In mid-May, the administration released its “skinny” budget request to Congress for Fiscal Year (FY) 2026. The proposal is extremely lite on detail and totals less than 50 pages for the entire federal government. The document calls for 40% funding cuts to NIH and deep reductions to other research, public health and patient care activities (doubling down on requested 20% cuts from the previous Trump administration). In any year, the budget request is a non-binding set of recommendations, but the draconian nature of the cuts will make it difficult for lawmakers to take seriously (particularly considering the FY 2026 appropriations process is already well underway). A summary of key information is included below.

• 32.7 billion in discretionary funding for the National Institutes of Health, a proposed decrease of $17.97 billion from FY 2025.
  • Congress is asked to create five new “focus areas”: the National Institute on Body Systems Research, the National Institute on Neuroscience and Brain Research, the National Institute of General Medical Sciences (which currently exists), the National Institute of Disability Related Research, and the National Institute on Behavioral Health.
  • Congress is asked to eliminate funding for the National Institute on Minority Health and Health Disparities, the Fogarty International Center, the National Center for Complimentary and Integrative Health, and the National Institute on Nursing Research.
  • The Advanced Research Projects Agency for Health is maintained.
• $4.35 billion in discretionary funding for the Centers for Disease Control and Prevention, a proposed decrease of $3.59 billion from FY 2025.
  • Congress is asked to consolidate funding for the HIV/AIDS, Viral Hepatitis, STD, and TB Prevention programs (which include opioid work too) into a single funding line and reduce the overall allocation to $300 million from $1.39 billion in FY 2025.
  • Congress is asked to eliminate the National Center for Chronic Disease Prevention and Health Promotion, the National Center for Environmental Health, the National Center for Injury Prevention and Control, the Global Health Center, Public Health Preparedness and Response, and the Preventative Services Block Grant.
• $7.18 billion in discretionary funding for the Health Resources and Services Administration (specifically, programs that have been housed here that would now be moved elsewhere in HHS), a proposed decrease of $1.73 billion from FY 2025.
  • Congress is asked to reduce or eliminate the Maternal and Child Health Programs, education and training activities, Health Workforce Programs, and family planning activities.
• $6.23 billion in discretionary funding for the Substance Abuse and Mental Health Services Administration, a proposed decrease of $1.07 billion from FY 2025.
  • Congress is asked to eliminate the Mental Health Programs of Regional and National Significant, Substance Use Prevention Programs of Regional and National Significance, and the Substance Use Treatment Programs of Regional and National Significance.
• $2.99 billion in discretionary funding for Program Management at the Centers for Medicare and Medicaid Services, a proposed decrease of $674 billion from FY 2025.
• $247 million in discretionary funding for the Agency for Healthcare Research (AHRQ) and Quality, a proposed decrease of $129 million from FY 2025.
  • Congress is asked to make AHRQ part of the new Office of Strategy.
• $530.96 million in discretionary funding for the Office of the HHS Secretary/Office of the Assistant Secretary for Health, a proposed decrease of $180 million from FY 2025.
  • Congress is asked to migrate core activities to the new Administration for a Healthy America.
  • Congress is asked to eliminate the Sexual Risk Avoidance Program and the Teen Pregnancy Prevention Program.
  • Congress is asked to reduce funding for the Office of Minority Health and the Office on Women’s Health.
  • $500 million for “Make America Healthy Again”, a proposed increase of $500 million from FY 2025.
• The allocation requested for nutrition, physical activity, healthy lifestyles, over-reliance on medication and treatments, the effects of new technological habits, environmental impacts, and food and drug quality and safety is significantly less than the amount eliminated for existing programs already working in these areas.

The White House FY 2026 budget documents can be viewed here.

The Republican House narrowly passed H.R. 1 the “big, beautiful bill” advancing budget reconciliation negotiations. The House proposal was fluid with many modifications to rally enough votes. Ultimately though, the package includes controversial provisions related to the SALT tax and reductions in benefits for SNAP and Medicaid coupled with drastic changes to student loans. The Senate has called the House package a non-starter and further negotiations toward a final package lie ahead. H.R. 1 information can be found here. A comprehensive summary of key healthcare and education elements from the current House package can be found here, here, and here.

By: Dane Christiansen, Washington Representative (the Health and Medicine Counsel)