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H.R. 266: Paycheck Protection Program and Health Care Enhancement Act

The federal government has enacted four main stimulus laws in response to the covid-19 pandemic. Here’s a brief rundown of what each of these legislative actions did.

Phase 1: Coronavirus Preparedness and Response Supplemental Appropriations Act

The law

The Coronavirus Preparedness and Response Supplemental Appropriations Act was enacted on March 6, at a cost of $8.3 billion.

The economic impact of the virus had barely hit at this point, with most shutdowns and stay-at-home orders arriving between one and two weeks later. Accordingly, the money here was primarily for measures such as vaccine development and public health funding, with most dollars going to agencies within the Department of Health and Human Services.

81% of funds were allocated domestically, with the other 19% allocated internationally. The virus had only killed 11 Americans when this law was passed. U.S. deaths have since surpassed 85,000.

It was introduced in the House on March 4 as bill number H.R. 6074, by Rep. Nita Lowy (D-NY17), Chair of the House Appropriations Committee.

House vote

It passed the House by 415–2, with only Republican Reps. Andy Biggs (R-AZ5) and Ken Buck (R-CO4) opposing.

The White House had originally requested about $2.5 billion in late February. House Democrats, who took the lead on crafting the chamber’s version of the legislation, more than tripled that amount in the final bill. Reps. Biggs and Buck opposed it on those grounds.

“In true Washington, D.C. fashion, congressional appropriators turned the president’s reasonable $2.5 billion request into a bloated $8.3 billion package. By passing this larded-up bill, Congress again fails to wisely appropriate taxpayer dollars,” Rep. Biggs said in a press release.”I would have supported the president’s request for $2.5 billion, knowing that, if we spent all the funds, Congress could have provided additional funding.”

“Since day one, Democrats have politicized the coronavirus. The president’s initial $2.5 billion request was a thoughtful proposal to address our coronavirus response needs. In typical fashion, the House passed a spending package of $8.3 billion with vague plans about how the extra money would be spent,” Rep. Buck said in a press release. “Throwing money at a problem without adequate forethought is not the answer.”

Reps. Biggs and Buck also voted against subsequent covid-19 relief bills.

Senate vote

Then it passed the Senate by 96–1, with only Sen. Rand Paul (R-KY) opposing. Sen. Paul had introduced an amendment to pay for the legislation by revoking planned payments for other expenditures, such as the government agency the Inter-American Foundation which (among other things) once helped fund a school for circus arts in Argentina.

“I support our government’s efforts to fight the coronavirus. We also owe it to the American people to do it in a way that avoids piling billions more in debt on their backs,” Sen. Paul said in a press release. “My amendment responsibly uses taxpayer resources by reducing waste to pay for this new spending.”

The Senate voted to table (or remove) Paul’s amendment by 81–15. All votes against tabling — in other words, to keep the amendment in — came from Republicans, although the party still largely supported tabling it by 37–15.

Sen. Paul cast the lone Senate vote against the final bill in protest.

Phase 2: Families First Coronavirus Response Act

The law

The Families First Coronavirus Response Act was enacted a week and a half later on March 18, the period when everything began shutting down in earnest and President Trump officially declared a national emergency. The law’s $104 billion cost was about a dozen times the prior law, but still a fraction of the $831 billion for 2009’s Great Recession stimulus package.

Among phase two’s major provisions included:

  • Requiring private health insurance plans and Medicare cover covid-19 testing.
  • Expanding unemployment insurance by $1 billion, a number immediately seen as far too low as the unemployment rates swelled, and loosened eligibility requirements
  • Providing for paid sick leave at an employee’s full salary, up to $511 per day, and paid family leave at ⅔ of a parent’s usual salary.

It was introduced on March 11 as bill number H.R. 6201, again by House Appropriations Committee Chair Rep. Nita Lowy (D-NY17).

House vote

It passed the House by 363–40, with one member voting “present.” All 40 votes of opposition came from Republicans.

The opposing Republicans’ worries were primarily economic. “It looks like a worker will be worse off under this bill by getting paid up to 10 weeks of wages at the bill’s mandated 2/3’s rate as ‘public health emergency leave’ instead of receiving workers compensation, because workers comp is non-taxable though employer paid leave is taxable,” Rep. Louie Gohmert (R-TX1) wrote.

The one lawmaker who voted “present” — refusing to take a stand one way or the other — was Rep. Justin Amash of Michigan, at the time an independent who has since joined the Libertarian Party. Amash claimed House leaders gave members only half an hour to review the bill before voting on it.

“Without time to confer with the drafters or others, we couldn’t determine why businesses with 500 or more employees are exempt from the paid emergency leave and FMLA [Family Medical Leave Act] requirements,” Rep. Amash tweeted. “An improper Wall Street carveout or is there some other justification?”

Senate vote

The Senate then passed it by 90–8. All eight votes in opposition came from Republicans.

The eight Republicans voiced similar concerns as Rep. Gohmert above, particularly regarding business mandates for paid sick leave and family leave. Several Republican senators introduced an amendment to strike those mandates and replace it with loosened eligibility for unemployment insurance.

The amendment received more support than opposition, by 50–48, but required three-fifths to pass. Republicans largely supported it 48–3, while Democrats largely opposed it 2–43.

Phase 3: Coronavirus Aid, Relief, and Economic Security (CARES) Act

The law

This was the big one. The Coronavirus Aid, Relief, and Economic Security (CARES) Act was enacted another week and a half later on March 27.

If anything, “the big one” may be an understatement. It was by far the most expensive single spending bill ever enacted in American history, at about $2.2 trillion. For context, in just one single law, Congress spent about half the $4.4 trillion it had spent in the *entire *previous fiscal year.

At 335 pages, it would be impossible to summarize all of the law’s provisions, but the most important included:

Technically, the bill was originally introduced more than a year prior in January 2019 as bill number H.R. 748 by Rep. Joe Courtney (D-CT2). That original legislation was used as a “shell” and largely replaced with new coronavirus-related provisions in March 2020.

Senate vote

The Senate passed it unanimously by 96–0. Four Republican senators didn’t vote.

Yet the chamber’s passage was hardly guaranteed, as the first two cloture votes for the bill — essentially a “vote on whether to vote” — both failed. Senate Democrats opposed early iterations of the bill because it “included a large corporate bailout provision with no protections for workers and virtually no oversight,” Senate Democratic Leader Chuck Schumer (D-NY) said.

With three-fifths required, the first cloture vote tied 47–47. Democrats unanimously opposed it 0–45, while Republicans almost entirely supported it 47–1. The lone Republican no vote was Senate Majority Leader Mitch McConnell (R-KY), who did so as a procedural move allowing him to call up the vote again.

The next day, the cloture vote received majority support by 49–46, but still fell short of the three-fifths required. Republicans supported it unanimously 48–0 while Democrats almost entirely opposed 1–44, with only Sen. Doug Jones (R-AL) in support.

Finally, after Senate leaders hammered out some compromises, the third time was the charm.

House vote

It looked possible that the House wouldn’t pass it either, not due to lack of support, but due to lack of sufficient representatives physically in the room because of social distancing.

Under an obscure congressional rule called a “quorum,” at least half of all House members are supposed to be physically present for a vote to occur. In practice, that rule is often waved. But if a member who opposes a bill “calls a quorum,” asking for a count of the number of members in the chamber, they can hold up a bill if less than half of House members are physically present.

Rep. Thomas Massie (R-KY4) attempted to do just that. “I came here to make sure our republic doesn’t die by unanimous consent in an empty chamber, and I request a recorded vote,” he said on the House floor. His request was quickly shot down by Rep. Anthony Brown (D-MD4), who was presiding over the chamber at the time. The bill then passed by a voice vote, a speedier process in which no record of members’ individual votes was taken.

President Trump called for Rep. Massie to be thrown out of the Republican Party as punishment. Currently, Rep. Massie remains a Republican.

“Phase 3.5”: Paycheck Protection Program and Health Care Enhancement Act

The law

The Paycheck Protection Program and Health Care Enhancement Act was enacted almost a month later on April 24.

Unlike the previous two laws, this one did not increase unemployment insurance funding nor create any new mandates for businesses. About three-quarters of the money went to replenish the Paycheck Protection Program (PPP) for small businesses, with the rest going to public health measures such as virus testing and hospital funding.

Some have nicknamed this “phase 3.5,” with the expectation that Congress will soon pass a much larger law once again in May or June that will more deservedly merit the “phase 4” nickname. However, at $484 billion, this “phase 3.5” law actually costs far more than either “phase 1” or “phase 2” did.

Congressional votes

The House vote was 388–5. Four Republicans opposed it over similar concerns as before, namely economics and spending. One Democrat also opposed it, Rep. Alexandria Ocasio-Cortez (D-NY14), claiming its priorities weren’t sufficiently progressive.

“It is a joke when Republicans say that they have urgency around this bill. The only folks that they have urgency around are Ruth’s Chris Steak House and Shake Shack. Those are the people getting assistance in this bill. You are not trying to fix this bill for mom-and-pops,” Rep. Ocasio-Cortez said on the House floor in late April. “It is unconscionable. If you had urgency, you would legislate like rent was due on May 1, and make sure that we include rent and mortgage relief for our constituents.”

Once again, Rep. Justin Amash was the lone House member to vote “present,” refusing to weigh in either way.

“Layoffs are still planned for companies getting targeted bailouts. PPP’s complex rules limit its usefulness for many businesses, and the program favors businesses that may be in less need of government support,” Rep. Amash tweeted. “Now that leaders have dumped it in our laps, it’s no surprise that the bill adds funds to PPP without fixing the problems within PPP or within the broader relief package. It’s inexcusable to double down on a flawed approach that continues to fail the people we represent.”

The Senate vote was by voice vote, a procedure used for relatively noncontroversial legislation, in which no record of individual senators’ votes is recorded.

Last updated May 14, 2020. View all GovTrack summaries.

The summary below was written by the Congressional Research Service, which is a nonpartisan division of the Library of Congress, and was published on Apr 25, 2020.

Paycheck Protection Program and Health Care Enhancement Act

This bill responds to the COVID-19 (i.e., coronavirus disease 2019) outbreak by providing additional funding for small business loans, health care providers, and COVID-19 testing.


(Sec. 101) This division provides additional lending authority for certain Small Business Administration (SBA) programs in response to COVID-19.

Specifically, the division increases the authority for (1) the Paycheck Protection Program, under which the SBA may guarantee certain loans to small businesses during the COVID-19 pandemic; and (2) advances on emergency economic injury disaster loans made in response to COVID-19. The division also expands eligibility for such disaster loans and advances to include agricultural enterprises.

Additionally, the division requires the SBA to guarantee no less than a specified amount of paycheck protection loans made by certain insured depository institutions, community financial institutions, and credit unions.

(Sec. 102) The amounts provided under this division are designated as an emergency requirement pursuant to the Statutory Pay-As-You-Go Act of 2010 (PAYGO) and the Senate PAYGO rule.


Additional Emergency Appropriations for Coronavirus Response

This division provides FY2020 supplemental appropriations for the Department of Health and Human Services (HHS) and the SBA in response to COVID-19.

The supplemental appropriations are designated as emergency spending, which is exempt from discretionary spending limits.


This title provides $100 billion in FY2020 supplemental appropriations to HHS for the Public Health and Social Services Emergency Fund, including

$75 billion to reimburse health care providers for health care related expenses or lost revenues that are attributable to the coronavirus outbreak; and $25 billion for expenses to research, develop, validate, manufacture, purchase, administer, and expand capacity for COVID-19 tests to effectively monitor and suppress COVID-19. The title allocates specified portions of the $25 billion for COVID-19 testing to

states, localities, territories, and tribes; the Centers for Diseases Control and Prevention; the National Institutes of Health; the Biomedical Advanced Research and Development Authority; the Food and Drug Administration; community health centers; rural health clinics; and testing for the uninsured. The title also establishes several reporting requirements for HHS, including requirements to submit to Congress details regarding COVID-19 cases and a strategic testing plan

(Sec. 101) This section specifies that certain authorities, conditions, and requirements included in the Coronavirus Aid, Relief, and Economic Security Act apply to the funds provided by this division to HHS.

(Sec. 102) This section sets forth authorities and restrictions that apply to transferring funds provided by this title.

(Sec. 103) This section requires specified funds provided by this title for the Public Health and Social Services Emergency Fund to be transferred to the HHS Office of Inspector General for oversight of activities supported with funds appropriated to HHS to respond to the COVID-19 outbreak.


This title provides FY2020 supplemental appropriations to the SBA, including

$2.1 billion for salaries and expenses to administer programs related to COVID-19, $50 billion for the Economic Injury Disaster Loan (EIDL) program, and $10 billion for Emergency EIDL grants. TITLE III--GENERAL PROVISIONS--THIS ACT

(Sec. 301) This section specifies that the funds provided by this division are in addition to funds otherwise appropriated for the fiscal year involved.

(Sec. 302) Funds provided by this division may not remain available beyond the current fiscal year, unless this division provides otherwise.

(Sec. 303) Unless otherwise specified by this division, the funds provided by this division are subject to the authorities and conditions that apply to the applicable appropriations account for FY2020.

(Sec. 304) This section specifies that certain funds provided or transferred by this division may only be used to prevent, prepare for, and respond to the coronavirus outbreak.

(Sec. 305) For the purposes of this division, the term coronavirus means SARS-CoV-2 or another coronavirus with pandemic potential.

(Sec. 306) This section provides that amounts designated by this division as emergency requirements are only available (or rescinded, if applicable) if the President subsequently designates the amounts and transmits the designations to Congress.

(Sec. 307) This section specifies that the emergency funds that are transferred pursuant to this division retain the emergency designation.

(Sec. 308) This section exempts the budgetary effects of this division from the Statutory Pay-As-You-Go Act of 2010 (PAYGO), (2) the Senate PAYGO rule, and (3) certain budget scorekeeping rules.