Reflecting and Looking Ahead: Federal Health Policy in 2019 and Beyond

December 18, 2019|1:07 p.m.| Carolyn Mullen | ASTHO Chief of Government Affairs and Public Relations

As we rolled into 2019 we saw the dawn of a new Congress: Elected officials were sworn in and pledged to uphold the constitution, all while the U.S experienced one of the longest partial federal government shutdowns in modern history. And yet, this was just the beginning of highs and lows throughout the year. As 2019 comes to a close, it is important to reflect back on the numerous public health accomplishments and acknowledge the ongoing challenges we’ll face in 2020.

The Wins and the Challenges
While Congress debated about how to reopen the federal government—which happened in late-January--ASTHO began our efforts to build a strong relationship with new and former Congressional offices. A welcome letter sent to Congressional offices that highlighted our state and territorial public health priorities got a 95 percent open rate--and this set in motion a year filled with hearings, thought leader discussions, and meetings to bolster our advocacy efforts.

The threat of sequestration or automatic spending cuts to all discretionary programs hung over Washington, D.C. like a dark cloud. Led by the Coalition for Health Funding and NDDUnited, the entire community rallied around messaging that emphasized what decreased funding would mean for populations and encouraged Congress to #raisethecaps. State and territorial health officials carried this message and conducted more than 70 meetings with Congress during our annual advocacy day in March. To our delight, a breakthrough occurred in the early summer when Congress approved legislation to end sequestration permanently and increased overall discretionary funding in the fiscal year 2020 and 2021.

If you blinked you might have missed it, but in June President Trump signed the Pandemic and All-Hazards Preparedness and Advancing Innovation Act (PAHPAI), S. 1379, into law. This comprehensive law reauthorizes programs to improve preparedness and responses, bolsters the emergency response workforce, and strengthens the National Health Security Strategy. This legislative victory was a top tier item for ASTHO and we were thrilled to see so many of our priorities included in the bill--this included reauthorization of the Public Health Emergency Preparedness (PHEP) program and Hospital Preparedness Program (HPP), and codified the role of CDC in administrating the PHEP program.

ASTHO also prepped 10 state and territorial health officials to testify before the House and Senate this year. This is no small feat-- it requires teams working between ASTHO, governors’ offices, and the health officials state staff. These hearings provided a public forum for health officials to discuss a range of topics including but not limited to: The opioid epidemic, the territorial Medicaid funding cliff, immunizations, public health funding, and the youth vaping epidemic. As a result of these efforts--and those by the broader public health advocacy community--Congress provided a significant increase in federal funding for public health, increased the federal age to purchase tobacco products from 18 to 21, and secured a two-year extension of Medicaid funding for the US territories in December. ASTHO’s recent legislative alert summarizes these end of the year accomplishments.

Looking Ahead
2020 will kick off with an impeachment trial in the Senate and the election cycle will move into high gear. We anticipate that both efforts will stall a lot of legislative activity in Congress and the prospects of a long-term continuing resolution or level funding for the start of fiscal year 2021 is very high. However, the House will hold oversight hearings in early January to investigate how the recent federal funds to combat the opioid epidemic are being used—it will also address the ongoing challenges and progress in combating this epidemic. Media reports also indicate that Congress would like to address surprise medical billing and prescription drug pricing.

ASTHO will continue our advocacy that’s guided by our annual federal legislative agenda. This legislative agenda is critical, and enables our team to strategically allocate resources and time to our members’ priorities--it also allows us to both be proactive and to also say “no” to non-priority items. We’ll have our annual advocacy day in late February this year and we will be calling upon state and territorial health officials, alumni, partners, and advocates to once again encourage Congress and the Trump administration to make policy changes that bring optimal health to all.

Advocacy is not accomplished through one single voice shouting into the void with the hopes that Congress will listen. Rather it is done with a chorus of dedicated public health advocates singing loud with one clear message: “Prioritize public health so we can protect and promote the health of the entire population.” Throughout the year the public health community met with hundreds of offices, testified at numerous hearings, spoke to the media, sent letters, emails, tweets, and more. It is through that tenacity that we accomplished so much together, and those successes belong to us.