Public Health Programs at Risk

Funding for the Centers for Disease Control and Prevention’s (CDC) public health programs has been steadily scaled back by Congress. When the Tax Cuts and Jobs Act went into effect, $750 million from the Prevention and Public Health Fund (PPHF) was siphoned to cover costs of the Children’s Health Insurance Program (CHIP).

On February 9, Congress passed a bill that will cut $1.35 billion from the PPHF over the next decade, leaving it $1 billion short of its goal each year. It is unclear which programs will be affected, but the shortfall will create gaps in public health programs.

Financed by the Affordable Care Act (ACA), the PPHF was established in 2010 with the goal of improving health outcomes and enhancing the quality of health care. The ACA authorized $500 million for the fund, which was to grow to $2 billion per year by 2015 and be protected during yearly appropriations allocations.

Despite such protective measures, PPHF funds have often been diverted to pay for programs not directly related to public health initiatives. In 2012, Congress passed legislation that slashed the fund by $6.25 billion over nine years to cover cuts to Medicare physician payments. And in 2016, the fund was dipped into again to pay $3.5 billion for the 21st Century Cures Act.

A recent decision not to renew funding for global health initiatives to monitor Ebola and other viral outbreaks also is intertwined with the PPHF, which provides infrastructure and support for some of those programs. By choosing not to renew funds for a five-year, $582-million supplemental package, the CDC will reduce or stop work in 39 of 49 countries focused on preventing infectious-disease epidemics and other health threats. According to Georges Benjamin, MD, executive director of the American Public Health Association, slashing those programs, along with financial support for PPHF, hinders the CDC’s ability to respond to and contain disease outbreaks.

Source: The Scientist, February 9, 2018.