The recent directive from the Office of Management and Budget and the Office of Personnel Management, requiring federal agencies to submit reorganization plans by March 13, 2025, signals significant impending changes to the federal workforce. This initiative, part of the Trump administration's broader strategy to reduce government size and enhance efficiency, is expected to lead to substantial layoffs and program consolidations across various departments. For health services researchers, these developments are particularly concerning due to their potential impact on critical health-related agencies and research funding such as NIH, VA, and other HHS agencies. 

These actions suggest a trend toward decreased federal support for health services research, which may result in reduced funding opportunities, project delays, and a potential decline in the advancement of medical knowledge and public health initiatives. AcademyHealth continues to monitor these developments. Health services researchers should continue to assess the potential impacts on their work and consider seeking alternative funding sources or collaborations. This edition of the Situation Report includes resources that may be helpful in response to these developments as well as updates on congressional actions related to Medicaid Cuts.  

In today’s issue: 

  • Strategies for Securing Funding and Job Loss Resources 
  • Sign the AHRQ Letter of Support Going to the Hill on Monday  
  • AcademyHealth on the Record for Braidwood  
  • Medicaid Cuts: A Pivotal Factor and Flashpoint in Budget Reconciliation 
  • Executive Orders & Public Health Practice: FAQs 

 

Strategies for Securing Funding and Job Loss Resources 

Join us on March 13 for an engaging webinar designed to sharpen your skills in securing research funding. Available only to AcademyHealth members, this interactive session features a moderated discussion with a researcher, a private funder, and an experienced grant writer, providing diverse perspectives on the funding process. Participants will also engage in breakout groups to tackle specific challenges and share strategies. Register for Securing Funding – Strategies for Researchers here. 

Individuals affected by job loss can learn more about filing a claim with the merit systems protection board (MSPB) via Democracy Forward’s new “Civil Service Strong” tool. The website has updates on current litigation, as well as guidance on how to file an appeal with the MSPB and tips for creating a “virtual employee ‘go bag’” among other FAQs and one-pagers. Access the resources for free at https://www.civilservicestrong.org/resources.  

As a reminder, you can browse AcademyHealth’s Career Center for free at any time. The American Public Health Association has also opened up Public Health CareerMart for free.  

Sign the AHRQ Letter of Support Going to the Hill on Monday  

On Monday, March 3, AcademyHealth will submit a letter of support for funding the Agency of Healthcare Research and Quality (AHRQ) in FY26 to the House Appropriations Committee. The letter has more than 180 signatories as of Thursday, breaking the previous record of number of supporters and representing a wide variety of health system and policy stakeholders. This speaks to the critical nature of AHRQ, which is the bridge between cures and care and ensures that Americans get the best health care at the best value. You can read the letter and have your organization sign it here by midnight tonight (February 28). AcademyHealth is planning to promote the letter widely and the more signatories we collect, the more powerful the letter will be. If you want to join the Friends listserv, email us at Advocacy@academyhealth.org.  

AcademyHealth on the Record for Braidwood  

The Supreme Court has taken up the case Braidwood v Becerra, now Braidwood v. Kennedy. This case  will decide if the ACA's preventive care mandate, based on United States Preventative Services Task Force (USPSTF) recommendations, is unconstitutional, potentially affecting millions' access to cost-free preventive services and restricting evidence-based policymaking. You can learn more about the case here.  

AcademyHealth has filed briefs to the courts throughout this case, and joined an additional one before the Supreme Court, here. In this brief, AcademyHealth highlights the importance of expert-led policymaking and the clear constitutionality of the USPSTF.   

Medicaid Cuts: A Pivotal Factor and Flashpoint in Budget Reconciliation 

Congressional Republicans are using a budget reconciliation process to pass legislation to extend tax cuts for the wealthy, increase investments in border security and defense, and to slash Medicaid while sidestepping a filibuster in the Senate. AcademyHealth is leading an education effort with congressional offices to communicate the evidence on the reforms that are being considered, such as work requirements, reducing the FMAP, and block granting, and how they will very likely harm beneficiaries, destabilize rural hospitals, and harm state budgets.   

Current Congressional Actions  

The legislative budget reconciliation process for fiscal year 2025 (FY25) has been ongoing, with the Senate and House Budget Committees currently moving forward with competing budget resolutions. Congress needs to agree on a budget resolution with instructions for reconciliation to begin the process.   

Both the House and Senate have passed competing versions of their budget resolutions with narrow votes. The Senate is proposing a two-step process where they split President Trump’s policy agenda into two different bills, with easier to pass proposals going first. The House is trying to pass the entire agenda in one bill. At this stage, the House and Senate need to reconcile these two strategies into one.  

Concerns for Medicaid  

With either of the proposed resolutions, it is largely expected that Medicaid funding will be heavily targeted to offset the deficit effects of the tax cuts – placing the program under serious threat. The primary reforms that are being considered for Medicaid include block grants, work requirements, or changing federal payment rates. Research reports that previously implemented state work requirements were inefficient in meeting their goals, leading to lost access through bureaucratic red tape without any meaningful increase in employment. There was also an additional administrative burden due to the need to monitor enrollee reporting. You can read more in AcademyHealth President and CEO Aaron Carroll’s New York Times op-ed.   

There is also major concern for the nine states that have “trigger laws” in place that are set to remove Medicaid expansion if federal Medicaid funding drops below a certain threshold, a move that would lead to millions immediately losing coverage.    

The cuts to Medicaid are both a key component of the reconciliation debate among congressional Republicans and a point of contention, as an increasing number of Members are worried about the implications of the cuts on beneficiaries and home state health systems. Due to these divisions, it is unclear what policies will make it into the final bill. These leads to a key opportunity for researchers and patients to meet with their representatives and discuss the importance of the program to policymakers.   

AcademyHealth Efforts  

AcademyHealth has met with dozens of targeted congressional offices and committees to provide educational briefings by members who are top Medicaid experts in the country. The meetings are an opportunity to inform staffers about the overwhelming evidence showing that the proposed reforms are likely to hurt beneficiaries, rural hospitals, and states.  

In addition, State-University Partnership Learning Network (SUPLN) and Medicaid Outcomes Distributed Research Network (MODRN) have been leading the charge in developing Medicaid one-pagers on how Medicaid supports rural health, long-term care, and opioid use disorder treatment that are being disseminated to congressional offices.  

Executive Orders & Public Health Practice: FAQs  

Act for Public Health presents FAQs to help explain executive orders, the goals and limits of their application, and how public health practitioners might think about them. While executive orders can be issued at all levels of government (federal, state, and local), this explainer focuses only on federal executive orders. Read the FAQs here.  

Previous Updates 

This is the seventh in a series of Situation Report updates from AcademyHealth. You can find prior issues below:  

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