The Senate this weekend passed a massive coronavirus relief bill that is now coming back to the United States House of Representatives for approval of changes to the original version.

The nearly $ 2 trillion bill includes money for struggling rural hospitals, billions for COVID-19 testing and contact tracing as well as additional grants to help people buy health coverage via the Affordable Care Act plans.

President Joe Biden said on twitter he hopes the bill, called the American Rescue Plan, “gets a quick passage through the House so that it can be sent to my office to be signed.”

The American Hospital Association said in a statement it was glad the legislation included many provisions to help hospitals, but disappointed the bill did not include general additions to the relief fund. for suppliers created by the Coronavirus Aid, Relief, and Economic Security Act.

The group had requested an additional $ 35 billion for the fund. However, the Senate added to the bill $ 8.5 billion in aid for rural hospitals, which were hit hardest during the COVID-19 crisis.

Suspension of elective procedures cost US hospitals $ 20 billion, according to the Annals of Surgery, and existing trends for hospitals in more rural areas put them at greater risk from these losses, the researchers said.

The AHA also criticized the bill for not granting loan exemption to providers for Medicare prepayments in the CARES Act and for failing to extend relief from Medicare escrow cuts. These were general reductions in provider reimbursement from the 2011 Budget Control Act that Congress suspended to help hospitals and medical groups stay afloat during the COVID-19 crisis. They are currently expected to return at the end of this month.

“America’s hospitals and healthcare systems, along with our heroic caregivers, have been on the front lines in the fight against the COVID-19 pandemic for over a year,” the AHA said in its statement. “Along the way, we have worked to save the lives of our patients, provided compassionate care to everyone who walks through our doors and now we are focusing day and night on immunization in our communities. “

Bill includes $ 14 billion for vaccine distribution and nearly $ 48 billion for contact tracing

The main purpose of the changes to ACA plans was to make it easier for people to obtain and pay for coverage. Instead of paying 10% of their income for the coverage, registrants would pay 8.5%. In addition, the current income limit for being eligible for grants is increased, expanding the number of people eligible for financial assistance to obtain coverage.

Some with lower incomes and those with unemployment would see their premiums fully covered.

Plus, people who stay on their employer plans through COBRA would see their premiums 100% covered. This is an increase from the house version of the bill, which paid 85% of those bonuses.

The bill also includes an additional incentive for states that have yet to expand Medicaid eligibility. It would increase federal matching funds by five percentage points for two years.

Medicaid extension may be a boon for hospitals reducing uncompensated health care costs and increasing Medicaid revenues and would be essential in helping facilities recover financially from the pandemic, a health affairs study found.