红领巾瓜报

On April 3, President Trump听听his fiscal year (FY) 2027 budget request to Congress, with听$111.1 billion听requested in discretionary budget authority for HHS for FY 2027, a听$15.8 billion听or 12.5 percent decrease from the FY 2026 enacted level. The President鈥檚 budget for HHS continues to advance the Administration鈥檚 MAHA vision through proposals to听establish听the Administration for a Healthy America and听eliminate听programs that are viewed as inconsistent with MAHA goals.听

As with the FY 2026 budget request, HHS once again听听to reorganize the department in the FY 2027 budget request, though the approach varies slightly from that proposed last year. As previously proposed, HHS seeks to consolidate the Office of the Assistant Secretary for Health (OASH), the Health Resources and Services Administration (HRSA), the Substance Abuse and Mental Health Services Administration (SAMHSA), and several centers and programs from the Centers for Disease Control and Prevention (CDC) into a new Administration for a Healthy America (AHA). Under this proposal, AHA would receive听$14.7 billion听in discretionary funding, reducing the funding of the听consolidated听programs by a total of听$5 billion. Additionally, as in the FY 2026 budget, the FY 2027 budget proposes to combine the Administration for Children and Families (ACF) and the Administration for Community Living (ACL) into a new Administration for Children, Families, and Communities (ACFC) with听$28.7 billion听in funding, a reduction of听$7 billion听from the current combined levels for the two programs.听

Differing from last year鈥檚 proposed organization, the budget proposes to consolidate the Agency for Toxic Substances and Disease Registry, CDC鈥檚 National Institute for Occupational Safety and Health and National Center for Environmental Health, FDA鈥檚 National Center for Toxicological Research, and the NIH鈥檚 National Institute for Environmental Health Sciences into a new 鈥淣ational Center for Chemicals and Toxins.鈥� The Center would receive听$1 billion听in funding. The budget also differs from last year鈥檚 proposal in that it funds ASPR and ARPA-H as their own divisions.听

As currently organized, the budget proposes the following amounts in discretionary funding for key HHS agencies:听

• $3.3 billion听for FDA, a decrease of 3.3 percent from FY 2026;听
• $5.3 billion听for CDC, a decrease of 42 percent from FY 2026;听
• $9.1 billion听for IHS, an increase of 14 percent from FY 2026; and听
• $41.2 billion听for NIH, a decrease of 11 percent from FY 2026.听

Notably, HHS is not proposing to reorganize the current structure of NIH as it did in the FY 2026 budget request. However, the budget does propose to eliminate the National Center for Complementary and Integrative Health, the Fogarty International Center, and the National Institute on Minority Health and Health Disparities, and to consolidate the National Institute of Drug Abuse and the National Institute on Alcohol Abuse and Alcoholism into a new National Institute of Substance Use and Addiction Research.听

In response to the budget, Senate Appropriations Chair Susan Collins issued a听, saying,听鈥�The President鈥檚 Budget Request is just that, a request鈥�. While there are some improvements over last year鈥檚 domestic discretionary budget request, including full support for the Pell Grant program, the request has several shortcomings. For example, the proposal includes unwarranted funding cuts in biomedical research.听After careful review, Congress decisively rejected these particular cuts last year.听While the Administration proposes a budget, Congress holds the power of the purse. The Senate Appropriations Committee will now hold hearings with cabinet members and agency heads to review these recommendations and to explore other fiscally responsible proposals.鈥�听

In addition to appropriations hearings, HHS Secretary Robert F. Kennedy, Jr. is expected to testify before the House Ways and Means Committee on April 16, followed by the House Energy and Commerce Committee on April 21, and the Senate HELP and Finance Committees on April 22.听Additional听hearings are expected to be announced in the upcoming weeks.听

On April 2, President Trump issued听a听听imposing a 100 percent tariff on certain patented pharmaceuticals and associated pharmaceutical ingredients.听The proclamation states that, through this investigation, the Secretary of Commerce has determined 鈥渢he present quantities and circumstances of imports of pharmaceuticals and pharmaceutical ingredients threaten to impair the national security and economy,鈥� via overreliance on foreign supply chains. As such, the proclamation imposes a 100 percent听ad valorem听duty rate on the import of certain patented pharmaceuticals and associated pharmaceutical ingredients, listed in听听of the proclamation, and 鈥渆xcept as otherwise detailed鈥� in the proclamation, which goes on to make several specific categorical exceptions.听

Companies that have fully executed听听with the White House to provide for 鈥渕ost-favored-nation鈥� pricing听and to听onshore domestic manufacturing of their products are fully exempt from the tariffs. Those that have not made these full agreements but have plans to onshore production of their products will see a 20 percent听ad valorem听duty rate on imports of pharmaceuticals and APIs. Rates for these companies will increase to 100 percent four years after the date of the proclamation.听

Additionally, the proclamation recognizes 鈥減harmaceutical-related commitments in existing trade deals with the European Union, Japan, the Republic of Korea, and Switzerland and Liechtenstein jointly, as well as a future pharmaceutical-related deal with the United Kingdom (on which the United States and the United Kingdom have reached an agreement in principle as of December 1, 2025).鈥� The White House听听accompanying听the proclamation clarifies that products from the EU, Japan, Korea, or Switzerland and Liechtenstein will see a rate of 15 percent, while 鈥渁 lower tariff鈥� will apply to the U.K.听

Finally, the proclamation makes a broad exception for generic pharmaceuticals and APIs, including biosimilars from tariffs, which the fact sheet states will be reassessed in one year. The proclamation also institutes exemptions for听a number of听specific product types, including orphan drugs with exclusively orphan indications, nuclear medicines, plasma-derived therapies, fertility treatments, cell and gene therapies, and medical countermeasures, among other categories.听

The tariffs will go into effect on July 31, 2026, for larger companies listed in听, and September 29, 2026, for smaller companies.听

On Monday, April 6, CMS听听the Calendar Year (CY) 2027 Medicare Advantage (MA) and Part D Rate Announcement, finalizing policies that 鈥渁re projected to result in an increase of听听or over听$13 billion听in payments to MA plans in CY 2027,鈥� in contrast with the much more modest 0.09 percent increase the agency had proposed in its initial Advance Notice.听Despite a higher rate increase, however, CMS did听finalize听certain policies expected to reduce payments for certain plans, including by excluding diagnoses from unlinked chart review records from risk adjustment, subject to an exception for enrollees transitioning to new plans.听

Additionally, on April 2, CMS issued several annual payment rules, including:听

• The听, which revises the Medicare Advantage (MA) Program, Medicare Prescription Drug Benefit Program (Part D), and Medicare Cost Plan Program for CY 2027. Notably, in the final rule, CMS听finalized听proposed MA and PD Star Ratings changes that are projected to result, on net, in an听additional听$18.56 billion听paid to plans between 2027 and 2036. CMS also听finalized听several changes intended to reduce administrative burden,听in accordance with听, such as by rescinding the requirement that MA plans send certain mid-year notices about unused supplemental benefits.听
• The听, which proposes to increase IPF PPS payment rates by 2.3 percent;听
• The听, which proposes to increase SNF PPS rates by 2.4 percent;听
• The听, which proposes in increase IRF PPS rates by 2.4 percent; and听
• The听, which proposes to increase the hospice payment rate by 2.4 percent.听

On April 2, ARPA-H听听the launch of the听听to听develop tools for measuring, researching, and removing microplastics and听nanoplastics听from the human body.听The program is structured in two phases. The first phase will focus on developing 鈥済old-standard鈥� measurement methods for microplastics in human organs, including a clinical test to quantify individual microplastic burden at scale, as well as a risk stratification mechanism to rank plastic materials by biological harm. CDC will serve as an independent validator of the measurement methods. The second phase will focus on developing interventions to remove harmful microplastics from the body, drawing on pharmaceutical biology and bioremediation science. ARPA-H noted that, while researchers have detected microplastics in human lungs, arterial plaques, and brain tissue, current measurement techniques produce inconsistent results across laboratories, limiting the ability to develop targeted interventions. The program is designed to prioritize tools that are affordable and听broadly available, with particular focus on vulnerable populations, including pregnant women, children, patients with chronic disease, and highly exposed workers. ARPA-H is seeking multidisciplinary performer teams and has opened a solicitation, with听initial听summaries due Monday, May 6 and full proposals due Monday, June 22. ARPA-H will hold a 鈥淧roposers鈥� Day鈥� event on April 22 for proposers to learn more about the opportunity.听