The highly partisan nature of public health funding was on full display Tuesday as House Energy and Commerce Republicans questioned the need for more federal funding for the Centers for Disease Control and Prevention.
Democrats, meanwhile, argued that a more sustained public health funding stream could improve the nation’s overall health.
The focus on the CDC reflects a broader Republican scrutiny of public health agencies. In the last few months, GOP members in both chambers have also released blueprints on how to reform, restructure and reorganize the National Institutes of Health.
Their concerns reflect a larger confidence crisis in the American public health apparatus. About one-quarter of Americans say they’ve lost trust in the CDC in the wake of the COVID-19 pandemic, according to a 2022 survey published in Health Affairs.
House Republicans hope to reduce the CDC’s funding by $1.8 billion, or a 22 percent reduction, in fiscal 2025 via the House Labor-HHS-Education funding bill.
The House GOP spending bill would also eliminate funding for 23 CDC initiatives, including Firearm Injury and Mortality Prevention Research, the Center for Forecasting and Analytics, Opioid Overdose Prevention and Surveillance, Tobacco Prevention and Control, the Climate and Health program and the Ending the HIV Epidemic initiative.
Six top CDC officials defended their agency’s work, telling lawmakers that further investment in the agency is the only way to improve public health readiness and response.
Full committee Chair Cathy McMorris Rodgers, R-Wash., said that the CDC did not meet the moment during the pandemic, and Congress needs to figure out why.
“Of all the government agencies that have broken the public’s trust, the CDC is at the top of the list,” McMorris Rodgers and health subcommittee Chair Brett Guthrie, R-Ky., said ahead of the hearing.
She questioned whether the agency is spreading itself too thin and needs to refocus its efforts on noncommunicable diseases, as well as the effectiveness of the agency’s “moving forward” initiative, which was meant to refocus and reorganize the public health agency after COVID-19.
But Democrats argued that the federal government is underfunding public health.
“There is a serious mismatch between our public health investments and our nation’s public health needs,” Rep. Anna G. Eshoo, D-Calif., said. “Public health has become a casualty of partisanship.”
Demetre Daskalakis, director of the CDC National Center for Immunization and Respiratory Diseases, touted the agency’s work in developing new respiratory syncytial virus vaccines.
Allison Arwady, director of the National Center for Injury Prevention and Control, highlighted the work the agency does to decrease overdose and suicide deaths, and how congressional dollars aid that work.
The House Republican fiscal 2025 funding bill eliminated funding for Arwady’s agency, a potential cut, she said, that “would be devastating.”
Multiple agencies have programs to reduce overdose deaths and suicides, she said, but the CDC’s work helps identify what substances Americans are overdosing on and sends that information to local public health agencies. Without this information it could be difficult to respond to drug overdoses.
Arwady told Rep. Dan Crenshaw, R-Texas, that her division is currently working to detect fentanyl and opioids in wastewater. Although the agency cannot yet distinguish illicit opioids from prescribed ones in wastewater, they have teams working on it. Crenshaw told Arwady this is an example of the kind of work he and other Republicans think the agency should be doing – tracking diseases.
However, the agency’s work to track and prevent communicable diseases is still ongoing – most recently monitoring the H5N1 outbreak in dairy cows that has infected 10 humans.
Daskalakis told lawmakers he is closely watching the spread of the virus from cows to dairy workers.
Rep. Morgan Griffith, R-Va., expressed concerns that the agency isn’t doing enough testing of dairy workers. Daskalakis told him the agency is working with state public health systems, especially in Michigan, to get more on-the-ground testing.
Two vaccine candidates are currently available for H5N1 bird flu should they be needed. The CDC is working with the Administration for Preparedness and Response to develop the vaccine.
Multiple Republicans, including McMorris Rodgers, Guthrie and Larry Bucshon of Indiana, said the CDC has strayed from its original mission and is doing too much. The CDC’s data modernization project has received more than $1 billion in funding, but Bucshon lamented that the project has “yet to bear fruit.”
Crenshaw criticized the CDC for researching how racism impacts public health and considering gun violence a public health issue. He told the CDC officials there’s no need for the health agency to research gun violence, because other agencies can handle it.
“When there’s more police doing their jobs, there’s less crime,” he said. “When there’s less police, when they get defunded, there’s more crime. I did all your research for you. It’s done. It’s that simple.”
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