A Deep Dive into an HHS Document Itemizing Billions in Terminated Funding

From day one, the Trump administration’s “flood the zone” strategy has sought to bombard the public with such a relentless barrage of funding cuts and policy decisions that opponents would be left, as the New York Times put it, “gasping in outrage.”

That outrage can yield paralysis, including in philanthropy. A funder could be expected to respond thoughtfully to discrete cuts in a specific area. But with the administration eliminating funding across seemingly every corner of the federal government, philanthropic leaders, by all accounts, have been as overwhelmed by the barrage of news as everyone else. It is difficult, almost impossible, to take in the full breadth of the need. Funders know affected organizations are out there, but it can be difficult to find a path forward because there are so many of them.

As it turns out, some federal agencies have taken it upon themselves to publicize the names of organizations affected by the cuts, in accordance with a memorandum signed by President Trump “requiring radical transparency regarding wasteful spending of taxpayer dollars by the federal government.” Among those agencies is the Department of Health and Human Services, which oversees departments including the National Institutes of Health (NIH), the Office for Civil Rights and the Centers for Medicare and Medicaid Services. 

In mid-April, a funding leader directed me to a disturbingly fastidious Department of Health and Human Services PDF file listing the organizations it defunded in the health space. It details “Unliquidated Obligations (As of Termination)” — that is, the amount or balance of committed funding to an organization that the HHS refused to allocate — and the purpose of the grant in question (which the HHS calls an “award.”) Add it all up, and the PDF lists approximately $6.8 billion in appropriated funds that organizations had planned on receiving across 1,236 grants, but now will not get.

I converted the the HHS PDF to Excel — it is available here — so I could sort the data and see which areas and organizations are on the receiving end of the cuts. Viewed through this lens, the HHS document doubles as a sobering companion to my colleague Connie Matthiessen’s recent piece cataloging how funding leaders at the Robert Wood Johnson Foundation and the California Wellness Foundation are reacting to HHS cuts.

Taxpayer money is finite and a grant’s utility is in the eye of the beholder, and as I went through the HHS document, I quickly recognized that even the most outraged funding leaders may begrudgingly acknowledge that some cuts could be justified based on their definition of how government grants can most effectively advance public health. That being said, it’s irrefutable that when it comes to an array of issues that deeply resonate with funders, the administration, as often noted here on IP, is haphazardly working at cross purposes with philanthropy. 

Before we dive in, it’s also worth noting that these cuts are being challenged in the courts. In early April, for example, researchers, along with American Public Health Association (APHA), the International Union and other groups filed a lawsuit challenging the NIH’s abrupt cancellation of research grants. (The NIH is part of HHS.) 

In a statement to IP, APHA Executive Director Dr. Georges Benjamin said, “All [HHS cuts] have been challenged in court in a variety of lawsuits, including ours. Some have been reinstated and some have not.”

The largest “unliquidated obligations” were to state agencies

On April 1, a coalition of states sued the HHS over its decision to cut $11 billion in federal funds earmarked for COVID-19 initiatives and public health projects. HHS defended the decision, saying that the funding was no longer needed since the pandemic was over. Two days later, a federal judge temporarily blocked the cuts. 

The 10 largest “unliquidated obligations” in the HHS document were intended to flow from the CDC’s Epidemiology and Laboratory Capacity for Prevention and Control of Emerging Infectious Diseases program, which “provides flexible funding to the nation’s health departments to detect, prevent and respond to infectious disease outbreaks.”

I specifically asked the APHA’s Benjamin about these unliquidated obligations. “Many of the Centers for Disease Control and Prevention grants have technically been allowed to go forward but the administration is slow-walking the return of them,” he said.

Ten largest “Unliquidated Obligations”

These “unliquidated obligations” speak to funders’ growing concerns over federal cuts to state agencies writ large. 

As the above table underscores, the HHS cut funding to state agencies. But should these cuts fully materialize, they will have profound implications for private funders. Vulnerable communities will be disproportionately affected, further amplifying calls for philanthropic interventions. The HHS document, which cites cuts to health agencies in practically every state, U.S. territory and many tribal nations, magnifies this trickle-down dynamic to an alarming degree. 

All the while, the lawsuits keep coming. On February 25, the city of Nashville sued HHS and HHS Secretary Robert F. Kennedy Jr. over what it called “devastating” public health cuts.

Many of the largest nongovernmental “unliquidated obligations” have affected universities

In March, the Council for Advancement and Support of Education found that philanthropic contributions to U.S. colleges and universities totaled $61.5 billion for the 2023-24 academic fiscal year (July 1, 2023 to June 30, 2024), representing a 3% increase over the previous year when adjusted for inflation. 

CASE’s report noted the perennial factors affecting higher ed funders’ generosity, the most important of which is the performance of the U.S. stock market. The table below, which lists the largest “unliquidated obligations” intended to flow to nongovernmental groups like state, county or city health agencies, suggests lost federal funding could influence the grantmaking calculus for higher ed donors at several major universities. 

20 Largest “Unliquidated Obligations” to Nongovernmental Entities

The HHS cuts take aim at many areas of special interest to funders, including neuroscience research, chronic diseases, health equity and recruitment of diverse researchers and faculty. The HHS has also terminated funding for areas where philanthropy support has been trending downward for years, like HIV research and treatment.

Take, for example, the $24.9 million “unliquidated obligation” to Family Health International (FHI 360), a contractor that implements the U.S. President’s Emergency Plan for AIDS Relief (PEPfAR) and other programs for the prevention and treatment of HIV/AIDS. It joined more than 65 nongovernmental organizations in February to urge the administration to rescind cuts to “life-saving programs.” A little over a month later, FHI 360 announced it would be eliminating 483 positions throughout the U.S., effective May 2, citing “the U.S. government’s reduction of federal funding and termination of projects.” 

According to my calculations, at least 120 universities had grants cut by the HHS. Readers will note that the above table lists three “unliquidated obligations” to Columbia University. In March, the Trump administration said it cancelled $400 million in grants “due to the school’s continued inaction in the face of persistent harassment of Jewish students.” 

On March 21, the university acceded to the Trump administration’s demands to restore funding. But on April 9, Science’s Sara Reardon reported that the HHS was “freezing all remaining grant money owed to the university until further notice.” In a statement to Science, the school said, “the university remains in active dialogue with the federal government to restore its critical research funding.”

“Unliquidated Obligations” were earmarked for cancer prevention, mental health research and reducing health disparities

The chart below lists “unliquidated obligations” toward 20 additional nongovernment organizations not listed in the previous table. I selected these organizations to give readers a sense of the issue-related breadth of HHS unliquidated obligations. My criteria included the organization’s geographic location and the extent to which their priority areas dovetailed with those of private funders, with an emphasis on smaller groups providing direct services.

20 “Unliquidated Obligations” to a Sampling of Non-Governmental Organizations

Setting aside the fact that the administration considers each of these grants “wasteful spending” while paradoxically hamstringing its professed efforts to “Make America Healthy Again,” the list mirrors philanthropic priorities like cancer research, mental health treatment and public health. 

Readers may notice that the list includes “unliquidated obligations” for vaccine research and outreach. A search of the word “vaccine” reveals that it appears in the “Award Title” column 189 times. Given that the HHS is run by notorious vaccine skeptic Kennedy, this may not come as a huge surprise. Then again, Kennedy has said he wasn’t aware of some of the cuts at the agency he leads, which, as IP’s Connie Matthiessen noted, “is disturbing in and of itself.”

One final point. The chart above exemplifies how the cuts have affected organizations of all sizes. Fred Hutchinson Cancer Center, for example, brought in over $1 billion in contributions for the fiscal year ending June 2023, suggesting, at least in theory, that its fundraising acumen could help it at least partly offset the $538 million in unliquidated obligations. Smaller organizations may be less fortunate.

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