NEW YORK — State health departments are grappling with mounting uncertainty in executing their messaging campaigns as the Trump administration moves to restrict public health communications, threaten funding freezes, and sow confusion.

“There is a lot of concern about what the future holds,” says Julie Colehour, a partner at Seattle-based communications firm C+C, which works with state health departments in Washington, Oregon, and Massachusetts.

Healthcare communications experts say that, at this point, states are most concerned about losing federal funding under Trump, which would significantly impede their public health messaging—while also limiting their ability to fill federal-level voids created by the administration’s growing restrictions on information.

“If the feds turn off the purse strings, it will impact every stage of communications,” Colehour said.

“There is a lot of federal funding that flows directly to states to spread the word about important public health matters, like increases in RSV and pediatric pneumonia, that people should know about,” said Marissa Padilla, executive vice president at Global Strategy Group. “That information flow is very much in jeopardy, and it will put a major strain on not only state budgets but also doctors’ offices and hospitals that will have to deal with the consequences and costs of caring for more people.”

Most states are in the midst of their fiscal years and are already challenging Trump’s directives in court. As a result, they wouldn’t feel the financial impact of funding freezes until July, when most begin their next fiscal year.

Yet communicators say they are already contending with executive orders that are suppressing healthcare communications at the federal level—what The Atlantic calls “The Erasing of American Science.”

“In less than a month, the Trump administration has frozen research funds, halted health communications and publications, vanished decades of health and behavior data from its websites, terminated federally funded studies, and prompted researchers to scrub extensive lists of terms from manuscripts and grant proposals,” The Atlantic science reporter Katherine J. Wu wrote. “Those changes are, by official accounts, in compliance with Donald Trump’s recent executive orders, which are intended to derail ‘wasteful’ DEI programs and purge any references to ‘gender ideology’ from content funded or published by the federal government.”

In an article about bird flu, Reuters reported that the onslaught of directives has disrupted the country’s response to the outbreak, “leading to confusion and concern among federal staff, state officials, veterinarians and health experts.”

“The confusion over messaging and who can say what—or anything—is complicating matters at a bad time,” Reuters quoted Keith Poulsen, director of the Wisconsin Veterinary Diagnostic Laboratory, as saying.

Richard Hatzfeld, who co-leads Finn Partners’ global health impact efforts, warned that such disruptions could have dire consequences.

“Clear, consistent communication among federal, state, and local agencies is vital—not just for national security but also for protecting public health—our life security. When that communication breaks down, trust erodes, progress stalls, and lives are impacted,” he said.

“The U.S. is grappling with multiple infectious disease outbreaks, from bird flu to RSV, while critical clinical trials—potential pathways to groundbreaking medical advances—have been put on hold. Even more concerning, a key driver of our economy and global competitiveness—U.S. health research and development—is stuck in limbo.

“It’s like having a sky full of planes without air traffic control to guide them to the ground safely. If public-sector communication falters, we risk jeopardizing our nation’s health, safety, and economic edge,” he said.

Carrie Jones, founder and CEO of JPA Health, noted that healthcare companies are navigating today’s uncertainty, even though many have been working through “what-if” scenarios since long before the presidential election.

“Right now, we're still in that 'flood-the-zone' phase where much of the health-related orders are in the hands of the courts. As a result, we're focusing on helping clients prioritize their resources,” Jones said.

Companies also stand to mitigate losses in government-led communications by taking on a greater role themselves.

“We’re also guiding them on how they can play a more proactive role in filling the gaps—helping to protect health and prevent disease in our communities. For instance, in the past, a CDC spokesperson would typically lead conversations about vaccines. Today, immunologists, family physicians, and others are stepping up to share their expertise, helping families understand the vital role vaccines play in keeping children healthy,” Jones said.

“There’s a growing interest in rethinking the value companies and organizations bring to the healthcare system. They are reimagining their roles in driving innovation, providing clear scientific information to the public, and making sure people have access to the care they need.

“As we move forward, it’s clear that the biggest challenge—and opportunity—will be addressing what really matters to most Americans: affordable and accessible healthcare. If we can focus on that, all the other noise from the executive orders will become secondary. It all comes down to healthcare that improves people’s lives—both now and in the future,” she said.