MIT first school to rebuff White House deal: ‘Scientific funding should be based on scientific merit alone’ | Fierce Bio | October 10, 2025
What’s Happening: MIT President Sally Kornbluth rejected the Trump administration’s “Compact for Academic Excellence in Higher Education,” making MIT the first of nine invited universities to decline the offer of preferential federal funding in exchange for adopting conservative policies. The compact requires universities to ban the use of race, sex, and religion in hiring and admissions, freeze tuition for five years, cap foreign undergraduate enrollment at 15%, and change governance structures, with the document suggesting non-compliant schools would forego federal funding.
Why it Matters: Health systems are caught in the political crossfire as Democrats frame the shutdown as a fight to preserve affordable health care access rather than a funding dispute. The extended shutdown duration affects federal services beyond the immediate operational disruptions, with constituents already peppering Democratic senators with questions about the shutdown’s impacts.
Vanderbilt professors recommend against signing Trump higher ed compact | WPLN | October 9, 2025
What’s Happening: Vanderbilt University’s faculty senate voted by a resounding margin to recommend against signing Trump administration’s “Compact for Academic Excellence in Higher Education,” which offers preferential access to federal research funding, student loans, and visa approvals in exchange for compliance with specific directives. Over 900 students and faculty members signed a petition opposing the compact, with professors arguing it violates the Civil Rights Act and creates an environment of fear that stifles academic growth.
Why it Matters: Academic health centers like Vanderbilt University Medical Center depend on diverse talent pipelines and federal research funding for clinical innovation. The compact’s gender restrictions could impact gender-affirming care programs and LGBTQ+ health services that many academic medical centers provide. Limiting international students to 15% would significantly reduce the pool of foreign-trained physicians and researchers who make up a substantial portion of the U.S. healthcare workforce, particularly in underserved areas and specialized fields.
CDC signs off on fall Covid shots. It may not be easy to get one, depending on where you live.
What’s Happening: The CDC updated its Covid vaccine guidance to recommend shots only for people 65 and older and those under 65 after consulting a doctor or pharmacist, following Health Secretary Robert F. Kennedy Jr.’s decision to fire and replace the entire vaccine advisory panel with his own picks, many of whom have spoken out against Covid vaccines. Twenty-six states (mostly those with Democratic governors) have already set their own broader Covid vaccination guidance to maintain access, creating a complex patchwork of conflicting policies nationwide
Why it Matters: The fragmented vaccine policy creates operational challenges for health systems navigating conflicting federal and state guidance while trying to protect vulnerable patients. The requirement for “shared clinical decision-making” adds administrative burden to already-strained primary care practices and may discourage vaccine uptake at a time when winter respiratory illness season approaches. Health systems must now track varying state-by-state eligibility rules, potentially confusing patients and staff about who qualifies for vaccination—complicating infection control efforts.
HHS employees to be fired as White House enacts mass terminations it blames on shutdown
What’s Happening: The White House began firing federal employees on Friday as part of mass terminations blamed on the government shutdown, with between 1,100 and 1,200 employees at the Department of Health and Human Services being let go—more than any other department except Treasury. The HHS layoffs were expected to focus on the Centers for Disease Control and Prevention, Health Resources and Services Administration, and Agency for Healthcare Research and Quality.
Why it Matters: Mass HHS firings directly threaten health systems’ ability to access federal support and guidance during public health emergencies. The CDC, HRSA, and AHRQ provide critical services that hospitals depend on—disease surveillance, outbreak investigation, rural health funding, maternal health programs, and evidence-based practice guidelines. Losing experienced federal health workers compounds existing workforce challenges from earlier 2025 layoffs that already reduced HHS staffing by thousands, potentially crippling the department’s capacity to respond to infectious disease outbreaks, coordinate vaccine distribution, or manage healthcare safety net programs.
CDC’s public image craters yet again under RFK Jr.: Gallup
What’s Happening: A new Gallup poll found that 42% of respondents rated the CDC as “poor”—the highest number ever recorded—with only 11% rating the agency’s work as “excellent” compared to two-thirds who ranked it excellent or good before the COVID-19 pandemic in 2017 and 2019. The Trump administration has overhauled the CDC by ousting Trump-appointed director Susan Monarez less than a month after her confirmation for alleged misalignment with the “Make America Healthy Again” agenda, though she claims she was pushed out for resisting politically directed changes in vaccine decision-making.
Why it Matters: The collapse of public trust in the CDC fundamentally undermines health systems’ ability to manage infectious disease outbreaks and implement evidence-based protocols. When only 31% of Americans rate the CDC as excellent or good, hospitals face greater challenges convincing patients to follow vaccination recommendations, infection control measures, and treatment guidelines that rely on CDC authority. The 31-percentage-point drop among Democrats from 2024 to 2025 represents a dramatic erosion of bipartisan confidence that health systems previously leveraged to promote public health interventions.
Dems open to income cap on ACA subsidies
What’s Happening: Some moderate Senate Democrats, including Senators Jeanne Shaheen, Tim Kaine, and Catherine Cortez-Masto, say they are open to placing an income cap on Affordable Care Act tax credit eligibility to facilitate a deal with Republicans on renewing subsidies that help roughly 22 million enrollees afford premiums. The enhanced subsidies are set to expire at the end of the year and previously had a cap at 400% of the federal poverty level ($62,000 for individuals), but Democrats removed that cap when they expanded subsidies in 2021.
Why it Matters: The expiration of ACA subsidies threatens to destabilize health insurance markets that health systems depend on for patient coverage and revenue stability. If 22 million Americans lose enhanced subsidies, many will drop coverage or downgrade to high-deductible plans, increasing uncompensated care costs for hospitals and reducing payment for services. Health systems in states that expanded Medicaid under the ACA have seen significant reductions in uninsured patients—losing ACA subsidies could reverse those gains and strain emergency departments with uninsured patients seeking care.
Emboldened Democrats dig in on health care demands in shutdown fight
What’s Happening: Democrats are refusing to end the government shutdown—now in its eighth day and the eighth-longest in U.S. history—without extending expiring Obamacare subsidies, emboldened by polling showing voters blame Trump and Republicans more for the shutdown and support Democrats’ health care demands by 78% to 22%. The enhanced ACA tax credits benefit an estimated 92% of the 24 million people enrolled in Obamacare, including 57% of “MAGA supporters,” while insurers are already sending out notices of upcoming premium rate hikes that will be difficult to reverse if Congress waits until year-end to act.
Why it Matters: This shutdown standoff creates immediate financial crisis for health systems as 24 million ACA marketplace enrollees face uncertainty about 2026 coverage and premiums. Insurers sending rate hike notices now means health systems must prepare for potential coverage disruptions, increased uninsured patients, and revenue volatility as individuals drop plans or switch to high-deductible coverage they cannot afford to use.
Virginia lawmakers threaten state funding consequences if UVA signs Trump compact
What’s Happening: Three leading Virginia Democratic state senators threatened the University of Virginia with “significant consequences in future Virginia budget cycles” if it signs the Trump administration’s higher education compact, calling it “political extortion” and an unprecedented intrusion into institutional autonomy. UVA’s faculty senate voted 60-2 to reject the compact, with lawmakers citing the recent forced resignation of former President Jim Ryan over diversity efforts as evidence that appeasing the administration only invites further interference.
Why it Matters: UVA Health System depends on both federal research grants and state appropriations to sustain its clinical care, medical education, and research missions. The compact’s requirement for public audits of viewpoints and elimination of diversity programs could undermine efforts to recruit diverse medical professionals and address healthcare disparities—key priorities for many health systems. The provision forcing students in humanities to subsidize STEM programs threatens medical education financing models.
Trump is cutting funding to universities with large Hispanic student populations – here’s what to know
What’s Happening: The Trump administration froze $350 million in federal grants to Minority-Serving Institutions in September, including over $250 million specifically for Hispanic-Serving Institutions (HSIs), arguing these programs constitute racial discrimination. he Justice Department announced it would no longer defend the federal definition of HSIs—colleges where at least 25% of undergraduates identify as Hispanic or Latino—putting Title V grants at risk that fund faculty training, updated facilities, new degree programs, and support services for first-generation students.
Why it Matters: HSIs are critical pipelines for training Hispanic physicians, nurses, and allied health workers who are more likely to practice in underserved Hispanic communities—addressing healthcare disparities and language barriers. Many HSI nursing and pre-med programs rely on Title V grants to maintain science laboratories, clinical training facilities, and mentorship programs that help first-generation students succeed in demanding healthcare curricula. Research shows Hispanic students at HSIs graduate at rates 5-8 percentage points higher than at non-HSI institutions, making these schools essential for workforce development as Hispanic Americans grow to nearly 20% of the U.S. population.
What’s on the Horizon
Ongoing impact of the government shutdown on health programs
The continuation of the shutdown is putting strain on health operations: some programs (e.g. the Acute Hospital Care at Home waiver) have already been rolled back. Agencies such as the CDC and parts of HHS are likely to see layoffs or suspensions, which could hamper disease surveillance, immunization programs, and public health preparedness. Keep watch on whether Congress passes a continuing resolution (CR) or other stopgap that restores funding — especially for health agencies and ACA premium subsidies.