May 2, 2025
TRUMP RELEASES HIGH LEVEL DISCRETIONARY BUDGET RECOMMENDATIONS FOR 2026
Today the Trump administration sent Congress the topline discretionary budget recommendations for 2026, outlining proposed discretionary funding levels to guide appropriations ahead of the full budget release expected later next week. Trump’s recommendations for 2026 include a more-than-20% cut in nondefense spending — a proposed level of cuts Congress is not accustomed to. The request also outlines cuts to the Substance Abuse and Mental Health Services Administration (SAMHSA), while stating its commitment to “combatting the scourge of deadly drugs” and proposal to “refocus activities formerly a part of SAMHSA and [reduce] waste by eliminating inefficient funding.” More will emerge on the administration’s request when more detailed agency request documents are published. The president’s proposed budget does not obligate Congress to follow it and provides a starting point for appropriations negotiations and a statement of the president’s priorities.
The Budget requests approximately $93.8 billion in discretionary funding for the Department of Health and Human Services (HHS) — a notable, roughly 20% decrease from the $127 billion in fiscal year (FY) 2025.The high-level budget request also outlines a broad restructuring of HHS reflecting previously announced plans to create the Administration for a Health America and inclusion of widespread program eliminations, consolidations, and significant funding reductions across agencies. These changes are framed as part of the administration’s push to improve efficiency, reduce duplication, and shift greater responsibility to states. The Budget also includes a proposed new investment in the President’s Make America Healthy Again (MAHA) initiative.The budget request outlines high-level cuts to programs previously under the Substance Abuse and Mental Health Services Administration (SAMHSA) and states the administration’s commitment to “combatting the scourge of deadly drugs” and proposes to “refocus activities formerly apart of SAMHSA and reduces waste by eliminating inefficient funding.”There are lots of documents with far more detail yet to be released WITH THE HIGH LEVEL RECOMMENDATIONS THAT CAME OUT TODAY. from the White House Stand by.
Statement of Sharon Parrott, CBPP President, on partial details of President Trump’s 2026 budget:
The Trump Administration’s partial budget plan released today is just its latest repudiation of the Trump campaign’s promises to help people struggling at the margins of the economy — an economy that President Trump’s misguided tariff policies are threatening to tank.
This partial budget does not discuss the President’s intended tax breaks — tilted to the well off — or policies he will include (like those he supports as part of the reconciliation bill) to take food assistance and health coverage away from people who need them to meet their basic needs and to make college more expensive. The full budget will come later. But while the Administration’s partial plan is limited to the part of the budget that Congress funds through the annual appropriations process, its proposal to cut that funding by nearly one-quarter is plenty bad enough, harming people, communities, and the economy.
During the campaign, President Trump said, “As soon as I get to office, we will make housing much more affordable.” But his budget proposes a devastating cut to rental assistance — which makes rent affordable for 10 million people — reducing funding by $27 billion below the amount provided in 2025 across five programs. This would cause millions of people to lose assistance they need to pay the rent each month, placing them at risk of eviction and homelessness.
These cuts would likely grow even deeper over time, since the budget would also consolidate multiple rental assistance programs into a block grant that would be more vulnerable to cuts in the future. The budget also would impose a two-year time limit on rental assistance (apparently except for seniors and people with disabilities), a policy that would abruptly evict or end assistance for many low-paid workers and others who aren’t able to afford market rents after that period.
In addition, the budget proposes severe cuts to other housing programs, such as sharply reducing funding for housing and other services for people experiencing homelessness, cutting housing resources for Indigenous people, and eliminating funding for local agencies protecting people from housing discrimination and other fair housing violations, and block grants that fund affordable housing and community development at the local level.
The President also said “your heating and air conditioning, electricity, gasoline — all can be cut down in half,” but this budget eliminates LIHEAP, the program that helps low-income households afford to heat and cool their homes; reduces availability of the most affordable sources of energy — solar and wind — by cutting efforts to bring these sources online and make them available in low-income communities; and cuts programs that reduce energy waste.
As the President’s ill-conceived trade policies threaten to tip the country into a recession later this year, the budget disinvests from key sources of long-run economic growth. The budget cuts the National Science Foundation by more than half and the National Institutes of Health by about 40 percent. This is short-sighted: NSF and NIH funding supports foundational research that spurs innovation, leading to greater economic growth. The private sector will not support this work because there is no financial incentive to do so.The budget also disinvests from America’s future workers, cutting $4.5 billion from K-12 education despite the Trump campaign’s statement that “we are going to keep spending our money” on education.
Most fundamentally, the budget fails to propose a serious agenda for the U.S. economy or for people who haven’t been included enough in the country’s overall prosperity. The budget presents no agenda for addressing housing or child care affordability, improving educational outcomes for those our education system doesn’t serve well, maintaining and strengthening innovation, or broadening opportunity.And today’s funding request again breaks President Trump’s repeated promises to protect Social Security, including “Save Social Security. Don’t destroy it.” On paper, the Administration provides the same amount of funding next year as this year, but this is not enough to keep up with inflation, fixed expenses, and growing demand as the number of Social Security recipients grows as the population ages. The Administration has already pushed out 7,000 Social Security Administration staff despite having the money to pay them, and it has already made it harder for seniors and people with disabilities to get the Social Security benefits they’ve earned. This is not what Congress intended when it passed this year’s budget.
The Administration is claiming these massive cuts are necessary under the guise of fiscal responsibility, but the proposed $2.5 billion cut to IRS funding — primarily for tax enforcement — reveals that any commitment to fiscal responsibility is limited. Funding for IRS enforcement pays for itself multiple times over: it provides the staff and technology to catch wealthy tax cheats and encourage everyone to pay the taxes they legally owe.
The Administration justifies many cuts by saying that states are better positioned to cover the costs of various public services and infrastructure needs. This ignores the federal government’s important role in ensuring adequate investment nationwide, including in states and communities that face more economic challenges. The problems would be compounded by potentially large cost shifts in Medicaid and SNAP being considered in Congress. States would face even greater challenges — and the impacts on people and communities would grow — in a recession when state revenues fall but they still have to balance their budgets.
The President’s budget counts on funding in the emerging tax and budget bill for immigration enforcement. With that, it continues to prioritize a mass deportation apparatus that has gone too far already by disappearing people without due process and ending lawful immigration status for hundreds of thousands of people.Since taking office, the Trump Administration, often acting through DOGE, has unilaterally frozen congressionally approved funding, implemented large-scale staffing reductions that are harming public services, and threatened the security of people’s personal information. Having frozen funding in contradiction to enacted funding laws, the President’s budget now asks Congress to codify and continue these unilateral cuts next year, including through the proposed cuts to NIH, NSF, and the Department of Education. Codifying these cuts would make congressional supporters accomplices in this Administration’s endeavor to make government less effective in finding cures for diseases, maintaining American technological leadership, and getting a good education.
The President’s harmful agenda goes well beyond what was released today. The President and his congressional allies are moving forward on a budget and tax bill that deeply cuts health coverage through Medicaid, food assistance through SNAP, and college aid to partially pay for expensive tax cuts skewed to the wealthy.At the same time, the President’s chaotic, indiscriminate, and steep tariffs have sharply increased the risk of recession, which could lead to a rise in unemployment and the number of people who need help to afford the basics, just as those supports are slated for cuts.Policymakers of both parties in Congress need to see this budget, and this entire agenda, for what it is — a direct assault on people, communities, and the economy — and plan a better course for the country.
READ THE STATEMENTor download the PDF (3 pp.)
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FYI. Below please find links to the articles including in the March Medicaid Update which was just sent out by NYSDOH.
Dear Medicaid Update Recipient,
The Office of Health Insurance Programs of the New York State Department of Health has approved the release of the March 2025 Medicaid Update. Please find the interactive issue as a PDF (Portable Document Format) file available to be downloaded at: https://health.ny.gov/health_care/medicaid/program/update/2025/docs/mu_no03_mar25.pdf. A print-ready version is also available on the Medicaid Update web page.
You may also go straight to an article or topic that pertains to you by selecting from the current issue’s table of contents below.
All Providers
- Office of the Medicaid Inspector General Selects Performant as Recovery Audit Contractor for the New York State Medicaid Program, Effective April 7, 2025 (Cover)
- Subscribe to the eMedNY LISTSERV®
- Register for the Project TEACH 2025 “Webinar Wednesday” Series
- New York State Medicaid Evidence Based Benefit Review Advisory Committee Update
- 2025 Spousal Impoverishment Income and Resource Levels Increase
Policy and Billing
- Medicaid Breast Cancer Surgery Centers
- Reminder: Recipient Restriction Program and Opioid Treatment Program Services
REMINDER: Please notify us immediately if your email address changes so that we may continue to keep you updated on current Medicaid policy guidelines and bulletins. It is the responsibility of each provider to alert Medicaid of any address or email changes as soon as they occur. Please send your new information to MedicaidUpdate@health.ny.gov. We thank you for your continued feedback.
Thank you,
Medicaid Update
New York State Department of Health
Office of Health Insurance Programs
99 Washington Ave, Albany, NY 12237
School Mental Health Grants Reduced by $1 Billion
The Trump administration this week said it will cancel $1 billion in school mental health grants, saying they do not reflect the new administration’s priorities. The Department of Education said in a notice to Congress that it plans “to re-envision and recompete its mental health program funds to more effectively support students’ behavioral health needs.” The grants were intended to help schools hire counselors, psychologists and other mental health professionals. As with other federal grant terminations in recent months, there may be litigation filed attempting to prevent these clawbacks, however, no such lawsuits have been filed as of this writing.
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SUPPORT Act Passes Committee, But Not Unanimously
On April 29, the E&C marked up and advanced a reauthorization of the SUPPORT Act, legislation originally passed in 2018 as the largest congressional investment in overdose prevention, creating critical funding sources for numerous community-based treatment and recovery programs. The vote, however, was not unanimous, as it had been the last time the bill was considered in July 2023. A majority of committee Democrats voted against it in the wake of workforce reductions and funding cuts at SAMHSA and many other government agencies that they view as critical to the nation’s fight against the opioid crisis. The final vote, 36-13 in favor, came after Democrats attempted to attach numerous amendments seeking to restore additional grant funding for substance use programs and to enshrine protections for Medicaid programmatic structure and funding against the potential threats posed by forthcoming reconciliation legislation.
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How Medicaid ‘Expansion’ Changes Could Affect New York
by Bill HammondAs House Republicans consider cutbacks to federal Medicaid funding, their focus has turned to the so-called expansion population.Although the details of these proposals remain undetermined, the stakes for New York in this debate are high. Its enrollment among the expansion population and its federal funding for those enrollees are both disproportionately large.
Medicaid’s “expansion population” refers to non-disabled adults under age 65 with incomes up to 138 percent of the federal level, which was the demographic group targeted by the Affordable Care Act’s expansion of Medicaid coverage.
New York and some others states covered much of this population prior to enactment of the ACA. However, many states offered coverage to relatively few non-disabled adults or excluded them from Medicaid entirely.As an incentive for states to broaden their programs, ACA offered enhanced federal aid for non-disabled adults, which currently stands at 90 percent of the costs. The federal share for other enrollees ranges from 50 percent for the wealthiest states (including New York) to almost 77 percent for the poorest (Mississippi).As the Congress seeks to slow the growth of federal Medicaid spending, its Republican leaders are considering proposals to change this policy – by, for example, phasing out the higher matching rate for expansion enrollees or establishing a growth cap on federal funding per enrollee.As of June 2024, New York’s Medicaid program covered 2.1 million expansion adults, according to federal data. That was 11 percent of the state’s total population, the sixth-highest rate among the 41 states that joined the ACA expansion.Read the Full Article on EmpireCenter.org