Our Analysis of the President’s FY 2026 Budget Proposal for HHS

On Monday, June 2, 2025, the Trump Administration released its proposed Fiscal Year 2026 Budget to Congress. Below is a general summary from Scott Frey, Alliance for Aging Research’s Senior Vice President of Public Policy and Government Relations, highlighting topline provisions related to  the Department of Health and Human Services (HHS). However, this summary is by no means exhaustive of the items of general interest and of deep concern that Alliance for Aging Research is tracking. The FY 2026 blueprint reflects the Administration’s goals for HHS sweeping restructure and dramatic reductions in program budgets and personnel. 

In many areas the usual budget justification narratives are lacking, thus this summary reflects our best understanding of proposed programmatic changes at this time.

Summary of the President’s FY 2026 Budget Proposal for the Department of Health and Human Services (HHS)
$93.8 Billion | -26.2% Billion

• The Administration’s proposed reorganization of HHS would consolidate 28 Operating Divisions into 15, and close five regional offices.
  

• The reorganization would move $14.1 billion in program costs to a new Administration for Healthy America (AHA), formed by the merger of five existing agencies including HRSA, SAMHSA and some CDC programs, among others. The HHS Office of Women’s Health and the Office of Minority Health would also be consolidated under AHA at reduced funding levels. The proposed new AHA would be led by an Assistant Secretary for a Healthy Future.
  

• CMS is for the most part funded at FY25 levels. However, the budget does eliminate $674 million in unspecified programs including inflation Reduction Act outreach and education activities. The 340B Drug pricing program and certain components of HRSA would move to CMS.
  

• The budget document contains $29.3 billion for a new Administration for Children, Families, and Communities, consolidating programs under existing ACF and Administration for Community Living (ACL). ACL programs are relatively level funded (before inflation), although the Low Income Home Energy Assistance Program (LIHEAP) is zeroed out.
  

• The budget proposes $27.5 billion for NIH, a 40 percent cut, with consolidation of 19 Institutes and Centers into eight to “focus on true science.” It also reaffirms the Administration position of a 15 percent cap on indirect cost to grantees. The usual Congressional Justification for the proposal was not included in the budget submission. NIA, NCI and NIAID were not consolidated with the other programs, but the NIA budget is reduced by about 40 percent, and NCI and NIAID are reduced by about 37 percent each. The budget also eliminates funding for the National Institute on Minority and Health Disparities a $534 million reduction.
  

• The work of most other Institutes would be consolidated into new entities which include:

1. National Institute on Body Systems
2. National Institute for Child and Women’s Health, Sensory Disorders and Communication
3. National Institute for Behavioral Health
4. National Institute for Neuroscience and Brain Research
   

• On a positive note, the budget proposes a $0.9 billion increase for the Indian Health Service, up from $7 billion in fiscal 2025.
  

• The budget includes $4.1 billion for CDC, a $550 million cut, with reorientation toward its “core mission” such as “emerging and infectious disease surveillance, outbreak investigations, and maintaining the Nation’s public health infrastructure, while streamlining programs and eliminating waste.” The budget proposes merging multiple programs into one grant program. The budget proposes consolidating funding for Infectious Disease and Opioids, Viral Hepatitis, Sexually Transmitted Infections, and Tuberculosis programs into one grant program funded at $300 million. The Budget eliminates programs the Administration deems unnecessary, including: the National Center for Chronic Diseases Prevention and Health Promotion; National Center for Environmental Health; National Center for Injury Prevention and Control; the Global Health Center; Public Health Preparedness and Response (to be left to the States); and the Preventive Health and Human Services Block Grant. The budget continues CDC efforts on emerging and infectious disease surveillance, outbreak investigations, preparedness and response, and maintaining the Nation’s public health infrastructure.
  

• The Administration proposes $3.2 billion for FDA plus $3.6 billion in user fees – a net cut of $271 million or 3.9 percent below the FY25 level after a 4 percent increase in user fees. The budget promotes user fee funding for medical devices with an increase of $118.2 million to “sustain medical device review and research.” The budget also affirms Administration’s preference support for a combination of user fees and discretionary resources to finance FDA’s work. Citing the administration’s “Make America Healthy Again” policy agenda, the document calls for increase of $234.6 million to “address the nation’s chronic disease epidemic, restore public trust in our food system, and strengthen our nation’s nutritional and food safety.” Reductions are said to reflect streamlining and consolidations across the Agency, including the elimination of 1,940 FTEs.

We are pleased that the Alliance’s strong advocacy for NIA, ACL, CMS and FDA have helped them to avoid consolidation. We also are pleased that ACL and CMS avoided significant reductions. Still the Administration’s budget is deeply disturbing in its scope. If enacted, it could set back the quality and effectiveness of our public health infrastructure and global leadership in biomedical research by decades. However, it is important to note that a final FY 2026 Appropriation will require bipartisan support in Congress. Under Senate rules, a 60-vote threshold will be necessary in the Senate and many of the proposals contained therein have raised bipartisan concern.