984: Childhood Vaccination Efforts; FY26 Public Health Funding

SUMMER JOHNSON: 

This is the award-winning Public Health Review Morning Edition for Friday, September 5, 2025. I'm Summer Johnson. Now, today's news from the Association of State and Territorial Health Officials.

ARTI BARNES: 

I feel the voices of our people, of our Illinoisans, can be the strongest that are heard when they are aware of what's going on with vaccinations in their communities.

JOHNSON: 

That's Dr. Arti Barnes, chief medical officer of the Illinois Department of Public Health. As recent changes to federal Medicaid funding threaten to reduce access to pediatric vaccinations, her department continues to work on reducing barriers to care. Barnes shares that her agency is working with the Illinois State Board of Education to pinpoint why and where vaccinations are declining.

BARNES: 

We have partnered very closely with them to look at school vaccination rates and look at exemptions that have been rising in terms of school vaccinations, providing both local health departments that are interested as well as the schools profile of the vaccine their own vaccination rate, so that they can use that information and determine how important would it be for them to start enforcing some of the exemptions.

JOHNSON: 

Illinois' efforts also include enrolling medical providers and birthing hospitals in the Vaccines for Children program, which provides free vaccinations to children who are Medicaid-eligible.

BARNES: 

We want children, babies that are born there to get the RSV and other important seasonal respiratory vaccines before they leave the hospital, to the best of our ability, and blunt the impacts of RSV among our babies and then, consequently, in the community at large.

JOHNSON: 

Barnes says her department's relationships with colleagues overseeing Medicaid in the Department of Health Care and Family Services allows them to be proactive in protecting constituents.

BARNES: 

During our recent measles outbreak, we were able to get our Medicaid agency to expand coverage for the additional MMR vaccine for children six months to 11 months old who might need that additional vaccine in an outbreak setting, and so we have a very productive partnership that's both proactive in terms of future needs as well as reactive in terms of situational needs that emerge that will impact our Medicaid population.

JOHNSON: 

Illinois isn't the only state with creative efforts to improve childhood vaccination rates. To hear more about what other states are doing, check out our recent conversation with the New Jersey Department of Health. We'll have a link to that episode in the show notes.

It's September, and things are only heating up in D.C. when it comes to funding the federal government for Fiscal Year 2026. ASTHO's, Senior Director for Government Affairs, Jeffrey Ekoma, is here to walk us through what is sure to be a busy month on Capitol Hill and a Legislative Alert ASTHO put out to its members this week.

Happy Friday, Jeffrey, we made it on this short week.

JEFFREY EKOMA: 

Yes, happy Friday. Glad to be back, as always.

JOHNSON: 

It's September. So, a lot of things are happening in D.C. Schools are open and Congress is back from recess. What are the public health priorities that you're looking out for in September?

EKOMA: 

Yes, as you mentioned, August recess has come and it's gone, and so much has changed within that period. There has been significant leadership changes within the CDC that resulted in the agency being without a director, and the resignation of agency officials that followed shortly thereafter. Members on both sides of the political aisle have expressed concern with changes at the agency, specifically considering that the director was confirmed by the Senate shortly before Congress went on recess. Also, funding for the federal government expires on September 30, and activity on LHHS' Appropriation Bill is expected to continue into the following weeks. There are also other discussions on 340B drug pricing program, vaccines, and AI that will likely be of interest to respective committees of jurisdiction, but like always, we'll be tracking that very closely.

JOHNSON: 

ASTHO sent out a Legislative Alert to members on Wednesday of this week about the LHHS subcommittee markup for FY26. How'd it go? Give us the analysis.

EKOMA: 

So, to begin and to take a little bit of a step back, you know, the Senate advance its FY26 LHHS Bill just prior to the August recess out of the full appropriations committee. Overall, the bill provided either level or slight increase in funding to a majority of programs. The bill also rejected the administration's FY26 budget proposal to restructure, eliminate, or consolidate many public health programs. Now, earlier in the week, the House advanced its FY26 Appropriation Bill out of the subcommittee, and consideration before the full appropriations committee is expected to be sometime next week. Similar to the Senate, the bill also rejected many of the recommendations of the administration's FY26 budget proposal, but it did propose steeper cuts to funding across HHS and this includes a $6.8 billion decrease to HHS budget, a $1.7 billion decrease of CDC's budget, including the elimination of programs like the Preventative Health and Health Services Block Grant, tobacco control, firearm injury and mortality prevention research, and also funding for domestic and global HIV/AIDS activities. Now, it's really important to note that the bill proposes funding increases for programs such as public health infrastructure and DMI, among other programs, but again, it still proposes other cuts, such as cuts to HRSA, and SAMHSA, and ASPR. Like you said, we did put out a Legislative Alert that delves a little bit deeper into the bill and also implications for public health agencies.

JOHNSON: 

From here, what are the next steps in the appropriation process?

EKOMA: 

Yeah, there's lots of things that have to be decided. You know, as we approach FY26 on October 1, both the House and the Senate are expected to negotiate up until the expiration of funding at the end of the month. Now, there's lots of chatter as to what could happen next. Some options on the table include maybe a potential short-term CR to provide Congress with a little bit more time to negotiate appropriation bills. Or maybe it's a CR for bills that are unresolved prior to the beginning of the next fiscal year, that is combined with an omnibus or a package of bills that are passed by Congress, or maybe a full-year CR, which doesn't seem as likely at this present moment. Another option could be a partial shutdown that is limited to agencies that do not have an appropriation bill that was passed by Congress and signed by the President, or a full shutdown. There's lots of options on the table with Congress coming back. They're just beginning to have those negotiations, not just only within Congress, but also with the administration. But you know, we'll be following really closely to really understand the impact on our members.

JOHNSON: 

And this all needs to be wrapped up by the 30th or then the shutdown conversation starts, right Jeffrey?

EKOMA: 

Correct, correct. Yeah, the current fiscal year ends on September 30, and the absence of any appropriation bills or CR or continuation of funding would trigger a shutdown on October 1.

JOHNSON: 

Thank you for your analysis, Jeffrey, and we look forward to hearing from you more on this show as things progress throughout September, we really appreciate it.

EKOMA: 

Thank you so much, and look forward to chatting very soon.

JOHNSON: 

Next up, if you missed the webinar ASTHO held on navigating ethical issues in wastewater surveillance for infectious diseases, you can still catch the full-length recording online now. Learn about the growing role of wastewater surveillance and get the tools you need to deploy it ethically. We've made it easy. Just click on the link in the show notes to get the recording.

Finally, this morning, ASTHO extends a hearty congratulations to new member, Dr. John Dunn, on his appointment as interim commissioner for the Tennessee Department of Health. Dunn was previously Tennessee's state epidemiologist and has held several leadership roles within the agency for over 18 years, including serving as director of foodborne, vector-borne, and zoonotic diseases. To learn more about Commissioner Dunn, visit the link in the show notes.

That'll do it for today. We're back on Monday morning with more ASTHO news and information. I'm Summer Johnson, you're listening to the award-winning Public Health Review Morning Edition. Have a great weekend.