Healthy Living

The Hidden Provision In The Affordable Care Act That, If Lost, Will Quickly Lead To Poorer Health

Losing this source of support would cripple key programs.
03/21/2017 08:45am ET | Updated March 21, 2017

While the attention of Obamacare repeal is focused on insurance, there’s a hidden and oft overlooked provision that, if lost, will lead to poorer health and higher costs—particularly for children and the elderly. The provision involves the existence of what is known as the Prevention and Public Health Fund.

The Prevention Fund provides investments into keeping people healthy and safe so they would be less likely to need expensive health services. The Prevention Fund allocates $890 million annually to the U.S. Centers for Disease Control and Prevention (CDC)—12 percent of the agency’s budget—of which more than 70 percent goes directly to states and big cities.

Because it provides significant sums to the CDC and local health departments, losing this source of support would cripple key programs. For example, the pioneering Tips From Former Smokers campaign—which motivated 500,000 tobacco smokers to quit—will be shuttered completely if the Prevention Fund is eliminated.

The Prevention Fund also ensures there are vaccines for children and the elderly. Researchers note that the flu is responsible for more than $87 billion in total economic burden. But without the Prevention Fund, 40 percent of the CDC’s vaccine distribution program would disappear.

Did you know that 1 out of every 25 hospitalizations leads to a different infection and these health care-acquired infections (HAIs) cost more than $30 billion a year? The Prevention Fund provides the sole funding for an innovative program that has begun to reduce HAIs and ensure when people go to the hospital they don’t contract another illness while they’re busy getting healthy.

Diabetes costs the country more than $200 billion a year. And heart disease is one of the nation’s biggest killers. Without the Prevention Fund, CDC’s work to prevent heart disease would be cut by 80 percent.

One last example: CDC maintains a vital database for tracking levels of lead poisoning. States and communities rely on the system to ensure children are safe. We learned recently just how important it is to monitor cases of lead poisoning. Yet, without the Prevention Fund, 100 percent of the funding will evaporate.

The Prevention Fund was designed to give local and state health officials the support they need to address their community’s most pressing health concern. As such, the Prevention Fund is typically overseen by the state health commissioner, often appointed by the governor. We know these funds are a lifesaver for public health offices, whose budgets haven’t rebounded from the reductions made during the 2008 recession.

Take, for example, Florida—a state which yearly battles weather-related emergencies, is still on the front lines of Zika prevention, saw deaths from opioids increase by nearly 50 percent over the last decade, and has an obesity rate among adults of 25 percent.

With all these consistent—but also emerging threats—you’d think funding for public health increases year after year. Yet, last year, Florida’s state public health budget declined by 8.2 percent.

Now, think if the Prevention Fund disappears. Florida will lose more than $20 million a year, including $1 million for vaccines for needy children and adults, nearly $1 million for battling HAIs, and nearly $3 million for prevention of chronic disease (such as diabetes, heart disease and stroke), among other vital endeavors.

These trends are mirrored nationally. The median per capita state spending on public health in FY 2015 was $1.2 billion lower—when adjusted for inflation—than in 2008. And, the cuts have occurred in the most critical areas. For example, excluding the one-time-only Zika allocation, funding for core public health emergency preparedness, once $940 million in fiscal year 2002, was just $660 million in FY 2016.

And, of course, the President’s proposed budget, which includes an 18 percent cut to the Department of Health and Human Services (HHS), would greatly exacerbate the situation. Combining the loss of the Fund, the huge cut in HHS and additional cuts to other agencies—like the Environmental Protection Agency (EPA) and the Department of Housing and Urban Development (HUD)—would be devastating to the nation’s health.

We know that threats to a person’s health are everywhere: in neighborhoods, hospitals, the ground we walk on and the food we eat. The CDC and our state and local public health agencies provide critical support, infrastructure and funding to quickly identify and prevent or constrain any threat.

Without the continuation of the Prevention Fund, there will be untold numbers of American people unsafe and unhealthy.

If the Prevention Fund is eliminated, the results won’t be hidden. We will see them in increased disease, hospitalization and premature death rates and, along with that, increased premiums.