Summary of FY27 House LHHS Appropriations Bill: June 2026

June 11, 2026

On June 4, the House Appropriations Labor, Health and Human Services, and Education (LHHS) Subcommittee released its version of the FY27 LHHS bill. The House LHHS subcommittee marked up the legislation on June 5, and the full committee marked up the bill on June 9. The proposed funding levels included in the bill are not final and are subject to change.

Outlook

The FY27 LHHS House bill can be viewed as a congressional indication of how lawmakers may respond to the Administration's proposed restructuring of HHS and significant reductions to federal public health programs. It rejects many of the Administration’s FY27 budget proposals to restructure public health programs, signaling that Congress remains cautious about large-scale reorganization. However, the bill continues the trend toward constrained discretionary spending by eliminating numerous critical programs, reflecting the administration’s focus on fiscal oversight and targeted investments.

It is important to note that the FY27 appropriations process remains in its early stages, and significant differences are expected between House and Senate proposals. Public health stakeholders should closely monitor upcoming committee markups and Senate action for indications of congressional support for foundational public health programs, emergency preparedness activities, workforce investments, and state and territorial health agency priorities.

ASTHO’s Government Affairs team will continue to advocate for state and territorial public health agencies and provide updates as negotiations progress and funding levels for critical public health programs become clearer.

Resources

Bill Text (PDF)
Legislative Summaries (Majority PDF and Minority PDF)
FY27 House LHHS Report (PDF)

Key Public Health Funding Proposal Highlights

The bill includes a total of $110.8 billion for the Department of Health and Human Services, a decrease of $4 billion below the FY26 enacted level. Please note that increases, decreases, and level funding mentioned below refer to comparisons with FY26 enacted levels of the LHHS Appropriations bill.

Notable Bill-Wide Report Language

In response to Congressional interest in better understanding federal grant-making, the Committee included the following report language centered on grant oversight:

The new Administration has identified numerous discrepancies within existing grant programs throughout the bill. In response to these issues the Committee directs, within 30 days of enactment of this Act, and every 30 days thereafter until November 30, 2027, to brief the Committee on the status of all formula and competitive grants. Each briefing is to include a summary of competitive and formula awards made in the prior 30 days, Notices of Funding Opportunities (NOFOs) the respective department anticipates issuing within the next 30 days, and a summary of Notices of Funding Opportunities issued in the preceding 30 days. As applicable per grant program, award and NOFO summaries are to indicate whether such awards are continuation awards, supplemental grant awards, and/or new competitions and if such amounts are forward funded. NOFO summaries are to include new competitive criteria, changes from the prior year, expected number of awards, expected amount per award, and status of review panels.

ASTHO member priorities saw the following in the bill:

$370 million, a $10 million increase, for Public Health Infrastructure and Capacity.
$230 million, a $45 million increase, for Public Health Data Initiative Modernization.
$750 million, a $15 million increase, for CDC’s Public Health Emergency Preparedness Cooperative Agreements.
$70.1 million, a $237 million decrease, for the ASPR Hospital Preparedness Program. The bill eliminates funding for formula grants.
Proposed elimination of the Preventive Health and Health Services Block Grant.

Centers for Disease Control and Prevention (CDC)

The bill includes a total of $8.1 billion for CDC, a decrease of $1 billion below the FY26 enacted level. This funding includes:

$370 million, a $10 million increase, for Public Health Infrastructure and Capacity.
$35 million, a $10 million increase, for the Infectious Diseases Rapid Response Reserve Fund.
$7 million, a $1 million increase, for the Office of Rural Health.
The bill eliminates funding for the Preventive Health and Health Services Block Grant, which was previously funded at $160 million.
The bill includes $928.3 million, a $15 million increase, for Immunization and Respiratory Diseases.

$696.9 million, a $15 million increase, for the Section 317 Immunization Program.

The committee continues to provide funding for vaccine outreach and awareness campaigns, including support for community-based approaches to addressing vaccine hesitancy. The Committee urges CDC to expand existing immunization infrastructure, including implementing strategies for underserved populations. The Committee requests an update in the FY28 congressional justification on these efforts and the rate of routine immunization across all age groups.

$231.4 million, or level funding, for Influenza Planning and Response.

$566 million, a $818.1 million decrease, for HIV/AIDS, Viral Hepatitis, Sexually Transmitted Infections (STIs), and Tuberculosis (TB) Prevention.

$220 million, or level funding, for the Ending HIV Epidemic.
Other HIV/AIDs activities, not funded, but previously funded at $793.7 million.
Viral Hepatitis, not funded, but previously funded at $46 million.
STIs, not funded, previously funded at $164.3 million.
$137 million, or level funding, for TB.
Infectious Diseases and Opioids, not funded, previously funded at $23 million.
The bill consolidates funding lines for Viral Hepatitis, STIs, and Infectious Diseases, and the Opioid Epidemic into a new consolidated grant that is funded at $209 million.

The committee directs CDC to allocate no less than $46 million to maintain national capabilities to support health departments in conducting viral hepatitis surveillance, prevention, and outbreak response, including addressing coinfections, to support viral hepatitis elimination planning and implementation, and to work with health clinics and community-based organizations to promote awareness of and uptake of updated national viral hepatitis testing, treatment, and vaccination recommendations.

$882.8 million, a $101.6 million increase, for Emerging and Zoonotic Infectious Diseases.

$207 million, a $10 million increase, for Antimicrobial Resistance Initiative.
$65.6 million, a $1 million increase, for Vector-Borne Diseases.
$28 million, a $1 million increase, for Lyme Disease.
$10 million, a $1 million increase, for Prion Disease.
Chronic Fatigue Syndrome, not funded, previously funded at $5.4 million.
$268 million, a $45 million increase, for Emerging Infectious Diseases.
$3.5 million, or level funding, Harmful Algal Blooms.
$79 million, a $5 million increase, for Food Safety.
$24 million, or level funding, for National Healthcare Safety Network.
$72.8 million, a $15 million increase, for Travel and Port Health Protection.
$58 million, a $15 million increase, for Advanced Molecular Detection.
$55 million, a $15 million increase, for Epidemiology and Lab Capacity.

The Committee encourages CDC to work with states and localities to start or improve wastewater programs; provide ongoing guidance and recommendations, particularly on methods to rapidly detect emerging pathogens; partner with public, private, and nonprofit entities at the forefront of this work; and prioritize resources for sites that can sample and test for multiple infectious diseases, pivot quickly to detect emerging threats, and apply scientifically rigorous standards to ensure reliable, comparable data.

$12 million, or level funding, for Healthcare-Associated Infections.

$1.3 billion, a $121.2 million decrease, for Chronic Disease Prevention and Health Promotion.

$246.5, or level funding, for Tobacco.
$16.5 million, a $37.8 million decrease, for Nutrition, Physical Activity, and Obesity.
School Health, not funded, previously funded at $19.4 million.
$61.6 million, or level funding, for Health Promotion.
Prevention Research Centers, not funded, previously funded at $29 million.
$160.3 million, a $4.2 million increase, for Heart Disease and Stroke.
$165.1 million, a $2 million increase, for Diabetes.
$39.3 million, a $2 million increase, for National Diabetes Prevention Program.
$420 million, a $7 million increase, for Cancer Prevention and Control.
$22.3 million, a $1 million increase, for Oral Health.
$115.5 million, a $2 million increase, for Safe Motherhood/Infant Health.

The Committee includes funding for this portfolio of programs to improve the health of pregnant and postpartum women and their infants. The Committee encourages CDC to prioritize funding to help Maternal Mortality Review Committees (MMRCs) strengthen data systems and improve data collection, including through the Maternal Mortality Review Information Application, to promote consistency and ensure accuracy and completeness in data collection, analysis, and reporting across state MMRCs. The Committee further encourages CDC to prioritize funding to expand Perinatal Quality Collaboratives (PQCs) in more jurisdictions, including building capacity of existing PQCs.

$2 million, or level funding, for Arthritis.
$11.5 million, or level funding, for Epilepsy.
$16 million, a $2 million increase, for National Lupus Registry.
$30 million, a $3 million increase, for Good Health and Wellness in Indian Country.
Million Hearts, not funded, previously funded at $5 million.
Hospitals Promoting Breastfeeding, not funded, previously funded at $9.8 million.
The Committee continues to support funding for the prevention and control of chronic disease and associated risk factors in the U.S.-affiliated Pacific Islands, U.S. Virgin Islands, and Puerto Rico.

$199.4 million, a $5.6 million decrease, for Birth Defects, Developmental Disabilities, and Disabilities and Health.

$61.6 million, a $9.7 million decrease, for Child Health Development.
$87.5 million, a $2.1 million increase, for Health and Development for People with Disabilities.
$21.1 million, or level funding, for Public Health Approach to Blood Disorders.
$4.3 million, or level funding, for Neonatal Abstinence Syndrome.
$25 million, a $2 million increase, for Surveillance for Emerging Threats to Mothers and Babies.

$827.5 million, a $60 million increase, for Public Health Scientific Services.

$187.4 million, or level funding, for Health Statistics.
$313.1 million, a $15 million increase, for Surveillance, Epidemiology, and Informatics.
$26 million, or level funding, for Advancing Laboratory Science.
$230 million, a $45 million increase for the Public Health Data Initiative Modernization.

The Committee recognizes CDC’s continued progress towards the implementation of CDC’s data modernization efforts to bolster the nation’s health security infrastructure and readiness response, including through the One CDC Data Platform (1CDP). The Committee provides increased funding to strengthen the core of public health data; accelerate access to analytic and automated solutions to support health investigations; visualize and share insights to inform public health action; and advance more open and interoperable public health data. Increased funding is provided to bolster and expand data surveillance systems across jurisdictional public health authorities, the health care sector, and other key federal partners.
The Committee also recognizes CDC’s efforts to engage with states, tribes, localities, and territories through data use agreements for core data sources as well as key recommendations from the Advisory Committee to the Director Data and Surveillance Workgroup. The Committee urges CDC to prioritize support for jurisdictions with existing data modernization barriers, including those facing significant workforce constraints, interoperability challenges, and aging data infrastructure.

$71 million, or level funding, for Public Health Workforce.

$241.9 million, a $1 million decrease, for Environmental Health.

$75.8 million, a $5 million increase, for Environmental Health Laboratory.
$41.6 million, a $7 million decrease, for Environmental Health Activities.

$17 million, or level funding, for Environmental Health.
$8.6 million, or level funding, for Safe Water.
$13 million, a $3 million increase, for Amyotrophic Lateral Sclerosis Registry.
Climate and Health, not funded, previously funded at $10 million.
$3 million, or level funding, for Trevor’s Law.

$34 million, or level funding, for Environmental and Health Outcome Tracking Network.
$34.5 million, a $1 million increase, for Asthma.
$5 million, or level funding, for Lead Exposure Registry.
$51 million, or level funding, for Childhood Lead Poisoning.

$705.8 million, a $55.5 million decrease, for Injury Prevention and Control.

$149.5 million, a $15.1 million decrease, for Intentional injury.

The Committee provides increased funding to state public health departments to support the Comprehensive Suicide Prevention program, and to increase funding to tribes and territories to build capacity and implement strategies to prevent suicide.

$24.5 million, or level funding, for National Violent Death Reporting System.
$15.3 million, a $2 million increase, for Unintentional Injury.
Injury Prevention Activities, not funded, previously funded at $30 million.
$505.6 million, or level funding, for Opioid Overdose Prevention and Surveillance.

The Committee directs CDC to fund awards to state, local, and tribal health departments at not less than the percentage of base funding provided for this program in fiscal year 2026.

$11 million, or level funding, for Injury Control Research Centers.
Firearm Injury and Mortality Prevention Research, not funded, previously funded at $12.5 million.

The Committee notes CDC’s historic avoidance of research into the crimes and fatalities prevented through self-defense with a firearm and therefore provides no funding for firearm research.

$311.2 million, a $55.6 million decrease, for the National Institute for Occupational Safety and Health.
$663.8 million, a $29 million decrease, for Global Health.
$924 million, a $10.8 million increase, for Public Health Preparedness and Response.

$750 million, a $15 million increase, for the Public Health Emergency Preparedness Cooperative Agreement.
$35 million, a $5 million increase, for Ready Response Enterprise Data Integration (RREDI) Platform/Forecasting and Outbreak Analytics.

The Committee provides increased funding for the RREDI platform to enable rapid information sharing across the U.S. government and with state and local health departments during a public health response. The Committee encourages CDC to continue expanding enterprise response capabilities within 1CDP, including improved data sharing with federal, state, tribal, local, and territorial partners. The Committee further supports the Center for Forecasting and Outbreak Analytics in its goals to deliver actionable analysis and response-ready modeling tools; generate practical decision support products; and drive technological and analytic innovation to guide public health action.

$139 million, or level funding, for CDC Preparedness and Response Capability.

$506.6 million, a $140 million decrease, for CDC-Wide Activities and Program Support.

$101.6 million, or level funding, for Public Health Leadership and Support & Office of the Director.
$35 million, a $10 million increase, for the Infectious Disease Rapid Response Reserve Fund (IDRRRF).

The Committee provides increased funding for IDRRRF to ensure that CDC remains positioned to respond quickly to an imminent public health emergency.
The Committee directs CDC to provide a detailed spend plan of the planned uses of funds, including a narrative description of planned and ongoing activities, within 30 days of enactment of this Act, and to provide quarterly updates on such plan for any active public health response. The Committee further directs CDC to provide a table to the Committee each month, which shall include all amounts available in the IDRRRF for the current fiscal year and the preceding two fiscal years, including: (1) each individual obligation above $5,000,000; (2) with respect to each such obligation, the notification to which it relates; and (3) the total amount unobligated in the IDRRRF.

$270 million, a $10 million increase, for Public Health Infrastructure and Capacity.
Preventive Health and Health Services Block Grant not funded, previously funded at $160 million.

Health Resources and Services Administration (HRSA)

The bill includes $8.3 billion for HRSA, a decrease of $873.2 million below the enacted FY26 level. This funding includes:

$1.9 billion, or level funding, for the Health Centers program.
$1.4 billion, a $25.1 million increase, for Health Workforce.
$1.1 billion, a $121.5 million decrease, for the Maternal and Child Health Bureau. This includes:

$839 million for the Maternal and Child Health Services Block Grant. Specifically:

$604.6 million, a $1 million increase, for the Maternal and Child Health (MCH) Services Block Grant – State Formula Grant.
$10.3, or level funding, for Community Integrated Services Systems.
$224.1 million, a $9 million increase, for the MCH Services Block Grant – Special Projects of Regional and National Significance.

The Healthy Start program, not funded, previously funded at $145 million.

The Committee notes that mandatory funding available for the Maternal, Infant, and Early Childhood Home Visiting (MIECHV) program continues to increase substantially and will reach $800,000,000 in fiscal year 2027. The MIECHV program supports pregnant women and parents with young children who live in communities that face greater risk and barriers to achieving positive maternal and child health outcomes. Therefore, consistent with the fiscal year 2027 budget request, the Committee does not recommend separate discretionary funding for this program.

$2.3 billion, a $224.9 million decrease, for the Ryan White HIV/AIDS program.
$575.8 million, a $157.9 million increase, for Rural Health programs.
Title X Family Planning, not funded, previously funded at $286.5 million.

Substance Abuse and Mental Health Services Administration (SAMHSA)

The bill includes $7.3 billion for SAMHSA, a $91 million decrease below the FY26 enacted level, excluding Community Project Funding projects included in the FY26 enacted bill. This funding includes:

$2.8 billion, a $32.8 million decrease, for Mental Health programs.
$4.2 billion, a $21.4 million decrease, for Substance Abuse Treatment programs.
- $1.6 billion, a $5 million increase, for State Opioid Response (SOR) grants.
  - The Committee encourages SAMHSA to increase awareness of grantees regarding the availability of SOR funding to support treatment and support for co-occurring addictions, including alcohol use disorder.
$204 million, a $36.9 million decrease, for Substance Abuse Prevention programs.
$148.7 million, a $54.3 million decrease, for Health Surveillance and Program Support.

Administration for Strategic Preparedness and Response (ASPR)

The bill includes $3.6 billion for ASPR, a decrease of $44 million below the FY26 enacted level. This funding includes:

$1.1 billion, a $10 million increase, for the Biomedical Advanced Research and Developmental Authority.
$880 million, a $30 million increase, for Project BioShield.
$1.1 billion, a $60 million increase, for the Strategic National Stockpile (SNS).

Guidance to State and Local Jurisdictions: The Committee recognizes that SNS focuses on Chemical, Biological, Radiological, or Nuclear (CBRN) threats, and therefore the Committee supports the efforts of state and local jurisdictions to secure additional drugs, vaccines, and other biological products, medical devices, and other medical supplies necessary to respond to a public health emergency or a major disaster. The Committee recognizes the importance of guidance to states on how best to establish, expand, procure, replenish, maintain, and manage their own state stockpile, while ensuring appropriate collaboration with the SNS. The Committee continues its directive under this heading in the explanatory statement that accompanied Division B of P.L. 119–75.
Made in America SNS: The Committee is concerned about the nation’s limited infrastructure to produce essential products such as medical countermeasures (MCMs) and personal protective equipment (PPE). The Committee recognizes the COVID pandemic highlighted both the vulnerability and necessity of maintaining a robust domestic supply of PPE. It is critical that the United States maintain a robust domestic production base. Doing so is vital for both the national security interests and protection of public health in the face of international infectious disease threats. The Committee directs ASPR to develop a long-term sustainable procurement plan that gives preference to and results in purchases directly from domestic manufacturers to the maximum extent practicable.
Reusable Respirators: The Committee recognizes the potential of reusable respirators to provide strategic long-term value to state stockpile programs due to their longer operational lifetime and extended shelf life when compared with disposable masks. The Committee encourages ASPR to work with states to consider reusable respirators when planning PPE investments. The Committee continues to support warm-base surge production capacity contracts with domestic PPE suppliers, including reusable respirators. ASPR is encouraged to maintain domestic manufacturing surge capabilities that can rapidly ramp up largescale PPE production in response to CBRN threats or other public health crises that pose a significant national security risk. The Committee instructs ASPR to complete the directive included under this heading in House Report 119–271.
Shared Responsibility for PPE Preparedness: The Committee recognizes that PPE is a critical component of national preparedness, and that effective PPE readiness cannot rest solely with the federal government. The Committee emphasizes that PPE procurement, stockpiling, and sustainment should be pursued through a coordinated partnership among federal, state, and local governments, informed by regional risk profiles and operational needs. While the SNS plays an important role as a national backstop, the Committee encourages ASPR to develop a strategy in collaboration with state and local partners to support distributed stockpiling strategies for consumables, including PPE. ASPR, in coordination with state and local partners, should establish clear roles and responsibilities, and predictable replenishment planning.
Stockpile Readiness: The Committee is concerned about the sufficiency and long-term sustainment of stockpiled MCMs in the SNS intended to address material threats. The lack of clarity regarding the division of expenditures between MCM procurement, consumables, storage, maintenance, lifecycle management, and other overhead expenses may complicate long-term procurement planning and operational readiness. The Committee notes that maintaining adequate and reliable stockpile levels for these MCMs is essential to national security, particularly given the limited or nonexistent commercial markets for such products. Emerging technologies may also enable the proliferation and dissemination of CBRN threats, underscoring the need to maintain effective MCMs. Therefore, the Committee strongly encourages ASPR to continue coordinating with key industry, governmental, and nongovernmental partners on procurement activities to address capacity issues and support sustained stockpile readiness for priority threats.
U.S.-Affiliated Pacific Islands: The Committee recognizes that the SNS plays a vital role in ensuring the availability and rapid deployment of MCMs and medical equipment and supplies. The Committee notes that existing SNS distribution models may not adequately address the logistical challenges and response timelines associated with geographically dispersed and remote regions such as the U.S.-Affiliated Pacific Islands. Therefore, the Committee encourages a briefing on the feasibility of establishing an SNS storage and distribution facility in U.S.-Affiliated Pacific Islands.

$313 million, a $5 million increase, for Pandemic Influenza Preparedness.

The Committee encourages ASPR to support the development of pandemic influenza therapeutics and vaccines to ensure a robust pipeline of influenza countermeasures.

$89.9 million, a $13 million increase, for the National Disaster Medical System.
$70.06 million, a $237 million decrease, for the Hospital Preparedness Program. The bill eliminates funding for formula grants.
$8.5 million, a $1 million increase, for the National Emerging Special Pathogens Training and Education Center.
$7 million, or level funding, for the Regional Disaster Health Response System.
$23 million, a $2 million increase, for the Regional Emerging Special Pathogen Treatment Centers.
$6.2 million, or level funding, for the Medical Reserve Corps (MRC).

The Committee recognizes the contributions of MRC volunteers for the almost 300,000 hours of service in 2025. The Committee encourages ASPR to continue supporting the operation and integration of the national MRC network.

Domestic Manufacturing of Essential Medicines and MCMs: The Committee encourages ASPR to continue to prioritize the use of existing domestic manufacturing capacity, in addition to pursuing investments that enhance domestic MCM manufacturing capabilities. The Committee directs ASPR, in coordination with other relevant partners, to assess opportunities to leverage idle or underutilized U.S.-based manufacturing infrastructure in ways that would address gaps in the public health supply chain, promote warm-based surge capacity, and reduce our reliance on foreign-based manufacturing. The assessment should also include updates on ASPR’s domestic onshoring efforts related to antibiotics, biologic drug-delivery systems, medical devices, active pharmaceutical ingredients (APIs), key starting materials (KSMs), and nitrile examination gloves noted in this section of the report.
Domestic Antibiotic Manufacturing: The Committee urges the Department, in coordination with DOD, to jointly implement a plan to onshore the end-to-end supply chain for the biomanufacturing of fermentation-based essential antibiotics to ensure necessary domestic manufacturing capacity.
Domestic Manufacturing of Biologic Drug-Delivery Systems: The Committee encourages ASPR to work with drug-delivery manufacturers and biopharmaceutical partners to reduce reliance on foreign sources and support continued innovation. The Committee further encourages ASPR to support supply-chain redundancy and surge readiness for critical drug-delivery components to ensure consistent availability during periods of increased demand or public-health emergencies.
Domestic Manufacturing of Medical Devices: To continue to ensure Americans have access to essential medical devices, the Committee encourages a more concerted effort to shore up domestic production and the U.S. supply chain. The Committee urges ASPR to advance programs and policies that preserve and protect U.S.-based manufacturing for essential medical devices.
Domestic Medicine and Active Pharmaceutical Ingredient Manufacturing: The Committee encourages ASPR to engage in public-private partnerships for U.S.-based advanced manufacturing for active pharmaceutical ingredients, including their chemical precursors for the SNS.
Domestic Nitrile Examination Glove Manufacturing Capacity and CBRN Preparedness: The Committee encourages ASPR, in coordination with the VA, to develop a long-term sustainable procurement plan for nitrile examination gloves that gives preference to, and results in purchases directly from, domestic manufacturers to the maximum extent practicable, consistent with the Make PPE in America Act (section 70953 of Public Law 117–58). The Committee further encourages ASPR to maintain warm-base surge production capacity contracts with domestic nitrile examination glove manufacturers to ensure large-scale production capability is available to respond to CBRN threats, public health emergencies, and other events that pose a significant national security risk.

Agency for Health Care Research and Quality (AHRQ)

The bill eliminates funding for AHRQ, which was previously funded at $345 million in FY26.

Office of the Secretary – General Departmental Management (GDM)

The bill includes $472.7 million for GDM, a decrease of $217 million below the FY26 enacted level. This funding includes:

Teen Pregnancy Prevention Program, not funded, previously funded at $108 million.
$45 million, a $30 million decrease, for the Office of Minority Health.
$20 million, a $36 million decrease, for the Minority HIV/AIDS Initiative.
$30 million, a $14 million decrease, for the Office on Women’s Health.
$40 million, a $5 million increase, for Abstinence-only Education.
$2 million, or level funding, for Food is Medicine.