November 2008

NACCHO 2008 Government Affairs Summary: Outlook for 2009

The 2008 elections have changed the policy landscape in Washington. The Congress and the White House will both be in the hands of the Democrats. There will be changes at all levels within the Administration, and NACCHO is monitoring the situation closely and working to make sure that the local public health message is heard clearly. President-elect Obama has outlined priorities that are much different from the Bush Administration. Legislation that was blocked by President Bush, such as the expansion of the State Children’s Health Insurance Program, will likely become law under the Obama Administration. In addition, legislation that came close to passing, such as FDA regulation of tobacco, will likely have a friendlier reception. Climate change may be another issue high on the agenda, and the public health community will need to continue delivering the message that health impacts are a crucial outcome of climate change.

NACCHO has been active in a number of areas in 2008 that affect the ability of local health departments to protect their communities and promote health. In a difficult budget environment, NACCHO advocated to sustain funding to local health departments, particularly in the areas of emergency preparedness, chronic disease prevention, and immunization. While FY09 appropriations have not been completed, we were successful in advocating for increases in several programs in the House version of the Labor-Health and Human Services-Education Appropriations bill. NACCHO worked to build visibility of the local public health message of prevention as part of the health reform debate. From climate change to HIV prevention, land use to infectious disease surveillance, and a wide range of other issues, NACCHO continued its efforts to increase policy makers’ understanding of the critical roles that local health departments play. 

The Obama campaign said that healthcare reform and providing health insurance coverage to the uninsured and underinsured will be among the top priorities. President-elect Obama’s Plan for a Healthy America highlights the need to strengthen the public health system, promote prevention, and strengthen public health to prevent disease and protect against natural and man-made disasters. Congressional work is already underway. The Senate Health, Education, Labor, and Pensions (HELP) Committee under the leadership of Senator Kennedy (D-MA) has taken the lead on health reform. This summer, NACCHO participated in a roundtable discussion with staff from the Senate HELP Committee on the role of prevention in health reform. NACCHO is working with many partners to build strong advocacy for addressing disease prevention and strengthening the public health infrastructure as part of health reform legislation.

Legislation to expand the State Children’s Health Insurance Program and fix the physician payment formula under Medicare are likely to be taken up early in 2009. A multitude of stakeholders are attempting to influence the eventual outcome of the health care debate. Local public health will be at the table and continue to carry the message that providing health insurance without also supporting community-based prevention will not improve the health of the American public.

The next two years present great opportunity along with serious challenges. The economic crisis will continue to be the top priority for the White House and Congressional leaders. However, with Democratic control of the White House and Congress and President-elect Obama’s commitment to change that will improve the lives of Americans, the chances for achieving meaningful improvements in federal public health policy are greater than they have been in years. On behalf of local public health, NACCHO will vigorously pursue the policy objectives and priorities determined by its Board, working constructively with the new Administration, the new Congress, and our many valued partners. Your participation is critical to these efforts. There will be renewed opportunities for action in the next year and building a robust network of local public health experts who can educate policymakers about important issues will be key to NACCHO’s success. NACCHO Government Affairs staff will support volunteers with talking points, sample letters, and guidance on policy issues and strategy. If you would like to be part of this invigorated grassroots network , please send an e-mail to Eli Briggs, NACCHO Senior Government Affairs Specialist.