‘It is astonishing’: Congress rebuffs Trump push to slash $33B from health, human services

U.S. Secretary of Health and Human Services Robert F. Kennedy Jr. speaks during a policy announcement event at the U.S. Department of Health and Human Services on Jan. 8, 2026 in Washington, DC.  (Photo by Anna Moneymaker/Getty Images)

WASHINGTON — Congress has approved the first public health funding bill since President Donald Trump began his second term, with lawmakers largely rejecting his proposed spending cuts and the elimination of dozens of programs. 

A bipartisan group of negotiators instead struck a deal to increase funding on several line items within the Department of Health and Human Services’ annual appropriations bill, including for major initiatives at the National Institutes of Health and the Centers for Disease Control and Prevention. 

“When you look at the differences between what was proposed and what was agreed to, it is astonishing,” House Appropriations Committee ranking member Rosa DeLauro, D-Conn., said during a hearing on the bill in late January.

The Trump administration’s budget request, released in May, called on Congress to cut funding for the Department of Health and Human Services by $33 billion, or 26.2%.

The president asked lawmakers to implement an $18 billion funding cut to the NIH, which he argued would bring the agency in line with the Make America Healthy Again agenda. 

The Trump administration proposed a $3.6 billion cut for CDC programs, including the elimination of the National Center for Chronic Diseases Prevention and Health Promotion, National Center for Injury Prevention and Control, and Public Health Preparedness and Response, all of which it said could “be conducted more effectively by States.”

The budget request said more than $1 billion should be cut from the Substance Abuse and Mental Health Services Administration, though it said the administration was “committed to combatting the scourge of deadly drugs that have ravaged American communities.”

Trump also requested lawmakers zero out any funding for the Low Income Home Energy Assistance Program, or LIHEAP, which he deemed “unnecessary.” The federal program helps millions of low-income households meet their home energy needs, via states and tribes.

The final spending bill Congress approved rejected nearly all of the major cuts. 

Collins, Murray both praise final product

Senate Appropriations Committee Chairwoman Susan Collins, R-Maine, said the bills “reflect months of hard work and deliberation and contributions from members of both parties and on both sides of the Capitol.”

“Funding for NIH is not decreased, as was proposed in the administration’s budget,” she said. “Rather, it is increased by $415 million, including increases of $100 million for Alzheimer’s research and $10 million more for diabetes research, with a focus on type 1 diabetes.” 

Collins also touted an increase in “funding for low-income heating assistance, which is absolutely crucial for states like Maine and is an issue that I have worked for years on with my Democratic colleague Jack Reed of Rhode Island.”

Senate Appropriations Committee ranking member Patty Murray, D-Wash., said the difference between Trump’s budget request and the final bills was like the difference between “night and day.”

“Our bill rejects President Trump’s asks to rubber stamp his public health sabotage,” she said. “Instead, it doubles down on lifesaving public health investments. It rejects Trump’s efforts to slash opioid response funds. It rejects his proposal to chop the CDC in half. It rejects his call to end programs like title X, the teen pregnancy program, essential HIV initiatives, and more.” 

Rare bipartisan agreement in Trump’s second term

Senators from both political parties indicated last summer they weren’t fully on board with Trump’s budget proposal and used a hearing with HHS Secretary Robert F. Kennedy Jr. in May and a separate hearing with NIH Director Jay Bhattacharya in June to highlight their concerns. 

The Senate Appropriations Committee approved its HHS spending bill on a broadly bipartisan vote in July, while the House Appropriations Committee approved its funding bill in September without any Democratic support.

Neither of the original bills went to the floor for debate and amendment votes, though negotiations to find compromise on a final bill began late last year after the record-breaking government shutdown ended in November. 

Republicans and Democrats brokered a final agreement on the HHS funding bill in late January, the first time bipartisan agreement was reached during Trump’s second term. 

Congress previously approved a series of stopgap spending bills to keep HHS up and running, mostly on funding levels and policies last set during the Biden administration. 

The House originally voted on Jan. 22 to send the package that included funding for HHS to the Senate. But it stalled after federal immigration agents shot and killed a second U.S. citizen in Minnesota and Democrats demanded changes to the spending bill for the Department of Homeland Security. 

The Senate voted 71-29 on Jan. 30 to send the package back to the House after removing the full-year DHS spending bill and replacing it with a two-week stopgap. The House then voted 217-214 on Tuesday to clear the package for Trump, who signed it later in the day, ending a four-day partial government shutdown.  

The package also holds funding for the departments of Defense, Education, Housing and Urban Development, Labor, State, Transportation and Treasury. 

‘Months of hard work turned into results’

House Appropriations Chairman Tom Cole, R-Okla., said during floor debate last month the process that led to the final bills proved lawmakers “can make tough decisions.”

“This is where months of hard work turned into results,” Cole said. “You see, we aren’t here for just another stopgap temporary fix. We’re here to finish the job by providing full-year funding and specifically this package addresses core areas of national consequence — defense; labor, health and education; and transportation and housing development.”

Congress is supposed to pass the dozen full-year appropriations bills by the start of the fiscal year on Oct. 1, though it hasn’t completed all of its work on time in decades. 

Last fiscal year, it didn’t complete its work at all, making March 2024 the last time Congress approved all of the funding bills. 

Cole said during debate the programs funded “aren’t abstract concepts on a page, they affect how Americans live, work, learn and travel every day.”

DeLauro said the package of bills represents “a strong bipartisan, bicameral agreement that rejects the Trump administration’s efforts to eviscerate public services and reasserts Congress’ power of the purse.”

“It provides funding levels, removing ambiguity that the White House sought to exploit in the past,” DeLauro said. “It establishes deadlines for required spending, provides minimum staffing thresholds to prevent agencies from being hollowed out and increases notification requirements to ensure the administration is complying with the laws that Congress makes.” 

HHS ends up with $210 million bump

The bill provides HHS with more than $116 billion, $210 million more in discretionary funding than the previous level and a rejection of Trump’s request to cut $33 billion, according to a summary from Murray’s office. 

NIH will receive $48.7 billion in funding, $415 million more than its current spending level, showing that lawmakers were unwilling to slice its budget by $18 billion as requested. 

Congress bolstered funding for the Substance Abuse and Mental Health Services Administration by $65 million to a total of $7.4 billion, according to Murray’s summary. Trump asked lawmakers to reduce its allocation by more than $1 billion. 

A $3.6 billion funding cut for the CDC was also rejected, with appropriators agreeing to provide the Atlanta-based agency with $9.2 billion.

A summary of the bill from DeLauro’s office says negotiators were able to keep funding for domestic and global HIV/AIDS activities, Firearm Injury and Mortality Prevention Research and Tobacco Prevention and Control, among other programs that House Republicans originally proposed to zero out. 

The legislation bolstered, instead of eliminated, funding for the Low Income Energy Assistance Program, or LIHEAP, according to a summary from Cole’s office. 

The bill, it said, “reprioritizes taxpayer dollars where they matter most: into lifesaving biomedical research and resilient medical supply chains, classrooms and technical programs that set Americans up for success, and rural hospitals and primary health care to support strong and healthy families.”

CDC program axed

The legislation does eliminate the CDC’s Social Determinants of Health program, which the agency’s website states are “nonmedical factors that influence health outcomes.” Those can include whether a person has access to clean air and water, a well-balanced diet, exercise, a good education, career opportunities, economic stability and a safe place to live.

HHS’ Office of Disease Prevention and Health Promotion writes that “people who don’t have access to grocery stores with healthy foods are less likely to have good nutrition. That raises their risk of health conditions like heart disease, diabetes, and obesity — and even lowers life expectancy relative to people who do have access to healthy foods.” 

Cole’s summary of the HHS spending bill says that program “promoted social engineering while distracting grant recipients from combating infectious and chronic diseases.” 

The American Public Health Association urged Congress to approve the bill, writing in a statement the compromise “rightly maintains funding for most public health agencies and programs.”

“While the bill is not perfect and we disagree with cuts to several HHS agency programs included, overall, the agreement rejects the devastating cuts and nonsensical agency reorganizations proposed by the Trump administration and is a positive outcome,” APHA wrote. “Importantly, the bill also includes language to ensure that CDC and other health agencies maintain an adequate level of staffing to carry out their statutory responsibilities. 

“The bill will also ensure that Congress exercises its oversight over any future proposed agency reorganizations.”