Special Analysis: Prevention and Public Health Fund Federal & State Allocations

January 2017

The U.S. Centers for Disease Control and Prevention (CDC) would lose 12 percent of its annual budget if the Prevention and Public Health Fund, part of the Affordable Care Act (ACA), were repealed, according to an analysis by the Trust for America's Health (TFAH). 

States would end up losing more than $3 billion over the next five years - from grants and programs supported by the Prevention Fund. 

The $890 million gap in CDC's annual funding created by eliminating the Prevention Fund could not be filled under current laws without drawing funds away from other Department of Labor, Education and Health and Human Services programs. Among activities supported directly by the Prevention Fund are grants to states for infectious disease control, resources through the Preventive Health and Health Services Block Grant and other core public health programs which, if cut, would increase illness, injuries and preventable deaths. 

If the Prevention Fund is eliminated, the impact will be felt at the local, state and federal levels as public health organizations respond to several major health crises that are on the rise, such as:

• Health Security Funds for Disease Outbreaks, Disasters and Bioterrorism: With the exception of the one-time-only funding for Ebola and Zika, the core funding for preparedness and response to health emergencies has been cut by more than one-third in the past decade. CDC has responded to more than 750 health emergencies in the past two years. Infectious diseases cost the country more than $120 billion per year, and that cost grows exponentially when major new diseases strike.
• Prescription Painkiller and Heroin Use: Deaths from opioids have more than quadrupled in the past 15 years. Nationally, more than 2 million Americans misuse prescription drugs, and nearly a half million are addicted to heroin, costing the country more than $55 billion a year in healthcare, workplace and criminal justice spending. CDC plays a critical role by providing support to states and healthcare providers to monitor and control the inappropriate prescribing of opioids.
• Obesity and Diabetes: Nearly 38 percent of adults are obese and more than one-third of children are overweight or obese, contributing to more than $200 billion in direct health costs. One in three children could develop diabetes in their lifetime, and one in four are not healthy enough to serve in the military by the ages of 17 to 24.
• Declining Life Expectancy: Life expectancy in the United States has declined for the first time in two decades. While death rates are higher among Blacks and other people of color, death rates have increased the fastest (by 10 percent since 1999) among middle-aged White men and women (ages 45 to 54). Increasing death rates among middle-aged Whites are the highest in West Virginia, Mississippi, Oklahoma, Tennessee, Kentucky, Alabama and Arkansas.

Amounts each state stands to lose over the next 5 years if the Prevention Fund was repealed (based on fiscal year 2016 grants to state)