President’s Budget Request Targets Vital Programs

On Friday the White House released President Trump’s budget request to Congress for fiscal year 2027 (FY27), which begins on October 1. It requests significant funding changes, including cuts to programs that help older adults and people with disabilities build health and economic security.

Overview

The budget requests $111.1 billion in discretionary budget authority for the U.S. Department of Health and Human Services (HHS) for FY27. This is a $15.8 billion (12.5%) decrease from the FY26 enacted level. 

Despite the idea being rejected by Congress last year, the administration is again seeking to reorganize HHS by establishing the Administration for a Healthy America (AHA). Under the White House’s vision, this new agency would fold in several current HHS components, including the Substance Abuse and Mental Health Services Administration (SAMHSA), the Health Resources and Services Administration (HRSA) and some functions of the Centers for Disease Control and Prevention (CDC).

Another shift combines the work formerly carried out by the Administration for Children and Families (ACF) and the Administration for Community Living (ACL) into the Administration for Children, Families, and Communities (ACFC). According to the White House, the consolidated ACFC “supports the economic and social well-being of families, children, older adults, and people with disabilities.” The FY27 ACFC budget request is $28.7 billion, nearly $7 billion below FY26 levels.

Important Programs Targeted for Cuts

The budget would cut projected spending for many programs that support families and communities. For example, it would eliminate the Low-Income Home Energy Assistance Program (LIHEAP), which helps six million families with young children, older adults, and people with disabilities pay their heating and cooling bills, as well as the Community Services Block Grant (CSBG) program, which helps local organizations assist five million low-income families and individuals each year.

It would also slash funding for HIV treatment and prevention, refugee resettlement, affordable housing, environmental programs, workforce and education support, rural initiatives, chronic disease prevention, and federal emergency response preparedness.

Medicare Program and Beneficiary Resources

Unlike last year, the budget would preserve funding for State Health Insurance Assistance Programs (SHIPs). The HHS Budget in Brief notes that by engaging “with Medicare beneficiaries to provide one-on-one counseling on informed enrollment and benefit decisions” SHIPs “ultimately reduce costs to both the beneficiary and Medicare.” The program would remain with other ACL functions, at ACFC.

The budget documents note the Centers for Medicare & Medicaid Services (CMS) “is committed to providing Medicare beneficiaries with tools to understand their coverage and benefits” including with investments that ensure the “1-800-MEDICARE call center will answer beneficiary calls in five minutes or less, consistent with recent years.” CMS will also continue to mail 52.5 million Medicare beneficiary households a copy of the “Medicare & You” handbook, with the option of receiving an electronic copy instead.

Operationally within CMS, the White House is looking to modernize Medicare claims processing systems. CMS explains the “proposed system will embrace AI, support state-of-the-art payment integrity controls, and establish a robust technology foundation that will lower costs and improve care delivery.” CMS also details efforts to address “infrastructure gaps that limit progress toward a digital health technology ecosystem.”

Presidential Budget Requests Are Messaging Tools

Presidential budgets are important policy and messaging tools that articulate the administration’s goals. They are often used by the White House to guide reforms, introduce or refine ideas, and stake out positions. But they are not binding—spending levels for annually appropriated programs are ultimately up to lawmakers. And in most years, they take little or no action on specific presidential requests.

But the release of the president’s request does officially kick off those discussions. The next step is for Congress to formally consider the request. Most immediately, this will involve HHS Secretary Kennedy appearing before several House and Senate Committees with jurisdiction over health care policy and funding. Lawmakers will then work to craft and pass spending legislation for all federal agencies by September 30. When this deadline is missed, as it often is, Congress may rely on shorter-term stop gap measures while they finalize the bills.

As this process advances, the Medicare Rights Center will continue to advocate for strong funding and support for programs that serve current and future Medicare beneficiaries, as well as their families and communities. This includes rejecting reconciliation efforts that build on HR 1 or otherwise jeopardize beneficiary health and well-being.

Read the HHS Budget in Brief, ACFC Congressional Justification, and CMS Congressional Justification.