Blue states hold on to public health dollars while red states lose out

A 1-year-old boy gets an MMR vaccine at a clinic in Texas in March. Texas was among the states with the most public funding grants canceled by the Trump administration earlier this year. (Jan Sonnenmair/Getty Images)

After the Trump administration slashed billions in state and local public health funding from the federal Centers for Disease Control and Prevention earlier this year, the eventual impact on states split sharply along political lines.

Democratic-led states that sued to block the cuts kept much of their funding, while Republican-led states lost the bulk of theirs, according to a new analysis from health research organization KFF.

The uneven fallout underscores how politics continues shaping health care in the United States. The nearly 700 CDC grants were worth about $11 billion and had been allocated by Congress during the COVID-19 pandemic. Since then, state and local health departments had spent or planned to spend the money not just on COVID-related efforts, but also on prevention of other infectious diseases, support for mental health and substance use, shoring up aging public health infrastructure, and other needs.

The CDC grant terminations initially affected red and blue states about evenly, according to KFF. California, the District of Columbia, Illinois and Massachusetts — all led by Democrats — had among the largest numbers of terminated grants.

But then nearly two dozen blue states and the District of Columbia sued the Trump administration in April, asking the court to block the grant terminations. They argued the federal government lacked the authority to rescind funding it had already allocated.

“The Trump administration’s illegal and irresponsible decision to claw back life-saving health funding is an attack on the well-being of millions of Americans,” said New York Attorney General Letitia James in an April statement announcing the lawsuit.

“Slashing this funding now will reverse our progress on the opioid crisis, throw our mental health systems into chaos, and leave hospitals struggling to care for patients.”

A federal judge sided with the blue states and blocked the cancellations  — but she limited her injunction to the jurisdictions that filed in the lawsuit.

Nearly 80% of the grant cuts have now been restored in blue states, according to the KFF analysis, compared with less than 5% in red states.

Now four of the five states with the most canceled grants are led by Republicans: Georgia, Ohio, Oklahoma and Texas. California, which is dominated by Democrats, kept all of its grants that had been initially terminated.

In the West and Midwest, Democratic-led Colorado — which joined the lawsuit — had 10 of its 11 grant terminations reversed. Its Republican-led neighbors that did not sue, including Kansas, Nebraska, Oklahoma, Utah and Wyoming, lost all of their grants, according to the KFF analysis.

Stateline reporter Anna Claire Vollers can be reached at avollers@stateline.org