This edition of AcademyHealth’s Situation Report highlights policy developments with far-reaching consequences for health care access and the research community. A divisive House GOP Medicaid proposal threatens coverage for millions and places new burdens on states, while a federal judge’s order temporarily blocks HHS workforce cuts amid ongoing legal battles over executive authority and gender-related grant terminations. At the same time, the looming expiration of ACA subsidies could leave millions uninsured. Researchers are urged to stay informed, leverage AcademyHealth’s advocacy tools, join the upcoming members-only town hall, and attend the 2025 Annual Research Meeting to strategize around these challenges facing the field.
In today’s issue:
- House GOP Medicaid Plan Burdens States and Splinters Support
- Judges Pause HHS Downsizing, Legal Questions Remain
- The Role of Crowdsourcing: Researchers Respond to Loss of Public Health Data
- Meeting This Moment as Researchers
- Other News We’re Tracking
House GOP Medicaid Plan Burdens States and Splinters Support
The House Energy and Commerce Committee released a proposal Sunday night that spares Medicaid of some of the most opposed cuts such as per capita caps on federal Medicaid payments to states; however, the draft plan includes a freeze to state provider taxes at their current rates, a work requirement for able-bodied adults without any dependents, and proposed cuts to federal funding of programs such as Planned Parenthood and bans on Medicaid coverage of gender-affirming care. If the health portions become law, the Congressional Budget Office estimates 8.6 million people would lose coverage with cuts of at least $715 billion. This will also strap states with tough choices on how they finance their programs, potentially leading to significantly higher losses of beneficiaries.
Opposition is fractured among Republicans, with some joining Democrats and others in opposing Medicaid cuts; agreeing that slashing health insurance for the working poor is both morally wrong and politically nonsensical. Energy and Commerce is scheduled to meet Tuesday to debate and advance the bill.
What researchers can do: Researchers should keep an eye on emerging changes to this proposed plan for continued estimation on how proposed cuts will impact state budgets and people on Medicaid.
Judges Pause HHS Downsizing, Legal Questions Remain
A federal judge ordered the Trump administration to halt much of its downsizing of the federal workforce in a lawsuit filed by labor unions and cities challenging the administration’s firings of federal agencies, including HHS. The temporary restraining order directs agencies to halt acting on the executive order requiring these cuts expires in 14 days and does not require departments to rehire employees. The judge noted that the president has authority to seek changes in the executive branch departments and agencies created by Congress, but only with the cooperation of Congress.
Recent court filings, however, cast doubt on whether the administration is complying with similar court orders. Although the Trump administration has been subject to a federal court order halting cuts of federal grants related to gender ideology and the provision of gender-affirming care in response to executive orders in the four states party to the suit (WA, MN, CO, OR), the Washington state attorney general alleges that the administration violated the injunction. Documents show that on the day of the injunction, NIH terminated a research grant to Seattle Children’s Hospital to develop and study an online education tool to reduce the risk of violence, mental health disorders, and sexually transmitted infections among transgender youth, stating that the agency’s policy is to not prioritize such studies on gender ideology. Although the request to hold the administration in contempt was denied, the court granted an expedited discovery process to determine if the administration breached the injunction, which will continue despite the reinstatement of the grant to Seattle Children’s Hospital. Additional whistleblower documents include internal records connecting grant terminations to the administration’s executive orders, such as an internal spreadsheet of grants marked for cancellation at NIH detailing the stated reason being “gender ideology (EA 14168),” a reference to Executive Order 14168 which banned the use of federal funds to “promote gender ideology.” The grant to Seattle Children’s Hospital was included on this spreadsheet.
You can learn more about the legal framework governing the HHS Secretary’s authority to reorganize the agency and legal questions this reorganization raises in a recent Congressional Research Service explainer here.
The Role of Crowdsourcing: Researchers Respond to Loss of Public Health Data
In the third post of our data series, we explore how researchers are turning to crowdsourced data to fill critical gaps left by the removal of public health datasets. While not a substitute for robust, government-collected data, these community-driven efforts offer timely insights and help sustain research, innovation, and public accountability. This piece highlights how this dual approach ensures that health policies are both informed by grassroots, real-time insights and grounded in authoritative, long-term data, thereby equipping policymakers to make decisions that truly reflect the diverse needs of the population
Meeting This Moment as Researchers
AcademyHealth CEO Aaron Carroll in Health Affairs calls on health services researchers to confront mounting threats to science by building community and trust. Amid budget uncertainty, data suppression, and political interference, he argues that researchers must reassert the essential role of evidence in shaping policy — and AcademyHealth’s Annual Research Meeting (ARM) is essential because it’s more than a convening — it’s a space for candid conversations, practical sessions on managing career disruptions and new technology, and a catalyst for collective action.
In the meantime, ahead of ARM, join Aaron Carroll and our Director of Advocacy Josh Caplan at our members-only town hall next week which offers updates on the HHS reorganization, strategies to navigate challenges facing the field, and more. Register here.
Other News We’re Tracking
White House Launches Initiation to Curb U.S. Drug Costs
In an attempt to lower U.S. drug prices, the White House unveiled a comprehensive plan on May 12, 2025. The plan includes an executive order to implement “most-favored-nation" prescription pricing, which could align U.S. drug prices with those in other countries offering the same medication at a lower rate. Ultimately, this would aim to slash prices in the U.S. and increase prices overseas through trade policy, although the impact on the pharmaceutical industry remains unclear. The plan also considers increasing the importation of medicines to increase competition and drive down costs. The administration’s bold actions aim to reshape pricing dynamics and affect drug affordability and accessibility for Americans.
Congress Navigates ACA Subsidies and Major Tax Proposals
A Congressional Budget Office (CBO) report warns that allowing Affordable Care Act (ACA) subsidies to expire could result in millions losing health coverage. Although traditionally opposed by many Republicans, there is a growing group within the party advocating for the extension of subsidies. Extending the enhanced Premium Tax Credits is estimated to cost over $350 billion over ten years but would prevent nearly four million people from losing insurance. Concurrently, House Republicans propose increases and extensions in popular tax breaks like the Child Tax Credit, aiming to raise taxes on private foundations, colleges, and wealthy individuals to offset costs. President Trump’s mixed stance on raising taxes for the wealthy adds further complexity to these legislative efforts.
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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