Last week’s congressional hearings on U.S. health policy covered familiar ground: outbreaks of preventable diseases, drug pricing, and proposed cuts to the Department of Health and Human Services (HHS). Lawmakers from both parties raised concerns about public trust and debated workforce reductions and funding gaps across federal health programs. The central issue driving the hearings was the administration’s FY2027 budget request, which proposes cutting HHS discretionary funding by 12.5% and reducing NIH’s budget by more than $5 billion.
Those are real issues, and they point directly to what FASD has always needed from the federal government: trusted leadership that gives families and providers honest, evidence-based guidance about what prenatal alcohol exposure can mean across a lifetime; a trained workforce that can identify it and respond; and coordination across the healthcare, education, child welfare, and justice systems.
Fetal alcohol spectrum disorder (FASD) shows up across healthcare, education, child welfare, and the justice system. It requires early identification, trained providers, and systems that can work together over time. Federal investments have supported prevalence studies and longitudinal research through initiatives like the Collaborative Initiative on Fetal Alcohol Spectrum Disorders (CIFASD), along with early efforts to build screening and intervention models. The scale of that investment, though, has never come close to matching the prevalence or scope of FASD.
The FY2027 President’s Budget makes that gap concrete. The dedicated federal line item for Fetal Alcohol Syndrome, which funds surveillance, data gathering, and evidence-based prevention, sits at $11 million under the proposed budget, a $500,000 reduction from current levels. Across the broader Birth Defects, Developmental Disabilities, and Disability and Health block, the FY2027 budget proposes cutting $28.25 million from current funding. The survival of the FASD line in that environment matters, and it gives advocates a real foundation for future appropriations requests. But $11 million was never an adequate base for a condition that touches virtually every system serving people across the lifespan.
The wider funding environment makes this worse. NIH’s enacted budget for FY2026 is $48.7 billion. Earlier this year, Congress rejected the administration’s proposal to cut the agency by 40%, but the FY2027 request now proposes to cut over $5 billion. That proposal drew criticism at the hearings from Republicans as well as Democrats. Sen. Shelley Moore Capito said she disagreed with the proposed cut even while calling it more reasonable than last year’s request. Sen. Susan Collins pressed Secretary Kennedy on how the administration’s prohibition on diversity and equity language has affected women’s health research, noting that grants are being denied simply for containing the word “women.”
FASD cannot be addressed through a single program or a short-term initiative. It requires what the current system struggles to provide: cross-system coordination, consistent training, integrated data, and long-term infrastructure that connects research to practice and policy to real outcomes. Last week’s hearings did not mention FASD, but they did not need to. They highlighted exactly the structural problems that have constrained progress for decades: fragmented systems, uneven capacity, and a policy environment that keeps debating immediate priorities while underinvesting in long-term design.
That is where advocates come in. Through the Respect Act provisions, Congress has passed new authorization for exactly this kind of work, authorizing $12.5 million annually through 2030 for FASD prevention, intervention, workforce training, and state and tribal capacity building. Ensuring those programs reach communities requires advocacy on two fronts. Meeting with federal representatives to make the case for increased funding to build national and state capacity to address FASD is one piece of it. Meeting with state legislators to build awareness of what the law requires, what capacity their states need to implement it, and why FASD-informed systems serve families better across every sector is the other. Authorization creates the framework. Funding and political will are what make it real. At a moment when Congress has already shown it will push back on the deepest cuts to public health research, there is real ground to work with, and the FASD community is well positioned to make its case.
HHS Justification of Estimates for Appropriations Committees
