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Research Letter
August 7, 2020

Allocation of COVID-19 Relief Funding to Disproportionately Black Counties

Author Affiliations
  • 1Harvard University, Cambridge, Massachusetts
  • 2Harvard John F. Kennedy School of Government, Harvard Business School, Cambridge, Massachusetts
  • 3Booth School of Business, University of Chicago, Chicago, Illinois
  • 4School of Public Health, University of California, Berkeley
JAMA. 2020;324(10):1000-1003. doi:10.1001/jama.2020.14978

The Coronavirus Aid, Relief, and Economic Security (CARES) Act and Paycheck Protection Program together designated $175 billion for coronavirus disease 2019 (COVID-19) response efforts and reimbursement to health care entities for expenses or lost revenues.1

The most important factor driving funding allocation is past revenue. However, revenue is an imperfect measure of need because it is also influenced by prices, overuse, payer mix, and market consolidation.2 Moreover, non-White and indigent populations generate lower revenues, due to underinsurance and undertreatment,3,4 and hospitals caring for them may receive less relief despite confronting a greater burden of COVID-19.5

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