June 2012

I. Health groups oppose bill to repeal clean air health protections
II. Senate rejects bill to offset student loan rates with the prevention fund
III. House passes sequester replacement bill – would cut public health and safety net programs
IV. House defunds Census Bureau’s American Community Survey
V. Senate introduces bill to close tobacco tax loopholes
VI. Registration open for APHA’s Midyear Meeting
VII. Updates from the states

Health groups oppose bill to repeal clean air health protections

On May 17, the House Energy and Commerce Committee passed H.R. 4471, the so-called Gasoline Regulations Act of 2012. This legislation, which would do nothing to reduce gas prices, instead would eliminate the requirement for the Environmental Protection Agency to base clean air standards solely on health science when determining whether air is healthy to breathe. H.R. 4471 would require EPA to consider “feasibility and cost” to industry in determining health-based standards for pollutants. In 1970, an overwhelming bipartisan majority in Congress agreed that to adequately protect public health, EPA must set air quality standards to protect health with an adequate margin of safety. In 2001, the U.S. Supreme Court ruled that any consideration of cost to industry would violate the Clean Air Act when EPA sets health standards for ozone or other air pollutants.

In addition, the legislation would indefinitely delay three overdue air quality safeguards, including standards for tailpipe emissions and gasoline sulfur content (Tier 3), air emissions standards for petroleum refineries and ground-level ozone standards. 

APHA and other public health organizations sent a letter to members of the House Energy and Commerce Committee urging them to oppose the bill. The groups will continue to actively oppose the bill should it come before the full House of Representatives for a vote. You can send a message to your members of Congress urging them to protect the Clean Air Act by visiting APHA’s advocacy website.

Senate rejects bill to offset student loan rates with the prevention fund

On May 24, the U.S. Senate rejected an amendment by Sen. Lamar Alexander, R-Tenn., to S. 2343, the Stop the Student Loan Interest Rate Hike Act of 2012, by a vote of 34-62. This amendment is identical to the bill passed by the U.S. House of Representatives on April 27 that would repeal the Prevention and Public Health Fund and rescind all unobligated funds to pay for the extension of student loan interest rates for undergraduate Federal Direct Stafford Loans.

APHA sent a letter to Senate Majority Leader Harry Reid, D-Nev., and Minority Leader Mitch McConnell, R-Ky., strongly opposing the amendment. APHA along with other public health advocates have urged the Senate to reject any effort to use the fund as an offset to pay for student loans.

It is critical that Congress continues to hear from advocates in support of the fund. APHA members are encouraged to continue to speak out in support of the fund and to send a message to your senators and representative expressing the importance of preserving this important public health investment.

House passes sequester replacement bill – would cut public health and safety net programs

On May 10, by a vote of 218-199, the House passed H.R 5652, the Sequester Replacement Reconciliation Act of 2012. The legislation would seek to delay the “sequestration” of fiscal year 2013 discretionary funding (for defense and nondefense programs) for one year by replacing it with cuts to several mandatory programs, including important public health and safety net programs. The pending sequestration was put into motion when the so-called “supercommittee,” which was created under the Budget Control Act, failed to produce a viable deficit reduction proposal last fall. Specifically, the House proposal would repeal the Prevention and Public Health Fund, cut $36 billion from the Supplemental Nutrition Assistance Program (formerly the Food Stamp Program) that would eliminate benefits to nearly 2 million people who currently depend on the program for food assistance, and cut funding for Medicaid and the Children's Health Insurance Program by modifying payment rates to providers, eliminating services for an estimated 300,000 children.

In addition to the cuts to mandatory programs, the bill would also combine the defense and nondefense spending caps included in the Budget Control Act for 2013 and reduce the combined cap by $19 billion – leaving critical public health programs at risk of deeper cuts.

APHA sent a letter to all members of the House urging them to oppose the bill. The bill is not expected to be taken up by the Senate.

House defunds Census Bureau's American Community Survey

On May 9, by a vote of 232-190, the House passed an amendment by Rep. Daniel Webster, R-Fla., to the fiscal year 2013 Commerce, Justice, Science and Related Agencies Appropriations bill that would prohibit any funds from being spent to conduct the Census Bureau’s American Community Survey, or ACS. The ACS is the only source of objective, consistent and comprehensive information about the nation’s social, economic and demographic characteristics down to the neighborhood level. The high-quality, objective and universal ACS data is used by decision makers at the local, state and federal levels to determine the number of uninsured Americans, people living with disabilities and the level of poverty down to the community level. The federal government uses this geographic-specific data to inform decisions when allocating funding, for programs from housing assistance to public health, to state and local governments.

APHA and hundreds of national, state and local organizations sent a letter to Senate leadership urging them to reject the House proposal. It is unclear as to whether the proposal will be considered in the U.S. Senate where Sen. Rand Paul, R-Ky., has introduced legislation that would make the ACS voluntary.

Senate introduces bill to close tobacco tax loopholes

On May 10, Sen. Dick Durbin, D-Ill., introduced S. 3081, the Tobacco Tax Equity Act of 2012, along with Sen. Frank Lautenberg, D-N.J., and Sen. Richard Blumenthal, D-Conn. APHA strongly supports this legislation that would close tax code loopholes for tobacco products and eliminate tax inequities by setting the federal tax rate for tobacco products such as snuff, chewing tobacco, smokeless tobacco, large cigars and certain processed tobacco at the same level as the federal tax on cigarettes. The bill would also generate federal revenue and accelerate our efforts to reduce tobacco use by helping Americans stop smoking and preventing young people from starting to smoke.

APHA sent a letter to the senators commending their leadership on this critical public health effort. Additionally, APHA and other tobacco prevention organizations, including Campaign for Tobacco-Free Kids, American Cancer Society Cancer Action Network, American Heart Association and American Lung Association released a press statement applauding the senators for taking action to close the tax loopholes, reduce tobacco consumption and save lives.

Registration open for APHA’s Midyear Meeting

Registration is open for APHA’s Midyear Meeting, “The New Public Health — Rewiring for the Future,” to be held June 26-28 in Charlotte, N.C. The meeting will discuss the opportunities and challenges in today’s public health system, and how to keep up with and anticipate changes to public health infrastructure. Topics discussed at the Midyear Meeting will include innovative programs, workforce development, health information technology, new funding strategies, public health messaging, integration with primary care and partnership opportunities. More information is available at www.apha.org/midyear.

Updates from the states

Massachusetts Senate passes first-in-nation health care cost-cutting bill

The Massachusetts Senate passed a landmark health care reform bill that would save the state $150 billion over the next 15 years while improving access and quality of care, and increasing the transparency and accountability of the state’s entire health care system. The bill would transform the health care industry without harming the number one employment sector in Massachusetts by supporting health care professionals in developing innovative payment and care delivery models, and establishing tools to help providers meet the targets in the bill through market-based solutions. Additionally, the bill would provide $100 million over the next 5 years to support several wellness initiatives that focus on community-based prevention, public health and wellness efforts, and expand on existing wellness programs for small businesses in order to address the escalating health care costs associated with preventable forms of chronic diseases.

Texas limits free vaccinations to schoolchildren

A change in the rules on free childhood vaccinations will have a major impact on eligibility and availability of doses. The Texas Vaccines for Children Fund provided 7.4 million free doses of vaccines between October 2010 and September 2011. Under the new rule and due to cuts to federal and state funds, the state estimates a reduction of 500,000 free doses this year. Whereas previously all children could receive vaccinations at free clinics — now most with health insurance will be turned away. Even though schools require as many as seven vaccinations for admission, most insured students will be forced to schedule appointments with outside providers that require out-of-pocket expenses. Officials worry that this policy change will confuse parents who are unfamiliar with their eligibility and insurance coverage. Additionally, local providers may likely become overwhelmed with the new demand. The confusion and inability to accommodate all students before the start of school could result in missed school days.

Florida gets involved in preventing Alzheimer’s disease

Florida will take part in the recently announced National Plan to Address Alzheimer’s Disease that aims to improve treatment and prevent Alzheimer’s by 2025. The University of South Florida Health Byrd Alzheimer’s Institute will conduct a major clinical trial testing the hypothesis that a shortage of insulin in the brain contributes to the deterioration and that boosting insulin levels with a nasal-spray will stem this deterioration. Additionally, efforts will go toward Alzheimer’s care and public awareness through education programs and providing reliable information and resources. Alzheimer’s affects more than 5 million Americans, and that number could more than double in the next few decades. The disease costs the nation as much as cancer or heart disease. This investment marks a step forward in treating and preventing a debilitating disease that impacts the well-being of millions of Americans along with our nation’s fiscal well-being.

California turns to improving community health

Research continues to highlight the connection between where you live, lifespan and quality of life. Healthycal.org recently reported that stress and violence can alter a child’s DNA. The poorest counties in California have the worst health and conversely, the richest generally have the best. The Jackson Triangle neighborhood in the city of Hayward in Alameda County received a “Promise Grant” as part of a program intended to improve the life chances of the residents in the neighborhood, which has been identified as a high-crime, low-income area. Currently, 17.3 percent of households in the Jackson Triangle are in poverty, unemployment is widespread and teen pregnancy is significantly higher — all contributing to mental health problems. The grant will provide $25 million over five years to target quality education, health, safety and stability.

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