What’s Inside HHS’ Budget Proposals for FY 2026?

The Trump administration’s fiscal 2026 budget-in-brief for the U.S. Department of Health and Services cuts deeply into some agencies including the National Institutes of Health, but calls for continued security and HIPAA regulatory enforcement actions under a consolidated watchdog organization.

See Also: New Attacks. Skyrocketing Costs. The True Cost of a Security Breach.

The budget justification documents describe plans for HHS’s proposed $94.7 billion total discretionary budget authority for fiscal 2026. That’s a $31 billion reduction from HHS’ $126 billion discretionary budget in fiscal 2025.

The documents provide a little more detail to flesh out broader proposals that the White House released in its “skinny budget” in May.

In March, HHS secretary Robert F. Kennedy Jr. announced a massive department-wide reorganization and downsizing that included consolidating HHS’ 28 divisions into 15 new units, closing five of HHS’s 10 regional offices and reducing its full time employee workforce from 82,000 to about 62,000 (see: RFK Jr Cuts at HHS Affect HIPAA, Cyber Response Units).

The HHS budget requests provide the HHS secretary “with resources needed for oversight of the largest cabinet department in terms of budget,” the budget document said.

“Funding supports program integrity oversight and operations and management in the Office of the Secretary, areas historically underfunded; departmental cybersecurity and health IT and external affairs to communicate Make America Healthy Again priorities and engage with Americans,” the document said.

Every year, a president’s budget request is little more than a wish list because Congress must enact appropriations, and the final funding levels always differ from the administration’s requests.

Also complicating matters this time is the ongoing political battle underway in Congress – not just with pushback from Democratic lawmakers but also with resistance from conservative spending hawks in the Republican Party – fueling uncertainty about what proposals will ultimately end up in President Trump’s “big beautiful” mega bill, especially as it works its way through the Senate this week.

That bill – which aims to extend Trump tax cuts that are slated to expire at the end of this year – also proposes huge cuts to a variety of HHS programs, including Medicaid and Affordable Care Act reforms.

HIPAA Efforts

Under HHS’ reorganization, a newly created Assistant Secretary for Enforcement consolidates under one umbrella several HHS units, including the Office for Civil Rights, which oversees HIPAA enforcement – along with the offices of Medicare Hearings and Appeals, Human Research Protections and the Departmental Appeals Board.

HHS’ budget request for ASE is nearly $237.7 million and a combined workforce of 893 full time employees.

“ASE will continue to enforce laws, investigate complaints, develop policy, promulgate regulations and provide technical assistance and public education,” the budget document said.

“The Office for Civil Rights requests non-trust fund Budget Authority levels that will maintain its current programmatic activities and continue defending the public’s right to nondiscriminatory access to HHS funded health and human services and enforcing health information privacy and security laws,” the budget document said.

In fiscal 2025, HHS sought an OCR budget of $57 million.

“OCR is experiencing an increase in its case backlog due to the recent sharp decrease in the number of investigators on staff,” the fiscal 2026 budget request documents said. “At the close of FY 2024, the backlog stood at 6,532, whereas in May 2025 it stands at 13,274.”

The budget document also notes that HHS OCR is separately expected to collect about $10 million in fiscal 2026 through enforcement actions such as HIPAA settlements and civil monetary penalties. Under the HITECH Act of 2009, settlement and penalty collections can be reinvested by HHS OCR to supplement its HIPAA enforcement and education programs.

Besides HIPAA privacy, security and breach-related activities, HHS OCR also enforces federal laws related to healthcare civil rights and conscience and religious freedom laws. “Funding proposed for FY 2026 will further enable the agency to support investigations and other operations to address new and pending claims,” the document said.

CTO Proposal

The HHS budget proposals also includes $130 million to establish the Chief Technology Officer. That include the Offices of the Chief Information Officer, which was previously under the Assistant Secretary for Administration, and the Assistant Secretary for Technology Policy.

ASTP was formerly known as the Office of the National Coordinator for Health IT before it was renamed during the Biden administration.

“Through OCIO and ASTP will lead and coordinate HHS’ cybersecurity and health information technology efforts, including through policy development, standards coordination and protecting data assets and IT systems,” HHS budget document said. “Each represents a potential cyber target for malicious actors.”

Within CTO, the budget designates $100 million for the HHS Cybersecurity Program, “which ensures that Departmental IT is designed and maintained with the advanced security and data privacy protections needed to operate in a landscape of growing cyberthreats,” the budget document said.

“CTO will focus on promoting a nationwide interoperable health IT infrastructure to ensure providers and patients can efficiently and securely exchange electronic information across all levels of the healthcare continuum,” the document said.

CTO will also continue implementing a nationwide technical floor for healthcare interoperability through the Trusted Exchange Framework and Common Agreement, or TEFCA. TEFCA provides network-to-network health information sharing and reduces barriers to accessing the network communication (see: 6 Networks Named in Nationwide Health Data Exchange).

Other Proposals

Among units seeing the biggest HHS budget cuts are the National Institutes of Health, which is slated to receive only $27.5 billion down from about $46 billion in fiscal 2025.

Also the Food and Drug Administration would receive a $6.8 billion under the budget, an overall decrease of $271.0 million compared to the FY 2025 enacted level.

But the budget proposals appear to increase funding for FDA device programs. The proposed FY 2026 budget for the devices program is $883 million including nearly $455 million in budget authority and $428.1 million in user fees. The FDA’s budget authority would increase by $8.2 million and user fees would increase by nearly $33.5 million over the FY 2025 enacted budget, the document said.

“The Devices Program drives innovation to empower healthcare providers, support healthier outcomes for patients and meet the mission to create a stronger, more resilient public health system,” the budget document said.

Still the budget document said certain cuts to the FDA’s center for devices and radiological health – which among other work conducts much of FDA’s cybersecurity work around medical devices – are slated to eliminate $84.2 million through “reduction of federal bureaucracy” including 260 fewer full-time employees.