Over the past few weeks, we have learned how recent federal policy proposals, including the potential Affordable Care Act (ACA) replacement plan and the President’s federal budget proposal, will have a drastic impact on crucial public health services in Baltimore and across the United States. In public health, we have a clear responsibility to speak up for those who may not be able to advocate on behalf of themselves, especially our society’s most vulnerable. In recent days, I have made it a priority discuss the impact of the Affordable Care Act repeal on the residents of Baltimoreand millions of other Americans who will lose coverage as a result of the proposed legislation.

That is why this week, I joined the Congressional Baby Caucus, chaired by Congresswoman Rosa DeLauro (D-CT), to discuss how investments in early childhood create success for infants, toddlers, and their families and how the ACA repeal would negatively affect infant health. We know that prenatal care is crucial for healthy babies: women who do not have prenatal care are seven times more likely to have a premature baby and are five times more likely to have their baby die in infancy. With health care coverage, many of these complications are preventable. As advocates for health, our mandate is clear: we must protect Medicaid and funding for programs supporting reproductive health services in order to safeguard the well-being of our families.

Meanwhile, Hank Greenberg, CEO of AARP Maryland, and I shared our deep concern for federal budget cuts that are threatening critical services to older adults in The Daily Record. In Baltimore City, there are more than 100,000 residents over the age of 60. One in six of these residents live below the poverty line. For older adults of color, that ratio is two in five. In addition to exacerbating the impacts of the potential ACA replacement by sabotaging the health safety net for seniors, the proposed budget will decrease funds for two critical nutrition programs, inhibit the ability of older adults to age in place, and eliminate several programs that help with employment and volunteerism for older adults. We cannot afford to place these inappropriate and illogical budgetary burdens on the backs of a generation of Americans who have already sacrificed so much for our country.

We must also remember there is even more to the repeal of the ACA than the potential loss of health insurance by tens of millions of Americans. The ACA currently includes a sustained mechanism to safeguard a healthier, more secure, and financially stable future for America, the Prevention and Public Health Fund (PPHF), that is now at risk. As I wrote in STAT this week, the PPHF, which currently accounts for nearly one-seventh of the Centers for Disease Control and Prevention's budget—approximately $1 billion a year— directly empowers communities to prevent chronic conditions and helps local jurisdictions be more agile in responding to health crises while reducing long-term health. In addition to punishing many of our society’s most vulnerable individuals, the elimination of the PHHF would endanger our national security and raise long-term costs to the detriment of taxpayers and insurers.

In short, repealing the ACA will be devastating for the health of Americans.

Those of us on the front line of health must remain vigilant in responding to both long-term challenges and emerging health threats. We must raise our voice for the most vulnerable populations to ensure that they do not lose access to the lifesaving services they need.

The future health of our country depends on it. 

Sincerely,

Leana Wen, M.D., M.Sc.