Policy Updates: Hill Happenings and Administration Activities
Hill Happenings
FY2026 Appropriations & Budget Reconciliation
On April 10, the House of Representatives approved a Senate-backed budget resolution, unlocking the budget reconciliation process for Fiscal Year 2026 (FY2026). Congressional Republicans will now leverage reconciliation to draft a landmark spending package that advances the Trump Administration’s policy priorities via a simple majority, including tax cuts for certain earners, increased defense spending, and scaling up immigration enforcement. The Republican Congressional caucus is aiming to pass the spending package quickly, but negotiations on the budget resolution sidestepped bicameral disagreements on spending and policy priorities, which could delay the approval of a final package until an agreement is reached. Democrats will have limited opportunities to block the reconciliation package if the Republican caucus is able to build consensus for a single, identical bill in both chambers.
On April 9, the House Appropriations Committee held the public witness day for the Labor, Health and Human Services, Education, and Related Agencies (LHHS) programs. Public health experts testified before the Committee on the importance of strong federal funding, including representatives for state and territorial health officials and epidemiologists and HIV researchers and providers. NASTAD submitted comments highlighting the essential role of state and local health departments in the nation’s HIV and viral hepatitis prevention and surveillance activities and the coordinating role of the Centers for Disease Control and Prevention (CDC). Additionally, on April 10, Senate Appropriations Committee leaders released FY2026 programmatic guidance for member requests and subcommittee deadlines. The Senate will mirror House deadlines for LHHS programs, requiring subcommittee programmatic funding requests by May 23.
NASTAD will continue to monitor the congressional appropriations process and advocate for the highest possible funding for HIV, hepatitis, and drug user health programs.
House Energy & Commerce Committee Holds Staff Briefing on HHS Changes
On April 11, health officials from the Department of Health and Human Services (HHS) briefed House Energy & Commerce (E&C) Committee staff on the agency’s sprawling reorganization and reduction in force (RIF) plans that went into effect on April 1. E&C Democrats urged Chair Guthrie (R-KY-02) to hold a committee-level hearing and invite HHS Secretary Robert F. Kennedy, Jr., but Republicans have been reluctant to publicly pressure the HHS Secretary to attend. On April 1, the Senate Health, Education, Labor, and Pensions (HELP) Chair and Ranking Member invited RFK to testify at a hearing before the Committee on April 10, but the Secretary did not accept the invitation and has yet to confirm whether he would participate in a future HELP Committee hearing.
Senate Budget Committee Ranking Member Demands OMB Release Documents Related to Federal Reduction in Force Plans
On April 7, Senate Budget Committee Ranking Member Jeff Merkley (D-OR), sent a letter to the Director of the White House Office of Management and Budget (OMB) demanding that the agency turn over all documents related the reduction in force directives impacting federal agencies and operating divisions, including HHS. The Ranking Member highlighted the negative impacts of destabilizing the infrastructure at federal agencies, disruptions to services and programs coordinated by the federal government, and the risks to the nation’s public health capacity. Sen. Merkley requested that OMB turn over the information by April 14.
NASTAD Calls on Appropriators to Provide Strong Funding for CDC, NIH Programs in FY2026 Spending Package
On April 18, NASTAD and the AIDS Budget and Appropriations Coalition (ABAC), a work group of the Federal AIDS Policy Partnership (FAPP), called on Congress to increase funding for domestic HIV/AIDS programs in FY2026. 155 organizations signed onto the letter, which raised concerns about the Trump Administration’s changes to HIV programs across HHS offices and operating divisions, including ending grants and contracts for HIV research, laying off key staff at HHS, and eliminating funding for several HIV programs. The coalition called for strong funding in FY2026 for the cross-agency Ending the HIV Epidemic Initiative, HIV programs coordinated under HHS and its operating divisions like CDC and the Health Resources and Services Administration (HRSA), the Ryan White HIV/AIDS Program, and other HIV programs operated by partner agencies like the Department of Housing and Urban Development and National Institutes of Health.
Additionally, on April 9, NASTAD and the CDC Coalition called on appropriators to provide strong funding for HIV and related health programs housed under the Centers for Disease Control and Prevention (CDC). 219 organizations signed the letter, requesting at least $11.581 billion for FY2026 and urging lawmakers to reject any efforts to cut funding or dismantle critical CDC centers or programs. The coalition highlighted the important role of CDC funding to support public health and prevention activities through state, tribal, local and territorial health organizations and agencies and national public health partners and academic institutions, including outbreak detection and epidemiological surveillance, chronic disease prevention, and health promotion.
And on April 7, NASTAD joined a coalition of over 55 organizations and called on Congress to provide strong funding for the National Institutes of Health (NIH) National Institute of Allergy and Infectious Diseases (NIAID). The coalition highlighted NIAID’s essential role in addressing a wide range of conditions affecting public health, including cancer, HIV/AIDS, tuberculosis, and other neglected diseases. Research coordinated by NIAID includes cutting-edge efforts to uncover the links between infectious diseases and chronic conditions, including HIV and hepatitis C. Notably, NIAID-funded research transformed HIV from a fatal to a chronic condition with the development of antiretroviral agents that suppress HIV to undetectable levels in the body.
Administration Activities
OMB Budget Document Reveals Deep Cuts Planned for FY2026
On April 17, a draft copy of the Department of Health and Human Services (HHS) FY2026 Discretionary Budget passback became public, which details the Administration’s plans to further reorganize HHS and cut about one third of its discretionary budget. If passed by Congress, the budget would dramatically restructure offices and operating divisions across HHS and eliminate many programs, including the CDC Division of HIV Prevention, Ending the Epidemic funding across the government, all funding for Part F of the Ryan White/HIV AIDS Program, Minority AIDS Initiative Funding, and a significant amount of SAMHSA Substance Abuse Treatment Programs of National and Regional Significance. In addition, the budget would create a block grant structure for Viral Hepatitis, Sexually Transmitted Infections, Tuberculosis, and Opioid and Infectious Diseases funding. Lastly, the document provides more details on programs that will be coordinated under the new HHS entity, the Administration for Health America (AHA), including an HIV/AIDS Branch. The HIV/AIDS Branch will contain the Ryan White HIV/AIDS Program Parts A through D at level funding and some funding for the Office of Infectious Disease and HIV/AIDS Policy, which was formerly under the Office of the Assistant Secretary. There is no funding for HIV prevention included in this branch.
The official President’s Budget proposal is expected to be released in May and will serve as a framework for Congress to negotiate and approve federal spending levels through the yearly appropriations process. Congress holds the power of the purse and will need to pass legislation to fund the government. NASTAD is already advocating on behalf of our programs in light of these changes and will fight hard to maintain funding. As of right now, there are no changes for current funding. NASTAD will continue to provide updates on this situation and provide an updated analysis when the President’s Budget Request is released.
CDC Releases 2023 Viral Hepatitis Surveillance Report and 2025 National Progress Reports
On April 17, CDC published two annual reports on hepatitis A, hepatitis B, and hepatitis C surveillance and mortality data, the Viral Hepatitis Surveillance Report – United States, 2023 and 2025 Viral Hepatitis National Progress Report. The 2023 surveillance report captures data from reported hepatitis cases during January 1, 2023–December 31, 2023, and includes the following key takeaways:
- After annual increases during 2015–2019, the rate of hepatitis A decreased 91% from 2019–2023.
- After nearly a decade of stable rates of acute hepatitis B from 2011–2019, a decrease was observed from 2019–2020, and rates have remained relatively stable through 2023.
- Following a decade of increasing rates of acute hepatitis C from 2011–2020, the rate has remained relatively stable from 2020–2023.
The yearly viral hepatitis surveillance report is an essential component of the planning, implementation, and evaluation activities conducted by the CDC Division of Viral Hepatitis and HHS Office of Infectious Disease Policy, which coordinates the Viral Hepatitis National Strategic Plan. Additionally, the yearly viral hepatitis national progress report evaluates progress made toward reaching the goals set in the Strategic Plan over previous calendar years. For the 2025 report, which captures data from 2023, the progress report shows:
- The goal of reducing HAV cases by at least 40% was met
- The goal of reducing new HBV cases by at least 20% was met, including a reduction of at least 25% among people who inject drugs (PWID)
- The goal of reducing HCV mortality by 20% was met, including a reduction of at least 30% among non-Hispanic Black persons
- There was stalled progress on reducing new cases of HCV, including among PWID. Additionally, the goal of reducing HCV mortality among non-Hispanic American Indian/Alaska Native persons by at least 30% was not met.
Resources
JAMA: Use of No-Cost Preventive Services Jeopardized by Kennedy v Braidwood
“Nationally, the most widely received services were screenings for cervical cancer (23.6 million), hepatitis C virus infection (11.1 million), and HIV infection (10.5 million). Across states, proportions of enrollees receiving no-cost services ranged from 20.5% to 38.5% (Table 2). Thirteen states had at least 1 million no-cost service recipients, including more than 3 million in Texas, where Braidwood originated.”
Advocates for Youth: Youth Activist Network Application 2025
Deadline: May 1
“Join our Youth Activist Network (YAN) to be one of over 100 youth activists aged 14-24 who receive training, support, and stipends to organize for bodily autonomy, reproductive justice, and sexual health & rights in your community! Those accepted will receive in-depth training at our all-expenses-paid Youth Activist Institute in Washington D.C. from Thursday, September 4th - Sunday, September 7th, 2025.”
“Overdose deaths involving both synthetic opioids and stimulants have increased sharply in recent years. Although some persons who co-use opioids and stimulants have cited motivations related to functionality and alertness in the workplace, occupational patterns of co-use remain uninvestigated. In this exploratory analysis of multiple cause of death data from 2022, occupations and industries with higher percentages of psychostimulant involvement in synthetic opioid overdose deaths tended to be physically demanding, whereas those with higher percentages of cocaine involvement tended to be less so.”
PrEP in Black America: Advancing the Movement: HIV Prevention Research for Black Communities
“Advancing the Movement: HIV Prevention Research for Black Communities is more than a report—it is a call to action, a cultural archive, and a love letter to Black communities across this nation. It represents the journey of listening, learning, and leading. In a time where uncertainty clouds our path forward in the fight against HIV, this report brings clarity, hope, and a fresh blueprint grounded in the lived realities and brilliance of Black people.”
GU O’Neill Institute: HIV Research Matters for America
“Since the beginning of this Trump administration, the assertion of new priorities and efforts to reduce federal spending have produced chaos at the NIH. The administration’s changes have been abrupt, arbitrary, and remain unpredictable. With NIH Director Bhattacharya now confirmed by the U.S. Senate, it is hoped that he can reassert NIH standards of evidence-based analysis and scientific leadership for setting research priorities and funding critical studies. HIV research supported by the NIH extends hope, improves lives, and helps the nation to avert unnecessary health spending. It is vital to our national interest to not unravel or undermine the successful HIV research system we have built and to continue making critical investments now and into the future.”
KFF: What Do Federal Staffing Cuts and HHS Restructuring Mean for the Nation’s HIV Response?
“On March 27th, the Trump administration announced that the U.S. Department of Health and Human Services (HHS) would implement “a dramatic restructuring” in accordance with President Trump’s Executive Order, “Implementing the President’s ‘Department of Government Efficiency’ Workforce Optimization Initiative.” This included plans to reduce the Department’s workforce by 10,000 employees. As a result, thousands of federal HHS employees were given “reduction in force” announcements (or RIFs) or otherwise learned that their roles had been eliminated when they were denied access to their offices. Others were offered reassignments. In addition, several HHS offices and functions have reportedly been reduced or ended. These actions seem to be particularly focused on the federal government’s work on HIV and have the potential to negatively affect the nation’s HIV response.”
Latino Commission on AIDS: HIV Trends and Inequities Among U.S. Hispanics
“The Latino Commission on AIDS and the Hispanic Health Network have released a critical report, HIV Trends and Inequities Among U.S. Hispanics, highlighting alarming increases in new diagnoses, stagnant viral suppression rates, and persistent geographic disparities. The report underscores the urgent need for comprehensive interventions to address structural inequities disproportionately impacting Hispanic communities across the U.S., Puerto Rico, and the U.S. Virgin Islands.”
Hepatitis C Mentor and Support Group Webinar: Hep C Stigma – From the Clinic to the Streets
Date: Tuesday, April 22 from 5-6 pm ET
“HCMSG will host a webinar focusing on stigma and hepatitis C. Learn how providers work with their hepatitis C patients experiencing stigma across various populations.”
Job Postings
Executive Director of Programs – New York City, NY
The New York City Health Department is seeking an Executive Director of Programs to join its Bureau of Hepatitis, HIV, and STIs (BHHS). The Executive Director of Programs will provide day-to-day oversight and operational support to BHHS’s HIV Care and Treatment Program, HIV Epidemiology Program, HIV Prevention Program, STI Program, and Viral Hepatitis Program, which comprise the majority of the bureau’s staff. The Executive Director of Programs will report to BHHS’s Assistant Commissioner and work alongside the Assistant Commissioner and BHHS leadership to ensure these Programs are supported to function optimally and collaboratively, and that BHHS is well-positioned to implement its strategic priorities and achieve its mission to improve the lives of New Yorkers by ending transmission, illness, stigma, and inequities related to viral hepatitis, HIV, and STIs. For more information or to apply for the position, visit the job posting on NYC Jobs, here.
Communicable Disease Epidemiologist – Cheyenne, Wyoming
This position will serve as the Communicable Disease AIDS Drug Assistance Program (ADAP) Coordinator, Wyoming TB Controller, and Disease Intervention Specialist (DIS) for the Communicable Disease (CD) Treatment Program. Assist in outbreak response to ensure the safety of Wyoming residents; by interviewing cases for exposure information, updating news outlets on the progress of outbreak control, analyzing exposure data utilizing epidemiological and statistical methods.
News Bulletin
In the middle of a hepatitis outbreak, U.S. shutters the one CDC lab that could help
“But on April 1, the outbreak investigation was brought to a halt. All 27 of the lab's scientists received an email from the U.S. Department of Health and Human Services informing them that they were losing their jobs. Like thousands of other employees who received similar emails that day, the scientists were told they would be placed on administrative leave until June 2, after which they would no longer work for the CDC.”
Officials of Atlanta-based CDC plan for the agency's splintering, but questions remain
“A top Centers for Disease Control and Prevention official told staff this week to start planning for the agency’s splintering. Several parts of CDC — mostly those devoted to health threats that aren’t infectious — are being spun off into the soon-to-be-created Administration for a Healthy America, the agency official told senior leaders in calls and meetings. The directive came from Dr. Debra Houry, the agency’s chief medical officer, according to three CDC officials who were in attendance. They declined to be identified because they weren’t authorized to talk about the plans and fear being fired if they were identified.”
Trump says ‘major’ pharmaceutical tariffs on the way
“President Donald Trump said Tuesday that pharmaceutical imports will soon be hit with “major” tariffs as part of his efforts to drive manufacturing back to the U.S. Drug imports evaded the first round of tariffs that Trump imposed on countries around the world, but the president said they will not be spared.”
Misinformation About Fentanyl Exposure Threatens To Undermine Overdose Response
“Fentanyl, the deadly synthetic opioid driving the nation’s high drug overdose rates, is also caught up in another increasingly serious problem: misinformation. False and misleading narratives on social media, in news reports, and even in popular television dramas suggesting people can overdose from touching fentanyl — rather than ingesting it — are now informing policy and spending decisions.”
How Trump 2.0 is slashing NIH-backed research — in charts
“Nature’s analysis shows that, looking at just the projects terminated so far, 17% are related to COVID-19, and 29% to HIV/AIDS (see ‘Terminated grant tally’) — although this represents less than 4% of all the grants awarded to each of those topics that the agency funded in 2024…The scientific fields hit hardest by the NIH’s cuts are those related to the health of transgender people, and the broader LGBT+ community, where around half of grants have been cut compared with what the NIH funded in 2024 (see ‘Fields under fire’).”