There is a principle in American governance: Once Congress appropriates money, the country assumes responsibility for the undertaking. Presidents administer those funds and cannot selectively remove them.
That is why the Trump administration’s plan to cut roughly $600 million in public health funding from California, Colorado, Illinois and Minnesota matters well beyond the dollar amount. The issue may seem only like a dollar amount being cut unjustly, when in reality, what also matters is how it’s being done and to whom.
The U.S. Department of Health and Human Services justified the decision by stating the grants were “inconsistent with agency priorities.”
These funds, distributed through the Centers for Disease Control and Prevention, support daily and preventative functions like staffing and outbreak response. About 24 of the programs losing funding focus on HIV and other sexually transmitted infections.
These are not symbolic or partisan programs — they are the quiet operating backbone of public health, drawing attention only when they fail.
Federal priorities change from president to president.
In this situation, only four states lose funding, all of which are governed by democrats in both their governorships and legislatures, who voted against Trump in 2016, 2020 and 2024. This pattern does not automatically establish intent, but it raises a concerning possibility that the federal government is targeting politically unsupportive states.
The Constitution divides responsibilities of governance deliberately. Congress controls spending and the executive branch implements the law Congress writes. When changes in implementation lack clear evidence or statutory reasoning, the administration begins to resemble a political entity that discards the foundational principles of the nation.
Supporters of the cuts may argue agencies must retain flexibility to properly implement the president’s agenda. Indeed, this is a compelling argument. Programs may fail to meet expected outcomes and data may not justify their continuation.
Those are legitimate concerns, but legitimate administrative decisions of this scale usually come with measurable findings such as audits and replacement models.
The reasoning here is vague at best: “The programs do not match priorities,” the Trump administration said. That is a political explanation, not an administrative metric.
Public health infrastructure cannot be flipped on and off like a switch. Epidemiology depends on continuity, including trained staff and long-term data collection.
Dr. Debra Houry, the former CDC chief medical officer, warned that removing funds during an active measles outbreak leaves communities less prepared. Houry had resigned from the CDC in protest because her superior, Director Susan Monarez, was fired by Secretary Robert F. Kennedy Jr. for refusing to fire career officials.
The effects are already tangible. Lurie Children’s Hospital in Illinois is set to lose more than $5 million for a program aimed at preventing HIV among Black women, a population disproportionately affected by the disease.
The best policy response to disparities can be left for debate. However, removing a program without addressing the underlying risk does not resolve the problem but instead leaves populations vulnerable.
The controversy therefore becomes a theory-of-governance question. The Trump administration appears to believe that the executive branch does not administer programs neutrally, but along political lines.
If this becomes the accepted practice, the precedent of bipartisanship will dissolve. Future administrations could do the same in reverse. Federal funding would become contingent on electoral geography. Policy ceases to be national policy, becoming a rotating reward structure. This has historically crippled nations.
The traditional American federal system assumes something different. Elections determine leadership, but the administration afterward applies to everyone. A resident of a state that voted against the president still lives under the same federal framework as a resident of one that supported him.
This expectation is fundamental. National programs only work if they are perceived as national commitments.
The administration may genuinely believe the programs are ineffective, but such debates belong in legislative chambers.
Otherwise, the meaning of federal authority changes. Agencies stop looking like administrators and start looking like instruments of the president’s unfiltered will.
The practical outcome today is $600 million. The institutional outcome is a precedent about who the federal government is for.
Instead of governing a country, Trump is governing a coalition. Once citizens begin to believe federal policy only depends on how their state votes, the architecture of American governance collapses beneath the people’s feet.
