Federal health budget discussions herald a fresh course for public health services
In a series of recent hearings, Health and Human Services (HHS) Secretary Robert F. Kennedy Jr. outlined the Trump Administration's proposed FY26 budget and reorganization plans. The proposed budget includes a sweeping reorganization of HHS and other federal agencies, with the aim of reducing bureaucratic inefficiencies and improving health care delivery. One of the key changes is the consolidation of various agencies under the new Administration for a Healthy America (AHA), including HRSA, SAMHSA, and parts of CDC. In the proposed budget, funding appropriated for health insurance will be used accordingly, and health insurance recommendations will continue to be made by the CDC's Advisory Committee on Immunization Practices (ACIP). However, the FY26 budget proposes eliminating a majority of programs at CDC's National Center for Injury Prevention and Control, including those driving progress on opioid surveillance and community-based interventions, which have reduced rates of overdose. The CDC's Center for Chronic Disease Prevention is also proposed for elimination, with the Diabetes Prevention Program Outcome Study paused. Sec. Kennedy also addressed topics such as supply chain independence from China for critical medicines and adequate funding for the Strategic National Stockpile and Biomedical Advanced Research and Development Authority. He is committed to addressing the public health crisis of overdose and supports harm reduction tools such as naloxone and community care programs, but needs to review the specific grant for the SAMHSA State Opioid Response Grant. On the subject of health insurance, Sec. Kennedy confirmed that funding appropriated for health insurance would be used accordingly and that health insurance recommendations would continue to be made by ACIP. However, on May 27, Sec. Kennedy directed CDC to remove COVID-19 as a recommended health insurance for pregnant women and children. The discussions centered around the proposed budget's elimination of the Hospital Preparedness Program and cuts to the Public Health Emergency Preparedness Program, potentially resulting in a net loss of hundreds of millions of dollars in federal support. Republicans generally supported the Make America Healthy Again (MAHA) initiative and AHA, while Democrats expressed concerns about program disruptions, layoffs, and undisbursed FY25 appropriated funds. In addition to addressing health care delivery and public health crises, Sec. Kennedy is focused on addressing nutrition and physical activity, and prioritizing healthy eating in the Head Start program. He is also working on combating fentanyl from entering the United States. HHS Secretary Robert F. Kennedy Jr. appeared before the House Appropriations Committee, Senate Appropriations Committee, and Senate Health, Education, Labor, and Pensions (HELP) Committee on May 2025 to discuss these proposals and answer questions from lawmakers. The decisions made in the FY26 budget will have significant implications for the future of public health and health care in the United States.
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