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Dear Community:
Happy New Year to our Cincinnati community. As we step into 2026, we do so with hope—but also with clear eyes about the challenges ahead.
As a December Time Magazine article noted, two moments in 2025 revealed just how vulnerable our health care system has become. Scientific guidance from the CDC appeared influenced by politics, and millions of families faced the reality of sharply rising insurance premiums without continued Affordable Care Act subsidies. Together, they underscored a troubling truth: our health system is increasingly exposed, unequal, and unstable.
This week brought some encouragement, as the U.S. House passed bipartisan legislation to extend enhanced ACA subsidies for three years. While more work remains in the Senate, this action matters. Our physician members see every day how rising costs and coverage barriers affect patients across ages and backgrounds. The path forward will not be easy. That’s why our guiding principle remains clear: We Must Save Us. Community, vigilance, and collective action will define our impact in the year ahead.
Wishing you a safe and healthy week ahead!
Renee Mahaffey Harris
President & CEO
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Time Magazine: How America’s Health Care System Broke in 2025
Two moments in 2025 revealed how vulnerable the U.S. health care system has become. The first was quiet but consequential. The Centers for Disease Control and Prevention (CDC) revised parts of its vaccine guidance in ways that appeared influenced by political pressure rather than scientific evidence. The second was impossible to ignore. Families across the country received notices that their insurance premiums would rise sharply in 2026 unless Congress extended Affordable Care Act subsidies.
The former signaled that national scientific guidance can now tilt toward ideology. The latter showed how fragile and costly it has become simply to stay healthy. Together, they revealed the same truth. America is entering 2026 with a health system that is more politically exposed, more unequal, and more unstable than at any time in recent memory.
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National Medical Association Applauds House Action to Protect Affordable Health Coverage
This week, the U.S. House of Representatives passed legislation to extend enhanced Affordable Care Act subsidies for three years, pushing back against efforts that would increase health care costs for millions of people across the country.
As physicians, our members see firsthand the impact that rising health care costs and barriers to coverage have on patients of all ages and backgrounds. We applaud efforts to advance solutions that help patients afford the care they need. While additional work remains in the Senate to ensure these subsidies are fully extended and accessible to the millions of Americans who rely on them, we are encouraged by this initial bipartisan action in the House.
“The National Medical Association and its physician members have long advocated for policies that protect patients’ access to care. Extending the subsidies is just the beginning. We must remain vigilant in combating the effects of H.R. 1 and focus on ensuring that millions of Americans are able to maintain their Medicaid coverage,” said Dr. Roger A. Mitchell, Jr., 126th President of the National Medical Association.
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Making America’s Children Healthy Requires Addressing Deep-Rooted Health Disparities
In early September, the Make America Healthy Again (MAHA) Commission released a 19-page strategy to improve children’s health and reverse the epidemic of chronic diseases. The document, a follow-up to MAHA’s first report in May, paints a dire picture of American children’s health: poor diets, toxic chemical exposures, chronic stress, and overmedicalization are some of the key drivers now affecting millions of young people.
Few would dispute that children should spend less time online, exercise more, and eat fewer ultra-processed foods. But child experts say that the strategy reduces a systemic crisis to personal action and fails to confront the structural inequities that shape which children can realistically adopt healthier behaviors. After all, in 2024, the National Academies of Science, Engineering, and Medicine updated Unequal Treatment, a report that clearly highlights the major drivers of health disparities.
Debbie Gross, a child psychiatric nurse and professor at Johns Hopkins School of Nursing, welcomes the administration’s stated focus on children’s health but notes the gap between ideas and implementation. “The ideas in it are good, but it’s all about how this is going to be executed,” she said in an interview with The Fulcrum. “The devil is in the details. The change this MAHA strategy seeks is at the community level. Who are the people you are bringing to the table?”
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How stripping diversity, equity and inclusion from health care may make Americans sicker
President Donald Trump’s administration has dramatically reshaped health and medical research by rolling back federal funding from institutions that have diversity, equity and inclusion initiatives and by cutting federal funding for research projects that the administration considers related to DEI.
As of Aug. 20, 2025, the National Institutes of Health has terminated over 5,100 grants totaling over US$4.4 billion in research funding. Likewise, the National Science Foundation, which seeks among other things to advance the nation’s health, has rescinded over 1,700 research grants totaling over $1 billion in funding.
These terminations have disproportionately affected projects that study the experiences of marginalized groups and funding to scientists from social groups that are underrepresented in academia. The federal judge overseeing a case challenging cuts to NIH grants said that he had “never seen government racial discrimination like this.”
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Why Americans are Dying Younger? NIH Is Not the Problem. Our Broken Healthcare Delivery Is
The United States leads the world in biomedical innovation, with NIH-funded research driving transformative advances in cancer, HIV, and gene therapy. Yet, these breakthroughs cannot achieve their full impact in a fragmented and inequitable health system. Millions remain uninsured, preventive care is undervalued, and social determinants perpetuate life expectancy gaps. Political efforts to restrict or defund the NIH threaten progress and disproportionately harm underserved populations. Biomedical research alone cannot fix systemic failures but strengthening science while repairing care delivery systems is essential to improving population health and ensuring that innovations benefit all.
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Closing the Gap: Mental Health During Menopause and Midlife
After decades of being shrouded in silence, menopause is having a big moment ― from Halle Berry and Naomi Watts boldly speaking out about their menopause journeys, to Drew Barrymore experiencing her first hot flash live on TV. Though discussions have improved around the more visible symptoms of menopause, these are just the surface of menopause’s effect on women.
Mental health challenges are prevalent during this stage of life. More than one-third of women in late perimenopause report depressive symptoms ― prior history doesn’t reduce the impact either. Some 58% of women are at greater risk for another episode during perimenopause, while those with no history of depression are two to four times more likely to experience it during perimenopause.
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Heart Failure Deaths Shift to Home, Hospice, but Racial Disparities Persist
Between 1999 and 2022, there was an increase in the proportion of heart failure (HF)–related deaths of people 65 years and older in their home or hospice care compared with medical facilities and nursing homes, according to a recent study published in the Journal of the National Medical Association.
As HF-related mortality shifts from hospitals to homes and hospice settings, this study suggests these trends might not benefit all populations equally. Prior research has shown that racial and ethnic disparities influence when patients first experience HF hospitalization, often delaying diagnosis and access to specialized care among minority populations.2 These new national data reveal persistent differences in where older adults with HF die, highlighting how structural inequities across race, sex, and geography may shape end-of-life care access and outcomes long after initial diagnosis.
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