On the House’s Proposed FY 2026 Spending Bill

Summary: House Republicans’ FY26 budget bill would eliminate all federal HIV prevention funding, cut the Ryan White Program by 20% ($525M), collapse STI and viral hepatitis funding into block grants, and dismantle decades of bipartisan progress in HIV care, prevention, and public health.

Republican House lawmakers have proposed a 2026 budget bill that would wipe out all federal HIV prevention money at the Centers for Disease
Control (CDC), ending President Trump’s Ending the HIV Epidemic effort (EHE). Their plan also cuts the Ryan White HIV/AIDS Program by about 20 percent—roughly $525 million.  

These cuts go way beyond President Trump’s own budget request, which had already looked to end CDC’s End the HIV Epidemic (EHE) work and eliminate Ryan White Part F programs (community-based dental partnerships and support, provider education, training, and technical assistance. Special Projects of National Significance, or SPNS). Even so, it kept core Ryan White services level

The House proposal must be rejected in conference to avoid devastating setbacks for public health.

The Senate took a very different approach in July, passing a bipartisan bill that keeps Ryan White funding steady, albeit flat, at $2.57 billion, protects Part F, and continues HIV prevention and EHE funding at current levels. The two bills set up a fight this fall over whether federal HIV care and prevention programs will be protected or sharply reduced.

At a time when science has given us the tools to prevent HIV transmission and cure Hepatitis C, Congress should be scaling-up investments, not eliminating them. 

Ending prevention programs will drive up new infections, create avoidable costs, and devastate the public health infrastructure that states and communities rely on. 

The Ryan White Program and aligned system(s) help maintain extremely high viral suppression rates among clients—upwards of 92% viral suppression rates; rates which ensure that onward transmission doesn’t occur.

Cutting 20% of services funding—when  combined with the elimination of prevention and STI programs—would undermine retention-in-care. It would further worsen differences in already underserved and marginalized communities. But above all, it will force state and local governments to either fill-in the gaps or face rising infection rates and treatment costs.

What It Entails

• Clinic and Provider Grants. Over 400 Ryan White–funded clinics and community organizations would lose a portion of their federal grants. These providers deliver HIV care, case management, treatment and adherence support, and wrap-around supportive services.
• Ending the HIV Epidemic (EHE) Grants. The proposal eliminates $165 million in EHE funding currently used to expand outreach, testing, and linkage-to- and retention-in-care efforts, especially in high-burden jurisdictions.
• STI and Hepatitis Block Grants. The bill would take away separate funding streams for STIs and hepatitis and fold them into one large state block grant. That means states would have more discretion but less accountability, and funds could easily be redirected away from already underfunded STI clinics. The result would be fewer resources for testing, treatment, and outbreak response — especially in places that depend almost entirely on federal dollars to keep their programs running.
• Direct Impact on Patients:
  • Fewer medical providers and case managers available.
  • Reduced access to HIV antiretroviral medications (through ADAPs, Part B).
  • Scaling-back of outpatient ambulatory, supportive services (like housing referrals, mental health and substance use treatment).
  • Potential waitlists or gaps in service. To be clear, waitlists for HIV medications have previously led to preventable transmissions and, in cases, deaths. Bringing them back would risk repeating history’s outcomes, putting lives and public health in jeopardy.