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.

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The Centers for Disease Control and Prevention on Monday released data on the vaccination rates of US kindergarteners in the 2025–2026 school year, revealing that rates have once again decreased from the previous school year.

Vaccination rates have been slipping since the 2019–2020 school year, when the US had obtained rates of around 95 percent, the threshold needed to keep outbreaks of vaccine-preventable diseases from spreading in communities. The latest data shows the US is moving further away from that target.

Nationally, only 92.4 percent of kindergartners were vaccinated with the measles, mumps, and rubella (MMR) vaccine in the 2025–2026 school year, down from 92.5 percent last year. Coverage with the DTaP vaccine, which covers diphtheria, tetanus, and acellular pertussis (whooping cough), similarly fell from 92.1 percent to 92.0 percent.

More than half of states saw decreases in coverage for MMR, DTaP, polio vaccine, and varicella/chickenpox vaccine. Only 10 states have MMR vaccination rates at or above the 95 percent threshold: West Virginia, Connecticut, Maine, New York, Mississippi, Rhode Island, Maryland, Massachusetts, California, and New Mexico.

While vaccination rates slipped further, the number of children with exemptions from school vaccine requirements jumped more dramatically. In the 2025–2026 school year, 4 percent of kindergartners had a nonmedical exemption—meaning it was an exemption based on personal or religious beliefs. That’s up from 3.2 percent nonmedical exemption rate in 2024–2025. Medical exemptions have held steady over recent years at 0.2 percent.

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Still, for Trump, holding onto the debunked and dangerous claim appears to be a personal issue. Trump’s health secretary, Robert F. Kennedy Jr., is an ardent anti-vaccine activist who has long promoted the false link while generally disparaging life-saving immunizations. But even Kennedy has recently shifted from publicly discussing vaccines, given the political peril.

Recent reporting indicates that the White House’s continued effort to forge a false connection between vaccines and autism is coming from Trump directly. The octogenarian reportedly wants to be remembered as the president who cured autism and believes he can achieve that by scaling back vaccines, according to reporting by The Wall Street Journal.

Given the push, Trump has reportedly chastised Kennedy on multiple occasions for not doing more on the issue. Kennedy confirmed the Journal’s reporting in a combative August 2 CNN interview. (He otherwise made a barrage of false claims during the interview; a comprehensive fact check can be found here.)

As Trump and his administration continue to flout the science on vaccines, White House spokesman Kush Desai gave a statement to the Post claiming, once again, the administration would use “gold standard science” to ensure the US has the “best childhood vaccine schedule in the world.”

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