In this edition of the Situation Report, Congressional Republicans narrowly passed Trump’s $9 billion rescission package despite internal tensions and dissatisfaction. A second round of rescissions is already being planned despite concerns it could disrupt bipartisan government funding talks and increase the risk of a shutdown as the September 30 deadline approaches. Furthermore, if tax credits are not extended, ACA premiums are expected to rise which could lead to a decrease in coverage, higher costs, and a higher rate of uninsured individuals. Finally, if your research has been affected by the loss of critical public health data, we need your story by August 8. Sharing your experience will help us fight to restore these essential datasets. Read on for the latest health policy updates and how you can take action.
In today’s issue:
- Rescission Package Passes the House, Another Round on the Horizon
- ACA Insurance Premiums to Rise in 2026, Much Higher if Tax Credits Not Extended
- Judge Ends Rule, Keeps Medical Debt on Credit Reports
- Drug Denials by Private Insurers on the Rise
- CMS Innovation Center Hiring Push Signals Shift Toward Preventive Care, Raises Questions
- Has Loss of Critical Health Data Impacted Your Research? Share Your Story.
Rescission Package Passes the House, Another Round on the Horizon
Congressional Republicans narrowly passed Trump’s $9 billion rescissions package (a set of budget cuts to reduce previously allocated spending) after a 216-213 vote in the House, but internal tensions and dissatisfaction with the opaque negotiations have left many wary of repeating the process. While fiscal conservatives welcomed the cuts to public radio and large portions of international aid, others, including senior GOP leaders, criticized White House budget director Russ Vought for bypassing normal channels and undermining congressional authority. A second round of rescissions is already being planned despite concerns it could disrupt bipartisan government funding talks and increase the risk of a shutdown as the September 30 deadline approaches. Republican leaders, under pressure from Trump and hardline fiscal hawks, may feel compelled to continue the cuts, though Senators stress the need for more collaboration and transparency next time. The ongoing financial tensions are compounded by ambiguities in the recently passed reconciliation bill, as well as mounting public dissatisfaction over the administration’s handling of the Epstein files.
This is the first time that Congress rolled back funding appropriated in a bipartisan bill with a partisan recession, further shaking the future of bipartisan appropriations in Congress.
These cuts and funding uncertainties threaten critical health data and research resources; health services researchers should share their experiences and engage with policymakers to help protect the data and funding essential for advancing health care.
ACA Insurance Premiums to Rise in 2026, Much Higher if Tax Credits Not Extended
People purchasing their health insurance on the individual market will see an average premium increase of 15 percent in 2026, the largest since 2018, according to a new analysis from KFF. Known colloquially as Affordable Care Act insurance, these plans are purchased either through HealthCare.gov or state-based marketplaces. The analysis reviewed insurers’ proposed rates, many of which were submitted to regulators prior to the recent budget reconciliation and may change as those policies go into effect. In their filings, insurance companies took the unusual step of discussing federal policy, namely the anticipated expiration of enhanced premium tax credits in the ACA markets in 2026, because analysts estimate that failing to extend the credits would drive up out-of-pocket premiums on ACA plans by over 75 percent on average. As a result, healthier enrollees would likely opt out of insurance entirely due to the high cost, resulting in a sicker, costlier risk pool, further incentivizing insurers to continue to raise premiums. In addition to reversing recent successes in reducing the uninsured population, such cycles, if left unchecked, could eventually trigger a cycle known as a “death spiral” – where rising costs push more people out of insurance, making coverage unaffordable for many. Indeed, the Congressional Budget Office estimates that allowing the subsidies to expire would increase the number of uninsured people by 4.2 million over the next decade. Insurers also cited rising health care costs for hospitalizations, physician care, and prescription drugs as reasons for increased premiums – no insurers requested premium decreases for 2026.
Health services researchers can help spotlight the real-world impact of rising premiums and potential subsidy loss by analyzing coverage trends, amplifying affected voices, and sharing data that informs policy solutions.
Judge Ends Rule, Keeps Medical Debt on Credit Reports
The Trump administration joined with trade groups representing credit bureaus and credit reporting agencies and sued to block a rule that aimed to limit the impact of unpaid medical bills on consumers’ credit history. The Biden-era rule, finalized shortly before President Trump took office, would have removed $49 billion in medical bills from the credit reports of 15 million Americans. Unpaid debt, including medical debt, can lower your credit score, make it more difficult to obtain loans for homes, cars, and small businesses, or rent an apartment.
Health services researchers have long pointed to the role of medical debt in driving financial hardship, limiting access to housing, and exacerbating health inequities. This decision allows lenders to continue penalizing patients for unpaid medical bills and even permits repossession of medical devices like wheelchairs and prosthetics used as loan collateral. The ruling underscores the intersection of health, credit policy, and economic mobility, an area increasingly relevant to HSR work on the social determinants of health and access to care.
Drug Denials by Private Insurers on the Rise
A new analysis of over 4.5 billion claims reveals that private insurers have increased their prescription drug denial rates by 25 percent since 2016, with denials rising across most major health plans, including UnitedHealthcare, Aetna, and Cigna. The findings provide a rare glimpse into opaque insurance practices that often shape patient access to care.
For health services researchers, the trend underscores growing concerns about administrative barriers to treatment (including prior authorization and AI-driven claim reviews) as potential contributors to delays, disruptions in care, and health inequities. Denial rates in private plans now exceed those in traditional Medicare, with some studies linking denials to measurable patient harm, including delayed cancer treatment and unmet medication needs.
The increasing use of automation, cost-containment strategies, and lack of transparency in private insurer decisions present critical challenges for evaluating real-world effectiveness, continuity of care, and patient outcomes. These trends also raise questions about the need for better data integration across claims, clinical outcomes, and social impact, an area where health services research can play a pivotal role.
CMS Innovation Center Hiring Push Signals Shift Toward Preventive Care, Raises Questions
The CMS Innovation Center is hiring roughly 100 new staff to advance its “Make America Healthy Again” agenda, with a focus on expanding preventive care models and improving Medicare and Medicaid outcomes. The Center is seeking expertise in clinical care, economics, and data - areas closely aligned with health services research and evaluation.
This hiring wave comes just months after a reduction in force that cut nearly 300 CMS staff. Some former employees say they were told not to reapply, despite federal rules requiring priority consideration, raising questions about workforce continuity and governance. The move also highlights how political priorities are shaping federal investments in care delivery innovation, with implications for research partnerships, model evaluations, and funding opportunities.
Has Loss of Critical Health Data Impacted Your Research? Share Your Story.
AcademyHealth is part of a federal lawsuit seeking to restore public health datasets removed earlier this year. While our case is strong, real-world examples from researchers like you are vital to showing the tangible impacts on health services research and the communities it serves.
If your work has been disrupted by the removal or alteration of key data—such as PRAMS, HIV, diabetes, mental health, or LGBTQIA+ health data—please share your experience by August 8. Your stories help make our legal case more compelling and increase the chances of restoring these essential resources.
How to share:
- Fill out this quick story submission form
- Or email Kristin Rosengren, Chief Strategy Officer, at Kristin.Rosengren@academyhealth.org
Thank you for standing with us to protect the data critical to advancing health services research.
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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