Prevention and Public Health Fund

The Affordable Care Act's Prevention and Public Health Fund represents a critical investment in our nation's health. Funding prevention activities is also a key step toward bending our unsustainable cost curve. 

Below are frequently asked questions about the Fund and links to useful resources created by APHA and other organizations.

Key resources
(See full list of resources

Frequently asked questions

1. What is the Prevention and Public Health Fund?

2. Why is the Prevention Fund necessary?

3. How much money is in the Fund?

4. How is the Fund being used?

1. What is the Prevention and Public Health Fund?
The Prevention and Public Health Fund was created by Section 4002 of the Affordable Care Act. Also known as the Prevention Fund or PPHF, it is the nation’s first mandatory funding stream dedicated to improving our nation’s public health. By law, the Fund must be used “to provide for expanded and sustained national investment in prevention and public health programs to improve health and help restrain the rate of growth in private and public health care costs.” ( FAQ top )

2. Why is the Prevention Fund necessary?
Today, seven in ten deaths in the U.S. are related to preventable diseases such as obesity, diabetes, high blood pressure, heart disease, and cancer. Another striking fact is that 75 percent of our health care dollars are spent treating such diseases. However, only 3 percent of our health care dollars go toward prevention.

To adequately meet our prevention needs, and to control our unsustainable growth in health care costs, a 2012 Institute of Medicine (IOM) report recommended that we increase federal funding for public health and prevention by $12 billion annually, a doubling of the FY 2009 federal investment in public health.

A key first step toward meeting this need is the Prevention and Public Health Fund. According to recent research, this kind of investment has the potential to improve health outcomes and reduce costs. For example, every 10 percent increase in funding for community-based public health programs is estimated to reduce deaths due to preventable causes by 1 to 7 percent, and a $2.9 billion investment in community-based disease prevention programs would be estimated to save $16.5 billion annually within five years (in 2004 dollars). (FAQ top)

3. How much money is in the Fund?
The Fund is intended to provide a stable and increased investment in activities that will enable communities to stay healthy in the first place. The ACA originally authorized $18.75 billion for the Fund between FY 2010 and FY 2022, gradually building from $500 million in FY 2010 to $2 billion per year by FY 2015.

However, in February 2012, Congress passed and the president signed legislation that cut the Fund by $6.25 billion over nine years (FYs 2013-21) to offset a scheduled cut to Medicare physician payments. Under the new allocations, the yearly amounts for the Fund are: $500 million in FY 2010, $750 million in FY 2011, $1 billion in FY 2012 through FY 2017, $1.25 billion in FY 2018 and FY 2019, $1.5 billion in FY 2020 and FY 2021, and $2 billion in FY 2022 and each year after.

In March and April 2013, FY 2013 funding was further reduced. Sequestration cut $51 million from the intended FY 2013 funding level of $1 billion, and the Department of Health and Human Services is diverting another $453.8 million to Health Insurance Exchange (Marketplace) implementation activities. Although $121.3 million from other HHS sources is planned to help offset these reductions, the net $616.5 million available for Prevention Fund activities in FY 2013 (after sequestration and the diversion of resources) is 38 percent lower than the $1 billion amounts enacted in FY 2012 and authorized for FY 2013. Final allocations posted April 16 by HHS reflect significant reductions to critical programs and services aimed at community prevention, immunization, substance abuse and mental health and health equity. (FAQ top)

4. How is the Fund being used?
So far, the Fund has provided $2.25 billion for prevention and public health activities: $500 million in FY 2010, $750 million in FY 2011, and $1 billion in FY 2012.

Prevention Fund dollars are being used in a variety of ways, including supporting the work of the Centers for Disease Control and Prevention and the Health Resources and Services Administration:

  • Community prevention:Funds are being used to enhance community-based preventive health programs at the local level including tobacco cessation, obesity prevention, and disease-specific efforts.
  • Clinical prevention: Funds are being used to expand awareness of clinical preventive services and benefits.
  • Public health infrastructure and training: Funds are being used to bolster public health infrastructure at the state and local level, increase training capacity for the health care workforce, and expand public health officials’ ability to prevent and respond to infectious disease outbreaks.
  • Research and tracking: Funds are being used to increase and expand data collection on public health services nationwide.

Examples of funded activities include:

  • Through the National Public Health Improvement Initiative, Virginia has achieved information technology savings of $1.2 million, seen a 32 percent increase in enrollment in the state’s Medicaid Family Planning Program, and realized an overall increase in efficiency.
  • Through the Community Transformation Grant program, Iowa is expanding access to blood pressure and tobacco use screenings at dental practices to over 300,000 patients, increasing the number of referrals to the state’s tobacco quitline service, and targeting health interventions at the region of the state with the highest stroke mortality rates. (FAQ top)

More information about the Prevention Fund and citations for the above numbers are available in APHA's June 2012 issue brief on the Prevention Fund.

Additional resources
(includes key resources highlighted above; also see our Useful Links page)

APHA resources

APHA statements, articles, and media mentions

Other resources on the Prevention Fund

Research and reporting on prevention funding

For more information, visit our Useful Links page.

APHA is continuing to update its health reform website and resources. Please check back as we add new content and links to existing pages, as well as new pages.   

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