Grants halted at agency devoted to safety of U.S. healthcare

The Trump administration has effectively shut down most of the Agency for Healthcare Research and Quality's activities, closing the spigot on federal funding estimated to have saved thousands of lives and billions of dollars over the past 27 years by improving medical practice.

In a July 15 letter, the small Department of Health and Human Services agency known as AHRQ told researchers it was halting at least 104 grants, many aimed at improving patient safety. Although Congress appropriated $345 million for AHRQ for this fiscal year, the agency has spent less than $15 million on grants and hasn't issued a new one in over a year, according to a review of federal records. About 75% of agency staffers have been fired or quit since President Donald Trump took office last year, according to HHS.

Trump and HHS Secretary Robert F. Kennedy Jr. have sought to slash the federal government's investment in biomedical research, terminating grants and forcing scientists out of agencies across the health department. The gutting of AHRQ strikes some of the administration's critics as particularly shortsighted, though, because of the agency's noncontroversial focus on patient safety and its overall alignment with Trump and Kennedy's "Make American Healthy Again" campaign against chronic illness.

"When you think about everything Americans hate about our health care system — that it costs too much, that you can't get in to see a physician, that the treatment isn't right, that the records contain wrong information — all that is what AHRQ studies," said Aaron Carroll, chief executive of AcademyHealth, a health services research group that supports AHRQ's work.

The Trump and Kennedy changes to AHRQ appear intended to be permanent. All of AHRQ's grant managers have been fired, so there would be no way for AHRQ to directly oversee future grants, said Brent Sandmeyer, a former AHRQ program officer. "You wonder about this administration's commitment to fighting fraud," he said.

HHS spokesperson Emily Hilliard said AHRQ intended to establish a new "framework" for grants. She did not reply to requests for further details.

Researchers who received the letter from AHRQ Director Roger Klein expressed bewilderment because much of their work has the same objectives that Klein highlighted as the agency's current priorities.

"AHRQ is the only federal agency that's focused on safety and quality," said Hardeep Singh, director of the Houston Methodist Safety, Quality and Well-Being Institute. His research, funded until recently by AHRQ, has aimed to reduce medical errors introduced by