National Institutes of Health (NIH) Funding: FY1996-FY2025

National Institutes of Health (NIH) Funding:
June 29, 2021May 20, 2022
FY1996-FY2022FY2023
Kavya Sekar
This report details the National Institutes of Health (NIH) budget and appropriations This report details the National Institutes of Health (NIH) budget and appropriations
Analyst in Health Policy Analyst in Health Policy
process with a focus on process with a focus on FY2020, FY2021, and FY2022. Coronavirus supplemental

funding for NIH is discussed in a dedicated section of the report but is general y not
included in the budgetary figures elsewhere in the report. The report also provides an

overview of funding trends in regular appropriations to the agency from FY1996 to
FY2022. Appendix A includes funding tables by account and program-specific funding levels for FY2020,
FY2021, and FY2022. Appendix B provides a list of acronyms and abbreviations used in the report.
FY2022 and FY2023. NIH is the primary federal agency NIH is the primary federal agency charged with conducting and supporting medical, health, and behavioral charged with conducting and supporting medical, health, and behavioral
research, and it is made up of 27 Institutes and Centers and the Office of the Director (OD). About 80% research, and it is made up of 27 Institutes and Centers and the Office of the Director (OD). About 80% of the of the
NIH budget funds extramural research through grants, contracts, and other awards. About 10% of NIH funding NIH budget funds extramural research through grants, contracts, and other awards. About 10% of NIH funding
goes to intramural researchers at NIH-operated facilities. Almost goes to intramural researchers at NIH-operated facilities. Almost al all of NIH’s funding is provided in the annual of NIH’s funding is provided in the annual
Departments of Labor, Health and Human Services, and Education, and Related Agencies (LHHS) Appropriations Departments of Labor, Health and Human Services, and Education, and Related Agencies (LHHS) Appropriations
Act. NIH also receives Act. NIH also receives smal ersmaller amounts of funding from Interior/Environmental (INT) appropriations and a amounts of funding from Interior/Environmental (INT) appropriations and a
mandatory budget authority for type 1 diabetes research. mandatory budget authority for type 1 diabetes research.
The The FY2021FY2022 NIH program level of $ NIH program level of $42.936 bil ion represents a $1.251 bil ion increase (+3.0%) above the
FY202046.183 billion represents a $3.146 billion increase (+7.3%) relative to FY2021-enacted program level. The -enacted program level. The FY2021-FY2022 enacted total for NIH is also $enacted total for NIH is also $3.802 bil ion (+9.7%) above the
FY20215.775 billion (-11.1%) less than the FY2022 budget request and $ budget request and $715 mil ion (+1.7%) above3.404 billion (-6.9%) less than the program level proposed by the House-passed LHHS the program level proposed by the House-passed LHHS
and INT and INT bil s. In FY2021, al bills. In FY2022, all Institute and Center (IC) accounts received an increase Institute and Center (IC) accounts received an increase above FY2020 funding
levels, except for the Buildings and Facilities account (see Table A-1). The Biden Administration’s FY2022
budget request proposes an FY2022 program level of $51.953 bil ion—a $9.017 bil ion increase (+21.0%) from
the FY2021 program level. It also proposes the creation of a new Advanced Research Projects Agency for Health
(ARPA-H) within NIH.
NIH has seen periods of high and low funding growth during the period covered by this report, as il ustrated in
Figure 1. Between FY1996 and FY1998, funding for NIH grew from $11.928 bil ion to $13.675 bil ion (nominal
dollars). Over the next five years, Congress and the President doubled the NIH budget to $27.167 bil ionrelative to FY2021 funding levels (see Table A-1). Additionally, the Biden Administration’s FY2022 budget request had proposed the creation of a new Advanced Research Projects Agency for Health (ARPA-H) within NIH with an initial funding level of $6.5 billion to be available for three years. FY2022 appropriations (P.L. 117-103; Division H) provided $1 billion in funding for ARPA-H in a new LHHS account (available for three years) and allowed for the Department of Health and Human Services (HHS) Secretary to transfer ARPA-H to any agency or office of the Department of Health and Human Services (including NIH) within 30 days of enactment. On March 30, 2022, HHS Secretary Xavier Becerra submitted a notice to the appropriations committees that ARPA-H is to reside within the NIH, while the ARPA-H Director is to report directly to the HHS Secretary. Appropriations for ARPA-H are therefore included within the NIH FY2022 program level in this report. The Biden Administration’s FY2023 budget request proposes an FY2023 program level of $62.503 billion—a $16.320 billion increase (+35.3%) from the FY2022 program level. Within the total, the request proposes $5 billion for ARPA-H, an increase of $4 billion from the FY2022-enacted level. The FY2023 request total also includes $12.05 billion in new mandatory appropriations for pandemic preparedness. NIH has seen periods of high and low funding growth during the period covered by this report, as illustrated in Figure 1. Between FY1996 and FY1998, funding for NIH grew from $11.928 billion to $13.675 billion (nominal dollars). Over the next five years, Congress and the President doubled the NIH budget to $27.167 billion in in
FY2003. In each of FY1999 through FY2003, NIH received annual funding increases of 14% to 16%. From FY2003. In each of FY1999 through FY2003, NIH received annual funding increases of 14% to 16%. From
FY2003 to FY2015, NIH funding increased more FY2003 to FY2015, NIH funding increased more gradual ygradually in nominal dollars. In some years (FY2006, FY2011, in nominal dollars. In some years (FY2006, FY2011,
and FY2013), funding for the agency decreased in nominal dollars. From FY2016 through and FY2013), funding for the agency decreased in nominal dollars. From FY2016 through FY2020FY2022, NIH has seen , NIH has seen
funding increases funding increases of over 5% each year. The largest increase was from FY2017 to FY2018, where the program each year. The largest increase was from FY2017 to FY2018, where the program
level increased by $3.level increased by $3.010 bil ion0 billion (+8.8%), making this the largest single-year nominal dollar increase since (+8.8%), making this the largest single-year nominal dollar increase since
FY2003. The proposed funding increase in the FY2003. The proposed funding increase in the FY2022FY2023 budget request would be budget request would be over twice this amounta single-year nominal dollar increase of $16.320 billion (+35.3%), which would represent the largest funding increase in the period covered in this report. .
When looking at NIH funding adjusted for inflation (in projected constant FY2022 dollars using the Biomedical When looking at NIH funding adjusted for inflation (in projected constant FY2022 dollars using the Biomedical
Research and Development Price Index; BRDPI), the purchasing power of NIH funding Research and Development Price Index; BRDPI), the purchasing power of NIH funding initially peaked in FY2003—the peaked in FY2003—the
last year of the five-year doubling period—and then declined fairly steadily for more than a decade last year of the five-year doubling period—and then declined fairly steadily for more than a decade until until back-to-
back funding increases were provided in each of FY2016 through funding increases were provided in each of FY2016 through FY2021. The FY2021FY2022. The FY2022 program level is program level is 3.3%
below0.6% Congressional Research Service link to page 21 link to page 15 link to page 24 National Institutes of Health (NIH) Funding: FY1996-FY2023 greater than the peak FY2003 program level. The the peak FY2003 program level. The FY2022FY2023 budget request would provide a program level that is budget request would provide a program level that is 14.4%
above the peak FY2003 program level.


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Contents
NIH Funding: FY1996-FY2022 ........................................................................................ 1
Funding Sources........................................................................................................ 2
Coronavirus Supplemental Appropriations (FY2020 and FY2021) .................................... 3
FY2021 Proposed and Enacted Funding ........................................................................ 5
FY2022 Budget and Appropriations.............................................................................. 7
Trends ..................................................................................................................... 8

Figures
Figure 1. National Institutes of Health (NIH) Funding, FY1996-FY2022 ............................... 10

Tables
Table 1. NIH Funding, FY1996-FY2022........................................................................... 11

Table A-1. National Institutes of Health Funding................................................................ 13
Table A-2. Specified NIH Funding Levels in FY2021 Explanatory Statement ......................... 15
Table A-3. Specified NIH Funding Levels in FY2022 Budget Request .................................. 17

Appendixes
Appendix A. NIH Funding Details ................................................................................... 13
Appendix B. Acronyms and Abbreviations ........................................................................ 18

Contacts
Author Information ....................................................................................................... 19


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NIH Funding: FY1996-FY2022
This report provides a historical overview of federal funding provided to the National Institutes of
Health (NIH) between FY1996 and FY2022a 32.8% increase relative to the peak FY2003 program level. This CRS report details NIH budget and appropriations for FY2022 and FY2023 and provides an overview of funding trends in regular appropriations to the agency from FY1996 to FY2023. Coronavirus supplemental funding for NIH is discussed in Appendix B of the report but is generally not included in the budgetary figures elsewhere in the report. Appendix A includes funding tables by account and program-specific funding levels for FY2021, FY2022, and FY2023. Appendix C provides a list of acronyms and abbreviations used in the report. Congressional Research Service link to page 5 link to page 6 link to page 7 link to page 11 link to page 12 link to page 13 link to page 15 link to page 17 link to page 20 link to page 15 link to page 21 link to page 21 link to page 24 link to page 25 National Institutes of Health (NIH) Funding: FY1996-FY2023 Contents NIH Funding: FY1996-FY2023 ...................................................................................................... 1 Funding Sources ........................................................................................................................ 2 FY2022 Proposed and Enacted Funding ................................................................................... 3 Trends ........................................................................................................................................ 7 Figures Figure 1. NIH Funding, FY1996-FY2023 ....................................................................................... 8 Tables Table 1. NIH Funding, FY1996-FY2023 ........................................................................................ 9 Table A-1. National Institutes of Health Funding ........................................................................... 11 Table A-2. Specified NIH Funding Levels in FY2022 Explanatory Statement............................. 13 Table A-3. Specified NIH Funding Levels in FY2023 Budget Request ........................................ 16 Appendixes Appendix A. NIH Funding Details ................................................................................................. 11 Appendix B. Coronavirus Supplemental Appropriations (FY2020 and FY2021) and Additional American Rescue Plan Act funding .......................................................................... 17 Appendix C. Acronyms and Abbreviations ................................................................................... 20 Contacts Author Information ........................................................................................................................ 21 Congressional Research Service link to page 21 National Institutes of Health (NIH) Funding: FY1996-FY2023 NIH Funding: FY1996-FY2023 This report provides a historical overview of federal funding provided to the National Institutes of Health (NIH) between FY1996 and FY2023. It also provides a brief explanation of the . It also provides a brief explanation of the
discretionary spending funding sources for NIH associated with the annual appropriations process discretionary spending funding sources for NIH associated with the annual appropriations process
(via the Labor, HHS, and Education and Interior/Environment Appropriations Acts) and the (via the Labor, HHS, and Education and Interior/Environment Appropriations Acts) and the
mandatory funding for special program on type 1 diabetes research.1mandatory funding for special program on type 1 diabetes research.1
NIH is the primary federal agency for medical, health, and behavioral research. It is the largest of NIH is the primary federal agency for medical, health, and behavioral research. It is the largest of
the eight health-related agencies that make up the Public Health Service (PHS) within the the eight health-related agencies that make up the Public Health Service (PHS) within the
Department of Health and Human Services (HHS).2 NIH consists of the Office of the Director Department of Health and Human Services (HHS).2 NIH consists of the Office of the Director
(OD) and 27 Institutes and Centers (ICs) that focus on aspects of health, human development, and (OD) and 27 Institutes and Centers (ICs) that focus on aspects of health, human development, and
biomedical science. The OD sets biomedical science. The OD sets overal overall policy for NIH and coordinates the programs and policy for NIH and coordinates the programs and
activities of activities of al all NIH components, particularly in areas of research that involve multiple institutes.NIH components, particularly in areas of research that involve multiple institutes. In addition, FY2022 appropriations established a new entity that has been placed within NIH: the Advanced Research Projects Agency for Health (ARPA-H), as discussed further in this report.
NIH activities cover a wide range of basic, NIH activities cover a wide range of basic,
Supplemental Funding for NIH
clinical, and translational research, focused on clinical, and translational research, focused on
In FY2021 and prior years, NIH received In FY2021 and prior years, NIH received supplemental supplemental
particular diseases, areas of human health and particular diseases, areas of human health and
appropriations provided as an emergency appropriations provided as an emergency requirement. requirement.
development, or more fundamental aspects of development, or more fundamental aspects of
Given that this report examines Given that this report examines trends in regular trends in regular
biology and behavior. Its mission also includes biology and behavior. Its mission also includes
annual appropriations to NIH enacted by Congress and annual appropriations to NIH enacted by Congress and
the President for the normalthe President for the normal operations of the agency, operations of the agency,
research training and health information research training and health information
amounts provided to NIH pursuant to an emergency amounts provided to NIH pursuant to an emergency
collection and dissemination.3 More than 80% collection and dissemination.3 More than 80%
requirement requirement are general y are generally excluded from this report. In excluded from this report. In
of the NIH budget funds extramural research of the NIH budget funds extramural research
some some years, supplemental funding to NIH was years, supplemental funding to NIH was
(i.e., external) through grants, contracts, and (i.e., external) through grants, contracts, and
substantial, such as the over $10 bil ion in substantial, such as the over $10 bil ion in
other awards. This funding supports research other awards. This funding supports research
appropriations provided in the American appropriations provided in the American Recovery and Recovery and
Reinvestment Act of 2009 (ARRA; P.L.Reinvestment Act of 2009 (ARRA; P.L. 111-5), which 111-5), which
performed by more than 300,000 individuals performed by more than 300,000 individuals
was a 33% increase was a 33% increase to the regular FY2009 to the regular FY2009
who work at over 2,500 hospitals, medical who work at over 2,500 hospitals, medical
appropriations NIH received. appropriations NIH received. NIH has also received NIH has also received
schools, universities, and other research schools, universities, and other research
supplemental appropriations during several supplemental appropriations during several infectious infectious
institutions around the country.4 About 10% of institutions around the country.4 About 10% of
disease disease emergencies,emergencies, such as for the Ebola and Zika such as for the Ebola and Zika
the agency’s budget supports intramural outbreaks. Given current interest,outbreaks. Given current interest, a summarya summary of the
the agency’s budget supports intramural
of the FY2020 and FY2021 amounts for the COVID-19 FY2020 and FY2021 amounts for the COVID-19
research (i.e., internal) conducted by nearly research (i.e., internal) conducted by nearly
pandemic is provided in pandemic is provided in Appendix B. “Coronavirus Supplemental
6,000 NIH physicians and scientists, most of 6,000 NIH physicians and scientists, most of
Appropriations.”
whom are located on the NIH campus in whom are located on the NIH campus in
Bethesda, Bethesda, Maryland.5

MD.5 1 “Mandatory spending” is controlled by authorization acts; “discretionary spending” is controlled by appropriations 1 “Mandatory spending” is controlled by authorization acts; “discretionary spending” is controlled by appropriations
acts. For further information, see CRSacts. For further information, see CRS Report R44582, Report R44582, Overview of Funding Mechanism sMechanisms in the Federal Budget
Process, and Selected Exam plesExamples. .
2 2 T heThe Public Health Service Public Health Service (PHS) also includesalso includes the Centers for Diseasethe Centers for Disease Control and Prevention (CDC), the Food and Drug Control and Prevention (CDC), the Food and Drug
Administration (FDA), the Agency for Healthcare Research and QualityAdministration (FDA), the Agency for Healthcare Research and Quality (AHRQ), the Health Resources and Services (AHRQ), the Health Resources and Services
Administration (HRSA), the SubstanceAdministration (HRSA), the Substance Abuse Abuse and Mental Health Services Administration (SAMHSA),and Mental Health Services Administration (SAMHSA), the Indian the Indian
Health Service (IHS),Health Service (IHS), and the Agency for and the Agency for T oxicToxic Substances Substances and Diseaseand Disease Registry (Registry (AT SDR).
ATSDR). 3 For further information on 3 For further information on T hethe National Institutes of Health (NIH), see CRS National Institutes of Health (NIH), see CRS Report R41705, Report R41705, The National Institutes
of Health (NIH): Background and Congressional Issues. .
4 NIH, “What We Do 4 NIH, “What We Do - Budget,” - Budget,” March 3June 29, 2020, at https://www.nih.gov/about-nih/what-we-do/budget., 2020, at https://www.nih.gov/about-nih/what-we-do/budget.
5 Ibid. 5 Ibid.
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Funding Sources
The vast majority of NIH funding comes from annual discretionary appropriations The vast majority of NIH funding comes from annual discretionary appropriations bil s. NIH
additional y bills. NIH additionally receives some mandatory funding and some funding due to unique transfer or receives some mandatory funding and some funding due to unique transfer or
budgetary rules, as explained below. The total funding availablebudgetary rules, as explained below. The total funding available for NIH activities, taking account for NIH activities, taking account
of add-ons and PHS tap transfers, is referred to as the NIH “program level.”of add-ons and PHS tap transfers, is referred to as the NIH “program level.”6
Discretionary budget authority: NIH’s discretionary budget authority comes primarily from NIH’s discretionary budget authority comes primarily from
annual Labor, HHS, and Education (LHHS) Appropriations Acts, with an additional annual Labor, HHS, and Education (LHHS) Appropriations Acts, with an additional smal ersmaller
amount for the Superfund Research Program and related activities from the Interior/Environment amount for the Superfund Research Program and related activities from the Interior/Environment
(INT) Appropriations Act.(INT) Appropriations Act.67
PHS Evaluation Set-Aside: Through LHHS appropriations, some funding is subject to the PHS Through LHHS appropriations, some funding is subject to the PHS
Evaluation Set-Aside or the “PHS Evaluation Tap” transfer authority.Evaluation Set-Aside or the “PHS Evaluation Tap” transfer authority.78 Authorized by Section 241 Authorized by Section 241
of the Public Health Service Act, the evaluation tap of the Public Health Service Act, the evaluation tap al owsallows the Secretary of HHS, with the the Secretary of HHS, with the
approval of appropriators, to redistribute a portion of eligible PHS agency appropriations across approval of appropriators, to redistribute a portion of eligible PHS agency appropriations across
HHS for program evaluation and implementation purposes. The PHSA section limits the set-aside HHS for program evaluation and implementation purposes. The PHSA section limits the set-aside
to not less than 0.2% and not more than 1% of eligibleto not less than 0.2% and not more than 1% of eligible program appropriations. However, LHHS program appropriations. However, LHHS
Appropriations Acts have commonly established a higher maximum percentage for the set-aside Appropriations Acts have commonly established a higher maximum percentage for the set-aside
and have appropriated specific amounts of “tap” funding to selected HHS programs—in the and have appropriated specific amounts of “tap” funding to selected HHS programs—in the
context of NIH, these appropriations have been made to National Institute of General Medical context of NIH, these appropriations have been made to National Institute of General Medical
Sciences in recent years.Sciences in recent years.89 Since FY2010, and including in Since FY2010, and including in FY2021FY2022, this higher maximum set-, this higher maximum set-
aside level has been 2.5% of eligibleaside level has been 2.5% of eligible appropriations.appropriations.910 Readers should note that totals in this report Readers should note that totals in this report
and NIH source documents include amounts “transferred in” pursuant to PHS tap but do not and NIH source documents include amounts “transferred in” pursuant to PHS tap but do not
include any amounts “transferred out” under this same authority.
Nonrecurring expenses fund (NEF): The NEF permits HHS to transfer unobligated balances of
expired discretionary funds from FY2008 and subsequent years into the NEF account. Statute
authorizes use of the funds for capital acquisitions, including information technology (IT) and
facilities infrastructure (42 U.S.C. §3514a), and can direct the funds to certain accounts through
appropriations acts. As shown in Table A-1, Congress directed specific amounts from the NEF to
the NIH Building and Facilities account in FY2020 and FY2021.

6 T he Hazardous Substance Basic Research and T raining Program (Superfund Research Program ) funds research on the
health effects of exposures to hazardous substances and related solutions at the National Institute of Environmental
Health Sciences. include any amounts “transferred out” under this same authority. 21st Century Cures Act Innovation Account: NIH also receives funding through LHHS appropriations, subject to different budget enforcement rules than the rest of the NIH funding in the act—appropriations to the NIH Innovation Account created by the 21st Century Cures Act 6 NIH program levels in this report reflect total funding for all Institutes and Centers (ICs), the Office of the Director (OD), the PHS Evaluation Set-Aside (“PHS Evaluation Tap”), the Superfund Research Program, mandatory type I diabetes research (provided in Public Health Service Act [PHSA] Section 330B), the nonrecurring expenses fund (NEF), and, when applicable, the Patient-Centered Outcomes Research Trust Fund (PCORTF) and mandatory pandemic preparedness funding proposed in the FY2023 budget. 7 The Hazardous Substance Basic Research and Training Program (Superfund Research Program) funds research on the health effects of exposures to hazardous substances and related solutions at the National Institute of Environmental Health Sciences. It is authorized by 311(a) of the Comprehensive Environmental Response, Compensation, and It is authorized by 311(a) of the Comprehensive Environmental Response, Compensation, and
Liability Act of 1980 (42 U.S.C. §9660(a)) and Section 126(g) of the SuperfundLiability Act of 1980 (42 U.S.C. §9660(a)) and Section 126(g) of the Superfund Amendments and Reauthorization Act Amendments and Reauthorization Act
of 1986. of 1986.
78 For more information on the PHS Evaluation For more information on the PHS Evaluation T apTap, or PHS Evaluation Set, or PHS Evaluation Set -Aside, see discussion-Aside, see discussion in CRSin CRS Report Report
R44916, R44916, Public Health Service Agencies: Overview and Funding (FY2016 -FY2018). .
8 9 Prior to FY2015, NIH had traditionally been by far the largest net donor of tap funds, rather than a net recipient. Prior to FY2015, NIH had traditionally been by far the largest net donor of tap funds, rather than a net recipient. T heThe
joint explanatory statement accompanying the FY2015 omnibus explained this shift asjoint explanatory statement accompanying the FY2015 omnibus explained this shift as being being intended to ensure that tap intended to ensure that tap
transfers are a “transfers are a “ net benefit to NIH rather than a liability” and noted that this change was in response to a growing net benefit to NIH rather than a liability” and noted that this change was in response to a growing
concern at the loss of NIH fundsconcern at the loss of NIH funds to the tap. Joint Explanatory Statement, Proceedings and Debatesto the tap. Joint Explanatory Statement, Proceedings and Debates of the of the
113th Congress, Second113th Congress, Second Session,Session, Congressional Record, vol. 160, no. 151, Book II, December 11, 2014, p. H9832. , vol. 160, no. 151, Book II, December 11, 2014, p. H9832.
910 See See Section 204 of Division H, Section 204 of Division H, T itle IITitle II, of P.L. of P.L. 116-260117-103 for the for the FY2021FY2022 maximum set-aside level. maximum set-aside level. T heThe last time that an last time that an
appropriations act set the PHS tap percentage at a level other than 2.5% was in FY2009, when it wasappropriations act set the PHS tap percentage at a level other than 2.5% was in FY2009, when it was 2.4% (see2.4% (see P.L. P.L.
111-8). 111-8). T he FY2020The FY2022 omnibus also retained a change to this provision, first included in the FY2014 omnibus, allowing omnibus also retained a change to this provision, first included in the FY2014 omnibus, allowing
tap transfers to be usedtap transfers to be used for the “evaluation and the implementation” of programs funded in the HHSfor the “evaluation and the implementation” of programs funded in the HHS title of the LHHS title of the LHHS
Appropriations Act. Prior to FY2014, such provisions had restricted tapAppropriations Act. Prior to FY2014, such provisions had restricted tap funds to the “funds to the “ evaluation of the evaluation of the
implementation” of programs authorized under the Public Health Service Act. implementation” of programs authorized under the Public Health Service Act.
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21st Century Cures Act Innovation Account: NIH also receives funding through LHHS
appropriations, subject to different budget enforcement rules than the rest of the NIH funding in
the act—appropriations to the NIH Innovation Account created by The 21st Century Cures Act
(“the Cures Act,” P.L. 114-255) to fund programs authorized by the act(“the Cures Act,” P.L. 114-255) to fund programs authorized by the act.10 for FY2017 through FY2026.11 For appropriated For appropriated
amounts to the account—up the limit authorized for each fiscal year—the amounts are subtracted amounts to the account—up the limit authorized for each fiscal year—the amounts are subtracted
from any cost estimate for enforcing discretionary spending limits (i.e., the budget caps). In from any cost estimate for enforcing discretionary spending limits (i.e., the budget caps). In
effect, appropriations to the NIH Innovation Account as authorized by the Cures Act are not effect, appropriations to the NIH Innovation Account as authorized by the Cures Act are not
subject to discretionary spending limits.subject to discretionary spending limits.1112 The NIH Director may transfer these amounts from the The NIH Director may transfer these amounts from the
NIH Innovation Account to other NIH accounts, but only for the purposes specified in the Cures NIH Innovation Account to other NIH accounts, but only for the purposes specified in the Cures
Act. If the NIH Director determines that the funds for any of the four Innovation Projects are not Act. If the NIH Director determines that the funds for any of the four Innovation Projects are not
necessary, the amounts may be transferred back to the NIH Innovation Account. necessary, the amounts may be transferred back to the NIH Innovation Account. Al amounts
All amounts authorized by the Cures Act have been fully appropriated to the Innovation Account from FY2017 authorized by the Cures Act have been fully appropriated to the Innovation Account from FY2017
to FY2021to FY2022, including $, including $404 mil ion for FY2021. Under the FY2022 budget request, the full
amount authorized by the Cures Act ($496 mil ion) would496 million for FY2022. For FY2023, $1.085 billion is authorized to be appropriated. be appropriated.
Mandatory Type I Diabetes Funding: In addition, NIH has received mandatory funding of $150 In addition, NIH has received mandatory funding of $150
mil ion annual ymillion annually that is provided in Public Health Service Act (PHSA) Section 330B, for a special that is provided in Public Health Service Act (PHSA) Section 330B, for a special
program on type 1 diabetes research, most recently extended through FY2023 by the program on type 1 diabetes research, most recently extended through FY2023 by the
Consolidated Appropriations Act, 2021 (P.L. 116-260Consolidated Appropriations Act, 2021 (P.L. 116-260 ; Division BB, Title III).
Coronavirus Supplemental Appropriations (FY2020 and FY2021)
NIH has also received FY2020 and FY2021 emergency supplemental appropriations to several IC
accounts and as transfers from the Public Health and Social Services Emergency Fund (PHSSEF)
account as provided by four coronavirus supplemental appropriations acts:12
 Division A of the Coronavirus Preparedness and Response Supplemental
Appropriations Act, 2020 (P.L. 116-123), enacted on March 6, 2020.
 Division B of the Coronavirus Aid, Relief, and Economic Security Act (CARES
Act, P.L. 116-136), enacted on March 27, 2020.
 Division B of the Paycheck Protection Program and Health Care Enhancement
Act (PPPHCEA, P.L. 116-139), enacted on April 24, 2020.
 Division M of Consolidated Appropriations Act, 2021 (P.L. 116-260), enacted on
December 27, 2020.
NIH received a total of $3.031 bil ion to NIH IC accounts, along with directed transfers from the
PHSSEF account to NIH accounts totaling not less than $1.806 bil ion. Accounting for transfers,
NIH is to receive a total of at least $4.837 bil ion (see text box below for information on
American Rescue Plan Act funding). Al appropriations to NIH accounts are available until
September 30, 2024, and al transfers from the PHSSEF are available until expended. This
funding was primarily provided in three categories:
Broadly Available Funding. In the first (P.L. 116-123) and third measure (CARES Act; P.L. 116-
136), funding was made available to several NIH IC accounts “to prevent, prepare for and

10 See section on 21st Century Cures Act in CRS Report R41705, The National Institutes of Health (NIH): Background
and Congressional Issues.
11 CRS Report R45778, Exceptions to the Budget Control Act’s Discretionary Spending Limits.
12 NIH did not receive supplemental appropriations from the Families First Coronavirus Response Act (FFCRA, P.L.
116-127), enacted on March 18, 2020.
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respond to coronavirus, domestical y and international y.” NIH IC accounts that received broadly
available funds and their totals include the following:
 National Institute of Allergy and
Infectious Diseases (NIAID): $1.542
American Rescue Plan Act of 2021
bil ion, including $836 mil ion in the
(ARPA; P.L. 117-2) Appropriations
first measure and $706 mil ion in the
The ARPA did not provide any appropriations directly
CARES Act. Some transfers or set-
to NIH. The law made available $6.050 bil ion to the
asides were directed for specific
HHS Secretary in mandatory appropriations (i.e., direct
purposes in the NIAID appropriations.
appropriations) for research, development,
The first measure directed a transfer
manufacturing, production, and the purchase of
of not less than $10 mil ion to the
vaccines, therapeutics, and ancil ary medical products
and supplies—available to address COVID-19, SARS-
National Institute of Environmental
CoV-2 or its variants, and any disease with potential for
Health Sciences (NIEHS) for
creating a pandemic (Title II, Section 2303). The HHS
“worker-based training to prevent and
Secretary can al ocate a portion of these funds to NIH
reduce exposure of hospital
accounts at his discretion.
employees, emergency first
responders, and other workers who are at risk of exposure to coronavirus through
their work duties.” The third measure set aside not less than $156 mil ion of the
total for “the study of, construction of, demolition of, renovation of, and
acquisition of equipment for, vaccine and infectious diseases research facilities of
or used by NIH, including the acquisition of real property.”
 National Heart, Lung, and Blood Institute (NHLBI): $103 mil ion in the
CARES Act.
 National Institute of Biomedical Imaging and Bioengineering (NIBIB): $60
mil ion in the CARES Act.
 National Library of Medicine (NLM): $10 mil ion in the CARES Act.
 National Center for Advancing Translational Sciences (NCATS): $36 mil ion
in the CARES Act.
 Office of the Director (OD): $30 mil ion in the CARES Act.
Diagnostic Testing Research and Development (R&D). In the fourth (Paycheck Protection
Program and Health Care Enhancement Act; PPPHCEA, P.L. 116-139) and fifth measure
(Division M of P.L. 116-260), NIH received funding for specific purposes related to diagnostic
test R&D. This funding was directed to NIH as “not less than” transfers from the PHSSEF
account in the fourth measure, and directly to the OD account in the fifth measure. These amounts
include the following:
 National Cancer Institute (NCI): Transfer of not less than $306 mil ion from
PHSSEF to NCI “to develop, validate, improve, and implement serological
testing and associated technologies” in the PPPHCEA.
 NIBIB: Transfer of not less than $500 mil ion from PHSSEF to NIBIB “to
accelerate research, development, and implementation of point of care and other
rapid testing related to coronavirus” in the PPPHCEA.
 OD: Transfer of not less than $1 bil ion from PHSSEF to OD “to develop,
validate, improve, and implement testing and associated technologies; to
accelerate research, development, and implementation of point of care and other
rapid testing; and for partnerships with governmental and non-governmental
entities” in the PPPHCEA. In the fifth measure, not less than $100 mil ion of the
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$1.250 bil ion total provided to the OD account is for “the Rapid Acceleration of
Diagnostics.”
NIH’s Rapid Acceleration of Diagnostics (RADx) initiative is a prize competition for diagnostics
development. As communicated to CRS, the $1.500 bil ion total for NIBIB and OD in the fourth
measure was used to support RADx initial y, with additional funds in the fifth measure as
specified above.13
Long-Term Studies of COVID-19. The fifth measure directed $1.150 bil ion of the total $1.250
bil ion provided to the OD account “for research and clinical trials related to long-term studies of
COVID-19.” The fifth measure also al ows the total $1.250 bil ion appropriation to OD to be
transferred to other IC accounts (in addition to other HHS transfer authorities in the law).
FY2021 Proposed and Enacted Funding
Former President Trump’s FY2021 initial budget request (February 10, 2020) proposed that NIH
be provided a total program level of $38.694 bil ion, a decrease of $2.991 bil ion (-7.2%) from
FY2020 program levels.14 Subsequently, on March 17, 2020, the Office of Management and
Budget submitted an amendment to President Trump’s original request that would increase
funding; Division BB, Title III). Nonrecurring expenses fund (NEF): The NEF permits HHS to transfer unobligated balances of expired discretionary funds from FY2008 and subsequent years into the NEF account. Statute authorizes use of the funds for capital acquisitions, including information technology (IT) and facilities infrastructure (42 U.S.C. §3514a), and appropriators can direct the funds to certain accounts through appropriations acts. As shown in Table A-1, appropriations directed specific amounts from the NEF to the NIH Building and Facilities account in FY2020 and FY2021. Appropriators did not direct a NEF transfer in FY2022. FY2022 Proposed and Enacted Funding President Biden’s FY2022 budget request (May 28, 2021) proposed that NIH be provided with a total program level of $51.958 billion, an increase of $8.92 billion (+20.7%) from the FY2021 program level. The proposed FY2022 program level would have been made up of13  $50.461 billion in discretionary LHHS budget authority (nontransfer);  $1.272 billion pursuant to the PHS program evaluation transfer;  $84 million for the Superfund research program and related activities from Interior/Environment appropriations; and  $141 million in annual funding for the mandatory type 1 diabetes research program.14 11 See section on 21st Century Cures Act in CRS Report R41705, The National Institutes of Health (NIH): Background and Congressional Issues. 12 CRS Report R45778, Exceptions to the Budget Control Act’s Discretionary Spending Limits. 13 Based mostly on budget request numbers in Congressional Record, vol. 168, no. 42, Book IV, March 9, 2022, pp. H2862-H2865, except where noted. 14 The FY2022 request amount for the mandatory type 1 diabetes research program differs from the already enacted amount for FY2022 of $150 million in PHSA Section 330B, as amended in P.L. 116-260, Division BB, Title III. According to the budget request, the FY2022 request amount reflects sequestration of $8.55 million. See “Budget Request by IC,” p. 1, at https://officeofbudget.od.nih.gov/pdfs/FY21/br/2022%20CJ%20Overview%20Volume%20Supplementary%20Tables%20May%2028_corrections%20Oct%204%20annotated.pdf Congressional Research Service 3 link to page 15 National Institutes of Health (NIH) Funding: FY1996-FY2023 Under this request, all existing IC accounts, except for the OD, would have received an increase compared with FY2021-enacted levels (see Appendix A). The proposed funding level for the OD ($2.25 billion) would have been $163 million less (-6.7%) than the FY2021-enacted level. The Buildings and Facilities (B&F) account would have received an increase of $51 million (+25.4%) in LHHS discretionary budget authority, but an overall decrease of $174 million (-41.1%) when accounting for the additional NEF transfer of $225 million directed to the B&F account in FY2021 appropriations.15 The FY2022 budget request also proposed the creation of an Advanced Research Projects Agency for Health (ARPA-H) within NIH. The budget request included $6.5 billion, available through September 30, 2024, for ARPA-H “to build platforms and capabilities to deliver cures for cancer, Alzheimer’s disease, diabetes, and other diseases.”16 The $6.5 billion for ARPA-H accounted for 72.9% of the FY2022 budget request’s proposed $8.92 billion increase from FY2021-enacted levels. Further information on the ARPA-H proposal is provided in the text box below. In July 2021, the House passed a consolidated appropriations bill, H.R. 4502, with proposed FY2022 funding levels for NIH accounts in Division A (LHHS appropriations) and Division E (Interior/Environment appropriations). The House-passed appropriations bill would have provided NIH with a FY2022 estimated program level of $49.587 billion, an increase of $6.550 billion (+15.2%) from FY2021-enacted levels and a decrease of $2.371 billion (-4.6%) from the FY2022 budget request. The House-proposed FY2022 program level would have included the following amounts:17  $48.082 billion in discretionary LHHS budget authority (nontransfer);  $1.272 billion pursuant to the PHS program evaluation transfer;  $84 million for the Superfund research program and related activities from Interior/Environment appropriations; and  $150 million in annual funding for the mandatory type 1 diabetes research program. House-passed appropriations would have provided increases to all existing IC accounts compared with FY2021 funding levels. Compared with the FY2022 budget request, House-passed appropriations would have provided increases to all existing IC accounts except for the National for the National Institute of Child Health and Human Development (-$252 million), the National Institute of Environmental Health Sciences (-$79 million), and the National Institute of Arthritis and Musculoskeletal and Skin Diseases (-$1 million). The House-passed measure also included $3.0 billion for ARPA-H available through September 30, 2024, a decrease of $3.5 billion (-53.8%) compared with the FY2022 budget request, and provided that funding would have been available only if legislation specifically establishing ARPA-H is enacted into law. The Senate Appropriations Committee LHHS and INT subcommittee chairs introduced regular appropriations bills (S. 3062 and S. 3034, respectively) that would have provided funding for NIH; the Senate did not consider these measures in committee or on the floor. 15 Accounting for the directed NEF transfer, the Buildings and Facilities account has a total FY2021 funding level of $424 million. This total account amount is not reflected in budget request documents. 16 NIH, Institute of Al ergy and Infectious Disease (NIAID) by $440 mil ion
relative to the original request. 15 The purpose of this additional requested funding was “to ensure
[NIAID] has the resources beginning October 1, 2020, to continue critical basic and applied
research on coronaviruses and other infectious diseases.” The amended NIH FY2021 request
would have provided a program level of $39.133 bil ion, a decrease of $2.552 bil ion (-6.1%)
from the FY2020 program level.16 Under the amended FY2021 budget request, al the existing
ICs and budget activity, except for NIAID and Buildings and Facilities, would have received a
decrease compared to FY2020-enacted levels.17 The NIAID appropriation of $5.885 bil ion would
have been the same amount as the program level for NIAID at the time. The Buildings and
Facilities appropriation of $300 mil ion would have been an increase of $100 mil ion from
FY2020 in terms of discretionary LHHS budget authority.18
In addition, the FY2021 budget request proposed consolidating the Agency for Healthcare
Research and Quality (AHRQ) into NIH, forming a 28th IC—the National Institute for Research
on Safety and Quality (NIRSQ). The creation of a new NIH institute would general y require an

13 CRS communication with NIH, July 24, 2020.
14 NIH, Congressional Justification: FY2021, February 10, 2020, p. 75, at https://officeofbudget.od.nih.gov/pdfs/FY21/
br/1-OverviewVolumeSingleFile-toPrint.pdf. T his report uses FY2020 enacted funding levels from NIH,
Congressional Justification: FY2022, May 28, 2021, p. , May 28, 2021, p. 89-9110, at , at
https://officeofbudget.od.nih.gov/pdfs/FY22/br/2022%20CJ%20Overview%20Volume%20May%2028.pdf.https://officeofbudget.od.nih.gov/pdfs/FY22/br/2022%20CJ%20Overview%20Volume%20May%2028.pdf.
15 Letter from Michael R. Pence, President of the Senate, to Donald T rump, President of the United States, March 17,
2020, at https://www.whitehouse.gov/wp-content/uploads/2020/03/Letter-regarding-additional-funding-to-support -the-
United-States-response-to-COVID-19-3.17.2020.pdf.
16 Amended budget request funding levels from Rep. Nancy Pelosi, “Explanatory Statement Submitted by Mrs. Lowey,
Chairwoman of the House Committee on Appropriations Regarding H.R. 133, Consolidated Appropriations Act,
2021,” House of Representatives, Congressional Record, daily edition, vol. 166, part No. 218—Book IV (December
21, 2020).
17 T hough the budget request provides an increase to the National Institute of General Medical Sciences (NIGMS)
through discretionary LHHS budget authority, the total amount for NI GMS with the PHS evaluation transfer included
is less than FY2020-enacted levels. For proposed FY2021 IC funding levels, see Table A-1.
18 FY2020 appropriations also directed a $225 million transfer from the HHS nonrecurring expenses fund (NEF) to the
NIH Building and Facilities (B&F) account; however, this transfer was not reflected in budget request tables.
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amendment to PHSA Section 401(d), which specifies that “[i]n the National Institutes of Health,
the number of national research institutes and national centers may not exceed a total of 27.” The
proposed NIRSQ would have received a total appropriation of $355 mil ion, including $257
mil ion in discretionary LHHS budget authority and $99 mil ion in mandatory appropriations
from the Patient-Centered Outcomes Research Trust Fund (PCORTF) in Social Security Act
Section 1181. Congress did not adopt this proposal in FY2021 and did not adopt similar proposals
to consolidate AHRQ into NIH as NIRSQ in FY2018, FY2019, or FY2020.
In July 2020, the House passed two consolidated appropriations bil s with proposed funding
levels for NIH accounts: H.R. 7617 with proposed LHHS appropriations in Division E19 and H.R.
7608 with proposed INT appropriations in Division C.20 In summary, House-passed
appropriations would have provided NIH with an FY2021 estimated program level of $42.221
bil ion.21 With this estimated funding, the House-proposed program level would be $536 mil ion
(+1.3%) more than the FY2020-enacted program level and $3.088 bil ion (+7.9%) more than the
amended FY2021 budget request program level.
The House LHHS appropriations bil (in Title VI of Division E) also included $5 bil ion in
emergency funding “to support biomedical research—including support for current grantees to
cover the shutdown costs, startup costs, and other costs related to delays in research in 2020.”22
The $5 bil ion would have been appropriated to the Office of the Director (OD). Of this total, the
NIH Director was directed to transfer not less than $2.500 bil ion to the IC accounts “in
proportion to the amounts otherwise made available” in FY2020-enacted LHHS appropriations,
and to transfer the full FY2020-enacted amount to the Building and Facilities account.23 As
shown in the House report, this funding would have been distributed to al NIH accounts, except
the Innovation Account, with funding levels ranging from $5 mil ion for the Fogarty International
Center, to $2.275 bil ion for the Office of the Director account.24
The Senate did not complete committee or floor consideration of FY2021 LHHS appropriations.
The Chair of the Senate Appropriations Committee, however, released drafts of al 12 annual
appropriations bil s along with draft accompanying committee reports. 25
On December 27, 2020, Congress and President Trump finalized the NIH FY2021 appropriations
by enacting the Consolidated Appropriations Act, 2021 (P.L. 116-260), which included final
FY2021 LHHS appropriations in Division H, Interior/Environment appropriations in Division G,

19 T he Defense, Commerce, Justice, Science, Energy and Water Development, Financial Services and General
Government, Labor, Health and Human Services, Education, T ransportation, Housing, and Urban Development
Appropriations Act, 2021.
20 T he State, Foreign Operations, Agriculture, Rural Development, Interior, Environment, Military Construction, and
Veterans Affairs Appropriations Act, 2021.
21 Estimated funding level also accounts for proposed full year extension of mandatory type I diabetes research funding
per H.Rept. 116-450, p. 399.
22 H.R. 7617, Division E, T itle VI. By convention, CRS does not add discretionary funding designated as an emergency
requirement to regular appropriations amounts. However, H.Rept. 116 -450 (p. 404) presents a combined proposed
FY2021 NIH program level with emergency funding included of $46.959.
23 Ibid.
24 H.Rept. 116-450, pp. 399-404.
25 U.S. Congress, Senate Committee on Appropriations majority staff, “ Committee Releases FY21 Bills in Effort to
Advance Process, Produce Bipartisan Results,” press release, November 10, 2020,
at https://www.appropriations.senate.gov/news/committee-releases-fy21-bills-in-effort-to-advance-process-produce-
bipartisan-results.
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and full year mandatory type 1 diabetes funding in Division BB. The enacted FY2021 NIH
program level is made up of the following:
 $41.432 bil ion in discretionary LHHS budget authority;
 $1.272 bil ion pursuant to the PHS program evaluation transfer and a $225
mil ion transfer from the HHS nonrecurring expenses fund (NEF);26
 $82 mil ion for the Superfund research program and related activities from
Interior/Environment appropriations; and
 $150 mil ion in annual funding for the mandatory type 1 diabetes research
program.
Accounting for transfers and other adjustments, cited budget documents show the FY2021
program level as $42.936 bil ion.27 This FY2021 NIH program level represents a $1.251 bil ion
increase (+3.0%) above the FY2020 program level. The FY2021 total for NIH is also $3.802
bil ion (+9.7%) above the FY2021 budget request and $715 mil ion (+1.7%) above the program
level proposed by the House-passed bil s. In FY2021, al IC accounts received an increase above
FY2020 funding levels, except for the Buildings and Facilities account, which had an unchanged
funding level of $200 mil ion (see Table A-1). For the Innovation Account, the full amount
authorized by the 21st Century Cures Act ($404 mil ion) was appropriated.
FY2022 Budget and Appropriations
President Biden’s FY2022 budget request (May 28, 2021) 17 H.Rept. 117-96, Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Bill, 2022, July 19, 2021, pp. 475-477, at https://www.congress.gov/117/crpt/hrpt96/CRPT-117hrpt96.pdf. The FY2022 House numbers incorporate the budgetary effects of the amendments to H.R. 4502 that were adopted by the House on July 29, 2021. Congressional Research Service 4 National Institutes of Health (NIH) Funding: FY1996-FY2023 On March 15, 2022, Congress and President Biden finalized NIH FY2022 appropriations by enacting the Consolidated Appropriations Act, 2022 (P.L. 117-103), which includes final FY2022 LHHS appropriations in Division H and Interior/Environment appropriations in Division G. The enacted FY2022 NIH program level is made up of the following:  $43.65 billion in discretionary LHHS budget authority;  $1.309 billion pursuant to the PHS program evaluation transfer;  $83 million for the Superfund research program and related activities from Interior/Environment appropriations; and  $141 million in annual funding for the mandatory type 1 diabetes research program.18 In total, the NIH FY2022 program level as enacted is $45.183 billion. In addition, the law provided $1 billion for the Advanced Research Projects Agency for Health to a new account under the Office of the Secretary. The law allowed the HHS Secretary to place the new agency anywhere within the department within 30 days of enactment. On March 30, 2022, HHS Secretary Xavier Becerra submitted a notice to the appropriations committees that ARPA-H is to reside within the NIH. Accounting for the ARPA-H transfer, the NIH FY2022-enacted program level is $46.183 billion. This FY2022 NIH program level represents a $3.146 billion increase (+7.3%) relative to the FY2021-enacted program level of $43.037 billion. The FY2022 enacted total for NIH is also $5.775 billion (-11.1%) less than the FY2022 budget request. In FY2022, all IC accounts received an increase relative to FY2021 funding levels. For the Innovation Account, the full amount authorized by the 21st Century Cures Act ($496 million) is appropriated. The Buildings and Facilities (B&F) account receives an increase of $51 million (+25.4%) in LHHS discretionary budget authority, but an overall decrease of $174 million (-41.1%) when accounting for the additional NEF transfer of $225 million directed to the B&F account in FY2021 appropriations. Advanced Research Projects Agency for Health (ARPA-H) President Biden’s FY2022 budget request to Congress proposed the creation of an Advanced Research Projects Agency for Health (ARPA-H) within the National Institutes of Health (NIH). The budget request included $6.5 bil ion for ARPA-H “to build platforms and capabilities to deliver cures for cancer, Alzheimer’s disease, diabetes, and other diseases.” Funding was requested for a period of three years to “allow for both scale-up in FY 2022 and redeployment of resources in the next two years if projects fail to meet performance milestones.” The vast majority of funding would support extramural research, with a small amount of funding reserved for staffing and administrative functions. Unlike NIH Institutes and Centers (ICs), ARPA-H would not have its own intramural research program. As proposed, ARPA-H is modeled after the Defense Advanced Research Projects Agency (DARPA), which works primarily with the Department of Defense (DOD), and would contain several “DARPA model” characteristics, including a flat and nimble organizational structure, tenure-limited program managers with a high degree of autonomy to select and fund projects, and a milestone-based contract approach. While this organizational structure would be “operationally unique” from NIH ICs, ARPA-H would stil coordinate research and activities with NIH ICs and other HHS agencies. 18 The FY2022-enacted amount for the mandatory type 1 diabetes research program differs from the amount for FY2022 of $150 million in PHSA Section 330B, as amended in P.L. 116-260 , Division BB, Title III. According to the budget request, the FY2023 amount reflects sequestration of $8.55 million. See “Budget Mechanism Table,” p. 44, at https://officeofbudget.od.nih.gov/pdfs/FY23/br/Overview%20of%20FY%202023%20Presidents%20Budget.pdf. 18 HHS, Budget in Brief: FY2023, pp. 53-54, https://www.hhs.gov/sites/default/files/fy-2023-budget-in-brief.pdf. Congressional Research Service 5 link to page 15 National Institutes of Health (NIH) Funding: FY1996-FY2023 The FY2022 budget request describes four broad project areas that ARPA-H would fund:  tackling bold challenges requiring large-scale, sustained, cross-sector coordination;  creating new capabilities (e.g., technologies, data resources, disease models);  supporting high-risk exploration that could establish entirely new paradigms; and  overcoming market failures through critical solutions, including financial incentives. Most ARPA-H awards would be given to industry, universities, and nonprofit research institutions, and may involve some agreements with other federal agencies.19 The Consolidated Appropriations Act, 2022 (P.L. 117-103), provides $1 bil ion to HHS to establish the Advanced Research Projects Agency for Health (ARPA-H). The law created a new ARPA-H account at HHS, with funding available until September 30, 2024, and allowed the HHS Secretary to place the new agency anywhere within the department within 30 days of enactment. On March 30, 2022, HHS Secretary Xavier Becerra submitted a notice to the appropriations committees that ARPA-H is to reside within the NIH, while the ARPA-H Director is to report directly to the HHS Secretary. For further information and analysis regarding ARPA-H, see CRS Report R47074, Advanced Research Projects Agency for Health (ARPA-H): Congressional Action and Selected Policy Issues. FY2023 Budget Request President Biden’s FY2023 budget request proposes that NIH be provided with a proposes that NIH be provided with a
total program level of $total program level of $51.953 bil ion62.503 billion, an increase of $, an increase of $9.017 bil ion (+21.0%) from FY2021-
16.320 billion (+35.3%) from FY2022-enacted levels. The proposed enacted levels. The proposed FY2022FY2023 program level would be made up program level would be made up of28
 $50.456 bil ionof20  $48.957 billion in discretionary LHHS budget authority (nontransfer); in discretionary LHHS budget authority (nontransfer);
 $1.272  $1.272 bil ion billion pursuant to the PHS program evaluation transfer; pursuant to the PHS program evaluation transfer;
 $ $84 mil ion 83 million for the Superfund research program and related activities from for the Superfund research program and related activities from
Interior/Environment appropriations; Interior/Environment appropriations; and
 $141  $141 mil ion million in annual funding for the mandatory type 1 diabetes research in annual funding for the mandatory type 1 diabetes research
program program.29
;21and  $12.05 billion in new mandatory appropriations for pandemic preparedness.22 Under this request, Under this request, al approximately half of existing IC accounts would receive existing IC accounts would receive an increase compared to FY2021-
increases compared with FY2022-enacted levels (enacted levels (see Appendix A). In addition, the full amount ($496 mil ion) authorized by the
21st Century Cures Act for FY2021 (P.L. 114-255) would be appropriated to the Innovation
Account. The Buildings and Facilities (B&F) account would receive an increase of $50 mil ion
(+25%) in LHHS discretionary budget authority, but an overal decrease of $175 mil ion (-41%)

26 T he NEF amount is not reflected in the FY2021 NIH program level in cited FY2022 budget request tables.
27 See see Appendix A). Funding for the National Institute on Minority Health and Health Disparities (NIMHD) would increase by the greatest percentage amount (+$201 million, +43.7%), and funding for OD would decrease by the greatest amount (-$319 19 NIH, NIH, Congressional Justification: FY2022, May 28, 2021, , May 28, 2021, p. 89-91pp. 10-11, at , at
https://officeofbudget.od.nih.gov/pdfs/FY22/br/2022%20CJ%20Overview%20Volume%20May%2028.pdfhttps://officeofbudget.od.nih.gov/pdfs/FY22/br/2022%20CJ%20Overview%20Volume%20May%2028.pdf.
Specifically, FY2022 budget documents reflect a transfer from NIH to HHS OIG, transfers between IC accounts, and
do not account for the NEF transfer to the B&F account.
28 and HHS, “FY2022 Budget in Brief,” pp. 59-60, at https://www.hhs.gov/sites/default/files/fy-2022-budget-in-brief.pdf. 20 NIH, NIH, Congressional Justification: FY2022, May 28, 2021, p. 89-91FY2023, “Budget Request by IC (Summary Table),” March 28, 2022, p. 86, at , at
https://officeofbudget.od.nih.gov/pdfs/https://officeofbudget.od.nih.gov/pdfs/FY22/br/2022%20CJ%20Overview%20Volume%20May%2028.pdf .
29 T hisFY23/br/Overview%20of%20FY%202023%20Presidents%20Budget.pdf. 21 This proposed amount for the mandatory type 1 diabetes research program differs from the already enacted amount proposed amount for the mandatory type 1 diabetes research program differs from the already enacted amount
for for FY2022FY2023 of $150 million in PHSA of $150 million in PHSA Section 330B, as amendedSection 330B, as amended in P.L. 116-260, Division BB, in P.L. 116-260, Division BB, T itleTitle III. According to III. According to
the budgetthe budget request, the request, the FY2022FY2023 amount reflects sequestration of $8.55 million. See “Budget amount reflects sequestration of $8.55 million. See “Budget Mechanism Mechanism T ableTable,” p. ,” p. 92
in44, at https://officeofbudget.od.nih.gov/pdfs/ https://officeofbudget.od.nih.gov/pdfs/FY22/br/2022%20CJ%20Overview%20Supplementary%20Tables.pdf .
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when accounting for the additional NEF transfer of $225 mil ion directed to the B&F account in
FY2021 appropriations.30
The FY2022 budget request also proposes the creation of an Advanced Research Projects Agency
for Health (ARPA-H) within NIH. The budget request included $6.5 bil ion for ARPA-H “to build
platforms and capabilities to deliver cures for cancer, Alzheimer’s disease, diabetes, and other
diseases.”31 The $6.5 bil ion for ARPA-H would account for 72.1% of the FY2022 budget
request’s $9.017 bil ion increase from FY2021-enacted levels. Further information on the ARPA-
H proposal is provided below.
Advanced Research Projects Agency for Health (ARPA-H) in the FY2022
Budget Request
On May 28, 2021, the Office of Budget and Management (OMB) submitted President Biden’s FY2022 budget
request to Congress. This budget request proposed the creation of an Advanced Research Projects Agency for
Health (ARPA-H) within the National Institutes of Health (NIH). The budget request included $6.5 bil ion for
ARPA-H “to build platforms and capabilities to deliver cures for cancer, Alzheimer’s disease, diabetes, and other
diseases.” Funding was requested for a period of three years to “al ow for both scale-up in FY 2022 and
redeployment of resources in the next two years if projects fail to meet performance milestones.” The vast
majority of funding would support extramural research, with a smal amount of funding reserved for staffing and
administrative functions. Unlike NIH Institutes and Centers (ICs), ARPA-H would not have its own intramural
research program.
ARPA-H would be modeled after the Defense Advanced Research Projects Agency (DARPA) , which primarily
works with the Department of Defense (DOD), and would contain several “DARPA model” characteristics,
including a flat and nimble organizational structure, tenure-limited program managers with a high degree of
autonomy to select and fund projects, and a milestone-based contract approach. While this organizational
structure would be “operational y unique” from NIH ICs, ARPA-H would stil coordinate research and activities
with NIH ICs and other HHS agencies.
The FY2022 budget request describes four broad project areas that ARPA-H would fund:

tackling bold chal enges requiring large scale, sustained, cross-sector coordination;

creating new capabilities (e.g., technologies, data resources, disease models);

supporting high-risk exploration that could establish entirely new paradigms; and

overcoming market failures through critical solutions, including financial incentives.
Most ARPA-H awards would be given to industry, universities, and nonprofit research institutions, and may
involve some agreements with other federal agencies. ARPA-H would make use of some of NIH’s flexible hiring
and funding authorities, such as its Other Transaction Authority mechanisms.32
For further information and analysis regarding ARPA-H, see CRS Insight IN11674, Advanced Research Projects
Agency for Health (ARPA-H): Considerations for Congress
Trends
Table 1 outlines NIH program level funding over the previous 25 years; Figure 1 il ustrates
funding trends in both current (also cal edFY23/br/Overview%20of%20FY%202023%20Presidents%20Budget.pdf. 22 The FY2023 budget request proposes an HHS-wide total of $81.7 billion for pandemic preparedness to “transform U.S. capabilities to prepare for and respond rapidly and effectively to future pandemics and other high consequence biological threats.” The $12.05 billion directed to NIH is for “NIH research and development of vaccines, diagnostics, and therapeutics against high priority viral families, biosafety and biosecurity, and to expand laboratory capacity and clinical trial infrastructure.” See HHS, Budget in Brief: FY2023, p. 55, https://www.hhs.gov/sites/default/files/fy-2023-budget-in-brief.pdf. Congressional Research Service 6 link to page 13 link to page 12 link to page 12 link to page 13 National Institutes of Health (NIH) Funding: FY1996-FY2023 million, -12.2%). In addition, the full amount ($1.085 billion) authorized by the 21st Century Cures Act for FY2023 (P.L. 114-255) would be appropriated to the Innovation Account. The FY2023 budget request also proposes $5 billion for ARPA-H, an increase of $4 billion from the FY2022-enacted level.23 Under the pandemic preparedness proposal, NIH would be provided $12.05 billion in new mandatory appropriations available for five years. This new appropriation makes up 73.8% of the proposed increase of $16.32 billion relative to FY2022-enacted program level. The pandemic preparedness proposal generally does not designate specific amounts for NIH ICs but describes a number of activities the new funding would support, including vaccine and therapeutic development, diagnostic test development and innovation, research infrastructure for clinical trials, and laboratory biosafety and biosecurity.24 If enacted, these mandatory appropriations generally would be controlled outside the annual appropriations process by authorizing law. Trends Table 1 outlines NIH program level funding from FY1996 until the FY2023 request. Figure 1 illustrates funding trends in both current (also called nominal dollars) and projected constant (i.e., inflation- nominal dollars) and projected constant (i.e., inflation-
adjusted) FY2022 dollars (funding shown is total budget authority).

30 Accounting for the directed NEF transfer, the Buildings and Facilities account has a total FY2021 funding level of
$425 million. T his total account amount is not reflected in budget request documents.
31 NIH, Congressional Justification: FY2022, May 28, 2021, p . 10, at
https://officeofbudget.od.nih.gov/pdfs/FY22/br/2022%20CJ%20Overview%20Volume%20May%2028.pdf.
32 NIH, Congressional Justification: FY2022, May 28, 2021, pp. 10-11, at
https://officeofbudget.od.nih.gov/pdfs/FY22/br/2022%20CJ%20Overview%20Volume%20May%2028.pdf and HHS,
“FY2022 Budget in Brief,” pp. 59-60, at https://www.hhs.gov/sites/default/files/fy-2022-budget-in-brief.pdf.
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adjusted) FY2022 dollars (funding shown is total budget authority). NIH has seen periods of high and low funding growth. Between FY1996 and FY1998, funding NIH has seen periods of high and low funding growth. Between FY1996 and FY1998, funding
for NIH grew from $11.928 for NIH grew from $11.928 bil ionbillion to $13.675 to $13.675 bil ionbillion (nominal dollars). Over the next five years, (nominal dollars). Over the next five years,
Congress and the President doubled the NIH budget to $27.167 Congress and the President doubled the NIH budget to $27.167 bil ionbillion in FY2003. In each of in FY2003. In each of
FY1999 through FY2003, NIH received annual funding increases of 14% to 16%. From FY2003 FY1999 through FY2003, NIH received annual funding increases of 14% to 16%. From FY2003
to FY2015, NIH funding increased more to FY2015, NIH funding increased more gradual ygradually in nominal dollars. in nominal dollars.3325 In some years, (FY2006, In some years, (FY2006,
FY2011, and FY2013) funding for the agency decreased in nominal dollars.FY2011, and FY2013) funding for the agency decreased in nominal dollars.3426 From FY2016 From FY2016
through through FY2020FY2022, NIH has seen funding increases , NIH has seen funding increases of over 5% each year. The largest increase was each year. The largest increase was
from FY2017 to FY2018, where the program level increased by $3.010 from FY2017 to FY2018, where the program level increased by $3.010 bil ionbillion (+8.8%), making (+8.8%), making
this the largest single-year nominal dollar increase since FY2003. this the largest single-year nominal dollar increase since FY2003. (If adopted, the FY2022
request program level would surpass this prior largest annual program level increase)The proposed funding increase in the FY2023 budget request would be a single-year nominal dollar increase of $16.320 billion (+35.3%)—it would represent the largest single-year increase in the period covered by this report. .
The lower half of The lower half of Figure 1 shows NIH funding adjusted for inflation (in projected constant shows NIH funding adjusted for inflation (in projected constant
FY2022FY2023 dollars) using the Biomedical dollars) using the Biomedical Research and Development Price Index (BRDPI).Research and Development Price Index (BRDPI).35 It
shows that the purchasing power of NIH funding peaked in FY2003 (the last year of the five-year
doubling period) and then declined fairly steadily for more than a decade until consecutive
funding increases were provided in each of FY2016 through FY2021. The FY2021 program level
is 3.3% below the peak FY2003 program level. The FY2022 budget request would provide a
program level that is 14.4% above the peak FY2003 program level.

33 Amounts shown in Table 1 include appropriations for the Global Fund to Fight AIDS, T B, and Malaria (FY2002 27 It 23 NIH, Congressional Justification: FY2023, “Budget Request by IC (Summary Table),” March 28, 2022, p. 86, at https://officeofbudget.od.nih.gov/pdfs/FY23/br/Overview%20of%20FY%202023%20Presidents%20Budget.pdf. 24 NIH, Congressional Justification: FY2023, pp. 17-20, https://officeofbudget.od.nih.gov/pdfs/FY23/br/Overview%20of%20FY%202023%20Presidents%20Budget.pdf. 25 Amounts shown in Table 1 include appropriations for the Global Fund to Fight AIDS, TB, and Malaria (FY2002--
FY2011) that were subject to transfer-out. As of FY2012, NIH no longer receives appropriations for the National FY2011) that were subject to transfer-out. As of FY2012, NIH no longer receives appropriations for the National
Institute of Allergy and Infectious DiseasesInstitute of Allergy and Infectious Diseases (NIAID) identify ing resources (NIAID) identifying resources for the Globalfor the Global Fund;Fund; this responsibility was this responsibility was
transferred to another federal agency. For further details on the amounts transferred out by fiscal year, see the transferred to another federal agency. For further details on the amounts transferred out by fiscal year, see the
“Supplemental Appropriation Data “Supplemental Appropriation Data T ableTable” for “History of Congressional Appropriations, Fiscal Years 2000-2012” at ” for “History of Congressional Appropriations, Fiscal Years 2000-2012” at
http://officeofbudget.od.nih.gov/approp_hist.html. http://officeofbudget.od.nih.gov/approp_hist.html.
3426 For instance, the FY2006 total was 0.1% lower For instance, the FY2006 total was 0.1% lower than the previous year, the first time that NIH than the previous year, the first time that NIH appropriatio nsappropriations had had
decreaseddecreased since FY1970; the FY2011 total, provided in the Full-Year Continuing Appropriations Act, 2011 (P.L. 112-since FY1970; the FY2011 total, provided in the Full-Year Continuing Appropriations Act, 2011 (P.L. 112-
10), was10), was 1.0% 1.0% below less than the previous fiscal year; the FY2013 total, provided in the Consolidated and Further Continuing the previous fiscal year; the FY2013 total, provided in the Consolidated and Further Continuing
Appropriations Act, 2013 (P.L. 113-6), was reducedAppropriations Act, 2013 (P.L. 113-6), was reduced by the March 2013 sequestration and a transfer of funding under by the March 2013 sequestration and a transfer of funding under
the authority of the HHS Secretary ($1.553 billion and $173 million, respectively), resulting in a budgetthe authority of the HHS Secretary ($1.553 billion and $173 million, respectively), resulting in a budget that was 5.0% that was 5.0%
lower than the prior year. lower than the prior year.
35 T he 27 The index is developed for NIH by the Bureau index is developed for NIH by the Bureau of Economic Analysis of the Department of Commerce. It of Economic Analysis of the Department of Commerce. It re flectsreflects the the
increase in prices of the resources neededincrease in prices of the resources needed to conduct biomedical research, includingto conduct biomedical research, including personnel services, supplies, and Congressional Research Service 7 link to page 15personnel services, supplies, and
equipment. It indicates how much the NIH budget must change to maintain purchasing power. See “ NIH Price
Indexes,” at https://officeofbudget.od.nih.gov/gbiPriceIndexes.html.
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National Institutes of Health (NIH) Funding: FY1996-FY2022FY2023 shows that the purchasing power of NIH funding initially peaked in FY2003 (the last year of the five-year doubling period) and then declined fairly steadily for more than a decade until consecutive funding increases were provided in each of FY2016 through FY2022. The FY2022 program level is 0.6% greater than the peak FY2003 program level. The FY2023 budget request would provide a program level that is 32.8% relative to the peak FY2003 program level. Figure 1. NIH

Figure 1. National Institutes of Health (NIH) Funding, FY1996-FY2022FY2023
Program Level Funding in Current and Projected Constant ( Program Level Funding in Current and Projected Constant (FY2022) Dol ars.

Source: FY2023) Dollars. Source: Sources used for FY2023 request, FY2022, and FY2021 program levels are in Table A-1. The FY2020 (and earlier) program levels are from NIH Budget Office, Appropriations HistoryNIH Budget Office, Appropriations History by Institute/Center (1938 to Present), at by Institute/Center (1938 to Present), at
http://officeofbudget.od.nih.gov/approp_hist.html.http://officeofbudget.od.nih.gov/approp_hist.html. The FY2020, FY2021, and FY2022 program levels are based on
NIH, Congressional Justification: FY2022, May 28, 2021, p. 89-91, at
Inflation adjustment reflects the Biomedical Research and Development Price Index (BRDPI), updated March 2022, at https://officeofbudget.od.nih.gov/gbiPriceIndexes.html. equipment. It indicates how much the NIH budget must change to maintain purchasing power. See “NIH Price Indexes,” at https://officeofbudget.od.nih.gov/pdfs/FY22/br/2022%20CJ%20Overview%20Volume%20May%2028.pdf . Inflation
adjustment reflects the Biomedical Research and Development Price Index (BRDPI), updated March 2021, at
https://officeofbudget.od.nih.gov/gbiPriceIndexes.html. https://officeofbudget.od.nih.gov/gbiPriceIndexes.html.
Congressional Research Service 8 link to page 21 link to page 14 link to page 15 link to page 13 National Institutes of Health (NIH) Funding: FY1996-FY2023 Notes: By convention, program level By convention, program level totals include amounts “transferredtotals include amounts “transferred in” pursuant to PHS tap but do not in” pursuant to PHS tap but do not
include any amounts “transferred out” under this same authority. Programinclude any amounts “transferred out” under this same authority. Program level includes level includes al all budget authority, budget authority,
including appropriations for the Global Fund to Fight AIDS,including appropriations for the Global Fund to Fight AIDS, TB, and Malaria (FY2002TB, and Malaria (FY2002 -FY2011) that were subject -FY2011) that were subject
to transfer-out. As of FY2012, NIH no longer receivesto transfer-out. As of FY2012, NIH no longer receives appropriations for the National Institute of appropriations for the National Institute of Al ergy Allergy and and
Infectious DiseasesInfectious Diseases (NIAID) identifying resources(NIAID) identifying resources for the Global Fund; this responsibilityfor the Global Fund; this responsibility was transferred to was transferred to
another federal agency. In general, amounts provided to NIH designated for emergencyanother federal agency. In general, amounts provided to NIH designated for emergency requirements requirements are are
excluded from these totals (e.g.,excluded from these totals (e.g., FY2020 amount does the FY2020 and FY2021 amounts do not include the amounts provided in the coronavirus not include the amounts provided in the coronavirus
supplemental appropriations acts, summarizedsupplemental appropriations acts, summarized in “Coronavirus Supplemental Appropriations”).
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in Appendix B).
Table 1. NIH Funding, FY1996-FY2022FY2023
Program Level Funding in Current and Constant ( Program Level Funding in Current and Constant (FY2022) Dol ars (bil ionsFY2023) Dollars (Billions) )
Program Level
Program Level Projected
% BelowRelative to
Fiscal Year
Current $
% Change
Constant FY2021 FY2023 $ FY2003a $
FY2003a
1996 1996
11.928 11.928
5.6% 5.6%
25.045 25.045

1997 1997
12.741 12.741
6.8% 6.8%
26.028 26.028

1998 1998
13.675 13.675
7.3% 7.3%
27.020 27.020

1999 1999
15.629 15.629
14.3% 14.3%
29.934 29.934

2000 2000
17.841 17.841
14.1% 14.1%
32.942 32.942

2001 2001
20.459 20.459
14.7% 14.7%
36.561 36.561

2002 2002
23.321 23.321
14.0% 14.0%
40.340 40.340

2003 2003
27.167 27.167
16.5% 16.5%
45.396 45.396

2004 2004
28.037 28.037
3.2% 3.2%
45.167 45.167
-0.5% -0.5%
2005 2005
28.594 28.594
2.0% 2.0%
44.341 44.341
-2.3% -2.3%
2006 2006
28.560 28.560
-0.1% -0.1%
42.328 42.328
-6.8% -6.8%
2007 2007
29.179 29.179
2.2% 2.2%
41.664 41.664
-8.2% -8.2%
2008 2008
29.607 29.607
1.5% 1.5%
40.385 40.385
-11.0% -11.0%
2009 2009
30.545 30.545
3.2% 3.2%
40.480 40.480
-10.8% -10.8%
2010 2010
31.238 31.238
2.3% 2.3%
40.176 40.176
-11.5% -11.5%
2011 2011
30.916 30.916
-1.0% -1.0%
38.657 38.657
-14.8% -14.8%
2012 2012
30.861 30.861
-0.2% -0.2%
38.099 38.099
-16.1% -16.1%
2013 2013
29.316 29.316
-5.0% -5.0%
35.526 35.526
-21.7% -21.7%
2014 2014
30.143 30.143
2.8% 2.8%
35.760 35.760
-21.2% -21.2%
2015 2015
30.311 30.311
0.6% 0.6%
35.243 35.243
-22.4% -22.4%
2016 2016
32.311 32.311
6.6% 6.6%
36.769 36.769
-19.0% -19.0%
2017 2017
34.301 34.301
6.2% 6.2%
38.044 38.044
-16.2% -16.2%
2018 2018
37.311 37.311
8.8% 8.8%
40.375 40.375
-11.1% -11.1%
2019 2019
39.313 39.313
5.4% 5.4%
41.661 41.661
-8.2% -8.2%
2020 2020
41. 41.685690
6.0% 6.0%
43.48345.018
-4. -4.24% %
2021 2021
42.93643.037
3. 3.0%
43.8872% 45.498 -3.3% 2022 46.183 7.3% 47.363 +0.6% 2023PB 62.503 35.3% 62.503 +32.8% Sources: Sources used for FY2023 request, FY2022, and FY2021 program levels are in Table A-1. The FY2020 (and earlier) program levels are from NIH Budget Office, Appropriations History by Institute/Center (1938 to Present), at http://officeofbudget.od.nih.gov/approp_hist.html
-3.3%
2022PB
51.953
21.0%
51.953
+14.4%
Sources: NIH Budget Office, Appropriations History by Institute/Center (1938 to Present), at
https://officeofbudget.od.nih.gov/approp_hist.html. The FY2020, FY2021, and FY2022 program levels are based
on NIH, Congressional Justification: FY2022, May 28, 2021, p. 89-91, at
https://officeofbudget.od.nih.gov/pdfs/FY22/br/2022%20CJ%20Overview%20Volume%20May%2028.pdf . Inflation . Inflation
adjustment reflectsadjustment reflects the Biomedicalthe Biomedical Research and DevelopmentResearch and Development Price Index (BRDPI), updatedPrice Index (BRDPI), updated March March 20212022, at , at
https://officeofbudget.od.nih.gov/gbiPriceIndexes.html.https://officeofbudget.od.nih.gov/gbiPriceIndexes.html.
Notes: By convention, budget tables, such aBy convention, budget tables, such as Table 1, include include amounts “transferred in” pursuant to PHS tap amounts “transferred in” pursuant to PHS tap
but do not include any amounts “transferred out” under this same authority. Program levelbut do not include any amounts “transferred out” under this same authority. Program level includes includes al budget
all budget Congressional Research Service 9 link to page 21 National Institutes of Health (NIH) Funding: FY1996-FY2023 authority, including appropriations for the Global Fund to Fight AIDS, TB, and Malaria (FY2002authority, including appropriations for the Global Fund to Fight AIDS, TB, and Malaria (FY2002 -FY2011) that -FY2011) that
were subject to transfer-out. As of FY2012, NIH no longer receiveswere subject to transfer-out. As of FY2012, NIH no longer receives appropriations for the National Institute of appropriations for the National Institute of
Al ergy Allergy and Infectious Diseasesand Infectious Diseases (NIAID) identifying resources(NIAID) identifying resources for the Global Fund; this responsibilityfor the Global Fund; this responsibility was was
transferred to another federaltransferred to another federal agency. In general,agency. In general, amounts provided to NIH for emergencyamounts provided to NIH for emergency requirements are
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requirements are excluded from these totals (e.g.,excluded from these totals (e.g., the FY2020 and FY2021 amounts do not include the amounts provided in the the FY2020 and FY2021 amounts do not include the amounts provided in the
coronavirus supplemental appropriations acts, summarizedcoronavirus supplemental appropriations acts, summarized in “Coronavirus Supplemental Appropriations”). in Appendix B). PB PB
denotes “President’s Budget.”denotes “President’s Budget.”
a. FY2003 was the year that NIH received the most programa. FY2003 was the year that NIH received the most program level funding (prior to FY2022) in 2023 constant dol arslevel funding. .
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Appendix A. NIH Funding Details
Table A-1. National Institutes of Health Funding
(budget authority, in (budget authority, in mil ions of dol ars)
FY2020
FY2021
FY2021
FY2022millions of dollars) FY2021 FY2022 FY2022 FY2023
Institutes/Centers
Final
Request
FinalEnacted
Request
Cancer Institute (NCI) Cancer Institute (NCI)
$6, $6,440
$5,881
$6,559
$6,733540 $6,733 $6,913 $6,714
Heart, Lung, and Blood Institute (NHLBI) Heart, Lung, and Blood Institute (NHLBI)
$3, $3,625654
$3, $3,298846
$3, $3,665
$3,846808 $3,823
Dental/Craniofacial Dental/Craniofacial Research (NIDCR) Research (NIDCR)
$ $478
$435
$485
$516
483 $516 $501 $513 Diabetes/Digestive/Kidney Diabetes/Digestive/Kidney (NIDDK)a
$2,115
$1,924
$2,132
$2,219 (NIDDK)a $2,126 $2,219 $2,204 $2,206
Neurological Neurological Disorders/StrokeDisorders/Stroke (NINDS) (NINDS)
$2, $2,447504
$2, $2,245783
$2, $2,511
$2,783
Al ergy/Infectious Diseases (NIAID)b
$5,876
$5,885
$6,067
$6,246
General Medical Sciences (NIGMS)c
$1,706
$1,931
$1,720
$1,825611 $2,768 Allergy/Infectious Diseases (NIAID) $6,049 $6,246 $6,323 $6,268 General Medical Sciences (NIGMS)b $1,715 $1,825 $1,783 $1,826
Child Health/Human Development Child Health/Human Development (NICHD(NICHD)d
) $1, $1,798588
$1, $1,416942
$1, $1,838
$1,942683 $1,675
National Eye Institute (NEI) National Eye Institute (NEI)
$ $823
$749
$836
$859
833 $859 $864 $853 Environmental Health Sciences (NIEHS Environmental Health Sciences (NIEHS)ec
$ $803
$730
$815
$937
812 $937 $842 $932 National Institute on Aging (NIA) National Institute on Aging (NIA)
$3, $3,546
$3,226
$3,900
$4,036888 $4,036 $4,220 $4,011
Arthritis/Musculoskeletal/Skin Arthritis/Musculoskeletal/Skin Diseases (NIAMS)
$625
$568
$634
$680
Deafness/Communication Disorders (NIDCD)
$491
$446
$498
$512
National Institute of Mental Health (NIMH)
$2,043
$1,845
$2,106
$2,214 Diseases $632 $680 $656 $676 (NIAMS) Deafness/Communication Disorders $497 $512 $515 $509 (NIDCD) Alcohol Abuse/Alcoholism (NIAAA) $553 $570 $574 $567 Nursing Research (NINR) $174 $200 $181 $199
National Institute on Drug Abuse (NIDA) National Institute on Drug Abuse (NIDA)
$1, $1,458476
$1, $1,432853
$1, $1,480
$1,853
Alcohol Abuse/Alcoholism (NIAAA)
$547
$497
$555
$570
Nursing Research (NINR)
$172
$157
$175
$200
Human Genome 595 $1,843 National Institute of Mental Health (NIMH) $2,100 $2,214 $2,217 $2,211 Human Genome Research Institute (NHGRI) Research Institute (NHGRI)
$ $604
$550
$616
$633
614 $633 $639 $629 Biomedical Biomedical Imaging/BioengineeringImaging/Bioengineering (NIBIB) (NIBIB)
$ $405
$368
$411
$422
Minority Health/Health Disparities (NIMHD)
$336
$305
$392
$652
Complementary/Integrative Health (NCCIH)
$152
$138
$154
$184
Advancing Translational Sciences (NCATS)
$833
$788
$855
$879
Fogarty International Center (FIC)
$81
$74
$84
$96
National Library of Medicine (NLM)
$457
$416
$462
$475
Office of Director (OD)f,
$2,007
$2,099
$2,175
$2,245
Innovation Accountg
$157
$109
$109
$150
Buildings and Facilities (B&F)h
$200
$300
$200
$250
National Institute for Research on Safety & Quality
(NIRSQ)
—
$257
—
—
Advanced Research Projects Agency for Health
(ARPA-H)
—
—
—
$6,500
Subtotal, NIH (LHHS Discretionary BA)
$40,223
$38,070
$41,432
$50,456
PHS Program Evaluation (provided to NIGMS)
$1,231
$741
$1,272
$1,272
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FY2020
FY2021
FY2021
FY2022
Institutes/Centers
Final
Request
Final
Request
Superfund (Interior approp. to NIEHS)i
$81
$74
$82
$84
Nonrecurring Expenses Fund (NEF) Transfer (to
($225)
—
($225)
—
Buildings and Facilities)j
Mandatory type 1 diabetes funds (to NIDDK)k
$150
$150
$150
$141l
Patient-Centered Outcomes Research Trust Fund
—
$98
—
—
(PCORTF)
NIH Program Level
$41,685
$39,133
$42,936
$51,953
Source: NIH, “FY2022 Budget Request by IC (Summary Table),” at
https://officeofbudget.od.nih.gov/pdfs/FY22/br/2022%20CJ%20Overview%20Supplementary%20Tables.pdf , pg. 89,
except as noted below. FY2021 request amounts from Rep. Nancy Pelosi, “Explanatory Statement Submitted by
Mrs. Lowey, Chairwoman of the House Committee on Appropriations Regarding H.R. 133, Consolidated
Appropriations Act, 2021,” House of Representatives, Congressional Record, daily edition, vol. 166, part
No.218—Book IV (December 21, 2020).
Notes: Totals may differ from the sum of the components due to rounding. Amounts in table may differ from
actuals in many cases. By convention, budget tables such as Table A-1 do not subtract the amount of transfers
to the evaluation tap from the agencies’ appropriation. In general, amounts provided to NIH for emergency
requirements are excluded from these totals (e.g., FY2020 and409 $422 $425 $419 Complementary/Integrative Health (NCCIH) $154 $184 $159 $183 Minority Health/Health Disparities (NIMHD) $390 $652 $459 $660 Fogarty International Center (FIC) $84 $96 $87 $96 National Library of Medicine (NLM) $461 $475 $479 $472 Advancing Translational Sciences (NCATS) $853 $879 $882 $874 Office of Director (OD)d $2,413 $2,250 $2,629 $2,310 Innovation Accounte $109 $150 $150 $419 Buildings and Facilities (B&F)f $199 $250 $250 $300 Research Quality — — — — ARPA-H — $6,500 $1,000g $5,000 Subtotal, NIH (LHHS Discretionary $41,309 $50,461 $44,650 $48,957 BA) PHS Program Evaluation (provided to $1,272 $1,272 $1,309 $1,272 NIGMS) Superfund (Interior approp. to NIEHS)h $82 $84 $83 $83 Mandatory type 1 diabetes funds (to $150 $141 $141 $141j NIDDK)i Congressional Research Service 11 link to page 16 link to page 16 link to page 15 link to page 21 National Institutes of Health (NIH) Funding: FY1996-FY2023 FY2021 FY2022 FY2022 FY2023 Institutes/Centers Final Request Enacted Request Pandemic Preparednessk (proposed — — — $12,050 mandatory) Nonrecurring Expenses Fund (NEF) Transfer $225 — — — (to Buildings and Facilities)l NIH Program Level $43,037 $51,958 $46,183 $62,503 Source: The FY2023 Request and FY2021 program levels are from NIH, Congressional Justification: FY2023, “Budget Request by IC (Summary Table),” March 28, 2022, p. 86, at https://officeofbudget.od.nih.gov/pdfs/FY23/br/Overview%20of%20FY%202023%20Presidents%20Budget.pdf. The FY2022 and FY2022 Request program levels are from Congressional Record, vol. 168, no. 42, Book IV, March 9, 2022, pp. H2862-H2865, except where noted below. Notes: Totals may differ from the sum of the components due to rounding. Amounts in table may differ from actuals in many cases. By convention, budget tables such as Table A-1 do not subtract the amount of transfers to the evaluation tap from the agencies’ appropriation. In general, amounts provided to NIH for emergency requirements are excluded from these totals (e.g., FY2021 amounts do not include the amounts FY2021 amounts do not include the amounts
provided in the coronavirus supplemental appropriations acts, summarizedprovided in the coronavirus supplemental appropriations acts, summarized in “Coronavirus Supplemental
Appropriations”). in Appendix B).
a. Amounts for the NIDDK do not include mandatory funding for type 1 diabetes researcha. Amounts for the NIDDK do not include mandatory funding for type 1 diabetes research (see note (see note k).
b. The White House amended the NIAID FY2021 budget request on March 17, 2020, in a supplemental
request letter for COVID-19 funding, to $5,885,470,000, which is $439,584,000 above the original FY2021
budget request.
c. Amounts for NIGMS do not include funds from PHS Evaluation Set-Aside (§241 of the PHS Act).
d. FY2020 and FY2021 funding level for NICHD adjusted for comparability in NIH FY2022 budget tables to
reflect the proposed transfer of the ECHO and INCLUDE programs from OD to NICHD.
ej). b. Amounts for NIGMS do not include funds from PHS Evaluation Set-Aside (§241 of the PHS Act). c. Amounts for NIEHS do not include Interior/Environment. Amounts for NIEHS do not include Interior/Environment Appropriations amount for Superfund research Appropriations amount for Superfund research
(see note i). (see note i).
f.
d. Includes $12.6 mil ionIncludes $12.6 mil ion transfer from the Pediatric Research Initiative Fund (PRIF) as authorized by the transfer from the Pediatric Research Initiative Fund (PRIF) as authorized by the
Gabriel a Mil er Gabriella Mil er Kids FirstKids First Research Act. FY2020 and FY2021 amounts for this account adjusted for
comparability reflect the proposed transfer of ECHO and INCLUDE programs from OD to NICHD in the
FY2022 request.
g Research Act. e. The amount shown for the NIH Innovation Account in each column represents. The amount shown for the NIH Innovation Account in each column represents only a portion of the total only a portion of the total
appropriation to the account ($404 mil ion appropriation to the account ($404 mil ion for FY2021: $496 mil ionfor FY2021: $496 mil ion for FY2022for FY2022. ; $1.085 bil ion for FY2023. The remainingThe remaining funds for funds for
this account are reflected,this account are reflected, where applicable, into the totals for other ICs. For FY2022, this includes $194 where applicable, into the totals for other ICs. For FY2022, this includes $194
mil ionmil ion to NCI for cancer researchto NCI for cancer research and $76 mil ionand $76 mil ion to each of NINDS and NIMH for the BRAIN Initiative to each of NINDS and NIMH for the BRAIN Initiative
($152 mil ion($152 mil ion total for BRAIN). total for BRAIN).
h. For FY2023, this includes $216 mil ion to NCI for cancer research and $225 mil ion to each of NINDS and NIMH for the BRAIN Initiative ($450 mil ion total). f. Amounts for the Building and FacilitiesAmounts for the Building and Facilities account do not include directed transfers from the nonrecurring account do not include directed transfers from the nonrecurring
expenses fund in expenses fund in FY2020 and FY2021 FY202-enacted appropriations (see note enacted appropriations (see note j).
i.
This is a separate account in the Interior/Environment appropriations for NIEHS research activities related
to Superfund research.
j.
The nonrecurring expenses fund (NEF) permits HHS to transfer unobligated balances of expired
discretionary funds from FY2008 and subsequent years into the NEF account. Congress and the President
authorized use of the funds for capital acquisitions including information technology (IT) and facilities
infrastructure (42 U.S.C. §3514a), and can direct the funds to certain accounts through appropriations acts.
NEF transfers are shown as non-add in this budget presentation as these amounts were not reflected in
FY2022 budget request tables.
k. l). g. Funding for ARPA-H in P.L. 117-103 was provided to a new ARPA-H account under the HHS Office of the Secretary. A proviso accompanying the appropriation gave HHS Secretary Becerra the ability to transfer the new agency anywhere within the department within 30 days of enactment. On March 30, 2022, HHS Secretary Xavier Becerra submitted a notice to the appropriations committees that ARPA-H is to reside within the NIH; therefore, ARPA-H is shown within NIH in this table presentation. h. This is a separate account in the Interior/Environment appropriations for NIEHS research activities related to Superfund research. i. Mandatory funds are available to NIDDK for type 1 diabetes research under PHSA Section 330Bm, which Mandatory funds are available to NIDDK for type 1 diabetes research under PHSA Section 330Bm, which
was most recently extended through FY2023 by the Consolidated Appropriations Act, 2021 (P.L. 116was most recently extended through FY2023 by the Consolidated Appropriations Act, 2021 (P.L. 116 -260; -260;
DivisionDivision BB, Title II)BB, Title II). j. The FY2022 and FY2023 amounts
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l.
FY2022 proposed amount for the type I diabetes research for the type I diabetes research program ($141 mil ion)program ($141 mil ion) is are lower lower than than the enacted enacted
funding funding level levels for FY2022 for FY2022 and FY2023 ($150 mil ion).($150 mil ion). According to the budget request, the According to the budget request, the FY2022 and FY2023 amounts reflect FY2022 amount reflects
sequestration of $8.55 mil ion.sequestration of $8.55 mil ion. See “Budget Mechanism Table,” p. See “Budget Mechanism Table,” p. 9244 in in
https://officeofbudget.od.nih.gov/pdfs/https://officeofbudget.od.nih.gov/pdfs/FY22/br/2022%20CJ%20Overview%20Supplementary%20Tables.pdf.
Program-Specific Funding
FY23/br/Overview%20of%20FY%202023%20Presidents%20Budget.pdf. k. The FY2023 request proposes new mandatory funding for pandemic preparedness to be available for five years. The request proposes an HHS-wide total of $81.7 bil ion for pandemic preparedness, with $12.05 bil ion of the total designated for NIH. l. The nonrecurring expenses fund (NEF) permits HHS to transfer unobligated balances of expired discretionary funds from FY2008 and subsequent years into the NEF account. Congress and the President authorized use of the funds for capital acquisitions, including information technology (IT) and facilities infrastructure (42 U.S.C. §3514a), and can direct the funds to certain accounts through appropriations acts. NEF transfers are shown as non-add in this budget presentation as these amounts were not reflected in FY2023 budget request tables. Congressional Research Service 12 link to page 17 link to page 20 National Institutes of Health (NIH) Funding: FY1996-FY2023 Program-Specific Funding In recent years, Congress and the President have increasingly specified funding levels for In recent years, Congress and the President have increasingly specified funding levels for
programs or research areas within NIH accounts throughout the budget and appropriations programs or research areas within NIH accounts throughout the budget and appropriations
process. Congress uses language in reports and explanatory statements accompanying
appropriations bil s to designate funding for specified purposes.process. Congress uses appropriations report language to designate funding for specified purposes, whereas the President proposes amounts in his annual budget request.28 This is a relatively new practice This is a relatively new practice
that has expanded since FY2015.that has expanded since FY2015.3629 For the most part, Congress does not specify NIH funding for For the most part, Congress does not specify NIH funding for
particular diseases or areas of researchparticular diseases or areas of research, instead al owing in the appropriations process and instead allows the ICs to award funding within their the ICs to award funding within their
mission areasmission areas. Funding is general y based on their own strategic planning and priority-setting processes. Research funding is generally awarded on a flexible and competitive basis through various awarded on a flexible and competitive basis through various
funding mechanisms intended to balance scientific funding mechanisms intended to balance scientific opportunity withand health priorities. health priorities.3730
In In FY2021FY2022, Congress used , Congress used explanatory statementappropriations report language to specify a certain amount of IC language to specify a certain amount of IC
funding for designated purposes, as summarized ifunding for designated purposes, as summarized in Table A-2. Sometimes the language specifies Sometimes the language specifies
that “no less than” a certain amount can be designated for a certain purpose; in other cases,
language “provides” or “recommends” that an amount be spent on a certain purpose. For FY2021,
while the House report (H.Rept. 116-450) also included funding levels for some of the below
programs, the amounts in the explanatory statement supersede those. Both the explanatory
statement and the House report include many additional a certain amount for a certain purpose; in other cases, the language provides increased or additional funding. The appropriations reports also include many additional statements directing the agency to statements directing the agency to
prioritize certain programs or areas of research, as prioritize certain programs or areas of research, as wel aswell as statements expressing the opinion or concerns of expressing the opinion or concerns of
Congress regarding NIH; these broad statements are not summarized here. In addition, the Congress regarding NIH; these broad statements are not summarized here. In addition, the
President has proposed broad funding increases for certain research and other areas in his President has proposed broad funding increases for certain research and other areas in his FY2022
budget request.
FY2023 budget request, as summarized in Table A-3. Table A-2. Specified NIH Funding Levels in FY2021FY2022 Explanatory Statement
Institute/Center
Program/Activity
Amount
Cancer Institute (NCI)
NCI Paylines
$250 mil ion, an increase of $38
Childhood Cancer Data Initiative (CCDI) $50 mil ion mil ion
Childhood Cancer Survivorship, Childhood Cancer Survivorship, Treatment Treatment
No less than $30 mil ion $30 mil ion
Access, Access, and Research (STAR) Act and Research (STAR) Act
Neurological
HEAL Initiative (opioid misuse and addiction)
No less than $270 mil ion
Disorders/Stroke
(NINDS)
Centers for AIDS Research
$61 mil ion, an increase of $10
mil ion

36 As recently as December 2014, the explanatory statement on the FY2015 omnibus stipulated, “ Cancer success rates An additional $150 mil ion National Heart, Lung, and Community Engagement Alliance Against $20 mil ion Blood Institute (NHLBI) COVID–19 Disparities (CEAL) Initiative Health disparities research* An increase of $50 mil ion National Institute of Opioids and pain/pain management research* An increase of $18 mil ion Dental and Craniofacial Research (NIDCR) National Institute of Opioids and pain/pain management research* An increase of $20 mil ion Diabetes and Digestive and Kidney Diseases (NIDDK) HEAL Initiative (opioids, stimulants, and pain No less than the FY2021 management) funding level ($270 mil ion) 28 For a general overview, see CRS Report R44124, Appropriations Report Language: Overview of Components and Development and CRS Report R47019, The Executive Budget Process: An Overview. 29 As recently as December 2014, the explanatory statement on the FY2015 omnibus stipulated, “In keeping with In keeping with
longstanding practice, the agreement does not recommend a specific amount of NIH fundinglongstanding practice, the agreement does not recommend a specific amount of NIH funding for this purpose for this purpose
[Alzheimer[Alzheimer'’s disease]s disease] or for any other individual disease.or for any other individual disease. Doing so wouldDoing so would establish a dangerousestablish a dangerous precedent that could precedent that could
politicize the NIH peer reviewpoliticize the NIH peer review system. Nevertheless, in system. Nevertheless, in reco gnitionrecognition that Alzheimer that Alzheimer'’s disease poses a seriouss disease poses a serious threat to threat to
the Nationthe Nation'’s long-term health and economic stability, the agreement expects that a significant portion of the s long-term health and economic stability, the agreement expects that a significant portion of the
recommended increase for NIA shouldrecommended increase for NIA should be directed to research on Alzheimer's. be directed to research on Alzheimer's. T he exact a mountThe exact amount should be determined should be determined
by scientific opportunity of additional research on this disease and the quality of grant applications that are submitted by scientific opportunity of additional research on this disease and the quality of grant applications that are submitted
for Alzheimerfor Alzheimer'’s relative to those submitted for other diseases.” Sees relative to those submitted for other diseases.” See Congressional Record, daily, daily edition, vol. 160, no. edition, vol. 160, no.
151, Book II (December 11, 2014), p. H9832. 151, Book II (December 11, 2014), p. H9832.
37 30 CRS CRS Report R41705, Report R41705, The National Institutes of Health (NIH): Background and Congressional Issues. .
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Institute/Center
Program/Activity
Amount
National Institute of National Institute of
Lyme disease and other tick-borne diseases
An increase of $10 mil ion
Al ergy and Infectious
Diseases (NIAID)
Regional biocontainment laboratories (RBL)
$40 mil ion
Universal flu vaccine
No less than $220 mil ion, an
increase of $20 mil ion
General Medical Sciences
Institutional Development Award (IDeA) Program $397 mil ion, an increase of $10
(NIGMS)
mil ion
Child Health/Human
Research on the survival and healthy development
An increase of $10 mil ion
Development (NICHD)
of preterm infants
Aging (NIA)
Alzheimer’s disease and related dementias
No less than $3.118 bil ion
Drug Abuse (NIDA)
HEAL Initiative (opioid misuse and addiction)
No less than $270 mil ion
Genome Research
Emerging Centers of Excel ence in Genomic
$13 mil ion
(NHGRI)
Sciences
Minority Health/Health
Research Centers in Minority Institutions
$80 mil ion, an increase of $5
Disparities (NIMHD)
mil ion
Advancing Translational
Clinical and Translational Science Awards
$588 mil ion
Sciences (NCATS)
(CTSAs)
Cures Acceleration Network
Up to $60 mil ion
Gene Vector Initiative
$10 mil ion
Office of the Director
Al of Us Precision Medicine Initiative
$500 mil iona
(OD)/ Multi-Institute
Research Initiatives
Artificial intel igence/big data
$105 mil ion, including $50
mil ion to expand machine
learning-focused grants and $55
mil ion for the Office of Data
Science Strategy
Grants for biomedical research facilities
$50 mil ion
Brain Research through Advancing Innovative
$560 mil ion,b including $40
Neurotechnologies (BRAIN) Initiative
mil ion for the Human Brain
Cel Atlas and $20 mil ion for
the Armamentarium for Brain
Cel Access.
Environmental Influences on Child Health
$180 mil ion
Outcomes (ECHO)
Firearm injury and mortality prevention research
$13 mil ion
HHS Office of National Security al ocation for
$5 mil ion
foreign threats program
IDeA States Pediatric Clinical Trials Network
No less than the FY2020
funding level ($15 mil ion)
Office of AIDS Research, for HIV/AIDS research
$3.090 bil ion
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Institute/Center
Program
Amount
Office of Research on Women's Health (ORWH)
an increase of $5 mil ion
Investigation of Co-Occurring Conditions Across
no less than $65 mil ion, an
the Lifespan to Understand Down Syndrome
increase of $5 mil ion
(INCLUDE)
Source: U.S. Congress, House and Senate Committees on Appropriations, Subcommittee on the Departments
of Labor, Health and Human Services, Education, and Related Agencies, Division H—Department of Labor, Health
and Human Services, and Education and Related Agencies [LHHS] Appropriations Act, 2021, committee print, 116th
Cong., 2nd sess., December 21, 2020, pp. 44-71, 154-159.
a. Amount likely includes $109 mil ion from the Innovation Account as authorized in the Cures Act.
b. Amount likely includes $100 mil ion Basic research related to opioids and pain* An additional $43 mil ion Neurological Disorders and Stroke (NINDS) National Institute of Centers for AIDS Research $71 mil ion, an increase of $10 Allergy and Infectious mil ion Diseases (NIAID) Consortium of Food Allergy Research $9.1 mil ion, an increase of $3 (CoFAR) mil ion Lyme disease and other tick-borne diseases An increase of $18 mil ion Regional biocontainment laboratories (RBL) $52 mil ion Responding to infectious diseases No less than $540 mil ion, an increase of $15 mil ion Rapid vaccine development platforms for $50 mil ion emerging infectious disease* SARS–CoV–2–Immunity: understanding diversity $5 mil ion and addressing disparity Universal flu vaccine No less than $245 mil ion, an increase of $25 mil ion National Institute of Increasing diversity in biomedical research An increase of $6.36 mil ion General Medical Sciences Institutional Development Award (IDeA) Program $410 mil ion, an increase of (NIGMS) $13.4 mil ion Eunice Kennedy Shriver Impact of COVID–19 on children An increase of $7.5 mil ion National Institute of Child Implementing a Maternal Health and Pregnancy $43 mil ion, an increase of $30 Health and Human Outcomes Vision for Everyone (IMPROVE) mil ion Development (NICHD) Initiative Research in pregnant and lactating $1.5 mil ion women- National Academies of Science, Education, and Medicine (NASEM) panel National Institute of Climate change research* An increase of $100 mil ion Environmental Health Sciences (NIEHS) National Institute on Alzheimer’s disease and related dementias An increase of $289 mil ion Aging (NIA) Center on Exposome Studies in Alzheimer’s $15 mil ion Disease and Related Dementias (ADRD) Opioids and pain/pain management research* An increase of $29 mil ion National Institute of Opioids and pain/pain management research* An increase of $24 mil ion Arthritis and Musculoskeletal and Skin Diseases (NIAMS) National Institute on HEAL Initiative (opioids, stimulants, and pain No less than $345 mil ion Drug Abuse (NIDA) management) Underage and perinatal marijuana use- NASEM $2 mil ion panel* National Institute of Impact of COVID on mental health An increase of $20 mil ion Mental Health (NIMH) National Institute of Health disparities research* An increase of $20 mil ion Nursing Research (NINR) National Human Genome Emerging Centers of Excellence in Genomic No less than $15 mil ion Research Institute Sciences (NHGRI) National Institute on Health disparities research An increase of $50 mil ion Minority Health and Research Centers in Minority Institutions $5 mil ion Health Disparities Coordination Network (NIMHD) Congressional Research Service 14 link to page 20 link to page 20 National Institutes of Health (NIH) Funding: FY1996-FY2023 Institute/Center Program/Activity Amount National Center for Pain and pain management research* An increase of $26 mil ion Complementary and Integrative Health (NCCIH) National Center for Clinical and Translational Science Awards $606.7 mil ion, an increase of Advancing Translational (CTSAs) $19.8 mil ion Sciences (NCATS) Cures Acceleration Network (CAN) $60 mil ion John E. Fogarty Health disparities research* An increase of $10 mil ion International Center (FIC) Office of the Director All of Us Precision Medicine Initiative $541 mil ion, an increase of $41 (OD)/ Multi-Institute mil iona Research Initiatives Amyotrophic lateral sclerosis (ALS) $25 mil ion for implementation of the Accelerating Access to Critical Therapies for ALS Act (P.L. 117-79). $1 mil ion for NASEM study “to identify and recommend actions for the public, private, and nonprofit sectors to undertake to make ALS a livable disease within a decade.” Grants for biomedical research facilities $60 mil ion Brain Research through Advancing Innovative $620 mil ion,b including $70 Neurotechnologies (BRAIN) Initiative mil ion for the Human Brain Cell Atlas, $30 mil ion for the Armamentarium for Brain Cell Access, and $10 mil ion for the Brain Connectivity Map Cybersecurity An increase of $40 mil ion Environmental Influences on Child Health $180 mil ion Outcomes (ECHO)* Firearm injury and mortality prevention research $12.5 mil ion HHS Office of Extramural Research allocation for $2.5 mil ion foreign influence investigations IDeA States Pediatric Clinical Trials Network No less than the FY2021 funding level ($15 mil ion) Investigation of Co-Occurring Conditions Across No less than $75 mil ion, an the Lifespan to Understand Down Syndrome increase of $10 mil ion (INCLUDE) Office of AIDS Research, for HIV/AIDS research No less than $3.2 bil ion Office of Research on Women's Health (ORWH) $59.5 mil ion, including $4 mil ion for the Building Interdisciplinary Research Careers in Women’s Health (BIRCWH) program Office of Behavioral and Social Sciences Research $38.9 mil ion (OBSSR) Office of the Chief Officer for Scientific $16.2 mil ion Workforce Diversity (COSWD) Source: Congressional Record, vol. 168, no. 42, Book IV, March 9, 2022, pp. H2674-H2679, and H.Rept. 117-96, pp. 108-166. House report amounts cited where not superseded by the explanatory statement per direction in the explanatory statement, “Unless otherwise noted, the language set forth in H.Rept. 117-96 carries the same weight as language included in this explanatory statement and should be complied with unless specifically addressed to the contrary in this explanatory statement” (p. H2668). Congressional Research Service 15 link to page 17 National Institutes of Health (NIH) Funding: FY1996-FY2023 Notes: Table does not include amounts already shown in Table A-2. Asterisks (*) denote amounts from H.Rept. 117-96. a. Amount includes $150 mil ion from the Innovation Account as authorized in the Cures Act. b. Amount includes $152 mil ion from the Innovation Account for the BRAIN Initiative as authorized by the from the Innovation Account for the BRAIN Initiative as authorized by
the Cures Act (split between NINDS and NIMH in Cures Act (split between NINDS and NIMH in FY2021FY2022 appropriations). appropriations).
Table A-3. Specified NIH Funding Levels in FY2022FY2023 Budget Request
Program/Activity
Amount
Opioid, stimulant, and pain research Opioid, stimulant, and pain research
$2. $2.26 bil ion—$811 mil ion bil ion—$811 mil ion for the Helping to End for the Helping to End
Addiction Long-term (HEAL) Initiative and Addiction Long-term (HEAL) Initiative and more than
$1.4$1.8 bil ion to support ongoing research bil ion to support ongoing research
across ICs Health disparities Health disparities and inequities research and inequities research
$330An increase of $350 mil ion—$ mil ion—$250 210 mil ionmil ion for NIMHD and $80 mil ion
for targeted cardiovascular, nursing, and international
health disparities and inequities research at NHLBI,
NINR, and the Fogarty International Center,
respectively
Research on the effects of climate change on human
$100 mil ion
health
Centers for AIDS Research
$26 mil ion
Maternal health and Pregnancy Outcomes Vision for
$30 mil ion
Everyone (IMPROVE) initiative
Firearm violence prevention research
$25 mil ion
Research on COVID-19 and individuals at risk for, or
$25 mil ion
experiencing, mental disorders
Col aboration to Assess Risk and Identify Long-term
$15 mil ion
Outcomes for Children with COVID (CARING for
Children with COVID) research program
Creating a Diverse Biomedical Workforce—increasing
$16 mil ion
opportunities for early-career investigators, reaching
underrepresented groups, and tracking and evaluating
diversity and inclusion metrics at NIH ICs
NIH cybersecurity modernization and improvements
$100 mil ion
Nonhuman primate resource infrastructure expansion
$30 mil ion
at the National Primate Research Centers and
Caribbean Primate Research Center
Source: HHS, “FY2022 Budget in Brief,” pp. 60-64, at https://www.hhs.gov/sites/default/files/fy-2022-budget-in-
brief.pdf. For the most part, the budget request does not specify funding amounts by institute/center or account.
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Appendix B. Acronyms and Abbreviations
Acronym/
Abbreviation
Organization/Term
ARPA-H
Advanced Research Projects Agency for Health
DARPA
Defense Advanced Research Projects Agency
DOD
Department of Defense
FIC
Fogarty International Center
FY
Fiscal Year
IC
Institutes and Centers
NASEM
National Academies of Sciences, Engineering, and Medicine
NCATS
National Center for Advancing Translational Sciences
NCCIH
National Center for Complementary and Integrative Health
NCI
National Cancer Institute
NEF
Nonrecurring Expenses Fund
NEI
National Eye Institute
NHGRI
National Human Genome Research Institute
NHLBI
National Heart, Lung, and Blood Institute
NIA
National Institute on Aging
NIAAA
National Institute on Alcohol Abuse and Alcoholism
NIAID
National Institute of Al ergy and Infectious Diseases
NIAMS
National Institute of Arthritis and Musculoskeletal and Skin Diseases
NIBIB
National Institute of Biomedical Imaging and Bioengineering
NICHD
National Institute of Child Health and Human Development
NIDA
National Institute on Drug Abuse
NIDCD
National Institute on Deafness and Other Communication Disorders
NIDCR
National Institute of Dental and Craniofacial Research
NIDDK
National Institute of Diabetes and Digestive and Kidney Diseases
NIEHS
National Institute of Environmental Health Sciences
NIGMS
National Institute of General Medical Sciences
NIMH
National Institute of Mental Health
NIMHD
National Institute on Minority Health and Health Disparities
NINDS
National Institute of Neurological Disorders and Stroke
NINR
National Institute of Nursing Research
NLM
National Library of Medicine
OD
NIH Office of the Director
PHS
Public Health Service

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National Institutes of Health (NIH) Funding: FY1996-FY2022




Author Information

Kavya Sekar

Analyst in Health Policy


Acknowledgments
CRS Research Assistant Isaac Nicchitta for the National Institute on Minority Health and Health Disparities (NIMHD) Office of Nutrition Research—to promote health and $97 mil ion reduce the burden of diet-related diseases. Universal influenza vaccine $260 mil ion, an increase of $15 mil ion above enacted Centers for AIDS Research $26 mil ion Maternal Health and Pregnancy Outcomes Vision for $30 mil ion Everyone (IMPROVE) Initiative Research on effects of COVID-19 on pregnant and additional $3 mil ion lactating women (National Institute of Child Health and Human Development [NICHD]) Studies of the social media impact on mental health $5 mil ion (National Institute of Mental Health [NIMH]) Studies to inform mental health treatment approaches, $5 mil ion service delivery, and system transformation (NIMH) Center for Sexual Orientation and Gender Identity $2 mil ion (SOGI) research Source: HHS, “FY2023 Budget in Brief,” pp. 55-58, at https://www.hhs.gov/sites/default/files/fy-2023-budget-in-brief.pdf. In several cases, the budget request does not specify funding amounts by institute/center or account. Congressional Research Service 16 National Institutes of Health (NIH) Funding: FY1996-FY2023 Appendix B. Coronavirus Supplemental Appropriations (FY2020 and FY2021) and Additional American Rescue Plan Act funding NIH received FY2020 and FY2021 emergency supplemental appropriations to several IC accounts and as transfers from the Public Health and Social Services Emergency Fund (PHSSEF) account as provided by four coronavirus supplemental appropriations acts:31  Division A of the Coronavirus Preparedness and Response Supplemental Appropriations Act, 2020 (P.L. 116-123), enacted on March 6, 2020.  Division B of the Coronavirus Aid, Relief, and Economic Security Act (CARES Act, P.L. 116-136), enacted on March 27, 2020.  Division B of the Paycheck Protection Program and Health Care Enhancement Act (PPPHCEA, P.L. 116-139), enacted on April 24, 2020.  Division M of Consolidated Appropriations Act, 2021 (P.L. 116-260), enacted on December 27, 2020. NIH received a total of $3.031 billion to NIH IC accounts, along with directed transfers from the PHSSEF account to NIH accounts totaling not less than $1.806 billion. Accounting for transfers, NIH received a total of at least $4.837 billion (see text box below for information on American Rescue Plan Act funding). All appropriations to NIH accounts are available until September 30, 2024, and all transfers from the PHSSEF are available until expended. This funding was primarily provided in three categories: Broadly Available Funding. In the first (P.L. 116-123) and third measure (CARES Act; P.L. 116-136), funding was made available to several NIH IC accounts “to prevent, prepare for and respond to coronavirus, domestically and internationally.” NIH IC accounts that received broadly available funds and their totals include the following:  National Institute of Allergy and Infectious Diseases (NIAID): $1.542 billion, including $836 million in the first measure and $706 million in the CARES Act. Some transfers or set-asides were directed for specific purposes in the NIAID appropriations. The first measure directed a transfer of not less than $10 million to the National Institute of Environmental Health Sciences (NIEHS) for “worker-based training to prevent and reduce exposure of hospital employees, emergency first responders, and other workers who are at risk of exposure to coronavirus through their work duties.” The third measure set aside not less than $156 million of the total for “the study of, construction of, demolition of, renovation of, and acquisition of equipment for, vaccine and infectious diseases research facilities of or used by NIH, including the acquisition of real property.”  National Heart, Lung, and Blood Institute (NHLBI): $103 million in the CARES Act.  National Institute of Biomedical Imaging and Bioengineering (NIBIB): $60 million in the CARES Act.  National Library of Medicine (NLM): $10 million in the CARES Act. 31 NIH did not receive supplemental appropriations from the Families First Coronavirus Response Act (FFCRA, P.L. 116-127), enacted on March 18, 2020. Congressional Research Service 17 National Institutes of Health (NIH) Funding: FY1996-FY2023  National Center for Advancing Translational Sciences (NCATS): $36 million in the CARES Act.  Office of the Director (OD): $30 million in the CARES Act. Diagnostic Testing Research and Development (R&D). In the fourth (Paycheck Protection Program and Health Care Enhancement Act; PPPHCEA, P.L. 116-139) and fifth measure (Division M of P.L. 116-260), NIH received funding for specific purposes related to diagnostic test R&D. This funding was directed to NIH as “not less than” transfers from the PHSSEF account in the fourth measure, and directly to the OD account in the fifth measure. These amounts included the following:  National Cancer Institute (NCI): Transfer of not less than $306 million from PHSSEF to NCI “to develop, validate, improve, and implement serological testing and associated technologies” in the PPPHCEA.  NIBIB: Transfer of not less than $500 million from PHSSEF to NIBIB “to accelerate research, development, and implementation of point of care and other rapid testing related to coronavirus” in the PPPHCEA.  OD: Transfer of not less than $1 billion from PHSSEF to OD “to develop, validate, improve, and implement testing and associated technologies; to accelerate research, development, and implementation of point of care and other rapid testing; and for partnerships with governmental and non-governmental entities” in the PPPHCEA. In the fifth measure, not less than $100 million of the $1.250 billion total provided to the OD account is for “the Rapid Acceleration of Diagnostics.” NIH’s Rapid Acceleration of Diagnostics (RADx) initiative is an effort to innovate and scale up COVID-19 diagnostic technologies. As communicated to CRS, the $1.5 billion total for NIBIB and OD in the fourth measure was used to support RADx initially, with additional funds in the fifth measure as specified above.32 Long-Term Studies of COVID-19. The fifth measure directed $1.15 billion of the total $1.250 billion provided to the OD account “for research and clinical trials related to long-term studies of COVID-19.” The $1.15 billion has since been directed toward NIH’s REsearching COVID to Enhance Recovery (RECOVER) Initiative, a large coordinated research initiative to study long COVID. 33 The fifth measure also allows the total $1.25 billion appropriation to OD to be transferred to other IC accounts (in addition to other HHS transfer authorities in the law). American Rescue Plan Act of 2021 (ARPA; P.L. 117-2) Appropriations The ARPA did not provide any mandatory appropriations directly to NIH but made available several appropriations that could be allocated to NIH. For example, $6.05 bil ion was provided to the HHS Secretary in mandatory appropriations (i.e., direct appropriations) for research, development, manufacturing, production, and the purchase of vaccines, therapeutics, and ancil ary medical products and supplies—available to address COVID-19, SARS-CoV-2 or its variants, and any disease with potential for creating a pandemic (Title II, Section 2303). The HHS Secretary can allocate a portion of these funds to NIH accounts at his discretion. In addition, NIH has 32 CRS communication with NIH, July 24, 2020. 33 See “How is RECOVER being paid for” at RECOVER: Frequently Asked Questions, https://recovercovid.org/faqs#paid. As reported by the Government Accountability Office (GA)-22-105497), HHS transferred $1,063.5 million of the $1.25 appropriation for NIH OD in the fifth measure to the Administration for Children and Families’ Unaccompanied Children Program (see Appendix: HHS COVID-19 Funding). NIH’s RECOVER website states that “the primary funding source for RECOVER has changed to the American Rescue Plan (ARP) Act of 2021 (Sec. 2401), the $1.15 billion budget remains and NIH RECOVER research activities have neither stopped nor had any delays.” Congressional Research Service 18 link to page 21 National Institutes of Health (NIH) Funding: FY1996-FY2023 reported that the HHS Secretary has allocated other ARPA funding in Section 2401 toward the RECOVER Initiative (see above) after an initial transfer of $1,063.5 from NIH to HHS’s Administration for Children and Families’ Unaccompanied Children Program of the original appropriation for that program in the fifth measure (see footnote 31). Congressional Research Service 19 National Institutes of Health (NIH) Funding: FY1996-FY2023 Appendix C. Acronyms and Abbreviations Acronym/ Abbreviation Organization/Term ARPA-H Advanced Research Projects Agency for Health DARPA Defense Advanced Research Projects Agency DOD Department of Defense FIC Fogarty International Center FY Fiscal Year IC Institutes and Centers NASEM National Academies of Sciences, Engineering, and Medicine NCATS National Center for Advancing Translational Sciences NCCIH National Center for Complementary and Integrative Health NCI National Cancer Institute NEF Nonrecurring Expenses Fund NEI National Eye Institute NHGRI National Human Genome Research Institute NHLBI National Heart, Lung, and Blood Institute NIA National Institute on Aging NIAAA National Institute on Alcohol Abuse and Alcoholism NIAID National Institute of Allergy and Infectious Diseases NIAMS National Institute of Arthritis and Musculoskeletal and Skin Diseases NIBIB National Institute of Biomedical Imaging and Bioengineering NICHD National Institute of Child Health and Human Development NIDA National Institute on Drug Abuse NIDCD National Institute on Deafness and Other Communication Disorders NIDCR National Institute of Dental and Craniofacial Research NIDDK National Institute of Diabetes and Digestive and Kidney Diseases NIEHS National Institute of Environmental Health Sciences NIGMS National Institute of General Medical Sciences NIMH National Institute of Mental Health NIMHD National Institute on Minority Health and Health Disparities NINDS National Institute of Neurological Disorders and Stroke NINR National Institute of Nursing Research NLM National Library of Medicine OD NIH Office of the Director PHS Public Health Service Congressional Research Service 20 National Institutes of Health (NIH) Funding: FY1996-FY2023 Author Information Kavya Sekar Analyst in Health Policy Acknowledgments CRS Research Assistants Isaac Nicchitta and John Gorman provided valuable assistance in analysis and writing for this report. provided valuable assistance in analysis and writing for this report.

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Congressional Research Service Congressional Research Service
R43341 R43341 · VERSION 4043 · UPDATED
1921

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