In this edition of AcademyHealth’s Situation Report, we highlight a recent commentary from AcademyHealth leaders about safeguarding science. We also review significant, ongoing changes in federal health policy, including rising Medicare Part B premiums, negotiations over the future of ACA tax credits, and proposed changes to Medicare Advantage. Finally, we highlight rising concerns about whether federal agency staff raising critical research questions may face career consequences.
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In today’s issue:
- Safeguarding Science: AcademyHealth Leaders Highlight Emerging Risks
- Republicans Open to Extending ACA Tax Credits, Possibly with Strings Attached
- Closing the Vaccine Delivery Gap: A Call to Industry and Philanthropy
- Medicare Beneficiaries Face Premiums Increases and Related Impacts
- Medicare Advantage Plans Expected to see Major Changes
- AcademyHealth Advocacy is Making a Difference
- NIH Suspends Outspoken Program Officer, Suggesting Trend of Removing Critics
Safeguarding Science: AcademyHealth Leaders Highlight Emerging Risks
In a new JAMA Pediatrics commentary, AcademyHealth’s Chief Programs & Science Officer Elizabeth Cope and President and CEO Aaron Carroll describe recent developments that pose significant challenges to scientific integrity — including politically driven grant terminations, the removal of public health datasets, the sidelining of experts, and the spread of disinformation. They outline how these actions, combined with longstanding vulnerabilities in the research ecosystem, risk undermining evidence-based policymaking, public health, and trust in science.
Cope and Carroll also point to the growing response from universities, associations, and organizations — including AcademyHealth — working to restore terminated research, defend data access, and strengthen public understanding of science. Their piece emphasizes that supporting evidence requires visible, sustained engagement from across the research community.
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Republicans Open to Extending ACA Tax Credits, Possibly with Strings Attached
The Trump administration is “willing to look at all options” when it comes to extending the Affordable Care Act (ACA) tax credits, said Center for Medicaid and Medicare Services (CMS) administrator, Dr. Mehmet Oz. According to Dr. Oz, the administration is open to extending subsidies in a way that also addresses “fraud, waste, and abuse.” House Democrats introduced a discharge petition to force debate on a three-year extension of the ACA tax credits, while House and Senate Republicans have aired a one-year extension with various strings attached. At least 14 Republican members in the House are open to a one-year extension, but it is unclear whether Republicans will break with House Speaker Mike Johnson to support the GOP-led one-year extension or the Democrats’ proposed three-year extension. Even if an extension includes certain changes, insurers, states, and experts warn that those changes come too late. Implementing specific changes, such as an income eligibility cap or minimum monthly premium payment requirements, would be “impossible.” It is uncertain whether a bill with such changes would even make it to the President’s desk; Speaker Johnson stated that, even if a deal addresses alleged fraud, most of the Senate Republican Conference is opposed to extending the tax credits. If the tax credits are not extended into 2026, millions of people could lose health care or see their premiums double.
Closing the Vaccine Delivery Gap: A Call to Industry and Philanthropy
Recent attacks on public health infrastructure—from cuts to NIH and AHRQ funding to the politicization of vaccine advisory committees—threaten the “last mile” of vaccine delivery. As AcademyHealth Chief Programs & Science Officer Elizabeth Cope highlights in this blog post, vaccines are only a public health success when they reach every arm. Vulnerable populations face missed vaccinations due to system failures, logistical barriers, and inequities.
Cope urges private industry and philanthropy to step in. Pharmaceutical companies can fund independent academic research and shared infrastructure, while foundations can provide long-term, risk-tolerant funding for high-risk equity research and workforce development in implementation science. In a climate of shrinking public support and rising anti-science policies, these collaborative investments are essential to translate breakthroughs into equitable, real-world protection for all.
As debates over federal health research budgets intensify, closing the vaccine delivery gap is not just a moral imperative, it is critical to national preparedness and health equity.
Medicare Beneficiaries Face Premiums Increases and Related Impacts
Medicare Beneficiaries are facing an 18-dollar, or about a 10 percent increase in their Medicare Part B premiums this year compared to last year. These premiums cover several types of routine outpatient care such as same-day hospital care and intravenous and injectable drugs and have gone up substantially over the past 10 years due to increases in demand following the COVID-19 pandemic and changing policies associated with new drugs. Actuaries from Medicare point to higher costs related to running Medicare Advantage, Medicare’s privately insured portion, to explain the higher premiums. Many additional older adults may consider switching to Medicare Advantage plans that offer 0-dollar premiums, which could in turn lead to even further increases given Medicare Advantage’s higher costs of operation.
Health services researchers, particularly health economists, can fill a crucial need in monitoring the consequences of higher Medicare premiums on beneficiaries’ health, finances, and coverage decisions.
Medicare Advantage Plans Expected to see Major Changes
Medicare experts and researchers anticipate that the Trump administration will be announcing changes to the Medicare Advantage program amidst ongoing criticism of its expense to the federal government. Indeed, CMS administrator Mehmet Oz described CMS as “upside down” and suggested changes to how the federal government regulates and pays Medicare plans. Any changes would become public in the suggested 2027 Medicare Advantage rule, which could come out as early as the end of 2025. CMS has previously announced an “aggressive” strategy that would expand audits of diagnoses within the program along with pilot programs that would change how the government pays insurers. Experts also anticipate modifications to the star rating system, which evaluates the quality of Medicare Advantage plans and determines bonus payments.
Currently, several Medicare Advantage plans that run privately do not charge monthly premiums. Moreover, many offer supplemental benefits such as assistance for over-the-counter drugs and dental coverage, which are not covered by traditional Medicare. Humana, Aetna, and UnitedHealthcare cover over 20 million older adults and, as such, are the largest Medicaid Advantage insurers. Privately run Medicare programs were originally created based on the assumption that care would be better managed and less costly when managed by private insurers rather than the federal government. The program has come under criticism, however, as some claim that insurers have attempted to get higher payments after claiming that some patients were sicker than they were.
While insurers claim that the statistic is skewed, Congressional advisors have claimed that Medicare Advantage enrollees would cost the federal government $84 billion more than traditional Medicare enrollees. Dr. Oz has been a proponent of Medicare Advantage, suggesting policies that offer “MA for All”. After leading CMS, however, Dr. Oz has become increasingly critical of the program amidst rising questions regarding the cost of the program from GOP policymakers. During the industry lobby’s conference in October, Dr. Oz further stated that he joined to “celebrate what you’re trying to do but also be honest about some of the issues that we’re seeing at CMS.” Catherine Howden, CMS’ director of media relations, also commented the program’s responsibility to maintain “program payments fair, transparent, and grounded in data.” Despite a favorable $25 billion increase in federal payments announced for 2026, there is skepticism about discourse surrounding Medicare Advantage will translate into significant policy changes, which might become more evident before midterm elections.
Health services researchers who work with Medicare can translate their findings to policymakers to ensure they are receiving reliable and evidence-based statistics to make informed decisions about the future of Medicare.
AcademyHealth Advocacy is Making a Difference
In the most challenging environment for health and science policy in recent memory, AcademyHealth has kept health services research funding top of mind, forced action where it had stalled, and delivered concrete wins for our members. In our latest blog post, we outline the actions AcademyHealth has taken from challenging funding impoundments and defending the USPSTF to supporting evidence-informed Medicaid policy. With limited resources, our team has kept the field informed and engaged while delivering tangible results.
This month, if you appreciate our work to defend the field and have the means to do so, we encourage you to support AcademyHealth’s Giving Tuesday campaign. Any amount helps. You can also support us by sharing our campaign with your network using this toolkit.
NIH Suspends Outspoken Program Officer, Suggesting Trend of Removing Critics
An outspoken program official, Jenna Norton, at the National Institute of Diabetes and Digestive and Kidney Disease (NIDDK) was abruptly placed on administrative leave without official explanation, raising concerns about whether staff raising critical research questions may face career consequences.
Norton had been vocal about recent changes within NIH, notably asking at the first agency town hall why grants measuring redlining’s impact on health were terminated despite NIH Director Bhattacharya calling this work “a legitimate kind of study.” She was also one of the organizers of the “Bethesda Declaration,” a letter of protest signed by over 300 agency staffers. Norton’s portfolio was focused on health disparities research, which has been thrown into disarray through targeted grant terminations, changes to language researchers can use in grant applications, and uncertainty about future funding opportunities.
Two leaders at NIH were also recently placed on administrative leave after expressing concerns over the agency’s termination of grants and increasing involvement by political appointees – one resigned, and one was fired. Norton’s placement on leave suggests a concerning trend of vocal critics of the administration’s changes at NIH being targeted for termination.
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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