A proposal to replace the Obama health care law would cut out a pillar of funding for the nation’s lead public health agency, and experts say that would likely curtail programs across the country to prevent problems like lead poisoning and hospital infections.
The Republican bill calls for the elimination of a $1 billion-a-year fund created for the Centers for Disease Control and Prevention by the Affordable Care Act in 2010. The fund’s goal: Pay for public health programs designed to prevent illness and, therefore, reduce health care costs.
Bureaucracy-slashing bills are nothing new in Washington, and many never pass. Introduced this week, the GOP’s plan to overhaul former President Barack Obama’s health care law is being hashed out in the House of Representatives before it goes to the Senate.
But some health experts say what’s being discussed now is far graver than the funding debates seen in other years.
The results “will be a major turning point” in how the nation promotes health and addresses health care needs, said John Auerbach, president of Trust for America’s Health, a Washington-based public health research and advocacy organization.
Some Republican legislators have championed the demise of the fund, equating it to a “slush fund.” They say they want more control over how public health funds are spent.
“We shouldn’t cede that to the executive branch,” said U.S. Rep. Andy Harris, a Maryland Republican who is an anesthesiologist. He sits on the House appropriations subcommittee that oversees health spending.
CDC officials declined to comment Thursday about the possibility of losing the fund.
“Until we know more about the final budget, we can’t say how we’ll be affected,” said agency spokeswoman Kathy Harben.
The CDC’s total budget is around $11.8 billion, but about a third of that is for specific projects mandated by Congress. Those programs, for example, pay for vaccines for poor children and monitor the health of survivors of the 9/11 World Trade Center disaster.
What’s left is the core of the agency’s budget. The Atlanta-based agency has received the special funding for seven years, and currently it accounts for about 12 percent, or about $900 million, of the core budget, according to the CDC.
Much of the money is passed on to state and local health departments. That funding bolsters vaccination programs, upgrades state laboratories that monitor for Zika and other infectious diseases, and pays for a push to reduce infections spread in hospitals. It supports programs to save people from diabetes, cancer, heart disease, and stroke. And it completely finances the CDC’s lead poisoning prevention program.
“The elimination of the fund would be devastating to state and local health departments,” said Laura Hanen, chief of government affairs for the National Association of County and City Health Officials.
Those health departments lost local funding during and after the 2007-2009 recession, said Michael Fraser of the Association of State and Territorial Health Officials. Today, the average state health department gets about 55 percent of its budget from federal money. In some states, it’s as much as 75 percent, he said.
Harris, the Maryland Republican, said that federal budget constraints mean that at some point more public health costs are going to shift to the states. Local public health officials and advocates “are not lobbying their legislatures adequately,” he said.
But eliminating the fund “will create a hole that states won’t be able to fill,” said Fraser.
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