State reduced funding for public health in decade before pandemic

Sharp reductions in state funding for core public health functions over the past decade may have weakened New York’s defenses against the coronavirus pandemic, according to testimony delivered today by Bill Hammond, the Empire Center’s senior fellow for health policy.

Click here for a copy of Hammond’s prepared testimony.

“Public health is the ultimate form of preventive medicine,” Hammond testified. “As we know from the recent experiences of better prepared countries, a relatively small strategic investment in pandemic preparedness has the power to save countless lives and avoid massive disruptions to the economy and normal life.”

The state’s allotment for core public health functions is a fraction of 1 percent of the Medicaid budget—a share that has been flat or declining for the past decade.

Among the areas cut sharply over the past decade was the division of the Department of Health that handles, among many other functions, nursing home inspections.

Also cut sharply, and slated for another deep cut this year, is the Wadsworth Center, one of the world’s foremost public health laboratories—whose recent accomplishments included quickly developing an alternative coronavirus test when the CDC’s test failed. Its state operating budget has plunged by 40 percent over the past decade, from $129 million in fiscal 2011 to $78 million in 2021.

During that same decade, the state share of Medicaid soared by 39 percent, or $6.8 billion.

Some of these public heath functions might be getting supplemental assistance through Health Research Inc., a quasi-governmental non-profit organization. HRI’s tax forms show $1.3 billion in expenditures during fiscal 2020, but its finances are not included in state budget documents. Since it appears to be playing a large and growing role in public health and other core state functions, the Legislature should insist on full transparency from this organization.

HRI’s role notwithstanding, there is little doubt that New York allowed its public health infrastructure to shrink in the years leading up to the worst public health crisis in at least a century.

“Bolstering the state’s public health system also requires at least some money—most likely a mere fraction of the annual increase in Medicaid. New York should make that strategic investment,” Hammond recommended in his testimony. “Doing it properly starts with a thoughtful examination of how the state’s public health infrastructure performed during this pandemic, and an honest assessment of where it needs improvement.”