Trump administration’s budget proposal seeks deep cuts

Federal agencies began sending President Trump’s budget proposal to Congress.

The main point: Expanding on the “skinny budget” that the White House sent to Congress earlier this month, the new documents detail the White House’s ambitions for spending cuts across government agencies. Trump is seeking non-defense funding cuts of more than 22%, including more than $60 billion in combined cuts from health, housing, and community development work.

• But: Reminder that this is still just a proposal — Congress, not the president, provides budgets and funding.

The details: The administration is seeking $94.7 billion for HHS in FY 2026, a decrease of about $31.3 billion from FY 2025.

• AHA: The new Administration for a Healthy America would combine the Office of the Assistant Secretary for Health, HRSA, SAMHSA, NIH’s National Institute of Environmental Health Sciences, and several centers/programs formerly in CDC. It would include divisions for Primary Care, Maternal and Child Health, Mental and Behavioral Health, Environmental Health, HIV/AIDS, Health Workforce, and AHA Policy, Research, and Oversight (which includes the surgeon general). The budget proposes $500 million for the Make America Healthy Again Commission’s priority activities.
• MH/SUD services: The proposal would fold SAMHSA into the new AHA and includes $5.8 billion for mental health and substance use disorder services, less than the $7.3 billion SAMHSA managed in 2024. The budget proposes to maintain funding for 988, including services for Spanish-speakers. It would eliminate many SAMHSA programs, including (among many others), several programs related to mental health, workforce, prevention (e.g., Strategic Prevention Framework; Sober Truth on Prevention Underage Drinking; Screening, Brief Intervention, and Referral to Treatment), naloxone and other harm reduction, treatment (including for pregnant/postpartum women, families, homeless individuals), recovery services, etc. The budget proposes $80 million within AHA for a newly funded Native American Behavioral Health and Substance Use Disorder program.
• MH/SUD Block Grants: It would consolidate funding from the Community Mental Health Services Block Grant, the Substance Use Prevention, Treatment, and Recovery Support Services Block Grant, and the State Opioid Response grants into one new program. This new Behavioral Health Innovation Block Grant would have a $4 billion budget (compared to over $1 billion for the mental health block grant, over $2 billion for the substance use block grant, and over $1.5 billion for the SOR grant provided in recent years).
• Research: The proposal calls for cutting NIH’s budget by roughly 40% and consolidating the agency’s 27 institutes and centers into 8. This would include combining the National Institute on Alcohol Abuse and Alcoholism, National Institute on Drug Abuse, and National Institute on Mental Health into a new National Institute of Behavioral Health. It proposes capping the indirect costs funding rate at 15%.
• Tobacco: It proposes cutting more than 11% in discretionary funding for FDA, as well as a decrease of 1,940 full-time FDA employees. The budget would maintain $712 million for the FDA Tobacco Program “to support product review, research, compliance, enforcement, public education campaigns, and policy development.”
• CDC: The budget proposes slashing CDC’s budget by roughly half and ending its work on chronic disease and HIV/AIDS. It would also eliminate programs related to injury prevention (which often includes overdose prevention) and adverse childhood experiences.

What’s coming: Congress must pass spending bills by September. Funding legislation will need support of several Democrats in the Senate, which is likely to require higher funding levels that will be opposed by House Republicans.