AcademyHealth’s Situation Report: What the GOP Bill Means for HSR, Ways to Support Our Advocacy Work

In this edition of the Situation Report, we highlight the expected impact of the Republican reconciliation bill that was signed into law on July 4 and will strip millions of their health coverage and food assistance over the next decade, further disrupting access to care and raising costs for some of the nation’s most vulnerable communities. We also highlight continued disruptions to the federal workforce and research grants. Read on to find out how members can support our work and attend a member-only town hall to stay informed of policy and funding challenges facing the field.

In today’s issue:

GOP Bill Passes, What it Means for HSR
As NIH Grants Reinstated, Leaked HHS Memo Outlines New Tactics for Funding Terminations
Trump Administration’s ACA Final Rule Sparks Lawsuit Against CMS
Morale Remains Low After FDA Layoffs, Could Compromise the Agency’s Work
Medical Societies Sue RFK and HHS Over Covid Vaccine Access Changes
AcademyHealth Takes Stand Against Disappearing Health Data
ICYMI Members-Only Town Hall: Navigating Today’s Health Policy and Research Landscape

GOP Bill Passes, What it Means for HSR

The Republicans' reconciliation bill passed the House after a brief and hurried round of deliberation, and Trump signed it into law on the Fourth of July. This proposal jeopardizes the health of some of the nation’s most vulnerable communities, slashing Medicaid and SNAP funding, imposing stricter work requirements, and increasing bureaucratic hurdles for States. These changes could strip 14 million people of their health coverage and food assistance over the next decade, even among those eligible for the services. Medicaid cuts will limit access to care, raise out-of-pocket costs, cause coverage disruptions, and jeopardize the survival of hundreds of rural hospitals. The law also impacts payments plans by capping payment rates for Medicare services, freezing provider taxes, and delaying the implementation of future state-directed payment plans. With these changes on the horizon, the need for data-driven policy solutions is urgent; unfortunately, the fates of the very agencies capable of generating these insights, such as AHRQ, remain uncertain as the struggle over proposed HHS reorganization continues.

Researchers must be prepared to rapidly analyze the effects of these changes—particularly on vulnerable populations—and communicate findings clearly to policymakers and the public. At the same time, our community must push back against the erosion of evidence-based policymaking by supporting federal research agencies, contacting elected officials, and making the value of rigorous, timely research impossible to ignore.

Need support turning evidence into action? We’ve compiled the below set of free resources to help researchers communicate findings for impact:

As NIH Grants Reinstated, Leaked HHS Memo Outlines New Tactics for Funding Terminations

An internal memo from the Office of the General Counsel at HHS reveals that the agency is developing a more cautious and legally rigorous strategy for canceling research deemed out of step with the Trump administration priorities. This move follows several legal defeats on NIH’s grant terminations and a resulting pause on terminations. The guidance instructs staff to consult with the Office of the General Counsel to ensure that funding terminations do not violate court orders, federal statutes, or the Constitution, and ranks five options for terminating awards from the most to least legal risk.

The most legally risky options include reasoning HHS has used in previous terminations that have been deemed void or prohibited, such as termination for non-alignment with agency priorities and termination for cause. The third option, to cite non-alignment with agency priorities following October 1, 2025, uses the start of a new fiscal year and resulting new OMB regulations to resurrect this termination option. The memo also recommends developing an “administrative record” to document reasons for terminations, an issue that was raised by a federal judge in previous lawsuits. The memo cites establishing a record to mitigate the overturning of previous blanket terminations. The final two options deal with canceling an award for non-compliance with the terms, or if the grantee provides consent for a termination.

This guidance comes to light at the same moment that NIH begins reinstating a subset of terminated grants. A federal judge’s decision that NIH grants must be reinstated only applies to grants submitted by the 16 state attorneys general and other plaintiffs. As a result, this reprieve largely extends only to researchers in Democratic states, whose attorneys general joined the lawsuit and whose congressional districts stand to see $2.1 billion in grants reinstated, compared to a potential $62 million in Republican districts. Considering this HHS guidance and reinstatement of funding, researchers note that they will need to promote the importance of research with their local communities, policymakers, and congressional representatives.

Trump Administration’s ACA Final Rule Sparks Lawsuit Against CMS

Two advocate organizations and three U.S. cities sued the Centers for Medicare & Medicaid Services (CMS) over a recent Affordable Care Act (ACA) final rule arguing the regulation makes affordable insurance coverage more inaccessible and increases the number of Americans who are under- and uninsured. The final rule ends monthly special enrollment periods, which allow individuals with incomes at or below 150 percent of the federal poverty level increased access to coverage. An HHS spokesperson defended the rule, saying it ensures taxpayer subsidies go only to eligible enrollees. The cities and advocacy groups cite enrollment will decrease by 14 percent to 33 percent from this provision, noting that until enrollees confirm their intent to remain on a plan covered by premium tax credits, they must pay a monthly surcharge. Moreover, the plaintiffs expect the rule to weaken safeguards that some ACA enrollees may unknowingly rely on, such as the sustaining of their plans, even when they fail to pay their premiums. The final rule goes into effect in August. Plaintiffs maintain the provisions will further restrict access to affordable health insurance coverage.

Morale Remains Low After FDA Layoffs, Could Compromise the Agency’s Work

Three months after losing nearly a fifth of its workforce, the Food and Drug Administration (FDA) continues to lose career staff and other talent amid an ongoing government-wide hiring freeze. For the FDA employees that remain, increased political involvement in agency decisions, far fewer support staff, and disregard of career staff’s expertise in commissioner’s office decisions challenge their morale and have pushed many to depart on top of layoffs. The exodus has already compromised the FDA’s work, as evidenced by the handful of its missed review target dates, and as one agency reviewer warned, vital regulatory questions will fall through the cracks without experts on hand to complete routine reviews. The current FDA commissioner, Marty Makary, denies any decline in morale, but multiple employees report otherwise.

Medical Societies Sue RFK and HHS Over Covid Vaccine Access Changes

Six leading medical organizations, including the American Public Health Association and the American Academy of Pediatrics, have filed a lawsuit against HHS Secretary RFK Jr. and HHS that seeks to restore Covid vaccines to the list of recommended immunizations for healthy children and pregnant women. In May, the HHS Secretary announced this vaccine policy change, which goes against years of evidence demonstrating the higher risk of severe illness for pregnant women who contract Covid. Usually, members of the Advisory Committee on Immunization Practices (ACIP) debate the research surrounding such a policy change and make recommendations to the agency director; however, RFK Jr. has sidestepped this process and made the announcement without consulting CDC staff or independent advisors. RFK Jr. has also reconfigured the membership of ACIP, including at least four new members who are vaccine skeptics. The lawsuit describes RFK Jr.’s numerous efforts to undermine vaccines and claims that his policies have promoted unfounded fears about vaccine safety, making it difficult for doctors to counsel and treat patients.

AcademyHealth Takes Stand Against Disappearing Health Data

AcademyHealth is leading the charge to protect public health data and safeguard the evidence that drives better decisions, stronger policies, and healthier communities. In a powerful new column in Health Affairs Forefront, our President and CEO Aaron Carroll outlines what’s at stake when critical data disappear—and why we’ve joined a federal lawsuit to restore access to them. Read the full column at here.

Our work doesn’t stop there. AcademyHealth is unwavering in its commitment to ensure that evidence informs every level of health care and policy. But we can’t do this alone. We need support from those who understand the value of evidence-based policymaking and the unique role AcademyHealth plays in defending a data-driven health system. Here’s how you can help:

Help Us Tell the Full Story: Share Your Experience
Our legal case is grounded in clear, documented examples of harm already included in our court filings. However, if your work or the communities you serve have been directly affected by the removal or alteration of federal health data, please consider sharing your story. Whether it's a derailed research project, a disruption to patient care, or a broader public health consequence, your experience could make a critical difference in the courtroom and in the public debate.
We are building a record of real-world harms to show the judge what’s at stake and are especially interested in how the loss of information has impacted your ability to conduct research, deliver care, inform communities, or protect public health.
Support Our Work Financially
Make a donation today here or by texting AcademyHealth to 44-321 to receive a secure donation link. Your support will help us strengthen the field, elevate the role of research in decision-making, and advance better health outcomes for everyone.

ICYMI Members-Only Town Hall: Navigating Today’s Health Policy and Research Landscape

Join us for an exclusive AcademyHealth members-only town hall with President and CEO, Aaron Carroll, Director of Advocacy, Josh Caplan, and Senior Vice President of Policy and Advocacy at the nonpartisan, nonprofit advocacy alliance, Research!America, Ellie Dehoney. The town hall provides members with critical insights into the policy and funding challenges shaping the health services and health policy research field. Participants will discover advocacy strategies and resources to navigate the current environment. This interactive session offers a unique opportunity to connect with peers, share experiences, and engage in open dialogue with AcademyHealth leadership.

Date and Time: Wednesday, July 16, 2025 | 12:00p.m. to 1:00p.m. ET

Previous Updates

This is the latest in a series of Situation Report updates from AcademyHealth. You can find prior issues here.

We’re pleased to offer this work as a free resource, and if you’d like to support our efforts to keep it going, we’d truly appreciate your donation. You can contribute here. Thank you for your support!