Wreck-It Russ Risks Breaking the Public Health System

OMB Director Russell Vought is holding federal funds for essential programs like public health hostage in order to punish Trump’s political enemies, the consequences to people’s lives be damned.

Jun 04, 2026

*Image Credit: “Impeach Russell Vought” by Joe Flood, April 3, 2026, CC BY-NC 4.0*

Note: This newsletter is slightly modified excerpts of a report published on Revolving Door Project’s website. For a deeper dive into Vought’s fiscal retaliation campaign and the resulting material harms to people, please see the report here.

From expressing his desire to put federal workers “in trauma” to crafting Project 2025, the Heritage Foundation’s right-wing playbook for a second Trump administration, Russell Vought, Trump’s director of the Office of Management and Budget (OMB), hasn’t exactly been subtle about his vision to reshape the federal government into an omnipotent white Christian nationalist regime. He has, however, been careful to avoid taking ownership of his ideas in the public limelight.

As our Kenny Stancil previously wrote for this newsletter, Vought is the gatekeeper of the federal money spigot and the central braintrust behind the Trump administration’s systematic dismantling of critical federal agencies. Voughtism has already succeeded in demoralizing the federal workforce and inflicting harms on public health and safety. Matters only stand to get worse. And yet, Vought has strategically evaded accountability for his scythe-swinging demolition agenda by using other Trump administration officials as his mouthpiece.

Case in point: Elon Musk served as the face for the administration’s Department of Government Efficiency (DOGE) while Vought operated in the shadows, resulting in mass layoffs of federal employees and the gutting of the Consumer Financial Protection Bureau (which is responsible for protecting consumers from corporate financial interests’ unfair, deceptive, or abusive practices), among other consequences. DOGE’s slash-and-burn assault on federal agencies and workers was Vought’s Project 2025 in action. Although Musk’s team officially disbanded in November 2025, Vought continues to wield a bludgeon to the federal government à la DOGE.

Vought has also been executing his agenda to shore up power through another means: a fiscal retaliation campaign against Trump’s perceived political enemies. This campaign has seen federal funding for education, food, health, transportation, and other life-affirming programs be cut, frozen, or withheld in Democratic-led cities and states. Just like with Musk and DOGE, Vought has relied on a sprawling cast of characters within the administration, including Donald Trump himself and Vice President JD Vance, as masks for this cruelty, framing the initiative as a war on “wokeism,” a war on “fraud,” or both, depending on the context.

Such actions are likely illegal, but while the public waits for courts to potentially catch up, millions of Americans are already dealing with the fallout and stand to suffer even more material harms, rendering legal relief too little, too late.

War on “Wokeism”

Vought has long championed “anti-woke” culture, popularizing the phrase “woke and weaponized” to describe anyone who is not aligned with the conservative movement. In late 2022, Center for Renewing America (CRA), a right-wing think tank founded by Vought in 2021, issued Vought’s 2023 budget proposal, wherein he advocated for a purge of “woke” ideology from across the entire federal apparatus (the “2023 budget proposal”). His proposal casts anyone who “emphasizes social justice, progressive dogma, and climate issues” as woke, effectively villainizing critical race theory, gender studies, and climate activism.

CRA’s 2023 Annual Report stated that Vought’s 2023 budget proposal would serve as a bedrock “for years to come on how conservatives can end the woke and weaponized bureaucracy through the power of the purse in Congress.” Certainly, these ideas have seeped into the second Trump administration.

War on “Fraud”

Vought’s war on “wokeism” has been accompanied by his war on “fraud.” DOGE was an early manifestation of MAGA’s sham concern for eliminating “waste, fraud, and abuse.” Vought’s fiscal retaliation campaign against Trump’s political enemies is a continuation. In practice, Vought’s war on “fraud” has taken the form of going after essential public goods and services that uplift working people.

Vought’s War on “Wokeism” and “Fraud” in Action: Public Health Programs

“Wokeism” and “fraud” are overlapping, sometimes synonymous, categories in Vought’s crusade against Trump’s political opponents.

As part of Vought’s commitment to “removing the scourge of woke” in the federal government, his 2023 budget proposal advocated for refocusing the Centers for Disease Control and Prevention’s (CDC) mission away from “woke public health policies” like “health equity.” Couched within this was his proposal for deprioritizing work aimed at preventing sexually transmitted diseases (STDs). He wrote, “The agency’s current ‘health equity’ agenda siphons substantial resources in the name of a woke political agenda for niche and small population groups at the expense of broader public health.”

In service of Vought’s wishes, the Trump administration cut $600 million in CDC grants for public health programs in the following Democratic-run states: California, Colorado, Illinois, and Minnesota. The grants were earmarked for programs like HIV surveillance, increasing the use of HIV prevention medication among Black women, and research studies on populations disproportionately affected by STDs.

These award cancellations are not just an extension of Vought’s war on “wokeism” but also of his complementary war on “fraud.” To be sure, an OMB spokesman told ABC News that the funding cuts were aimed at states with a “history of fraud and mismanagement.”

While the cuts appear targeted against specific minority communities, Elizabeth Finley, director of communications of National Coalition of STD Directors, a group of state health department STD officials, explained to the New York Times that the funding cuts will have consequences for all people. “Every person benefits from the surveillance work that tracks infections and helps people understand their risk,” she told the Times. “Every person is equally served by the availability of information or outbreak prevention services.”

Senator Tammy Baldwin (D-WI), Ranking Member on the Senate Appropriations Subcommittee for Labor, Health, and Human Services, and Education, similarly said in a statement, “Diseases don’t stop spreading at state lines or care what political party you are. Taking away this funding for these communities makes all Americans less safe and puts the health of all Americans at risk.”

In February 11, 2026, the four affected states initiated a lawsuit against Vought in his official capacity as OMB Director and other defendants to block the Trump administration from cancelling their public health funding. A federal judge granted the states a preliminary injunction to enjoin the government from halting their health funding and voided the grant terminations.

Even with a victory like this, repeated pauses in federal funding still risk seriously collapsing the public health system. As Max Crowley, professor of Human Development, Family Studies and Public Policy at Penn State, wrote for the Conversation: “Policy priorities will always evolve. Courts review executive actions. Congress revisits allocations. Change is part of governance. But if policymakers want stronger, more resilient public health infrastructure, stability is not simply administrative convenience. It is part of the foundation that makes prevention and preparedness possible.”

It’s Not Over

On May 29, 2026, Vought’s OMB proposed revisions to the Guidance for Federal Financial Assistance, which governs the conditions of federal awards to hospitals, nonprofit organizations, states, tribes, universities, and other recipients. Consistent with Vought’s favorite buzzwords, this latest rule laments that between 2021 and 2024, “[f]ederal awards were often used…to promote a ‘woke’ policy agenda[]” that has resulted in “wasteful spending” and “fraud.” It also openly cites the Heritage Foundation several times.

Against this backdrop, the rule empowers senior political appointees to conduct pre-issuance reviews of discretionary grants to ensure that they “advance the President’s policy priorities” and do not deny “the sex binary in humans,” “[i]llegal immigration,” or “promote anti-American values.” In other words, the Trump administration will have carte blanche to block federal assistance to anyone not on board with its far-right, white Christian nationalist ideology—an institutionalized scale-up of Vought’s fiscal retaliation campaign.

Public comments on the proposed rule are due by July 13, 2026, but short of court intervention at some nebulous time, Americans’ futures once again hang in the balance of a broken system.

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