Preliminary Budget Would Slash HHS Funding, Encourage Restructuring

Discretionary spending by HHS is the major target of cuts in a preliminary budget from the Trump administration obtained by the Washington Post.1 This budget, which is still in the early stages of development, could affect the budget proposed by Congress for fiscal year 2026.

The budget proposal from the Trump administration not only covers areas in which budgets would be cut across HHS but also illustrates restructurings that would occur in conjunction with the reduction of funds. This reduction would mean a decrease from a discretionary budget of $121 billion in the 2024 fiscal year to $80 billion, an approximate one-third decrease. This is in addition to the downsizing of HHS that has already taken place, leaving employees of agencies including the CDC and FDA out of work.

The proposed budget outlines several other areas that will see major changes, primarily covering prevention-related services. Although it is not known how many of these proposals will be included in the House budget, the outline provides a glimpse at the areas that the administration sees as vulnerable to change going into the next fiscal year.

Various cuts are proposed in the preliminary budget put together by the Trump administration | Image credit: Jirapong - stock.adobe.com

Notable cuts are proposed in rural programs, which include rural hospital flexibility grants, the rural residency development program, and at-risk rural hospital program grants. The CDC would also see a major budget decrease, going from $9.2 billion to $5.2 billion, primarily cutting chronic disease programs that focus on heart disease, obesity, smoking cessation, and diabetes as well as cutting work in HIV that is occurring domestically.

The National Institutes of Health (NIH) would see its budget go from $47 billion to $27 billion under this proposal as well as the closure of 19 NIH institutes, specifically institutes focusing on minority health, health disparities, and nursing research. The remaining 8 NIH institutes would merge in their intentions, with institutes focused on body systems merging from 3 institutes into 1, streamlining the focus of the research undertaken at the institutes.

Amid the creation of a new Administration for a Healthy America (AHA) and the allocation of $500 million to policy and research funding, some programs would be cut, specifically in areas that have to do with rural health, amyotrophic lateral sclerosis, childhood lead poisoning, and increasing the workforce in health care. AHA would consolidate other programs under its umbrella, including those on HIV, environmental health, and primary care.

Along with these proposals, the FDA would receive funds to continue collecting fees from industries that produce drugs and medical devices but would have limited use of these funds if the FDA is not funded at a certain level.

Last, the budget calls for the elimination of the Head Start program, which provides education and childcare for families who are considered low-income.

This proposed budget would build on cuts already conducted by the Trump administration to health programs in the US. HHS had previously cut $12 billion used for tracking infectious diseases, mental health services, and addiction treatment among other uses in various states.2 Mass layoffs at the FDA, CDC, and NIH were also conducted on April 1, totaling 10,000 employees across the health agencies.3 This new budget would seek to build on those actions toward the Trump administration’s goal of balancing the federal budget.

The budget for the next fiscal year will be approved no later than June 30, and it is unknown how many of these proposals will make it into a budget voted on in Congress. However, this proposal offers a glimpse into the priorities laid out by the administration that the House can either use as a blueprint or scrap in favor of its preexisting budget, voted on in February.4

References

1. Sun LH, Johnson CY, Roubein R, Achenbach J, Weber L. Internal budget document reveals extent of Trump’s proposed health cuts. Washington Post. April 16, 2025. Accessed April 17, 2025. https://www.washingtonpost.com/health/2025/04/16/hhs-budget-cut-trump/
2. Mandavilli A, Sanger-Katz M, Hoffman J. Trump administration abruptly cuts billions from state health services. New York Times. March 26, 2025. Accessed April 17, 2025. https://www.nytimes.com/2025/03/26/health/trump-state-health-grants-cuts.html
3. Douglas L, Taylor M, Steenhuysen J. Trump begins mass layoffs at FDA, CDC, other US health agencies. Reuters. April 1, 2025. Accessed April 17, 2025. https://www.reuters.com/business/healthcare-pharmaceuticals/trump-administration-begins-mass-layoffs-health-agencies-sources-say-2025-04-01/
4. Klein HE. House passes budget resolution cutting billions from Medicaid funding. AJMC®. February 25, 2025. Accessed April 17, 2025. https://www.ajmc.com/view/house-passes-budget-resolution-cutting-billions-from-medicaid-funding