August 2012

I. House FY 2013 funding bill contains deep cuts to public health
II. House and Senate leaders announce six-month continuing resolution
III. House committee passes farm bill reauthorization; cuts food stamps
IV. House votes again to repeal the Affordable Care Act
V. House passes regulatory reform bill
VI. ‘Ending the HIV/AIDS epidemic’ bill introduced in House
VII. Senate introduces Medicare Diabetes Prevention Act
VIII. Action to avert sequestration
IX. CDC releases updated guidance on anti-lobbying restrictions for grantees
X. APHA Public Health Action Campaign in full swing
XI. Registration open for APHA’s Annual Meeting
XII. Updates from the states


House FY 2013 funding bill contains deep cuts to public health

On July 18, the House Appropriations Subcommittee on Labor, Health and Human Services, Education and Related Agencies passed its version of the FY 2013 Labor-HHS-Education Appropriations bill which contains significant cuts in public health funding, rescinds the Prevention and Public Health Fund, blocks funding for implementing much of the Affordable Care Act and includes a number of troubling anti-public health legislative riders which will harm the health of all Americans and increase the cost of health care. APHA strongly opposed the bill and sent a letter to all members of the subcommittee urging them to vote against the bill.

Unlike the bill passed by the Senate Appropriations Committee, which contains modest increases to key public health programs and fully allocates the $1 billion available in 2013 through the Prevention and Public Health Fund, the House bill rescinds the entire Prevention and Public Health Fund, reducing total resources for the Centers for Disease Control and Prevention by 11 percent below current levels. The draft bill also proposes significant reductions to other important agencies, including the Health Resources and Services Administration and the Substance Abuse and Mental Health Services Administration. In addition, the draft bill would completely eliminate funding for the Agency for Healthcare Research and Quality and the Title X Family Planning program.

House and Senate leaders announce six-month continuing resolution

On July 31, Senate Majority Leader Harry Reid, D-Nev. and House Speaker John Boehner, R-Ohio, announced an agreement on a six-month continuing resolution that would keep the federal government operating at current levels through March 31. House Democratic Leader Nancy Pelosi, D-Calif., called the move a good start but cautioned that the details of the agreement must still be worked out. The move would avoid a potential showdown over federal spending leading up to the September 30 end of the 2012 fiscal year and the November elections. Once the details of the agreement are finalized, the House and Senate will each have to vote on the spending bill extension when they return from the summer congressional recess in early September. Congress will have its hands full after the November elections when they must try to address several other contentious issues including the pending sequester (across-the-board cuts of 8 to 10 percent to defense and nondefense discretionary programs set to kick in on Jan. 2), a 27 percent payment cut to Medicare providers scheduled to kick in on Jan. 1 as well as the expiration of Bush administration-era tax cuts.

While we wait on the final details of the proposed six-month continuing resolution, it is critical that advocates continue to contact their members of Congress in support of strong funding for public health agencies and programs because Congress will have to finalize an FY 2013 spending bill when the proposed continuing resolution expires at the end of March.

House committee passes farm bill reauthorization; cuts food stamps

On July 12, the House Agriculture Committee passed its version of legislation to reauthorize the federal farm bill for the next five years. APHA released a statement shortly after the bill passed expressing its strong opposition to the more than $16 billion in cuts to the Supplemental Nutrition Assistance Program over the next 10 years contained in the draft bill. It is estimated that the House bill could deny 2 million to 3 million people access to the SNAP program and several hundred thousand low-income children access to no-cost school meals. Timing for the bill to come to the full House for a vote is unclear. Recent plans in the House to bring a shorter one-year extension of the current farm bill tied to assistance for ranchers who have been impacted by the ongoing drought were abandoned when it looked like House leaders did not have the votes to pass the measure.

The Senate version of the farm bill was passed by the full Senate on June 21 by a vote of 64-35. The Senate bill would cut the SNAP program by much less than the House bill, about $4.5 billion over the next 10 years.

House votes again to repeal the Affordable Care Act

On July 11, the U.S. House of Representatives voted once again to repeal the Affordable Care Act in its entirety. The legislation passed on a mostly party-line vote of 244-185. APHA sent a letter to all members of the House urging them to vote against the bill. The vote marked the 33rd time the House has voted to repeal, defund or block some portion of the ACA. In a statement released prior to the vote, APHA Executive Director Dr. Georges Benjamin said that efforts to repeal the law are “distracting and do nothing to reduce rates of chronic disease, increase productivity and control costs within the health system.” Benjamin went on to say that instead of voting yet again to repeal the law, Congress should instead spend its time “working to ensure the law reaches its full potential.”

In an effort to better educate public health advocates and the general public about the important provisions within the ACA as well as the implications of the recent Supreme Court decision upholding most of the law, APHA has developed a number of new fact sheets and issue briefs to explain key provision in the law. Most recently APHA, in conjunction with the National Health Law Program and the Network for Public Health Law released a new in-depth analysis of the Supreme Court’s ruling and its impact on the Medicaid expansion provision in the ACA. In addition, you can download the Nation’s Health’s special section on the Supreme Court’s Affordable Care Act decision.

House passes regulatory reform bill

On July 25, the U.S. House of Representatives passed legislation that contained a number of anti-regulatory bills by a vote of 245-172. The bill, known as the Red Tape Reduction and Small Business Job Creation Act, would prevent the development or issuance of most significant public health and safety regulations until the unemployment rate is below 6 percent. Instead of creating jobs, this legislation would block critical public health protections, endangering the health and safety of all Americans.

In a letter to the full House, APHA expressed its opposition to the bill and the impact the legislation would have on important public health laws. APHA highlighted that the legislation would delay the yet-to-be-released final regulations under the Food Safety Modernization Act that would improve the safety oversight of domestic produce and processed foods, as well as imported food products. The letter also highlighted the impact the legislation would have on protecting public health through the Clean Air Act by delaying rules to update and strengthen critical health standards to protect the public from fine particle (soot) pollution. The legislation is unlikely to be taken up by the U.S. Senate.

Ending the HIV/AIDS epidemic bill introduced in House

On July 18, Rep. Barbara Lee, D-Calif., along with 34 co-sponsors, introduced H.R. 6138, the Ending the HIV/Aids Epidemic Act of 2012, which would provide a policy and financing framework to put a stop to the spread of HIV/AIDS in the United State and around the world. APHA supports this legislation, which would end stigma and discrimination that inhibits access to health services; repeal and reform outdated and misguided laws that violate human rights and limit the positive impact of resources; and maximize coordinated efforts to drive greater efficiency and improve results. More specifically, the bill would enhance the national HIV surveillance system, identify evidence-based strategies for improving linkage to and retention in appropriate care, expand support for services to reduce HIV infections among injection drug users and expand comprehensive sexual health education programs.

Senate introduces Medicare Diabetes Prevention Act

On July 31, Sen. Al Franken, D-Minn., joined by seven co-sponsors including Sens. Lugar, R-Ind. and Rockefeller, D-W.Va., introduced S. 3463, the Medicare Diabetes Prevention Act of 2012. APHA strongly supports this effort to decrease the rate of diabetes and improve the health of seniors through community-based preventive health measures. The Diabetes Prevention Program has demonstrated significant reductions in the incidence of diabetes and has proven highly cost-effective. This bill would ensure coverage of this program under Medicare, offering beneficiaries increased access to the Diabetes Prevention Program. Including Diabetes Prevention Program as a covered benefit for people on Medicare who are at high risk for diabetes will provide an additional tool to help shift our health system from one that focuses on treating the sick to one that focuses on keeping people healthy. It will allow seniors to live stronger and longer and save billions of dollars in health care costs.

APHA sent a letter thanking Franken for his leadership on this critical public health effort.

Action to avert sequestration

APHA along with other organizations that would be impacted by the cuts to nondefense discretionary programs under sequestration are taking action to urge Congress to reject the pending cuts and to instead develop a balanced approach to deficit reduction. On July 25, APHA joined the Coalition for Health Funding and hundreds of other advocates from the nondefense discretionary community for a rally on Capitol Hill to show strong support for public health and other nondefense discretionary programs. Additionally, nearly 3,000 national, state, and local organizations from all 50 states delivered an unprecedented, cross-community letter of support for nondefense discretionary programs to Congress, urging the leaders to avert sequestration by finding a balanced approach.

In 2011, Congress passed the Budget Control Act which established caps on defense and nondefense discretionary programs such as public health, environmental protection, law enforcement, transportation, etc., that will reduce this funding by $1 trillion over 10 years. The BCA also created the Joint Select Committee on Deficit Reduction, better known as the “supercommittee,” to come up with a plan to reduce the deficit by another $1.2 trillion over the same decade. In the event the supercommittee failed to come up with a viable plan, the BCA established “sequestration” as an incentive to force bipartisan compromise. Sequestration is a rigid budgetary tool that will force automatic, across-the-board cuts of another $1 trillion to nearly all government programs, including public health. Since the supercommittee failed to produce an agreement, sequestration is scheduled to begin on Jan. 2.

Senate Labor-HHS-Education Appropriations Subcommittee Chairman Tom Harkin, D-Iowa, released a report providing detailed, state-level analysis of sequestration’s effects on dozens of education, health and labor programs under his committee’s jurisdiction. For more information about how the pending sequestration will impact critical public health programs, read APHA’s Sequestration FAQ.

CDC releases updated guidance on anti-lobbying restrictions for grantees

In late July, the Centers for Disease Control and Prevention released its updated anti-lobbying restrictions guidance for CDC grantees. The new guidance is in response to expanded anti-lobbying language that was included in the FY 2012 Consolidated Appropriations Act. The full updated guidance is available on the CDC website as well as APHA’s advocacy website. Grantees are encouraged to contact their CDC project officer with any additional questions regarding the guidance.

APHA Public Health Action Campaign in full swing

In May, APHA launched its annual Public Health Action (PHACT) Campaign to mobilize its members, affiliates and other advocates to educate their members of Congress on important public health issues that help to build and maintain healthy communities. The August congressional recess presents the perfect opportunity to take action and support public health. While members of Congress are at home in their states and districts during August congressional recess (Aug.4-Sept.9), we are asking APHA members and affiliates to reach out to their congressional delegation to express support for increasing critical funding for public health agencies and protecting the Prevention and Public Health Fund. Several APHA affiliates are already under way with their planned activities.

The PHACT Campaign toolkit offers sample questions for town hall meetings, sample emails and scripts for sending messages to, or calling, congressional offices, tips for setting up meetings with congressional district staff and tips for using social media to publicize advocacy activities. Advocates can also send messages to their members of Congress expressing the importance of public health funding. The PHACT website will be updated throughout the summer with a list of town hall meetings in your community, information on public health funding and other helpful resources to use in advocacy efforts. APHA is also requesting that advocates and APHA affiliates share success stories about why public health funding is important to their community or state. Email us at phact@apha.org with any questions.

Registration open for APHA Annual Meeting

Registration is open for APHA’s 140th Annual Meeting and Exposition, “Prevention and Wellness Across the Life Span,” to be held Oct. 27-31 in San Francisco. The meeting will present an opportunity to discuss the impact prevention and wellness have on health, both physical and mental, at all ages. Register by Aug. 16 to receive special savings. Visit APHA’s website for more information.

Updates from the states

Oregon improving the health of people with disabilities

Oregon was one of 18 states to receive grants funded by the Centers for Disease Control and Prevention to focus on prevention of secondary disability. According to CDC reports, 1 in 5 adults in the U.S. lives with a disability. People with disabilities are four times more likely to report fair or poor health and two-and-a-half times more likely than their peers without disabilities to report unmet health needs. The grant will require states to demonstrate that people with disabilities are included in preventive screenings and state-based emergency plans. Oregon initiatives include: providing emergency training specifically for people with disabilities, improving access to mammograms for women with disabilities and preventing secondary disabilities, such as chronic conditions. Already, the state has provided healthy lifestyle classes on how to live with a disability. Prevention efforts will be aimed to help people with disabilities become more physically active and educate the individual and health care providers about risks associated with the particular disability.

California governor signs two bills into law to protect seniors

This month, two bills were signed into law by Governor Jerry Brown, D-Calif. to protect the safety and rights of senior residents. The first bill, A.B. 1793, enables counties to access federal funds during state emergencies and incorporates nursing home facilities into emergency response plans in the event of a natural disaster.

The second bill, A.B. 1823, ensures that veterans receive clear notification of the costs of care. Currently, seniors living in veteran’s homes receive quarterly reports of costs. However, these reports often mislead veterans and families because they are not bills requiring payment. Families of veterans often dismiss the reports and then are surprised to receive a large bill for costs of care after the veteran dies. California’s new law will provide clear and transparent reminders to veterans and their families, and it will ensure costs of care are understood to mitigate potential financial problems.

Both laws will go into effect on Jan. 1.
  

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