Policy Updates: Hill Happenings and Administration Activities
Hill Happenings
FY2026 Appropriations
Congressional Republicans are working to initiate the budget reconciliation process to advance a Fiscal Year 2026 (FY2026) spending package, which is expected to contain significant cuts to federal health programs among other key GOP policy priorities. Senate Leader John Thune (R-SD) is aiming to pass the FY2026 package by the Easter holiday, but a bicameral consensus has not emerged between Senate and House Republicans. Despite the lack of agreement, the Senate is working to introduce a basic budget resolution on April 2 that can recruit enough House support to kick off budget reconciliation while leaving enough flexibility to work out differences across Congressional chambers later in the budget process. Democrats will have limited opportunities to block the reconciliation package if the Republican caucus is able to coalesce their majority behind a single, identical bill in both chambers.
NASTAD will continue to monitor the congressional appropriations process and advocate for the highest possible funding for HIV, hepatitis, and drug user health programs.
Bipartisan Group of Top Appropriators Question Legal Authority for Trump Administration’s Budget Cuts
On March 27, Senate Appropriations Committee Chair Susan Collins (R-ME) and Vice Chair Patty Murray (D-WA) and House Appropriations Committee Ranking Member Rep. Rosa DeLauro (D-CT-03) sent letters to the White House Office of Management and Budget (OMB) expressing concern over the Trump Administration’s decision to unilaterally depart from Congressionally-approved funding levels for certain federal programs. The appropriators warned that withholding funds appropriated by Congress could be unconstitutional and would make it harder for lawmakers to achieve bipartisan funding deals if the government would not be held to the agreed-upon budget.
Senate Confirms FDA Commissioner, NIH Director Nominees
On March 26, the Senate voted to confirm the nominations of Jay Bhattacharya for Director of the National Institutes of Health (NIH) and Marty Makary for US Food & Drug Administration (FDA) Commissioner. Bhattacharya, a professor at Stanford University, will oversee federal health research programs and implement the Trump Administration’s efforts to shrink the nation’s leading health research agency. Makary, a surgeon at Johns Hopkins University, will oversee federal drug and vaccine approvals as FDA commissioner and play a key role in implementing the Trump Administration’s policies on vaccines and reproductive drugs and medical devices.
Administration Activities
HHS Announces More Mass Layoffs as Agency Implements Reorganization and Reduction in Force Plan
On March 27, the US Department of Health and Human Services (HHS) announced that it is operationalizing its plans reduce the federal health workforce and restructure health agencies and operating divisions in accordance with the Executive Order, “Implementing the President’s ‘Department of Government Efficiency’ Workforce Optimization Initiative.” According to agency officials, approximately 10,000 workers across HHS will be laid off, totaling about 20% of the HHS workforce. Notably, the plan includes the termination of all staff at the HHS Office of Infectious Disease and HIV/AIDS Policy (OIDP), the HHS and Centers for Medicare and Medicaid Services (CMS) Offices of Minority Health, and the data and policy staff at the Health Resources and Services Administration (HRSA) Ryan White HIV/AIDS Program (RWHAP).
Additionally, the Administration announced its plans to dramatically restructure the federal health infrastructure and create a new HHS entity, the Administration for a Healthy America, or AHA. Notably, the Trump Administration will:
- Combine the Office of the Assistant Secretary for Health (OASH), Health Resources and Services Administration (HRSA), Substance Abuse and Mental Health Services Administration (SAMHSA), Agency for Toxic Substances and Disease Registry (ATSDR), and National Institute for Occupational Safety and Health (NIOSH) to create AHA
- Transfer the Administration for Strategic Preparedness and Response (ASPR) to the Centers for Disease Control and Prevention (CDC)
- Creates a new Assistant Secretary for Enforcement to oversee the Departmental Appeals Board (DAB), Office of Medicare Hearings and Appeals (OMHA), and Office for Civil Rights (OCR) to combat waste, fraud, and abuse in federal health programs
HHS claims that these changes will centralize core functions such as Human Resources, Information Technology, Procurement, External Affairs, and Policy, and improve HHS’ ability to be responsive and efficient. Public Health experts expressed concern over the potential impact of the workforce cuts and reorganization plan for existing health programs.
Trump Administration Announces HHS Assistant Secretary for Health Nominee
On March 26, the Trump Administration announced that it will nominate Brian Christine for Department of Health and Human Services (HHS) Assistant Secretary for Health (ASH). Christine, a urologist based in Alabama, ran an unsuccessful bid for Alabama state Senate in 2022. The ASH serves as the primary advisor to the HHS Secretary and plays a key role in developing federal health programming across HHS agencies and operating divisions, such as CDC, FDA, and CMS, and oversees the US Public Health Service.
FDA Approves First Home Self-Test for Chlamydia, Gonorrhea, and Trichomoniasis
On March 28, the US Food & Drug Administration (FDA) granted marketing authorization for the first at-home, single use self-test for diagnosing chlamydia, gonorrhea, and trichomoniasis in females. The Visby Medical Women’s Sexual Health Test, manufactured by Visby Medical, does not require a prescription and delivers results in 30 minutes. Prior to the Visby test, FDA approved at-home tests for syphilis in 2024 and chlamydia and gonorrhea in 2023. Notably, the Visby test will provide new testing options for trichomoniasis, which CDC estimates is the most prevalent STI in the US.
President Trump Appoints New ONDCP Director
On March 29, the Trump Administration announced that it appointed Sara Carter, a journalist and former Fox News contributor, to lead the White House Office of National Drug Control Policy (ONDCP). As a journalist, Carter criticized the Biden Administration’s enforcement of immigration policies at the southern border and has called for greater efforts to address drug trafficking and the fentanyl and opioid crisis. As Director of ONDCP, Carter will develop the National Drug Control Strategy and provide recommendations to the President for addressing the opioid crisis.
Resources
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.”
CDC MMWR: Newly Reported Chronic Hepatitis C Among Adults
“In Alaska, the average annual rate of newly reported chronic hepatitis C cases decreased by 30% from 142 during 2016–2019 to 99 during 2020–2023, with an average for the overall period of 121 cases per 100,000 adults.”
CDC MMWR: Synthetic Opioid and Stimulant Co-Involved Overdose Deaths by Occupation and Industry
“People who died of synthetic opioid (e.g., fentanyl) overdoses that also involved psychostimulants (e.g., methamphetamine) were often employed in physically demanding jobs Conversely, those who died of synthetic opioid overdoses involving cocaine were often employed in less physically strenuous jobs.”
“The U.S. Centers for Disease Control and Prevention (CDC) has led a concerted effort to curb the spread of HIV in the U.S. over the past 15 years. An amfAR analysis shows increased funding to the CDC’s Division of HIV Prevention has been associated with a nearly 20% reduction in new HIV infections across the U.S. between 2010 and 2022. The first Trump administration made ending the HIV epidemic in the U.S. by 2030 a priority. The government is now proposing drastic cuts in funding for the CDC’s Division of HIV Prevention. Not only will we lose momentum in driving down HIV cases, but the nation’s epidemic will become considerably worse.”
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
CDC is pulling back $11B in Covid funding sent to health departments across the U.S.
“The Centers for Disease Control and Prevention is pulling back $11.4 billion in funds allocated in response to the pandemic to state and community health departments, nongovernment organizations and international recipients, the Department of Health and Human Services confirmed Tuesday… The funding slash comes on the heels of other cuts under new Health and Human Services Secretary Robert F. Kennedy Jr., including the canceling of hundreds of millions of dollars in grants for research into vaccine hesitancy, LGBTQ populations and supporting HIV prevention.”
Drugmakers sink after key FDA official ousted as Trump plans health overhaul
“Shares of U.S. drugmakers fell on Monday after reports that the Food and Drug Administration's top vaccine official, Peter Marks, had been forced to resign, the most high-profile exit at the regulator as the Trump administration undertakes an overhaul of federal health agencies. The pharma and biotech sector has been under pressure since Donald Trump returned to the White House earlier this year. Shares have dropped on worries Trump's extensive plans for tariffs will include drugs, which have traditionally been excluded from such levies, and Secretary of Health and Human Services Robert F. Kennedy Jr's plans to revamp the federal agencies.”
“Philadelphia’s street opioid supply – or “dope” market – is constantly changing. As health care workers and researchers who care for people who use drugs in our community, we have witnessed these shifts firsthand. New adulterants are frequently added to the mix. They bring additional and often uncertain risks for people who use drugs, and new challenges for the health care providers and systems who treat them. The latest adulterant to dominate the supply is medetomidine.”
Trump administration aims to freeze family-planning grants, WSJ reports
“U.S. President Donald Trump's administration is planning to freeze federal family-planning grants worth about $120 million this year, the Wall Street Journal reported on Tuesday, citing people familiar with the matter. The WSJ said the money for the groups, which include Planned Parenthood affiliates, would be held while the administration reviews whether any of the funds were used in diversity efforts, adding that the pause could be announced as soon as this week.”