State legislators have cut Indianapolis public health funding by more than 70% — hampering long-term efforts to improve the city’s vaccination rates, maternal mortality and child health.
The money was from Health First Indiana, a bipartisan initiative led by former Republican Gov. Eric Holcomb that funneled $225 million into local health departments across the state in the last two years. The goal was to reverse Indiana’s poor health outcomes by investing in basic services.
The Marion County Public Health Department used its annual shares — about $11.8 million in 2024 and $22.5 million in 2025 — for various initiatives, including screening community members for heart conditions, passing out protective glasses for the solar eclipse and running back-to-school vaccination clinics. But that money has been slashed to $6 million for 2026, said Dr. Virginia Caine, the department’s chief medical officer.
“It’s a huge reduction,” Caine told Health and Hospital Corp. board members at a May 20 meeting.
The Marion County Public Health Department is looking for ways to keep funding for its core programs intact: “If needed, we’ll look at ways to shift resources in future years to continue serving the public,” a spokesperson said in an April 28 email. The department has not made Dr. Caine available for an interview or answered questions about the specific programs impacted.
But experts warn the spending reduction will compromise Indiana’s progress. The state regularly ranks as one of the worst in the country for obesity rates, cancer deaths and dismal outcomes for mothers and infants. And, before Health First Indiana, it was spending well below the national average on public health.
“We were just beginning to see some momentum and it’s been cut off at the knees,” said Paul Halverson, the founding dean of the Richard Fairbanks School of Health at IU Indianapolis. “People will suffer and die earlier because we’re not seeing health as an asset for the community.”
Halverson, now a dean in Oregon, was a member of Holcomb’s public health commission, which studied the state’s health system and made recommendations. A mix of business leaders, government officials and health advocates supported increasing the state’s funding.
That unity was a stark contrast to the cuts that emerged from the Statehouse this session. Legislators said they had to roll back health services and other programs to rein in Indiana’s $2 billion budget shortfall.
Some members questioned whether Health First Indiana was making enough of an impact in its first year.
“When this was proposed, we were going to see more immediate results,” Sen. Liz Brown, R-Fort Wayne, said during a March 13 Senate Appropriations Committee meeting. “We’re not seeing significant results yet.”
Valerie Yeager, a policy researcher at the Fairbanks school, said investments in public health take time — but they do make a big difference. She studied the early impacts of the program and found the state was getting a 200% return rate on its investment in prenatal care, blood pressure screenings and fall prevention.
“It’s always less expensive to prevent people from getting ill and injured than it is to make them well again,” Yeager said. “If you take these dollars away before they can even make changes, it feels like a wasted resource.”
‘Diseases don’t understand immigration status’
Republican leaders don’t want to talk much about the cuts.
Gov. Mike Braun has promised to “Make Indiana Healthy Again.” He recently hosted top Trump officials Robert F. Kennedy Jr. and Dr. Mehmet Oz in Indianapolis. The group announced new state executive orders on health, including one that bans residents from using food assistance to buy soda and candy.
Braun said his approach would empower Hoosiers to “live healthier, longer lives.”
Democrats said the move rang hollow. They pointed out that the new governor reduced public health funding by $50 million in his proposed budget.
The final cuts from the legislature were much steeper than that — all the local health departments that split $150 million this year will only share $40 million annually between them in 2026 and 2027. A spokesperson for Braun did not respond to multiple requests for comment.
Sen. Ed Charbonneau, a Republican from Valparaiso who authored the Health First Indiana bill, declined Mirror Indy’s request for an interview. So did Rep. Brad Barrett, R-Richmond, the chair of the House Public Health Committee.
Through a spokesperson, Barrett said the $40 million allocated to public health in the budget is “consistent” with what was actually spent by public health departments in 2024.
“Dollars that were previously appropriated were going unspent as local health departments were still building up their programs,” the May 7 statement said. “We remain focused on improving health care outcomes and reducing health care costs while protecting taxpayer dollars.”
Yeager, the health policy researcher at Fairbanks, said initiatives like Health First Indiana take time to get off the ground — and they need sustainable funding to do so.
“Health departments used the first year to be really thoughtful about how they used the funds and they were allowed to carry some into 2025,” she said.
Concerns about who the state health initiative serves also came up during the session.
Republicans have claimed immigrants living here without legal permission are benefiting from the program, the Indiana Capital Chronicle reported. In response, the budget bill restricted local health departments from spending Health First Indiana dollars on anyone who is not a “legal citizen” or state resident.
Halverson, the former Fairbanks dean, said no group should be singled out and excluded from investments in public health — for their benefit and everyone else’s. He pointed to vaccination rates as an example.
“Diseases don’t understand immigration status,” Halverson said. “They infect everybody, and you want widespread immunization to prevent the spread.”
The Marion County Public Health Department did not answer questions about how it will implement the new state restrictions on the program or if it will require people to show proof of citizenship to receive health services.
Mirror Indy, a nonprofit newsroom, is funded through grants and donations from individuals, foundations and organizations.
Mirror Indy reporter Mary Claire Molloy covers health. Reach her at 317-721-7648 or email maryclaire.molloy@mirrorindy.org. Follow her on X @mcmolloy7.
Republish our articles for free, online or in print, under a Creative Commons license.
