Experts and Senators Warn of AHRQ Collapse Under Trump Administration

The federal agency tasked with studying ways to improve America’s outstandingly poor healthcare system is “on the brink,” experts warn. The Trump administration has cut its staff by 75 percent, canceled its grants en masse, and is refusing to spend tens of millions of dollars appropriated by Congress.

Whether the agency “will survive the second Trump administration is an open question,” health policy experts Aaron Carroll and David Atkins wrote in an opinion piece published today in the Annals of Internal Medicine.

The agency in question is the Agency for Healthcare Research and Quality (AHRQ), which has focused on ways to improve patient safety, healthcare quality, care delivery, and new technologies and practices since the 1990s. In the past, “Republican leaders recognized that health care disparities were fundamental quality problems,” Carroll and Atkins wrote. But recently, disparities in care have become partisan issues.

During Trump’s second term, DOGE cuts led to the firing or retirement of an estimated 75 percent of the AHRQ’s staff. In July, AHRQ abruptly sent grant cancellation letters to around 150 researchers. More than 100 research grants collectively worth over $250 million have been canceled. Although Congress appropriated $345 million for the 2026 fiscal year, much of it has gone unspent, with only $15 million going to grants so far. As such, scientists across over 30 states have halted research, laid off staff, shut down programs, and stopped pursuing new lines of research.

“Profound concern”

In addition to the losses in data and research findings, Carroll and Atkins lament the loss to the scientific community. “This is what it looks like when we stop developing the next generation of health services researchers.” Reversing the damage is doable, but will be difficult, they write, while calling on Congress to act.

Last week, 30 Democratic senators sent a fiery letter to anti-vaccine Health Secretary Robert F. Kennedy Jr. Noting the same series of events as Carroll and Atkins, they called Kennedy’s handling of AHRQ “sabotage” and an “outrageous abuse of administrative power that will leave Americans sicker, poorer, and dying from preventable causes.”

They highlighted just a few of the research programs that were axed under Kennedy, including studies on training rural healthcare workers to handle maternal medical emergencies in Connecticut, improving access to home dialysis in New York, reducing risks of patient falls in rural hospitals in Colorado, reducing overuse of antibiotics in Utah, improving autism screening and care for Black children in North Carolina, and improving chronic pain management to reduce reliance on opioids in Virginia. The senators also noted that grants were canceled out of the blue with form letters, which had contradictory explanations and incorrect citations.

With “profound concern and unequivocal opposition” to the mass grant cancellations, the senators wrote, “We demand that you immediately rescind these cancellations and ensure that the funding Congress appropriates to AHRQ is invested in health research in accordance with the law.”

“We want to be clear: Democrats and Republicans did not work together to appropriate funds for AHRQ as a gentle suggestion for the [health] Department to follow at their discretion or leisure,” they wrote. “We provided this money with the explicit instruction that the Department faithfully support life-saving research to improve access and health outcomes for Americans.”

The health department under Kennedy has previously defended the cuts. The senators gave Kennedy until August 25 to respond to their letter.