Advocacy + Policy
2019 Policy Priorities
These documents summarize the Big Cities Health Coalition priorities and can be used by members and others when advocating for funding and policies at the Federal level:
BCHC Letters to Congress and the Administration
Coalition joins over 100 Organizations To Urge the Senate to Match the Funding for CDC’s Programs in the House FY20 Appropriations Bill
June 21, 2019 - The Big Cities Health Coalition signed a letter to urge the Senate to match the $8.22bn provided to the Centers for Disease Control and Prevention’s programs in the House FY20 Labor, Health and Human Services, and Education, and Related Agencies Appropriations Bill. Read the full letter here.
Coalition Joins 27 Organizations in Writing to Senators On Tobacco 21 Legislation
June 20, 2019 - The Big Cities Health Coalition joined other leading health organizations in writing to Senators to set out their views on two recently introduced bills in the Senate. The organizations voiced their support for the Tobacco to 21 Act, and commended Senators Brian Schatz (D-HI), Todd Young (R-IN), Dick Durbin (D-IL), and Mitt Romney (R-UT) for introducing the bill. The organizations also commended Senate Majority Leader Mitch McConnell (R-KY) and Senator Tim Kaine (D-VA) for introducing the Tobacco-Free Youth Act, though urged the removal of one clause requiring states to enact their own Tobacco 21 laws or risk losing federal substance abuse prevention and treatment funding. Read the full letter here.
Coalition Joins 36 Organizations to Support the Tobacco to 21 Act 2019 and the Reversing the Youth Tobacco Epidemic Act 2019
June 3, 2019 - The Big Cities Health Coalition signed a letter to Representatives to support these two Bills, which seek to prohibit the sale of tobacco to those under 21 - the Bills have been drafted to ensure they can be implemented quickly and contain no special interest provisions. Read the full letter here.
Coalition Joins 50 Organizations to Support the Introduction of the Reversing the Youth Tobacco Epidemic Act 2019
May 21, 2019 - The Big Cities Health Coalition signed a letter to Rep Frank Pallone and Rep Donna Shalala to support the Act, which seeks to prohibit flavorings to cigarettes (including menthol) and e-cigarettes, as well as prohibiting the sale of tobacco to those under 21. Read the full letter here.
Coalition Joins 550 Organizations to Seek Stronger Funding for Health and Human Services Programs
April 1, 2019 - The Big Cities Health Coalition signed on to a letter to federal appropriators urging an increase funding in 302(b) for the Departments of Labor, Health and Human Services and Education.
Coalition Joins Over 60 Organizations in Call for Congress to Pass Pandemic and All-Hazards Preparedness & Advancing Innovation Act
March 22, 2019 - The Big Cities Health Coalition joined over 60 health organizations in a sign-on letter that urges the U.S. Senate to pass the Pandemic and All-Hazards Preparedness & Advancing Innovation Act, PAHPAI, H.R. 269, which was passed by the U.S. House of Representatives and the Senate Health Education, Labor & Pensions (HELP) Committee. The legislation provides the U.S. Department of Health and Human Services (HHS) with authorities for preparing the healthcare and public health systems for disasters and strengthening the medical countermeasures enterprise.
BCHC Joins CDC Coalition in Urging Congress to Fully Fund Programs
March 4, 2019 - The CDC Coalition, a group of 225 members including the Big Cities Health Coalition (BCHC), sent a letter to Congressional leaders to fund the Centers for Disease Control and Prevention (CDC) with at least $7.8 billion in FY 2020. The CDC’s work is essential to protect public health from threats like emerging disease, opioid use and misuse, tobacco and obesity epidemics and to ensure preparedness in the face of disasters and emergencies.
Coalition Lauds Reintroduction of Climate Change Health Bill
March 4, 2019 - In a letter sent to Senator Markey and Representative Cartwright, the Big Cities Health Coalition (BCHC) thanked the two lawmakers for reintroducing the Climate Change Health Protection and Promotion Act. The letter, which was signed by more than 30 health and medical organizations, highlighted the impacts that climate change is expected to have on public health and the importance of the proposed legislation in preparing both Federal agencies and local health departments for these challenges,
Coalition Calls on Congress to Increase Funding for Environmental Health
February 27, 2019 - The Big Cities Health Coalition (BCHC) called on Congressional leaders to increase funding for the CDC’s National Center for Environmental Health in FY2020 to provide at least $230 for vital programs that protect environmental health. The letter sent today, which was co-signed by other public health and environmental health organizations, urges lawmakers to invest in environmental health prevention programs that will help reduce illness, disease, injury and death now and in the future.
BCHC Urges Congress to Fund CDC Firearm Research
February 21, 2019 - The Big Cities Health Coalition (BCHC) today sent letters to House and Senate leaders urging them to provide $50 million in funding to the Centers for Disease Control and Prevention (CDC) in 2020 to research firearm morbidity and mortality research. Because of 1996 amendment to a federal spending bill that barred the CDC from advocating for gun control, the CDC has not been conducting research into important issues related to firearm injuries and death. Earlier this month, the Secretary of Health and Human Services (HHS) stated that CDC can in fact conduct this research if the funds are appropriated by Congress. This research would be critical in addressing the gun violence in communities across the country.
Coalition Joins Other Health Orgs in Calling on President to End Shutdown
January 17, 2019 - The Big Cities Health Coalition (BCHC) joined 279 other public health organizations in signing a letter to the President outlining the numerous health impacts of the partial government shutdown including food safety, environmental health, nutrition and food assistance and the general impact of financial insecurity on health. The signers urged the President and Congress to act quickly to find a solution and reopen the government.
Coalition Joins Host of Health Groups in Urging Senate to Act Now on PAHPAI
January 11, 2019 - The Big Cities Health Coalition (BCHC) joined other health organizations in sending a letter urging Senate leaders to quickly pass the Pandemic and All-Hazards Preparedness & Advancing Innovation Act (PAHPAI, HR 269). The bill first passed the U.S. House in December 2018, but the Senate failed to act. The House has again passed the bill to start the new year. It would be a setback for our national health security, the letter reads, to further delay reauthorization.
Coalition Joins Others to Urge Congress to Fund Gun Violence Research
December 19, 2018 - The Big Cities Health Coalition (BCHC) joined other public health organizations in a letter urging Congressional leaders to fund essential gun violence research at the Centers for Disease Control and Prevention (CDC). Research into gun violence is the first step in enacting policies that will stem the gun violence epidemic facing communities across the country, and CDC leadership has said the agency is ready to begin the research when funding is provided. Read the letter here.
BCHC Voices Opposition to Proposed Changes to “Public Charge Rules”
December 10, 2018 - The Big Cities Health Coalition (BCHC) submitted comments in a letter to the Department of Homeland Security (DHS) to voice opposition to proposed changes to the “Public Charge Rule,” which would severely restrict access to safety net benefits designed for poor families, including Supplemental Nutrition Assistance Program (SNAP), Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) and Children's Health Insurance Program (CHIP). The letter described that just the proposed changes are having a “chilling effect” on people seeking necessary primary and preventive health care, and among those who are eligible for assistance programs designed to help low-income families stay strong, productive and raise children who thrive.
BCHC Calls on Congressional Leaders to Reauthorize Health Security Legislation
December 5, 2018 - The Big Cities Health Coalition (BCHC) signed a letter to Congressional leaders encouraging them to pass the Pandemic and All-Hazards Preparedness & Advancing Innovation Act (PAHPAI). This important legislation is essential to our nation’s health security, providing the U.S. Department of Health and Human Services (HHS) with authorities for preparing the healthcare and public health systems for disasters. Many of these authorities have already expired, or are due to expire this month, and the letter urges Congress to pass the legislation without delay.
BCHC Head Urges the Surgeon General to Focus on Health Equity in Response Call to Action on Community Health Investment
November 9, 2018 – Chrissie Juliano, Director of the Big Cities Health Coalition (BCHC) submitted comments to the Surgeon General in response to the “Surgeon General’s Call to Action to Improve Community Health and Prosperity”. In coordination with the Centers for Disease Control and Prevention, the Surgeon General has requested comment on the planned document, which will look to use case studies and other evidence to prove the business case for investing in community health. Ms. Juliano’s comments cover a number of topics, all of which focus on the need to address the social determinants of health and health equity in order to improve health and prosperity.
Members Push FDA to Ban Flavored E-Cigarettes in Light of New Data on Teen Tobacco Use
October 9, 2018 - In a letter to Scott Gottlieb, MD, Commissioner of the Food and Drug Administration (FDA) members of the Big Cities Health Coalition (BCHC) urged the agency to use its regulatory authority to ban flavors in e-cigarettes, or vaping products. The FDA banned flavors in traditional cigarettes in 2009. New data makes clear that young people are now using e-cigarettes at record rates, and the FDA has announced that it is currently considering whether to ban flavors is these new products.
BCHC Questions HHS Funding for Care of Detained Children on US Border
October 4, 2018 — In a letter to the Secretary of Health and Human Services (HHS), Alex Azar, the Big Cities Health Coalition (BCHC) joined 109 other health organizations today in voicing their concern over how the department is funding care of immigrant children forcibly separated from their parents at the US border. These children are being detained in custody for extended periods of time, as a direct result of the administration’s own immigration policies, and the cost of their care is being drawn directly from funds appropriated in FY 2018 for public health and medical research. The letter writers urged HHS to make clear their plan to deal with this public health crisis and to request from Congress the funds necessary to ensure the health and wellbeing of these children.
Coalition Urges Congress to Include Trauma Provisions in Final Version of Opioids Bill
September 20, 2018 — The Big Cities Health Coalition (BCHC) joined 49 organizations and 27 individuals in signing a letter to leaders in the House of Representatives and the Senate. The letter praised them for the recent passage of the Opioid Crisis Response Act and encouraged them to ensure that all trauma provisions in the Senate bill remain in the final version of the legislation. One consequence of the ongoing opioid crisis is the impact on children. More children are experiencing adverse childhood experiences and being referred to foster care—these trauma have a profound effect on children and continue to impact the rest of their lives. The signers highlighted the importance of specific provisions of the bill that address childhood trauma as a result of the opioid crisis and implored Congressional leaders to ensure that they remained in the final version.
BCHC Submits Comments on Proposed EPA Rule to Limit Access to Science and Data
August 16, 2018 - Chrissie Juliano, Director of the Big Cities Health Coalition (BCHC) submitted comments on the EPA's proposed rule "Strengthening Transparency in Regulatory Science" in a letter to Acting Administrator Andrew Wheeler. Speaking on behalf of the coalition, she voiced opposition to the proposed rule because it would limit the available science that can be used in regulatory decision and could lead to the repeal of important regulations that currently protect the public's health.
Coalition Submits Comments on Proposed Title X Program Changes
July 31, 2018 - Title X is the federal family planning program that about 4 million people rely upon each year for affordable birth control and reproductive health care. BCHC submitted comments to HHS, standing with our partners across the health landscape in firm opposition to the proposed regulatory changes to the Title X Program. More than half of Title X grantees are state and local health departments that play a critical role in ensuring access to a broad range of family planning and complete preventive health services to communities. And, those departments that are not Title X grantees work alongside funded entities to ensure services such as family planning and STI and HIV testing are available in communities across the U.S. The Coalition believes that health care services should be evidence-based, and patients should have the autonomy to make the decisions that are right for their health and themselves with the help and support of their provider.
Coalition Joins Opposition to New EPA Transparency Rule
July 16, 2018 - BCHC joins 68 other health organizations in a statement opposing the EPA's proposed new "Strengthening Transparency in Regulatory Science" rule. The rule would prohibit the EPA from enacting new regulations based on data that is not publicly available, which will make it much more difficult to make new policies and as a result,could expose people to real harm.
Letter to CDC Director Redfield on Lack of Opioid Dollars to Large Local Jurisdictions
July 13, 2018 - States, territories, and five big cities – Chicago, Houston, Los Angeles, Philadelphia, and New York - were recently pre-approved to receive funds from the CDC quickly and directly in a public health emergency. However, in a recent opioid funding opportunity using this emergency mechanism, the five large local jurisdictions were not included. Leaders from the five cities today sent a letter to Dr. Redfield explaining the importance of federal dollars getting local to address the opioid crisis.
Coalition Weighs in on HHS Request for Information on Teen Pregnancy Prevention Program Data
June 4, 2018 - Chrissie Juliano, director of the Big Cities Health Coalition (BCHC), wrote a letter to Health and Human Services (HHS) Secretary Alex Azar in response to HHS’s request for information about data collection related to the Teen Pregnancy Prevention Program (TPPP). The future of the program is being discussed at HHS and the letter highlighted the importance of having accurate data to assess the outcomes that TPPP has produced.
Coalition Supports FDA Move Toward a Product Standard to Reduce Nicotine Levels in Cigarettes
May 21, 2018 - The Big Cities Health Coalition signed on to a letter. along with 40 other public health organizations, to the U.S. Food and Drug Administration Commissioner Dr. Scott Gottlieb. The letter was written in support of the FDA initiative moving toward a product standard to reduce the nicotine level in cigarettes to non-addictive or minimally addictive levels. The letter also urged the commissioner to move quickly in enacting the proposal.
Coalition Calls on Congress to Protect the FDA's Authority Under the Family Smoking Prevention and Tobacco Control Act
May 4, 2018 - Along with 54 other public health organizations, the Big Cities Health Coalition sent letter to relevant House and Senate Appropriations Subcommittees, requesting user fees the the Tobacco Control Act authorizes the FDA to collect. It also urges the subcommittees to not restrict the FDA's authority under the Act.
Coalition Urges HHS Not to Undermine Title X Family Planning Program through "Global Gag Rule"
May 18, 2018 - The Big Cities Health Coalition joined more than 110 other organizations in signing a letter to Secretary of Health and Human Services Alex Azar in urging him to reject calls to issue a "domestic gag rule". The gag rule would require health professionals to knowingly withhold counseling on and referrals for safe legal abortions or would impose onerous requirements in order to exclude certain providers from Title X funding. The letter highlights the fact that these changes would disproportionately impact people of color.
Coalition Urges Congress to Fund Teen Pregnancy Prevention and Opioid Prevention
March 13, 2018 – Lawmakers in Congress have until March 23 to pass a funding bill to keep the federal government funded and open. The Big Cities Health Coalition (BCHC) wrote letters to House and Senate Leadership on behalf of its members urging them to enact final, omnibus legislation for FY2018 that includes all spending bills, especially for the Labor-HHS bill. The letters highlighted the need to continue funding for the Teen Pregnancy Prevention Program (TPPP) rather than abruptly end important work going on in localities across the county. The letters also call on Congress to continue to provide funding for the ongoing opioid crisis and makes an appeal for additional funds for opioid prevention efforts.
Coalition Joins Public Health Organizations Against Cuts to Prevention & Public Health Fund
November 29, 2017 - The Big Cities Coalition signed onto a letter with 60+ organizations to Congress coming out in support of the swift re-authorization of important safety net programs without using funding from the Prevention & Public Health Fund as an offset. Cutting the Prevention Fund - which supports 12% of the Centers for Disease Control and Prevention's budget and important lead poisoning, vaccination and chronic disease prevention programs - would undermine the very core mission of this legislatation and we urge the support of the full continuum of programs that improve Americans' health.
Coalition Submits Comments to HHS on FY2018-2022 Draft Strategic Plan
October 27, 2017 - The Big Cities Health Coalition submitted a letter with comments on the U.S. Department of Health and Human Services's Draft Strategic Plan FY2018-2022. While the Coalition agrees with some of the plan's major goals that align with the core missions of local health departments and public health, members are equally concerned with specific parts of the plan that pose great risk to patient choice, reduce health coverage, exacerbate health disparities and worsen health outcomes.
Coalition Submits Comments to FDA on Nutrition Facts Proposed Rule Extension
October 31, 2017 - The Big Cities Health Coalition submitted a comment letter to the U.S. Food and Drug Administration (FDA) opposing the agency's proposal to delay the compliance deadline for the Nutrition Facts Label Final and Serving Size Final Rules. Further delay of the rulings would deprive consumers of accurate and scientific information critical to making informed food choices. The Coalition urges the FDA to move quickly to maintain the current compliance dates and implement the rulings, giving consumers access to science based nutrition labeling information.
Coalition Voices Opposition to Cuts to Prevention and Public Health Fund
October 4, 2017 - The Big Cities Health Coalition wrote a letter to Majority and Minority leaders of the U.S. House of Representatives and the Chairperson and Ranking Member of the House Energy and Commerce Committee expressing opposition to a recent legislative proposal that would cut over $6 billion in funds from the PPHF over the next decade. The cuts to the fund,the nation’s first and only funding stream dedicated solely to improving public health through prevention and wellness, would prove devastating for the ability of member health departments to promote health, prevent illness, and treat disease.
Coalition Opposes Latest Version of Affordable Care Act Repeal, Graham-Cassidy
September 18, 2017 - The Big Cities Health Coalition wrote to the Majority and Minority leaders of the U.S. Senate, voicing opposition to the most recent Congressional efforts to repeal the Affordable Care Act. Along with cancelling Medicaid coverage for millions of Americans, the legislation, like those before it, would defund the Prevention and Public Health Fund, a key source of support for local health departments all over the country.
Coalition Urge HHS to Reconsider Decision to Eliminate Funding for Teen Pregnancy Prevention Program (TPPP)
July 25, 2017 - Members of the Big Cities Health Coalition sent a letter to U.S. Department of Health & Human Services Secretary Tom Price, urging agency leadership to reconsider their decision to cut funding and prematurely end the Office of Adolescent Health's Teen Pregnancy Prevention Program (TPPP). Members expressed concern that an abrupt cut to TPPP funding will waste critical spending efforts and impact U.S. teen pregnancy rates in the near future.
Coalition Welcomes CDC Director, Dr. Brenda Fitzgerald
July 24, 2017 - The Big Cities Health Coalition sent a letter to newly confirmed CDC Director, Dr. Brenda Fitzgerald, congratulating the Director on the appointment and welcoming her to the agency. The Coalition affirmed the importance of the CDC and the offices and programs that provide critical support to local health departments as they work to keep their residents healthy and safe.
City Health Departments Urge FDA to Keep Nutrition Label Improvements on Track
May 31, 2017 - Members of the Big Cities Health Coalition wrote a letter to the United States Food and Drug Administration (FDA), urging officials to maintain the July 2018 compliance date for the implementation of an updated Nutrition Facts label for packaged foods. Some food industry executives have requested that the deadline be delayed. The new labels will show the amount of added sugar foods contain for the firm time, which is essential nutritional information for all consumers to know. Some companies have already begun implementing these new requirements, exhibiting their feasibility.
Coalition Joins with Other Public Health Groups to Protect Smoking Prevention Funds
April 3, 2017 - Public health groups joined to write a letter to U.S. House and Senate Appropriations Committee leaders, requesting that they protect the Centers for Disease Control and Prevention’s Office on Smoking and Health.
Coalition Urges U.S. House Leaders to Protect Public Health Funding that is Currently at Risk
March 22, 2017 - The Big Cities Health Coalition wrote a letter to Speaker of the House, Paul Ryan and Minority Leader, Nancy Pelosi today, urging them to protect the Prevention and Public Health Fund, which is threatened by the passage of the American Health Care Act.
Coalition Stands with over 500 Organizations to Protect Prevention and Public Health Fund
March 3, 2017 - The Big Cities Health Coalition signed onto a letter urging President Trump to maintain funding made possible by the Prevention and Public Health Fund and safeguard funding for the CDC and other programs under the Labor-HHS-Education spending bill.
Coalition Joins with 300 Public Health Organizations to Defend Prevention and Public Health Fund
January 9, 2017 - The Big Cities Health Coalition joined with 300 other public health groups to warn Congressional leaders about the "dire consequences" that would occur if the Prevention and Public Health Fund were to be repealed without a replacement. The fund was passed as part of the Affordable Care Act, and is therefore in jeopardy if the law is repealed without a comparable replacement. The purpose of the fund is, "to provide expanded and sustained national investments in prevention and public health, to improve health outcomes, and to enhance health care quality."
Cities Urge Incoming Trump Administration and Congress to Strengthen Public Health
December 5, 2016 - The Big Cities Health Coalition wrote to President-Elect Trump's transition team and Congressional leaders, urging them to empower city health officials to create and execute an ambitious urban public health strategy. The Coalition shared priorities for Empowering Big City Health Departments to Fully be their Community's Chief Health Strategist. The Coalition also advocated recommendations for the Public Health Emergency Fund and Violence Prevention.
Coalition Urges FDA to Implement New Sodium Reduction Targets as Quickly as Possible
December 2, 2016 - The Big Cities Health Coalition wrote a letter to the Commissioner of the Food and Drug Administration today, requesting that the agency enforce new sodium reduction targets as soon as possible in order to save lives.
Coalition Makes the Case for a Strong, Secure Public Health and Prevention Fund
December 1, 2016 - The Big Cities Health Coalition wrote a letter to Congressional leaders today, requesting their support for a strong, secure Prevention and Public Health Fund (PPHF), which was passed as part of the Affordable Care Act. They called the fund the single best resource to invest in prevention, prepare for and respond to infectious disease outbreaks, reduce rates of chronic illness, save lives, and save money. The Coalition also expressed support for the 21st Century Cures bill, but pressed Congressional leaders to avoid offsetting the cost of the bill with cuts to the PHPF.
Coalition Urges Congress to Immediately End Sequestration and Provide a Balanced Budget
October 24, 2016 - The Big Cities Health Coalition sent letters to the Senate and House urging them to act immediately to end sequestration and immediate pass a balanced budget investing in critically important priorities for protecting the public’s health to be funded sufficiently.
Coalition Supports FDA Proposal to set Sodium-Reduction Targets for Processed Foods
October 21, 2016 - The Big Cities Health Coalition sent a letter in support of the Food and Drug Administration’s (FDA) proposal to set voluntary sodium-reduction targets and upper bound concentrations for commercially processed, packaged, and prepared foods.
Coalition Urges Congress to Pass Zika Funding, Restore Public Health Emergency Program
September 15, 2016 - The Big Cities Health Coalition sent a letter urging U.S. Senators to provide emergency funding to address the Zika virus threat at the highest possible funding level for an entire 12 months, without partisan riders. The group also urged Congress to restore FY2016 funds repurposed for Zika from the Public Health Emergency Preparedness program at the Centers for Disease Control and Prevention.
Coalition Opposes Extension of Comment Period for Voluntary Guidance to Industry for Sodium-Reduction Targets
July 29, 2016 - The Big Cities Health Coalition sent a letter to the Food and Drug Administration voicing opposition to any extension of the comment period for the two-year targets for the Food and Drug Administration's draft Voluntary Guidance to Industry for Sodium-Reduction Targets.
Members Push Regulators to Expand Access to Evidence-Based Treatment for Opioid Addiction
May 31, 2016 - The Big Cities Health Coalition requested that the U.S. Department of Health and Human Services review a rule that puts an arbitrary cap on the number of patients medical providers are allowed to treat with an opioid addiction treatment called buprenorphine. Opioid addiction has reached epidemic levels across the nation, and the Coalition advocates for a multi-pronged approach to treat those affected. Buprenorphine is an evidence-based medication-assisted treatment option with a much lower chance of overdose than methadone. Experts say that increasing access could be part of the solution to quelling the opioid crisis.
Coalition Advises Senate Against Using Prevention Fund for Zika Response
May 13, 2016 - The Big Cities Health Coalition sent a letter to Senate leaders today, urging them to avoid using the Public Health Prevention Fund to pay for the nation's response to the Zika virus emergency.
Funding Requests for Fiscal Year 2017
April 12, 2016 - The following letter was sent to the leadership of the House Appropriations Committee and Appropriations Subcommittee on Labor, Health and Human Services, Education and Related Agencies.
Our Letter to Senate on Opioid Abuse Prevention Legislation
March 7, 2016 - The following letter was sent to the leadership of the Senate in support of the Recovery Enhancement for Addiction Treatment (TREAT) Act and Comprehensive Addiction and Recovery Act (CARA).
Coalition Comments on The CDC's Opioid Prescription Guidelines
January 13, 2016 - The Coalition weighed in on the Food and Drug Administration's proposed guidelines on the federal government's Guideline for Prescribing Opioids for Chronic Pain, calling it "an important part of a multi-pronged approach needed at the federal, state, and local level to combat the opioid addiction crisis facing the nation today."