The Nation's Health February/March 2017As a new president and Congress settle into office, many advocates are doing what front-line public health workers do every day: hoping for the best while preparing for the worst.

Work under President Donald Trump and the new Congress has just begun, but advocates say that based on statements during the presidential campaign, the histories of people chosen to serve in Trump’s cabinet and backgrounds of new congressional leaders, core public health activities and priorities likely face a challenging future.

The most imminent threat to America’s health under the new administration are attacks on the Affordable Care Act and a reversal of historic gains in insurance coverage. But in addition to insurance losses, the strategy that opponents are using to repeal the ACA — a budgetary process that targets spending and revenue associated with the law — could also mean elimination of the Prevention and Public Health Fund. Created under the ACA, the vital fund provides almost $900 million annually to the Centers for Disease Control and Prevention and has become entwined with CDC’s base budget, said Emily Holubowich, MPP, executive director of the Coalition for Health Funding and an APHA member.

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