In this edition of AcademyHealth’s Situation Report, we examine how new federal policies are disrupting health research funding, weakening public health agencies, and politicizing essential programs like Medicaid. As researchers and advocates raise alarms, this week’s issue underscores what individuals, institutions, and networks can do to respond. Whether it’s submitting public comments on workforce proposals, leveraging new toolkits to push back on Medicaid cuts, or joining networks to advance health equity, your voice and action matter. This edition features “What You Can Do” callouts throughout—because in times like these, staying informed is only the first step.
In today’s issue:
- Federal Health Grant Payments Delayed Under New Review Policy
- Public Health Agencies Scale Back Research and Workforce Capacity
- Federal Policymakers Target Medicaid Funding and Accountability
- New Drug Pricing Policies Spark Debate on Costs and Innovation
- Member-Only Resources Offer Funding Strategies for Health Researchers
- Other News We’re Tracking
Federal Health Grant Payments Delayed Under New Review Policy
The Department of Government Efficiency (DOGE) has implemented a new “Defend the Spend” initiative requiring manual review and approval of all federal health-care grant payments. This shift—affecting agencies like NIH and AHRQ—has led to widespread delays, with grantees reporting stalled funding for salaries, services, and research activities.
Health services researchers may face disruptions to ongoing projects, increased administrative burden, and uncertainty around future funding. The new policy requires justifications for each payment aligned with administration priorities, raising concerns about political influence in what has traditionally been a science-led process. Community-based and equity-focused research may be particularly vulnerable to delays or denials.
While DOGE describes the initiative as a step toward greater transparency and accountability, stakeholders are warning that the changes risk undermining evidence generation and slowing the delivery of timely, policy-relevant research. We are monitoring developments closely and will share guidance as more details become available.
Public Health Agencies Scale Back Research and Workforce Capacity
Amid federal budget and workforce cuts, AcademyHealth is tracking the impacts to health research and workforce capacity. Today, we’re highlighting the effects in basic disease prevention, women’s health, and chronic disease treatment.
Mass firings at the NIH and CDC are being described as a “generation-defining experience” that will directly impact Americans’ health. Examples include the CDC’s recent action to scrap a plan to offer Texas schools help in curbing the state’s measles outbreak and the loss of over $2 billion in childhood immunization and vaccination funding from states and cities to fight preventable and potentially deadly diseases.
Women’s health has been particularly impacted by these cuts, with the HHS Division of Reproductive Health gutted. Experts say that this little-known office was critical in supporting programs on maternal and child health, collecting data on assisted reproductive technology clinics’ pregnancy success rates and the Pregnancy Risk Assessment Monitoring System (PRAMS). A recent AcademyHealth blog post details the critical value of this dataset and shares resources for advocates to educate state policymakers how they can help restore this data.
The Division of Violence Prevention was also reduced, worrying experts that the work supporting state and local programs on sexual assault or domestic violence, which occur more frequently among women, will be diminished. State and local domestic violence shelters and rape crisis centers, which overwhelmingly rely on federal funds, have already seen funding interruptions and expect more.
Individuals with chronic diseases will be similarly impacted by these cuts, including those who experience chronic pain or are HIV positive. HHS cuts effectively eliminated the NIH Office of Pain Policy and Planning, which coordinated research across the federal government related to pain. Reports highlight how crucial research projects will cease and opportunities to address knowledge gaps will disappear. Cuts included the National Center for HIV, Viral Hepatitis, STD, and Tuberculosis Prevention, which could hamper our ability to effectively address HIV, leading to a higher HIV incidence. Additionally, the recent disruptions in foreign aid funding for the President’s Emergency Plan for AIDS Relief (PEPFAR) and other HIV/AIDS-related international aid programs, have left the global fight against HIV/AIDS in tatters.
While cuts to the federal health workforce and research have already impeded these agency’s ability to do their work, President Trump is looking to reclassify 50,000 federal employees under Schedule F, turning civil servants into political appointees, who are more easily dismissed.
What You Can Do: Comment on the proposed Schedule F rule here, and help defend against more debilitating federal workforce cuts.
Federal Policymakers Target Medicaid Funding and Accountability
A recent White House statement equates Medicaid improper payments with eliminating waste, fraud, and abuse in government spending and calls on Congress to charge states for improper payments. However, experts are highlighting that the statement ignores the steady decline in Medicaid improper payment rates since 2021 and assumes that all improper payments are erroneous, when in fact nearly three quarters are attributed to insufficient documentation. They also note that it does not estimate the impacts of the proposal by state, a clear gap given the differing improper payment rates among states.
Additionally, critics note that while the Trump Administration targets fraud in Medicare, Medicaid, and Social Security, Trump issued several pardons and commutations for people involved in extensive health care fraud cases in his previous term raising doubts as to the sincerity of these recent actions.
What You Can Do: In light of Congress’ potential cuts to Medicaid, Manatt Health created this toolkit and accompanying policy brief to assist state officials prepare or review their own impact estimates of federal policy changes and to offer estimates to states that do not have their own analyses. Utilize yourself or share broadly with your networks.
New Drug Pricing Policies Spark Debate on Costs and Innovation
The Trump administration has rolled out new efforts to address high drug prices, but not without controversy. A newly signed Executive Order (EO) focuses on aligning Medicare drug price negotiation timelines for small-molecule drugs and biologics, reinstates discounted insulin for federally qualified health centers, and encourages states to import cheaper drugs. While these initiatives aim to lower costs, critics warn that they could stifle innovation and raise concerns about the safety of imported drugs.
Meanwhile, the Centers for Medicare and Medicaid Services (CMS) has introduced a final rule aimed at bringing down drug prices for Americans. While proponents argue these efforts are crucial for reducing the financial burden on U.S. patients, critics caution that they may not do enough to address the root causes of high drug prices and could undermine incentives for the development of new therapies.
As these changes unfold, the debate continues about whether they will successfully reduce drug prices while ensuring access to innovative and safe treatments.
NSF Director Resigns Amid Budget Cuts and Policy Shifts—Implications for Health Research
NSF Director Sethuraman Panchanathan has stepped down early, citing an inability to continue advancing the agency’s mission. His resignation follows White House directives to drastically cut NSF’s budget, halt certain new awards, and return already-approved grants that conflict with recent executive orders. For health services researchers, this signals potential challenges ahead in securing federal support, especially for work related to diversity, equity, misinformation, and environmental justice.
Member-Only Resources Offer Funding Strategies for Health Researchers
In the wake of recent administration decisions, researchers face a transformed landscape in securing funding for their projects. In response, AcademyHealth hosted a members-only Field in Focus webinar "Securing Funds – Strategies for Researchers,” which offers strategies for finding and securing private foundation support. Experts including Dr. Jamae Morris of the Robert Wood Johnson Foundation and AcademyHealth Chief Programs & Science Officer Dr. Elizabeth Cope broke down the nuances between NIH grants, federal contracts, and private foundation funding, highlighting how researchers can tailor proposals, build funder relationships, and center impact-driven narratives. Read more of the takeaways on the AcademyHealth blog here. AcademyHealth members can also access a resource guide with additional strategies for tailoring proposals and tools for identifying funding opportunities here.
Other News We’re Tracking
Women and minority scientists who served on Boards of Scientific Counselors at the NIH were removed at much higher rates than their counterparts. Of the 43 scientists dismissed, 38 were women or minorities, with Black and Hispanic females experiencing the highest dismissal rates. More specifically, half of Black and Hispanic females were dismissed, in stark contrast to 6 percent of their white male counterparts. HHS has denied accusations of race and gender bias, although 12 board chairs have voiced concerns about the potential targeting based on demographic traits and have reported their findings to the Senate Committee on Health, Education, Labor and Pensions (HELP). Analysts argue that the pattern of firings implies a bias, posing questions about future representation within the NIH.
What You Can Do: Advocate for transparency and accountability within the NIH by contacting your representatives and urging them to investigate the recent dismissals. Participate in research that examines the impact of diversity of scientific outcomes to provide evidence-based arguments for the importance of representation in research boards. Publish and disseminate findings to raise awareness of biases in scientific governance.
Medicare Advantage Under Fire: Rural Hospitals Battle Financial Challenges
Rural hospitals are facing significant financial challenges in maintaining contracts with Medicare Advantage plans, as private insurers generally offer lower reimbursement rates than traditional Medicare. Rural hospitals dropping these contracts may disrupt local patient access to in-network providers unless patients switch coverage, which might be cost-prohibitive. Medicare Advantage’s administrative burden also strains rural facilities by requiring extensive authorizations and paperwork. Rural health advocates advocate for fairer payments from private plans and that Medicare Advantage contracts do not disproportionately disadvantage smaller health systems.
What You Can Do: Contact your lawmakers to express the importance of equitable health care access for rural communities. Support rural health organizations by sharing rural health research findings with policymakers to advocate for reimbursement models that sustain rural healthcare infrastructure.
Health Equity Policy Hub Converts Information to Action
Health Begins’ Health Equity Policy Hub transforms information into actionable efforts aimed at advancing health equity. This tool provides individuals, organizations, and communities with the tools and resources they need to interpret policy changes and their impacts on disproportionately affected populations, allowing them to respond effectively. The Mobilization Network, specifically, supports change-makers in driving meaningful change through connecting a network of organizers to help advance health equity through spheres of influence.
What You Can Do: Join the Mobilization Network to connect with other change-makers and collaborate on initiatives that drive meaningful progress in health equity. Encourage your community to engage with these resources to promote informed, effective responses to policy shifts.
Previous Updates
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!