O'Neill Institute | March 10, 2026
Read the PublicationStates have primary responsibility for protecting the health of their residents. This can lead to innovation and local leadership, but it can also result in disparate public health outcomes nationwide in the face of significant variation in available resources, public health services, and political will across states. Over the past year, disruptions and delays in federal grant awards, mid-year cancellations, and reductions in funding have exacerbated pressure on state and local health departments.
This Quick Take highlights innovative steps states can take to reduce harm and sustain the HIV response. That includes raising revenue before cutting services, protecting core prevention and care programs, improving enrollment and renewal systems so people do not lose coverage, and documenting the real-world effects of funding instability on vulnerable communities. State leadership is essential — now more than ever — to keep HIV prevention and care systems functioning, especially as federal support becomes less reliable.
Citations
1. CDC’s Funding for State and Local Public Health: How Much and Where Does it Go?
2. Medicaid Work Requirements and People with HIV
3. Cutting HIV Prevention Funding at CDC: What Would it Mean?
4. The Ryan White HIV/AIDS Program: The Basics
5. What Do We Know About People with HIV Who Are Not Engaged In Regular HIV Care?
6. How Might Expiring Premium Tax Credits Impact People with HIV?
7. NASTAD Impact Survey (Oct. 16, 2025)
8. Issue Brief: Federal Policy Changes and ADAPs
9. Copy of National HIV Clinician Survey – 10.10.25
10. What are state rainy day funds and how do they work?
11. States Should Reverse Tax-Cut Spree, Take Brighter Path in 2024
14. National Ryan White HIV/AIDS Program Part B ADAP Monitoring Project
16. For Tens of Thousands in U.S., Access to Long-Acting HIV Treatment Remains Elusive
18. National Ryan White HIV/AIDS Program Part B ADAP Monitoring Project
19. NASTAD ADAP Watch February 2026
20. State Priorities Partnership
21. How Did Medicaid Renewal Outcomes Change During the Unwinding?
22. HIV Testing and Outreach Falter as Trump Funding Cuts Sweep the South
23. The Critical Importance of CDC’s HIV Prevention Branch Core Functions and Funding
24. Impact of Proposed Federal Budget Cuts on Health Departments
25. Trump administration letter terminating addiction, mental health grants
26. Excess HIV Infections and Costs Associated With Reductions in HIV Prevention Services in the US
27. About | State Priorities Partnership