According to an internal document, the Trump administration is planning to drastically reduce health agencies, cut about a third of the federal health budget, and terminate dozens of programs.
White House budget officials sent the Department of Health and Human Services a preliminary memo outlining the administration’s plans to restructure health agencies and cut discretionary federal health spending in line with President Donald Trump and HHS Secretary Robert F. Kennedy Jr.’s “Make America Healthy Again” agenda.
The April 10 document may still be finalised with revisions. It has the potential to reduce annual government health spending by tens of billions of dollars if it is implemented as is.
Additionally, it would combine dozens of health departments and programs into the Administration for a Healthy America (AHA), a new organisation that Kennedy introduced earlier this month after widespread layoffs.
The administration’s proposal would result in a budget decrease of over 40% for the Centres for Disease Control and Prevention, which is the target of the plan.
Additionally, the CDC’s global health centre and its domestic HIV/AIDS and chronic disease preventive programs are eliminated.
Programs on drowning, minority health, injury prevention, youth violence prevention, and gun violence would all be discontinued, however some of the agency’s work would be transferred to new AHA centres.
The sweeping reduction-in-force announcements on April 1 resulted in the layoff of several employees in various CDC departments.
A number of HHS rural health initiatives, such as grants and residency programs for rural hospitals and state offices, would also be discontinued under the proposal.
Black lung clinics and other rural health initiatives would continue, but they would be located in the primary care division of the new AHA.
Republicans seeking to reduce federal spending may find a model in the planned cuts.
Congress, which is arguing over Republican proposals to cut the federal budget by up to $1.5 trillion, will get the president’s budget request.
The National Institutes of Health’s 27 research institutes and centres would be reduced to only eight under the preliminary plan, which would also cut the organization’s funding by almost 40%.
In contrast, the National Institute on Ageing, the National Institute of Allergy and Infectious Diseases, and the National Cancer Institute would remain intact.
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Five new organizations—the National Institute on Body Systems, the National Institute on Neuroscience and Brain Research, the National Institute of General Medical Sciences, the National Institute of Disability Related Research, and the National Institute of Behavioural Health—would be created by reorganising institutes that study childhood illnesses, mental health, chronic disease, disabilities, and substance abuse.
The administration’s previous attempt to cap indirect payments to universities at 15%, which was halted by a court, is likewise assumed to remain in place in the budget.
Historically, a large portion of these payments have been used to support medical research.
Although funding increases for NIH have traditionally received bipartisan support, calls for reform among GOP lawmakers have grown. Last year, House Republican leaders requested a minor budget increase along with a plan to combine the institutes into 15 entities.
Additionally, a wage cap for workers appointed under Title 42—a National Institutes of Health provision that allows the agency greater discretion in appointing specialists to high positions—would be established by the proposal.
Title 42 workers include many high-ranking officials, such as Anthony Fauci, the now-retired head of the National Institutes of Allergy and Infectious Disease.
