In the final FY2026 spending bill the Appropriations Committees released last week, Congress rejected the House Republicans’ spending bill that would have decimated domestic HIV programs by cuts of over $1.7 billion, including the elimination of all HIV prevention programs, the entire Ending the HIV Epidemic initiative, and $525 million, or 20 percent, of the Ryan White HIV/AIDS Care and Treatment Program.
“After a tumultuous year of proposed program cuts and eliminations, Congress has agreed to reject them and instead has maintained funding for domestic HIV prevention and treatment programs on a bipartisan basis. Now, the Trump administration must focus its attention on properly implementing these programs in order to get the nation back on track to end HIV in the US,” Carl Schmid, executive director of the HIV+Hepatitis Policy Institute, said in a statement.
The final spending package largely mirrors the bipartisan Senate bill that advanced out of committee in July 2025, reflecting months of negotiations and stakeholder engagement.
Learn more: The Business Sector's Advocacy to Maintain Funding for HIV Prevention, Research, Treatment
Throughout the year, advocates, including the HIV+Hepatitis Policy Institute, have worked to underscore the importance of sustained federal investment in domestic HIV prevention and treatment programs. These efforts intensified as lawmakers considered deep proposed cuts, which advocates warned would create widespread uncertainty and disrupt services nationwide.
What You Need to Know
Lawmakers blocked more than $1.7 billion in reductions that would have eliminated HIV prevention efforts, the Ending the HIV Epidemic initiative, and significantly cut the Ryan White HIV/AIDS Program, opting instead to maintain funding on a bipartisan basis.
Sustained engagement from groups like the HIV+Hepatitis Policy Institute helped avert devastating cuts, yet advocates warn that flat funding will strain programs as demand grows and new prevention and treatment tools require broader deployment.
With funding secured, attention shifts to the Trump administration’s ability to effectively implement HIV and hepatitis programs, alongside new PBM reforms intended to improve drug affordability and access for patients.
“We urge Congress to pass the bill that hopefully will end the instability, particularly for HIV prevention, and allow state and local health departments, community-based organizations, and the federal staff to do their work,” said Schmid. “With such promising tools as long-acting treatment and prevention, there is so much more to be done to get them to the people who need them. Flat funding will certainly not address the growing demands, but it is far better than receiving no funding.”
In addition to HIV programs, the legislation increases funding for hepatitis prevention by $3 million, bringing total funding to $46 million.
The spending package also includes long-awaited reforms to regulate pharmacy benefit managers (PBMs), which play a significant role in determining prescription drug access and patient out-of-pocket costs. The bill would delink PBM compensation from drug prices in Medicare, require full pass-through of rebates and fees, and impose enhanced transparency and reporting requirements.
Look for further commentary from Schmid later this week.
Reference
1. Congress funds domestic HIV programs—Trump administration must now implement them. The HIV+Hepatitis Policy Institute. January 20, 2026. Accessed January 28, 2026.
https://hivhep.org/press-releases/congress-funds-domestic-hiv-programs-trump-administration-must-now-implement-them/
