Policy Updates: Hill Happenings and Administration Activities

Hill Happenings 

FY2026 Appropriations & Budget Resolution 

The Republican Congressional caucus is building bicameral consensus to pass a landmark budget reconciliation proposal for Fiscal Year 2026 (FY2026). Republicans on House committees are resolving internal disagreements on spending and policy priorities, including how to apply spending cuts to achieve overall reduction goals, to advance a spending bill through the budget reconciliation process by Memorial Day. A bipartisan group of lawmakers, including a growing list of Republicans, have warned that many of the cuts proposed by House committees and the Administration go too far, including cuts to Medicaid funding and health programs at the Centers for Disease Control and Prevention (CDC). Democrats will have limited opportunities to block the reconciliation package if the Republican caucus can successfully leverage their bicameral majority to advance the mega-bill. 

NASTAD Calls on Congress to Reject Budget Cuts Proposed in Executive Budget Request 

On April 25, NASTAD joined the Coalition for Health Funding and called on Congress to reject discretionary spending cuts proposed in the Administration’s draft FY2026 budget for the Department of Health and Human Services. Over 530 organizations signed onto the letter, which uplifted the key public health functions and programs coordinated by the Department of Health and Human Services (HHS) and its agencies and operating divisions, including the Food and Drug Administration (FDA), the Centers for Disease Control and Prevention (CDC), the Health Resources and Services Administration (HRSA), and the Substance Abuse and Mental Health Services Administration (SAMHSA).  

NASTAD Calls on House Energy & Commerce Committee to Reject Medicaid Cuts in FY2026 

On April 28, NASTAD joined the Disability and Aging Collaborative (DAC), the Health and Long-Term Services and Supports Task Forces of the Consortium for Constituents with Disabilities (CCD), and over 110 organizations and called on the House of Representatives Energy & Commerce (E&C) Committee to reject any budget cuts or eligibility restrictions for the Medicaid program in FY2026. The coalition highlighted the impact of the budget resolution approved on April 10 that called for cuts of at least $880 billion in the E&C Committee bill, which would require major cuts to the Medicaid program. If approved, the bill would remove coverage for millions of people through changes to beneficiary eligibility rules, such as implementing work requirements and repealing policies that streamline enrollment, and funding structures, such as limiting federal Medicaid spending through per capita caps or block grants. 

Senate HELP Committee Schedules FY2026 HHS Budget Hearing 

On May 2, the Senate Committee on Health, Education, Labor and Pensions (HELP) scheduled a hearing on May 14 to review the Administration’s justification for the FY2026 budget request to Congress. HHS Secretary Robert F. Kennedy, Jr. will appear before the committee and defend the health agency’s funding proposal, which includes major cuts to health programs across HHS agencies and operating divisions and provides more details on the agency reorganization plan. Senators on the HELP Committee are expected to grill the Secretary on the sweeping changes to HHS programs and reduction in force initiatives, including Committee Chair Bill Cassidy (R-LA), who extended an invitation for the Secretary to appear before the Committee in April that went unanswered. 

Administration Activities 

White House Releases FY2026 Discretionary Budget Request 

On May 2, the White House released its Fiscal Year 2026 (FY2026) Discretionary Budget Request, commonly referred to as the “skinny budget.” Like previous years, this document outlines broad funding priorities but offers few specifics on individual programs. A full budget request is expected later this spring. Still, several proposed consolidations and funding reductions raise significant concerns for our programs.   

Key proposals include: 

• CDC Program Consolidation and Cuts: The budget calls for combining CDC funding for infectious disease and drug user health programs—including viral hepatitis, sexually transmitted infections (STIs), and tuberculosis (TB)—into a single $300 million grant. This represents a $77 million cut from FY2024 levels, with no details provided on how funds would be distributed across disease areas.
• HRSA Ryan White Program Reductions: The request eliminates funding for Ryan White HIV/AIDS Program Part F, which supports education, training, and capacity-building. The $74 million cut would significantly impact workforce development and system-level support efforts.
• Housing Program Consolidation: The Housing Opportunities for Persons with AIDS (HOPWA) program would be merged into a broader Emergency Solutions Grant (ESG) program, which caps housing assistance at two years and shifts the focus to short- and medium-term housing for “homeless and at-risk individuals.” This change threatens long-term housing stability for people living with HIV.
• Ongoing Risks to HIV Prevention: Although the budget doesn’t explicitly call for eliminating the Ending the HIV Epidemic (EHE) initiative or CDC’s Division of HIV Prevention, proposed CDC cuts and vague language around program eliminations suggest these critical efforts remain at risk.
• Harm Reduction Undermined: The proposal also takes aim at harm reduction programs, framing services like syringe access and safer use supplies as inappropriate uses of federal funding. This language signals a shift away from evidence-based approaches and raises concerns about the future of federal support for harm reduction. 

Together, these proposals signal a potential restructuring of the federal HIV response that could disrupt prevention, care, housing, and harm reduction services nationwide. While the skinny budget is not legally binding, it sets a policy direction that will shape negotiations with Congress in the months ahead. NASTAD will continue to advocate for strong federal investments in HIV, hepatitis, STI, and harm reduction programs and ensure these services are not weakened through funding cuts or structural changes.  

HHS Commemorates Actions Taken During the First 100 Days of the Trump Administration 

On April 29, the Department of Health and Human Services (HHS) commemorated the public health initiatives and actions taken during the first 100 days of the Trump Administration. Notably, the Administration highlighted the agency reorganization and reduction in force changes across HHS that were made to reshape the nation’s federal health infrastructure under the “Make America Healthy Again” (MAHA) agenda. HHS and the Department of Government Efficiency (DOGE) purport that the sweeping changes will eliminate redundant offices, streamline programs, and improve research.  

Resources 

Fenway Institute Brief: In first 100 days, Trump-Vance Administration dismantles critical policies promoting LGBTQI+ health equity, racial and ethnic health equity, and HIV/STI prevention and care 

“In its first 100 days in power, the Trump Vance Administration has effected a radical restructuring of the nation’s public health, research, and foreign policy infrastructure. In the process it has dismantled policies developed over the past several decades that advanced equality and health equity for LGBTQI+ people and other populations, and that advanced effective, science-based HIV and STI prevention and care. This dramatic shift in public health and human rights policy could have devastating effects of people in the U.S. and around the world, according to a policy brief published by The Fenway Institute on April 30, 2025—the 100th day of the new administration.” 

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 allegedly cancels Emory's HIV self-testing program after not enough workers left to oversee it 

“A local HIV program has allegedly been canceled as a result of funding cuts, firings and layoffs that have recently hit the Centers for Disease Control and Prevention, according to a program lead. On April 22, the federal health agency informed Emory University in Atlanta that its large HIV self-testing program, called Together TakeMeHome, was being canceled two years early…Dr. Patrick Sullivan, the project's lead scientist and professor of epidemiology at Emory University's Rollins School of Public Health, said he was told the cancellation is because the CDC does not have enough staffers to oversee the program.”  

Trump Administration Slashes Research Into L.G.B.T.Q. Health 

“The Trump administration has scrapped more than $800 million worth of research into the health of L.G.B.T.Q. people, abandoning studies of cancers and viruses that tend to affect members of sexual minority groups and setting back efforts to defeat a resurgence of sexually transmitted infections, according to an analysis of federal data by The New York Times... Of the 669 grants that the National Institutes of Health had canceled in whole or in part as of early May, at least 323 — nearly half of them — related to L.G.B.T.Q. health, according to a review by The Times of every terminated grant.” 

Collins urges reversal of Trump’s biomedical research clawbacks 

“Sen. Susan Collins has an urgent warning about the state of biomedical research in the United States, saying the country could lose its edge if it continues on its current track. At the Senate Appropriations Committee’s first full hearing this Congress Wednesday, Collins, the Maine Republican who chairs the panel, called on the Trump administration to reverse course on cutbacks. She cited the administration’s cap on indirect research costs, the canceling of grants and the mass firing of employees across the Health and Human Services Department.”

"Health care for transgender children questioned in 400-page Trump administration report" 

"In a statement, Dr. Susan Kressly, president of the American Academy of Pediatrics, wrote that the organization is "deeply alarmed" by the new HHS document. "This report misrepresents the current medical consensus and fails to reflect the realities of pediatric care," she wrote. She asserted that the report was not credible because it relied "on select perspectives and a narrow set of data.""