Democratic governors form state public health alliance to counter RFK Jr.

Fifteen Democratic governors on Wednesday announced the formation of a state public health alliance designed to counter turmoil at federal agencies under the Trump administration.

Leaders of the Governors Public Health Alliance said it will serve as a hub for governors and public health leaders to monitor disease outbreaks, establish public health policy guidance, prepare for pandemics and buy vaccines and other supplies.

The alliance, spanning states where roughly 1 in 3 Americans live, underscores the increasing fragmentation of the public health system that has been upended by Health and Human Services Secretary Robert F. Kennedy Jr.

Kennedy’s challenge to long-standing vaccine recommendations has already prompted Democratic governors to form regional initiatives to provide immunization guidance. The latest alliance goes further in rebuking the Trump administration, encroaching on the federal government’s typical role coordinating the country’s preparation for disease threats and cooperating with global authorities.

“When the federal government abandons science for conspiracy theories, slashes Medicaid, and undermines vaccine integrity, states must stand united to defend the facts,” Illinois Gov. JB Pritzker (D) said in a statement.

The alliance members are California, Colorado, Connecticut, Delaware, Guam, Hawaii, Illinois, Maryland, Massachusetts, New Jersey, New York, North Carolina, Oregon, Rhode Island and Washington.

Connecticut Gov. Ned Lamont (D) said in an interview that the alliance mirrors how his state worked with neighboring ones to coordinate public messaging during the early months of the coronavirus pandemic. “We’re in another period where there’s a lot of contradictory information coming out of HHS, our departments of public health and what people are reading,” Lamont said.

In a statement, HHS spokesman Andrew Nixon said states led by Democrats imposed “unscientific school closures, toddler mask mandates, and vaccine passports during the COVID era.”

“Now, the same governors who eroded that trust are trying to reinvent public health under the guise of ‘coordination,’” Nixon said. “The Trump Administration and Secretary Kennedy are rebuilding that trust by grounding every policy in rigorous evidence and gold standard science — not the failed politics of the pandemic.”

Federal health agencies set national policies and send billions of dollars to local and state departments to fund health programs.

Under Kennedy, agencies such as the Centers for Disease Control and Prevention have endured cuts to personnel and funding for health programs. During the federal shutdown, the Trump administration has fired hundreds of additional employees at agencies under HHS and rescinded some of the cuts, sowing more confusion.

Governors are on “the front lines of public health” because of fewer resources from Washington, D.C., Colorado Gov. Jared Polis (D) said in a statement. “This new partnership will help states deliver consistent, common sense solutions that prevent the spread of disease, save lives, and protect our freedom.”

At the same time, states cannot match the ability of the CDC, which has unique data systems for infectious-disease surveillance, said Anand Parekh, chief health policy officer at the University of Michigan School of Public Health and a former HHS deputy assistant secretary of health.

Additionally, “there is the concern of further politicization of public health if Republican governors do not join this effort,” he said.

Despite those concerns, Tom Frieden, a former CDC director, said states have little choice.

“Really, what’s the alternative?” Frieden said. “You’ve got a CDC that has been hijacked by people who are obscuring or denying facts, and you have life-and-death decisions that have to be made.”

The initiative is being coordinated by Governors Action Alliance, a nonprofit that spearheaded a similar move in 2023 to coordinate Democratic-run states in supporting access to abortion following the Supreme Court’s decision to strike down the constitutional right to terminate pregnancies, leaving the decisions to the states. The health alliance’s advisers include Mandy Cohen, who led the CDC under President Joe Biden, and Anne Zink, a former president of the Association of State and Territorial Health Officials.

Cohen said the public health alliance is a bipartisan effort, citing former Republican governors on the nonprofit’s advisory board, and seeks participation from Republican governors. She said staff from red states joined the alliance’s recent briefings on prescription drug prices and vaccine policy.

“The door is open for more folks to join, even if they can’t join formally,” Cohen said. “Even if they don’t join, we will continue to reach out and to offer support.”

Zink, who is also a former chief medical officer for Alaska, said she only agreed to join because the alliance is nonpartisan, and because much stronger coordination on public health needs to take place at the state level. “We have deferred to the federal government too much, and that’s not what works best for people,” she said.

But states will have a hard time replacing lost federal public health funding, said Michelle M. Mallo, professor of law and health policy at Stanford University. Regional divisions in disease preparations could result in a patchwork of responses to future pathogens that easily cross state lines.

“We will increasingly see a two-track system of public health protection with states that are inclined to wield government power — often in ways that limit individual autonomy to protect public health — and prepare for the next pandemic and states that don’t,” Mallo said.