In this edition of the Situation Report, we highlight pressing developments in U.S. health policy: billions in NIH research funds remain unspent, state-level MAHA initiatives advance while federal recommendations hold back, GOP leaders consider Medicaid cuts, the CBO warns of potential Medicare reductions, and HHS has revived the child vaccine safety panel. AcademyHealth is responding by sharing member stories with Congress, analyzing funding trends, mobilizing coalitions to protect evidence-based programs, and raising awareness in the media. By spotlighting these issues, we ensure the human and research impacts of these policies are seen, and that policymakers have the information they need to make decisions grounded in evidence.
- Your Stories Are Powering Our Fight for Evidence-Based Policymaking
- NIH Faces Idle Research Funds and Reduced Patient Intake
- Federal MAHA Report Stops Short of State-Level Measures
- Internal Tensions Surface as GOP Weighs Medicaid Cuts
- CBO Report Warns of Medicare Cuts
- HHS Revives Dormant Child Vaccine Safety Panel
Your Stories Are Powering Our Fight for Evidence-Based Policymaking
Over the past few months, we’ve been collecting your stories about how disruptions to health research are affecting careers, projects, and the communities we serve. The themes are striking: early-career researchers questioning whether to stay in the field, projects stalled midstream, and patients left waiting for answers. These aren’t abstract challenges, they’re the real costs of undermining research.
AcademyHealth is making sure those voices are heard. We’ve shared them in advocacy meetings on the Hill, elevated them in the press, and linked them to broader threats: from the freeze on AHRQ grants, to the removal of federal health data, to risks facing the U.S. Preventive Services Task Force. In recent weeks, we’ve:
- Put AHRQ back in the headlines by analyzing grant funding trends, which revealed a concerning halt in awards since April. Our work has already prompted congressional questions and media coverage.
- Led advocacy to protect the independence of the USPSTF by mobilizing over 100 organizations in a congressional letter and working with Sen. Angus King on a Senate resolution.
- Driven national visibility of the importance of our field in STAT News, Politico, the Washington Post, NPR, CNN, USA Today, and others.
- Filed suit alongside partners to restore erased federal health data.
In the weeks ahead, we’ll continue featuring member stories to put a human face on these debates and we’re still collecting more. If you’d like to share your experience, you can do so here.
Your voices remind us why this community matters, and they strengthen our ability to defend evidence-based research when it matters most.
As NIH Research Funding Remains Frozen, Patients Bear the Cost
The Association of American Medical Colleges (AAMC) reports that billions of dollars congressionally appropriated to the NIH remain unavailable for research, despite the legal requirement for the executive branch to award all funds as Congress has appropriated by September 30. The analysis reveals that the NIH committed nearly $5 billion less in research grants to US institutions in the past year than the previous one, caused by disruptions and slowdowns in the processes for awarding federal grants. However, the true shortfall in NIH funding is likely far greater, due to the thousands of grants terminated mid-project, frozen funds, and the inability of some institutions to draw down obligated funds.
These significant funding disruptions are incredibly serious for the patients and families who rely on research innovations at US institutions for treatment. Indeed, patient numbers at the NIH Clinical Center, a renowned research hospital caring for patients with rare or life-threatening diseases, have fallen drastically during the February-April timeframe where there were mass firings at HHS, gutting of research projects, and a broad crackdown on immigration. A NIH cancer scientist noted that the number of cancer clinical trial participants at the hospital in July was down 20 percent from last year, while current and former employees say that the departure of clinicians, scientists, and other staff due to firings, cancellation of grants, and lowered morale has limited how many patients can be treated. A former clinician also noted that the immigration crackdown has made international patients “terrified to come.” Around 600 patients in 2024 were from abroad.
While researchers have been feeling the impacts of these dynamics for months, the effects of these policies on patients and the care they do or do not receive are starting to show. Health services researchers must continue to shine a spotlight on the real-world impacts of these cuts to research and science and share these with policymakers working to ensure congressionally appropriated funds are spent accordingly.
Federal MAHA Report Stops Short of State-Level Measures
The “Make America Healthy Again” (MAHA) movement, championed by Health Secretary Robert F. Kennedy Jr. has been actively gaining momentum at the state level. A recent Politico analysis found that state legislatures this year have introduced nearly 900 measures echoing elements of MAHA agenda, including 130 bills aimed at regulating ultra-processed foods and improving nutrition and over 60 bills seeking to restrict the application of pesticides and other chemicals. Notably, lawmakers across both sides of the aisle have supported these measures, with Democrat-led states like New York and Massachusetts introducing more than two dozen proposals to limit ultra-processed foods.
A recently obtained draft of the forthcoming MAHA report detailing recommendations to curb childhood chronic disease indicates a more tempered approach at the federal level. While the report is not yet publicly released, details reported by the New York Times suggest that the report steers clear of specific policy recommendations and instead calls for more research. Specifically, if left unchanged, the report does not propose recommended restrictions on chemical pesticides or ultra-processed foods.
While the final report is yet to be released, the seeming divergence between state-level legislative action and federal recommendations highlight the complex dynamics of public health policy in the U.S. This complexity is underscored by Senate appropriators’ recent decision to not fulfill the Administration’s broader budget requests for HHS, including funding for the proposed reorganized Administration for a Healthy America. Amid this evolving health policy landscape, health services researchers play a critical role in evaluating the effectiveness of state-level initiatives, identifying best practices, and advocating for sustained investment in public health infrastructure. This work is essential to ensure that success gained at the state level translates into comprehensive, evidence-based federal policies to address the nation's public health challenges.
Internal Tensions Surface as GOP Weighs Medicaid Cuts
House Republicans are holding staff-level discussions on potential health policy changes that could be included in a second budget reconciliation bill later this year. Republican Study Committee (RSC) composed of 189 house members is a multitude of topics, including the enhanced tax credits for ACA health insurance premiums that are due to expire at the end of 2025, the 340B drug discount program, and possible Medicare funding considerations. A source with direct knowledge of these early conversations noted that spending offsets are drastically limited and both Medicaid and Medicare likely to emerge as targets to reduce funding. However, Senate Republicans are skeptical of support to pass a second reconciliation package, with some warning there would be significant pushback to pursue deeper Medicaid cuts, especially with the budget deadline looming at the end of September.
CBO Report Warns of Medicare Cuts
A 2010 law requires automatic cuts to several federal programs if legislation increases the federal deficit. Since the Trump administration’s tax and spending law is expected to add $3.4 trillion to the federal deficit over the next decade, Medicare and other safety net programs could be at risk of extreme cuts if Congress does not act to mitigate the impacts. Trump and Republicans vowed to not cut Medicare through their legislation; it is a program that millions of Americans rely on. From 2027 to 2034, however, the CBO estimates the program could lose as much as $491 billion if left unprotected.
Health services researchers continue to serve a vital function in understanding the impacts of the Trump’s administration legislation. As evidenced by the potential indirect impact of the H.R. 1 bill on Medicare, there is still work to be done.
HHS Revives Dormant Child Vaccine Safety Panel
HHS has reinstated the Task Force on Safer Childhood Vaccines, which was disbanded after its last report on 1998. Working closely with the Advisory Commission on Childhood Vaccines, this group is tasked with making recommendations on the development, distribution, and safety monitoring of vaccines, with an emphasis reducing serious adverse reactions. While additional members are to be announced, the NIH Director, CDC Director, and FDA Commissioner will all be included. According to the announcement, this task force will submit a report to Congress within two years and provide update every two years thereafter. Critics express concern that reinstating this panel may implies existing safety monitoring for childhood vaccines in insufficient, potentially eroding public trust in immunization. There are also concerns that this could be an additional forum to be disproportionated populated with a bias against vaccines. These developments underscore the critical role of health services researchers in generating robust, evidence-based data and effectively communicating findings to policymakers and the public to maintain and enhance trust in immunization programs.
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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