While Congress is on a two-week recess, there is still big federal policy news to report this week. An internal document reported by the Washington Post on Wednesday provides an early look at the President’s 2026 HHS budget priorities and illustrates what a restructured HHS would look like.  See this Quick Take article from the Kaiser Family Foundation which gives a condensed and user-friendly explanation of the “passback” budget.  

A “passback” budget is a term used in the development of (any) President’s budget, where budgets are “passed back” and forth between the agencies (like HHS) and the Office of Management and Budget (OMB). OMB is the arm of the federal government whose job is to develop the President’s Budget, which doesn’t have the force of law but lays out the Administration’s vision and priorities. This “passback” document is only one part of the development of the President’s FY2026 Budget, which is expected to be released on May 19.  

This document implements much of the re-organization of HHS that was announced at the end of March. It establishes a $20 billion Administration for a Health America (AHA) agency under which a number of HHS programs would be consolidated, including the Ryan White HIV treatment program currently being implemented by HRSA. Within the Ryan White program, however, this passback would eliminate funding for Part F of the Ryan White HIV/AIDS Program, including funding for the AETCs, Ryan White Dental Program, and the SPNS Program.  

This document also eliminates all Ending the HIV Epidemic (EHE) funding—funding previously administered by HRSA, CDC, and IHS. It also proports to cut 44% of the CDC’s budget, including the elimination of CDC’s Division of HIV Prevention.  

This passback also creates a “2026 Consolidated Hepatitis, STD & Tuberculosis Grant” combining spending for Viral Hepatitis, STI, and TB prevention as part of one large block grant. From the document: “The Budget gives states more flexibility to address local needs by consolidating future funds for Infectious Disease and Opioids, Viral Hepatitis, Sexually Transmitted Infections, and Tuberculosis Programs into one grant program.” If this new block grant could or would include HIV prevention activities is unclear. What flexibility states would have to implement this funding is also unclear.  

In this passback document, this new block grant is funded at $898 million. However, if you add up all the current federal funding lines specifically mentioned in this document pertaining to this new “2026 Consolidated Hepatitis, STD & Tuberculosis Grant” (i.e., Infectious Disease and Opioids, Viral Hepatitis, Sexually Transmitted Infections, and Tuberculosis Programs), that total is $377.3 million—bringing into question how the $898 million total mentioned for this block grant was determined.  

Again, this is a leaked document—not a final—for a process to develop the President’s Budget—which does not have the force of law. The federal budgetary and appropriations process is completed by Congress, who would need to act to allow these changes to be implemented. But—this proposal does outline where the administration is planning to re-organize HHS and is a major departure from current practice.  

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