Historic Health Reform Legislation Becomes Law
On March 21, the House of Representatives passed the Patient Protection and Affordable Care Act, which was signed by the President on March 23. The Senate passed the Act on Dec. 24, 2009.
The landmark health reform legislation makes significant investments in population-based prevention activities and recognizes the unique role played by public health departments while expanding access to affordable care for millions of individuals and families.
Little-noticed in the debates that have focused on health insurance reforms is the creation of a novel federal funding mechanism for prevention, wellness and public health activities, called the Prevention and Public Health Fund, as well as language that establishes new programs for population-based chronic disease prevention and public health workforce development, among other programs.
The Prevention and Public Health Fund provides $15 billion over ten years, starting with $500 million in FY10 and ramping up to $2 billion in FY15 and each year thereafter. More information is available below and at NACCHO’s health reform Web page.
For the first time, this legislation promises an ongoing national investment in prevention and public health system improvement, as well as a potential for new roles for the governmental public health system as reforms in the healthcare and health insurance systems evolve.
The efforts of NACCHO members from across the United States in advocacy on health reform over the past year have succeeded. Once this legislation is signed into law, NACCHO will monitor its implementation and communicate with NACCHO members when your input is needed.
Public Health Funding in Final Health Reform Bill
| Public health investment | Establishes a Prevention and Public Health Fund to provide for national investment in prevention and public health programs. Administered by HHS Secretary. | $15 billion/10 years, beginning with $500 million in FY10, ramping up to $2 billion/year in FY15 and thereafter |
| Community-based prevention | Community Transformation Grants: Competitive grants to state and local governmental agencies and community-based organizations to reduce chronic disease rates, address health disparities, and develop a stronger evidence-base of effective prevention programming. 20 percent of the grants are targeted to rural and frontier areas. Prevention and Public Health Fund resources may be used. | Not specified |
| Public health workforce | Public Health Workforce Recruitment and Retention Programs Establishes a public health workforce loan repayment program, allied health workforce recruitment and retention programs, and training for mid-career public health professionals. | Authorizes $195 million/year for loan repayment, $30 million/year each for allied health and mid-career programs. |
| Epidemiology and lab capacity grant program | Grants to state, local, and tribal health departments to improve surveillance and response with respect to infectious diseases and other conditions of public health importance. | $190 million/year, FY10–FY13 |
| Home visitation | Grantees of this state grant program for evidence-based early childhood home visitation will measure improvement in maternal and child health, childhood injury prevention, school readiness, juvenile delinquency, family economic factors, and coordination with community resources. | $3 billion over 5 years |
| Health disparities/ data collection | Requires the collection and reporting of data on race and ethnicity, gender, geographic location, socioeconomic status (including education, employment or income), primary language, and, disability status, data at the smallest geographic level such as state, local, or institutional levels if such data can be aggregated; data by racial and ethnic subgroups. | N/A |
