Trump’s COVID-era funding clawback hits local health efforts hard

The Trump administration's abrupt cancellation of tens of billions of dollars in grants has state and local health departments reeling.  

State and local officials said the move will make it even harder for them to continue to fight infectious disease outbreaks, fund substance use disorder support programs and address other concerns.  

Departments are already operating on thin margins and need to balance sometimes competing public health priorities. Due to the loss, some health departments are already starting to cancel contracts and lay off scientists, epidemiologists and community health workers. 

“This is going to stop work in its tracks that was really important for their communities,” said Adriane Casalotti, chief of government and public Affairs at the National Association of County & City Health Officials. 

“Work to prevent the spread of infectious diseases in nursing homes, for example, or to be able to track measles cases ... the work has to stop, and yet the needs in the community remain,” Casalotti said.  

The Department of Health and Human Services said the funds, totaling $11.4 billion, were primarily used for COVID-19 response, including testing, vaccination and hiring community health workers.  

The federal government said it expects to recover the money starting 30 days after the termination notices were sent out. 

"The COVID-19 pandemic is over, and HHS will no longer waste billions of taxpayer dollars responding to a non-existent pandemic that Americans moved on from years ago,” HHS said in a statement. 

The administration also canceled about $1 billion in grants awarded by COVID-19 relief legislation and allocated by the Substance Abuse and Mental Health Services Administration. 

But state and local health department leaders said the money was already in their hands. Even though the grants were initially authorized by COVID relief legislation, they were allowed to be used for non-COVID priorities, including responding to the measles outbreak in Texas. 

The stop-work notices began arriving late Monday night or early Tuesday morning and were effective immediately.  

“The end of the pandemic provides cause to terminate COVID related grants and cooperative agreements,” one of the notices described to The Hill said. 

“These grants and cooperative agreements were issued for a limited purpose; to ameliorate the effects of the pandemic. Now that the pandemic is over, the grants and cooperative agreements are no longer necessary as their limited purpose has run out.” 

Manisha Juthani, commissioner of Connecticut’s public health department, said the state stands to lose “millions and millions of dollars” for disease outbreak surveillance, newborn screenings and childhood immunizations. 

“The ripple effects are profound,” she said.  

Junathi said the state was using some of the funding to modernize their information systems to allow for electronic, real-time reporting of test results. Due to the cuts, providers will now have to fax results to the department. 

"This is going to be a major dent in our ability…to be prepared for whatever new threat might come,” Junathi said.

The health grants were authorized and appropriated by Congress, and it’s not clear the administration has the authority to unilaterally take the money back. Similar cancellations of grants across other parts of the government have led to lawsuits, and states said they were looking at their options. 

“Donald Trump was elected and promised to make life cheaper, healthier and easier for people, but he’s taking us backwards on all of those fronts,” Massachusetts Gov. Maura Healey (D) said in a statement.  

“We will continue to assess the full impacts and are in touch with the Attorney General’s Office and the 49 other states facing similar challenges.” 

The grants were expected to bring nearly $100 million to Massachusetts over the next year, Healey said, which would have been distributed among local agencies and departments. 

Philip Huang, director of the Dallas County Health and Human Services, said the impact to cash-strapped smaller health departments will be even more devastating. 

"It may not be in the millions, but these are really small health departments that have very few staff, very little capacity. And then if you hit those, then it starts to really impact their ability to respond,” Huang said.  

Dallas is in the process of building a new public health laboratory, Huang said, and had earmarked the grants to purchase testing equipment  

In Congress, Democrats slammed the move as political and destructive. 

 Sen. Patty Murray (D-Wash.) said Washington lost $160 million that had already been awarded to the state’s health department, Tribes, and other organizations. The sudden termination will put at least 200 jobs at risk, she said. 

"Senselessly ripping away this funding Congress provided will undermine our state’s ability to protect families from infectious diseases like measles and bird flu and to help people get the mental health care and substance use treatment they need—causing immediate harm for millions of real people and communities across America," Murray said. 

“This is another destructive move by an administration intent on breaking government with no discernible strategy or plan—making our communities less safe in the process—and it should be immediately reversed.”