APHA says tax legislation holds disastrous consequences for public health

Date: Dec 02 2017

Contact: Megan Lowry, 202-777-3913

Washington, D.C., December 2, 2017 -  Tax legislation passed today by the Senate holds disastrous consequences for public health by repealing the individual health insurance mandate, creating deep automatic cuts to key health programs like Medicare and the Prevention and Public Health Fund and increasing income inequality. 

“This legislation will have immediate consequences for Americans’ health. It not only fails to deliver on the promise of increasing prosperity for the lower and middle classes, but will ruin their health in the process,” said Georges Benjamin, MD, executive director of APHA. “It will leave Americans sicker, poorer and with a government unprepared and unequipped to respond to urgent threats to public health as soon as next year.”

The deficit created by this tax plan would trigger concerning automatic spending cuts that would lead to the complete elimination of the Prevention and Public Health Fund and other mandatory spending over the next 10 years. The fund currently makes up 12 percent of the entire Centers for Disease Control and Prevention budget, and its elimination would be a disaster for public health. The elimination of the fund would cripple the public health workforce’s ability to respond to infectious disease outbreaks and continue critical prevention programs. Cuts to other essential public health programs like Medicare would harm older adults and those who depend on government-funded health programs. Unless Congress votes to waive the budget rules, the effect of these spending cuts would have long reaching and severe consequences for the health of all Americans.

The public health community also strongly opposes efforts to weaken the Affordable Care Act by including a repeal of the individual mandate in the Senate’s latest tax legislation. The individual mandate is central to reducing the number of uninsured Americans, controlling health care costs for everyone and ensuring the availability of affordable health insurance coverage. Repealing the individual mandate will only undermine our progress in creating a healthier nation. 

The Congressional Budget Office and Joint Committee on Taxation estimate that repealing the mandate would cause the number of people with health insurance to decrease by 13 million in 2027. They also estimate that average premiums would increase by about 10 percent in most years of the next decade. Instead, we urge Congress to continue bipartisan efforts to improve and build upon the successes of the ACA, and expand access to health insurance for the more than 28 million who still lack coverage.

The tax legislation would create tax cuts for the wealthy while increasing the tax burden on those who earn less, making the rich richer and the poor sicker, as income inequality is widely known to be a key determinant of health. In an official policy statement passed this November, APHA calls on federal, state and local governments to shift toward progressive taxation to help diminish income inequality and provide funding to mitigate the growing gap. 

Legislation affecting our nation’s health should be bipartisan and aim to improve the health of all Americans. Any changes made to existing health care laws should, at a minimum, increase the number of insured individuals and lower costs for Americans buying insurance. This tax bill will only undo the progress we’ve made over the last decade and harm public health in the long term. 


APHA champions the health of all people and all communities. We strengthen the public health profession. We speak out for public health issues and policies backed by science. We are the only organization that combines a 145-year perspective, a broad-based member community and the ability to influence federal policy to improve the public’s health. Visit us at www.apha.org