HHS states that MACs will still be able to perform all their duties despite decreased funding because the budget “reflects efficiencies gained by descoping non-statutory workload and optimizing the level of effort.”##
On May 30, 2025, the executive branch released a 55-page document of the FY2026 fiscal year budget requests from the White House to Congress.
These annual "budget requests" are *not* the federal budget - they are the executive branch's proposals to the legislative branch. In one year or another, they may include budget items that are much higher, or indeed, much lower, than Congress allocates.
With that caveat, here are:
- HHS FY2026 Budget in Brief, 55pp
- Discussion, open access, at STAT
- Discussion of CMS budget components, at McDermott Plus
First, the 55-page budget is concise compared to previous years. The 2025 Budget in Brief was 184 pages and included more detail per agency per year, and year-on-year comparisons. The briefer Budget in Brief released now generally omits year-on-year comparisons, and may compress items detailed in 2025, into a single gross budget line, representing 2026.
According to STAT, the document "doubles down" on NIH budget cuts, cutting $18B or 405, while compressing 27 institutes into just 8.
McDermott Plus
More detail on CMS budget cuts is found in the CMS section, pages 24-28, and these are analyzed and explained in the McDermott document linked above. Note that the CMS budget is program operations, not actual medical care payments. Program administration, both at CMS central office and at MACs, is cut from $3.7B to $3.0B. If I read McDermott correctly, MAC operations would fall in 2026 to $589M, a cut of $261M compared to 2024. MAC claims are about flat at about 1.2B claims. McDermott makes year-on-year comparisons by digging out past published budgets, since year-on-year tables are generally omitted in the new HHS document.
McDermott adds, "CMS states that MACs will still be able to perform all their duties despite decreased funding because the budget 'reflects efficiencies gained by descoping non-statutory workload and optimizing the level of effort. " HHS proposes to budget $20M in new money for more DME competitive bidding, and $53M (up $5M) to accurately update payment systems and fee schedules.
Fraud and Abuse
CMS proposes $2.6B for fraud and abuse, of which almost $1B is "discretionary" rather the Congressional fixed budget.
