US Senate defends public health programs in the face of budget cuts

The 1On August 25, 2025, the Senate Committee on Finance approved increased funding for the Centers for Disease Control and Prevention (CDC) programs, including those dedicated to combating chronic diseases and tobacco use. This bipartisan vote comes amid a marked disengagement from the executive branch in public health, illustrated by the massive budget cuts imposed since Donald Trump's return to power.[1].

Bipartisan Support for CDC Programs

Faced with threats of budget cuts imposed by the federal executive, the Senate Finance Committee sent a strong signal in favor of public health. On July 31, 2025, it overwhelmingly adopted (26 votes to 3) the Labor, Health and Human Services, Education, and Related Agencies (LHHS) budget bill for the 2026 financial yearThis text, which covers federal public health spending in particular, provides for the maintenance — or even the strengthening — of several strategic budget lines, starting with the programs of the Centers for Disease Control and Prevention (CDC).

Specifically protected positions include chronic disease prevention programs, environmental health, injury control, gun violence research, global health, immunization, and the Office on Smoking and Health, which oversees federal tobacco control policies. The Senate committee explicitly rejects proposals to eliminate or redeploy these functions, as proposed by the Trump administration.

This bipartisan consensus reflects a cross-party recognition of the importance of the CDC's missions. The committee notes that programs targeting chronic disease and tobacco are among the most cost-effective in the federal system: according to data provided by the Alliance for a Healthier Generation and the Campaign for Tobacco-Free Kids, every dollar invested in tobacco prevention would save $55 in avoided health care costs in the medium and long term. Moreover, the Office on Smoking and Health remains the sole federal source of support for national prevention media campaigns, such as "Tips from Former Smokers," which have helped more than 1 million Americans quit smoking.

In the adopted text, the senators introduced an additional clause aimed at regulating any attempt at internal restructuring of the CDC. It now requires that any proposed merger, elimination, or transfer of a division be subject to a detailed report, submitted to Congress for approval. This provision aims to prevent the political manipulation of health agencies and protect their technical independence.

The Trump administration, an unprecedented setback for public health

Since returning to the presidency in January 2025, Donald Trump has launched a massive restructuring of federal agencies[2]-[3], marked by the elimination of nearly 20,000 positions, including more than 1,300 at the CDC and more than 3,000 at the Food and Drug Administration (FDA). This wave of layoffs affected areas as crucial as cancer prevention, mental health, consumer product safety and epidemiological monitoring.

In addition to the job cuts, several budget lines passed by Congress have been frozen or eliminated entirely by the Office of Management and Budget. Between $200 and $300 million in prevention programs (tobacco, diabetes, violence, firearm injuries) have been blocked without any health justification. Internal documents have also revealed that the administration is considering cutting the CDC's overall budget in half, from $9.2 billion to approximately $4.5 billion, which would have dramatic consequences for all health prevention and alert systems.

Direct consequences on the fight against tobacco

Budget cuts have particularly affected tobacco prevention programs. Several states have been forced to suspend their smoking cessation services, while activities to monitor smoking trends have been halted. Researchers and health professionals have sounded the alarm, pointing out that abandoning these tools seriously weakens the country's ability to reduce smoking, particularly among young people, even as nicotine consumption in new forms (e.g., vaping, pouches) continues to increase.

The federal decisions come as the Office on Smoking and Health and other tobacco control programs have proven effective, particularly in states that have implemented comprehensive prevention strategies. According to experts at the Lung Foundation, reducing or eliminating these programs could lead to a rapid increase in preventable deaths and an explosion in public health spending in the medium term.

A strong political signal, but a fight still uncertain

The Senate's vote is a clear response to the executive branch's policy of disengagement. By maintaining funding for public health programs, lawmakers are reaffirming Congress's role in preserving prevention tools, in the face of a federal administration accused of sacrificing health on the altar of budgetary ideology. Several Republican and Democratic senators have taken a public stand to defend the CDC's actions, including Susan Collins (R-ME), Shelley Moore Capito (R-WV), Patty Murray (D-WA), and Tammy Baldwin (D-WI), reiterating the importance of having strong health agencies with sufficient resources to respond to contemporary health challenges. In their view, weakening the CDC's response capacity would compromise the resilience of the health system as a whole.

But this progress remains fragile. The absence of an explicit tobacco control strategy in the Trump administration's health plan ("Make America Healthy Again") illustrates the low priority given to these issues. Vigilance therefore remains essential. Several states have already filed appeals against the LHHS reorganizations, believing that they violate the prerogatives of Congress. At the same time, voices are being raised within the scientific community and civil society to denounce the growing marginalization of health expertise in public decision-making.

The sustainability of anti-tobacco policies and, more broadly, public health policies in the United States will depend in the coming months on the ability of elected officials, health institutions, researchers and associations to maintain pressure in the face of an executive determined to reduce the role of the State in the field of prevention.

©Generation Without Tobacco

AE

[1] Press release, Senate Appropriations Committee Acts to Protect Public Health by Funding CDC's Chronic Disease and Tobacco Control Programs, CTFK, published August 1, 2025, accessed August 4, 2025

[2] Tobacco-free generationMass layoffs at FDA raise public health concerns, published March 3, 2025, accessed August 4, 2025

[3] Tobacco-free generation, FDA tobacco regulator fired, published April 7, 2025, accessed August 4, 2025