RFK Jr. on AHA: Administration for Healthy America part of HHS’s 2027 budget

Reducing federal health bureaucracy, prioritizing chronic disease prevention and the efforts to Make America Healthy Again could come with a $111.1 billion price tag over the next year.

On April 21, U.S. Department of Health and Human Services (HHS) Secretary Robert F. Kennedy, Jr. continued his public explanations to Congress about the department’s fiscal year 2027 budget. He appeared before the House Energy & Commerce Committee’s Health Subcommittee in the morning and was the scheduled witness before the Senate Appropriations Committee in the afternoon.

His testimony and a committee memorandum outlined key funding highlights across HHS, with details about the federal government’s health spending. During the Energy & Commerce Committee Health Subcommittee hearing, the atmosphere was similar to Kennedy’s earlier appearances in Congress. Republicans generally were supportive and Democrats were critical about the administration’s policies and Kennedy’s proclamations about public and personal health, including vaccine safety and effectiveness.

A new agency takes shape

HHS will continue its structural overhaul with the proposed creation of the Administration for a Healthy America (AHA), a new unified entity that would consolidate the Office of the Assistant Secretary for Health, the Health Resources and Services Administration, the Substance Abuse and Mental Health Services Administration, and select centers and programs from the Centers for Disease Control and Prevention.

AHA would receive $17.6 billion in total funding, including $14.7 billion in discretionary spending. Its programmatic focus areas would include primary care, maternal and child health, mental and behavioral health, HIV/AIDS, and health workforce development, according to the committee memorandum.

Within those categories, the budget proposes $3.5 billion for primary care, $1.1 billion for maternal and child health, $6.8 billion for mental health and substance use disorder services, and $393 million for health care workforce programs. The budget also includes $2.5 billion for Ryan White HIV/AIDS Programs and $535 million for the 988 Suicide and Crisis Lifeline.

Kennedy framed the consolidation as a necessary step toward eliminating duplicative administrative functions.

“By reducing duplication, improving accountability, and maximizing the impact of resources, HHS can reduce silos that lead to inconsistent guidance, prevent collaboration, and misalign efforts to deliver optimal health outcomes and services for the American people,” Kennedy said in his written testimony.

The budget also proposes eliminating various programs currently administered by HRSA, SAMHSA, CDC, and the Office of the Assistant Secretary for Health, though the testimony did not specify which programs would be cut.

NIH, FDA, and research priorities

The budget requests $41.2 billion in discretionary funding for the National Institutes of Health (NIH). Kennedy said the amount is intended to maintain U.S. global competitiveness in biomedical research at a time when China is increasing its own investment. Kennedy cited data indicating that since 2022, more Phase I first-in-human clinical trials have been conducted in China than in the United States.

The administration's NIH priorities include research into chronic disease, identification of biomarkers for aging and disease, privacy-preserving data sharing, and expanded use of non-animal research models.

For the Food and Drug Administration (FDA), the proposal includes $7.2 billion in total program-level funding — a $160.5 million, or 3.3%, increase from the FY 2026 enacted level. That figure includes $3.3 billion in budget authority and $2.92 billion in user fees.

Kennedy highlighted the FDA's new Commissioner's National Priority Voucher pilot program, which uses a collaborative review process to accelerate approval of products addressing national health priorities. He cited two recent approvals under the program: a lung cancer drug approved just over one month after submission and a multiple myeloma treatment issued 55 days after filing, compared to the historical standard of 10 to 12 months.

The budget also includes $945 million for the Advanced Research Projects Agency for Health, or ARPA-H, to accelerate development of breakthrough treatments.

Chronic disease, nutrition, and food safety

Kennedy devoted significant attention to the administration's anti-chronic disease platform, arguing that poor nutrition underlies much of the country's disease burden and that federal dietary guidance has historically steered Americans in the wrong direction.

"The bedrock of health — the key to reversing the chronic disease epidemic — is nutrition," Kennedy said, noting the release of new Dietary Guidelines emphasizing "real, whole, nutrient-dense foods" including meat, seafood, eggs, dairy, citrus, berries, root vegetables, and fiber-rich whole grains.

He also announced that the administration has secured voluntary commitments from more than 50 medical schools to require 40 hours of nutrition education, or a competency equivalent, for all medical students beginning this fall, developed in partnership with the Department of Education.

On food safety, the budget proposes $57 million for FDA initiatives including the removal of petroleum-based synthetic dyes from food, a review of chemicals classified under the generally recognized as safe (GRAS) standard, reduction of toxic elements in children's foods, and infant formula safety improvements. Kennedy described the GRAS standard as a loophole that has allowed manufacturers to introduce ingredients into the food supply "with secret safety data" and without FDA oversight.

The budget also includes additional CDC funding to improve surveillance of foodborne and waterborne disease outbreaks and to advance methods for measuring microplastics in the human body.

Medicare, Medicaid, and fraud prevention

The Centers for Medicare and Medicaid Services (CMS), would receive $6.8 billion in total program management funding under the proposal. The budget includes $811 million for traditional Medicare administration and $155 million for Medicaid and the Children's Health Insurance Program, or CHIP.

Kennedy emphasized fraud prevention as a fiscal and moral priority, announcing the CRUSH initiative, short for Comprehensive Regulations to Uncover Suspicious Healthcare, and a CMS-State Tax Fraud Partnership with 28 states. He said the administration is shifting from a "pay and chase" recovery model to a real-time "detect and deploy" strategy using artificial intelligence tools to identify improper payments before they are disbursed.

The budget requests $976 million in additional discretionary spending for the Health Care Fraud and Abuse Control Program, on top of an estimated $1.8 billion in mandatory spending. According to the committee memorandum, Medicare program integrity efforts returned more than $14 for every $1 spent in FY 2024 and generated over $10 billion in annual savings. Medicaid integrity efforts saved an estimated $1.5 billion in federal taxpayer dollars in FY 2024.

The budget also provides $487 million for the survey and certification program that oversees nursing homes and hospice facilities. According to the committee memo, that funding would allow CMS to complete mandatory surveys for 78% of nursing homes and 85% of hospices nationally.

Indian Health Service and tribal communities

The budget proposes $9.1 billion for the Indian Health Service — an increase of $1.1 billion from the FY 2026 enacted level — to serve more than 2.8 million eligible American Indians and Alaska Natives across 575 federally recognized tribes. Kennedy said he has made tribal health a personal priority and that the budget includes advance appropriations for FY 2028 to provide continuity of funding during potential appropriations disruptions.

The proposal also invests $742 million to modernize outdated IHS facilities and $14 million to launch a new Tribal Health Quality Initiative to support data collection, quality improvement, and patient safety research for tribal populations.

Legislative requests

Kennedy closed his testimony with a direct appeal to Congress, urging passage of what he called the "Great Healthcare Plan." Key elements include codifying the administration's most favored nation drug pricing framework, under which U.S. drug prices would align with those paid in other countries; expanding over-the-counter drug availability; reforming pharmacy benefit manager practices; and requiring hospitals and insurers that accept Medicare or Medicaid to publicly post their pricing.

He also called on Congress to prohibit Medicaid funding for gender transition procedures for minors, close the GRAS loophole through legislation, end what he characterized as deceptive direct-to-consumer drug advertising, and build on existing fraud prevention initiatives to protect federal health programs under future administrations.

“Without these changes, we will have lost a generational opportunity to make health care more affordable, restore trust in our institutions, end the chronic disease crisis, and punish the bad actors who profited from the poisoning, sickening, and exploitation of our most vulnerable,” Kennedy said in his written testimony.