Coverage of the forthcoming Supreme Court ruling on the constitutionality of the Affordable Care Act has centered almost exclusively on the individual mandate and the impact on health insurance coverage. Yesterday, John Reichard, editor of CQ HealthBeat—Washington's source for health policy news—ran a story on another important side effect of the ruling, the elimination of the Prevention and Public Health Fund. The Prevention and Public Health Fund was established by the Affordable Care Act to bolster investments in public health with a stable, mandatory funding stream that flows automatically outside the bounds of the annual appropriations process. But as Reichard reports, "Congress and the Obama administration have trimmed base spending at the agencies and made up for those cuts, at least in part, by using money from the Prevention and Public Health Fund." The impact would be devastating: Core public health programs at the Centers for Disease Control and Prevention would be immediately cut by 13 percent. Funding for the U.S. Preventive Services Task Force at AHRQ would be zeroed out. Public health budgets at the Health Resources and Services Administration and the Substance Abuse and Health Services Research Administration would also feel the effects. "As money goes from the Fund to [CDC], it's not a coincidence that over time equal—or in some cases greater—amounts come out of CDC's base discretionary funding," said Emily Holubowich, senior vice president at CRD Associates and AcademyHealth's Washington representative. Other programs authorized by the ACA that support our field would also be eliminated, including the new Patient-Centered Outcomes Research Institute and the Center for Medicare and Medicaid Innovation. In the absence of funding increases during these austere fiscal times, ACA-related funding has provided a safety net for public health and health services research. The future of both are riding on the Supreme Court's ACA decision.  

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