In a new Lancet Americas study, Miranda Yaver, PhD, assistant professor of health policy and management at Pitt’s School of Public Health, and colleagues from the University of Michigan School of Public Health examine the early effects of recent presidential federal policy changes on the U.S. health system.
Using the Health Systems Performance Assessment Framework, the authors evaluate developments across key domains, including governance, financing, service delivery, and data and scientific integrity.
The analysis finds that, in its first 100 days, the administration implemented actions that affected a range of services, including Medicaid, the Affordable Care Act (ACA), reproductive and gender-affirming care, and emergency management.
The study highlights the consequences of these changes on health system functions:
• Medicaid and ACA changes that could reduce coverage for millions
• Reductions in federal funding for local health departments and public health programs
• Reduced data infrastructure and scientific staffing, weakening public health surveillance efforts
• Regulatory changes that reduce oversight of food safety, tobacco and environmental health
Yaver and co-authors emphasize that large-scale layoffs and policy shifts may undermine long-term institutional capacity, with uncertain, and likely negative, effects on health outcomes and system resilience. The article frames these developments in terms of their practical and significant challenges to public health infrastructure and health care delivery in the U.S.
-Clare Collins