In this edition of AcademyHealth's Situation Report, we examine a wave of federal resignations and furloughs that has triggered the most severe “brain drain” in the civil service in nearly 80 years—leaving health agencies like AHRQ, FDA, CDC, and CMS struggling to maintain essential functions. We also highlight the sudden removal of over 20 CDC webpages, many tied to health equity and LGBTQIA+ care, raising alarm about political interference and public access to trusted health information. Meanwhile, key Medicare-supported programs—telehealth and hospital-at-home—have expired amid the shutdown, disrupting care for vulnerable populations. AcademyHealth remains steadfast in promoting evidence-based policy and calls on health services researchers to stay engaged in defending access, transparency, and the research infrastructure that supports public health. Read on to learn more and see how you can take action.
In today’s issue:
- Federal “Brain Drain” As Resignations, Furloughs Remove Experts from Civil Service
- More CDC Webpages & Datasets Disappearing
- Health Care Services Impacted by Government Shutdown
- New Direct to Consumer Government Pharmaceutical Website
- The Think Tank Influencing GOP Health Policy
- AI Pediatric Cancer Research Announced
Federal “Brain Drain” As Resignations, Furloughs Remove Experts from Civil Service
The U.S. government is facing mass exodus of experienced workers, fueled by a tidal wave of resignations and shutdown-spurred furloughs. More than 150,000 federal employees that accepted a buyout that kept them on the government payroll through September are exiting the civil service this week. This represents the largest single-year exodus of civil servants in nearly 80 years, alarming experts who point out the substantial loss of institutional knowledge. Prior to this September deadline, many workers had already left their agencies, which continue to grapple with the loss of experienced staff and struggle to carry out their work. This “brain drain” has hit health agencies hard – a current employee noted that the FDA is struggling to update its National Youth Tobacco Survey because of buyouts and layoffs at the FDA unit responsible for the survey.
At the same time, many remaining federal employees have been furloughed by the government shutdown, including more than 32,000 employees at HHS. As a result, CDC communications will be impeded, NIH’s clinical center will not admit new patients, and the FDA will likely not accept new drug applications. These furloughs further compound the disruption of basic HHS functions created by the mass firings by the Trump administration. Although essential programs, like Medicare and Medicaid payments and disease surveillance will continue, a lack of available staff will likely slow down remaining core functions. According to HHS’ implementation plan, the Centers for Medicare and Medicaid Services (CMS) will be unable to provide oversight of major contractors, like the Medicare Call Center, and certain rulemaking may be delayed. The plan also notes that CDC subject matter experts will be unable to provide guidance to state and local health departments on programs including overdose prevention and HIV prevention. These resignations and furloughs from health agencies will continue to degrade the ability of health services researchers to gather evidence and perform the high-quality research that policymakers require to make sound decisions to improve health in America.
More CDC Webpages & Datasets Disappearing
As of September 20, 2025, over 20 Centers for Disease Control and Prevention (CDC) webpages appeared to be offline. Most of the webpages covered topics such as health equity, LGBTQIA+ care, and sexually transmitted infections; however, some seemingly random pages were removed such as one with information on parasitic infections. The CDC whistleblower who shared the list of offline webpages said she thinks this is because “asexual reproduction” was flagged in the contents. Similar such cases were observed with webpages that included the prefix “trans,” such as those that mentioned “neurotransmitters” or “transmission.”
This is the second time a number of webpages have been taken down from the CDC website. The first time, back in late January, Doctors for America successfully sued the Trump Administration based on the argument that the public relies on the webpages as resources and therefore the federal government cannot remove them without first justifying or notifying the public of their removal.
Health services researchers should look out for opportunities to support legal battles that aim to restore these webpages. As evidenced by the Doctors for America lawsuit and similar efforts such as AcademyHealth’s major legal victory restoring federal health data removed earlier this year, there are opportunities to oppose the censoring of important and useful health information and resources.
Health Care Services Impacted by Government Shutdown
Medicare-sponsored telehealth services and hospital at home programs have effectively expired for the first time as a consequence of the government shutdown. While most Medicaid and Medicare operations will continue throughout the shutdown, both programs were created during the pandemic and are up for renewal. While telehealth coverage will continue for Medicaid enrollees living in rural areas, Medicare group practices and health systems associated with the American Telemedicine Association cut off telehealth for older adults. Physicians may continue to provide telehealth services to Medicare enrollees; however, they will not be paid for it and, while some plan to submit claims after the shutdown, it remains unclear if such claims will be reimbursed.
Moreover, CMS ordered hundreds of Medicare-funded hospitals providing care to patients in their homes to discharge all patients or send them to other medical facilities by Tuesday at midnight. By providing inpatient care to an estimated 1,000 patients, these hospitals had freed up overcrowded hospitals. While these programs have been effective in freeing up beds in overcrowded hospitals, some hospital leaders have been cautious to expand such programs amidst fears that the Medicare waiver will not become permanent. This program is currently under consideration to be extended for five years under a bipartisan bill.
The expiration of Medicare-funded programs during the government shutdown underscores a critical juncture for health services researchers as the future of these initiatives, which have increased access to care, remains unclear. Health services researchers working with CMS and/ or telehealth or hospital at home programs can contact their representatives and provide evidence-based insights to advocate for the extension of these programs.
New Direct to Consumer Government Pharmaceutical Website
On Tuesday the Administration announced a new deal with Pfizer to sell some of its drugs at lower prices to Medicaid patients on a new direct to consumer website in exchange for a 3-year grace period on the tariffs on pharmaceuticals made abroad. The deal includes a large majority of Pfizer’s primary care drugs along with some specialty brand-name drugs, with discounts averaging 50 percent and reaching as high as 85 percent. The administration hopes the website and new pricing will be implemented by early 2026. Officials have not yet commented on whether people would be able to use their insurance on their website, and typical direct-to-consumer sales require patients to pay out of pocket. Experts assert this would mainly help the uninsured as most Americans purchase drugs through their insurance plans. Critics highlight that while this deal is being lauded has lower drug prices, minimal Americans will be served whereas the average American is likely to be harmed by broader pharmaceutical policies like the 100 percent tariff on drugs, which will raise prices for consumers. For health services researchers, this will be a notable development to continue tracking prescription drug accessibility amid ongoing policy changes.
The Think Tank Influencing GOP Health Policy
Paragon Health Institute, a think tank founded in 2021, has been a significant influence in shaping GOP health policy. Despite being a small organization with only 11 full-time staffers, they have found success influencing policies via their vast alumni network spread across many levels of government. Founder Brian Blase has been credited with creating many of the proposals that became the basis for the Medicaid cuts passed in July. Currently, the organization is actively campaigning against the extension of enhanced ACA tax credits, the debate that drove the government to shut down. Paragon advocates against the subsidies given their cost, an estimated $350 billion through 2035, and asserts it primarily benefits the health insurance industry. However, this position has sparked internal debate within the Republican party. Some members express concern that the think tank close ties to government positions and deep influence may prioritize ideological goals over the party’s broader political strategy and that aggressive health policy changes may result in potential political repercussions during mid-term elections.
AI Pediatric Cancer Research Announced
On Tuesday, President Trump signed an executive order directing federal agencies to use artificial intelligence (AI) to analyze data from the Childhood Cancer Data Initiative (CCDI), a program he launched in 2019. The goal is to accelerate research, clinical trials, and the development of treatments for childhood cancer.
Simultaneously, the Department of Health and Human Services (HHS) announced it is doubling funding for the CCDI. While AI will be used to analyze data, officials emphasized that parents would retain control over their child’s health information.
NIH Director Jay Bhattacharya called the order a step toward “faster diagnoses” and “more precise treatments.” By enabling faster and more precise identification of treatment patterns, clinical outcomes, and disparities, this effort could serve as a model for AI-enabled research in other disease areas. However, it is critical that health services researchers are incorporated throughout this work to ensure that any investigations and interventions are patient-centered, identify health disparities, and address real-world challenges. These researchers are vital for ensuring that any AI-driven insights are not only scientifically robust, but also practically implemented to improve patient outcomes and health care efficiency.
Voices of HSR: Share Your Story of Federal Disruption
We hear you. Over the past couple of months you sent in stories related to shifting policy and funding cuts. Your experiences detailed how the ongoing changes at the federal level impact our health services research community professionally, particularly around research that has been disrupted in a multitude of ways from stalled grant reviews to work on specific topics and populations to cut funding or missing data. Further, you told us about job losses on your team and post-doc placements that disappeared. These impacts are further experienced personally, those in our community have had painful experiences including possible housing insecurity due to finances and grief for the loss of one’s career, among others. Given the impact of the government shutdown across health agencies, we want to continue collecting and sharing the impact on the field.
We reached out to some of you who shared your stories and were willing to be contacted regarding activities, such as advocacy opportunities. We have more upcoming activities in the works. If you have a story or experience related to the impacts of current federal changes, please consider sharing here.
Previous Editions
This is the latest in a series of Situation Report updates from AcademyHealth. You can find prior issues here.
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