NIH capped indirect research cost reimbursement at 15%, cutting billions from university and hospital research infrastructure nationwide.

Enhanced ACA premium tax credits expired, raising average benchmark silver plan premiums 18% nationally and affecting 21 million enrollees.

CMS approved additional state Medicaid waivers imposing work requirements and premiums — conditioning health coverage on employment in low-wage labor markets.

Social Security Administration accelerated field-office closures and staffing cuts — lengthening disability and retirement claim backlogs for millions of beneficiaries.