Government grants
The White House’s new, quiet plan to attack public health | Opinion
If this policy change is implemented, medical research and public health programs affecting American lives would be judged on political ideology tests instead of their impact on our nation’s health
Richard Besser
Opinion contributor
Aug. 9, 2026, 5:05 a.m. ET
Over the past 18 months, the Trump administration has taken health insurance away from millions of people, worked to dismantle our childhood vaccination schedule, fired thousands of federal health officials and slashed billions of dollars from state and local health departments.
The administration has made no secret of its push for these disastrous policies, but it is taking a far more subversive approach to its next and perhaps most far-reaching assault on health
The administration has quietly issued a sweeping regulation that seems to make political ideology, rather than scientific merit, the overriding determinant in all federal research and grant funding decisions
The health ramifications of this proposal, which is scheduled to take effect on Oct. 1, would be enormous. If implemented, medical research and public health programs that affect the lives of people across America would be judged on political ideology tests rather than their impact on our nation’s health
In my four decades in medicine and public health, I have never seen a federal regulation this misguided, or with this much potential for both immediate and long-lasting harm. It must be stopped
Federal grants shouldn’t be tied to political litmus tests
Most Americans are probably unfamiliar with the federal budget process. Before joining the Centers for Disease Control and Prevention, I was one of them. But my 13 years at CDC, during Republican and Democratic administrations – which included four years leading emergency preparedness and response, and a stint as acting director – taught me the importance of approaching that process with integrity, rather than political favor
The federal government distributes more than $1 trillion in federal grants each year to states, localities, hospitals, universities, nonprofits and other organizations. These funds support the research that leads to treatments and cures for illness
They power vaccine clinics and responses to disease outbreaks. They support programs to prevent drug overdose deaths, provide health care to veterans and keep mothers and babies safe during childbirth
I saw firsthand during my time in government why our nation’s biomedical research system was long considered second to none. For decades, the United States attracted many of the brightest students and researchers from around the world because of our extraordinary investments and commitment to scientific integrity
However, the current administration is demolishing this system by cutting federal research grants, interfering in what scientists can study and treating immigrants with contempt
This proposed regulation is this administration’s most insidious step yet. Federal grant awards would be required to “demonstrably advance the President’s policy priorities.” Federal agency heads would be empowered to “designate” appointees to review those awards prior to distribution. The proposal also states that peer review recommendations should not be “routinely deferred to.”
Here is what those code words mean: Grant criteria and selections would be tied directly to the political priorities of this or any other White House. These awards could be terminated simply for ideological reasons, ending promising research or effective community health programs in their tracks
People’s health would suffer for it, and lives would be lost.
Politicizing federal funding has tragic consequences
We have already seen how this approach plays out in practice
Wildfires in Southern California in 2025 destroyed more than 18,000 homes and displaced more than 200,000 residents. Yet President Donald Trump repeatedly threatened to condition federal disaster relief on California adopting completely unrelated policies, such as more stringent voter identification laws
The Federal Emergency Management Agency illegally withheld disaster relief grants from California and other states for months in the aftermath of the devastation. It took federal court orders to release those dollars.
This proposal would supercharge such corrupt and immoral practices
The American Heart Association said it raises “serious concerns about the independence of science and the future of biomedical and population-based research in the United States.”
The Academic Pediatric Association warned it “could limit federally funded research, training, innovation, care delivery and public health efforts that are essential to enhancing the health and well-being of all children.”
Trump administration purports to Make America Healthy. Its record shows otherwise
Other independent experts and leaders across the political spectrum are also sounding the alarm. The Republican chair of the Senate Appropriations Committee, Susan Collins of Maine, predicts this regulation “would harm small and rural communities.”
In the words of other detractors, it could “jeopardize the future of cancer research” and “have a detrimental impact” on preventing and treating diabetes. It would “discourage and defund” research on health disparities, such as higher rates of maternal mortality faced by Black women. It “creates funding insecurity” for and “fails to honor” Native American tribal nations
When people and organizations representing such diverse constituencies all arrive at the same conclusion, we should pay attention. Indeed, the vast majority of Americans across the political spectrum care deeply about health, and independent analysis shows that the public comments submitted in response to this proposal are overwhelmingly in opposition
Still, the administration is barreling ahead to give itself and any future White House the power to reward allies, silence critics and rule by decree at the expense of people’s lives
The Trump administration talks a big game about making America healthy, but its record shows otherwise. Those of us who do genuinely care about health must use every tool at our disposal to stop this regulation, including legislative oversight, the legal system and the court of public opinion
Health simply cannot be wielded as a political weapon. A proposal this dangerous – especially in the hands of an authoritarian administration – should never see the light of day
Richard Besser, MD, is the president and chief executive officer of the Robert Wood Johnson Foundation and former acting director of the Centers for Disease Control and Prevention
