In this edition of AcademyHealth’s Situation Report, we assess growing uncertainty around federal funding as Congress approaches a potential partial government shutdown and consider what even short-term disruptions could mean for health services research. We also examine early signs of a slowdown in the health care workforce amid policy shifts and mounting concerns about diminished expertise guiding NIH grantmaking. In addition, we explore the rapid emergence of new health AI infrastructure and its implications for care delivery, evidence generation, and equity. Together, these developments underscore the need for health services researchers to closely monitor federal policy changes, evaluate real-world impacts, and continue engaging policymakers to ensure evidence informs decision making during a period of heightened volatility.
In today's issue:
- AcademyHealth in Action
- What a Potential Partial Shutdown Would Mean for Health Researchers
- Health Care Job Growth Begins to Stall
- NIH Advisory Council Vacancies Reduce Expertise Guiding Grant Decisions
- What New Health AI Infrastructure Means for the Field
AcademyHealth in Action
Following our advocacy team’s visit to the Hill last week, AcademyHealth CEO Aaron Carroll spoke on a panel hosted by FamiliesUSA’s Health Action Conference on the impact the current landscape has on protecting public health, efforts to undermine our public health infrastructure, and strategies to advance health care for all.
Aaron, along with our director of advocacy Josh Caplan, will host a member-only town hall at 2PM ET on February 3rd offering a candid discussion about the pressing challenges currently affecting the health services and health policy research field. Register here.
What a Potential Partial Shutdown Would Mean for Health Researchers
As Congress approaches a Friday funding deadline, the likelihood of a partial government shutdown has increased due to disagreements in the Senate over how to advance the remaining appropriations bills. Senators across both parties are concerned that the current funding package includes the Department of Homeland Security (DHS) appropriations in the wake of the shooting death of ICU nurse Alex Pretti by federal immigration agents. Since the House sent the remaining bills to the Senate as a single combined package, any split would require the House to return from its recess and approve changes, which at the moment is unlikely due to winter weather and Speaker Johnson opposing renegotiating the legislation.
Current expectations now suggest that the Senate may not advance the larger packages, significantly increasing shutdown risks for agencies like the Department of Health and Human Services (HHS). For health services researchers, the odds of HHS being pulled into another government shutdown remain elevated and rising. Continued monitoring is essential, as even short funding lapses can disrupt federal operations, grantmaking, and long-term planning across the research industry.
Health Care Job Growth Begins to Stall
Job growth in the health care field, one of the leading contributors to the labor market since the COVID-19 pandemic, is starting to slow. Recent cuts to federally funded health programs, the rise of AI automation, and rising costs overall are leading health systems and other health-related employers to limit hiring, even for positions that require a professional license. For more about the impact of H.R.1 and the narrowing of the definition of a “professional degree” has on the health care workforce and the future of nursing, read this AcademyHealth blog.
Other recent federal policy changes, such as those limiting federal student loan borrowing and those that create a hostile immigration landscape via increased visa fees, additional immigration eligibility requirements, and widespread deportations and detainment, many with increased use of force, may further exacerbate hiring shortages. Fewer students may look to clinical careers with shrinking student loan options, more foreign-born health professionals face deportation and detainment, and immigrants have less opportunity to enter the U.S. healthcare workforce with fewer student visas available and higher fees for visas specifically intended to bolster the U.S. healthcare workforce such as H-1B visas.
Some health care systems, such as Alameda Health System in California’s Bay Area and Revere Health in Utah, have already announced layoffs due to pressures such as AI replacement and funding shortages due to Medicaid cuts.
Since the need for health care remains, shortages in health care labor could worsen existing health disparities and broaden gaps in care. Health services researchers should continue to monitor how workforce changes impact service delivery, and how gaps in care continue to be shaped by federal policy changes.
NIH Advisory Council Vacancies Reduce Expertise Guiding Grant Decisions
In August 2025, the Government Accountability Office found that the Trump administration violated the Impoundment Control Act of 1974 by withholding funding from the NIH. Challenges within the NIH persist as the organization struggles with numerous vacancies in vital areas. Key advisory panels that recommend final funding decisions for medical centers and universities are continuing to shrink. Most of the 25 advisory councils are operating with half of their members. While others, like the National Institute on Minority Health and Health Disparities, prepare to have all six members’ terms end in February 2026 with no current plans to replace these members. In July 2025 Nature reported that dozens of NIH appointees were dismissed to align with the President’s priorities. These vacancies have created gaps in the range of expertise needed to make informed funding decisions. As outlined in federal law, members of the advisory council must meet at least three times per fiscal year. Concerns about the Trump administration’s prolonged period of filling these key roles sparks concerns over the increased politicization of NIH decision-making.
Each advisory council ideally has 18 and 27 members of the public in addition to top health officials. These council members are appointed by the secretary of Health and Human Services. Federal law requires that two-thirds of the Secretary’s appointees are representatives from health and scientific disciplines- including no less than two individuals who are leaders in the fields of behavioral, social sciences, or public health. The remaining one-third of the advisory council members come from public policy, health policy, management, economics, and law. This federal law also requires that the Secretary appoints members within 90 days from when the vacancy occurs.
Adhering to this requirement requires preparation well ahead of the members’ term is set to expire. This process could take many months, and often up to a full year, before advisory council members are confirmed. As the slowdown on issuing new funding for FY2026 continues, concerns about the scarce capacity in the NIH’s advisory councils amplifies.
What New Health AI Infrastructure Means for the Field
Over the first few weeks of January, major tech companies have unveiled new Health AI tools aimed at both clinical and consumer use, introducing new infrastructure to the AI landscape with significant potential to shape care delivery. Amazon’s One Medical's Health AI assistant and Open AI’s ChatGPT Health are both consumer-facing tools designed to deliver personalized guidance and context-aware responses within a closed system rather than the open web. Each tool has its own unique mechanisms–such as connecting to health information app data or integrating with user medical records—that will shape how some patients access information, interpret health data, and decide when and how to seek care.
In contrast, Anthropic’s Claude for Healthcare is primarily provider-facing for health systems, providers, and payers. This HIPAA-ready model is equipped with specialized “connectors” that pull information directly from key clinical and administrative data sources (e.g., CMS coverage databased, ICD-10 and National Provider Identifier registries, and PubMed) to support tasks like prior authorization, coverage checks, documentation, and care coordination. Additionally, there are features designed for life-sciences research to further enable synthesis of scientific literature, streamline regulatory and reporting workflows, and accelerate evidence generation as well as assist with drafting clinical trial protocols aligned with FDA and NIH requirements.
This emerging layer of infrastructure has great power to not only streamline core workflows but also influence care delivery and patient-provider interactions. For health services researchers, the ever-evolving AI landscapes introduce pressing research questions about how these tools affect access, equity, safety, patient privacy, communication, decision-making, and workflow dynamics. Real-world evaluation of these technologies is essential for the field to understand the broader implications for health systems. Beyond their clinical and operational effects, the life-sciences features also matter to the field of health services research because it has potential to influence how evidence is generated, evaluated, and ultimately translated into practice.
Previous Editions
This is the latest in a series of Situation Report updates from AcademyHealth. You can find prior issues here.
We’re pleased to offer this work as a free resource, and if you’d like to support our efforts to keep it going, we’d truly appreciate your donation. You can contribute here. Thank you for your support!