The Honorable John Boehner, Speaker of the House, U.S. House of Representatives
The Honorable Nancy Pelosi, Democratic Leader, U.S. House of Representatives
The Honorable Tom Price, Chairman, Budget Committee
The Honorable Chris Van Hollen, Ranking Member, Budget Committee

October 8, 2015

Dear Speaker Boehner, Leader Pelosi, Chairman Price and Ranking Member Van Hollen:

On behalf of Healthcare Ready, a non-profit organization and public-private partnership dedicated to improving public health preparedness from the community to the national level, I’m writing to voice our strong opposition to the reconciliation legislation, which repeals key sections of the Affordable Care Act (ACA). Versions of budget reconciliation legislation produced by the House Energy and Commerce, Ways and Means, and Education and Workforce Committees include a repeal of critically important provisions of the ACA, including the Prevention and Public Health Fund (the Prevention Fund). On this basis alone, we urge you to oppose passage of this proposal – which would eliminate $15.5 billion in future funding  (FY16-FY25) for critical public health and prevention activities. In the first six years since its inception, the Prevention Fund has invested nearly $5.25 billion in resources to states, communities, tribal and community organizations in support of community-based prevention, including tobacco use prevention, healthy eating and active living, as well as childhood immunizations and clinical prevention.

Our organization exists because the immediate response after Hurricane Katrina highlighted the preparedness gaps that existed in our domestic infrastructure.   We aim to ensure that what happened during and after Katrina never happens again.  A key element to this is the creation of a strong, resilient healthcare system.  We believe that a bolstered health system will be able to withstand natural and man-made disasters.  We focus on building communities’ crisis response capabilities by identifying and working to solve critical issues before and during events, bridging response organizations and private sector partners, and serving as a trusted resource for information sharing, coordination, and expertise during disasters.  We believe that communities are central to resilience planning and therefore work to amplify their voice in key discussions to ensure all residents have continuous access to continuous healthcare delivery.

Decimating the Prevention Fund would dramatically impede efforts underway to improve the healthcare system, including:

• Expanding Access to Cancer Screenings: In FY 2015, the Fund provided $104 million for the National Breast and Cervical Cancer Early Detection Program, which is helping states across the country provide cancer screenings to high risk women who are uninsured or

• Funding for the Section 317 childhood immunization program, which has been vital to preventing and responding to measles outbreaks, and increasing epidemiology and laboratory capacity in all states, which are key to preventing and containing infectious disease

• The Section 317 Immunization Program aims to achieve and sustain high vaccination coverage rates among children and adults to prevent death and disability Section 317 funds are used not only to purchase vaccines for those in need, but to also provide critical support for the people and systems that make national and state immunization programs work, including surveillance of vaccine-preventable diseases, outbreak response, immunization information systems, and vaccine safety monitoring. Section 317 funding also supports the operations of the federal Vaccines for Children (VFC) program as well as state initiatives to increase vaccine uptake. This infrastructure is critical for the delivery of immunization services, and as more individuals have access to vaccines through health insurance coverage.

• Furthermore, Section 317 funding is critically needed in order to achieve national immunization coverage goals; assure equitable access; target populations at-risk; and monitor the coverage, effectiveness, and safety of vaccines.

These are just a few examples of the initiatives designed to improve public health underway that the Prevention Fund makes possible.

Massively reducing the Fund would set public health back by a decade slashing life-saving investments in every state that are desperately needed. An approach to deficit reconciliation that cuts prevention may in fact have the opposite effect – less prevention of illness and disease and increased future health care spending.

It is important to note that over 900 state and national organizations have pledged their support for the Fund, including the American Medical Association (AMA), which has spoken out multiple times in opposition to using the Fund for purposes other than preventing disease and promoting health. In November 2012, the AMA House of Delegates adopted a resolution to “actively oppose policies that aim to cut, divert, or use as an offset, dollars form the Prevention and Public Health Fund for purposes other than those stipulated in the Affordable Care Act.” In a June 2013 letter, the AMA again stated that, “We think it is critical that the funds allocated to the Prevention Fund remain focused on prevention and not be diverted to other purposes.” We strongly urge you to oppose the Energy and Commerce Reconciliation Instructions and any measure which would repeal or reduce funding for the Prevention and Public Health Fund.  Thank you for your consideration.

Sincerely,

Emily Lord, Executive Director of Healthcare Ready