President Trump Releases FY27 Budget Proposal: April 2026

April 07, 2026

On April 3, the White House released President Trump’s FY27 discretionary budget proposal, which outlines the Administration’s funding priorities for the upcoming fiscal year beginning on October 1, 2026.

The documents reflect the Administration’s planned HHS reorganization, proposed funding levels, and various policy and legislative proposals.

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

For additional information, please review the following documents:

It is challenging to conduct a detailed analysis of the budget proposal because many programs are eliminated, funding is consolidated or moved to different agencies. As a result, the ASTHO Government Affairs team cannot make a comprehensive comparison between FY26 enacted funding levels and the FY27 budget proposal. The information provided below is pulled directly from tables in the budget documents released by the Administration.

Key Public Health Funding Proposals

Overall, the budget proposes $111.1 billion in discretionary budget authority for HHS, a $15.8 billion or 12.5% decrease from the 2026 enacted level.
Eliminates the Prevention and Public Health Fund, which provided $1.4 billion in funding across various CDC programmatic activities in FY26.
Proposes establishment of the Administration for a Healthy America (AHA) (similar to the FY26 budget proposal) as part of a major reorganization of the Department of Health and Human Services. Specifically, it consolidates and relocates programs from across the Office of the Assistant Secretary for Health (OASH), the Health Resources and Services Administration (HRSA), the Substance Abuse and Mental Health Services Administration (SAMHSA), and from several CDC centers such as the National Center for Chronic Disease Prevention and Health Promotion, National Center for Injury Prevention and Control, and the National Center on Birth Defects and Developmental Disabilities.
Establishes a new National Center for Chemicals and Toxins within CDC, to bring together complementary programs across HHS, to include:

National Institute for Toxicological Research (from FDA)
Agency for Toxic Substances and Disease Registry
National Institute for Occupational Safety and Health (CDC)
National Center for Environmental Health (CDC)
National Institute for Environmental Health Sciences (from NIH)

Establishes (similar to the FY26 budget proposal) a new $300 million grant program that consolidates hepatitis, STI, and tuberculosis grant funding into one program.

The budget eliminates the following programs to reset the balance between federal and state responsibilities, among other reasons:

Previously in CDC:

Tobacco and Prevention Control
Nutrition, Physical Activity, and Obesity
School Health
Vision and Eye Health
Inflammatory Bowel Diseases
Interstitial Cystitis
Excessive Alcohol Use
Chronic Kidney Disease
Chronic Disease Education and Awareness
Prevention Research Centers
Heart Disease and Stroke
Diabetes
National Diabetes Prevention Program
Oral Health
Arthritis
Epilepsy
National Lupus Patient Registry
Racial and Ethnic Approaches to Community Health (REACH)
Million Hearts
National Early Child Care Collaboratives
Hospitals Promoting Breastfeeding
Safe Motherhood/Infant Health
Adverse Childhood Experiences
Firearm Injury and Mortality Prevention Research
Drowning
Elderly Falls
Other Injury Prevention Activities
Injury Control Research Centers

Previously in HRSA:

Rural Hospital Flexibility Grants
State Offices of Rural Health
Rural Hospital Stabilization Pilot Program
Rural Hospital Provider Assistance Program
AIDS Education and Training Centers – Part F
Dental Reimbursement Program – Part F
Special Projects of National Significance
Minority HIV/AIDS Fund
Early Hearing Detection and Intervention
Emergency Medical Services for Children
Healthy Start
Title X Family Planning
Loan Repayment/Faculty Fellowships
Scholarships for Disadvantaged Students
Health Careers Opportunity Program
Primary Care Training and Enhancement
Oral Health Training Programs
Medical Student Education
Area Health Education Centers (AHEC)
Geriatric Programs
Mental and Behavioral Health
Public Health/Preventative Medicine
Advanced Nursing Education
Nursing Workforce Diversity
Nurse Education, Practice, and Retention
Nurse Faculty Loan Repayment
Public Health Reports

Previously in SAMHSA:

Seclusion and Restraint
Mental Health Awareness Training
Healthy Transitions
Infant and Early Childhood Mental Health
Children and Family Programs
Consumer and Family Network Grants
Mental Health System Transformation
Project LAUNCH
Primary and Behavioral Health Care Integration
Primary and Behavioral Health Care Integration Tribal Training and Technical Assistance Center
Mental Health Crisis Response Partnership Pilot Program
Homelessness Prevention Programs
Criminal and Juvenile Justice Program
Assertive Community Treatment for Individuals with Severe Mental Illness
Homelessness Prevention Programs
Mental and Behavioral Health Minority AIDS
Mental Health Minority Fellowship Program
Tribal Behavioral Health Grants
Interagency Taskforce on Trauma-Informed Care
Eating Disorder Identification, Treatment, and Recovery
Community Mental Health Services Block Grant
Substance Use Treatment Minority AIDS
SAT Minority Fellowship Program
Substance Use Prevention, Treatment, and Recovery Services Block Grant
State Opioid Response Grants
Strategic Prevention Framework
Substance Use Prevention Minority AIDS
Sober Truth on Preventing Underage Drinking
Minority Fellowship Program
Tribal Behavioral Health Grants
Drug Abuse Warning Network
Behavioral Health Workforce Data and Development
Hepatitis C

Previously in OASH:

Teen Pregnancy Prevention
Kidney X
Sexual Risk Avoidance
Office of Adolescent Health

Administration for a Healthy America

The request proposes $17.5 billion for the Administration for a Healthy America (AHA).

Primary Care

$3 billion, for Health Centers, including $1.8 billion in discretionary funding and $1.1 billion in mandatory resources, a decrease of $3.5 billion.
$59 million, or level funding, for the Organ Transplantation program.
$41.3 million, a $11 million decrease, for the Cell Transplantation program and Cord Blood Stem Cell Bank program.
$14 million, or level funding, for the National Hansen’s Disease program.
$11 million, or level funding, for Rural Health Policy Development.
$111 million, or level funding, for Rural Health Outreach Grants.
$4 million, a $2 million increase, for Radiation Exposure Screening and Education Program.
$12 million, or level funding, for the Black Lung Clinics program.
$145 million, or level funding, for the Rural Communities Opioid Response program.
$14 million, or level funding, for Rural Residency Planning and Development.
$70 million, a $24.5 million increase including $20 million for chronic care telehealth centers of excellence, for the Office for the Advancement of Telehealth.
$26 million, or level funding, for the Office of Disease Prevention and Health Promotion.
$45 million, a $30 million decrease, for the Office of Minority Health.
$19 million for a new Prevention Innovation Program.

Chronic Disease and Health Prevention

$448 million, a $985 million decrease, for chronic disease and prevention activities.

$35 million, a $6.5 million decrease, for Alzheimer’s disease.
$413 million, or level funding, for Cancer Prevention and Control.

Injury Prevention and Control

$588 million, a $173 million decrease, for Injury Prevention and Control (formerly in CDC). Specifically:
- $12 million, a $18 million decrease, for Comprehensive Suicide Prevention.
- $38 million for the Preventing Intimate Partner and Sexual Violence Program. This program replaces the Rape Prevention Education and Domestic Violence Prevention Enhancements and Leadership Through Alliances programs.
- $25 million, or level funding, for the National Violent Death Reporting System.
- $506 million, or level funding, for the opioid overdose prevention and surveillance.
- $8 million, or level funding, or traumatic brain injuries.

HIV/AIDs

$2.7 billion, a $923 million decrease, for HIV/AIDS programs. Specifically:
- $680.7 million, or level funding, for Part A- Emergency Relief Grants.
- $1.4 billion for Part B Comprehensive Care, which includes $900 million for the AIDS Drug Assistance program.
- $209 million, or level funding, for Part C Early Intervention Services.
- $78 million, or level funding, for Part D Women, Infants, Children, and Youth.
- $165 million, or level funding, for the Ryan White HIV/AIDS Ending HIV Epidemic.
- $220 million, or level funding, for the Ending HIV Epidemic initiative transferred from the CDC Domestic HIV Prevention and Research.
- $8 million, or level funding, for the Office of Infectious Disease and HIV/AIDS Policy.

Maternal & Child Health

$1.9 billion, a $561 million decrease, to support maternal and child health programs.

$767 million, a $51 million decrease, for the Maternal and Child Health Block Grant.
$17 million, or level funding, for the Alliance for Innovation for Maternal Health program.
$10 million, or level funding, for the Integrated Services for Pregnant and Postpartum Women program.
$8 million, or level funding, for the Maternal Mental Health Hotline.
$21 million, or level funding, for Heritable Disorders in Newborns and Children.
$13 million, or level funding, for Pediatric Mental Health Care Access.
$12 million, or level funding, for the Screening and Treatment for Maternal Mental Health and Substance Use Disorders program.
$28 million, or level funding, for the Poison Control Program.
$1 million, a $5 million decrease, for the Family-to-Family Health Information Centers.
$754 million, a $141 million increase, for the Maternal, Infant, and Early Childhood Home Visiting Program.
$154 million, a decrease of $28 million, for a wide variety of birth defects, developmental disabilities, and disability and health activities. (Please view pages 206-219 of the AHA congressional justification for additional details.)
$30 million, a $14 million decrease, for the Office on Women’s Health.
$1 million, a $1 million decrease, for the Embryo Adoption Awareness Campaign.

Mental and Behavioral Health

$6.8 billion, a $576 million decrease, to provide mental health services, suicide prevention, substance use prevention, and substance use treatment. Specifically:

$121 million, a $20 million decrease, for Project Aware.
$30 million, or level funding, for the National Strategy for Suicide Prevention.
$11 million, or level funding, for the Suicide Prevention Resource Center.
$56 million, or level funding, for the Garret Lee Smith (GLS) Youth Suicide Prevention programs.
$5 million, or level funding, for the Tribal Training and Technical Assistance Center.
$535 million, or level funding, for the 9-8-8 Suicide and Crisis Lifeline.
$8 million, or level funding, for Practice Improvement and Training.
$2 million, or level funding, for Consumer and Consumer-Support Technical Assistance Centers.
$2 million, or level funding, for Disaster Response.
$21 million, or level funding, for Assisted Outpatient Treatment for Individuals with Serious Mental Illness.
$101 million, or level funding, for the Child Traumatic Stress Network.
$385 million, or level funding, for Certified Community Behavioral Health Clinics.
$132 million, or level funding, for Children’s Mental Health Services.
$67 million, or level funding, for Projects for Assistance in Transition from Homelessness.
$14 million, a $26 million decrease, for the Protection and Advocacy for Individuals with Mental Illness Program.
$11 million, or level funding, for Opioid Treatment Programs.
$29 million, or level funding, for the Screening, Brief Intervention, and Referral to Treatment program.
$125 million, or level funding, for Targeted Capacity Expansion.
$16 million, or level funding, for grants to prevent prescription drug/opioid overdose-related deaths.
$59 million, or level funding, for the First Responder Training for Overdose Reversal Drugs.
$1.5 billion, or level funding, for the Improving Access to Overdose Treatment program.
$39 million, or level funding, for the Pregnant and Postpartum Women program.
$4 million, or level funding, for the Recovery Community Services program.
$37 million, or level funding, for Treatment Systems for the Homeless.
$80 million, or level funding, for Criminal Justice Activities.
$17 million, or level funding, for the Building Communities of Recovery program.
$8 million, or level funding, for Emergency Department Alternatives to opioids.
$12 million, or level funding, for the Treatment, Recovery, and Workforce Support program.
$2 million, or level funding, for the Peer Support Technical Assistance Center program.
$9 million, or level funding, for the Addiction Technology Transfer Centers Program.
$7 million, or level funding, for Comprehensive Opioid Recovery Centers.
$3 million, or level funding, for the Youth Prevention and Recovery Initiative.
$5 million, or level funding, for the Federal Drug-Free Workplace Programs.
$9 million, or level funding, for the Prevention Technology Transfer Centers Network.
$4 million, or level funding, for the Substance Use Disorder Prevention Engagement Initiatives.
$70 million, a $39 million decrease, to address substance use prevention within the Drug-Free Communities Support Program.
$4.5 billion for the Behavioral Health Innovation Block Grant, a new formula-based block grant program to consolidate funding for the Community Mental Health Services Block Grant, Substance Use Prevention, Treatment and Recovery Support Services Block Grant, and State Opioid Response Grant.
$80 million for a new Behavioral Health and Substance Use Disorder Resources for Native Americans grant program.

Health Workforce

$1.1 billion, a $872 million decrease, for health workforce programs. Specifically:

$213 million, a $267 million decrease, for the National Health Service Corps. This includes $130 million in discretionary and $83 million in mandatory funding.
$25 million, or level funding, for the Centers of Excellence Program.
$6 million, or level funding, for health care workforce assessments.
$129 million, a $25 million decrease, for Behavioral Health Workforce Development programs.
$395 million, or level funding, for the Children’s Hospitals Graduate Medical Education Payment program.
$236 million, a $11 million increase, for the Teaching Health Center Graduate Medical Education Payment program.
$43 million, a $10 million increase, for the National Practitioner Data Bank.
$10 million, or level funding, for the Pediatric Subspecialty Loan Repayment program.

Policy, Research, and Oversight

$224 million for Program Management activities to support AHA’s operations, including the integration and streamlining of business processes, data solutions, and customer services.
$67 million, a $19 million decrease, for mental and behavioral health surveillance activities.
$24 million, a $2 million increase, for the Immediate Office of Assistant Secretary for Health and Surgeon General.
$292 million, a $10 million increase, for the National Vaccine Injury Compensation Program.
The budget proposes using carryover funding to support the Countermeasures Injury Compensation Program.

CDC

The request proposes $5.5 billion for CDC, representing a $3 billion cut to CDC programs and activities. This level includes activities transferred to CDC from other agencies (see the proposed National Center for Chemicals and Toxins) but does not account for CDC programs and activities proposed for transfer to other agencies.

The budget reorganizes all or some of the funding for the following to AHA:

HIV/AIDs activities (a decrease of $1 billion below FY26 CDC enacted levels).
Chronic Disease Prevention and Health Promotion (a decrease of $1.4 billion below FY26 CDC enacted levels).
Birth Defects, Developmental Disabilities, Disability and Health (a decrease of $205 million below FY26 CDC enacted levels).
Injury Prevention and Control (a decrease of $761 million below FY26 CDC enacted levels).

The budget proposes the elimination of the Prevention and Public Health Fund.
$963 million, a $50 million increase, for Immunization and Respiratory Diseases.
$300 million to support a new Consolidated Viral Hepatitis, STI, and Tuberculosis Prevention Grant program. The request realigns the funding lines, Viral Hepatitis, STIs, Domestic TB, and Infectious Diseases and Opioid Epidemic into the new proposed Consolidated Viral Hepatitis, STI, and Tuberculosis Prevention Grant program.

This represents a $70 million decrease from current funding levels for this line.

$928 million, a $94 million increase after adjusting for program transfers, for Emerging and Zoonotic Infectious Diseases. Specifically:

$219 million, a $22 million increase, for the Antimicrobial Resistance Initiative.
$80 million, a $22 million increase, for the Travel and Port Health Protection program, formerly known as “Quarantine.”
$304 million, a $28 million increase, for Emerging Infectious Diseases. The budget reflects the proposed realignment of the following activities into Emerging Infectious Diseases: Surveillance for Emerging Threats to Mothers and Babies, Parasitic Diseases, and Malaria.
$88 million, a $4 million decrease, for Vector-Borne Diseases. The budget consolidates funding for Lyme Disease and Other Tick-Borne Diseases into this funding line.
$24 million, or level funding, for the National Healthcare Safety Network.
$66 million, a $23 million increase, for Advanced Molecular Detection.
$107 million, a $33 million increase, for Food Safety.
$40 million, or level funding, for the Epidemiological and Laboratory Capacity program.
The budget proposes the elimination of Prion Disease, Chronic Fatigue Syndrome, Harmful Algal Blooms, and Healthcare-Associated Infections.

$1 billion for the National Center for Chemicals and Toxins. The request proposes this new center within CDC that will include programs from the National Center for Environmental Health, National Institute for Occupational Safety and Health, Agency for Toxic Substances and Disease Registry, National Institute of Environmental Health Sciences (formerly of NIH), and National Center for Toxicological Research (formerly of FDA). Specifically:

$71 million, or level funding, for Environmental Health Laboratory.
$17 million, or level funding, for Environmental Health Threats.
$9 million, or level funding, for Safe Water program.
$10 million, or level funding, for the National ALS Registry.
$5 million, or level funding, for Lead Exposure Registry.
$51 million or level funding, for the Childhood Lead Poisoning Prevention program.
$78 million, a $1.8 million decrease, for the Agency for Toxic Substances and Disease Registry.
$16 million, a $7 million decrease, for Personal Protective Technology.
$69 million, or level funding, for Mining Health and Safety program.
$1.2 million, or level funding, for the National Mesothelioma Virtual Bank.
$6.5 million or level funding, for the Firefighter Cancer Registry.
$594 million, a $320 million decrease, for the National Institute of Environmental Health Sciences (NIEHS).
$52 million, a $25 million decrease, for the NIEHS Superfund-Related Activities program.
$56 million, a $15 million decrease, for the National Center for Toxicological Research.
Eliminates the following programs:

Climate and Health
Trevor’s Law
Environmental and Health Outcome Tracking Network
Asthma
National Occupational Research Agenda
Education and Research Centers
Other Occupational Safety and Health Research

$705 million, a $95 million increase after accounting for programmatic transfers, for Public Health Scientific Services. Specifically:

$328 million, a $30 million increase, for Surveillance, Epidemiology, and Informatics.
$26 million, or level funding, for Advancing Laboratory Science.
$280 million, a $95 million increase, for Public Health Data Modernization. The budget also proposes to consolidate the Center for Forecasting and Outbreak Analytics and the Ready Response Enterprise Data Integration programs into the Data Modernization line.

$71 million, or level funding, for Public Health Workforce.
$664 million, or level funding, for Global Health.
$489 million, a $394 million decrease after accounting for programmatic transfers, for Public Health Preparedness and Response. Specifically:

$350 million, a $385 million decrease, for the Public Health Emergency Preparedness program.
$139 million, or level funding, for CDC’s Preparedness and Response activities.
Eliminates Academic Centers for Public Health Preparedness.

$102 million, or level funding, for Public Health Leadership and support.
The budget does not propose budget authority for the Infectious Disease Rapid Response Reserve Fund; however, this program is proposed to continue. There are existing funds that are available until expended.
$260 million, a $100 million decrease, for Public Health Infrastructure and Capacity.
The budget includes the following legislative proposals:

CDC continues to seek authority to set data reporting requirements to improve data reporting from health care providers to public health authorities.
CDC seeks the ability to convert CDC fellowship and training program appointments to term or permanent positions in the competitive service within 120 days of program completion, without having to use the competitive examination and hiring process.

ASPR

The request proposes $3.3 billion for ASPR, a $355 million decrease. Specifically:

30 million, a $277 million decrease, for Health Care Readiness and Recovery. Specifically:

Eliminates the Hospital Preparedness Program.
Eliminates funding for the Regional Disaster Health Response System.
Eliminates funding for Trauma Care.

$654 million, a $290 million decrease, for the Biomedical Advanced Research and Development Authority (BARDA).
$725 million, a $125 million decrease, for Project BioShield.
$1 billion, or level funding, for the Strategic National Stockpile. This includes $938 million in budget authority.
$65 million, a $12 million decrease, for the National Disaster Medical System.
$335 million, a $325 million increase, for Pandemic Preparedness and Biodefense.
$308 million, or level funding, for Pandemic Influenza.
Eliminates the Medical Reserve Corps.
Eliminates the Preparedness and Response Innovation program.

FDA

The request proposes $7.2 billion, a $215 million increase, for FDA. This includes $3.3 billion in budget authority, a decrease of $113 million, and $3.8 billion in user fees, an increase of $303 million.

$91 million, a $57 million increase, for FDA to implement MAHA priorities that remove unsafe chemicals in our food supply, support artificial intelligence and machine learning initiatives, and invest in research and development for alternatives to animal testing for regulatory science purposes.
$687 million, a $918 million decrease, for the tobacco program to support product review, research, compliance, enforcement, public education campaigns, and policy development.
The budget also includes the following pertinent legislative proposals (pages 16-27 of FDA’s congressional justification)

Strengthening Oversight of Critical and Other Foods to Better Protect Infants and Children.

This proposal would strengthen oversight of critical foods, such as infant formula and other foods consumed by infants and young children.

Ensure FDA Access to Industry Data to Strengthen Food Chemical Safety.

This proposal would strengthen FDA’s post-market surveillance of food chemical safety.

Increase Agency Flexibility Regarding the Convening of Advisory Committees and the Composition of Such Committees.

This proposal would increase the agency’s flexibility to appoint representatives of consumer interests and the drug manufacturing industry to Scientific Advisory Panels.

Strengthen Enforcement Against Importation of Unauthorized Electronic Nicotine Delivery Systems and Other Illegal Tobacco Products.

This proposal would address significant challenges in addressing the sale and distribution of unauthorized tobacco products across the supply chain.

Creating Parity Between Nicotine and Nicotine Analog in Statute.

This proposal would amend statute to define “nicotine analog” and regulate products containing “nicotine analogs” similar to other tobacco products.

Share Food Safety Information with State, Local, Tribal, and Territorial Authorities.

This proposal would amend statute to authorize FDA to share certain food-related information with state, local, tribal, and U.S. territorial authorities, to improve speed, efficiency and promote collaboration to protect the public’s health.

CMS

The request proposes $21 million, a $8 million increase, for the 340B Drug Pricing Program and transfers the program from HRSA to CMS.

EPA

The request proposes $150 million, a $976 million decrease, for the Drinking Water State Revolving Fund Program (DWSRF). The budget encourages states to take responsibility for funding their own water infrastructure projects and, for states operating a DWSRF, to fund water infrastructure using funds that have already been repaid from past loans. The budget eliminates ($715 million in FY2026) Congressional Directed Spending projects in the DWSRF.

The request proposes $155 million, a $1.5 billion decrease, for the Clean Water State Revolving Fund Program (CWSRF). Similar to DWSRF, the budget encourages states operating a CWSRF to use funds that have already been repaid as part of water infrastructure projects.