Staffing Crises at AHRQ and VA Jeopardize Health Care Research and Services

Strategic Insights -

The nation is on the brink of losing the only federal agency dedicated to studying how health care is delivered, as the Agency for Healthcare Research and Quality (AHRQ) faces a near-total workforce reduction, and the Department of Veterans Affairs (VA) grapples with severe staffing shortages. These crises are compromising the quality of care for veterans and jeopardizing critical health care research and services.

Key Takeaways:

  • AHRQ has not awarded a single new grant since April 1, 2025, resulting in a near-total collapse of grantmaking, which halts critical, congressionally funded research to improve the quality, safety, and affordability of health care.
  • The staffing shortages at AHRQ and VA are due to up to 90 percent of the workforce being gone and over 4,400 severe shortages reported in fiscal year 2025, respectively.
  • The VA's staffing shortages affect both clinical and non-clinical roles, compromising the quality of care for veterans.
  • The Administration's funding freezes have raised alarms about the future of health services research.
  • A federal appeals court ruling has made it more difficult for researchers to challenge funding freezes, potentially slacking the restoration of funding for critical research.
  • The CMS demonstration project on prior authorization requirements in traditional Medicare has raised concerns among House Democrats, who question the need for this initiative, especially amid recent efforts to reduce the use of prior authorizations.
  • Updated data from health insurers' rate filings and CMS on ACA marketplace enrollment are fueling concerns about broker fraud, increasing premiums, and enrollees leaving the ACA marketplace.
  • Experts note that removal of premium tax subsidies will increase premium costs for marketplace enrollees, and recent program integrity changes to crack down on waste, fraud, and abuse may weaken the risk pool and increase premiums.
  • Health services researchers recommend monitoring data from CMS and insurers closely over the coming year to inform policymakers about the impact of the reconciliation bill provisions and other efforts by CMS on the marketplaces and Americans' access to health care.

Statistics:

  • AHRQ has not awarded a single new grant since April 1, 2025.
  • Up to 90 percent of the AHRQ workforce is gone.
  • Over 4,400 severe staffing shortages have been reported in fiscal year 2025 at the VA.
  • 17 House Democrats have raised concerns about the new CMS demonstration project on prior authorization requirements in traditional Medicare.
  • 35% of ACA marketplace enrollees last year didn't file a claim.
  • The CMS final rule on new prior authorization requirements has led to a rate increase request of more than 50% by Centene's QCA Health Plan in Arkansas.

Sources:

  • AcademyHealth
  • STAT News
  • Fierce Healthcare
  • Centers for Disease Control and Prevention (CDC)
  • Department of Health and Human Services (HHS)
  • CMS (Centers for Medicare and Medicaid Services)
  • House Democrats (Congressional Press Release)
  • AHRQ (Agency for Healthcare Research and Quality)
  • VA (Department of Veterans Affairs)
  • Centene's QCA Health Plan (Arkansas)