Why It Matters
The Centers for Disease Control and Prevention is the federal government's primary engine for disease surveillance, outbreak response, and public health grants to states and localities. A large share of its budget flows directly to state and local health departments. When that funding changes, the effects ripple outward fast.
A new Congressional Research Service report on CDC funding lays out in stark terms the distance between what Congress has appropriated for the nation's public health agency and what the Trump administration wants to spend.
The report, updated May 14, 2026, documents that as of that date, the Trump administration had already terminated 444 CDC grants totaling $5.78 billion in unliquidated obligations, meaning funds that had been appropriated by Congress but not yet spent. That's happening even before Congress takes up the administration's proposed budget for the next fiscal year, which would cut CDC's core public health program level by more than 40 percent in nominal terms.
The Big Picture
What Congress Actually Approved
For the current fiscal year, Congress enacted a CDC core public health program level of $9.227 billion, a modest decrease of $21 million, or 0.2 percent, from the prior year. When mandatory programs like the Vaccines for Children program and the World Trade Center Health Program are included, the agency's total program level comes to an estimated $16.266 billion, down $459 million, or 2.7 percent, from the year before.
That number reflects years of relatively stable CDC congressional funding. From 2011 to 2021, the agency's core public health program level held mostly between $6.5 and $8 billion. It rose sharply in 2022 and 2023, driven largely by COVID-19 relief legislation and the American Rescue Plan Act. Since 2023, it has been roughly flat, with slight dips in 2024 and again this year.
What the Administration Wants
The Trump administration's proposed budget for the next fiscal year requests a CDC core public health program level of $5.485 billion. The administration notes the figure isn't directly comparable to current spending because of proposed program relocations, but even accounting for those moves, the CRS report calculates a reduction of $1.228 billion, or 18.3 percent, on a comparable basis. In nominal terms, the proposed cut is $3.743 billion, or 40.6 percent.
The proposal would also eliminate the Prevention and Public Health Fund, a mandatory funding stream created by the Affordable Care Act that provided $1.398 billion to CDC in the current fiscal year. That fund supports programs including tobacco prevention, the Section 317 immunization program, diabetes prevention, heart disease and stroke programs, and public health infrastructure grants.
Beyond the dollar figures, the administration has proposed moving entire CDC divisions to a new entity called the Administration for a Healthy America, a proposed new operating division within the Department of Health and Human Services. Programs targeted for relocation include those covering HIV/AIDS, viral hepatitis, sexually transmitted infections, and tuberculosis prevention; chronic disease prevention and health promotion; birth defects and developmental disabilities; and injury prevention and control.
The administration also proposes eliminating several programs outright, including youth violence prevention, adverse childhood experiences programs, firearm injury and mortality prevention research, and several other injury prevention activities.
Congress Pushes Back
Congress did not simply appropriate money and move on. The fiscal year 2026 spending law included several new provisions that appear designed specifically to constrain executive flexibility over CDC's budget.
One provision, Section 236, legally incorporates the funding tables from the accompanying explanatory statemen into the law itself. In prior years, Congress had specified funding for more than 160 individual CDC programs in those tables, but agencies were not legally required to follow them. The new provision changes that, making the line-item allocations binding by law.
A second provision, Section 239, requires HHS to submit a detailed reorganization plan to the appropriations committees at least 60 days before initiating any reorganization of CDC programs or functions. Given that the administration has already terminated hundreds of grants and proposed moving major divisions out of the agency, this provision sets up a direct tension between congressional intent and executive action.
A third provision, Section 524, requires HHS to notify appropriations committees at least three days before terminating or not renewing any grant, along with a brief explanation. The CRS report notes that as of May 13, HHS had already terminated 444 CDC grants totaling $5.78 billion in unliquidated obligations.
Emergency Reserve Funds Remain Intact
One area where the picture looks more stable is the Infectious Diseases Rapid Response Reserve Fund, established in 2019 and used for responses to Ebola outbreaks, the mpox outbreak, and COVID-19. As of March 2026, the fund holds an unobligated balance of $541.3 million. Congress has continued to appropriate $25 million annually to the fund in recent years, including in the current fiscal year.
By contrast, the older Public Health Emergency Fund currently holds a balance of just $56,508 and has not received appropriations in many years.
Political Stakes
For the Administration
The proposed restructuring of CDC represents one of the most significant proposed changes to the federal public health architecture in decades. The administration's budget would not just cut spending — it would fundamentally reorganize where programs sit within HHS, eliminate the ACA-created mandatory funding stream that has underpinned prevention programs for over a decade, and eliminate research programs that have been politically contentious, including firearm injury research.
The grant terminations already underway suggest the administration is not waiting for the appropriations process to begin reshaping the agency. That creates legal exposure, given the new congressional notification requirements in the fiscal year 2026 spending law.
For Congress
The new provisions embedded in the fiscal year 2026 appropriations law signal that at least the appropriations committees are paying close attention. By legally binding CDC to the explanatory statement funding tables and requiring advance notice of reorganizations and grant terminations, Congress has created a paper trail and a potential enforcement mechanism for oversight.
Whether Congress ultimately goes along with the administration's proposed cuts for the next fiscal year remains an open question. The CRS report provides the baseline data lawmakers need to evaluate what programs would be affected and at what scale.
For States and the Public
A large share of CDC's budget flows outward as grants to state and local health departments, tribal governments, academic institutions, and nonprofits. In fiscal year 2023, CDC obligated more than $12.5 billion in grants for public health programs and research. The termination of 444 grants worth $5.78 billion in unspent funds means that money is no longer flowing to those recipients, before Congress has acted on the administration's proposed budget.
The Bottom Line
The CRS report on disease control and prevention funding makes two things clear. First, the gap between what Congress has enacted and what the Trump administration has proposed is not a rounding error; it represents a fundamental disagreement about the size and scope of the federal public health enterprise. Second, that disagreement is already playing out in real time, through grant terminations and reorganization proposals that predate any congressional action on next year's budget.
For Congress, the question is whether the guardrails it built into the fiscal year 2026 spending law are sufficient to shape what happens next or whether the administration's restructuring will outpace the oversight mechanisms lawmakers put in place.
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