Piggy bank photo by DNY59, courtesy iStockphoto
Public health leaders are hoping dangerous cuts proposed in the White House fiscal year 2027 federal budget are dead on arrival in Congress. But even if that does come to fruition, leaders warn the nation's public health capacity remains in jeopardy.
Many of the proposed cuts, including a more than 50% funding decrease to the U.S. Environmental Protection Agency, mirror massive reductions in emergency preparedness, chronic disease prevention and housing assistance funds that were floated by the Trump administration during last year's fiscal year 2026 budget process. Congress ultimately rejected that budget, opting instead to increase funding for the National Institutes of Health and protect programs under the Centers for Disease Control and Prevention.
Even so, public health supporters should not sit back and relax. Scott Becker, MS, CEO of the Association of Public Health Laboratories, said he has already seen a reduction in the number of public health laboratory scientists nationwide. Federal preparedness funding cuts occurred after the end of the federal COVID-19 public health emergency.
The White House has proposed a 13% cut in overall funding for the Department of Health and Human Services in its fiscal year 2027 budget proposal, which was released April 3. Among the cuts would be a $356 million drop for the Administration for Strategic Preparedness and Response. Having fewer dollars will not help an already-strained system, Becker said.
“Preparedness means getting ready for the next thing or the thing that's coming in five and 10 years,” Becker told The Nation's Health.
The Trump administration's proposed $5.5 billion cut in discretionary funding for CDC would be a $3.6 billion drop from the prior fiscal year and would end programs such as the Prevention and Public Health Fund, which is a critical funding stream for health departments. Programs such as the National Institute on Minority Health and Health Disparities would also disappear under a proposed $5 billion cut to National Institutes of Health funding.
At the American Lung Association, officials such as Ranjana Caple, MPH, director of federal advocacy, are concerned about the future of CDC's Office on Smoking and Health, National Asthma Control Program, the Chronic Disease Education and Awareness program, and the Climate and Health Program.
Cutting such programs conflicts with the Trump administration's promise to make America healthier and target chronic diseases, Caple said. Workforce capacity at CDC and its impact on the larger health system is also a concern.
“Staffing is vital, not just for getting funding out the door, but for providing that technical expertise, that assistance and guidance to states and other grantees,” she told The Nation's Health.
The loss of on-the-ground expertise is an ongoing concern in this budget's second attempt to reorganize HHS into a proposed Administration for a Healthy America. The reorganization would combine and strip down multiple agencies and centers such as the Health Resources and Services Administration and CDC's National Center for Chronic Disease Prevention and Health Promotion.
Experts say they are confident Congress will dismiss the restructuring. But public health advocates should work to protect existing capability and capacity, said Dara Lieberman, MPP, director of government relations for Trust for America's Health.
Public health advocates are encouraged to talk to their legislators about the dangers of the White House budget proposal.
Photo by SDI Productions, courtesy iStockphoto
“The proposed budget doesn't just move programs around, it eliminates them,” Lieberman told The Nation's Health.
Capacity is also a concern at EPA after the Trump administration purged over 4,000 positions in 2025, marking the lowest staffing levels in over 40 years, said Liz Scott, senior director of nationwide advocacy for clean air at the American Lung Association. As with last year's proposed budget, the bulk of EPA cuts call for eliminating most categorical grants that go toward state and tribal level environmental work, such as reducing radon exposure and cleaning up diesel pollution, she said.
“Diesel is cancer-causing,” Scott told The Nation's Health. “This is bipartisan funding that has been around for quite a while, and this is just a straight elimination of that.”
EPA grants are essential to everyday on-the-ground public health work, despite the false perception that the funding is an optional bonus for programs, according to Kyle Jones, JD, director of federal affairs for the Natural Resources Defense Council.
“A large portion of these grants comprise clean water, safe drinking water money,” Jones told The Nation's Health. “These are states of all stripes across the political spectrum.”
With the loss of federal infrastructure funding that expires in fiscal year 2026, any further reductions in funding would be “abrupt and alarming,” he said.
Vulnerable populations would be at risk under a nearly 13% proposed cut in Housing and Urban Development funding, which would include a $922 million cut in homelessness assistance. The move would eliminate existing programs that support building permanent housing and community-based efforts to provide emergency shelter, deliver services and prevent U.S. families from sliding into homelessness.
Though proposed funding for HUD's Housing Choice Voucher Program increased 1% or $407 million, it was not enough to match the program's rising costs, said David Gonzalez Rice, PhD, senior vice president of public policy for the National Low Income Housing Coalition. The budget also proposes freezing any new vouchers, he added.
“If HUD was being a really strong steward of the voucher program, they would go to Congress with an ask for the amount of money it would cost to keep running it,” Rice told The Nation's Health.
Even if Congress largely ignores White House budget cuts, a bigger problem lies with the administration's failure to disburse funding to state and local agencies on time, experts said. If health departments cannot rely on federal funding to come on schedule, they are forced to lay off workers, according to Jeffrey Ekoma, MBA, MS, senior director of government affairs for the Association of State and Territorial Health Officials. Losing staff at the state and local level can affect vital work on everything from tobacco control to hepatitis B prevention, he said.
“And then think about whether data is being collected — that's going to be interrupted as well,” Ekoma told The Nation's Health. “There's a ripple effect of things that are not going out on time.”
With midterm elections coming in November, experts are doubtful Congress will pass a budget by the Sept. 30 deadline and instead expect a series of continuing resolutions to keep the federal government funded. But they agreed complacency is not an option.
Rice said the housing coalition is already preparing to educate Congress about the dangers of budget proposals on housing work requirements and limits on housing rental assistance.
For more information on the Trump administration's budget proposal, visit www.omb.gov/budget.
- Copyright The Nation’s Health, American Public Health Association
