President Trump released an outline of his budget request for Fiscal Year 2026 — this is known as the “skinny budget.”

The context: Congress, not the president, is responsible for passing budgets. The president’s budget request represents an administration wish list that is typically viewed as symbolic and rarely adhered to by Congress.

• But: Trump has shown that he holds unparalleled sway over Congress’s spending bills.

The basics:

• The proposal seeks massive spending cuts across the federal government, asking Congress to slash spending on non-defense programs by more than $163 billion.
• Why it’s important: It proposes cutting $33.3 billion from HHS, a 26.2% reduction in its discretionary budget (i.e., not Medicare or Medicaid). It would cut millions of dollars from public health agencies and consolidate several smaller health offices.

The justification: The administration justified proposed cuts across the Department of Health and Human Services (HHS) by saying programs are duplicative, overly ideological, or better left to states, despite many of them being supported in the first Trump administration and many previous administrations.

The details:

• MAHA: The proposal includes an extra $500 million for priorities related to HHS Secretary Kennedy’s Make America Healthy Again (MAHA) agenda.
• SAMHSA: The proposal includes more than $1 billion in cuts to the Substance Abuse and Mental Health Services Administration (SAMHSA). It characterizes harm reduction efforts previously funded by SAMHSA (e.g., safe smoking supplies and syringes for people who use drugs) as “dangerous activities.” It says the proposal “reduces waste” and inefficiencies by eliminating programs that “either duplicate other Federal spending or are too small to have a national impact” and “promote[s] federalism” because the services are also supported by the mental health and substance use block grants.
• NIH: It recommends nearly $18 billion in cuts to the National Institutes of Health (NIH), nearly 40% of the agency’s budget. It seeks to consolidate NIH’s 27 institutes/centers into just 5, including the National Institute on Behavioral Health (which would likely combine the National Institute on Alcohol Abuse and Alcoholism, National Institute on Drug Abuse, and National Institute of Mental Health).
• CDC: It proposes slashing the Centers for Disease Control and Prevention’s (CDC) budget by roughly half, from $9 billion to over $4 billion, to “refocus” the agency on infectious disease. The budget would cut the National Center for Chronic Disease Prevention and Health Promotion, the National Center for Injury Prevention and Control, and the Preventive Health and Human Services Block Grant.
• HRSA: The budget would consolidate a number of Health Resources and Services Administration (HRSA) programs and reduce funding by $1.7 billion.
• Interdiction: The proposal requests cutting $212 million from the Drug Enforcement Administration (DEA) to reduce presence “in places that are equipped to counter drug trafficking on their own, such as Belgium, England, France, Austria, and Poland,” while targeting spending to “regions with criminal organizations that traffic significant quantities of deadly drugs into the United States – Mexico, Central America, South America, and China.” It would also cut funding for International Narcotics Control & Law Enforcement at the State Department.

What’s coming: A more detailed budget request is expected to be sent to Congress later this month. Congress is aiming to have its funding bills for FY 2026 passed by the August recess.