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Disappointing Cuts to the ACA Prevention Fund

Posted by John McDonough  February 20, 2012 11:00 PM

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Late last week, Congress and the President agreed to fund short term extensions of the payroll tax cut, unemployment benefits, and a 10-month delay in scheduled cuts to Medicare physician payments (known as the "sustainable growth rate" (SGR), discussed earlier here). $5 billion of the cost of this agreement will come from cuts to a part of the Affordable Care Act (ACA) known as the "Prevention and Public Health Investment Fund."

This cut is a big disappointment.

The Fund started in 2010 at $500 million, and going up each year until it was scheduled to reach $2 billion by 2015 and thereafter. Under the new deal, the Fund will not reach $2 billion until 2022 at the earliest, according to the Congressional conference report.

The Fund is run by the Office of the Secretary of the Department of Health & Human Services. The Secretary may transfer amounts from the Fund to increase funding for any program authorized by the Public Health Service Act for “prevention, wellness, and public health activities including prevention research and health screenings, such as the Community Transformation grant program, the Education and Outreach Campaign for Preventive Benefits, and immunization programs.”

These reductions were opposed by Senator Tom Harkin (D-IA), Chairman of the Health, Education, Labor and Pensions Committee, and by Cong. Henry Waxman (D-CA), Chairman of the House Committee on Energy & Commerce.  Senator Majority Leader Harry Reid (D-NV) has promised the cuts will be reversed -- whether that is possible depends on the yet-unknown results of the November 2012 elections. 

The public health community views the creation of the Fund as one of the most significant contributions to advancing public health ever.  This cutback is a significant blow to that community, and an indication that the public health community needs help protecting its gains.
This blog is not written or edited by or the Boston Globe.
The author is solely responsible for the content.

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About the author

John E. McDonough is a professor of practice at the Harvard School of Public Health. He is the author of the book “Inside National Health Reform”, published in 2011 by More »


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