Trump's Fiscal Year 2026 Budget Proposes Deep Cuts to Health and Human Services

What could go wrong?

President Donald Trump's Fiscal Year 2026 budget proposal outlines significant reductions to the Department of Health and Human Services (HHS), aiming to reshape federal health priorities and reduce discretionary spending.

The full budget document can be found here: Fiscal Year 2026 Discretionary Budget Request.

Key Highlights:

• Budget Reduction: The proposal seeks to decrease HHS's discretionary budget by approximately $33.3 billion, a 26.2% cut from the previous fiscal year.

• Agency Restructuring: Plans include consolidating several health agencies into a new entity, the Administration for a Healthy America, and eliminating programs like Head Start and the Long-Term Care Ombudsman Program.

• Impact on Research and Public Health: The National Institutes of Health (NIH) faces a proposed 40% funding cut, potentially affecting research on cancer, Alzheimer's, and infectious diseases. The Centers for Disease Control and Prevention (CDC) would see a 44% budget reduction, impacting disease prevention and emergency preparedness.

More details:

Here are some of the cuts and their justification directly quoted from the document. I also go into detail about why these changes are problematic. There are several other cuts, but here are a few of them:

• Centers for Disease Control and Prevention (CDC) Programs (cutting $3.588 billion): The Budget refocuses CDC’s mission on core activities such as emerging and infectious disease surveillance, outbreak investigations, and maintaining the Nation’s public health infrastructure, while streamlining programs and eliminating waste. The Budget proposes merging multiple programs into one grant program and giving States more flexibility to address local needs. Specifically, the Budget proposes consolidating funding for Infectious Disease and Opioids, Viral Hepatitis, Sexually Transmitted Infections, and Tuberculosis programs into one grant program funded at $300 million. The Budget eliminates duplicative, DEI, or simply unnecessary programs, including: the National Center for Chronic Diseases Prevention and Health Promotion; National Center for Environmental Health; National Center for Injury Prevention and Control; the Global Health Center; Public Health Preparedness and Response, which can be conducted more effectively by States; and the Preventive Health and Human Services Block Grant, the purposes for which can be best funded by States. The Budget refocuses CDC on emerging and infectious disease surveillance, outbreak investigations, preparedness and response, and maintaining the Nation’s public health infrastructure. The Budget maintains more than $4 billion for CDC

  • This budget claims to "refocus" the CDC, but in reality, it guts the very programs that protect Americans from chronic disease, environmental hazards, and public health emergencies.

  • Let’s unpack the spin: the proposal eliminates entire CDC divisions—including the National Center for Chronic Disease Prevention and Health Promotion, the National Center for Environmental Health, and the Injury Prevention and Control Center—under the guise of “eliminating waste.” These programs are not wasteful. They are essential. They reduce the burden of diabetes, heart disease, asthma, cancer, and violence—conditions that kill far more Americans annually than any emerging infectious disease.

  • Consolidating targeted programs for HIV, viral hepatitis, STIs, TB, and opioids into a single $300 million grant is a recipe for fragmentation and underfunding. These are separate epidemics with distinct challenges that require specialized expertise and infrastructure. Collapsing them into a one-size-fits-all fund will force states to triage crises rather than address them comprehensively.

  • Moreover, eliminating the Global Health Center and the Public Health Preparedness and Response division ignores lessons from COVID-19. Global surveillance and coordinated emergency response are not luxuries—they are frontline defenses. Claiming states can “do it better” on their own betrays a fundamental misunderstanding of how pandemics and environmental threats cross borders.

  • This budget’s proposed $4 billion for CDC may sound generous, but it comes with deep structural dismantling and a toxic message: that long-term public health doesn’t matter. If we ignore chronic disease, climate-related illness, and injury prevention today, we will pay the price tomorrow—in lives lost and dollars spent.

• National Institute of Health (NIH) (cutting $17.965 billion): The Administration is committed to restoring accountability, public trust, and transparency at the NIH. NIH has broken the trust of the American people with wasteful spending, misleading information, risky research, and the promotion of dangerous ideologies that undermine public health. While evidence of the origins of the COVID-19 pandemic leaking from a laboratory is now confirmed by several intelligence agencies, the NIH’s inability to prove that its grants to the Wuhan Institute of Virology were not complicit in such a possible leak, or get data and hold recipients of Federal funding accountable is evidence that NIH has grown too big and unfocused. Further, the NIH has been involved in dangerous gain-of-function research and failed to adequately address it, which further undermines public confidence in NIH. The NIH has also promoted radical gender ideology to the detriment of America’s youth. For example, the NIH funded a study titled “Psychosocial Functioning in Transgender Youth after 2 Years of Hormones,” in which two participants tragically committed suicide. The Budget proposes to reform NIH and focus NIH research activities in line with the President’s commitment to MAHA, including consolidating multiple overlapping and ill-focused programs into five new focus areas with associated spending reforms: the National Institute on Body Systems Research; National Institute on Neuroscience and Brain Research; National Institute of General Medical Sciences; National Institute of Disability Related Research; and National Institute on Behavioral Health. The Budget also eliminates funding for the National Institute on Minority and Health Disparities (-$534 million), which is replete with DEI expenditures, the Fogarty International Center (-$95 million), the National Center for Complementary and Integrative Health (-$170 million), and the National Institute of Nursing Research (-$198 million). NIH research would align with the President’s priorities to address chronic disease and other epidemics, implementing all executive orders, and eliminating research on climate change, radical gender ideology, and divisive racialism. This new structure retains the Advanced Research Projects Agency for Health. The Budget maintains $27 billion for NIH research

  • The Trump administration claims its FY 2026 budget will “restore accountability” at the NIH. In truth, it represents a blatantly political purge of scientific institutions, justified by conspiratorial language, cherry-picked tragedies, and deeply misleading claims about NIH's work and mission. We recently saw two scientists get awarded $500 million without normal peer review process for their vaccine research that was awarded by a political appointee.

  • Lab Leak Speculation is Not Evidence of NIH Misconduct: Citing “confirmed” lab leak origins of COVID-19 is a misrepresentation. While some U.S. intelligence agencies suggest a lab origin is plausible, others conclude it was likely zoonotic. There is no consensus, and no evidence NIH knew or supported any misuse of funds by the Wuhan Institute of Virology. The Wuhan grants were reviewed, legal, and focused on pandemic prevention—not secret bioweapons development. NIH cannot be held responsible for every international partner’s lack of transparency. Instead of providing more tools for oversight, this budget punishes NIH for global collaboration and scientific diplomacy.

  • Dangerous Distortion of Suicide and Trans Health Research: The administration attacks a peer-reviewed NIH-funded study of transgender youth—tragically citing two suicides as if the research caused them. This is morally reprehensible and scientifically dishonest. The study’s goal was to understand and support vulnerable youth navigating gender dysphoria. Misusing these deaths to demonize research into transgender health is not about public safety—it’s about censorship.

  • "Dangerous Ideologies" Is a Smokescreen for Dismantling Equity: Eliminating the National Institute on Minority Health and Health Disparities, the Fogarty International Center, and research into climate and racial health equity sends a clear message: equity and global cooperation are no longer priorities. Yet these are exactly the areas that determine long-term public health resilience—both domestically and abroad. These are not “woke” programs—they are what help us understand why Black women are three times more likely to die in childbirth, why asthma is worse in polluted urban neighborhoods, and how to build cross-border surveillance to stop pandemics. If you want to improve the life expectancy numbers, then you have to also focus on the most vulnerable populations. As an example, the average life expectancy in Chicago varies widely by neighborhood: 63.4 years in West Garfield Park compared to 88 years in the Loop.

  • What the NIH Reorganization Really Means: The proposed five new “focus areas” are vague, narrow, and ideologically filtered. Cutting entire NIH divisions—such as Nursing Research, Complementary Medicine, Global Health, and Minority Health—undermines decades of investment in disease prevention, community health, and holistic care. The administration claims to maintain $27 billion for research, but this number is grossly misleading. Much of that money is tied to a radical restructuring that could cause years of disarray in grant cycles, delay cures for chronic illnesses, and deter researchers from entering the field.

  • This Isn’t Reform. It’s Retaliation. The real goal of this NIH overhaul is not reform or efficiency—it’s retribution. Retaliation for COVID-era policies, for DEI efforts, for gender-affirming research, and for a scientific consensus that doesn’t align with political ideology. Slashing NIH’s core programs won’t improve trust—it will erode it. And worse, it will delay progress on cancer, Alzheimer’s, heart disease, mental illness, and emerging threats such as H5N1 bird flu.

• Substance Abuse and Mental Health Services Administration (SAMHSA) Eliminations (cutting $1.065 billion): This Administration is committed to combatting the scourge of deadly drugs that have ravaged American communities. Unfortunately, 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. The Budget proposes to refocus activities that were formerly part of SAMHSA and reduces waste by eliminating inefficient funding for the Mental Health Programs of Regional and National Significance, Substance Use Prevention Programs of Regional and National Significance, and the Substance Use Treatment Programs of Regional and National Significance. These programs either duplicate other Federal spending or are too small to have a national impact. These eliminations also promote federalism as these services are also supported by mental health and substance use disorder block grant funding. The Budget maintains $5.7 billion for activities that were formerly part of SAMHSA.

  • This budget claims to “combat the scourge of deadly drugs” while simultaneously gutting the very programs that have proven effective at reducing overdose deaths, preventing disease transmission, and connecting people to treatment.

  • Let’s be clear: harm reduction is not “dangerous”—it’s evidence-based public health. The programs being slashed by this budget—such as syringe service programs (SSPs), Narcan, and safe smoking supplies—are not encouraging drug use; they are reducing harm and saving lives. According to the CDC, people who use SSPs are five times more likely to enter drug treatment and three times more likely to stop using drugs altogether. These programs also help curb the spread of HIV and hepatitis C, ultimately saving taxpayer dollars.

  • Eliminating SAMHSA’s targeted regional programs under the false premise that they’re “too small to have a national impact” ignores the very nature of a localized epidemic. Substance use crises do not look the same in every state or community—regional grants allow for tailored, responsive interventions where they are most needed. The administration’s suggestion that block grants alone can fill this void is misleading and unsupported by state-level public health infrastructure.

  • Moreover, the notion that these cuts “promote federalism” is a smokescreen. In practice, they shift responsibility to state and local governments without adequate resources, leaving already overburdened health departments to pick up the pieces of a worsening overdose crisis.

  • This budget may maintain $5.7 billion in baseline funding, but it abandons innovation, dismantles localized responses, and demonizes harm reduction under a veil of moral panic. If the goal is truly to save lives, cutting SAMHSA’s most effective tools is not just counterproductive—it’s deadly.

• Centers for Medicare and Medicaid Services (CMS) Program Management (cutting $674 million): This cut will have no impact on providing benefits to Medicare and Medicaid beneficiaries. The Budget eliminates funding that had been used to carry out non-statutory, wasteful, and woke activities while maintaining funding for core Medicare and Medicaid operations, such as ending unnecessary DEI and support contracts. It eliminates health equity-focused activities and Inflation Reduction Act-related outreach and education activities.

  • “This cut will have no impact on providing benefits” is flat out not true. Removing equity and outreach programs will strip away the ability for people to navigate a complex and fragmented healthcare system. Folks will not see “DEI” disappear; instead, they’ll see fewer culturally competent providers, less support for managing chronic diseases, more confusion around Medicare and Medicaid benefits, and more preventable ER visits and deaths.

  • DEI is not wasteful, it is lifesaving! “Ending unnecessary DEI and support contracts” sounds like cutting bureaucratic red tape, but in reality, it means cutting services that help hospitals and healthcare professionals provide better care for their patients from underserved backgrounds. Black, Indigenous, and Hispanic patients already have higher rates of maternal mortality, diabetes, kidney failure, and delayed diagnoses. Cutting these initiatives will only cause further gaps in healthcare coverage.

• Agency for Healthcare Research and Quality (AHRQ) (cutting $129 million): AHRQ is supposed to support research to examine the quality, safety, and affordability of healthcare delivery from the perspectives of patients, caregivers, and clinical professionals. However, much of its research is wasteful or duplicative of research conducted elsewhere in the Department, such as NIH. The Budget eliminates funding for duplicative and wasteful grants and contracts, including those not aligned with the Administration’s priorities. The previous administration used AHRQ to publish information wholly unrelated to MAHA, including a document titled, “Reducing Healthcare Carbon Emissions: A Primer on Measures and Actions to Mitigate Climate Change.” AHRQ has also pushed radical gender ideology onto children, funding a project at the Seattle Children’s Hospital titled, “Using Telehealth to Improve Access to Gender-Affirming Care for BIPOC and Rural Gender-Diverse Youth.” The Budget increases accountability by prioritizing AHRQ’s statistical work, eliminates the digital health portfolio, ends new grants, and offloads contracts and interagency agreements not associated with statistical activities. In the Budget, consistent with the recent announcement of HHS reorganization, AHRQ’s functions are now a part of the new HHS Office of Strategy.

  • The proposed elimination of the AHRQ is a short-sighted and ideologically motivated attack on one of the most essential but underappreciated arms of American healthcare.

  • AHRQ Saves Lives and Money: AHRQ is not “duplicative”—it is distinct in its focus. Unlike the NIH, which funds biomedical research on diseases, AHRQ studies how to deliver care safely, efficiently, and equitably. It produces the playbook hospitals use to reduce medical errors, avoid unnecessary hospitalizations, and improve outcomes for millions of Americans. From infection prevention to opioid prescribing guidance to telehealth optimization, AHRQ improves the care patients actually receive.

    Dismissing this work as “wasteful” ignores its proven return on investment. AHRQ-funded safety protocols have prevented tens of thousands of hospital-acquired infections, saving lives and billions of dollars.

  • AHRQ’s work aligns with patients and not politicians: AHRQ exists to help make healthcare better for patients and healthcare providers. Their mission is to enhance the quality, appropriateness, and effectiveness of health services, and access to such services through the establishment of a broad base of scientific research and through the promotion of improvements in clinical and health system practices, including the prevention of diseases and other health conditions. Their work aligns with what Americans want: safe, affordable, equitable care that works.

  • AHRQ is being gutted: While the proposal claims that AHRQ’s functions are being merged into the new HHS “Office of Strategy,” this is actually a significant cut. The abolition of new grants, end of the digital health portfolio, and elimination of contracts will stop AHRQ’s ability to carry out real-time research.

Conclusion:

These proposed cuts are highly concerning because it will likely cause severe setbacks in medical research, disease prevention and healthcare services - especially for vulnerable populations.

While the budget proposal reflects the administration's priorities, it requires congressional approval. Debates are expected as lawmakers consider the potential impacts on public health and the nation's healthcare infrastructure.