JUANA SUMMERS, HOST:
President Trump's 2026 proposed budget would have remade the Department of Health and Human Services. The budget for biomedical research was set to be cut in half. Whole centers at the CDC were eliminated. The mental health agency would be dismantled. But the budget law enacted yesterday looks absolutely nothing like that vision, as NPR's Selena Simmons-Duffin is here to explain. Hello.
SELENA SIMMONS-DUFFIN, BYLINE: Hi, Juana.
SUMMERS: So, Selena, what does the new federal health budget look like?
SIMMONS-DUFFIN: You know, it looks very similar to past Health and Human Services budgets in a lot of ways. Instead of slashing the National Institutes of Health budget, it's increased. Centers that Trump and Health Secretary Robert F. Kennedy junior have hollowed out are fully funded. This was a bipartisan bill and a really resounding rejection, I would say, of the changes that Trump and Kennedy had been trying to execute at the federal health agencies, and it was crafted in a way to give less room to the executive branch for acting suddenly and unilaterally like they did in 2025.
SUMMERS: How so?
SIMMONS-DUFFIN: Well, I talked to Senator Tammy Baldwin today. She's a Democrat from Wisconsin and helped write the bill as the ranking member of the appropriations subcommittee that oversees HHS. Here is what she described as her mission in crafting this budget.
TAMMY BALDWIN: How do we rein in an agency that has gone rogue with regard to personnel, with regard to how they choose to use appropriated funding?
SIMMONS-DUFFIN: What they did was to write into the law itself detailed instructions. You must fund these centers. You must fully staff them. You must pay out money promptly. You must give Congress notice before you reorganize and more. She says this makes it very different from last year's continuing resolution that funded the government.
BALDWIN: It's very, very specific. It is law. And by the way, the president just signed it.
SUMMERS: OK, Selena, I get all that, but will it actually work?
SIMMONS-DUFFIN: Well, you know, a lot of the things that were taken - a lot of the actions taken last year were already violations of Congress' instructions in terms of what programs to fund and how and with what staff, and Kennedy and his team didn't seem to be worried about that. Kennedy hasn't testified in Congress in many months, even as he's done provocative and norm-shattering things, like remaking the childhood vaccine schedule, for instance. Richard Frank is a senior fellow at the Brookings Institution, and he ran an HHS agency under President Obama. Here is his assessment of whether these new guardrails will work.
RICHARD FRANK: Only if their feet are held to the fire.
SIMMONS-DUFFIN: He says Congress does have tools to hold the executive branch accountable and restore the power of the purse. There just hasn't been a lot of that so far in Trump's second term.
SUMMERS: So on a practical level, what does this mean inside of these health agencies?
SIMMONS-DUFFIN: You know, I asked HHS several questions today about Kennedy's response to the new budget, and I didn't hear back. The health agency staff I've checked in with are wary that it really means HHS can get back to doing what it had been doing before. They're still on guard that the Trump administration and Kennedy will just find new ways to change or defang programs they don't like. Kennedy has been absolutely determined to put his stamp on Health and Human Services. And remember, this is an agency he sued many times as an antivaccine activist, whose staff he has disparaged and accused of trying to hurt Americans. It seems unlikely to me that he will go along with a restoration of HHS as it was, but we're going to have to wait and see whether this budget changes how Kennedy runs the agency in the coming year.
SUMMERS: NPR's Selena Simmons-Duffin, thank you so much.
SIMMONS-DUFFIN: You're welcome. Transcript provided by NPR, Copyright NPR.
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