In this edition of AcademyHealth's Situation Report, we highlight developments affecting federal health and research infrastructure—including the recent cancellation of a U.S. Preventive Services Task Force (USPSTF) meeting and the ongoing government shutdown—and how AcademyHealth is engaging to uphold the integrity of evidence-based policymaking.
In today’s issue:
- AcademyHealth Leads Push to Protect the USPSTF
- Continued Congressional Deadlock Extends Federal Shutdown
- Federal Guidance Undermines State Medical Debt Protections
- CMS Faces Staffing Shortage Amid Medicare Open Enrollment
- Changing NIH Grant Title Requirements Threaten Future Directions of the Field
- Federal Vaccine Guidance Disrupted as ACIP Support Team Gets Laid Off
- Judge Indefinitely Barrs Federal Layoffs During Shutdown
AcademyHealth Leads Push to Protect the USPSTF
On Wednesday, the Department of Health and Human Services announced that the November meeting of the U.S. Preventive Services Task Force (USPSTF) was cancelled, citing the government shutdown. This 16-member expert panel that is responsible for making recommendations for preventative services that health insurers must cover at no cost to enrollees under the Affordable Care Act has not met since March.
This cancellation comes months after Secretary Robert F. Kennedy Jr. canceled the July meeting. Earlier this year, the Secretary of Health and Human Services removed members of other advisory bodies, specifically the CDC’s Advisory Committee on Immunization Practice, raising concerns across the research community about continuity of expert input. In response to concerns about preserving the USPSTF’s independence and continuity, AcademyHealth and the Friends of AHRQ acted quickly in response crafting a letter signed by over 100 organizations urging Congress to protect the current structure of the Task Force, emphasizing its scientific independence, transparency, and nonpartisan approach to issuing evidence-based preventive care recommendations.
In wake of the cancellation of the November meeting, AcademyHealth is mobilizing again and elevating this issue in national media. See below for a sampling of AcademyHealth-initiated media coverage:
- Axios: Obamacare coverage panel meeting postponed by shutdown
- The Hill: HHS again postpones meeting of preventive services coverage panel
- MedPage Today: HHS Nixes Another USPSTF Meeting
- National Journal: Meeting Cancellation Sparks Fears about HHS Advisory Panel
- Inside Health Policy: HHS Postpones November USPSTF Meeting, Blames Govt Shutdown
Our ability to respond swiftly and credibly reflects our unique position at the intersection of research, policy, and public discourse. When the evidence base is under threat, AcademyHealth serves as a trusted voice—amplifying the concerns of the research community and championing the role of science in decision-making.
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Continued Congressional Deadlock Extends Federal Shutdown
As the federal government shutdown reaches day 30, the American Federation of Government Employees (AFGE), the nation’s largest union representing federal workers, pressured Democrats to consider Republican measures to end the shutdown. The Republican-proposed stopgap measure would pay all federal government workers—essential and furloughed—but would require the Democrats to abandon their position on extending the Affordable Care Act (ACA) tax subsidies before the government reopens. AFGE saw “no clear end in sight,” prompting the organization to urge Congress to immediately reopen the federal government under a continuing resolution (CR) so the parties could debate larger issues as all federal workers are paid. Despite the pressure from AFGE, Democrats largely remain committed to their position, citing support from their constituents and other interest groups. Democrats are also considering legislation that would fund the Supplemental Nutrition Assistance Program (SNAP) and extend funding for the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC). However, Vice President J.D. Vance reportedly urged Senate Republicans to keep pressure on Senate Democrats by not allowing votes on legislation that would provide partial relief, such as funding SNAP or paying air traffic controllers during the shutdown. These bills would also require House Speaker Mike Johnson to reconvene the House to vote on the bills, something he has been against. With the Democrats brushing off heat from AFGE, there appears to be no clear path out of the nation’s second-longest government shutdown.
Federal Guidance Undermines State Medical Debt Protections
New federal guidance asserting that only the federal government can regulate how medical debt appears on credit reports could weaken or stall dozens of state-level consumer protections. With roughly 100 million Americans carrying some level of health care debt, the change has major implications for access to housing, employment, and financial stability.
Amid these challenges, AcademyHealth is working to better understand and address the impact of medical debt. Our Advancing Trust: A Focus on Medical Debt project funded by the ABIM Foundation focuses on the critical intersection of medical debt and trust in health care. Building on a three-and-a-half year project with ABIM focused on trust, this new initiative launched in 2025 explores system and system innovations that can protect consumers. Additionally, AcademyHealth leads the Enhancing Systems of Care for Children with Medical Complexity Coordinating Center which has underscored the financial toxicity experienced by families of children with medical complexity (CMC).
For health services researchers, this development reinforces the importance of examining how financial and policy environments can shape social determinants of health.
CMS Faces Staffing Shortage Amid Medicare Open Enrollment
Staffing shortages at the Centers for Medicare and Medicaid Services (CMS), first caused by mass cuts earlier this year by Health and Human Services Secretary Robert F. Kenney Jr. and now exacerbated by the continuing government shutdown, are causing alarm as open enrollment for Medicare plans began earlier this month. Open enrollment runs from October 15 to December 7 this year and allows people 65 years old and older to make changes to their Medicare plans. Health policy experts warn that the current CMS infrastructure does not allow Medicare benefits to be delivered and communicated well. Weeks after placing 47 percent of their workers on furlough earlier this month, CMS called furloughed workers back to work last week for this year’s open enrollment season. While applying and navigating Medicare has always been an onerous task, this year will be particularly challenging given premiums are expected to spike in 2026. Health policy experts emphasize that more staffing is needed to help people navigate coverage and to improve benefit design and add that the oversight and management of benefit delivery are irreplaceable by computers.
Health services researchers should remain poised to monitor staffing shortages across the health field and their impact on health as they relate to Medicare and people aged 65 and older as well as to other programs and populations more broadly.
Changing NIH Grant Title Requirements Threaten Future Directions of the Field
Recent changes in grant title requirements at the National Institutes of Health (NIH) exemplify the complex relationship between changing administrative processes and scientific research, particularly with regard to health disparities research and, consequentially, the field of health services research. Researchers on over 700 multiyear grants have changed their grant titles, often removing terms like "equity" and "disparities," to align with changing guidelines from the current administration, according to Jeremy Berg’s analysis on NIH reported data. Researchers have expressed concern that the implications of these title changes extend far beyond mere name changes as they could fundamentally change the direction and focus of research projects. Monitoring of language used by scientists is not unprecedented, as researchers examining AIDS were asked to avoid certain language during the George W. Bush administration.
This dynamic poses challenges for health services researchers, who must navigate the balance between securing necessary funding and maintaining the integrity and focus of their work. The required language changes can impact the overall morale within the field and may lead to a shift in research priorities, potentially affecting the scope and impact of health services research. As NIH grant proposals undergo reviews by different stakeholders, health services researchers can advocate for clarity and consistency in communication from NIH leaders to ensure that scientific objectives relating to health services remain the primary focus. Researchers who wish to continue their research under different names can continue to move the needle while others may opt to look for research outside of federal funding or shift their research focus altogether to avoid backlash. Regardless of the decisions of individual researchers, it is important that the field come together to identify creative ways to continue critical research shaping effective policies and practices to improve health outcomes across all populations in an evidence-based and objective manner.
Federal Vaccine Guidance Disrupted as ACIP Support Team Gets Laid Off
The consequences of the CDC layoffs earlier this month, which dismantled the entire support team for the Advisory Committee on Immunization Practices (ACIP), are beginning to reverberate across the nation’s vaccine policy infrastructure. While the ACIP consists of independent advisers, the CDC support staff provide logistical support and subject matter expertise while also ensuring that the committee is complying with rules and regulations. With this department of support staff now gone and the Oct 22nd-23rd ACIP meeting indefinitely postponed, uncertainty remains whether the U.S. government will be able to make routine vaccine recommendations for children in 2026. A former director for the National Center for Immunization and Respiratory Diseases noted that in the most recent ACIP meetings, the lack of logistical support was evident, citing missing presentations, broken zoom links and microphones, and a lack of distributing language of the votes to the public or the advisers ahead of the meeting.
Beyond the main committee, the ACIP’s working groups—often composed of subject experts, local health department officials, and representatives from medical groups—have also been impacted. While there are typically eight to ten working groups each focused on specific pathogens, most of these groups have not met in at least 6 months. The lack of logistical support to maintain this crucial work is an increasingly difficult barrier to overcome now that the entire HR department for the CDC is also gone, and their role was to bring on special government employees and new federal advisory committee act members. For health services researchers and those interested in vaccine policy, these developments underscore the critical role of strong institutional capacity within federal health agencies. When these foundations are weakened, it becomes necessary to seek guidance from other trusted sources, such as the independently formed Vaccine Integrity Project.
For researchers studying vaccine policy and health systems performance, these disruptions highlight the importance of strong, resilient public health infrastructure grounded in transparent, evidence-based processes.
Judge Indefinitely Barrs Federal Layoffs During Shutdown
On Tuesday, a federal judge extended an order blocking the government from firing federal employees during the ongoing government shutdown. The ruling came after several federal employee unions, including the American Federation of Government Employees, filed suit arguing that the administration's plan to issue mass layoff notices during a funding lapse was unlawful. In the decision to indefinitely extend the order, the judge cited that labor unions were likely to prevail on their claims that the cuts were politically motivated and arbitrary. Legal officials representing the government assert that the district court does not have the authority to hear personnel challenges and that the President has broad authority to reduce the federal workforce. While this does not apply to RIFs that were sent right before the shutdown, this decision is essential to retain the federal health workforce and protect the institutional capacity of key federal health agencies.
Previous Editions
This is the latest in a series of Situation Report updates from AcademyHealth. You can find prior issues here.
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