Trump's Budget Hawk Is Still Trying To Slash Medical Research. Congress Is Saying No.

White House budget director Russ Vought isn’t done trying to cut the National Institutes of Health's funding, but Congress isn’t taking him seriously anymore.

Vought released a proposal last week to slash the 2027 budget for the world’s largest funder of health research by 10 percent, down from 40 percent last year. It's unlikely Congress or the agency’s head will listen to him.

Lawmakers rejected Vought’s first big cut in the spending bill they passed in February and already promised to reject the smaller one this year. While Vought has succeeded in trimming spending at some other agencies, the NIH has proven a hard target because lawmakers have a symbiotic relationship with the agency. Most of the money they dole out is returned to their states for disease research, clinical trials and other medical advances — plus photo-ops with researchers boasting about their breakthroughs are a win with voters.

The health research agency’s director, Jay Bhattacharya, is expected to defend the budget to Congress, but it’s unclear whether he stands behind cuts to his agency any more than Congress does. While other agencies, like the State Department, defied Congress and implemented Vought’s cost-cutting vision by not spending their budgets last year, Bhattacharya spent every dollar Congress gave him.

Vought, considered one of the most powerful budget directors in recent history, held the same position during Trump’s first term. He’s used his second go-around to aggressively wield his budget tools to act as a chokepoint on government spending. But the NIH is likely to illustrate the limits on his power.

Bhattacharya’s vision for the agency “doesn’t align” with the budget put forward by Vought, said Sudip Parikh, president of the American Association for the Advancement of Science, the world’s largest professional society for scientists.

“There’s a disconnect between the budget process and the scientific leadership,” he said. “It’s really perplexing to me — how that aligns with the idea that we’re going to be competitive, the idea that we are going to have a golden era of science in this country.”

Vought’s plan for the NIH last year, combined with cuts directed by Elon Musk’s Department of Government Efficiency, sent lawmakers of both parties into a panic. Besides the Democrats’ hand-wringing, Senate Appropriations Chair Susan Collins of Maine and another Republican on her panel, Katie Britt of Alabama, spoke out publicly about the threat posed to universities in their states. In the end, Congress gave the agency a $415 million raise. After a DOGE-directed slowdown in grant-making, Bhattacharya made a show of spending the agency’s budget by the end of the fiscal year on Sept. 30.

The agency largely disperses that money through grants to universities and research facilities to support scientific studies and clinical trials.

Vought’s decision to re-up his proposal to cut the agency’s budget is even more improbable than it was last year.

Just three weeks before the White House budget’s April 3 release, Bhattacharya chummed it up with lawmakers, including Democrats, on the House Appropriations panel. Referencing the boost lawmakers approved over Vought’s objections, Bhattacharya reassured representatives that the days of slow-walked grants were over. “You all are very generous, actually, with the NIH last year, and my job is to make sure every single dollar goes out, and it will go out by the end of the year on excellent science,” he said.

The White House’s 2027 budget proposal requests $41 billion for the agency, a $5 billion decrease from 2026 levels. The proposal would ax several NIH institutes, including the National Institute on Minority Health and Health Disparities and the Fogarty International Center — which funds global health research.

Already, some Republicans have said they will oppose the cuts. Collins called them “unwarranted” after she got a look. Three days before Vought released the new budget plan, Bhattacharya was in Philadelphia touring a University of Pennsylvania cancer lab with Sen. Dave McCormick (R-Pa.).

The symbiotic relationship between the agency and the lawmakers who fund it was on full display. “Here we met patients who have been given a second lease on life from deadly cancer,” Bhattacharya said, according to a local radio station’s report.

McCormick called the work of Carl June, the lab’s director, using patients’ immune cells to cure their cancer, “remarkable” and promised to oppose any cuts to the NIH.

Vought’s budget is still living in the pandemic era, with the budget proposal arguing that cutting the NIH is justified because it “broke the trust of the American people with wasteful spending, misleading information, risky research, and the promotion of dangerous ideologies that undermine public health.”

In a statement to POLITICO, Rachel Cauley, a budget office spokesperson, defended the proposed cuts. “We have seen that a dollar invested doesn’t always mean we get a dollar of good science in return. NIH has what it needs,” Cauley said. “Being $39 trillion in debt after NIH’s years of failure, $41 billion which is more than COVID levels is actually quite generous.”

Health and Human Services spokesperson Andrew Nixon echoed that sentiment, arguing the cuts were aimed at “politicized and ideologically driven research.” The agency is “returning to rigorous, patient-centered science — focused on chronic diseases like cancer and dementia,” he said.

No one would seem more sympathetic to that case than Bhattacharya, who made his name as a critic of then-NIH official Anthony Fauci, who some Republican members criticized for the agency’s pandemic response. But Bhattacharya hasn’t embraced Vought’s view that cutting the agency’s budget or staffing is the answer.

Last fall, for example, Vought sought to cut more than 4,000 NIH jobs after Democrats refused to pass an appropriations bill. With Bhattacharya at the helm, it ended up cutting no one.

Speaking to House appropriators last month, Bhattacharya said the agency had indeed lost trust during the pandemic but that the solution was “to deliver better treatments, better cures, better wages, prevent disease.”

Some Democrats who saw the pandemic differently than Bhattacharya now say they see him as the anti-Vought.

“I wish you were the face instead of Russ Vought or some DOGE bro, because that really has hurt us,” Democratic Rep. Mark Pocan of Wisconsin, chair emeritus of the Congressional Progressive Caucus, told Bhattacharya at the House hearing.

Agency heads are expected to defend the president’s budget to Congress, and Bhattacharya is unlikely to break from tradition when he testifies before appropriators in the next few months. But ultimately, Congress controls how much funding the agency gets, and keeping NIH funding flowing benefits lawmakers on both sides of the aisle as the midterms approach.

The agency’s tens of billions of dollars are largely funneled toward grants to universities and research facilities in both red and blue states, which support jobs and drive local economies. Republicans have been urging Bhattacharya to give their states a bigger slice of the pie.

Republicans and the NIH’s scientific leaders also view investing in the agency as essential to beating China in the race to discover the next medical breakthroughs.

“We have a biomedical research enterprise and ecosystem in this country that is capable of achieving cures and treatments for patients in the United States and around the world,” said AAAS’s Parikh. “It would be crazy for us to have made all these investments, gotten us to the cusp of these enormous opportunities, only to watch it brought to fruition by competitors."

The White House budget office seems to be suffering from a “Covid hangover effect,” citing the agency’s pandemic response as a justification for cuts, said Carrie Wolinetz, former chief of staff to longtime NIH director Francis Collins. But many Republicans in Congress have moved on from their pandemic-era criticisms, she added. The popular view among lawmakers and patients is that finding cures for diseases like cancer, HIV and cystic fibrosis hinges on robust NIH funding, she said.

Recent polling has found overwhelming public support across the political spectrum for using federal dollars to fund medical research and improve public health.

“Republicans are not immune to what they’re hearing from their constituents who are suffering from disease,” said Wolinetz, who now chairs the health and bioscience practice at Lewis-Burke Associates, a lobbying group. What motivates lawmakers to fund NIH, she added, “is a recognition that the only way to solve the pressing needs of patients is through investment in medical research.”