The U.S. Department of Government Efficiency (DOGE) has imposed new restrictions on federal healthcare grant payments, significantly slowing the distribution of funds to health centers and other grantees, according to 12 people familiar with the matter, as reported by The Washington Post on April 17.
Here are six things to know:
- DOGE has launched an initiative called “Defend the Spend,” requiring all federal healthcare grant payments to undergo manual review and justification before approval — a major shift from the previous automatic system.
- The new process has created a backlog of payments, delaying funding for salaries, medical supplies, and essential services at health centers that serve low-income and uninsured patients. Some payments expected last week have yet to be released.
- The review process has been implemented at agencies including the National Institutes of Health and the Administration for Children and Families. Federal officials say they’ve received inconsistent instructions and are unsure when payments will resume.
- According to internal briefings cited by The Washington Post, only President Trump political appointees are authorized to approve fund disbursements. Payment justifications must now show how funds align with the Trump administration’s priorities.
- Critics, including former HHS officials, warn the move could harm vital health programs. One NIH staffer reportedly told colleagues: “The bottom line is no one is getting any money right now.” Despite DOGE’s claim that the initiative promotes transparency and combats waste, the abrupt rollout has left thousands of grantees in limbo.
- The Department of Health and Human Services (HHS) said the DOGE initiative is meant to root out fraud and abuse, asserting that “the era of rubber stamping is over.” The agency emphasized that the changes would not threaten “support for critical programs.”
Becker’s reached out to HHS for comment and will update the story if more information is learned.
