Editor's Note: House Passes Reconciliation Bill Despite Public Outcry
Just moments after this Situation Report was published, the House voted to pass the reconciliation bill. While we had hoped there was still time to influence the outcome, the speed of the vote underscores exactly what we said earlier: this process has prioritized speed over substance, politics over evidence. AcademyHealth will continue to advocate for policymaking that respects data, deliberation, and the real-world impact on communities.
In this edition of the Situation Report, we highlight backlash to the recently-passed Republican budget reconciliation bill that could leave millions uninsured, and offer a call to action as well as other ways to get involved with AcademyHealth’s advocacy work. We also highlight a recent federal ruling against recent mass layoffs at HHS, which blocks the downsizing of the agency by 10,000 employees. Meanwhile, NIH staff spoke out against funding cuts, agency priorities, and the termination of critical studies which put patients at risk. Read on for the latest news impacting health policy and research and how you can get involved.
In today’s issue:
- The Fight Isn’t Over: House Vote Looms on GOP Bill
- Judge Stops Key Elements of Trump Administration’s HHS Downsizing Plan
- States Sue Trump Administration Over Use of Medicaid Data for Immigration Enforcement
- More Than 300 NIH Staff Voice Concerns About Agency’s Direction
- In a Win for Research Infrastructure, Court Blocks NSF Cap on Indirect Costs
- ICYMI: Opportunities to Engage with AcademyHealth
The Fight Isn’t Over: House Vote Looms on GOP Bill
As reported in our previous edition, the Senate narrowly passed the Republican budget reconciliation bill by a 51–50 vote, with Vice President JD Vance serving as tiebreaker. Three GOP senators—Susan Collins (ME), Thom Tillis (NC), and Rand Paul (KY)—joined all Democrats in opposition to the bill after hours of intense negotiations. The bill sparked intense backlash over its projected $1 trillion in Medicaid cuts, which could leave nearly 12 million Americans uninsured and threatens to force dozens of rural hospitals to close their doors or cut essential services. One Republican Senator, Lisa Murkowski, refused to vote for the bill until it was modified to exempt her home state of Alaska from Medicaid cuts and the rural health fund was doubled to $50 billion. Several House Republicans have already signaled their opposition to the bill, including the handful of Representatives who voted against the bill back in May when it passed by a single vote, 215-214. For the more moderate Republican Representatives, the Senate’s exaggerated cuts to social services are alarming, and the fiscally focused continue to decry the multi-trillion dollar increase in deficit spending. If voting falls along party lines, the GOP can only afford a few dissenters. President Trump continues to pressure GOP lawmakers to pass the bill, but passage by the self-imposed deadline of July 4th seems increasingly less likely.
AcademyHealth’s Take: When Evidence Is Ignored, Everyone Pays the Price
The data on Medicaid, ACA subsidies, and Medicare changes was clear. The research was widely circulated. AcademyHealth alone held more than 85 meetings with lawmakers and staff on the Hill. Some Republican offices expressed concern about the harms—and then voted yes anyway.
That’s one form of disregard: seeing the evidence and choosing ideology over impact.
Another is speeding the process so much that lawmakers never even have to confront the evidence in the first place. Unlike the year-long debate over the ACA—with nearly 80 House hearings, 100 Senate markups and roundtables, and more than 150 amendments—this bill moved in under three months, with just four House hearings and a single Senate session (if you count the vote-a-rama).
We say science should inform policy. But science isn’t a set of instructions—it’s a set of facts, as best we know them, about what’s likely to happen next. Good policy weighs those facts against values, budgets, and tradeoffs. That process demands transparency, honesty, and a willingness to grapple with complexity.
Instead, this bill reflects a different approach. One where tradeoffs are hidden. Harms are acknowledged privately, then ignored publicly. And the values driving decisions—shrinking the safety net, advancing tax cuts—go unspoken and unexamined.
Act Now: Tell the House Reject Harmful Cuts
The current draft of the budget bill will cause catastrophic harm to public health, scientific progress, and vulnerable communities across the country, but there is still time to fight for a better proposal! As the House deliberates, you can make an impact by contacting your representatives today. You can find the contact information for your representative here, and you can use this website to quickly email your representative about the dangers of the current GOP reconciliation bill. It only takes a few dissenting Republican Representatives to stop this proposal from going through. Tell your representatives to vote no on the reconciliation bill to protect Medicaid, CHIP, SNAP, and other essential services.
Judge Stops Key Elements of Trump Administration’s HHS Downsizing Plan
Ruling that recent mass layoffs at HHS were likely unlawful, a federal judge has ordered the Trump administration to stop plans to downsize and reorganize the department. The judge granted a preliminary injunction for the case brought by a coalition of 20 state attorneys general in early May. The judge noted that the states had shown “irreparable harm,” from the cuts and would likely prevail in their claims that the cuts by HHS were arbitrary, capricious, and contrary to law. This order blocks the Trump administration from finalizing the almost 10,000 layoffs previously announced in March or issuing further firings, and directs HHS to file a status report by July 11. An HHS spokesperson said that the administration is considering their next steps.
The ruling applies to employees within specific parts of HHS, including the CDC, the Center for Tobacco Products within the FDA, the Office of Head Start within the Administration for Children and Families and employees of regional offices who work on Head Start, and the Office of the Assistant Secretary for Planning and Evaluation. This case is one of a handful of cases against the Trump administrations Executive Order 14210, and one of twenty cases related to HHS, including responses to FOIA requests, removal of information and data from HHS websites, and widespread termination of grant funding, among other topics.
States Sue Trump Administration Over Use of Medicaid Data for Immigration Enforcement
20 state attorneys general sued the Trump administration on Tuesday for sharing Medicaid enrollees’ personal information with immigration officials. The suit asserts that the administration transferred large swaths of Medicaid data to the Department of Homeland Security, illegally revealing immigration status among other private health information. The attorneys general aim to stop Washington from obtaining any additional Medicaid data and from leveraging the acquired data for immigration enforcement purposes. The Trump administration has defended the data share, arguing it was legal and ensures federal Medicaid dollars remain reserved for people with U.S. citizenship. The lawsuit adds to mounting legal challenges to the Administration from California and other states and comes amid widespread attempts from immigration officials to identify undocumented immigrants. One of the suing attorneys, Rob Bonta of California, promised that this data seizure will have a “chilling effect” on health access and called the data share “an attack on public health and a breach of public trust” that will have long lasting repercussions.
Behind the Bethesda Declaration: NIH Staff Detail Origins of Their Moral Stand
In early June, the Bethesda Declaration open letter was published with over 300 NIH employees expressing dissent about recent decisions regarding NIH funding cuts and agency priorities. A recent interview with Dr. Jenna Norton, Program Director at the National Institute of Diabetes and Digestive and Kidney Diseases, delves into the origin story of the Bethesda Declaration. After being asked to terminate studies midstream, potentially putting participants at risk, and reviewing grants no longer on the basis of science but rather alignment with agency priorities around gender, race, and sexuality, many employees were experiencing moral distress and seeking emotional support. A natural coalition of employees across NIH institutes, seeking emotional support and better understanding of the ambiguous guidelines. These meetings revealed a troubling absence of leadership—or revelations that leaders who spoke out were being forced out of the agency. Inspired by NIH Director Jay Bhattacharya’s rhetoric on dissent in the science community, coordinated a public statement to express their dissent. Since being released, Congress has referenced the letter in various avenues, including a Seate hearing with Bhattacharya and a recent Energy and Commerce Committee meeting with RFK Jr.
In a Win for Research Infrastructure, Court Blocks NSF Cap on Indirect Costs
A federal judge has ruled against the National Science Foundation’s (NSF) policy capping indirect cost recovery at 15 percent, finding it inconsistent with federal law and administrative procedures. This is the fourth attempted cap by a federal agency to be blocked, following similar outcomes at NIH, DOE, and DoD. The decision allows institutions to continue recovering negotiated indirect rates, which fund essential research infrastructure like data systems, compliance, and administrative support. For health services researchers, the ruling helps maintain institutional capacity for federally funded work. The NSF has not announced whether it will appeal, so the ruling currently remains in effect.
ICYMI: Opportunities to Engage with AcademyHealth
Members-Only Town Hall: Navigating Today’s Health Policy and Research Landscape
Join us for an exclusive AcademyHealth members-only town hall with President and CEO, Aaron Carroll, Director of Advocacy, Josh Caplan, and Senior Vice President of Policy and Advocacy at the nonpartisan, nonprofit advocacy alliance, Research!America, Ellie Dehoney. The town hall provides members with critical insights into the policy and funding challenges shaping the health services and health policy research field. Participants will discover advocacy strategies and resources to navigate the current environment. This interactive session offers a unique opportunity to connect with peers, share experiences, and engage in open dialogue with AcademyHealth leadership.
Date and Time: Wednesday, July 16, 2025 | 12:00p.m. to 1:00p.m. ET
Register Now: AcademyHealth Town Hall Meeting | AcademyHealth
Apply Now: AcademyHealth Opens Fall Health Policy Fellowship for Emerging Advocates
AcademyHealth's advocacy team is hiring a policy fellow for this fall. This opening is for a current or recent graduate student who wants hands-on experience in applying their health policy and health systems knowledge and research skills to federal advocacy. The fellow will work alongside the Director of Advocacy to advance the mission and objectives of AcademyHealth through advocacy, public policy, education, and policy communication. This full-time position can be done hybrid or remote. Learn more and apply here.
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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