President Trump Issues Executive Order; Memoranda Related to COVID-19

Last week, President Donald Trump issued a series of executive orders and memoranda related to telehealth, unemployment benefits, suspending the ‘payroll tax’, and pausing student loan repayment and interest accrual. These actions addressed several policy priorities that are being negotiated between the U.S. House and Senate, as well as the Administration. The President’s executive actions seek to continue and/or build upon policy provisions in the Coronavirus Aid, Relief, and Economic Security (CARES) Act, which became law on March 27, 2020. 

Summary of the orders:

• Telehealth Access: This executive order directs the U.S. Department of Health and Human Services (HHS) Secretary to review and extend, as appropriate, current telehealth waivers put in place during the Coronavirus Disease 2019 (COVID-19) public health emergency (PHE). The Centers for Medicare & Medicaid Services (CMS) subsequently included provisions in the 2021 Medicare Physician Fee Schedule proposed rule to expand certain telehealth services permanently, consistent with the executive order. However, limits on its regulatory authority prevent CMS from permanently enabling audiologists and speech-language pathologists (SLPs) to provide telehealth under Medicare without congressional approval, though they have the ability to do so for certain services during the PHE.
• Unemployment Benefits: This memorandum seeks to extend the pandemic unemployment assistance (PUA) established by the CARES Act, lowering the weekly additional benefit from $600 to $400. To fund the program, the Administration calls on states to fund 25% of the cost—equivalent to $100 toward the weekly benefit—with the federal government covering the remaining 75% through money already allocated to the Federal Emergency Management Agency. Leaders of the National Governors Association have raised concerns related to the significant administrative burdens and costs this approach would place on states.
• Payroll Tax: This memorandum directs the U.S. Department of the Treasury to allow employers to defer payment of employee-side Social Security payroll taxes from September 1¬ – December 31, 2020, for employees earning less than about $100,000 annually. Given the uncertainty of the legal authority of the memorandum and possibly the future ability to pay the suspended payroll tax, it remains to be seen whether employers will stop withholding payroll taxes.
• Student Loans: This memorandum directs the U.S. Department of Education (ED) to take the necessary steps to continue the CARES Act policy that temporarily pauses payments and waives interest on student loans held by ED until December 31, 2020. The memorandum does not specifically reference student loan debt collection or counting non-payments toward public service loan forgiveness, both of which were included in the CARES Act. In addition, it does not offer coverage for federal student loan borrowers whose debt is held by private lenders or their colleges.

The President’s actions have faced political, practical, and legal criticism from both Congressional Republicans and Democrats, as well as state governments, which likely impacts negotiations on future legislation in response to the COVID-19 pandemic.

ASHA will monitor the implementation of the executive actions and negotiations on future COVID-19 response legislation. Further updates will be sent as developments warrant.

Questions?

For questions related to Medicare telehealth reimbursement, please contact reimbursement@asha.org. For questions related to unemployment benefits, payroll taxes and student loans, please contact Eric Masten, ASHA’s director of federal affairs for education, at emasten@asha.org.