Last Friday, the White House published the Department of Health and Human Services (HHS) Budget in Brief for 2026. While this budget is separate from the ongoing reconciliation fight and is likely to change under Congress’s scrutiny, it does shine a light on the Administration’s priorities and top line numbers. The proposal outlines a significant restructuring within HHS and an approximately 25% reduction in discretionary spending compared to FY 2025 (this equates to a $31.3 billion decrease). Discretionary spending requests like this one are separate from Social Security, Medicare, and Medicaid as those are mandatory spending and not subject to the Appropriations process. However, we do see decreases in the discretionary programmatic and administrative funding to CMS of over half a billion dollars, which includes the cutting of roughly 200 full-time positions on staff. 

The biggest decrease is to the National Institutes of Health (NIH), which stands to have its current budget cut by 40% (or $18 billion). In addition to the overall NIH budget cuts, we also see the advancement or a proposed 15% cap on indirect research costs, which would further limit reimbursements for expenses tied to NIH-funded research.  

Other cuts include the Centers for Disease Control and Prevention (CDC), the Food and Drug Administration (FDA), and workforce reductions. The CDC’s budget stands to decrease from $9 billion in 2025 to roughly $5 billion in FY 2026 under the current budget proposal. This 44% cut includes the elimination of the National Center for Chronic Disease Prevention and Health Promotion. Certain functions will be transferred to the newly formed Administration for a Healthy America (AHA), which will focus on wellness and prevention. The FDA is looking at a $500 million reduction and a shift in routine food inspections to state agencies. The plan includes a reduction in administrative expenditures, proposing the elimination of thousands of full-time positions across HHS. 

The budget also outlines the funding for the AHA, which would manage $14 billion in funding and is intended to coordinate public health programs focused on primary care, chronic disease, behavioral health and prevention. The AHA will consolidate functions from various public health offices. 

This budget released by the Trump Administration is a proposal to Congress, who is ultimately in charge of the appropriations process. Some believe it unlikely that Congress will agree to many of these cuts, as we have already seen opposition on both sides of the aisle to the proposed cuts to NIH and the FDA. AHPA will continue to monitor the budget as it moves through the appropriations process.