The Northern Michigan Public Health Alliance, which comprises local health departments serving 25 counties and more than 600,000 individuals, issued a press release Tuesday noting their concerns by the harms the American Health Care Act would potentially make to the public health system and health insurance availability.
The health alliance is also alarmed by recent talks to cut domestic agency budgets, including the U.S. Environmental Protection Agency.
The Northern Michigan Public Health Alliance concurred with the American Medical Association, the American Hospital Association and the AARP in saying the America Health Care Act would weaken health insurance programs including Medicaid and Medicare, resulting in fewer insured Americans and hurt vulnerable patient populations.
The organization's region has more than 43,000 individuals who are insured by Medicaid and more than 29,000 who have insurance through the Patient Protection and Affordable Care Act health insurance marketplace.
According to the alliance, the American Health Care Act puts tens of thousands of Northern Michigan residents insured by the Affordable Care Act at risk of losing their coverage by rolling back Medicaid expansion and decreasing subsidy amounts for insurance exchanges.
The alliance also declared the proposed law would gut the Prevention and Public Health Fund, which makes up 12 percent of the Centers for Disease Control and Prevention's budget. Many of those dollars make their way to Northern Michigan local health departments and communities and fund chronic disease prevention programs such as diabetes prevention courses, which can have a 5-to-1 return on investment and bend the health care cost curve, the Alliance claims.
Recently, dollars from the Prevention and Public Health Fund provided 10 municipal governments and nonprofits with funds to improve greenspaces, including parks and trails.
Heath officers of the Northern Michigan Public Health Alliance, including Lisa Peacock of the Health Department of Northwest Michigan, said stripping local health departments of Prevention and Public Health Fund resources would also limit or end programs which have served Northern Michigan residents for decades, including the provision of immunizations, child lead poisoning prevention and epidemiology and laboratory capacity.
"At a time when there are imminent public health threats facing the region - threats that don't stop at county, state, or national borders such as the ongoing H7N9 avian influenza outbreak in China - now is not the time to defund public health," Peacock said.
Denise Bryan, health officer at District Health Department No. 2 and District Health Department No. 4, has concerns an executive branch proposal would slash the EPA budget by up to 30 percent, which includes a 97 percent cut in Great Lakes Restoration Initiative funding.
"The idea of fewer resources for environmental testing, surveillance and mitigation is insulting to the residents of Iosco County who have had to rely on alternative water as a result of their well water being tainted by perfluorinated chemicals," said Bryan, who also cited her ongoing advocacy for identifying hazardous chemical plumes discharged from the Wurtsmith Air Force Base. "Moreover, the proposed cuts to the EPA would end beach water quality testing as we know it, which will negatively impact the health of Northern Michigan residents and visitors."
Peacock mentioned health officials in Northern Michigan are "closely monitoring proposals to limit access to health care services, end important and lifesaving public health programs and cut off resources to protect the Great Lakes and its surrounding environment.
"We take these proposals seriously and want to actively warn the 600,000 residents of our region of these threats as required of us under the Michigan Public Health Code," Peacock said.
Peacock, Bryan, District Health Department No. 10 health officer Kevin Hughes and Wendy Trute, health officer of the Grand Traverse County Health Department, wrote a letter Monday to Michigan senators Gary Peters and Debbie Stabenow and state representatives Jack Bergman, Bill Huizenga, John Moolenaar and Dan Kildee sharing their concerns and detailed how pending federal legislation and budgets could impact public health in Northern Michigan.
The letter focused on three specific and timely issues facing the Congress including:
- The ACA replacement recently passed by House committees zeros out funding for the Prevention and Public Health Fund.
- ACA replacement legislation, in current form, also raises concerns about access to insurance and affordability.
Local health departments in Northern Michigan have been leading successful efforts to decrease emergency room utilization and inappropriate care while increasing access. Heath officers are concerned the changes proposed to the insurance market will set efforts back.
The health officers are also concerned by Ohio Gov. John Kasich's assessment that the phase out of Medicaid would "risk out ability to treat the drug-addicted, mentally ill and working poor who now have access to a stable source of care." Northern Michigan has been hit hard by the opioid epidemic, with hundreds of deaths the last five years and the regional introduction of the more deadly fentanyl and carfentanil; less access to treatment will further escalate the epidemic.
- Reported executive branch cuts to domestic agency budgets would roll back crucial public health programs.
In particular, the reported proposed elimination of EPA state grants for beach water quality testing would harm both the region's health and economy. Many residents and visitors of Northern Michigan trust local health departments beach testing to keep them safe. Local health departments in Northern Michigan would likely be directly impacted by cuts to other agencies they regularly depend on, including CDC (Centers for Disease Control and Prevention), CMS (Centers for Medicare and Medicaid Services), HHS (Health and Human Services) and SAMHSA (Substance Abuse and Mental Health Services Administration).
The health officers agreed with state representative Tom Cole, who was quoted in STAT News saying "what CDC does is probably more important to the average American than, in a sense, the Defense Department. You're much more likely to be killed in a pandemic than you are in a terrorist attack, so you need to look at it that way. Those investments are extraordinarily important for the protection of the country."
The Northern Michigan Public Health Alliance comprises six Northern Michigan local health departments, spanning across 25 counties. The alliance works across the region to increase public health capacity, maximize resources, reduce duplication and improve health status.