Uneven Effects of Trump Administration's CDC Funding Cuts to State and Local Health Departments

Strategic Insights -

A KFF Health News analysis reveals that the Trump administration's cuts to Centers for Disease Control and Prevention funding for state and local health departments had vastly uneven effects depending on the political leanings of a state. Democratic-led states and select blue-leaning cities fought back in court and saw money for public health efforts restored, while GOP-led states sustained big losses. The Department of Health and Human Services in late March canceled nearly 700 Centers for Disease Control and Prevention grants nationwide, worth about $11 billion, which supported efforts to vaccinate people, reduce health disparities, upgrade systems for detecting infectious disease outbreaks, and hire community health workers.

Key Takeaways:

  • The KFF Health News analysis found that nearly 80% of the CDC grant cuts have been restored in blue states, compared with fewer than 5% in red states.
  • The five states with the most canceled grants, four of which are led by Republicans, received at least 370 terminations, totaling more than half of the canceled grants.
  • Public health departments in red states canceled vaccine clinics, laid off staff, and put contracts on hold, health officials said in interviews.
  • California retained every grant the Trump administration attempted to claw back, while Texas remains the state with the most grants terminated, with at least 30.
  • The Columbus, Ohio, health department had planned to buy a new electronic health record system for easier access to patients' hospital records, but that was put on ice due to the funding cuts.
  • The federal CDC funding accounts for more than half of state and local health department budgets, according to KFF, a health information nonprofit that includes KFF Health News.
  • The Trump administration's nationwide CDC grant terminations reflect the polarization that permeates health care issues, with access to safety-net health programs, abortion rights, and the ability of public health officials to respond to disease threats diverging significantly depending on the political party in power.
  • The cuts were "the predictable result of 'boom, bust, panic, neglect' funding" for public health, said Brent Ewig, chief policy and government relations officer for the Association of Immunization Managers.
  • The system is "blinking red," Ewig said, as immunization programs will be less prepared to respond to disease outbreaks, including measles.

Statistics:

  • 780 grants were initially terminated, but 400 of these grants were later restored, leaving approximately 380 grants still canceled.
  • $10.9 billion in funding was terminated, but $5.4 billion has since been restored, leaving $5.5 billion in terminated grants still in effect.
  • 25 red states, 17 blue states, and eight purple states were identified based on the classification of state governments and voter preferences.
  • At least 40 CDC grants were terminated that were meant for global health efforts or assisting public health activities in other nations.
  • 64 state, local, and territorial immunization programs are represented by the Association of Immunization Managers.

Sources:

  • KFF Health News analysis of Centers for Disease Control and Prevention grants
  • Department of Health and Human Services website showing grant terminations
  • USAspending.gov database tracking grants by state
  • National Institutes of Health grant terminations analysis by KFF Health News
  • Creative Commons Attribution-NoDerivatives 4.0 International License
  • Quotes and statements from Andrew Nixon, HHS spokesperson; Susan Kansagra, chief medical officer of the Association of State and Territorial Health Officials; Joe Grogan, senior scholar at the University of Southern California's Schaeffer Institute; Ken Gordon, Ohio Department of Health spokesperson; and Brent Ewig, chief policy and government relations officer for the Association of Immunization Managers.