Bethesda, MD -- A new policy brief from Health Affairs and the Robert Wood Johnson Foundation focuses on the Prevention and Public Health Fund created under the Affordable Care Act of 2010. The fund was originally authorized to spend $15 billion over its first ten years, but will be cut by a third under an agreement between the Obama administration and Congress to finance an extension of payroll tax cuts and to forestall Medicare payment cuts for physicians. Meanwhile, some lawmakers have targeted the fund for complete elimination, arguing mainly that the spending is unnecessary or less urgent than other priorities.

The brief covers the following:

• The rationale for creation of the fund. Much of the public health funding in the past focused on averting or containing epidemics of infectious disease. However, the biggest health threats today are chronic, noncommunicable diseases, which are highly preventable through public education, behavior changes, and other interventions. The fund was expected to be a vehicle for making important gains in health promotion and prevention and addressing these newer health threats.
  
  
• How monies from the fund have been spent by federal, state, and local agencies. Much of the $500 million disbursed during the fund's first year went to programs, such as developing the primary care workforce, prompting some public health advocates to worry that resources weren't all being used as intended by the law. Some dollars from the prevention fund have also been used to offset earlier cutbacks in public health spending.
  
  
• What's next? The prevention fund faces pressures beyond the one-third cut in funding now agreed to by President Obama and Congress. Lawmakers are likely to scrutinize how the fund's prevention dollars are spent and what, if any, benefits can be traced to that spending. Ultimately, whether the fund succeeds or fails will depend on whether it leads to increased health promotion and prevention efforts that in turn translate into improved health outcomes across a diverse set of communities and populations.

Health Policy Briefs are aimed at policy makers, congressional staffers, and others who need short, jargon-free explanations of health policy basics. The briefs, which are reviewed by experts in the field, include competing arguments on policy proposals and the relevant research supporting each perspective.

Previous policy briefs have addressed:

• Small Business Insurance Exchanges: States must form new marketplaces aimed at helping small companies buy coverage more easily and cheaply.
  
  
• Next Steps for ACOs: Will this new approach to health care delivery live up to the dual promises of reducing costs and improving quality of care?
  
  
• Medicaid Reform: Many states want greater flexibility, and there is pressure to limit federal spending. Critics fear serious damage to the social safety