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Executive Action Updates

Upon assuming office in mid-January 2025, the new Presidential administration began to pursue far-reaching policy changes that have impacted maternal-fetal medicine subspecialists and their patients. The ultimate effect of executive actions will depend on many factors, including how agency officials interpret and apply them and, in many cases, the decisions of federal courts after a challenge.

SMFM is closely monitoring these activities and identifying opportunities for engagement. Below, you’ll find updates on select executive actions.* If you have questions about the impact of an executive action on your practice or research, we encourage you to reach out to your institutional leadership. If you have questions or relevant information to share, please e-mail ResponseTeam@smfm.org.  

STATUS: Ongoing

The Department of Health and Human Services (HHS) has taken several actions to significantly reduce its workforce. Most recently (4/1), HHS initiated layoffs of as many as 10,000 employees across its agencies. Given the lack of transparency in the process, the full scope and impact of the force reduction are still unknown.

Previously, the administration eliminated the positions of thousands of employees on probationary status due to a recent hire or job change and terminated contract workers. Taken together, HHS has terminated approximately one-fourth of its employees. 

SMFM will continue to gather information on the impact of force reductions on the Society’s priorities and monitor potential litigation and relevant congressional action.   

  • Select News Coverage - April 1 Reduction in Force: Washington Post | STAT
  • Select News Coverage - February 14 Probationary Employee Separation: STAT | New York Times
  • SMFM Action: SMFM issued a statement expressing concerns about federal public health workforce reductions.
On March 27, the Department of Health and Human Services (HHS) announced a drastic reorganization of the department and its agencies, consolidating its 28 divisions into 15 and shuttering regional offices. The National Institutes of Health (NIH), Centers for Disease Control and Prevention (CDC), Food and Drug Administration (FDA), and Centers for Medicare and Medicaid Services (CMS) will remain agencies, though they will change in structure. The Health Resources and Services Administration (HRSA), Substance Abuse and Mental Health Service Administration (SAMHSA), and other HHS offices and agencies will become a new Administration for a Healthy America (AHA). The Agency for Healthcare Research and Quality (AHRQ) will be effectively eliminated as it is merged into a new HHS Office of Strategy. 
The legality of the reorganization without Congressional authorization is suspect. SMFM will continue to monitor administration actions, confer with Congress, and track legal actions.
STATUS: Paused due to court order
On February 7, the National Institutes of Health (NIH) announced that it was capping the indirect cost rate paid to new and existing grant recipients at 15 percent. Indirect costs, or facilities and administration (F&A), support basic operating costs associated with biomedical research. Quickly after the announcement, a federal judge based in Massachusetts issued a temporary restraining order blocking the policy pending further consideration by the courts. The same judge issued an injunction in March, extending the policy pause. SMFM will continue to monitor litigation and relevant congressional action and coordinate with other community stakeholders on next steps.  
  • Select News Coverage: NPR | New York Times | Science
  • SMFM Action: Joined stakeholder letter calling on Congress to include provisions in FY 2025 funding bills to prevent reductions in indirect cost rates (2/19/2025)

STATUS: Paused due to court order

On January 27, the Office of Management and Budget (OMB) temporarily paused all federal grants, cooperative agreements, and loans. According to an OMB memo, the suspension was set to go into effect on January 28, and federal agencies would have had until February 10 to submit detailed information on programs and projects related to the temporary pause. The OMB directive is on hold, subject to a temporary restraining order by federal courts in Rhode Island and Washington, DC. However, recent press reports indicate that funds might still not flow to grantees. SMFM will monitor litigation and relevant Congressional action and coordinate with other community stakeholders on the next steps. 

 

Select News Coverage: Washington Post | Reuters | New York Times
STATUS: Ongoing
In response to Executive Orders, the Centers for Disease Control and Prevention (CDC) and other federal agencies took steps in the first month of the new administration to remove several clinical guidance documents from their public websites, including guidance on the treatment of sexually transmitted infections, vaccination in pregnancy, and the provision of contraceptive options for patients with medical conditions. In response to court orders from a federal judge in Washington state, some of these documents have been returned to government websites, while others have not.   
Select News Coverage: AP | STAT
SMFM In the News: Medscape 
SMFM Action: SMFM will host guidance relevant to high-risk pregnancy to preserve access to these evidence-based resources. If you would like us to consider hosting other relevant guideline resources on the SMFM website to support patient care in your practice, please contact us at ResponseTeam@smfm.org. 

*This list is not exhaustive. You can learn about other activities of the executive branch at trackers maintained by news outlets, such as CNN and the New York Times. Many universities are also maintaining their own online trackers, which will include relevant information for clinicians and physician-scientists. 

Take Action
Share Your Experiences

To help SMFM best advocate for you and your patients, please share how these policy changes have affected or could affect your practice, patients, or research by filling out this form. The form gives you the option of sharing identifying information or not. You can also share your story directly with SMFM staff via a video call by scheduling a time here. 

Access Federal Clinical Guidance Documents 

The Centers for Disease Control and Prevention (CDC) and other federal agencies have recently removed several clinical guidance documents from their public websites. To ensure continued access to these critical resources, SMFM is hosting many evidence-based guidelines.