In this edition of AcademyHealth's Situation Report the Senate’s decision to preserve funding for critical health programs pushes back against the Administration’s proposals for deep budget cuts, signaling ongoing bipartisan support for the existing public health infrastructure and research. At the same time, recent federal actions on vaccine policy and gender-affirming care have sparked legal challenges and concern among medical experts, reflecting the high stakes of policymaking that shapes access to care, public trust, and the integrity of evidence-based decision-making.
In today’s issue:
- Senate Appropriations Blocks NIH Cuts, Boosts Funding in Bipartisan Deal
- HHS Shake-Up Raises Concerns About Vaccine Policy and Compensation Program Integrity
- States Sue Administration for De Facto Ban on Gender Affirming Care
- Increased Focus on Advancing Women’s Health
- Rebuilding Public Trust in Science Requires Transparent, Empathetic Communication
- Tune In: Podcast on the Fight to Restore Vital Public Health Data
Senate Appropriations Blocks NIH Cuts, Boosts Funding in Bipartisan Deal
The Senate Appropriations Committee has sidestepped major proposed changes to public health funding and structure, rejecting both the Trump administration’s call for an $18 billion (40 percent) cut to the National Institutes of Health (NIH) and Health Secretary RFK Jr.’s plan to reorganize HHS. Instead, the committee approved a bipartisan bill that increases NIH funding by $400 million, with targeted boosts of $100 million for Alzheimer’s disease research, $150 million for cancer research, and $30 million for women’s health research. Lawmakers also rejected proposed structural overhauls, including the proposed consolidation of NIH’s 27 institutes into eight and altering reimbursements for overhead costs. The committee criticized repeated attempts by the White House Office of Management and Budget (OMB) to delay or withhold already-approved funding, including a controversial memo that temporarily froze $15 billion in NIH grants. Outside of the NIH, the bill maintains flat funding for programs like Title X family planning and domestic HIV prevention, and it rejects the administration’s proposed $4 billion (50 percent) cut to CDC programs. Meanwhile, Kennedy’s Administration for a Healthy America (AHA) reorganization plan was effectively dismissed by the Senate, largely because HHS failed to submit a formal reorganization proposal to Congress, and lawmakers expressed skepticism about cutting prevention programs while claiming to prioritize chronic disease. Overall, the appropriations bill signals strong bipartisan support for existing public health infrastructure and research, while pushing back against executive overreach and attempts to sidestep congressional budget authority. This development reinforces the value of data-driven, rather than ideology-driven, health policy and governance. Health services researchers should continue to champion these values, striving to ensure that critical studies on access, quality, costs, and outcomes of care can proceed without disruption from politically driven restructuring or financial uncertainty.
HHS Shake-Up Raises Concerns About Vaccine Policy and Compensation Program Integrity
Health and Human Services Secretary Robert F. Kennedy Jr.’s (RFK Jr.) latest vaccine-related announcements concern the Vaccine Injury Compensation Program (VICP) and the Advisory Committee on Immunization Practices (ACIP). On social media and on a talk show, RFK Jr. indicated discontent with VICP and his intentions to make changes, noting that the program is failing to compensate individuals who are injured by vaccines in a timely and just way. While experts agree to a certain extent that the VICP could use some modernization, such as increasing the number of staff to be proportionate to the increased number of vaccines the program reviews cases for, experts are wary of what RFK Jr. will propose. RFK Jr. has previously indicated he wants to expand the adverse events that claimants can qualify for awards for and that he claims are linked to vaccines, such as autism, diabetes and narcolepsy. He could also unofficially settle cases for injuries that are not on the list without adding them. These changes, if implemented, could lead to bankruptcy within the program, given its finite funding source. Claimants are paid through a trust fund from an excise tax on vaccine manufacturers, who in turn, are granted a limited liability shield. RFK Jr. has indicated he wants to eliminate this protection.
Moreover, just months after abruptly replacing the existing ACIP with RFK Jr.’s selections, top medical organizations from across the country report receiving notice from United States health officials that they will no longer be involved in establishing vaccination recommendations with ACIP. One email to the organizations cited bias as the reason, calling the organizations “special interest groups.” The American Medical Association, along with several other organizations, put out a statement in response, calling the removal of the medical expertise they and other organizations provide dangerous, irresponsible, and a threat to both the public and clinicians' trust in vaccines.
Health services researchers are uniquely positioned to monitor how these changes in vaccine policy infrastructure might impact public health both in the near- and long-term future.
States Sue Administration for De Facto Ban on Gender Affirming Care
A coalition of 16 states and the District of Columbia have sued the Trump administration, accusing them of unlawfully intimidating health care providers into halting gender-affirming care for transgender youth and creating a de facto national ban. In the past month, at least eight major hospitals and hospital systems announced they were stopping or restricting such care in response to the Trump administration’s notices that it was sending subpoenas to providers and considering investigating them for fraud. These closures, combined with a slew of state-level restrictions on gender-affirming care for minors, have sparked a scramble for treatment and worry that care will be disrupted or even stopped for many youths. Gender-affirming care includes a range of medical and mental health services, and the American Medical Association, among other experts, oppose policies that restrict access to such care. For health services researchers, this legal battle underscores critical questions about access, quality, and outcomes of care for transgender populations. The Trump administration’s focus on ending the practice of providing gender-affirming care to minors leaves the experts who care for transgender youth and their families with few opportunities to continue necessary services.
Increased Focus on Advancing Women’s Health
Recent actions by the FDA and the Gates Foundation mark a pivotal moment in addressing the longstanding underfunding and neglect in women's health research. FDA Commissioner Marty Makary has emphasized the chronic underfunding and insufficient research in women's health and the need for comprehensive studies. He has asserted the agency has overstated the breast cancer risks associated with menopausal hormone therapy, which he believes has deterred women from beneficial treatments for over two decades. In response, he convened a panel earlier this month to reassess these risks and the appropriateness of existing "black box" warnings on estrogen products. For those with professional or personal interests in this topic, share your thoughts with the FDA while they are seeking public input during an open comment period. Engaging in this process offers an opportunity to influence future policies and ensure that women's health receives the attention and resources it deserves.
Meanwhile, in a significant philanthropic move, the Bill & Melinda Gates Foundation committed $2.5 billion to women's health by 2030. A significant increase from what the foundation has previously dedicated to women’s health, this investment aims to advance innovations in five critical underfunded areas: obstetric care and maternal immunization, maternal health and nutrition, gynecological and menstrual health, contraceptive innovation, and sexually transmitted infections.
These developments are particularly significant in light of recent legislative and executive actions that have adversely affected women's health care access and research funding. For health services researchers, these initiatives offer a beacon of hope, demonstrating that despite funding cuts, there is increasing momentum to address women's health disparities.
Rebuilding Public Trust in Science Requires Transparent, Empathetic Communication
In a recent op-ed in the Washington Post, AcademyHealth President and CEO Dr. Aaron E. Carroll critiques the science communication missteps that have fueled growing public skepticism and declining trust, especially amid politically charged debates and federal funding threats. Carroll points to the pandemic-era mantra “follow the science” as a major contributor to misunderstanding, as it conflated scientific evidence with policy mandates, shutting down dialogue and dismissing critics. He emphasizes that science provides evidence and uncertainty, not fixed instructions.
Carroll calls for a new model of public engagement grounded in empathy, transparency about scientific limits, and humility. Acknowledging the complexity of evidence and the trade-offs in policy decisions, rather than presenting science as absolute, is essential to restoring trust. Effective communication must move beyond fear and authority to foster honest, nuanced conversations, building trust one dialogue at a time.
Tune In: Podcast on the Fight to Restore Vital Public Health Data
AcademyHealth’s President and CEO Aaron Carroll joins a new Health Affairs podcast to unpack the critical issue of disappearing federal health data and why it matters for researchers and communities alike. As a leading plaintiff in the lawsuit to restore these datasets, AcademyHealth is taking a stand to protect the information that drives public health policy and action.
Listen to the episode and hear firsthand why this fight is so important.
Also, for one more week, we’re collecting experiences from researchers and practitioners whose work has been disrupted by missing or restricted health data (including key datasets on maternal health, HIV, diabetes, mental health, and LGBTQIA+ communities). Your story can help strengthen the case to restore access.
Submit your story by August 8:
Fill out this brief submission form here.
Or email Kristin Rosengren, Chief Strategy Officer, at Kristin.Rosengren@academyhealth.org.
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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