March 3, 2017 The Honorable Donald J. Trump President of the United States of America The White House 1600 Pennsylvania Avenue, NW Washington, DC 20500 Dear President Trump: On behalf of the more than 500 undersigned organizations, we are writing to warn of the dire consequences of repealing the Prevention and Public Health Fund (the Prevention Fund), authorized under the Affordable Care Act. Repealing the Prevention Fund without a corresponding increase in the allocation for the Labor-Health and Human Services-Education appropriations bill would leave a funding gap for essential public health programs, and could also foretell deep cuts for other critical programs funded in the bill. Today, more than 12 percent of the Centers for Disease Control and Prevention (CDC) budget is supplied through Prevention Fund investments. This includes core public health programs that provide essential funds to help states keep communities healthy and safe, such as the 317 immunization program, epidemiology and laboratory capacity grants, the entire Preventive Health and Health Services (Prevent) Block Grant program, cancer screenings, chronic disease prevention and other critically important programs. For example, the Prevent Block Grant provides all 50 states, the District of Columbia, two American Indian tribes, and eight U.S. territories with flexible funding to address their unique public health issues at the state and community level. Despite the growing and geographically disparate burden of largely preventable diseases, health threats such as the opioid epidemic, and emerging infectious disease outbreaks such as the Zika virus, federal disease prevention and public health programs remain critically underfunded. Public health spending is still below pre-recession levels, having remained relatively flat for years. The CDC’s budget authority has actually decreased by 11.4 percent since FY 2010 adjusted for inflation, and the Prevention Fund has helped to make up the difference. Discretionary programs, including public health, education, and job training programs funded through the Labor-Health and Human Services-Education (LHHS) appropriations spending bill have been cut dramatically and disproportionately in recent years as lawmakers have worked to reduce the deficit, even though experts across the political spectrum agree these programs are not a driving factor behind our nation’s mid- and long term fiscal challenges. Eliminating the Prevention Fund would be disastrous to the CDC budget and programs, and to the LHHS bill as a whole, leaving a nearly $1 billion budget hole which would be impossible to fill under current discretionary spending caps. Funding prevention not only saves lives but it saves money. A comprehensive study of evidence-based prevention programs found that every dollar invested yields $5.60 in savings. There are many provisions of the Affordable Care Act aimed at promoting health and prevention, but the Prevention Fund is particularly important – a dedicated investment in prevention and public health activities to counteract the much larger bill – $3.2 trillion and growing – we pay every year as a country to treat illness and disease. We urge you to maintain funding made possible by the Prevention and Public Health Fund and safeguard funding for the CDC and other programs under the Labor-HHS-Education spending bill. Sincerely, 1965 American Association on Health and Disability Ability360 American Cancer Society Cancer Action Network Academy of Geriatric Physical Therapy American College of Cardiology Academy of Nutrition and Dietetics American College of Clinical Pharmacy Action for Healthy Kids (AFHK) American College of Preventive Medicine Active Living By Design American College of Sports Medicine Active Transportation Alliance American Council on Exercise Ad Hoc Group for Medical Research American Diabetes Association ADAP Advocacy Association (aaa+) American Federation of State, County and Addiction Connections Resource Municipal Employees Adult Congenital Heart Association American Foundation for Suicide Prevention Advancement Project California American Heart Association Advocate Good Shepherd Hospital American Immunization Registry Association Advocates for Better Children's Diets American Indian/Alaska Native/Native Hawaiian African American Health Alliance APHA Caucus AIDS Alliance for Women, Infants, The American Academy of HIV Medicine Children, Youth & Families American Lung Association The AIDS Institute American Medical Student Association AIDS Research Consortium of Atlanta American Organization of Nurse Executives AIDS United American Psychological Association Allamakee County Public Health American Public Health Association American Academy of HIV Medicine American School Health Association American Academy of Pediatrics American Sexual Health Association American Association for Dental Research American Society for Nutrition American Association for the Study of American Society of Hematology Liver Diseases American Society of Tropical Medicine & Hygiene American Association of Colleges of Nursing American STD Association American Association of Colleges of Pharmacy American Thoracic Society American Association of Naturopathic Ann & Robert H. Lurie Foundation Physicians APICAT for Healthy Communities American Association of Neuromuscular & APLA Health Electrodiagnostic Medicine The Arc Arizona Center for Law in the Public Interest Big Cities Health Coalition Arizona Health Care Association Boston Alliance for Community Health Arizona Medical Association Boston Public Health Commission The Arizona Partnership for Immunization Boston Senior Home Care Arizona Public Health Association Boston University School of Public Health Arizona Rural Health Association Boulder County Public Health Arkansas Public Health Association The Bronx Health Link Asian & Pacific Islander American Bronx Health REACH Health Forum California Public Health Association-North Asian Services In Action California WIC Association Association for Clinical and Translational California WIC Association Science Cambridge Health Alliance Association for Prevention Teaching Campaign for Tobacco-Free Kids and Research Camptonville Community Partnership Association for Professionals in Cancer Council of the Pacific Islands Infection Control and Epidemiology Canyon Ranch Center for Prevention & Association of Accredited Naturopathic Health Promotion Medical Colleges Cedar County Public Health Association of Accredited Public Health Center for Behavioral Epidemiology & Programs Community Health Association of American Cancer Institutes Center for Health and Learning Association of American Medical Colleges Center for Health Promotion and Disease Prevention Association of Community Health Nursing Center for Science in the Public Interest Educators Center in the Park Association of Maternal & Child Health Central California Asthma Collaborative Programs Central Jersey Family Health Consortium Association of Montana Public Health Officials Central Michigan District Health Department Association of Public Health Laboratories Central Michigan Regional Rural Health Network Association of Public Health Nurses Centralina Area Agency on Aging Association of Reproductive Health Centro Multicultural La Familia Professionals Cerro Gordo County Department of Public Health Association of Schools and Programs of Chalk Talk Science Project Public Health ChangeLab Solutions Association of State and Territorial Health Chicago Commons Officials Childhood Obesity Prevention Coalition (WA State) Association of State Public Health Nutritionists Children and Adults with Attention Deficit Association of University Centers on Hyperactivity Disorder (CHADD) Disabilities Children's Environmental Health Network Asthma and Allergy Foundation of America Children's Health Fund Atrius Health Children's Mental Health Network Authority Health City-County Health District Barnes ON THE MOVE Partnership Clinical Research Forum Behavioral Health Leadership Institute Coalition for Clinical and Translational Science Benzie Leelanau District Health Department Coalition for Health Funding (Benzonia, MI) Coalition for Healthy School Food Berean Wellness & Community Support Center Coconino County Public Health Services District College of Public Health and Human Sciences, Dorchester County Health Department Oregon State University Duxbury Council On Aging Colorado Association of Local Public Health Dystonia Medical Research Foundation Officials Early Impact Virginia Colorado Association of School Nurses Edna Bennett Pierce Prevention Center, Colorado Children's Immunization Coalition Penn State University Colorado Public Health Association Ehrens Consulting Commissioned Officers Association of the Elder Options U.S. Public Health Service, Inc. (COA) Elder Services of the Merrimack Valley, Inc. CommonHealth ACTION Elder Services of Worcester Area, Inc. Community Access National Network (CANN) Element Health, Inc. Community Clinic Consortium Emory University Community Health Councils Endocrine Society Community Health Improvement Partners Enhance Asian Community on Health Connecticut Directors of Health Association Evidence-Based Leadership Council Connecticut Public Health Association Fairhill Partners Conrad House, Inc. The Family Van: Harvard Medical School Contact Wellness Foundation Fayette County Health Department Cooley's Anemia Foundation Feeling Good MN COPD Foundation First In Families of North Carolina Council for Diabetes Prevention Florida Breastfeeding Coalition Council