Today the Administration released its FY2026 budget request to Congress. After the leaked release of the HHS “passback” budget over two weeks ago, we had hoped the release of this budget request would provide more clarity on the Administration’s plans for the federal budget. Unfortunately, that was not completely true with this submission—there are still a lot of details missing. If you think of presidential budget proposals as tomes of hard to follow funding charts, that is not the case here—this is a rather easy to follow (though thin on details) 46-page table of text! (HHS starts on page 9, HRSA and CDC are on page 11.)

Here’s what we know: Overall, the Administration proposes to cut funding for the Centers for Disease Control and Prevention by 45%, proposing to maintain “more than” $4 billion for CDC.  It proposes to eliminate entire Centers at CDC such as the National Center for Chronic Diseases Prevention and Health Promotion, and the National Center for Injury Prevention, among others.

More specifically, this submission contains:

• • • A proposed Consolidated Funding grant program for: Infectious Disease and Opioids, Viral Hepatis, Sexually Transmitted Infectious, and Tuberculosis programs funded at $300 million. This is a proposed $77.3 million funding cut from current funding for these four combined funding streams.
    • No mention of HIV prevention. The “passback” budget noted that it eliminated the Division of HIV Prevention, but this document does not mention it at all. Given the level of funding cuts proposed here, we believe this budget continues the proposal of DHP elimination.
    • Direct statements that it “refocuses CDC’s missions on core activities such as emerging and infectious disease surveillance, outbreak investigations, and maintaining the Nation’s public health infrastructure…” but it is unclear how it continues to support these listed activities, particularly surveillance for specific infections like HIV.
    • Proposed “consolidation” (which I read to mean elimination) of “Ryan White HIV/AIDS program activities that do not focus on core healthcare and support services directly to patients, such as: education and training…” This is the elimination of the Ryan White Part F program: AIDs Education and Training Centers, Dental, and the Special Programs of National Significance programs.
    • Proposed elimination of the Title X Program, “which use[s] taxpayers funds to nonprofits that are not aligned with several Administration policies.”
    • Proposed elimination of the Preventive Health and Human Services Block grant, “the purposes for what can be best funded by the States.”
    • Proposes to provide $500 million for the “Make American Health Again [MAHA]” initiative “which would allow the Secretary [of HHS] to tackle 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 across HHS.”
    • Proposed almost $18 million in cuts at NIH, and $1 million at SAMSHA, including a mention of “under the previous administration, SAMHSA grants were used to fund dangerous activities billed as ‘harm reduction,’ which included funding ‘safe smoking kits and supplies’ and ‘syringes’ for drug users.”

In a “typical” year, I would usually now emphasis that the President’s budget submission is just a proposal and is the start of the budget process, which is implemented by Congress. All of that is still true, but this year has been anything but typical, and that includes this budget proposal. The adage is “the President proposes, Congress disposes” and we shall see how that holds true in the coming weeks.

We continue to expect a FY2025 recissions package from the Administration to be submitted to Congress in the coming weeks. And markups on a budget reconciliation package in committees continue, which could result in reductions in mandatory spending programs, like Medicaid. (The markup in the House Energy and Commerce Committee, which was scheduled for next week has been pushed to the week of May 12. This is the House Committee that has jurisdiction over Medicaid.)