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Looking ahead to FY 25 public health appropriations.

Learn how the U.S. Government has responded to Long COVID to reduce cases and mitigate the effects, common among women, Hispanic persons, and other groups.

Learn about health legislative priorities through the end of 2025, related to Medicaid and Medicare, the Affordable Care Act, site-neutral payments, and more.

State and territorial health officials gathered on Capitol Hill to meet with lawmakers and discuss public health priorities—learn more about Hill Day in this blog post.

Learn about chairs of key committees in the 119th Congress, their priorities, and what may be in store for public health funding in this federal health policy update.

(More) Recent Shifts in HHS Leadership: June 2026 More Recent Shifts in HHS Leadership: June 2026 Catherine Murphy Get the latest updates on changes in leadership at CDC, FDA, HHS, and more in this Federal Health Policy Update. This provides updates to a previous Federal Health Policy Update: Recent HHS Leadership Changes That Impact Public Health. As Congress heads into a busy summer of work on FY27 appropriations, a potential reconciliation package, and looming midterm elections, the Trump Administration continues shaping HHS to the President’s Make America Healthy Again agenda. Since our last update in April, there have been a handful of new leadership shifts within HHS agencies. CDC Since the departure of Susan Monarez from her role as CDC Director in August 2025, the position has been covered by acting directors. In April, President Trump announced Erica Schwartz as his new pick for CDC Director. Schwartz brings experience as a physician in the U.S. Navy, as chief medical officer in the Coast Guard, and helped lead the government’s response to the COVID-19 pandemic as deputy surgeon general. The Senate HELP Committee has not yet noticed a hearing to review her nomination. Public response to her nomination, though, has been generally positive. In the same announcement, President Trump also highlighted his appointment of Jennifer Shuford as the CDC Deputy Director and Chief Medical Officer, and Sean Slovenski as CDC Deputy Director and Chief Operating Officer. Shuford, an ASTHO alumni member, is the former commissioner of the Texas Department of State Health Services and an infectious disease physician. Before her tenure as commissioner, she was the chief state epidemiologist. Slovenski brings a background as a health care executive and entrepreneur, with experience ranging from telehealth and wellness incentives, major companies and brands, and advocacy. Surgeon General The confirmation proceedings of President Trump’s previous pick for Surgeon General, Casey Means, stalled as senators deliberated on her statements on vaccine safety after her appearance before the Senate HELP Committee in February. At the end of April, the President announced his nomination of Nicole Saphier, a radiologist, director of breast imaging at Memorial Sloan Kettering Monmouth, and former medical contributor to the Fox News Channel. Saphier is viewed as a more mainstream nominee given that she is generally supportive of vaccines. Her priorities also include building trust in public health recommendations, combating chronic disease, and reducing ultra-processed foods. FDA In early May, it was announced that Commissioner Marty Makary would be leaving his role. Kyle Diamantas, formerly FDA’s Deputy Commissioner for Human Foods, has taken over as Acting Commissioner for the agency. Before joining FDA, Acting Commissioner Diamantas practiced law, focusing on food, drug, and life sciences regulatory matters. A nominee for FDA Commissioner has not yet been announced. Donald A. Prater has taken over as acting head of the Human Foods Program. ASPR In April, Sean Kaufman was announced as the White House nominee to lead ASPR as the Assistant Secretary for Preparedness and Response. He specializes in preventing spread of infectious disease and brings experience as a Senior Advisor for Global Affairs at CDC and, in previous roles, responded to infectious disease outbreaks including anthrax, SARS, and West Nile virus. HHS Additionally, Sara Brenner was announced as Senior Counselor for Public Health to Secretary Robert F. Kennedy, Jr. In her past roles, she served within FDA as Acting Commissioner and Principal Deputy Commissioner within the Office of the Commissioner. She is a preventive medicine and public health physician with extensive experience in federal health policy. In her broad federal experience, she has worked on COVID-19 response, within the White House Office of Science and Technology Policy, and worked on medical countermeasures and preparedness efforts. Leadership Promotes Trust in Public Health Minimizing leadership turnover bolsters stability in the public health continuum and allows for a more robust response to current and emerging public health threats. Ongoing changes within HHS can create uncertainty for the entire health ecosystem, from practitioners awaiting public health guidance to the broader public. In an environment where stability, clear communication, and transparency are needed, confirming leadership that promotes concise, well-researched advice will help continue efforts to rebuild trust in our governmental public health enterprise. These recently announced leaders bring a wealth of experience to their roles and have an opportunity to promote strong, evidence-based public health guidance for Americans. The Senate HELP Committee has not yet noticed confirmation hearings to review the nominations of the Senate-confirmed positions: the CDC Director, Surgeon General, and Assistant Secretary for Preparedness and Response are expected to be reviewed by the panel. ASTHO will continue to track updates to HHS leadership and confirmations. Reviewed by - Ekoma, Staley article yes

Recent HHS Leadership Changes That Impact Public Health Recent HHS Leadership Changes Impacting Public Health Catherine Murphy Get a rundown of recent HHS leadership changes that impact public health, including to CDC director, ACIP, and the U.S. Surgeon General. Over the last 16 months, the Trump Administration has championed the Make America Healthy Again (MAHA) agenda within HHS — with Secretary Robert F. Kennedy, Jr., leading the department. He was confirmed by the Senate and sworn in on Feb. 13, 2025, and has since worked to implement sweeping changes in the department and MAHA priorities (e.g., addressing chronic disease and childhood allergies, removing specific food dyes, and increasing transparency within the agency). Significant changes within HHS over this period include the termination of 10,000+ employees via Reductions in Force and more departures via voluntary separation incentives. This has left many agencies and offices to adjust and impacted how state and territorial health departments collaborate with partners at HHS agencies like CDC. Alongside these major ongoing changes (and more proposed) to the department are the appointments and alterations to HHS leadership by President Trump. CDC Director CDC has seen a handful of changes during the first year of the Trump Administration. Its director leads the agency and directs public health priorities like disease prevention, outbreak control, and health threat defense. In July 2025, Susan Monarez was confirmed as CDC director but removed a month later due to disagreements with the Administration over vaccine policy. Soon after, she appeared before the Senate Health, Education, Labor & Pensions (HELP) Committee to testify about events around her termination. The lack of CDC leadership was a source of concern for the public health community, as leaders cited the importance of evidence-based decision-making from the agency and sound leadership to respond to ongoing health threats and emergencies. Following the departure of Monarez, Jim O’Neill, deputy secretary of HHS, was appointed acting director of CDC. In February 2026, however, he was removed from the role amid his departure from HHS to be nominated as the director of the National Science Foundation. Meanwhile, department restructuring elevated Chris Klomp to chief counselor, in charge of all HHS operations. While HHS searches for a new CDC director, Jay Bhattacharya, director of NIH, is performing delegable duties. Federal law dictates that Senate-confirmed positions, including CDC director, have acting replacements for a maximum of 210 days — a deadline that passed on March 25. The agency says that they are actively looking for a replacement. Advisory Committee on Immunization Practices CDC’s Advisory Committee on Immunization Practices (ACIP) is a group of up to 19 voting members — independent medical and public health experts — who make recommendations on vaccines, which become CDC policy once adopted by its director. Recommendations bear on immunization schedules, the Vaccines for Children program, and clinical decision-making, and have downstream effects on whether insurance providers cover vaccines and the context in which they can be administered (i.e., pharmacy vs. office visit). ACIP has also seen considerable change under this Administration: In June 2025, HHS removed all 17, Biden-appointed members of ACIP. In a press release, the department noted the goal to “reestablish public confidence in vaccine science.” This move garnered bipartisan response from Congressional leaders, especially those on the Senate HELP Committee, who specifically questioned Secretary Kennedy on his potential revisions to CDC’s vaccine recommendations during his confirmation hearing. In January 2026, HHS announced an overhaul of the childhood vaccine schedule outside of the ACIP recommendation process. The announcement included changes to recommendations for hepatitis A, rotavirus, influenza vaccines, and more. In March 2026, a federal judge placed a stay on all of Secretary Kennedy’s appointments to ACIP, the panel's recommendations, and the 2026 schedule change. Surgeon General Finally, the U.S. Surgeon General role, which advises the public on health and leads the Commissioned Corps of the U.S. Public Health Service, has been marked by ongoing shifts. In May 2025, after withdrawing his nomination for Janet Nesheiwat, President Trump announced Casey Means, MD, as his new nominee for the position. Means is a doctor and wellness influencer who advocates for MAHA priorities, including finding ways to reduce rates of chronic disease. Several members of the Senate HELP Committee have stalled her confirmation, citing concerns around Means’ statements on vaccine safety. Means appeared before the committee in February 2026. Public Health Impacts The flux within HHS — a side effect of the administration’s desired changes within the department — has had ongoing impacts on the process for issuing public health guidance, approving and altering vaccine recommendations, and more. Congress remains interested in understanding the impact of reforms occurring within HHS, including in hearings centered around agencies and nominees. ASTHO will continue to track changes within HHS as well as responses from legislators, and work to be a resource to Congress on best practices for public health. article yes

Learn how flexible telehealth policies expand access to care.

An Ounce of Prevention (and Public Health Fund) Is Worth a Pound of Cure Catherine Murphy The Prevention and Public Health Fund (PPHF) is critical to state public health work. Historically it has faced cuts even though prevention has proven return on investment. Read the latest information the future of PPHF in this week's Health Policy Update. Among federal funding for public health programs, one line is particularly unique. The Prevention and Public Health Fund (PPHF) is the nation’s first mandatory fund for prevention and public health programs. Before enacting PPHF, there was no fund that guaranteed investment in prevention programs that was not contingent on the annual appropriations process. PPHF was part of the 2010 Patient Protection and Affordable Care Act and it helps provide funding for crucial programs. During the past 15 years, PPHF has been utilized across agencies including CDC, CMS, HRSA, and SAMHSA. In fact, about 95% of PPHF funding goes to CDC. In FY24, the fund contributed 13% of CDC’s overall budget. From FY25 through FY30, PPHF is projected to provide $9.8 billion in funding to achieve these goals. Where the Money Goes As the adage goes, “an ounce of prevention is worth a pound of cure.” Through dollars distributed by CDC — more than 70% of CDC’s budget supports the work of state and local health organizations — PPHF funds numerous critical nationwide efforts including immunization, epidemiology and laboratory capacity, tobacco use, heart attack and stroke, childhood lead poisoning, and the Preventive Health and Health Services Block Grant. Many of these programs receive a majority, if not all, of their funding from PPHF, and the demonstrated return-on-investment is significant. For example, California’s tobacco control program saved $155 in health care cost savings for every $1 invested. CDC has found that removing lead hazards from children's environment can, “generate approximately $84 billion in long-term benefits per birth cohort. Sustained Commitment for the Decade Ahead Unfortunately, PPHF has historically been subject to cuts via budget agreements, including the Bipartisan Budget Act (2018), and to calls to repeal and replace the Affordable Care Act. Since its enactment, PPHF has been amended five times, ultimately resulting in a reduction in appropriations for the fund. Recently, President Trump’s “Skinny” Budget Proposal outlined cuts to a number of PPHF-funded programs, indicating that the overall funding could be at risk. Eliminating PPHF would open a significant funding gap for preventive health programs across the nation. These programs have proven records of promoting health and preventing infectious and chronic disease. Loss of funding would likely result in greater disease burden and health care costs. Investing in prevention isn’t just smart policy, it’s smart economics. The PPHF is designed to build a strong public health foundation, brick by brick, community by community. Over the years, ASTHO has worked in coalition with public health organizations to share the importance of PPHF and to advocate for sustained investment to the fund. ASTHO will continue to monitor discourse and share the importance of this funding in interactions with lawmakers. Table - Blog - An Ounce of PPHF Is Worth a Pound of Cure article yes

Reviewing federal policies to mitigate public health risks of heat exposure.