How research shapes health policy on Capitol Hill

Are you seeing pushback around scientific research or expertise? How has that relationship evolved?

I believe there's still a want, especially at the staff level: 99% of them said that they want access to high-quality evidence-based research, but only 32% of them felt like they had that access. So I always feel like there is a want and a need from staff. 

Every time I go to the Hill and meet with staff, they seem excited to meet with us, just because we're not coming in there telling them what to do. We're not an advocacy organization trying to push them to do one thing over the other. We're going in there and saying, “We have all this incredible expertise and resources. How can we help you make the best policy decisions?” and empowering them with what they need to make sure they're making the right decisions on behalf of people.

But we also want it to be a two way street. We also want to be meeting with staff to know what questions they are trying to get answered. So that way we can incorporate it in our research and that way our research is more relevant to what policymakers are trying to figure out and decide. 

Republicans now have control of the presidency, House and Senate. Does that mean Republicans will make big changes to our health care policy? 

I think it's probably highly unlikely for major reforms to happen because the majorities are so slim in the House and the Senate. In the House, Speaker Johnson can't afford to really lose any votes, so it's hard to get consensus even within your own party to pass major reform. And I think the same thing in the Senate. So it's going to be a little bit tricky, at least from the congressional standpoint, to get major health care reform or anything like that done. But I think there's things that we could see on the margins.

Does that include budgets?

Yeah, I think the biggest one is going to be health care costs. I think in the election we saw the voters were concerned about the economy and the rising costs and health care affordability falls under that umbrella, right? And that's a lot of the research that's happening in the Center for Advancing Health Policy through Research: how do we make health care more affordable, more accessible and have higher quality?

So what other policy priorities are you seeing for 2025, besides cost?

Something that doesn't go away for policymakers each year is the opioid crisis. I think the Congress last year was supposed to get the SUPPORT Act reauthorization, which was a big comprehensive bill to address the opioid epidemic that was passed a while ago. Those programs are up for expiration. So now they need to reauthorize that. 

What would you say to people concerned about the incoming administration’s approach to health care services like vaccines? Are there going to be big changes to the way health care happens in this country?

Yeah, I try to keep a positive outlook because it helps me on a daily basis. I definitely think there's always cause for concern, but we just don't know what's going to happen and so until we know, it's really hard to say. I always look to the House and Senate Appropriations Committees, because these are the committees that fund the government every year. So when you think about major reforms to the NIH or CDC in terms of funding, those are the committees that have jurisdiction over that. And the leadership of those committees have always been very pro-science and pro-NIH on both sides of the aisle, and there's been a lot of bipartisanship around that. So that gives me some optimism and hope that there won't be huge significant cuts to NIH funding. 

What about someone like RFK Jr. getting confirmed to a cabinet position? What would you expect to see from him?

It's hard. The nomination process is going to be a long process. He's got to go through confirmation hearings. Anything can happen in those confirmation hearings. And then after they get through those hearings, he's got to pass with a simple majority in the Senate. And again they have a slim majority, so it may make it a little bit more difficult. I don't like guessing on whether he's gonna get passed or not because it's so hard to say right now until we get through the confirmation hearings. I think that's something republicans and Democrats have both always said is that we’ve got to give them a hearing before we make a decision.

I think when the president's budget drops in March, that'll also be a very strong signal of what some of their priorities are. We also might see a lot of career people get shifted around under the new administration. People who are in leadership could be moved to different positions. So seeing who they bring in underneath RFK. Jr. might be as important as RFK Jr.'s appointment itself. Those people are going to be shaping the different centers and the different administrations underneath HHS. 

So I don't know if I would say hit the panic button just yet, but I always try to remember that there are safeguards in place that keep them from just pushing through Congress. So I try to keep some optimism in that sense.