In this edition of AcademyHealth’s Situation Report, we spotlight the growing role of the courts in stabilizing key elements of the U.S. health system amid ongoing policy uncertainty. A series of recent judicial rulings have preserved or temporarily protected critical streams of health funding and patient-centered programs, underscoring how legal decisions are shaping near-term access to care, research infrastructure, and public health capacity. We also cover mounting erosion of the U.S. Preventive Services Task Force and AcademyHealth efforts to safeguard the agency, congressional scrutiny of rising insurance premiums following the expiration of ACA subsidies, legislative efforts to revive those subsidies, and temporary financial relief for Medicaid providers ahead of looming budget cliffs. Together, these developments highlight the urgent need for health services research and evidence to inform policymakers, courts, and the public during a period of significant flux.
In this issue:
- AcademyHealth Defends USPSTF as NYT Details Erosion of Task Force Work
- Congress Moves to Stabilize Federal Science Funding
- Lawmakers to Question Health Insurers on Rising Premiums
- House Advances ACA Subsidy Extension to Senate, Trump Floats Veto
- Medicaid Providers Receive Temporary Financial Boost Before Imminent Budget Reductions
- Recent Court Decisions Influence Health Funding & Care Access
AcademyHealth Defends USPSTF as NYT Details Erosion of Task Force Work
The New York Times reported last week that the U.S. Preventive Services Task Force (USPSTF) — the independent panel whose evidence-based recommendations determine which preventive services must be covered without cost-sharing — has seen its work increasingly stalled under HHS, with canceled meetings, delayed recommendations, and five of its 16 members rolling off on January 1 without replacement. AcademyHealth President and CEO Dr. Aaron Carroll emphasized the real-world stakes in the story, noting that access to free mammograms, colonoscopies, and HIV screenings exists because of the USPSTF’s work. The article also highlighted AcademyHealth’s leadership of a July letter signed by more than 100 organizations urging Congress to protect the Task Force’s scientific independence, reinforcing the growing concern that continued disruption threatens evidence-based policymaking, public trust, and patient care nationwide. “If you’ve ever gotten a free mammogram or a free colonoscopy or a free HIV screening, it’s because of the USPSTF,” said Carroll in the article. Disrupting this work threatens evidence-based preventive care nationwide.
Congress Moves to Stabilize Federal Science Funding
Recent bipartisan action in Congress signals a renewed commitment to maintaining federal investments in scientific research, despite earlier proposals for steep funding reductions. Lawmakers are advancing appropriations bills that would largely preserve, and in some cases modestly increase, support for basic research across federal agencies, helping avoid major disruptions to the research ecosystem.
If enacted, the congressional package would sustain funding levels close to recent years and protect core research infrastructure that underpins health, innovation, and economic competitiveness. Analysts note that investments in basic research, often the foundation for advances in health care delivery, population health, and data-driven decision-making, may even see slight growth.
For the health services research community, this moment underscores the importance of steady, predictable federal funding to support long-term studies, interdisciplinary teams, and the translation of evidence into practice and policy. While challenges remain, congressional action reinforces the role of research as a public good and a cornerstone of a stable, evidence-informed health system.
Lawmakers to Question Health Insurers on Rising Premiums
As part of a series of hearings focused on health care affordability, House Republicans asked health insurance executives from five top companies to testify on January 22. The summon comes just over a week after Affordable Care Act (ACA) subsidies expired, which caused significant out-of-pocked cost increases for tens of millions of Americans on ACA plans.
Democrats have been homed in on health care affordability, particularly ACA subsidies expiring, as evidence that Republicans are not concerned with affordability for middle- and low-income Americans. Trump has encouraged House Republicans to focus on health care to increase political stronghold.
Health policy experts on both sides of the aisle are skeptical of Trump’s plan to pressure health insurers to lower prices. They note that in the absence of extended federal subsidies for ACA enrollees, the only way to significantly lower costs would be to lower the rates that hospitals and providers are charging. This is a process that many agree is complex and would take time. Health services researchers, particularly health economists, should continue to monitor policy and debate related to health care costs in the coming weeks as health insurers testify.
House Advances ACA Subsidy Extension to Senate, Trump Floats Veto
The House has approved a three-year renewal of enhanced Affordable Care Act (ACA) premium subsidies with a 230-196 vote. The proposed bill is expected to cost $80 billion in the next ten years, according to an estimate by the nonpartisan Congressional Budget Office. The fact that the proposal was revisited following extensive negotiations and the longest government shutdown in history demonstrates increasing concern regarding rising health care costs amongst Republicans. The bill will now move to the Senate, with policymakers expecting a compromise bill as early as next week. While several representatives are optimistic about arriving at an agreement in the near future, some Republicans are insisting on including abortion restrictions, income limits, and no zero-dollar premiums. President Trump, however, claims that he may veto any proposal that extends ACA subsidies if it does reach his desk.
Health service researchers can take advantage of the current moment and communicate their research findings and implications for health care affordability with Republican policymakers as the issue becomes increasingly important to their constituents.
Medicaid Providers Receive Temporary Financial Boost Before Imminent Budget Reductions
According to a recent STAT article, the Centers for Medicare & Medicaid Services (CMS) approved more than 100 state-directed payment (SDP) programs between late July and November 2025. This effectively authorized approximately $60 billion in supplemental Medicaid funds for Medicaid providers. Known as state directed payment programs, these funds allow states to lock in Medicaid payment rates that are closer to those paid by commercial insurers. While these approvals preserve higher reimbursement levels, the funds are slated to dissipate in 2028 under the tax and budget reconciliation bill that was passed in July 2025. The timing of these approvals could temporarily shield provider revenues, but they also raise significant concerns about long-term fiscal sustainability and potential disruptions to provider participation once the enhance payments phase down in a few years. For health services researchers, these approvals provide an opportunity to measure elevated payment effects on care access & quality as well as a challenge to identify necessary guardrails and strategies to avert an access cliff in 2028 when funds expire.
Recent Court Decisions Influence Health Funding & Care Access
A series of recent judicial rulings have preserved or temporarily protected key streams of health funding and patient-centered programs, reinforcing the courts’ growing role as a stabilizing force amid policy and administrative uncertainty. Together, these decisions help maintain continuity in research, workforce capacity, and patient care, and preventing sudden disruptions that could ripple across the health system.
- Preserves NIH Indirect Cost Funding: Federal appeals court judges upheld a ruling blocking the NIH from cutting indirect cost reimbursements, which support essential research infrastructure such as labs, compliance, data systems, and administrative capacity at universities and medical centers. Protecting these funds is critical to sustaining the nation’s health research enterprise, ensuring institutions can continue conducting federally funded research, training the next generation of scientists, and translating evidence into improved care. It remains unclear whether the administration will petition the Supreme Court to hear the case, but for now, the decision provides much-needed stability for research institutions already operating under significant financial pressure.
- HHS to Restore Pediatric Funding: A federal judge granted a preliminary injunction requiring HHS to restore $12 million in funding to the American Academy of Pediatrics (AAP), reinstating seven terminated grants. These programs support core health system functions, including strengthening pediatric care in rural communities, preventing sudden unexpected infant death, and improving early identification of developmental disabilities. The court found evidence suggesting the funding cuts may have been retaliatory, underscoring broader concerns about the politicization of health funding decisions. Restoring these grants helps protect vulnerable populations while maintaining trusted delivery channels for evidence-based pediatric care.
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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