An emergency room nurse tends to a patient at Houston Methodist The Woodlands Hospital in Texas. States, counties and nonprofits are striving to continue their work to close racial health disparity gaps but are struggling amid a loss of federal dollars. (Photo by Brandon Bell/Getty Images)

Racial health disparities may widen as states, universities and nonprofits grapple with federal funding cuts to programs that were aimed at filling gaps in care, public health experts say.

As part of its federal restructuring and crackdown on diversity, equity and inclusion (DEI) programs, the Trump administration has been shuttering federal offices and rescinding grants dedicated to addressing worse health care access and outcomes for racial minorities.

The shake-up has caused some state agencies and nonprofits to pause programs and some groups and universities to apply for foundation grants instead.

Hundreds of grants have been terminated for state, local and territorial health departments as well as nonprofits and universities, many of which addressed health equity across rural, low-income and communities of color.

The nation’s racial health disparities were laid bare during the COVID-19 pandemic, when the virus killed Black, Hispanic and Indigenous people at higher rates than white people. The police murder of George Floyd in May 2020 also fueled a racial reckoning across the nation, prompting efforts by states, universities, health systems and the federal government to address racial health disparities.

Those approaches ranged from targeted vaccine campaigns and efforts to enroll more people of color in clinical trials to corrections of diagnostic tests that relied on inaccurate information about race and biology.

Communities of color have long had less access to health care, increased exposure to environmental pollutants and higher rates of certain chronic illnesses and cancer deaths. They also have more diabetes-related amputations because of a lack of access to care. And specific genetic diseases, such as sickle cell disease, disproportionately affect Black people.

“COVID revealed the impact of health disparities to individual health — as well as how not addressing these disparities undermines the health system for everyone,” said Dr. Georges Benjamin, executive director of the American Public Health Association.

Now, many of the programs trying to address health disparities are being rolled back.

As a result, health policy experts, clinicians and researchers fear those disparities will widen as states, universities and nonprofits grapple with lost federal dollars while the administration continues to limit federal funding for DEI programs. In July, the U.S. Department of Justice released guidance saying such initiatives should not receive federal funding, alleging they are “discriminatory.”

Entities that receive federal funds “must ensure that their programs and activities comply with federal law and do not discriminate on the basis of race, color, national origin, sex, religion, or other protected characteristics—no matter the program’s labels, objectives, or intentions,” the news release said.

Several state and local health officials were reluctant to speak with Stateline on the record about how the federal administration’s DEI crackdown has left them in a bind, fearing retaliation or targeting by the federal government. The White House did not respond to Stateline’s request for comment.

“My concern about what the administration is doing is that they are, in effect, making these disparities worse,” Benjamin said. “Everybody’s health is not the same. … It’s important to know that the disparities are really profound.”

Benjamin added that the cumulative effect of disparities means more late-stage disease — costing both patients and health systems more.

“There’s a trope or misunderstanding out there that DEI is a ‘woke’-related agenda. DEI is not a ‘woke’ agenda. DEI is an American agenda, because it’s really one that is the same thing as ‘rising tides lift all boats,’” said Brandon Wilson, senior director of Health Innovation and Public Health at Community Catalyst, a health equity advocacy organization. “When you cut [resources] off, you’re actually disproportionately impacting those who are already impacted.”

‘Increasing need’

The administration canceled billions of dollars in grants from the National Institutes of Health (NIH), the Centers for Disease Control and Prevention, the Environmental Protection Agency and the Department of Health and Human Services.

Many of the grants helped recipients create solutions tailored to their communities’ needs and strengths.

At least three dozen state, local and territorial health departments have had pandemic-era grants that addressed health equity terminated. While originally focused on COVID-19, agencies have since used that grant money for other public health efforts: testing and contact tracing for a wide range of diseases, better data reporting, and community partnerships that address social and environmental effects on health.

The money was part of a $2.2 billion national health equity initiative that aimed to address vulnerabilities and protect those communities ahead of the next outbreak.

The Department of Health and Human Services told media such cancellations were due to the pandemic emergency ending in 2023.

At NIH, the administration terminated more than 5,400 NIH research grants, although about 2,800 were reinstated. Canceled grants included research toward illnesses like HIV and AIDS, which disproportionately affect Black and Hispanic people as well as gay and transgender people.

The Trump administration has also gutted federal offices dedicated to fighting disparities, including the Offices of Minority Health under the Centers for Medicare & Medicaid Services and the Department of Health and Human Services.

At the state level, the Arkansas Department of Health recently shut down its own minority health-focused office. Ashley Whitlow, a spokesperson for the department, said in a statement that it “relies on federal grant funding to support a variety of public health programs.”

“The recent reduction in program staff reflects the Arkansas Department of Health’s ongoing efforts to operate more efficiently with the resources available. Despite these changes, ADH remains fully committed to serving communities across the state,” the statement said.

Meanwhile, Maryland’s Department of Health said its minority health office is funded through state general funds and not directly impacted by the federal cuts.

The nation has seen a spike in congenital syphilis cases, which disproportionately occur among Black and Indigenous families.

“Regardless of whether you’re at the highest risk, any outbreak that’s not controlled can spread widely and broadly, and you can see that that’s what’s happening with measles,” said Dr. Julie Morita, former executive vice president of the Robert Wood Johnson Foundation and former health commissioner Chicago Department of Public Health.

But states likely can’t replace all the lost federal dollars.

“You’ve got declining capacity, and increasing need — which is a formula for problems,” said Richard Frank, director of the Brookings Institution Center on Health Policy.

“It’s impossible to make all that up with state and local dollars,” he continued. “You’re going to see programs that serve real people getting pulled back.”

Frank and Wilson also expressed concern about the Medicaid changes included in the broad tax and spending law President Donald Trump signed in July. The law is projected to cut federal Medicaid spending by an estimated $911 billion over the next decade, largely because new work requirements will push people off the rolls. Data shows the majority of Medicaid enrollees already work, and experts say many will be kicked off the rolls due to difficulties in states’ reporting processes. Black and Hispanic people are disproportionately represented on the Medicaid rolls.

OB-GYN Dr. Versha Pleasant, a clinical assistant professor at the University of Michigan, directs the Cancer Genetics and Breast Health Clinic at Von Voigtlander Women’s Hospital. She treats patients at high risk for breast and ovarian cancers. Black women have an almost 40% higher risk of death from breast cancer than white women.

“That, to me, is unacceptable,” she said, adding that such disparities speak to the need for ongoing programs to “provide everyone with a fair chance at leading a long and healthy life.”

“If we don’t make a special effort to save the most vulnerable lives … where does that leave us?” she continued. “The changes that we’re seeing are only going to magnify preexisting challenges.”

Data and dollars

Dr. Sarah Rudman, acting public health officer at the Santa Clara County Public Health Department in California, and others have told Stateline that federal officials are informing health agencies that race and ethnicity data are no longer required to be reported.

“We are being asked to change the way we collect our own data here and report it,” Rudman said, adding that her county is going to continue collecting data to “understand who is here, who’s experiencing what health outcome and what they need.”

Many families, in the shadow of the county’s Silicon Valley, still struggle with poverty — more than 27,000 children suffer food insecurity, United Way Bay Area says.

“It is sometimes surprising and striking to people to understand how much poverty and other types of vulnerability are hidden among the more visible wealth of Silicon Valley, and that’s where we’ve dedicated our resources,” Rudman said.

“It’s hard to even imagine what my colleagues in smaller areas of California or in other parts of the country are experiencing,” she added about lower-income counties. “We are feeling extremely strained and already in our second round of layoffs, knowing that many more are likely. So I think that the hits are going to be that much more significant in areas who have less resources than we do.”

Federal officials also canceled the county’s $5.7 million grant to address COVID-19-related disparities, used to shore up vulnerable communities ahead of the next disease outbreak, natural disaster or heat wave, Rudman said. The money helped the county conduct basic laboratory testing and vaccine outreach for a wide range of diseases, not just COVID-19.

Stateline reporter Nada Hassanein can be reached at nhassanein@stateline.org.

The roof of the Hotel Verdant in Downtown Racine is topped with a green roof planted with sedum and covered with solar panels. (Wisconsin Examiner photo)

The news that $130 million in already-committed clean-energy funding for Wisconsin is on the chopping block is not abstract politics. It pulls real tools out of Wisconsin homes, schools, farms, and shop floors — right as our state is building momentum. The result is simple: higher bills, fewer choices, and lost jobs.

In a purple state like ours, climate action has succeeded because it’s kitchen-table common sense. It lowers costs, creates good local jobs, and protects the air and water families depend on. Our playbook is pragmatic — align smart policy with market innovation, center justice, and let businesses, workers, tribes and frontline communities lead together. Clawing back funds mid-stream breaks that compact and injects uncertainty just when we need reliability and speed.

What’s at stake here and now

Across Wisconsin, 82 clean-energy projects are moving forward: EV-charging corridors that support tourism and commerce from Superior to Kenosha; solar on schools and farms that cuts operating costs and keeps dollars local; grid upgrades that reduce outages for households and manufacturers. Clean energy already supports more than 71,000 Wisconsin jobs, with manufacturers, contractors and building trades poised to add tens of thousands more if the rules stay steady.

This is not coastal hype — it’s Menomonee Valley and the Fox Valley. Companies like Ingeteam in Milwaukee build components that power wind and EV projects nationwide. Give our manufacturers clear, predictable rules and Wisconsin will keep making core parts of the transition -— batteries, solar panels, wind components, EV chargers, and smart-grid equipment -— right here at home.

Schools and local governments are also using direct-pay to put solar on rooftops, electrify buses, and cut fuel and maintenance. Green Homeowners United and similar groups are helping thousands of households -— including many lower-income homeowners of color — tap rebates that reduce bills and carbon at the same time. These are the practical tools that stretch tight budgets and improve health outcomes in neighborhoods that have carried the burden the longest.

The real cost of policy whiplash

Rolling back incentives is a hidden tax on working families — up to $400 more a year on energy without the savings tools people are using now. With AI and data centers accelerating demand, the cheapest, fastest reliability gains come from efficiency, storage, and renewables. Cut those tools and we invite more price volatility and more outage risk — exactly what Wisconsin manufacturers, hospitals and farms can’t afford.

The “Big, Broken Bill” passed in Washington goes further, weakening EPA pollution standards and letting big polluters sidestep responsibility. That doesn’t eliminate costs; it shifts them to families in the form of asthma, missed school days and medical bills. It’s not fiscal conservatism to socialize pollution costs while privatizing short-term profits.

And for farmers, whose energy and conservation projects were finally penciling out with IRA tools, canceling support mid-contract leaves family farms holding the bag after planning in good faith. That’s not how you build durable rural economies.

Momentum that continues even if funds are cut

Here’s the other half of the story: Wisconsin’s transition won’t stop because some programs are attacked. Market forces, including  the declining cost of renewables and storage, efficiency that pays for itself and corporate and municipal sustainability commitments, continue to drive projects. Public-private partnerships, rural co-ops, tribal governments, school districts and village halls are working together to reduce risk, share data, and scale what works. That coalition will keep moving.

But let’s be clear: Clawbacks and moving goalposts slow us down and raise costs. They strand planning, freeze hiring and deter investment — especially in manufacturing corridors that depend on multi-year production schedules. If Congress wants to improve programs, fine. Just don’t pull the rug out mid-project.

Purple-state practicality: Results over rhetoric

Wisconsin’s approach is neither red nor blue; it’s results-based:

• Lower bills and stronger reliability through weatherization, heat pumps, rooftop and community solar and batteries that keep homes and Main Street businesses running during heat waves and deep freezes.
• Good local jobs in design, construction, electrical, HVAC, machining and advanced manufacturing.
• Cleaner air from electrified school buses and efficient buildings, health benefits that show up in fewer sick days and lower costs.
• Fairness by ensuring benefits land first where burdens have been heaviest.

We’ve also learned to say no when it matters and yes to better options. When a $2 billion methane gas plant was proposed, business and civic leaders asked basic questions: Is this the least-cost, least-risk path for ratepayers? Would it lock us into volatile fuel prices just as renewables, storage, demand response and efficiency are scaling? Pushing for a cleaner, more affordable portfolio wasn’t ideology. It was risk management.

A constructive path forward

• Keep the tools that help Wisconsin build here, hire here, and save here. Don’t rip away commitments families, schools, farms and manufacturers are already using.
• Provide certainty so manufacturers can invest in people and equipment. Certainty is economic development.
• Target affordability and reliability: Expand programs that lower bills, reduce outages, and prioritize investments in communities that have waited the longest for cleaner air and safer housing.
• Let locals lead: Support direct-pay and streamlined approvals for schools, municipalities, tribes and rural co-ops to deploy projects faster and cheaper.

Wisconsin has the talent, the supply chains — more than 350 in-state clean-energy companies — and the tradition of stewardship to lead the clean-energy economy. If we stay focused on trust, collaboration and measurable results, Wisconsin’s green momentum will outpace politics.

Don’t make Wisconsinites pay more to get less. Let’s build it here, power it here and prosper here.

John Imes is co-founder and executive director of the Wisconsin Environmental Initiative and village president of Shorewood Hills. He will speak Oct. 22 on the American Sustainable Business Network national panel “Purple State, Green Momentum” — how Wisconsin’s pragmatic climate playbook lowers bills, creates good local jobs, and protects our air and water.

GET THE MORNING HEADLINES.

SUBSCRIBE

President Donald Trump speaks during a Cabinet meeting at the White House on Oct. 9, 2025 in Washington, D.C. (Photo by Anna Moneymaker/Getty Images)

WASHINGTON — President Donald Trump said Thursday he’s prepared to cancel funding approved by Congress that he believes is going toward programs supported by Democrats, though he didn’t share any additional details during a Cabinet meeting. 

“We’ll be cutting some very popular Democratic programs that aren’t popular with Republicans,” he said. “They wanted to do this, so we’ll give them a little taste of their own medicine.” 

Meanwhile, on day nine of the government shutdown, members of the U.S. Senate for the seventh time failed to advance either a Democratic or Republican stopgap spending bill, and House Speaker Mike Johnson said partisan tensions in his chamber are so intense he is reluctant to bring members back until a resolution is found. 

“This gets personal. Emotions are high. People are upset. I’m upset,” Johnson told reporters at a morning press conference.

Layoffs, denial of back pay also threatened

Trump has signaled throughout the shutdown he wants to unilaterally cancel funding approved by Congress, lay off federal workers by the thousands and may try to reinterpret a 2019 law that requires back pay for furloughed federal employees after the funding lapse ends. 

He has yet to give any real details on those plans or say exactly when he’ll try to take those steps, which would likely result in additional lawsuits. 

Trump said during the hour-long public portion of the Cabinet meeting that Office of Management and Budget Director Russ Vought would be able to share more details, but Vought never spoke and Trump didn’t call on him. 

“The shutdown has been, you know, pretty damaging. I mean, not yet, because it’s early. But it gets a little bit worse as it goes along,” Trump said. “And we’ll be making cuts that will be permanent and we’re only going to cut Democrat programs. I hate to tell you. I guess that makes sense, but we’re only cutting Democratic programs. But we’re going to start that and we have Russell, who can talk to you about it if he wants to.”

The president is generally required to faithfully execute the laws that Congress approves, including the government funding bills. 

The White House budget office has frozen or canceled funding several times this year without going to lawmakers for approval, which is required under a 1970s law. 

That has led to a slew of lawsuits and the Government Accountability Office repeatedly citing the administration for illegally impounding funds. 

No progress on votes

On Capitol Hill, lawmakers remained deadlocked over how to advance a stopgap bill to fund the government for a few weeks. 

The Senate voted 54-45 on the House-passed bill that would fund federal programs through Nov. 21 and 47-50 on Democrats’ counterproposal that would provide spending authority through Oct. 31 and make substantial changes to health care policy. 

The tally for the seventh vote to advance those two proposals wasn’t much different from the previous ones. Nevada Sen. Catherine Cortez Masto and Pennsylvania Sen. John Fetterman, both Democrats, as well as Maine independent Sen. Angus King voted with Republicans to advance their bill. Kentucky GOP Sen. Rand Paul voted no.

Legislation needs the support of at least 60 senators to advance under that chamber’s legislative filibuster rule. 

The vote came shortly after Speaker Johnson, R-La., made disparaging remarks about Senate Democratic Leader Chuck Schumer during his press conference, with the two increasingly blaming each other for the funding impasse.  

“There is one thing that Chuck Schumer cares about more than anything else and that is his Senate seat,” Johnson said. “The guy has been in Congress for 44 years. He doesn’t know how to live life outside this building and so he will do anything to make sure that he keeps that seat.”

Johnson, asked about the increasing tensions between Republicans and Democrats over the funding lapse and health care policy, said it is likely better to keep lawmakers in that chamber separated until a resolution is reached. 

“I’m a very patient man, but I am very angry right now because this is dangerous stuff,” Johnson said. “And so, is it better for them, probably, to be physically separated right now? Yeah, it probably is, frankly. 

“I wish that weren’t the case. But we do have to turn the volume down. The best way to turn the volume down is to turn the lights back on and get the government open for the people.”

Shutdown pay for members of the military 

Johnson reiterated that he does not intend to bring the House back from an extended recess to vote on a stand-alone bill to provide on-time paychecks to military members during the shutdown. 

Johnson stuck to his position that the best way to ensure pay for U.S. troops is for Democrats to pass the GOP stopgap spending bill, despite Trump breaking with Johnson on that particular issue. 

Trump, asked Wednesday about the upcoming Oct. 15 payday for military members, said “that probably will happen” and that the “military is always going to be taken care of.”

But, Johnson said during his Thursday press conference the only way out is through the Republican stopgap bill that remains stalled in the Senate. 

“We have already voted to pay the troops. We did it three weeks ago. We put that bill on the floor, and the Republicans voted to pay the troops, TSA agents, border patrol, air traffic control and everybody else,” Johnson said. “So coming back here and doing it and having a duplicative vote to do the same thing they already did would accomplish nothing.”

Schumer, D-N.Y., said during a floor speech the shutdown will not end until after Republicans and Democrats find a way to extend tax credits for people who buy their health insurance from the Affordable Care Act Marketplace past the end of the year. 

Schumer also rebuked Johnson for the House schedule, which has only had members in Washington, D.C., for 12 days since the end of July. 

“If you’re someone who works two jobs or weekends or overtime to make ends meet, what on Earth are you supposed to think when House Republicans can’t even be bothered to show up to reopen the government?” Schumer said. 

New England senators initiate talks

Senate Appropriations Chairwoman Susan Collins, R-Maine, said she has been speaking with New Hampshire Democratic Sen. Jeanne Shaheen about possible solutions to the impasse. 

“I have been in very close contact with Sen. Shaheen, who is very constructive, and is trying to find a path forward,” Collins said.  

“The ACA issue is important to a lot of us, not just to Democrats,” she added. “The tax subsidies were enhanced during COVID. They do need to be reformed, but they do need to be extended as well. They expire at the end of the year. We need to open up government today before more harm is done, before people in the military don’t have their paychecks.”

 Ariana Figueroa and Shauneen Miranda contributed to this report.