‘Nobody answers’: The unraveling of a patient care research agency – Roll Call

## Summary
AHRQ hasn’t funded any new research projects in almost a year, and it hasn’t issued grant funding for existing projects since before the end of the previous fiscal year in September, according to multiple people familiar with the matter. That has left the agency, created in 1999 to fund research into how health care delivery can be safer and better for patients, in limbo as the Trump administration signals its desire to reduce its funding or transfer its functions elsewhere. “In practice, the agency has stopped functioning,” said Aaron Carroll, president of AcademyHealth, a professional organization for researchers who study health services, including projects that had been funded by AHRQ. They include studies related to reducing unnecessary antibiotic use, which can be dangerous for patients; the role of telehealth in improving access to care for Medicaid patients; and better care for acute low-back pain. ‘Black hole’ AHRQ Director Roger Klein, who was appointed last summer, has not issued directives to staff about the work the agency should be funding and frequently denigrates existing projects as “worthless,” according to a former employee who spoke anonymously for fear of retribution. Asked why no new grants have been issued in one year, Nixon said in an email that “efforts have been focused on the reorientation toward Presidential and Secretarial priorities, and a return to AHRQ’s core statutory mission of improving health outcomes for the American people.” He added that AHRQ will “hire staff as needed and award new grants in the future.” HHS’ fiscal 2027 budget request, however, proposes eliminating one-third of the agency’s funding, stating that “much of AHRQ’s research on quality, safety, and affordability of healthcare delivery is wasteful or duplicative of research conducted at NIH” and that it has “pushed radical gender ideology onto children.” As for the descriptions of Klein’s handling of operations, Nixon said the claims “are based on anonymous sources and don’t reflect the reality of what’s happening at AHRQ.

## Article Content
The seal of the Department of Health and Human Services is pictured on a podium before a news conference in April 2025. (
Tom Williams/CQ Roll Call
)
By
Jessie Hellmann
Posted April 7, 2026 at 7:00am
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A small federal agency responsible for studying how health care works for patients is largely dormant despite receiving millions of dollars from Congress for research into antibiotic resistance, health care access and safety or quality of care.
The Agency for Healthcare Research and Quality has spent none of the $345 million appropriated by Congress for the current fiscal year, and $80 million of its fiscal 2025 funding was sent back to the Treasury.
AHRQ hasn’t funded any new research projects in almost a year, and it hasn’t issued grant funding for existing projects since before the end of the previous fiscal year in September, according to multiple people familiar with the matter.
That has left the agency, created in 1999 to fund research into how health care delivery can be safer and better for patients, in limbo as the Trump administration signals its desire to reduce its funding or transfer its functions elsewhere.
“In practice, the agency has stopped functioning,” said Aaron Carroll, president of AcademyHealth, a professional organization for researchers who study health services, including projects that had been funded by AHRQ.
Much of the staff left through reductions in force or layoffs last year, including all employees who process grants, the sources say. About 90 employees remain at the agency which once employed 300 people.
Researchers who were awarded grants have been unable to reach staff and at times have been given incorrect information or told they should withdraw their proposals and submit them somewhere else. Still, researchers haven’t received termination notices or received information about when or if they might get funding.
“Not only has that money not come, if you call them, nobody answers the phone. Nobody replies when you email them,” said Ronald Ackerman, the senior associate dean for public health and director of the Institute for Public Health and Medicine at Northwestern.
Grants are typically awarded for five years, with funding released annually as researchers report progress and demonstrate they are meeting milestones. Program officers usually review those reports and provide guidance between funding periods.
Researchers have essentially been abandoned by the agency in the middle of their projects.
Five grants in Ackerman’s institute haven’t received funding in a year. They include studies related to reducing unnecessary antibiotic use, which can be dangerous for patients; the role of telehealth in improving access to care for Medicaid patients; and better care for acute low-back pain.
‘Black hole’
AHRQ Director Roger Klein, who was appointed last summer, has not issued directives to staff about the work the agency should be funding and frequently denigrates existing projects as “worthless,” according to a former employee who spoke anonymously for fear of retribution.
Klein has insisted on reviewing every public facing communication, report and presentation, however most submissions seem to go into a “black hole,” the former employee said. They either aren’t released publicly or employee requests about them aren’t responded to, effectively muzzling the agency.
As a result, at the end of fiscal 2025, the agency had to give a significant portion of its congressionally approved funding back to the Treasury, the person said.
AHRQ has canceled funding notices — announcements asking researchers to apply for funding to study certain topics — including several related to antibiotic resistance and hospital-acquired infections.
And panels that are supposed to meet several times a year to determine which applications should be funded have not met in a year, according to the agency’s website.
“If you were willing to roll the dice and assume that AHRQ will at some point do something, you literally cannot submit to the agency. It is not possible to request funds from the agency,” said Dr. Leora Horwitz, a researcher who received AHRQ funding in the past.
Agency history
AHRQ is the only federal agency focused solely on studying how to improve health care delivery in the U.S.
It has supported research on infections acquired in health care settings, finding that central-line infections, which affect catheters inserted into the bloodstream, could be prevented using checklists and safety practices such as hand hygiene. The agency then helped scale those practices nationwide, contributing to a significant reduction in infections and reducing health care costs.
“This one study paid for AHRQ forever, basically,” Horwitz said.
While the National Institutes of Health funds research into cures, this agency focuses on how to get those treatments to people.
“There is no perfect health care system right now. AHRQ’s externally funded research program aims to fix that,” Horwit

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## Expert Analysis

### Merits
- Grants are typically awarded for five years, with funding released annually as researchers report progress and demonstrate they are meeting milestones.
- As a result, at the end of fiscal 2025, the agency had to give a significant portion of its congressionally approved funding back to the Treasury, the person said.
- The agency then helped scale those practices nationwide, contributing to a significant reduction in infections and reducing health care costs. “This one study paid for AHRQ forever, basically,” Horwitz said.
- Beyer Jr., D-Va., who has been pushing for answers and funding, said in a statement. “It is unthinkable to deliberately undermine an agency that improves healthcare delivery for Americans and ensures that taxpayer dollars are spent on effective, affordable, and safe care.

### Areas for Consideration
- The administration argues, though, that statute doesn’t actually require AHRQ to issue grants or review every application it receives, and that the appropriations are a “lump-sum that could be used for any purpose in furtherance of AHRQ’s mission.” The government seeks to have the lawsuit thrown out on the grounds that the plaintiffs — the Society of General Internal Medicine and the North American Primary Care Research Group — don’t have standing to sue.

### Implications
- Researchers who were awarded grants have been unable to reach staff and at times have been given incorrect information or told they should withdraw their proposals and submit them somewhere else.
- Still, researchers haven’t received termination notices or received information about when or if they might get funding. “Not only has that money not come, if you call them, nobody answers the phone.
- They include studies related to reducing unnecessary antibiotic use, which can be dangerous for patients; the role of telehealth in improving access to care for Medicaid patients; and better care for acute low-back pain. ‘Black hole’ AHRQ Director Roger Klein, who was appointed last summer, has not issued directives to staff about the work the agency should be funding and frequently denigrates existing projects as “worthless,” according to a former employee who spoke anonymously for fear of retribution.
- As a result, at the end of fiscal 2025, the agency had to give a significant portion of its congressionally approved funding back to the Treasury, the person said.

### Expert Commentary
This article covers agency, ahrq, funding topics. Notable strengths include discussion of agency. Areas of concern are also raised. Readability: Flesch-Kincaid grade 0.0. Word count: 1457.