Congress gave the president a check for foreign aid, he signed it, and then his administration refused to cash it.

"It is a huge grab of power from the president, taking powers away from Congress."

— David Super, professor of law and economics at Georgetown University

Last year, the Trump administration did something unprecedented: it dismantled the U.S. Agency for International Development, terminating thousands of aid programs and letting funding expire without congressional permission. Clinics closed. Medicine deliveries stopped. People who depended on U.S. assistance found themselves on their own.

Congress eventually responded by passing a foreign aid spending bill that detailed precisely how much the State Department should spend and on what: $9.4 billion on global health, more than $5 billion on emergency humanitarian aid, hundreds of millions for family planning, nutrition, and neglected diseases. Trump signed it into law.

Now, eight months into the fiscal year, ProPublica has found that Trump officials are largely refusing to follow those orders.

The administration has delayed spending on global health, blocked funds for specific programs, and labeled aid money as "unallocated" to retain control over how it is spent. Lawmakers' letters go unanswered. Required reports remain unfiled. When pressed, officials offer denials that contradict publicly available budget data.

Translation: the president signed a spending bill he knew Congress would pass, then told his own agencies to ignore it.

The mechanism for this defiance runs through the Office of Management and Budget, run by Russell Vought. The OMB has labeled more than $500 million in global health money as "unallocated," meaning the State Department cannot spend it without OMB approval. The same treatment was applied to humanitarian aid funds, some of which began releasing only in May.

Legal experts say this violates the Impoundment Control Act, the 1974 law passed after President Nixon tried the same thing. The Government Accountability Office, Congress's watchdog, has already declared Vought's preferred maneuver of "pocket rescission" to be illegal. That technique involves asking Congress to cancel funds so late in the fiscal year that there is no time to spend them, even if Congress refuses.

A federal court initially blocked the maneuver in USAID-related lawsuits. The administration appealed to the Supreme Court, which issued an emergency ruling split along ideological lines that allowed the clawback to continue without ruling on the merits.

The GAO has standing to sue. Its general counsel, Edda Emmanuelli Perez, told ProPublica that her office is "continuing to review potential impoundments and monitoring ongoing litigation" but has not yet filed any lawsuits.

Cerin Lindgrensavage, a former Justice Department lawyer at Protect Democracy, called the situation a "fundamental threat to the rule of law." She put it simply: "Congress has said spend the money, and the president doesn't want to. The question is, who wins? Under the law, Congress is supposed to win. Right now, the president is."

While constitutional scholars debate the legality, the human impact is already documented. A peer-reviewed study published in The Lancet projected that global aid cuts could lead to at least 9.4 million additional deaths by 2030 if the current funding trend continues. About 2.5 million of those would be children under the age of five.

The Center for Global Development estimated that the decline in U.S. aid spending alone may have led between 500,000 and 1,000,000 lives lost in 2025 compared to previous years. Their projection for annual losses going forward: 670,000 to 1,600,000 lives per year.

The State Department dismissed The Lancet as a "failed journal" and called the study "rooted in outdated thinking." But independent experts who were not affiliated with the study confirmed the general conclusion. Jeremy Konyndyk, president of Refugees International, told CNN: "What we can say with confidence is these cuts are already killing people. The scale of that is still hard to fully compile, in part because the aid cuts themselves have made it harder to do so. Places are not collecting data. We're flying blind."

In the Democratic Republic of Congo, the cholera death toll rose 361 percent from 2024 to 2025, after USAID funding for clean water programs was cut in Goma. In Côte d'Ivoire, 70 percent of antiretroviral medication comes through PEPFAR. In Afghanistan, clinics like the one in Larga village sit empty, locals cut off from health services.

Congress directed the State Department to spend money on specific programs: $524 million for family planning, $165 million for nutrition, $109 million for neglected tropical diseases. According to ProPublica's review of government records, State Department officials have made little or no effort to spend from those pots.

Congress told the State Department to make good on U.S. pledges to the Global Fund to Fight AIDS, Tuberculosis and Malaria in a timely manner. The administration should contribute another $661 million and has not. Sen. Brian Schatz called the situation clear: "The State Department is underfunding the Global Fund. It's out of compliance with congressional appropriations."

When Schatz confronted Secretary of State Marco Rubio about this during a recent Senate hearing, Rubio said the money "will move shortly, very quickly." Asked about OMB's decision to withhold $3.2 billion in global health funds to pay USAID severance costs, Rubio claimed those were under OMB's purview. Schatz pointed out that Rubio himself had just wrestled money away from the OMB to respond to an Ebola outbreak, proving he was "perfectly capable of getting money released from those closeout funds if you wish."

The pattern is unmistakable: funds Congress explicitly directed to be spent simply sit there, labeled and delayed and re-directed, while the people they were meant to serve lose access to medicine and food and clean water.

The administration's replacement for USAID's programmatic network involves Jeremy Lewin, a 29-year-old lawyer who came into government through Elon Musk's Department of Government Efficiency with no prior humanitarian experience. Lewin is performing the duties of undersecretary for foreign assistance and humanitarian affairs without a congressional nomination, personally approving routine payments and rarely meeting with career staff.

He has funneled $3.8 billion to a small arm of the United Nations, the Office for the Coordination of Humanitarian Affairs, quadrupling its budget. The agreement does not allow the U.S. to independently audit the funds. Meanwhile, the administration is signing bilateral deals with poor nations that ask for access to health data as a condition for receiving lifesaving medications.

The State Department disputes independent analyses showing that by the end of March, only $190 million had been obligated of the more than $9 billion Congress told the administration to spend on global health last year, just 5 percent of what was typically obligated by that date in previous years. The department's counterclaim, that it has "approved and implemented spending" for more than $7.5 billion, references bilateral agreements whose specifics are still being determined and whose funding has yet to actually flow.

Oxfam America's president and CEO Abby Maxman summarized the situation after witnessing the impact firsthand in multiple countries: "We have run out of words to describe the depths of suffering we have witnessed after President Trump took a sledgehammer to U.S. humanitarian assistance."

The constitutional question here is not academic. It is about whether Congress can actually control how federal money is spent when the president does not want to follow the law. The Impoundment Control Act was passed for exactly this scenario. The GAO has declared the administration's maneuvers illegal. Courts have partially blocked them. The Supreme Court has not resolved the underlying question.

Meanwhile, the fiscal year ends in September. If the OMB's $3.2 billion in withheld global health funds is not obligated by then, it expires and can no longer be spent. Career officials fear the administration is withholding funds because it plans not to spend them at all. That is exactly what happened last year.

Congress gave the president a check. He signed it. Now he is refusing to cash it. The people counting on that money are the ones who will never know which version of events is the official one.