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Policy Trends Shaping Public Health Funding and Administration in 2026 Policy Trends Shaping Public Health Funding in 2026 Learn about policy trends shaping public health funding and administration in 2026, including increased funding for behavioral health and other areas. Decades of underinvestment in the nation’s public health system have impacted agencies’ ability to respond to health challenges. The COVID-19 pandemic revealed the fragility of a chronically under-resourced sector tasked with responding to a global emergency. While public health has received influxes of funding through the CARES Act and American Rescue Plan Act over the last five years, both were temporary injections of funding in response to COVID-19. There have been efforts to provide longer term funding for public health improvements through the Public Health Infrastructure Grant and the Prevention and Public Health Fund, but this funding faces an uncertain future: There have been multiple reductions in federal funding to the Prevention and Public Health Fund since its creation in 2010. Moreover, state public health agencies are preparing for the possibility of federal funding being reduced or cancelled. This, coupled with balanced budget requirements, is driving states to explore ways to improve their public health investments while bolstering infrastructure — focusing on health departments’ core services, and ensuring access to quality public health programs at the state and local levels. Increased Funding for Public Health In 2025, 47 states enacted or will enact budget bills. While overall nationwide funding for public health in FY26 was roughly equivalent to FY25, at least half of the state health departments had some form of increased funding (e.g., Medicaid, provider reimbursement rates, and specific public health initiatives and programs). For example: Behavioral Health: Colorado SB 25-206 included a $1.6 million increase in funding to provide behavioral health services in primary care settings. Certification: Illinois SB 2510 includes a $6 million increase to support licensing, inspecting, and certifying health care facilities for compliance with state and federal regulations. Maternal and Child Health: Georgia HB 68 provided a nearly $3 million increase in funding to expand a pilot program that provides home visits in at-risk and underserved communities during pregnancy and early childhood. Rural Health: Arizona’s budget bills include $4 million to expand access to health care through the development of rural medical residency programs. School-Based Health Centers: Delaware HB 225 appropriates funding to develop school-based health centers in elementary schools with more than 90% of students classified as low-income, multilingual learners, or underrepresented minorities. Leg Prospectus-2026 - Funding - Rural Health Improved Public Health Administration Several states passed legislation restructuring their public health systems. Nevada enacted SB 494, dividing the previous Department of Health and Human Services into two separate agencies. The bill gives the new health agency, called the Nevada Health Authority, the authority to oversee health programs (e.g., Medicaid and the Children's Health Insurance Program), manage health care compliance and consumer health services, and develop policy that improves health care access and cost efficiency. Hawaii’s HB 1120 formally gives the Department of Health the authority to prevent, address, and abate any issues that pose a threat to public health and/or environmental health, such as toxic materials, vector-borne diseases, and climate change. More than half of U.S. state health agencies are decentralized or largely decentralized, meaning many public health services are provided by city, county, or regional health departments that are separate from the state health agency. In 2025, at least two states enacted legislation enhancing local health departments’ abilities to provide core public health services: Utah SB 172 requires the Department of Environmental Quality to enter into cooperative agreements with local health departments to prevent and respond to potential health and safety threats from the environment. It also establishes a governance committee of state and local health department personnel to evaluate proposed policy changes affecting local health departments and ensure allocated resources meet the minimum performance standard. Washington HB 1946 modifies the membership requirements for local health boards, allowing federally recognized tribes with reservation or trust lands in the board’s jurisdiction to have members on the board. It also allows urban Indian organizations recognized by the Indian Health Service that provide services within that jurisdiction to have members. Looking Ahead ASTHO anticipates states and territories will continue considering and adopting legislation to provide state funding for public health and improve public health infrastructure, including those that: Create contingency plans or rainy-day funds in the event of reduced federal funding. Establish partnerships with neighboring states to share health data. Promote sharing services and resources within local health departments. Leverage regionalization as a tool to consolidate and share scarce public health resources. Adapt the funding and management of public health grants to ensure efficiency. Improve public health data systems to promote greater efficiency. OE22-2203 PHIG article yes

This toolkit is designed to support public health leaders in leveraging the policy development process to achieve health equity in their jurisdiction.

Adopting a public health approach to substance use by implementing harm reduction policies across all levels of government can help communities address the overdose crisis. This post analyzes e

There are significant disparities in pregnancy-related outcomes in the United States. Many of these deaths considered preventable, so state and federal policy makers are taking steps to improve health outcomes for pregnant people.

Under the Tenth Amendment, states have the power to protect the health and welfare of their populations, including the authority to implement isolation and quarantine orders to limit the spread of disease. This post is an examination of state public health authority for isolation and quarantine.

Several states and territories, as well as many local governments, are going beyond recommendations and requiring individuals to wear face coverings when they are in public settings and spaces (i.e. grocery stores, retail stores, restaurants, public and private transportation services, parks, etc.). Ongoing research and evidence suggests the relationship between mandatory face coverings and declines in daily COVID-19 growth rates is statistically significant.

The 2020 holiday season is coinciding with a nationwide surge of COVID-19 cases. With great concern that holiday travel to see loved ones may exacerbate community spread of the virus, many states are increasing public health measures before the winter holiday season. As of November 16, 2020, 13 states and D.C. had a quarantine requirement for out-of-state travelers. The U.S. territories also have instituted travel restrictions to limit the spread of COVID-19.

ASTHO Legislative Prospectus | Prevention 2025 state legislative action on infectious disease control and prevention.

State Policies Aim to Eliminate Food Deserts Beth Giambrone Learn how states are working to improve access to healthy foods and eliminate food deserts in this Health Policy Update. The environment where we live, work, and play can shape eating habits and make healthy eating difficult. This is especially true when nutritious foods are costly and unavailable and unhealthy foods are abundant and accessible. More than 47 million people nationwide live in food insecure households, including more than 7 million children. In addition, more than 27 million people live in "food deserts," generally defined as areas where residents do not have a convenient option for affordable, healthy food, like a supermarket or large grocery store. People who live in food deserts may be at higher risk of obesity and chronic disease. Furthermore, children and young adults who live in food insecure households are more likely to have poor academic outcomes. Increasing Access to Healthy Foods In recent years, jurisdictions have taken a multi-layered approach to increasing access to healthy foods. In 2023, the Texas legislature enacted HB 3323, which established a food system security and resiliency planning council, and requires a food system security plan for reasonably-priced food to ensure public health and welfare, economic development, the protection of the state’s agricultural resources, and includes legislative recommendations to facilitate the availability of food in the state. In 2024, Delaware enacted SB 254, establishing the Delaware Grocery Initiative to expand access to healthy foods in the state’s food deserts and areas at risk of becoming food deserts. The bill authorizes the state’s Division of Small Business to award grants and financial assistance to entities that provide or support affordable, accessible, or healthy food, including food banks and pantries, supermarkets, and corner stores. It also directs the Delaware Council on Farm & Food Policy to develop a strategy to address food insecurity in communities throughout the state and issue a report by June 1, 2025. Also in 2024, Colorado enacted HB 24-1416, codifying an incentive program designed to increase access to fresh fruits and vegetables in low-income communities. In 2024, jurisdictions also enacted legislation that makes supplemental nutritional assistance more accessible. California (AB 2786) requires the Department of Food and Agriculture to allow newly created certified mobile farmers’ markets to participate in the Women, Infants, and Children Program (WIC) Farmers’ Market Nutrition Program, if approved by USDA. Connecticut (HB 5003) requires the Department of Agriculture to purchase and make needed equipment available so certain nutrition program participants can make purchases at farmers’ markets. And Pennsylvania (SB 721) established a permanent Women, Infants, and Children State Advisory Board to advise the Department of Health on solutions to increase participation in the WIC program, including increasing access to WIC-authorized stores for participants. Jurisdictions also enacted legislation ensuring students receive healthy school meals through farm-to-school programs. New Hampshire HB 1678 created a pilot program that incentivizes school districts to buy food for school meals that come from local farms and producers. Virginia HB 830/SB 314 established a Farm to School Program Task Force within the Department of Education to increase farm-to-school school programs within the state, including programs where public schools purchase and feature locally produced food prominently in school meals and learning opportunities related to local food and agriculture. Ensuring Students are Fed At the beginning of the 2023-2024 school year, eight states, including California, Colorado, Maine Massachusetts, Michigan, Minnesota, New Mexico, and Vermont, provided free school meals to all public-school students regardless of income. In 2023, Illinois (HB 2471) and Washington (HB 1238) also enacted legislation to provide universal free school meals or expand access to free school meals for public school students. The programs in both states are subject to funding. In 2024, at least two jurisdictions enacted legislation to study and report on the cost and impact of providing free breakfast and lunch to all public-school students. Maryland (SB 579) required the Department of Education to submit a report on the cost of providing free meals to all public school students by December 1, 2024, while Virginia (SB 283) directed the Superintendent of Public Instruction to explore the impact of offering free school meals to all students and identify options to eliminate student and school meal debt and leverage federal and state programs to provide school meals. Virginia’s report was published in November 2024 and, while noting the significant costs and sustainability concerns associated with free school meals for all students, it included several strategies for maximizing existing meal programs in the state. A number of jurisdictions have also expanded eligibility requirements or updated student meal program policies in recent legislative sessions. Two states enacted legislation requiring all public schools to provide a free breakfast and lunch to students who qualify for a reduced-price meal under the Federal School Breakfast Program and Federal School Lunch Program: Louisiana in 2023 (HB 282) and Delaware in 2024 (HB 125). New Jersey (A5684) took a similar approach and also expanded state-based income eligibility criteria to allow more students to receive free meals at school. In 2023, North Dakota (HB 1494) enacted a law requiring schools participating in the federal school lunch program to adopt and publish a school meals policy that prohibits schools from taking action against students who lack funds or have unpaid meal balances, such as taking away a student’s food if they have already been served, requiring the student to work to pay off the debt, or limiting participation in school activities due to an unpaid balance. Several states also enacted legislation to benefit students during the non-school months through summer food programs. In 2023, Maine enacted LD 947, which requires summer food service program rules to allow for maximum flexibility under federal law for mealtimes and packaging of meals to send home with students. That same year, as part of a broader piece of human services legislation, California (AB 120) required the State Department of Social Services to maximize participation in the Summer EBT program, which provides funding to families with school-aged children to buy groceries during the summer. And in 2024, Hawaii (HB 2430) and New Hampshire (SB 499) enacted legislation authorizing participation in the Summer EBT program. ASTHO will continue to monitor and report on this important issue. article yes

ASTHO staff identified a range of evidence-supported policies considered by state legislatures that could prevent ACEs. This report synthesizes these research and policy proposals and is intended for public health practitioners and policymakers who are considering adopting similar policies.

As new diseases or emergencies arise, working alongside trusted committees can help health officials quickly respond and prevent undue burden on at-risk groups such as people with disabilities, pregnant people, and children.

In 2023 legislative sessions, states considered measures to improve access to care for pregnant people experiencing substance use disorder, increase provider knowledge of screening and treatment practices, coordinate care for conditions co-occurring with SUD, and keeping families together.

The COVID-19 pandemic has had a particularly negative impact on the mental health of adolescent girls. Fortunately, state legislators have been addressing school-based mental health through legislation enacted since the beginning of the pandemic.

An ASTHO blog article on leave policies to support better work/life balance.

Continuing ASTHO’s Legislative Prospectus series—which highlights the top 10 public health policy issues for 2022—this post focuses on mental and behavioral health, as well as supporting the public health workforce.