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What the request contains
Released April 3, the request seeks $111.1 billion in HHS discretionary funding, $15.8 billion or 12.5% less than in fiscal 2026. That cut is much smaller than the $94.7 billion reduction the administration requested a year ago. The plan again proposes an Administration for a Healthy America that would combine HRSA, SAMHSA and some CDC functions. Congress did not act on that idea last year.
The request also calls for reductions at NIH, AHRQ and ASPR. It includes no major Medicare or Medicaid policy proposals but stresses program integrity, with $976 million in discretionary funding for that work, up $35 million, including $740 million for CMS. HHS says Medicare program integrity activities returned more than $14 for every dollar spent in fiscal 2024. Budget hearings begin next week, and HHS Secretary Robert F. Kennedy Jr. is expected to testify before several committees.
Exposure points for hospitals
- Research. Academic medical centers that depend on NIH grants face continued uncertainty about award levels and indirect cost support.
- Preparedness. ASPR supports hospital emergency preparedness. Reductions could affect regional coalitions and surge planning.
- Workforce and rural programs. HRSA funds training and rural grants that many hospitals use. A reorganization could disrupt grant cycles even if total dollars hold.
- Audits. More program integrity money means more reviews. Documentation and billing compliance deserve attention now.
How to read a budget request
A presidential budget is a statement of priorities, not law. Congress writes the appropriations bills and did not act on the proposed consolidation last year. Even so, requests shape agency planning, signal enforcement priorities and set the starting point for negotiations that may run past Oct. 1.
Leaders should ask finance teams to list every federal grant the organization depends on, the agency that awards it and the renewal date. That inventory makes it possible to model losses quickly if appropriations follow the request. Government relations teams should coordinate with state and national hospital associations ahead of the hearings, where members will press HHS on the proposed cuts.
Archive entry for Apr 7, 2026, added Nov. 11, 2026.