August 6, 2025
Federal Budget: Update
When elected leaders return to Washington in September, their top priority will be funding the federal government before the September 30th (end of federal fiscal year) deadline. It’s likely that lawmakers will pass a CR (continuing resolution) to avoid a government shutdown. A CR would continue current year funding levels beyond the end of the current federal fiscal year. Some Republicans, however, are now suggesting that they should focus on passing a full-year CR that would mostly lock in March 2024 spending levels for even longer. This would amount to cuts since current funding year levels don’t keep up with the demand for services and programs. This is going to be a tough hall since both parties will need to work together to get to an agreement. Read more. Leader Schumer and House Minority Leader Jeffries have already reached out to the Republicans to ask for a “four corners” meeting to get the conversation started. Read more. That will be even more contentious given a blow up from last week in the Senate where Democrats hindered Trump and the Senate Republicans from zipping through their Senate confirmations, forcing negotiations over restoration of some federal funding for NIH and other agencies. Trump, who had been pushing the Senate to stay in town and finish confirming his nominees, ended up frustrated and telling the GOP Senators to go home. So far, the House and Senate haven’t passed most of the bills they need for appropriations (for the coming federal fiscal year that begins October 1) even out of committees, much less on the floor. A federal government shutdown seems more and more likely.
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Federal Grants
The NYS Council continues to track actions taken by the Trump Administration to restrict, delay, freeze or terminate various federal grant funds that support programs it says do not align with the Administration’s policy priorities. As such, we wanted to share this information with all members. Read all the way to the bottom where there is brief discussion of specific funds that remain at risk and that are (currently) frozen. If you need assistance, please feel free to reach out. Two articles on this topic directly below:
1) Roll Call: Harm reduction techniques being phased out under Trump
The Trump administration is escalating its push against what has become a key part of the way states, localities and communities respond to the overdose epidemic: harm reduction.
A public health approach aimed at mitigating the negative health effects associated with drug use, harm reduction aims to prevent overdoses and infectious disease transmission.
Methods can involve the use of opioid overdose reversal medications such as naloxone, providing sterile needles to limit the transmission of infectious diseases, test strips that detect fentanyl in drugs, and “safe consumption sites,” where people can use drugs under supervision in case they need intervention.
In the past week, the administration began removing educational materials related to harm reduction from government websites.
2) CDC to disburse delayed funds for fighting fentanyl and more, staffers say
By Selena Simmons-Duffin, Brian Mann, NPR, 8/6
The Centers for Disease Control and Prevention will be able to fully fund the Overdose Data to Action or OD2A program ahead of a key budget deadline, according to a CDC senior leader. A second CDC staff member confirmed that “there have been developments and we are likely to have full funding,” although they did not have details on when the funding would become available.
Both spoke to NPR on the condition of anonymity because they fear retribution for speaking to the press without authorization. Some staffers at CDC expressed to NPR that this appeared to be good news, although the funding situation was still fluid and confusing.
NPR reported last month that the Trump administration was withholding $140 million from the OD2A program, which state and local public health departments rely on to lower overdose deaths from fentanyl, methamphetamines and other drugs across the U.S.
Previously frozen funding for other CDC programs, including rape and domestic violence prevention, is also getting released, the senior CDC leader said.
Funding, 30 days at a time
The delays were part of a broader issue with funding at CDC. As NPR reported in June, for months, CDC waited for the $9 billion Congress intended for the agency for fiscal year 2025. In the meantime, it received small amounts of money every 30 days to cover payroll and other limited expenses.
The senior leader described the process like receiving money “with an eyedropper.”
Without a pot of money to distribute out to various centers and divisions, the CDC couldn’t send out the notice of awards that state and local health departments need to be able to do their work and know they will be reimbursed for it.
“Most state health departments get most of their funding from the feds — in Alabama’s case, we get more than two thirds of our funding from federal grants, predominantly CDC,” Dr. Scott Harris, who runs Alabama’s health department, told NPR in June.
Deadlines missed
Health departments across the country sounded the alarm as deadlines approached or passed for CDC funding of HIV prevention, cancer registries and overdose prevention programs.
Now, most of those programs across CDC apparently can continue, including OD2A. Grantees for the OD2A program, who had been told in July they would be receiving only half of their funding, will soon be told they will receive the full amount, according to the senior leader at CDC.
The news comes after advocates had been warning for weeks of the harms that delayed or partial funding to the program could have. If full funding is actually coming, “it’ll be welcome, but it’s not without the toll that it’s already taken,” says Sharon Gilmartin, director of the Safe States Alliance, a national membership association for the field of injury and violence prevention. As an example of the toll, NPR reported on a local health department in North Carolina that laid off staff because of CDC funding delays, only to have the funding come through weeks late without explanation.
“I don’t think anybody will feel confident until they have money in hand,” Gilmartin adds. “And I’ll be honest, I think the concern is that — if this is what we went through this year, even if funding comes through, are we going to be doing this again next year?”
There was no available explanation from the Trump administration or the Office of Management and Budget for the delays or the release of the funding. OMB and the Department of Health and Human Services did not respond to NPR’s request for comment.
The CDC senior leader describes the release of funding for the agency as a relief. “It’s great we have our apportionment,” they tell NPR.
Some funds frozen
But there’s a new funding challenge. Several dozen specific CDC programs have now had their budget lines frozen at the direction of OMB, according to the senior leader at CDC. The news of the frozen funds was first reported by the Wall Street Journal.
The frozen programs are mostly in the National Center for Chronic Disease Prevention and Health Promotion, according to the senior leader at CDC.
A list of frozen programs reviewed by NPR includes those that address tobacco use, nutrition, physical activity and obesity, school health, inflammatory bowel disease, excessive alcohol use, chronic disease education and awareness, national diabetes prevention program, oral health, epilepsy, and more.
“What does it all mean?”
Funding for five programs at the CDC’s Injury Center was frozen by OMB as well, including youth violence prevention, adverse childhood experiences, firearm injury, injury control research centers, and injury prevention activities. Gilmartin of the Safe States Alliance says it’s hard to understand why these programs were targeted. “I can’t come up with an ideological reason why you would want to cut funding that supports positive early childhood,” for instance, she says.
The senior leader at CDC says there are some big questions for OMB and the Trump administration: “How do we interpret all of this? What does it all mean?”
There were whole teams fired during the dramatic reduction in force across HHS in April that appear to have full funding, the senior leader says, such as the Rape Prevention and Education Program.
Similarly, there are programs with their budget lines frozen by OMB that are fully staffed, and still other priorities set forth in President Trump’s 2026 budget, they say, which leaves the impression that there’s no overarching strategy.
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INFORMATION FOR CARE RECIPIENTS WHO PURCHASE INSURANCE THROUGH THE NYS OF HEALTH
ACA Health Insurance Exchanges and Premium Tax Credits
ACA Enhanced Premium Tax Credits Will Expire in December!Republicans had an opportunity to renew or make permanent these tax credits for millions of consumers who buy their insurance on ACA exchanges in their OBBBA package. But they passed. The result? Premiums will skyrocket and millions of people will lose coverage. See below for the basic points you need to know. There are many materials coming:
- What are the premium tax credits and what does it mean that they are “enhanced”? People that are covered by the ACA’s private insurance plans buy that insurance on an “exchange”–basically a marketplace where they choose a plan–and many qualify for help with affording their premiums. Most people get a tax credit to help afford the coverage. A few years ago, the tax credit was expanded to be more generous and include more people–that’s why it’s “enhanced” but those changes were not permanent. The enhanced premium tax credits were originally set to expire at the end of 2022 but were then extended as part of the Inflation Reduction Act. Now they expire this year.
- How many people use the premium tax credits? More than 90% of ACA customers receive a tax credit to help afford the coverage. Since the introduction of the enhanced premium tax credits, enrollment in the ACA Marketplaces has soared, more than doubling from 11.4 million people in 2020 to 24.3 million people in 2025.
- Are there any signs yet about the impact of the expiring tax credits on costs? Insurance commissioners will be announcing rates over the coming two months and there are already a lot of predictions about rising premiums. insurance companies have to file rate increases with their state regulators over the summer so we already know about increases in some states:
Keep in mind that for some people, premiums will go up way more depending on age and location. KFF reports that the expiration of the enhanced tax credits will result in an over 75% increase in enrollee premium payments. The Congressional Budget Office (CBO) projects that, on average, gross benchmark silver premiums will ultimately be 7.9% higher than they would otherwise be as the risk pool becomes sicker, on average, and that many enrollees will become uninsured.
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Mother Jones: This $50 Billion Band-Aid Won’t Save Rural Health Care
Half of the $50 billion fund will be evenly distributed to states without accounting for factors like population size. In fact, this means that some of them—such as Wyoming and North Dakota—may receive more from the rural health fund than they lose in federal Medicaid funding. On the flip side, the $50 billion fund would leave other states—such as Kentucky, Washington, and Oregon—in the red. By McBride’s calculations, Wyoming is in an enviable position, potentially receiving stands to cover 1,453 percent of what the state loses in Medicaid cuts. Meanwhile, Kentucky is expected to lose $5.4 billion through the cuts and gain only $1.9 billion from the fund, covering just 36 percent of the state’s losses. Coincidentally, the states that stand to gain the most from this half of the rural health fund’s distribution are governed by Republicans, and the states that stand to lose the most are not.
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In a sign of a deepening mental health crisis behind bars, the number of people who died by suicide in prisons more than doubled in the past year to 25 people, according to newly released data obtained by a prison oversight group, The City reports.