On July 31, the Senate Appropriations Committee approved its Fiscal Year 2026 (FY26) Labor, Health and Human Services, Education, and Related Agencies (Labor-HHS) Appropriations bill with bipartisan support in a 26-3 vote. Senators on both sides of the aisle noted that they were encouraged by the bipartisan process. In her opening remarks, Senator Shelley Moore Capito (R-WV), Chair of the Labor, Health and Human Services, and Education Appropriations Subcommittee stated, “I am proud that Ranking Member Baldwin and I were able to once again craft an effective bill that maintains provisions that are critical to the departments our subcommittee oversees. This bill also continues our bipartisan record by including a number of priorities from both sides of the aisle like, investments in America’s biomedical research, child care, education, mental and rural heath, and continued efforts to combat the opioid epidemic.” Vice Chair Patty Murray (D-WA) echoed this sentiment in her opening statement noting that the legislation represents, “serious bipartisan work to make some truly critical investments in families and our country’s future. From defense funding that supports our military and keeps our country safe to funding for health care, child care, schools, seniors, medical research, public health, workforce training and safety—and so many other programs that keep our communities strong.”

The Senate bill includes $116.6 billion for the Department of Health and Human Services, which would be a slight increase of $446 million (or 0.38%) over FY25 levels. The Senate proposal aligns with the current structure of federal health programs and does not adopt the Administration’s announced HHS reorganization or the newly proposed Administration for a Healthy America (AHA). (For an analysis of the changes proposed in the President’s Budget Request, see NACCHO’s analysis here.)

While the Senate Appropriations Committee vote is an important step toward getting FY26 funding passed into law, there are still many to go in the process. Notably, the House Labor-HHS Appropriations Subcommittee has not yet released its bill and is not scheduled to consider it until September. Currently, both the House and the Senate are in August recess with plans to return to Washington, DC in September, leaving little time to finalize a FY26 appropriations package ahead of the September 30 fiscal year deadline. It is very likely that Congress will need to pass a Continuing Resolution (CR) to push the funding deadline and avert a government shutdown. 

Centers for Disease Control and Prevention (CDC)

The Senate proposal would fund the CDC at $9,152,090,000, which would be a slight decrease from $9,222,090,000 (-$70 million or >1%) from FY25 CR funding levels.

Under the Senate proposal, some key programs for local health departments would receive level funding or slight decreases in funding from FY25: 

• Public Health Infrastructure and Capacity, $350 million (no change)
• Public Health Data Modernization, $160 million ($15 million decrease from FY25)
• Public Health Emergency Preparedness Cooperative Agreements, $735 million (no change)
• 317 Vaccine Program, $681.9 million (no change)

Administration for Strategic Preparedness and Response (ASPR)

The Senate bill includes $3.617 billion for ASPR, a decrease from $3.634 billion (>1%) in FY25. 

• Medical Reserve Corps program at $6.24 million (no change)
• Hospital Preparedness Program at $309 million (+$4 million from FY25)

Health Resources and Services Administration (HRSA)

The Senate bill includes $8.86 billion in discretionary funding for HRSA, a slight decrease from $8.9 billion in FY25. Within HRSA, the bill would provide level-funding for the Ryan White HIV/AIDS program at $2.57 billion and maintains level-funding for the Ending the HIV Epidemic Initiative at FY25 levels. Unfortunately, no funds were included for the Public Health Workforce Loan Repayment Program, a key NACCHO priority.

Substance Abuse and Mental Health Services Administration (SAMHSA)  

The Senate bill includes $7.4 billion in funding for SAMHSA, which is level funding compared to the final FY25 continuing resolution.

Committee Report Language  

Along with the specific funding allocations, committee report language gives context to the funding decisions and shows Congress’ intent and expectations for the use of federal funds. The accompanying report included language championed by NACCHO to strengthen local public health:

• Local Public Health Departments (CDC)—The Committee notes that Federal funding intended for both State and local health departments does not consistently reach local health departments beyond those directly-funded. The Committee encourages CDC to require States to fund local health departments when programmatically appropriate.
• Public Health Infrastructure and Capacity (CDC)—The Committee includes $350,000,000 in public health funding that is not segmented by disease, condition, activity. Rather, it is provided for cross-cutting, core public health infrastructure needs, including but not limited to workforce, health information and data systems, public health policy and communications, financial management, community partnership development, and organizational capacity. By providing maximum flexibility, this funding will allow public health agencies to determine and address their greatest needs and build core capabilities that will strengthen and support new and existing programmatic functions. The Committee again directs that no less than 70 percent of this funding be awarded to health departments. The Committee encourages CDC to strengthen infrastructure in local health departments by continuing to directly award funds to local health departments, and by urging State health department recipients to allocate resources to local health departments. The Committee urges CDC to publicly track and report to the Committee how funds provided to State health departments are passed through to local health departments.
• Public Health Data Modernization Initiative [DMI] (CDC)—The Committee commends CDC’s work to advance public health data modernization and acknowledges that efforts to enhance public health data system capabilities will result in fast and more reliable data sharing. The Committee provides continued funding for CDC to continue bringing together State, Tribal, local and territorial public health jurisdictions and public and private sector partners with the goal of establishing modern, interoperable, and real-time public health data and surveillance systems to protect the American public. The Committee recommends CDC ensure that funding from DMI is allocated to jurisdictions through the National Center for Health Statistics to support necessary upgrades to their vital statistics systems to enable more, better, and faster vital records data. The Committee requests a briefing within 90 days of enactment of this act on the progress and plans for programs and activities supported by DMI funding. The Committee directs HHS to prioritize CDC data modernization and IT projects, focusing on improving enterprise capabilities and infrastructure. The Committee further directs HHS to continue to provide quarterly reports for all ongoing projects.

In response to recent actions by the Administration and delays in FY25 funding, the committee report includes responses from the Senate Appropriations Committee. This report language is a reflection of the collective efforts of local health departments who shared how administrative changes were impacting their communities with their federal elected officials. Some examples relevant to the work of local health departments are included below.

• Payment Management System [PMS] (HHS)—The Committee notes with concern reports of payment delays and disruptions from the PMS, which can cause significant challenges and inefficiencies for states and local organizations administering Federal programs. Within 30 days of enactment of this act, the Committee directs HHS to brief the Committees on the status of the PMS and any technical improvements that HHS has made to improve payees ability to use the PMS to access funds in a timely manner. The Committee further directs HHS to immediately notify the Committees of any PMS outages or technical problems exceeding 48 hours, and any payment delays or disruptions in the PMS distribution of funds exceeding 14 days for individual payees, including any delays resulting from Executive Order 14158 or Executive Order 14222.
• CDC Technical Expertise (CDC)—The Committee recognizes CDC’s unique public health expertise, which allows the agency to provide technical assistance, data, and research to States, communities, and international partners. The Committee encourages CDC to continue efforts that support strengthening public health across its wide range of programs including preventing and responding to infectious diseases, injury prevention and control, and addressing chronic illnesses. As such, section 238 requires the Secretary to submit a detailed plan and justification to the Committees on Appropriations prior to initiating a reorganization or transfer of functions carried out by CDC. Additionally, the Committee notes the number of political appointees at CDC has increased significantly and further notes the importance of maintaining staff with the technical expertise to support the agency’s mission to protect the health, safety, and security of the American people.
• Childhood Lead Poisoning Prevention (CDC)—The Committee includes $51,000,000 to prevent and mitigate childhood lead exposure and expand the data capabilities of the program to rapidly identify and address emerging threats in communities with elevated risk of exposure to lead. CDC is expected to support local capacity to improve the health of children through efforts to eliminate lead from their environment. Additionally, the Committee is disappointed by the recent upheaval in the Childhood Lead Poisoning Prevention Program, caused by the terminations of the entire branch’s staff, before those terminations were reversed months later. The funding provided in this act is intended to support the program’s activities as they existed in fiscal year 2024. As such, CDC is directed to continue providing funding and technical support to health departments for identifying, tracking, and responding to lead exposures in children; maintaining the blood lead surveillance system; developing and updating guidance and training for health departments and healthcare providers to support lead poisoning prevention efforts; and offering technical assistance for lead exposure events, including through the deployment of CDC Childhood Lead Poisoning Prevention branch staff to localities requesting assistance after a lead exposure event.
• Opioid Overdose Prevention and Surveillance (CDC)—The Committee notes that recent data shows a reduction in deaths from drug overdoses, including from dangerous opioids like fentanyl. While the data is trending in the right direction, the Committee is concerned that this progress could be interrupted by the delay in the release of funding for overdose prevention efforts, which help State and local health departments have the capacity to prevent deaths from overdoses. The Committee directs CDC to issue timely awards for this program and to provide a briefing to the Committees within 60 days of enactment on the Overdose Data to Action program, including how States have used the funding to reduce overdose deaths.

Where the President’s Budget Request for FY26 makes meaningful changes from previous proposals, we noted those differences in the chart using asterisks. More information is below.

*Previously supported through the Prevention and Public Health Fund, which is eliminated under this proposal. 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 Center for Preparedness and Response would include the following programs formerly in the Administration for Strategic Preparedness and Response (ASPR): National Disaster Medical System, Preparedness and Response Innovation, and Health Care Readiness and Recovery, totaling $99 million under the PBR.

*** The FY 2026 PB 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. 

NACCHO Blog: White House Releases Additional Details for the Fiscal Year 2026 President’s Budget Request

FY26 LHHS Bill Summary

FY26 LHHS Bill Text

FY26 LHHS Senate Report

FY26 LHHS Adopted Amendments

FY26 LHHS CDS