situation report

In this edition of the Situation Report, a divided Supreme Court ruling allows for the cancellation of more than $780 million in NIH grants, primarily affecting diversity, equity, and vaccine-related research, while raising questions about the legal scope of executive authority. DOJ subpoenas requesting confidential records from hospitals providing gender-affirming care for minors have led some major providers to pause services. HHS staff have also called for steps to protect the public health workforce and ensure the accuracy of federal health guidance. While some CDC funding has been restored, ongoing uncertainty around grant approvals may continue to disrupt research infrastructure. AcademyHealth remains committed to monitoring these developments, supporting impacted researchers, and advocating for evidence-based policy.

In today’s issue:

  • Split Supreme Court Allows $780 Million in Cuts to NIH Grants
  • DOJ Subpoenas Patient Records, Hospitals Halt Youth Gender-Affirming Care
  • Open Letter Calls to Stop Misinformation, Safeguard HHS Workforce
  • More Medical Association Diverge from CDC Vaccine Guidance Amid Warnings
  • $200 Million CDC Research Funds Restored

Split Supreme Court Allows $780 Million in Cuts to NIH Grants

The Supreme Court ruled 5-to-4 that the Trump administration can cancel more than $780 million in grants from NIH for projects focused on diversity, equity, and inclusion, as well as “gender ideology” and vaccine hesitancy. The court also let stand a lower court ruling that the policy directing those cuts may be unlawful and should be put on hold. As a result, previously cancelled grants will not be immediately reinstated, but recipients may be able to seek legal remedies, and further cancellations could be limited. The Government Accountability Office recently found that the administration broke the law by withholding congressionally allocated funds from the NIH; such non-binding decisions are meant to give Congress objective, non-partisan analysis.

The case is similar to one from April in which the Supreme Court allowed the administration to temporarily suspend $65 million in teacher-training grants and the justices were also split 5-to-4. The government claimed, in an emergency application, that the NIH case was legally identical to this April case, while the challengers claimed otherwise, noting that the April case concerned individual contracts rather than overall policy. This very issue divided the justices, with dissenting Chief Justice Roberts writing that the policy guidance and its consequences were legally inseparable and that funding should be restored. Justice Jackson noted the far-reaching consequences of this ruling, that the U.S. will lose valuable medication trials, researchers, and community health clinics. Ultimately, this ruling paves the way for the politicization of scientific priorities, disrupts ongoing research and existing infrastructure, and will directly harm the health of Americans for decades to come.

DOJ Subpoenas Patient Records, Hospitals Halt Youth Gender-Affirming Care

According to a subpoena made public in a court filing earlier this month, the Department of Justice (DOJ) is requesting hospitals that provide gender-affirming health care to minors provide confidential patient information. The subpoena was to the Children’s Hospital of Philadelphia and requests records from physicians related to the delivery of hormone therapy, puberty blockers, and gender transition surgery to minors as well as each patient’s clinical diagnoses or assessment leading to such care and the related informed consent, patient intake, and parent or guardian authorization documentation.

This subpoena is one of the twenty subpoenas the DOJ says it has sent to physicians and clinics involved in what they term “transgender medical procedures” on minors for investigations in “healthcare fraud” and “false statements” among others. These subpoenas come among a slew of other actions by the administration that affect gender-affirming care for minors, such as an executive order that recognizes only two genders and a call from the FBI to the public to report tips related to medical providers offering pediatric gender affirming care.

In the midst of these various disruptions, two major U.S. hospitals, Kaiser Permanente and Children’s National Hospital, announced plans to pause gender-related surgeries and stop prescribing gender-affirming medications, respectively, by the end of the month. These two add to over a dozen major hospital systems that have stopped gender-affirming care for minors amid scrutiny since Trump took office in January.

Legal and regulatory actions impacting gender-affirming care for minors may disrupt clinical service delivery and data availability. Health services researchers should monitor these developments and provide rigorous, unbiased evidence to guide policymakers and health systems.

Open Letter Calls to Stop Misinformation, Safeguard HHS Workforce

Over 750 current and former Department of Health and Human Services (HHS) staff members signed a letter urging Secretary Robert F. Kennedy Jr. to halt the dissemination of inaccurate health information and to enhance protection for public health professionals. This plea follows a recent shooting at the Centers for Disease Control and Prevention (CDC) headquarters, allegedly motivated by COVID-19 vaccine misinformation. The incident has sparked concerns over increasing mistrust in public health institutions, exacerbated by “politicized rhetoric that has turned public health professionals from trusted experts into targets of villainization —and now, violence,” as noted in the letter. The letter further emphasized that such discourse not only endangers public health workers but also undermines America’s overall health infrastructure and erodes stability and trust in scientists. 

The letter also raised concerns about recent policy and structural changes within HHS, including the dissolution of a vaccine advisory panel, statements regarding vaccine safety, and workforce reductions. Signatories highlighted that these changes may affect CDC operations, staff capacity, and the dissemination of evidence-based guidance. The letter calls for steps to ensure continuity of public health services and support for federal public health personnel.

Another  Medical Association Diverges from CDC Vaccine Guidance 

On Friday, the American College of Obstetricians and Gynecologists (ACOG) issued a practice advisory reaffirming support for the use of COVID-19 vaccines during pregnancy, making it the second major medical association this week to issue guidance differing from federal recommendations. Earlier, the American Academy of Pediatrics (AAP) issued guidance supporting COVID-19 vaccination for children six months and older. Secretary Kennedy criticized the AAP’s recommendations, questioning whether guidance was influenced by pharmaceutical industry tries rather than solely public health considerations. Amid backlash from medical associations like AAP and ACOG countering federal health policies, Kennedy has also warned that doctors and hospitals who diverge from the CDC’s official immunization list are not shielded from liability under the 1986 Vaccine Injury Act. 

This divergence underscores growing tensions between medical associations and federal health leadership. Notably, ACOG has increasingly distanced itself from the federal government, including making a stance to longer accept federal funding, citing that federal policy changes do not align with its program goals, policy positions, and ability to provide timely, evidence-based guidance. In early July, they partnered with the Vaccine Integrity Project to develop immunization guidelines in lieu of changes the Advisory Committee on Immunization Practices (ACIP). Beyond vaccination stances, ACOG has also publicly challenged an FDA advisory panel over its scrutiny of antidepressant use during pregnancy. These developments highlight for health services researchers the implications of shifts in federal guidance on professional trust and influence on evidence-based clinical practice. 

$200 Million CDC Research Funds Restored

Tens of millions of dollars in funding for health programs run by the Centers for Disease Control and Prevention (CDC) that had been blocked by the Trump administration is being released to grantees after the White House Office of Management and Budget (OMB) approved the agency’s spending plans for specific grants. The agency is now distributing funds related to public health, research on chronic disease, preventing gun violence, and more. CDC employees are scrambling to get the grants out as quickly as possible and public health experts are trying to spend the money before it expires on September 30—and there is still confusion regarding whether the administration could reverse its decision or withhold other funds as well as delays due to external reviews and layoffs. Health services researchers should continue to monitor these developments as this re-establishes vital infrastructure for key health topics. However, political appointees still have unprecedented control over the federal grantmaking process and there are still concerns that all appropriated funds won’t be able to be used by end of fiscal year.

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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