
In this edition of the Situation Report, we examine the NIH’s directive to re-evaluate all planned research projects, the stalled launch of the Make America Healthy Again (MAHA) agency due to congressional inaction and legal pushback, and the American Academy of Pediatrics’ decision to break from federal COVID-19 vaccine guidance. These developments signal growing instability in the federal health policy landscape, with direct consequences for research funding, scientific direction, and public trust. AcademyHealth is actively working to inform policymakers, elevate the voices of affected researchers, and track shifting agency priorities.
In today’s issue:
- New MAHA Agency Faces Inactivity by Congress, Judicial Roadblocks
- NIH Unveils New Research Strategy, Orders Review of All Planned Research
- Pediatricians Split with Federal Policy on Child Vaccines
- States Enhance Support for LGBTQ+ Youth Amid 988 Hotline Changes
New MAHA Agency Faces Inactivity by Congress, Judicial Roadblocks
Despite HHS Secretary RFK Jr.’s plans to fully restructure HHS, which he announced in March, Congress has yet to take the necessary steps to develop the “Make America Healthy Again” agency. The White House’s fiscal 2026 budget request calls for $14.1 billion to be set aside in discretionary funding to establish the new agency; however, as of writing, neither the Senate’s bipartisan Labor-HHS-Education spending bill nor the House and Senate’s respective Interior funding bills appropriate any money for the new agency. Similarly, lawmakers who are members of the Make America Healthy Again Caucus have not introduced legislation to speed up the process of creating the new agency that shares their caucus’ name.
The Trump Administration’s proposed restructuring of HHS faces ongoing litigation, during which the District Court in Rhode Island temporarily blocked HHS’ reorganization efforts, stating that the Executive Branch lacks the authority to implement “wholesale changes to the structure and function of the agencies created by Congress.” Though both Congress and the Trump Administration have avenues for establishing a new agency, creating the “Make America Health Again” agency would require transferring statutory duties; in cases like this, Congress typically steps in. Ultimately, there are narrow workarounds that the Trump Administration could use to further their priorities without creating a new agency, but most experts agree that Congress will eventually have to formally weigh in, and that the case around the reorganization could still go to the Supreme Court. The reorganization and refocusing of HHS on certain priorities has direct impacts for health services researchers, many who have already had important projects halted or been reassigned. Researchers should continue to share their stories with federal policymakers in light of the critical role Congress will play in this decision.
NIH Unveils New Research Strategy, Orders Review of All Planned Research
Dr. Jay Bhattacharya, the director of the US National Institutes of Health (NIH), revealed a strategy statement on Friday that he said was meant to clarify the Institute’s priorities following major changes at the agency in recent months. In the statement, Dr. Bhattacharya names specific issues, such as autism, nutrition, HIV/AIDS, racial disparities, and transgender care, as topics that require additional guidance. More specifically, the guidance outlines the NIH’s intention to promote “more promising avenues of research” in transgender care, which the statement stipulates includes researching harms of therapies and procedures related to transgender care, as well as prioritizing domestic and replicable research. Moreover, Dr. Bhattacharya identified artificial intelligence as a key priority for NIH as well as pursuing “innovative, and sometimes controversial, questions.”
Furthermore, Dr. Bhattacharya directed NIH employees to review all current and planned research activities on an individual basis. Should projects reviewed not align with the strategy NIH has put forth, they could be terminated or otherwise paused, changed, or discontinued. This order adds to the growing concern that NIH’s allocated grant money will return to the US Treasury in the case that the NIH does not distribute it before the end of next month.
Health services researchers should prepare for additional scrutiny of NIH grants and the possibility of changes or discontinuations.
Pediatricians Split with Federal Policy on Child Vaccines
In a notable divergence from federal policy, the American Academy of Pediatrics (AAP) has issued its own immunization guidance for the upcoming respiratory virus season, explicitly recommending COVID-19 vaccination for all children aged six to 23 months and for older children at high risk. This guidance differs from the FDA’s recent framework that shifts away from universal access and limits COVID-19 vaccines to those 65 and older and others at high risk of serious illness. In May, the FDA also stated it will require manufactures to demonstrate vaccines benefit healthy younger adults and children through clinical trials. Simultaneously, a JAMA research letter revealed that financial conflicts of interest among members of the CDC’s Advisory Committee on Immunization Practices (ACIP) and the FDA’s Vaccines and Related Biological Products Advisory Committee (VRBPAC) have dropped to historic lows. Such evidence counters Health Secretary Robert F. Kennedy Jr.’s which Secretary Kennedy Jr. had cited in his decision to disband ACIP.
For researchers, these dynamics reflect the intersection of evidence and policymaking. The AAP’s commitment to offering evidence-based guidance may impact parental trust, vaccine uptake, and child health outcomes. Along with the data about conflicts of interests, these developments underscore the importance of transparency and credibility in health care decision-making to ensure evidence is backing policy and practice.
States Enhance Support for LGBTQ+ Youth Amid 988 Hotline Changes
Following the July 17th discontinuation of the "Press 3" option from the national 988 Suicide & Crisis Lifeline—which provided tailored support for LGBTQIA+ youth—states such as California, Colorado, Illinois, and Nevada are actively addressing the resulting service gap. California has partnered with The Trevor Project to train crisis counselors specifically on LGBTQIA+ youth issues, facilitated by a $700,000 contract announced by Governor Gavin Newsom's office. In Colorado, the director of the 988 hotline, Gordon Coombes, has reported enhanced training for call-takers while considering a fee increase on cellphone lines to improve funding. Nevada’s state health department spokesperson, Daniel Vezmar, has outlined plans to train all crisis counselors on supporting LGBTQ+ callers, supported by a $50 million investment in a new call center in July. In Illinois, the Department of Human Services is promoting affirming imagery and enhancing counselor training, supported by an increased telecommunications tax.
Bipartisan opposition to the end of the LGBTQIA+ service has emerged at the federal level. In a move advocating for its restoration, Republican Representatives Mike Lawler and Young Kim, along with Democratic colleagues, have urged Health and Human Services Secretary Robert F. Kennedy Jr. to reverse the decision. The National Alliance on Mental Illness has suggested both federal and state-level funding solutions, drawing on Washington state's example of the "Press 4" option for Indigenous populations. For researchers, these state-level responses offer opportunities to study crisis line capacity, funding mechanisms, and the impact of tailored services on youth mental health outcomes.
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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