Sequestration

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Sequestration Fact Page

Sequestration Fact Page

Scheduled Funding Cuts Jeopardize Our Public Health

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(March 4, 2013) Legislative Alert: Federal Sequester Takes Effect

On Friday, as defined by law, President Obama signed the order that puts in place the across-the-board spending cuts more commonly known as sequestration. The $85 billion worth of immediate cuts to the federal government, initially delayed by the American Taxpayer Relief Act of 2012, will now proceed.

The Office of Management and Budget (OMB) sent the heads of federal departments and agencies a memorandum informing them that the president signed the order and that "agencies shall apply the same percentage reductions to all programs, projects, and activities within a budget account." The order is accompanied by a report from OMB to House Speaker John Boehner (R-OH) "that provides calculations of the amounts and percentages by which various budgetary resources are required to be reduced, and a listing of the reductions required for each non-exempt budget account."

U.S. Department of Health and Human Services operating division figures are listed beginning on page 24 of the OMB report, but details on grant-by-grant reductions are not available. The percentage reduction applied to nondefense discretionary funding is 5 percent; however, OMB states that "because these cuts must be achieved over only seven months instead of 12, the effective percentage reductions will be approximately 13 percent for non-exempt defense programs and 9 percent for non-exempt nondefense programs."

(Feb. 28, 2013) OMB memo sent to federal agencies regarding sequestration. Read more »

(Feb. 20, 2013): "Sequestration: Which States Are Most Vulnerable?" By Wells Fargo Securities LLC Economics Group. Read more »

(Feb. 8, 2013): "Fact Sheet: Examples of How the Sequester Would Impact Middle Class Families, Jobs and Economic Security;" issued by The White House. Read more »  

(Feb. 8, 2013): Newly released: "Discretionary Appropriations Will Reach Historic Lows Under Existing Law;" a report by the House Appropriations Committee Democrats. Read more »

(Jan. 22, 2013): Automatic budget cuts — known as sequestration — had been scheduled for Jan. 2, but the so-called “fiscal cliff” budget deal postponed them until March 1. Here is a chart describing what will happen if sequestration takes effect as scheduled. Read more »

(Jan. 15, 2013): OMB Memo to Federal Agency Heads: Planning for Budgetary Uncertainty Due to Sequestration and FY 2013 Appropriations Delays

On Jan. 14, the White House Office of Management and Budget (OMB) sent a memo to the heads of executive departments and agencies about planning for a number of FY 2013 budgetary uncertainties, including sequestration and delayed final FY 2013 appropriations. The memo states that, should Congress fail to amend current law, the president is required to issue a sequestration order on March 1, canceling roughly $85 billion in budgetary resources across the federal government, which will mean significant and harmful impacts on government services and operations. OMB includes a number of guiding principles for agencies to follow, including: identifying appropriate means to reduce civilian workforce where necessary through hiring freezes, not renewing term or contract hires, authorizing separation incentives and early retirements, or implementing administrative furloughs; reviewing grants and contracts to achieve cost savings; and taking advantage of funding flexibilities, such as reprogramming and transfer authorities. OMB may release additional guidance, as appropriate. As more information becomes available, ASTHO will keep members informed through the ASTHO website and the State Public Health Weekly newsletter.

(Jan. 2, 2013): Fiscal Cliff Bill Signed Into Law, Sequester Decision Delayed  Read More »

Background

The federal sequester originally scheduled for Jan. 2, 2013, would cut about $2.4 billion in funding to the major federal agencies concerned with public health in FY 2013, according to a recent ASTHO report, “Potential Impact of Sequestration on Public Health.” As a result of sequestration, the major federal public health agencies will have significantly reduced funds to devote to state health grants and programs, which could have severe implications for how effectively public health agencies can respond to emergencies.

Sequestration bar chartThe upcoming sequester will affect such critical public health programs as childhood and adult vaccination, disaster preparedness and recovery, maternal and child health, and foodborne outbreak prevention and investigation. After sequestration, funding for these and other programs will plummet to $26.5 billion.

Sequestration defined

Sequestration is a process whereby Congress schedules automatic budget cuts to federal government programs. It is one part of the fiscal cliff, which refers to the package of spending cuts and expiring tax breaks that will take effect in January 2013. The sequester was included as a budget reduction enforcement mechanism in the Budget Control Act of 2011. Sequestration will occur unless Congress passes legislation to postpone it or finds other ways to reduce the federal deficit.

Severe consequences for health programs

For state health agencies, which already have limited funding, losing federal grants and other forms of support will compound the challenges they already face when responding to public health crises. Forty-eight state and territorial health agencies report budget cuts since 2008, and more than 45,000 state and local public health jobs have been lost. At the federal level, public health funding has declined from $31.4 billion in 2010 to $28.9 billion in 2012.

     "The net effect of additional budget cuts to state and local public health agencies equates to the devastation of vital public health programs,” says ASTHO Executive Director Paul Jarris. “Sequestration’s cuts will put the public at greater risk for infectious disease outbreaks, foodborne illnesses, and life-threatening infections from routine hospital stays. Health departments must be kept whole to ensure that all Americans are safe."

Fast Facts on Sequestration’s Impact on Public Health

CDC funding holds together a fragile nationwide network of front-line public health responders; sequester would make all Americans less safe, increase preventable illness, and increase healthcare costs. Virtually every state and community in the United States would be at higher public health risk from natural or terrorist threats, and the ability to stop deadly outbreaks would be undermined…The time it takes to deliver medical countermeasures after an attack or natural disaster will increase.
– The Coalition for Health Funding

More than 750,000 mothers and infants will be cut from WIC.
– Friends of Maternal and Child Health and the Association of Maternal & Child Health Programs

The time to identify and appropriately treat victims of a chemical attack would double from five days to up to two weeks, increasing suffering and death, as support is eliminated for laboratories, which can diagnose and help doctors treat patients. The uncertainty resulting from this delay would have significant consequences in national security and economic stability.
– The Coalition for Health Funding

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Sequestration In the News

NPR. "For Native Americans, Mental Health Budget Cuts Hit Hard." Accessed on 9-13-13.

Government Executive. "Flu Shots Fall Victim to the Sequester." Accessed on 9-13-13.

MedPage Today. "Funding Cuts Hurt Disaster Readiness." Accessed on 8-19-13.

Public Health Newswire. "Saving public health during sequestration." Accessed on 6-3-13.

The Columbus Dispatch. "Federal cuts to Ohio’s public-health programs add up to $8.5 million." Accessed on 5-29-13.

Climate Science Watch. "Federal budget sequestration begins to undercut extreme event preparedness." Accessed on 5-20-13.

Reuters. "Budget cuts hit healthcare from flu watch to hospitals." Accessed on 5-9-13.

4-traders. "Sequestration cuts $200M from state & local health budgets." Accessed on 5-9-13.

ABC News. "Drills That Readied Boston Hospitals, EMS for Bombings Face Funding Cuts." Accessed on 4-26-13.

National Law Review. "CMS Issues Memorandum Detailing Effects of Sequestration on Survey & Certification." Accessed on 4-17-13.

NPR. "Sequester Scorecard: A Month Later, Effects Still Up In Air." Accessed on 4-8-13.

The Washington Post. "Cancer clinics are turning away thousands of Medicare patients. Blame the sequester." Accessed on 4-4-13.

Association of Public Health Laboratories. "The End of Sequestration: Not as Great as it Sounds." Accessed on 4-3-13.

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Other Resources on Sequestration’s Repercussions*

Center for American Progress. "10 Ways the Sequester Will Expose Americans to Greater Health Risks and Other Perils." Accessed on 2-22-13.

ASTHO. “Potential Impact of Sequestration on Public Health.” Accessed on 11-07-2012.

ASTHO. “State Health Departments Race to Respond to Meningitis Outbreak Despite Budget Cuts and Looming Sequester.” Accessed on 11-07-2012.

Sen. Tom Harkin, Chairman, Senate Appropriations Subcommittee on Labor, Health and Human Services, and Education, and Related Agencies. “Under Threat: Sequestration’s Impact on Nondefense Jobs and Services.” Accessed on 11-07-2012.

Bipartisan Policy Center. “Everything You Ever Wanted to Know About the Sequester.” Accessed on 11-19-2012.

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 * Inclusion on list does not mean endorsement of all views presented in documents.