The White House recently unveiled a more detailed budget proposal that sheds additional light on the Trump administration’s plans to overhaul the Department of Health and Human Services (HHS) in the coming year. The proposal includes significant funding cuts to the National Institutes of Health (NIH).
The revised budget reinforces earlier intentions to reduce the NIH’s funding by nearly half, consolidate HHS’s 28 operating divisions into 15, eliminate numerous federal healthcare and social welfare programs, and end over 5,000 federal contracts.
According to the administration, these changes are aimed at streamlining HHS operations and scaling back initiatives related to diversity, equity, and inclusion—priorities that have faced conservative criticism.
However, the administration cannot enact the proposed budget on its own. Congress holds the power to modify or reject the executive branch’s spending plans through the appropriations process.
6/4/25 Update
Read the most recent update from AJCM in its entirety here.
Key Takeaways from the current budget proposal:
- The proposed budget reduces HHS discretionary funding by $31 billion, with a 40% cut for NIH, marking its lowest funding in decades.
- NIH restructuring consolidates 27 institutes into 8 new entities, aiming to create efficiencies and focus on “true science.”
- Oversight of the 340B drug pricing program shifts from HRSA to CMS, raising concerns about potential reimbursement reductions.
- The FDA faces a $409 million funding cut, yet is tasked with increased inspections and enforcement under the MAHA agenda.
What are the impacts on the epilepsy and rare disease communities from these changes?
The updated budget slashes NIH discretionary funding by nearly $18 billion and outlines a major restructuring of the organization. Of the agency’s current institutes and centers, only 3 would remain intact: the National Cancer Institute, the National Institute of Allergy and Infectious Diseases, and the National Institute on Aging. The rest would be consolidated into 5 new entities in an effort the administration says will “create efficiencies” and allow NIH to focus on “true science.”
More specifically, the NIH’s current 27 institutes and centers would be consolidated into 8 new bodies, which would see reduced funding.1 New NIH bodies would include:
- National Institute on Body Systems, encompassing institutes focused on heart, lung, blood, arthritis, and diabetes
- National Institute on Neuroscience and Brain Research, combining research on neurological, eye, dental, and craniofacial disorders
- National Institute of General Medical Sciences, merging genome research, biomedical imaging, and other general medical work
- National Institute for Child and Women’s Health, Sensory Disorders, and Community, consolidating research on reproductive health and sensory conditions
- National Institute of Behavioral Health, combining institutes focused on mental health, substance use, and addiction
Information provided by the American Journal of Manged Care (AJMC). AJMCÂ is an independent, peer-reviewed publication dedicated to disseminating clinical information to managed care physicians, clinical decision-makers, and other health care professionals.
4/17/25 Update
The Trump administration’s preliminary FY26 budget proposal would reduce the Department of Health and Human Services’ discretionary spending by approximately one-third, from $121 billion to $80 billion, with proposed cuts affecting agencies such as NIH, CDC, and rural health programs. The proposal also outlines agency consolidations and program restructuring, but it remains to be seen how much will be adopted by Congress. For more information, go here.
Information provided by the American Journal of Manged Care (AJMC). AJMCÂ is an independent, peer-reviewed publication dedicated to disseminating clinical information to managed care physicians, clinical decision-makers, and other health care professionals.
