NIH on Track to Spend $47 Billion Budget After Delays
After months of delays caused by agency-wide layoffs and pauses in grant proposal evaluations, the National Institutes of Health is now on pace to spend its entire $47 billion budget before the September 30 deadline. NIH had been lagging by billions throughout the spring and summer, raising concerns it would leave taxpayer-appropriated funds unused. The agency is now rapidly accelerating awards to health systems, academic medical centers, and research institutions.
Key Takeaway: Hospitals and universities should prepare for a surge of late-stage NIH awards and funding decisions before fiscal year-end. Administrators should ensure grant management systems are ready for quick turnaround, as last-minute allocations could create bottlenecks. Strategic alignment with NIH’s shifting priorities will be critical for sustaining research capacity amid broader federal policy upheavals.
Health Care Costs Surge, Employers Brace for 2026 Premium Hikes
Health care inflation reached a three-year high in August, with medical care costs rising 4.2% year-over-year compared to overall inflation at 2.9%. Corporations are projecting health benefit costs to rise by at least 9% in 2026, Axios reports. Employers cite federal policy shifts, tariffs, and broader medical cost growth as drivers.
Key Takeaway: Hospitals will face heightened pressure from both payers and patients as rising costs cascade into higher premiums and out-of-pocket expenses. Employers may reduce benefits or pass costs to workers, increasing uncompensated care risks. Health systems should prepare for slower elective procedure demand, advocate for fair reimbursement, and expand financial assistance programs.
ACA Marketplace Enrollees Face Steep Premium Hikes if Subsidies Expire
A new KFF analysis finds that nearly half of ACA Marketplace enrollees are small business owners, employees, or self-employed workers. Currently, 92% of enrollees benefit from enhanced premium tax credits first enacted under the American Rescue Plan Act and extended through the Inflation Reduction Act. If Congress allows credits to expire at the end of 2025, average premiums would rise by more than 75%. Insurers are already proposing 18% gross premium increases for 2026, anticipating market instability.
Key Takeaway: Health systems should prepare for significant coverage disruptions if subsidies lapse. Hospitals will see higher uninsured rates and more uncompensated care, particularly in communities reliant on small business employment. Leaders should intensify advocacy with lawmakers, equip financial counselors to guide patients, and prepare for heightened strain on charity care programs.
Schumer Threatens Shutdown Over Health Care Demands
Senate Democratic Leader Chuck Schumer warned that Democrats could allow a government shutdown unless Republicans accept their health care demands in ongoing budget negotiations. Central to the standoff are ACA premium tax credits, which Democrats want extended as part of a broader funding deal. Republicans remain divided, with some demanding offsetting Medicaid cuts under the “One Big Beautiful Bill.”
Key Takeaway: Hospitals face heightened uncertainty as federal budget brinkmanship threatens health care funding. System leaders should scenario-plan for disruptions to subsidies, Medicaid, and safety-net funding. Engaging with policymakers and preparing rapid-response communication for patients will be crucial as negotiations unfold.
Trump Orders Crackdown on Pharmaceutical Advertising
President Donald Trump has directed HHS to crack down on direct-to-consumer pharmaceutical advertising. The FDA has already begun issuing warning letters to drugmakers, warning that ads must comply with existing regulations. The move aligns with past pledges by Secretary Robert F. Kennedy Jr. to rein in pharmaceutical marketing.
Key Takeaway: Hospitals and providers should anticipate shifts in patient demand as restrictions tighten on drug advertising. Reduced exposure to promotional messaging could alter prescribing trends, particularly for high-cost branded therapies. Health systems should prepare to counsel patients on treatment options and ensure clinicians are equipped to address questions absent heavy pharmaceutical marketing.
Looking Ahead
Former CDC Director Fired by RFK Jr. to Testify Before Senate
Susan Monarez, the former CDC director dismissed by HHS Secretary Robert F. Kennedy Jr. after clashes over vaccines and operational decisions, will testify before Congress next week. Monarez’s abrupt ouster, which drew national headlines, is expected to dominate questioning as lawmakers probe the direction of HHS and CDC under Kennedy’s leadership.
Key Takeaway: Hospitals and health systems should expect continued instability in federal public health guidance. Leadership turnover and political intervention in vaccine policy risk eroding confidence in CDC recommendations. Providers should monitor testimony closely, reinforce evidence-based practices, and develop communication strategies to reassure patients amid policy uncertainty.