DOGE Begins To Freeze Health-Care Payments For Extra Review

Poster — A torn image of Elon Musk is seen along Independence Ave SW. Musk's group, the U.S. DOGE Service, has placed new curbs on federal grant payments. (Matt McClain/The Washington Post)

By Dan Diamond, Carolyn Y. Johnson and Hannah Natanson

The U.S. DOGE Service is putting new curbs on billions of dollars in federal health-care grants, requiring government officials to manually review and approve previously routine payments — and paralyzing grant awards to tens of thousands of organizations, according to 12 people familiar with the new arrangements.

The Trump administration is pushing to cut federal spending and crack down on grants that political officials say conflict with White House priorities.

DOGE, which stands for the Department of Government Efficiency, said the new initiative, which is being rolled out across parts of the Department of Health and Human Services, will force grantees and officials to justify spending and create transparency.

“Thanks to the great work by @HHSGov, for the first time ever, the American people will be able to see line-by-line payment descriptions & justifications — coming soon to the DOGE website,” the group posted on X last Saturday.

Typically, an organization that has been awarded a grant does not receive the funding up front. The money is held in a secure account managed by the government, and an organization will request “drawdowns” — tranches of money periodically throughout the year — to cover expenses such as salaries or research costs.

Under Defend the Spend, organizations must now include a justification for each transaction. Federal officials then review the justification before deciding whether to approve the payment.

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