Editorial note: The Read on Washington is a monthly column on happenings in DC that affect the field of health services research. In addition, AcademyHealth recently began offering ad hoc updates via the Situation Report series. The Situation Report can be found on our blog and is also emailed directly to our members. All of AcademyHealth’s advocacy work is supported by member dues.
Senate considers HHS appropriations as distrust grows
The Senate Appropriations Committee is expecting to release and markup its FY26 Labor-HHS funding bill on Thursday, July 31. This is expected to be one of the more difficult bills for the Committee to pass because Senators on both sides of the aisle lack confidence that the Administration will faithfully execute the law. The pervasive distrust is a result of rescissions and impoundments by the Administration that have devastated HHS, the federal workforce, and government-funded health and research enterprises.
Highlighting the increasingly politically untenable nature of impoundments, Senator Katie Britt (R-AL) and 13 Senate Republicans sent a letter to OMB Director Vought to stop withholding NIH funds. The signatories include Senate Appropriations Chair Susan Collins (R-ME) and Labor-HHS Appropriations Chair Shelley Moore Capito (R-WV), which shows that even frustrated Senate leaders are unable to free up impounded funds through private conversations with the Administration.
Supreme Court allows HHS to finalize layoffs while court case proceeds
HHS fired thousands of federal workers on July 14 following a Supreme Court ruling that the Department can move forward with the reduction in force announced on April 1 that had been previously held up in courts. In a reorganization announced March 27, HHS eliminated 10,000 employees across HHS agencies. This reduction in force has direct implications for researchers, as AHRQ has begun communicating that it lacks the staff to manage and administer many of its grant programs.
Party-line rescission package passes, more on the way
Republicans narrowly passed President Trump’s proposed $9.4 billion rescission package earlier this month. The package included deep cuts to foreign aid and public broadcasting, though a proposed $400 million cut to PEPFAR, a major HIV/AIDS program, was spared to gain the votes necessary to pass. Although the first round of rescissions was controversial, the White House is already preparing a second package targeting education-related programs, including funding tied to teacher training, immigrant education, and LGBTQ+ initiatives. It is possible that HHS cuts may also be included. These party-line votes are overturning bipartisan funding agreements. OMB Director Russ Vought has also floated the use of pocket rescissions to bypass Congress. The Government Accountability Office states unambiguously that there is no legal authority to engage in pocket rescissions.
New Executive Order injects partisan priorities in AI regulation
President Trump has signed an executive order requiring AI companies doing business with the federal government to eliminate what the administration calls “ideological agendas” from their models, explicitly banning systems that incorporate concepts like diversity, equity and inclusion (DEI), instead pursuing “ideological neutrality.” The administration also plans to roll back Biden-era AI safety guidelines by removing DEI, climate, and misinformation provisions. Critics, including AI experts and tech industry figures, warn the directive imposes vague, politically motivated standards that could undercut safety guardrails and force companies to redesign systems in ways that may compromise fact-based protections, potentially destabilizing the sector amid ongoing concerns over bias, misinformation, and hate speech.
NIH to limit funding applications
Scientists hoping to obtain some of the National Institutes of Health’s (NIH’s) dwindling research funds face a new challenge: they will be limited to submitting six applications per calendar year, according to a notice the agency released this week. The policy, which also prohibits applications written with the assistance of generative artificial intelligence, is ostensibly designed to prevent researchers from overwhelming the NIH grant-review system with large numbers of proposals, especially low-quality ones produced with AI. But some critics worry the cap—which applies to grant resubmissions, renewals, and revisions as well as original applications—will hurt scientists who are already struggling to obtain federal funding as NIH freezes and rescinds many grants for political reasons, and President Donald Trump's administration seeks to cut the agency’s annual budget by more than one-third.
ACA insurance premiums to spike as Congress seems to allow subsidies expire
Each spring and summer, health insurers submit rate filings to state regulators to justify premium changes for the coming calendar year. Enhanced premium tax credits that make coverage more affordable will expire at the end of 2025, driving up out-of-pocket premium payments by over 75% on average. This is expected to cause healthier enrollees to drop their coverage and create a sicker risk pool. Tariffs could drive up the cost of some drugs, medical equipment, and supplies. Some insurers report that tariffs—and the uncertainty around them—are driving rate increases about 3% higher than they otherwise would be. Indeed, the Congressional Budget Office estimates that allowing the subsidies to expire would increase the number of uninsured people by 4.2 million over the next decade.
HELP Chairman calls for delays at ACIP following purge, ACIP meets as scheduled
The Chairman of the Senate Health, Education, Labor, and Pensions Committee called on Secretary Kennedy to delay a meeting of the Advisory Committee on Immunization Practices (ACIP) following the Secretary purging the experts on the panel. “Although the appointees to [the Advisory Committee on Immunization Practices] have scientific credentials, many do not have significant experience studying microbiology, epidemiology or immunology. In particular, some lack experience studying new technologies such as mRNA vaccines, and may even have a preconceived bias against them,” said Sen. Cassidy. The meeting was not delayed.
What we’re reading
The odds of a patient beating cancer continue to improve with new biomedical innovations, but the benefits are especially true for insured patients. A new article in JAMA Open Network found that the survival rate for patients across all insurance types increased with the introduction of immune checkpoint inhibitors; however, the survival gap widened based on insurance coverage. The two-year survival rate of privately insured patients (with melanoma) jumped from nearly 29% to 46%, whereas in uninsured patients, the survival rate increased from about 16% to just over 28%.
Congressional staff turnover has always been a problem as institutional knowledge becomes difficult to build up in many offices. New research shows that Republican offices in the 119th Congress are experiencing significantly higher staff turnover than their Democratic counterparts, nearly 75% higher, indicating more than half of GOP staffers are projected to leave by year’s end. Of the top 100 highest-turnover offices, 78 belong to Republicans, with Rep. Victoria Spartz (R-Ind.) leading at an index of 3.68, suggesting her office has turned over the equivalent of its entire staff more than three times already in 2025. Turnover is notably higher in the House than in the Senate, where turnover rates remain much lower across both parties.
New analysis by Komodo Health and the New York Times found that prescription drug denials by private insurers jumped 25 percent from 2016 to 2023, according to an analysis of more than four billion claims. The report shows that denial rates rose from 18.3 percent to 22.9 percent. Experts who have studied denials said the skyrocketing costs of popular new weight loss medications and greater automation of the claims process with artificial intelligence may have contributed to the rising rejection rates.