Over the past year, many scientific research grants have been cut by the Trump administration, which said they were “wasteful,” or too “woke,” and not fitting with its goal of eliminating the diversity, equity, inclusion, and accessibility emphasis of the Biden administration. The ramifications of these changes for research are well-explained in Kelly Fleming’s recent article.
The new Office of Management and Budget proposal, rule “2 CFR Part 200,” plans to extend such cuts well beyond scientific research, into our everyday lives. It also seeks to codify these into regulations (laws) rather than just “guidances” for agencies. It will affect every federal grant to states, cities, local agencies, and nonprofits across the entire country. As Elizabeth Ginexi wrote, “This new OMB Rule Is Bigger Than Science—Much Bigger.”
It’s essential to understand that every federal grant will be subject to review by a political appointee rather than undergoing standard peer review by others with experience in the field. The goal is to ensure that the grants are not somehow “un-American” or contrary to Trump’s desires. Every decision will undergo a political litmus test. Keep in mind that the OMB proposal notes in § 200.340 that they can terminate existing awards if they are no longer aligned with “Federal agency priorities, or that an agency otherwise determines is no longer in the Federal Government’s interest.”
Melinda Rostal, DVM, MPH, PhD, was studying Rift Valley Fever, a mosquito-borne virus that infects people and livestock, in Africa with a group called the EcoHealth Alliance. She told me the Rift Valley virus is a security threat to the Western Hemisphere as well, and fears it may become the next Zika virus with unexpected birth defects like microcephaly. All of EcoHealth’s funding was cut, and the agency was forced to close. Rostal calls this the “first shot across the bow of science” of international, collaborative research.
Rostal now has some funding from overseas agencies, but is currently devoting much of her attention to working with Defend Public Health and to educate about the proposed OMB rule. She said, “I’m desperate to do this, because for my family, my friends, everyone, these regulations put our entire community under threat. It risks legalized, politicized extortion.”
Here are some of the ways these rules will likely affect you and your community’s health and quality of life. You should delve more deeply and, if you have concerns, write a comment in the Federal Register and call your local representatives. You must comment before July 13.
Medicaid
Medicaid spending was $919 billion in FY 2024. The Federal government paid almost 2/3 of this, or $594 billion.
Most Medicaid funding goes to those who are elderly or disabled. It also covers over 40% of births nationally, more in rural areas. We know that the pregnancy-related mortality for Black women is more than 3 times higher than for White women, and that women of color receive less prenatal care and have worse birth outcomes. DOGE cut at least $3 billion in grants affecting women, including research on racial disparities in pregnancy outcomes. More research cuts are likely, since existing grants will need to align more closely with the administration’s goals if this OMB proposal passes.
Is allocating extra resources for those who are impoverished and disadvantaged DEI? Or is it a smart investment in our future?
Mental Health And Drug Crisis Interventions
As Ginexi wrote, this OMB rule will hamstring some organizations, as it creates an “impossible conflict: the populations these organizations serve are, by definition, the ones equity-focused programs are designed to reach.” For example, a local drug crisis grant to a Maine county noted in the comments that with large generational fishing families, the geography, economic barriers, and social support are isolating to youth. But it adds that the county also has a high number of LGBTQ youth. Do you think that grant will be renewed under the new rules?
Similarly, mental health programs that target homeless people or people of color who are burdened by disparities and who may need additional support are likely to be denied under a political appointee’s review.
Health Disparities
In addition to differences in pregnancy outcome and mental health needs, many illnesses have racial or economic disparities at their root. This ranges from asthma and lung diseases related to increased pollution in poor, Black neighborhoods, to effects of climate change, to sexually-transmitted and HIV.
The OMB proposal’s section 200.218 prohibits funding that supports “Disparate-Impact Liability” research. Nancy Krieger, a social epidemiologist at Harvard, summed the proposal as “empowering the belief that power, not evidence, should determine which scientific research is deemed worthy of funding.” She also noted the spillover effects of cutting grants as a threat to the economic health of entire communities affected by the research.
Other Health Effects
This OMB proposal affects grants for public health, housing, Supplemental Nutrition Assistance Program (SNAP), and Women, Infants, and Children (WIC) Nutrition, each of which will impact people’s health and the cost of care. All these funding cuts will result in threats to rural hospitals, too, increasing their risk of closure.
Other OMB Targets
This OMB proposal affects grants for schools, local governments, workforce programs, broadband, transportation/road construction and repair, and community nonprofits. Section § 200.321 puts minority-, women-, and veteran-owned businesses at risk under review for DEI.
It’s shocking how wide-ranging OMB’s tentacles are, and how little attention this is getting from mainstream media.
An example comes from my home county. Last year, flooding devastated Westernport, in Allegany County, and adjacent Garrett County, Maryland. FEMA estimated damages at $33.7 million. Although these two counties vote reliably red (Trump won Allegany by 40 points), and Westernport is a Trump stronghold, the president denied a disaster declaration, and FEMA deemed the relief request “unwarranted.” Yet it had appproved $11.7 million in aid for two West Virginia counties shortly afterwards. Some believe the denial stemmed from bad blood between Trump and Gov. Wes Moore over National Guard deployments in Baltimore. The bottom line is that under Section § 200.340, any grant can be terminated by a political appointee.
What Can You Do?
If you have concerns, you should submit a comment here to the Federal Register prior to July 13. It needn’t be elaborate. Put how these changes will affect you or your community. If possible, cite the specific provision (list is in the Federal Register’s table of contents), e.g.
§200.340 — Discretionary Termination, because a political appointee decides to do so.
§200.202 — Program Goals Must Align with Administration Priorities
§200.206 — Denial Based on Organizational Affiliations, or “un-American” views
§200.300 — DEI and Related Prohibitions
§200.218 — Disparate Impact Research and Programming
§200.450 — Issue Advocacy Prohibition
Do NOT cut and paste. Your comment must be unique or will be cut by AI.
State what you want OMB to do—be it retract a specific provision or not finalize the rule.
