Author: Mina Shahinfar

On February 26, 2025, the U.S. House of Representatives narrowly passed a budget resolution proposing $880 billion in spending cuts from the agency that oversees the safety-net insurance funding, including Medicaid. This decision has sparked significant concern among healthcare advocates and policymakers, threatening to undermine a program that provides essential health services to over 70 million Americans. 

In response to the proposed cuts, several states are initiating legal actions to protect their Medicaid programs. For instance, Michigan Attorney General Dana Nessel announced her intention to file a lawsuit against the federal government’s recent funding freeze, which affected Medicaid and Head Start. Nessel emphasized the immediate and significant impacts on the state, highlighting the urgency of seeking legal remedies to restore funding that would ultimately improve health outcomes and prevent death. 

Similarly, Illinois Governor JB Pritzker has accused the Trump administration of withholding nearly $1.9 billion in federal funds from state agencies, non-profits, and small businesses. This withholding came after a federal judge blocked an order to freeze these funds. Illinois is one of nine states that have “trigger laws” that require states to terminate Medicaid expansion if the federal government’s financial support dwindles. Pritzker warned that up to 770,000 Illinois residents could lose Medicaid coverage due to the proposed budget cuts, and Illinois is pursuing additional litigation to protect Medicaid under the Affordable Care Act. 

Beyond individual state actions, a coalition of organizations, including the National Council of Nonprofits and the American Public Health Association, has filed a lawsuit to block the federal funding freeze. They argue that the freeze lacks legal basis and rationale and will have devastating consequences on their operations and the communities they serve. The freeze fails to consider the reliance interest of many grant recipients, including those to whom money had already been promised. The organizations were recently granted a preliminary injunction to halt the freeze and restore Medicaid funding. 

Moreover, civil rights groups argue that the funding freeze and subsequent Medicaid cuts could disproportionately harm communities of color, potentially violating the Equal Protection Clause of the Fourteenth Amendment. If the lawsuits proceed, courts may be asked to weigh the disparate impact of the budget cuts on marginalized populations.

Healthcare advocates urge the public to voice their concerns to their representatives. The National Health Law Program emphasizes that cutting $880 billion from Medicaid would have devastating consequences, forcing states to slash services or remove individuals from coverage.

As the budget proposal moves to the Senate, its fate remains uncertain. However, the growing wave of legal challenges highlights the crucial role of the judiciary in safeguarding access to essential healthcare services for millions of Americans.

As Donald Trump prepares to take office in 2025, public health and policies are expected to shift significantly, particularly around vaccine policy. The Trump Administration, coupled with the appointment of prominent vaccine skeptic Robert F. Kennedy Jr. (RFK) to lead the Department of Health and Human Services, suggests a potential departure from the previous vaccine strategies implemented in recent years. 

Vaccines are among the most effective tools healthcare workers have to prevent disease. Vaccines have saved at least 154 million lives in the past 50 years. Kennedy, a vocal critic of vaccine mandates and mainstream vaccination programs, has consistently raised questions about vaccine safety and government oversight. As the head of health policy, he may prioritize “medical freedom,” allowing individuals more choices about vaccination and minimizing federal mandates. While Kennedy’s stance appeals to those wary of government intervention, it raises concerns among public health experts who worry that easing vaccine recommendations could lead to lower vaccination rates and the re-emergence of diseases, such as measles, mumps, and whooping. Kennedy has made false claims that vaccines cause autism, and his misinformation has been linked to a deadly measles outbreak in Samoa in 2019. Meanwhile, measles cases in the U.S. matched their 2023 total numbers in just the first months of 2024. 

Moreover, COVID-19 vaccines, which have been widely distributed and recommended by health authorities since their rollout, are also expected to see changes. Under the Biden administration, COVID-19 vaccines were central to managing the pandemic. Trump’s previous stance during the pandemic was to expedite vaccine development through “Operation Warp Speed,” though he opposed vaccine mandates. In 2025, Trump and RFK may continue cutting government funding for vaccination programs while advocating for natural immunity and alternative treatments. This could push states to loosen vaccine requirements and adopt a choice-drivel model, which may influence public perceptions and acceptance of COVID-19 boosters. 

A significant pivot in vaccine policy could challenge the infrastructure for managing vaccine-preventable diseases. The public health sector relies on high vaccination rates to maintain herd immunity, reducing the risk of outbreaks. By decreasing federal support for vaccinations, particularly in schools and workplaces, Trump’s administration may face challenges in maintaining this level of immunity. Lower vaccination rates could strain hospitals and public health systems especially, if vaccine-preventable diseases start to resurface. 

The future of public health under Trump, with RFK overseeing vaccine policy, may prioritize personal choice over federal mandates. While this approach appeals to advocates of medical freedom, it poses potential risks to the established public health framework. As these changes take effect, the impact on vaccination rates and overall health outcomes in the U.S. will gradually become evident. RFK and Trump’s proposed policies will likely fuel continued debate around the balance between individual choice and public health safety.