White House proposes $5B NIH cut

The White House’s fiscal 2027 budget request would cut $5 billion from the National Institutes of Health, reducing the agency to $41 billion and eliminating several NIH components, according to administration budget documents and the Department of Health and Human Services. The proposal was released in early April as part of a broader request for $111.1 billion in discretionary funding for HHS, down $15.8 billion from the enacted fiscal 2026 level. Congress will decide whether any of the proposed cuts become law. The proposal lands after a separate wave of NIH grant terminations that researchers say has already disrupted ongoing studies. A November 2025 research letter in *JAMA Internal Medicine*, summarized by AJMC, found that terminated NIH grants disrupted about 1 in 30 active clinical trials and affected more than 74,000 participants. The same analysis said 694 NIH grants were terminated between February 28 and April 8, 2025, with a cumulative value of $1.81 billion. (appliedclinicaltrialsonline.com) ### What exactly did the White House propose for NIH? The April budget request would reduce NIH funding to $41 billion from the prior enacted level and eliminate the National Institute on Minority Health and Health Disparities, the Fogarty International Center and the National Center for Complementary and Integrative Health, according to Applied Clinical Trials’ summary of the administration documents. The White House budget materials frame the broader HHS request as part of its policy priorities for fiscal 2027. (ajmc.com) The HHS budget request also proposes $111.1 billion in discretionary budget authority for the department overall. Applied Clinical Trials reported that the NIH reduction is one of the most significant research-related pieces of the package. ### How much damage have prior NIH grant terminations already done? A *JAMA Internal Medicine* research letter published online on November 17, 2025, found that 3.5% of active clinical trials with prior NIH funding were affected by grant terminations. (appliedclinicaltrialsonline.com) AJMC reported that infectious-disease studies were hit hardest and that more than 74,000 trial participants were affected. (hhs.gov) The same analysis said the National Institute of Mental Health and the National Institute on Minority Health and Health Disparities had the largest numbers of terminated grants. It also found that the National Institute of Allergy and Infectious Diseases and NIMHD accounted for the largest terminated funding totals. (jamanetwork.com) ### Why are researchers and trial teams focused on operations, not just topline dollars? Applied Clinical Trials quoted Craig Lipset, co-chair of the Decentralized Trials & Research Alliance, describing the effect on day-to-day trial work: “It’s the things that make patients feel really comfortable coming in to do research” that get pushed into the background as teams become more reactive. That reporting described disruption to recruitment, staffing and trial support functions as funding priorities shift. (ajmc.com) AJMC’s summary of the *JAMA Internal Medicine* letter said the authors warned that continued monitoring would be needed to assess effects on data integrity and future research design. The article also said prevention-focused studies and trials outside the United States were more likely to lose funding. (appliedclinicaltrialsonline.com) ### What are outside medical groups saying about the new budget request? The American Society of Clinical Oncology said on April 14 that the administration’s fiscal 2027 request proposes a 12% NIH cut and warned that the changes risk slowing cancer research. ASCO also said the proposal includes a modest increase for the National Cancer Institute while changing grant-funding rules, including a planned 15% cap on indirect cost rates and a shift to fully funding research project grants upfront starting in 2027. (ajmc.com) ASCO told congressional appropriators it is asking for $51.3 billion for NIH in fiscal 2027, according to testimony it submitted to the House in April and the Senate in May. That request is higher than the administration’s proposal and underscores that the final number will be set on Capitol Hill. (asco.org) ### What happens next in Washington? Congressional appropriators will write the fiscal 2027 spending bills before the new fiscal year starts on October 1, 2026. HHS Secretary Robert F. Kennedy Jr. testified on the president’s fiscal 2027 budget before the House Ways and Means Committee on April 16, and outside groups including ASCO have already submitted funding requests to House and Senate appropriators. (hhs.gov) (asco.org)