AH Situation Report

In today’s issue, we spotlight the ongoing health sector's collective response to the sweeping HHS reorganization, highlighting risks to essential research funding and the potential threat to health services for vulnerable groups. We delve into the vital contribution of the Agency for Healthcare Research and Quality (AHRQ) to health system innovation and improvement, as well as the Congressional debates over Medicaid changes alongside proposed tax cuts. Additionally, we cover the troubling NIH grant disruptions affecting pivotal research, and the lawsuit sparked by concerns over political influence in research funding decisions. 

AcademyHealth is taking decisive action by engaging with congressional allies, facilitating accurate media narratives, and collaborating with advocacy groups to address these challenges. We are committed to empowering our members with advocacy tools to bolster our collective voice. Our thoughts are with our colleagues at AHRQ and other HHS agencies, whose dedicated service to the nation's health and well-being deserves profound respect and stability. Together, we remain steadfast in our commitment to responsible stewardship of our nation's health and research enterprise. In today’s issue: 

  • HHS Reorganization Sparks Uncertainty, Advocacy for Health Services Research
  • Summary of This Week’s Friends of AHRQ Meeting Respond to RIF
  • Congress Weighs Medicaid Changes Amid Push to Extend Tax Cuts
  • NIH: Stalled Grants, Legal Action, and Reform Proposals
  • AcademyHealth Members Only-Events: Measuring and Communicating Research Impact  

HHS Reorganization Sparks Uncertainty, Advocacy for Health Services Research 

The recent restructuring within HHS has significant implications for health services researchers, particularly concerning AHRQ. On Thursday, March 27, HHS Secretary Robert F. Kennedy Jr, announced a major reorganization of HHS and last week 10,000 layoffs were announced across the agency. AcademyHealth has been closely monitoring the situation and amping up our advocacy efforts in response. We actively engaged in efforts to understand these changes and advocate diligently on behalf of AHRQ and the broader health research enterprise.  

What We Know about the Impact at AHRQ  

HHS has announced the consolidation of the Assistant Secretary for Planning and Evaluation (ASPE) with AHRQ to form a new entity called the Office of Strategy. With few details on the merger available, AcademyHealth continues to decry the lack of transparency in the reorganization process and the potential jeopardy to essential health research funding and patient care initiatives. ​ 

As layoffs were implemented across HHS beginning on Tuesday, April 1, approximately 100 AHRQ staff members are undergoing reductions in force (RIF). When combined with recent buyouts, this likely accounts for over half of the agency's workforce. Reports regarding the USPSTF staff remain inconsistent, but here is a list of the key AHRQ offices that were affected by the RIFs:  

  • Office of the Director (except Acting Director)
  • Office of Extramural Research, Education, and Priority Populations (OEREP)
  • Division of Priority Populations (DPP) and Division of Scientific Review (DSR)
  • Office of Management Services
  • Center for Evidence and Practice Improvement (CEPI) 

KFF Health News published a thorough article on the implications of these cuts at AHRQ and we encourage everyone to read it and share it broadly: What’s Lost: Trump Whacks Tiny Agency That Works To Make the Nation’s Health Care Safer 

HHS Anticipates Some Reinstatements  

While HHS began to implement plans to reduce the workforce from 82,000 to 62,000 full-time employees, recent announcements by Secretary Kennedy state that some of these individuals will be reinstated.  

For those submitting appeals to the Merit Systems Protection Board, it is recommended to include reference to Kennedy’s statements including: 

  • "Personnel that should not have been cut were cut -- we're reinstating them, and that was always the plan." 
  • "The part of that, DOGE — we talked about this from the beginning — is we're going to do 80% cuts, but 20% of those are going to have to be reinstalled, because we'll make mistakes." 

Bipartisan Briefing and Senate Testimony Requests 

House and Senate committee leaders are intensifying scrutiny on the HHS reorganization. The Senate Health, Education, Labor and Pensions Committee, led by Sens. Bill Cassidy (R-La.) and Bernie Sanders (I-Vt.), has invited Secretary Kennedy to testify about HHS changes on April 10. Cassidy emphasized the routine nature of this request as Kennedy had agreed to quarterly updates upon his confirmation. Meanwhile, House Energy and Commerce Committee Chair Brett Guthrie (R-Ky.) has arranged a bipartisan staff briefing next week, following his discussions with Kennedy. House Democrats are pressing for a formal hearing to ensure transparency, accusing Republicans of procedural stalling, while Republicans criticize Democrats for political maneuvering. Kennedy's response to the invitation remains uncertain, amid concerns his leadership could affect vaccine safety and public health. 

Next Steps for Researchers 

In response to these developments, AcademyHealth has called for immediate clarity and action to preserve AHRQ's critical role in health system innovation and improvement. We are emphasizing the need for transparency and stakeholder input in the reorganization process to ensure that patient access to necessary care is not compromised. Join us by: 

AcademyHealth also does not advise anyone to be working on federal grant submissions at moment unless they are a very easy lift. 

Summary of This Week’s Friends of AHRQ Meeting Respond to RIF 

AcademyHealth and the Friends of AHRQ met to discuss the HHS reorganization and the devastation that it inflicted on AHRQ. AcademyHealth’s President and CEO Aaron Carroll, Director of Advocacy Josh Caplan, and Public Citizen attorney Stephanie Garlock briefed the friends on the cuts and possible advocacy strategies moving forward to roll them back. More than 200 attendees joined the call, reinforcing the broad coalition support. The majority of the meeting was focused on information sharing among Friends of AHRQ and answering questions, however the lack of transparency from the federal government was clear with attendees from across the health care sector expressing confusion about the current status of AHRQ and related initiatives. Key topics and themes discussed included the status of AHRQ overall, AHRQ-housed databases, and AHRQ-funded grants; concerns for the US Patient Task Force (USPTF); and advocacy strategies. There was overwhelming gratitude from attendees for AcademyHealth’s efforts to communicate current policy news and ongoing advocacy to save AHRQ. If you would like to become a Friend of AHRQ and receive updates and calls to action, please email advocacy@academyhealth.org.   

Congress Weighs Medicaid Changes Amid Push to Extend Tax Cuts 

The ongoing debate in Congress over Medicaid funding is closely tied to efforts to extend and expand tax cuts initiated during President Trump's first term. House Republicans have proposed significant spending reductions, including up to $880 billion in cuts to Medicaid over the next decade, aiming to offset the cost of these tax cuts. They assert that these savings would come from eliminating fraud, waste, and abuse within the program, as well as implementing work requirements for certain beneficiaries. ​  

However, analyses suggest that achieving such substantial cuts without affecting benefits is unlikely. The Congressional Budget Office (CBO) indicates that Medicaid accounts for 93% of the mandatory spending overseen by the relevant House committee, implying that cuts of this magnitude would inevitably impact the program's services. ​  

In the Senate, there is a more cautious approach. Some Republican senators, including Susan Collins, Lisa Murkowski, and Josh Hawley, have expressed reservations about deep Medicaid cuts. Senator Hawley, for instance, stated, "I would not do severe cuts to Medicaid." This internal GOP friction has led to delays in advancing the budget resolution. ​  

To address funding concerns for the proposed tax cuts, the administration is considering alternative revenue sources, such as increased tariff revenues. ​  

Amid these developments, the Senate has confirmed Dr. Mehmet Oz as the new Administrator for the Centers for Medicare and Medicaid Services. Dr. Oz has emphasized promoting healthier lifestyles and integrating technology into healthcare but has not publicly opposed the proposed Medicaid cuts.  

NIH: Stalled Grants, Legal Action, and Reform Proposals  

The NIH is facing mounting challenges as researchers express alarm over the agency's recent decision to quietly remove numerous grant applications from the peer-review process. This move, described as part of a "review of its research priorities," has left at least 20 applications in limbo, especially affecting projects related to LGBTQ+ health amid significant administrative changes. With NIH rescheduling study section meetings with limited re-invitations, the uncertainty threatens the continuation of essential research and the financial stability of projects reliant on anticipated grant funding. 

Additionally, a coalition of scientists and health organizations is suing the NIH, alleging that research grants were unlawfully terminated based on political considerations. The lawsuit, filed in federal court, claims that NIH cut funding for studies on HIV prevention, vaccine hesitancy, and health disparities, among other topics, in violation of its standard review process. The plaintiffs argue the move undermines scientific progress and wastes taxpayer dollars. NIH’s parent agency, HHS, declined to comment on the lawsuit. 

Meanwhile, a recent perspective piece titled “A Blueprint for NIH Reform” is stirring debate in academic and policy circles. Authored by Martin Kulldorff, a close collaborator of new NIH Director Jay Bhattacharya, the article lays out 12 proposals for reshaping the agency—ranging from breaking it into smaller entities to altering research funding models and creating a COVID-19 Commission to reassess the agency’s pandemic response. While some ideas align with long-standing reform discussions, experts warn that the blueprint’s focus on pandemic-era grievances may introduce biases and unintended consequences. NIH staff and researchers are closely watching whether these proposals will shape the agency’s direction under the new administration. 

AcademyHealth Members Only-Events: Measuring and Communicating Research Impact  

How can researchers make sure their work drives real-world change and attracts future funding? This members-only session will explore the importance of making research meaningful and accessible to funders and the broader community. Speakers will share strategies for developing and communicating the societal impacts of research, offer actionable tips for measuring research impact, and provide guidance on establishing systems to track and report outcomes effectively. Participants will walk away with practical tools to strengthen research communication and increase the potential for long-term funding and real-world influence.  

Time and Date: Wednesday, April 23, 3:00p.m. - 4:00p.m. ET  

Register Now: Field in Focus Connecting Science and Society - Measuring and Communicating Research Impact | AcademyHealth  

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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