Thousands of healthcare payments delayed as DOGE rolls out manual checks on grant disbursements. Organizations serving vulnerable communities report serious disruptions as funds stall without clear explanation.
The Department of Government Efficiency (DOGE) has implemented a sweeping review process affecting the disbursement of billions in federal health-care grants, triggering widespread delays across agencies. The new measure, part of an initiative dubbed Defend the Spend, introduces mandatory manual reviews for all payment requests from grantees.
This abrupt shift has led to a backlog of pending transactions, affecting health centers, research institutions, and nonprofits that rely on routine funding from bodies such as the National Institutes of Health (NIH) and the Administration for Children and Families. The delay is reportedly disrupting operations tied to basic health services for underprivileged populations.
Routine Healthcare Funding Paralyzed Across Federal Programs
Previously standard procedures for distributing healthcare grants have been significantly disrupted under Defend the Spend, a federal oversight mechanism intended to bolster transparency in public spending.
According to 12 individuals familiar with the matter, the new framework now requires grantees to provide individual justifications for each transaction before release.
This manual approval process has stalled thousands of payments to organizations that depend on regular federal support. According to officials at the NIH, the situation has created a funding bottleneck, with no current system in place to approve the accumulated drawdown requests. As one NIH official reportedly stated during a staff meeting, “The bottom line is no one is getting any money right now.”
The Department of Health and Human Services (HHS) has maintained that the delays will not endanger “support for critical programs” and claims the changes are designed to reduce fraud.
Nonetheless, grantees—including federally funded health centers for low-income communities—are facing uncertainty. These institutions rely on steady drawdowns to pay salaries and cover essential medical costs, according to internal communications obtained by The Washington Post.
DOGE Review Adds Political and Bureaucratic Layers to Approval
Beyond the operational delays, DOGE’s implementation appears to be influenced by political considerations. According to internal briefings at multiple agencies, only Trump-appointed political staff are authorized to approve disbursements—even when career officials have already signed off.
In addition, each payment must include an explanation of how it aligns with the Trump administration’s priorities.
A DOGE engineer reportedly gained administrative access to the government’s Payment Management Services system on January 22, according to a court filing. This platform processed more than $850 billion in transactions last year. The abrupt changes were not accompanied by formal announcements, contributing to confusion among grant recipients.
The process has raised concerns among former officials. Robert Gordon, former assistant secretary at HHS under the Biden administration, stated that “instead of cutting red tape, they are strangling grantees with it.”
Meanwhile, nonprofit organizations such as Catholic Charities of Fort Worth have referenced the new requirements in legal filings, describing them as burdensome and lacking clarity.
