A Department of Government Efficiency (DOGE) initiative called “Defend the Spend” has frozen healthcare grants to the tune of billions of dollars, The Washington Post is reporting.
These grants are forcing government officials to individually approve each grant award to thousands of organizations relying on the funds. The effort is part of a broader push from the Trump administration to rein in spending and unilaterally cancel grants and contracts.
Last month, the DOGE X account said the Program Support Center in the Department of Health and Human Services (HHS) processes $215 billion a year in grant payments and often does not require documentation or explanation to award the funds. Now, organizations and government agencies must include a justification for each grant.
The rollout has started at the National Institutes of Health and the Administration for Children and Families but has reportedly led to delays and backlogs of payment processing. The HHS told the Post the “era of rubber stamping is over.”
Some anonymous officials reportedly said a Trump political appointee must sign off on the grant approval, not just a career official, and the grant must go toward priorities supported by the new administration. Staffers at the agency told the Post they believe it is causing unnecessary administrative burden and is threatening the existence of federally qualified health centers by delaying payments used for providers’ salaries and medical supplies.
The DOGE has published a giant "wall of receipts" of canceled contracts, grants and leases on its website, doge.gov. The website has been criticized for featuring incorrect information and sensationalizing dollars suddenly cut from past administrations’ priorities, but it highlights just how extensive the cuts are to federal agencies.
Team members at the DOGE have also modified grants.gov, a clearinghouse for more than $500 billion in grants traditionally managed by the HHS, the Post reported last week. Reportedly, the DOGE has sole authority to post new grant opportunities, and, if it chooses not to, the funds are effectively impounded, said Robert Gordon, former HHS assistant secretary of financial resources.
In a statement, the HHS said funding opportunities will still be published, but they must be aligned with the Make America Healthy Again agenda.
Simultaneously, some federal IT and cybersecurity staffers worry reductions in force at the HHS are causing a unique threat to public health data. These staff renewed contracts for IT services and managed contractors, they told Wired.
The HHS stated it’s “unfortunate that some former employees are spreading unfounded rumors,” and there is no cybersecurity danger as a result of reductions in force.
The DOGE’s influence at the HHS is even stretching to the nation’s contentious immigration battle. Immigration and Customs Enforcement, or ICE, officials have requested a Centers for Medicare & Medicaid Services (CMS) database called the Integrated Data Repository, containing personal health information and addresses, according to a separate Post report.
ICE and the DOGE want to check immigrants’ Social Security numbers against the Medicare claims database, and its unclear whether the CMS has relented to the request. The Integrated Data Repository is already shared with law enforcement agencies to track down fraud, such as monitoring how hospitals bill the Medicare program, said the Post.
Medicare, Medicaid and the Children’s Health Insurance Program do not cover undocumented immigrants.
Trump signed an executive order this week, requiring Attorney General Pam Bondi and HHS Secretary Robert F. Kennedy Jr. to create a “fraud-prosecutor program” for CMS-administered programs by Oct. 1 to prosecute identity theft and benefits fraud.
Health officials say this level of access across agencies is unprecedented, but it’s far from the first time DOGE chief architect Elon Musk has faced privacy complaints.
In March, Trump signed an executive order to promote data sharing between the HHS and other agencies to rescind or modify guidance restricting access to unclassified records and systems.
Musk and the Trump administration accessed sensitive Treasury Department systems this year, though lawsuits brought by states attorneys general eventually stripped away some control of the systems from DOGE.
Critics argued DOGE’s access to these systems created an obvious privacy risk to millions of Americans and alarmed states that rely on Treasury disbursements through Medicaid to fund critical programs.
Media reports also indicate they have been interested in contracting data at the CMS Acquisition Lifecycle Management system, as well as data at the Healthcare Integrated General Ledger Accounting System, which contains personally identifiable information on health program beneficiaries.