An internal memo proposes carving out $40 billion from federal health agencies while eliminating dozens of programs. Congress has ultimate appropriation authority.

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The Trump administration is eyeing about $40 billion in cuts to the Department of Health and Human Services’s budget next year, according to a memo obtained by The New York Times, as the White House charges ahead with plans for drastic changes to the agencies that regulate food and drugs, protect Americans from disease and research new treatments.

The proposed cuts laid out in the preliminary budget memo would reduce the department’s budget from about $121 billion to about $80.4 billion. The document also proposes eliminating dozens of programs focused on various public health challenges, such as autism, teen pregnancy, lead poisoning, opioid recovery and support for rural hospitals. The memo was first reported by The Washington Post.

The cuts deal with discretionary H.H.S. funding, not what the federal government is obligated by law to spend annually on insurance programs like Medicare and Medicaid, which insure nearly half of Americans.

While it is not yet clear if the Trump administration will pursue all of the cuts the document outlines, it is Congress that will decide whether to enact them, as the legislature appropriates the federal government’s funding.

Still, the memo reveals how President Trump and Robert F. Kennedy Jr., the health secretary, might put into practice their plans to overhaul the department and refashion it as a crucible for Mr. Kennedy’s “Make America Healthy Again” movement.

About a quarter of the funds that would survive the proposed cuts would be directed toward the Administration for a Healthy America, a new $20 billion effort that would oversee agencies focused on H.I.V. and AIDS, maternal and child health, environmental health, mental health and primary care.