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NACCHO Analysis: FY27 President’s Budget Request

Apr 07, 2026

Last week, the White House released its Fiscal Year 2027 (FY27) President’s Budget Request and related documents, including a series of fact sheets highlighting the administration’s priority areas for the next fiscal year. While the President’s Budget is an important marker of funding priorities and new policy proposals from the administration, it is not binding. Ultimately, Congress is responsible for drafting the budget and appropriating funds to federal agencies, and they do not always align with the President’s priorities.   

Overall, the budget requests $111.1 billion in discretionary funding for the Department of Health and Human Services (HHS), which would represent a cut of $15.8 billion from the FY26 enacted level or about a 13% reduction. The FY27 request includes many of the same health-related funding cuts, restructuring, and program eliminations as the FY26 request, which were largely rejected by Congress in its final FY26 funding law.  

Additional details on specific funding lines are included in the charts below. 

Centers for Disease Control and Prevention (CDC) 

The budget would provide $5.486 billion in discretionary funding for CDC, which includes $5.280 billion in budget authority and $205 in Public Health Service Evaluation funds. This would represent a $3.62 billion, or about a 40% reduction, when compared to FY26 enacted funding levels. When factoring in the funds previously at the CDC that would be transferred to the proposed Administration for a Healthy America (AHA), the total funding reduction to existing CDC programs would be a more than 30% for FY27. The budget also does not allocate any funding from the Prevention and Public Health Fund, which the administration has tried to eliminate.  

Similar to last year’s proposal, the budget request would transfer a number of CDC programs to AHA, and significantly cut or eliminate funding. This includes many programs currently in CDC’s chronic disease, HIV, and injury prevention areas. More details on AHA are below.  

Key funding lines at CDC important to the work of local health departments include: 

  • Public Health Infrastructure and Capacity, $260 million (-$100 million) 

  • Public Health Emergency Preparedness Cooperative Agreements, $350 million (-$385 million) 

  • 317 Vaccine Program, $731.9 million (+$50 million) 

 

Proposed realignments: 

  • Creates the Consolidated Hepatitis, STD and Tuberculosis Prevention Grant, $300 million (-$70.3 million). This proposed block grant program would combine the following separate programs: Viral Hepatitis, Sexually Transmitted Infections (STIs), Domestic TB, and Infectious Diseases and the Opioid Epidemic. 

  • Realignment and consolidation of the Ready Response Enterprise Data Integration and the Center for Forecasting and Outbreak Analytics activities, previously under the Public Health Preparedness and Response account, within the Public Health Data Modernization activity, and funds the overall effort at $280 million (+$65 million). 

  • Creation of a new National Center for Chemicals and Toxins, which would be housed in the CDC and allocated $1 billion. This Center would combine the following federal programs currently at different agencies: Agency for Toxic Substances and Disease Registry (CDC), National Institute for Occupational Safety and Health (CDC), National Center for Environmental Health (CDC), the National Center for Toxicological Research (FDA), and National Institute for Environmental Health Sciences (NIH). 

Administration for a Healthy America (AHA) 

The FY27 request to establish AHA would consolidate chronic care and disease prevention programs across the Office of the Assistant Secretary for Health (OASH), Health Resources and Services Administration (HRSA), Substance Abuse and Mental Health Services Administration (SAMHSA), and several centers and programs at CDC. AHA would be funded at $14.7 billion in discretionary budget authority, $525.6 million in Public Health Service Evaluation funding, $115 million in user fees, and $2.2 billion in mandatory funding for a total of $17.5 billion. Some of the programs that would move from CDC to AHA would have significantly reduced funding or be eliminated 

Some key programs important to local health departments include: 

  • Ryan White HIV/AIDS Program, $2.3 billion – eliminates Ryan White Part F 

  • Ending the HIV Epidemic (EHE), $385 million – includes $165 million for Ryan White EHE and $220 million for EHE activities formerly carried out at CDC (no change) 

  • Eliminates other HIV Prevention funding previously at CDC (-$755.6 million) 

  • Maternal and Child Health Block Grant, $767.3 million (-$51.7 million) 

  • Chronic Disease Prevention and Health Promotion programs formerly at CDC, $448 million (-$985 million)  

  • Injury Prevention and Control programs formerly at CDC, $588 million (-$173 million) 

A chart of all programs that would move to AHA and be eliminated is below. Notably, the FY26 budget request eliminated all funding for chronic disease programs; however, this year’s request would move chronic programs to AHA and retain a small amount of funding for chronic disease programs including Alzheimer’s disease and cancer prevention, while eliminating most other programs. Some key programs proposed for elimination that would impact local health departments include: 

  • Adverse Childhood Experiences 

  • Ryan White Part F (including AIDS Education and Training Centers and the Dental Reimbursement Program) 

  • Community Mental Health Services Block Grant 

  • Climate and Health 

  • Diabetes 

  • Drowning 

  • Elderly Falls 

  • Minority HIV/AIDS Fund 

  • Million Hearts 

  • REACH program 

  • School Health 

  • Substance Use Prevention, Treatment, and Recovery Services Block Grant 

  • Substance Use Treatment Minority AIDS 

  • State Opioid Response Grants 

  • Title X Family Planning 

  • Tobacco and Prevention Control 

  • Youth Violence Prevention 

Administration for Strategic Preparedness and Response (ASPR)  

The budget proposes a total of $3.337 billion for ASPR, a decrease of approximately $356 million from FY26 enacted levels. Unlike the President’s FY26 budget request, the FY27 request does not propose consolidating ASPR with CDC and maintains the agency. However, it does propose the following funding levels: 

  • Eliminates the Medical Reserve Corps, Hospital Preparedness Program, the Regional Disaster Health Response System, and other Health Care Readiness and Recovery programs.  

  • The budget requests $938.1 million for the Strategic National Stockpile, a decrease of approximately $61.8 million from FY26 levels. 

NACCHO will continue to provide updates as the FY27 federal funding process continues.  
 

 

 

 

FY27 President’s Budget Request 

FY26 Enacted 

+/- FY26 

Centers for Disease Control and Prevention 

$5.4 billion 

$9.147 billion 

-$3.7 billion 

Immunization and Respiratory Diseases 

$963 million 

$916.9 million 

-$46.1 million 

Influenza Planning and Response 

$231.358 million 

$231.358 million 

+/-$0 

Domestic HIV Prevention and Research 

Proposed shift to AHA at $220 million 

 

$1.013 billion 

-$793.712 million 

New Block Grant: Viral Hepatitis, Sexually Transmitted Infections, and Tuberculosis  

$300 million 

N/A 

+$300 million 

New Block Grant: Sexually Transmitted Infections and Tuberculosis Prevention 

Encompassed in new consolidated grant program combining funded at a total $300 million 

N/A 

 

Viral Hepatitis Prevention** 

Encompassed in new consolidated grant program combining funded at a total $300 million 

$46 million 

 

Sexually Transmitted Infections Prevention ** 

Encompassed in new consolidated grant program combining funded at a total $300 million 

$164.310 million 

 

Tuberculosis Prevention ** 

Encompassed in new consolidated grant program combining funded at a total $300 million 

$137.034 million 

 

Infectious Diseases and the Opioid Epidemic** 

Realigns this funding stream into Consolidated Viral Hepatitis, Sexually Transmitted Infections (STIs) and Domestic TB funding line 

$23 million 

 

Emerging and Zoonotic Infectious Diseases  

$928 million 

$729.272 million 

+$94.492 million 

Emerging Infectious Diseases  

$303.897 million to include SET-NET to Mothers and Babies, Parasitic Diseases and Malaria 

$223.997 million 

+27.9 million  

Food Safety  

$107 million 

$74 million 

+$33 million 

Epidemiology and Laboratory Capacity Grants * 

$40 million 

$40 million 

+/-$0 

National Healthcare Safety Network  

$24 million 

$24 million 

+/-$0 

Advanced Molecular Detection (AMD)  

$66 million 

$43 million 

+$23 million 

Chronic Disease Prevention and Health Promotion  

$448 million 

$1.43 billion 

 -$982 million 

Racial and Ethnic Approaches to Community Health  

 eliminated 

$68.95 million 

-$68.95 million 

Tobacco (Office of Smoking and Health) 

eliminated 

$246.5 million 

- $246.5 million 

Tobacco * 

eliminated 

$200 million 

- $200 million 

Million Hearts * 

eliminated 

$5 million 

- $5 million 

Cancer Prevention and Control  

Moved to AHA at $413 million for ten cancer prevention and control programs formerly at CDC  

$401.04 million 

+$11.96 million 

Safe Motherhood/Infant Health  

eliminated 

$113.5 million 

- $113.5 million 

Diabetes Prevention Program  

 eliminated 

$45 million 

- $45 million 

Diabetes Prevention Program*  

eliminated 

$118.130 million 

- $118.130 million 

School Health  

eliminated 

$19.4 million 

- $19.4 million 

Birth Defects, Developmental Disabilities, Disabilities and Health  

Moved to AHA at $154 million 

$205.06 million 

-$51.06 million 

Surveillance for Emerging Threats to Mothers and Babies (SET-NET)  

Encompassed in Emerging Infectious Diseases: Surveillance for Emerging Threats to Mothers and Babies and Parasitic Diseases and Malaria 

$23 million 

 

Climate and Health 

eliminated 

$10 million 

-$10 million 

Environmental Health Activities  

$35.6 million 

$48.6 million 

-$13 million 

Childhood Lead Poisoning Prevention  

$51 million 

$51 million 

+/-$0 

Asthma  

eliminated 

$33.5 million 

- $33.5 million 

Environmental and Health Outcome Tracking Network  

eliminated 

$34 million 

- $34 million 

Injury Prevention and Control  

Moved to AHA at $588 million 

$761.379 million 

-$173.379 million 

National Violent Death Reporting System (NVDRS)  

$24.5 million 

$24.5 million 

+/-$0 

Other Injury Prevention Activities  

eliminated 

$29.950 million 

- $29.950 million 

Opioid Abuse and Overdose Prevention and Surveillance  

Proposed shift to AHA at $505.579 million 

$505.579 million 

+/-$0 

Public Health Preparedness and Response 

$489 million 

$913.2 million 

-$424.2 million 

Public Health Emergency Preparedness Cooperative Agreements 

$350 million 

$735 million 

-$385 million 

Public Health Scientific Services  

$499.6 million 

$767.497 million 

-$267.897 

Public Health Workforce Development  

$71 million 

$71 million 

+/-$0 

Surveillance, Epidemiology, and Public Health Informatics  

$327.6 million 

$298.1 million 

+$29.5 million 

Health Statistics  

Moved to HHS Office of Strategy at $175 million 

$187.397 million 

-$12.397 

CDC-Wide Activities and Program Support  

$361.570 million 

$396.570 million 

-$35 million 

Public Health Leadership and Support  

$101.570 million 

$101.570 million 

+/-$0 

Preventive Health and Health Services Block Grant* 

eliminated 

$160 million 

-$160 million 

Infectious Diseases Rapid Response Reserve Fund  

$0 

$25 million 

-$25 million 

Public Health Infrastructure and Capacity  

$260 million 

$360 million 

-$100 million 

Vector-Borne Diseases (including Lyme and Tick-Borne Disease Programs) 

$87.817 million  

$91.6 million 

-$3.783 million 

  

  

 

 

  

FY27 President’s Budget Request 

FY26 Final Agreement 

+/- FY26 

Administration for Strategic Preparedness and Response 

$3.3 billion 

$3.692 billion 

-$355 million 

  

  

 

 

Medical Reserve Corps  

eliminated 

$6.24 million 

-$6.24 million 

Hospital Preparedness Program 

eliminated 

$307.055 million 

-$307.055 million 

Biomedical Advanced Research and Development Authority  

$654 million 

$1.015 billion 

-$395.5 million 

Strategic National Stockpile  

$938 million 

$1 billion 

-$61.8 million 

Project BioShield  

$725 million 

$850 million 

-$125 million 

  

  

 

 

  

FY27 President’s Budget Request 

FY26 Final Agreement 

+/- FY26 

Health Resources and Services Administration  

Moved to AHA 

$8.9 billion 

 

  

  

 

 

Primary Healthcare Access: Community Health Center Fund  

Moved to AHA @ $1.756 billion 

$1.737 billion 

+$19 million 

Public Health and Preventive Medicine  

eliminated 

$18 million 

-$18 million 

Maternal and Child Health Block Grant  

Moved to AHA at $767 million 

$818.7 million 

-$51.7 million 

Healthy Start  

eliminated 

$145.250 million 

-$145.250 million 

Ryan White Part A  

$2.5 billion for Ryan White HIV/AIDS Programs previously housed in HRSA 

 

$680.752 million 

 

Ryan White Part B  

$2.5 billion for Ryan White HIV/AIDS Programs previously housed in HRSA 

 

$1.365 million 

 

Ending the HIV Epidemic Initiative  

Moved to AHA at $165 million 

$165 million 

+/-$0 

  

  

 

 

 

*Supported through the Prevention and Public Health Fund, which is eliminated under the President’s Budget Request (PBR). Under the PBR, some of these proposed funding levels, including Epidemiology and Lab Capacity and Immunization and Respiratory Diseases, would now be covered under traditional budget authority in the PBR.  

** The FY 2026 PBR proposes to realign the following lines into the new proposed line, Consolidated Hepatitis, STD and Tuberculosis Prevention Grant: Consolidated Viral Hepatitis, STD and Tuberculosis Prevention Grant, Viral Hepatitis, Sexually Transmitted Infections (STIs), Domestic TB, and Infectious Diseases and the Opioid Epidemic. 

 

Programs Proposed for Elimination 

FY26 Enacted  

Primary Care 

 

Rural Hospital Flexibility Grants 

$70.277 million 

State Offices of Rural Health 

$13.500 million 

Rural Hospital Stabilization Pilot Program 

$14.000 million 

Rural Hospital Provider Assistance Program 

$25.000 million 

Tobacco and Prevention Control, Program Level 

$246.500 million 

 

Nutrition, Physical Activity, and Obesity 

$54.320 million 

School Health 

$19.400 million 

Vision and Eye Health 

$4.500 million 

Inflammatory Bowel Diseases 

$3.000 million 

Interstitial Cystitis 

$2.100 million 

Excessive Alcohol Use 

$3.000 million 

Chronic Kidney Disease 

$4.500 million 

Chronic Disease Education and Awareness 

$4.500 million 

Prevention Research Centers 

$28.961 million 

Heart Disease and Stroke, PL; 

$156.105 million 

Diabetes, PL 

$163.130 million 

National Diabetes Prevention Program 

$37.300 million 

Oral Health 

$21.250 million 

Safe Motherhood/Infant Health 

$113.500 million 

Arthritis 

$2.000 million 

Epilepsy 

$11.500 million 

National Lupus Patient Registry 

$14.000 million 

Racial and Ethnic Approaches to Community Health 

$68.950 million 

Million Hearts 

$5.000 million 

National Early Child Care Collaboratives 

$5.000 million 

Hospitals Promoting Breastfeeding 

$9.750 million 

Adverse Childhood Experiences 

$9.000 million 

Firearm Injury and Mortality Prevention Research 

$12.500 million 

Drowning 

$2.000 million 

Elderly Falls 

$3.050 million 

Other Injury Prevention Activities 

$29.950 million 

Injury Control Research Centers 

$11.000 million 

HIV/AIDS 

 

AIDS Education and Training Centers – Part F 

$34.886 million 

Dental Reimbursement Program Part F 

$13.620 million 

Special Projects of National Significance 

$25.000 million 

Minority HIV/AIDS Fund 

$56.00 million 

Maternal and Child Health 

 

Early Hearing Detection and Intervention 

$18.818 million 

Emergency Medical Services for Children 

$24.334 million 

Healthy Start 

$145.250 million 

Family Planning 

$286.479 million 

Teen Pregnancy Prevention 

$107.800 million 

Office of Adolescent Health 

$433 thousand 

Public Health Reports 

$470 thousand 

Mental and Behavioral Health 

 

Seclusion and Restraint 

$1.147 million 

Mental Health Awareness Training 

$27.963 million 

Healthy Transitions 

$18.451 million  

Infant and Early Childhood Mental Health 

$15.000 million 

Children and Family Programs 

$7.729 million 

Consumer and Family Network Grants 

$3.954 million 

Mental Health System Transformation 

$3.779 million 

Project LAUNCH 

$19.605 million 

Primary and Behavioral Health Care Integration   

$55.877 million 

Primary and Behavioral Health Care Integration TTA 

$3.991 million 

Mental Health Crisis Response Partnership Pilot Program 

$20.000 million 

Homelessness Prevention Programs 

$28.096 million 

Criminal and Juvenile Justice Program 

$11.269 million 

Assertive Community Treatment for Individuals with SMI 

$6.000 million 

Homelessness Prevention Programs TTA 

$2.296 million 

Mental and Behavioral Health Minority AIDS 

$9.224 million 

Mental Health Minority Fellowship Program 

$11.059 million 

Tribal Behavioral Health Grants 

$26.250 million 

Interagency Taskforce on Trauma Informed Care 

$2.000 million 

Eating Disorder Identification, Treatment, and Recovery 

$2.000 million 

Community Mental Health Services Block Grant 

$991.532 million 

Substance Use Treatment Minority AIDS 

$66.881 million 

SAT Minority Fellowship Program 

$7.136 million 

Substance Use Prevention, Treatment, and Recovery Services Block Grant 

$1,933.879 billion 

State Opioid Response Grants 

$1,595.000 billion 

Strategic Prevention Framework 

$137.484 million 

Substance Use Prevention Minority AIDS 

$43.205 million 

Sober Truth on Preventing Underage Drinking 

$14.500 million 

Minority Fellowship Program 

$1.321 million 

Tribal Behavioral Health Grants 

$25.665 million 

Health Workforce 

 

Loan Repayment/Faculty Fellowships 

$2.310 million 

Scholarships for Disadvantaged Students 

$55.014 million 

Health Careers Opportunity Program 

$15.000 million 

Primary Care Training and Enhancement 

$49.924 million 

Oral Health Training Programs 

$43.673 million 

Medical Student Education 

$65.000 million 

Area Health Education Centers 

$47.000 million 

Geriatric Programs 

$48.245 million 

Mental and Behavioral Health 

$44.053 million 

Public Health/Prevention Medicine 

$18.000 million 

Advanced Nursing Education 

$96.581 million 

Nursing Workforce Diversity 

$22.343 million 

Nurse Education, Practice, and Retention 

$65.413 million 

Nurse Faculty Loan Repayment 

$28.500 million 

Policy, Research and Oversight 

 

Drug Abuse Warning Network 

$10.000 million 

Behavioral Health Workforce Data and Development 

$1.000 million 

Kidney X 

$5.000 million 

Sexual Risk Avoidance 

$35.000 million 


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