Services (HHS) appropriations (greater than $20 billion dollars each) have been specifically directed to aid in expanding COVID- 19 testing, including increasing test availability: Paycheck Protection Program and Health Care Enhancement Act (P.L. 116-139, Division B, Title I), enacted April 2020, provided $25 billion total, available until expended, to the Public Health and Social Services Emergency Fund (PHSSEF) account for a variety of COVID-19 testing- and contact tracing-related purposes. The law directed HHS to reserve or transfer some of these funds. For example, not less than $11 billion was specified for grants to states, localities, territories, tribes, and other tribal entities (SLTTs). In addition, the law specified several transfers to other HHS agencies for specific purposes (e.g., the Food and Drug Administration was to receive $22 million for its testing-related activities). The remaining funds were appropriated for broader activities to boost testing infrastructure, manufacture, capacity, and administration, including the purchase of testing supplies. Coronavirus Response and Relief Supplemental Appropriations Act, 2021 (CRRSA, P.L. 116-260; Division M), enacted December 2020, provided a total of $22.4 billion, available until September 30, 2022, to the PHSSEF account for a variety of COVID-19 testing- and contact tracing-related purposes. The law specified that these funds were intended for SLTT governmental entities (at least $21 billion has since been awarded as Centers for Disease Control and Prevention [CDC] SLTT grants). The law also directed a $790 million transfer to the Indian Health Service for testing. American Rescue Plan Act of 2021 (ARPA, P.L. 117-2, Title II, Section 2401), enacted March 2021, provided a total of $47.8 billion to the HHS Secretary, to remain available until expended, for COVID-19 testing, contact tracing, and mitigation activities. The law directed the HHS Secretary to implement a national, evidence-based strategy for testing; award grants for and support SLTT testing programs; and support the development, manufacture, purchase, distribution, and administration of COVID-19 tests, among other actions. In addition to these appropriations, other HHS COVID-19 relief appropriations (such as certain funding made available to CDC and the HHS Secretary), can also be used to support COVID-19 test availability. According to GAO, HHS allocated a total of $58.3 billion for testing as of November 30, 2021 (GAO-22-105291; total does not reflect all HHS SLTT testing-related grants). This allocation supports test purchase and distribution, community-based testing programs, testing among high-risk populations, screening in schools, and other activities. As of November 30, 2021, $34.9 billion of the total funds has been obligated and $15.5 billion has been expended. COVID-19 relief appropriations have also funded non-HHS federal support for COVID-19 test availability. For example, relevant FEMA activities draw from the Disaster Relief Fund (DRF), a no-year account that supports all assistance provided under the Robert T. Stafford Emergency Assistance and Disaster Relief Act (the Stafford Act, P.L. 93-288, as amended). Test Manufacturing and Supply HHS funding has supported test and testing supply manufacturing throughout the pandemic. In February 2021, the Biden Administration launched a partnership between HHS and Department of Defense (DOD) to boost such manufacturing through federal contracts. The Trump and Biden Administrations also invoked authorities under the Defense Production Act of 1950 (DPA, P.L. 81-774, as amended) to redress certain COVID-19 test supply shortages. The Trump Administration's actions included DOD contracts to expand manufacturing capacity for test swabs. The Biden Administration's National Strategy for the COVID-19 Pandemic and several subsequent executive orders announced that the federal government would invoke DPA authorities to expand private-sector manufacturing capacity and federal purchase of tests. ARPA appropriated $10 billion, provided to a new HHS account, to support DPA actions for the purchase, manufacture, and distribution of medical supplies, to include COVID-19 tests. The full ittps://Crsreports.congress.gov