The Trump administration is refusing to release billions of dollars that Congress allocated for health programs, a move that could see those funds expire at the end of the fiscal year on Wednesday. The standoff is drawing sharp criticism from Democrats and even some Republicans, who argue the White House is violating the law and testing the limits of executive power over spending.
At stake are more than $2.5 billion in unspent appropriations, including $1.3 billion for global health initiatives, $1.2 billion for development assistance, and $725 million that is set to lapse. Lawmakers warn that the administration is effectively impounding funds—a practice that requires congressional approval under the Impoundment Control Act—and using the money to cover costs associated with dismantling the U.S. Agency for International Development (USAID).
Senator Susan Collins (R-Maine), chair of the Senate Appropriations Committee, has pressed administration officials for answers about the withheld funds, but her requests have gone unanswered. In a letter last week, Collins and top Democrats expressed alarm that the administration is diverting money meant for global health programs and development aid to pay for USAID's shutdown.
The global health funding includes $9.4 billion appropriated for fiscal 2026, which preserved the President's Emergency Plan for AIDS Relief (PEPFAR), the Global Fund to Fight TB, AIDS and Malaria, and other HIV/AIDS programs. The administration has yet to spend $1.3 billion earmarked for maternal and child health and infectious disease control, including efforts against HIV/AIDS, malaria, and tuberculosis.
Under the administration's "America First" foreign aid policy, the U.S. is shifting to bilateral agreements with individual countries, aiming to reduce long-term reliance on American funding. But lawmakers argue that the impoundment undermines congressional intent and could have devastating consequences for global health efforts.
Teen pregnancy prevention program in jeopardy
Domestically, the Teen Pregnancy Prevention (TPP) program, which Congress funded at $101 million this year, has seen only about $500,000 spent. The program, established in 2010, supports evidence-based initiatives to reduce sexual risk behaviors and unintended teen pregnancies. Conservatives have long targeted it, and President Trump's 2027 budget proposal called for its elimination, but he signed the fiscal 2026 budget that included the funding.
In June, the Department of Health and Human Services (HHS) abruptly terminated 53 grants worth about $67 million, two years before their expiration, citing a shift in agency priorities toward abstinence-only education. A federal judge in August blocked the changes while a lawsuit proceeds, but the funding has not been restored. In a letter to HHS, 92 House and Senate Democrats, led by the Democratic Women's Caucus, warned that local programs have halted operations. "HHS's only options are to either return the funding to the communities and teens who rely on it or let it go to waste," they wrote.
Health research agency gutted
The Agency for Healthcare Research and Quality (AHRQ), which funds research to improve patient safety and healthcare efficiency, is also facing a near-total funding freeze. Congress appropriated about $345 million for AHRQ this year, but the agency has halted at least 104 grants across 32 states. Top Democratic appropriators, including Senators Patty Murray (D-Wash.) and Tammy Baldwin (D-Wis.), said HHS plans to award just 90 grants this year and is seeking to transfer $100 million to other agencies.
At his confirmation hearing on Sept. 16, Chris Klomp, the nominee for HHS deputy secretary, told senators that AHRQ is "on track to expend 97 percent of its appropriated funds by the end of the fiscal year." But Aaron Carroll, CEO of AcademyHealth, a health services research group, disputed that, noting that "we've seen almost no money go out the door." He warned of a "massive impoundment at AHRQ," which would likely trigger lawsuits or further congressional action.
This fight over spending authority is part of a broader pattern of executive overreach, as the administration has also moved to unilaterally cancel nearly $1 billion in congressionally appropriated funds last week. The impasse is raising questions about whether Congress will assert its constitutional power of the purse, with some lawmakers hinting at legal challenges. As the fiscal year ends, the clock is ticking on billions in health funding that could vanish, affecting programs from global disease prevention to domestic teen health and medical research.
The stakes are high, and the political fallout could shape the upcoming midterm elections. For now, the administration shows no signs of backing down, leaving the fate of these programs uncertain. As Democrats have accused the administration of misusing funds, this latest impoundment could become a flashpoint in the broader battle over executive authority and fiscal responsibility.
