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Budget Cuts at HHS Threaten America’s Health and Innovation—Including in North Carolina
A perspective from Nathan Boucher
By slashing nearly one-fourth of the Department of Health and Human Services (HHS) discretionary budget, the Trump administration’s proposed fiscal year 2026 budget signals a dramatic retreat from evidence-based health research, disease prevention, and innovation. This $33.3 billion cut—to just under $95 billion—may be framed as a reorganization to tackle chronic disease and reduce healthcare costs, but beneath the rhetoric lies a troubling dismantling of the very infrastructure designed to advance public health, drive medical discovery, and protect our most vulnerable.
Nowhere is the proposed rollback more alarming than in the realm of scientific research. The National Institutes of Health (NIH), the engine of U.S. biomedical innovation from which we all benefit, would see its funding slashed by $18 billion—from $45 billion to $27.5 billion—and its structure gutted, consolidating into just eight institutes or centers. Such a move ignores decades of bipartisan support for the NIH and undermines the United States’ global leadership in medical research. These cuts will decelerate clinical trials, delay therapies, and disincentivize young scientists from entering the field. The American Cancer Society Cancer Action Network warns that the 37% cut to the National Cancer Institute would “stall scientific breakthroughs” and hamper efforts against the increasing incidence of cancer across America. Translation: lives will be lost waiting for discoveries that now may never happen.
The effects of these cuts will be especially devastating in states like North Carolina, a national leader in biomedical research, academic medicine, and public health innovation. Institutions such as Duke University, the University of North Carolina at Chapel Hill, Wake Forest, and East Carolina University receive hundreds of millions annually from NIH and HHS to fund research on everything from cancer to mental health to rural healthcare delivery. If these funding sources dry up or diminish, North Carolina’s research infrastructure—its labs, its jobs, and its ability to develop life-saving treatments—will likely suffer.
In 2022 alone, North Carolina institutions received over $1.8 billion in NIH funding. These dollars supported everything from HIV prevention programs in underserved areas to groundbreaking cancer immunotherapy research. The University of North Carolina’s Gillings School of Global Public Health, which has led critical studies on pandemic response and maternal health, faces a direct threat under these budget proposals. And Duke’s renowned Clinical and Translational Science Institute, which works to turn research into real-world healthcare solutions, would likely struggle to maintain operations at current levels.
Beyond academic campuses, the proposed cuts threaten North Carolina’s community health centers, rural hospitals, and telehealth programs—many of which rely on HHS grants to reach underserved populations. The elimination of key funding for CDC public health initiatives and the Affordable Care Act’s Prevention and Public Health Fund will hit rural counties the hardest, where high rates of chronic illness and limited access to care demand more investment, not less.
The proposed budget does include some provocative titles—like the $500 million “Make America Healthy Again” initiative—but these piecemeal programs offer a fraction of the scale needed to address national health challenges. Only $119 million is allocated for a Prevention Innovation program, while over $1.5 billion in HIV prevention programs are being slashed. North Carolina, which continues to fight high rates of HIV, will feel the consequences firsthand.
Innovation is not just about profit or prestige—it’s about people. Patients waiting for a clinical trial in Charlotte, veterans accessing mental health support through telehealth in Western NC, and community health workers in rural East NC trying to curb diabetes rates. These are the real faces behind the numbers.
Congress now holds the line. It must reject this dangerous budget, reinvest in science and health equity, and protect the institutions that allow America—and North Carolina—not just to respond to crises, but prevent them. Innovation cannot survive on slogans. It thrives on sustained, strategic, and science-driven investment. Anything less is not just shortsighted—it’s reckless.
Dr. Nathan Boucher is associate professor of medicine, nursing, and public policy at Duke University
“Viewpoints” on Chapelboro is a recurring series of community-submitted opinion columns. All thoughts, ideas, opinions and expressions in this series are those of the author, and do not reflect the work or reporting of 97.9 The Hill and Chapelboro.com.
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