Maryland’s health department and universities are slated to lose more than $300 million in federal funding, a sum that will likely continue rising as the Trump administration looks for more existing grants to cut.

The money had been pledged to the state for things like vaccinating children against infectious diseases, increasing HIV preventive measures and supporting people with addiction and mental health disorders. Many of the cuts target often marginalized groups such gay Black men, transgender people and those living with HIV.

The cuts to health care and medical research represent another in a line of potentially staggering losses for the state, provided they survive court challenges and are implemented. Previous cuts targeted the overhead costs of research and global humanitarian aid. Thousands of jobs at universities and federal agencies and contractors are also at stake.

The U.S. Department of Health and Human Services terminated grants to the Maryland Department of Health for the first time in the latest round of cuts.

The action is being taken because the funding “is not aligned” with federal priorities, according to a statement to The Baltimore Banner from the National Institutes of Health, one of the main agencies terminating grants.

“We remain dedicated to restoring our agency to its tradition of upholding gold-standard, evidence-based science,” the statement said. “We will leave no stone unturned in identifying the root causes of the chronic disease epidemic as part of our mission to Make America Healthy Again.”

Grants have been terminated at Johns Hopkins University and the University of Maryland’s Baltimore and College Park campuses. They also have been cut at the Maryland Department of Health. The grants were worth a total of more than $900 million, nearly $308 million of which had not been paid out at the time of termination, grant data from the U.S. Department of Health and Human Services showed Monday.

The money could affect what services Maryland residents get from the state and local governments, though it’s not clear which programs ultimately will be affected.

About $52 million of the cuts to the state health department were for vaccines for children, according to the federal list of terminated grants. Another $41 million in mental health and substance use grants was canceled.

Chase Cook, a spokesman for the state health department, said last week before the latest round of cuts that officials were “currently determining the full extent of these federal actions.”

Several local health departments, including Baltimore City, Baltimore County and Howard County, said they are waiting to hear how their programs will be affected by the cuts.

“The potential funding cuts coming from HHS are very concerning as they potentially affect how we are able to address public health needs at a county level,” said Lisa de Hernández, a spokeswoman for the Howard County health department.

“At this time, we don’t have detailed information about how we will be impacted,” she said. “Once we have more information, we will determine how to move forward in this challenging environment with the least disruption to services provided to our residents.”

The list of terminated grants does not appear to be fully up to date. Officials at the University of Maryland, Baltimore, said they had been alerted to more cuts than appear in the official tally maintained by federal authorities.

But they said in nearly every instance, the reason cited by federal authorities was that the grant “involves gender identity issues or promotes diversity, equity, and inclusion.”

The university said it expected to lose $11.6 million from its pledged contracts. The official tally as of Monday reflected $5 million in terminated grants for the school.

Based on the official federal tally, Johns Hopkins University is slated to lose at least $9 million and the University of Maryland, College Park, is expected to lose about $680,000.

The grants are from the U.S. Centers for Disease Control and Prevention, the National Institutes of Health, and the Substance Abuse and Mental Health Services Administration.