The Prevention and Public Health Fund

A $15 billion effort to improve health by preventing disease has been cut amid debate over whether it’s really needed.

The Affordable Care Act of 2010 created the Prevention and Public Health Fund to invest in public health and disease prevention. Supporters consider the fund a key component of the law’s overall thrust of helping to reorient U.S. health care toward wellness, while also restraining cost growth driven by the high prevalence of chronic disease.

The health care reform legislation allocated the prevention fund with $15 billion over its first 10 years. But President Barack Obama signed legislation on February 22, 2012 that cuts the fund by $5 billion over 10 years to help pay for other initiatives, including a continuation of payroll tax breaks. Earlier, congressional Republicans had targeted the fund for cuts or complete elimination, arguing either that it was unnecessary and wasteful or that it would accomplish little on top of existing federally funded efforts for disease prevention and health promotion.

This Health Affairs Policy Brief examines where spending has gone to date and lays out the debate over preserving, cutting, or eliminating the fund altogether, and was published online on February 23, 2012 in Health Affairs.