In this edition of AcademyHealth's Situation Report, the administration’s FY26 budget proposal outlines a significant restructuring of HHS and reductions in discretionary funding for key health agencies. We also highlight ongoing Senate deliberations over a budget reconciliation bill that could impact Medicaid coverage for millions. AcademyHealth is taking action through legal, advocacy, and community mobilization efforts to protect public health data, research funding, and access to care. Now more than ever, our collective voice is essential. Read on to see how you can get involved.
In today’s issue:
- HHS Faces $32 Billion Cut, Major Overhaul Under President’s FY26 Budget Proposal
- Senate Deliberates on Budget Reconciliation Bill
- When Research Is at Risk, AcademyHealth Mobilizes: How You Can Help
- Other News We’re Tracking
HHS Faces $32 Billion Cut, Major Overhaul Under President’s FY26 Budget Proposal
On Friday afternoon, the Office of Management and Budget released the full President’s Budget Request for FY26, providing additional details regarding the administration’s intended reorganization and sweeping budget cuts for the HHS. The President’s Budget Request is a proposal, but Congress must still act to appropriate funding. Total discretionary funding for HHS would be $95 billion, down from $127 billion in FY25. The NIH, CDC, and FDA would see their budgets cut nearly in half. A new agency, the Administration for a Healthy America (AHA), would be created to consolidate several health divisions and would receive $14 billion in discretionary funding. The budget proposes a cut of $129 million in discretionary funding for what was AHRQ, and the elimination of all $125 million of PCORTF funding. The proposal also includes the controversial 15 percent cap on indirect research costs, which has previously been blocked by the courts.
These budget cuts are being justified through the reorganization and “streamlining” of the federal agencies, though the reorganization has been scrutinized and challenged in its current form. For example, the proposal seeks to consolidate the NIH’s 27 institutes into just eight. Only three existing institutes—the National Cancer Institute, the National Institute of Allergy and Infectious Diseases, and the National Institute on Aging—would be preserved, though all will operate with restricted budgets. According to the report, multiple agencies will be combined to create the new AHA, including “Health Resources and Services Administration (HRSA), Substance Abuse and Mental Health Services Administration (SAMHSA), Office of the Assistant Secretary for Health (OASH), National Institute for Environmental Health Sciences (NIEHS), and some programs from the Centers for Disease Control and Prevention (CDC).” The proposal also aims to combine the office of the Assistant Secretary for Planning and Evaluation (ASPE) with AHRQ to create the new Office of Strategy, a move that would severely hinder the lifesaving research of AHRQ and their partners. Additionally, the budget proposal calls for legislation to eliminate the Patient-Centered Outcomes Research Trust Fund (PCORTF), which funds PCORI, AHRQ, and ASPE.
These cuts would leave HHS and the federal government in a far weaker position to promote the health of Americans, ensuring that Americans will be sicker, poorer, and more likely to die from preventable causes. AcademyHealth and the Friends of AHRQ have continued our advocacy campaign to prevent the unlawful reorganization, deep cuts to the federal health and research workforce, and the devastation of federal research grants. Join us here.
Separately, the Senate is considering the House reconciliation bill, which among other things would cut $800 billion from Medicaid spending and reduce the number of beneficiaries by at least 10 million people in order to partially offset tax cuts for the ultrawealthy. The reconciliation process requires that legislation meets very restrictive standards in the Senate to bypass the filibuster, which will be deliberated behind closed doors in the coming weeks.
The combination of the reconciliation bill and the President’s Budget Request has left the future of HHS and health and science research in the U.S. in deep uncertainty.
Senate Deliberates on Budget Reconciliation Bill
The Senate convened this week for the first full, in-person session since the House approved the budget reconciliation bill. The chamber is facing an ambitious timeline, as Republican leaders are aiming to send the bill to the president by July 4. However, this reconciliation package that only necessitates a simple majority to pass is already facing divisions among Republican Senators, with fiscal conservatives opposed to adding to the federal deficit, while others express concerns about cuts to key programs like Medicaid and SNAP that serve their constituency and could jeopardize their future re-elections. Senator Majority Leader John Thune (R-SD) has signaled there will be alterations, but it remains unclear which provisions the Senate will focus its efforts on.
Meanwhile, Democratic Senators are prepping ways to halt the filibuster-proof bill by using all procedural tools at their disposal. The “Byrd rule” is expected to be exercised, which requires items being stripped from budget bills if their impacts on the budget are “merely incidental to the non-budgetary components of the provision.” Major policies in the budget bill might violate the Byrd rule, including the state ban on regulating AI and the provision to prevent federal courts from enforcing contempt orders.
When Research Is at Risk, AcademyHealth Mobilizes: How You Can Help
AcademyHealth is mobilizing the health services research community in response to serious threats to public data, research integrity, and evidence-informed policymaking. Here’s how you can get involved:
Defend Public Health Data Access
AcademyHealth has joined a federal lawsuit to restore vital public health data recently removed from federal websites by the Trump Administration. This sweeping erasure affects key health information on topics like LGBTQ health, reproductive care, HIV/AIDS, and clinical trials—data that has saved lives and informed critical policy and care decisions. You can help by:
- Spreading the word: Use our Supporter Toolkit to raise awareness.
- Donating to support our mission: Standing up for science and evidence has risks. By donating to AcademyHealth, you help sustain our ability to advocate for transparency, innovation, and progress in health research.
Publicly funded data belongs to all of us. Join us in standing up for access to trustworthy, life-saving information.
Share Your Story
AcademyHealth is collecting stories from across the health services research community to document the real-world impact of federal policy and funding changes. What happens when research is delayed, defunded, or derailed? Help us show policymakers and the public what’s truly at stake when research is sidelined. Your story can inform advocacy, spark action, and protect progress. Share your story here.
Stay Informed: May Advocacy Update (Members Only)
AcademyHealth’s May Read on Washington, available only to AcademyHealth members, offers updates on Medicaid and reconciliation, congressional testimony on impoundments, our legal action to retrieve data removed from federal website, other news we’re following, and more. Not a member? Join today to access exclusive advocacy insights.
Make Your Research Matter
Communicating and measuring the impact of your research is more important than ever. In a recent Field in Focus, AcademyHealth offered practical tools to assess and convey research impact to funders, policymakers, and the public. Read more for key takeaways, tips on how to craft your own impact assessment, and additional resources to demonstrate the value of research.
Other News We’re Tracking
CMS Warns States Against Using Medicaid Funds for Health Care for Undocumented Immigrants
CMS revealed plans to increase federal oversight to prevent states from covering health care for immigrants who are undocumented with federal Medicaid funds. They plan to do so by evaluating state Medicaid spending reports, reviewing states’ financial management systems, and assessing existing eligibility rules and policies for loopholes and weaknesses in enforcement. According to the press release, Medicaid funding is generally only available to noncitizens for emergency medical services, granted they would otherwise qualify for Medicaid. However, CMS noted that some states have not followed this guideline strictly, and if they uncover improper spending on noncitizens, it will be subject to recoupment.
‘Corrupt’ Medical Journals Have to Change, RFK Jr. Says, or the NIH Will Publish In-House
Health Secretary Robert F. Kennedy (RFK) Jr. suggested that government scientists may be precluded from publishing their research in prestigious medical journals such as the Lancet, New England Journal of Medicine, and JAMA, among others. In a recent podcast episode, RFK Jr. labeled the journals “corrupt,” stating that they publish studies funded by the pharmaceutical industry, and asserted that unless these journals changed “radically,” the National Institutes of Health (NIH) will establish its own medical journals. The comments represent a significant shift in approach compared to the previous century in which scientists aimed to limit the government from exerting too much power over research, which threatens the reputation building of current independent journals and scientists themselves, and leaves funding for many journals in a state of limbo.
Previous Updates
This is the latest in a series of Situation Report updates from AcademyHealth. You can find prior issues here.
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