NEW YORK — A draft budget proposal currently under consideration by federal officials suggests severe reductions at the nation’s leading health agency, potentially cutting some public health initiatives entirely and setting the stage for substantial layoffs. The circulated document indicates a potential reduction in the U.S. Department of Health and Human Services’ (HHS) discretionary funding by as much as one third, a cut equivalent to tens of billions of dollars, according to individuals knowledgeable about the details.
While still in the preliminary stages, this draft reflects the Trump administration’s fiscal priorities as it organizes its 2026 budget request to Congress. This comes amidst widespread funding and employment reductions already occurring across several federal departments.
The proposal outlines a significant reorganization within HHS and proposes the elimination or reduction of numerous programs. These include Head Start, which supports over half a million underprivileged children, as well as initiatives focused on teen pregnancy, family planning, Lyme disease, and global health initiatives.
The National Institutes of Health (NIH), recognized as the world’s largest sponsor of biomedical research, is proposed to experience a budget cut, reducing from $48.5 billion to $27.3 billion. In addition to financial cuts, a restructuring is proposed that would consolidate NIH’s 27 institutes and centers into eight, merging several institutes focusing on distinct diseases such as cardiac, diabetic, and skeletal conditions.
NIH-supported research has been integral to the development of numerous treatments approved in the U.S. recently and has historically enjoyed bipartisan support. It remains uncertain if Congress will agree to these proposed changes, as it previously rejected substantial cuts to NIH’s budget during the first Trump administration.
“I just have not heard anybody say, ‘We wish the government would spend less money trying to cure cancer or trying to deal with Alzheimer’s,’” stated Jeremy Berg, a University of Pittsburgh professor and former director of an NIH institute. He stressed that the $20 billion budget reduction would significantly impact efforts to address major health issues and noted that restructuring itself would require both money and time.
The Food and Drug Administration’s (FDA) budget would face a near half-billion dollar reduction to $6.5 billion, partly by transferring certain long-standing federal responsibilities to state entities. For instance, the draft proposes removing FDA’s role in conducting routine food inspections, transitioning to relying entirely on state inspectors for these services.
Budget cuts would also impact the Centers for Disease Control and Prevention (CDC), with its core budget proposed to be slashed to approximately $5 billion from over $9 billion. Numerous programs might face termination or transfer to a newly proposed agency called the Administration for a Healthy America.
Among the cuts is the proposed elimination of the CDC’s National Center for Chronic Disease Prevention and Health Promotion, which employed 1,000 staff at the start of the year and houses several critical CDC health programs targeting issues such as adolescent and reproductive health, cancer prevention, cardiovascular disease, stroke, smoking cessation, nutrition, physical activity, and obesity.
Though officially unconfirmed by the Trump administration, the draft serves as an important indicator of the administration’s direction, noted David Harvey, executive director of the National Coalition of STD Directors. His organization, representing health department leaders working on sexually transmitted infection prevention and surveillance, is taking the draft and its potential implications very seriously.
This proposal was initially reported by The Washington Post, with The Associated Press also reviewing a 64-page document dated April 10. Stemming from a collaborative process between HHS and the White House Office of Management and Budget, this “passback” document represents feedback from both offices.
A spokesperson for HHS did not provide a comment when contacted Thursday.