A recent budget document prepared by the White House is giving new clarity over how the Department of Health and Human Services (HHS) could operate for fiscal year 2026.
The document closely mirrored other budgetary insights from earlier this year. Under the wishes of President Donald Trump’s staff, the department’s discretionary budget would be nearly $95 billion, a $32 billion decrease amounting to a one-fourth slashing.
Congress has final authority on submitting the budget, so some proposals may not be carried out, but the newest budget outline gives the clearest sense yet of the administration’s priorities. Committees on the Hill are expected to begin marking up the budget this week.
HHS leadership argues the reorg and dramatic funding changes are necessary to revive a country overtaken by chronic disease and rising healthcare costs.
The administration reiterated its desire to ax funding to the National Institutes of Health (NIH) by $18 billion to $27.5 billion. Internally, the NIH will have just eight institutes or centers, and even the centers that will not get consolidated will see diminished funding levels.
A new Make America Healthy Again initiative was once again included in the proposal. Totaling $500 million in funding, there is $119 million dedicated to a Prevention Innovation program for broadband, access to nutrition and physical activity and “reducing dependence on medication.” There is also $20 million for a chronic care telehealth Centers for Excellence program and $8 million for a telehealth nutrition grant program.
In the Food and Drug Administration, nearly a quarter of a billion dollars will go toward a safer food supply and healthy nutrition, while $49 million will address “risks associated with ultra-processed foods.”
The budget does not tackle mandatory spending like Medicare and Medicaid, but $699 million in discretionary funding would still go to the Centers for Medicare & Medicaid Services. The Department of Justice would receive $133 million, and the Office of Inspector General at HHS $109 million. Funding for health equity, community outreach and administrative functions of the Inflation Reduction Act will not be continued.
It would also continue the HHS’ march to consolidate offices deemed as duplicative, the termination of 5,000 contracts and a staffing level return similar to the pre-COVID-19 days. And a new office, the Administration for a Healthy America (AHA), is again set for a $14 billion budget and will combine the Health Resources and Services Administration (HRSA), the Substance Abuse and Mental Health Services Administration and some programs within the Centers for Disease Control and Prevention (CDC).
HIV+Hepatitis Policy Institute Executive Director Carl Schmid warned the agency’s reorganization and funding shifts will result in more than $1.5 billion in cuts for programs designed to slow or stop the spread of HIV.
“While we are reassured that the 576,000 low-income people currently accessing care and treatment through the Ryan White HIV/AIDS Program, along with those using [pre-exposure prophylaxis (PrEP)] at community health centers, can maintain their services, the obliteration of CDC HIV prevention and surveillance programs is an absurd proposal that will just increase HIV infections and health costs down the road,” said Schmid in a statement. “We urgently call on Congress to reject these cuts in order to ensure that states and community-based organizations have the resources to prevent HIV, which is still a serious infectious disease and results in about 32,000 new cases.”
He noted $220 million will still be in place for the CDC’s Ending the HIV Epidemic in the U.S. initiative, half of the previous year’s funding.
The American Cancer Society Cancer Action Network joined in the condemnation of the proposal, which calls for a 37% cut, $2.7 billion, from the National Cancer Institute.
“Moving backwards in funding would not only stall scientific breakthroughs but also impact our ability to combat the rising incidence of cancer nationwide,” the organization said. “Cuts have consequences, and those consequences are life threatening for cancer patients who could be waiting for the next clinical trial or research breakthrough.”
Public health concerns don’t stop there, said Richard Hughes IV, a partner at law firm Epstein Becker & Green.
The budget would slash funding for the U.S. Preventive Services Task Force, at the forefront of the Braidwood case before the Supreme Court, from $18 million to $7 million, as well as eliminate the Affordable Care Act Prevention and Public Health Fund. This fund invested in “evidence-based activities” surrounding tobacco prevention, public health workforce training, surveillance, immunizations and screenings, and more.
Notably, the 340B Drug Pricing Program would now fall under the CMS Program Management’s authority instead of HRSA or the newly created AHA.
Half a billion dollars would be dedicated for the 988 Suicide and Crisis Line, and three mental health and substance abuse programs will be combined under one Behavioral Health Innovation block grant.