A sweeping federal budget proposal released by the White House on April 4, 2026 would slash public health funding by billions of dollars, eliminate dozens of programs that local and state health departments depend on, and restructure major federal health agencies in ways that advocates warn could undermine the nation’s public health infrastructure for years to come.
The proposed cuts span the Centers for Disease Control and Prevention (CDC), the Administration for Strategic Preparedness and Response (ASPR), the National Institutes of Health (NIH), and other major health agencies. The National Association of County and City Health Officials (NACCHO) published a detailed analysis of the proposal, outlining the specific funding lines most likely to affect local health departments across the country.
CDC Takes the Deepest Cut
The CDC would face a $3.62 billion reduction — approximately 40 percent — under the proposal, falling from $9.147 billion in FY26 enacted funding to $5.486 billion. Even accounting for programs that would be transferred to a newly proposed Administration for a Healthy America (AHA), the net reduction to existing CDC programs would exceed 30 percent.
Key funding lines for local health departments would be significantly affected. Public Health Emergency Preparedness Cooperative Agreements — the primary federal funding mechanism supporting state and local emergency preparedness — would be cut by $385 million, from $735 million to $350 million. Public Health Infrastructure and Capacity funding would fall by $100 million. The Prevention and Public Health Fund, which supports a range of foundational public health activities, would receive no funding allocation under the proposal — consistent with the administration’s stated goal of eliminating it.
The budget also proposes consolidating several infectious disease programs — Viral Hepatitis, Sexually Transmitted Infections, Domestic TB, and Infectious Diseases and the Opioid Epidemic — into a single Consolidated Hepatitis, STD and Tuberculosis Prevention Grant funded at $300 million, representing a combined reduction of approximately $70.3 million from current levels.
One notable increase: the 317 Vaccine Program would receive a $50 million boost, rising to $731.9 million.
The Administration for a Healthy America: Restructuring or Reduction?
Central to the FY27 proposal is the creation of the Administration for a Healthy America (AHA), which would consolidate chronic disease and prevention programs from across the Office of the Assistant Secretary for Health, HRSA, SAMHSA, and CDC. AHA would receive a total of $17.5 billion across discretionary and mandatory funding streams.
However, the migration of programs to AHA comes with significant funding reductions. Chronic Disease Prevention and Health Promotion programs moved from CDC to AHA would see a net cut of roughly $985 million. Injury Prevention and Control programs would face a $173 million reduction. Dozens of programs would be eliminated outright, including the Community Mental Health Services Block Grant ($991.5 million), the Substance Use Prevention, Treatment, and Recovery Services Block Grant ($1.93 billion), State Opioid Response Grants ($1.6 billion), Title X Family Planning, Ryan White Part F, the REACH program, School Health, Tobacco Prevention and Control, and Youth Violence Prevention, among many others.
Preparedness Infrastructure Also at Risk
ASPR would receive $3.337 billion — a decrease of approximately $356 million from FY26. The proposal would eliminate the Hospital Preparedness Program, which provided $307 million in FY26 and funds emergency readiness planning at hospitals and health systems nationwide. The Medical Reserve Corps and the Regional Disaster Health Response System would also be eliminated. The Strategic National Stockpile would see a $61.8 million reduction, and the Biomedical Advanced Research and Development Authority (BARDA) would be cut by nearly $395.5 million.
Congressional Pushback Likely
The president’s budget is a policy statement, not law. Congress retains authority over appropriations, and lawmakers have already demonstrated willingness to push back on similar proposals. The FY26 budget request included many of the same proposed cuts and restructuring measures — most of which were rejected in the final FY26 funding law. The NIH, for example, received a $415 million increase in FY26 despite a White House request to cut it by approximately 40 percent. The CDC also emerged from the FY26 process with its budget largely intact.
Healthcare and research advocacy organizations have moved quickly to oppose the latest proposals. The Association of American Medical Colleges stated the budget “would have far-reaching adverse effects on the future of American health care,” and hundreds of organizations have called for an increased NIH budget of $51 billion.
Why This Matters for Public Health Security
If enacted, the proposed reductions would represent the most significant restructuring of the federal public health system in decades. Cuts to emergency preparedness funding, surveillance infrastructure, and workforce development could directly compromise the nation’s ability to detect, respond to, and recover from disease outbreaks and other public health emergencies. The elimination of programs targeting chronic disease, substance use, maternal health, and HIV — which together represent a substantial share of the U.S. disease burden — could reverse years of public health progress at the community level.
Sources and further reading:
NACCHO Analysis: FY27 President’s Budget Request – National Association of County & Cit Health Officials
Trump proposes cutting billions to health programs in 2027 budget: Questions and answers – Chief Healthcare Executive