The repeal of Obamacare could cost Georgia more than $20 million a year, eliminating a little-known fund that focuses on immunization programs, preventing heart disease and strokes, and responding to public health crises.
The move to scrap the federal Prevention and Public Health Fund could also deal a multi-million-dollar blow to the Atlanta-based Centers for Disease Control and Prevention, a major employer in the metro region.
The fund is part of the Affordable Care Act, the Obama-era health law that President Trump and the GOP-led Congress have vowed to repeal and replace. It's separate from the politically controversial money that subsidizes people's health insurance.
Still, GOP lawmakers have targeted it as a “slush fund.” They say it sends out millions in unaccountable dollars, sometimes for pet projects that do little to benefit public health.
In Georgia, the loss of the fund could rip a hole in the budgets of state and local health departments as well as some nonprofits and universities. A total of $20 million a year comes to Georgia to recipients such as the state Department of Public Health, the DeKalb Board of Health, Georgia State University and Morehouse School of Medicine.
The state could suffer another blow, as well. The fund channels a total of $891 million a year through the CDC. While the CDC sends the majority to state health agencies around the country, the agency itself uses about $265 million. Used to fight Zika, Ebola and influenza, the money also pays for staff salaries and programs to stem obesity and smoking.
CDC officials said they did not know how many jobs might be at risk, but emphasized that the great majority of the $265 million goes toward the costs of programs, not jobs.
“This funding saves lives by preventing cancer and heart disease, finding and stopping deadly outbreaks in hospitals and communities, and immunizing our children,” said Tom Frieden, the CDC chief who recently left the post. “Eliminating these funds will cost more money than it saves, but, more importantly, it will cost lives.”
All tolled, the demise of the fund could eliminate a wide swath of Georgia health programs and endanger a number of public health jobs.
The stakes are rising as Georgia Rep. Tom Price advances through the confirmation process to the post of U.S. Secretary of Health and Human Services, a position that oversees the prevention fund. Price has been an outspoken critic of Obamacare. He declined requests for comment for this article.
The repeal-and-replace effort has slowed of late, with some GOP leaders saying they might make partial changes in the Affordable Care Act. So it remains unclear whether this prevention fund will be extinguished, or whether some programs might survive through other means.
GOP: It’s a slush fund
Republican lawmakers blast the fund for paying for such projects as urban gardens and farmers markets. They complain that while Congress allocates the money, it has scant oversight over the dollars.
“(That) has resulted in the abuse of taxpayer dollars through pet projects such as lobbying campaigns for higher taxes and urban gardening,” said U.S. Rep. Michael Burgess, R-Texas.
But simply scrapping the fund is not the answer, said U.S. Sen. Johnny Isakson, R-Georgia.
“If the fund is eliminated, it is important that Congress appropriates sufficient funding specifically for the CDC to be able to carry out its mission to protect Americans against the next public health threat,” said his spokeswoman Amanda Maddox.
Georgia Republican Rep. Barry Loudermilk took scornful aim at a program to create a mobile farmers market in DeKalb County.
“Is that the responsibility of taxpayers across the country to fund a farmers market in suburban Atlanta?” Loudermilk said.
He added, “When you get a large fund not allocated to a specific purpose, government tends to waste that money. We have to be more responsible than that.”
DeKalb health officials, for their part, say the the farmers market helps keep people healthy, which they say is the essence of public health. The market serves low-income areas where people don’t have ready access to fresh produce, they said.
“One of the objectives of the fund is improving nutrition, and what better way to do that than providing locally grown fruits and vegetables,” said DeKalb Board of Health Director Elizabeth Ford.
Sounding the alarm
Across Georgia, state and local health officials are sounding the alarm to spare the fund from the chopping block. They say that after years of budget-tightening, this money has filled funding gaps and become a critical source of money for core health programs.
The state Department of Public Health receives $14.7 million a year from the prevention fund. The majority of this funding is used to support immunizations and the prevention of strokes, diabetes and tobacco use. The remainder is used to support staff and operating costs.
“It is critical that this funding continues to exist regardless of changes made in Washington to overall healthcare policy,” said Nancy Nydam, spokeswoman for the state Department of Public Health.
The School of Public Health at Georgia State University has research projects supported by the federal Prevention and Public Health Fund, including current partnerships with DeKalb County and Fulton County.
In DeKalb, the school is collaborating with the DeKalb County Board of Health for a project focused on reducing childhood obesity and related health problems.
In Fulton, the school is working with the county to conduct research on the prevalence of smoking and attitudes toward second-hand smoke.
The two projects, which are in their third and final year of funding, together cost $900,000.
Elsewhere, the American Cancer Society Global Headquarters, located in Atlanta, receives $1.8 million annually to increase vaccination rates for human papillomavirus (HPV). That promotes a vaccine for adolescents across the nation to reduce cervical and other cancers. There have been stumbling blocks to more young people getting the vaccine. Some physicians aren’t recommending it and people are uncomfortable talking about HPV because it’s sexually transmitted.
The grant supports six full-time positions and a portion of seven others, in addition to several contractors across the country.
“It would be a tremendous loss if there were cuts” to the program, said Debbie Saslow, a society senior director.
The federal Prevention and Public Health Fund channels roughly $20 million a year to Georgia. Public health advocates say the fund is in danger because it is part of the Affordable Care Act, the Obama-era health law that President Trump and the GOP-led Congress have vowed to repeal and replace. Here are some Georgia groups that receive the money.
1. The Georgia Department of Public Health - $14.7 million.
2. The DeKalb County Board of Health - $928,453.
3. Morehouse School of Medicine - $999,214.
4. American Cancer Society Global Headquarters - $1.8 million.
5. Task Force for Global Health - $1.6 million.
6. National Association of Chronic Disease Directors - $179,000.
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