The federal government plays a major role in keeping us safe and healthy. Disease tracking is a critical part of public health initiatives, so federal scientists run monitoring programs and organize nationwide testing campaigns when epidemics and pandemics occur, like the COVID-19 outbreak. Medical professionals working for federal agencies also directly help more than 12 million Americans meet their daily healthcare needs, making nursing one of the most common occupations among federal employees in 2025.
By the numbers
Each year, the CDC conducts full genomic sequencing of 6,000 flu viruses to prepare for possible outbreaks and ensure that vaccines are effective against new flu variations.
South Carolina’s measles outbreak was largest the U.S. saw in 20 years, infecting mostly children, all of whom were not fully vaccinated.
The CDC paused rabies and pox virus testing, leaving public health labs with fewer options and increasing difficulty of tracking potential outbreaks.
NIH director and acting CDC director canceled the publication of a federal study demonstrating the impact of COVID-19 vaccines on emergency care and hospitalization.
Profile · On the Ground
Executive Director of the Addiction Prevention Coalition
Homewood, Alabama
The Addiction Prevention Coalition in Birmingham, Alabama, is scrappy by necessity.
On a budget of less than $2 million that relies heavily on federal funding alongside donations, it served nearly 3,000 people in 2025, primarily those struggling with, or at risk of, substance abuse as well as families looking to understand the risks.
In January 2026, when the federal Substance Abuse and Mental Health Services Administration, or SAMHSA, announced it was cutting $2 billion from programs that it said did not align with the Trump administration’s agenda, the coalition knew it was in trouble.
“We lost a quarter of our budget overnight with just the snap of a finger,” recalled Nichole Dawsey, the executive director of the coalition.
Dawsey knew the organization would likely have to pare back recovery fellowship groups that meet each week. It would have to trim school-based prevention services along with other addiction treatment services. It would have to slice scholarships and housing aid for recovering addicts.
Then, less than 24 hours later, SAMHSA changed its mind without explanation, creating a sense of short-term relief but for public health authorities, an ongoing sense of whiplash and fear and a need to plan for a future without the certainty of federal support.
“The general funding uncertainty permeates everything we do these days,” Dawsey said. “I have definitely held off on new initiatives and hiring because of it.”
From Alabama to Illinois to California, health agencies, clinics and practitioners say they are dealing with continuing threats to programs and staff because of other cuts, reversals, unclear shifts in federal policies and hope that the courts—which have temporarily put cuts on hold—will ultimately reverse all of President Trump’s demands.
The attempted cuts so far have come from SAMHSA, the Centers for Disease Control and Prevention and from Trump attempts to claw back $11 billion in ongoing COVID-era health grants.
The cuts and claw backs would affect the ability to track infectious diseases, provide immunizations, and offer mental health and substance abuse services, according to one of the lawsuits. The Colorado Department of Public Health and Environment, for example, said that one of Trump’s demands would force it to “cut or significantly reduce” the work of over 190 public health staff and contractors.
A judge’s temporary order put those cuts on hold for now. But the uncertainty continues.
“If you are in the nonprofit space, particularly if you are doing work in addiction, immigrant services, housing, communicable disease and LGBTQ issues, you are waiting for the other shoe to drop,” Dawsey said. “I have worked in leadership in this field for 20 years and I’ve never seen it like this.”