This edition of AcademyHealth’s Situation Report spotlights a wave of legislative and administrative threats to health research—from proposed Medicaid caps and steep NIH budget cuts to the potential elimination of AHRQ and critical transparency functions at HHS. Researchers are encouraged to take action by contacting Congress using AcademyHealth’s advocacy tools, connecting with the advocacy team at the AcademyHealth’s 2025 Annual Research Meeting, and joining the upcoming members-only town hall to explore the pressing challenges facing the field.
In today’s Issue:
- AcademyHealth Advocacy Update: Meet the Team at the Annual Research Meeting
- Poll Finds Health Agency/Program Cuts Unpopular, State AGs Sue over HHS Cuts
- Republicans Eye Medicaid Cuts to Tackle Budget Deficit
- Budget Proposes $18B NIH Cut, Threatens Research Infrastructure
- Other News We’re Tracking
- What Researchers Can Do
AcademyHealth Advocacy Update: Meet the Team at the Annual Research Meeting
AcademyHealth continues to advocate for the Agency for Healthcare Research and Quality (AHRQ) and health services research (HSR). With the fiscal year 2026 (FY26) appropriations process underway, the AcademyHealth advocacy team has been meeting with congressional offices on behalf of the Friends of AHRQ to advocate for AHRQ funding in the upcoming year (see the Friends of AHRQ FY26 Budget Request here). While AHRQ remains under threat, stakeholders continue to highlight the damage that the elimination of the agency would have. This week, members of the National Advisory Council to AHRQ sent a letter to Congressional leaders calling for the preservation of AHRQ while highlighting the importance of the agency and its role in ensuring safer, accessible, and more cost-effective health care. Additionally, a recently published AcademyHealth blog post details the importance of AHRQ’s EvidenceNOW initiative, a program that has been improving health outcomes for a decade and is currently at risk of being eliminated.
We are closely monitoring the upcoming House Appropriations Committee hearing on the Department of Health and Human Services (HHS) FY26 budget request on May 14 at 9:30 AM ET and the Senate Health, Education, Labor and Pensions (HELP) Committee hearing on the Department of Health and Human Services (HHS) FY26 Budget on May 14 at 1:30 PM ET. Both of these hearings will provide Members and opportunity to question Secretary Robert F. Kennedy, Jr. about the activities of his Department.
AcademyHealth’s Annual Research Meeting in June provides an opportunity to connect with the advocacy team and learn more about how to translate your research into advocacy. In addition to sessions such as “Bridging the Gap: Communicating Evidence Across Political Divides” and “State Policy-Making: Progress on States’ Health and Spending Goals” there will be opportunities to meet Josh Caplan, AcademyHealth’s Director of Advocacy, during “Meet the Advocacy Team” hours over the course of conference.
Poll Finds Health Agency/Program Cuts Unpopular, State AGs Sue over HHS Cuts
A coalition of twenty state attorneys general sued the Trump administration over the mass firings and dismantling of various agencies within HHS, led by New York Attorney General Letitia James. The lawsuit alleges that the administration violated the law and bypassed congressional authority by attempting to consolidate HHS agencies and fire around 20,000 employees. The lawsuit claims that the terminations of HHS employees left critical offices unable to perform statutory functions and that abandoning the department’s core functions was the intended result of the March 27 Directive. The lawsuit identifies critical programs that have been undermined by these firings, such as the Head Start Program, Low-Income Home Energy Assistance Program, and the World Trade Center Health Program. In April, 23 attorneys general sued HHS over the termination of $11 billion in public heath grants. These cuts have been blocked by a federal judge, but no final ruling has been issued.
Polling data reveal that these cuts to federal health agencies and programs are unpopular with the broader public. A new nationally representative KFF Health Tracking Poll shows that most of the public (61 percent) oppose major health spending and staff cuts at federal health agencies. Though opposition to these cuts differs by political leaning, majorities of Democrats (89 percent), independents (67 percent), and Republicans and Republican-leaning, non-MAGA aligned individuals (52 percent) oppose the cuts. Those who identify as MAGA-aligned, however, overwhelmingly support the cuts (78 percent).
Republicans Eye Medicaid Cuts to Tackle Budget Deficit
Republican leaders have their targets set on Medicaid to reduce a large portion of the $880 billion the House Energy and Commerce Committee has been tasked with reducing in the deficit. Many avenues are still under consideration for budget cuts, including eliminating the enhanced match rate for the Affordable Care Act (ACA) expansion population, implementing a per capita cap on the federal share of Medicaid spending, and implementing work requirements, the last of which would disproportionately impact low-income women. However, the U.S. Senate and House of Representatives have considered per capita caps on the Medicaid expansion population, which limit the growth in federal spending on a per-enrollee basis, as one way to contribute to budget cuts.
The estimated effects of these per capita caps depend on how states approach such cuts; however, KFF estimates that a per capita cap on the expansion population could degrade the effective enhanced federal match rate for the ACA expansion population over time, eventually falling below states’ traditional match rates, and could shift $246 billion in costs to states over the next ten years. Moreover, the Urban Institute finds that in order to maintain their Medicaid programs, states with Medicaid expansion and with lower per capita incomes would face the largest percentage increases in their state spending.
Budget Proposes $18B NIH Cut, Threatens Research Infrastructure
President Trump's proposed 2026 federal budget includes a $17.97 billion reduction to the National Institutes of Health (NIH), decreasing its funding from $48.5 billion to $27 billion. Significant structural changes accompany the budget proposal, including the consolidation of the NIH's 27 institutes into five entities. Notably, funding for the National Institute on Minority Health and Health Disparities, the National Institute of Nursing Research, and the Fogarty International Center would be eliminated. Additionally, the MOSAIC program, designed to support early-career scientists from underrepresented backgrounds, has been terminated, affecting approximately 200 researchers.
The budget cuts have broader implications for HSR. The AAMC released a new analysis (PDF) on May 6 on the impact of NIH grant terminations on U.S. institutions. To date, U.S. institutions have lost $1.9 billion in funding across 777 terminated NIH grants, including 245 R01 grants and over 100 active clinical trials spanning a broad range of diseases. This data brief provides insight into the nature of the terminated grants as institutions grapple with the implications of this unprecedented loss of funding and threat to scientific progress. Additionally, the indefinite suspension of the Environmental Health Perspectives journal, due to funding constraints, represents a loss of a critical platform for disseminating research on environmental health risks. Furthermore, the elimination of the National Cancer Institute's Board of Scientific Advisors removes a key source of expert guidance for cancer research initiatives.
Other News We’re Tracking
HHS Rehires FOIA Staff After Backlash Over Mass Layoffs
In a partial reversal of sweeping layoffs, the Department of Health and Human Services has reinstated some FDA staff responsible for fulfilling Freedom of Information Act (FOIA) requests, following public outcry, legal action, and missed court-ordered deadlines. The March layoffs—aimed at cutting 10,000 HHS jobs—gutted transparency operations across FDA, CDC, and NIH, stalling access to records vital for public health, including records related to vaccines, outbreaks of illnesses, and more. Although HHS Secretary Kennedy has promised to restore FOIA functions, key offices, including at CDC, remain shuttered. For health services researchers, the disruption underscores mounting barriers to accessing information and further showcases the impact of reducing the HHS workforce.
HHS Report Challenges Gender-Affirming Care and Criticizes Medical Associations
Backed by the Trump administration’s broader rollback of transgender health protections, a newly released 400-page report characterizes the evidence for gender-affirming treatments as low quality and emphasizes the potential for harm—while promoting "exploratory therapy," a practice critics liken to conversion therapy. The report’s anonymous authorship, selective methodology, and alignment with recent federal policies triggered strong pushback from professional societies and LGBTQ+ advocates, who argue it misrepresents scientific consensus and disrupts patient care.
What Researchers Can Do
As threats to health research funding and infrastructure mount, researchers have a critical role to play in advocating for the value of their work and its impact on health systems and communities. Here are some immediate actions you can take:
- Advocate for AHRQ: The most impactful action you can take to support AHRQ is to directly contact your congressional representatives. Use or Stand with AHRQ toolkit to help you communicate with Congress about the importance of working together to preserve AHRQ’s vital contributions to national health.
- Connect with the Advocacy Team at ARM: Stop by the “Meet the Advocacy Team” hours during AcademyHealth’s Annual Research Meeting to learn how you can become a more effective advocate. Whether you're new to advocacy or seasoned in policy engagement, the team can help tailor actions to your comfort level and expertise.
- Join the AcademyHealth Town Hall Meeting: Join us on May 21 for an exclusive, members-only AcademyHealth town hall with President and CEO Aaron Carroll and Director of Advocacy Josh Caplan to explore the pressing challenges facing the health services and health policy research field and discuss strategies to navigate them.
- Support AcademyHealth: Want to support experts, researchers, and policymakers working to turn evidence into action? A donation to AcademyHealth helps ensure that the best research leads to real-world improvements in health and health care.
Now is the time to speak up—not just as researchers, but as stewards of public health and evidence-based decision-making.
Previous Updates
This is the latest in a series of Situation Report updates from AcademyHealth. You can find prior issues here.
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