It will take nearly $95 billion in discretionary funding in fiscal year 2026 to “Make America Healthy Again,” according to the Trump Administration’s budget for the Department of Health and Human Services (HHS).
More details about the administration’s plans came into focus on Friday with the release of the HHS FY 2026 Budget. While Congress still needs to weigh in on the spending plans, if enacted as proposed, HHS will face drastic cuts to the National Institutes of Health (NIH) and the Centers for Medicare & Medicaid Services (CMS) diversity, equity, and inclusion efforts. These cuts are on top of the reductions HHS has already made to its programs, including the elimination of 20,000 employees.
The cuts to the full-time workforce will bring HHS to 90 percent of its pre-COVID staffing level and could save an estimated $3.1 billion per year, according to the budget plan.
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The 51-page budget proposal asks for $94.7 billion in discretionary spending for fiscal year 2026, a 25 percent decrease from this year. The spending wish list reflects Trump’s vision to make America the healthiest in the world while achieving his goal of transforming bureaucracy, the budget proposal says.
Here are five things to know about HHS’ proposed budget:
Reorganizes key divisions
As previously reported, HHS is combining multiple HHS agencies into a new division called the Administration for a Healthy America (AHA). The former agencies include the Health Resources and Services Administration (HRSA), Substance Abuse and Mental Health Services Administration (SAMHSA), Office of the Assistant Secretary for Health (OASH), National Institute for Environmental Health Sciences, and some programs from the Centers for Disease Control and Prevention (CDC). The new AHA division would have $14 billion in discretionary funding for programs that aim to reverse the chronic disease epidemic by focusing on prevention efforts.
The budget also consolidates programs that were in the Administration for Community Living into the Administration for Children and Families under a new operating division, the Administration for Children, Families, and Communities (ACFC). The new division would receive $29.3 billion in discretionary funding for programs that address the social service needs.
Eliminates dozens of programs
As part of the plan, the following programs that were formerly under the HRSA will be cut: Healthy Start, newborn screening for heritable disorders, early hearing detection and intervention, emergency medical services for children, Ryan White Part, Rural Hospital Flexibility Grant, State Offices of Rural Health, rural hospital stabilization, family planning, and 15 workforce programs, including some nursing workforce programs and medical student education.
CDC programs slated to be slashed: youth violence prevention, adverse childhood experiences, firearm injury and mortality prevention research, traumatic brain injury, elderly falls, drowning, other injury prevention activities, injury control research centers, the national occupational research agenda, education and research centers, personal protective technology, other occupational safety and health research (total worker health), the Amyotrophic Lateral Sclerosis (ALS) registry, climate and health, Trevor's Law, environmental and health outcome tracking network, and asthma.
SAMHSA programs to be cut: mental health awareness training, healthy transitions, infant and early childhood mental health, mental health children and family programs, consumer and family network grants, mental health system transformation, Project LAUNCH, primary and behavioral health care integration programs, mental health crisis response partnership program, homelessness prevention, mental health criminal and juvenile justice programs, assertive community treatment for individuals with serious mental health illness, homelessness technical assistance, minority AIDS, seclusion and restraint, minority fellowship program, tribal behavioral health grants, interagency task force on trauma-informed care, strategic prevention framework, sober truth on prevention underage drinking, screening, brief intervention and referral to treatment, targeted capacity expansion, grants to prevent prescription drug and opioid overdose-related deaths, first responder training, improving access to overdose treatment, pregnant and postpartum women, recovery community services program, substance abuse treatment children and families, treatment systems for homeless, building communities of recovery, substance abuse treatment criminal justice activities, emergency department alternatives to opioids, treatment, recovery, and workforce support, peer support technical assistance center, comprehensive opioid recovery centers, youth prevention and recovery Initiative, and drug abuse warning network.
OASH programs that will be eliminated: Office of Population Affairs, teen pregnancy prevention, Secretary's minority HIV/AIDS fund, KidneyX, stillbirth task force, and sexual risk avoidance.
Makes deep financial and structural cuts to NIH
The proposed budget would cut NIH’s budget by 43 percent, from $47 billion to $27.5 billion, and reorganize the agency’s institutes and centers from 27 to eight. It will retain the National Cancer Institute, National Institute of Allergy and Infectious Diseases, and National Institute on Aging. The other institutes would be absorbed into new divisions: the National Institute on Body Systems, the National Institute on Neuroscience and Brain Research, the National Institute of General Medical Sciences, the National Institute of Disability-Related Research, and the National Institute of Behavioral Health.
The potential cuts have alarmed advocates for science, discovery, and innovation. “If the proposal is enacted, Americans today and tomorrow will be sicker, poorer, and die younger,” said Research!America President and CEO Mary Woolley in a statement. “American research has a proven track record of increasing survival, reducing the burden of illness, and creating jobs. Cutting research funding helps no one; instead, it hurts everyone.”
The American Association of Immunologists (AAI) also said it opposes the proposed cut. “The loss of NIH’s essential role would cripple the development pipeline of new treatments and cures,” said AAI President Stephen C. Jameson in a statement. “Critical medical advances for diseases such as cancer, cardiovascular disease, neurodegenerative disease, and autoimmune disease could be delayed or abandoned entirely.“
Slashes CDC budget by more than half
In addition to the program cuts, the CDC would see its budget drop from $9 billion to $4.3 billion.
The proposed cuts aim to refocus the agency on its core mission to support infectious disease surveillance, outbreak investigations, preparedness, and response, and maintaining the public health infrastructure. “For too long,” the budget proposal said, “CDC has grown beyond these core functions, at the detriment of being a trusted voice amongst the American people. Going forward, CDC will be focused on gold standard science and regaining the confidence of the American people. The mission of the CDC is too great for continued inefficiencies and failed, dangerous public health advice.”
But state and local communities worry that the cuts will leave departments unable to respond to new pandemics and old diseases that are reemerging. The CDC sends about 80 percent of its budget to state and local communities, the AP reported.
"Without the appropriate funding, we can't properly address these threats," Michael Eby, MHA, director of clinical services in Mecklenburg County, Charlotte, N.C., told the AP. "We're at risk of them getting out of control and really causing a lot of damage and death to individuals that we could have saved, that we could have protected."
Cuts CMS health equity programs but gives agency a new responsibility
CMS’ program management budget in fiscal year 2026 would be $3.5 billion, a $673 million cut from last year. The proposed funding includes $699 million for fraud and abuse but eliminates money for health equity and certain community outreach activities.
As part of the proposed HHS reorganization, CMS would take over the 340B program from the HRSA. The program requires drug manufacturers to provide discounts on outpatient drugs to safety-net providers or covered entities like hospitals and federally qualified health centers. The requested budget for the program is $12.2 million, which is the same level that HRSA received in FY 2024.