Carroll: Congress has made it clear that they want AHRQ to exist and to function. Funding for it was passed in a bipartisan manner, and last year's budget was signed by the President, but unfortunately, right now the agency is barely operating, and that matters, because AHRQ is one of the few parts of the federal government that focuses on a basic question: how do we make healthcare work better for patients? 

What's striking at this moment is that the problem is not that Congress refused to fund AHRQ. Congress did fund AHRQ. The problem is that since September 2025, the agency has not been functioning in the way Congress intended. No new grants have been issued or approved and ongoing research hasn't been funded. The agency has lost most of its staff, and with that, much of its ability to carry out its core grant-making and operational responsibilities.

HCI: So then where is the money going?

Carroll: I imagine it sits in the Treasury, although I'm not 100% certain. It's not being spent. Recent decisions, including the early cancellation of existing grant mechanisms, only reinforce the same point — that there is no real pipeline for new research right now. So the funding is there, and the needs are obvious. What's missing is the capacity to do the work.

HCI: Are there dozens of research organizations that have applied for grants and are hearing nothing back?

Carroll: Yes. we hear from people all the time that e-mails go unanswered. They don't know exactly what's going on. If I remember correctly, Secretary Kennedy claimed that AHRQ is operating normally, and that there are still hundreds of staff and it's still functioning, but that does not match what many people across the field are seeing. The agency's lost most of its staff. It hasn't issued grants in months. Its ability to carry out its mission has been hollowed out. And that's really the key point. This is not about personalities. It's not merely about who sits in what chair. It's about whether the agency has the people and infrastructure needed to function, and right now it does not.

HCI: Did I see that the GAO is going to investigate this?

Carroll: Yes. Again, Congress appropriated, and if money that's been appropriated is not being spent despite statutory direction, that raises concerns, and that's why the GAO is now looking into what's happening. But this should not be reduced to a political slogan. This is a basic question of governance. If Congress makes a decision to fund an agency, that decision should be carried out.

HCI: I would think whichever party people are in, if you're a member of Congress, you'd be upset that you appropriated funds and the executive branch is not spending it.

Carroll: If I were a member of Congress, and we had worked to come to a compromise and created a budget, and passed it in both houses, and then the President signed it, I would be very upset if then it was ignored.

HCI: I recently watched a presentation and wrote about practice-based research networks. These are groups of primary care practices working together to answer community-based healthcare questions and translate those research findings into practice. That work is funded in part by AHRQ. I'm wondering if that work is threatened by this stalling of grant funds?

Carroll: Well, I would imagine that everything, in part, is threatened. One of the most frustrating aspects of this is that I would love to be able to definitively answer these kinds of questions, but we can't even tell who's still working at AHRQ, what they are still funding and what they are not. All of these things used to be just the bread and butter of how government and public service works. You could get answers to very simple questions to see what's going on and now you can't. Even when we have hearings, like we did last week with the Secretary of HHS, he will claim AHRQ still has hundreds of employees who are doing the work and nothing has slowed down. But you can just look and see there are no new grants, and so many people have been fired.

HCI: Secretary Kennedy also talked about committing to resuming the work of the U.S. Preventive Service Task Force and to restoring its regular meeting schedule. What's the status of that task force now? If he is going to appoint new members, is it important that they're credible and non-partisan? 

Carroll: It is incredibly important that they are credible and non-partisan and experts in their field. We've seen over the past year, they haven't had a single meeting, which means they've missed at least three, if not more, which means they haven't done any of their important work. It means that no new recommendations are coming out, nor have there have been re-evaluations.

Of course, the concern has been that he could dismantle the entire task force, as he did with ACIP [Advisory Committee on Immunization Practices], and just appoint whoever he wants. We have not seen that happen, which is good, but there are five empty seats that need to be filled. It's our hope that that it will be done in the near future. Again, some transparency and some open discussions about how that's occurring would be welcome. But we're optimistic that that we'll see some movement in the near future and get to see the USPSTF start to function as it is supposed to.

HCI: I heard Secretary Kennedy make disparaging remarks during the congressional testimony about DEI in response to questions about funding work to study Black maternal mortality. I'm wondering if the approach of this administration is having a dampening effect, not only on federal funding, but also on health systems’ own focus on working to eliminate outcome disparities.

Carroll: I think that's been a real concern of the field — that the executive orders, and a lot of the ways that the administration has been looking into research that focuses on disparities, get swept up in their concerns about broader DEI initiatives that place in universities and academic settings and other other places.

I don't think that the administration is denying that health disparities exist, but perhaps they are more interested in focusing on broader solutions-oriented research that tries to get at what we can do to make those things better. Sometimes the way that executive orders and other things get interpreted is that we're not allowed to focus on anything that might focus on racial disparities or on issues of equity, when, of course, those are very real, well-documented and take place at all levels of the healthcare system. A lot of the good work that I think was being done to address these issues has unfortunately been caught up in that and sometimes dismantled, when it's incredibly important.

HCI: I asked about this because I used to get pitches from health systems all the time wanting to interview their new chief health equity officers about their focus on improvements in disparity reduction. I don't seem to get pitches like that anymore. 

Carroll: The Black maternal mortality rate is horrific and significantly higher than it is for other races. And to try to deny that is truly problematic. That is a measurable fact. Now, I am sure that Secretary Kennedy would defend his testimony by saying that they want to look into all mortality, but of course, there are disparities, and sometimes fixing disparities requires a focused, targeted approach.

HCI: Switching gears a bit, AcademyHealth has another Health Datapalooza meeting coming up this fall. The annual meeting started back in 2010 and AcademyHealth took it over in 2016. How would you characterize how it's changed over the years, and how the panel topics and presentations have evolved? Is there more data fluidity now and so more opportunities for collaboration and research on quality and cost than there was 10 to 15, years ago?

Carroll: First of all, technology has improved so dramatically that some of the things we're talking about now weren't even imaginable back then — artificial intelligence being the most obvious, Now lots of data warehouses exist. And there’s been incredible growth of private data and data that's not managed by the government, so I think a lot of the discussions focus on new types of data and new partnerships and new regulations. Of course, some of the issues still remain. Having the ability to move between different data sets is still problematic. Sometimes the linkages are problematic. Sometimes finding ways to work between stakeholder groups can still be problematic. So there's still plenty of work to be done, although the potential just gets greater and greater every year. 

HCI: Anything else that you want to stress about the situation at AHRQ?

Carroll: The things that bother Americans and that they're angriest about healthcare every day are the things AHRQ focuses on. When they're complaining that healthcare costs too much, when they're complaining that it takes too long to get in to see someone, when they complain that wait times are too long, or that care is fragmented, or that even after so much expenditure and effort, the results are not what people hope for — that’s what AHRQ studies. These aren't side issues. These are the issues that Americans care about, and it's just absolutely tragic that they cannot do it. AHRQ looks at how care is delivered, where the systems fail, how to reduce errors, how to improve outcomes, and how to do all of that perhaps at lower cost. When that work slows or stops, the problems don't go away. We just lose one of the best tools we have to solve them.