What the Leaked HHS Budget Means for U.S. Emergency Preparedness

The full leaked document can be accessed here: Leaked FY2026 HHS Budget Proposal (PDF).

With over $40 billion in proposed cuts - more than 30% of the agency’s discretionary budget - the draft outlines deep reductions to the programs and personnel responsible for protecting the nation’s health during crises.

This overview highlights how these cuts could undermine emergency preparedness and response capacity across the country. In the coming days, we’ll publish a series of deeper dives into specific impacts, including changes to the Medical Reserve Corps (MRC), the HHS Coordination Operations and Response Element (H-CORE), and the future of surge response through the National Disaster Medical System (NDMS).

A Drastic Overhaul

The budget proposal would slash HHS discretionary funding from $116.8 billion to approximately $80.4 billion. It also calls for consolidating more than a dozen health programs into a new umbrella agency - the Administration for a Healthy America (AHA) - with $14 billion in funding. Programs from CDC, NIH, HRSA, and others would be absorbed into this new structure. According to Politico, this includes eliminating several specialized offices and programs outright.

Two of the most essential federal agencies for emergency response are directly impacted: the Centers for Disease Control and Prevention (CDC) and the Administration for Strategic Preparedness and Response (ASPR). CDC’s Office of Public Health Preparedness and Response, which supports state and local readiness, appears to be dissolved. ASPR’s H-CORE - the hub for federal deployment coordination and logistics during health emergencies - is set to be eliminated. These are the same capabilities that supported federal responses to COVID-19, natural disasters, and nationwide medical supply shortages.

Also at risk is the Hospital Preparedness Program (HPP). As reported by Inside Health Policy, the proposal would eliminate HPP in its current form. While some activities may be integrated into the new AHA, it is unclear whether the program’s critical regional coordination and healthcare coalition infrastructure would continue. These functions have been vital to managing multi-state emergencies, including the COVID-19 pandemic and the ongoing avian flu response.

What’s at Stake for Emergency Preparedness

These are not just accounting changes - they represent operational disruptions. Key implications include:

• Preparedness and Response Capacity: As This Week in Public Health notes, the cuts would weaken essential public health infrastructure, including disease surveillance, risk communication, and rapid response staffing.

• Food Safety and Contamination Response: According to The Guardian, the FDA has already suspended its FERN Proficiency Testing Program due to staff reductions. This program ensures labs can detect harmful pathogens and contaminants in the food supply - a core pillar of national health security.

• Public Health Workforce Losses: As many as 20,000 HHS employees have reportedly taken buyouts or been laid off, including teams responsible for coordinating surge medical responses, reviewing critical drug safety data, and leading infectious disease investigations. This comes as new outbreaks, like avian flu, remain an active threat.

Disproportionate Impact on Vulnerable Communities

These proposed cuts would disproportionately affect Americans already facing systemic barriers to care:

• Programs such as Head Start, LIHEAP, and rural health initiatives are slated for elimination, as detailed by Axios. These programs provide essential services such as childcare, heating assistance, and rural medical access.

• The Ryan White HIV/AIDS Program and the Office of Minority Health face significant funding cuts. These programs help close persistent gaps in access and outcomes for communities of color, low-income populations, and people living with chronic illness.

• Cuts to mental health block grants would reduce the availability of local crisis response services and ongoing behavioral health care at a time when demand is rising across the country.

What Comes Next

It’s important to reiterate that this is a draft budget proposal and not yet finalized. It must go through the full Congressional appropriations process and is subject to change. However, the proposal provides a clear window into the administration’s current direction and policy intent. These aren’t minor tweaks - they signal a fundamental rethinking of the federal government’s role in public health preparedness.

The timing could not be worse. Hurricane season is approaching, infectious disease threats persist, and public health systems are still recovering from the strain of the pandemic. Navigating these challenges with fewer federal resources will require creative, coordinated approaches across sectors.

We’ll be publishing follow-up briefings on:

• The Medical Reserve Corps (MRC)

• The elimination of H-CORE

• The future of NDMS surge support

• The phase-out of the Hospital Preparedness Program (HPP)

• State-level preparedness gaps without CDC cooperative agreements

Each analysis will explore what’s changing, what’s at risk, and how public health leaders can adapt in this shifting landscape.

Why Coordination Matters More Than Ever

In this environment, Health Response Alliance is more essential than ever. As federal support retracts, HRA is stepping up to ensure that state and local governments can still leverage every available resource from private sector and nonprofit partners.

Our work bridges the gaps left when traditional federal assets are scaled back. We help keep critical supplies moving, share real-time intelligence, and coordinate action across the full spectrum of response actors. By serving as a connective tissue between frontline responders and national capabilities, we’re helping communities prepare, respond, and recover with resilience.

Now more than ever, every resource counts - and every partnership matters.

Click here to see how Health Response Alliance can support your readiness efforts.