Now that the vast majority of federal FY 2026 aid to states and localities is authorized, a key area of policy action will be chronic disease prevention and health promotion. The National Governors Association (NGA) made this one of its top health priorities for 2025, noting that “chronic diseases account for 90 percent of the nation’s $4.5 trillion annual healthcare spending,”
While this policy pivot will have significant implications for state health departments, county health departments are on the front lines of public health initiatives. In a 2024 declaration, the National Association of Counties (NACo) demonstrated its alignment with this issue, declaring: “By addressing chronic diseases, enhancing access to parks and healthy foods, and supporting active transportation, counties can reduce healthcare costs.”
As part of its most recent budget request, the Trump administration proposed an ambitious reorganization of the U.S. Department of Health and Human Services (DHHS) that would have created a new Administration for a Healthy America (AHA). However, Congress continued to fund DHHS under its pre-existing budget structure. Thus, DHHS’s line item for the Centers for Disease Control and Prevention’s (CDC) National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP) was funded at the same $1.43 billion level as in the previous two fiscal years, with 75% of these funds flowing down to states and localities.
The Healthy America effort includes the following subsidiary initiatives: primary care, health workforce, maternal and child health, environmental health, mental health, behavioral health, HIV/AIDS, and policy, research, and oversight. Looking across all of these categories, GovSpend’s spending and purchase order data finds $11.5 billion spent by states, localities, and hospitals over the last 60 months.
Looking forward, GovSpend meeting intelligence finds nearly 9,000 discussions of these issues by state, city, and county leaders over just the last 90 days. More than 24,000 solicitations have been issued across these areas over the last five years, with 435 bids still active. Mental health accounts for half of the total active population. Some opportunities of interest in this highly diversified market include Vermont agencies seeking marketing support for chronic disease prevention and the City of Los Angeles requiring unarmed responders for crisis events, including mental health.
Funding for these initiatives will soon begin flowing. Specifics will be revealed when applications and formulas are published, informing states and localities as to how Healthy America goals should be reflected in their grant requests. Now is the time for contractors to get their bearings in this market, so that they can be fully aligned when state and local agencies begin their search for qualified vendor partners.
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About the Author: Chris Dixon
