On April 16th, 2025, the press reported that the White House Office of Management and Budget (OMB) is planning to propose massive cuts to the Department of Health and Human Services (HHS) budget in the President’s FY 2026 Budget Request, according to a leaked draft. The document, called a “passback,” has not been finalized and agencies are allowed to make appeals to OMB regarding the proposed cuts, but they have been told they cannot change the bottom line for spending.

Ultimately, it would require Congressional action to implement the cuts outlined in the passback. The President’s Budget Request is largely a policy statement, requesting that Congress include the spending levels or cuts put forward; Congress is not obligated to enact any of the changes in the document. The House and Senate Appropriations Committees may take the President’s request under advisement and try to enact some of his agenda, but Congress, not the Administration, has the power to write and pass a budget.

So what is in the passback?

As advocacy and government watchdog groups have been calling for more transparency into the Administration’s plan to restructure HHS, an initiative that began with the firing of thousands of workers on April 1, this leaked document is a first look at what’s to come. Consistent with the restructuring announcement made by Secretary Kennedy, the proposed budget would consolidate a number of Administration offices, including the Substance Abuse and Mental Health Services Administration (SAMHSA) and the Health Resources and Services Administration (HRSA) among others, into a new office, the Administration for a Healthy America (AHA). It also dismantles the Administration for Community Living (ACL) and divides up ACL offices among other entities, such as the Administration for Children and Families (ACF) and the Centers for Medicare and Medicaid Services (CMS).

The passback also details an astounding number of program eliminations and cuts as part of the restructuring efforts. The headline for people and organizations concerned about child maltreatment prevention is the proposed elimination of Head Start, which was created in 1965 and has long had strong bipartisan support, serving more than 900,000 children and their families with early childhood education and home visiting programs. Head Start and Early Head Start are proven to strengthen families by improving access to health and other necessary services and have made millions of children ready to learn as they enter school. Early Head Start has a demonstrated link to family preservation.

Other programs that would be eliminated under the President’s plan include:

  • Programs focused on child safety, such as Adverse Childhood Experiences (ACES), Youth Violence Prevention, and Firearm Injury and Mortality Prevention Research,
  • Teen Pregnancy Prevention, a key program in ensuring better outcomes for youth
  • Maternal and newborn health programs including Healthy Start and part of the Title V Maternal and Child Health Block Grant focused on minority populations
  • Mental health programs for children, including Infant and Early Childhood Mental Health, and Children and Family Programs for mental health, including the only federal funding that allows tribes to plan for culturally appropriate children’s mental health services in their communities
  • Funding for LGBTQ+ youth services in the 988 suicide prevention hotline
  • ACL’s Developmental Disabilities and Advocacy Program, which also provides oversight on congregate care facilities
  • Severe cuts for Tribes, including a recission of the advanced appropriation for the Indian Health Service (IHS) and elimination of Tribal Behavioral Health Grants
  • Cuts to several rural health programs and supports
  • SAMHSA’s Pregnant and Postpartum Women SUD Treatment Program, which funds parent-child residential treatment
  • Other substance abuse services, such as Overdose Prevention
  • Multiple education and training programs for the mental health and substance abuse workforce, which is already inadequate to the level of need
  • The Community Services Block Grant
  • The Low Income Heating and Energy Assistance Program (LIHEAP)
  • Refugee support and medical services,
  • Youth homelessness prevention

Budget line items specific to child welfare are largely protected and most programs flat funded, with a couple of exceptions:

  • Community based Child Abuse Prevention (CBCAP) is cut by about $10M, from $71M to $60.7M
  • Promoting Safe and Stable Families (PSSF) discretionary funding is cut by $10M, from $72.5M to $62.5M

The Administration has affirmed its commitment to protecting children, but these program cuts and eliminations would make millions of children less safe than they are now and would rip away supportive services from loving caregivers, driving families to the door of the child welfare system. It is not an exaggeration to say that cuts of this magnitude would decimate the human services field.

What is not included in the passback?

This document only details cuts and eliminations of discretionary programs and funding. Discretionary funding is subject to the appropriations process every year – these programs are funded at the will of Congress, with the Appropriations Committees determining the funding levels.

There is a line in the passback that mentions a “mandatory passback,” indicating that a second document that details cuts and eliminations of mandatory funding is also in the works. Most child welfare funding is mandatory, such as Title IV-E, part of Title IV-B, the Social Services Block Grant (SSBG), and the Temporary Assistance for Needy Families (TANF) program. Medicaid is also mandatory entitlement funding.

Mandatory funding is not subject to appropriations, and only a legislative act of Congress can change mandatory funding levels. A mandatory passback would indicate the Administration’s priorities for Congress’s budget reconciliation bill, which is one mechanism that Congress can use to make changes and cuts to mandatory spending.

What happens next?

The passback is still a draft, which means that there will likely be changes between this version and what is eventually released to the public in the President’s FY 2026 Budget Request, which we expect to see in early May sometime. Only Congress has the authority to make the cuts outlined above, and the appropriations bills are subject to the filibuster in the Senate; the Senate bills will need at least seven Democratic votes to pass, giving the minority party some leverage in the process.

The Administration does not have the authority to hold back, or impound, funds that Congress has appropriated. Until otherwise directed by Congress, OMB and HHS cannot cut or eliminate the programs listed.

Take Action

Congress can and should pass a budget that truly prioritizes child safety and fully funds the programs and services that promote healthy and safe childhood experiences. Contact your Senators and Representative today to demand that Congress reject these proposed cuts and fully fund human service programs for children and families!