CDC Leaders Resign in Protest, Citing RFK Jr.’s Undermining of Vaccine Science
Three senior CDC officials resigned after the ouster of Director Susan Monarez, warning they were asked to endorse “unscientific” vaccine recommendations that could endanger public health. The resignations by top vaccine, immunization, and infectious-disease leaders came as HHS Secretary Robert F. Kennedy Jr. moved to reshape the CDC’s Advisory Committee on Immunization Practices (ACIP), replacing experts with vaccine skeptics. Departing leaders said Kennedy’s appointees are pushing ideological changes such as rolling back hepatitis B vaccination at birth and questioning RSV immunizations, despite strong scientific evidence. Their protest, joined by widespread staff revolt, has fueled bipartisan alarm in Congress. Sen. Bill Cassidy (R-LA) urged postponement of ACIP’s September meeting, while Sen. Bernie Sanders (I-VT) called for a full investigation, warning Kennedy’s actions could “manipulate science” and jeopardize children’s health.
Key Takeaway: Hospitals, health systems, and pediatric providers face heightened uncertainty in vaccine policy as trusted scientific leaders exit the CDC. Kennedy’s restructuring threatens the legitimacy of ACIP’s recommendations and may undermine public trust in immunization schedules. Health organizations should prepare communication strategies to reassure patients, monitor policy shifts that could alter routine vaccination protocols, and engage policymakers to defend evidence-based standards in immunization oversight.
CDC Grant Cuts Hit Red States Harder as Blue States Win Court Restorations
A new KFF Health News analysis finds the Trump administration’s cancellation of nearly 700 CDC grants worth about $11 billion has disproportionately impacted Republican-led states. While Democratic attorneys general sued and restored nearly 80% of their states’ funding, red states such as Texas, Georgia, Oklahoma, and Ohio retained less than 5% of grants. The grants, awarded during the COVID-19 pandemic, supported vaccination programs, disease surveillance, and community health workers. Their loss has forced layoffs, canceled clinics, and delayed upgrades to public health infrastructure in many GOP-led areas, even as outbreaks of measles and flu strain systems. In Jackson County, Ohio, community health workers were laid off mid-cycle, while Columbus lost $3 million in infectious disease funding and canceled plans for a new health record system. In contrast, California successfully kept every grant it was slated to lose.
Key Takeaway: The uneven fallout from CDC grant clawbacks highlights how political polarization is reshaping public health capacity. Hospitals and health systems in red states may face rising disease outbreaks, staffing shortages, and infrastructure gaps as federal support erodes. Leaders should anticipate greater demand on emergency and safety-net care, strengthen local partnerships to fill service gaps, and monitor litigation outcomes that may further determine state and regional public health resources.
Hospitals, Insurers Mount September Push to Save ACA Subsidies
Hospitals, insurers, and health groups are launching an aggressive lobbying campaign to extend enhanced ACA premium tax credits before they expire at the end of 2025, warning of massive coverage losses and premium spikes if Congress fails to act. The subsidies, first expanded during the pandemic and later extended through the Inflation Reduction Act, support millions of enrollees and are credited with keeping premiums affordable. Industry groups, including the coalition Keep Americans Covered, are pressing lawmakers to fold an extension into a September funding package, with open enrollment for 2026 plans looming in November. Without action, the Congressional Budget Office estimates 4.2 million people would lose insurance and millions more would face higher costs. But GOP leaders, already touting $1 trillion in Medicaid cuts through the One Big Beautiful Bill, remain divided over whether to spend an additional $335 billion over 10 years to make subsidies permanent. Advocates warn sticker shock could hit consumers before midterms, creating political backlash if subsidies lapse.
Key Takeaway: Health systems should prepare for patient confusion and potential coverage disruptions heading into fall enrollment. Hospitals in particular may see higher uncompensated care and delayed treatments if subsidies expire. Engaging lawmakers, equipping patient navigators with updated messaging, and monitoring budget negotiations will be critical as subsidy decisions converge with broader fights over federal health spending and government funding.
Medicare to Test Prior Authorization in Six States, Raising Concerns Over Delays and Denials
Starting in January 2026, Medicare will launch a six-year pilot program in Arizona, New Jersey, Ohio, Oklahoma, Texas, and Washington that requires prior approval for certain procedures, bringing a controversial practice from Medicare Advantage into traditional Medicare. The Wasteful and Inappropriate Service Reduction Model will use private contractors and AI tools to screen requests for a dozen high-cost or low-value services, such as some spine surgeries, steroid injections, and incontinence devices. While CMS says denials will be finalized by licensed clinicians and target only wasteful care, critics argue the financial incentives to deny claims mirror those in Medicare Advantage, where prior authorization has long been linked to patient harm, administrative burdens, and lawsuits. Physicians, patient advocates, and lawmakers warn the model risks creating barriers to medically necessary care and could be a back door to broader privatization of Medicare.
Key Takeaway: Hospitals and providers in pilot states should prepare for new administrative hurdles and potential care delays for older adults as Medicare adopts insurer-style prior authorization. While CMS frames the program as targeting unnecessary spending, patients may perceive it as rationing care, fueling distrust in Medicare at a politically sensitive time. Health systems should be ready to provide patient support for appeals, track denials for trends, and engage in advocacy as policymakers weigh whether to expand the program nationally.
FDA Revokes Emergency Use for COVID-19 Vaccines, Limiting Access for Healthy Children
The FDA has revoked remaining emergency use authorizations for COVID-19 vaccines, restricting easy access for people under 65 without underlying health risks. While older adults and those with conditions such as obesity or immune compromise can still get vaccinated under new approvals for Pfizer, Moderna, and Novavax, healthy young children and adults must now consult with a physician for off-label use. HHS Secretary Robert F. Kennedy Jr. framed the change as maintaining choice, but pediatricians and public health experts warned the move creates confusion and new barriers for families, especially parents of infants and toddlers, whom the American Academy of Pediatrics strongly recommends for vaccination. Nearly 90% of doses have been delivered through pharmacies, but in at least 18 states, pharmacists’ authority depends on CDC or ACIP recommendations, raising further uncertainty as Kennedy’s newly restructured ACIP has yet to issue updated guidance. Critics say the decision could depress already-low uptake, expose gaps in access, and politicize Covid vaccination further.
Key Takeaway: Hospitals and providers in pilot states should prepare for new administrative hurdles and potential care delays for older adults as Medicare adopts insurer-style prior authorization. While CMS frames the program as targeting unnecessary spending, patients may perceive it as rationing care, fueling distrust in Medicare at a politically sensitive time. Health systems should be ready to provide patient support for appeals, track denials for trends, and engage in advocacy as policymakers weigh whether to expand the program nationally.
On the Horizon
CMS ICD-10 Code Updates Take Effect October 1, 2025: CMS and CDC will implement the annual update to ICD-10-CM diagnosis and ICD-10-PCS procedure codes, effective for discharges and patient encounters between October 1, 2025, and September 30, 2026. The update includes new and revised codes reflecting expanded medical conditions, treatments, and procedures. CMS has released updated coding guidelines, addenda, and conversion tables to support compliance and a smooth transition.
Why it matters for hospitals: All HIPAA-covered entities, hospitals, providers, and payers must use the new codes starting October 1 to avoid claim denials, compliance issues, and documentation gaps. Hospitals should coordinate with vendors, billing departments, and clinical documentation teams to ensure EHRs and coding systems are updated in advance and provide staff training on notable code changes. Annual updates like these are critical for capturing evolving clinical practice and maintaining accurate reimbursement.