Values for America · Brief for congressional offices

To the office of U.S. Representative Monica De La Cruz

Re: HR 10086 (119th Congress), Diabetes Prevention Program Reauthorization Act of 2026 · Latest action (2026-08-13): Referred to the House Committee on Energy and Commerce.
VFA SI Solution #268 · published 2026-08-16 · https://www.valuesforamerica.com/solutions/268
Office of record (Congress.gov): 1415 Longworth House Office Building, Washington, DC · (202) 225-9901

State Diabetes Prevention Block Grant Act of 2026

The measure, as described from the official record: Reauthorize federal funding for community-based diabetes prevention programs to reduce the incidence of type 2 diabetes and associated healthcare costs.

The proposal

This Act establishes a new block grant program under the Public Health Service Act, administered by the Secretary of Health and Human Services, to provide flexible funding to states for evidence-based diabetes prevention initiatives. Each state receiving a grant shall submit a plan describing how funds will be used to reduce the incidence of type 2 diabetes in high-risk populations, including through community-based lifestyle interventions, screening, and referral programs. The Secretary shall define minimum evidence standards based on peer-reviewed research, but states retain discretion in program design and implementation. No state shall be required to adopt any specific curriculum or partner with any private entity as a condition of receiving funds. Grantees must report annually on outcomes, including number of participants, changes in risk factors, and cost-effectiveness. The program is funded by an annual appropriation from general revenues, capped at $500 million, and shall sunset after 5 years unless reauthorized by Congress. The HHS Office of Inspector General shall audit a random sample of state programs each year to ensure compliance with evidence standards and proper use of funds. If a state is found to have materially misused funds, the Secretary may reduce future allocations by up to 20% for one year.

Operative provisions (VFA proposal)

funding source: Annual appropriation from general revenues (non-earmarked Treasury funds).
funding amount: $500 million per fiscal year, adjusted for inflation.
sunset years: 5 years
oversight body: Office of Inspector General, Department of Health and Human Services
enforcement mechanism: Audit-based reduction of future grant allocations for noncompliance; no criminal penalties.
effective date: October 1, 2026

Constitutional basis

Article I, Section 8, Clause 1 (Spending Clause – general welfare and conditional grants to states)
Tenth Amendment (reserving to states powers not delegated to the United States)
Article I, Section 8, Clause 18 (Necessary and Proper Clause to carry out the spending power)

Concerns with the measure as written:

Potential overreach under the Commerce Clause if the program mandates specific state-level activities or regulates private conduct without a clear nexus to interstate commerce.
Risk of circumventing the Tenth Amendment by requiring states to implement federally prescribed prevention models rather than allowing flexibility.

Why both sides can back it (VFA’s assessment)

Democratic priorities: Continued federal investment in public health prevention, targeting underserved communities, and requiring evidence-based outcomes. Republican priorities: State flexibility through block grants, funding caps, sunset provisions, and no federal mandates on private partnership or curriculum.

Values for America is a nonpartisan, constitution-first SI think tank. This brief is informational. It is a policy proposal, not law, and it does not support or oppose any candidate or party. Full analysis and sources: https://www.valuesforamerica.com/solutions/268 · Methodology: https://www.valuesforamerica.com/methodology