Trust for America's Health supports President's proposal to end sequestration

The following is a statement from Jeffrey Levi, PhD, executive director of the Trust for America's Health (TFAH) and chair of the Advisory Group on Prevention, Health Promotion, and Integrative and Public Health.

"If adopted, the President's budget would take a major step toward building a culture of health in the United States, as it invests in programs and policies that enable Americans to be healthier – and to be better protected from infectious diseases, foodborne illnesses and other threats.

TFAH strongly supports the President's proposal to end sequestration. Sequestration has resulted in sharp and indiscriminate cuts to public health programs – and ending it shows a commitment to the need for a strong, effective public health system in this country.

We are pleased to see increased support for programs that can improve health in people's daily lives – where they live, learn, work and play. Mounting evidences shows programs like the Earned Income Tax Credit, the Child Care Tax Credit, early childhood education, family home visiting and the Children's Health Insurance Program contribute to the long-term health of children and their families and are essential building blocks to a lifetime of wellbeing.

The proposal also recognizes the need for increased resources to fight one of the country's fastest growing, most troubling and most preventable public health epidemics – devoting more than $100 million in new investments to combat prescription drug misuse and related heroin abuse.

In addition, the budget also demonstrates how important ongoing investments into a standardized set of core "foundational capabilities" for all health departments are. All Americans should be assured that their state and local health departments have the same ability to help them be healthy. To this important end, the President's budget identifies $8 million to start down the path of this kind of assurance.

However, while this is important, it is more than offset by the zeroing out of the $160 million Preventive Services Block Grant, a mechanism that is currently used by health departments to maintain capabilities and services. We recommend restoration of the block grant funding, along with clear direction that the funding be used for foundational public health capabilities and services.

Another low-point of the budget is the proposal to significantly cut chronic disease prevention programs – including some of the most important programs that support preventing obesity, tobacco cessation and related health problems. Given the national priority to reduce healthcare costs, this is particularly ironic since we know chronic diseases are one of the biggest drivers of these costs.

Some key public health highlights in the budget include:

• A $36 million increase to the Strategic National Stockpile, which provides medicine and medical supplies to protect the American people during a public health emergency;
• A $264 million investment to help the Centers for Disease and Prevention (CDC) combat antibiotic resistance;
• A $107 million increase for the Biomedical Advance Research and Development Authority (BARDA) to spark the research and development of new antibiotics, vaccines, medical treatments and medical devices;
• The creation of a single, independent food agency to provide leadership and prevent and respond to outbreaks of foodborne illness and an increase of $109.5 million to the Food and Drug Administration to implement the Food Safety Modernization Act (though much of this increase is in the form of unauthorized user fees which Congress should enact regardless of a policy decision on user fees);
  • The creation of a single food safety agency has been a long-standing priority for TFAH and we hope it is the start of a broader coordination of public health programs across the federal government;
• A $31.5 million increase in programs to combat viral hepatitis, almost doubling the nation's resources;
• A $10 million increase for the CDC climate and health program to fund 30 additional state and local grantees, though this is offset by an $11 million cut to the National Environmental Public Health Tracking program; and
• A $128.1 million increase in the Vaccines for Children Program, though this is offset to some degree by a $50 million cut in the discretionary immunizations program.

Some key public health low-lights include:

• Zeroing out the $160 million Preventive Services Block Grant – which is a key mechanism state and local public health agencies use to maintain capabilities and services;
• A $20 million cut to the Partnerships for Improving Community Health (PICH), which works to address common risk factors for chronic disease;
• A $7.5 million cut from the Division of Nutrition, Physical Activity and Obesity for programs focused on reducing obesity in high obesity rate counties; and
• Elimination of the Racial and Ethnic Approaches to Community Health (REACH), which helps address key chronic disease conditions in the hardest hit populations.

TFAH looks forward to working with the Administration and Congress to ensure strong and sustained funding for public health – to foster a nationwide culture of health and improve the health and wealth of the nation."