Health Director warns of possible shortfall if ACA is repealed


Brittney Burns – Staff Writer

Dating back to the 1960s, health departments across the country have received federal dollars marked for preventative care. Funding programs such as children’s vaccinations and health screenings, health departments across the country have depending on the funds each year, but that may soon change and could potentially result in a $396,643 shortfall for Macon County Public Health.

Macon County Public Health Director Jim Bruckner who also serves with the North Carolina Association of Local Health Directors, informed members of the board of health last week that if Congress approves a complete repeal of the Affordable Care Act (ACA), Macon County will likely lose $396,643, $352,000 of which is a regional grant that impacts all western counties and programs like child immunizations will immediately cease. Bruckner said that they Macon County health department would likely lose $44,642 for immunization and healthily communities funding. While health departments have been getting the funds for decades, with the ACA was passed in 2010, Bruckner said that funds for preventative care were rolled into the ACA. The move wasn’t publicized and according to Bruckner, health departments weren’t even aware of the action until last week when an ACA repeal was mentioned by the Donald Trump administration.

“Unless you sat down and read all 5,000 pages of the Affordable Care Act, you would never know that this pool of money was tied to that legislation,” Bruckner said. “We are talking about $931 million nationwide for preventative programs.”

Bruckner informed the board that he worked with the local health directors association to send a letter to the federal government to consider shifting the preventative care dollars out of the ACA before approving an appeal. While the association already sent the letter, Bruckner asked permission to send a similar letter on behalf of the Macon County Board of Health, a move he said health departments across the state were making.

“As a local board of health, we are concerned that if the prevention and public health funds within the ACA are eliminated without considering the impact that will have on these important public health initiatives that the overall health of the nation will suffer and health care costs will inevitably continue to rise,” reads a letter signed on Tuesday afternoon by Board of Health Chairman Chris Hanners. “What we don’t want to have happen is for state and local public health to be inadvertently harmed by the across the board elimination of these critical infrastructure funds. In light of recent national and international concern around communicable disease outbreaks, it is imperative that continued funding of state and local public health programs focused on protecting the public’s health, improving quality and reducing the cost of healthcare are maintained or even increased as these programs are essential in helping create a healthier and more economically secure nation.”

Outlining the problem, Hanners’ letter to federal legislators reads, “In an attempt to bolster prevention activities under the ACA, approximately $931 million of traditional public health funding which existed long before the ACA was enacted were moved under the ACA,” said Hanners. “These funds which had nothing to do with the enactment of the ACA have historically been and are still used to fund existing local public health prevention initiatives nationwide. These initiatives include: Childhood Immunizations, Chronic Disease Prevention, Diabetes Prevention, Heart Disease Prevention, Stroke Prevention, Lead Poisoning Prevention, Public Health Epidemiology and Laboratory Capacity, among other important programs. Of these federal funds, North Carolina receives approximately $20.1 million; and, Macon County approximately $396,643.”

Bruckner noted that while last week the state thought Macon County would be losing funds for things such as clinical services, that is no longer the case.

Congress has yet to make a decision on the ACA or a repeal, but officials such as Congressman Meadows have been adamant that a replacement should be decided before a repeal vote is made. Without additional information, an ACA repeal is speculation at this point, while Congress works to address the issue, without leaving millions of Americans without health care coverage.

“While Republicans continue to debate how to best repeal and replace Obamacare, we agree on the big picture: our current system does not work. Obamacare is flawed, failing, and not fixable—and it needs to be fully repealed. Americans cannot afford to bear the burden of its failure any longer,” Meadows said in mid-January. “While serious concerns remain, I have been pleased to hear the Speaker [Paul Ryan] commit to bringing up a healthcare replacement bill within days, not weeks, of a repeal measure. This has been a top priority of mine and the Freedom Caucus’, as I believe it is critical that we give the American people a clear direction and assurance of a smooth transition toward a sound, high quality, and affordable healthcare market — especially so the most vulnerable can get the coverage they need. Going forward, I strongly believe and will continue to express that a full repeal of Obamacare should take effect within two years during the 115th Congress. That is what we promised the voters we would do. That is our job – -and it’s high time we accomplish it.”