108 
prominent identification of the date of 
such expiration; and 
(ii) that such individual may be eligi-
ble for coverage without any premium as-
sistance through— 
(I) COBRA continuation cov-
erage; or 
(II) coverage under a group 
health plan. 
(B) EXCEPTION.—The requirement for the 
group health plan administrator to provide the 
written notice under subparagraph (A) shall be 
waived if the premium assistance for such indi-
vidual expires pursuant to clause (i) of para-
graph (2)(A). 
(C) PERIOD SPECIFIED.—For purposes of 
subparagraph (A), the period specified in this 
subparagraph is, with respect to the date of ex-
piration of premium assistance for any assist-
ance eligible individual pursuant to a limitation 
requiring a notice under this paragraph, the pe-
riod beginning on the day that is 45 days before 
the date of such expiration and ending on the 
day that is 15 days before the date of such ex-
piration.
109 
(D) MODEL NOTICES.—Not later than 45 
days after the date of enactment of this Act, 
with respect to any assistance eligible indi-
vidual, the Secretary of Labor, in consultation 
with the Secretary of the Treasury and the Sec-
retary of Health and Human Services, shall 
prescribe models for the notification required 
under this paragraph. 
(7) REGULATIONS.—The Secretary of the 
Treasury and the Secretary of Labor may jointly 
prescribe such regulations or other guidance as may 
be necessary or appropriate to carry out the provi-
sions of this subsection, including the prevention of 
fraud and abuse under this subsection, except that 
the Secretary of Labor and the Secretary of Health 
and Human Services may prescribe such regulations 
(including interim final regulations) or other guid-
ance as may be necessary or appropriate to carry 
out the provisions of paragraphs (5), (6), and (8). 
(8) OUTREACH.— 
(A) 
IN
GENERAL.—The 
Secretary 
of 
Labor, in consultation with the Secretary of the 
Treasury and the Secretary of Health and 
Human Services, shall provide outreach con-
sisting of public education and enrollment as-
110 
sistance relating to premium assistance pro-
vided under this subsection. Such outreach shall 
target employers, group health plan administra-
tors, public assistance programs, States, insur-
ers, and other entities as determined appro-
priate by such Secretaries. Such outreach shall 
include an initial focus on those individuals 
electing continuation coverage who are referred 
to in paragraph (5)(C). Information on such 
premium assistance, including enrollment, shall 
also be made available on websites of the De-
partments of Labor, Treasury, and Health and 
Human Services. 
(B) ENROLLMENT
UNDER
MEDICARE.— 
The Secretary of Health and Human Services 
shall provide outreach consisting of public edu-
cation. Such outreach shall target individuals 
who lose health insurance coverage. Such out-
reach shall include information regarding en-
rollment for Medicare benefits for purposes of 
preventing mistaken delays of such enrollment 
by such individuals, including lifetime penalties 
for failure of timely enrollment. 
(9) DEFINITIONS.—For purposes of this sec-
tion:
111 
(A) ADMINISTRATOR.—The term ‘‘admin-
istrator’’ has the meaning given such term in 
section 3(16)(A) of the Employee Retirement 
Income Security Act of 1974. 
(B) COBRA
CONTINUATION
COVERAGE.— 
The term ‘‘COBRA continuation coverage’’ 
means continuation coverage provided pursuant 
to part 6 of subtitle B of title I of the Em-
ployee Retirement Income Security Act of 1974 
(other than under section 609), title XXII of 
the Public Health Service Act, or section 
4980B of the Internal Revenue Code of 1986 
(other than subsection (f)(1) of such section in-
sofar as it relates to pediatric vaccines), or 
under a State program that provides com-
parable continuation coverage. Such term does 
not include coverage under a health flexible 
spending arrangement under a cafeteria plan 
within the meaning of section 125 of the Inter-
nal Revenue Code of 1986. 
(C) COBRA
CONTINUATION
PROVISION.— 
The term ‘‘COBRA continuation provision’’ 
means the provisions of law described in sub-
paragraph (B).
112 
(D) 
COVERED
EMPLOYEE.—The 
term 
‘‘covered employee’’ has the meaning given such 
term in section 607(2) of the Employee Retire-
ment Income Security Act of 1974. 
(E) QUALIFIED BENEFICIARY.—The term 
‘‘qualified beneficiary’’ has the meaning given 
such term in section 607(3) of the Employee 
Retirement Income Security Act of 1974. 
(F) GROUP
HEALTH
PLAN.—The term 
‘‘group health plan’’ has the meaning given 
such term in section 607(1) of the Employee 
Retirement Income Security Act of 1974. 
(G) STATE.—The term ‘‘State’’ includes 
the District of Columbia, the Commonwealth of 
Puerto Rico, the Virgin Islands, Guam, Amer-
ican Samoa, and the Commonwealth of the 
Northern Mariana Islands. 
(H) PERIOD
OF
COVERAGE.—Any ref-
erence in this subsection to a period of coverage 
shall be treated as a reference to a monthly or 
shorter period of coverage with respect to which 
premiums are charged with respect to such cov-
erage. 
(I) PLAN
SPONSOR.—The term ‘‘plan 
sponsor’’ has the meaning given such term in
113 
section 3(16)(B) of the Employee Retirement 
Income Security Act of 1974. 
(J) PREMIUM.—The term ‘‘premium’’ in-
cludes, with respect to COBRA continuation 
coverage, any administrative fee. 
(10) IMPLEMENTATION FUNDING.—In addition 
to amounts otherwise made available, out of any 
funds in the Treasury not otherwise appropriated, 
there are appropriated to the Secretary of Labor for 
fiscal year 2021, $10,000,000, to remain available 
until expended, for the Employee Benefits Security 
Administration to carry out the provisions of this 
subtitle. 
(b) COBRA PREMIUM ASSISTANCE.— 
(1) ALLOWANCE OF CREDIT.— 
(A) IN GENERAL.—Subchapter B of chap-
ter 65 of the Internal Revenue Code of 1986 is 
amended by adding at the end the following 
new section: 
‘‘SEC. 6432. CONTINUATION COVERAGE PREMIUM ASSIST-
ANCE. 
‘‘(a) IN GENERAL.—The person to whom premiums 
are payable for continuation coverage under section 
2401(a)(1) of the American Rescue Plan Act of 2021 shall 
be allowed as a credit against the tax imposed by section
114 
3111(b), or so much of the taxes imposed under section 
3221(a) as are attributable to the rate in effect under sec-
tion 3111(b), for each calendar quarter an amount equal 
to the premiums not paid by assistance eligible individuals 
for such coverage by reason of such section 2401(a)(1) 
with respect to such calendar quarter. 
‘‘(b) PERSON TO WHOM PREMIUMS ARE PAYABLE.— 
For purposes of subsection (a), except as otherwise pro-
vided by the Secretary, the person to whom premiums are 
payable under such continuation coverage shall be treated 
as being— 
‘‘(1) in the case of any group health plan which 
is a multiemployer plan (as defined in section 3(37) 
of the Employee Retirement Income Security Act of 
1974), the plan, 
‘‘(2) in the case of any group health plan not 
described in paragraph (1)— 
‘‘(A) which is subject to the COBRA con-
tinuation provisions contained in— 
‘‘(i) the Internal Revenue Code of 
1986, 
‘‘(ii) the Employee Retirement Income 
Security Act of 1974, or 
‘‘(iii) the Public Health Service Act, 
or
115 
‘‘(B) under which some or all of the cov-
erage is not provided by insurance, 
the employer maintaining the plan, and 
‘‘(3) in the case of any group health plan not 
described in paragraph (1) or (2), the insurer pro-
viding the coverage under the group health plan. 
‘‘(c) LIMITATIONS AND REFUNDABILITY.— 
‘‘(1) CREDIT
LIMITED
TO
CERTAIN
EMPLOY-
MENT TAXES.—The credit allowed by subsection (a) 
with respect to any calendar quarter shall not exceed 
the tax imposed by section 3111(b), or so much of 
the taxes imposed under section 3221(a) as are at-
tributable to the rate in effect under section 
3111(b), for such calendar quarter (reduced by any 
credits allowed against such taxes under sections 
3131, 3132, and 3134) on the wages paid with re-
spect to the employment of all employees of the em-
ployer. 
‘‘(2) REFUNDABILITY OF EXCESS CREDIT.— 
‘‘(A) CREDIT
IS
REFUNDABLE.—If the 
amount of the credit under subsection (a) ex-
ceeds the limitation of paragraph (1) for any 
calendar quarter, such excess shall be treated 
as an overpayment that shall be refunded under 
sections 6402(a) and 6413(b).
116 
‘‘(B) CREDIT MAY BE ADVANCED.—In an-
ticipation of the credit, including the refundable 
portion under subparagraph (A), the credit may 
be advanced, according to forms and instruc-
tions provided by the Secretary, up to an 
amount calculated under subsection (a) through 
the end of the most recent payroll period in the 
quarter. 
‘‘(C) TREATMENT
OF
DEPOSITS.—The 
Secretary shall waive any penalty under section 
6656 for any failure to make a deposit of the 
tax imposed by section 3111(b), or so much of 
the taxes imposed under section 3221(a) as are 
attributable to the rate in effect under section 
3111(b), if the Secretary determines that such 
failure was due to the anticipation of the credit 
allowed under this section. 
‘‘(D) TREATMENT
OF
PAYMENTS.—For 
purposes of section 1324 of title 31, United 
States Code, any amounts due to an employer 
under this paragraph shall be treated in the 
same manner as a refund due from a credit 
provision referred to in subsection (b)(2) of 
such section.
117 
‘‘(3) OVERSTATEMENTS.—Any overstatement of 
the credit to which a person is entitled under this 
section (and any amount paid by the Secretary as a 
result of such overstatement) shall be treated as an 
underpayment by such person of the taxes described 
in paragraph (1) and may be assessed and collected 
by the Secretary in the same manner as such taxes. 
‘‘(d) GOVERNMENTAL ENTITIES.—For purposes of 
this section, the term ‘person’ includes the government of 
any State or political subdivision thereof, any Indian tribal 
government (as defined in section 139E(c)(1)), any agency 
or instrumentality of any of the foregoing, and any agency 
or instrumentality of the Government of the United States 
that is described in section 501(c)(1) and exempt from 
taxation under section 501(a). 
‘‘(e) DENIAL OF DOUBLE BENEFIT.—For purposes 
of chapter 1, the gross income of any person allowed a 
credit under this section shall be increased for the taxable 
year which includes the last day of any calendar quarter 
with respect to which such credit is allowed by the amount 
of such credit. No credit shall be allowed under this sec-
tion with respect to any amount which is taken into ac-
count as qualified wages under section 2301 of the 
CARES Act or section 3134 of this title or as qualified 
health plan expenses under section 7001(d) or 7003(d) of
118 
the Families First Coronavirus Response Act or section 
3131 or 3132 of this title. 
‘‘(f) EXTENSION OF LIMITATION ON ASSESSMENT.— 
Notwithstanding section 6501, the limitation on the time 
period for the assessment of any amount attributable to 
a credit claimed under this section shall not expire before 
the date that is 5 years after the later of— 
‘‘(1) the date on which the original return 
which includes the calendar quarter with respect to 
which such credit is determined is filed, or 
‘‘(2) the date on which such return is treated 
as filed under section 6501(b)(2). 
‘‘(g) REGULATIONS.—The Secretary shall issue such 
regulations, or other guidance, forms, instructions, and 
publications, as may be necessary or appropriate to carry 
out this section, including— 
‘‘(1) the requirement to report information or 
the establishment of other methods for verifying the 
correct amounts of reimbursements under this sec-
tion, 
‘‘(2) the application of this section to group 
health plans that are multiemployer plans (as de-
fined in section 3(37) of the Employee Retirement 
Income Security Act of 1974),
119 
‘‘(3) to allow the advance payment of the credit 
determined under subsection (a), subject to the limi-
tations provided in this section, based on such infor-
mation as the Secretary shall require, 
‘‘(4) to provide for the reconciliation of such 
advance payment with the amount of the credit at 
the time of filing the return of tax for the applicable 
quarter or taxable year, and 
‘‘(5) allowing the credit to third party payors 
(including professional employer organizations, cer-
tified professional employer organizations, or agents 
under section 3504).’’. 
(B) CLERICAL AMENDMENT.—The table of 
sections for subchapter B of chapter 65 of the 
Internal Revenue Code of 1986 is amended by 
adding at the end the following new item: 
‘‘Sec. 6432. Continuation coverage premium assistance.’’. 
(C) EFFECTIVE DATE.—The amendments 
made by this paragraph shall apply to pre-
miums to which subsection (a)(1)(A) applies 
and wages paid on or after April 1, 2021. 
(D) SPECIAL RULE IN CASE OF EMPLOYEE 
PAYMENT THAT IS NOT REQUIRED UNDER THIS 
SECTION.— 
(i) IN GENERAL.—In the case of an 
assistance eligible individual who pays,
120 
with respect any period of coverage to 
which subsection (a)(1)(A) applies, the 
amount of the premium for such coverage 
that the individual would have (but for this 
Act) been required to pay, the person to 
whom such payment is payable shall reim-
burse such individual for the amount of 
such premium paid in excess of the 
amount required to be paid under sub-
section (a)(1)(A). 
(ii) CREDIT OF REIMBURSEMENT.—A 
person to which clause (i) applies shall be 
allowed a credit in the manner provided 
under section 6432 of the Internal Rev-
enue Code of 1986 for any payment made 
to the employee under such clause. 
(iii) PAYMENT
OF
CREDITS.—Any 
person to which clause (i) applies shall 
make the payment required under such 
clause to the individual not later than 60 
days after the date on which such indi-
vidual elects continuation coverage under 
subsection (a)(1).
121 
(2) PENALTY FOR FAILURE TO NOTIFY HEALTH 
PLAN OF CESSATION OF ELIGIBILITY FOR PREMIUM 
ASSISTANCE.— 
(A) IN GENERAL.—Part I of subchapter B 
of chapter 68 of the Internal Revenue Code of 
1986 is amended by adding at the end the fol-
lowing new section: 
‘‘SEC. 6720C. PENALTY FOR FAILURE TO NOTIFY HEALTH 
PLAN OF CESSATION OF ELIGIBILITY FOR 
CONTINUATION COVERAGE PREMIUM ASSIST-
ANCE. 
‘‘(a) IN GENERAL.—Except in the case of a failure 
described in subsection (b) or (c), any person required to 
notify a group health plan under section 2401(a)(2)(B) 
of the American Rescue Plan Act of 2021 who fails to 
make such a notification at such time and in such manner 
as the Secretary of Labor may require shall pay a penalty 
of $250 for each such failure. 
‘‘(b) INTENTIONAL FAILURE.—In the case of any 
such failure that is fraudulent, such person shall pay a 
penalty equal to the greater of— 
‘‘(1) $250, or 
‘‘(2) 110 percent of the premium assistance 
provided under section 2401(a)(1)(A) of the Amer-
122 
ican Rescue Plan Act of 2021 after termination of 
eligibility under such section. 
‘‘(c) REASONABLE CAUSE EXCEPTION.—No penalty 
shall be imposed under this section with respect to any 
failure if it is shown that such failure is due to reasonable 
cause and not to willful neglect.’’. 
(B) CLERICAL AMENDMENT.—The table of 
sections of part I of subchapter B of chapter 68 
of such Code is amended by adding at the end 
the following new item: 
‘‘Sec. 6720C. Penalty for failure to notify health plan of cessation of eligibility 
for continuation coverage premium assistance.’’. 
(3) COORDINATION WITH HCTC.— 
(A) IN GENERAL.—Section 35(g)(9) of the 
Internal Revenue Code of 1986 is amended to 
read as follows: 
‘‘(9) CONTINUATION COVERAGE PREMIUM AS-
SISTANCE.—In the case of an assistance eligible in-
dividual who receives premium assistance for con-
tinuation coverage under section 2401(a)(1) of the 
American Rescue Plan Act of 2021 for any month 
during the taxable year, such individual shall not be 
treated as an eligible individual, a certified indi-
vidual, or a qualifying family member for purposes 
of this section or section 7527 with respect to such 
month.’’.
123 
(B) EFFECTIVE
DATE.—The amendment 
made by subparagraph (A) shall apply to tax-
able years ending after the date of the enact-
ment of this Act. 
(4) EXCLUSION OF CONTINUATION COVERAGE 
PREMIUM ASSISTANCE FROM GROSS INCOME.— 
(A) IN GENERAL.—Part III of subchapter 
B of chapter 1 of the Internal Revenue Code of 
1986 is amended by inserting after section 
139H the following new section: 
‘‘SEC. 139I. CONTINUATION COVERAGE PREMIUM ASSIST-
ANCE. 
‘‘In the case of an assistance eligible individual (as 
defined in subsection (a)(3) of section 2401 of the Amer-
ican Rescue Plan Act of 2021), gross income does not in-
clude any premium assistance provided under subsection 
(a)(1) of such section.’’. 
(B) CLERICAL AMENDMENT.—The table of 
sections for part III of subchapter B of chapter 
1 of such Code is amended by inserting after 
the item relating to section 139H the following 
new item: 
‘‘Sec. 139I. Continuation coverage premium assistance.’’. 
(C) EFFECTIVE DATE.—The amendments 
made by this paragraph shall apply to taxable
124 
years ending after the date of the enactment of 
this Act. 
TITLE III—COMMITTEE ON 
ENERGY AND COMMERCE 
Subtitle A—Public Health 
CHAPTER 1—VACCINES AND 
THERAPEUTICS 
SEC. 3001. 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, mon-
itor, and track COVID–19 vaccines. 
(b) USE OF FUNDS.—The Secretary, acting through 
the Director of the Centers for Disease Control and Pre-
vention, and in consultation with other agencies, as appli-
cable, shall, in conducting activities referred to in sub-
section (a)— 
(1) conduct activities to enhance, expand, and 
improve nationwide COVID–19 vaccine distribution
126 
tems that enhance vaccine safety, effectiveness, 
and uptake, particularly among underserved 
populations; 
(E) facilities enhancements; 
(F) communication with the public regard-
ing when, where, and how to receive COVID– 
19 vaccines; and 
(G) transportation of individuals to facili-
tate vaccinations, including at community vac-
cination centers and mobile vaccination units, 
particularly for underserved populations. 
SEC. 3002. FUNDING FOR VACCINE CONFIDENCE ACTIVI-
TIES. 
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 posses-
sions; 
(2) to provide further information and edu-
cation with respect to vaccines licensed under section 
351 of the Public Health Service Act (42 U.S.C.
127 
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 pos-
sessions, including through activities described in 
section 313 of the Public Health Service Act, as 
amended by section 311 of division BB of the Con-
solidated Appropriations Act, 2021 (Public Law 
116–260). 
SEC. 3003. 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.
128 
SEC. 3004. FUNDING FOR COVID–19 VACCINE, THERA-
PEUTIC, 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, safe-
ty, 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 ac-
tivities related to production of vaccines and related mate-
rials; facilitation and conduct of inspections related to the 
manufacturing of vaccines, therapeutics, and devices de-
layed or cancelled for reasons related to COVID–19; re-
view of devices authorized for use for the treatment, pre-
vention, 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 diag-
nosis of COVID–19 by the Food and Drug Administra-
tion.
129 
CHAPTER 2—TESTING 
SEC. 3011. 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 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 strat-
egy 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 agree-
ments to State, local, and territorial public health 
departments for activities to detect, diagnose, trace, 
and monitor SARS–CoV–2 and COVID–19 infec-
tions and related strategies and activities to mitigate 
the spread of COVID–19;
130 
(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, manufac-
ture, procurement, and distribution of supplies 
necessary for administering tests, such as per-
sonal protective equipment; and 
(B) support for the acquisition, construc-
tion, alteration, or renovation of non-federally 
owned 
facilities 
for 
the 
production 
of 
diagnostics and ancillary medical supplies where 
the Secretary determines that such an invest-
ment 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 capabili-
ties, including investments in laboratory capacity, 
community-based testing sites, and mobile testing 
units, particularly in medically underserved areas; 
(5) enhance information technology, data mod-
ernization, and reporting, including improvements 
necessary to support sharing of data related to pub-
lic health capabilities;
131 
(6) award grants to, or enter into cooperative 
agreements or contracts with, State, local, and terri-
torial public health departments to establish, ex-
pand, and sustain a public health workforce; and 
(7) to cover administrative and program sup-
port costs necessary to conduct activities related to 
subparagraph (a). 
SEC. 3012. FUNDING FOR SARS–COV–2 GENOMIC SEQUENC-
ING 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 work-
force 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;
132 
(2) award grants or cooperative agreements to 
State, local, Tribal, or territorial public health de-
partments 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 capa-
bilities of the public health workforce; and 
(4) award grants for the construction, alter-
ation, or renovation of facilities to improve genomic 
sequencing and surveillance capabilities at the State 
and local level. 
SEC. 3013. 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 ac-
133 
tivities 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. 3014. 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 ac-
tivities to be conducted acting through the Director of the 
Centers for Disease Control and Prevention to support 
public health data surveillance and analytics infrastruc-
ture modernization initiatives at the Centers for Disease 
Control and Prevention, and establish, expand, and main-
tain efforts to modernize the United States disease warn-
ing 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.
134 
CHAPTER 3—PUBLIC HEALTH 
WORKFORCE 
SEC. 3021. FUNDING FOR PUBLIC HEALTH WORKFORCE. 
(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, $7,660,000,000, to remain available until 
expended, to carry out activities related to establishing, 
expanding, and sustaining a public health workforce, in-
cluding by making awards to State, local, and territorial 
public health departments. 
(b) USE OF FUNDS FOR PUBLIC HEALTH DEPART-
MENTS.—Amounts made available to an awardee pursuant 
to subsection (a) shall be used for the following: 
(1) Costs, including wages and benefits, related 
to the recruiting, hiring, and training of individ-
uals— 
(A) to serve as case investigators, contact 
tracers, social support specialists, community 
health workers, public health nurses, disease 
intervention specialists, epidemiologists, pro-
gram 
managers, 
laboratory 
personnel, 
informaticians, communication and policy ex-
perts, and any other positions as may be re-
135 
quired to prevent, prepare for, and respond to 
COVID–19; and 
(B) who are employed by— 
(i) the State, territorial, or local pub-
lic health department involved; or 
(ii) a nonprofit private or public orga-
nization with demonstrated expertise in im-
plementing public health programs and es-
tablished relationships with such State, 
territorial, or local public health depart-
ments, particularly in medically under-
served areas. 
(2) Personal protective equipment, data man-
agement and other technology, or other necessary 
supplies. 
(3) Administrative costs and activities necessary 
for awardees to implement activities funded under 
this section. 
(4) Reporting to the Secretary on implementa-
tion of the activities funded under this section. 
(5) Subawards from recipients of awards under 
subsection (a) to local health departments for the 
purposes of the activities funded under this section.
136 
SEC. 3022. FUNDING FOR MEDICAL RESERVE CORPS. 
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, 
$100,000,000, to remain available until expended, for car-
rying out section 2813 of the Public Health Service Act 
(42 U.S.C. 300hh–15). 
CHAPTER 4—PUBLIC HEALTH 
INVESTMENTS 
SEC. 3031. FUNDING FOR COMMUNITY HEALTH CENTERS 
AND COMMUNITY CARE. 
(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, $7,600,000,000, to remain available until 
expended, for necessary expenses for awarding grants and 
cooperative agreements under section 330 of the Public 
Health Service Act (42 U.S.C. 254b) to be awarded with-
out regard to the time limitation in subsection (e)(3) and 
subsections (e)(6)(A)(iii), (e)(6)(B)(iii), and (r)(2)(B) of 
such section 330, and for necessary expenses for awarding 
grants to Federally qualified health centers, as described 
in section 1861(aa)(4)(B) of the Social Security Act (42 
U.S.C.1395x(aa)(4)(B)), and for awarding grants or con-
tracts to Papa Ola Lokahi and to qualified entities under 
sections 4 and 6 of the Native Hawaiian Health Care Im-
137 
provement Act (42 U.S.C. 11703, 11705). Of the total 
amount appropriated by the preceding sentence, not less 
than $20,000,000 shall be for grants or contracts to Papa 
Ola Lokahi and to qualified entities under sections 4 and 
6 of the Native Hawaiian Health Care Improvement Act 
(42 U.S.C. 11703, 11705). 
(b) USE OF FUNDS.—Amounts made available to an 
awardee pursuant to subsection (a) shall be used— 
(1) to plan, prepare for, promote, distribute, 
administer, and track COVID–19 vaccines, and to 
carry out other vaccine-related activities; 
(2) to detect, diagnose, trace, and monitor 
COVID–19 infections and related activities nec-
essary to mitigate the spread of COVID–19, includ-
ing activities related to, and equipment or supplies 
purchased for, testing, contact tracing, surveillance, 
mitigation, and treatment of COVID–19; 
(3) to purchase equipment and supplies to con-
duct mobile testing or vaccinations for COVID–19, 
to purchase and maintain mobile vehicles and equip-
ment to conduct such testing or vaccinations, and to 
hire and train laboratory personnel and other staff 
to conduct such mobile testing or vaccinations, par-
ticularly in medically underserved areas;
138 
(4) to establish, expand, and sustain the health 
care workforce to prevent, prepare for, and respond 
to COVID–19, and to carry out other health work-
force-related activities; 
(5) to modify, enhance, and expand health care 
services and infrastructure; and 
(6) to conduct community outreach and edu-
cation activities related to COVID–19. 
(c) PAST EXPENDITURES.—An awardee may use 
amounts awarded pursuant to subsection (a) to cover the 
costs of the awardee carrying out any of the activities de-
scribed in subsection (b) during the period beginning on 
the date of the declaration of a public health emergency 
by the Secretary under section 319 of the Public Health 
Service Act (42 U.S.C. 247d) on January 31, 2020, with 
respect to COVID–19 and ending on the date of such 
award. 
SEC. 3032. FUNDING FOR NATIONAL HEALTH SERVICE 
CORPS. 
(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, $800,000,000, to remain available until ex-
pended, for carrying out sections 338A, 338B, and 338I
139 
of the Public Health Service Act (42 U.S.C. 254l, 254l– 
1, 254q–1) with respect to the health workforce. 
(b) STATE LOAN REPAYMENT PROGRAMS.— 
(1) IN GENERAL.—Of the amount made avail-
able pursuant to subsection (a), $100,000,000 shall 
be made available for providing primary health serv-
ices through grants to States under section 338I(a) 
of the Public Health Service Act (42 U.S.C. 254q– 
1(a)). 
(2) CONDITIONS.—With respect to grants de-
scribed in paragraph (1) using funds made available 
under such paragraph: 
(A) Section 338I(b) of the Public Health 
Service Act (42 U.S.C. 254q–1(b)) shall not 
apply. 
(B) Notwithstanding section 338I(d)(2) of 
the Public Health Service Act (42 U.S.C. 254q– 
1(d)(2)), not more than 10 percent of an award 
to a State from such amounts, may be used by 
the State for costs of administering the State 
loan repayment program. 
SEC. 3033. FUNDING FOR NURSE CORPS. 
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,
140 
$200,000,000, to remain available until expended, for car-
rying out section 846 of the Public Health Service Act 
(42 U.S.C. 297n). 
SEC. 3034. FUNDING FOR TEACHING HEALTH CENTERS 
THAT OPERATE GRADUATE MEDICAL EDU-
CATION. 
(a) IN GENERAL.—In addition to amounts otherwise 
available, and notwithstanding the capped amount ref-
erenced in sections 340H(b)(2) and 340H(d)(2) of the 
Public Health Service Act (42 U.S.C. 256h(b)(2) and 
(d)(2)), there is appropriated to the Secretary for fiscal 
year 2021, out of any money in the Treasury not otherwise 
appropriated, $330,000,000, to remain available until 
September 30, 2023, for the program of payments to 
teaching health centers that operate graduate medical 
education under section 340H of the Public Health Serv-
ice Act (42 U.S.C. 256h) and for teaching health center 
development grants authorized under section 749A of the 
Public Health Service Act (42 U.S.C. 293l–1). 
(b) USE OF FUNDS.—Amounts made available pursu-
ant to subsection (a) shall be used for the following activi-
ties: 
(1) For making payments to establish new ap-
proved graduate medical residency training pro-
grams pursuant to section 340H(a)(1)(C) of the
141 
Public 
Health 
Service 
Act 
(42 
U.S.C. 
256h(a)(1)(C)). 
(2) To provide an increase to the per resident 
amount described in section 340H(a)(2) of the Pub-
lic Health Service Act (42 U.S.C. 256h(a)(2)) of 
$10,000. 
(3) For making payments under section 
340H(a)(1)(A) of the Public Health Service Act (42 
U.S.C. 256h(a)(1)(A))) to qualified teaching health 
centers for maintenance of filled positions at existing 
approved graduate medical residency training pro-
grams. 
(4) For making payments under section 
340H(a)(1)(B) of the Public Health Service Act (42 
U.S.C. 256h(a)(1)(B)) for the expansion of existing 
approved graduate medical residency training pro-
grams. 
(5) For making awards under section 749A of 
the Public Health Service Act (42 U.S.C. 293l–1) to 
teaching health centers for the purpose of estab-
lishing new accredited or expanded primary care 
residency programs. 
(6) To cover administrative costs and activities 
necessary for qualified teaching health centers re-
ceiving payments under section 340H of the Public
142 
Health Service Act (42 U.S.C. 256h) to carry out 
activities under such section. 
SEC. 3035. FUNDING FOR FAMILY PLANNING. 
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, 
$50,000,000, to remain available until expended, for nec-
essary expenses for making grants and contracts under 
section 1001 of the Public Health Service Act (42 U.S.C. 
300). 
SEC. 3036. FUNDING FOR OFFICE OF INSPECTOR GENERAL. 
In addition to amounts otherwise available, there is 
appropriated to the inspector general of the Department 
of Health and Human Services for fiscal year 2021, out 
of any money in the Treasury not otherwise appropriated, 
$5,000,000, to remain available until expended, for over-
sight of activities supported with funds appropriated to 
the Department of Health and Human Services to pre-
vent, prepare for, and respond to coronavirus 2019 or 
COVID–19, domestically or internationally. 
CHAPTER 5—INDIAN HEALTH 
SEC. 3041. FUNDING FOR INDIAN HEALTH. 
(a) 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,
143 
$6,094,000,000, to remain available until expended, of 
which— 
(1) $5,484,000,000 shall be for carrying out 
the Act of August 5, 1954 (42 U.S.C. 2001 et seq.) 
(commonly referred to as the Transfer Act), the In-
dian Self-Determination and Education Assistance 
Act (25 U.S.C. 5301 et seq.), the Indian Health 
Care Improvement Act (25 U.S.C. 1601 et seq.), 
and titles II and III of the Public Health Service 
Act (42 U.S.C. 201 et seq. and 241 et seq.) with re-
spect to the Indian Health Service, of which— 
(A) $2,000,000,000 shall be for lost reim-
bursements, in accordance with section 207 of 
the Indian Health Care Improvement Act (25 
U.S.C. 1621f); 
(B) $500,000,000 shall be for the provi-
sion of additional health care services, services 
provided through the Purchased/Referred Care 
program, and other related activities; 
(C) $140,000,000 shall be for information 
technology, telehealth infrastructure, and the 
Indian Health Service electronic health records 
system; 
(D) $84,000,000 shall be for maintaining 
operations of the Urban Indian health program,
263 
(D) certifies to the Secretary that such air 
carrier will— 
(i) refrain from conducting involun-
tary furloughs or reducing pay rates or 
benefits until September 30, 2021, or the 
date on which assistance provided under 
this section is exhausted, whichever is 
later; 
(ii) refrain from purchasing an equity 
security of the air carrier or the parent 
company of the air carrier that is listed on 
a national securities exchange through 
September 30, 2022; 
(iii) refrain from paying dividends, or 
making other capital distributions, with re-
spect to common stock (or equivalent inter-
est) of such air carrier through September 
30, 2022; 
(iv) during the 2-year period begin-
ning April 1, 2021, and ending April 1, 
2023, refrain from paying— 
(I) any officer or employee of the 
air carrier whose total compensation 
exceeded $425,000 in calendar year 
2019 (other than an employee whose
269 
(i) the amount received by the air car-
rier pursuant to section 403(a) of division 
N of the Consolidated Appropriations Act, 
2021 (Public Law 116-260) bears to 
(ii) $15,000,000,000. 
(C) ELIGIBLE
CONTRACTORS.—The Sec-
retary shall apportion, to each eligible con-
tractor, an amount equal to the total amount 
such contractor received pursuant to section 
403(a) of division N of the Consolidated Appro-
priations Act, 2021 (Public Law 116-260). 
(3) IN GENERAL.— 
(A) FORMS; TERMS
AND
CONDITIONS.— 
The Secretary shall provide financial assistance 
to an eligible air carrier or eligible contractor 
under this section in the same form and on the 
same terms and conditions as determined by 
pursuant to section 403(b)(1)(A) of subtitle A 
of title IV of division N of the Consolidated Ap-
propriations Act, 2021 (Pub. L. No. 116-260). 
(B) PROCEDURES.—The Secretary shall 
publish streamlined and expedited procedures 
not later than 5 days after the date of enact-
ment of this section for eligible air carriers and
306 
(2) ELIGIBILITY FOR SECOND DRAW LOANS.— 
Section 7(a)(37)(A)(iv)(II) of the Small Business 
Act, as amended by the Economic Aid to Hard-Hit 
Small Businesses, Nonprofits, and Venues Act (title 
III of division N of Public Law 116–260), is amend-
ed by striking ‘‘clause (iii)(II), (iv)(IV), or (vii)’’ and 
inserting ‘‘subclause (II) or (III) of clause (iii), sub-
clause (IV) or (V) of clause (iv), clause (vi), or 
clause (vii)’’. 
(c) COORDINATION WITH CONTINUATION COVERAGE 
PREMIUM ASSISTANCE.— 
(1) PAYCHECK
PROTECTION
PROGRAM.—Sec-
tion 7A(a)(12) of the Small Business Act (as redes-
ignated, transferred, and amended by section 304(b) 
of the Economic Aid to Hard-Hit Small Businesses, 
Nonprofits, and Venues Act (Public Law 116–260)) 
is amended— 
(A) by striking ‘‘CARES Act or’’ and in-
serting ‘‘CARES Act,’’; and 
(B) by inserting before the period at the 
end the following: ‘‘, or premiums taken into 
account in determining the credit allowed under 
section 6432 of the Internal Revenue Code of 
1986’’.