PAHPA Reauthorization in 2026: Why Public Health Preparedness Is Back in Focus
Key points
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PAHPA is a major U.S. law that supports national public health emergency preparedness and response.
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The law has been overdue for reauthorization since 2023, creating uncertainty for long-term planning.
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In 2026, Congress is showing new bipartisan momentum to restart the reauthorization process.
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Policy discussions include a shift of more readiness responsibility to states, including stockpiling and planning.
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Experts warn that inconsistent “boom-and-bust” funding weakens preparedness between crises.
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The outcome of the 2026 effort could shape how the U.S. funds and manages future emergencies.
What is PAHPA?
The Pandemic and All-Hazards Preparedness Act (PAHPA) is a federal law that authorizes programs and powers used to prepare for, respond to, and recover from public health emergencies—helping coordinate federal agencies with state and local health systems.
After years of delay, Congress is again turning its attention to one of the most important laws governing national emergency health readiness. The Pandemic and All-Hazards Preparedness Act (PAHPA), the backbone of U.S. public health emergency infrastructure, is expected to return to legislative debate in 2026.
Originally enacted in 2006 and updated in 2013 and 2019, PAHPA created the framework that coordinates federal, state, and local responses to health emergencies. It authorizes programs that manage medical countermeasures, disaster medical response, stockpiles of critical supplies, and protections for vulnerable populations. Many of the systems used during COVID-19 were built on authorities granted under this law.
Yet despite its central role, PAHPA has been overdue for renewal since 2023. Congressional gridlock and budget negotiations sidelined the legislation for more than two years. Temporary funding measures kept key programs alive, but the absence of formal reauthorization created uncertainty for agencies and state partners responsible for preparedness planning.
A New Bipartisan Push
Momentum appears to be returning. Lawmakers have reopened discussions this spring, with bipartisan leadership taking charge of drafting an updated bill. Congressional offices are actively collecting stakeholder input, signaling that formal legislative text may emerge later this year.
Public health organizations say the delay has highlighted how dependent preparedness systems are on predictable funding. Without long-term authorization, states struggle to plan staffing, stockpile investments, and training programs. Emergency readiness requires steady infrastructure, not short-term patches.
Shifting Responsibilities to the States
At the same time, the federal government is reevaluating how disaster response authority is distributed. Recent executive policy has emphasized transferring more readiness responsibilities to state and local governments. This includes expectations that states maintain their own protective equipment reserves and evaluate supply chain resilience independently.
Supporters argue that local control increases flexibility and speed. Critics worry that uneven funding across states could widen preparedness gaps. Public health leaders stress that collaboration — not replacement — must define the relationship between federal and state agencies.
Funding Stability Remains a Central Concern
Experts across the preparedness community warn that emergency systems suffer from “boom and bust” cycles. Funding spikes after crises and declines once public attention fades. That pattern weakens long-term infrastructure and makes it harder to maintain trained personnel.
Programs supporting hospital preparedness and public health emergency coordination rely heavily on consistent federal investment. These cooperative agreements allow local agencies to translate national policy into operational readiness. Without stable funding, response capacity erodes quietly between disasters.
The Broader Stakes for National Security
Preparedness advocates increasingly frame public health readiness as a national security issue. Biological threats, supply chain disruptions, and emerging diseases carry economic and geopolitical consequences. Maintaining vaccine development pipelines, stockpiles, and emergency logistics is not just a health concern — it is strategic defense planning.
Industry leaders also emphasize that predictable federal partnerships encourage private investment in medical innovation. Long-term commitments reduce risk for companies developing vaccines, diagnostics, and countermeasures that may not be immediately profitable but are essential during crises.
What Happens Next
Congressional timelines remain uncertain, but stakeholders expect renewed negotiations throughout 2026. The upcoming federal budget process may shape the direction of PAHPA updates, particularly as policymakers debate how responsibilities should be shared between Washington and the states.
For now, preparedness agencies continue operating under temporary extensions. Public health experts say the longer formal reauthorization is delayed, the harder it becomes to sustain the infrastructure built after the COVID-19 pandemic.
The outcome of this legislative cycle will determine whether the nation strengthens its emergency framework — or continues navigating crises with short-term fixes.
ASTHO blog: The Future of PAHPA and National Public Health Preparedness (Feb 16, 2026)
