Why It Matters

The Trump administration is seeking to narrow the CDC’s mission and reduce its workforce, setting up a clash with Congress over the future scope, funding and structure of the nation’s principal public health agency.

A Congressional Research Service report published in June details the structure, functions and congressional funding framework of the Centers for Disease Control and Prevention as the Trump administration pursues a narrower mission for the agency. CDC's responsibilities have expanded over decades beyond infectious disease control to include chronic disease prevention, injury prevention, environmental health, occupational health and other public health functions.

The Trump administration's fiscal 2026 and fiscal 2027 budget proposals sought to refocus CDC on core functions such as infectious disease surveillance, outbreak investigations and public health infrastructure while shifting or consolidating some other programs. The fiscal 2027 budget proposes $5.28 billion in CDC budget authority, down $484 million from the comparable fiscal 2026 level, and 9,054 full-time equivalent positions, down 1,282.

Congress, however, retains authority over CDC appropriations and can accept, reject or modify the administration's proposals.

The Big Picture

The CDC's current footprint reflects decades of expansion. Its mission extends beyond infectious diseases to preventing leading causes of death, injury and disability and promoting health more broadly. CDC also provides leadership and coordination to state, local, territorial and tribal public health agencies and assists them in investigating and responding to health threats.

CDC distributes a significant portion of its funding through grants and cooperative agreements. In fiscal 2023, the agency awarded 6,982 grants totaling more than $12.6 billion in obligations, including $6.7 billion in non-COVID-related awards and $5.8 billion in COVID-related awards, most of which came from supplemental appropriations. Recipients included state and local governments, nonprofits, tribal entities, foreign governments and organizations, and for-profit organizations.

The Trump administration's proposed restructuring would reverse some of the agency's expansion. The fiscal 2026 budget sought to refocus CDC on emerging and infectious disease surveillance, outbreak investigations and maintaining public health infrastructure. The fiscal 2027 proposal continues that approach, emphasizing data, surveillance, laboratory science, global preparedness and infectious disease response.

The fiscal 2027 proposal also calls for transferring several CDC programs into a new Administration for a Healthy America, which would combine programs from CDC with the Health Resources and Services Administration, Substance Abuse and Mental Health Services Administration and Office of the Assistant Secretary for Health.

Congress has historically exercised substantial influence over CDC priorities through annual appropriations. That congressional role is particularly significant because CDC lacks a single overarching statutory authorization establishing all of its responsibilities. Instead, the agency administers programs under numerous separate statutory authorities while Congress directs funding toward individual programs and activities.

The administration has also pursued workforce reductions. Its fiscal 2027 budget anticipates 9,054 CDC full-time equivalent positions, compared with an estimated 10,336 in fiscal 2026 and 11,534 in fiscal 2025 on a comparably adjusted basis. That would represent a reduction of roughly 2,480 positions from fiscal 2025 through the fiscal 2027 proposal.

The Bottom Line

The debate over CDC's future centers on how broadly the federal government's principal public health agency should define its mission. The administration is seeking to concentrate CDC resources on infectious diseases, surveillance, laboratories, outbreak response and other foundational public health capabilities while reorganizing or transferring other functions.

Congress can take a different approach through appropriations and legislation. The tension therefore extends beyond the size of CDC's budget to which public health functions should remain within the agency and how much discretion an administration should have to reorganize programs that Congress has funded.

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