The Agency for Healthcare Research and Quality has been dramatically reduced due to the still litigated Reduction in Force (RIF) order on April 1. AcademyHealth staff have analyzed information posted in the TAGGS database, a publicly available record of grantmaking by the Department of Health and Human Services, that reveals a concerning slowdown in the AHRQ's ability to fund health services research corresponding with the loss of federal personnel at the Agency.
Since April 1, AHRQ has not approved a single new grant award, compared to nearly $6 million in new awards during the same period last year. Even ongoing projects have been impacted, with just $23 million in continuing grants awarded this year versus more than $50 million at the same time last year. These delays risk interrupting crucial research funded by Congress specifically to improve the quality, safety, and affordability of health care.
We reviewed multiple years of federal grant data, including 2021 when a new administration took office. Even then, AHRQ funded 19 new research projects during this period of time. But this year, funding has come to a complete halt. This signals a deep breakdown in AHRQ’s grantmaking process amid ongoing federal restructuring. STAT News reports that up to 90% of AHRQ staff who were in place on January 19 are now gone, derailing the ability of the Agency to manage their grant portfolio and continue with scientific and peer review.
The urgent challenges facing AHRQ are not a matter of politics, they are a concern that unites policymakers, health care leaders, and communities across the political spectrum. Indeed AHRQ is uniquely positioned to generate the real-world evidence needed to make America healthy. Its studies into cost-effective interventions, nutrition’s role in chronic illness, and preventive care are directly aligned with the administration’s priorities.
When AHRQ Can’t Do Its Job, We All Lose
AHRQ is the only federal agency dedicated not only to studying how health care is delivered, but also to helping the frontlines of clinical care put that evidence into practice. It is unique within HHS because it focuses on discovering what truly matters for health care and ensuring that it makes a real difference. Without AHRQ, we lose critical insights that help hospitals and clinics provide better, safer care for patients across the country.
One promising example is the Healthcare Extension Service. This program was designed to support 15 state-based collaboratives and two national coordinating centers. The effort would help health systems integrate behavioral health services, expand access in rural areas, and bring proven innovations into everyday clinical practice. The program had strong bipartisan support and the potential to reach millions.
Unfortunately, this initiative is now stalled. Applicants were informed that due to agency changes, AHRQ will not move forward with peer review or funding consideration for these proposals. There are currently no plans to reissue this opportunity. AcademyHealth led a letter to Congress with over 60 other health organizations calling on this program to be restored.
Pauses like this have real-world consequences. In Washington State, for instance, the proposed extension service would have supported more than 100 primary care practices, most serving rural communities, to better diagnose and treat depression, potentially reaching 400,000 patients. Now, projects like this are on hold, researchers and health systems are left without critical resources, and the data needed to improve patient care is missing.
Congress Must Act Now
The health challenges facing America demand an urgent response and that includes ensuring AHRQ has the resources and support to fulfill its mission. Protecting and strengthening AHRQ is not just good for researchers; it is essential for delivering on the promises of a healthier country.
Congress passed appropriations for AHRQ to support the funding that has collapsed due to the RIFs. In fact, earlier this month the Senate Appropriations Committee passed on a strong bipartisan vote additional funding for AHRQ, which the Agency might not have the staff to lawfully execute. The Executive Branch does not have the legal authority to prevent lawfully passed funding from being spent, creating a clear impoundment of this funding that Congress must address.
We are calling for urgent Congressional oversight and a clear, public commitment to restore AHRQ’s funding and operational capacity. Transparency and accountability are critical to ensuring that this essential agency can continue its mission. Without swift action, the lights will go out on research that saves lives and strengthens our health care system. It is highly corrosive to American research and innovation by injecting uncertainty in the lawful functioning of a federal grantmaking and research dissemination Agency.
The future of American health care depends on Congress meeting this moment.