​​WASHINGTON — As a measles outbreak spreads across the country, 23 states are embroiled in a legal battle over $12 billion in federal dollars that have been used for vaccine clinics and other public health measures.

The states filed a lawsuit against the Trump administration after it clawed back the money last week, arguing the funding, originally spent by Congress to help departments respond to COVID-19, is now unnecessary and wasteful.

The move plunged public health in the U.S. into chaos. While federal judge Mary McElroy said Thursday evening she would temporarily block those cuts, stating that it could cause irreparable harm, many states already began layoffs and canceled vaccine clinics aimed at improving vaccination rates in their communities.

The fight has landed in a state that is in the epicenter of the outbreak.

In Dallas, about 100 miles from the nearest measles outbreak, health officials recently had to cancel plans for 50 clinics aimed at improving vaccination rates in schools, laying off the staff that ran those clinics.

“It’s very disruptive, and I think it’s intentional,” said Philip Huang, director of Dallas County Health and Human Services.

It’s not clear if McElroy’s ruling applies to Texas, which did not take part in the lawsuit.

“This isn’t just affecting blue states or red states or red communities. This is affecting everyone,” Huang said. “It seems like with these decisions they don’t care about the impact. But the impact is going to be felt in every community across the country.”

About every state in the country had received approval from the Centers for Disease Control and Prevention to use the COVID-19 money to improve public health in their communities, including by increasing vaccination rates, not just for COVID-19 and flu but for childhood vaccines that protect against measles.

The funding wasn’t scheduled to end until next year. So when the Trump administration clawed it back, states like Colorado, Texas, Pennsylvania, Connecticut, Minnesota and likely others, had already laid off staff and canceled planned vaccine clinics, used by departments to remove barriers to vaccination like a lack of transportation.

“This was the CDC who wrote the grants and it was approved by the federal government,” said Adriane Casalotti, chief of government and public affairs at National Association of County and City Health Officials. “We have not seen this in public health — where money already obligated and out the door was clawed back.”

The administration told departments in notices that “now that the pandemic is over, the grants and cooperative agreements are no longer necessary as their limited purpose has run out.” The 23 states filed suit, arguing the terminations were illegal and were not done with “cause.”

In Washington state, the State Department of Health canceled 104 vaccination clinics that had been scheduled to run through June 30. It lost $20 million which had been used to increase vaccinations and track and respond to disease outbreaks, including through the hiring of 46 full-time employees.

Since July 2024, its vaccine “care-a-van” had administered nearly 7,000 COVID-19 vaccines, nearly 4,000 flu vaccines and more than 5,700 childhood vaccines, said Lacy Fehrenbach, chief of prevention, safety and health at the Washington State Department of Health in a press briefing.

They had anticipated providing 900 more COVID-19 vaccines, 500 flu vaccines and 2000 childhood vaccines.

“One of the goals of the care-a-van project is to reach people who have increased barriers in accessing preventive care, specifically communities with low-income, unhoused populations, people who don’t trust traditional medical systems,” Fehrenbach said.

“The impact of this is significant. It will limit people’s access. It will likely be a disproportionate burden to people that have faced access barriers in the past,” she said.

In Minnesota, 170 employees at the state Department of Health were laid off. Vaccine clinics were immediately suspended.

“It is devastating to be forced to reduce critical services and give notices to so many dedicated public health professionals because the federal government decided to renege on its commitment to our state,” Minnesota Commissioner of Health Brooke Cunningham said in a statement.

Other states, like Arizona and Maine, haven’t canceled clinics yet but said they will have to if funding isn’t restored.

“The termination of these grants will compromise Maine’s ability to respond to disease outbreaks, maintain vaccine availability, address health disparities, and support community-based health workforce efforts,” Maine Department of Health and Human Services Commissioner Sara Gagné-Holmes said in a statement earlier this week.

Measles outbreak

The disruption comes amid a growing measles outbreak. As of March 27, there were 483 confirmed measles cases in 20 states, according to the CDC.

Health and Human Services Secretary Robert F. Kennedy Jr. has said the outbreak is a “top priority” but his advisors have criticized the “breathless” coverage of measles that should instead be focused on chronic diseases.

Kennedy has long questioned the safety of the measles vaccine, and the CDC will reportedly review whether it causes autism — a claim that has been debunked.

He published a Fox News op-ed encouraging vaccination but said people should consult their doctors. “The decision to vaccinate is a personal one,” he wrote.

While there have only been two deaths from measles this year, infection can lead to lifelong health complications, including brain damage.

Connecticut does not yet have measles cases. But the public health infrastructure that prevented that would be weakened by the early termination of funding said Manisha Juthani, commissioner of the Connecticut Department of Public Health.

“Part of the way we kept no cases here is local health departments were getting funding to be able to vaccinate their communities,” Juthani said.

The changes come as the administration guts the CDC. The administration said it will fire at least 2,400 employees, or about 18% of the staff. Some of those firings began this week.

“These are the experts that we rely on at the local level,” said Huang of Dallas County Health and Human Services. “We’re losing that expertise.” ​ ​

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