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Congresswoman Debbie Dingell (MI-06) led 40 of her House colleagues in sending a letter to Department of Health and Human Services Secretary Robert F. Kennedy Jr. demanding answers about the agency’s actions to pull back billions of dollars of funding sent to state and community health departments by the Center for Disease Control and Prevention (CDC) and Substance Abuse and Mental Health Services Administration (SAMHSA). 

“The agency rescinding $11.4 billion of authorized funding without any congressional action or input is extremely concerning. This funding includes support for state and local health department employees who work around vaccines which are paramount for defending our population from any disease,” the lawmakers wrote. “Especially with the outbreak of measles and avian flu, our nation needs a robust public health system for effectively investigating and tracking disease outbreak and disseminating that data. With the cuts to the agency, we are worried that sufficient support will no longer be available leading to a breakdown in our public health infrastructure."

“We are also concerned about the future of vaccines. Funds supporting vaccine implementation were expected to expire in 2027, and we are alarmed that they could now be cut two years short. These immunization programs are used to educate people in communities about vaccines and preventable diseases and support surveillance and lab capacity to track infectious diseases. Inadequate funding will severely limit outreach to vulnerable populations including rural communities and nursing homes for vaccines. In addition, this funding supports staff who work on multiple projects, and it is unclear which other programs may be affected until staff have left,” the lawmakers continued.” Beyond infectious diseases control and prevention, the CDC also provides critical support for the management of other chronic diseases. This includes people with asthma, allergies, diabetes, and heart disease. These patients are at greater risk for more serious infection or hospitalization from infectious diseases, and they rely on a strong public health infrastructure with employees to carry out critical public health interventions tailored to the needs of the local community. We fear clawing back this funding will impact the health of people living with chronic conditions across the nation.”

“Regarding SAMHSA, we are concerned about $1 billion of grants that will be discontinued. Such cuts and restructuring will deteriorate our mental health infrastructure,”the lawmakers concluded. “We know that over 84.5 million American adults have a substance use or mental health condition, and we cannot cut resources for these services. Last year alone, SAMHSA distributed over $6.9 billion in grants to fight the opioid epidemic, end suicide deaths, and transform the lives of countless Americans facing substance use disorder and mental illness."

Specifically, the lawmakers requested answers to the following questions: 

1. Does the Department certify that all the nearly $11.4B funds being rescinded from CDC are non-obligated, expired by statute funds? If so, please specify under which statue they are expired.
2. Does the Department certify that the $1B being rescinded from SAMHSA are nonobligated, expired by statue funds? If so, please specify under which statue they are expired.
3. Please provide a detailed list of the state, local, territorial, and tribal health departments that will be impacted, and how much funding they will lose and from which authorization or appropriation legislation the funding is being rescinded.
4. Has HHS determined how this funding cut will impact payroll or cause staff layoffs throughout local health departments? If so, how will HHS track this?
5. Please provide the agency’s plan to maintain FY2024 appropriated activities for the following diseases in light of the announced reduction in funds:
   1. COVID-19
   2. Measles
   3. H1N1
   4. RSV
   5. Whooping Cough
   6. Tuberculosis
   7. Avian Flu
   8. Healthcare-Associated Infection (HAI)
   9. Antimicrobial Resistance (AR) Programs

View the full text of the letter here.