Trump’s Budget Proposes Massive Cuts in Public Health, Workforce Initiatives

On May 2, President Donald Trump sent a partial budget request to Congress. The request proposes a massive cut in non-defense discretionary spending of 23 percent while boosting defense spending 13 percent. Overall, it cuts federal spending $163 billion in FY 2026, with the biggest cuts impacting healthcare, education, foreign aid, and environmental programs.  

While Congress generally doesn’t follow presidential budget requests exactly, they do lay out the Administration’s key priorities, and Congress has already begun working toward meeting these requests. For example, Congress approved a budget blueprint in early April requiring $1.7 trillion in savings over the next 10 years, in line with the President’s request.  

The Administration’s partial budget proposal is largely consistent with a leaked Office of Management and Budget’s passback document outlining the Trump Administration’s initial budget plans for the U.S. Department of Health and Human Services. The passback would impose huge cuts in spending for healthcare agencies and programs, including workforce development programs on which the healthcare industry depends.  

Overall, funding at the U.S. Department of Health and Human Services (HHS) would be cut 34 percent, with HHS getting $80 billion in 2026, rather than that $121 billion it was allocated for 2025. In addition, funding for the Centers for Disease Control and Prevention (CDC) would be cut from $9.2 billion to nearly $5.2 billion, a 44 percent cut. The National Institutes of Health would be slashed 40 percent, with funding decreasing from $47 billion to $27 billion. The Centers for Medicare and Medicaid Services would see its discretionary budget cut by $674M to $4.1 billion, or 14 percent. The President’s request here does not impact mandatory spending programs, such as Medicare and Medicaid benefits, though eligibility to these programs could be impacted in the coming months. 

The proposal eliminates funding for several HHS agencies, including the Health Resources and Services Administration (HRSA), the Agency for Healthcare Research and Quality, the Substance Abuse and Mental Health Services Administration, and the Administration for Community Living, and others.  

The proposed elimination of HRSA is obviously a concern for ASCP, as the agency is responsible for many of the federal government healthcare workforce development programs. Among the HRSA programs that would be eliminated under the Trump proposed budget are the following: Scholarships for Disadvantaged Students, Faculty Loan Repayment, Public Health Workforce Development, Medical School Education, Area Health Education Centers. With the exception of the Scholarships for Disadvantaged Students and Faculty Loan Repayment Program, laboratory professionals were generally not able to access federal workforce dollars from HRSA. 

It is not clear from the document what impact it may have on the laboratory training and support programs currently administered by CDC. ASCP will be monitoring the reconciliation process closely over the coming months to learn more about how the cuts at CDC and other healthcare agencies will impact the laboratory field. 

In Congress, Republicans on the House Education Committee recently proposed a number of significant cuts to key education programs and the cuts to federal student loan programs could have serious implications for STEM/healthcare fields. For example, the House Education and Workforce Committee approved legislation that would eliminate subsidized loans to undergraduates, eliminate the graduate student loan program, cap loans for existing borrowers, set strict limits on Parent PLUS loans, tighten eligibility for Pell Grants, and require colleges and universities to reimburse the federal government for a portion of any student loan debt that their students fail to repay.   

The Committee also modified eligibility for the Public Service Loan Forgiveness (PSLF) program, eliminating time spent in medical or dental residency programs. In addition, Income Contingent Loan Repayment Programs (ICRP) would be replaced with the Administration’s proposed “Repayment Assistance Plan.”  This proposal would also change the terms after which any outstanding debt could be forgiven. Previously, individuals meeting their payment obligations under income contingent loan repayment programs would have outstanding loans dismissed after 20 to 25 years, depending on the program. Under the Trump plan, it would take 30 years before loans could be forgiven.  

Many of these programs are critical to financing careers in medicine and healthcare. One study found that ICRPs are the most common repayment programs used by physicians, with 77 percent participating in such programs, and that approximately 88 percent of recent medical school graduates intend to apply to the PSLF program. Similarly, these programs are also important to medical laboratory professionals. ASCP will soon publish the findings of a recent survey conducted to determine how frequently these options are used to help medical laboratory professionals manage their student loan debt.  ASCP plans to use the survey findings to lobby Congress to continue its support of ICRP and PSLF programs.

Both the healthcare field, which is dependent on large numbers of individuals with baccalaureate and graduate degrees, as well as the student financial aid community have expressed concern about the impact these proposals could have on college attendance and workforce development. That said, the House Education Committee’s proposal is in its early stages and will likely undergo changes before legislation could be made available for the president to sign into law. ASCP will be monitoring this situation closely and will be working with its advocacy partners to protect workforce development programs that serve the laboratory workforce.