December 15, 2017 Edition

Congressional Republicans Reach Deal on Tax Reform, Votes to be Held Next Week

On Wednesday, Senate and House Republicans struck an agreement on a consolidated sweeping tax reform bill. Recall, Congressional Republicans entered into conference last week to reconcile the differences between the Senate and House tax reform measures that were recently passed by both houses.

Full details of the agreed-upon measure were not available at the time of this update, but the bill language is expected to be released later today. Reports suggest the conference committee will lower the individual tax rate to 37 percent and set the corporate tax rate at 21 percent.

Also included in the measure will be a repeal of the Affordable Care Act (ACA) individual insurance coverage mandate tax penalty. The Congressional Budget Office (CBO) previously estimated that by eliminating the individual mandate, the number of uninsured Americans will increase by 13 million over the next decade. Average health insurance premiums are also expected to increase by 10 percent with elimination of the mandate.

A budget score from the Joint Committee on Taxation is expected in the coming days.

As with the previously-passed tax reform measures, this consolidated bill threatens existing vital programs, including the Prevention and Public Health Fund (PPHF). Reports suggest the federal deficit will increase in upwards of $1.5 trillion over the next decade with the enactment of this bill. If Congress does not implement offsetting budgetary savings, the Statutory Pay-As-You-Go Act of 2010 (SPAYGO) will be triggered, resulting in massive automatic program funding cuts over the next ten years.

With one week remaining in the Congressional session, votes on the tax reform measure are slated to be held next week. Republicans are confident they have enough votes to secure passage of the measure. Several uncertain Congressional Republicans have reportedly been won over by GOP leadership and the Trump Administration with promises to work on future legislation, such as measures to make improvements to the individual health insurance marketplaces.

Congressional Republicans will hold an initial procedural vote on Monday and a final Senate vote on Tuesday. After passage in the Senate, the measure will head to the House for final passage and then onto President Donald Trump for his signature.

CHIP Reauthorization, PPHF Cuts Proposed in Latest House Government Funding Bill

This week, House Committee on Appropriations Chairman Rodney Frelinghuysen (R-New Jersey) introduced a continuing resolution to extend government funding through January 19, 2018. Recall, last week Congress passed a two-week government funding measure that expires next Friday, December 22.

In addition to extending overall government funding, H.J. Res. 124, which is currently in the House Appropriations Committee, would reauthorize the Children’s Health Insurance Program (CHIP) for five years, as well as provide two years of funding for community health centers. However, the legislation includes a $6.35 billion cut to the Prevention and Public Health Fund (PPHF) over the next 10 years as an offset for community health center funding.

The California State Association of Counties (CSAC) and CHEAC submitted a letter to California’s House delegation, as well as leadership of the House Committee on Appropriations, expressing our opposition to the use of PPHF as a funding offset. The offsets proposed in H.J. Res. 124 continue to also be opposed by House Democrats. At this time, it is not clear when the measure will be considered or held for a vote. CHEAC will continue to monitor the proposal and provide updates as necessary.

CMS No Longer Accepting State Proposals to Finance Medicaid 1115 Demonstrations

Today, the U.S. Centers for Medicare & Medicaid Services (CMS) released a letter to states announcing that CMS will no longer accept state proposals to finance Medicaid 1115 Demonstrations by drawing down federal funds for programs that have historically been paid for by states outside of Medicaid. These time-limited arrangements, known as Designated State Health Programs (DSHP), allow states to bypass paying their usual share of Medicaid expenses for demonstration programs. Current DSHP demonstrations will continue until the end of the demonstration period, but will not be extended or renewed.

More information on CMS’s decision is available here.

NACCHO Announces Accreditation Support Initiative Awardees

The National Association of County and City Health Officials (NACCHO) announced today the awardees of the 2017-2018 Accreditation Support Initiative (ASI). These awards will support local health departments in addressing needs in preparing and applying for accreditation through the Public Health Accreditation Board (PHAB). The ASI awards are made possible by funding and support of the U.S. Centers for Disease Control and Prevention (CDC) Office for State, Tribal, Local and Territorial Support (OSTLTS).

We are pleased the following California counties were among the latest ASI awardees:

  • Madera County Public Health
  • Mono County Health Department
  • San Luis Obispo County Public Health Department
  • Santa Cruz County Health Services Agency, Public Health Division
  • Tulare County Health & Human Services Agency, Public Health Branch

Please join us in congratulating our California ASI awardees. More information on NACCHO’s Accreditation Support Initiative is available here.

CDPH to Host Let’s Talk Cannabis Community Toolkit Webinar Next Week

The California Department of Public Health (CDPH) will hold a webinar to preview the Let’s Talk Cannabis Community Toolkit on Tuesday, December 19 from 9:00 am to 10:00 am. The webinar is designed to assist local health agencies, public health practitioners, and other local partners start a conversation on the potential health effects of using cannabis. Part 1 of the toolkit will be unveiled during the webinar, and a discussion will be held on various resource items and needs of communities.

More information is available here. The webinar may be accessed here. For questions, please contact CDPH at

Tobacco Free Kids Releases Annual Tobacco Prevention Funding Report

The Campaign for Tobacco Free Kids, along with a handful of other partner organizations, released this week Broken Promises to Our Children: A State-by-State Look at the 1998 Tobacco Settlement 19 Years Later. The report examines the expenditure of tobacco settlement funds and taxes and finds that many states are significantly underfunding tobacco prevention and cessation programs. Throughout the country this fiscal year, states will collect $27.5 billion from tobacco settlement and taxes; however, less than three percent of these funds—$721.6 million—are spent on tobacco-related programs.

However, according to the report, California’s recent efforts in tobacco prevention and cessation have made the state an exception. When ranked by percent of CDC-recommended funding levels, California is ranked first in the country, spending 94.2 percent of the CDC’s recommendation ($327.8 million).

California alone accounts for 45 percent of total state spending on tobacco prevention and cessation programs throughout the country, largely due to Proposition 56 which raised the state’s tobacco tax by $2.00. The revenue from Proposition 56 is by far the most any state has spent on tobacco prevention and cessation programs, and California increased its previous year’s tobacco prevention and cessation expenditures by more than $252 million.

More information and an overview of the report are available here. The full report is available here.

FDA to Begin New Tobacco Cessation Campaign

The U.S. Food and Drug Administration plans to launch a new tobacco cessation campaign in January 2018 titled Every Try Counts. The campaign will target adults with cessation education aimed at encouraging cigarette smokers to quit tobacco use through messages of support that highlight health benefits of quitting tobacco use. These messages will be displayed in and around gas stations and convenience stores – retail locations where smokers face triggers that typically feature cigarette advertisements. The campaign will feature a variety of cessation resources, including a text message program, a mobile app, trained cessation coaches, and information about FDA-approved cessation medications.

More information on the campaign is available here. A new website,, has also been launched and is available here.