Ever since the Ebola and Zika epidemics, public health officials have advocated for a special emergency fund that would allow the United States to respond rapidly to disease outbreaks. This budget blueprint creates a new Federal Emergency Response Fund, but provides no specifics about how large it would be or where the funds will come from.
Top health officials, including Tom Frieden, former director of the Centers for Disease Control and Prevention, have repeatedly called for such a fund, especially after Congress delayed nine months in approving emergency funding to fight the Zika epidemic.
The president's blueprint for the Department of Health and Human Services does not include a proposed 2018 budget figure for the CDC, which is part of HHS. Its current core budget is about $7 billion.
Nor does the 2018 summary list what CDC programs might be cut. CDC, the nation's chief public health agency, is responsible for everything from investigating disease outbreaks to figuring out how best to prevent the leading causes of death in the United States, such as heart disease and cancer.
The 2018 spending plan for HHS says there will be “reforms” in “key public health, emergency preparedness and prevention programs.” It provides no specifics, but a substantial portion of CDC’s work falls in those areas.
CDC's budget is already in jeopardy under the latest Republican health-care bill to repeal the Affordable Care Act. The GOP repeal plan would eliminate the ACA's Prevention and Public Health Fund starting in October 2018. That fund provides almost $1 billion annually to CDC, now about 12 percent of CDC's budget. It includes prevention of bioterrorism and disease outbreaks, as well as money to provide immunizations and heart-disease screenings.
No clear replacement has been proposed in Congress, nor is there any mention of its replacement in Trump’s proposed spending plan.
The spending plan says the budget “reforms” CDC by establishing a new $500 million block grant “to increase State flexibility and focus on the leading public health challenges specific to each State.” No additional details are provided. But it is likely these funds would be pulled from within the existing CDC budget to be provided as lump sums to states.
Block grants give states more autonomy. Critics say they are used by states to plug holes in their budgets, without the accountability that federal programs usually require.
“CDC protects Americans in ways that aren’t readily apparent,” Frieden said. “When CDC doesn’t have the support and resources to do this, Americans are less healthy and less safe and health-care costs increase.”
