The Details

Significant reductions in HHS preventive and public health programs could undermine America’s ability to protect and improve health in communities. The leaked plan targets many initiatives aimed at infectious disease control, chronic disease prevention, maternal and child health, mental health, and health equity – all of which would likely suffer:

Infectious Disease Control

The Passback calls for a 44% cut to the Centers for Disease Control and Prevention (CDC) budget (from $9.2 billion to $5.2 billion), which would now focus mainly on acute outbreaks and biothreats. The CDC’s Global Health Center and domestic HIV/AIDS prevention programs​ would disappear. Two of the CDC’s flagship peer-reviewed journals – Emerging Infectious Diseases and Preventing Chronic Disease – are set to be defunded. This not only saves negligible dollars but also stifles the dissemination of vital public health findings. Such journals have been platforms for scientists worldwide to report outbreak intelligence and public health successes; their loss would hinder the sharing of evidence in real-time.

In a recent report by the American Public Health Association, if these cuts were to occur, the U.S. would be slow to detect new and emerging threats, leaving it “largely unprepared” for the next pandemic, leading to “needless deaths”.

Chronic Disease Prevention

The draft budget would eliminate all CDC chronic disease programs, including initiatives on heart disease, obesity, diabetes, cancer screening, and smoking cessation​. Vital prevention efforts – such as youth anti-tobacco campaigns, diabetes prevention programs, asthma control initiatives, and healthy aging programs – would be eliminated.

Maternal and Child Health

The Title V Maternal & Child Health Block Grant, a key source of funding for prenatal care, infant screenings, and home visiting, is slated for elimination​. The plan also ends the Teen Pregnancy Prevention program and shuts down the HHS Office of Population Affairs, which administers Title X family planning.

The Head Start early childhood program would lose all federal funding, removing not only educational opportunities but also health screenings and nutrition support for approximately a million low-income children. Without Title V and related programs, state and local health departments will have fewer resources to ensure safe pregnancies and healthy childhood development.

The leaked budget discontinues the CDC’s childhood lead poisoning prevention program​. This move could leave kids in high-risk housing without critical lead exposure screening and intervention, with lifelong cognitive and health consequences.

Mental Health

The proposal would dismantle the Substance Abuse and Mental Health Services Administration (SAMHSA) as an independent agency. Some functions would be folded into the new AHA, but with significant funding reductions. Federal support for mental health services would drop about 25%, substance use treatment by 13%, and substance use prevention by 92%​.

SAMHSA’s grant programs currently fund treatment for over 1.5 million Americans with substance use disorders annually. These cuts could leave many individuals struggling with opioid or alcohol addiction without access to treatment and recovery programs. Similarly, reductions in the mental health block grants would strain community mental health centers that provide counseling, psychiatric care, and housing support for severe mental illness.

Less funding for initiatives like the national 988 suicide & crisis lifeline (which SAMHSA helps support) could undermine this critical safety net​.

Health Equity

The leaked reorganization appears to deprioritize health equity initiatives that target underserved populations. The plan would eliminate the NIH’s National Institute on Minority Health and Health Disparities (NIMHD), the CMS Office of Health Equity and other equity-focused programs serving communities of color, low-income families, and rural residents such as the CDC’s Racial and Ethnic Approaches to Community Health (REACH) grants and initiatives like the Minority HIV/AIDS Program. Funding for Native American health prevention would shrink.

Impacts on Research and Innovation

The HHS proposal suggests significant reductions to biomedical and public health research. Funding for the National Institutes of Health (NIH) would decrease by approximately 40%, from roughly $47 billion in FY2025 to $27 billion in FY2026. This would force NIH to terminate or scale back hundreds of research projects across all fields of medicine​. Scientists warn that promising studies on cancer, Alzheimer’s, diabetes, infectious diseases, and more would be halted mid-stream​. Entire NIH institutes are slated for elimination or merger.

Fewer grants and programs mean fewer discoveries – the pipeline of new drugs, vaccines, and medical technologies would slow to a trickle.  According to a report by the American Public Health Association, patients waiting for breakthrough cures could face longer waits as “ground-breaking medical treatments go undiscovered.” Diseases with smaller patient populations, such as pediatric rare diseases and rare cancers, would be especially vulnerable as funding shifts to only the perceived highest priorities.

The proposal would eliminate the Agency for Healthcare Research and Quality (AHRQ), ending federal research into healthcare quality, patient safety, and health systems improvement. AHRQ’s studies have helped reduce hospital-acquired infections and medical errors; losing it means future improvements in care may stagnate.

While the U.S. considers a 40% reduction in NIH funding, China and other countries are increasing their R&D spending, eager to claim leadership in biotech and pharmaceuticals. In the APHA report, former HHS officials caution that such cuts “will have a decades-long impact” and that China would “gladly step into any vacuum we create” in scientific leadership.

Consequences for Healthcare Delivery and Access

Rural communities stand to be among the hardest hit. Under the new Administration for Healthy America, the Passback eliminates the Rural Hospital Flexibility Grants, State Offices of Rural Health, At-Risk Rural Hospitals Program Grants, and the Rural Residency Development Program that have helped keep remote hospitals open and healthcare staff in rural clinics​. When a rural hospital shuts down, residents must travel long distances for emergency or specialty care, often resulting in worse outcomes (for instance, higher mortality for time-sensitive conditions like trauma or heart attacks).

Rural areas already face provider shortages; cutting federal support will exacerbate the lack of primary care, maternity care, and mental health services in these regions. A recent KFF report noted that rural hospital closures lead to job losses and can destabilize local economies,​ accelerate the rural healthcare crisis, and widen the rural-urban health gap.

Food and Drug Safety Risks

The budget plan would remove the Food and Drug Administration (FDA) from routine food facility inspections, shifting that responsibility to the states​. This puts food safety at risk, as not all states have the necessary resources or expertise to regulate food manufacturers, processing plants, and farms adequately.

The 2011 Food Safety Modernization Act was predicated on a strong FDA role to prevent outbreaks; rolling that back could increase the likelihood of contamination events going undetected. A coalition of public health groups emphasized that reducing staffing and resources for food safety inspections will have both immediate and long-term consequences for the public.  We could see more foodborne illness outbreaks (E. coli in produce, Salmonella in poultry, Listeria in packaged foods, etc.) if oversight lapses.

The proposal also reduces the FDA’s budget by about 19%, just enough to maintain industry user fees, but possibly insufficient for robust enforcement of drug and device safety. With fewer FDA inspectors and scientists, the approval of new medications could slow, and the monitoring of medical product quality could be reduced. For patients, this might mean delays in accessing new, life-saving therapies and an increased risk of unsafe products being released on the market. In essence, deregulating and defunding key FDA functions threatens to compromise the safety of everyday goods – from the food on our tables to the medicines in our cabinets – thereby endangering public health.

Less Support for Seniors and People with Disabilities

The plan would eliminate the Administration for Community Living (ACL)as an independent agency, scattering or cutting its programs​. ACL administers services that help older Americans and individuals with disabilities live independently, including home- and community-based support services, caregiver respite programs, meals for seniors, and protections against elder abuse. Under the proposal, many of these programs have ended or have been devolved to states with lower funding​.