The preliminary memo, sent from White House budget officials to the Department of Health and Human Services, previews the administration’s plans to slash discretionary federal health spending and rework health agencies in the image of President Donald Trump and HHS Secretary Robert F. Kennedy Jr’s “Make America Healthy Again” mandate.
The document, dated April 10, could still be finalized with changes. If enacted as is, it could cut total federal health spending by tens of billions of dollars a year. It would also consolidate dozens of health programs and departments into the Administration for a Healthy America (AHA), a new entity unveiled by Kennedy during mass layoffs earlier this month.
The plan calls for steep cuts to the Centers for Disease Control and Prevention, which would see its budget reduced by more than 40% under the administration’s proposal.
It also eliminates CDC’s global health center and programs focused on chronic disease prevention, and domestic HIV/AIDS prevention. While some of the agency’s work would be moved into new AHA centers, programs on gun violence, injury prevention, youth violence prevention, drowning, minority health and others would be eliminated entirely.
Many of the staff in those CDC departments were laid off in the mass reduction-in-force announcements on April 1.
The proposal would also eliminate a number of rural health programs at HHS, including grants and residency programs for rural hospitals and state offices. Other rural health efforts, such as black lung clinics, would remain but be housed in the new AHA’s primary care department.
The proposed cuts could provide a blueprint for Republicans looking to slash federal spending. The president will send his budget request to Congress, which is wrangling over Republican plans to reduce the federal budget by up to $1.5 trillion.
The Washington Post first reported on the proposed budget request.
The preliminary plan would slash the National Institutes of Health’s budget by more than 40% and reduce its 27 research institutes and centers down to just eight.
While the National Cancer Institute, the National Institute of Allergy and Infectious Diseases, and the National Institute on Aging would be preserved. Institutes researching childhood illnesses, mental health, chronic disease, disabilities and substance abuse would be shuffled into five new entities: the National Institute on Body Systems, National Institute on Neuroscience and Brain Research, National Institute of General Medical Sciences, the National Institute of Disability Related Research and National Institute of Behavioral Health.
The budget also assumes that the administration’s earlier attempt to cap indirect payments to universities at 15%, blocked by a court, would be in effect. Many of these payments have traditionally helped fund medical research.
While NIH has historically enjoyed bipartisan support for funding increases, there have been growing calls among GOP lawmakers for reform. House Republican leaders proposed last year to consolidate the institutes into 15 entities but also suggested a slight budget increase in that plan.
The proposal would also establish a salary cap for employees hired under Title 42, a National Institutes of Health provision that gives the agency more leeway to hire experts into senior roles. Many top officials, including the now-retired National Institutes of Allergy and Infectious Disease director Anthony Fauci, are hired as Title 42 employees.
This story has been updated with additional reporting.