Medical community ‘shocked and blindsided’ as courts review Trump’s grant freeze order
A recent executive order from President Donald J. Trump pausing trillions of dollars in federal grant and loan funding has led to widespread confusion across the medical community, as experts await the ultimate result of multiple lawsuits.
“We were shocked and blindsided,” Cassandra Calabrese, DO, of the departments of rheumatic and immunologic disease, and infectious disease, at the Cleveland Clinic, told Healio. “The most upsetting feature is that there is very little information. This is happening seemingly with no plan, no timeline. It seems reckless and has created a lot of uncertainty in the medical community and in our patients.”
On Jan. 27, the White House issued memorandum M-25-13 from the Office of Management and Budget, which stipulated that federal financial assistance programs and supporting activities were to be identified and reviewed. A suspension in distribution of funding was ordered while the review was underway. The pause in funding was set to take effect Jan. 28, at 5:00 pm Eastern.
Just minutes before that deadline, U.S. District Judge Loren L. AliKhan in Washington, D.C., issued a stay that temporarily blocked the funding pause through at least 5 pm Eastern on Feb. 3. The same judge on Monday issued a restraining order again blocking the freeze. Meanwhile, a federal judge in Rhode Island has also blocked the federal spending pause in a separate lawsuit.
The OMB on Jan. 28 released a Q&A describing some of the programs that would not be subject to the freeze, including, “mandatory programs like Medicaid and SNAP (food stamps), funds for small businesses, farmers, Pell grants, Head Start, rental assistance, and other similar programs.”
However, for several hours on Jan. 28, the federal Medicaid portal was down, and state Medicaid agencies were unable to gain access to federal funding. In addition, the original freeze order appeared to apply to myriad NIH-funded projects and other medical research grants.
The OMB has since rescinded the pause in federal grants. Still, members of the Trump administration, including Press Secretary Karoline Leavitt, have stated that the White House remains committed to some form of spending freeze. The White House has not fully clarified which programs will ultimately be impacted, if any.
According to the Associated Press, some nonprofit groups that filed the Washington lawsuit reported they are still unable to access their grants and loans.
As this all plays out, fear and uncertainty, particularly regarding the disruption in Medicaid, has put many in the wider health care community on edge.
“Although temporary operational pauses during administration transition periods are not unusual, what occurred last week is unusual and has caused much confusion,” Allan Gibofsky, MD, JD, of Weill Medical College of Cornell University and the Hospital for Special Surgery, in New York, told Healio. “The decision to rescind the original memo was viewed as good news for all affected and facing a funding freeze. Yet the sequence of events has created an atmosphere of uncertainty, and has resulted in a chilling effect as researchers, clinicians and patients are worried that there could be interruptions in payments to programs that depend on federal funds.”
Individuals with chronic conditions are especially vulnerable to this kind of uncertainty, according to Calabrese.
“If Medicaid is included in the freeze, that will be very problematic, because it provides care to many of our patients,” she said.
“Rheumatology patients already face significant obstacles in getting medications approved, which can lead to care disruptions,” Calabrese added. “This confusion will not help.”
Beyond patient care, the funding freeze could also have significant implications for research.
“At any given time, there are many NIH-funded projects and grants doing a lot of good things,” Calabrese said. “Colleagues who have been working on grant submissions for 2 years are suddenly unsure if their grants will be reviewed. They are upset, disheartened and disappointed.”
For Gregg J. Silverman, MD, Mamdouha S. Bobst professor of internal medicine in the department of medicine at NYU Langone Health, the impact may even extend beyond individual researchers to all people inclined toward medicine as a life path.
“A career in science and medicine takes many years of preparation, and bright, well trained and motivated professionals have many potential career choices,” he said. “Leadership at the federal level must be responsible and predictable, and not impulsive and shortsighted, or we could rapidly alienate our next generation of academic physician-scientists and bench researchers. Our current and future trainees already face considerable challenges, and with additional headwinds they could instead choose more dependable and lucrative careers.”
References:
OMB Q&A:
https://www.whitehouse.gov/fact-sheets/2025/01/omb-q-a-regarding-memorandum-m-25-13/
Collapse