Apr 20, 2025 Current Resources

DOGE Freezes Health Care Payments, Delaying Salaries & Services

A new federal policy under the Trump administration has triggered a widespread freeze of health care payments, disrupting salaries, medical services, and research at clinics and nonprofits across the country. The Department of Government Efficiency (DOGE) has paused billions in routine health grant payments, requiring a new layer of approval for each transaction.

The initiative, called “Defend the Spend,” has created major backlogs across federal agencies, including the National Institutes of Health (NIH) and the Administration for Children and Families, according to agency insiders and grant recipients.

Clinics and Nonprofits in Limbo

Under normal conditions, organizations receiving federal grants request funds in scheduled intervals to cover salaries, supplies, and operations. Now, DOGE demands a justification for every “drawdown,” which federal officials must individually review and approve — slowing the entire system to a crawl.

“All funding is on hold,” an NIH official told colleagues during a leaked meeting, according to The Washington Post. “No one is getting any money right now. But they don’t know it because the system just says ‘in transit.’”

Federally qualified health centers, which serve millions of low-income and uninsured patients, face the greatest risk. These organizations rely on steady funding to pay staff and deliver care. Without those funds, many may reduce services or shut down critical programs.

A New Layer of Political Review

DOGE has instructed federal employees that only Trump political appointees can authorize payments — even if career officials have already approved them. Each justification must also explain how the funds align with current White House priorities.

In January, DOGE assumed administrative control over Payment Management Services, the government’s centralized grant distribution platform. This system processes more than 500,000 transactions totaling $850 billion annually. A DOGE engineer became a system administrator on January 22.

Backlogs and Confusion Grow

DOGE implemented the freeze without any formal announcement. Organizations began noticing unexplained delays and missing payments. While some received automated notices claiming their funds were “in transit,” internal agency records confirm those payments remain on hold.

Even the Maternal Mental Health Hotline, which supports postpartum women, faces disruption. Clinics that operate the hotline say staff paychecks are at risk.

“Instead of cutting red tape, they’re strangling grantees with it,” said Robert Gordon, former assistant secretary of financial resources at HHS.

Lawsuits and Pressure Mount

Catholic Charities of Fort Worth raised legal concerns last week, citing the new documentation requirements as a barrier to accessing approved grant funding. Other health agencies and nonprofits have reported similar experiences.

HHS employees across multiple divisions say the rollout was chaotic, with inconsistent instructions and no clear chain of approval. Many grantees still haven’t received official explanations for delays.

Despite DOGE’s public claim that the freeze improves transparency and prevents fraud, grantees argue the process is damaging vital health infrastructure. The delays arrive at a time when many communities already struggle with staffing shortages and rising health care costs.

Final Takeaway

As “Defend the Spend” continues, its effects are hitting the front lines of American health care. Clinics are canceling appointments. Doctors are going unpaid. Nonprofits are scrambling to stay afloat.

DOGE has promised a new public portal to display payment justifications. But for thousands of health centers, the wait for funding isn’t just inconvenient — it may prove life-threatening.

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