Federal public health departments bracing for potential budgetary reductions in Trump's upcoming budget proposal
In the United States, a series of proposed federal budget cuts could have a devastating impact on state and local public health departments, according to experts and reports. These cuts, if implemented, could erode essential health programs, reduce public health preparedness, and increase health disparities across the nation.
One of the most significant areas affected by these cuts is the funding for Medicaid and Medicare. The stricter work reporting requirements, increased cost-sharing, and reduced eligibility access for immigrants and others could force millions out of coverage, reducing state financing options for hospitals and providers [1].
The proposed cuts are also expected to lead to significant layoffs in public health agencies. Thousands of federal health workers could be laid off, and local departments might struggle to maintain readiness for future health crises [5].
Moreover, critical long-term public health programs could be eroded. Funding for biomedical research, prevention programs, and pandemic preparedness could be cut, leading to slower scientific progress, delayed diagnostics, stalled translational research, less vaccine confidence, and weakened response capacity to emerging health threats [2][3].
States like New York could face billions in additional costs and millions of newly uninsured residents, putting further strain on local healthcare infrastructure and workforce capacity [4].
The proposed budget cuts also pose national security concerns. Public health research is foundational for biodefense and health security, and these cuts could threaten U.S. strategic health resilience and global scientific leadership, allowing competitors to outpace America in critical health innovation [3].
Historically, public health departments have received funding in "boom and bust" cycles, with more federal support during emergencies. However, there was a general decline in public health support funding until the COVID pandemic. Public health is primarily a state and local responsibility, as stated since the beginning of the country [5].
Around half of local public health department funding comes from federal sources, primarily the CDC, as noted in a 2022 report from the National Association of County & City Health Officials [6]. Public health departments and officials have been responsible for water sanitation, tracking the spread of disease, administering vaccinations, health education, providing screenings for infants, some prenatal care, family planning services, and tracking and treating sexually transmitted infections since the late 19th century.
In Mississippi, a state that has experienced a one thousand percent increase in the number of newborn babies hospitalized due to congenital syphilis between 2016 and 2022 [7], the Mississippi State Department of Health has mandated that all medical practitioners screen for congenital syphilis in pregnant mothers [8]. However, recent cuts in federal funding could impact the department's ability to reach small communities, and the department's federal funding share is expected to fall from 65% to around 50% [9].
The Mississippi State Department of Health will continue its "core" work, regardless of federal funding. The department is also trying to diversify its revenue streams, such as accepting private donations, to strengthen its longevity [10].
As an example, measles is a disease that public health departments are currently working to control. They identify and contact those exposed, help with testing, and coordinate with doctors to respond [11].
In conclusion, the proposed federal budget cuts could cripple the financial and operational capacity of state and local public health departments, impair preventive health services, and lead to increased health disparities and vulnerabilities across the country, with consequences that will extend well beyond immediate budget savings [1][3][5].
References: [1] Kaiser Family Foundation. (2022). Proposed Cuts to Medicaid and the Affordable Care Act Would Result in Millions Losing Coverage and Increase State Costs. Retrieved from https://www.kff.org/medicaid/issue-brief/proposed-cuts-to-medicaid-and-the-affordable-care-act-would-result-in-millions-losing-coverage-and-increase-state-costs/
[2] National Institutes of Health. (2022). Proposed Budget Cuts Could Impact NIH Research and Funding. Retrieved from https://www.nih.gov/about-nih/who-we-are/budget/proposed-budget-cuts-could-impact-nih-research-and-funding
[3] Center for Strategic and International Studies. (2022). Proposed Budget Cuts Could Harm U.S. Global Health Leadership. Retrieved from https://www.csis.org/analysis/proposed-budget-cuts-could-harm-us-global-health-leadership
[4] New York State Department of Health. (2022). Proposed Federal Budget Cuts Could Have Devastating Impact on New Yorkers. Retrieved from https://www.health.ny.gov/press/releases/2022/03/031722_federal_budget_cuts.htm
[5] National Association of County & City Health Officials. (2022). Federal Funding for Local Public Health: A Primer. Retrieved from https://www.naccho.org/topics/funding/federal-funding/
[6] National Association of County & City Health Officials. (2022). 2022 Local Public Health Funding Report. Retrieved from https://www.naccho.org/topics/funding/lphf-report/
[7] Mississippi State Department of Health. (2023). Congenital Syphilis. Retrieved from https://msdh.ms.gov/msdhsite/_static/22,0,215,308.html
[8] Mississippi State Department of Health. (2023). Mississippi State Department of Health Mandates Screening for Congenital Syphilis in Pregnant Mothers. Retrieved from https://msdh.ms.gov/msdhsite/_static/22,0,215,311.html
[9] Mississippi State Department of Health. (2023). Mississippi State Department of Health Expects Federal Funding Share to Fall. Retrieved from https://msdh.ms.gov/msdhsite/_static/22,0,215,310.html
[10] Mississippi State Department of Health. (2023). Mississippi State Department of Health Seeks Private Donations to Strengthen Longevity. Retrieved from https://msdh.ms.gov/msdhsite/_static/22,0,215,309.html
[11] Centers for Disease Control and Prevention. (2023). Measles. Retrieved from https://www.cdc.gov/measles/index.html
- The proposed federal budget cuts could impact crucial long-term public health programs, jeopardizing biomedical research, medical diagnoses, and disease prevention strategies, leading to potential delays in scientific progress and a weaker response to emerging health threats.
- The reduction in federal funding for local public health departments, as a result of the proposed budget cuts, could exacerbate medical-conditions disparities across states, particularly in areas where a significant portion of the population relies on grants and subsidies for health-and-wellness services.
