CDC’s Funding for State and Local Public Health: How Much and Where Does it Go?

Summary

Federal funds have long been a major source of support for public health efforts across the United States, estimated for the budget of more than half the state and local health department. The primary public health agency of the federal government, the Center for Disease Control and Prevention Center (CDC) provides most of this money, which helps support public health systems and activities across the country. However, CDC and other federal health agencies are targeted by the Trump administration for downsing and budget cuts, cuts that can affect the amount of funds available for public health. To understand how much CDC funding is provided to the state and local courts, we analyzed FY 2023 funding liability data (see methods and appendix 1). Of the major findings:

• In FY 2023, CDC forced approximately $ 15 billion to the state and local courts. While most (62% or $ 9.2 billion) were from the regular budget of CDC, a significant part (38% or $ 5.7 billion) was a time-limit, complementary funds for Covid-19 and public health infrastructure.
• Of the $ 9.2 billion in regular budget obligations, half ($ 4.7 billion or 51%) was for the Children’s program for vaccines, a mandatory program that offers vaccines without any cost to children who are unlicensed or less and other qualified children (4% were for additional compulsory programs). The remaining $ 4.1 billion (45%) was discretionary funds, with HIV/AIDS, viral hepatitis, STI and TB prevention, chronic disease prevention and health enhancement, public health preparation and response, and many programs, including injury prevention and control, were supported.
• Both Red and Blue States benefit from CDC funding, the states that voted for President Trump in 2024 received most funding (56%) compared to the states voting for Kamla Harris (44%); On per capita basis, the states voting for Harris received a little more than those who voted for Trump ($ 46 vs $ 43 per person).
• The top five state recipients also represent a mixture of red and blue states (California, Texas, New York, Florida and Georgia), as the top five states by financing per capita (district, Alaska, Maryland, Vermont and Vyaming of Colombia).
• According to the region, the southern states obtained the largest part of funding (43%) after the southern states, midwest (19%), and northeast (17%); The south was also in the first place in per capita wealth.

Therefore, funding cuts can have a significant impact on the amount of funds available to states and local courts for public health activities. Such a double vaimi can also represent a double vaimi, combined with the expected end in supplemented funding to support the covid-19 and public health infrastructure, which affects both red and blue states, and especially affect states in the south. While the state and local governments may potentially fill some gaps left by federal dollars, they can withstand their own budget deficiency and other cuts in federal funding, making the country’s public health infrastructure ability uncertain.

conclusion

• In FY 2023, CDC forces $ 14.9 billion for state and local courtsIt included $ 9.2 billion (62%) as part of its regular budget and $ 5.7 billion (38%) in supplementary funding (see Figure 1). These zodiac signs were distributed in the jurisdiction in many categories (see Figure 2).

• Of the regular budget obligations, out of $ 9.2 billion, $ 5.1 billion (56%) was compulsory funds, which was required by law, and $ 4.1 billion (44%) was discretionary and depended on annual appropriation from the Congress. The part of compulsory vs. discretionary funding is provided varied by the state (see Appendix Table 2).
  • The most mandatory money (92%) was for children’s program for vaccinesThe remaining chronic disease was prevented and health enhancement, cross-cutting activities and programs support, and many other small mandatory programs.
  • The discretionary funding was spread over a wide range of public health sectors, with HIV/AIDS, viral hepatitis, STI and the largest share directed for TB prevention efforts (22%). Prevention of chronic disease and health enhancement received the next largest share (17%), followed by public health preparation and response (16%), and injury prevention and control (15%). Different types of other programs included the remaining (see Figure 3).
• Out of $ 5.7 billion in supplementary funds, most ($ 4.9 billion or 87%) were from Public Health and Social Services Emergency Fund (PHSSEF) Covid-19 transferred to CDC by HHS to support public health infrastructure and workforce along with reaction activitiesThe remaining cross-cutting activities and the program supported, including the covid response activities and storm supplementary funds.

• There was a significant variation in the amount of CDC funding provided to 50 states and Washington DCs, from $ 45.9 million to $ 1.4 billion; When the population is standardized by the size of the population, the funding ranged from $ 35 to $ 314 per person. (See Figure 4 and Appendix Table 3).
  • Funding was concentrated in one of the states, in which the top 10 states recipients accounting for 51% of all funding, and the top five states account for a third (34%). The top five states were California, Texas, New York, Florida and Georgia. The per capita, the top five states recipients were Columbia, Alaska, Maryland, Wormant and Vyoming districts (see Figure 5).
  • If the supplementary funds are removed, the CDC funding by the state ranged from $ 25.7 million to $ 906 million, or $ 21 to $ 235 per capita; The top five state recipients represent more than a third (36%) of non-east funds, remaining the same (California, Texas, New York, Florida and Georgia), with a few variety in rank by Capita Funding (District, Alaska, Vermont, Road Island and Viaming) per capita funding (District, Alaska, Vermont, Road Island and Viaming).

• According to the region, the south got the largest part of the total (43%) funding, after which West (22%), Midwest (19%), and Northeast (17%)In per capita terms, the top funded region remained after the South East, West and Midwest. Complementary funding is removed, funding distribution is largely the same as the rank per capita by the region (see Figure 6).
• The states who voted for President Trump in the 2024 election obtained most of the CDC funding, although there was more distribution when the population was standardized by the size of the population. 31 states who voted for President Trump received 56% of the total CDC funding, compared to 44% for 20 states voting for Kamla Harris. Based on per capita, the states voting for Harris received a slightly more ($ 46 per person) than voting ($ 43 per capita) for Trump. With the removal of supplementary funds, the distribution of funding is almost identical (57% for the Trump states and 43% for the states of Harris) while the per capita money was almost (see $ 27 per capita vs $ 28 per capita for the states) (see Fig. 7) (see Fig. 7) (see Fig. 7),

Appendix 1: What is included in the CDC budget?

The budget of CDC is with three major categories:

• A Discretionary Budget prescribed and approved by Congress every year;
• A Mandatory The budget is determined by a specific set of compulsory programs as Congress, such as vaccine for Children’s program;
• Over a few years, Supplement CDCs are also provided funding outside the regular annual appropriation process, usually to help in response to the outbreak of the disease or other health emergencies. Starting in 2020, CDC funding includes supplementary funds supporting the Covid-19 response.

FY 2023, CDC Discretionary The budget was $ 8.28 billion, while Mandatory The budget was a total of $ 6.97 billion. Accurate amount of Supplement Funding is not clear in CDC’s FY2023 budget. Since 2020, the Congress provided the CDC with additional funds through five separate Covid-19 relief laws, most of which were provided to be spent in many years. In addition, other supplements are provided to CDCs through transfer from other agencies. In addition, in the latter law, the Congress canceled some of the pre-approved Covid-19 relief fund for the CDC. The CDC does not publicly suggest how much supplementary funding is available in its budget, so developing a complete picture of the available funding of CDC is a challenge.

However, the CDC reports the funds that it directs the state and local institutions, which was $ 14.9 billion in FY 2013. The CDC reports this funding by category and sub-class (program areas and activities), moreover, KFF specified them by funding types (discrendent, compulsory and supplements), as determined by the appropriation bill language; Appendix Table 1 reflects these categories and corresponding amounts.

Appendix 2: Additional Chart