Public health experts worry the confusion stirred by a Trump administration funding freeze memo will not end quickly, harming public health services.
“It’s really hard to tell what’s actually happening, and I’m sure the agencies don’t know what’s happening and whether they should go forward or not, whether funding should continue or whether funding should stop,” said Josh Michaud, associate director of Global Health Policy at health policy nonprofit KFF. “It’s just a land of confusion right now.”
A memo issued by the head of the Office of Management and Budget (OMB) on Monday directing a widespread pause to federal loans and grants set off a wave of uncertainty and alarm among federal assistance programs, federally funded health clinics, nonprofits and schools as they wondered if they would lose government funding.
The Trump administration said the order would not impact Medicare, Social Security or other direct assistance, but the public health world feared assistance programs like Medicaid, the Supplemental Nutrition Assistance Program and the Special Supplemental Nutrition Program for Women, Infants, and Children risked losing their government funding.
A federal judge in Washington, D.C., temporarily blocked the order Tuesday afternoon, and on Wednesday the OMB rescinded it after days of backlash. Shortly thereafter, however, a White House spokesperson sparked further confusion with a post on social platform X stating that the funding freeze was in “full force” and what had been rescinded was the OMB memo outlining the order.
The uncertainty surrounding the freeze has created a “deep chill” among federal agencies regarding spending and services both in the U.S. and abroad, health experts told The Hill.
They warned that this “chill” could cause interruptions in service or trepidation in issuing payments or moving forward on program activities — potentially including vital services like disease surveillance and outbreak control — as public health workers question if their work will continue to receive federal funding.
For instance, a federally funded laboratory working on processing samples of H5N1 bird flu might soon think twice before purchasing much-needed supplies, Michaud explained.
And the longer public health workers remain unclear about the memo and its impact, the more programs and people are going to be affected, according to Michaud.
“It’s throwing up a lot of smoke into the system, which can cause all kinds of havoc,” Michaud told The Hill.
Confusion over the OMB memo, and its rescission, will also continue to harm U.S. foreign aid programs that are still reeling from other Trump administration freezes, according to Lawrence Gostin, director of the O’Neill Institute for National and Global Health Law at Georgetown University.
President Trump directed a 90-day pause on U.S. foreign aid and issued “stop work” orders to nongovernmental organizations on his first day in office.
Among the foreign assistance programs impacted by that freeze are the U.S. President’s Emergency Plan for AIDS Relief (PEFAR) and other programs providing antiretroviral medications to fight HIV and AIDs in Africa.
About 60 top-ranking workers at the U.S. Agency for International Development (USAID) were put on immediate administrative leave shortly after the order was issued, and days later roughly 400 USAID contractors were laid off.
USAID is the governmental agency that manages foreign aid and development assistance and oversees humanitarian aid, economic development and global health programs.
The agency, which describes its HIV/AIDS office as “a key implementer of PEPFAR,” temporarily stopped providing antiretroviral medications in Africa after the stop-work order was issued.
The Trump administration has since allowed HIV medication to be provided again under the program, but there is still confusion within the organization and on the ground in Africa as to what work can be done.
And that confusion has frozen many workers into inaction.
“There is uncertainty as to whether they are allowed to provide medication and even if they can, there is a freeze on funding for health workers and clinics that are needed to administer the medications,” Gostin said.
“I don’t know of anyone in the federal government who really understands where things stand and they are frozen into inaction,” Gostin said in an email.
Health experts also warned that the memo sent a damaging message to federal public health workers.
“It’s a signal that the goal, ultimately, is to cut as much federal funding and cut as many government jobs as possible,” Michaud said. “The intent was clear … it’s just a harbinger of what might come down the road.”
