President Trump’s budget request for Fiscal Year 2027 (FY27) appropriations released on April 3, 2026,  signals continued efforts to reshape many programs impacting LeadingAge members.

Building on LeadingAge’s initial April 3 review of the President’s budget request, and our April 7 look at the budget requests for the  Department of Labor (DOL) and Department of Education (DOE), here we review budget requests for two key agencies under the Department of Health & Human Services (HHS), the Centers for Medicare & Medicaid Services (CMS) and the Centers for Disease Control & Prevention (CDC).

Centers for Medicare & Medicaid Services

For CMS, the President has requested an approximate $50 million increase over FY 26 enacted levels for survey and certification at $487.0 million to achieve a goal of 78% completion of mandatory surveys and 10% completion of non-statutory surveys. Mandatory surveys includes certification, standard recertification, complaint, and revalidation surveys. Survey funding has notably been flatlined for several years. CMS points to flatline funding as a contributing factor in standard recertification survey backlogs. LeadingAge advocates for implementation of the risk-based survey, which would help address survey backlogs, and would push for increased survey funding to be used to reform the survey and certification process such as increased training for and accountability of surveyors and improved collaboration with providers through off-survey education and quality improvement activities.

CMS has prioritized Medicare and Medicaid program integrity and FY 27 funding will be directed towards identifying and addressing fraud and abuse. CMS intends to “strengthen partnerships” with the Department of Justice and HHS Office of Inspector General and “expand investigations across all programs.” Several nursing home tasks are already on the OIG work plan. CMS has also announced intent to more effectively utilize data technology, both in program integrity efforts and program administration.

Medicare Administrative Contractors (MACs) are responsible for many operations impacting LeadingAge members. The budget request for MAC operations, which includes claims processing, appeals, provider and supplier services, outreach and education, and provider contact centers, is $33 million below enacted FY 26 levels at $620.2 million. The request for Part A and B operational support functions and claims processing are both increases over the enacted FY 26 levels. Part A and B operational support, which includes data analysis and other support for policymaking, is a $1.7 million increase over enacted FY 26 levels at $50.7 million, while the request for claims processing functions is a $2.3 million increase above enacted FY 26 levels at $79.9 million. Funding for Part A and B appeals is requested at $51.5 million, a $9.0 million decrease from the enacted FY 26 level. Budget requests for Part C and D shows decreased funding for both oversight and management ($73.1 million) and appeals ($38.7 million).

Funding for value-based care is requested at $90.0 million, a reduction of $12.8 million compared to enacted FY 26 levels. Initiatives in this cost center include the Medicare Shared Savings Program (MSSP) and Quality Payment Program (QPP). The MSSP includes Accountable Care Organizations (ACOs), while the QPP includes the Merit-Based Incentive Payment System (MIPS) and Advanced Alternative Payment Models (APMs). The value-based care cost center also includes the Consumer Assessment of Healthcare Providers and Systems (CAHPS) surveys. While a CAHPS survey is not currently in use for nursing homes, there are efforts to incorporate a consumer satisfaction measure into the quality programs, and that could result in a CAHPS measure being introduced.

Health Insurance Portability and Accountability Act (HIPAA) Administrative Simplification includes the advancement of electronic healthcare transaction standards, which we saw CMS initiate in FY 26 and further advancements are intended in FY 27. However, the requested $27.4 million in funding is a reduction of $18.7 million below FY 26 enacted levels. CMS attributes this reduction, in part, to system operational and technical enhancements that occurred in FY 26.

Centers for Disease Control & Prevention

The President requests $5.485 billion in discretionary funding for CDC in FY 27. This includes increases in two programs impacting LeadingAge members: Immunization and Respiratory Diseases and Emerging and Zoonotic Infectious Diseases.

The President requests a $50 million increase over FY 26 enacted levels for Immunization and Respiratory Diseases. This program includes disease surveillance activities and implementation of disease control approaches such as vaccines, therapeutics, non-pharmacological interventions and behavioral mitigation strategies to reduce transmission and severity of respiratory diseases such as flu, Respiratory Syncytial Virus (RSV), and novel respiratory diseases. This funding also supports coordination with state, local, and tribal public health related to immunizations and respiratory diseases.

The President requests a $94,492,000 increase over FY 26 enacted levels for Emerging and Infectious Zoonotic Diseases. This funding supports activities such as public health surveillance, outbreak preparedness and response, and support for state and local health departments related to emerging and zoonotic infectious diseases. This includes outbreaks caused by bacteria, viruses, fungi, parasites, and pathogens transferred from animals to humans.

As noted, the figures discussed above are part of the President’s budget request for FY 27 appropriations.  The President has additionally requested reconciliation for the FY 27 budget, meaning that the budget would be passed with a simple majority vote, bypassing the Senate filibuster. LeadingAge will continue to monitor and update members on the FY 27 appropriations process.