In this edition of the Situation Report, we delve into the escalating staffing crises at two pivotal federal agencies: the Agency for Healthcare Research and Quality (AHRQ) and the Department of Veterans Affairs (VA). AHRQ has experienced a near-total workforce reduction, leading to a cessation of new grant awards and raising alarms about the future of health services research. Simultaneously, the VA is grappling with severe staffing shortages, affecting both clinical and non-clinical roles, and compromising the quality of care for veterans. AcademyHealth is actively advocating for the restoration of staffing and funding, providing timely analysis and resources to help researchers respond, and elevating these crises in national discussions about health care research and services.
- Our Analysis Puts AHRQ’s Crisis in the National Spotlight
- Court Limits Who Can Challenge Administration’s Funding Freezes
- AcademyHealth Shapes the National Conversation on Health Data
- CDC Director Warns of the Dangers of Misinformation
- House Democrats Raise Questions About Medicare Prior Authorization Pilot
- New Insurer Rates, CMS Enrollment Data, Increase Concerns for ACA Marketplace Enrollment
- Timely AcademyHealth Resources to Navigate a Changing Policy Landscape
Our Analysis Puts AHRQ’s Crisis in the National Spotlight
AcademyHealth’s analysis of federal grants data made headlines this week in STAT News, revealing that the Agency for Healthcare Research and Quality (AHRQ) has not awarded a single new grant since April 1 – a stark departure from nearly $6 million in new awards during the same period last year. The story, which we actively helped bring to light, underscores the devastating impact of the ongoing staffing crisis at AHRQ, where up to 90 percent of the workforce is now gone.
This collapse in grantmaking halts critical, congressionally funded research to improve the quality, safety, and affordability of health care — including bipartisan-supported initiatives like the Healthcare Extension Service to expand rural access and integrate behavioral health. The freeze also raises legal questions about whether the administration is unlawfully withholding appropriated funds.
We’re keeping the spotlight on this issue, with interviews underway with other national media outlets to ensure policymakers and the public understand what’s at stake. Our outreach is already generating increased attention from Congress, with lawmakers signaling interest in how AHRQ is being restructured and how it plans to fulfill its funding obligations.
Our advocacy is clear: Congress must act to restore AHRQ’s staffing and operational capacity so it can carry out its mission. Without urgent action, the nation risks losing the only federal agency dedicated to studying how health care is delivered and ensuring those findings improve care in every community.
The Department of Veterans Affairs (VA) also faces record-high staffing shortages, with more than 4,400 severe shortages reported in fiscal year 2025, an increase of 50% from the previous year. Shortages span across over 40 critical occupations, including nurses, doctors, and psychologists, leading to reduced access and care for veterans. While VA leadership has attempted to minimize the gravity of these trends, lawmakers warn of a looming crisis as experienced professionals leave federal positions for the private sector and hiring lags far behind attrition. These staffing shortages directly jeopardize patients, clinical providers, and the health care systems that support them; the longer these vacancies continue, the more patients will suffer unnecessarily.
Court Limits Who Can Challenge Administration’s Funding Freezes
A federal appeals court ruled that only the Government Accountability Office (GAO) can sue when a president withholds federal funds under the Impoundment Control Act — not states, organizations, or researchers affected by the cuts. This decision is a distinct shift in how the ICA has always been interpreted and how it was drafted, which was written to provide protections for any party to litigate concerns with impoundments. This decision could affect numerous ongoing cases, including challenges to halted research grants at agencies like NIH and AHRQ. For health services researchers, the ruling matters because it may slow or block legal avenues to restore funding for critical research, making GAO oversight even more central to ensuring that Congress’s appropriations are spent as intended. AcademyHealth is monitoring these developments.
AcademyHealth Shapes the National Conversation on Health Data
AcademyHealth President and CEO Aaron Carroll was featured this week in Fierce Healthcare’s coverage of CMS’ new Health Tech Ecosystem Initiative, underscoring both the promise and the challenges of advancing interoperability, privacy, and trust in health data. As the voice for health services research, AcademyHealth is ensuring the field’s priorities are part of national debates on how health data is shared, protected, and put to work for better care.
Those conversations continue at Health Datapalooza, the meeting where policymakers, researchers, tech innovators, and industry leaders come together to shape the future of health data. On Sept. 5 in D.C., you’ll hear directly from Aneesh Chopra in a closing keynote responding to the CMS initiative and exploring its implications for the health research community. If you care about how health data policy will impact your research, your patients, or your organization, you belong at this table. Don’t miss the chance to join the conversation. Register here.
CDC Director Warns of the Dangers of Misinformation
Susan Monarez, the Centers for Disease Control and Prevention (CDC) Director, met with CDC staffers for the first time since Friday’s shooting at the CDC’s headquarters. In her virtual address, Monarez noted the dangers of misinformation to public health and trust. Department of Health and Human Services (HHS) Health Secretary Robert F. Kennedy (RFK) Jr. has not spoken publicly about how vaccine misinformation may have been related to the shooting, and HHS spokesperson Andrew Nixon responded that CDC leadership will remain focused on supporting staff when asked whether RFK Jr. would address vaccine misinformation.
Health services researchers have a vital role to play in the trust-building that Monarez calls for. As she suggests, compassionate, rational, and evidence-based communication is key for rebuilding compromised trust in public health.
House Democrats Raise Questions About Medicare Prior Authorization Pilot
House Democrats have raised concerns about a new HHS demonstration project that introduces prior authorization requirements in traditional Medicare. Prior authorization, the process of requiring pre-approval for certain medical services, is uncommon in traditional Medicare but prevalent in private Medicare Advantage plans. Seventeen Democratic lawmakers, led by Reps Suzan DelBene (D-Wash.) and Ami Bera (D-Calif.) wrote a letter to CMS Administrator Dr. Mehmet Oz requesting details on the rationale behind this initiative, its scope, implementation, and beneficiary safeguards. Under this demonstration model, CMS will partner with private companies, including Medicare Advantage plans, to test prior authorization for specific outpatient procedures identified as susceptible to fraud or misuse. House Democrats question the need for this demonstration project, especially amid recent efforts by the Trump Administration to reduce the use of prior authorizations. They highlighted that prior authorization has been associated with care delays and adverse patient outcomes. These lawmakers expressed concerns about whether this initiative could create incentives to deny care, potentially compromising patient access and increasing administrative burden on health care providers.
The introduction of prior authorization in traditional Medicare offers health services researchers a unique opportunity to study its impact on health care delivery and patient outcomes. This development could provide critical insights into balancing cost containment strategies with quality of care.
New Insurer Rates, CMS Enrollment Data, Increase Concerns for ACA Marketplace Enrollment
Updated data from health insurers’ rate filings and CMS on ACA marketplace enrollment are fueling concerns about broker fraud, increasing premiums, and enrollees leaving the ACA marketplace. Experts note that removal of premium tax subsidies will increase premium costs for marketplace enrollees, some of whom never filed a claim and were thus keeping rates low for everyone else. CMS notes that about 35% of enrollees last year didn’t file a claim, though these data are not entirely accurate. In addition, recent program integrity changes to crack down on waste, fraud, and abuse in the individual market encourage review of certain insurance brokers’ actions, such as misstating enrollees’ income and switching enrollees’ plans without authorization. These are steps brokers have taken in efforts to improve the expansion of enrollment in silver and bronze plans over the years, many of which are fully subsidized. Experts worry that these program integrity changes, while rooting out fraudulent enrollees, will weaken the risk pool, increase premiums, and kick off some legitimate enrollees. Already, Centene’s QCA Health Plan in Arkansas is requesting a rate increase of more than 50%, citing a new CMS final rule and the expiration of enhanced premium subsidies. Heath services researchers must monitor data from CMS and insurers closely over the coming year to inform policymakers how the reconciliation bill provisions and other efforts by CMS are impacting the marketplaces and, ultimately, Americans’ access to health care.
Timely AcademyHealth Resources to Navigate a Changing Policy Landscape
Health Policy Orientation: Build Your Policy Skills in a Time of Rapid Change
With major policy shifts transforming the health care system, now is the time to build a strong foundation in health policymaking and understand how the many pieces of the health care puzzle fit together. Learn how to communicate effectively with policy leaders, explore the roles of the executive, judicial, and legislative branches, and assess the current policy landscape at both the national and state levels. Through presentations from leading experts, interactive panels, and small group discussions, you’ll gain practical tools to navigate the policymaking process and advance your goals. Participation is limited to 50 people to support meaningful collaboration, peer exchange, and engagement with faculty. Join us in DC October 27-29, 2025!
Communicating to Build Trust Course: Strengthen Your Voice in a Polarized Environment
With credibility under attack and distrust and politicization running rampant, today’s researchers must learn how to navigate this landscape to become a credible force for facts and evidence. AcademyHealth’s newest course, Communicating to Build Trust, empowers researchers not to shy away from public communication, but to confidently step up to make a meaningful impact with their work. Enrollment is open for the October 30 to November 20 course. Enroll today and learn how to communicate evidence in a way that builds trust.
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!