In this edition of AcademyHealth’s Situation Report, we examine concerns over the nation’s public health data infrastructure, including widespread pauses in CDC health surveillance systems that threaten timely disease monitoring and evidence-based policymaking. We also track coordinated efforts to roll back state-level vaccine requirements as well as congressional concerns surrounding the launch of the TrumpRX.gov platform. Alongside these policy developments, we feature new AcademyHealth blog posts that explore the administrative costs of Medicaid eligibility changes, the role of doulas in improving maternal health outcomes, and tools to strengthen rigor and reproducibility in Medicaid research. Together, these issues underscore the importance of staying informed and taking action as public health policy and infrastructure face increasing strain.
In today's issue:
- AcademyHealth in Action: The First Town Hall of 2026
- Significant Pauses in CDC Health Surveillance Databases Raise Concern
- Continued Efforts to Undermine State-Level Vaccine Requirements
- Senators Concerned About the Launch of the Upcoming TrumpRX.gov Website
- Tips for Submitting an RFI (Request for Information)
- On the AcademyHealth Blog
AcademyHealth in Action: The First Town Hall of 2026
AcademyHealth’s first members-only town hall of the year, hosted by President and CEO Aaron Carroll and Director of Advocacy Josh Caplan, offered a candid look at the ongoing challenges facing health services and health policy research. Both underscored growing threats to science—from stalled AHRQ grantmaking and federal workforce reductions to weakened scientific guardrails—while reaffirming AcademyHealth’s nonpartisan role in defending evidence, data, and independent scientific processes. The discussion highlighted ongoing advocacy efforts to protect AHRQ and the USPSTF, correct misinformation, and secure sustained investment in data infrastructure, alongside emerging partnerships beyond the federal government. The session provided members with timely insights, practical advocacy updates, and a shared space to engage on how the field can continue standing up for science and chart a path forward together. Caplan noted that the FY27 Friends of AHRQ letter will be circulating soon for organizations to sign onto. If you want to ensure your organization is supporting AHRQ and health services research and are not receiving Friends of AHRQ emails, just let us know at [email protected] that you would like to join the listserv.
Significant Pauses in CDC Health Surveillance Databases Raise Concern
A newly reported audit reveals that nearly half of the CDC’s routinely updated health surveillance databases stopped or significantly delayed updates throughout 2025, leaving major gaps in national disease monitoring capacity. According to the analysis, 38 of 82 CDC databases, that should be updated monthly, experienced unexplained pauses, many beginning in spring 2025. Nearly 90 percent of these paused systems track vaccination‑related information, including COVID‑19 vaccination rates and other routine immunization data, while others cover respiratory diseases and drug overdose deaths.
Experts warn that interruptions of this scale could undermine evidence‑based policymaking, clinical guidance, and the ability of researchers and public health officials to identify emerging threats in real time. Former National Institute of Allergy and Infectious Diseases Director, Dr. Jeanne Marrazzo, described the consequences as potentially “dire,” emphasizing that gaps in these datasets leave the nation unprepared in the face of preventable illnesses.
For the health services research and public health communities, this represents both a barrier to conducting timely, high‑quality research and an urgent reminder of the importance of transparent, reliable federal data infrastructure. Continued monitoring and advocacy for restoration of full data reporting, is essential for upholding scientific integrity and protecting population health. You can learn more about what AcademyHealth is doing by checking out our letter to CDC in support of federal investments in the Pregnancy Risk Assessment Monitoring System, or PRAMS here and about our successful legal action to protect public health data access here.
Continued Efforts to Undermine State-Level Vaccine Requirements
Efforts by advocates at the state level may reshape the country’s vaccine landscape regarding vaccine requirements to attend day cares and public schools. Advocacy groups in favor of ‘medical freedom’ or ‘health freedom’ including the Children’s Health Defense, which was founded by Secretary Kennedy, have been working to get bills that would roll back or eliminate vaccine requirements in every statehouse in the country. The federal changes to the vaccine schedule and to undermine expertise in vaccine recommendations, which we’ve covered extensively in previous editions of the Situation Report, have built momentum for these efforts. If passed, this new legislation will lead to lower uptake of shots that have long been required for entry in school districts across the country as well as increased illness of preventable diseases. This is part of a broader pattern to undermine public health expertise, leading to confusion and misinformation surrounding the effectiveness of vaccines and evidence-based recommendations.
This shows the importance and influence of state-level advocacy. Health services researchers and public health experts should stay informed and correct misinformation regarding this coordinated effort to undermine vaccine requirements and advocate for the current vaccine system at the state level. This also shows the value of being informed of state level—not just federal—policy shifts.
Senators Concerned About the Launch of the Upcoming Drug Pricing Platform
The HHS has ignored questions from Congress regarding the scope, structure, and legal authority of the upcoming TrumpRX website. The website is designed to directly connect consumers with pharmaceutical manufacturers, similar to CostPlusDrugs (owned by Dallas Mavericks minority owner, Mark Cuban). On January 29, 2026 three Senators, Dick Durbin (D-IL), Elizabeth Warren (D-Mass), and Peter Welch (D-Vt.), sent written concern about potential compliance challenges related to the Federal Anti-Kickback Statute to the Inspector General Bell’s office at the Department of Health and Human Services. The AKS is a criminal law that prohibits knowingly and willfully accepting payment of “remuneration” (i.e. anything of value, including money paid for work or a service), to create or reward patient referrals or the creation of business involving any payable service or item by the Federal health care programs. Federal health care programs can include supplies, prescription drugs, or health care services for Medicare and Medicaid patients.
The Senators called attention to the Special Advisory Bulletin, the HHS Office of Inspector General (OIG) issued on January 27, 2026, which outlined safeguards for Direct-to-Consumer (DTC) drug programs who aim to lower costs for consumers, including Medicare and Medicaid recipients. The Bulletin notably mitigates the Anti-Kickback Statue (AKS) risks for the upcoming TrumpRX website. This is done by offering pharmaceutical manufacturers assurance to sell prescription drugs direct-to-consumers who opt to pay cash-an option extended to consumers enrolled in federal health care programs-under specific conditions. The conditions are met when the drug: 1) is not billed to Medicare, Medicaid, or other federal programs, 2) is not connected to future referrals or purchases, or 3) is not used to market other federally reimbursable products (i.e. products payable through HSAs, FSAs, or HRAs). The upcoming TrumpRX platform has been criticized over its inducement to purchase other products, potential conflicts of interest related to third-party companies, and manufactures potentially using the platform to influence consumers to use a specific medication. In their letter, the Senators noted that there is a lack of clarity for how HHS OIG will engage in oversight of the pharmaceutical manufacturers selling to consumers within the TrumpRX.gov platform, in addition to other concerns to which they requested a response from HHS OIG by February 15, 2026.
Ahead of the TrumpRX launch, the HHS OIG has opened a request for information (RFI) to accept responses through 03/30/2026.
Tips for Submitting an RFI (Request for Information)
Federal Requests for Information (RFIs) are a formal mechanism for agencies to gather input from researchers, practitioners, and other stakeholders. For health services researchers, RFIs provide an opportunity to ensure that policy development is informed by evidence, data, and real-world implementation experience.
When preparing an RFI submission, consider the following best practices:
- Anchor your comments in evidence
Cite peer-reviewed research, evaluations, or credible data sources whenever possible. Clearly distinguish empirical findings from professional judgment or implementation experience. - Address feasibility and implementation
Agencies are often seeking input on how policies will work in practice. Comment on operational considerations such as data availability, administrative burden, compliance challenges, equity implications, and unintended consequences. - Be specific and responsive
Respond directly to the questions posed in the RFI and reference them explicitly. Concrete examples and clearly defined concerns are more useful than broad statements of support or opposition. - Clarify implications for data and research
Highlight how proposed policies may affect data collection, access, quality, transparency, or the ability to conduct rigorous, reproducible research. - Use neutral, professional language
RFIs are part of the public administrative record. Submissions that focus on evidence, statutory considerations, and policy design are most effective and align with nonpartisan research norms.
On the AcademyHealth Blog
The Cost of Exclusion: Due Process & the Administrative Costs of H.R. 1
Our latest blog examines how Medicaid eligibility changes under H.R. 1, including work requirements and the exclusion of certain legal migrants may trigger millions of coverage denials, reductions, and terminations. Each of these actions carries a constitutional and statutory obligation to provide due process, including meaningful notice and a fair hearing. Drawing on legal precedent and state-level cost analyses, the post outlines how compliance with due process requirements will impose significant administrative burdens on states and cost hundreds of millions of dollars—often more than providing care itself. The blog argues that these resources would be better spent on delivering and improving care, and urges policymakers to pursue reforms that expand access rather than make exclusion more expensive than treatment. Read the full post here.
Supporting Mothers Beyond Maternal Health Awareness Day
Maternal health advocate and Program Manager of the Black Mothers' Breastfeeding Association Kimberly Price highlights the importance of supporting mothers well beyond Maternal Health Awareness Day as well as the role of doulas in addressing the maternal health crisis as a key component to clinical care to assist with the physical recovery and emotional challenges of birth. Because Medicaid covers about 40 percent of births in the United States, it has enormous potential to shape maternal health outcomes. Programs that include doula care are an important step forward, even as challenges remain around access, reimbursement, and integration into care teams. Through the author’s involvement as a community partner in AcademyHealth’s Project DREAM, she highlights the value of pairing research with the lived experiences of mothers and doulas. Evidence matters, but so does listening to the people affected by health systems, clinical care decisions, and policy changes.
TAF Reporting Checklist: Raising the Standard for Medicaid Research
A recent blog spotlights the publication of the T‑MSIS Analytic Files (TAF) Analysis Reporting Checklist, a Medicaid-research tool developed by the Medicaid Data Learning Network (MDLN) and managed by AcademyHealth. TAF contains rich, detailed information on Medicaid enrollment, eligibility, and service use, but its decentralized collection and variation in state reporting, file versions, and data elements make analysis technically complex and can undermine comparability and reproducibility across studies. This post outlines the development of this checklist and how the tool addresses these challenges by standardizing what researchers should disclose when publishing TAF-based research. Making methodological choices explicit reduces ambiguity, enables validation and longitudinal synthesis, and increases the policy relevance and trustworthiness of results. Drafted and vetted by MDLN members, an expert advisory group, and journal editors, this checklist is a high-value resources for the field—guiding authors toward transparent reporting, helping journals and reviewers assess study quality consistently, and ultimately, strengthening the evidence base that informs Medicaid policy. For more details about the TAF Analysis Reporting checklist, read the full post 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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