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Many small doctors’ practices are struggling to survive as many patients shelter at home and put off consultations for all but the most urgent issues, the Washington Post reported. Although they’re still ministering to patients amid a health crisis, they’ve been unable to get loans under the Paycheck Protection Act, passed as part of the coronavirus relief package in late March. A survey done by a Richmond-based advocacy group for primary care doctors, called the Larry A. Green Center, found that half the doctors who sought such loans were unsuccessful. Of 2,774 doctors who responded to the survey, 19 percent said they had to temporarily close their practices because of financial problems; 42 percent had to lay off or furlough staff. About 10 percent say they will have to close in the next month because of financial shortfalls. Some are angry their plight has been ignored by federal lawmakers while cash-starved hospitals are slated to receive $100 billion in government relief. About $3.9 billion of that pool has gone to practices with 10 or fewer clinicians, according to the American Academy of Family Physicians, but it has generally paid out far less than the Small Business Association loans.

Republicans universally rejected a $3 trillion stimulus measure drafted by House Democrats to bolster the U.S. economy, but the draft plan has the seeds for an eventual, smaller compromise, Bloomberg News reported. With House Speaker Nancy Pelosi (D-Calif.) pushing the House toward a Friday vote on the Democratic package, a Senate Republican aide said that Majority Leader Mitch McConnell (R-Ky.) doesn’t plan to move on any GOP alternative until June at the earliest. The framework for a compromise — probably still weeks away — likely will be built on state and local government aid, expanded tax breaks and legal protections for businesses and assistance for unemployed workers. There are several pressure points looming that will increase the stakes, including expiring pandemic unemployment insurance and Paycheck Protection Program provisions at the end of July, and the Sept. 30 ending of grant funding for airlines, as well as the fiscal year. Republicans are counting on the lifting of lockdowns in many states along with the previous stimulus money still flowing out to juice the economy enough that another big spending package won’t be necessary. That aligns them with President Donald Trump, who has said he’s in “no rush” for another stimulus package. Treasury Secretary Steven Mnuchin, who was a linchpin in the negotiations that produced the previous stimulus bills, dismissed the Democratic bill and said that both sides should spend the next 30 days assessing how well those earlier efforts are working. Federal Reserve Chairman Jerome Powell yesterday urged Congress to keep spending in order to avoid long-term damage. “Additional fiscal support could be costly, but worth it if it helps avoid long-term economic damage and leaves us with a stronger recovery,” he said. Read more.

The “Health and Economic Recovery Omnibus Emergency Solutions Act” (HEROES Act), introduced on May 12 by Rep. Nita Lowey (D-N.Y.), is the latest legislative spending package aimed at stabilizing the economy amidst the COVID-19 pandemic. In addition to providing funding for states, localities and territories to pay essential workers, conduct additional testing and provide an additional round of direct payments to households, the legislation has included a few bankruptcy provisions. According to the bill summary:

• Sec. 20104 protects Economic Impact Payments from any form of transfer, assignment, execution, levy, attachment, garnishment, legal process, bankruptcy or insolvency law, and any other means of capture prohibited for payments made under Chapter 7, Subchapter 2, of the Social Security Act.

• Section 90001 (c) makes a technical clarification to ensure that hospitals in bankruptcy still qualify for PPP loans due to the essential nature of their operations.

• Sec. 110203 extends and expands the eviction moratorium and foreclosure moratorium in the CARES Act to include all renters and homeowners, improves the forbearance provided under the CARES Act, and specifies the loan modifications and loss mitigation that should be available to homeowners following a moratorium to prevent any homeowner from facing a lump-sum payment that they cannot afford. Additionally, this section protects federal relief payments from being taken in bankruptcy proceedings, ensuring that homeowners in bankruptcy proceedings can participate in the mortgage forbearance program created by the CARES Act and other COVID-19 mortgage assistance; increases the amount of home equity protected in the bankruptcy process to $100,000; makes it easier for homeowners to exit bankruptcy so they can resume normal economic activity and continue paying off their mortgages; and opens up chapter 13 to more homeowners and small businesses by raising the limits for debt to qualify for a bankruptcy through chapter 13.

Click here for the bill text.

Click here for the bill summary.

One of the most progressive lawmakers in the House and one of the most conservative in the Senate, staring down a pandemic-driven unemployment rate at its highest level since the Great Depression, have come to the same conclusion: It’s time for the federal government to cover workers’ salaries, the New York Times reported. As Congress prepares to wage a new battle over how to best aid workers and businesses devastated by the coronavirus crisis, Representative Pramila Jayapal (D-Wash.) and Sen. Josh Hawley (R.-Mo.) are both making the case to their party’s leaders that guaranteed income programs should be part of the federal relief effort. Jayapal’s bill would cover workers’ salaries up to $90,000 for up to six months — allowing businesses to rehire furloughed and laid-off employees — and distribute grants to businesses to cover operating costs. It would cost $654 billion over six months and benefit more than 36 million workers, according to an analysis by Moody’s prepared for her office. Hawley has introduced a similar proposal mirroring the British government’s plan that would cover 80 percent of employers’ payroll costs up to the median wage, about $49,000 a year. A companion bill that Hawley introduced goes further, providing families and single parents making less than $100,000 with a monthly check for the duration of the crisis.

After learning that some small businesses received less than they asked for under the Paycheck Protection Program, three Democratic Senators want more scrutiny of the banks, the New York Times reported. In a letter to Treasury Secretary Steven Mnuchin and Small Business Administrator Jovita Carranza on Wednesday, three members of the Senate Banking Committee asked for more oversight of banks making loans under the Paycheck Protection Program. The program is designed to provide forgivable loans that help small businesses pay their employees and some of their overhead during the coronavirus lockdowns. But some business owners are saying that they had not received as much money as they had asked for, and said they had been told that the decision was made by the banks — not the Small Business Administration, which is funding the program. “Whether inadvertent or intentional, this troubling report warrants a response from your agencies,” the senators, Sherrod Brown of Ohio, Robert Menendez of New Jersey and Tina Smith of Minnesota, wrote in the letter. Treasury rules say that for Paycheck Protection Program loans to be forgiven, businesses must spend the money in precise ways, including rehiring a certain portion of their employees. If the amount they receive isn’t enough to rehire enough employees, their loans cannot be forgiven. The senators asked Mnuchin and Ms. Carranza to offer those borrowers options for getting additional funds to cover the gap. They also asked whether the officials had a plan for identifying which borrowers had not gotten as much money as they needed and determining the reason for the discrepancy.

Negotiations on Capitol Hill over the next package of coronavirus economic relief have revived discussions about ending surprise medical billing, an effort to bolster patient protections that has sparked heavy spending by opponents who warn of damage to the health-care system, the Wall Street Journal reported. Surprise billing typically occurs when a patient is treated at a hospital that is in their insurance network by a medical professional who isn’t, potentially leading to crippling medical charges. The push to end surprise billing pits patient advocates and health-insurance providers, who back the effort, against hospital and medical groups who say it amounts to government rate-setting that would jeopardize the finances of some hospitals and mean out-of-network doctors earn less money. Lawmakers and the administration have already ensured that anyone without insurance getting treated for Covid-19, the disease caused by the new coronavirus, can’t get stuck with an unexpected medical bill — and advocates say that protection should be expanded to cover patients with any medical issue. But the pandemic’s effect on hospitals, especially rural hospitals that have halted the elective procedures that bring in much of their revenue, adds a complication to the debate, according to congressional aides. Moving to end surprise medical billing could cost hospitals more money just as they are already struggling. The top Republicans and Democrats on the Senate health committee and House Energy and Commerce panel have been pushing for almost a year to end surprise medical billing. They reached a rare, high-level bipartisan agreement in December, backed by President Trump, to end the surprise bills and include a new system in which insurers would pay at least an agreed-upon rate for services, and independent arbitration would settle billing disputes. But its supporters — chief among them the Senate health committee’s chairman, Sen. Lamar Alexander (R-Tenn.) — weren’t able to include it in a must-pass spending measure at year’s end, leaving its fate uncertain. Alexander is retiring at the end of this year and has made ending surprise medical billing one of his final goals.

Speaker Nancy Pelosi (D-Calif.) and House Democrats are planning to move ahead with a Friday vote on a $3 trillion package to respond to the coronavirus crisis, Politico reported. President Donald Trump and Senate Republicans also object to the Democratic proposal, saying that there hasn’t been enough time since the $2 trillion CARES Act passed to determine whether new legislation is needed or necessary. Democrats released their sprawling package, known as the Heroes Act, on Tuesday afternoon. The legislation includes $875 billion for cash for state and local governments, which Democratic leaders say is the centerpiece of this coronavirus relief package. It also includes $20 billion each for tribal nations and for U.S. territories. The measure also includes provisions to support multi-employer pensions. The legislation also includes a slew of liberal priorities left out of previous bills, including $75 billion for mortgage relief and $100 billion in assistance for renters, $25 billion for the U.S. Postal Service and $3.6 billion to shore up elections. The bill goes further than previous bills in other ways, too: It would include another round of $1,200 checks for adults making up to $75,000. Under this bill, kids would receive the same amount, instead of $500. It would make $10 billion available to small businesses that haven’t received funds from the Paycheck Protection Program. Republicans dismissed the bill even before the text was public, calling it a Democratic wishlist that would not move in the GOP-controlled Senate. Read more.

In related news, Congress is looking to help struggling local newspapers, TV and radio stations qualify for federal coronavirus aid, the Wall Street Journal reported. The coming coronavirus legislation expected to be introduced in the House as soon as this week will include a provision to expand newspapers’ and broadcasters’ eligibility for forgivable small business loans, the people said. Meanwhile, Sens. Maria Cantwell (D-Wash.) and Amy Klobuchar (D-Minn.) are working to find ways to move the proposal forward in the Republican-controlled Senate. “The Covid-19 crisis has shown us how essential local news and information is to us,” Cantwell said. “Now is not the time to cut newsroom jobs critical to giving the public regional data and news on Covid-19 outbreaks.” Many local news outlets haven’t been able to apply for the Small Business Administration’s forgivable Paycheck Protection Program loans because of “affiliation rules” that force them to be measured by the size of their parent companies. The new provision to be considered by Congress would waive such rules when it comes to local news outlets. Read more. (Subscription required.)