Earlier this week, the House Appropriations Committee passed its fiscal year (FY) 2027 Labor, Health and Human Services (LHHS) funding bill. The bill can be found HERE, and the Committee Report HERE. In the committee report (the document with more detailed text information), the section for HRSA funding starts on page 36 and CDC begins on page 63.

A funding chart outlining funding levels proposed in the bill and compared to previous year’s funding can be found here.

Overall Funding

Overall, the bill proposes $201.8 billion, a decrease of $19.1 billion below last year. The bill would provide a $100 million increase for the NIH while eliminating funding for several programs, including Title X family planning grants and certain research initiatives related to maternal health, HIV/AIDS, gun violence, and climate. The bill would also eliminate the Agency for Healthcare Research and Quality (AHRQ).

CDC Funding

The bill eliminates base HIV prevention funding at the CDC but maintains funding for the Ending the HIV Epidemic (EHE) at CDC to “continue implementation of EHE strategies, including nationwide HIV surveillance, testing, prevention outbreak response and laboratory services. Surveillance data is used to inform resource allocation, including for the Ryan White HIV/AIDS program.” 

This bill revives an administrative proposal to block grant funding streams at NCHHSTP, specifically STDs, Hepatitis, and Infectious Diseases and Opioids, with a proposed total funding level of $208,966,000, a total funding cut of $23.4 million from current funding.

Additionally, the committee report notes that “Within the funding provided, the Committee directors CDC to allocate not less than $46 million to maintain national capabilities to support health departments…” essentially establishing a “carve out” in this bill to maintain the current funding levels for hepatitis prevention. Tuberculosis continues to have a stand-alone funding line in this bill, which is level-funded compared to current funding.

HRSA Funding

This bill proposes reducing funding for the Ryan White HIV/AIDS Program by $224 million. This proposal would eliminate Ending the HIV Epidemic Initiative funding, as well as Special Projects of National Significance and AIDS Education and Training Centers. The bill proposes flat funding for Part A, Part B Base, Part B ADAP, Part C, Part D, and Dental Programs within Part F.  Currently, it is unclear if the Ending the HIV Epidemic Initiative Funding at the Bureau of Primary Care (which funds EHE activities at Community Health Centers) is maintained.

Under the Bureau of Primary Health Care, the report includes the following language: “Testing and Treatment.—The Committee is concerned about the continued rise in syphilis infections in the U.S., including con genital syphilis, and the impact on underserved communities served by FQHCs. The Committee recognizes that FQHCs play a critical role in providing services to individuals at increased risk for sexually transmitted infections. Therefore, the Committee urges HRSA to encourage increased testing and treatment for syphilis, including prenatal syphilis screening, to prevent congenital syphilis. The Committee further urges HRSA to provide technical assistance and training, utilizing expertise from outside organizations for assistance, to FQHCs on implementation of screening protocols and coordination with State and local public health departments.”

Looking to the Senate side, there is still no resolution between the Republicans and Democrats on top line spending for the FY’27 appropriations bills, which delays the start of the Senate’s appropriations process. Democrats are dug in and will not support increases in defense spending without corresponding increases for domestic programs. They also want language that would permanently block President Trump’s anti-weaponization fund.

The Senate Appropriations Committee has postponed markups for bills over the last few weeks, with no new markup schedules set at this time. As a reminder, Congress has until the end of September to complete work on FY2027 funding or pass a continuing resolution or the government will shut down. It is highly likely that the government will be working under CRs for a period of time, with appropriations work stretching into December or even early into next calendar year.