Public health officials in Pennsylvania won't say how they'd handle a $500M cut sought by Trump admin

Yahoo

22-04-2025

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Pennsylvania health officials are facing down a potential $500 million loss of federal funding, but are tight-lipped about which programs and how many people might be affected by the Trump administration's decision.
The funding helps Pennsylvania purchase and administer vaccines, monitor the spread of infectious diseases like measles and influenza, and contact people who might have been exposed to dangerous pathogens.
'We're the only organization who does that in Chester County,' said Jeanne Franklin, director of the health department there.
She was one of the few local health officials contacted by Spotlight PA who was willing to speak on the record about how the money keeps Pennsylvanians healthy and safe from communicable illness.
In late March, the U.S. Department of Health and Human Services issued notices terminating $11 billion in grants to state and local health departments nationwide. The grants were created to help these agencies during the COVID-19 pandemic, but the Trump administration says they are obsolete.
Pennsylvania and 22 other states have sued to keep the funding, arguing Congress intended the money to be a 'wide-ranging' investment in public health beyond the pandemic. In addition to disease surveillance, the commonwealth has used the money for addiction treatment, childhood vaccinations, and services at community health centers.
The cuts are currently blocked as a federal judge reviews the suit, and Pennsylvania officials warn of damage to the public health system if the clawbacks are allowed.
The state health department declined to speak with Spotlight PA about how it uses the funding and whether the money could be replaced. A spokesperson said in a statement that it 'is analyzing potential impacts,' and that so far 'the actions at HHS have not led to any furloughs or terminations of full-time federally-funded employees within the Department.'
Exactly how Pennsylvanians would be affected by the loss of the money is hard to parse without input from the state health department, which receives the federal grants, and then passes a portion of the money on to county and city governments.
One public health worker, who was granted anonymity because they are not authorized to speak with the media, said leadership at their agency fears retaliation from the Trump administration. In recent months, the administration has slashed programs and personnel.
Of the 10 Pennsylvania public health agencies contacted by Spotlight PA, just two would speak about which services could be at risk.
Franklin of Chester County said that one way her agency uses federal funding is to pay the salaries of most of its disease investigation and surveillance staff.
If HHS yanks these grants, Franklin said, Chester County will have to pull back on contact tracing and analyzing data. That work allows her staff to determine which communities are most vulnerable to infectious disease outbreaks and then direct help their way.
Ronnie Das, public information officer for the Allegheny County Health Department, said the agency 'would cut programs' if it loses the federal funds, but would not go into further detail while the suit is pending.
But he added that money inevitably shapes what services the county can provide. 'It's not like we have this unlimited pot.'
Because the goal of public health is prevention, one measure of success is the absence of a crisis. That can lead to complacency and is partly why the U.S. is grappling with a measles outbreak, said Maureen Lichtveld, a physician and dean of the University of Pittsburgh's School of Public Health.
Measles is extremely contagious, and although outbreaks are preventable if enough people are vaccinated, immunization rates across the country have fallen over the past decade.
'We let our guard down,' Lichtveld said.
Federal funding undergirds much of the public health system, which is a patchwork of state and local agencies with varying policies and resources.
Until COVID-19, that support had been drying up, a trend that started during the 2008 financial crisis, said Josh Michaud of the health policy research group KFF. This left public health authorities underfunded and overwhelmed at the onset of the pandemic.
Before at-home tests became available, for example, Pennsylvanians sometimes waited more than two weeks to learn if they were infected with COVID-19 because local agencies couldn't process such large volumes of samples.
The grants that HHS wants to rescind were designed to prevent that level of tumult during another pandemic, which epidemiologists warn is a serious possibility.
States' suit over the funding will probably make its way to the U.S. Supreme Court, said Allison Winnike of the Network for Public Health Law, a research and policy nonprofit .
It's normal for new administrations to create policies that reflect their political priorities or sunset programs they don't like. But in the past, states could trust new presidents to honor legal agreements signed by their predecessors. Winnike told Spotlight PA that this abrupt termination of grant contracts is shocking and unprecedented.
'The states should be very, very nervous,' she said.
Winnike, Michaud, and others who spoke with Spotlight PA said the timing of this attempted disinvestment in public health is troubling.
CDC data show that 11% of 800 people infected with measles this year have been hospitalized. As of April 18, two children in Texas have died, and a third death in New Mexico is under investigation. Other long-term health consequences include the risk of permanent brain damage and a depressed immune response to new infections.
Pennsylvania has so far had few cases. That might change, warned Lichtveld: The kindergarten vaccination rate for 44 of Pennsylvania's 67 counties is under the recommended threshold to prevent spread, meaning there are enough unvaccinated kids in these communities for a potential outbreak. Also, most counties in Pennsylvania don't have a local health department and instead rely on the state for disease surveillance, which is less comprehensive.
'You really need to have a continuous active surveillance system,' she said.
Other infectious diseases making comebacks include tuberculosis and pertussis, which is also known as whooping cough. Pennsylvania saw a 658% increase in whooping cough cases between 2023 and 2024.
Franklin said Chester County is in a much stronger position today to handle emerging diseases compared to March 2020. It has responded to nearly 30 measles exposures since the start of the year using the protocols it refined during the pandemic, she noted.
If these systems had been in place at the onset of the pandemic, Franklin said, the virus would have spread more slowly in Chester County, and resulted in fewer critically ill patients at a time when health systems were overwhelmed and rationing medical care.
Josh Maxwell, chair of the Chester County Board of Commissioners, noted that his county is one of Pennsylvania's wealthiest and has a growing tax base. If the HHS funding ends, he said Chester County would have to cut other parts of its budget to sustain its public health department.
'As difficult as it's going to be on us, it's going to be more difficult on our neighbors,' he said.
Michaud also noted that health departments with fewer resources will especially feel the crunch of funding cuts, and be forced to prioritize certain public health threats over others.
'More people might die. You might have more illnesses occurring in the community,' said Michaud. 'So it doesn't seem to support a vision for making America healthy again.'
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