The White House has published a “skinny budget” for FY 2026, outlining its funding and policy priorities. A skinny budget is a shorter document than a regular budget proposal and is common for the first year of a new administration. The document has been sent to congress, which will soon proceed to work on its appropriations bills. Congress is under no obligation to follow the president’s recommendations, although several members of the president’s party are likely to endorse his vision. At the end of this month, we are expecting more information from the White House on its budget proposal, when it sends what is known as “congressional justifications” to Congress with more detail for specific agencies. For now, we can safely say that the White House is not interested in increasing any investments or programs that the SUD treatment and recovery community endorses. Moreso, they recommend the elimination of SAMHSA altogether. In short, advocates have work to do.
As part of a recommended major reorganization of the Department of Health & Human Services (HHS), the administration recommends the creation of an Administration for a Healthy America (AHA.) This new entity would house programs and grants that currently exist in SAMHSA, HRSA, and three other smaller agencies. AHA would then be divided into five branches: Maternal and Child Health, HIV/AIDS, Mental Health, Chronic Disease, and Workforce Development. Such a reorganization would, by law, require congressional approval.
In the skinny budget document, the administration recommends preserving the SUPTR Block Grant, as well as the Mental Health Services Block Grant. Also preserved is the State Opioid Response (SOR) grant, and funding for the 988 suicide prevention hotline, and the Garret Lee Smith suicide prevention grants. Almost every other program and funding stream at SAMHSA would be eliminated under the president’s plan. This includes the Building Communities of Recovery (BCOR) grant, Technical Assistance grants for peer support, and various other grant programs that endorse recovery. Also recommended for elimination are grant programs for naloxone distribution & training, underage alcohol use prevention, and several other programs we value.
The implementation of this recommendation would be one of the largest re-organizations in the history of government. It calls for the shifting of billions of dollars between agencies, with no evidence that it would produce more efficient or more productive outcomes. It comes at a time when we are witnessing a precipitous drop in overdose deaths, after historic investments in SUD treatment, recovery, and harm reduction practices. It also marginalizes the work of the SUD community, by placing it underneath the heading of “Mental Health,” instead of allowing it to continue as its own pursuit.
Although we cannot predict what Congress will do when preparing their own budget documents, we are hopeful they will see the folly in a proposed elimination of SAMHSA. Our goal is to work with Congress in an effort to maintain SAMHSA and its functions, and to keep recovery in the forefront of HHS policy efforts.