Welcome to this edition of AcademyHealth's Situation Report, where we provide key insights into federal developments reshaping the health care and research sectors. As we explore the potential government shutdown, the NIH's recent policy shifts, and key considerations for the HHS buyout offer, we also invite you to engage with our ongoing advocacy efforts. This issue's call to action highlights the importance of publicizing a recent KFF poll showing broad Medicaid support. Your efforts in sharing this information can help educate policymakers about the importance of this program.
In today’s issue:
- Risk of Government Shutdown Starting this Weekend Remains High
- NIH Cancels LGBTQ+ and DEI Research Grants, Disbands Key Office in Sweeping Policy Shift
- HHS Sends $25K Buyout Offers to Employees in Major Workforce Reduction Move
- Majority of Republicans Oppose Medicaid Cuts, Poll Shows
Risk of Government Shutdown Starting this Weekend Remains High
As noted in our previous edition, current federal funding authority runs out on March 14, and the pathway to avoiding a government shutdown remains unclear. Over the weekend, House Republicans released a proposed continuing resolution (CR) that would go until September 30. The main issue continues to be a power struggle between President Trump, Elon Musk's Department of Government Efficiency (DOGE), and Congress over control of federal spending. Congressional Democrats and some Republicans have raised significant concerns about DOGE unilaterally cutting programs funded by law, and have demanded checks on DOGE’s actions. Speaker Mike Johnson and President Trump fully support DOGE’s efforts and have opposed any checks or guardrails. The White House has preemptively declared that it will still unilaterally cut programs funded by Congress in any appropriations bill that passes. DOGE has backtracked on some cuts, but are only working with Republican offices that are supporting President Trump.
While a CR typically keeps funding levels relatively consistent, the House proposal would include a $15 billion cut to nondefense discretionary accounts and a $6 billion increase to defense spending and immigration enforcement. This proposal would also eliminate all earmarks from FY24, including cutting about $890 million for construction and renovation of health care facilities and training grants through the Health Resources and Services Administration (HRSA), the primary federal agency for improving access to health care services for people who are uninsured, isolated or medically vulnerable.
Even more notable than the cuts is what is missing – any relief for federal research programs that have been disrupted by the Administration canceling billions of dollars in grants, support for the federal workforce that has seen waves of DOGE-initiated purges, or any limitations at all on DOGE or requirements that the Administration fully execute the appropriations laws. AcademyHealth has continued to meet with congressional offices to ensure that any funding bill supports researchers, patients, and better health outcomes.
Speaker Johnson aims to pass this bill through the House today or Wednesday on soley Republican votes and then immediately adjourn the House to prevent the Senate from sending back any changes or counterproposals. This would force Senate Minority Leader Chuck Schumer to either provide enough votes to pass the bill or potentially take the blame for a shutdown. The top Senate Democrat on Appropriations, Sen. Patty Murray (D-WA) called the CR a “slush fund” that “threatens families”. She has instead called for a short-term CR that allows for bipartisan negotiations on FY25 to finish. Congressional Democrats that represent large groups of federal workers, and are typically exceptionally sensitive to the harms of a shutdown, are lining up in opposition to Speaker Johnson’s CR. Rep. Don Beyer (D-VA) said, “this is not a funding bill, it is a defunding bill, and I will vote against it.” Sen. Tim Kaine (D-VA) said that he was a “hell no” on the bill.
While Congress still struggles to finalize the funding bills for FY25, which started on October 1, 2024, the race for FY26 support is underway. AcademyHealth and the Friends of AHRQ are meeting with congressional offices to educate them about the needs of the Agency for both fiscal years. Over 190 organizations signed onto the FY26 Friends of AHRQ request.
You can learn more about the status of federal appropriations at our member-only town hall on March 19 at 12:00 PM ET with President and CEO Aaron Carroll and Director of Advocacy Josh Caplan. Members can register here (you will be asked to login to your AcademyHealth profile before seeing registration options).
HHS Sends $25K Buyout Offers to Employees in Major Workforce Reduction Move
The U.S. Department of Health and Human Services (HHS) has extended a $25,000 buyout offer to the majority of its approximately 80,000 employees as part of federal cost-cutting measures. The deadline for responding is 5 p.m. on Friday, March 14.
Employees are advised to conduct a thorough assessment of their financial situation and personal circumstances before making a decision. Considerations include:
- Legality and authority
There have been concerns raised by experts and lawmakers about the legal authority of the Trump administration to offer such buyouts. The legality of the buyouts has been questioned, with discussions on whether the administration has the statutory power to make such offers.
- Financial implications
Financial planners recommend consulting with advisors to evaluate the long-term impact of accepting a buyout. This involves considering severance, salary continuation, and potential retirement implications.
- Impact on benefits
It's crucial to understand how leaving federal service affects benefits like health insurance, retirement plans, and other government perks. Some agencies may offer continued health insurance for a period post-resignation, but this varies by agency.
- Career considerations
Career trajectories need to be considered carefully, particularly as the loss of federal protections can lead to a less stable job environment.
- Unions
Unions have expressed concerns about the buyout offer, advising employees to consider the potential risks and challenges.
- Timing
Timing of resignation and the fiscal year can impact various benefits, including leave accrual and performance evaluations. Employees should consider the timing before making a decision.
NIH Cancels LGBTQ+ and DEI Research Grants, Disbands Key Office in Sweeping Policy Shift
The NIH abruptly terminated multiple federally funded research grants focused on LGBTQ+ health, gender identity, and diversity, equity, and inclusion (DEI), citing political priorities over scientific merit. These cancellations, which impact studies on aging, dementia risk, and health disparities, were communicated to researchers with no opportunity for corrective action. Additionally, reports indicate that NIH staff have been instructed to review and potentially cancel grants related to DEI in the scientific workforce, environmental justice, climate change, and collaborations with Chinese universities. The agency has also disbanded its Sexual and Gender Minority Research Office (SGMRO), which previously coordinated research on LGBTQ+ health.
These actions align with Executive Order 14168, which redefines sex strictly based on reproductive function and has triggered changes in federal health agencies’ data collection and research terminology. The terminations disrupt long-term studies that rely on continuous data collection, threatening the ability to track health outcomes over time. Beyond the immediate impact on affected researchers—who now face layoffs and project shutdowns—the broader concern is the chilling effect on future studies addressing health inequities. If politically motivated funding cuts continue, key areas of health services research could be systematically undermined.
The scientific community has raised alarms about the long-term implications of these decisions, warning that canceling vetted grants for ideological reasons threatens research integrity. Experts emphasize that such actions amount to censorship, creating uncertainty around the reliability of federal funding and discouraging researchers from pursuing work that could be deemed politically sensitive. Meanwhile, other critical research fields are also feeling the strain—Alzheimer’s research centers across the U.S., for example, are experiencing a $65 million funding shortfall due to administrative delays. As health services researchers navigate this shifting landscape, diversifying funding sources and advocating for the protection of scientific integrity will be essential to sustaining work on vulnerable populations.
Majority of Republicans Oppose Medicaid Cuts, Poll Shows
A recent KFF poll reveals substantial support among President Trump's voters and Republicans for maintaining Medicaid funding. Over 60 percent of Republicans and Trump supporters consider Medicaid "very important" to their communities, with only 33 percent favoring cuts. This sentiment is particularly strong in rural areas, with only 23 percent of residents supporting funding reductions. These findings indicate a shift in public perception, placing Medicaid alongside Social Security and Medicare as programs that should not face budget cuts. This presents a significant challenge for GOP lawmakers contemplating proposals to slash Medicaid spending by $880 billion over the next decade, despite some proposals being ruled out by House Speaker Mike Johnson.
Researchers aiming to educate congressional members about Medicaid's critical role and broad public support, could use the below script to do so:
"Good [morning/afternoon], Representative [Name]. I'm [Your Name], a researcher from [Your Town]. I want to share insights from a recent KFF poll showing that over 60% of Republicans and Trump voters consider Medicaid essential to their communities, with minimal support for funding cuts. This highlights Medicaid's critical role in providing health care access to millions, particularly in rural areas. As you consider legislative decisions, please recognize that maintaining or strengthening Medicaid aligns with the interests and well-being of your constituents. Thank you."
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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