The White House calls this 9/11-era fund wasteful.” Red and blue states depend on it.

The White House calls this 9/11-era fund wasteful.” Red and blue states depend on it.

President Donald Trump's push to eliminate a federal disaster preparedness program is jeopardizing a fund used by public health systems from Republican-led Texas to Democratic stronghold California.

The Hospital Preparedness Program was created more than two decades ago in response to the Sept. 11, 2001, terrorist attacks on New York's World Trade Center and the Pentagon, as well as the deadly anthrax attacks that began days later. The Fund has provided nearly $2.2 billion over the past 17 years to states, territories, metropolitan areas and other entities to prepare health systems for the next pandemic, cyberattack or mass casualty event.

Recently, that money was used to fight bird flu, which has sickened at least 70 people in the United States, killed at least one and continues to pose a threat. Funds have also been used to address crises such as hurricanes, tornadoes, mass shootings, floods and heat waves.

But the budget request sent to Congress by Trump's budget director Russell Vought proposes eliminating the program. The effort was “wasteful and unfocused” and a cut would allow states and cities to “adequately” fund their own preparedness plans. All measures are currently stalled by the government shutdown stemming from a partisan dispute over expiring health care subsidies that affect many of the 24 million Americans who get insurance through Affordable Care Act marketplaces.

Red and blue states say the hospital preparedness funds are essential and cannot easily be replaced by local funds. This is an example of how the White House's efforts to reduce its role in responding to public health and natural disasters have jeopardized states and local governments' reliance on federal resources to meet community needs.

The program "is the state's primary source of disaster preparedness funding for hospitals, emergency medical service providers and other parts of the health care system," said Chris Van Deusen, spokesman for the Texas Department of State Health Services.

Texas received more than $20 million from the Hospital Preparedness Program this year, and Van Deusen said it is unlikely the state will be able to fill a short-term federal funding gap since the budget is finalized by August 2027.

The funds will help Texas health care providers create disaster plans and test hospitals' ability to increase capacity in an emergency, he said, while allowing medical resources and patient numbers to be distributed so hospitals are not overwhelmed during disasters. The program, along with state funding, supports the state Emergency Medical Task Force, which responded to this year's deadly floods and the Uvalde school shooting in 2022, among many other emergencies.

Georgia, which received $13.5 million this year, "continues to monitor and plan for potential changes to future federal funding while ensuring health care efforts across Georgia remain strong and sustained," said Eric Jens, public health spokesman.

A California health official called the money essential to ensuring local health systems can respond to emergencies beyond their usual capacity. The program is the only federal funding dedicated to preparing the health system for such disasters, said Robert Barsanti, spokesman for the Department of Health and Human Services.

“Without this funding, California risks losing critical emergency response infrastructure, weakening its ability to protect lives, maintain continuity of care and meet federal preparedness benchmarks,” Barsanti said.

As the most populous state, California is receiving the most money - nearly $29 million this year - as it struggles with a massive budget deficit and engages in a constant rhetorical battle with Trump administration officials. The funds go to the state health department; the California Emergency Medical Services Authority, which coordinates the state's emergency medical system; health associations; and approximately 60 local units. Los Angeles County, home to more than a quarter of the state's population, received another $11 million, and the University of California system received $1.2 million.

Neither the White House, the Administration for Strategic Preparedness and Response, which administers the program under the U.S. Department of Health and Human Services, nor the Office of Management and Budget responded to repeated requests for comment on the May proposal to cut the Hospital Preparedness Program.

According to a New York Times report, the Administration for Strategic Preparedness and Response experienced an 81% reduction in staffing levels last year. It is by far the largest workforce reduction at HHS and part of the broader purge of federal workers under Trump.

HHS has already delayed distribution of this year's Hospital Preparedness Program funds by nearly three months. The funds were supposed to be available for states to use starting in July, but the bulk of the money wasn't released until late September. In the final days of the Biden administration, health officials wanted to quickly distribute funding for the country's response to the H5N1 avian flu.

The months-long delay “is another example of how federal change and uncertainty threaten important public health programs in New York state,” said Cadence Acquaviva, a spokesman for the Department of Health. Despite health officials' best efforts, "delays or loss of funding place New Yorkers at significant risk in the event of a disaster or emergency," Acquaviva said.

New York State received nearly $14 million and New York City received more than $9 million.

Jim Leach, spokesman for the Illinois Department of Public Health, said the medical system needs federal funding to prepare for natural and man-made disasters of all types, "regardless of the ebb and flow of any individual disease."

Illinois and Chicago received a combined $15 million from the preparedness program.

During emergencies, the state's federally funded crisis response program "transforms hundreds of Illinois hospitals, emergency medical services and other health care facilities into a single, coordinated system," Leach said, adding that it saves both lives and taxpayer dollars. “If a natural disaster or infectious disease outbreak occurs, a state would not be able to respond quickly enough without HPP funding.”

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