As the TCS rolling analysis has shown, ARP contains roughly a metric ton of cash (that’s hyperbole; we have no idea how much $1.9 trillion actually weighs) targeted at economic recovery from the pandemic. We’ve been open about our doubts that all of it will actually be money well-spent.

But we won’t quibble with the money ARP directs at vaccine activities nor that for contact tracing. Vaccine activities are defined in the legislation as those to, “plan, prepare for, promote, distribute, administer monitor, and track COVID-19 vaccines.” There are some tweaks to that definition in the many different titles of the bill, but those are the basics.

Sharp-eyed readers may ask why there doesn’t seem to be money specifically to develop vaccines. Development responsibilities have fallen mostly to the private sector and, this late in the pandemic, the Administration and the Congress are concentrating federal spending on getting those vaccines where they need to go. However, there is some money for further research and development (among other things) in Section 3003 which we write about below.

Section 3001 of the legislation devotes $7.5 billion to the Centers for Disease Control and Prevention (CDC) for the above quoted activities. More specifically, the money is to:

• Enhance, expand and improve the distribution and administration of the vaccines and products and supplies related to vaccination
• Provide assistance to State, local, Tribal, and territorial public health agencies, including
  • Distribution and administration of vaccines
  • Establishment and staffing of vaccination centers
  • Deployment of mobile vaccination units – targeted at underserved locations
  • The means to share data related to vaccine distribution
  • Facilities enhancement
  • Communications with the public on where they can receive a vaccination
  • Transportation of people to vaccination sites

Section 3002 would devote an additional $1 billion to the Director of the CDC for programs related to increasing the confidence of Americans in the efficacy and safety of the vaccine. The specific activities are:

• Strengthening confidence in the vaccines
• Providing information and education on the vaccines
• Improving rates of vaccination

Section 3003 would provide just over $6 billion on improving the supply chain for vaccines, therapeutics and medical supplies. This, presumably, is alongside work being done under the Defense Production Act, which we wrote about here. And this is where money is supplied for further development among a list of other priorities for vaccines, therapeutics, and the necessary ancillary medical supplies:

• Research and development
• Manufacturing
• Production
• Purchase

Section 3004 would spend an additional $500 million at the Food and Drug Administration. This money is directed at continuing evaluation of the performance, safety, and effectiveness of vaccines, therapeutics, and device activities.

Section 3011 would spend a whopping great $47.8 billion at the Department of Health and Human Services on activities to, “detect, diagnose, trace, and monitor” infections as well as related strategies to reduce the spread of COVID-19.

Specifically, the money is to be spent on:

• Implementing a strategy for testing, tracing, surveillance and mitigation
• Providing technical assistance and awarding grants or cooperative agreements with public health departments at the local, state and, territorial levels.
• Supporting the development, production, and use of diagnostic tests
• Improving contact tracing at the federal, state, territorial, and local levels
• Enhancing data sharing
• Awarding grants to improve the public health workforce
• Covering costs of administering this new effort

Section 8002 would give the Department of Veterans Affairs (VA) an additional $13.4 billion for “medical care and health needs.” Again, as with the waiving of copays for veterans we write about here, there is no requirement that this additional money be spent on costs related to COVID-19. Sigh. Another case of pandemic relief legislation being used to pay for things not necessarily related to the specific health needs of dealing with COVID-19.

Section 8003 would, likewise, give the Department of Veterans Affairs an additional $100 million to modernize its supply chain. Again, no requirement exists in the bill language to spend that money on anything actually related to COVID-19.

Section 3201 would change the law and require the Children’s Health Insurance Program (CHIP) to cover COVID-19 vaccinations and treatment. The statutory change acknowledges a need for temporary enhanced payments to cover these new requirements. But, strangely, for an emergency appropriation, no money is made available by the bill to pay for the new programs under CHIP.

As we’ve said about several items in this massive legislation, there are items funded under the rubric of vaccines and contact tracing that don’t appear to relate directly to the pandemic. (Looking at you, VA!) And there is a new statutory requirement that seems to have an invisible price tag (CHIP.) Questions should be asked about these issues as the Congress considers the legislation.