CDC may face double jeopardy with Senate health bill
July 27, 2017 | Lev Facher | STAT
If Senate Republicans pass a version of their health reform bill, and if a current House GOP spending plan is enacted, it could spell double jeopardy for the Centers for Disease Control and Prevention.
The House Appropriations Committee earlier this month voted to approve a spending plan that would reduce the CDC’s budget by $198 million from 2017. But its bill relies on a fund Republicans are intent on repealing potentially as soon as the coming fiscal year — meaning the agency could take an even steeper cut.
The Prevention and Public Health Fund, a once-flexible, roughly $1 billion pot of money created by the Affordable Care Act, is now used to consistently fund a variety of preventive health programs around the country.
The CDC, under the spending plan passed last week, is set to receive $841 million in PPHF money in 2018, and plans to use it for a number of preventive health and immunization programs. Other Department of Health and Human Services programs set to receive money from the fund include chronic disease management, Alzheimer’s education and outreach, and suicide prevention.
All told, the Senate bill’s passage and adoption of the current House GOP spending plan would result in a loss of more than $1 billion for the CDC from a roughly $7 billion budget.
The Senate Appropriations Committee has not yet finished work on its appropriations bill, and would have time — if the health reform bill is signed into law — to adjust the CDC’s allocation in the post-prevention fund era.
The chairmen of the spending committees overseeing health care have long acknowledged the CDC’s importance — Sen. Roy Blunt (R-Mo.) has defended the cut in the House-enacted health reform bill by noting it continued the fund through 2018, giving Congress time to make up the budget losses.
A previous version of the Senate bill, however, would have killed the fund entirely beginning in October, and it is possible the same language will remain in a “skinny repeal” option. A version of the “skinny repeal” sent by Democrats to the Congressional Budget Office, however, assumed the repeal would not take place until 2019.
The Senate health reform package must achieve equivalent deficit savings to the House-passed bill — north of $100 billion — making it difficult to re-implement more than $10 billion in prevention fund spending authority over the next decade, as estimated by the CBO.
A statement Thursday from a coalition of public health groups estimated the PPHF funds make up 12 percent of the CDC’s budget.
“Slashing public health and prevention funding would increase preventable suffering and death, make the poorest and sickest communities fall even further behind, and leave our country far less prepared for and capable of responding to public health emergencies,” the letter stated, signed by executives from the American Public Health Association, Prevention Institute, Public Health Institute, Society for Public Health Education, and Trust for America’s Health.