White House proposes health budget cuts

The White House released its budget request for FY 2027.

• Note: This is just a proposal and effectively a statement of priorities, as Congress is responsible for determining budgets.

The main point: The administration’s budget again requests substantial cuts to health agencies, including for mental health and addiction agencies/programs, suggesting a continued desire to shrink the federal workforce and reduce spending on public health and safety net programs.

• But: The proposed cuts are largely less drastic than those proposed by the administration last year. Congress rejected the administration’s deep cuts to health agencies in last year’s budget, and it seems likely they would again this time around.

The details:

• HHS: The proposal would provide $111.1 billion for the Department of Health and Human Services (HHS) discretionary spending, a 12.5% decrease from enacted levels last year.
• AHA: It again proposes combining the Office of the Assistant Secretary for Health, the Health Resources and Services Administration (HRSA), the Substance Abuse and Mental Health Services Administration (SAMHSA), and several Centers for Disease Control and Prevention (CDC) programs into a new Administration for a Healthy America (AHA), cutting $5 billion. AHA would focus on primary care, maternal and child health, mental health, HIV/AIDS, and workforce development.
• MH/SUD services: AHA’s budget includes $6.7 billion for mental health/substance use disorder (MH/SUD) services, a decrease of $576 million from FY 2026. Funding for mental health, substance use prevention, and substance use treatment would all decrease.
• SAMHSA: The administration suggests that substance use grants were previously used to “fund dangerous activities billed as ‘harm reduction,’” and proposes cuts to SAMHSA to “[eliminate] funding for programs that duplicate block grant funding, or are too small to have a national impact,” including Programs of Regional and National Significance. It would eliminate SAMHSA programs including Primary and Behavioral Health Care Integration Programs, Tribal Behavioral Health Grants, Children and Family Programs, Strategic Prevention Framework, Sober Truth on Preventing Underage Drinking, Drug Abuse Warning Network, and several others.
• Block grants: The budget proposes combining the Community Mental Health Block Grant, Substance Use Prevention, Treatment, and Recovery (SUPTRS) Block Grant, and State Opioid Response (SOR) Grant into one Behavioral Health Innovation Block Grant.
• NIH: The budget proposes a roughly 10% cut to the National Institutes of Health (NIH). It would consolidate the National Institute on Drug Abuse (NIDA) and the National Institute on Alcohol Abuse and Alcoholism (NIAAA) into the new National Institute for Substance Use and Addiction Research, which would receive $165 million less than the combined budgets for the two centers in 2026.
• CDC: CDC would see a 42% cut. The budget would eliminate CDC’s Chronic Disease Prevention and Heath Promotion activities and Injury Prevention and Control programs, including ACEs (adverse childhood experiences), other injury prevention activities, and injury control research centers.
• FDA: The budget proposes an increase for the Food and Drug Administration (FDA), including funding to maintain FDA’s Tobacco program.
• Other health/social services: The budget says that the Centers for Medicare and Medicaid Services (CMS) will ramp up oversight of key Medicaid programs, and it proposes cutting from the Agency for Healthcare Research and Quality (AHRQ). It would also eliminate several HIV prevention/treatment programs, the Community Services Block Grants, the Low-Income Home Energy Assistance Program, several housing assistance and homelessness prevention programs, the National Technical Assistance Center on Kinship and Grandfamilies, etc.
• Law enforcement/interdiction: The budget proposes a 15% increase for federal law enforcement, including a $362 million increase for fighting drug cartels. That would provide resources to hire over 300 Drug Enforcement Administration (DEA) agents to be equipped with advanced drug trafficking network intelligence systems. The budget proposes increases for the Department of Justice, the Coast Guard, and the Treasury’s Office of Terrorism and Financial Intelligence, as well as funding at the State Department, to combat drug trafficking and cartels.

Read more: White House budget proposes billions in cuts to health programs; White House proposes 12% cut to federal health agencies in 2027 budget request; NIH would get $5 billion cut under Trump’s 2027 budget, but Congress unlikely to go along; White House budget proposes cuts to mental health and gender-affirming care; Trump budget seeks $1.5T in defense spending alongside cuts in domestic programs