→ New Report: STAT Network highlights increasing threats, shows how states are rewriting playbooks in real time to protect American health, safety and economic vitality 

→ First-ever survey reveals urgent need for coordinated action: only 5 percent of state health officials feel “very prepared”, 61 percent relied on federal funds now in flux. 

PROVIDENCE, R.I. — November 3, 2025 — A new report from the STAT Network reveals that extreme weather events are jeopardizing the health, safety and economic prospects of Americans. Published today in partnership with the Federation of American Scientists and supported by The Rockefeller Foundation and the Robert Wood Johnson Foundation, the report reveals first-of-its-kind data from state public health officials in 45 states and territories on the urgent need for state-led coordination. The report also spotlights innovations that are being adopted and scaled through the STAT Network despite drastic cuts in federal funding to public health.

“States are navigating a new normal of extreme weather crises—heat waves following floods, wildfires overlapping with hurricanes—while the federal support and data tools they’ve relied on are eroding. No state should be left to shoulder this alone. Through our Extreme Weather & Health group and this report, we elevate what’s working on the ground as states are leading the response and offer a practical roadmap for acting at the speed and complexity of today’s hazards” said Stefanie Friedhoff, Professor of the Practice and STAT Network Lead, Brown University School of Public Health.

The STAT Network, which supports state public health officials across a range of pressing public health issues, started a dedicated extreme weather and health group in August 2024, serving as an essential connection point for collective problem solving in a shifting landscape. Of 136 state respondents who participated in the STAT Extreme Weather & Health survey shared with states in summer 2025: 

→ only 5% feel “very prepared” to handle the escalating public health impacts of extreme weather
→ 61% prepared for extreme weather using federal funds that are now in flux
→ 39% cited federal partnerships as historically one of the most effective mechanisms to address impacts
→ 94% are concerned that socioeconomic disparities moderately (27%) or significantly (67%) contribute to unequal outcomes during extreme weather events in their state.

The new report, Protecting the Health of Americans in the Face of Extreme Weather: A Roadmap for Coordinated Action was developed to support these leaders at this moment of evolving challenges, needs and opportunities. The report details how states are pivoting their preparedness playbooks, showcases replicable new models, and identifies pressing gaps that funders, policymakers and thought leaders must still fill. 

Download the full report

“Extreme weather events are no longer just natural disasters—they’re public health emergencies. From heat waves that overwhelm hospitals to floods that cut off access to care, Americans are feeling the strain in their communities. That’s why The Rockefeller Foundation launched the STAT Network at the height of the COVID-19 pandemic—to strengthen public health infrastructure through interstate collaboration and cross-sector partnerships. That same level of coordination is just as critical today as we face growing threats to health, safety, and economic opportunity” said Derek Kilmer, Senior Vice President for U.S. Program and Policy, The Rockefeller Foundation.

“One in three Americans report being personally affected by extreme weather in just the past two years – illustrating that extreme weather has become extremely common. The good news is that the negative health impacts of extreme weather are largely preventable. FAS is excited to partner with the STAT Network to help states step up as the federal government steps back, putting in place the innovative, evidence-based strategies we need to protect people and communities across the country,” said Dr. Hannah Safford Associate Director of Climate and Environment, Federation of American Scientists.

A changed landscape

Protecting the Health of Americans describes how extreme weather events have become more frequent, severe and widespread. From wildfires that quickly spiraled out of control in Maui and Los Angeles, to illness from extreme heat overloading emergency rooms across the Southwest, to sudden flash flooding from Hurricane Helene catching entire regions off-guard across Appalachia, it is clear that existing playbooks are no longer sufficient to respond to rapidly evolving threats. At the same time, cuts in 2025 at the Centers for Disease Control, the Environmental Protection Agency, the National Weather Service and other federal agencies have removed the backbone of funding, data and technical assistance many states relied on. 

States lead the way

Summarizing ongoing preparedness and response efforts across states, Protecting the Health of Americans offers three pillars for action and shares concrete, replicable examples that emerge from the STAT Extreme Weather & Health Network:

Collaboration. States like Minnesota and California are embedding public health voices in climate and infrastructure decisions, while North Carolina and Texas have demonstrated that shared frameworks like FEMA’s Community Lifelines can unite health, energy and emergency systems under one coordinated response. Partnerships break down silos and accelerate action.

Data. In North Carolina, advanced modeling now informs heat alerts based on real-time health and climate data; Illinois is developing predictive tools that warn hospitals before storms hit; and Alaska’s Local Environment Observer Network turns community observations into early-warning intelligence. States are making data more interoperable, localized and actionable. 

Communication. Massachusetts amplified risk messaging on Triple E and West Nile via medical providers, community groups and local media. California is co-developing an interactive curriculum with community health workers on responding to poor air quality events. Kansas convenes a cross-sector Extreme Weather Events Work Group with community-based organizations to co-create practical toolkits. States are modernizing their communications capacity, building trusted messenger networks and moving past an over-focus on social media outreach.

The new report also includes case examples from states such as Oregon, Arizona and Texas that illustrate how housing insecurity, energy burden, medical dependence on electricity, and lack of access to timely, trusted information add additional burden for low-income, elderly and rural populations—and how systems-level interventions focused on energy resilience, targeted mitigation and partnerships with community-based organizations can save lives.

Insights from this report can serve as a pathway to building community resilience and protecting health from the impacts of extreme weather. Looking ahead, the STAT Network, the Federation of American Scientists and other collaborators look forward to working with state leaders and their partners to translate this roadmap into sustained progress.

The announcement comes ahead of the STAT Network’s participation in The Rockefeller Foundation and Heartland Forward’s “Big Bets for America” convening in Oklahoma City, where leaders across the public, private, and non-profit sectors will discuss opportunities to help communities flourish.

To learn more, download the full report.  

Media Contact:
STAT Network:
Caroline Hoffman
Assistant Director of Content and Strategy
STAT Network at Brown University
caroline_hoffman2@brown.edu 

FAS:
Katie McCaskey
Communications Manager, Media and PR
Federation of American Scientists
(202) 933-8857
kmccaskey@fas.org

About the STAT Network
At a time of unprecedented disruption in the U.S. public health system, the STAT Network serves as a strategic, nonpartisan, practice-focused partner to the state public health workforce in all 50 states as well as three territories. Originally created as the State and Territory Alliance for Testing by the Rockefeller Foundation in 2020 to meet the urgent need for more state-to-state collaboration during the COVID-19 pandemic, the network convenes state health leaders across the country on a weekly basis to problem-solve ongoing threats, share best practices, and support one another. Learn more about STAT at https://sites.brown.edu/stat/ 

About the STAT Extreme Weather & Health sub-network and this report
The STAT Extreme Weather and Health Group was created in August 2024 and meets monthly. Over 480 state officials from public health, preparedness and related departments in 45 states and some countries have attended these sessions over the past year. Between May and July 2025, the Network also fielded a comprehensive Extreme Weather and Health survey, which yielded 136 responses (78% from state officials, 10% from local health officials, and 12% from federal, academic and other partners to state teams). Responses came from 34 states, with near equal participation across the political spectrum. The STAT team also met individually with state- and county-level teams in more than 25 states for in-depth conversations about ongoing response needs and innovations. Protecting the Health of Americans summarizes findings across overall network presentations and discussions, the dedicated state-level survey, and state-level interviews.    

About FAS
The Federation of American Scientists (FAS) works to advance progress on a broad suite of contemporary issues where science, technology, and innovation policy can deliver transformative impact, and seeks to ensure that scientific and technical expertise have a seat at the policymaking table. Established in 1945 by scientists in response to the atomic bomb, FAS continues to bring scientific rigor and analysis to address urgent challenges. More information about our work at the intersection of climate change and health can be found at fas.org/initiative/climate-health.

Earlier this year, FAS sounded the alarm that federal reductions in force, funding pauses and freezes, program elimination, and other actions were stalling or setting back national preparedness for extreme heat – just as summer was kicking into gear. The areas we focused on included:

• Leadership and governance infrastructure
• Key personnel and their expertise
• Data, forecasts, and information availability
• Funding sources and programs for preparedness, risk mitigation and resilience
• Progress towards heat policy goals

With summer 2025 in the rearview mirror, we’re taking a look back to see how federal actions impacted heat preparedness and response on the ground, what’s still changing, and what the road ahead looks like for heat resilience. Consider this your 2025 State of the Heat.

2025 State of the Heat

The State of Summer: How Hot Was It and How Did Communities Cope?

Summer didn’t feel as sweltering this year as it has the past couple of years. That’s objectively true – but only because the summers of 2023 and 2024 were true scorchers.

Summer 2025 was cooler than the past two summers, but still the third-hottest on record. Credit: Amanda Montañez in Scientific American; Source: Copernicus Climate Change Service (data)

Summer 2025 was still the third-hottest on record. High temperature records were shattered across the country. Eight states broke their all-time heat records for June, and in July almost the entire country – including Alaska – saw above-average temperatures. Temperature extremes continued into September. Places like the San Francisco Bay Area experienced their hottest temperatures of the year even as the season turned to autumn. In addition, humidity was a particularly potent threat. One hundred twenty million people experienced near-record humidity this summer alongside temperature extremes. Humidity and heat are a deadly combination because sweating is less effective when humidity is high, raising the risk of overheating and experiencing heat-related illness. This heat led to spikes in heat-related illnesses and hospitalizations, longer droughts, road buckling and damage, and even a federal energy emergency in June 2025.

Since January 2025, and continuing over the course of the summer, FAS’s Climate and Health team has been in regular touch with local and state government officials involved in heat preparedness, response, and resilience. These officials generally shared that heat management activities continued successfully in most places throughout the summer despite disruptions to federal funding and programs. Officials emphasized three specific developments that helped enable that continuity:

1. Tools like the National Weather Service’s HeatRisk tool remained functional. HeatRisk is a critical tool for subnational governments to understand risks, inform and coordinate partners, and design thresholds for emergency response alerts and actions. Further, the Centers for Disease Control and Prevention (CDC)’s Heat and Health Tracker, which monitors heat-related visits in emergency departments across the country, was brought back online following reversals in CDC reductions in force.
2. Some key sources of federal funds, like American Rescue Plan Act (ARPA) funding, remained available. Many local governments – particularly in places without large emergency management programs and Hazard Mitigation Assistance Program (HMGP) funds – have used ARPA funding to support heat response.
3. Low-Income Home Energy Assistance Program (LIHEAP) funding was released after considerable advocacy from the external community and members of Congress. This funding is critical to support home energy assistance for cooling bills.

Yet this continuity is fragile:

• The future of the National Integrated Heat Health Information System (NIHHIS) and the CDC’s Climate and Health program remains uncertain and the National Oceanic and Atmospheric Administration (NOAA) and CDC have faced notable staffing cuts and could face more cuts, jeopardizing the maintenance and existence of tools like HeatRisk and the Heat and Health Tracker. 
• Officials are also concerned about their ability to keep robust heat response programs going in a more austere funding landscape. For example, ARPA funding must be spent by December 31, 2026, and many officials are expecting a steep funding cliff that could lead to cuts to heat-related programs. We are already seeing evidence of this in Miami-Dade County, which eliminated its Chief Heat Officer position as a part of an effort to close a $400 million funding gap that emerged in part as ARPA funds were exhausted. Additional cuts to, and restrictions on, federal health preparedness programs and emergency management programs will also impact the staffing capacity of state and local governments. For example, one of the state officials FAS was working with on heat lost their job because of state budget shortfalls, and others have worried about their future job security.
• Finally, while the LIHEAP program is currently intact, and has bipartisan support in Congress, it could be undermined by Executive Branch pocket rescissions and reductions in force.

The State of Federal Heat Governance: What Changed?

The federal heat landscape continues to be highly dynamic. While extreme heat is no longer a stated priority of the federal government, both this Administration and Congress have acknowledged heat’s risks. Against this backdrop, federal agencies are advancing a mixed bag of heat-related policies. For example:

• The Occupational Safety and Health Administration (OSHA) continues to pursue a heat rule. This rule, which was initiated under the Biden Administration and is a top priority for worker advocates, was included on the Trump Administration’s Unified Agenda as a regulation in development. However, given comments made at summer hearings on this rule, recent reporting has hypothesized that OSHA may model the rule after Nevada’s newer and weaker “performance-based” standards. This rule includes no “trigger temperatures” above which certain protections are required. An evaluation of the Nevada rule’s effectiveness will be limited by cuts to the staff at the National Institute of Occupational Safety and Health (NIOSH), and less funding for NIOSH’s research.
• The National Institutes of Health (NIH) recommits to research on extreme heat and health. The NIH’s Climate Change and Health (CCH) Initiative was reintroduced as the Program on Health and Extreme Weather (HEW). The HEW Program’s strategic framework eliminates language directly referencing climate change and greenhouse gases and aligns with the Department of Health and Human Services’ broader MAHA strategy. As both houses of Congress rejected cuts to the National Institute of Environmental Health Sciences (NIEHS), there could be funding available through NIEHS for studies on the outcomes of heat exposure, long-term health risks, and preventative measures.
• The Government Accountability Office (GAO) says the Federal Emergency Management Agency (FEMA) needs to evaluate its role in addressing extreme heat. A recent GAO report recommended that FEMA improve its benefit-cost analysis for heat, identify heat mitigation projects it might fund, and evaluate its role in heat response – all recommendations from FAS’s 2025 Heat Policy Agenda. FEMA agreed to act partially on the recommendations, citing changes made to HMGP to make extreme heat projects ineligible for standalone funding as a barrier to full action.
• The Department of Energy acknowledges heatwaves as a particular risk. In July, the Department of Energy published a report entitled A Critical Review of the Science of Climate Change. This report has been widely discredited for cherry-picking and misrepresenting scientific studies. However, it is notable that even as the report minimizes the risks of greenhouse gas emissions, it emphasizes the importance of taking action on extreme heat, stating that “heatwaves have important effects on society that must be addressed” and that “inability to afford energy leaves low-income households exposed to weather extremes”. While there are partisan disagreements on how to secure that affordable energy, the report demonstrates that heat risk is an area of consensus between the parties that merits further pursuit.
• The ongoing government shutdown could be used by the Trump Administration to continue their mass firing of federal workers. With the status of Appropriations negotiations stalled, the Office of Management and Budget has asked agencies to prepare contingency plans, and has threatened mass layoffs of furloughed employees. Given that most heat-related activities are not statutorily authorized, this could lead to further cuts to the federal heat workforce. On Friday October 10th, hundreds of workers were laid off across Health and Human Services, including at the CDC’s National Center for Health Statistics and the Administration for Strategic Preparedness and Response.

Congressional actions are also shaping what’s possible for nationwide heat preparedness. To start, the One Big Beautiful Bill Act (OBBBA) cut funding necessary to mitigate extreme heat’s impacts as well as respond to the negative health consequences of heat. Impacts include:

Beyond OBBBA, Congressional appropriations proposals for Fiscal Year (FY) 2026 represent a mixed bag for federal heat policy. The House and the Senate proposals diverge in key ways, and will need to be rectified. Some of the things we are tracking include:

State of the Future: What Comes Next for Heat Policy

Looking ahead, it is essential that the federal government maintains its role as a data collector, steward, and analyst, supports heat-related research and development, supports social services for the most vulnerable American households facing extreme heat. and continues to make investments in state, local, territorial, and tribal (SLTT) governments and their heat mitigation infrastructure and preparedness capacity. At the same time, SLTT governments are rapidly innovating in heat policy, and will be sites of innovation to watch this next year. Our team is tracking promising signs in three key areas:

• More places are standing up heat governance infrastructure. A growing number of state, regional, and local plans acknowledge extreme heat as a risk; at the same time, more and more communities are developing standalone heat preparedness, response, or action plans (see heatplans.org to learn more, and read our “Framework for a Heat Ready Nation” to learn about progress in the Sunbelt region). New heat plans that launched in 2025 include Lincoln-Lancaster Heat Response Plan, the Low Country Heat Action Plan Toolkit, Orange County, NC’s Heat Action Plan, and King County’s Extreme Heat Mitigation Strategy. Many more plans are in the development pipeline. Further, more networks of local governments, including the Ten Across Network and Climate Mayors, are making heat technical assistance a priority.
• More places are expanding their extreme heat protections. Policies that protect people from extreme heat exposure inside of their homes, inside of schools, and at the workplace are also starting to see uptake. LA County set an indoor temperature maximum of 82°F for rental units, creating a legal right to cooling for tenants. Meanwhile, the state of California recently enacted a law that all homes should be able to attain and maintain safe indoor temperatures, without specifying that limit. New Jersey now restricts utilities from shutting off the power due to non-payment from June 15 through August 31; New Jersey is also providing direct utility relief to New Jersey ratepayers. New York State became the first state in the country to regulate extreme heat in schools, setting a maximum temperature threshold of 88F for safe school operations. Finally, in Boston and in New Orleans, ordinances passed that require basic protections from heat, like rest breaks, for all city workers and city contractors. Scaling up these policies that minimize heat overexposure will be critical to be ready for hotter heat seasons to come.
• Regional networks are forming to advance evidence-based public health measures. In light of rollbacks to public health infrastructure at the federal level, two regional networks have formed to coordinate across state public health departments, the West Coast Health Alliance and the Northeast Public Health Collaborative. While the initial focus is on developing evidence-based recommendations on vaccines and combining forces on vaccine procurement for their populations, we will be tracking how these networks address other public health efforts under threat, such as the health risks of extreme heat.

Protecting Americans from extreme heat will require a multiplicity of leadership across the levels of government in the United States and the capacity to connect hundreds of diverse organizations and experts around a shared solution set. To meet this moment, FAS will develop the 2026 State & Local Heat Policy Agenda, a blueprint for polycentric action towards a Heat Ready Nation. The 2026 Heat Policy Agenda will align the growing heat community around a shared set of objectives and equip state and local decision makers with the strategies they can deploy for heat season 2026 and beyond. We are focused on strategies that (1) build government capacity to address the threat of extreme heat and (2) ensure every American can be safe from heat in their homes, in their workplaces, and in their communities. 

Over the next couple of months, the FAS team will be documenting the policy levers available at the state and local levels to address extreme heat and crafting model guidance, model executive orders, model legislation, and financing models. Want to be a part of this effort? Reach out to Grace Wickerson at gwickerson@fas.org if you want to contribute by:

• Identifying promising extreme heat policies as well as evidence for their effectiveness.
• Offering your expertise on potential heat-related policy interventions.
• Sharing about heat-related advocacy efforts and potential technical assistance needs. 
• Raising your hand as an extreme heat champion inside of state or local government.

Extreme heat poses serious and growing risks to children’s health, safety, and education. Yet, schools and childcare facilities are unprepared to handle rising temperatures. To protect the health and well-being of American children, Congress should (1) set policies that guide childcare facilities and schools in preparing for and responding to extreme heat, (2) collect the data required to inform extreme heat readiness and adaptation, and (3) strategically invest in necessary infrastructure upgrades to build heat resilience.

Children are Uniquely Vulnerable to Extreme Heat Exposure and Acute and Chronic Health Impacts

At least five factors drive children’s vulnerability to negative health outcomes from extreme heat, like heat-related illnesses and chronic complications. First, children’s bodies take a longer time to increase sweat production and acclimatize to higher temperatures. Second, young children are more prone to dehydration than adults because a larger percentage of their body weight is water. Third, infants and young children have challenges regulating their body temperatures and often do not recognize when they should act to cool down. Fourth, compared with adults, children spend more time active outdoors, which results in increased exposure to high ambient heat. Fifth, children usually depend on others to provide them with water and protect them from unsafe outdoor environments, but children’s caretakers often underestimate the seriousness of the symptoms of heat stress. Research shows that extreme heat days are linked to increased emergency room (ER) visits for children, especially the 16% of children living at or below the federal poverty line. Extreme heat also exacerbates children’s chronic diseases, like asthma and eczema, increasing health care costs and decreasing children’s overall quality of life.

The Consequences of Chronic Extreme Heat Exposure on Children’s Learning and Well-Being 

Studies show that excess temperatures reduce cognitive functioning. Hot weather also impacts children’s behavior, making them more prone to restlessness, irritability, aggression, and mental distress. Finally, nighttime extreme heat exposure can disrupt sleep patterns, making it harder to fall asleep and stay asleep. These factors can all reduce children’s ability to focus, learn and succeed in school. For each 1°F rise in average annual temperature in school districts without air conditioning or proper heat protections, there is a 1% drop in learning. The Environmental Protection Agency found that these learning losses could translate into nearly $7 billion dollars in annual future income losses if warming trends continue.

Extreme Heat’s Threat to Schools and Childcare Facilities

Rising temperatures force school districts and childcare facilities into a dilemma: choosing between staying open in unsafe heat or closing and disrupting learning and care. 

Staying open can expose students and young children to extreme indoor and outdoor temperatures. The Government Accountability Office found that 41% of U.S. schools need to upgrade their heating, ventilation, and air conditioning (HVAC) systems: upgrades that will cost billions of dollars that schools in low-income areas do not have. Similar infrastructure challenges extend to childcare facilities. Extreme heat also makes outdoor recess more dangerous, as unshaded playgrounds and asphalt surfaces can heat up far above ambient temperatures and pose burn risks. 

Yet when schools close for heat, children still suffer. Even five days of closures for inclement weather in a school year can cause measurable learning loss. Additionally, students may lose access to school meals; while food service continuation plans exist, overheated facilities can complicate implementation. Many children, especially in low-income families, also don’t have access to reliable cooling at home, meaning that when schools close for heat, these children receive little respite. Finally, parents are directly impacted as well: school closures also mean parents lose access to childcare, forcing many to miss work or pay for alternative arrangements, straining vulnerable households. 

Advancing Solutions that Safeguard American Children from the Impacts of Extreme Heat

To support the capacity of child-serving facilities to adapt to extreme heat, Congress should direct the Department of Education to develop extreme heat guidance, technical assistance programs, and temperature standards, following existing state-level policies as a model for action. Congress should also direct the Administration for Children and Families to develop analogous policies for early childhood facilities and daycare centers receiving federal funding. Finally, Congress should direct the U.S. Department of Agriculture to develop a waiver process for continuing school food service when extreme heat disrupts schedules during the school year. 

To support improved federal data collection efforts on extreme heat’s impacts, Congress should direct the Department of Education and Administration for Children and Families to collect data on how schools and childcare facilities are experiencing and responding to extreme heat. There should be a particular focus on the infrastructure upgrades that these facilities need to make to be more prepared for extreme temperatures — especially in low-income and rural communities.Lastly, to foster much-needed infrastructure improvements in schools and childcare facilities, Congress should consider amending Title I of the Elementary & Secondary Education Act or directing the Department of Education to clarify that funds for Title I schools may be used for school infrastructure upgrades needed to avoid learning losses. These upgrades can include the replacement of HVAC systems or installation of cool roofs, walls, and pavement, solar and other shade canopies, and green roofs, trees, and other green infrastructure, which can keep school buildings at safe temperatures during heat waves. Congress should also direct the Administration for Children and Families to identify funding resources that can be used to upgrade federally-supported childcare facilities.

Public health insurance programs, especially Medicaid, Medicare, and the Children’s Health Insurance Program (CHIP), are more likely to cover populations at increased risk from extreme heat, including low-income individuals, people with chronic illnesses, older adults, disabled adults, and children. When temperatures rise to extremes, these populations are more likely to need care for their heat-related or heat-exacerbated illnesses. Congress must prioritize addressing the heat-related financial impacts onthese programs. To boost the resilience of these programs to extreme heat, Congress should incentivize prevention by enabling states to facilitate health-related social needs (HRSN) pilots that can reduce heat-related illnesses, continue to support screenings for the social drivers of health, and implement preparedness and resilience requirements into the Conditions of Participation (CoPs) and Conditions for Coverage (CfCs) of relevant programs. 

Extreme Heat Increases Fiscal Impacts on Public Insurance Programs

Healthcare costs are a function of utilization, which has been rapidly rising since 2010. Extreme heat is driving up utilization as more Americans seek medical care for heat-related illnesses. Extreme heat events are estimated to be annually responsible for nearly 235,000 emergency department visits and more than 56,000 hospital admissions, adding approximately $1 billion to national healthcare costs. 

Heat-driven increases in healthcare utilization are especially notable for public insurance programs. One recent study found that there is a 10% increase in heat-related emergency department visits and a 7% increase in hospitalizations during heat wave days for low-income populations eligible for both Medicaid and Medicare. Further demonstrating the relationship between increased spending and extreme heat, the Congressional Budget Office found that for every 100,000 Medicare beneficiaries, extreme temperatures cause an additional 156 emergency department visits and $388,000 in spending per day on average. These higher utilization rates also drive increases in Medicaid transfer payments from the federal government to help states cover rising costs. For every 10 additional days of extreme heat above 90°F, annual Medicaid transfer payments increase by nearly 1%, equivalent to an $11.78 increase per capita. 

Additionally, Medicaid funds services for over 60% of nursing home residents. Yet Medicaid reimbursement rates often fail to cover the actual cost of care, leaving many facilities operating at a financial loss. This can make it difficult for both short-term and long-term care facilities to invest in and maintain the cooling infrastructure necessary to comply with existing requirements to maintain safe indoor temperatures. Further, many short-term and long-term care facilities do not have the emergency power back-ups that can keep the air conditioning on during extreme weather events and power outages, nor do they have emergency plans for occupant evacuation in case of dangerous indoor temperatures. This can and does subject residents to deadly indoor temperatures that can worsen their overall health outcomes.

The Impacts of the One Big Beautiful Bill Act

The One Big Beautiful Bill Act (H.R. 1) will have consequential impacts on federally-supported health insurance programs. The Congressional Budget Office projects that an estimated 10 million people could lose their healthcare coverage by 2034. Researchers have estimated that a loss of coverage could result in 50,000 preventable deaths. Further, health care facilities and hospitals will likely see funding losses as a result of Medicaid funding reductions. This will be especially burdensome to low-resourced hospitals, such as those serving rural areas, and result in reductions in available offerings for patients and even closure of facilities. States will need support navigating this new funding landscape while also identifying cost-effective measures and strategies to address the health-related impacts of extreme heat.

Advancing Solutions that Safeguard America’s Health from Extreme Heat

To address these impacts in this additionally challenged context, there are common-sense strategies to help people avoid extreme heat exposure. For example, access to safely cool indoor environments is one of the best preventative strategies for heat-related illness. In particular, Congress should create a demonstration pilot that provides eligible Medicare beneficiaries with cooling assistance and direct CMS to encourage Section 1115 demonstration waivers for HRSN related to extreme heat. Section 1115 waivers have enabled states to finance pilots for life-saving cooling devices and air filter distributions. These HRSN financing pilots have helped several states to work around the challenges of U.S. underinvestment in health and social services by providing a flexible vehicle to test methods of delivering and paying for healthcare services in Medicaid and CHIP. As Congress members explore these policies, they should consider the impact of H.R. 1’s new requirements for 1115 waiver’s proof of cost-neutrality.

To further support these efforts for heat interventions, Congress should direct CMS to continue Social Drivers of Health (SDOH) screenings as a part of Quality Reporting Programs and integrate questions about extreme heat exposure risks into the screening process. These screenings are critical for identifying the most vulnerable patients and directing them to the preventative services they need. This information will also be critical for identifying facilities that are treating high proportions of heat-vulnerable patients, which could then be sites for testing interventions like energy and housing assistance.

Congress should also direct the CMS to integrate heat preparedness and resilience requirements and metrics into the Conditions of Participation (CoPs) and Conditions for Coverage (CfCs), such as through the Emergency Preparedness Rule. This could include assessing the cooling capacity of a health care facility under extreme heat conditions, back-up power that is sufficient to maintain safe indoor temperatures, and policies for resident evacuation in the event of high indoor temperatures. For safety net facilities, such as rural hospitals and federally qualified health centers, Congress should consider allocating resources for technical assistance to assess these risks and the infrastructure upgrades.

Agriculture, food, and related industries produce nearly 90% of the food consumed in the United States and contribute approximately $1.54 trillion to the national GDP. Given the agricultural sector’s importance to the national economy, food security, and public health, Congress must pay attention to the impacts of extreme heat. To boost the resilience of this sector, Congress should design strategic insurance solutions, enhance research and data, and protect farmworkers through on-farm adaptation measures.  

Extreme Heat Reduces Farm Productivity and Profitability

Extreme heat threatens agricultural productivity by increasing crop damage, causing livestock illness and mortality, and worsening water scarcity. Hotter conditions can damage crops through crop sunburn and heat stress, reducing annual yields for farms by as much as 40%. Animals raised for meat, milk, and eggs also experience increased risks of heat stress and heat-related mortality. For dairy production in particular, an estimated 1% of total annual yield is lost to heat stress alone. Further straining agricultural productivity, extreme heat accelerates water scarcity by increasing water evaporation rates. These higher evaporation rates force farmers to use even more water, drawing often from already stressed water sources. The compounding pressures posed by extreme heat can translate into significant economic losses: a study of Kansas commodity farms found that for every 1°C (1.8°F) increase in temperature, net farm incomes drop by 66%. Together, this means reduced revenue for farms and less food available for people.

Insurance solutions can help mitigate these financial impacts from extreme heat if employed responsibly. Multiple permanently authorized federal programs provide insurance or direct payments to help producers recover losses from extreme heat, including the Federal Crop Insurance Program, the Noninsured Crop Disaster Assistance Program, the Livestock Indemnity Program, and the Emergency Assistance for Livestock, Honey Bees, and Farm-Raised Fish Program. These programs need to ensure that producers are adequately covered against heat-related impacts and incentivize practices that reduce the risk of extreme heat related damages. This in turn will reduce the fiscal exposure of federal farm risk management programs. Congress should call on the United States Department of Agriculture (USDA) to research the feasibility of incentivizing heat resilience through federal crop insurance rates. Congress should also consider insurance premium subsidies for producers who adopt practices that enhance heat resilience for crops and livestock. 

Given the increasing stress of extreme heat on the water systems necessary to sustain agricultural production, National Oceanic and Atmospheric Administration (NOAA) should build on its Weather, Water, and Climate Strategy and collaborate with USDA on a national water security strategy that accounts for current and future hotter temperatures. To enhance system-wide drought resilience, Congress can also appropriate funds to leverage existing USDA programs to support on-farm adoption of shade systems, effective water management, cover crops, and soil regeneration practices. 

Finally, there are still notable knowledge gaps around extreme heat and its impacts on agriculture. These gaps include the long-term effects of higher temperatures on yields, farm input costs, and federal program spending. To address these information gaps and guide future research, Congress can direct the USDA Secretary to submit a report to Congress on the impacts of extreme heat on agriculture, farm input costs and losses, consumer prices, and the federal government’s spending (e.g.,  federal insurance and direct payment programs for losses of agricultural products and the provision of Supplemental Nutrition Assistance Program (SNAP) benefits).

Extreme Heat Lowers Agricultural Workers’ Productivity and Exposes Them to Health Risks

Higher temperatures and resulting heat stress are endangering farmer and farmworker safety and reducing their overall productivity, impacting bottom lines. Farmworkers are essential to the American food system, yet they are among the most vulnerable to extreme heat, facing a 35 times greater risk of dying from heat-related illnesses than workers in other sectors. This risk is intensifying as the sector increasingly relies on H‑2A farmworkers, who are hired to fill persistent domestic farm labor shortages. In many regions, over 25% of certified H‑2A farmworkers are required to work when local average temperatures exceed 90°F, and counties with the highest concentrations of H‑2A workers often coincide with the hottest parts of the country. After the work day, many of these workers return to substandard employer-provided housing that lacks essential cooling or ventilation, preventing effective recovery from daily heat exposure and exacerbating heat-related health risks. On top of the health risks, these conditions make people less effective on the job, which translates to economy-wide impacts: heat-related labor productivity losses across the U.S. economy currently exceeds $100 billion annually.

To address these risks, Congress should pass legislation requiring the Occupational Safety and Health Administration to finalize a federal heat standard that provides sufficient coverage for farming operations. In tandem with Occupational Safety and Health Administration (OSHA) finalizing the standard, USDA should be funded to provide technical assistance to agricultural employers for tailoring heat illness prevention plans and implementing cost-effective interventions that improve working conditions while maintaining productivity. This should include support for agricultural employers to integrate heat awareness into workforce training, resources for safety equipment and education, and support for the addition of shade structures. Doing so would ensure that agricultural workers across both large and small-scale farming operations have access to essential protections, like shade, clean water, and breaks, as well as sufficient capacity to comply. Current funding streams that could have an extreme heat infrastructure “plus-up” include the Environmental Quality Incentives Program and the Farm Service Agency’s microloans program.Lastly, Congress should also direct OSHA to continue implementing its National Emphasis Program on Heat, which enforces employers’ obligation to protect workers against heat illness or injury. OSHA should additionally review employers’ practices to ensure that H2A and other agricultural workers are protected from job or wage loss when extreme heat renders working conditions unsafe.

This memo addresses HUD’s learning agenda question, “How do the impacts, costs, and resulting needs of slow-onset disasters compare with those of declared disasters, and what are implications for slow-onset disaster declarations, recovery aid programs, and HUD allocation formulas?” We examine this using heat events as our slow-onset disaster, and hurricanes as declared disaster.

Heat disasters, a classic “slow-onset disaster”, result in significant damages, which can exceed damage caused by more commonly declared disasters like hurricanes due to high loss of life from heat. The Federal Housing and Urban Development agency (HUD) can play an important role in heat disasters because most heat-related deaths occur in the home or among those without homes; therefore, the housing sector is a primary lever for public health and safety during extreme heat events. To enhance HUD’s ability to protect the public from extreme heat, we suggest enhancing interagency data collection/sharing to facilitate the federal disaster declarations needed for HUD engagement, working heat mitigation into HUD’s programs, and modifying allocation formulas, especially if a heat disaster is declared.

Challenge and Opportunity

Slow-Onset Disasters Never Declared As Disasters

Slow-onset disasters are defined as events that gradually develop over extended periods of time. Examples of slow-onset events like drought and extreme heat can evolve over weeks, months, or even years. By contrast, sudden-onset disasters like hurricanes, occur within a short and defined timeframe. This classification is used by international bodies such as the United Nations Office for Disaster Risk Reduction (UNDRR) and the International Federation of Red Cross and Red Crescent Societies (IFRC).

HUD’s main disaster programs typically require a federal disaster declaration , making HUD action reliant on action by the Federal Emergency Management Agency (FEMA) under the Stafford Act. However, to our knowledge, no slow-onset disaster has ever received a federal disaster declaration, and this category is not specifically addressed through federal policy.

We focus on heat disasters, a classic slow-onset disaster that has received a lot of attention recently. No heat event has been declared a federal disaster, despite several requests. Notable examples include the 1980 Missouri heat and drought events, the 1995 Chicago heat wave, which caused an estimated 700 direct fatalities, as well as the 2022 California heat dome and concurrent wildfires. For each request, FEMA determined that the events lacked sufficient “severity and magnitude” to qualify for federal assistance. FEMA holds a precedent that declared disasters need to have a discrete and time-bound nature, rather than a prolonged or seasonal atmospheric condition.

“How do the impacts, costs, and resulting needs of slow-onset disasters compare with those of declared disasters?” 

Heat causes impacts in the same categories as traditional disasters, including mortality, agriculture, and infrastructure, but the impacts can be harder to measure due to the slow-onset nature. For example, heat-related illness and mortality as recorded in medical records are widely known to be significant underestimates of the true health impacts. The same is likely true across categories.

Sample Impacts

We analyze impacts within categories commonly considered by federal agencies–human mortality, agricultural impacts, infrastructure impacts, and costs for heat, and compare them to counterparts for hurricanes, a classic sudden-onset disaster. Other multi-sectoral reports of heat impacts have been compiled by other entities, including SwissRe and The Atlantic Council Climate Resilience Center.

We identified 3,478 deaths with a cause of “cataclysmic storms” (e.g., hurricanes; International Classification of Disease Code X.37) and 14,461 deaths with a cause of heat (X.30) between 1999-2020 using data from the Centers for Disease Control and Prevention’s (CDC). It is important to note that the CDC database only includes death certificates that list heat as a cause of death, while it is widely recognized that this can be a significant underaccount. However, despite these limitations, CDC remains the most comprehensive national dataset for monitoring mortality trends.

HUD can play an important role in reducing heat mortality. In the 2021 Pacific Northwest Heat Dome, most of the deaths occurred indoors (reportedly 98% in British Columbia) and many in homes without adequate cooling. In hotter Maricopa County, Arizona, in 2024, 49% of all heat deaths were among people experiencing homelessness and 23% occurred in the home.  Therefore, across the U.S., HUD programs could be a critical lever in protecting public health and safety by providing housing and ensuring heat-safe housing.

Agricultural Labor

Farmworkers are particularly vulnerable to extreme heat, and housing can be part of a solution to protect them. According to the Environmental Protection Agency (EPA), between 1992 to 2022, 986 workers across industry sectors died from exposure to heat, with agricultural workers being disproportionately affected. According to the Environmental Defense Fund, farmworkers in California are about 20 times more likely to die from heat-related stress, compared to the general population, and they estimate that the average U.S agricultural worker is exposed to 21 working days in the summer growing season that are unsafe due to heat. A study found that the number of unsafe working days due to extreme heat will double by midcentury, increasing occupational health risks and reducing labor productivity in critical sectors. Adequate cooling in the home could help protect outdoor workers by facilitating cooling periods during nonwork hours, another way in which HUD could have a positive impact on heat.

Infrastructure and Vulnerability

Rising temperatures significantly increase energy demand, particularly due to the widespread reliance on air conditioning. This surge in demand increases the risk of power outages during heat events, exacerbating public health risks due to potential grid failure. In urban areas, the built environment can add heat, while in rural areas residents are at greater risk due to the lack of infrastructure. This effect contributes to increased cooling costs and worsens air quality, compounding health vulnerabilities in low-income and urban populations. All of these impacts are areas where HUD could improve the situation through facilitating and encouraging energy-efficient homes and cooling infrastructure.

Costs

In all categories we examined, estimates of U.S.-wide costs due to extreme heat rivaled or exceeded costs of hurricanes. For mortality, the estimated economic impact of mortality (scaled by value of statistical life, VSL = $11.6 million) caused by extreme heat reached $168 billion, significantly exceeding the $40.3 billion in VSL losses from hurricanes during the same period. Infrastructure costs further reflect this imbalance. Extreme heat resulted in an estimated $100 billion in productivity loss in 2024 alone, with over 60% of U.S. counties currently experiencing reduced economic output due to heat-related labor stress. Meanwhile, Hurricanes Helene and Milton together generated $113 billion in damage during the 2024 Atlantic hurricane season.

Crop damage reveals the disproportionate toll of heat and drought, with 2024 seeing $11 billion in heat/drought impacts compared to $6.8 billion from hurricanes. The dairy industry experiences a substantial recurring burden from extreme heat, with annual losses of $1.5 billion attributed to heat-induced declines in production, reproduction, and livestock fatalities. Broader economic impacts from heat-related droughts are severe, including $14.5 billion in combined damages from the 2023 Southern and Midwestern drought and heatwave, and $22.1 billion from the 2022 Central and Eastern heat events. Comparatively, Hurricane Helene and Hurricane Milton produced $78.7 billion and $34.3 billion in damages, respectively. Extreme heat and drought exert long-term, widespread, and escalating economic pressures across public health, agriculture, energy, and infrastructure sectors. A reassessment of federal disaster frameworks is necessary to appropriately prioritize and allocate funds for heat-related resilience and response efforts.

Resulting Needs

Public Health and Medical Care: Immediate care and resources for heat stroke and exhaustion, dehydration, and respiratory issues are key to prevent deaths from heat exposure. Vulnerable populations including children, elderly, and unhoused are particularly at risk. There is an increased need for emergency medical services and access to cooling centers to prevent the exacerbation of heat stress and to prevent fatalities.

Cooling and Shelter: Communities require access to public cooling centers and for air conditioning. Clean water supply is also essential to maintain health.

Infrastructure and Repair: The use of air conditioning increases energy consumption, leading to power outages. Updated infrastructure is essential to handle demand and prevent blackouts. Building materials need to include heat-resistant materials to reduce Urban Heat Island effects.

Emergency Response Capacity: Emergency management systems need to be strengthened in order to issue early warnings, produce evacuation plans, and mobilize cooling centers and medical services. Reliable communication systems that provide real-time updates with heat index and health impacts will be key to improve community preparedness.

Financial Support and Insurance Coverage: Agricultural, construction, and service workers are populations which are vulnerable to heat events. Loss of income may occur as temperatures rise, and compensation must be given.

Social Support and Community Services: There is an increasing need for targeted services for the elderly, unhoused, and low-income communities. Outreach programs, delivery of cooling resources, and shelter options must be communicated and functional in order to reduce mortality. Resilience across these sectors will be improved as data definitions and methods are standardized, and when allocations of funding specifically for heat increase. 

“What are implications for slow-onset disaster declarations, recovery aid programs, and HUD allocation formulas?”

Slow-onset disaster declarations

No heat event–or to our knowledge or other slow-onset disaster–has been declared a disaster under the Stafford Act, the primary legal authority for the federal government to provide disaster assistance. The statute defines a “major disaster” as “any natural catastrophe… which in the determination of the President causes damage of sufficient severity and magnitude to warrant major disaster assistance to supplement the efforts and available resources of States, local governments, and disaster relief organizations in alleviating the damage, loss, hardship, or suffering caused thereby.” Though advocacy organizations have claimed that the reason for the lack of disaster declaration is because the Stafford Act omits heat, FEMA’s position is that amendment is unnecessary and that a heat disaster could be declared if state and local needs exceed their capacity during a heat event. This claim is credible, as the COVID-19 pandemic was declared a disaster without explicit mention in the Stafford Act.

Though FEMA’s official position has been openness to supporting an extreme-heat disaster declaration, the fact remains that none has been declared. There is opportunity to improve processes to enable future heat declarations, especially as heat waves affect more people more severely for more time. The Congressional Research Service suggests that much of the difficulty might stem from FEMA regulations focusing on assessment of uninsured losses makes it less likely that FEMA will recommend that the President declare a disaster. Heat events can be hard to pin down with defined time periods and locations, and the damage is often to health and other impacts that are slow to be quantified^. Therefore, real-time monitoring systems that quantify multi-sectoral damage could be deployed to provide the information needed. Such systems have been designed for extreme heat, and similar systems are being tested for wildfire smoke–these systems could rapidly be put into use.

The U.S. Department of Housing and Urban Development (HUD) plays a critical role in long-term disaster recovery, primarily by providing housing assistance and funding for community development initiatives (see table above). However, HUD’s ability to deploy emergency support is contingent upon disaster declaration under the Stafford Act and/or FEMA activation. This restriction limits HUD’s capacity to implement timely interventions, such as retrofitting public housing with cooling systems or providing emergency housing relief during extreme heat events. 

Without formal recognition of a heat event as a disaster, HUD remains constrained in its ability to deliver rapid and targeted support to vulnerable populations facing escalating risks from extreme temperatures. Without declared heat disasters, the options for HUD engagement hinge on either modifying program requirements or supporting the policy and practice needed to enable heat disaster declarations.

HUD Allocation Formulas

Congress provides funding through supplemental appropriations to HUD following major disasters, and HUD determines how best to distribute funding based on disaster impact data. The calculations are typically based on Individual and Public Assistance data from FEMA, verified loss data from the Small Business Administration (SBA), claims from insurance programs such as the National Flood Insurance Program (NFIP), and housing and demographic data from the U.S Census Bureau and American Community Survey. CDBG-DR and CDBG-MIT typically require that at least 70% and 50% of funds benefit low and moderate income (LMI) communities respectively. Funding is limited to areas where there has been a presidentially declared disaster.

For example, the Disaster Relief Supplemental Appropriations Act, 2025 (approved on 12/21/2024) appropriated $12.039 billion for CDBG-Disaster Recovery funds (CDBG-DR) for disasters “that occurred in 2023 or 2024.” HUD focused its funding on areas with the most serious and concentrated unmet housing needs from within areas that experienced a declared disaster within the time frame. Data used to determine the severity of unmet housing needs included FEMA and SBA inspections of damaged homes; these data were used in a HUD formula. 

Opportunities exist to adjust allocation formulas to be more responsive to extreme heat, especially if CDBG is activated for a heat disaster. For example, HUD is directed to use the funds “in the most impacted and distressed areas,” which it could interpret to include housing stock that is unlikely to protect occupants from heat.

Gaps

Extreme heat presents multifaceted challenges across public health, infrastructure, and agriculture, necessitating a coordinated and comprehensive federal response. The underlying gap is the lack of any precedent for declaring an extreme-heat disaster; without such a declaration, numerous disaster-related programs in HUD, FEMA, and other federal agencies cannot be activated. Furthermore, likely because of this underlying gap, disaster-related programs have not focused on protecting public health and safety from extreme heat despite its large and growing impact.

Plan of Action 

Recommendation 1. Improve data collection and sharing to enable disaster declarations.

Because lack of real-time, quantitative data of the type most commonly used by disaster declarations (i.e., uninsured losses; mortality) is likely a key hindrance to heat-disaster declarations, processes should be put in place to rapidly collect and share this data.

Health impacts could be tracked most easily by the CDC using the existing National Syndromic Surveillance System and by expanding the existing influenza-burden methodology, and by the National Highway Traffic Safety Association’s Emergency Medical Services Activation Surveillance Dashboard. To get real-time estimates of mortality, simple tools can be built that estimate mortality based on prior heatwaves; such tools are already being tested for wildfire smoke mortality. Tools like this use weather data as inputs and mortality as outputs, so many agencies could implement–NOAA, CDC, FEMA, and EPA are all potential hosts. Additional systems need to be developed to track other impacts in real time, including agricultural losses, productivity losses, and infrastructure damage.

To facilitate data sharing that might be necessary to develop some of the above tools, we envision a standardized national heat disaster framework modeled after the NIH Data Management and Sharing (DMS) policy. By establishing consistent definitions and data collection methods across health, infrastructure, and socioeconomic sectors, this approach would create a foundation for reliable, cross-sectoral coordination and evidence-based interventions. Open and timely access to data would empower decision-makers at all levels of government, while ethical protections—such as informed consent, data anonymization, and compliance with HIPAA and GDPR—would safeguard individual privacy. Prioritizing community engagement ensures that data collection reflects lived experiences and disparities, ultimately driving equitable, climate-resilient policies to reduce the disproportionate burden of heat disasters.

While HUD or any other agency could lead the collaboration, much of the National Integrated Heat Health Information System (NIHHIS) partnership (HUD is a participant) is already set up to support data-sharing and new tools. NIHHIS is a partner network between many federal agencies and therefore has already started the difficult work of cross-agency collaboration. Existing partnerships and tools can be leveraged to rapidly provide needed information and collaboration, especially to develop real-time quantification of heat-event impacts that would facilitate declaration of heat disasters. Shifting agency priorities have reduced NIHHIS partnerships recently; these should be strengthened, potentially through Congressional action.

Recommendation 2. Incorporate heat mitigation throughout HUD programs

Because housing can play such an important role in heat health (e.g., almost all mortality from the 2021 Heat Dome in British Columbia occurred in the home; most of Maricopa County’s heat mortality is either among the unhoused or in the home), HUD’s extensive programs are in a strong position to protect health and life safety during extreme heat. Spurring resident protection could include gentle behavioral nudges to grant recipients, such as publishing guidance on regionally tailored heat protections for both new construction and retrofits. Because using CDBG funds for extreme heat is uncommon, HUD should publish guidance on how to align heat-related projects with CDBG requirements or how to incorporate heat-related mitigation into projects that have a different focus. In particular, it would be important to provide guidance on how extreme heat related activities meet National Objectives, as required by authorizing legislation.

HUD could also take a more active role, such as incentivizing or requiring heat-ready housing across their other programs, or even setting aside specific amounts of funds for this hazard. The active provision of funding would be facilitated by heat disaster declarations, so until that occurs it is likely that the facilitation guides suggested above are likely the best course of action.

HUD also has a role outside of disaster-related programs. For example, current HUD policy requires residents in Public Housing Agency (PHA) managed buildings to request funding relief to avoid surcharges from heavy use of air conditioning during heat waves; policy could be changed to proactively initiate that relief from HUD. In 2024, Principal Deputy Assistant Secretary Richard Monocchio sent a note encouraging broad thinking to support residents through extreme heat, and such encouragement can be supported with agency action. While this surcharge might seem minor, ability to run air conditioning is key for protecting health, as many indoor heat deaths across Arizona to British Columbia occurred in homes that had air conditioning but it was off.

Recommendation 3. HUD Allocation Formula: Inclusion of Vulnerability Variables

When HUD is able to launch programs focused on extreme heat, likely only following an officially declared heat disaster, HUD allocation formulas should take into account heat-specific variables. This could include areas where heat mortality was highest, or, to enhance mitigation impact, areas with higher concentrations of at-risk individuals (older adults, children, individuals with chronic illness, pregnant people, low-income households, communities of color, individuals experiencing houselessness, and outdoor workers) at-risk infrastructure (older buildings, mobile homes, heat islands). By integrating heat-related vulnerability indicators in allocations formulas, HUD would make the biggest impact on the heat hazard.

Conclusion

Extreme heat is one of the most damaging and economically disruptive threats in the United States, yet it remains insufficiently recognized in federal disaster frameworks. HUD is an agency positioned to make the biggest impact on heat because housing is a key factor for mortality. However, strong intervention across HUD and other agencies is held back by lack of federal disaster declarations for heat. HUD can work together with its partner agencies to address this and other gaps, and thereby protect public health and safety.

Record-breaking heat is increasing the need for home cooling solutions to maintain safe and liveable indoor temperatures. Over the last two decades, U.S. consumers and the private sector have leaned heavily into purchasing and marketing conventional air conditioning (AC) systems, such as central air conditioning, window units and portable ACs, to cool down overheating homes. But in the absence of intentional planning, the rapid scaling of AC can intensify dangerous vulnerabilities, including rising energy bills and increased utility debt; surging electricity demand that increases reliance on high-polluting power infrastructure; and increasing pressure on an aging power grid, making it prone to life-threatening blackouts.

To be prepared for more extreme temperatures, Americans need resilient cooling: a holistic strategy that works across three interdependent systems: buildings, communities, and the electric grid. Buildings are the front line of defense, and must be designed to maintain comfortable indoor temperatures both with and without power. Communities comprise the physical environment around and between buildings, where shared infrastructure can cool ambient temperatures, while making indoor environments cooler and safer. And electric grids are the backbone of mechanical cooling, and ensure that buildings and neighborhoods have the power needed to stay safe under extreme conditions. A resilient cooling strategy that works across these systems ensures that everyone can affordably maintain safe indoor temperatures during extreme heat events while reducing power outage risks.

FAS’s new Resilient Cooling Strategy and Policy Toolkit is designed to help state and local policymakers implement resilient cooling in ways that cut costs, protect public health, and reduce grid strain. This toolkit is organized around the Policy Principles for Resilient Cooling, a set of objectives for a robust resilient cooling strategy, and also includes actionable policy options and levers that state and local governments can deploy to expand access to resilient cooling technologies and strategies across technology systems. This work is a part of ongoing translation of FAS’ 2025 Heat Policy Agenda, a national strategy focused on improving extreme heat preparedness, management, and response.

The Policy Principles for Resilient Cooling are:

• Expand Cooling Access and Affordability. Affordable and accessible cooling reduces the population-wide risk of heat-related illness and death. Targeted financial supports, such as subsidies, rebates, and incentives, can reduce both upfront and ongoing costs of cooling technologies, thereby lowering barriers and enabling broader adoption.
• Incorporate Public Health Outcomes as a Driver of Resilience. Indoor heat exposure and heat-driven factors that reduce indoor air quality are health risks. Policymakers can embed heat-related health risks into building codes, energy standards, and guidelines for energy system planning, including by establishing minimum indoor temperature and air quality requirements, integrating health considerations into energy system planning standards, and investing in multi-solving community interventions like green infrastructure.
• Advance Sustainability Across the Cooling Lifecycle. Rising AC demand is intensifying the problem it aims to solve: ambient extreme heat. This happens as AC increases electricity consumption, prolongs reliance on high-polluting power plants, and leaks refrigerants that release powerful greenhouse gases. Policymakers can adopt codes and standards that reduce reliance on high-emission energy sources and promote low-global warming potential (GWP) refrigerants and passive cooling strategies.
• Promote Solutions for Grid Resilience. The U.S. electric grid is struggling to keep up with rising demand for electricity, creating potential risks to communities’ cooling systems. Policymakers can proactively identify potential vulnerabilities in energy systems’ ability to sustain safe indoor temperatures. Demand-side management strategies, distributed energy resources, and grid-enhancing technologies can  ensure its reliability during extreme heat events.
• Build a Skilled Workforce for Resilient Cooling. Resilient cooling provides an opportunity to create pathways to good-paying jobs, reduce critical workforce gaps, and bolster the broader economy. Investing in a workforce that can design, install, and maintain resilient cooling systems can strengthen local economies, ensure preparedness for all kinds of risks to the system, and bolster American innovation.

By adopting a resilient cooling strategy, state and local policymakers can address today’s overlapping energy, health, and affordability crises, advance American-made innovation, and ensure their communities are prepared for the hotter decades ahead. 

For more information and insights on solutions to foster resilience to extreme heat, contact us:

• Autumn Burton, Senior Associate, Climate, Health, and Environment, aburton@fas.org 
• Grace Wickerson, Senior Manager, Climate and Health, gwickerson@fas.org 
• Megan Husted, Climate and Energy Associate, mhusted@fas.org

Every region in the U.S. is experiencing year after year of record-breaking heat. More households now require home cooling solutions to maintain safe and liveable indoor temperatures. Over the last two decades, U.S. consumers and the private sector have leaned heavily into purchasing and marketing conventional air conditioning (AC) systems, such as central air conditioning, window units and portable ACs, to cool down overheating homes. 

While AC can offer immediate relief, the rapid scaling of AC has created dangerous vulnerabilities: rising energy bills are straining people’s wallets and increasing utility debt, while surging electricity demand increases reliance on high-polluting power infrastructure and mounts pressure on an aging power grid increasingly prone to blackouts. There is also an increasing risk of elevated demand for electricity during a heat wave, overloading the grid and triggering prolonged blackouts, causing whole regions to lose their sole cooling strategy. This disruption could escalate into a public health emergency as homes and people overheat, leading to hundreds of deaths. 

What Americans need to be prepared for more extreme temperatures is a resilient cooling strategy. Resilient cooling is an approach that works across three interdependent systems — buildings, communities, and the electric grid — to affordably maintain safe indoor temperatures during extreme heat events and reduce power outage risks. 

This toolkit introduces a set of Policy Principles for Resilient Cooling and outlines a set of actionable policy options and levers for state and local governments to foster broader access to resilient cooling technologies and strategies. For example, states are the primary regulators of public utility commissions, architects of energy and building codes, and distributors of federal and state taxpayer dollars. Local governments are responsible for implementing building standards and zoning codes, enforcing housing and health codes, and operating public housing and retrofit programs that directly shape access to cooling. 

The Policy Principles for Resilient Cooling for a robust resilient cooling strategy are:

• Expand Cooling Access and Affordability. Ensuring that everyone can affordably access cooling will reduce the population-wide risk of heat-related illness and death in communities and the resulting strain on healthcare systems. Targeted financial support tools — such as subsidies, rebates, and incentives — can reduce both upfront and ongoing costs of cooling technologies, thereby lowering barriers and enabling broader adoption. 
• Incorporate Public Health Outcomes as a Driver of Resilience. Indoor heat exposure and heat-driven factors that reduce indoor air quality — such as pollutant accumulation and mold-promoting humidity  — are health risks. Policymakers should embed heat-related health risks into building codes, energy standards, and guidelines for energy system planning, including establishing minimum indoor temperature and air quality requirements, integrating health considerations into energy system planning standards, and investing in multi-solving community system interventions like green infrastructure.
• Advance Sustainability Across the Cooling Lifecycle. Rising demand for air conditioning is intensifying the problem it aims to solve by increasing electricity consumption, prolonging reliance on high-polluting power plants, and leaking refrigerants that release powerful greenhouse gases. Policymakers can adopt codes and standards that reduce reliance on high-emission energy sources and promote low-global warming potential (GWP) refrigerants and passive cooling strategies.
• Promote Solutions for Grid Resilience. The U.S. electric grid is struggling to keep up with rising demand for electricity, creating potential risks to communities’ cooling systems. Policymakers can proactively identify potential vulnerabilities in energy systems’ ability to sustain safe indoor temperatures. Demand-side management strategies, distributed energy resources, and grid-enhancing technologies can prepare the electric grid for increased energy demand and ensure its reliability during extreme heat events.
• Build a Skilled Workforce for Resilient Cooling. Resilient cooling provides an opportunity to create pathways to good-paying jobs, reduce critical workforce gaps, and bolster the broader economy. Investing in a workforce that can design, install, and maintain resilient cooling systems can strengthen local economies, ensure preparedness for all kinds of risks to the system, and bolster American innovation.

By adopting a resilient cooling strategy, state and local policymakers can address today’s overlapping energy, health, and affordability crises, advance American-made innovation, and ensure their communities are prepared for the hotter decades ahead.

Imagine: it’s the peak of summer in the Southwest, and a heat wave is surging after a spring of heavy rains. To keep cool, you crank up the air conditioning. In the distance, an aging power line sags under the strain of the heat. A spark escapes the line’s faulty insulation, landing in overgrown brush that grew during the rainy season but has died and dried up in the heat, turning to tinder. Flames erupt and before long, a wildfire is beginning to spread. The local utility, hoping to avoid additional ignitions that could spread firefighting resources too thin, shuts off power. The tactic works – firefighters are able to contain the emerging threat before it reaches your neighborhood and home – but at a cost. With people unable to keep their AC running while the power shutoff is in place, temperatures inside homes soar and dozens of people are rushed to the hospital for heat-related illness. 

This scenario is becoming less and less hypothetical as the risks of wildfire and extreme heat compound with an aging electric grid.

We are a nation powered by, well, power; modern American society has evolved around the electric grid. Yet aging U.S. electric infrastructure (the majority of which was built over 30 years ago and has received minimal upgrades since) is increasingly strained by growing cooling demand as heat waves become more frequent and widespread, as well as physically threatened by wildfires and other extreme weather events. And when the power goes out during or after extreme weather, hamstringing essential health, information, and emergency-response systems, the consequences of extreme weather become much worse. In these ways, the electric grid is a backbone of U.S. resilience to extreme weather. The grid is the place where cascading impacts of extreme weather and other effects of climate change converge – but managed appropriately, the grid can also be a robust line of defense.

Zooming in on the intersections between the grid, heat, and wildfire illustrates these broader trends while also yielding immediately actionable insights. The electric grid is a critical asset for keeping people cool during extreme heat. Yet the electric grid is also a wildfire risk because old and outdated equipment can emit sparks that catch fire in nearby vegetation or other flammable materials. Extreme heat increases energy demand on this same outdated equipment, which strains generation, transmission, and distribution systems and heightens wildfire risk. 

Addressing these challenges involves complex questions about who should pay for necessary infrastructure upgrades and who is liable for grid failures that endanger lives and property. Fortunately, there are powerful opportunities to advance co-beneficial technologies and strategies that simultaneously strengthen the grid, build resilience to extreme heat and wildfires, and bring down energy costs for consumers. 

Wildfires, Extreme Heat, and an Aging Grid: A Dangerous Combination

The electric grid poses a substantial wildfire threat for many states. In California, for example, 10% of all wildfires between 2016 and 2020 were caused by electrical power, leading to over 3.3 million acres burned. Since 2015, power lines have caused six out of California’s 20 most destructive wildfires. In 2023, the citizens of Lahaina, Maui experienced the deadliest U.S. wildfire in more than 100 years when a broken power line set nearby vegetation ablaze. The following year, the largest wildfire in Texas history burned more than a million acres; after several months of investigation, the cause was determined to be a decaying utility pole that caught fire.  

Extreme heat brings the chances of wildfire ignition resulting from aging grid infrastructure to a rolling boil. Record-high temperatures drive up air conditioning (AC) use, which increases energy demand and strains the grid. Extreme heat can also cause power lines to sag and expand and transformers to overheat. In 2022, Southern California Edison power lines sagged under extreme heat conditions and came in contact with a communications line, producing sparks that ignited the dry vegetation below. The resulting wildfire near Hemet, California impacted tens of thousands of residents. 

Given the wildfire risk that grids can pose, some utilities have implemented safety mechanisms to protect the public. For example, transmission lines in some service areas shut off automatically when the presence of smoke or fire is detected nearby. Additionally, utilities may proactively shut off power when the risk of wildfire is high in order to reduce the likelihood of equipment-related ignitions that could get out of control. This is a common practice; roughly one in three wildfire-related outages from 2000 to 2024 were public safety power shutoffs (PSPS). 

While these PSPS shutoffs can reduce wildfire risk, they come at a dangerous cost when combined with high temperatures. Power shutoffs meant to prevent fire damage leave people without air conditioning, which most Americans rely on exclusively for cooling. Without AC or alternative cooling strategies, people are more vulnerable to developing heat-related illness. Power outages can also compound the heat-health risk by leaving people without refrigerated medications and electricity-dependent medical devices, and limiting communication options during medical emergencies – emergencies that are more likely to occur during extreme heat events.

Protecting Communities by Investing in a Resilient Grid 

A resilient electric grid helps communities stay safe, comfortable, and healthy in the face of extreme weather. Examples of strategies that can be used to build community resilience through grid resilience include: 

• Grid hardening. Grid hardening refers to techniques that improve the ability of physical grid infrastructure to resist damage from external stressors like extreme temperatures and wildfires. One example is “undergrounding”; i.e., replacing overhead transmission lines with subsurface networks. Undergrounding reduces the risk of wildfire ignition from electrical equipment and protects transmission infrastructure from heat-related sagging, though it can have a high cost per mile to implement. Another example of grid hardening is replacing traditional wood poles with composite materials such as steel or fiberglass that are more resilient to high temperatures and fire.
• Grid-enhancing technologies. Grid-enhancing technologies can be deployed when feasible, which can increase capacity on the current electrical system. The usage of advanced conductors, which can maintain better performance at higher operating temperatures, and demand-response algorithms can reduce grid loads during peak periods, such as the hottest parts of the day.
• Building additional distributed generation while expanding transmission capacity. Decentralized electricity generation (such as solar-plus-storage systems, flexible load programs, and community microgrids) can operate independently during power outages caused by PSPSs or rolling blackouts. Decentralized generation systems provide localized backup during emergencies and relieve pressure on centralized grid infrastructure during heat waves and other periods of very high energy demand. In the long term, getting more renewable energy resources connected to the grid and building high-voltage transmission lines that can transport the energy over longer distances can support a more abundant and flexible power supply.
• Increasing local, regional, and interregional coordination. Coordination is essential because responsibilities for grid operations, emergency response, and utility regulation are often shared across multiple jurisdictions and agencies. For example, utilities maintain infrastructure, while Public Utility Commissions (PUCs) regulate service standards and local governments often manage emergency response and planning. When multiple service areas are affected by a wildfire and extreme heat event, interregional coordination, such as data sharing and real-time weather-impacts monitoring, ensures that potential grid risks and vulnerabilities are shared and response efforts are coordinated. For instance, utilities can coordinate with first responders and emergency response agencies when ordering PSPSs in their service territories.
• Planning for negative externalities from power outages. Utilities can identify and support customers at the highest risk for negative outcomes (e.g., food spoilage, illness, business impacts, emergency services) associated with PSPS, especially those compounded by co-occurring hazards like extreme heat and wildfires. States like Colorado have had to intervene on behalf of customers for negative impacts of PSPS. Thus, it is important for utilities to plan for how they will support their customers. 

Opportunity Areas for Policy Action

Many of the measures identified above require substantial upfront investment as well as coordination across multiple levels of government. This raises an important policy question: who should be responsible for shouldering the costs of grid resilience upgrades in the face of more frequent and costly extreme weather events? 

Certain resilience measures can only be implemented by utilities who own the physical infrastructure that needs upgrading in the face of worsening hazards. Some utilities argue that they need legal protections from liability in order to remain financially viable, to be able to invest in essential infrastructure, and to continue delivering the energy that powers our lives. To this end, some utilities have advocated for liability protection legislation in multiple states that would grant them (the utilities) legal immunity or limit the damages they must pay if their infrastructure sparks a wildfire, on the condition that they follow approved wildfire mitigation plans. In return for taking mitigation actions required under these plans, utilities can seek protection from lawsuits that could expose them to billions in damages. 

However, extreme weather event victims, insurers, and trial lawyers argue that such protections shift the burden onto residents, leaving them with fewer avenues for compensation and creating perverse incentives for utilities to avoid accountability. Additionally, some utility companies are passing the costs of lawsuit payouts, as well as those of system improvements and delayed maintenance, on to ratepayers through higher electricity bills, raising affordability concerns. For example, Southern California Edison raised rates 13% in 2021 to pay for fire mitigation efforts. 

The reality is that no single entity can bear the full cost of making the grid resilient to compounding extreme weather risks, as these are shared risks with shared stakes. Utilities, as noted, have a critical role to play: they own and operate the infrastructure, and they must invest in resilience while keeping energy affordable. But making upgrades and investments at the scale needed to reduce overall risk to the grid and communities in a multi-hazard environment requires a cross-sectoral, multi-pronged approach. The following section identifies the key stakeholders that must partner with electric utilities to build a more resilient grid, outlines their current roles and responsibilities, and suggests opportunity areas for action in this evolving landscape. 

Congress

Roles and Responsibilities. Congress plays a key role in supporting subnational utility work. For example, Congress supports grid resilience through funding programs like the Grid Resilience and Innovation Partnership (GRIP) from the Department of Energy (DOE) and the Wildfire Electric Grid Resilience Program from Sandia National Laboratory. Congress also appropriates funds to executive branch agencies for the development of foundational federal data and tools, as well as the technical assistance needed for better anticipation and response to compounding risks. Agencies such as the National Oceanic and Atmospheric Administration (NOAA) and the National Aeronautics and Space Administration (NASA) produce high-resolution extreme weather projections that can help utilities and subnational governments assess risk. 

Opportunity Areas. Understanding where extreme heat and wildfire are likely to co-occur in the future under various scenarios is essential for supporting proper planning. Where possible, Congress can support modeling and research efforts that provide this information more cost-effectively than subnational efforts and develop technical assistance to help communities plan for these compounding hazards. Congress can also authorize and appropriate funding for test beds and prize challenges that support innovation in multi-hazard grid resilience. 

National and International Regulatory Bodies

Roles and Responsibilities. Regulatory bodies such as the Federal Energy Regulatory Commission (FERC) and the North American Electric Reliability Corporation (NERC) play vital roles in advancing grid resilience and reliability efforts and standards. NERC develops reliability standards for the electricity sector and FERC enforces them. 

Opportunity Areas. Since both FERC and NERC play a role in ensuring the reliability of the electric grid, they should expand their extreme weather reliability standards to include risks when extreme heat and wildfires occur in the same region. FERC and NERC can work together to build on existing and proposed efforts to develop standards related to extreme heat and wildfires that support utilities and grid operators in prioritizing multi-hazard resilience in their planning. In late 2024, NERC finalized standards aimed at improving transmission system planning for extreme heat and extreme cold events. 

Additionally, NERC can track how utilities are addressing the risks of wildfires and heat waves as part of its grid reliability monitoring efforts and can include these efforts in its seasonal assessments. 

State Legislatures and Public Utility Commissions (PUCs)

Roles and Responsibilities. State legislatures and public utility commissions play an important role in regulating state electricity markets which positions them to incentivize and support resilience. In general, they are responsible for ensuring that their customers receive appropriate services and that rate increases are justified, while ensuring that the utility can recover its costs and reward investors. In most states, the legislature provides the foundation for PUCs to build their underlying statute-informed regulations. 

Opportunity Areas. State legislatures can direct utilities and PUCs to prioritize wildfire and extreme heat mitigation through statute and can authorize funding mechanisms – such as cost-recovery provisions or risk-sharing models – that enable utilities to invest in resilience. Some advocates have called for the creation of a voluntary program that incentivizes utilities to take certain mitigation actions by rewarding them with access to an “insurance-like backstop mechanism.” PUCs, in turn, can evaluate and approve utility proposals aligned with these policy goals, including pilot programs that implement grid measures with co-benefits for wildfire and extreme heat resilience.

Investors and Innovators

Roles and Responsibilities: Investors and innovators can provide other types of funding mechanisms to help the aforementioned stakeholders fund their initiatives or provide research services to improve them, especially at the extreme heat and wildfire nexus.

Opportunity Areas. Given the high upfront costs of many existing risk reduction tools, innovation is key to driving down the overall cost of multi-hazard resilience. Private capital and nonprofits can play a broader role in building a more robust innovation ecosystem. For example, Conservation X Labs’s Fire Grand Challenge is offering more than $1 million in prizes and support for wildfire innovation in collaboration with Gordon and Betty Moore Foundation, The Coca-Cola Foundation, Esri, and Planet. One of the 12 finalists advancing to field testing is Witching Hour, which is testing a robotic system that installs low-cost insulation onto power lines to reduce fire risk. Future programs modeled on this and other prize challenge efforts can reward innovations that support resilience under both extreme heat and high fire risk. 

Looking Ahead: Preparing for Compounding Heat and Wildfire Hazards

A comprehensive approach to upgrading the grid, grid operations, and emergency management protocols driven by the federal government, state governments, utilities, and private sector actors is the most impactful way forward. Lives, economic wellbeing, and property are all costs of inaction.

While grid infrastructure interventions are critical, other measures can also provide important backstops and reduce overall risk that deserve further exploration and integration into an extreme heat and wildfire preparedness and response strategy. For example, alternative cooling strategies that do not rely on air conditioning can reduce grid load – which in turn reduces wildfire risk – and ensure that people are not left sweltering in the heat during public safety power shutoffs. These strategies include passive cooling measures like reflective surfaces, natural ventilation, shading, and insulation. At the same time, prescribed fire and other risk reduction measures in the wildland urban interface can reduce the likelihood that fires that do start are destructive to life or property. 

With strategic investment, cross-sector coordination, and long-term planning, it is possible to reduce risks and protect vulnerable communities. We can build a future where power lines no longer spark disaster and homes stay safe and connected — no matter the weather.

The Federation of American Scientists supports H.R. 4420, the Cool Corridors Act of 2025, which would reauthorize the Healthy Streets program through 2030 and seeks to increase green and other shade infrastructure in high-heat areas.  

Science has shown that increasing sources of shade, including tree canopy and other shade infrastructure, can cool surrounding areas as much as 10 degrees, protecting people and critical infrastructure. The Cool Corridors Act of 2025 would create a unique and reliable funding source for communities to build out their shade infrastructure.

“Extreme heat is a serious threat to public health and critical infrastructure,” says Grace Wickerson, Senior Manager for Climate and Health at the Federation of American Scientists. “Increasing tree canopies and shade infrastructure is a key recommendation in FAS’ 2025 Heat Policy Agenda and we commend Reps Lawler and Strickland for taking action on this.”

‘Framework for a Heat-Ready Nation’ puts heat emergencies on the same footing as other natural disasters, reimagines how governments respond

Washington, D.C. – July 22, 2025 – Shattered heat records, heat domes, and prolonged heat waves cause thousands of deaths and hundreds of billions of dollars in lost productivity, damages, and economic disruptions. In 2023 alone, at least 2,300 people died from extreme heat, and true mortality could be greater than 10,000 annually. Workplaces are seeing $100 billion in lost productivity each year. Increased wear and tear on aging roads, bridges, and rail is increasing maintenance costs, with road maintenance costs expected to balloon to $26 billion annually by 2040. Extreme heat also puts roughly two-thirds of the country at risk of a blackout.

Extreme heat events that were uncommon in many places are becoming routine and longer lasting – and communities across the United States remain highly vulnerable.

To help prepare, the Federation of American Scientists has drawn upon experts from Sunbelt states to identify decisive actions to save lives during extreme heat events and prepare for longer heat seasons. The Framework for a Heat-Ready Nation, released today, calls for local, state, territory, Tribal, and federal governments to collaborate with community organizations, private sector partners and research institutions.

“The cost of inaction is not merely economic; it is measured in preventable illness, deaths and diminished livelihoods,” the report authors say. “Governments can no longer afford to treat extreme heat as business as usual or a peripheral concern.”

The Framework for a Heat-Ready Nation focuses on five measures to protect people, their livelihoods, and their communities:

1. Establish leaders with responsibility and authority to address extreme heat. Leaders must coordinate actions across all relevant agencies and with non-governmental partners. 
   
2. Accurately assess extreme heat and its impacts in real time. Use the data to inform thresholds that trigger emergency response protocols, safeguards, and pathways to financial assistance.
   
3. Prepare for extreme heat as an acute emergency as well as a chronic risk. Local governments should consider developing heat-response plans and integrating extreme temperatures into their long-term capital planning and resilience planning.
   
4. When extreme heat thresholds are crossed, local, state, territory, Tribal and federal governments should activate response plans and consider emergency declarations. There should be a transparent and widely understood process for emergency responses to extreme heat that focus on protecting lives and livelihoods and safeguarding critical infrastructure.
   
5. Develop strategies to plan for and finance long-term extreme heat impact reduction. Subnational governments can incentivize or require risk-reduction measures like heat-smart building codes and land-use planning, and state, territory, Tribal and federal governments can dedicate funding to support local investments in long-term preparedness. 

Extreme heat in the Sunbelt region of the United States is a harbinger of what’s coming for the rest of the country. But the Sunbelt is also advancing solutions. In April 2025, representatives from states, cities, and regions across the U.S. Interstate 10 corridor from California to Florida, convened in Jacksonville, Florida for the Ten Across Sunbelt Cities Extreme Heat Exercise. Attendees worked to understand the available levers for government heat response, discussed their current efforts on extreme heat, and identified gaps that hinder both immediate response and long-term planning for future extreme heat events. 

Through an analysis of efforts to date in the Sunbelt, gaps in capabilities, and identified opportunities, and analysis of previous calls to action around extreme heat, the Federation of American Scientists developed the Framework for a Heat-Ready Nation. 

The report was produced with technical support from the Ten Across initiative associated with Arizona State University, and funding from the Natural Resources Defense Council.

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About FAS

The Federation of American Scientists (FAS) works to advance progress on a broad suite of contemporary issues where science, technology, and innovation policy can deliver transformative impact, and seeks to ensure that scientific and technical expertise have a seat at the policymaking table. Established in 1945 by scientists in response to the atomic bomb, FAS continues to bring scientific rigor and analysis to address national challenges. More information about FAS work at fas.org.

Extreme heat is a major occupational hazard with far-reaching impacts on the national economy as well as worker health and safety. Extreme heat costs an estimated $100 billion per year in lost productivity, and causes an average of at least 3,389 heat-related injuries and 33 heat-related fatalities annually – numbers that are likely vast undercounts. To protect workers, Congress must mandate a federal heat standard, retain federal workers with expertise in heat stress management strategies, and establish Centers of Excellence to support research, training, and sector-specific mitigation strategies. Through investments in infrastructure for heat safety, Congress can save lives, protect the economy, and enhance resilience nationwide.

Heat-Related Risks are Heightened in Many Work Environments

Extreme heat puts workers of all types at risk: OSHA has documented hospitalizations and heat-related deaths in close to 275 industries. Some work environments present extreme heat risk, particularly those involving high exposures to the outdoors and limited access to cooling. With roughly one in three U.S. employees regularly working outdoors, a large share of the workforce is at elevated risk during summer months. Indoor workers also face high exposure, especially in kitchens, warehouses, manufacturing plants, and other poorly ventilated environments because heat and humidity easily build up in enclosed spaces without adequate air flow and climate-control. 

Business and Economic Impacts of High Heat Exposure in the Workplace 

On top of the $100 billion in direct annual losses, high temperatures are also linked to increased healthcare costs for employers and workers’ compensation claims, with claim frequencies rising by up to 10% during temperature extremes. Some industries are more exposed than others; for example, agriculture, construction, and utility companies face twice the risk of incurring increased healthcare claims due to extreme weather and other environmental conditions. This growing number of claims increases companies’ experience modification rates, which insurers use as a key factor for calculating higher future premiums. Higher premiums translate to greater insurance and overall operating costs, which is especially burdensome for small and low-margin businesses. Despite all these risks, many employers continue to underestimate the financial burden of extreme heat and other weather-related health impacts. 

Many Military Personnel and Federal Workers Face Above-Average Risks of Heat-Related Illness

Military personnel, federal law enforcement officers, border patrol officers, wildland firefighters, federal transportation workers like railroad inspectors, and postal employees are all in positions that require long, labor-intensive hours outdoors, raising the risk for heat-related illness. In 2024, heat-related illnesses were among the top five most reported medical events among U.S. active duty service members. Without consistent standards in place to protect these workers from extreme heat, military and other federal operations will continue to be vulnerable to disruption and reduced workforce capacity.

Advancing Solutions: Establish a Strong Federal Heat Standard and Sector-Specific Centers of Excellence for Heat Workplace Safety

To begin to address heat-related injuries and illnesses in workplaces, OSHA in 2022 established the National Emphasis Program (NEP) on Outdoor and Indoor Heat-Related Hazards, which remains in effect until April 2026. As of 2025, OSHA reports that this NEP has conducted nearly 7,000 inspections connected to heat risks, which lead to 60 heat citations and nearly 1,400 “hazard alert” letters being sent to employers.

However, in the absence of a federal mandate for effective heat safety practices, most workplaces rely on voluntary guidance that is not tailored to specific job conditions, backed by consistent data, or subject to enforcement. This puts both workers and businesses at risk. OSHA’s proposed Heat Injury and Illness Prevention rule would be a critical step forward to establishing common-sense baseline protections. According to the agency’s projections, compliance with this standard could prevent thousands of heat-related illnesses and deaths. The projected benefits from reduced fatalities, illness, and injury amount to $9.18 billion per year. Importantly, this action has broad public backing: 90% of American voters support the implementation of federal protections from extreme heat in the workplace. 

Congress should act swiftly to ensure OSHA finalizes and enforces a strong, evidence-based heat standard. To do this effectively, it is essential that funding for experts at the National Institute for Occupational Safety and Health (NIOSH) is retained in the FY26 budget request, as these critical workers develop criteria for recommended standards on occupational heat stress. These experts have been impacted by reductions in force at NIOSH, and as of July 2025 have not been brought back by the agency.

Some employers have raised concerns about the technical and financial feasibility of the proposed rule. To address these concerns, Congress should pair regulation with practical support by creating federally funded, sector-specific Centers of Excellence (CoEs)for Heat Workplace Safety. These Centers would develop and implement evidence-based solutions tailored to different work environments, such as agriculture and construction. The CoE approach includes comprehensive data collection at worksites that form the basis of occupational safety and health protocols best practices and policies to enhance productivity, prevent injury and illness, and ensure a return on investment. Once strategies are developed, CoEs implement them, track their impact, and work with workers, employers, and cross-sector partners to ensure long-term success.

By leveraging advanced technology, predictive analytics, and continuously updated industry standards, CoEs can help modernize OSHA regulations and make them more aligned with current workplace realities that go beyond simple compliance or post-injury responses.  Federal agencies and other industries with sizable workforces that receive government contracts are key places to develop best practices, technologies, and public-private partnerships for these interventions, all while reducing fiscal risk to the federal government.