Hawaii Could Lose More than $40 Million to Fight Health Epidemics over Five Years if the ACA and Prevention and Public Health Fund are Repealed

Washington, D.C., January 17, 2017 -- The state of Hawaii would lose at least $40,025,880 to counter health crises over the next 5 years if the Prevention and Public Health Fund (PPHF), part of the Affordable Care Act (ACA), were repealed, according to an analysis by the Trust for America's Health (TFAH). The U.S. Centers for Disease Control and Prevention (CDC) stands to lose 12 percent of its annual budget.

In total, states would end up losing more than $3 billion over the next five years - from grants and programs supported by the Prevention Fund.

"CDC is the world's leading public health authority and the front line against major threats to the health and well-being of the American people-such as disease outbreaks, prescription drug misuse and diabetes," said John Auerbach, President and CEO of TFAH. "Losing the Prevention Fund would result in diminished support for public health in every state, undermining their ability to fight epidemics and keep people safe. The costs of these vital public health efforts will either be passed along to states or the efforts will be eliminated-resulting in more people becoming sick and higher healthcare costs."

The $890 million gap in CDC's annual funding created by eliminating the Prevention Fund could not be filled under current laws without drawing funds away from other Department of Labor, Education and Health and Human Services programs. Among activities supported directly by the Prevention Fund are grants to states for infectious disease control, resources through the Preventive Health and Health Services Block Grant and other core public health programs which, if cut, would increase illness, injuries and preventable deaths.

If the Prevention Fund is eliminated, the impact will be felt at the local, state and federal levels as public health organizations respond to several major health crises that are on the rise, such as:

• Health Security Funds for Disease Outbreaks, Disasters and Bioterrorism: With the exception of the one-time-only funding for Ebola and Zika, Hawaii's core funding for preparedness and response to health emergencies have been cut by more than one-third in the past decade, with the state now only receiving $4,694,308 per year for these protections. CDC has responded to more than 750 health emergencies in the past two years. Infectious diseases cost the country more than $120 billion per year, and that cost grows exponentially when major new diseases strike.
• Prescription Painkiller and Heroin Use: Deaths from opioids dropped by 18 percent in Hawaii in the past 10 years. Nationally, more than 2 million Americans misuse prescription drugs, and nearly a half million are addicted to heroin, costing the country more than $55 billion a year in healthcare, workplace and criminal justice spending. CDC plays a critical role by providing support to states and healthcare providers to monitor and control the inappropriate prescribing of opioids.
• Obesity and Diabetes: 22.7 percent of adults in Hawaii are obese and 11.5 percent of children are overweight or obese. Nationally this contributes to more than $200 billion in direct health costs. One in three children could develop diabetes in their lifetime, and one in four are not healthy enough to serve in the military by the ages of 17 to 24.
• Declining Life Expectancy: Life expectancy in the United States has declined for the first time in two decades. While death rates are higher among Blacks and other people of color, death rates have increased the fastest (nationally, by 10 percent since 1999) among middle-aged White men and women (ages 45 to 54), whose death rates have increased by 31 percent in Hawaii since 1999. Increasing death rates among middle-aged Whites are the highest in West Virginia, Mississippi, Oklahoma, Tennessee, Kentucky, Alabama and Arkansas.

Hawaii: At-Risk for Immediate Losses Use of CDC Prevention Funds in the State Annually
Annual Prevention Fund Grants to States (based on FY 2016)	$8,005,176
Vaccines to Needy Children and Adults (based on FY 2015)	$170,208
Core State-Health Needs (identified by state department of health) (based on FY 2015)	$1,300,218
Infectious Disease Prevention and Healthcare-Associated Infections (based on FY 2015)	$603,666
Chronic Disease Prevention including diabetes, heart disease and stroke, and tobacco cessation (based on FY 2016)	$3,405,794

Amounts each state stands to lose over the next 5 years if the Prevention Fund was repealed (based on fiscal year 2016 grants to state) include:

State	Potential Five Year PPHF Loss, Based on FY 2016 Funding
Alabama	$44,867,115
Alaska	$22,312,985
Arizona	$46,840,075
Arkansas	$29,599,945
California	$307,768,530
Colorado	$44,671,845
Connecticut	$36,728,860
Delaware	$12,462,820
District of Columbia	$51,533,080
Florida	$101,864,250
Georgia	$100,421,755
Hawaii	$40,025,880
Idaho	$22,428,585
Illinois	$93,084,850
Indiana	$41,381,450
Iowa	$35,630,210
Kansas	$45,329,065
Kentucky	$40,687,570
Louisiana	$45,111,030
Maine	$27,588,000
Maryland	$84,876,045
Massachusetts	$88,112,505
Michigan	$110,739,075
Minnesota	$80,759,870
Mississippi	$31,276,855
Missouri	$53,853,865
Montana	$24,831,145
Nebraska	$47,957,625
Nevada	$19,174,580
New Hampshire	$24,967,020
New Jersey	$60,558,365
New Mexico	$43,257,135
New York	$207,587,230
North Carolina	$85,917,320
North Dakota	$14,975,550
Ohio	$114,951,125
Oklahoma	$46,585,755
Oregon	$46,462,400
Pennsylvania	$111,991,355
Rhode Island	$40,238,960
South Carolina	$56,576,525
South Dakota	$18,732,825
Tennessee	$67,537,910
Texas	$147,214,850
Utah	$49,396,510
Vermont	$14,637,565
Virginia	$77,104,520
Washington	$70,060,890
West Virginia	$22,669,320
Wisconsin	$64,120,145
Wyoming	$11,024,970

Trust for America's Health is a non-profit, non-partisan organization dedicated to saving lives by protecting the health of every community and working to make disease prevention a national priority.www.healthyamericans.org

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