S-2398-119
Presented to President.
Sponsored by Susan Collins (R-ME)
What it does
This bill would reauthorize two federal public health programs originally created under the Kay Hagan Tick Act: (1) a national strategy and regional Centers of Excellence focused on vector-borne diseases (such as Lyme disease and Rocky Mountain spotted fever), and (2) enhanced grant support to state and local health departments addressing vector-borne diseases. Both programs would be extended from their current 2021–2025 authorization window to 2026–2030. The bill also makes minor technical adjustments to how the national strategy is coordinated, removing a specific reference to the Tick-Borne Disease Working Group and updating coordination language.
Who benefits
People diagnosed with or at risk of tick-borne and other vector-borne illnesses, including the estimated 476,000 Americans diagnosed with Lyme disease annually. State and local public health departments that receive federal grants to build surveillance and response capacity. Researchers and staff at regional Centers of Excellence who would continue receiving federal funding. Rural and suburban communities in high-tick-burden regions (particularly the Northeast, Upper Midwest, and Mid-Atlantic). Physicians and clinicians who benefit from improved diagnostic guidance and research outputs.
Who is hurt
Federal discretionary spending would face continued pressure from these authorizations, potentially competing with other public health funding priorities. The Tick-Borne Disease Working Group, whose formal coordination role is removed by a technical amendment, may have reduced institutional influence over the national strategy. Taxpayers broadly bear the cost of continued program funding. No group faces a direct regulatory burden from this bill.
Supporters argue
Supporters argue that tick-borne diseases represent a growing and underaddressed public health burden — CDC data show reported Lyme disease cases have more than doubled since the 1990s, and many cases go undiagnosed. They contend that the Centers of Excellence and health department grants have built critical infrastructure for surveillance, diagnosis, and treatment, and that allowing these authorizations to lapse would disrupt ongoing research and state-level response capacity at precisely the moment the threat is expanding.
Opponents argue
Opponents argue that reauthorization should be accompanied by a rigorous evaluation of whether the existing programs have produced measurable improvements in disease outcomes, rather than extending funding on autopilot. They contend that the removal of the Tick-Borne Disease Working Group's formal coordination role reduces accountability and expert oversight of the national strategy, and that limited federal public health dollars may be better directed toward diseases with broader or more acute national impact.
Constitutional context
Congress funds and authorizes these programs under the Taxing and Spending Clause (Art. I, §8, cl. 1) and regulates public health infrastructure under the Commerce Clause (Art. I, §8, cl. 3). No significant constitutional tension is present; reauthorizing an existing grant program falls well within established congressional authority affirmed in NFIB v. Sebelius (2012).
Checks and balances
Congress holds the authorization and appropriations power; HHS and CDC implement the programs administratively; annual appropriations processes provide ongoing congressional oversight of actual spending levels.
Historical precedent
The original Kay Hagan Tick Act was enacted in 2019 as part of the Kay Hagan Tick Act (P.L. 116-22), which first established these Centers of Excellence and health department grant programs; this bill is a direct reauthorization of that legislation.