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State and Territorial Health Leaders Convene on Capitol Hill to Advocate for Sustained Funding ARLINGTON, VA—The Association of State and Territorial Health Officials (ASTHO) leadership and public health officials will gather in Washington, D.C. from March 10-13 for the annual Spring Leadership Forum. Attendees will gather to discuss key policy issues, attend peer learning sessions, and advocate for critical funding on Capitol Hill. Health officials are expected to highlight the value of federal funding to public health agencies as well as infrastructure needs, with the looming expiration of federal funding on March 14. Specifically, ASTHO requests Congress provide $365 million in FY25 and invest $1 billion, which equates to about $3 per person in the United States, in FY26 for vital public health infrastructure. “This week, ASTHO members are meeting with Congress to advocate for adequate resources to sustain vital, life-saving public health operations,” says Joseph Kanter, MD, MPH, ASTHO CEO. “In-person meetings allow health officials to shed light on the impact of legislation on state-level health systems. Our goal is to foster bipartisan collaboration and advocate for Americans across the country who rely on federally funded programs to stay healthy.” Additionally, senior leadership from the five U.S. territories and three freely associated states (T/FAS) will participate in an island-tailored set of meetings with Congressional and federal agency partners. On Capitol Hill, ASTHO’s T/FAS members will discuss the impact of the recently renegotiated Compacts of Free Association, as well as emphasize the importance of territorial Medicaid funding and the challenges associated with the Section 1108b cap on territorial Medicaid funding. "ASTHO’s Spring Leadership Forum is a critical opportunity for U.S. territorial and freely associated state health officials to make our voices heard in Washington, D.C. We look forward to working with members of Congress and federal agencies on emerging federal and island public health priorities," says Dr. Esther Muña, CEO of the Commonwealth of the Northern Mariana Islands’ Commonwealth Healthcare Corporation, chair of the ASTHO Insular Affairs Committee, and Director on the ASTHO Board. ASTHO Press Release Boilerplate website yes

COVID-19 has stressed the U.S. healthcare and public health systems and highlighted racial and ethnic disparities in pre-existing conditions and health outcomes. In this episode, our guests discuss how health officials can serve as chief health strategists to work across sectors and ensure that all people have access to the services and resources that allow them to be well. This episode also details how states and territories can transform service delivery, ensure equitable access to prevention and healthcare services, and ultimately build stronger, more resilient communities.

This episode emphasizes the importance of addressing heart disease and stroke prevention through approaches that center on health equity, including systems-level changes, quality improvement, and community development. CDC’s Division for Heart Disease and Stroke Prevention is partnering with ASTHO to support jurisdictions in successfully integrating efforts with healthcare and community partners and implementing best practices and evidence-based policies to identify, control, and improve blood pressure.

On March 2, 2023, ASTHO announced that during the 2023 spring meeting, island health officials will also meet with Congress and the administration to urge them to strengthen island health systems and infrastructure.

ASTHO and PIHOA Praise Approval of Medicaid Funding Fix for U.S. Territories ARLINGTON, VA—This week, Congress approved legislation to extend Medicaid funding for two years for the U.S. territories in their fiscal year 2020 appropriations bills and extenders package. Esther Muña, the chief executive officer of the Commonwealth Healthcare Corporation, Association of State and Territorial Health Officials (ASTHO) board member, and Emi Chutaro, executive director of the Pacific Island Health Officer’s Association (PIHOA), issued the following statements applauding the bipartisan and bicameral extenders package. The legislation avoided devastating cuts to the territories’ health care services for their most vulnerable residents, scheduled to take place at the end of the year—widely called the “Medicaid Cliff.” “The U.S. territories face unique healthcare and public health challenges and the support provided through the Medicaid program allows us to care for Americans who live on these islands in their communities,” says Chutaro. “It is vital that we prioritize public health for Americans living in the U.S. territories,” says Nate Smith, secretary of health at the Arkansas Department of Health and ASTHO president. “Ensuring access to care is essential to protect and ensure health equity among and well-being within this population. As state health officials, we know that what benefits the territories will help us in our quest to bring optimal health to all.” “We are grateful for the bipartisan and bicameral legislation which provides a two-year increase in funds and federal match for the Medicaid program in the U.S. territories," says Muña. “The increased funding will allow the health care and public health systems in the U.S. territories to further improve access and quality of care to the population. This funding continues to be vital to all of the U.S. territories, and while we are grateful for this temporary fix, we must find a long-term solution to Medicaid funding to provide stability to our system of care. In the upcoming year, we look forward to working collaboratively with Congress and the Trump Administration to further bolster health care and public health systems to build healthy and resilient communities throughout the U.S. territories.” ASTHO Press Release Boilerplate PIHOA Boilerplate website yes

In this ASTHO Member Spotlight, Esther Muña of the Commonwealth of the Northern Mariana Islands discusses her routine, professional influences, and public health priorities.

Public Health Leaders Will Visit Congress and Stress the Need to Invest in Infrastructure, the WIC Program, and Island Priorities ARLINGTON, VA—Members of the Association of State and Territorial Health Officials (ASTHO) will gather in Washington, D.C. this week to advocate for critical investments in public health infrastructure, the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC), and stronger island health systems. Health officials are expected to stress the importance of a strong public health system, building on post-COVID-19 investments in state, territorial, and island jurisdiction health agencies during their meetings with members of Congress and key officials at the Capitol. ASTHO requests Congress sustain funding of $350 million in FY24 and invest $1 billion or about $3 per person in the U.S. in FY25 for vital public health infrastructure. This urgently needed, flexible, disease-agnostic, sustainable funding is crucial for building a resilient system that protects all Americans. "The nation can’t afford another boom-and-bust or panic-neglect cycle, especially after all we learned from the COVID pandemic," says Michael Fraser, PhD, ASTHO CEO. "Emergency funding surges during crises, then disappears, leaving us unprepared for the next threat. Sustained funding matters. We are grateful Congress has taken steps over the years to invest in public health infrastructure and it is critical that these funds are maintained and increased to continue to meet evolving national healthcare needs. We are talking about less than the price of a cup of coffee a year for every American to support states and the islands to continue to build the public health system we need in the years ahead." ASTHO is also urging Congress to provide full funding for the WIC program in the final FY24 appropriations bill. WIC could face a $1 billion shortfall in 2024, resulting in a significant reduction in participation, that will disproportionately affect Black and Hispanic families if Congress maintains the current funding level for WIC. The impact of cuts would force states to limit participation and possibly establish waiting lists or turn away eligible individuals from the program. Senior leadership from the Atlantic and Pacific U.S. territories and freely associated states (FAS) will meet with key Congressional and federal partners to address unique healthcare challenges. Two challenges are at the center of their agenda: seeking a legislative change to achieve Medicaid funding for the U.S. territories in parity with state Medicaid funding structures and ensuring critical health financing is available to the FAS through an extension of the Compacts of Free Association. "ASTHO’s Spring Meeting is a critical convening for U.S. territories and freely associated state leaders to advocate for their priorities. We look forward to working with members of Congress and with federal agencies to find solutions to island health equity challenges," says Dr. Esther Muna, CEO of the Commonwealth of the Marianas Islands Healthcare Corportation and chair of the ASTHO Insular Affairs Committee and Director on the ASTHO Board. For more information about ASTHO’s advocacy, view ASTHO’s 2024 Federal Legislative Agenda. ASTHO Press Release Boilerplate website yes

U.S. Territories Face Healthcare Cuts if Congress Does Not Address Impending Medicaid Financing Cliff ARLINGTON, VA—Association of State and Territorial Health Officials (ASTHO) member Esther Muña, MHA, chief executive officer at the Northern Mariana Islands Commonwealth Health Corporation, and other territorial health leaders from Guam, Puerto Rico, America Samoa, and the U.S. Virgin Islands testified today before the United States House Committee on Natural Resources about the impact that cuts to Medicaid would have on U.S. territory populations. “On the heels of Super Typhoon Yutu, which devastated the Commonwealth of the Northern Mariana Islands’ economy and its people, we face another crisis – our Medicaid program is unable to sustain its operations with the low statutory cap on federal contributions,” says Muña. “Low federal contributions, coupled with the exhaustion of the Patient Protection and Affordable Care Act funds this year, creates a fiscal cliff for our Medicaid program. This fiscal cliff threatens to unweave our substantial improvements over the past ten years in the delivery of healthcare, further erodes our economy, and threatens the health and well-being of our people. “I strongly urge Congress to stabilize Medicaid financing for the territories by raising or eliminating the arbitrary cap on federal dollars to the program so I can continue my work to protect and promote the health our population,” Muña continues. Unless Congress acts, the U.S. territories’ Medicaid programs will become gravely underfunded. Federal funding for Medicaid in territories is capped and it is subject to a fixed federal matching rate. For more information about the hearing, visit the committee’s website. ASTHO Press Release Boilerplate website yes