Getting to Work: ASTHO’s Federal Policy Priorities in 2020

January 15, 2020 | ASTHO Staff

The band U2 once said, “nothing changes on New Year’s Day.” That may be the case for some, but at ASTHO there are a few important things that begin anew as the year clicks over—namely, the effort to implement our 2020 Federal Legislative Agenda. This agenda is a trusted map for ASTHO’s government affairs team, as it keeps us on track and in line with our members’ priorities. Each year, in close partnership with the ASTHO Government Relations Committee and Board of Directors, we prioritize our advocacy activities by three tiers. The programs and issues that we will lead on are considered tier one, issues we’ll partner to support are tier two, and issues we’ll continue to monitor are tier three.

Those areas we’re planning to lead federal advocacy initiatives on—otherwise known as tier one priorities—are:

• The Public Health Emergency Preparedness cooperative agreement at the Centers for Disease Control and Prevention (CDC).
• The Hospital Preparedness Program run by the Assistant Secretary for Preparedness and Response.
• Ebola treatment centers.
• Programs funded via the prevention and public health fund.
• The Preventive Health and Health Services Block Grant.
• Continued support for territories.

On the heels of a very successful year in advocacy and a looming presidential election, ASTHO anticipates that many of our tier one priorities will not be addressed until 2021. Congress is expected to approve a continuing resolution through February 2021, level-funding many public health programs and punting any major decisions until after the election. However, ASTHO cannot sit back and wait. We must advocate with our members and partners during our upcoming Hill Day and encourage Congress to prioritize funding for public health programs—it provides the backdrop that will influence policy decisions in 2021.

Priorities in our tier two are those where ASTHO’s partners and affiliated organizations lead the way. We, in turn, take the role of a partner by providing support in bringing its voice to the table, participating actively in advocacy coalition efforts, and providing our members’ input on federal public health legislation and funding decisions. We expect there will be a ramping up of tier two activities because of the funding in the fiscal year 2020 appropriations bills. Here are some of the areas where we expect we’ll partner on:

• “Ending the HIV Epidemic,” a 10-year goal from the Trump administration to end the epidemic once and for all.
• Data sharing and modernization initiatives, which received an injection of support from Congress for fiscal year 2020. States should expect a dynamic year in this space and ASTHO will work with our members to ensure smooth implementation.
• Tobacco policy overall will remain a hot topic in 2020. The U.S. Food and Drug Administration banned sales to those under age 21 in December, and there’s movement to limit the availability of flavored products and regulate marketing tactics and packaging. The situation is complex—federal laws and regulations fluctuate quickly, as do state responses to youth vaping and the new E-cigarette or Vaping Product Use-Associated Lung Injury (EVALI).
• The Lower Health Care Costs Act remains outstanding from the first congressional session and includes sections to improve maternal morbidity and mortality as well as vaccine uptake—both are tier two priorities for ASTHO.

Finally, tier three priorities are those issues that ASTHO will report on, monitor, and provide advocacy support on if time and resources allow. For example, ASTHO might join letters of support to help promote a specific topic area or provide a written update to our members. We expect our tier three priority areas will include:

• Special Supplemental Nutrition Program for Women, Infants, and Children.
• Housing and Urban Development.
• Environmental Protection Agency.
• Monitoring an abundance of proposed regulations and legislative action related to Perfluorooctanoic acid (PFOA) and Perfluorooctanesulfonic acid (PFOS).
• Ongoing changes in the Title X program. As states work to meet the deadlines by the HHS Office of Population Affairs for the changes in the Title X program, legal challenges continue to work their way through the courts that could disrupt state implementation of new rules.

Sorting issues into these priority tiers allows ASTHO the ability to travel through an incredibly complex environment, one that could easily bog down an organization with limited resources or dilute its voice in a chorus of many appealing for the ear of decision-makers. But there are always adjustments to made. Unexpected currents that might require a course correction are always possible. After all, public health is not a stagnant field.

If all this weren’t enough, the 2020 Census is upon us. States are leading efforts to make it a reality in partnership with the federal government, but are also impacted by the results through funding and Congressional representation in Washington, D.C.

We are grateful for the input and guidance from our members as well as the ASTHO staff for the creation and implementation of its federal legislative priorities. When it comes to optimal health for all we must maintain a focus on the priorities included in this legislative agenda—it’s ASTHO’s hope that it helps our members in their work toward that worthy purpose.