The hidden cost of 2025 federal funding cuts on nursing and midwifery leadership

When we showed up for work on January 20, 2025, we had no idea that within months, we would be among the hundreds of thousands of people whose jobs were eliminated this year as a direct result of the U.S. federal funding cuts and policy changes.

Executive Orders and funding cuts to U.S. foreign assistance struck first, ending decades-long partnerships to strengthen health systems worldwide—from improving maternal-child health to countering HIV, malaria, and tuberculosis. Subsequent waves of terminations at the Department of Health and Human Services (HHS) and its agencies extended the impact domestically, bringing the disruption of health services to our own backyards. Cuts at the Centers for Disease Control and Prevention (CDC) ended public health programs relied on by community health centers. The National Institutes of Health (NIH) suspended nurse-led research projects on some of the world’s most complex health challenges. The proposed 2026 HHS budget would eliminate the National Institute for Nursing Research entirely and end Health Resources and Services Administration programs addressing the U.S. nursing shortage, especially in rural areas.

In the glare of these sweeping cuts to essential public health institutions, one notable consequence risks going overlooked. Through a wide range of agencies and programs, the U.S. federal government has served as a primary source of nursing career pathways “beyond the bedside.” The displacement of nurses from government or government-funded institutions has immediate effects and long-term implications for our profession.

The visibility problem

A primary reason this consequence remains overlooked is that nurses and midwives in nontraditional roles have gone under-recognized within the profession. These “non-traditional roles” are roles held by people with nursing or midwifery backgrounds that don’t involve direct clinical care but benefit from a nursing perspective, including positions in public health, research, policy, nonprofit or nongovernmental organizations (NGOs), and the private sector.

No reliable data exist on how many nurses work in these nontraditional roles or how many have lost or shifted work as a result of funding cuts. Information through professional networks suggests that hundreds of nurses and midwives have been displaced domestically this year and thousands globally. An exact number is likely impossible to determine, as neither employers nor professional nursing associations tracked these data. Many of these nurses had stopped using nursing credentials in their professional designations, either because their roles didn’t require them or to avoid bias in competitive spaces. However, they represented the voice and vision of the nursing profession in critical decision-making spaces. (See Eliminated Roles.)

The sweeping elimination of these roles, and the programs they supported, has created a substantial and growing cohort of unemployed nurses and midwives with invaluable yet underestimated leadership and management skills. How we, as a profession, support them now will determine whether we can preserve and expand nursing’s influence long-term.

Immediate impact on nurses

The shocks of this year have affected displaced nurses differently, but many share the experience of sudden unemployment and loss of professional networks. Maslow’s Hierarchy of Needs provides a lens for understanding the full scope of impact.

At the foundation sits survival. With only days of notice before losing income and health insurance, many of the unexpectedly unemployed sought any job to maintain housing and food security. Numerous nurses returned to clinical roles by necessity, incurring significant costs to renew licenses and rebuild clinical competencies.

Higher needs collapsed simultaneously, with professional identities severed overnight and lifelong careers and community networks destroyed. Dedicated professionals were forced to abandon the mission-driven work they’d built their careers upon and watch its impact be devalued in public discourse.
These nurses have found transferring skills unexpectedly difficult. One nurse leader who had guided global nursing strategy for a well-known international NGO, managing complex programs impacting hundreds of thousands of people, was told she wasn’t qualified for a hospital chief nursing officer or even nurse manager role. Her decades of leadership expertise and current clinical practice were dismissed as irrelevant.

Long-term impact on the profession

The loss of nursing roles in public health, government, research, and partnerships is more than individual unemployment—it’s an erosion of nursing’s influence in systems that shape health outcomes.

If we allow nursing and midwifery to be confined to clinical and academic settings, we narrow our own professional definition of nursing and midwifery leadership. We lose the nursing lens in policy development, program management, research design, systems thinking, cross-cultural leadership, and advocacy. These are precisely the skills that could strengthen domestic healthcare systems and add essential value to clinical and academic environments, but only if there was both acknowledgment of the problem and clear pathways to actively recruit displaced nurse leaders. As this cohort of nurses from nontraditional roles suddenly explores options to pivot back to clinical practice, they face barriers including the time and financial cost of licensure renewals, having their professional expertise underestimated by recruitment teams, and being filtered out by artificial intelligence-based recruitment scanners.

This is a crisis of innovation for the profession. Nursing is losing designers of future care models, policy advisors who shape equitable systems, and mentors who have proven track records of guiding emerging leaders. The nursing voice is being removed from rooms where health systems are designed, funded, and governed.

What can we do about it?

To protect nursing’s influence and integrity, we must act now to support displaced colleagues and preserve the pathways they helped build. The unprecedented displacement of nurses from policy, research, and global health roles in 2025 represents a critical juncture for our profession. The actions we take now will determine whether the nursing voice remains and grows stronger at tables where health decisions are made—outside of our own professional spaces—or whether we retreat to a narrower, limited vision of what nursing is and can be. (See Take action now.)

Eliminated roles

The following are examples of roles held by U.S. nurses and midwives that were eliminated in 2025:

• Investigated outbreaks through the Epidemic Intelligence Service at CDC.
• Provided expert clinical advice to the design and management of global health programs through the U.S. Agency for International Development and its nonprofit implementing partners.
• Served as chief nursing officers and senior technical advisors for international nonprofit organizations.
• Developed and led multi-country nursing workforce development programs.
• Led the National Institute for Nursing Research at NIH.
• Developed and led health equity research and programs at the Health Resources and Services Administration.
• Researched social determinants of health and approaches to promote health equity.

Take action now

The actions outlined below will help preserve and leverage the expertise of displaced nurses and ensure the nursing voice is increasingly strong, visible, and central to the design and management of national and global health systems.

Nurses and individuals

• Amplify your voice through the American Nurses Association’s advocacy initiatives at RNAction.org and through involvement in your constituent/state nurses association.
• Support displaced colleagues through mentorship and networking.
• Speak up about why it matters to have nurses in policy and research.
• Advocate for diverse career pathways within the profession.

Professional associations

• Continue to advocate publicly for restoration of federal health funding and speak out about the critical role of nurses in policy, research, and global health.
• Create emergency funds to support license renewal for nurses displaced by federal funding cuts and policy changes.
• Establish platforms for networking and career development that connect displaced nurses with opportunities.

Academic institutions

• Develop flexible arrangements to engage displaced nurses as educators, researchers, and advisors.
• Research, recommend, and implement strategic actions to preserve nursing’s and midwifery’s sphere of influence.

Healthcare systems

• Actively recruit nurses with non-traditional backgrounds for leadership and management roles.
• Train HR and recruitment teams to recognize the transferable value of policy, research, and global health experience.
• Create bridge programs that help displaced nurses transition back to clinical environments.

— Jerilyn Hoover provides expert consulting in health workforce, public health, and health policy. Emily Headrick is a family nurse practitioner and technical advisor in global health security. Pandora Hardtman is a health systems leadership expert and an incoming director of midwifery in Atlanta, Georgia, leading workforce, policy, and maternal health reforms.

References

American Association of Colleges of Nursing. President’s FY 2026 budget request proposes steep reductions and eliminations to nursing education and research funding. May 5, 2025. aacnnursing.org/news-data/all-news/presidents-fy-2026-budget-request-proposes-steep-reductions-and-eliminations-to-nursing-education-and-research-funding

American Nurses Association. Statement by the American Nurses Association on the importance of nursing specific science and research and the leaked FY 2026 HHS budget proposal. April 17, 2025. nursingworld.org/news/news-releases/2025/statement-by-the-american-nurses-association-on-the-importance-of-nursing-specific-science-and-research-and-the-leaked-fy-2026-hhs-budget-proposal/

Cavalcanti DM, de Oliveira Ferreira de Sales L, Ferreira da Silva A, et al. Evaluating the impact of two decades of USAID interventions and projecting the effects of defunding on mortality up to 2030: A retrospective impact evaluation and forecasting analysis. Lancet. 2025;406(10500):283-94. doi:10.1016/S0140-6736(25)01186-9

Mandavilli A, Sanger-Katz M, Hoffman J. Trump administration abruptly cuts billions from state health services. The New York Times. March 26, 2025. nytimes.com/2025/03/26/health/trump-state-health-grants-cuts.html

Mullin E. A quarter of the CDC is gone. WIRED. October 14, 2025. wired.com/story/cdc-terminations-workforce-shutdown-rifs/

National Association of Community Health Centers. NACHC statement on house passage of the “One Big Beautiful Bill”. July 3, 2025. nachc.org/nachc-statement-on-house-passage-of-the-one-big-beautiful-bill/

U.S. Department of Health and Human Services. HHS grants terminated. taggs.hhs.gov/Content/Data/HHS_Grants_Terminated.pdf

The White House. Reevaluating and realigning United States foreign aid. January 20, 2025. whitehouse.gov/presidential-actions/2025/01/reevaluating-and-realigning-united-states-foreign-aid