The Trump administration’s cuts to Centers for Disease Control and Prevention funding for state and native well being departments had vastly uneven results relying on the political leanings of a state, based on a KFF Health News evaluation. Democratic-led states and choose blue-leaning cities fought again in court docket and noticed cash for public well being efforts restored — while GOP-led states sustained huge losses.
The Department of Health and Human Services in late March canceled almost 700 Centers for Disease Control and Prevention grants nationwide — collectively price about $11 billion. Awarded in the course of the covid-19 pandemic, they supported efforts to vaccinate folks, scale back well being disparities amongst demographic teams, improve antiquated programs for detecting infectious illness outbreaks, and rent neighborhood well being staff.
Initially, grant cancellations hit blue and red states roughly evenly. Four of the 5 jurisdictions with the most important quantity of terminated grants had been led by Democrats: California, the District of Columbia, Illinois, and Massachusetts.
But after attorneys common and governors from about two dozen blue states sued in federal court docket and gained an injunction, the stability flipped. Of the 5 states with the most canceled grants, 4 are led by Republicans: Texas, Georgia, Oklahoma, and Ohio.
In blue states, almost 80% of the CDC grant cuts have been restored, in contrast with fewer than 5% in red states, based on the KFF Health News evaluation. Grant quantities reported in an HHS database often called the Tracking Accountability in Government Grants System, or TAGGS, typically don’t match what states confirmed. Instead, this evaluation targeted on the quantity of grants.
The divide is an instance of the polarization that permeates well being care points, through which entry to safety-net well being applications, abortion rights, and the flexibility of public well being officers to answer illness threats diverge considerably relying on the political celebration in energy.
In an emailed assertion, HHS spokesperson Andrew Nixon stated the company “is committed to protecting the health of every American, regardless of politics or geography. These funds were provided in response to the COVID pandemic, which is long over. We will continue working with states to strengthen public health infrastructure and ensure communities have the tools they need to respond to outbreaks and keep people safe.”
The cash in query wasn’t spent solely on covid-related actions, public well being consultants say; it was additionally used to bolster public well being infrastructure and assist comprise many varieties of viruses and illnesses, together with the flu, measles, and RSV, or respiratory syncytial virus.
“It really supported infrastructure across the board, particularly in how states respond to public health threats,” stated Susan Kansagra, chief medical officer of the Association of State and Territorial Health Officials.
The Trump cutbacks got here because the U.S. recorded its largest measles outbreak in over three many years and 266 pediatric deaths in the course of the most current flu season — the highest reported outdoors of a pandemic since 2004. Public well being departments canceled vaccine clinics, laid off workers, and put contracts on maintain, well being officers stated in interviews.
After its funding cuts had been blocked in court docket, California retained each grant the Trump administration tried to claw again, while Texas stays the state with the most grants terminated, with a minimum of 30. As the CDC slashed grants in Texas, its measles outbreak unfold throughout the U.S. and Mexico, sickening a minimum of 4,500 folks and killing a minimum of 16.
Colorado, which joined the lawsuit, had 11 grant terminations at first, however then 10 had been retained. Meanwhile, its neighboring states that didn’t sue — Wyoming, Utah, Kansas, Nebraska, and Oklahoma — collectively misplaced 55 grants, with none retained.
In Jackson, Ohio, a half-dozen neighborhood well being staff got here to work at some point in March to search out the Trump administration had canceled their grant 5 months early, leaving the Jackson County Health Department half 1,000,000 {dollars} quick — and them with out jobs.
“I had to lay off three employees in a single day, and I haven’t had to do that before. We don’t have those people doing outreach in Jackson County anymore,” Health Commissioner Kevin Aston stated.
At one level, he stated, the funding helped 11 Appalachian Ohio counties. Now it helps one.
Marsha Radabaugh, one worker who was reassigned, has scaled again her neighborhood well being efforts: She’d been serving to serve sizzling meals to homeless folks and realized that many purchasers couldn’t learn or write, so she introduced types for companies corresponding to Medicaid and the Supplemental Nutrition Assistance Program to their encampment in a neighborhood park and helped fill them out.
“We would find them rehab places. We’d get out hygiene kits, blankets, tents, zero-degree sleeping bags, things like that,” she stated. As a counselor, she’d additionally remind folks “that they’re cared for, that they’re worthy of being a human — because, a lot of the time, they’re not treated that way.”
Sasha Johnson, who led the neighborhood well being employee program, stated folks like Radabaugh “were basically a walking human 411,” providing assist to these in want.
Radabaugh additionally partnered with a meals financial institution to ship meals to homebound residents.
Ashton stated the abrupt approach they misplaced the funds — which meant the county unexpectedly needed to pay unemployment for extra folks — may have ruined the well being district financially. Canceling funding midcycle, he stated, “was really scary.”
HHS Secretary Robert F. Kennedy Jr., a longtime anti-vaccine activist and promoter of vaccine misinformation, has called the CDC a “cesspool of corruption.” At HHS, he has taken steps to undermine vaccination within the U.S. and overseas.
Federal CDC funding accounts for more than half of state and native well being division budgets, based on KFF, a well being data nonprofit that contains KFF Health News. States that President Donald Trump gained within the 2024 election acquired a better share of the $15 billion CDC allocated in fiscal 2023 than these that Democrat Kamala Harris gained, based on KFF.
The Trump administration’s nationwide CDC grant terminations mirror this. More than half had been in states that Trump gained in 2024, totaling a minimum of 370 terminations earlier than the court docket motion, based on KFF Health News’ evaluation.
The Columbus, Ohio, well being division had acquired $6.2 million in CDC grants, however roughly half of it — $3 million — disappeared with the Trump cuts. The metropolis laid off 11 individuals who labored on investigating infectious illness outbreaks in such locations as colleges and nursing houses, Columbus Health Commissioner Mysheika Roberts stated.
She additionally stated the town had deliberate to purchase a brand new digital well being document system for simpler entry to sufferers’ hospital data — which may enhance illness detection and supply higher therapy for these contaminated — however that was placed on ice.
“We’ve never had a grant midcycle just get pulled from us for no reason,” Roberts stated. “This sense of uncertainty is stressful.”
Columbus didn’t obtain its cash immediately from the CDC. Rather, the state gave the town some funds it acquired from the federal authorities. Ohio, led by Republican Gov. Mike DeWine and a Republican legal professional common, didn’t sue to dam the funding cuts.
Columbus sued the federal government in April to maintain its cash, together with different Democratic-led municipalities in Republican-governed states: Harris County, Texas, house to Houston; the Metropolitan Government of Nashville and Davidson County in Tennessee; and Kansas City, Missouri. A federal decide in June blocked these cuts.
As of mid-August, Columbus was awaiting the funds. Roberts stated the town gained’t rehire workers as a result of the federal funding was anticipated to finish in December.
Joe Grogan, a senior scholar on the University of Southern California’s Schaeffer Institute and former director of the White House Domestic Policy Council in Trump’s first time period, stated state and native companies “are not entitled” to the federal cash, which was awarded “to deal with an emergency” that has ended.
“We were throwing money out the door the last five years,” Grogan stated of the federal authorities. “I don’t understand why there would ever be a controversy in unspent covid money coming back.”
Ken Gordon, Ohio Department of Health spokesperson, wrote in an electronic mail that the $250 million in grants misplaced had helped with, amongst different issues, upgrading the illness reporting system and boosting public well being laboratory testing.
Some of the canceled HHS funding wasn’t slated to finish for years, together with 4 grants to strengthen public well being in Indian Country, a grant to a Minnesota nonprofit targeted on lowering substance use problems, and some to universities about occupational security, HIV, tuberculosis, and extra.
Brent Ewig, chief coverage and authorities relations officer for the Association of Immunization Managers, stated the cuts had been “the predictable result of ‘boom, bust, panic, neglect’ funding” for public well being.
The affiliation represents 64 state, native, and territorial immunization applications, which Ewig stated can be much less ready to answer illness outbreaks, together with measles.
“The system is blinking red,” Ewig stated.
KFF Health News’ evaluation of Centers for Disease Control and Prevention grants sought to reply 4 questions: 1) How many grants have been terminated within the U.S. underneath the Trump administration since March? 2) Which states noticed the most grants minimize? 3) What had been the grants for? and 4) Did the grant terminations have an effect on blue, red, and purple states in another way? This follows the same evaluation by KFF Health News for an article on nationwide NIH grant terminations.
Our major knowledge supply was a Department of Health and Human Services web site displaying grant terminations. We in contrast an preliminary checklist of grant terminations from April 3 to 1 from July 11 to find out what number of grants had been restored. The USAspending.gov database helped us observe grants by state.
To classify states politically, we adopted the identical steps from our April coverage on National Institutes of Health grant terminations. States had been “blue” if Democrats had full management of the state authorities or if the bulk of voters favored Democratic presidential candidates within the final three elections (2016, 2020, 2024). “Red” states had been labeled equally with respect to the Republican Party. “Purple” states had politically cut up state governments and/or had been usually thought of to be presidential election battleground states. The end result was 25 red states, 17 blue states, and eight purple states. The District of Columbia was labeled as blue utilizing comparable strategies.
This evaluation doesn’t account for potential grant reinstatements in native jurisdictions the place the funds had been awarded not directly moderately than immediately from the CDC; it accounts just for the recipients’ location, and excludes grants terminated from Compacts of Free Association states and different overseas entities that acquired grants immediately from the CDC. At least 40 CDC grants had been terminated that had been meant for world well being efforts or aiding public well being actions in different nations following the Trump administration’s order for the CDC to withdraw assist for the World Health Organization.
KFF Health News is a nationwide newsroom that produces in-depth journalism about well being points and is one of the core working applications at KFF — the impartial supply for well being coverage analysis, polling, and journalism.