Deep cuts to the CDC’s budget are poised to undermine the public health infrastructure that gastroenterology heavily relies on — all amid GI clinicians’ struggles with reimbursement declines and growing access challenges.
At least 600 CDC employees received permanent termination notices, including about 100 in violence prevention, according to an Aug. 21 NBC News report.
The layoffs follow a federal court decision that protected some CDC programs but left others exposed, and come amid restructuring that has already cut nearly 25% of the agency’s workforce, according to a June 17 GovExec report.
In April, JAMA called the cuts “staggering” and warned they could dismantle functions like cancer prevention, outbreak response and vaccination programs.
Here are five key ways these public health cuts could exacerbate current pressures on GI care:
1. Shrinking workforce and loss of expertise
The loss of field epidemiologists and program managers could ripple across disease surveillance, including GI-related outbreaks such as hepatitis, norovirus and foodborne illnesses. Without these experts, state and local partners will have fewer resources to support GI physicians during outbreaks.
2. Chronic reimbursement erosion
Adjusted reimbursements for GI procedures fell 33% between 2007 and 2022, with colonoscopy and biopsy payments down as much as 38%.
More recently, Medicare payments for key GI procedures dropped over 22% from 2018 to 2023 after inflation adjustment. With weakened public health prevention programs, practices may see more late-stage patients — just as revenues continue to shrink.
3. Inflation-adjusted income declines amid rising costs
While nominal GI provider compensation rose 33.8% since 2015, inflation-adjusted pay has fallen. A $370,000 annual salary in 2015 would need to exceed $502,000 today to maintain buying power, but average incomes remain below that level. With thinner margins, physicians are less able to absorb added strain if CDC-supported testing and prevention programs disappear — meaning more patients present later and sicker, creating longer, more resource-intensive cases that aren’t reimbursed at higher rates.
4. Growing strain from payers and administrative burden
GI providers cite payer challenges as a top frustration — including lower reimbursements, limited engagement and prior authorization requirements that continue to expand.
“Cutting reimbursement doesn’t make the patient disappear. If we can’t provide that care, those patients end up in the ER with serious conditions,” Omar Khokhar, MD, a gastroenterologist at OSF St. Joseph Medical Center in Bloomington, Ill., told Becker’s in December.
5. Access and equity under threat
A GI physician shortage of 1,630 providers has emerged in 2025, while private equity-backed groups surged 28% since 2021. Without CDC-backed prevention and screening infrastructure, underserved and rural communities risk even greater inequities in colorectal cancer detection and hepatitis treatment.
