Editorial note: The Read on Washington is a monthly column on happenings in DC that affect the field of health services research. In addition, AcademyHealth recently began offering ad hoc updates via the Situation Report series. The Situation Report can be found on our blog and is also emailed directly to our members. All of AcademyHealth’s advocacy work is supported by member dues.
Congressional negotiations on government funding remain stalled
Federal funding runs out on March 14. In order to avoid a government shutdown, Congress must pass additional funding in the form of appropriations bills or a continuing resolution. Congress has been trying to negotiate a pathway forward in FY25, which started on Oct 1, 2024, but has struggled as roadblocks continue to pile up. As of this writing, Congress has been unable to agree on the top-lines, or total amount of discretionary spending. Because it typically takes several weeks for appropriators to go through the technical process of drafting appropriations bills, many are concerned that it may already be too late to pass the bills by March 14.
The Friends of AHRQ seeks organizational signatures to help make the case for funding this critical agency for our field. Read and sign onto the letter here. The breadth and depth of support for this letter is one of the key tools our field uses to promote the future of the Agency for Healthcare Research and Quality. The deadline is February 27.
Congress considers deep cuts to Medicaid coverage
A top priority of President Trump and Congressional Republicans is the passage of a budget reconciliation package that includes tax cuts for the wealthy and increased funding for the border and military. A key strategy for raising the revenue necessary for those priorities is a dramatic reduction in the number of Medicaid beneficiaries. Possible Medicaid reforms include block grants to the program and instituting work requirements for beneficiaries. The House is expected to pass their initial budget resolution step later this week.
Separately, the Senate advanced their budget reconciliation plan on a party line vote after rejecting numerous amendments designed to protect Medicaid and health care access.
AcademyHealth has met with dozens of targeted congressional offices to provide educational briefings by members who are top Medicaid experts in the country. The meetings are an opportunity to inform staffers about the overwhelming evidence showing that the proposed reforms are likely to hurt beneficiaries, rural hospitals, and states. We will have more to share soon.
Despite earlier assurances to Senator Cassidy, HHS Secretary Kennedy calls for reexamining childhood vaccines
At a welcoming ceremony following being sworn in, Secretary Robert F. Kennedy, Jr. vowed to investigate the childhood vaccine schedule that prevents measles, polio, and other dangerous diseases. “Nothing is going to be off limits,” Kennedy said, adding that pesticides, food additives, microplastics, antidepressants and the electromagnetic waves emitted by cellphones and microwaves also would be studied. While he did not specifically call for changes to the vaccine schedule, his plan to investigate raises questions about his earlier commitment to Republican Sen. Bill Cassidy, a Louisiana physician who harbored deep misgivings over the health secretary’s anti-vaccine advocacy.
CMMI stops collecting race, ethnicity, and gender data
The Center for Medicare and Medicaid Innovation (CMMI) will cease collecting data on race, ethnicity, sexual orientation, gender identity, and preferred language from payment model participants as part of executive orders from President Donald Trump (Politico Pro, subscription required). CMMI is part of the Affordable Care Act's effort to test alternative payment and care delivery under Medicare, Medicaid, and the Children's Health Insurance Program. The 2021 strategic redesign of CMMI aimed to improve health equity and encourage rural medical providers to adopt value-based care payment models to better target the needs of patients and beneficiaries.
Despite court order, NIH grants still frozen
Last month, the Trump Administration issued an order freezing all grants and loans issued by federal agencies as part of the Administration’s review and suspension of spending, and in particular anything it considered to be related to diversity, equity and inclusion. A federal court immediately issued a restraining order prohibiting the freeze. The NIH internally recognized that their funding falls under this restraining order and could not be frozen. grant review remains on hold, effectively keeping the grants portfolio frozen. This freeze affects both the administrative step of continuing an existing grant and in the form of stopping grant review meetings. The freezing of these grants are shaking the 80-year-old partnership between the federal government and research institutions has made the U.S. the leader in scientific innovation.
Trump Administration stops program for lower Medicaid and Medicare drug costs
President Trump rescinded an effort by former President Joe Biden to lower drug costs by directing Medicare and Medicaid to test models that would bring down prescription-drug prices and make cell- and gene-therapy treatments more accessible. In reversing the executive order Biden signed in 2022, Trump halted an effort to cap the copayment for generic medications at $2 for Medicare beneficiaries, along with another program that would see Medicare pay less for drugs that receive accelerated approval from the Food and Drug Administration. The cell- and gene-therapy program, meanwhile, would have helped state Medicaid programs pay for therapies that are highly effective but expensive. The Center for Medicare and Medicaid Innovation had started the process of enrolling states in the pilot program, and the application process was expected to be open through Feb. 28.
What we’re reading
The American Medical Association (AMA) surveyed physician sentiment on artificial intelligence (AI) in healthcare and showed a significant change over the previous survey a year earlier. AI use cases nearly doubled over the year, and they found that 68 percent of physicians indicated they see definite or some advantage to using AI tools. Respondents emphasized the need for a designated feedback channel (88%), data privacy assurances (87%) and EHR integration (84%) as critical factors for AI adoption. Nearly half of the physicians – 47% – ranked increased oversight as the No. 1 regulatory action needed to increase their trust in healthcare AI tools.
Countless thousands of federal scientists, medical staff, grant managers, and more have abruptly lost their jobs in a massive, unprecedented, and chaotic wave of firings across the U.S. government. Administration statements and sources defended the cuts as strategic measures to increase efficiency, saying they are well-planned and affect less important employees. But critics note the probationary firings swept away recently promoted, veteran federal scientists and experienced researchers who had just been lured to government service. They also say the chaotic rollout, which included last-minute scrambles to remove employees from to-be-fired lists and rehire needed people, reflected hastiness.
A growing number of federal health agencies are screening grants for banned words, which has led to uncertainty, fear, frustrations, and anger among researchers and users of research. The lists seem to have been largely inspired by President Trump’s executive orders directing federal agencies to stop funding grants involving diversity, equity, and inclusion, and gender.