The FY 2027 HHS Budget Proposal: Changes, Cuts, and Investments

In this episode of Health Affairs This Week, host Jeff Byers welcomes Jessica Bylander to discuss the White House's proposed fiscal year 2027 budget for the Department of Health and Human Services (HHS). The proposal requests $111 billion in discretionary funding for HHS—12.5% less than the 2026 enacted level—marking significant cuts to key agencies like the National Institutes of Health (NIH), which faces a $5 billion reduction and potential elimination of the National Institute on Minority Health and Health Disparities and the National Center for Complementary and Integrative Health. The budget also proposes slashing the Low Income Home Energy Assistance Program (LIHEAP) by $4 billion and creating the Administration for a Healthy America (AHA), a new initiative tied to the 'Make America Healthy Again' (Maha) agenda. This initiative focuses on nutrition, food safety, and chronic disease prevention, including efforts to phase out petroleum-based food dyes and update dietary guidelines to emphasize whole foods and reduce ultra-processed foods. The episode explores how these changes reflect broader ideological priorities, particularly the targeting of diversity, equity, and inclusion (DEI) initiatives as 'misuse of funds,' while also highlighting the political nature of the budget process, which remains subject to congressional negotiation and potential delays or shutdowns. Despite the sweeping cuts, the only major investment highlighted in the proposal is the Maha initiative, signaling a strategic realignment of HHS priorities. The episode concludes with a note on the symbolic and practical implications of these changes, such as the visual transformation of products like Doritos Simply, which now appear in plain packaging. The hosts emphasize that while the budget is a political signal rather than a final law, it reveals the administration’s priorities and ideological leanings. The discussion underscores the tension between public health goals and political agendas, particularly around food policy, research funding, and social equity programs.