CNN claims to have a document which calls for tens of billions of dollars in health care cuts. The cuts, if this leaked document is valid, appear to be focused on HHS, but many other departments and agencies as well. It should be noted that almost every federal department and agency has health care research budget line items, a chaos which leads to duplication of effort and dismal results. Health care research is a very popular line item amongst federal bureaucrats because it hardly ever gets challenged by Congress:
https://www.cnn.com/2025/04/16/politics/trump-rfk-jr-budget-cut-health/index.html
Internal Trump administration document reveals massive budget cut proposal for federal health agencies
By Sarah Owermohle and Meg Tirrell - April 16, 2025The Trump administration is formulating plans to cut roughly a third of the federal health budget, eliminate dozens of programs and vastly whittle down health agencies, according to an internal document reviewed by CNN.
The preliminary memo, sent from White House budget officials to the Department of Health and Human Services, previews the administration’s plans to slash discretionary federal health spending and rework health agencies in the image of President Donald Trump and HHS Secretary Robert F. Kennedy Jr’s “Make America Healthy Again” mandate.
The document, dated April 10, could still be finalized with changes. If enacted as is, it could cut total federal health spending by tens of billions of dollars a year. It would also consolidate dozens of health programs and departments into the Administration for a Healthy America (AHA), a new entity unveiled by Kennedy during mass layoffs earlier this month.
The plan calls for steep cuts to the Centers for Disease Control and Prevention, which would see its budget reduced by more than 40% under the administration’s proposal.
It also eliminates CDC’s global health center and programs focused on chronic disease prevention, and domestic HIV/AIDS prevention. While some of the agency’s work would be moved into new AHA centers, programs on gun violence, injury prevention, youth violence prevention, drowning, minority health and others would be eliminated entirely.
Many of the staff in those CDC departments were laid off in the mass reduction-in-force announcements on April 1.
The proposal would also eliminate a number of rural health programs at HHS, including grants and residency programs for rural hospitals and state offices. Other rural health efforts, such as black lung clinics, would remain but be housed in the new AHA’s primary care department.
The proposed cuts could provide a blueprint for Republicans looking to slash federal spending. The president will send his budget request to Congress, which is wrangling over Republican plans to reduce the federal budget by up to $1.5 trillion.
The Washington Post first reported on the proposed budget request.
The preliminary plan would slash the National Institutes of Health’s budget by more than 40% and reduce its 27 research institutes and centers down to just eight.
While the National Cancer Institute, the National Institute of Allergy and Infectious Diseases, and the National Institute on Aging would be preserved. Institutes researching childhood illnesses, mental health, chronic disease, disabilities and substance abuse would be shuffled into five new entities: the National Institute on Body Systems, National Institute on Neuroscience and Brain Research, National Institute of General Medical Sciences, the National Institute of Disability Related Research and National Institute of Behavioral Health.
The budget also assumes that the administration’s earlier attempt to cap indirect payments to universities at 15%, blocked by a court, would be in effect. Many of these payments have traditionally helped fund medical research.
While NIH has historically enjoyed bipartisan support for funding increases, there have been growing calls among GOP lawmakers for reform. House Republican leaders proposed last year to consolidate the institutes into 15 entities but also suggested a slight budget increase in that plan.
The proposal would also establish a salary cap for employees hired under Title 42, a National Institutes of Health provision that gives the agency more leeway to hire experts into senior roles. Many top officials, including the now-retired National Institutes of Allergy and Infectious Disease director Anthony Fauci, are hired as Title 42 employees.
$ 40 billion is a rounding error in HHS' budget. In FY 2025, the Department of Health and Human Services (HHS) spent $ 2.61 trillion among its 14 sub-components:
Leaked HHS budget signals $40B in cuts, assumes ACA subsidies expire
By Noah Tong - April 17, 2025The Department of Health and Human Services (HHS) reorganization plans appear to have been revealed through a leaked Office of Management and Budget (OMB) document.
The 64-page PDF with HHS’ plans were first reported by Inside Medicine and later reported by The Washington Post and other news publications. In an update, Inside Medicine said the entire document was authenticated by The Washington Post.
The HHS has not authenticated the document and has not yet responded to a request for comment.
The preliminary budget document, labeled “Not For Distribution, 04/10/2025,” includes a “Pre-decisional” header and outlines the department’s budget for the fiscal year 2026 president’s budget, which requires congressional approval. It also includes a blurry organizational chart.
While the restructuring was broadly announced, and individual offices have been reportedly axed in recent weeks, the leak provides greater insight into how the reorganization, firings, reductions in force and office eliminations and consolidations will fundamentally alter the agency.
“Many difficult decisions were necessary to reach the funding level in this passback,” the OMB said in the document.
The overall budget for the HHS would decrease by approximately $40 billion to slightly over $80 billion, not counting funding from additional sources. The HHS’ newest agency, the Administration for a Healthy America (AHA), would have a budget of approximately $14 billion. The National Institutes of Health (NIH) budget will decrease by about 40%, from $47 billion to $27 billion, reports The Washington Post.
Notably, the budget at the Centers for Medicare & Medicaid Services (CMS) "assumes a decline in Federal Exchange enrollment due to the expiration of the enhanced premium tax credits."
These Affordable Care Act subsidies have been a longtime target of Republicans. A recent report from the Commonwealth Fund found that letting these subsidies expire would cost states $34 billion in gross domestic product and $2 billion in tax revenue, while states that have not extended Medicaid would lose out the largest over time. Hospitals and providers would also see big revenue declines, particularly in rural areas. Others estimate 4 million individuals would lose their insurance, and the Congressional Budget Office projects a 4.3% premium increase.
A closer look at the reorg
Eliminated agencies include the Health Resources Services Administration (HRSA), the Administration for Community Living (ACL), the Substance Abuse and Mental Health Services Administration, the Agency for Healthcare Research and Quality and the Administration for Strategic Preparedness and Response.
The new AHA will include components of these agencies. It will house the surgeon general and a primary care department made up of former HRSA offices, the Centers for Disease Control and Prevention (CDC) National Center for Injury Prevention and Control and an Office of Minority Health.
It will also include departments for policy and research, maternal and child health, mental health, environmental health, HIV/AIDS and the workforce.
Within agencies, entire offices are deleted or absorbed by other agencies. They include the Head Start program, the Low Income Home Energy Assistance Program and the National Institute on Minority Health at the NIH.
At the CDC, gone too are the Global Health Center, HIV and AIDS programs, the Office of Readiness and Response and almost the entirety of the Prevention & Public Health Fund.
The document also outlines eliminations at certain agencies. These items are listed via bullet point on the first page.
In the HRSA, that includes “State Offices of Rural Health,” Title V Block grants, certain Ryan White HIV program services, public health workforce development, geriatric programs, primary care training and enhancement, nursing workforce diversity, medical school education, training in oral health and behavioral health programs.
For the CDC, that includes youth violence prevention, traumatic brain injury, elderly falls, climate and health, asthma, childhood lead poisoning, mining research and personal protective technology.
Under “GDM Eliminations,” possibly representing general departmental management, food as medicine, still birth taskforce and teen pregnancy prevention are listed. “Embryo Adoptive Awareness Campaign" is listed twice.
At the CMS, “Health Equity” and discretionary Inflation Reduction Act implementation funding is eliminated. Under the Office of the Assistant Secretary for Health, the Office of Population Affairs is gone. For Indian Health Services, “Preventive Health” is a casualty.
The CMS appears to pick up a number of ACL offices focused on aging under the restructuring. Funding for National Institute for Occupational Safety and Health programs is discontinued, except for the Firefighter Cancer Registry, the National Mesothelioma Registry & Tissue Bank, the World Trade Center Health and Energy Employees Occupational Illness Compensation Act programs.
The NIH will be restructured into an eight-institute structure.
More budgetary impacts
The budget would institute significant changes, if approved by Congress.
Among the changes, it implements a pay freeze for employees and eliminates funding for the HIV Epidemic Initiative.
The Food and Drug Administration will no longer have a “direct role in routine inspections of food facilities,” but the budget promises the department will be able to meet user fee requirements as outlined in federal law.
Funding by the CDC for two monthly peer-reviewed journals, Emerging Infectious Diseases and Preventing Chronic Disease, will be cut. So is funding for programs on Lyme and Prion diseases.
It does establish a “new biodetection system that can rapidly detect novel pathogens with 24-hour turnaround times” in collaboration with the Department of Defense.
At the Administration for Children and Families, the budget will "scrub" grants and contracts that "promote abortions and high-risk sexual behavior, inflict radical gender ideology on already vulnerable children, and facilitate discriminatory practices in service delivery."
"Examples: The Budget ends federal dollars for facilitating abortions for migrant children, and eliminates grants to woke NGOs that promote abortion and teach kids how to engage in high-risk sexual behavior in the Personal Responsibility Education Program," the document reads.
The budget, if approved, also instructs the Advanced Research Projects Agency for Health to "update all contracts to include a clause for the agency to recoup profits for invested products." These funds will be directly utilized in a newly created U.S. Sovereign Wealth Fund, as announced in this executive order.
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