The Trump administration has proposed cutting over $28.6 billion in health care and mental health-related spending under its newly released discretionary budget for FY 2026. At the top of the chopping block is a nearly $18 billion deficit for the National Institute of Health (NIH).

As part of the proposal, the agency will maintain $27 billion for research, the administration notes that the cuts were propelled by the NIH’s “wasteful spending, misleading information, risky research, and the promotion of dangerous ideologies that undermine public health.” The cuts will consolidate what Trump sees as redundant programs into five new areas of research, including a National Institute on Behavioral Health.

The administration also suggests cutting nearly $3.6 billion from the Centers for Disease Control and Prevention (CDC), $1.7 billion from the Health Resources and Services Administration (HRSA), more than $1 billion from the Substance Abuse and Mental Health Services Administration (SAMHSA) and $129 million from the Agency for Healthcare Research and Quality.

The recommendations propose the CDC maintain $4 billion. Still, the potential budget cuts propel the consolidation of funding for several health issues, including opioids and infectious diseases, into a single grant program with $300 million in funding.

While the budget recommends that SAMHSA retain $5.7 billion for its research and activities, it will be absorbed into a new entity dubbed the Administration for a Healthy America. The document specifically demonizes how funding was used by the agency under the previous administration, criticizing that its grants “were used to fund dangerous activities billed as ‘harm reduction,’ which included funding ‘safe smoking kits and supplies’ and ‘syringes’ for drug users.”

Although the draft proposes to cut funding to these programs, harm reduction measures like the ones mentioned have been proven through evidenced-based research by SAMHSA and HHS to “minimize negative consequences of drug use” and decrease overdoses and negative effects of substance use.

The AHRQ, which has historically focused on setting quality standards across health care, including for behavioral health and on efforts to integrate behavioral health into primary care for more effective mental health treatments, will become part of the new HHS Office of Strategy. The recommended $129 million in cuts will slash spending on new grants and eliminate its digital health portfolio.

Under the proposal, The Centers for Medicare and Medicaid Services will lose $674 million. Yet, the administration notes that this “will have no impact on providing benefits to Medicare and Medicaid beneficiaries” and is strictly eliminating funding for “non-statutory, wasteful, and woke activities.”

Research funding for the National Science Foundation will be cut by $3.5 billion for what the administration has deemed “programs in low-priority areas of science,” which it cites “behavioral science” falls under.

As of May 5, attorneys general from 19 states and the District of Columbia have filed a lawsuit against the administration over these cuts, particularly related to how “mental health and substance use services have been completely gutted as a result of the administration’s restructuring.”

Simultaneously, the Department of Health and Human Services, now overseen by Robert F. Kennedy Jr., will likely receive a suggested surplus of $500 million to help the secretary carry out his Make America Healthy Again priorities to address things like an “over-reliance on medication and treatments,” according to the documents. 

While mental health and substance use funding is being slashed in other departments, interestingly, the Department of Veterans Affairs is the only other health care-related area receiving a boost in proposed budget funding. This patient population tends to be disproportionately affected by mental health and substance use issues. It will receive an additional $3.3 billion for medical care, which includes supporting veterans’ case management and support services and nearly $2.2 billion for electronic health record modernization.