So… Re NIH: Behavioral Health is not part of Brain Research but Dental and Craniofacial is??? Last I checked the brain drove behavior and teeth were not part of the brain.
I mean....at the end of the day, we don't know where these programs will land. Will they be in some reasonable place? Some unreasonable place? Gone? What's lacking is transparency...and discussion with actual HHS employees. Most of this is coming from a few favored DOGE operatives, I'm told.
And those DOGE operatives never talked with ACL before firing half the staff and breaking up the agency for spare parts. Several of the critical services that their statements imply.that they are protecting aren't protected and to the best of my knowledge nobody from DOGE spoke with career staff or our stakeholders to assess what is being done. The result for seniors and people with disabilities will likely be devastating
I just read through the PDF and my suspicions were correct. There’s likely to be a second round of RIFs associated with the reorg. The agency I work with will likely see a 35% funding reduction from what we expected for FY26 🫠
ACL looks like it had several programs moved and broken out from their previous organization charts , apparently to make it all the easier to terminated in whole at the end of the budget year
My sense is that they did the majority of the elimination already, but I suspect there will be more once the reorg is in full swing. There are also lots of retirements and resignations lately even in my small agency that wasn’t hit by RIFs (yet…).
The cuts to aging and disability programs are absolutely devastating. Even a quarter of the cuts would be absolutely appalling and do immeasurable damage to the well being of seniors and people with disabilities living in the community. ADRCs, P&As , DD COUNCILS, National Institute on Disability Independent Living and Rehabilitation, Falls Prevention, Paralysis, Limb Loss , Elder Justice programs all destroyed, maybe a bit of funding for states to do some of the OAA activities if they want to.
This looks about right. I work for state public health in Massachusetts. These cuts are extremely damaging to our entire infrastructure. Starting July 1st (FY26) we have lots of programs ending and people cut, and will basically be running on a skeleton crew. This will take years to rebuild. Thanks for sharing this.
Can't read it all, but I can't find CDC's infectious disease labs, nor the many branches and Divisions that are focused on specific infectious diseases -- what I think of as the heart of CDC, its original core mission. Viral diseases, zoonoses, viral hepatitis, bacterial diseases (like meningococcal disease, etc(. Also can't tell whether these is a unit tasked with receiving, organizaing, and disseminating information case reports of nationally notifiable diseases. And where would the MMWR be?
It seems that for Older Americans Act programs, $2.3B worth of funding is still budgeted (out of $2.6B originally requested in 2025). Still, many programs are being eliminated entirely, including State Long-Term Care Ombudsman and other elder justice initiatives. I put together a spreadsheet of what remains and what has been eliminated for ACl programs here: https://docs.google.com/spreadsheets/d/15jhF_VaZ48qrArK55nQ0Wzd-O4BveZI1uJxEaC9sZXg/edit?gid=444296134#gid=444296134
Thanks for posting this. I’ve written previously about the PEPFAR elements tied to the State Department reorganization, but there’s another critical angle that deserves attention: the CDC’s Global Health Center. It’s facing major cuts in the HHS budget, and it’s still unclear whether any parts will be salvaged or relocated within HHS.
What’s clear is this: PEPFAR implementation will take a hit. Roughly one-third of PEPFAR flows through CDC, and weakening that infrastructure will have real consequences for global HIV programs.
This is depressing, the State Offices of Rural Health policy were the real meat of the program and supported primary care across the nation. In addition, the HRSA med ed was more sensibly financed in the design of its reimbursement than Medicare and also more geographically diverse. Finally, they hit nurses hard and it's the source of training funds and support (what do they hate them.)
I have not been able to stop thinking about all of this since seeing it yesterday. As a pediatric NP, I am so worried about the elimination of Head Start, the universal newborn hearing screening program, the newborn screening program for heritable disorders and the CPSC. If I’m interpreting this document correctly, I believe parts of the CPSC are being re-organized/redistributed but know that it will never be the same. The work done in that department alone saves countless lives- who will be there to investigate and inform the public about products that are widely used for infants like swings and loungers that have been connected to infant deaths?
I also noticed that there is a policy that all supplies used need to be “Made in America” and that there is a waiver for this but I have a feeling it will be next to impossible to be granted an exception. As we all know, there are certain things critical to the research and other missions that the US simply does not have the resources to produce. So even programs that are not being eliminated will effectively be impossible to operate.
As an FNP, and a mom, and a former postpartum RN, I share all your concerns. I have been shouting from the rooftops about the changes proposed to the newborn screening for heritable disorders advisory panel (they want to kick ACOG off). It is truly devastating and cruel what they are planning to destroy. Our healthcare system is already so fragile, and this is putting dynamite inside. People will die.
Fascinating read. I’m Harrison, an ex fine dining industry line cook. My stack "The Secret Ingredient" adapts hit restaurant recipes (mostly NYC and L.A.) for easy home cooking. Dm me if interested in a recommendation swap — we’re growing fast!
So… Re NIH: Behavioral Health is not part of Brain Research but Dental and Craniofacial is??? Last I checked the brain drove behavior and teeth were not part of the brain.
I mean....at the end of the day, we don't know where these programs will land. Will they be in some reasonable place? Some unreasonable place? Gone? What's lacking is transparency...and discussion with actual HHS employees. Most of this is coming from a few favored DOGE operatives, I'm told.
And those DOGE operatives never talked with ACL before firing half the staff and breaking up the agency for spare parts. Several of the critical services that their statements imply.that they are protecting aren't protected and to the best of my knowledge nobody from DOGE spoke with career staff or our stakeholders to assess what is being done. The result for seniors and people with disabilities will likely be devastating
The information about my very small corner of the department coincides with what I’ve heard internally. That’s all I’ll say publicly.
Do you think there's a chance that it'll be more re-org and less "eliminate"?
I just read through the PDF and my suspicions were correct. There’s likely to be a second round of RIFs associated with the reorg. The agency I work with will likely see a 35% funding reduction from what we expected for FY26 🫠
A re-org generally results in justifying “redundant positions” I.e. eliminating positions and laying people off. My two cents.
ACL looks like it had several programs moved and broken out from their previous organization charts , apparently to make it all the easier to terminated in whole at the end of the budget year
My sense is that they did the majority of the elimination already, but I suspect there will be more once the reorg is in full swing. There are also lots of retirements and resignations lately even in my small agency that wasn’t hit by RIFs (yet…).
It's not fake. Leaks are never fake. Thank you for looking into this.
Wth AI, we will someday see a REALLY good fake. But, yeah, so far, these documents have always been real.
The cuts to aging and disability programs are absolutely devastating. Even a quarter of the cuts would be absolutely appalling and do immeasurable damage to the well being of seniors and people with disabilities living in the community. ADRCs, P&As , DD COUNCILS, National Institute on Disability Independent Living and Rehabilitation, Falls Prevention, Paralysis, Limb Loss , Elder Justice programs all destroyed, maybe a bit of funding for states to do some of the OAA activities if they want to.
Pg 29: Sell surplus in the national stockpile. Someone who knows about this - What does that mean if there is a national emergency?
We’d be screwed.
We’d be screwed.
It’s impossible to read this. Can someone please find a way to make the pdf more clear?
Same here. I'm unable to expand the graph.
This looks about right. I work for state public health in Massachusetts. These cuts are extremely damaging to our entire infrastructure. Starting July 1st (FY26) we have lots of programs ending and people cut, and will basically be running on a skeleton crew. This will take years to rebuild. Thanks for sharing this.
Can't read it all, but I can't find CDC's infectious disease labs, nor the many branches and Divisions that are focused on specific infectious diseases -- what I think of as the heart of CDC, its original core mission. Viral diseases, zoonoses, viral hepatitis, bacterial diseases (like meningococcal disease, etc(. Also can't tell whether these is a unit tasked with receiving, organizaing, and disseminating information case reports of nationally notifiable diseases. And where would the MMWR be?
let me see if I can learn anything. thx for flagging
The commenter is conflating funding lines with the operating units (i.e., divisions, branches) those funding lines fund.
Is there a private way to tell you what I know about some software that has been set to Washington regarding what you just wrote?
yes on Signal at InsideMedicine.88 or via email jsfaust@bwh.harvard.edu
I sent you an email.
It seems that for Older Americans Act programs, $2.3B worth of funding is still budgeted (out of $2.6B originally requested in 2025). Still, many programs are being eliminated entirely, including State Long-Term Care Ombudsman and other elder justice initiatives. I put together a spreadsheet of what remains and what has been eliminated for ACl programs here: https://docs.google.com/spreadsheets/d/15jhF_VaZ48qrArK55nQ0Wzd-O4BveZI1uJxEaC9sZXg/edit?gid=444296134#gid=444296134
Impacts on the DD Act side are absolutely devastating
Thanks for posting this. I’ve written previously about the PEPFAR elements tied to the State Department reorganization, but there’s another critical angle that deserves attention: the CDC’s Global Health Center. It’s facing major cuts in the HHS budget, and it’s still unclear whether any parts will be salvaged or relocated within HHS.
What’s clear is this: PEPFAR implementation will take a hit. Roughly one-third of PEPFAR flows through CDC, and weakening that infrastructure will have real consequences for global HIV programs.
sniffs post
Smells like project 2025 🤢
This is depressing, the State Offices of Rural Health policy were the real meat of the program and supported primary care across the nation. In addition, the HRSA med ed was more sensibly financed in the design of its reimbursement than Medicare and also more geographically diverse. Finally, they hit nurses hard and it's the source of training funds and support (what do they hate them.)
I have not been able to stop thinking about all of this since seeing it yesterday. As a pediatric NP, I am so worried about the elimination of Head Start, the universal newborn hearing screening program, the newborn screening program for heritable disorders and the CPSC. If I’m interpreting this document correctly, I believe parts of the CPSC are being re-organized/redistributed but know that it will never be the same. The work done in that department alone saves countless lives- who will be there to investigate and inform the public about products that are widely used for infants like swings and loungers that have been connected to infant deaths?
I also noticed that there is a policy that all supplies used need to be “Made in America” and that there is a waiver for this but I have a feeling it will be next to impossible to be granted an exception. As we all know, there are certain things critical to the research and other missions that the US simply does not have the resources to produce. So even programs that are not being eliminated will effectively be impossible to operate.
As an FNP, and a mom, and a former postpartum RN, I share all your concerns. I have been shouting from the rooftops about the changes proposed to the newborn screening for heritable disorders advisory panel (they want to kick ACOG off). It is truly devastating and cruel what they are planning to destroy. Our healthcare system is already so fragile, and this is putting dynamite inside. People will die.
Can someone who doesn’t have terrible eyes explain the chart to me?
It’s impossible to read this. Can someone please find a way to make the pdf more clear?
Fascinating read. I’m Harrison, an ex fine dining industry line cook. My stack "The Secret Ingredient" adapts hit restaurant recipes (mostly NYC and L.A.) for easy home cooking. Dm me if interested in a recommendation swap — we’re growing fast!
check us out:
https://thesecretingredient.substack.com