National Institutes of Health (NIH) Funding: FY1996-FY2025
Changes from May 20, 2022 to March 8, 2023
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National Institutes of Health (NIH) Funding:
May 20, 2022
FY1996-FY2023FY1996-FY2023
March 8, 2023
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
process with Analyst in Health Policy Analyst in Health Policy
process with a focus on FY2022 and FY2023. NIH is the primary federal agency a focus on FY2022 and FY2023. NIH is the primary federal agency
charged with conducting and charged with conducting and
supporting medical, health, and behavioral researchsupporting medical, health, and behavioral research, and it
. It is made up of 27 Institutes and Centers and the Office of the Director (OD). is made up of 27 Institutes and Centers and the Office of the Director (OD).About 80%
More than 84% of the NIH budget funds extramural research of the NIH budget funds extramural research
through grants, contracts, and other through grants, contracts, and other
awardsawards to universities and other research institutions. About 10% of NIH funding goes to intramural researchers at NIH-operated facilities. Almost all of NIH’s . About 10% of NIH funding goes to intramural researchers at NIH-operated facilities. Almost all of NIH’s
funding is provided in the annual Departments of Labor, Health and Human Services, and Education, and Related funding is provided in the annual Departments of Labor, Health and Human Services, and Education, and Related
Agencies (LHHS) Appropriations Act. NIH also receives smaller amounts of funding from Agencies (LHHS) Appropriations Act. NIH also receives smaller amounts of funding fromInterior/Environmental
(INT) appropriationsthe Interior, Environment, and Related Agencies (INT) Appropriations Act and a mandatory budget authority for type 1 diabetes research. and a mandatory budget authority for type 1 diabetes research.
The TheFY2022FY2023 NIH program level of $ NIH program level of $4649.183 billion represents a $3.183 billion represents a $3.146 billion increase (+ billion increase (+7.36.5%) relative to %) relative to
FY2021-FY2022 enacted program level. The enacted program level. The FY2022FY2023 enacted total for NIH is also $ enacted total for NIH is also $5.77513.324 billion (- billion (-11.121.3%) less than the %) less than the
FY2022 budget request and $3.404 billion (-6.9%) less than the program level proposed by the House-passed
LHHS and INT bills. In FY2022FY2023 budget request program level. (The budget request included a $12 billion pandemic preparedness mandatory appropriations proposal that was not adopted by Congress.) In FY2023, all Institute and Center (IC) accounts , all Institute and Center (IC) accounts receivedreceive an increase relative to an increase relative to FY2021FY2022
funding levels (funding levels (seesee Table A-1). In addition, the NIH FY2023 program level in this CRS report includes $1.5 billion for the Table A-1).
Additionally, the Biden Administration’s FY2022 budget request had proposed the creation of a new Advanced 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 preparednessResearch Projects Agency for Health (ARPA-H), a new agency within NIH that was first funded in FY2022. ARPA-H received FY2023 appropriations in a separate account under the HHS Office of the Secretary. ARPA-H was formally authorized as a part of the PREVENT Pandemics Act (P.L. 117-328, Division FF, Title II), which placed the agency within NIH by statute. .
NIH has seen periods of high and low funding growth during the period covered by this report, as illustrated in 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 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 dollars). Over the next five years, Congress and the President doubled the NIH budget to $27.167 billion 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 gradually in nominal dollars. In some years (FY2006, FY2011, FY2003 to FY2015, NIH funding increased more gradually in nominal dollars. In some years (FY2006, FY2011,
and FY2013), and FY2013),funding for the agencyagency funding decreased in nominal dollars. From FY2016 through decreased in nominal dollars. From FY2016 through FY2022FY2023, NIH has seen , NIH has seen
funding increases each year. The largest increase was from FY2017 to FY2018, where the program level
increased by $3.0 billion (+8.8%), making this the largest single-year nominal dollar increase since FY2003. The
proposed funding increase in the FY2023 budget request would be a 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.funding increases each year.
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 initially peaked in Research and Development Price Index; BRDPI), 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 FY2003—the last year of the five-year doubling period—and then declined fairly steadily for more than a decade
until funding increases were provided in each of FY2016 through until funding increases were provided in each of FY2016 throughFY2022. The FY2022 program level is 0.6%
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greater than the peak FY2003 program level. The FY2023 budget request would provide a program level that is a
32.8% increase relative to the peak FY2003 programFY2023. In inflation-adjusted dollars, the FY2023 program level is 1.2% greater than the FY2003 program level at the end of the doubling period. However, the inflation-adjusted FY2023 program level includes funding for the new ARPA-H, and therefore is not directly comparable to the FY2003 level. Excluding ARPA-H, the inflation-adjusted FY2023 program level is -1.9% less than the FY2003 level. level.
This CRS report details NIH budget and appropriations for FY2022 and FY2023 This CRS report details NIH budget and appropriations for FY2022 and FY2023, and provides an overview of and provides an overview of
funding trends in regular appropriations to the agency from FY1996 to FY2023. Coronavirus supplemental funding trends in regular appropriations to the agency from FY1996 to FY2023. Coronavirus supplemental
funding for NIH is discussed funding for NIH is discussedinin Appendix B of the report but is generally not included in the budgetary figures of the report but is generally not included in the budgetary figures
elsewhere in the elsewhere in thereportreport. Appendix A includes funding tables by account and program-specific funding levels for includes funding tables by account and program-specific funding levels for
FY2021, FY2022, and FY2023.FY2023. Appendix C provides a list of acronyms and abbreviations used in the report. provides a list of acronyms and abbreviations used in the report.
Congressional Research Service Congressional Research Service
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Contents
NIH Funding: FY1996-FY2023 ...................................................................................................... 1
Funding Sources ........................................................................................................................ 2
FY2022Proposed and Enacted Funding ......................................................................................................... 3 FY2023 Budget Request ....... 3
Trends .................................................................................................... 4 FY2023 Enacted Funding ........................................ 7
Figures
Figure 1. NIH Funding, FY1996-FY2023 ................................................................. 5 Trends ........................................................................................................................................ 8
Tables
Table6
Figures Figure 1. NIH Funding, FY1996-FY2023 ........................................................................................ 9 7
Tables TableA-1. National Institutes of Health Funding 1. NIH Funding, FY1996-FY2023 .................................................................................... 11
.... 8 Table A-2. Specified NIH Funding Levels in FY2022 Explanatory Statement1. National Institutes of Health Funding .......................................................................... 1310
Table A-32. Specified NIH Funding Levels in FY2023 Budget Request ...........Explanatory Statement............................. 1612
Appendixes
Appendix A. NIH Funding Details ................................................................................................. 11 10
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
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NIH Funding: FY1996-FY2023
This report This reportprovides 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
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
mandatory funding for special program ondetails the National Institutes of Health (NIH) budget and appropriations process with a focus on FY2022 and FY2023. Almost all of NIH’s funding is provided in the annual Departments of Labor, Health and Human Services, and Education, and Related Agencies (LHHS) Appropriations Act. NIH also receives smaller amounts of funding from the Interior, Environment, and Related Agencies (INT) Appropriations Act and a mandatory budget authority for type 1 diabetes research.1 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 theeight health-related agencies that make up the Public Health Service (PHS) within the 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. biomedical science. Of these, 24 ICs and OD support research programs. The OD sets overall policy for NIH and coordinates the programs and The OD sets overall policy for NIH and coordinates the programs and
activities of all NIH components, particularly in areas of research that involve multiple institutes. activities of all NIH components, particularly in areas of research that involve multiple institutes.
Through the annual appropriations process, Congress provides funding to the 24 research ICs, OD, and a Buildings and Facilities account. Three support centers are funded through transfers from other accounts. In addition, FY2022 appropriations established a new entity that has been placed within NIH: the 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. 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 supplemental In FY2021 and prior years, NIH received supplemental
particular diseases, areas of human health and particular diseases, areas of human health and
appropriations provided as an emergency requirement. appropriations provided as an emergency requirement.
development, or more fundamental aspects of development, or more fundamental aspects of
Given that this report examines trends in regular Given that this report examines 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 normal operations of the agency, the President for the normal 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 collection and dissemination.3 More than8084% %
requirement are generally excluded from this report. In requirement are generally excluded from this report. In
of the NIH budget funds extramural research of the NIH budget funds extramural research
some years, supplemental funding to NIH was some 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 Recovery and appropriations provided in the American Recovery and
Reinvestment Act of 2009 (ARRA; P.L. 111-5), which Reinvestment Act of 2009 (ARRA; P.L. 111-5), which
performed by more than 300,000 individuals performed by more than 300,000 individuals
was a 33% increase to the regular FY2009 was a 33% increase to the regular FY2009
who work at over 2,500 hospitals, medical who work at over 2,500 hospitals, medical
appropriations NIH received. NIH has also received appropriations NIH received. NIH has also received
schools, universities, and other research schools, universities, and other research
supplemental appropriations during several infectious supplemental appropriations during several infectious
institutions around the country.4 About 10% of
disease emergencies, such as for the Ebola and Zika disease emergencies, such as for the Ebola and Zika
the agency’s budget supports intramural
outbreaks. Given outbreaks. Given currentongoing interest, a summary of the interest, a summary of the
FY2020 and FY2021 amounts for the FY2020 and FY2021 amounts for theCOVID-19
research (i.e., internal) conducted by nearly
Coronavirus Disease 2019 (COVID-19) pandemic is provided inpandemic is provided in Appendix B.
6,000 NIH physicians and scientists, most of
whom are located on the NIH campus in Bethesda, MD.5
Appendix B.
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 CRS Report R44582, acts. For further information, see CRS Report R44582, Overview of Funding Mechanisms in the Federal Budget
Process, and Selected Examples. .
2 The Public Health Service (PHS) also includes the Centers for Disease Control and Prevention (CDC), the Food and 2 The Public Health Service (PHS) also includes the Centers for Disease Control and Prevention (CDC), the Food and
Drug Administration (FDA), the Agency for Healthcare Research and Quality (AHRQ), the Health Resources and Drug Administration (FDA), the Agency for Healthcare Research and Quality (AHRQ), the Health Resources and
Services Administration (HRSA), the Substance Abuse and Mental Health Services Administration (SAMHSA), the Services Administration (HRSA), the Substance Abuse and Mental Health Services Administration (SAMHSA), the
Indian Health Service (IHS), and the Agency for Toxic Substances and Disease Registry (ATSDR). Indian Health Service (IHS), and the Agency for Toxic Substances and Disease Registry (ATSDR).
3 For further information on the National Institutes of Health (NIH), see CRS Report R41705, The National Institutes of
Health (NIH): Background and Congressional Issues.
4 NIH, “What We Do - Budget,” June 29, 2020, at https://www.nih.gov/about-nih/what-we-do/budget.
5 Ibid.
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National Institutes of Health (NIH) Funding: FY1996-FY2023
HHS also made an administrative decision to change the preexisting Office of the Assistant Secretary Preparedness and Response to a PHS operating division, the Administration for Strategic Preparedness and Response. 3 For further information on the National Institutes of Health (NIH), see CRS Report R41705, The National Institutes of Congressional Research Service 1 National Institutes of Health (NIH) Funding: FY1996-FY2023 institutions around the country.4 About 10% of the agency’s budget supports intramural research (i.e., internal) conducted by nearly 6,000 NIH physicians and scientists, most of whom are located on the NIH campus in Bethesda, MD.5 Funding Sources
The vast majority of NIH funding comes from annual discretionary appropriationsThe vast majority of NIH funding comes from annual discretionary appropriations bills. NIH . NIH
additionally receives some mandatory funding and additionally receives some mandatory funding andsomeother funding due to unique transfer or funding due to unique transfer or
budgetary rules, as explained below. The total funding available for NIH activities, taking account budgetary rules, as explained below. The total funding available for NIH activities, taking account
of add-ons and of add-ons andPHS tap transfers, is referred to as the NIH “program level.”6 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 annualLabor, HHS, and Education (LHHS)LHHS Appropriations Acts, with an additional smaller Appropriations Acts, with an additional smaller
amount for the Superfund Research Program and related activities from the amount for the Superfund Research Program and related activities from theInterior/Environment
(INT)INT Appropriations Act.7 Appropriations Act.7
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.8 Authorized by Section 241 Evaluation Set-Aside or the “PHS Evaluation Tap” transfer authority.8 Authorized by Section 241
of the Public Health Service Act, the evaluation tap allows the Secretary of HHS, with the of the Public Health Service Act, the evaluation tap allows 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 eligible program appropriations. However, LHHS to not less than 0.2% and not more than 1% of eligible 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 and haveappropriateddirected transfers of specific amounts of “tap” funding to selected HHS programs specific amounts of “tap” funding to selected HHS programs—in. In the the
context of NIH, these context of NIH, theseappropriationstransfers have been made to National Institute of General Medical have been made to National Institute of General Medical
Sciences in recent years.9 Since FY2010, and including in Sciences in recent years.9 Since FY2010, and including inFY2022FY2023, this higher maximum set-, this higher maximum set-
aside level has been 2.5% of eligible appropriations.10 aside level has been 2.5% of eligible appropriations.10Readers should note thatBy convention, totals in this totals in this
report and NIH source documents include amounts “transferred in” pursuant to report and NIH source documents include amounts “transferred in” pursuant to the PHS tap as directed by appropriations Health (NIH): Background and Congressional Issues. 4 NIH, “What We Do - Budget,” August, 2022, at https://www.nih.gov/about-nih/what-we-do/budget. 5 Ibid.PHS tap but do
not 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 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 (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 diabetes research (provided in Public Health Service Act [PHSA] Section 330B), the nonrecurring expenses fund
(NEF), and, when applicable, (NEF), and, when applicable,the Patient-Centered Outcomes Research Trust Fund (PCORTF) and mandatory and mandatory
pandemic preparedness funding proposed in the FY2023 budget. pandemic preparedness funding proposed in the FY2023 budget.
7 The Hazardous Substance Basic Research and Training Program (Superfund Research Program) funds research on the 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 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 Health Sciences. 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 Superfund Amendments and Reauthorization Act Liability Act of 1980 (42 U.S.C. §9660(a)) and Section 126(g) of the Superfund Amendments and Reauthorization Act
of 1986. of 1986.
8 For more information on the PHS Evaluation Tap, or PHS Evaluation Set-Aside, see discussion in CRS Report 8 For more information on the PHS Evaluation Tap, or PHS Evaluation Set-Aside, see discussion in CRS Report
R44916, R44916, Public Health Service Agencies: Overview and Funding (FY2016-FY2018). .
9 Prior to FY2015, NIH had traditionally been by far the largest net donor of tap funds, rather than a net recipient. The 9 Prior to FY2015, NIH had traditionally been by far the largest net donor of tap funds, rather than a net recipient. The
joint explanatory statement accompanying the FY2015 omnibus explained this shift as being intended to ensure that tap joint explanatory statement accompanying the FY2015 omnibus explained this shift as being intended to ensure that tap
transfers are a “net benefit to NIH rather than a liability” and noted that this change was in response to a growing transfers are a “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 funds to the tap. Joint Explanatory Statement, Proceedings and Debates of the concern at the loss of NIH funds to the tap. Joint Explanatory Statement, Proceedings and Debates of the
113th Congress, Second Session, 113th Congress, Second 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.
10 See Section 204 of Division H, Title II, of P.L. 117- 10 See Section 204 of Division H, Title II, of P.L. 117-103328 for the for the FY2022FY2023 maximum set-aside level. The last time that maximum set-aside level. The last time that
an appropriations act set the PHS tap percentage at a level other than 2.5% was in FY2009, when it was 2.4% (see P.L. an appropriations act set the PHS tap percentage at a level other than 2.5% was in FY2009, when it was 2.4% (see P.L.
111-8). The 111-8). TheFY2022FY2023 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 used for the “evaluation and the implementation” of programs funded in the HHS title of the LHHS tap transfers to be used for the “evaluation and the implementation” of programs funded in the HHS title of the LHHS
Appropriations Act. Prior to FY2014, such provisions had restricted tap funds to the “evaluation of the Appropriations Act. Prior to FY2014, such provisions had restricted tap funds to 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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measures or proposed in the budget request, but do not 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 (“the(“the Cures Act,” P.L. 114-255) to fund programs authorized by the act for FY2017 through Cures Act,” P.L. 114-255) to fund programs authorized by the act for FY2017 through
FY2026.11 For appropriated amounts to the account—up the limit authorized for each fiscal FY2026.11 For appropriated amounts to the account—up the limit authorized for each fiscal
year—the amounts are subtracted from any cost estimate for enforcing discretionary spending year—the amounts are subtracted from any cost estimate for enforcing discretionary spending
limits (i.e., the budget caps). In effect, appropriations to the NIH Innovation Account as limits (i.e., the budget caps). In effect, appropriations to the NIH Innovation Account as
authorized by the Cures Act are not subject to discretionary spending limits.12 The NIH Director authorized by the Cures Act are not subject to discretionary spending limits.12 The NIH Director
may transfer these amounts from the NIH Innovation Account to other NIH accounts, but only for may transfer these amounts from the NIH Innovation Account to other NIH accounts, but only for
the purposes the purposes specified in the Cures Actspecified in the Cures 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. All amounts authorized by the Cures Act have been fully appropriated to the . All amounts authorized by the Cures Act have been fully appropriated to the
Innovation Account from FY2017 to Innovation Account from FY2017 toFY2022, including $496 million for FY2022. For FY2023,
$1.085 billion is authorized to be appropriatedFY2023, including $1.085 billion for FY2023. .
Mandatory Type I Diabetes Funding: In addition, NIH has received mandatory funding of $150 In addition, NIH has received mandatory funding of $150
million annually that is provided in Public Health Service Act (PHSA) Section 330Bmillion annually 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
Consolidated Appropriations Act, 2021 (P.L. 116-260; 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%20an
notated.pdf
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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
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, Congressional Justification: FY2022, May 28, 2021, p. 10, at https://officeofbudget.od.nih.gov/pdfs/FY22/br/
2022%20CJ%20Overview%20Volume%20May%2028.pdf.
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.
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National Institutes of Health (NIH) Funding: FY1996-FY2023
for a special program on type 1 diabetes research, most recently extended through FY2023 by the Consolidated Appropriations Act, 2021 (P.L. 116-260; Division BB, Title III).
FY2022 Enacted Funding On March 15, 2022, Congress and President Biden finalized NIH FY2022 appropriations by On March 15, 2022, Congress and President Biden finalized NIH FY2022 appropriations by
enacting the Consolidated Appropriations Act, 2022 (P.L. 117-103), which enacting the Consolidated Appropriations Act, 2022 (P.L. 117-103), whichincludesincluded final FY2022 final FY2022
LHHS appropriations in Division H and Interior/Environment appropriations in Division G. The LHHS appropriations in Division H and Interior/Environment appropriations in Division G. The
enacted FY2022 NIH program level enacted FY2022 NIH program leveliswas made up of the following made up of the following: (see Table A-1):
$43.65 billion in discretionary LHHS budget authority $43.65 billion in discretionary LHHS budget authority (nontransfer); ;
$1.309 billion pursuant to the PHS program evaluation transfer; $1.309 billion pursuant to the PHS program evaluation transfer;
$83 million for the Superfund research program and related activities from $83 million for the Superfund research program and related activities from
Interior/Environment appropriations; and Interior/Environment appropriations; and
$141 million in annual funding for the mandatory type 1 diabetes research $141 million in annual funding for the mandatory type 1 diabetes research
program. program.1813
In total, the NIH FY2022 program level as enacted In total, the NIH FY2022 program level as enactediswas $45.183 billion. In addition, the law $45.183 billion. In addition, the law
provided $1 billion for the Advanced Research Projects Agency for Health provided $1 billion for the Advanced Research Projects Agency for Health (ARPA-H) to a new account to a new account
under the Office of the Secretaryunder the Office of the Secretary with funding available until the end of FY2024. The law allowed the HHS Secretary to place the new agency . 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 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 Secretary Xavier Becerra submitted a notice to the appropriations committees that ARPA-Hiswas to to
reside within the NIH. reside within the NIH.
Accounting for the ARPA-H transfer, the NIH FY2022-enacted program level Accounting for the ARPA-H transfer, the NIH FY2022-enacted program level iswas $46.183 billion.
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 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 FY2022 $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 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. https://officeofbudget.od.nih.gov/pdfs/FY23/br/Overview%20of%20FY%202023%20Presidents%20Budget.pdf.
1813 HHS, HHS, Budget in Brief: FY2023, pp. 53-54, https://www.hhs.gov/sites/default/files/fy-2023-budget-in-brief.pdf. , pp. 53-54, https://www.hhs.gov/sites/default/files/fy-2023-budget-in-brief.pdf.
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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 proposed $6.5 bil ion for ARPA-H “to build platforms and capabilities to deliver cures for cancer, Alzheimer’s disease, diabetes, and other diseases.” The agency was proposed to fol ow a Defense Advanced Research Projects Agency (DARPA) approach to funding research. Funding was requested for a period of three years. As mentioned here, the Consolidated Appropriations Act, 2022 (P.L. 117-103), provided 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 $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 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 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 department within 30 days of enactment. On March 30, 2022, HHS Secretary Xavier Becerra submitted a notice
to the appropriations committees that ARPA-H to the appropriations committees that ARPA-Hiswas to reside within the NIH, while the ARPA-H Director is to to reside within the NIH, while the ARPA-H Director is to
report directly to the HHS Secretary.
report directly to the HHS Secretary. The Consolidated Appropriations Act, 2023 (P.L. 117-328), provided additional funding of $1.5 bil ion for ARPA-H, available until the end of FY2025, in a separate account under the HHS Office of the Secretary. The law also formally authorized the new agency as a part of the PREVENT Pandemics Act in Division FF, Title II of the law, Section 2331. The new authorization places ARPA-H within NIH by statute. For further information and analysis regarding ARPA-H, see CRS Report R47074, 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 President Biden’s FY2023 budget requestproposes that NIH bewould have provided provided NIH with a total program with a total program
level of $62.503 billion, an increase of $16.320 billion (+35.3%) from FY2022-enacted levels. level of $62.503 billion, an increase of $16.320 billion (+35.3%) from FY2022-enacted levels.
The proposed FY2023 program level would The proposed FY2023 program level wouldbe made up of20
$48.957 have provided the following (see Table A-1):
$48.962 billion in discretionary LHHS budget authority (nontransfer); billion in discretionary LHHS budget authority (nontransfer);
$1.272 billion pursuant to the PHS program evaluation transfer; $1.272 billion pursuant to the PHS program evaluation transfer;
$83 million for the Superfund research program and related activities from $83 million for the Superfund research program and related activities from
Interior/Environment appropriations; Interior/Environment appropriations;
$141 million in annual funding for the mandatory type 1 diabetes research $141 million in annual funding for the mandatory type 1 diabetes research
program; program;21and14 and
$12.05 billion in $12.05 billion innewproposed mandatory appropriations for pandemic preparedness mandatory appropriations for pandemic preparedness.22,
to be available for five years.15
Under this request, approximately half of existing IC accounts would Under this request, approximately half of existing IC accounts wouldreceivehave received increases compared increases compared
with FY2022with FY2022- enacted levels (seeenacted levels (see Appendix A). Funding for the National Institute on Minority . Funding for the National Institute on Minority
Health and Health Disparities (NIMHD) would Health and Health Disparities (NIMHD) wouldincreasehave increased by the greatest percentage amount by the greatest percentage amount
(+$201 million, +43.7%), and funding for OD would (+$201 million, +43.7%), and funding for OD woulddecreasehave decreased by the by the greatest amount (-$314 million, -12%). In addition, the full amount ($1.085 billion) authorized by the 21st Century Cures Act for FY2023 (P.L. 114-255) would have been appropriated to the
14greatest amount (-$319
19 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.
20 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.
21 This proposed amount for the mandatory type 1 diabetes research program differs from the already enacted amount This proposed amount for the mandatory type 1 diabetes research program differs from the already enacted amount
for FY2023 of $150 million in PHSA Section 330B, as amended in P.L. 116-260, Division BB, Title III. According to for FY2023 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, 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. at https://officeofbudget.od.nih.gov/pdfs/FY23/br/Overview%20of%20FY%202023%20Presidents%20Budget.pdf.
2215 The FY2023 budget request The FY2023 budget request proposesproposed an HHS-wide total of $81.7 billion for pandemic preparedness to “transform 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 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 biological threats.” The $12.05 billion directed to NIHiswould have been for “NIH research and development of vaccines, diagnostics, for “NIH research and development of vaccines, diagnostics,
and therapeutics against high priority viral families, biosafety and biosecurity, and to expand laboratory capacity and and therapeutics against high priority viral families, biosafety and biosecurity, and to expand laboratory capacity and
clinical trial infrastructure.” See HHS, clinical trial infrastructure.” See HHS, Budget in Brief: FY2023, p. 55, https://www.hhs.gov/sites/default/files/fy-2023-p. 55, https://www.hhs.gov/sites/default/files/fy-2023-
budget-in-brief.pdf. budget-in-brief.pdf.
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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 Innovation Account. The
FY2023 budget request also FY2023 budget request alsoproposesproposed $5 billion for ARPA-H, an increase of $4 billion from the $5 billion for ARPA-H, an increase of $4 billion from the
FY2022-FY2022 enacted level.enacted level.2316
Under the pandemic preparedness proposal, NIH would Under the pandemic preparedness proposal, NIH wouldbehave been provided $12.05 billion in new provided $12.05 billion in new
mandatory appropriations available for five years. This new appropriation mandatory appropriations available for five years. This new appropriationmakesmade up 73.8% of the up 73.8% of the
proposed increase of $16.proposed increase of $16.32325 billion relative to FY2022 billion relative to FY2022- enacted program level. The pandemic enacted program level. The pandemic
preparedness proposal generally preparedness proposal generallydoesdid not designate specific amounts for NIH ICs not designate specific amounts for NIH ICs, but describes a but describes a
number of activities the new funding would support, including vaccine and therapeutic number of activities the new funding would support, including vaccine and therapeutic
development, diagnostic test development and innovation, research infrastructure for clinical development, diagnostic test development and innovation, research infrastructure for clinical
trials, and laboratory biosafety and biosecurity.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 request17
FY2023 Enacted Funding On December 29, 2022, Congress and President Biden finalized NIH FY2023 appropriations by enacting the Consolidated Appropriations Act, 2023 (P.L. 117-328), which includes final FY2023 LHHS appropriations in Division H and Interior/Environment appropriations in Division G. The enacted FY2023 NIH program level is made up of the following (see Table A-1):
$46.047 billion in discretionary LHHS budget authority; $1.412 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 FY2023 program level as enacted is $47.683 billion. In addition, the law provides $1.5 billion for ARPA-H in an account under the Office of the Secretary with funds available until the end of FY2025. According to the new authorization for ARPA-H, also enacted in Consolidated Appropriations Act, 2023 (P.L. 117-328; Division FF; Title II, Section 2331), the new agency is established within NIH.
Accounting for the ARPA-H, the NIH FY2023 enacted program level is $49.183 billion. This FY2023 NIH program level is a $3 billion increase (+6.5%) relative to the FY2022 enacted program level of $46.183 billion. The FY2022 enacted total for NIH is also $13.324 billion (-21.3%) less than the FY2023 budget request. The $13.324 billion difference between FY2023 enacted and FY2023 requested program level is primarily because Congress did not fund the Pandemic Preparedness proposal and also funded ARPA-H at a lower level than requested. The President’s budget requested $5 billion for ARPA-H, while in the FY2023 enacted law, ARPA-H instead receives $1.5 billion.
In FY2023, all IC accounts receive an increase relative to FY2022 funding levels. For the Innovation Account, the full amount authorized by the 21st Century Cures Act ($1.085 billion) is appropriated.
16 Congressional Record, vol. 168, no. 198, Book II, December 20, 2022, pp. S9145-S9147, S8853 17 NIH, Congressional Justification: FY2023, pp. 17-20, https://officeofbudget.od.nih.gov/pdfs/FY23/br/Overview%20of%20FY%202023%20Presidents%20Budget.pdf.
18 The FY2023 enacted amount for the mandatory type 1 diabetes research program differs from the appropriated amount for FY2023 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.
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link to page 11 link to page 10 link to page 10 link to page 11 National Institutes of Health (NIH) Funding: FY1996-FY2023
Trends Table 1 outlines NIH program level funding from FY1996 until FY2023.. Figure 1
illustrates funding trends in both current (also called nominal dollars) and projected constant (i.e., illustrates funding trends in both current (also called nominal dollars) and projected constant (i.e.,
inflation-adjusted) FY2022 dollars (funding shown is total budget authority). inflation-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 billion to $13.675 billion (nominal dollars). Over the next five years, 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 FY2003. In each of Congress and the President doubled the NIH budget to $27.167 billion 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 gradually in nominal dollars.to FY2015, NIH funding increased more gradually in nominal dollars.2519 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.2620 From FY2016 From FY2016
through throughFY2022FY2023, NIH has seen funding increases each year. The largest increase was from , NIH has seen funding increases each year. The largest increase was from
FY2017 to FY2018, where the program level increased by $3.010 billion (+8.8%), making this FY2017 to FY2018, where the program level increased by $3.010 billion (+8.8%), making this
the largest the largestsingle-year nominal dollarpercentage increase since FY2003. The FY2023 program level represents a 6.5% increase over the FY2022 level (including ARPA-H funding) increase since FY2003. 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
FY2023FY2022 dollars) using the Biomedical Research and Development Price Index (BRDPI). dollars) using the Biomedical Research and Development Price Index (BRDPI).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.
2521 It 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 FY2023. The FY2023 program level is 1.2% greater than the peak FY2003 program level, although the FY2023 program level includes funding for a new agency, ARPA-H, and therefore may not be comparable to the FY2003 level. When excluding funding for ARPA-H, the FY2023 level is 1.9% less than the FY2003 level.
19 Amounts shown Amounts shown in Table 1 include appropriations for the Global Fund to Fight AIDS, TB, and Malaria (FY2002-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 Diseases (NIAID) identifying resources for the Global Fund; this responsibility was Institute of Allergy and Infectious Diseases (NIAID) identifying resources for the Global Fund; 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 Table” for “History of Congressional Appropriations, Fiscal Years 2000-2012” at “Supplemental Appropriation Data Table” 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.
2620 For instance, the FY2006 total was 0.1% lower than the previous year, the first time that NIH appropriations had For instance, the FY2006 total was 0.1% lower than the previous year, the first time that NIH appropriations had
decreased since FY1970; the FY2011 total, provided in the Full-Year Continuing Appropriations Act, 2011 (P.L. 112-decreased since FY1970; the FY2011 total, provided in the Full-Year Continuing Appropriations Act, 2011 (P.L. 112-
10), was 1.0% less than the previous fiscal year; the FY2013 total, provided in the Consolidated and Further 10), was 1.0% less than the previous fiscal year; the FY2013 total, provided in the Consolidated and Further
Continuing Appropriations Act, 2013 (P.L. 113-6), was reduced by the March 2013 sequestration and a transfer of Continuing Appropriations Act, 2013 (P.L. 113-6), was reduced 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 budget funding under the authority of the HHS Secretary ($1.553 billion and $173 million, respectively), resulting in a budget
that was 5.0% lower than the prior year. that was 5.0% lower than the prior year.
2721 The index is developed for NIH by the Bureau of Economic Analysis of the Department of Commerce. It reflects the The index is developed for NIH by the Bureau of Economic Analysis of the Department of Commerce. It reflects the
increase in prices of the resources needed to conduct biomedical research, including personnel services, supplies, and increase in prices of the resources needed to conduct biomedical research, including personnel 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. Congressional Research Service Congressional Research Service
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National Institutes of Health (NIH) Funding: FY1996-FY2023
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 Funding, FY1996-FY2023
Program Level Funding in Current and Projected Constant ( Program Level Funding in Current and Projected Constant (FY2023FY2022) Dollars. ) Dollars.
Source: Sources used for FY2023 Sources used for FY2023request, FY2022, and FY2021and FY2022 program levels are program levels are inin Table A-1. The The FY2020
FY2021 (and earlier) program levels are from NIH Budget Office, Appropriations History by Institute/Center (1938 to (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. Inflation adjustment reflects the Biomedical Present), at http://officeofbudget.od.nih.gov/approp_hist.html. Inflation adjustment reflects the Biomedical
Research and Development Price Index (BRDPI), updated March 2022, at https://officeofbudget.od.nih.gov/Research and Development Price Index (BRDPI), updated March 2022, at https://officeofbudget.od.nih.gov/
gbiPriceIndexes.html. 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/gbiPriceIndexes.html.
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Notes: By convention, program level totals include amounts “transferred in” pursuant to PHS tap but do not By convention, program level totals include amounts “transferred in” pursuant to PHS tap but do not
include any amounts “transferred out” under this same authority. Program level includes all budget authority, include any amounts “transferred out” under this same authority. Program level includes all budget authority,
including appropriations for the Global Fund to Fight AIDS, TB, and Malaria (FY2002-FY2011) that were subject including 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 Institute of Allergy and to transfer-out. As of FY2012, NIH no longer receives appropriations for the National Institute of Allergy and
Infectious Diseases (NIAID) identifying resources for the Global Fund; this responsibility was transferred to Infectious Diseases (NIAID) identifying resources for the Global Fund; this responsibility was transferred to
another federal agency. In general, amounts provided to NIH designated for emergency requirements are another federal agency. In general, amounts provided to NIH designated for emergency requirements are
excluded from these totals (e.g., the FY2020 and FY2021 amounts do not include the amounts provided in the excluded from these totals (e.g., the FY2020 and FY2021 amounts do not include the amounts provided in the
coronavirus supplemental appropriations acts, summarized incoronavirus supplemental appropriations acts, summarized in Appendix B). .
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Program Level Funding in Current and Constant ( Program Level Funding in Current and Constant (FY2023FY2022) Dollars (Billions) ) Dollars (Billions)
Program Level
Program Level ProjectedProjected
Program Level
Constant
% Relative to
Fiscal Year
Current $
% Change
Constant FY2023FY2022 $
FY2003a
1996 1996
11.928 11.928
5.6% 5.6%
25. 25.045763
1997 1997
12.741 12.741
6.8% 6.8%
26. 26.028774
1998 1998
13.675 13.675
7.3% 7.3%
27. 27.020795
1999 1999
15.629 15.629
14.3% 14.3%
29.93430.792
2000 2000
17.841 17.841
14.1% 14.1%
32.94233.886
2001 2001
20.459 20.459
14.7% 14.7%
36.56137.608
2002 2002
23.321 23.321
14.0% 14.0%
40.34041.496
2003 2003
27.167 27.167
16.5% 16.5%
45.39646.697
2004 2004
28.037 28.037
3.2% 3.2%
45.16746.461
-0.5% -0.5%
2005 2005
28.594 28.594
2.0% 2.0%
44.34145.611
-2.3% -2.3%
2006 2006
28.560 28.560
-0.1% -0.1%
42.32843.541
-6.8% -6.8%
2007 2007
29.179 29.179
2.2% 2.2%
41.66442.858
-8.2% -8.2%
2008 2008
29.607 29.607
1.5% 1.5%
40.38541.543
-11.0% -11.0%
2009 2009
30.545 30.545
3.2% 3.2%
40.48041.640
-10.8% -10.8%
2010 2010
31.238 31.238
2.3% 2.3%
40.17641.328
-11.5% -11.5%
2011 2011
30.916 30.916
-1.0% -1.0%
38.65739.764
-14.8% -14.8%
2012 2012
30.861 30.861
-0.2% -0.2%
38.09939.191
-16.1% -16.1%
2013 2013
29.316 29.316
-5.0% -5.0%
35.52636.545
-21.7% -21.7%
2014 2014
30.143 30.143
2.8% 2.8%
35.76036.785
-21.2% -21.2%
2015 2015
30.311 30.311
0.6% 0.6%
35.24336.253
-22.4% -22.4%
2016 2016
32.311 32.311
6.6% 6.6%
36.76937.822
-19.0% -19.0%
2017 2017
34.301 34.301
6.2% 6.2%
38.04439.134
-16.2% -16.2%
2018 2018
37.311 37.311
8.8% 8.8%
40.37541.532
-11.1% -11.1%
2019 2019
39.313 39.313
5.4% 5.4%
41.66142.855
-8.2% -8.2%
2020 2020
41.690 41.690
6.0% 6.0%
45.01844.666
-4.4% -4.4%
2021 2021
43.03742.941
3. 3.2%
45.498
-3.30%
44.885
-3.9% %
2022 2022
46.183 46.183
7. 7.3%
47.363
+0.6%
2023PB
62.503
35.3%
62.503
+32.8%5%
46.183
-1.1%
2023
49.183
6.5%
47.236
1.2%
Sources: Sources used for FY2023 Sources used for FY2023request, FY2022, and FY2021and FY2022 program levels are in program levels are in Table A-1. The The FY2020
FY2021 (and earlier) program levels are from NIH Budget Office, Appropriations History by Institute/Center (1938 to (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. Inflation adjustment reflects the Biomedical Present), at http://officeofbudget.od.nih.gov/approp_hist.html. Inflation adjustment reflects the Biomedical
Research and Development Price Index (BRDPI), updated Research and Development Price Index (BRDPI), updatedMarch 2022February 2023, at https://officeofbudget.od.nih.gov/, at https://officeofbudget.od.nih.gov/
gbiPriceIndexes.html. gbiPriceIndexes.html.
Notes: By convention, budget tables, such aBy convention, budget tables, such as Table 1, include amounts “transferred in” pursuant to PHS tap nclude amounts “transferred in” pursuant to PHS tap
but do not include any amounts “transferred out” under this same authority. Program level includes all budget but do not include any amounts “transferred out” under this same authority. Program level includes all budget
authority, including appropriations for the Global Fund to Fight AIDS, TB, and Malaria (FY2002-FY2011) that Congressional Research Service Congressional Research Service
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authority, including 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 Institute of were subject to transfer-out. As of FY2012, NIH no longer receives appropriations for the National Institute of
Allergy and Infectious Diseases (NIAID) identifying resources for the Global Fund; this responsibility was Allergy and Infectious Diseases (NIAID) identifying resources for the Global Fund; this responsibility was
transferred to another federal agency. In general, amounts provided to NIH for emergency requirements are transferred to another federal agency. In general, amounts provided to NIH for emergency requirements are
excluded from these totals (e.g., the FY2020 and FY2021 amounts do not include the amounts provided in the excluded from these totals (e.g., the FY2020 and FY2021 amounts do not include the amounts provided in the
coronavirus supplemental appropriations acts, summarized incoronavirus supplemental appropriations acts, summarized in Appendix B). FY2022 and FY2023 amounts include funding for the Advanced Research Projects Agency for Health (ARPA-H). PB denotes “President’s Budget.” PB denotes “President’s Budget.”
a. FY2003 was the year that NIH received the most program level funding (prior to FY2022) in a. FY2003 was the year that NIH received the most program level funding (prior to FY2022) in20232022 constant constant
dol ars. dol ars.
Congressional Research Service Congressional Research Service
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Appendix A. NIH Funding Details
Table A-1. National Institutes of Health Funding
(budget authority, in millions of dollars) (budget authority, in millions of dollars)
FY2021
FY2022
FY2022FY2023
FY2023
Institutes/Centers
FinalEnacted
Request
Enacted
Request
Enacted
Cancer Institute (NCI) Cancer Institute (NCI)
$6, $6,540
$6,733913
$6, $6,913
$6,714714
$7,320
Heart, Lung, and Blood Institute (NHLBI) Heart, Lung, and Blood Institute (NHLBI)
$3, $3,654808
$3, $3,846823
$3,982
$3,808
$3,823
Dental/Craniofacial Research (NIDCR) Dental/Craniofacial Research (NIDCR)
$ $483
$516
$501
$513501
$513
$520
Diabetes/Digestive/Kidney (NIDD Diabetes/Digestive/Kidney (NIDDK)a
$2, $2,126
$2,219204
$2, $2,204206
$2, $2,206301
Neurological Disorders/Stroke (NINDS) Neurological Disorders/Stroke (NINDS)
$2, $2,504
$2,783611
$2, $2,611768
$2, $2,768814
Allergy/Infectious Diseases (NIAID) Allergy/Infectious Diseases (NIAID)
$6, $6,049323
$6, $6,246268
$6,562
$6,323
$6,268
General Medical Sciences (NIGMS General Medical Sciences (NIGMS)b
$1, $1,715783
$1, $1,825826
$1,827
$1,783
$1,826
Child Health/Human Development (NICHD) Child Health/Human Development (NICHD)
$1, $1,588683
$1, $1,942675
$1,749
$1,683
$1,675
National Eye Institute (NEI) National Eye Institute (NEI)
$ $833
$859
$864
$853864
$853
$897
Environmental Health Sciences (NIEHS Environmental Health Sciences (NIEHS)c
$ $812
$937
$842
$932842
$932
$914
National Institute on Aging (NIA) National Institute on Aging (NIA)
$ $3,888
$4,0364,220
$4, $4,220011
$4, $4,011408
Arthritis/Musculoskeletal/Skin Diseases Arthritis/Musculoskeletal/Skin Diseases
$ $632
$680
$656
$676656
$676
$685
(NIAMS) (NIAMS)
Deafness/Communication Disorders Deafness/Communication Disorders
$ $497
$512
$515
$509515
$509
$534
(NIDCD) (NIDCD)
Alcohol Abuse/Alcoholism (NIAAA) Alcohol Abuse/Alcoholism (NIAAA)
$ $553
$570
$574
$567574
$567
$595
Nursing Research (NINR) Nursing Research (NINR)
$ $174
$200
$181
$199181
$199
$198
National Institute on Drug Abuse (NIDA) National Institute on Drug Abuse (NIDA)
$1, $1,476595
$1,843
$1,663
$1,853
$1,595
$1,843
National Institute of Mental Health (NIMH) National Institute of Mental Health (NIMH)
$2, $2,100217
$2, $2,214211
$2,338
$2,217
$2,211
Human Genome Research Institute (NHGRI) Human Genome Research Institute (NHGRI)
$ $614
$633
$639
$629639
$629
$663
Biomedical Imaging/Bioengineering (NIBIB) Biomedical Imaging/Bioengineering (NIBIB)
$ $409
$422
$425
$419425
$419
$441
Complementary/Integrative Health (NCCIH) Complementary/Integrative Health (NCCIH)
$ $154
$184
$159
$183159
$183
$170
Minority Health/Health Disparities (NIMHD) Minority Health/Health Disparities (NIMHD)
$ $390
$652
$459
$660459
$660
$524
Fogarty International Center (FIC) Fogarty International Center (FIC)
$ $8487
$96 $96
$ $87
$9695
National Library of Medicine (NLM) National Library of Medicine (NLM)
$ $461
$475
$479
$472479
$472
$498
Advancing Translational Sciences (NCATS) Advancing Translational Sciences (NCATS)
$ $853
$879
$882
$874882
$874
$923
Office of Director Office of Director (OD)d
$2, $2,413629
$2, $2,250315
$2, $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
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FY2021
FY2022
FY2022
FY2023
Institutes/Centers
Final656
(Common Fund)
($657)
($646)
($772)
(Office for Research on Women’s Health)
($59)
($53)
($76)
Innovation Accounte
$150
$419
$419
Buildings and Facilities (B&F)
$250
$300
$350
Research Quality
—
—
Advanced Research Projects Agency for Health
$1,000f
$5,000
$1,500f
(ARPA-H) Subtotal, NIH (LHHS Discretionary
$44,650
$48,962
$47,547
BA)
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FY2022
FY2023
FY2023
Institutes/Centers
Enacted
Request Enacted PHS Program Evaluation (provided to $1,309 $1,272 $1,412 NIGMS) Superfund (Interior approp. to NIEHS)g $83 $83 $83 Mandatory type 1 diabetes funds (to $141 $141 $141 NIDDK)h Pandemic Preparednessi (proposed — $12,050 — mandatory)i NIH Program Level $46,183 $62,508 $49,183 Source: The FY2023 enacted, FY2023 request and FY2022 enacted amounts are from
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. , vol. 168, no. 42198, Book , Book IV, March 9, 2022, pp. H2862-H2865, except where
noted belowII, December 20, 2022, pp. S9145-S9147, S8853. .
Notes: Totals may differ from the sum of the components due to rounding. Amounts in table may differ from 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 suchactuals in many cases. By convention, budget tables such as Table A-1 do not subtract the amount of transfers do not subtract the amount of transfers
to the evaluation tap from the agencies’ appropriation. In general, amounts provided to NIH for emergency 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 provided in the requirements are excluded from these totals (e.g., FY2021 amounts do not include the amounts provided in the
coronavirus supplemental appropriations acts, summarized incoronavirus supplemental appropriations acts, summarized in Appendix B).
a. Amounts for the NIDDK do not include mandatory funding for type 1 diabetes research (see note a. Amounts for the NIDDK do not include mandatory funding for type 1 diabetes research (see notejh). ).
b. Amounts for NIGMS do not include funds from PHS Evaluation Set-Aside (§241 of the PHS Act). 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 Appropriations amount for Superfund research c. Amounts for NIEHS do not include Interior/Environment Appropriations amount for Superfund research
(see note (see noteig). ).
d. Includes $12.6 mil ion transfer from the Pediatric Research Initiative Fund (PRIF) as authorized by the d. Includes $12.6 mil ion transfer from the Pediatric Research Initiative Fund (PRIF) as authorized by the
Gabriella Mil er Kids First Research Act Gabriella Mil er Kids First Research Act P.L. 113-94). .
e. The amount shown for the NIH Innovation Account in each column represents only a portion of the total e. The amount shown for the NIH Innovation Account in each column represents only a portion of the total
appropriation to the account appropriation to the account ($404 mil ion for FY2021: $496 mil ion for FY2022; $1.085 bil ion for FY2023. : $496 mil ion for FY2022; $1.085 bil ion for FY2023.
The remaining funds for The remaining funds for this account are reflected, where applicable, into the totals for other ICs. For this account are reflected, where applicable, into the totals for other ICs. For
FY2022, this includes $194 mil ion to NCI for cancer research and $76 mil ion to each of NINDS and NIMH FY2022, this includes $194 mil ion to NCI for cancer research and $76 mil ion to each of NINDS and NIMH
for the BRAIN Initiative ($152 mil ion total for BRAIN). For FY2023, this includes $216 mil ion to NCI for for the BRAIN Initiative ($152 mil ion total for BRAIN). 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).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 Facilities account do not include directed transfers from the nonrecurring
expenses fund in FY202-enacted appropriations (see note l).
g. Funding for ARPA-H in P.L. 117-103 was provided to a new ARPA-H
f.
ARPA-H was funded under a separate account under the account under the HHS Office of the Office of the
Secretary. ASecretary in both FY2022 and FY2023. In FY2022, a proviso accompanying the appropriation gave HHS Secretary Becerra the ability to transfer the 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 new agency anywhere within the department within 30 days of enactment. On March 30, 2022, HHS
Secretary SecretaryXavier Becerra submitted a notice to the appropriations committees that ARPA-H is to reside 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 tablewithin the NIH; therefore, ARPA-H is shown within NIH in this table presentation.
h. For FY2023, ARPA-H authorizing legislation in Division FF (P.L. 117-328) established it as a component of NIH. Therefore, ARPA-H is shown within the NIH program level in this report.
g. This is a separate account in the Interior/Environment appropriations for NIEHS research activities related . This is a separate account in the Interior/Environment appropriations for NIEHS research activities related
to Superfund research. to Superfund research.
i.
h. 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. 116-260; was most recently extended through FY2023 by the Consolidated Appropriations Act, 2021 (P.L. 116-260;
Division BB, Title II). Division BB, Title II).
j.
The FY2022 and FY2023 amounts for the type I diabetes research program ($141 mil ion) are lower than The FY2022 and FY2023 amounts for the type I diabetes research program ($141 mil ion) are lower than
the enacted funding levels for FY2022 and FY2023 ($150 mil ion). According to the budget request, the the enacted funding levels for FY2022 and FY2023 ($150 mil ion). According to the budget request, the
FY2022 and FY2023 amounts reflect sequestration of $8.55 mil ion. See “Budget Mechanism Table,” p. 44 in FY2022 and FY2023 amounts reflect sequestration of $8.55 mil ion. See “Budget Mechanism Table,” p. 44 in
https://officeofbudget.od.nih.gov/pdfs/FY23/br/Overview%20of%20FY%202023%20Presidents%20Budget.pdf. https://officeofbudget.od.nih.gov/pdfs/FY23/br/Overview%20of%20FY%202023%20Presidents%20Budget.pdf.
k. i.
The FY2023 request The FY2023 request proposesproposed new mandatory funding for pandemic preparedness to be available for five new mandatory funding for pandemic preparedness to be available for five
years. The request years. The request proposesproposed an HHS-wide total of $81.7 bil ion for pandemic preparedness, with $12.05 an HHS-wide total of $81.7 bil ion for pandemic preparedness, with $12.05
bil ion of the total designated for NIH. 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
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Congressional Research Service
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National Institutes of Health (NIH) Funding: FY1996-FY2023
Program-Specific Funding
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
process. Congress uses appropriations report language to designate funding for specified
purposes, whereas the President proposes amounts in his annual budget request.purposes, whereas the President proposes amounts in his annual budget request.2822 This is a This is a
relatively new practice that has expanded since FY2015.relatively new practice that has expanded since FY2015.2923 For the most part, Congress does not For the most part, Congress does not
specify NIH funding for particular diseases or areas of research in the appropriations process and specify NIH funding for particular diseases or areas of research in the appropriations process and
instead allows the ICs to award funding within their mission areas based on their own strategic instead allows the ICs to award funding within their mission areas based on their own strategic
planning and priority-setting processes. Research funding is generally awarded on a flexible and planning and priority-setting processes. Research funding is generally awarded on a flexible and
competitive basis through various funding mechanisms intended to balance scientific and health competitive basis through various funding mechanisms intended to balance scientific and health
priorities.priorities.3024
In InFY2022FY2023, Congress used appropriations report language to specify a certain amount of IC , Congress used appropriations report language to specify a certain amount of IC
funding for designated purposes, as summarized ifunding for designated purposes, as summarized in Table A-2. Most of these amounts are specified in the explanatory statement accompanying enacted appropriations;25 in a few cases, amounts specified in the House Appropriations report (H.Rept. 117-96) are incorporated by reference.26 Sometimes the language specifies Sometimes the language specifies
a certain amount for a certain purpose; in other cases, the language provides increased or 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 additional funding. The appropriations reports also include many additional statements directing
the agency to prioritize certain programs or areas of research, as well as statements expressing the the agency to prioritize certain programs or areas of research, as well as statements expressing the
opinion or concerns of Congress regarding NIHopinion or concerns of Congress regarding NIH; these. These broad statements are not summarized here. broad statements are not summarized here.
In addition, the President has proposed broad funding increases for certain research and other
areas in his FY2023 budget request, as summarized in Table A-3.
Table A-2. Specified NIH Funding Levels inFY2022FY2023 Explanatory Statement
Institute/Center
Program/Activity
Amount
National Cancer Institute Childhood Cancer Data Initiative (CCDI) Childhood Cancer Data Initiative (CCDI)
No less than $50 mil ion (NCI) including no less than $750 thousand to continue to support enhancement of the CCDI Molecular Characterization Initiative.$50 mil ion
Childhood Cancer Survivorship, Treatment Childhood Cancer Survivorship, Treatment
No less than $30 mil ion No less than $30 mil ion
Access, and Research (STAR) Act Access, and Research (STAR) Act
Cancer success rates
An additional $150
(including $2 mil ion for cancer registry case capture efforts for childhood and adolescent cancers.*)
NCI Paylines
An increase of $150 mil ion
Health Disparities Researcha
An increase of $10 mil ion
National Heart, Lung, and
Community Engagement Alliance Against
$30 mil ion
Blood Institute (NHLBI)
COVID–19 Disparities (CEAL) Initiative Health Disparities Researcha
An increase of $15 mil ion
22 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, For a general overview, see CRS Report R44124, Appropriations Report Language: Overview of Components and
Development, and CRS Report R47019, and CRS Report R47019, The Executive Budget Process: An Overview. .
2923 As recently as December 2014, the explanatory statement on the FY2015 omnibus stipulated, “In keeping with As recently as December 2014, the explanatory statement on the FY2015 omnibus stipulated, “In keeping with
longstanding practice, the agreement does not recommend a specific amount of NIH funding for this purpose longstanding practice, the agreement does not recommend a specific amount of NIH funding for this purpose
[Alzheimer’s disease] or for any other individual disease. Doing so would establish a dangerous precedent that could [Alzheimer’s disease] or for any other individual disease. Doing so would establish a dangerous precedent that could
politicize the NIH peer review system. Nevertheless, in recognition that Alzheimer’s disease poses a serious threat to politicize the NIH peer review system. Nevertheless, in recognition that Alzheimer’s disease poses a serious threat to
the Nation’s long-term health and economic stability, the agreement expects that a significant portion of the the Nation’s long-term health and economic stability, the agreement expects that a significant portion of the
recommended increase for NIA should be directed to research on Alzheimer's. The exact amount should be determined recommended increase for NIA should be directed to research on Alzheimer's. The exact amount 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 Alzheimer’s relative to those submitted for other diseases.” See for Alzheimer’s relative to those submitted for other diseases.” See Congressional Record, daily edition, vol. 160, no. , daily edition, vol. 160, no.
151, Book II (December 11, 2014), p. H9832. 151, Book II (December 11, 2014), p. H9832.
3024 CRS Report R41705, CRS Report R41705, The National Institutes of Health (NIH): Background and Congressional Issues. .
25 Congressional Record, vol. 168, no. 198, Book II, December 20, 2022, pp. S8881-S8887, S8853. 26 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. 117-403 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” (Congressional Record, vol. 168, no. 198, Book II, December 20, 2022, p. S8874). Congressional Research Service 12 link to page 19 link to page 19 link to page 19
Congressional Research Service
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National Institutes of Health (NIH) Funding: FY1996-FY2023
Institute/Center
Program/Activity
Amount
National Institute of
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)
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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 $10Valvular Heart Disease Research
$20 mil ion
National Institute of
Pain Management Researcha
An increase of $9 mil ion
Dental and Craniofacial Research (NIDCR) National Institute of
Special Diabetes Program
$8.55 mil ion to restore cuts
Diabetes and Digestive
for SDP from sequestration
and Kidney Diseases
Pain Management Research
An increase of $5 mil ion
(NIDDK) National Institute of
Alzheimer’s Disease and Alzheimer’s Disease
An increase in $75 mil ion for
Neurological Disorders
Related Dementias (AD/ADRD)
NINDS out of the $226
and Stroke (NINDS)
increase for AD/ADRD across NIH
HEAL Initiative (opioids, stimulants, and pain
No less than $280.295 mil ion,
management)
an increase of $10 mil ion
Undiagnosed Diseases Network (UDN)
$18 mil ion
National Institute of
Consortium of Food Allergy Research
$12.1 mil ion, an increase of $3
Allergy and Infectious
(CoFAR)
mil ion
Diseases (NIAID)
Regional biocontainment laboratories (RBL)
$52 mil ion of which non less than $1 mil ion shall be provided to each of the 12 RBLs to support the maintenance of a capable research workforce, facilities, and equipment.
Centers for AIDS Research (CFARS)a
$71 mil ion
Responding to infectious diseases/Antimicrobial
No less than $565 mil ion, an
Resistance
increase of $25 mil ion
Universal flu vaccine
No less than $270 mil ion, an increase of $25 mil ion
Health Disparities Researcha
$10 mil ion
National Institute of
Health Disparities Research
An increase of $5 mil ion
General Medical Sciences
Increasing diversity in biomedical research
An increase of $10 mil ion
(NIGMS)
Institutional Development Award (IDeA) Program $425.956 mil ion, an increase of
$15.503 mil ion
Eunice Kennedy Shriver
Heath Impacts on Children of Technology and
$15 mil ion
National Institute of Child Social Media Use Health and Human
Impact of COVID–19 on children
An increase of $2.5 mil ion
Development (NICHD)
Impact of COVID-19 on Pregnant and Lactating
An increase of $3 mil ion
Women Implementing a Maternal Health and Pregnancy
No less than $43.4 mil ion
Outcomes Vision for Everyone (IMPROVE) Initiative
National Institute of
Additional Research
An increase of $40 mil ion
Environmental Health Sciences (NIEHS)
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Institute/Center
Program/Activity
Amount
National Institute on
Alzheimer’s disease and related dementias
An increase in $151 mil ion for
Aging (NIA)
NINDS out of the $226 increase for AD/ADRD, including $1.5 mil ion for a National Academies of Sciences, Engineering, and Medicine (NASEM) report on research priorities on AD/ADRD informed by an expert panel.
National Institute of
Opioids and pain/pain management researcha
An increase of $5 mil ion
Arthritis and Musculoskeletal and Skin Diseases (NIAMS) National Institute on
HEAL Initiative (opioids, stimulants, and pain
No less than $355.295 mil ion
Drug Abuse (NIDA)
management) Pain and pain management
Additional $10 mil ion
Youth and Perinatal Marijuana Usea
$2 mil ion to enter into contract with NASEM to study youth and perinatal marijuana use
National Institute of
Impact of COVID on mental health
An increase of $5 mil ion
Mental Health (NIMH)
Mental Health Treatment Research
An increase of $5 mil ion
National Institute of
Health disparities research
An increase of $10 mil ion
Nursing Research (NINR) National Institute on
Chronic Disease Centers
An additional $11 mil ion
Minority Health and
Health disparities research
An increase of $25 mil ion
Health Disparities
Research Centers in Minority Institutions
$88.765 mil ion
(NIMHD)
Coordination Network Research Endowment Program
$12 mil ion
National Center for
Pain and pain management researcha
An additional $5 mil ion
Complementary and Integrative Health (NCCIH) National Center for
Clinical and Translational Science Awards
$629.56 mil ion, an increase of
Advancing Translational
(CTSAs)
$22.914 mil ion
Sciences (NCATS)
Cures Acceleration Network (CAN)
$70 mil ion
John E. Fogarty
Health disparities researcha
An increase of $5 mil ion
International Center (FIC) Office of the Director
Administration Offices
$4.55 mil ion
(OD)/ Multi-Institute
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) Amyotrophic lateral sclerosis (ALS)
$ $2575 mil ion for implementation mil ion for implementation
Research Initiatives of the Accelerating Access to of the Accelerating Access to
Critical Therapies for ALS Act Critical Therapies for ALS Act
(P.L. 117-79)(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, an increase of $50 mil ion.
All of Us Precision Medicine Initiativea
$541 mil ion, including $419 mil ion from the Innovation Account
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Institute/Center
Program/Activity
Amount
Artificial Intelligence/Machine Learning (AI/ML)
$135 mil ion including $85 mil ion for Office of Data Science Strategy (an increase of $15 mil ion), $50 mil ion for AI/ML focused investment, and $3 mil ion for the Office of Portfolio Analysis
Grants for biomedical research facilities
$80 mil ion
Brain Research through Advancing Innovative
$680 mil ion,b including $95
Neurotechnologies (BRAIN) Initiative Neurotechnologies (BRAIN) Initiative
mil ion for the Human Brain mil ion for the Human Brain
Cell Atlas, $Cell Atlas, $3010 mil ion for the mil ion for the
Armamentarium for Brain Cell Armamentarium for Brain Cell
Access, and $Access, and $1030 mil ion for the mil ion for the
Brain Connectivity Map Brain Connectivity Map
Cybersecurity
An increase of $40 mil ion
Environmental Influences on Child Health
$180 mil ion
Outcomes (ECHO)*
Foreign Threats to Research $5 mil ion transferred from NIH to the Inspector General to conduct investigation into foreign threats to research* Common Fund Increase of $65 mil ion Office of Nutrition Research (ONR)a $40 mil ion Cybersecurity $265 mil ion an increase of $40 mil ion Development Delays $100 mil ion Environmental Influences on Child Health $180 mil ion, the same level as Outcomes (ECHO)a FY2022 Firearm injury and mortality prevention research Firearm injury and mortality prevention research
$12.5 mil ion $12.5 mil ion, the same level as FY2022
HHS Office of Extramural Research allocation for HHS Office of Extramural Research allocation for
$2.5 mil ion $2.5 mil ion
foreign influence foreign influence investigations
IDeA States Pediatric Clinical Trials Network
No less than the FY2021
funding level ($15 mil ion) NASEM Study on Heritable Genetic Information
$1.3 mil ion
Investigation of Co-Occurring Conditions Across Investigation of Co-Occurring Conditions Across
No less than $ No less than $7590 mil ion mil ion, an
the Lifespan to Understand Down Syndrome the Lifespan to Understand Down Syndrome
increase of $10 mil ion
(INCLUDE) (INCLUDE)
Office of AIDS Research, for HIV/AIDS research Office of AIDS Research, for HIV/AIDS research
No less than $3.2 bilAn increase of $100 mil ion ion
Office of Research on Women's Health (ORWH) Office of Research on Women's Health (ORWH)
$ $59.5 mil ion, including $4
mil ion76.48 mil ion, including $5 mil ion, an increase of $1 mil ion, for the Building for the Building
Interdisciplinary Research Interdisciplinary Research
Careers in Women’s Health Careers in Women’s Health
(BIRCWH) program(BIRCWH) program
Office of Behavioral and Social Sciences Research
$38.9 mil ion
(OBSSR)
. $10 mil ion to establish an Office of Autoimmune Disease Research (OADR). $2 mil ion to contract NASEM on a study on gaps in knowledge of women’s health. Office of the Chief Officer for Scientific Office of the Chief Officer for Scientific
$ $16.222.415 mil ion mil ion
Workforce Diversity (COSWD) Workforce Diversity (COSWD)
Source: Congressional Record, vol. 168, no. , vol. 168, no.42198, Book , Book IV, March 9, 2022, pp. H2674-H2679, and H.Rept. 117-96,
pp. 108-166. House II, December 20, 2022, pp. S8881-S8887, S8853. House report amounts cited where not superseded by the explanatory statement per direction in 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-the explanatory statement, “Unless otherwise noted, the language set forth in H.Rept. 117-96403 carries the same 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).
weight as Congressional Research Service Congressional Research Service
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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 $152language included in this explanatory statement and should be complied with unless specifically addressed to the contrary in this explanatory statement” (p. S8874). Notes: Table does not include amounts already shown in Table A-2. Dol ar amounts are at the level of detail used in the appropriations report text. a. From H.Rept. 117-96. b. Amount includes $450 mil ion from the Innovation Account for the BRAIN Initiative as authorized by the mil ion from the Innovation Account for the BRAIN Initiative as authorized by the
Cures Act (split between NINDS and NIMH in FY2022 appropriations). Cures Act (split between NINDS and NIMH in FY2022 appropriations).
Table A-3. Specified NIH Funding Levels in FY2023 Budget Request
Program/Activity
Amount
Opioid, stimulant, and pain research
$2.6 bil ion—$811 mil ion for the Helping to End
Addiction Long-term (HEAL) Initiative and $1.8 bil ion
to support ongoing research across ICs
Health disparities and inequities research
An increase of $350 mil ion—$210 mil ion 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.
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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 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) accounts and as transfers from the Public Health and Social Services Emergency Fund (PHSSEF)
account as provided by four coronavirus supplemental appropriations acts:account as provided by four coronavirus supplemental appropriations acts:3127
First Measure:
Division A of the Coronavirus Preparedness and Response Division A of the Coronavirus Preparedness and Response Supplemental
Supplemental Appropriations Act, 2020 (P.L. 116-123), enacted on March 6, 2020. Appropriations Act, 2020 (P.L. 116-123), enacted on March 6, 2020.
Second Measure: Division B of the Coronavirus Aid, Relief, and Economic Division B of the Coronavirus Aid, Relief, and Economic Security Act (CARES Security Act (CARES
Act, P.L. 116-136), enacted on March 27, 2020. Act, P.L. 116-136), enacted on March 27, 2020.
Third Measure: Division B of the Paycheck Protection Program and Health Division B of the Paycheck Protection Program and Health Care Enhancement Care Enhancement
Act (PPPHCEA, P.L. 116-139), enacted on April 24, 2020. Act (PPPHCEA, P.L. 116-139), enacted on April 24, 2020.
Fourth Measure: Division M of Consolidated Appropriations Act, 2021 (P.L. Division M of Consolidated Appropriations Act, 2021 (P.L. 116-260), enacted on 116-260), enacted on
December 27, 2020. December 27, 2020.
NIH received a total of $3.031 billion to NIH IC accounts, along with directed transfers from the 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, 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 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, 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 2024, and all transfers from the PHSSEF are available until expended. This funding was primarily
provided in three categories: provided in three categories:
Broadly Available Funding. In the first (P.L. 116-123) and third measure (CARES Act; P.L. 116-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 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 respond to coronavirus, domestically and internationally.” NIH IC accounts that received broadly
available funds and their totals include the following: available funds and their totals include the following:
National Institute of Allergy and Infectious Diseases (NIAID): $1.542 billion, $1.542 billion,
including $836 million in the first measure and $706 million in the CARES Act. 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 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 appropriations. The first measure directed a transfer of not less than $10 million
to the National Institute of Environmental Health Sciences (NIEHS) for “worker-to the National Institute of Environmental Health Sciences (NIEHS) for “worker-
based training to prevent and reduce exposure of hospital employees, emergency based training to prevent and reduce exposure of hospital employees, emergency
first responders, and other workers who are at risk of exposure to coronavirus 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 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 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 acquisition of equipment for, vaccine and infectious diseases research facilities of
or used by NIH, including the acquisition of real property.” or used by NIH, including the acquisition of real property.”
National Heart, Lung, and Blood Institute (NHLBI):: $103 million in the $103 million in the
CARES Act. CARES Act.
National Institute of Biomedical Imaging and Bioengineering (NIBIB): $60 $60
million in the CARES Act. million in the CARES Act.
National Library of Medicine (NLM): $10 million in the CARES Act.
3127 NIH did not receive supplemental appropriations from the Families First Coronavirus Response Act (FFCRA, P.L. NIH did not receive supplemental appropriations from the Families First Coronavirus Response Act (FFCRA, P.L.
116-127), enacted on March 18, 2020. 116-127), enacted on March 18, 2020.
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National Library of Medicine (NLM): $10 million in the CARES Act. National Center for Advancing Translational Sciences (NCATS): $36 million $36 million
in the CARES Act. in the CARES Act.
Office of the Director (OD): $30 million in the CARES Act. $30 million in the CARES Act.
Diagnostic Testing Research and Development (R&D). In the fourth 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)and fifth measures, NIH received funding for specific purposes related to diagnostic , 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 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 account in the fourth measure, and directly to the OD account in the fifth measure. These amounts
included the following: included the following:
National Cancer Institute (NCI): Transfer of not less than $306 million from Transfer of not less than $306 million from
PHSSEF to NCI “to develop, validate, improve, and implement serological PHSSEF to NCI “to develop, validate, improve, and implement serological
testing and associated technologies” in the testing and associated technologies” in thePPPHCEAfourth measure. .
NIBIB: Transfer of not less than $500 million from PHSSEF to NIBIB “to Transfer of not less than $500 million from PHSSEF to NIBIB “to
accelerate research, development, and implementation of point of care and other accelerate research, development, and implementation of point of care and other
rapid testing related to coronavirus” in the rapid testing related to coronavirus” in thePPPHCEAfourth measure. .
OD: Transfer of not less than $1 billion from PHSSEF to OD “to develop, Transfer of not less than $1 billion from PHSSEF to OD “to develop,
validate, improve, and implement testing and associated technologies; to validate, improve, and implement testing and associated technologies; to
accelerate research, development, and implementation of point of care and other accelerate research, development, and implementation of point of care and other
rapid testing; and for partnerships with governmental and non-governmental rapid testing; and for partnerships with governmental and non-governmental
entities” in the entities” in thePPPHCEAfourth measure. In the fifth measure, not less than $100 million of the . 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 $1.250 billion total provided to the OD account is for “the Rapid Acceleration of
Diagnostics.” Diagnostics.”
NIH’s Rapid Acceleration of Diagnostics (RADx) initiative is an effort to innovate and scale up 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 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 and OD in the fourth measure was used to support RADx initially, with additional funds in the
fifth measure as specified above.fifth measure as specified above.3228
Long-Term Studies of COVID-19. The fifth measure directed $1.15 billion of the total $1.The fifth measure directed $1.15 billion of the total $1.25025
billion provided to the OD account “for research and clinical trials related to long-term studies of 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 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 Enhance Recovery (RECOVER) Initiative, a large coordinated research initiative to studylongLong
COVID.COVID. 3329 The fifth measure also allows the total $1.25 billion appropriation to OD to be 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). 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
28 CRS communication with NIH, July 24, 2020. CRS communication with NIH, July 24, 2020.
3329 See “How is RECOVER being paid for” at RECOVER: Frequently Asked Questions, https://recovercovid.org/ 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 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’ of the $1.25 appropriation for NIH OD in the fifth measure to the Administration for Children and Families’
Unaccompanied Children Program (see Unaccompanied Children Program (see “Appendix: HHS COVID-19 FundingAppendix: HHS COVID-19 Funding,” GAO-22-105397). NIH’s RECOVER website states that ). 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 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.” the $1.15 billion budget remains and NIH RECOVER research activities have neither stopped nor had any delays.”
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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 National Institutes of Health (NIH) Funding: FY1996-FY2023
reported that the HHS Secretary has allocated other ARPA funding in Section 2401 toward the RECOVER 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 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 Families’ Unaccompanied Children Program of the original appropriation for that program in the fifth measure
(see (seefootnote 31)footnote 27). .
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Appendix C. Acronyms and Abbreviations
Acronym/
Abbreviation
Organization/Term
ARPA-H
Advanced Research Projects Agency for Health Advanced Research Projects Agency for Health
DARPA
Defense Advanced Research Projects Agency Defense Advanced Research Projects Agency
DOD
Department of Defense Department of Defense
FIC
Fogarty International Center Fogarty International Center
FY
Fiscal Year Fiscal Year
IC
Institutes and Centers Institutes and Centers
NASEM
National Academies of Sciences, Engineering, and Medicine National Academies of Sciences, Engineering, and Medicine
NCATS
National Center for Advancing Translational Sciences National Center for Advancing Translational Sciences
NCCIH
National Center for Complementary and Integrative Health National Center for Complementary and Integrative Health
NCI
National Cancer Institute National Cancer Institute
NEF
Nonrecurring Expenses Fund Nonrecurring Expenses Fund
NEI
National Eye Institute National Eye Institute
NHGRI
National Human Genome Research Institute National Human Genome Research Institute
NHLBI
National Heart, Lung, and Blood Institute National Heart, Lung, and Blood Institute
NIA
National Institute on Aging National Institute on Aging
NIAAA
National Institute on Alcohol Abuse and Alcoholism National Institute on Alcohol Abuse and Alcoholism
NIAID
National Institute of Allergy and Infectious Diseases National Institute of Allergy and Infectious Diseases
NIAMS
National Institute of Arthritis and Musculoskeletal and Skin Diseases National Institute of Arthritis and Musculoskeletal and Skin Diseases
NIBIB
National Institute of Biomedical Imaging and Bioengineering National Institute of Biomedical Imaging and Bioengineering
NICHD
National Institute of Child Health and Human Development National Institute of Child Health and Human Development
NIDA
National Institute on Drug Abuse National Institute on Drug Abuse
NIDCD
National Institute on Deafness and Other Communication Disorders National Institute on Deafness and Other Communication Disorders
NIDCR
National Institute of Dental and Craniofacial Research National Institute of Dental and Craniofacial Research
NIDDK
National Institute of Diabetes and Digestive and Kidney Diseases National Institute of Diabetes and Digestive and Kidney Diseases
NIEHS
National Institute of Environmental Health Sciences National Institute of Environmental Health Sciences
NIGMS
National Institute of General Medical Sciences National Institute of General Medical Sciences
NIMH
National Institute of Mental Health National Institute of Mental Health
NIMHD
National Institute on Minority Health and Health Disparities National Institute on Minority Health and Health Disparities
NINDS
National Institute of Neurological Disorders and Stroke National Institute of Neurological Disorders and Stroke
NINR
National Institute of Nursing Research National Institute of Nursing Research
NLM
National Library of Medicine National Library of Medicine
OD
NIH Office of the Director NIH Office of the Director
PHS
Public Health Service Public Health Service
Congressional Research Service Congressional Research Service
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National Institutes of Health (NIH) Funding: FY1996-FY2023
Author Information
Kavya Sekar Kavya Sekar
Analyst in Health Policy Analyst in Health Policy
Acknowledgments
CRS Research CRS ResearchAssistants Isaac Nicchitta and John Gorman provided valuable assistance in analysis and
writingAssistant John Gorman provided assistance for this report. for this report.
Disclaimer
This document was prepared by the Congressional Research Service (CRS). CRS serves as nonpartisan This document was prepared by the Congressional Research Service (CRS). CRS serves as nonpartisan
shared staff to congressional committees and Members of Congress. It operates solely at the behest of and shared staff to congressional committees and Members of Congress. It operates solely at the behest of and
under the direction of Congress. Information in a CRS Report should not be relied upon for purposes other under the direction of Congress. Information in a CRS Report should not be relied upon for purposes other
than public understanding of information that has been provided by CRS to Members of Congress in than public understanding of information that has been provided by CRS to Members of Congress in
connection with CRS’s institutional role. CRS Reports, as a work of the United States Government, are not connection with CRS’s institutional role. CRS Reports, as a work of the United States Government, are not
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Congressional Research Service Congressional Research Service
R43341 R43341 · VERSION4345 · UPDATED
21 21
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
process with Analyst in Health Policy Analyst in Health Policy
. It is made up of 27 Institutes and Centers and the Office of the Director (OD). is made up of 27 Institutes and Centers and the Office of the Director (OD).
funding is provided in the annual Departments of Labor, Health and Human Services, and Education, and Related funding is provided in the annual Departments of Labor, Health and Human Services, and Education, and Related
Agencies (LHHS) Appropriations Act. NIH also receives smaller amounts of funding from Agencies (LHHS) Appropriations Act. NIH also receives smaller amounts of funding from
The The
funding levels (funding levels (
NIH has seen periods of high and low funding growth during the period covered by this report, as illustrated in 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 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 dollars). Over the next five years, Congress and the President doubled the NIH budget to $27.167 billion 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 gradually in nominal dollars. In some years (FY2006, FY2011, FY2003 to FY2015, NIH funding increased more gradually in nominal dollars. In some years (FY2006, FY2011,
and FY2013), and FY2013),
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 initially peaked in Research and Development Price Index; BRDPI), 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 FY2003—the last year of the five-year doubling period—and then declined fairly steadily for more than a decade
until funding increases were provided in each of FY2016 through until funding increases were provided in each of FY2016 through
This CRS report details NIH budget and appropriations for FY2022 and FY2023 This CRS report details NIH budget and appropriations for FY2022 and FY2023, and provides an overview of and provides an overview of
funding trends in regular appropriations to the agency from FY1996 to FY2023. Coronavirus supplemental funding trends in regular appropriations to the agency from FY1996 to FY2023. Coronavirus supplemental
funding for NIH is discussed funding for NIH is discussed
elsewhere in the elsewhere in the
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Contents
NIH Funding: FY1996-FY2023 ...................................................................................................... 1
Funding Sources ........................................................................................................................ 2
FY2022
Tables Table
.... 8 Table A-
Table A-
Appendixes
Appendix A. NIH Funding Details ................................................................................................
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 Congressional Research Service
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NIH Funding: FY1996-FY2023
This report This report
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 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. biomedical science. Of these, 24 ICs and OD support research programs. The OD sets overall policy for NIH and coordinates the programs and The OD sets overall policy for NIH and coordinates the programs and
activities of all NIH components, particularly in areas of research that involve multiple institutes. activities of all NIH components, particularly in areas of research that involve multiple institutes.
Through the annual appropriations process, Congress provides funding to the 24 research ICs, OD, and a Buildings and Facilities account. Three support centers are funded through transfers from other accounts. In addition, FY2022 appropriations established a new entity that has been placed within NIH: the 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. 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 supplemental In FY2021 and prior years, NIH received supplemental
particular diseases, areas of human health and particular diseases, areas of human health and
appropriations provided as an emergency requirement. appropriations provided as an emergency requirement.
development, or more fundamental aspects of development, or more fundamental aspects of
Given that this report examines trends in regular Given that this report examines 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 normal operations of the agency, the President for the normal 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 collection and dissemination.3 More than
requirement are generally excluded from this report. In requirement are generally excluded from this report. In
of the NIH budget funds extramural research of the NIH budget funds extramural research
some years, supplemental funding to NIH was some 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 Recovery and appropriations provided in the American Recovery and
Reinvestment Act of 2009 (ARRA; P.L. 111-5), which Reinvestment Act of 2009 (ARRA; P.L. 111-5), which
performed by more than 300,000 individuals performed by more than 300,000 individuals
was a 33% increase to the regular FY2009 was a 33% increase to the regular FY2009
who work at over 2,500 hospitals, medical who work at over 2,500 hospitals, medical
appropriations NIH received. NIH has also received appropriations NIH received. NIH has also received
schools, universities, and other research schools, universities, and other research
supplemental appropriations during several infectious supplemental appropriations during several infectious
FY2020 and FY2021 amounts for the FY2020 and FY2021 amounts for the
Appendix B.
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 CRS Report R44582, acts. For further information, see CRS Report R44582, Overview of Funding Mechanisms in the Federal Budget
Process, and Selected Examples. .
2 The Public Health Service (PHS) also includes the Centers for Disease Control and Prevention (CDC), the Food and 2 The Public Health Service (PHS) also includes the Centers for Disease Control and Prevention (CDC), the Food and
Drug Administration (FDA), the Agency for Healthcare Research and Quality (AHRQ), the Health Resources and Drug Administration (FDA), the Agency for Healthcare Research and Quality (AHRQ), the Health Resources and
Services Administration (HRSA), the Substance Abuse and Mental Health Services Administration (SAMHSA), the Services Administration (HRSA), the Substance Abuse and Mental Health Services Administration (SAMHSA), the
Indian Health Service (IHS), and the Agency for Toxic Substances and Disease Registry (ATSDR). Indian Health Service (IHS), and the Agency for Toxic Substances and Disease Registry (ATSDR).
HHS also made an administrative decision to change the preexisting Office of the Assistant Secretary Preparedness and Response to a PHS operating division, the Administration for Strategic Preparedness and Response. 3 For further information on the National Institutes of Health (NIH), see CRS Report R41705, The National Institutes of Congressional Research Service 1 National Institutes of Health (NIH) Funding: FY1996-FY2023 institutions around the country.4 About 10% of the agency’s budget supports intramural research (i.e., internal) conducted by nearly 6,000 NIH physicians and scientists, most of whom are located on the NIH campus in Bethesda, MD.5 Funding Sources
The vast majority of NIH funding comes from annual discretionary appropriationsThe vast majority of NIH funding comes from annual discretionary appropriations
additionally receives some mandatory funding and additionally receives some mandatory funding and
budgetary rules, as explained below. The total funding available for NIH activities, taking account budgetary rules, as explained below. The total funding available for NIH activities, taking account
of add-ons and of add-ons and
Discretionary budget authority: NIH’s discretionary budget authority comes primarily from NIH’s discretionary budget authority comes primarily from
annual annual
amount for the Superfund Research Program and related activities from the amount for the Superfund Research Program and related activities from the
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.8 Authorized by Section 241 Evaluation Set-Aside or the “PHS Evaluation Tap” transfer authority.8 Authorized by Section 241
of the Public Health Service Act, the evaluation tap allows the Secretary of HHS, with the of the Public Health Service Act, the evaluation tap allows 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 eligible program appropriations. However, LHHS to not less than 0.2% and not more than 1% of eligible 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 and have
context of NIH, these context of NIH, these
Sciences in recent years.9 Since FY2010, and including in Sciences in recent years.9 Since FY2010, and including in
aside level has been 2.5% of eligible appropriations.10 aside level has been 2.5% of eligible appropriations.10
report and NIH source documents include amounts “transferred in” pursuant to report and NIH source documents include amounts “transferred in” pursuant to the PHS tap as directed by appropriations Health (NIH): Background and Congressional Issues. 4 NIH, “What We Do - Budget,” August, 2022, at https://www.nih.gov/about-nih/what-we-do/budget. 5 Ibid.
6 NIH program levels in this report reflect total funding for all Institutes and Centers (ICs), the Office of the Director 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 (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 diabetes research (provided in Public Health Service Act [PHSA] Section 330B), the nonrecurring expenses fund
(NEF), and, when applicable, (NEF), and, when applicable,
pandemic preparedness funding proposed in the FY2023 budget. pandemic preparedness funding proposed in the FY2023 budget.
7 The Hazardous Substance Basic Research and Training Program (Superfund Research Program) funds research on the 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 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 Health Sciences. 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 Superfund Amendments and Reauthorization Act Liability Act of 1980 (42 U.S.C. §9660(a)) and Section 126(g) of the Superfund Amendments and Reauthorization Act
of 1986. of 1986.
8 For more information on the PHS Evaluation Tap, or PHS Evaluation Set-Aside, see discussion in CRS Report 8 For more information on the PHS Evaluation Tap, or PHS Evaluation Set-Aside, see discussion in CRS Report
R44916, R44916, Public Health Service Agencies: Overview and Funding (FY2016-FY2018). .
9 Prior to FY2015, NIH had traditionally been by far the largest net donor of tap funds, rather than a net recipient. The 9 Prior to FY2015, NIH had traditionally been by far the largest net donor of tap funds, rather than a net recipient. The
joint explanatory statement accompanying the FY2015 omnibus explained this shift as being intended to ensure that tap joint explanatory statement accompanying the FY2015 omnibus explained this shift as being intended to ensure that tap
transfers are a “net benefit to NIH rather than a liability” and noted that this change was in response to a growing transfers are a “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 funds to the tap. Joint Explanatory Statement, Proceedings and Debates of the concern at the loss of NIH funds to the tap. Joint Explanatory Statement, Proceedings and Debates of the
113th Congress, Second Session, 113th Congress, Second 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.
10 See Section 204 of Division H, Title II, of P.L. 117- 10 See Section 204 of Division H, Title II, of P.L. 117-
an appropriations act set the PHS tap percentage at a level other than 2.5% was in FY2009, when it was 2.4% (see P.L. an appropriations act set the PHS tap percentage at a level other than 2.5% was in FY2009, when it was 2.4% (see P.L.
111-8). The 111-8). The
tap transfers to be used for the “evaluation and the implementation” of programs funded in the HHS title of the LHHS tap transfers to be used for the “evaluation and the implementation” of programs funded in the HHS title of the LHHS
Appropriations Act. Prior to FY2014, such provisions had restricted tap funds to the “evaluation of the Appropriations Act. Prior to FY2014, such provisions had restricted tap funds to 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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measures or proposed in the budget request, but do not 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 (“the
FY2026.11 For appropriated amounts to the account—up the limit authorized for each fiscal FY2026.11 For appropriated amounts to the account—up the limit authorized for each fiscal
year—the amounts are subtracted from any cost estimate for enforcing discretionary spending year—the amounts are subtracted from any cost estimate for enforcing discretionary spending
limits (i.e., the budget caps). In effect, appropriations to the NIH Innovation Account as limits (i.e., the budget caps). In effect, appropriations to the NIH Innovation Account as
authorized by the Cures Act are not subject to discretionary spending limits.12 The NIH Director authorized by the Cures Act are not subject to discretionary spending limits.12 The NIH Director
may transfer these amounts from the NIH Innovation Account to other NIH accounts, but only for may transfer these amounts from the NIH Innovation Account to other NIH accounts, but only for
the purposes the purposes specified in the Cures Act
Innovation Account from FY2017 to Innovation Account from FY2017 to
Mandatory Type I Diabetes Funding: In addition, NIH has received mandatory funding of $150 In addition, NIH has received mandatory funding of $150
million annually that is provided in Public Health Service Act (PHSA) Section 330Bmillion annually that is provided in Public Health Service Act (PHSA) Section 330B
enacting the Consolidated Appropriations Act, 2022 (P.L. 117-103), which enacting the Consolidated Appropriations Act, 2022 (P.L. 117-103), which
LHHS appropriations in Division H and Interior/Environment appropriations in Division G. The LHHS appropriations in Division H and Interior/Environment appropriations in Division G. The
enacted FY2022 NIH program level enacted FY2022 NIH program level
$43.65 billion in discretionary LHHS budget authority $43.65 billion in discretionary LHHS budget authority (nontransfer); ;
$1.309 billion pursuant to the PHS program evaluation transfer; $1.309 billion pursuant to the PHS program evaluation transfer;
$83 million for the Superfund research program and related activities from $83 million for the Superfund research program and related activities from
Interior/Environment appropriations; and Interior/Environment appropriations; and
$141 million in annual funding for the mandatory type 1 diabetes research $141 million in annual funding for the mandatory type 1 diabetes research
program. program.
In total, the NIH FY2022 program level as enacted In total, the NIH FY2022 program level as enacted
provided $1 billion for the Advanced Research Projects Agency for Health provided $1 billion for the Advanced Research Projects Agency for Health (ARPA-H) to a new account to a new account
under the Office of the Secretaryunder the Office of the Secretary with funding available until the end of FY2024. The law allowed the HHS Secretary to place the new agency . 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 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 Secretary Xavier Becerra submitted a notice to the appropriations committees that ARPA-H
reside within the NIH. reside within the NIH.
https://officeofbudget.od.nih.gov/pdfs/FY23/br/Overview%20of%20FY%202023%20Presidents%20Budget.pdf. https://officeofbudget.od.nih.gov/pdfs/FY23/br/Overview%20of%20FY%202023%20Presidents%20Budget.pdf.
Congressional Research Service Congressional Research Service
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Research Projects Agency for Health (ARPA-H). The law created a new ARPA-H account at HHS, with funding 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 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 department within 30 days of enactment. On March 30, 2022, HHS Secretary Xavier Becerra submitted a notice
to the appropriations committees that ARPA-H to the appropriations committees that ARPA-H
report directly to the HHS Secretary. The Consolidated Appropriations Act, 2023 (P.L. 117-328), provided additional funding of $1.5 bil ion for ARPA-H, available until the end of FY2025, in a separate account under the HHS Office of the Secretary. The law also formally authorized the new agency as a part of the PREVENT Pandemics Act in Division FF, Title II of the law, Section 2331. The new authorization places ARPA-H within NIH by statute. For further information and analysis regarding ARPA-H, see CRS Report R47074, 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 President Biden’s FY2023 budget request
level of $62.503 billion, an increase of $16.320 billion (+35.3%) from FY2022-enacted levels. level of $62.503 billion, an increase of $16.320 billion (+35.3%) from FY2022-enacted levels.
The proposed FY2023 program level would The proposed FY2023 program level would
$1.272 billion pursuant to the PHS program evaluation transfer; $1.272 billion pursuant to the PHS program evaluation transfer;
$83 million for the Superfund research program and related activities from $83 million for the Superfund research program and related activities from
Interior/Environment appropriations; Interior/Environment appropriations;
$141 million in annual funding for the mandatory type 1 diabetes research $141 million in annual funding for the mandatory type 1 diabetes research
program; program;
$12.05 billion in $12.05 billion in
Under this request, approximately half of existing IC accounts would Under this request, approximately half of existing IC accounts would
with FY2022with FY2022
Health and Health Disparities (NIMHD) would Health and Health Disparities (NIMHD) would
(+$201 million, +43.7%), and funding for OD would (+$201 million, +43.7%), and funding for OD would
for FY2023 of $150 million in PHSA Section 330B, as amended in P.L. 116-260, Division BB, Title III. According to for FY2023 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, 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. at https://officeofbudget.od.nih.gov/pdfs/FY23/br/Overview%20of%20FY%202023%20Presidents%20Budget.pdf.
U.S. capabilities to prepare for and respond rapidly and effectively to future pandemics and other high consequence 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 biological threats.” The $12.05 billion directed to NIH
and therapeutics against high priority viral families, biosafety and biosecurity, and to expand laboratory capacity and and therapeutics against high priority viral families, biosafety and biosecurity, and to expand laboratory capacity and
clinical trial infrastructure.” See HHS, clinical trial infrastructure.” See HHS, Budget in Brief: FY2023, p. 55, https://www.hhs.gov/sites/default/files/fy-2023-p. 55, https://www.hhs.gov/sites/default/files/fy-2023-
budget-in-brief.pdf. budget-in-brief.pdf.
Congressional Research Service Congressional Research Service
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FY2023 budget request also FY2023 budget request also
Under the pandemic preparedness proposal, NIH would Under the pandemic preparedness proposal, NIH would
mandatory appropriations available for five years. This new appropriation mandatory appropriations available for five years. This new appropriation
proposed increase of $16.proposed increase of $16.
preparedness proposal generally preparedness proposal generally
number of activities the new funding would support, including vaccine and therapeutic number of activities the new funding would support, including vaccine and therapeutic
development, diagnostic test development and innovation, research infrastructure for clinical development, diagnostic test development and innovation, research infrastructure for clinical
trials, and laboratory biosafety and biosecurity.trials, and laboratory biosafety and biosecurity.
illustrates funding trends in both current (also called nominal dollars) and projected constant (i.e., illustrates funding trends in both current (also called nominal dollars) and projected constant (i.e.,
inflation-adjusted) FY2022 dollars (funding shown is total budget authority). inflation-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 billion to $13.675 billion (nominal dollars). Over the next five years, 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 FY2003. In each of Congress and the President doubled the NIH budget to $27.167 billion 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 gradually in nominal dollars.to FY2015, NIH funding increased more gradually in nominal dollars.
FY2011, and FY2013) funding for the agency decreased in nominal dollars.FY2011, and FY2013) funding for the agency decreased in nominal dollars.
through through
FY2017 to FY2018, where the program level increased by $3.010 billion (+8.8%), making this FY2017 to FY2018, where the program level increased by $3.010 billion (+8.8%), making this
the largest the largest
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
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 Diseases (NIAID) identifying resources for the Global Fund; this responsibility was Institute of Allergy and Infectious Diseases (NIAID) identifying resources for the Global Fund; 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 Table” for “History of Congressional Appropriations, Fiscal Years 2000-2012” at “Supplemental Appropriation Data Table” 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.
decreased since FY1970; the FY2011 total, provided in the Full-Year Continuing Appropriations Act, 2011 (P.L. 112-decreased since FY1970; the FY2011 total, provided in the Full-Year Continuing Appropriations Act, 2011 (P.L. 112-
10), was 1.0% less than the previous fiscal year; the FY2013 total, provided in the Consolidated and Further 10), was 1.0% less than the previous fiscal year; the FY2013 total, provided in the Consolidated and Further
Continuing Appropriations Act, 2013 (P.L. 113-6), was reduced by the March 2013 sequestration and a transfer of Continuing Appropriations Act, 2013 (P.L. 113-6), was reduced 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 budget funding under the authority of the HHS Secretary ($1.553 billion and $173 million, respectively), resulting in a budget
that was 5.0% lower than the prior year. that was 5.0% lower than the prior year.
increase in prices of the resources needed to conduct biomedical research, including personnel services, supplies, and increase in prices of the resources needed to conduct biomedical research, including personnel 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. Congressional Research Service Congressional Research Service
link to page link to page
National Institutes of Health (NIH) Funding: FY1996-FY2023
Program Level Funding in Current and Projected Constant ( Program Level Funding in Current and Projected Constant (
Source: Sources used for FY2023 Sources used for FY2023
FY2021 (and earlier) program levels are from NIH Budget Office, Appropriations History by Institute/Center (1938 to (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. Inflation adjustment reflects the Biomedical Present), at http://officeofbudget.od.nih.gov/approp_hist.html. Inflation adjustment reflects the Biomedical
Research and Development Price Index (BRDPI), updated March 2022, at https://officeofbudget.od.nih.gov/Research and Development Price Index (BRDPI), updated March 2022, at https://officeofbudget.od.nih.gov/
gbiPriceIndexes.html. gbiPriceIndexes.html.
include any amounts “transferred out” under this same authority. Program level includes all budget authority, include any amounts “transferred out” under this same authority. Program level includes all budget authority,
including appropriations for the Global Fund to Fight AIDS, TB, and Malaria (FY2002-FY2011) that were subject including 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 Institute of Allergy and to transfer-out. As of FY2012, NIH no longer receives appropriations for the National Institute of Allergy and
Infectious Diseases (NIAID) identifying resources for the Global Fund; this responsibility was transferred to Infectious Diseases (NIAID) identifying resources for the Global Fund; this responsibility was transferred to
another federal agency. In general, amounts provided to NIH designated for emergency requirements are another federal agency. In general, amounts provided to NIH designated for emergency requirements are
excluded from these totals (e.g., the FY2020 and FY2021 amounts do not include the amounts provided in the excluded from these totals (e.g., the FY2020 and FY2021 amounts do not include the amounts provided in the
coronavirus supplemental appropriations acts, summarized incoronavirus supplemental appropriations acts, summarized in Appendix B). .
Congressional Research Service 7 link to page 12 link to page 13 link to page 11 National Institutes of Health (NIH) Funding: FY1996-FY2023 Table 1. NIH Funding, FY1996-FY2023
Program Level Funding in Current and Constant ( Program Level Funding in Current and Constant (
Program Level
% Relative to
Fiscal Year
Current $
% Change
FY2003a
1996 1996
11.928 11.928
5.6% 5.6%
25. 25.
1997 1997
12.741 12.741
6.8% 6.8%
26. 26.
1998 1998
13.675 13.675
7.3% 7.3%
27. 27.
1999 1999
15.629 15.629
14.3% 14.3%
2000 2000
17.841 17.841
14.1% 14.1%
2001 2001
20.459 20.459
14.7% 14.7%
2002 2002
23.321 23.321
14.0% 14.0%
2003 2003
27.167 27.167
16.5% 16.5%
2004 2004
28.037 28.037
3.2% 3.2%
-0.5% -0.5%
2005 2005
28.594 28.594
2.0% 2.0%
-2.3% -2.3%
2006 2006
28.560 28.560
-0.1% -0.1%
-6.8% -6.8%
2007 2007
29.179 29.179
2.2% 2.2%
-8.2% -8.2%
2008 2008
29.607 29.607
1.5% 1.5%
-11.0% -11.0%
2009 2009
30.545 30.545
3.2% 3.2%
-10.8% -10.8%
2010 2010
31.238 31.238
2.3% 2.3%
-11.5% -11.5%
2011 2011
30.916 30.916
-1.0% -1.0%
-14.8% -14.8%
2012 2012
30.861 30.861
-0.2% -0.2%
-16.1% -16.1%
2013 2013
29.316 29.316
-5.0% -5.0%
-21.7% -21.7%
2014 2014
30.143 30.143
2.8% 2.8%
-21.2% -21.2%
2015 2015
30.311 30.311
0.6% 0.6%
-22.4% -22.4%
2016 2016
32.311 32.311
6.6% 6.6%
-19.0% -19.0%
2017 2017
34.301 34.301
6.2% 6.2%
-16.2% -16.2%
2018 2018
37.311 37.311
8.8% 8.8%
-11.1% -11.1%
2019 2019
39.313 39.313
5.4% 5.4%
-8.2% -8.2%
2020 2020
41.690 41.690
6.0% 6.0%
-4.4% -4.4%
2021 2021
3. 3.
2022 2022
46.183 46.183
7. 7.
Sources: Sources used for FY2023 Sources used for FY2023
FY2021 (and earlier) program levels are from NIH Budget Office, Appropriations History by Institute/Center (1938 to (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. Inflation adjustment reflects the Biomedical Present), at http://officeofbudget.od.nih.gov/approp_hist.html. Inflation adjustment reflects the Biomedical
Research and Development Price Index (BRDPI), updated Research and Development Price Index (BRDPI), updated
gbiPriceIndexes.html. gbiPriceIndexes.html.
Notes: By convention, budget tables, such aBy convention, budget tables, such as Table 1, include amounts “transferred in” pursuant to PHS tap nclude amounts “transferred in” pursuant to PHS tap
but do not include any amounts “transferred out” under this same authority. Program level includes all budget but do not include any amounts “transferred out” under this same authority. Program level includes all budget
authority, including appropriations for the Global Fund to Fight AIDS, TB, and Malaria (FY2002-FY2011) that Congressional Research Service Congressional Research Service
link to page link to page
were subject to transfer-out. As of FY2012, NIH no longer receives appropriations for the National Institute of were subject to transfer-out. As of FY2012, NIH no longer receives appropriations for the National Institute of
Allergy and Infectious Diseases (NIAID) identifying resources for the Global Fund; this responsibility was Allergy and Infectious Diseases (NIAID) identifying resources for the Global Fund; this responsibility was
transferred to another federal agency. In general, amounts provided to NIH for emergency requirements are transferred to another federal agency. In general, amounts provided to NIH for emergency requirements are
excluded from these totals (e.g., the FY2020 and FY2021 amounts do not include the amounts provided in the excluded from these totals (e.g., the FY2020 and FY2021 amounts do not include the amounts provided in the
coronavirus supplemental appropriations acts, summarized incoronavirus supplemental appropriations acts, summarized in Appendix B). FY2022 and FY2023 amounts include funding for the Advanced Research Projects Agency for Health (ARPA-H). PB denotes “President’s Budget.” PB denotes “President’s Budget.”
a. FY2003 was the year that NIH received the most program level funding (prior to FY2022) in a. FY2003 was the year that NIH received the most program level funding (prior to FY2022) in
dol ars. dol ars.
Congressional Research Service Congressional Research Service
link to page link to page
Appendix A. NIH Funding Details
Table A-1. National Institutes of Health Funding
(budget authority, in millions of dollars) (budget authority, in millions of dollars)
FY2023
Institutes/Centers
Request
Cancer Institute (NCI) Cancer Institute (NCI)
$6, $6,
$6, $6,
Heart, Lung, and Blood Institute (NHLBI) Heart, Lung, and Blood Institute (NHLBI)
$3, $3,
$3, $3,
Dental/Craniofacial Research (NIDCR) Dental/Craniofacial Research (NIDCR)
$ $
Diabetes/Digestive/Kidney (NIDD Diabetes/Digestive/Kidney (NIDDK)a
$2, $2,
$2, $2,
$2, $2,
Neurological Disorders/Stroke (NINDS) Neurological Disorders/Stroke (NINDS)
$2, $2,
$2, $2,
$2, $2,
Allergy/Infectious Diseases (NIAID) Allergy/Infectious Diseases (NIAID)
$6, $6,
$6, $6,
General Medical Sciences (NIGMS General Medical Sciences (NIGMS)b
$1, $1,
$1, $1,
Child Health/Human Development (NICHD) Child Health/Human Development (NICHD)
$1, $1,
$1, $1,
National Eye Institute (NEI) National Eye Institute (NEI)
$ $
Environmental Health Sciences (NIEHS Environmental Health Sciences (NIEHS)c
$ $
National Institute on Aging (NIA) National Institute on Aging (NIA)
$ $
$4, $4,
$4, $4,
Arthritis/Musculoskeletal/Skin Diseases Arthritis/Musculoskeletal/Skin Diseases
$ $
(NIAMS) (NIAMS)
Deafness/Communication Disorders Deafness/Communication Disorders
$ $
(NIDCD) (NIDCD)
Alcohol Abuse/Alcoholism (NIAAA) Alcohol Abuse/Alcoholism (NIAAA)
$ $
Nursing Research (NINR) Nursing Research (NINR)
$ $
National Institute on Drug Abuse (NIDA) National Institute on Drug Abuse (NIDA)
$1, $1,
National Institute of Mental Health (NIMH) National Institute of Mental Health (NIMH)
$2, $2,
$2, $2,
Human Genome Research Institute (NHGRI) Human Genome Research Institute (NHGRI)
$ $
Biomedical Imaging/Bioengineering (NIBIB) Biomedical Imaging/Bioengineering (NIBIB)
$ $
Complementary/Integrative Health (NCCIH) Complementary/Integrative Health (NCCIH)
$ $
Minority Health/Health Disparities (NIMHD) Minority Health/Health Disparities (NIMHD)
$ $
Fogarty International Center (FIC) Fogarty International Center (FIC)
$ $
$96 $96
$ $
National Library of Medicine (NLM) National Library of Medicine (NLM)
$ $
Advancing Translational Sciences (NCATS) Advancing Translational Sciences (NCATS)
$ $
Office of Director Office of Director (OD)d
$2, $2,
$2, $2,
$2, $2,
Request Enacted PHS Program Evaluation (provided to $1,309 $1,272 $1,412 NIGMS) Superfund (Interior approp. to NIEHS)g $83 $83 $83 Mandatory type 1 diabetes funds (to $141 $141 $141 NIDDK)h Pandemic Preparednessi (proposed — $12,050 — mandatory)i NIH Program Level $46,183 $62,508 $49,183 Source: The FY2023 enacted, FY2023 request and FY2022 enacted amounts are from
Notes: Totals may differ from the sum of the components due to rounding. Amounts in table may differ from 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 suchactuals in many cases. By convention, budget tables such as Table A-1 do not subtract the amount of transfers do not subtract the amount of transfers
to the evaluation tap from the agencies’ appropriation. In general, amounts provided to NIH for emergency 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 provided in the requirements are excluded from these totals (e.g., FY2021 amounts do not include the amounts provided in the
coronavirus supplemental appropriations acts, summarized incoronavirus supplemental appropriations acts, summarized in Appendix B).
a. Amounts for the NIDDK do not include mandatory funding for type 1 diabetes research (see note a. Amounts for the NIDDK do not include mandatory funding for type 1 diabetes research (see note
b. Amounts for NIGMS do not include funds from PHS Evaluation Set-Aside (§241 of the PHS Act). 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 Appropriations amount for Superfund research c. Amounts for NIEHS do not include Interior/Environment Appropriations amount for Superfund research
(see note (see note
d. Includes $12.6 mil ion transfer from the Pediatric Research Initiative Fund (PRIF) as authorized by the d. Includes $12.6 mil ion transfer from the Pediatric Research Initiative Fund (PRIF) as authorized by the
Gabriella Mil er Kids First Research Act Gabriella Mil er Kids First Research Act P.L. 113-94). .
e. The amount shown for the NIH Innovation Account in each column represents only a portion of the total e. The amount shown for the NIH Innovation Account in each column represents only a portion of the total
appropriation to the account appropriation to the account
The remaining funds for The remaining funds for this account are reflected, where applicable, into the totals for other ICs. For this account are reflected, where applicable, into the totals for other ICs. For
FY2022, this includes $194 mil ion to NCI for cancer research and $76 mil ion to each of NINDS and NIMH FY2022, this includes $194 mil ion to NCI for cancer research and $76 mil ion to each of NINDS and NIMH
for the BRAIN Initiative ($152 mil ion total for BRAIN). For FY2023, this includes $216 mil ion to NCI for for the BRAIN Initiative ($152 mil ion total for BRAIN). 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).cancer research and $225 mil ion to each of NINDS and NIMH for the BRAIN Initiative ($450 mil ion total).
new agency anywhere within the department within 30 days of enactment. On March 30, 2022, HHS new agency anywhere within the department within 30 days of enactment. On March 30, 2022, HHS
Secretary Secretary
within the NIH; therefore, ARPA-H is shown within NIH in this tablewithin the NIH; therefore, ARPA-H is shown within NIH in this table
to Superfund research. to Superfund research.
was most recently extended through FY2023 by the Consolidated Appropriations Act, 2021 (P.L. 116-260; was most recently extended through FY2023 by the Consolidated Appropriations Act, 2021 (P.L. 116-260;
Division BB, Title II). Division BB, Title II).
the enacted funding levels for FY2022 and FY2023 ($150 mil ion). According to the budget request, the the enacted funding levels for FY2022 and FY2023 ($150 mil ion). According to the budget request, the
FY2022 and FY2023 amounts reflect sequestration of $8.55 mil ion. See “Budget Mechanism Table,” p. 44 in FY2022 and FY2023 amounts reflect sequestration of $8.55 mil ion. See “Budget Mechanism Table,” p. 44 in
https://officeofbudget.od.nih.gov/pdfs/FY23/br/Overview%20of%20FY%202023%20Presidents%20Budget.pdf. https://officeofbudget.od.nih.gov/pdfs/FY23/br/Overview%20of%20FY%202023%20Presidents%20Budget.pdf.
bil ion of the total designated for NIH. bil ion of the total designated for NIH.
purposes, whereas the President proposes amounts in his annual budget request.purposes, whereas the President proposes amounts in his annual budget request.
relatively new practice that has expanded since FY2015.relatively new practice that has expanded since FY2015.
specify NIH funding for particular diseases or areas of research in the appropriations process and specify NIH funding for particular diseases or areas of research in the appropriations process and
instead allows the ICs to award funding within their mission areas based on their own strategic instead allows the ICs to award funding within their mission areas based on their own strategic
planning and priority-setting processes. Research funding is generally awarded on a flexible and planning and priority-setting processes. Research funding is generally awarded on a flexible and
competitive basis through various funding mechanisms intended to balance scientific and health competitive basis through various funding mechanisms intended to balance scientific and health
priorities.priorities.
In In
funding for designated purposes, as summarized ifunding for designated purposes, as summarized in Table A-2.
a certain amount for a certain purpose; in other cases, the language provides increased or 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 additional funding. The appropriations reports also include many additional statements directing
the agency to prioritize certain programs or areas of research, as well as statements expressing the the agency to prioritize certain programs or areas of research, as well as statements expressing the
opinion or concerns of Congress regarding NIHopinion or concerns of Congress regarding NIH
Table A-2. Specified NIH Funding Levels in
Institute/Center
Program/Activity
Amount
National Cancer Institute Childhood Cancer Data Initiative (CCDI) Childhood Cancer Data Initiative (CCDI)
No less than $50 mil ion (NCI) including no less than $750 thousand to continue to support enhancement of the CCDI Molecular Characterization Initiative.
No less than $30 mil ion No less than $30 mil ion
Access, and Research (STAR) Act Access, and Research (STAR) Act
Development, and CRS Report R47019, and CRS Report R47019, The Executive Budget Process: An Overview. .
longstanding practice, the agreement does not recommend a specific amount of NIH funding for this purpose longstanding practice, the agreement does not recommend a specific amount of NIH funding for this purpose
[Alzheimer’s disease] or for any other individual disease. Doing so would establish a dangerous precedent that could [Alzheimer’s disease] or for any other individual disease. Doing so would establish a dangerous precedent that could
politicize the NIH peer review system. Nevertheless, in recognition that Alzheimer’s disease poses a serious threat to politicize the NIH peer review system. Nevertheless, in recognition that Alzheimer’s disease poses a serious threat to
the Nation’s long-term health and economic stability, the agreement expects that a significant portion of the the Nation’s long-term health and economic stability, the agreement expects that a significant portion of the
recommended increase for NIA should be directed to research on Alzheimer's. The exact amount should be determined recommended increase for NIA should be directed to research on Alzheimer's. The exact amount 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 Alzheimer’s relative to those submitted for other diseases.” See for Alzheimer’s relative to those submitted for other diseases.” See Congressional Record, daily edition, vol. 160, no. , daily edition, vol. 160, no.
151, Book II (December 11, 2014), p. H9832. 151, Book II (December 11, 2014), p. H9832.
25 Congressional Record, vol. 168, no. 198, Book II, December 20, 2022, pp. S8881-S8887, S8853. 26 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. 117-403 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” (Congressional Record, vol. 168, no. 198, Book II, December 20, 2022, p. S8874). Congressional Research Service 12 link to page 19 link to page 19 link to page 19
Institute/Center
Program/Activity
Amount
$ $
Research Initiatives of the Accelerating Access to of the Accelerating Access to
Critical Therapies for ALS Act Critical Therapies for ALS Act
(P.L. 117-79)(P.L. 117-79)
Neurotechnologies (BRAIN) Initiative Neurotechnologies (BRAIN) Initiative
mil ion for the Human Brain mil ion for the Human Brain
Cell Atlas, $Cell Atlas, $
Armamentarium for Brain Cell Armamentarium for Brain Cell
Access, and $Access, and $
Brain Connectivity Map Brain Connectivity Map
Foreign Threats to Research $5 mil ion transferred from NIH to the Inspector General to conduct investigation into foreign threats to research* Common Fund Increase of $65 mil ion Office of Nutrition Research (ONR)a $40 mil ion Cybersecurity $265 mil ion an increase of $40 mil ion Development Delays $100 mil ion Environmental Influences on Child Health $180 mil ion, the same level as Outcomes (ECHO)a FY2022 Firearm injury and mortality prevention research Firearm injury and mortality prevention research
$12.5 mil ion $12.5 mil ion, the same level as FY2022
HHS Office of Extramural Research allocation for HHS Office of Extramural Research allocation for
$2.5 mil ion $2.5 mil ion
foreign influence foreign influence
Investigation of Co-Occurring Conditions Across Investigation of Co-Occurring Conditions Across
No less than $ No less than $
the Lifespan to Understand Down Syndrome the Lifespan to Understand Down Syndrome
Office of AIDS Research, for HIV/AIDS research Office of AIDS Research, for HIV/AIDS research
Office of Research on Women's Health (ORWH) Office of Research on Women's Health (ORWH)
$ $
Interdisciplinary Research Interdisciplinary Research
Careers in Women’s Health Careers in Women’s Health
(BIRCWH) program(BIRCWH) program
. $10 mil ion to establish an Office of Autoimmune Disease Research (OADR). $2 mil ion to contract NASEM on a study on gaps in knowledge of women’s health. Office of the Chief Officer for Scientific Office of the Chief Officer for Scientific
$ $
Workforce Diversity (COSWD) Workforce Diversity (COSWD)
Source: Congressional Record, vol. 168, no. , vol. 168, no.
the explanatory statement, “Unless otherwise noted, the language set forth in H.Rept. 117-the explanatory statement, “Unless otherwise noted, the language set forth in H.Rept. 117-
weight as Congressional Research Service Congressional Research Service
15 15
link to page link to page
Cures Act (split between NINDS and NIMH in FY2022 appropriations). Cures Act (split between NINDS and NIMH in FY2022 appropriations).
16 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 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) accounts and as transfers from the Public Health and Social Services Emergency Fund (PHSSEF)
account as provided by four coronavirus supplemental appropriations acts:account as provided by four coronavirus supplemental appropriations acts:
Second Measure: Division B of the Coronavirus Aid, Relief, and Economic Division B of the Coronavirus Aid, Relief, and Economic Security Act (CARES Security Act (CARES
Third Measure: Division B of the Paycheck Protection Program and Health Division B of the Paycheck Protection Program and Health Care Enhancement Care Enhancement
Fourth Measure: Division M of Consolidated Appropriations Act, 2021 (P.L. Division M of Consolidated Appropriations Act, 2021 (P.L. 116-260), enacted on 116-260), enacted on
NIH received a total of $3.031 billion to NIH IC accounts, along with directed transfers from the 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, 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 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, 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 2024, and all transfers from the PHSSEF are available until expended. This funding was primarily
provided in three categories: provided in three categories:
Broadly Available Funding. In the first (P.L. 116-123) and third measure (CARES Act; P.L. 116-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 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 respond to coronavirus, domestically and internationally.” NIH IC accounts that received broadly
available funds and their totals include the following: available funds and their totals include the following:
National Institute of Allergy and Infectious Diseases (NIAID): $1.542 billion, $1.542 billion,
including $836 million in the first measure and $706 million in the CARES Act. 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 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 appropriations. The first measure directed a transfer of not less than $10 million
to the National Institute of Environmental Health Sciences (NIEHS) for “worker-to the National Institute of Environmental Health Sciences (NIEHS) for “worker-
based training to prevent and reduce exposure of hospital employees, emergency based training to prevent and reduce exposure of hospital employees, emergency
first responders, and other workers who are at risk of exposure to coronavirus 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 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 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 acquisition of equipment for, vaccine and infectious diseases research facilities of
or used by NIH, including the acquisition of real property.” or used by NIH, including the acquisition of real property.”
National Heart, Lung, and Blood Institute (NHLBI):: $103 million in the $103 million in the
CARES Act. CARES Act.
National Institute of Biomedical Imaging and Bioengineering (NIBIB): $60 $60
million in the CARES Act. million in the CARES Act.
116-127), enacted on March 18, 2020. 116-127), enacted on March 18, 2020.
Congressional Research Service Congressional Research Service
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National Institutes of Health (NIH) Funding: FY1996-FY2023
National Library of Medicine (NLM): $10 million in the CARES Act. National Center for Advancing Translational Sciences (NCATS): $36 million $36 million
in the CARES Act. in the CARES Act.
Office of the Director (OD): $30 million in the CARES Act. $30 million in the CARES Act.
Diagnostic Testing Research and Development (R&D). In the fourth In the fourth
test R&D. This funding was directed to NIH as “not less than” transfers from the PHSSEF 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 account in the fourth measure, and directly to the OD account in the fifth measure. These amounts
included the following: included the following:
National Cancer Institute (NCI): Transfer of not less than $306 million from Transfer of not less than $306 million from
PHSSEF to NCI “to develop, validate, improve, and implement serological PHSSEF to NCI “to develop, validate, improve, and implement serological
testing and associated technologies” in the testing and associated technologies” in the
NIBIB: Transfer of not less than $500 million from PHSSEF to NIBIB “to Transfer of not less than $500 million from PHSSEF to NIBIB “to
accelerate research, development, and implementation of point of care and other accelerate research, development, and implementation of point of care and other
rapid testing related to coronavirus” in the rapid testing related to coronavirus” in the
OD: Transfer of not less than $1 billion from PHSSEF to OD “to develop, Transfer of not less than $1 billion from PHSSEF to OD “to develop,
validate, improve, and implement testing and associated technologies; to validate, improve, and implement testing and associated technologies; to
accelerate research, development, and implementation of point of care and other accelerate research, development, and implementation of point of care and other
rapid testing; and for partnerships with governmental and non-governmental rapid testing; and for partnerships with governmental and non-governmental
entities” in the entities” in the
$1.250 billion total provided to the OD account is for “the Rapid Acceleration of $1.250 billion total provided to the OD account is for “the Rapid Acceleration of
Diagnostics.” Diagnostics.”
NIH’s Rapid Acceleration of Diagnostics (RADx) initiative is an effort to innovate and scale up 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 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 and OD in the fourth measure was used to support RADx initially, with additional funds in the
fifth measure as specified above.fifth measure as specified above.
Long-Term Studies of COVID-19. The fifth measure directed $1.15 billion of the total $1.The fifth measure directed $1.15 billion of the total $1.
billion provided to the OD account “for research and clinical trials related to long-term studies of 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 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 Enhance Recovery (RECOVER) Initiative, a large coordinated research initiative to study
COVID.COVID.
transferred to other IC accounts (in addition to other HHS transfer authorities in the law). transferred to other IC accounts (in addition to other HHS transfer authorities in the law).
faqs#paid. As reported by the Government Accountability Office (GA)-22-105497), HHS transferred $1,063.5 million 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’ of the $1.25 appropriation for NIH OD in the fifth measure to the Administration for Children and Families’
Unaccompanied Children Program (see Unaccompanied Children Program (see “Appendix: HHS COVID-19 FundingAppendix: HHS COVID-19 Funding,” GAO-22-105397). NIH’s RECOVER website states that ). 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 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.” the $1.15 billion budget remains and NIH RECOVER research activities have neither stopped nor had any delays.”
Congressional Research Service Congressional Research Service
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Initiative (see above) after an initial transfer of $1,063.5 from NIH to HHS’s Administration for Children and 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 Families’ Unaccompanied Children Program of the original appropriation for that program in the fifth measure
(see (see
Congressional Research Service Congressional Research Service
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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 Advanced Research Projects Agency for Health
DARPA
Defense Advanced Research Projects Agency Defense Advanced Research Projects Agency
DOD
Department of Defense Department of Defense
FIC
Fogarty International Center Fogarty International Center
FY
Fiscal Year Fiscal Year
IC
Institutes and Centers Institutes and Centers
NASEM
National Academies of Sciences, Engineering, and Medicine National Academies of Sciences, Engineering, and Medicine
NCATS
National Center for Advancing Translational Sciences National Center for Advancing Translational Sciences
NCCIH
National Center for Complementary and Integrative Health National Center for Complementary and Integrative Health
NCI
National Cancer Institute National Cancer Institute
NEF
Nonrecurring Expenses Fund Nonrecurring Expenses Fund
NEI
National Eye Institute National Eye Institute
NHGRI
National Human Genome Research Institute National Human Genome Research Institute
NHLBI
National Heart, Lung, and Blood Institute National Heart, Lung, and Blood Institute
NIA
National Institute on Aging National Institute on Aging
NIAAA
National Institute on Alcohol Abuse and Alcoholism National Institute on Alcohol Abuse and Alcoholism
NIAID
National Institute of Allergy and Infectious Diseases National Institute of Allergy and Infectious Diseases
NIAMS
National Institute of Arthritis and Musculoskeletal and Skin Diseases National Institute of Arthritis and Musculoskeletal and Skin Diseases
NIBIB
National Institute of Biomedical Imaging and Bioengineering National Institute of Biomedical Imaging and Bioengineering
NICHD
National Institute of Child Health and Human Development National Institute of Child Health and Human Development
NIDA
National Institute on Drug Abuse National Institute on Drug Abuse
NIDCD
National Institute on Deafness and Other Communication Disorders National Institute on Deafness and Other Communication Disorders
NIDCR
National Institute of Dental and Craniofacial Research National Institute of Dental and Craniofacial Research
NIDDK
National Institute of Diabetes and Digestive and Kidney Diseases National Institute of Diabetes and Digestive and Kidney Diseases
NIEHS
National Institute of Environmental Health Sciences National Institute of Environmental Health Sciences
NIGMS
National Institute of General Medical Sciences National Institute of General Medical Sciences
NIMH
National Institute of Mental Health National Institute of Mental Health
NIMHD
National Institute on Minority Health and Health Disparities National Institute on Minority Health and Health Disparities
NINDS
National Institute of Neurological Disorders and Stroke National Institute of Neurological Disorders and Stroke
NINR
National Institute of Nursing Research National Institute of Nursing Research
NLM
National Library of Medicine National Library of Medicine
OD
NIH Office of the Director NIH Office of the Director
PHS
Public Health Service Public Health Service
Congressional Research Service Congressional Research Service
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National Institutes of Health (NIH) Funding: FY1996-FY2023
Author Information
Kavya Sekar Kavya Sekar
Analyst in Health Policy Analyst in Health Policy
Acknowledgments
CRS Research CRS Research
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