Repealing Prevention and Public Health Fund

Date: April 13, 2011
Location: Washington, DC

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Mr. PALLONE. I yield myself such time as I may consume.

Mr. Chairman, it's been 100 days of the Republicans' no jobs agenda and they've chosen to devote time and energy to bills and resolutions that would defund the Affordable Care Act, eliminate mandatory support for preventive care, and abolish any and all Federal support for Planned Parenthood. House Republicans know that these measures won't be approved by the Senate and would never be signed by the President. It's just another political gesture at a time when we should be working to create jobs and promote economic recovery.

The bill on the floor this week, H.R. 1217, would abolish the affordable care law's Prevention and Public Health Fund. This is a fund that prevents disease, that detects it early, and that helps manage conditions before they become severe. All empirical data, all experience and plain old common sense informs us that prevention and early treatment not only save lives, they also save money. In fact, the Prevention and Public Health Fund addresses one of the major deficiencies in our approach to health in America, and that's preventing illness before people get sick.

The Republican assertion that mandatory funding, which I've heard over and over again today and also in the Health Subcommittee, that this is somehow mandatory funding and it's unprecedented, that's completely not true. Medicaid and Medicare are funded with mandatory support, and there are a lot of other programs within our committee's jurisdiction and in Congress in general that are funded through mandatory funding.

I don't know how many times I'm going to come to the floor and hear about repealing the health care reform. I understand tomorrow there's going to be an enrolled bill that goes along with the CR that's going to defund the whole Affordable Care Act. Here today we're going to defund one piece, the prevention fund. Tomorrow we've got another enrollment resolution that defunds the whole bill. Again, another resolution tomorrow to defund Planned Parenthood.

How many times are we going to keep voting on the same thing over and over and over again? Meanwhile, I don't see a single piece of legislation coming to this floor that addresses jobs or the economy. When I go home, people want to know what we're doing about the economy. They know that their health care reform has passed, that they're benefiting from it, that it's gradually unfolding before them. They don't want us to continue to debate the same thing over and over again. Repeal, defund, and no suggestion about what you would do to replace it either, by the way.

I reserve the balance of my time.

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Mr. PALLONE. Madam Chairwoman, I yield myself the balance of my time.

Madam Chair, we are simply never going to bend the cost curve on health care or improve America's quality of life until we focus much more on disease prevention, and that's what this prevention fund is for.

I always thought that both Democrats and Republicans wanted to keep people out of the hospital, off of disability, leading productive lives, and trying to prevent diseases before they occur. I never thought this was a partisan issue. Because we need to have a system of well care, not sick care, if we're really going to have success in saving money and bending the cost curve.

So I don't understand why my Republican colleagues so many times in the committee would talk about prevention, but all of a sudden now they want to abolish the prevention fund. It just doesn't make any sense.

Before the Affordable Care Act, prevention activities were chronically underfunded, accounting for only 2 to 4 percent of the national health care expenditure by some estimates. Considering that chronic diseases eat up an estimated 75 percent of our $2 trillion in annual health care spending, to spend an additional $2 billion for wellness and prevention is a wise investment.

Since the Affordable Care Act was enacted, every State has benefited from the prevention and wellness fund. This year, over $750 million in grants were dispersed--building on a $500 million investment last year--and repealing this program would mean putting the brakes on investments that are already beginning to make a difference.

In my home State of New Jersey, many of my constituents have benefited from over $15 million in prevention and public health grants, funding for such things as HIV prevention, tobacco cessation, mental health care, critical public health infrastructure improvements, as well as support for primary care training and workforce development.

I could do the same, I have a sheet here--I'm not going to read it, but I have a similar sheet for Mr. Pitts and Dr. Burgess and others on the Republican side who specified these are the types of grants that are being made available in their States.

I simply don't understand. There are 600 national, State, and local organizations supporting the fund as a primary vehicle for making public health investments that would create jobs and help lower long-term health care costs. The Energy and Commerce Committee and the Health Subcommittee have heard me many times say that we can never calculate the huge savings that come from prevention.

We had the CBO in the other day and I said to the CBO, why don't you calculate prevention, because we would save trillions of dollars? Well, they don't do it. But the bottom line is we all know that prevention saves money. If you concentrate just on chronic diseases, this law helps move the Nation from a focus on sickness and disease to one based on wellness and prevention. And if you take away this critical new investment in prevention, it's going to be harmful to the health of Americans now and also in the future.

Madam Chairwoman--and I will address this directly to my Republican colleagues--in the last few weeks, when we had hearings in the Health Subcommittee on the various measures that the Republicans wanted to defund--and I know they want to repeal the whole bill and I know they want to defund everything, and that's what they're going to try to do again tomorrow. I understand all that. I totally disagree with it, but I understand that they're against the Affordable Care Act. They want to defund it, they want to do whatever they can to get rid of it.

But it just seems to me that to pick the one fund that deals with prevention is really the worst thing you could have done today because what we're trying to do with the Affordable Care Act--and what I've sought to do in everything that we've done in the subcommittee since I've been on it--is to really stress prevention because we can avoid people going to hospitals, we can avoid people going to nursing homes. They can lead a better quality of life and we save money.

So I just think it is really unfortunate today that after so many years of a bipartisan effort to deal with prevention, to fund prevention issues, that this is the one fund that's actually picked on today to come to the floor. I think it's really a horrible thing that that is the case.

So I would urge my colleagues to vote against this resolution because if you really believe in prevention, if you really believe that we can make a difference in making people well and preventing them from getting sick, then you should vote against this bill.

Madam Chairwoman, I yield back the balance of my time.

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