In this edition of the Situation Report, HHS’s newly released children’s health strategy prioritizes voluntary industry commitments over regulatory action, drawing concern from public health experts. Meanwhile, Medicaid funding changes could significantly impact children’s hospitals, and high-profile vaccine-related whistleblower claims are fueling debate around scientific integrity and public trust. Federal efforts to improve data transparency and patient communication have also stalled, with delays to key CDC and CMS initiatives. As federal health policy shifts, AcademyHealth remains committed to advancing evidence-informed decision-making and protecting the infrastructure needed to support high-quality research and care. Read on to understand the implications for health systems and how you can take action.
In today’s issue:
- HHS Children's Health Strategy Report Emphasizes Voluntary Commitments, Not Policy
- Medicaid Changes for Adults Put Children’s Hospitals at Risk
- Monarez to Testify in Senate, NIH Vaccine Whistleblower Goes Public
- HHS Indefinitely Pauses CDC Infections Disease Data Project
- CMS Delays Biden-Era Medicare Advantage Notification Rule
- Other News We’re Tracking
HHS Children's Health Strategy Report Emphasizes Voluntary Commitments, Not Policy
Health and Human Services Secretary Robert F. Kennedy Jr. unveiled the "Make Our Children Healthy Again Strategy," which emphasizes voluntary industry commitments from companies over regulation or policy mandates. In an effort to “reverse the failed policies that fueled Amercia’s childhood chronic disease epidemic,” MAHA commission members identified chemical exposures, prescription medications, stress, and a lack of physical activity as the major threats to child health. To address these alleged causes, the commission will define ultra-processed food, introduce new packaging for such food, and remove a GRAS regulatory loophole that has allowed food companies to include additional ingredients with no notice to the Food and Drug Administration (FDA). The commission will also deregulate the sale of dairy and meat, decrease animal testing at the FDA, promote full-fat dairy products, and implement a presidential fitness test at schools. While the strategy called on the FDA and EPA to examine environmental toxins, MAHA supporters criticized the report, stating that it was too lenient on agrochemicals.
The report has also been criticized by the pharmaceutical sector, represented by the group PhRMA, who has stated that the report, “casts doubt on the very things that have helped protect and improve health for generations”, such as vaccines and medicines. This statement is in response to a vaccine injury research program that NIH and HHS will be launching to examine alleged injuries caused by vaccines, which Kennedy hopes to expand across the country. Even President Trump has recently pushed back against Kennedy’s anti-vaccine rhetoric, stating that some vaccines, “pure and simple work”. Medical and public health experts have also taken issue with the lack of mention of gun violence in the report, which has taken the lives of 2,500 children in 2022 and has been the leading cause of childhood deaths since. Instead, the NIH will be examining the role of social media, video games, and psychiatric drugs in causing gun violence, according to Kennedy. Indeed, Kennedy has frequently claimed that antidepressants may cause violence; research, however, failed to find evidence of causation between psychiatric drug use and mass shootings. Researchers note that observed correlation between the two can be explained by the fact that many people who have been prescribed antidepressants experience multiple mental health challenges. According to pediatric infectious-disease specialist Dr. Adam Ratner, the strategy reflects a tendency within the current HHS leadership to emphasize certain perceived risks while giving less attention to leading documented health threats.
Medicaid Changes for Adults Put Children’s Hospitals at Risk
While recent Medicaid funding cuts were promised to only target waste, fraud, and abuse in the program and increase the number of working non-disabled enrollees, the cuts may impact pediatric care once fully enacted. According to the Children’s Hospital Association, some children’s hospitals could collectively lose billions of dollars in revenue due to the bill. State-directed payments, or payments that supplement care for children enrolled in Medicaid, will be capped starting in 2028 under Trump’s law. Many hospitals are already lobbying to prevent that provision from rolling out; however, if it is implemented, children’s hospitals will have to figure out how to make up for an average third loss of Medicaid revenue. While children’s hospitals are generally well funded given limited competition and consistent philanthropic support, that is not the case for all, and they are particularly vulnerable to Medicaid cuts since they rely on the program much more heavily than general hospitals do. Moreover, Medicaid funding cuts are just one way Trump’s law will impact children’s hospitals. Reductions in federal research and education funding add additional strain.
Health services research focused on pediatric populations now proves more important than ever. Evidence that enlightens the disproportionate impact on children of Medicaid cuts could help inspire potential policy delays or reversals in Congress. These developments underscore the need for rigorous research documenting the financial and clinical impacts of Medicaid changes on pediatric populations.
Monarez to Testify in Senate, NIH Vaccine Whistleblower Goes Public
Recent developments have underscored eroding trust in federal health agencies. Susan Monarez, former CDC Director, is set to testify to the Senate Health Committee next week on September 17th. This hearing follows her contentious removal from the agency and the subsequent resignation of four senior officials. One of these officials, Debra Houry, former CDC Chief Medical Officer, will be joining Monarez for the testimony. Monarez has claimed that she was fired because she refused to pre-approve vaccine recommendations from the newly reformed vaccine advisory panel, comprised of individuals who have expressed skepticism about vaccines.
Concurrently, former director of the National Institute of Allergy and Infectious Disease Jeanne Marrazzo has filed a whistleblower complaint alleging she was ousted for resisting efforts to cancel vaccine research and clinical trials. In the complaint, Marrazzo alleges that the NIH actions to downplay vaccines undermines the agency’s goal of furthering medical research, endangers public health and safety, and wastes funds before research findings could be implemented. For HSR, the implications include public trust in health systems, uptake of preventive services, and evaluation of new advisory structures.
HHS Indefinitely Pauses CDC Infections Disease Data Project
The Department of Health and Human Services has pumped the brakes on a CDC project that would have allowed real-time access to information on dozens of diseases, with data pulled from the National Notifiable Diseases Surveillance System. The development of a user-friendly website to report case counts on 127 notifiable conditions alongside expert commentary has been put on indefinite hold. Recently departed CDC scientists report that the project would have served as a one-stop-shop for all notifiable conditions, searchable by state, making it an invaluable resource for public health officials who often find it difficult to comprehensively monitor such information. Former scientists shared that recent funding and staffing cuts have made it impossible to continue their work, despite the team’s successes in establishing a new public health data strategy and building an enterprise data platform that eliminated redundant systems and improved inter-system connectivity. While the initiative is on hold, the progress made lays important groundwork for future improvements in public health data transparency and system coordination.
CMS Delays Biden-Era Medicare Advantage Notification Rule
CMS has postponed the implementation of a rule requiring Medicare Advantage (MA) plans to notify members about unused supplemental benefits, such as dental and vision services. The CMS rule, initially slated for 2026, mandated that MA plans send personalized notices to members between June 30 and July 31, detailing any supplemental benefits not accessed during the first half of the year. This initiative was designed to address the low utilization rates of supplemental benefits, despite the substantial federal investment exceeding $80 billion annually. Evidence suggests that members are not utilizing these benefits and the funds are instead profiting private insurers rather than enhancing patient care. In the announcement letter, CMS said it would delay implementation for contract year 2026 and beyond. For health services researchers, this leads to further questions about the utilization of these benefits and the potential financial impact on the Medicare program.
Other News We’re Tracking
Secretary Kennedy Eyes New Members for Vaccine Panel
Ahead of next week’s CDC Advisory Committee on Immunization Practices (ACIP) meeting, Secretary Robert F. Kennedy Jr. plans to add new members to the 8-member panel. Among the nominees, STAT identified a doctor who called for the suspension of mRNA Covid vaccines, an epidemiologist who testified in Ohio against Covid vaccine mandates, and an affiliate of the Independent Medical Alliance, a nonprofit group that has avidly support Kennedy’s vaccine efforts. This raises additional concern for public health officials and researchers about the panel’s integrity and its ability to provide unbiased, evidence-based recommendations.
New $100 Million Initiative to Accelerate Women’s Health Research
Philanthropist Melinda Gates has launched a $100 million initiative to accelerate research in women’s health through a new partnership between her organization, Pivotal, and the nonprofit Wellcome Leap. The effort will target high-mortality areas like autoimmune disease, mental health, and cardiovascular health, aiming to significantly reduce the time it takes to see meaningful results. The move builds on Gates’ long-standing commitment to addressing the historic underfunding of women’s health research.
Judge Halts DOJ Subpoena of Trans Youth Medical Records
A federal judge has blocked a subpoena from the U.S. Department of Justice seeking the medical records of transgender patients who received gender-affirming care at Boston Children’s Hospital. U.S. District Judge Myong Joun ruled that the subpoena was issued in bad faith and the court found the request overly broad and not sufficiently tied to the DOJ’s stated investigative aims. The judge noted that the request sought highly sensitive patient information and did not appear relevant to the DOJ’s stated aim of investigating off-label drug use. The decision underscores ongoing legal tensions over access to gender-affirming care, which is protected under Massachusetts law but increasingly restricted in other states. For researchers, this case raises questions about data privacy protections and their impact on patient willingness to participate in studies.
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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