Local and state health agencies mobilize when there is a disease outbreak or a community health need, but proposed funding cuts in the GOP’s two healthcare bills could significantly hamper that work, experts say.
One critical area for concern is the elimination of the Prevention and Public Health Fund, which was established under the Centers for Disease Control and Prevention as part of the Affordable Care Act. The Senate’s bill, the Better Care Reconciliation Act of 2017, would eliminate the program on Oct. 1, a move Chrissie Juliano, director of the Big Cities Health Coalition, said is “really dangerous for local communities across the country.”
The cuts, if they go through as currently proposed, would happen so quickly that local health departments would not have time to fill budgetary holes, Juliano said. The House’s bill, the American Health Care Act, had intended to cut the fund at a later date than the Senate’s bill.
Juliano was joined by Laura Hanen, interim executive director and chief of governmental affairs for the National Association of County and City Health Officials; John Douglas, M.D., executive director of the Tri-County Health Department in Colorado; and Merle Gordon, director of the Cleveland Department of Health at a briefing on the impact the ACA repeal bills could have on public health agencies and the services they provide.
Douglas said a major area of concern for his department is reduction of Medicaid funding. He said the increased access to Medicaid, as Colorado is an expansion state, has improved community health and offered options for people addicted to opioids.
“The ACA is not a perfect legislation, but neither the AHCA or BCRA is a step forward,” Douglas said.
As an example of how valuable funding is, Douglas described a recent response to a single measles case in a child too young to be vaccinated. That child had visited hospitals, other health facilities and other public areas before being diagnosed with measles, so the Tri-County department launched an “enormous” response to prevent transmission; responding to that single case alone cost $50,000, he said.
These local health officials join the growing chorus of healthcare stakeholders who are against both the Senate and House bills. Both bills were widely panned by major provider groups, who also expressed concerns about deep cuts to the Medicaid program and the impacts on children and women.
The Senate has delayed a vote on its bill until after Congress’ Fourth of July recess following party infighting, but Senate Majority Leader Mitch McConnell could submit an updated bill to the Congressional Budget Office as early as tomorrow in an effort to keep the process moving quickly.