Senate Majority Leader Mitch McConnell
Senate Majority Leader Mitch McConnell, who led the effort to pass the "skinny bill." Jacquelyn Martin/AP Photo

Funding to fight lead poisoning, opioid addiction, and chronic disease could have vanished with the “skinny repeal” of the ACA.

With Republicans’ latest attempt to repeal the Affordable Care Act defeated in the wee hours of Friday morning, millions of Americans are breathing a sigh of relief.

Based on the reported content of the so-called “skinny repeal”— introduced mere hours before last night’s vote—the Congressional Budget Office estimated the bill would have increased the number of uninsured Americans by 16 million by 2026.

Unlike previous repeal-and-replace attempts, this bill did nothing to directly undo the Affordable Care Act’s historic expansion of Medicaid. But between those unable to afford what would have been price-hiked ACA marketplace plans, and millions left uncovered by their jobs once the employer mandate disappeared, “the skinny bill as policy is a disaster,” the Republican Senator Lindsey Graham said at a press conference on Thursday. (He then proceeded to vote “yes.”)

Besides stranding countless individuals, the bill would have left ailing urban communities high and dry. Established by the Affordable Care Act, the Prevention and Public Health Fund appropriated nearly $1 billion last year to stem chronic disease, prevent infectious outbreaks, and promote health equity, largely through research, grants, and programs orchestrated by the CDC. This fund, set to double by 2022, would have been repealed by 2019. Every corner of the country would have felt some impact, with states losing up to $3 billion over the next five years.

Cities would have felt the greatest impact, though, with their concentrated health inequities and closely-quartered populations. Here’s some of what could have been lost with the PPHF:

  • The CDC spent $13 million on lead prevention programs nationwide in 2016. Houston, Los Angeles, Washington, D.C., Chicago, New York, and Philadelphia have all recently received millions to monitor lead poisoning risks, educate communities, and manage treatment.
  • Another $40 million bolstered the CDC’s Epidemiology and Laboratory Capacity program, which distributes money to cities and states for research on infectious diseases like Ebola and Zika. Miami is surely grateful.
  • The CDC distributed another $160 million of PPHF dollars to Preventive Health and Health Services Block Grants, which support localized solutions to community health challenges. Think text-based health alerts in California, bike paths in Connecticut, and farmers markets in rural Kansas.
  • The CDC dishes out nearly $51 million per year to a longstanding, remarkable program called Racial and Ethnic Approaches to Community Health. Rooted in neighborhoods from the West Bronx, to suburban Detroit, to South L.A., some 49 REACH non-profits around the country connect minority communities with high health risks to care and prevention services.

By healing communities outside the costly strictures of the doctor’s office, preventive care programs like these aim to stretch healthcare dollars further. As with so many kinds of federal funding cuts—including those to Planned Parenthood, also proposed by the “skinny repeal”—low-income Americans, who are disproportionately black and brown, stand to lose most. For now, with the years-long Republican effort to kill the ACA dead, they won’t.

But the fight to protect public health programs isn’t over. Republicans will soon turn to passing a budget, guided by the blueprint released by the White House earlier this year. In addition to cuts to the FDA, the NIH, Medicaid, and Planned Parenthood, it called for to slash the CDC’s budget by $1.3 billion, which could encompass AIDS research, opioid addiction interventions, and programs to fight diabetes, heart disease, and obesity.

About the Author

Most Popular

  1. An aerial photo of downtown Miami.
    Life

    The Fastest-Growing U.S. Cities Aren’t What You Think

    Looking at the population and job growth of large cities proper, rather than their metro areas, uncovers some surprises.

  2. a photo of a full parking lot with a double rainbow over it
    Transportation

    Parking Reform Will Save the City

    Cities that require builders to provide off-street parking trigger more traffic, sprawl, and housing unaffordability. But we can break the vicious cycle.   

  3. a map comparing the sizes of several cities
    Maps

    The Commuting Principle That Shaped Urban History

    From ancient Rome to modern Atlanta, the shape of cities has been defined by the technologies that allow commuters to get to work in about 30 minutes.

  4. Life

    Mapping the Changing Colors of Fall Across the U.S.

    Much of the country won’t see those vibrant oranges and reds until mid-October, which leaves plenty of time for leaf peepers to plan their autumn road trips.

  5. A photo of a police officer in El Paso, Texas.
    Equity

    What New Research Says About Race and Police Shootings

    Two new studies have revived the long-running debate over how police respond to white criminal suspects versus African Americans.

×