The two-year-old Prevention and Public Health Fund, created by the Affordable Care Act, has provided a long-overdue boost in funding for prevention, wellness and public health programs that improve community health and lower health care costs. Yet much of the amount originally intended for the fund has already been cut, says a new APHA report.
According to the brief, the fund, which is only a small component of the health reform law, represents a critical investment in health for a nation where only 3 percent of the U.S. health care dollar is spent on preventing disease yet 75 percent of U.S. health care costs are related to preventable conditions.
“The prevention fund is already working in communities across the country to control the obesity epidemic, reduce tobacco use, strengthen immunizations and bolster a range of other important public health interventions that will improve the nation’s physical and fiscal health,” said Georges Benjamin, executive director of APHA. “It’s a tremendously important investment.”
Despite its success, the report argues that short-sighted political decisions have already resulted in a 33 percent cut in the original amounts allocated by the ACA.
The fund was initially designed to provide a stable base of $19 billion in new money from 2010 to 2021. According to the report, it was to grow from $500 million in fiscal year 2010 to $2 billion per year by fiscal year 2015, and every year thereafter. However, earlier this year, Congress reduced funding for the measure by $6.25 billion over nine years to help postpone a cut in Medicare physician payments, thereby reducing the fund by a third from 2010 to 2021.
“While the fund is making important investments in improving the health of our communities, it was intended to do more,” said Benjamin.
According to the brief, “The Prevention and Public Health Fund: A Critical Investment in Our Nation’s Physical and Fiscal Health,” the fund has disbursed $1.25 billion for fiscal years 2010 and 2011, and another $1 billion has been allocated for fiscal year 2012. However, despite the fact that Congress created the fund to supplement existing prevention funding, 17 percent of the fund has been used to supplant rather than supplement public health appropriations in 2011 and 2012.
“Monies from the fund were intended to expand our public health programming, not make up for cuts in annual appropriations,” said Benjamin.
Despite the cuts, the report points to enormous contributions that the fund is making to promote and protect the public’s health. Virginia, for instance, has achieved information technology savings of $1.2 million and increased enrollment in the state’s Medicaid Family Planning Program by 32 percent through the National Public Health Improvement Initiative. And Iowa is expanding tobacco and blood pressure screenings to more than 300,000 people and increasing referrals to its tobacco quitline thanks to the fund’s Community Transformation Grants program.
“The United States faces significant health and fiscal challenges that could be mitigated by a better and more reliably funded public health system,” concludes the report. “The Prevention and Public Health Fund is a vital part of the effort to create such a system.”
The Supreme Court decision on the Affordable Care Act, which is expected in the next week, may have further implications for the fund’s future.