President Trump Releases FY26 Budget Proposal

May 02, 2025

On the morning of May 2, the White House released President Trump’s FY26 discretionary budget proposal, which outlines the Administration’s funding priorities for the upcoming fiscal year beginning on October 1, 2025. It does not include mandatory proposals for programs like Medicaid. It is important to note that this proposal presents top-level requests for each federal agency and does not include details such as funding tables that are usually shared as part of congressional justification documents transmitted from agencies to Congress. We are reviewing this document closely and what follows is a preliminary review.

As a reminder, Congress has the authority to approve, reject, or modify the Administration’s budget recommendations. Therefore, it is critical that public health leaders continue to educate and inform members of Congress about the impact of public health funding and the need for sustainable and predictable resources for governmental public health activities at federal, state, territorial, and local agencies.

A complete budget request with additional details such as congressional justifications and mandatory funding proposals is expected to be released by the White House in the coming weeks. Following the more detailed budget release, the ASTHO government affairs team will analyze the budget when additional information becomes available.

For more information view the FY26 budget proposal.

Public Health Funding Proposals

Note this information is pulled directly from the budget documents released this morning by the Administration.

• Overall, the budget proposes a $163 billion, or 23%, reduction in non-defense discretionary spending.
• Prioritizes $500 million in funding for Make America Healthy Again by, “providing resources to HHS that would allow the Secretary to tackle issues related to 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.” Specifically:
• Supports the creation of food boxes that would be filled with commodities sourced from domestic farmers and given directly to American households.
• Prioritizes food safety nationwide including support for increased production and demand for services.

CDC

• The budget “maintains more than $4 billion for CDC” and decreases funding by $3.6 billion.
• “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.”
• Merges multiple programs into one grant program and proposes to give states 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.
• Eliminates the following:
• National Center for Chronic Diseases Prevention and Health Promotion
• National Center for Environmental Health
• National Center for Injury Prevention and Control
• Global Health Center
• Public Health Preparedness and Response
• Preventive Health and Human Services Block Grant
• The budget refocuses CDC on emerging and infectious disease surveillance, outbreak investigations, preparedness and response, and maintaining the nation’s public health infrastructure.

HRSA

• The budget “maintains $6 billion for activities that were formerly part of HRSA” and decreases funding by $1.7 billion.
• The budget consolidates a variety of programs that were “formerly part of HRSA,” and proposes reductions or eliminations, including the following:
• $74 million decrease in funding for Ryan White HIV/AIDS program activities that do not focus on core health care and support services directly to patients, such as education and training.
• $274 million decrease in funding for Maternal and Child Health programs, which are duplicative of other federal programs or could be addressed through block grant funding.
• $1 billion decrease in funding for health workforce programs that provide scholarships and support for individuals to enter “high-paying medical careers.”
• $286 million decrease in funding for Title X Family Planning programs.

SAMHSA

• The budget “maintains $5.7 billion for activities that were formerly part of SAMHSA” and decreases funding by $1 billion.
• The budget proposes to refocus activities that were formerly part of SAMHSA by eliminating funding for the following:
• Mental health programs of regional and national significance.
• Substance use prevention programs of regional and national significance, and 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. According to the budget document text, “These eliminations are also supported by mental health and substance use disorder block grant funding.”

ASPR

• Decreases funding by $240 million for ASPR.
• Eliminates funding for ASPR’s Hospital Preparedness Program. This proposal, “allows States and Territories to properly scope and fund hospital preparedness.”

Other HHS Programs

• Eliminates the Sexual Risk Avoidance Program.
• Eliminates the Teen Pregnancy Prevention program, which is “similar to the mandatory Personal Responsibility Education program administered by Administration for Children and Families.”
• Reduces funding levels for the HHS Office of Minority Health and Office on Women’s Health to promote efficiency and invest in areas that align with Administration priorities.
• These programs were previously under the Office of Assistant Secretary of Health. Consistent with the recently announced HHS reorganization, the budget relocates these programs within the newly formed Administration for a Healthy America.

FEMA

• The budget cuts FEMA grant programs, refocusing the agency on emergency management.
• The budget would end activities such as webinars promoting the distribution of disaster aid based on “intersectional” factors like sexual orientation and prioritizing “investment in diversity and inclusion efforts...and multicultural training” over disaster prevention and response.
• FEMA will no longer “instill equity as a foundation of emergency management.”
• Other eliminated programs, such as National Domestic Preparedness Consortium, lack authorization from Congress and duplicate the efforts of existing federal and state programs.

EPA

• Provides $124 million, a $9 million increase in funding, for the EPA's drinking water program, which protects Americans, and especially children, from unsafe or contaminated water. The $9 million increase from the 2025 enacted level is to “properly equip EPA with funds to respond to drinking water disasters, directly helping people on the ground recover from such emergencies.”
• Decreases funding by $2.4 billion for the state revolving fund (SRF). When it comes to water infrastructure, the “States should be responsible for funding their own water infrastructure projects.”
• Contrary to that design, in practice, the program has been heavily earmarked by Congress for projects that are ultimately not repaid into the program and bypass states’ interest and planning. In addition, the SRFs are largely duplicative of the EPA’s Water Infrastructure Finance and Innovation Act (WIFIA) program and the Department of Agriculture’s (USDA) Water and Wastewater Loan and Grant program, and they received a massive investment in the Infrastructure Investment and Jobs Act (IIJA).
• The budget proposes to return the SRFs to their intended structure of funds revolving at the state level, and therefore provides the decreased funding level of $305 million total to allow states to adjust to alternative funding sources for their water infrastructure.
• Environmental Protection Agency Environmental Justice Program: The budget eliminates this funding that sought to support reduce environmental harms, including health outcomes, to minority and low-income communities that face disproportionate harm from pollution.