Fourth COVID-19 Relief Package (P.L. 116-139): In Brief — R46325 (April 24, 2020)
Summary
This Congressional Research Service report (R46325, April 24, 2020) summarizes the Paycheck Protection Program and Health Care Enhancement Act, P.L. 116-139, the fourth COVID-19 relief measure, passed by the House 388-5 on April 23, 2020 and the President signed the next day. Division A raises the PPP authorization limit from $349 billion to $659 billion, reserves at least $30 billion each for loans by mid-sized lenders and by community financial institutions, and opens EIDL to agricultural enterprises with not more than 500 employees. Division B appropriates $100 billion to HHS, including $75 billion for the Provider Relief Fund and $25 billion for testing and contact tracing, and $62 billion to the SBA. CBO estimates $321.3 billion in additional direct spending for the PPP. The SBA had stopped taking PPP applications on April 15, 2020 after approving over 1.66 million loans.
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Fourth COVID-19 Relief Package
(P.L. 116-139): In Brief
William L. Painter, Coordinator
Specialist in Homeland Security and Appropriations
Robert Jay Dilger
Senior Specialist in American National Government
Bruce R. Lindsay
Analyst in American National Government
Sarah A. Lister
Specialist in Public Health and Epidemiology
April 24, 2020
Congressional Research Service
7-....
www.crs.gov
R46325
SUMMARY
R46325
Fourth COVID-19 Relief Package (P.L. 116-139):
April 24, 2020
In Brief William L. Painter,
On April 23, 2020, Congress passed its fourth measure including supplemental appropriations to Coordinator
respond to the COVID-19 pandemic. The Paycheck Protection Program and Health Care Specialist in Homeland
Enhancement Act (the act; P.L. 116-139) includes enhancements for the Small Business Security and
Administration’s Paycheck Protection Program (PPP), Economic Injury Disaster Loans (EIDL), Appropriations
and Emergency EIDL grants, and emergency supplemental appropriations for the Department of -redacted-@crs.loc.gov
Health and Human Services (HHS) and Small Business Administration (SBA). The President Robert Jay Dilger
signed the bill into law on April 24, 2020. Senior Specialist in
American National
The Congressional Budget Office estimates that the act will result in $321.3 billion in additional Government
direct spending for the PPP, and $162.1 billion in additional discretionary spending, including -redacted-@crs.loc.gov
$50 billion for EIDL and $10 billion for Emergency EIDL grants.
Bruce R. Lindsay
Analyst in American
This report provides a brief overview of that measure.
National Government
-redacted-@crs.loc.gov
Sarah A. Lister
Specialist in Public Health
and Epidemiology
-redacted-@crs.loc.gov
For a copy of the full report,
please call 7-.... or visit
www.crs.gov.
Congressional Research Service
Fourth COVID-19 Relief Package (P.L. 116-139): In Brief
Contents
Introduction ..................................................................................................................................... 1
Legislative History .................................................................................................................... 1
Provisions of the Paycheck Protection Program and Health Care Enhancement Act ..................... 1
Division A—Small Business Programs..................................................................................... 1
Division B—Additional Emergency Appropriations for Coronavirus Response ...................... 3
Title I—Department of Health and Human Services .......................................................... 5
Title II—Independent Agencies .......................................................................................... 6
Tables
Table 1. Supplemental Appropriations in P.L. 116-139, Division B ............................................... 4
Contacts
Author Contact Information ............................................................................................................ 7
Congressional Research Service
Fourth COVID-19 Relief Package (P.L. 116-139): In Brief
Introduction
On April 23, 2020, Congress passed its fourth measure including supplemental appropriations to
respond to the Coronavirus Disease 2019 (COVID-19) pandemic. The Paycheck Protection
Program and Health Care Enhancement Act (the act; P.L. 116-139) includes enhancements for the
Small Business Administration’s Paycheck Protection Program (PPP), Economic Injury Disaster
Loans (EIDL), and Emergency EIDL grants, and emergency supplemental appropriations for the
Department of Health and Human Services (HHS) and Small Business Administration (SBA).
The Congressional Budget Office estimates that the act will result in $321.3 billion in additional
direct spending for the PPP, and $162.1 billion in additional discretionary spending, including
$50 billion for EIDL and $10 billion for Emergency EIDL grants.1
Legislative History
H.R. 266 was first passed by the House on January 11, 2019, as an FY2020 annual appropriations
measure unrelated to COVID-19. The bill was read twice and placed on the Senate Legislative
Calendar on January 15, 2019, but the Senate did not act on the original legislation. The Senate
agreed to take up the measure on April 21, 2020. The bill was laid before the Senate by
unanimous consent and an amendment in the nature of a substitute replaced the original text with
that of the “Paycheck Protection Program and Health Care Enhancement Act.” The Senate passed
the bill the same day by voice vote.
The House of Representatives took up the amended bill on April 23, 2020, suspending the rules
and passing it by a vote of 388-5, with one Member voting present.2 The President signed the bill
into law on April 24, 2020, as P.L. 116-139.
Provisions of the Paycheck Protection Program and
Health Care Enhancement Act
Division A—Small Business Programs
The Coronavirus Aid, Relief, and Economic Security Act (P.L. 116-136; the CARES Act)
established the Paycheck Protection Program (PPP), and provided it $349 billion.3 The PPP
authorized loans with a two-year term at a 1% interest rate to small businesses and other
organizations adversely affected by COVID-19. Loan payments are deferred for six months and
feature loan forgiveness up to the amount borrowed under specified conditions related to the
borrower’s retention of employees and employee wages.4
1 Congressional Budget Office, “H.R. 266, Paycheck Protection Program and Health Care Enhancement Act,” April 22,
2020, at https://www.cbo.gov/publication/56338.
2 Roll call vote 104, available at http://clerk.house.gov/evs/2020/roll104.xml.
3 In addition to the $349 billion for the Paycheck Protection Program (PPP), the CARES Act also included $675 million
for the SBA’s salaries and expenses account, $25 million for the SBA’s Office of Inspector General (OIG), $265
million for entrepreneurial development programs, $17 billion for subsidies for certain loan payments, and $10 billion
for Emergency Economic Injury Disaster Loan (EIDL) grants, for a total of almost $377 billion in total appropriations
to the SBA.
4 For more details on the Paycheck Protection Program, see CRS Report R46284, COVID-19 Stimulus Assistance to
Congressional Research Service 1
Fourth COVID-19 Relief Package (P.L. 116-139): In Brief
The SBA started accepting PPP loan applications on April 3, 2020. Because the program neared
its $349 billion authorization limit, the SBA stopped accepting new PPP loan applications on
April 15, 2020. Over 1.66 million loans were approved by nearly 5,000 lenders. Most of the loans
(74%) were for under $150,000.5
The CARES Act also enhanced SBA Economic Injury Disaster Loans (EIDL) from January 31,
2020, through December 31, 2020, expanding eligibility and taking other steps, such as
establishing Emergency EIDL grants of up to $10,000, to make resources more broadly and
quickly available to small businesses. The Coronavirus Preparedness and Response Supplemental
Appropriations Act, 2020 (P.L. 116-123) had provided the SBA an additional $20 million to
support EIDL. The CARES Act appropriated $10 billion for Emergency EIDL grants.6
The SBA also stopped accepting new COVID-19-related EIDL loan applications on April 15,
2020, because that program neared its appropriations limit for credit subsidies.7 COVID-19-
related EIDL applications which had already been received continue to be processed on a first-
come first-served basis. The SBA approved nearly 30,000 COVID-19-related EIDLs totaling
nearly $5.7 billion, and 755,476 Emergency EIDL grants totaling nearly $3.3 billion.8
Division A of P.L. 116-139 increases the PPP authorization limit from $349 billion to $659
billion, and increases the direct appropriation in the CARES Act for the program from $349
billion to more than $670 billion to support that authorization amount.
Division A of the act also:
requires that no less than $30 billion of the additional PPP authorization amount
be set aside for loans issued by insured depository institutions and credit unions
with consolidated assets of $10 billion to $50 billion;
requires that no less than $30 billion of the additional PPP authorization amount
be set aside for loans issued by community financial institutions (including
community development financial institutions (CDFIs), minority depository
institutions, community development corporations, and SBA microloan
intermediaries), and insured depository institutions and credit unions with
consolidated assets less than $10 billion; and
Small Businesses: Issues and Policy Options, by Robert Jay Dilger, Bruce R. Lindsay, and Sean Lowry.
5 U.S. Small Business Administration (SBA), “Statement from Secretary Steven T. Mnuchin and Administrator Jovita
Carranza on the Success of the Paycheck Protection Program,” April 17, 2020, at https://www.sba.gov/about-sba/sba-
newsroom/press-releases-media-advisories/statement-secretary-steven-t-mnuchin-and-administrator-jovita-carranza-
success-paycheck-protection.
6 For more details on the EIDL program, see CRS Insight IN11232, SBA Economic Injury Disaster Loans for COVID-
19, by Bruce R. Lindsay.
7 SBA, “Statement by Secretary Mnuchin and Administrator Carranza on the Paycheck Protection Program and
Economic Injury Disaster Loan Program,” April 15, 2020, at https://www.sba.gov/about-sba/sba-newsroom/press-
releases-media-advisories/statement-secretary-mnuchin-and-administrator-carranza-paycheck-protection-program-and-
economic (hereinafter SBA, “Statement by Secretary Mnuchin and Administrator Carranza on the Paycheck Protection
Program and Economic Injury Disaster Loan Program.”)
8 SBA, “COVID-19 EIDL Loans Report,” April 20, 2020, at https://www.sba.gov/document/report—covid-19-eidl-
loans-report; and SBA, “COVID-19 EIDL Advance Report,” April 20, 2020, at https://www.sba.gov/document/
report—covid-19-eidl-advance-report.
Congressional Research Service 2
Fourth COVID-19 Relief Package (P.L. 116-139): In Brief
makes agricultural enterprises with not more than 500 employees eligible for
EIDL and Emergency EIDL grants during the covered period (January 31, 2020,
through December 31, 2020).9
Division B—Additional Emergency Appropriations for
Coronavirus Response
Division B of P.L. 116-139 is a supplemental appropriations measure providing $100 billion for
the Department of Health and Human Services (HHS) through the Public Health and Social
Services Emergency Fund (PHSSEF) and $62 billion for the Small Business Administration ($50
billion for EIDL, $10 billion for Emergency EIDL grants, and $2.1 billion for SBA salaries and
expenses). All of the supplemental appropriations are designated as being emergency
requirements under the Balanced Budget and Emergency Deficit Control Act of 1985 (P.L. 99-
177, as amended), and thus do not count against the statutory limits on discretionary spending for
FY2020.
Each appropriation in P.L. 116-139, Division B, explicitly provides its resources “to prevent,
prepare for, and respond to coronavirus, domestically or internationally.”
Table 1 details the supplemental appropriations included in Division B, as well as subdivision
and transfers of those appropriations outlined in P.L. 116-139.
9 Under the Small Business Act (P.L. 85-536, as amended), agricultural enterprises, other than small agricultural
cooperatives, small aquaculture enterprises, and eligible small nurseries, are not eligible for EIDL.
Congressional Research Service 3
Table 1. Supplemental Appropriations in P.L. 116-139, Division B
Thousands of dollars of discretionary budget authority
SUBCOMMITTEE Appropriation Amount
Agency Subappropriation / Transfer [non-add]
Labor, HHS, and Education and Related Agencies
Department of Health and Office of the Public Health and Social Services Emergency Fund—TOTAL 100,000,000
Human Services (HHS) Secretary
Public Health and Social Services Emergency Fund—Provider Relief Fund 75,000,000
Public Health and Social Services Emergency Fund—Testing and contact tracing 25,000,000
Testing funding for states, localities, territories, and tribes [not less than 11,000,000]
Transfer to CDC-Wide Activities and Program Support [not less than 1,000,000]
Transfer to National Institutes of Health (NIH)—National Cancer Institute [not less than 306,000]
Transfer to NIH—National Institute of Biomedical Imaging and Bioengineering [not less than 500,000]
Transfer to NIH—Office of the Director [not less than 1,000,000]
Biomedical Advanced Research and Development Authority [not less than 1,000,000]
Transfer to the Food and Drug Administration, Salaries and Expenses [22,000]
Transfer to HRSA—Primary Health Care for Health Centers Grants [600,000]
Testing resources for rural health clinics [225,000]
Testing resources for the uninsured [not more than 1,000,000]
Transfer to the HHS Office of Inspector General (General Provision) [not more than 6,000]
Financial Services and General Provisions Government-Wide
Small Business Administration Salaries and Expenses 2,100,000
Disaster Loan Program Account 50,000,000
Emergency Economic Injury Disaster Loan (EIDL) Grants 10,000,000
Source: CRS analysis of P.L. 116-139, Division B.
Notes: CDC = Centers for Disease Control and Prevention; HRSA = Health Resources and Services Administration; NIH = National Institutes of Health.
CRS-4
Fourth COVID-19 Relief Package (P.L. 116-139): In Brief
Title I—Department of Health and Human Services
Title I provides $100 billion in emergency supplemental appropriations to the HHS Public Health
and Social Services Emergency Fund (PHSSEF), an account used in appropriations acts to
provide the HHS Secretary with one-time or emergency funding, as well as annual funding for the
office of the HHS Assistance Secretary for Preparedness and Response (ASPR).
Of the $100 billion, $75 billion is additional funding for the HHS “Provider Relief Fund,”
established with an initial appropriation of $100 billion in the CARES Act.10 These funds remain
available until expended, and are to be used “to prevent, prepare for, and respond to coronavirus,
domestically or internationally, for necessary expenses to reimburse, through grants or other
mechanisms, eligible health care providers for health care related expenses or lost revenues that
are attributable to coronavirus….” Both P.L. 116-139 and the CARES Act define eligible
providers broadly as any that provide “diagnoses, testing, or care for individuals with possible or
actual cases of COVID-19….” HHS has made initial distributions from the Provider Relief
Fund.11
The remaining $25 billion, also available until expended, is provided to augment national
capacity for COVID-19 containment, such as expanded testing capacity—including supplies such
as personal protective equipment (PPE)—and workforce and technical capacity for disease
surveillance and contact tracing. Among other allowable uses, these funds may be used to build,
purchase, renovate, or rent non-federally owned facilities. Of the $25 billion, the act requires the
HHS Secretary to transfer specified amounts to HHS agencies as follows:
Not less than $11 billion for states, localities, territories, tribes, tribal
organizations, urban Indian health organizations, or health service providers to
tribes.
o Of this amount, not less than $2 billion is for states, localities, and territories
according to the formula for the CDC Public Health Emergency Preparedness
cooperative agreement in FY2019; and12
o not less than $4.25 billion is for the same awardees according to a formula
based on relative number of cases of COVID-19.
Of that $4.25 billion, not less than $750 million is for tribes, tribal
organizations, urban Indian health organizations, or health service
providers to tribes.
Not less than $1 billion for CDC for surveillance, epidemiology, and laboratory
capacity expansion; contact tracing; data systems modernization; outreach; and
workforce support to expand and improve COVID-19 testing.
Not less than $1.806 billion for the National Institutes of Health (NIH) as
follows:
10 For more information on the new fund, see U.S. Department of Health and Human Services (HHS), “CARES Act
Provider Relief Fund” (a name given to this fund by HHS), April 22, 2020, at https://www.hhs.gov/provider-relief/
index.html.
11 HHS, “HHS Announces Additional Allocations of CARES Act Provider Relief Fund,” press release, April 22, 2020,
at https://www.hhs.gov/about/news/index.html.
12 The allocation formula for this grant provides a base amount and an additional amount according to population to all
50 states, the territories, and Washington DC, New York City, Los Angeles County, and Chicago. FY2019 allocations
are at Centers for Disease Control and Prevention, Public Health Emergency Preparedness (PHEP) Cooperative
Agreement, FY2019 funding table, https://www.cdc.gov/cpr/readiness/00_docs/
PHEP_Budget_Period_1_FY_2019_Funding_Table_August_2_2019.pdf.
Congressional Research Service 5
Fourth COVID-19 Relief Package (P.L. 116-139): In Brief
o not less than $306 million for the National Cancer Institute to develop,
validate, improve, and implement serological testing and associated
technologies for COVID-19;
o not less than $500 million for the National Institute of Biomedical Imaging
and Bioengineering for research, development, and implementation of point-
of-care and other rapid testing for COVID-19; and
o not less than $1 billion for the NIH Office of the Director, broadly to support
the agency’s research and development efforts regarding COVID-19 testing.
Not less than $1 billion for the Biomedical Advanced Research and Development
Authority (BARDA) for advanced research, development, manufacturing,
production, and purchase of diagnostic, serologic, or other COVID-19 tests or
related supplies, and other activities related to COVID-19 testing.
$22 million for the Food and Drug Administration (FDA), Salaries and Expenses,
for activities associated with diagnostic, serological, antigen, and other COVID-
19 tests, and related administrative activities.
$600 million for the Health Resources and Services Administration (HRSA) for
grants under the Health Centers program, covering a broader range of facilities
than was previously eligible.13
$225 million for HRSA for rural health clinics, using the distribution procedures
developed for the Provider Relief Fund established under the CARES Act.14
Not more than $1 billion to cover the cost of testing for the uninsured, using the
National Disaster Medical System (NDMS) Definitive Care Reimbursement
Program according to the Families First Coronavirus Response Act, P.L. 116-
127.15
Numerous reporting requirements apply to this $25 billion appropriation.
General provisions in Title I allow the HHS Secretary to transfer PHSSEF funds to HHS
agencies, as specified, with attendant reporting to the appropriations committees; and require the
Secretary to transfer up to $6 million to the HHS Office of Inspector General for oversight of
activities funded by this act through the PHSSEF.
Title II—Independent Agencies
Because Division A provides significant additional authorization, resources, and direction for
SBA’s PPP and EIDL programs, the Title II provisions are for the most part straightforward. $50
billion is provided for the cost of EIDL, and $10 billion for Emergency EIDL grants, to fulfil the
authorization in Division A. The $2.1 billion included for SBA’s Salaries and Expenses
13 These funds may also be awarded to entities that are eligible for, but not currently receiving such funds (i.e.,
Federally Qualified Health Center “look-alikes”). For more information on these facilities, see U.S. Department of
Health and Human Services, Health Resources and Services Administration, “Health Center Program Look-Alikes,” at
https://bphc.hrsa.gov/programopportunities/lookalike/index.html.
14 For more information on the new fund, see U.S. Department of Health and Human Services (HHS), “CARES Act
Provider Relief Fund” (a name given to this fund by HHS), April 22, 2020, at https://www.hhs.gov/provider-relief/
index.html.
15 134 Stat. 182. See also “Title V. Department of Health and Human Services, Public Health and Social Services
Emergency Fund” in CRS Report R46316, Health Care Provisions in the Families First Coronavirus Response Act,
P.L. 116-127, coordinated by Sarah A. Lister and Paulette C. Morgan.
Congressional Research Service 6
Fourth COVID-19 Relief Package (P.L. 116-139): In Brief
appropriation remains available until the end of FY2021, to support the agency’s increased rate of
operations in providing COVID-19 pandemic relief.
Author Contact Information
William L. Painter, Coordinator Bruce R. Lindsay
Specialist in Homeland Security and Appropriations Analyst in American National Government
/redacted/@crs.loc.gov, 7-.... /redacted/@crs.loc.gov
, 7-....
Robert Jay Dilger Sarah A. Lister
Senior Specialist in American National Government Specialist in Public Health and Epidemiology
/redacted/@crs.loc.gov
, 7-.... /redacted/@crs.loc.gov
, 7-....
Congressional Research Service R46325 · VERSION 2 · NEW 7
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