The just-passed federal government spending bill and coronavirus relief package was a vehicle for seemingly every policy priority under the Capitol dome. It included landmark legislation on climate change, a long-desired deal to end surprise medical billing, and billions of dollars for everything from Amtrak to vaccine distribution and coronavirus-related funeral expense relief.
But despite coming in at 6,000 pages and $2.3 trillion in taxpayer dollars—$900 billion of which was for COVID relief—a conspicuous item was left on the cutting room floor. At the last minute, legislation that would have set aside a mere $3 million in funding for a program to address the dramatically worsening rates of burnout and mental illness among frontline health care workers—who are under unprecedented strain because of the pandemic—was dropped from the text. And now each side is blaming the other.
The bill is titled The Dr. Lorna Breen Health Care Provider Protection Act. Its namesake, Lorna Breen, is a tragic example of the pandemic’s toll on such workers. A longtime New York City emergency room doctor, Breen died by suicide in April as the virus surged in the city and overwhelmed doctors and nurses treating the sick and dying. As the pandemic has dragged on nationally, it has “brought physician wellness to a crisis point,” wrote the president of the American Medical Association in September.
Introduced in July by a bipartisan group of lawmakers in the House and Senate, the legislation had widespread backing on Capitol Hill and off it. Nearly every major health care and medical group in the country, including the top groups representing doctors, nurses, hospitals, and emergency room physicians, had endorsed the legislation. For these groups, which often compete with one another on policy matters, to be on the same page on a bill is rare.
“Everyone is supportive,” said Corey Feist, Breen’s brother-in-law and co-founder of the Dr. Breen Heroes Foundation, an advocacy organization set up in her honor. “It tells me we’re onto something, we’re headed in the right direction.”
Advocates were hoping to include the bill as part of another round of coronavirus relief legislation or, failing that, must-pass year-end spending legislation. Ultimately, congressional leaders combined the two. The bills passed on Sunday after weeks of marathon negotiating, only to encounter an 11th-hour threat from President Donald Trump on Tuesday to derail the entire package.
The package Congress passed does have several important provisions aimed at boosting frontline health care workers. There is $8 billion to speed vaccine distribution, for example, which will protect medical professionals. The bill also seeks to address the broader increase in depression, anxiety, and mental illness during the pandemic by providing $4.25 billion for mental health and substance abuse initiatives and $50 million for suicide prevention programs.
But as they combed the bill’s text, supporters of the Breen Act were disappointed to find that, in a bill packed with line items big and small, the relatively smaller proposal to spend $1 million per year, over the next three years, to bolster frontline health care workers was missing. Figuring out why, however, is not easy.
“We pushed hard for the inclusion of the bill. It was on the table until late in the process,” said a Democratic staffer, speaking anonymously to discuss the process candidly. “We were initially hopeful it would be included and were disappointed to find it didn’t make it into the final package.”
In the aftermath, other Democrats pointed fingers at the GOP for the failure to secure the Breen Act’s inclusion in the year-end COVID legislation. A senior Democratic aide told The Daily Beast that Senate Republican lawmakers insisted on “weakening it too severely” during negotiations taking place at the committee level. Another aide said that “Democrats offered [the bill] a number of times but it was not accepted by Republicans.”
The GOP staff of the Senate Health, Labor, and Pensions Committee—where the Breen Act originated—and the Senate Appropriations Committee, which was central to funding talks, did not respond to requests for comment from The Daily Beast. A senior GOP aide said that Senate Majority Leader Mitch McConnell’s office (R-KY) was not involved in discussions about the Breen Act.
The Breen Act would establish a program of government grants to enable the training of health care professionals in strategies to prevent suicide, reduce burnout, and counter substance abuse. It would prioritize those grants in areas hardest-hit by COVID-19.
Feist said the legislation is a “first of its kind” approach to improving mental health issues among medical professionals.
And the legislation would also commission a comprehensive study on the impact of COVID-19 on frontline medical workers’ mental health and an ensuing report to Congress. It would be the first such study commissioned by the federal government. So far, the only real source of data on the subject of medical professionals’ burnout in the pandemic has come from surveys commissioned by nonprofits and companies and academic reviews.
While research has long shown that medical professionals die by suicide at higher rates than do people in most other occupations, advocates believe that COVID’s emergence, and endurance, has made it even more urgent to understand the phenomenon so it can be addressed.
“Even though the issue predated the pandemic, the pandemic shined a huge light on it,” Feist told The Daily Beast. “Then it magnified the need.” He expressed confidence that the bill remains viable and will be passed shortly after the new Congress convenes in January.
“It is going to be important to get this passed early in the next Congress and have it become effective very quickly,” said Feist.