Kimbell & Associates: Highlights of President Trump’s FY 2027 Budget Request

April 9, 2026

On Friday, April 3, President Trump sent to Congress his Fiscal Year (FY) 2027 Budget Request, titled “Budget of the U.S. Government,” proposing $660.1 billion in non-defense base discretionary funding, including $111.1 billion for the Department of Health and Human Services (HHS). Please see below for excerpts of the HHS Budget relevant to the life sciences community.

The President’s FY 2027 Budget proposal and accompanying materials are available HERE.

The HHS Budget in Brief and supporting documents are available HERE.

HHS Budget

• HHS states that the Budget “demonstrates the Administration’s commitment to the Make America Healthy Again (MAHA) agenda, making Americans the healthiest in the world through strategic investments to battle chronic disease and support advancements in health. The budget continues to prioritize resources to achieve HHS’s mission while saving taxpayer dollars.”

Centers for Medicare and Medicaid Services (CMS)

Overall Budget: The Budget estimates $1.476 trillion in total funding for CMS, including all appropriated accounts. This represents an increase of $98.177 billion from FY 2026.

CMS Program Integrity: The Budget proposes $2.714 billion for the Health Care Fraud and Abuse Control Program and $2.822 billion for the Medicaid Integrity Program.

CMS Program Management: The Budget estimates $6.848 billion in total program management funding for CMS, including $3.7 billion in discretionary budget authority, $3.1 billion in user fees, and $93 million in current law mandatory fund. This budget represents a decrease of $1.434 billion in 2026.

Medicare: The CMS Program Management budget includes $811 million to provide operational needs and beneficiary rights under Original Medicare (Parts A and B). The Budget also includes $112 million for Medicare Parts C and D administrative needs.

340B Integration Into CMS: The Budget proposes to shift the 340B program from HRSA to CMS as part of the HHS reorganization to allow the program to benefit from greater in-house drug-pricing resources and expertise for streamlined processes. The Budget proposes $21 million for the 340B program, representing an increase of $8 million from 2026, to increase oversight of covered entities and drug manufacturers.

Medicaid: The Budget’s total mandatory appropriation request for Medicaid is $785.2 billion, an increase of $16 billion from FY 2026, for the Grants to States for Medicaid account.

The Budget includes $154.6 million for Medicaid and CHIP administrative operations for FY 2027, an increase of 10.7 million from FY 2026.

In the CMS Program Integrity section, the Budget includes a mandatory appropriation of $108 million for the Medicaid Integrity Program, reflecting an increase of $2 million from FY 2026 due to an annual inflation adjustment. This section also discusses strengthening oversight of Medicaid programs by expanding audits and investigations to build on CMS’ work on fraud and abuse imitative to eliminate improper enrollments and implementing new oversight requirements from the Working Families Tax Cut Act.

The Budget estimates 80.1 million Americans will be enrolled in Medicaid in FY 2027, covering an estimated 20% of Americans. Between FY 2026 and FY 2027, the Budget estimates a decrease in enrollment of 2.9 million individuals.

Center for Medicare and Medicaid Innovation (Innovation Center): The Budget requests $122.4 million in information technology (IT) funding for the Innovation Center as part of the Cross-Cutting Program portfolio to support models, pilots, and data-driven experimentation to allow CMS to explore payment and delivery system reform and improve value-based care.

Private Health Insurance: The Budget requests $11.6 million for FY 2027, a reduction of $5.3 million from FY 2026 for insurance market reform and oversight.

CMS Legislative Proposals: The Budget contains no CMS legislative proposals.

Administration for a Healthy America (AHA)

Administration for a Healthy America (AHA) Overall Budget: The Budget proposes $14.7 billion in discretionary funding for AHA, along with $525.6 million in Public Health Service Evaluation funding, $115 million in user fees, and $2.2 billion in mandatory funding, for a total program level of $17.5 billion.

Overview: The AHA is proposed as a central coordinating entity for prevention, primary care, and community-based programs, consolidating the Office of the Assistant Secretary for Health (OASH), the Health Resources and Services Administration (HRSA), the Substance Abuse and Mental Health Services Administration (SAMHSA), and select Centers for Disease Control and Prevention (CDC) programs to improve coordination and reduce administrative duplication.

Primary Care and Prevention: The Budget includes $3.5 billion for primary care programs, including $1.9 billion for Health Centers and an additional $19 million to expand nutrition services at 50 health centers to improve patient outcomes and strengthen the nutrition workforce. Additional investments include:

• $413 million for Cancer Prevention and Control
• $316.1 million for Rural Health Care
• $129 million for Organ Transplantation
• $70.1 million for Telehealth
• $35 million for Alzheimer’s disease initiatives
• $25.6 million for Disease Prevention and Health Promotion
• and $45 million for Minority Health Programs

HIV/AIDS Programs: The Budget includes $2.7 billion for HIV/AIDS programs, including $2.3 billion for the Ryan White HIV/AIDS Program and $385 million for the Ending the HIV Epidemic Initiative to support care, treatment, and prevention services.

Maternal and Child Health: The Budget includes $1.1 billion in discretionary funding for maternal and child health programs, including $767.3 million for the Maternal and Child Health Block Grant and $47.3 million for maternal health initiatives.

Mental and Behavioral Health: The Budget includes $6.8 billion for mental health and substance use disorder services and proposes new flexible funding streams to expand access to evidence-based care.

Health Workforce: The Budget includes $831 million for health workforce programs, including $130 million for the National Health Service Corps and $102.6 million for Nurse Corps scholarship and loan repayment programs.

Policy, Research, and Oversight: The Budget includes $330.5 million for policy, research, and oversight activities, including $201.5 million for AHA operations and $22 million to support integration of business processes, data solutions, and customer services. The request also includes $19.6 million for the Immediate Office of the Secretary for Health and the Surgeon General, $91.8 million for behavioral health data and surveillance activities, and $15.2 million for the Vaccine Injury Compensation Program.

AHA Legislative Proposals: The Budget includes several legislative proposals to support AHA priorities, including:

• Establishing a Behavioral Health Innovation Block Grant (BHIBG) to consolidate existing mental health and substance use programs into a single flexible funding source
• Creating an independent Certified Community Behavioral Health Clinic (CCBHC) accreditation process
• Clarifying and expanding Organ Procurement and Transplantation Network (OPTN) fee authority
• Sunsetting the Hill-Burton Uncompensated Services Program
• Amending legislative authority for the Office for the Advancement of Telehealth (OAT)
• Aligning authorities of the U.S. Public Health Service Commissioned Corps with other uniformed services

Food and Drug Administration (FDA)

Overall Budget: The Budget proposes $7.2 billion in funding to FDA, which represents an increase of $232 million from 2026. This includes $3.3 billion in discretionary funding and $3.9 billion in user fees.

Pharmaceutical Manufacturing: The Budget includes $9 million to establish the FDA PreCheck Program to strengthen domestic manufacturing capacity to mitigate drug shortages and enhance the resilience of the national pharmaceutical supply chain.

MAHA Initiatives: The Budget includes $57 million to support FDA and MAHA public health missions, including: $50 million to remove chemicals in the food supply, $2 million to support artificial intelligence and machine learning initiatives, and $5 million to invest in research and development for alternatives to animal testing for regulatory science purposes.

User Fees: The Budget includes $3.9 billion in user fees to support safety programs for food and medical products, including $71 million for a new proposed user fee for food facilities and importers under FDA’s human and animal foods program.

FDA Legislative Proposals: The Budget includes many legislative proposals to support FDA priorities, including several relevant to the health innovation community:

• Holding Firms Accountable Using Misleading Advertising to Drive Profits at the Expense of Consumers
• Allow Companies Manufacturing Generic Medications Domestically to File Paragraph IV Certifications Earlier, Giving Exclusivity Rights to US Manufacturers
• Allow Disclosure of Certain Information in Complete Response Letters
• Create Efficiencies for Review and Approval of Biosimilar Applications and Deem that Approved Biosimilars are Interchangeable
• Increase Agency Flexibility Regarding the Convening of Advisory Committees and the Composition of Such Committees
• Mutual Recognition Authority for Bioresearch Monitoring Inspection
• Create an Additional Abbreviated Licensure Pathway for Biological Products
• Explicitly Address Generic Drug-Device Combination Products
• Clarify When Patent Information Must Be Submitted for a 30-Month Stay to Be Available
• Require Retention of Data and Records Supporting Marketed Medical Products and Marketed Medical Product Applications and to Address Fraudulent Data
• Authorize the Disclosure and Use of Certain Information Related to Impurities in Drugs That Pose a Risk to Human and Animal Health
• Postapproval Quality Updates
• Modernizing the Requirements in BPCA and PREA for Agency Review of Pediatric Postmarket Safety Reporting
• Disrupt the Flow of Problematic Imported Medical Devices
• Clarify FDA’s Enforcement Authority Regarding Manufacturing Changes to Approved Drugs and Biological Products
• Align the FD&C Act with Longstanding Timelines and Procedures Governing Application Reviews and Streamline Appeals When an application is Not Approvable
• Create a new Clinical Trial Notification Pathway to Serve as an Alternative to the Burdensome Existing Investigational New Drug Pathway to accelerate drug development timeline to Make America Healthy Again
• Give FDA significant enforcement authorities, including civil monetary penalties and the authority to pull products off of market if active pharmaceutical ingredient source data is not reported.
• Permanently authorize the rare pediatric disease priority review voucher program and related user fees.

National Institutes of Health (NIH)

Overall Budget: The Budget provides a discretionary budget authority total of $41.2 billion to NIH for FY 2027, a decrease of $3.5 billion from the FY 2026 funding level.

The budget will focus on ending the chronic disease epidemic and better understanding aging and biomarkers for disease for FY 2027. The budget also specifies that NIH will build on work to restore trust in public health research, enhance biosafety and biosecurity oversight, and expand infrastructure for non-animal research approaches.

The budget proposes to consolidate the National Institute of Drug Abuse and the National Institute on Alcohol Abuse and Alcoholism into the new National Institute of Substance Use and Addiction Research and proposes to eliminate the National Center for Complementary and Integrative Health, Fogarty International Center, and National Institute on Minority Health and Health Disparities.

Health Resources and Services Administration (HRSA)

340B Reorganization: Following HHS’ planned reorganization, the Budget includes $20.5 million, an $8.3 million increase from FY 2026, to enable CMS to manage the growing 340B program complexity through policy development, guidance, and operational support. More details on the 340B integration into CMS are included in the CMS section of this memorandum.

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