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HHS Overhaul: Streamlining for a “Healthier America,” But at What Cost?
The Department of Health and Human Services (HHS) has unveiled a sweeping budget proposal for the 2026 fiscal year, a plan that would consolidate the department’s current 28 divisions into 15. This restructuring paves the way for a new agency, the Administration for a Healthy America (AHA), and a significant reallocation of resources.
The AHA, armed with a $20.6 billion budget, is the cornerstone of Health Secretary Robert F. Kennedy Jr.’s “Make America Healthy Again” initiative.
The agency will absorb numerous programs currently under the Centers for Disease Control and Prevention (CDC) and the National Institutes of Health (NIH), including those focused on chronic disease and global health. However, this consolidation comes with substantial budget cuts to these existing programs.
While the AHA emphasizes a “root cause” approach to chronic disease prevention, the proposed budget eliminates the CDC’s chronic disease center entirely, diverting a portion of its funding to the AHA. This shift raises concerns about the impact on state and local health departments, which rely heavily on CDC funding for their community health initiatives. Experts also question whether the AHA can effectively replicate the CDC’s expertise and infrastructure, particularly in areas like infectious disease response.
The NIH also faces a significant reduction in funding, approximately 40%, with several agencies, including the Substance Abuse and Mental Health Services Administration and the Health Resources Service Administration, slated for dissolution. HHS defends these cuts as necessary reforms to address the nation’s high healthcare costs and improve health outcomes. However, critics argue that dismantling established programs could jeopardize decades of progress in public health.
One of the most contentious aspects of the budget proposal is the elimination of the CDC’s Center for Chronic Disease Prevention and Health Promotion. While the AHA will fund programs related to primary care, environmental health, mental health, and nutrition, numerous health organizations have expressed strong opposition to this change, fearing it will destabilize public health systems.
The CDC’s Global Health Center also faces elimination, with its functions consolidated under a broader CDC budget line. This decision has drawn criticism given the ongoing global health challenges and the importance of international collaboration in preventing and controlling outbreaks.
The AHA will also consolidate federal HIV/AIDS prevention and research efforts, absorbing programs from various agencies but with an overall funding decrease compared to the previous fiscal year. Other CDC centers focused on birth defects, developmental disabilities, injury prevention, and occupational safety and health will also be moved under the AHA umbrella.
The proposed budget now faces congressional scrutiny, with subcommittees set to review the plan before the House and Senate develop their own budget resolutions later this year. The debate surrounding this ambitious restructuring of the HHS is likely to continue as lawmakers weigh the potential benefits and drawbacks of this significant shift in public health priorities and funding.