Confusion remains after Trump administration abruptly halts public health funding to cities and states, then reverses course

By Jamie Gumbrecht, Brenda Goodman, Deidre McPhillips, CNN

(CNN) — As public health departments across the country prepared for a massive winter storm this weekend, notice landed in their inboxes that pivotal grant funding from the US Centers for Disease Control and Prevention was paused. No more money could be spent.

Within hours, a US Department of Health and Human Services spokesperson confirmed to CNN that the pause had been lifted, although grant recipients said they had yet to get an update from HHS.

“It’s just more chaos, more uncertainty,” said Dr. Phil Huang, director of Dallas County Health and Human Services in Texas. “It just interferes with our ability to provide these public health services to our community.”

No grants were terminated, according to HHS.

“The Public Health Infrastructure Grants were temporarily paused so HHS could implement a new review process, one that will ensure funds are used for their intended purposes and in alignment with agency priorities,” HHS spokesperson Andrew Nixon said in an email to CNN. “HHS will continue to protect taxpayer money and ensure they are used for legitimate purposes.”

According to the CDC, the grants funded health departments in 50 states and Washington, DC, eight territories and 48 large localities. As of December 2025, $5.1 billion had been awarded: $4.7 billion to 107 health departments and $382 million to national partners. Funds are used for lab testing, responding to and preparing for emergencies and direct patient care. They paid for thousands of public health jobs across the country.

For several hours Saturday, it seemed that this funding pause would come on top of cuts to Covid-era funding that states and local governments absorbed last year.

Huang said Dallas County’s grant, worth more than $2 million, was used for key systems for disease investigation and surveillance, vaccine management – including check-in systems for large public vaccination events – and everyday activities like patient transportation.

There are already systems in place to track spending and ensure that money is used as intended, public health officials said.

The pause notices sent Saturday — and apparent quick reversal — echoed an earlier pivot by the Trump administration, which announced cuts to thousands of grants for substance abuse and mental health this month before abruptly reversing course.

Chrissie Juliano, executive director of the Big Cities Health Coalition, said that a brief pause won’t have any serious impact, but it’s a fire drill in the middle of other emergencies. It also raises questions about whether “safe” dollars that officials expected to last for years will be available and as flexible for public health agencies trying to meet local needs.

“It takes people away from preparing for helping people in the middle of a winter storm,” Juliano said. “It makes people question what’s coming next. Which shoe is going to drop, and what program is going to be cut?”

Public Health Infrastructure Grant funds were meant to be a once-in-a-generation investment in staffing and training public health departments, said Brian Castrucci, president and CEO of the de Beaumont Foundation, a nonprofit that studies and supports the US public health workforce.

“This is jobs,” Castrucci said. “If you freeze PHIG funding, every health department that is a recipient will lose staff, and quickly.

“Anyone who’s paid by this grant – the new epidemiologist to help do better surveillance for disease, the outreach worker to help people get the health care they need – those people would all be gone.”

Castrucci said the US has lost the idea that public health provides 24/7 protection, like air traffic controllers or the military.

“Not investing in public health infrastructure after the pandemic is like defunding the military after losing a war,” he said. “It’s just not smart.”

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