In this issue of AcademyHealth's Situation Report, we highlight mass layoffs at HHS as the government shutdown continues, further confusion around vaccine guidance and patient safety, and declining public trust in the CDC.

In this issue of AcademyHealth’s Situation Report, we new challenges to scientific integrity and public health leadership as former top officials express concern about vaccine policy changes and agency cuts, while the Supreme Court considers a case with implications for LGBTQ+ youth mental health and health equity.

In this issue of AcademyHealth’s Situation Report, we examine growing financial and operational strain on health systems due to Medicaid cuts, shifting vaccine policies that are complicating pediatric care, and new questions about federal public health leadership. These developments have significant implications for access, equity, and the stability of health systems and care delivery nationwide.

In this issue of AcademyHealth’s Situation Report, we examine a historic exodus of federal health experts and widespread furloughs are crippling key agencies like the FDA and CDC, while disappearing CDC webpages and the expiration of Medicare-funded care programs raise urgent concerns about public health access, transparency, and research continuity.

In this issue of AcademyHealth's Situation Report, we examine ongoing shutdown negotiations affecting ACA subsidies and Medicaid work requirements, as well as AHRQ’s new research strategy and its implications for health equity and implementation science.