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

Changes from March 8, 2023 to May 17, 2023

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National Institutes of Health (NIH) Funding: FY1996-
~~FY2023~~
~~March 8~~FY2024 May 17, 2023 , 2023
Kavya Sekar
This report details the National Institutes of Health (NIH) budget and appropriations process with This report details the National Institutes of Health (NIH) budget and appropriations process with
Analyst in Health Policy Analyst in Health Policy
a focus on a focus on ~~FY2022 and FY2023~~FY2023 and FY2024. NIH is the primary federal agency charged with conducting and . NIH is the primary federal agency charged with conducting and

supporting medical, health, and behavioral research. It is made up of 27 Institutes and Centers supporting medical, health, and behavioral research. It is made up of 27 Institutes and Centers
and the Office of the Director (OD). More than 84% of the NIH budget funds extramural research and the Office of the Director (OD). More than 84% of the NIH budget funds extramural research

through grants, contracts, and other awards to universities and other research institutions. About through grants, contracts, and other awards to universities and other research institutions. About
10% of NIH funding goes to intramural researchers at NIH-operated facilities. Almost all of NIH’s funding is provided in the 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 Agencies (LHHS) Appropriations 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) 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. Appropriations Act and a mandatory budget authority for type 1 diabetes research.
The FY2023 NIH program level of $49.183 billion represents a $3 billion increase (+6.5%) relative to FY2022 enacted The FY2023 NIH program level of $49.183 billion represents a $3 billion increase (+6.5%) relative to FY2022 enacted
program level. The FY2023 enacted total for NIH is also $13.324 billion (-21.3%) less than the FY2023 budget request program level. The FY2023 enacted total for NIH is also $13.324 billion (-21.3%) less than the FY2023 budget request
program level. (The budget request included a $12 billion pandemic preparedness mandatory appropriations proposal that 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 receive an increase relative to FY2022 was not adopted by Congress.) In FY2023, all Institute and Center (IC) accounts receive an increase relative to FY2022
funding levels (seefunding levels (see Table A-1). In addition, the NIH FY2023 program level in this CRS report includes $1.5 billion . In addition, the NIH FY2023 program level in this CRS report includes $1.5 billion in FY2023 funding for the for the
Advanced Research Projects Agency for Health (ARPA-H), a new agency within NIH that was first funded in FY2022. Advanced Research 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 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 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.~~
within NIH by statute. The FY2024 budget request for NIH proposes an increase of $1.92 billion (+3.9%) relative to the FY2023 enacted funding level. Under this request, most ICs would receive no changes in funding compared with FY2023 enacted levels. The FY2024 budget request also proposes $2.5 billion for ARPA-H, an increase of $1.0 billion from the FY2023 enacted level. The request also proposes $2.69 billion in new mandatory appropriations for pandemic preparedness to be made available for five years. Accounting for this proposed mandatory funding, NIH and ARPA-H would receive a total FY2024 program level of $53.788 billion, a $4.610 billion (+9.4%) increase from FY2023 enacted levels. NIH has seen periods of high and low funding growth during the period covered by this report, as illustrated inNIH has seen periods of high and low funding growth during the period covered by this report, as illustrated in Figure 1.
Between FY1996 and FY1998, funding for NIH grew from $11.928 billion to $13.675 billion (nominal dollars). Over the 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 FY2003. In each of FY1999 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 to FY2015, NIH funding increased 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, and FY2013), agency funding decreased in nominal more gradually in nominal dollars. In some years (FY2006, FY2011, and FY2013), agency funding decreased in nominal
dollars. From FY2016 through FY2023, NIH has seen funding increases each year. dollars. From FY2016 through FY2023, NIH has seen funding increases each year.
When looking at NIH funding adjusted for inflation (in projected constant FY2022 dollars using the Biomedical Research 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 FY2003—the last year of 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 until funding increases were provided 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 FY2023. In inflation-adjusted dollars, the FY2023 program level is 1.2% greater than the FY2003 in each of FY2016 through FY2023. 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 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 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.FY2023 program level is -1.9% less than the FY2003 level. The FY2024 proposed inflation-adjusted NIH program level is 1.9% greater than the FY2003 program level, but -2.7% less than the FY2003 level when excluding proposed ARPA-H funding.
This CRS report details NIH budget and appropriations for This CRS report details NIH budget and appropriations for ~~FY2022 and FY2023~~FY2023 and FY2024, and provides an overview of funding trends , and provides an overview of funding trends
in regular appropriations to the agency from FY1996 to in regular appropriations to the agency from FY1996 to ~~FY2023~~FY2024 (proposed). Coronavirus supplemental funding for NIH is discussed in . Coronavirus supplemental funding for NIH is discussed in
Appendix B of the reportof the report, but is generally not included in the budgetary figures elsewhere in the but is generally not included in the budgetary figures elsewhere in the ~~repor~~treport. Appendix A includes includes
funding tables by account and program-specific funding levels for FY2023.funding tables by account and program-specific funding levels for FY2023. Appendix C provides a list of acronyms and provides a list of acronyms and
abbreviations used in the report. abbreviations used in the report.

Congressional Research Service Congressional Research Service

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NIH Funding: FY1996-FY2023
This report details the National Institutes of Health (NIH) budget and appropriations process with This report details the National Institutes of Health (NIH) budget and appropriations process with
a focus on FY2022a focus on FY2022 ~~and FY2023~~, FY2023, and the FY2024 request. Almost all of NIH’s funding is provided in the annual . Almost all of NIH’s funding is provided in the annual
Departments of Labor, Health and Human Services, and Education, and Related Agencies 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, (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 Environment, and Related Agencies (INT) Appropriations Act and a mandatory budget authority
for type 1 diabetes research.1 for 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 agencies that make up the Public Health Service (PHS) within the Department of Health and 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 (OD) and 27 Institutes 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 biomedical science. Of Centers (ICs) that focus on aspects of health, human development, and biomedical science. Of
these, 24 ICs and OD support research programs. The OD sets overall policy for NIH and these, 24 ICs and OD support research programs. The OD sets overall policy for NIH and
coordinates the programs and activities of all NIH components, particularly in areas of research coordinates the programs and activities of all NIH components, particularly in areas of research
that involve multiple institutes. Through the annual appropriations process, Congress provides 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 funding to the 24 research ICs, OD, and a Buildings and Facilities account. Three support centers
are funded through transfers from other accounts. 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 84% collection and dissemination.3 More than 84%
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
disease emergencies, such as for the Ebola and Zika disease emergencies, such as for the Ebola and Zika
outbreaks. Given ongoing interest, a summary of the outbreaks. Given ongoing interest, a summary of the
FY2020 and FY2021 amounts for the Coronavirus FY2020 and FY2021 amounts for the Coronavirus
Disease 2019 (COVID-19) pandemic is provided in Disease 2019 (COVID-19) pandemic is provided in
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). HHS also made an 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 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. operating division, the Administration for Strategic Preparedness and Response.
3 For further information on the National Institutes of Health (NIH), see CRS Report R41705, 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. Congressional Research Service Congressional Research Service

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National Institutes of Health (NIH) Funding: FY1996-~~FY2023~~FY2024

institutions around the country.4 About 10% of the agency’s budget supports intramural research 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 (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 located on the NIH campus in Bethesda, MD.5
Funding Sources
The vast majority of NIH funding comes from annual discretionary appropriations. NIH The vast majority of NIH funding comes from annual discretionary appropriations. NIH
additionally receives some mandatory funding and other funding due to unique transfer or additionally receives some mandatory funding and other 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 transfers, is referred to as the NIH “program level.”6 of add-ons and 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 LHHS Appropriations Acts, with an additional smaller amount for the Superfund Research annual LHHS Appropriations Acts, with an additional smaller amount for the Superfund Research
Program and related activities from the INT Appropriations Act.7 Program and related activities from the INT 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 directed transfers of specific amounts of “tap” funding to selected HHS programs. In the and have directed transfers of specific amounts of “tap” funding to selected HHS programs. In the
context of NIH, these transfers have been made to National Institute of General Medical Sciences context of NIH, these transfers have been made to National Institute of General Medical Sciences
in recent years.9 Since FY2010, and including in FY2023, this higher maximum set-aside level in recent years.9 Since FY2010, and including in FY2023, this higher maximum set-aside level
has been 2.5% of eligible appropriations.10 By convention, totals in this report and NIH source has been 2.5% of eligible appropriations.10 By convention, totals in this report and NIH source
documents include amounts “transferred in” pursuant to the PHS tap as directed by appropriations 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. 4 NIH, “What We Do - Budget,” August, 2022, at https://www.nih.gov/about-nih/what-we-do/budget.
5 Ibid. 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, and mandatory pandemic preparedness funding proposed in the FY2023 budget. (NEF), and, when applicable, and mandatory pandemic preparedness funding proposed in the FY2023 budget.
7 The Hazardous Substance Basic Research and Training Program (Superfund Research Program) funds research on the 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. 117-328 for the FY2023 maximum set-aside level. The last time that 10 See Section 204 of Division H, Title II, of P.L. 117-328 for the FY2023 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 FY2023 omnibus also retained a change to this provision, first included in the FY2014 omnibus, allowing 111-8). The FY2023 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” measures or proposed in the budget request, but do not include any amounts “transferred out”
under this same authority. under this same authority.
21st Century Cures Act Innovation Account: NIH also receives funding through LHHS NIH also receives funding through LHHS
appropriationsappropriations, subject to different budget enforcement rules than the rest of the NIH funding in 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 act: appropriations to the NIH Innovation Account created by the 21st Century Cures Act (“the
Cures Act,” P.L. 114-255) to fund programs authorized by the act for FY2017 through FY2026.11 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 year—the 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 limits (i.e., 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 authorized by the 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 may transfer these 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 the purposes amounts from the NIH Innovation Account to other NIH accounts, but only for the purposes
specified in the Cures Act. All amounts authorized by the Cures Act have been fully appropriated specified in the Cures Act. All amounts authorized by the Cures Act have been fully appropriated
to the Innovation Account from FY2017 to FY2023, including $1.085 billion for FY2023. to the Innovation Account from FY2017 to FY2023, including $1.085 billion for FY2023.
For FY2024, $407 million is authorized to be appropriated. Mandatory Type I Diabetes Funding: In addition, NIH has received mandatory funding of $150 In addition, NIH has received mandatory funding of $150
million annually that is provided in Public Health Service Act (PHSA) Section 330B for a special million 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 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). 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~~
~~enacting the Consolidated Appropriations Act, 2022 (P.L. 117-103), which included final FY2022~~
~~LHHS appropriations in Division H and Interior/Environment appropriations in Division G. The~~
~~enacted FY2022 NIH program level was made up of the following (see Table A-1):~~
~~ $43.65 billion in discretionary LHHS budget authority (nontransfer);~~
~~ $1.309 billion pursuant to the PHS program evaluation transfer;~~
~~ $83 million for the Superfund research program and related activities from~~
~~Interior/Environment appropriations; and~~
~~ $141 million in annual funding for the mandatory type 1 diabetes research~~
~~program.13~~
~~In total, the NIH FY2022 program level as enacted was $45.183 billion. In addition, the law~~
~~provided $1 billion for the Advanced Research Projects Agency for Health (ARPA-H) to a new~~
~~account under the Office of the Secretary with funding available until the end of FY2024. The~~
~~law allowed the HHS Secretary to place the new agency anywhere within the department within~~
~~30 days of enactment. On March 30, 2022, HHS Secretary Xavier Becerra submitted a notice to~~
~~the appropriations committees that ARPA-H was to reside within the NIH. Accounting for the~~
~~ARPA-H transfer, the NIH FY2022-enacted program level was $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 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.~~
~~13 HHS, Budget in Brief: FY2023, 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)~~
Advanced Research Projects Agency for Health (ARPA-H) President Biden’s FY2022 budget request to Congress proposed the creation of an Advanced Research Projects 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 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, 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) 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. 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 $1 bil ion to HHS to Consolidated Appropriations Act, 2022 (P.L. 117-103), provided $1 bil ion to HHS to
establish the Advanced Research Projects Agency for Health (ARPA-H). The law created a new ARPA-H account establish the Advanced Research Projects Agency for Health (ARPA-H). The law created a new ARPA-H account
at HHS, with funding available until September 30, 2024, and allowed the HHS Secretary to place the new agency at HHS, with funding available until September 30, 2024, and allowed the HHS Secretary to place the new agency
anywhere within the department within 30 days of enactment. On March 30, 2022, HHS Secretary Xavier Becerra 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 was to submitted a notice to the appropriations committees that ARPA-H was to ~~reside~~be housed within the NIH, while the ARPA- within the NIH, while the ARPA-
H Director H Director iswas to report directly to the HHS Secretary. to report directly to the HHS Secretary.
The Consolidated Appropriations Act, 2023 (P.L. 117-328)The Consolidated Appropriations Act, 2023 (P.L. 117-328), provided additional funding of $1.5 bil ion for ARPA- provided additional funding of $1.5 bil ion for ARPA-
H, H, available until the end of FY2025, in a separate account under the HHS Office of the Secretary. The law also 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 IIformally 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 statuteSection 2331. The new authorization places ARPA-H within NIH by statute.
with the Director reporting to the HHS Secretary. 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 would have provided NIH with a total program level of President Biden’s FY2023 budget request would have provided NIH with a total program level of
$62.$62.~~503~~508 billion, an increase of $16. billion, an increase of $16.~~320~~330 billion (+35. billion (+35.34%) from FY2022%) from FY2022- enacted levels. The enacted levels. The
proposed FY2023 program level would have provided proposed FY2023 program level would have provided ~~the following~~ (se(see Table A-1):
~~ $48.962~~ • $43.962 billion in discretionary LHHS budget authority (nontransferbillion in discretionary LHHS budget authority (nontransfer; does not include funding for ARPA-H); •);
 $1.272 billion pursuant to the PHS program evaluation transfer; $1.272 billion pursuant to the PHS program evaluation transfer;
 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. Congressional Research Service 3 link to page 14 National Institutes of Health (NIH) Funding: FY1996-FY2024 • $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;~~14 and~~13
• $12.05 billion in proposed mandatory appropriations for pandemic preparedness, $12.05 billion in proposed mandatory appropriations for pandemic preparedness,
to be available for five years to be available for five years~~.15~~
~~Under this request, approximately half of existing IC accounts would have received increases~~
~~compared with FY2022 enacted levels (see Appendix A). Funding for the National Institute on~~
~~Minority Health and Health Disparities (NIMHD) would have increased by the greatest~~
~~percentage amount (+$201 million, +43.7%), and funding for OD would have decreased 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~~

14;14 and • $5 billion for ARPA-H, to be available for three years. 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): • $46.042 billion in discretionary LHHS budget authority (nontransfer; does not include ARPA-H);15 • $1.412 billion in PHS program evaluation transfers; • $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.16 In total, the NIH FY2023 program level as enacted is $47.678 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 (see textbox above for further details). Accounting for the ARPA-H funding, the NIH FY2023 enacted program level is $49.178 billion. This FY2023 NIH program level is a $3 billion increase (+6.5%) relative to the FY2022 enacted program level of $46.178 billion. The FY2023 enacted total for NIH is also $13.329 billion (-21.3%) less than the FY2023 budget request. The difference between FY2023 enacted and FY2023 requested program level is primarily because Congress did not fund the Administration’s 13 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.

1514 The FY2023 budget request proposed an HHS-wide total of $81.7 billion for pandemic preparedness to “transform The FY2023 budget request proposed 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 would have been for “NIH research and development of biological threats.” The $12.05 billion directed to NIH would have been for “NIH research and development of
vaccines, diagnostics, and therapeutics against high priority viral families, biosafety and biosecurity, and to expand vaccines, diagnostics, and therapeutics against high priority viral families, biosafety and biosecurity, and to expand
laboratory capacity and clinical trial infrastructure.” See HHS, laboratory capacity and clinical trial infrastructure.” See HHS, Budget in Brief: FY2023, p. 55, https://www.hhs.gov/p. 55, https://www.hhs.gov/
sites/default/files/fy-2023-budget-in-brief.pdf. sites/default/files/fy-2023-budget-in-brief.pdf.
15 Includes some post-appropriations adjustments. 16 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 (42 U.S.C. §254c-2), as amended in P.L. 116-260, Division BB, Title III. According to the FY2024 budget request, the FY2023 amount reflects sequestration of $8.55 million. See “Appropriations Adjustments Table for FY 2023,” p. 102, at https://officeofbudget.od.nih.gov/pdfs/FY24/br/Overview%20of%20FY%202024%20Presidents%20Budget.pdf. Congressional Research Service 4 link to page 16 link to page 14 link to page 14~~Congressional Research Service~~

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~~Innovation Account. The FY2023 budget request also proposed $5 billion for ARPA-H, an~~
~~increase of $4 billion from the FY2022 enacted level.16~~
~~Under the pandemic preparedness proposal, NIH would have been provided $12.05 billion in new~~
~~mandatory appropriations available for five years. This new appropriation made up 73.8% of the~~
~~proposed increase of $16.325 billion relative to FY2022 enacted program level. The pandemic~~
~~preparedness proposal generally did not designate specific amounts for NIH ICs, but describes a~~
~~number of activities the new funding would support, including vaccine and therapeutic~~
~~development, diagnostic test development and innovation, research infrastructure for clinical~~
~~trials, and laboratory biosafety and biosecurity.17~~
~~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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~~Trends~~
~~Table 1~~ ~~outlines NIH program level funding from FY1996 until FY2023~~FY2024 $12 billion Pandemic Preparedness mandatory funding proposal17 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 Institutes and Centers (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. Among the ICs, the National Institute of Minority Health and Health Disparities (NIMHD) saw the largest percentage increase compared with FY2022 (+14.2%). Of the total $65 million increase for NIMHD, $25 million was directed for health disparities research in the explanatory statement.18 The explanatory statement also directed increases for certain diseases and research areas within NIH accounts (see Table A-2 ). For example, a $226 million total increase for Alzheimer’s disease and related dementias research across NIH, including increases specified for the National Institute of Neurological Disorders and Stroke ($75 million) and for the National Institute on Aging ($151 million).19 The explanatory statement also directed $75 million for implementing the Accelerating Access to Critical Therapies for ALS Act (ACT for ALS Act; P.L. 117-79), an increase of $50 million within the Office of the Director account.20 FY2024 Budget Request President Biden’s FY2024 budget request proposes a NIH total program level of $48.598 billion, an increase of $920 million (+1.9%) from FY2023 enacted levels. The proposed FY2024 program level would provide (see Table A-1) • $46.317 billion in discretionary LHHS budget authority (nontransfer); • $1.948 billion in PHS program evaluation transfers; • $83 million for the Superfund research program and related activities from Interior/Environment appropriations; and • $250 million in proposed funding for the mandatory type 1 diabetes research program.21 The FY2024 budget request also proposes $2.5 billion for ARPA-H, an increase of $1.0 billion from the FY2023 enacted level.22 Accounting for the ARPA-H funding, the FY2024 request includes a total program level of $51.098 billion for both NIH and ARPA-H, a proposed increase of $1.92 billion (3.9%) from the FY2023 enacted level. Under this request, almost all accounts would receive no changes in funding compared with FY2023 enacted levels (see Table A-1), except for the National Cancer Institute (+$503 million; +6.9%), the National Institute of Neurological Disorder and Stroke (+16 million; +0.6%), the 17 The FY2023 request proposed $12 billion in new mandatory appropriations for pandemic preparedness activities at NIH, to be made available for five years. This is out of a $81.7 billion HHS-wide total. See NIH, Overview of FY2023 Presidential Budget Proposal, p. 17, https://officeofbudget.od.nih.gov/pdfs/FY23/br/Overview%20of%20FY%202023%20Presidents%20Budget.pdf. 18 Congressional Record, vol. 168, no. 198 (December 20, 2022), p. S8884. 19 Congressional Record, vol. 168, no. 198 (December 20, 2022), pp. S8882-S8883. 20 Congressional Record, vol. 168, no. 198 (December 20, 2022), p. S8885. 21 Under current law, funding for the type 1 diabetes research program expires at the end of FY2023. See Public Health Service Act Sec. 330B; 42 U.S.C. §254c-2. 22 NIH, Overview of FY 2024 Presidential Budget Proposal, p. 100, https://officeofbudget.od.nih.gov/pdfs/FY24/br/Overview%20of%20FY%202024%20Presidents%20Budget.pdf. Congressional Research Service 5 link to page 20 link to page 12 link to page 11 National Institutes of Health (NIH) Funding: FY1996-FY2024 National Institute of Environmental Health Sciences (+$25 million; +2.7%), the National Institute of Mental Health (+$200 million; +8.5%), and the Office of the Director (+$251 million; +9.5%). (The National Institute of General Medical Sciences would be flat-funded when taking into account proposed PHS evaluation tap transfers.) The Innovation Account would receive the full amount authorized to be appropriated: $407 million.23 The budget request also proposes $2.69 billion in new mandatory appropriations for pandemic preparedness, to be made available for five years. Accounting for this proposed mandatory funding, NIH and ARPA-H would receive a total FY2024 program level of $53.788 billion, a $4.61 billion (+9.4%) increase from FY2023 enacted. (CRS follows conventions used in the budget request documents and treats the pandemic preparedness proposed funding as a non-add within the request.) The pandemic preparedness proposal generally did not designate specific amounts for NIH ICs but describes a number of activities the new funding would support, including vaccine and therapeutic development, expanding laboratory capacity, manufacturing drugs for research, and developing next-generation diagnostics to fill critical gaps.24 The Administration estimates that the proposed FY2024 funding level would support 44,410 research project grants, an increase of 790 from FY2023 enacted, with a total of 10,414 new and competing grants.25 With respect to specific research areas and initiatives, some selected funding requests include (see Table A-3 for a full list) the following: 26 • Cancer Moonshot: $716 million total for the Cancer Moonshot initiative at the National Cancer Institute, an increase of $500 million more than FY2023 enacted. This research would support the President’s goal of reducing the cancer death rate by half within 25 years and improving the lives of people with cancer and cancer survivors. • All of US Precision Medicine Initiative and Brain Research Through Advancing Innovative Neurotechnologies (BRAIN): An additional $462 million to continue these two initiatives authorized by the 21st Century Cures Act. • Innovating mental health research and treatment: An increase of $200 million to support better diagnostics, improved treatments, and enhanced precision of care for mental health. • Impact of climate change on human health: Increase of $25 million. Trends Table 1 outlines NIH program level funding from FY1996 to the FY2024 request.. Figure 1 illustrates illustrates
funding trends in both current (also called nominal dollars) and projected constant (i.e., inflation-funding trends in both current (also called nominal dollars) and projected constant (i.e., inflation-
adjusted) FY2022 dollars (funding shown is total budget authority). 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
23 NIH, Overview of FY 2024 Presidential Budget Proposal, p. 7, https://officeofbudget.od.nih.gov/pdfs/FY24/br/Overview%20of%20FY%202024%20Presidents%20Budget.pdf. 24 NIH, Overview of FY 2024 Presidential Budget Proposal, p. 7, https://officeofbudget.od.nih.gov/pdfs/FY24/br/Overview%20of%20FY%202024%20Presidents%20Budget.pdf. 25 HHS, Budget in Brief: FY2024, p. 47, https://www.hhs.gov/sites/default/files/fy-2024-budget-in-brief.pdf. 26 HHS, Budget in Brief: FY2024, pp. 47-51, https://www.hhs.gov/sites/default/files/fy-2024-budget-in-brief.pdf. Congressional Research Service 6 link to page 11 link to page 12 National Institutes of Health (NIH) Funding: FY1996-FY2024 to FY2015, NIH funding increased more gradually in nominal dollars.27~~to FY2015, NIH funding increased more gradually in nominal dollars.19~~ 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.2028 From FY2016 From FY2016
through FY2023, NIH has seen funding increases each year. The largest increase was from through FY2023, 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 percentage increase since FY2003. The FY2023 program level represents a 6.5% the largest percentage increase since FY2003. The FY2023 program level represents a 6.5%
increase over the FY2022 level (including ARPA-H funding).increase over the FY2022 level (including ARPA-H funding).
The FY2024 budget request would provide a 3.9% increase to the FY2023 enacted level. 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
FY2022 dollars) using the Biomedical Research and Development Price Index (BRDPI).FY2022 dollars) using the Biomedical Research and Development Price Index (BRDPI).2129 It It
shows that the purchasing power of NIH funding initially peaked in FY2003 (the last year of the 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 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 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 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 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 to the FY2003 level. When excluding funding for ARPA-H, the FY2023 level is 1.9% less than
the FY2003 level.the FY2003 level.

19 The FY2024 proposed inflation-adjusted NIH program level is 1.9% greater than the FY2003 program level, but 2.7% less than the FY2003 level when excluding proposed ARPA-H funding. 27 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.
2028 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.
2129 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 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. Indexes,” at https://officeofbudget.od.nih.gov/gbiPriceIndexes.html.
Congressional Research Service Congressional Research Service

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link to page link to page ~~13 link to page 20~~14

National Institutes of Health (NIH) Funding: FY1996-~~FY2023~~FY2024

Figure 1. NIH Funding, FY1996-~~FY2023~~FY2024
Program Level Funding in Current and Projected Constant (FY2022) Dollars. Program Level Funding in Current and Projected Constant (FY2022) Dollars.

Source: Sources used for Sources used for ~~FY2023 and FY2022~~FY2024 and FY2023 program levels are in program levels are in Table A-1. The The ~~FY2021~~FY2022 (and earlier) (and earlier)
program levels are from NIH Budget Office, Appropriations History by Institute/Center (1938 to Present), at 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 Research and http://officeofbudget.od.nih.gov/approp_hist.html. Inflation adjustment reflects the Biomedical Research and
Development Price Index (BRDPI), updated Development Price Index (BRDPI), updated ~~March 2022~~January 2023, at https://officeofbudget.od.nih.gov/, at https://officeofbudget.od.nih.gov/
gbiPriceIndexes.html. gbiPriceIndexes.html.
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~~
~~coronavirus supplemental appropriations acts, summarized in Appendix B).~~
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~~Table 1. NIH Funding, FY1996-FY2023~~ Congressional Research Service 8 link to page 22 link to page 13 link to page 14 National Institutes of Health (NIH) Funding: FY1996-FY2024 excluded from these totals (e.g., the FY2020 and FY2021 amounts do not include the amounts provided in the coronavirus supplemental appropriations acts, summarized in Appendix B). PB = President’s Budget. Table 1. NIH Funding, FY1996-FY2024
Program Level Funding in Current and Constant (FY2022) Dollars (Billions) Program Level Funding in Current and Constant (FY2022) Dollars (Billions)
Program Level
Projected
Program Level
Constant
% Relative to
Fiscal Year
Current $
% Change
FY2022 $
FY2003a
1996 1996
11.928 11.928
5.6% 5.6%
25.763 25.763

1997 1997
12.741 12.741
6.8% 6.8%
26.774 26.774

1998 1998
13.675 13.675
7.3% 7.3%
27.795 27.795

1999 1999
15.629 15.629
14.3% 14.3%
30.792 30.792

2000 2000
17.841 17.841
14.1% 14.1%
33.886 33.886

2001 2001
20.459 20.459
14.7% 14.7%
37.608 37.608

2002 2002
23.321 23.321
14.0% 14.0%
41.496 41.496

2003 2003
27.167 27.167
16.5% 16.5%
46.697 46.697

2004 2004
28.037 28.037
3.2% 3.2%
46.461 46.461
-0.5% -0.5%
2005 2005
28.594 28.594
2.0% 2.0%
45.611 45.611
-2.3% -2.3%
2006 2006
28.560 28.560
-0.1% -0.1%
43.541 43.541
-6.8% -6.8%
2007 2007
29.179 29.179
2.2% 2.2%
42.858 42.858
-8.2% -8.2%
2008 2008
29.607 29.607
1.5% 1.5%
41.543 41.543
-11.0% -11.0%
2009 2009
30.545 30.545
3.2% 3.2%
41.640 41.640
-10.8% -10.8%
2010 2010
31.238 31.238
2.3% 2.3%
41.328 41.328
-11.5% -11.5%
2011 2011
30.916 30.916
-1.0% -1.0%
39.764 39.764
-14.8% -14.8%
2012 2012
30.861 30.861
-0.2% -0.2%
39.191 39.191
-16.1% -16.1%
2013 2013
29.316 29.316
-5.0% -5.0%
36.545 36.545
-21.7% -21.7%
2014 2014
30.143 30.143
2.8% 2.8%
36.785 36.785
-21.2% -21.2%
2015 2015
30.311 30.311
0.6% 0.6%
36.253 36.253
-22.4% -22.4%
2016 2016
32.311 32.311
6.6% 6.6%
37.822 37.822
-19.0% -19.0%
2017 2017
34.301 34.301
6.2% 6.2%
39.134 39.134
-16.2% -16.2%
2018 2018
37.311 37.311
8.8% 8.8%
41.532 41.532
-11.1% -11.1%
2019 2019
39.313 39.313
5.4% 5.4%
42.855 42.855
-8.2% -8.2%
2020 2020
41.690 41.690
6.0% 6.0%
44.666 44.666
-4.4% -4.4%
2021 2021
42.941 42.941
3.0% 3.0%
44.885 44.885
-3.9% -3.9%
2022 2022
46. 46.~~183~~178
7.5% 7.5%
46. 46.~~183~~178
-1.1% -1.1%
2023 2023
49. 49.~~183~~178
6.5% 6.5%
47. 47.~~236~~242 1.2% 2024 Proposed 51.098 3.9% 47.577 1.9%
~~1.2%~~
Sources: Sources used for Sources used for ~~FY2023 and FY2022~~FY2024 and FY2023 program levels are in program levels are in Table A-1. The The ~~FY2021~~FY2022 (and earlier) (and earlier)
program levels are from NIH Budget Office, Appropriations History by Institute/Center (1938 to Present), at 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 Research and http://officeofbudget.od.nih.gov/approp_hist.html. Inflation adjustment reflects the Biomedical Research and
Congressional Research Service 9 link to page 12 link to page 22 National Institutes of Health (NIH) Funding: FY1996-FY2024 Development Price Index (BRDPI), updated February 2023, at https://officeofbudget.od.nih.gov/Development Price Index (BRDPI), updated February 2023, 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 authority, including appropriations for the Global Fund to Fight AIDS, TB, and Malaria (FY2002-FY2011) that
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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 FY2022 ~~and FY2023~~ , FY2023, and FY2024 amounts amounts
include funding for the Advanced Research Projects Agency for Health (ARPA-H). PB denotes “President’s include funding for the Advanced Research Projects Agency for Health (ARPA-H). PB denotes “President’s
Budget.” Budget.”
a. FY2003 was the year that NIH received the most program level funding (prior to a. FY2003 was the year that NIH received the most program level funding (prior to ~~FY2022~~FY2023) in 2022 constant ) in 2022 constant
dol ars. dol ars.
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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)
~~FY2022~~FY2023
FY2023
~~FY2023~~FY2024
Institutes/Centers
~~Enacted~~
~~Request~~
~~Enacted~~Request Enacted Request
Cancer Institute (NCI) Cancer Institute (NCI)
$6, $6,~~913~~
~~$6,714~~
~~$7,320~~714 $7,317 $7,820
Heart, Lung, and Blood Institute (NHLBI) Heart, Lung, and Blood Institute (NHLBI)
$3, $3,~~808~~823
$3, $3,~~823~~985
$3, $3,~~982~~985
Dental/Craniofacial Research (NIDCR) Dental/Craniofacial Research (NIDCR)
$ $~~501~~
~~$513~~513 $520
$520 $520
Diabetes/Digestive/Kidney (NIDD Diabetes/Digestive/Kidney (NIDDK)a
$2, $2,~~204~~206
$2, $2,~~206~~303
$2, $2,~~301~~303
Neurological Disorders/Stroke (NINDS) Neurological Disorders/Stroke (NINDS)
$2, $2,~~611~~768
$2, $2,~~768~~809
$2, $2,~~814~~825
Allergy/Infectious Diseases (NIAID) Allergy/Infectious Diseases (NIAID)
$6, $6,~~323~~268
$6, $6,~~268~~562
$6,562 $6,562
General Medical Sciences (NIGMS General Medical Sciences (NIGMS)b
$1, $1,~~783~~826
$1, $1,~~826~~827
$1, $1,~~827~~292
Child Health/Human Development (NICHD) Child Health/Human Development (NICHD)
$1, $1,~~683~~675
$1, $1,~~675~~748
$1, $1,~~749~~748
National Eye Institute (NEI) National Eye Institute (NEI)
$ $~~864~~
~~$853~~
~~$897~~853 $896 $896
Environmental Health Sciences (NIEHS Environmental Health Sciences (NIEHS)c
$ $~~842~~
~~$932~~
~~$914~~932 $914 $939
National Institute on Aging (NIA) National Institute on Aging (NIA)
$4, $4,~~220~~011
$4, $4,~~011~~412
$4, $4,~~408~~412
Arthritis/Musculoskeletal/Skin Diseases Arthritis/Musculoskeletal/Skin Diseases
$ $~~656~~
~~$676~~
~~$685~~676 $688 $688
(NIAMS) (NIAMS)
Deafness/Communication Disorders Deafness/Communication Disorders
$ $~~515~~
~~$509~~509 $534
$534 $534
(NIDCD) (NIDCD)
Alcohol Abuse/Alcoholism (NIAAA) Alcohol Abuse/Alcoholism (NIAAA)
$ $~~574~~
~~$567~~
~~$595~~567 $597 $597
Nursing Research (NINR) Nursing Research (NINR)
$ $~~181~~
~~$199~~199 $198
$198 $198
National Institute on Drug Abuse (NIDA) National Institute on Drug Abuse (NIDA)
$1, $1,~~595~~843
$1, $1,~~843~~663
$1,663 $1,663
National Institute of Mental Health (NIMH) National Institute of Mental Health (NIMH)
$2, $2,~~217~~211
$2, $2,~~211~~342
$2, $2,~~338~~542
Human Genome Research Institute (NHGRI) Human Genome Research Institute (NHGRI)
$ $~~639~~
~~$629~~
~~$663~~629 $661 $661
Biomedical Imaging/Bioengineering (NIBIB) Biomedical Imaging/Bioengineering (NIBIB)
$ $~~425~~
~~$419~~419 $441
$441 $441
Complementary/Integrative Health (NCCIH) Complementary/Integrative Health (NCCIH)
$ $~~159~~
~~$183~~183 $170
$170 $170
Minority Health/Health Disparities (NIMHD) Minority Health/Health Disparities (NIMHD)
$ $~~459~~
~~$660~~
~~$524~~660 $525 $525
Fogarty International Center (FIC) Fogarty International Center (FIC)
$ $8796
$ $9695
$95 $95
National Library of Medicine (NLM) National Library of Medicine (NLM)
$ $~~479~~
~~$472~~
~~$498~~472 $495 $495
Advancing Translational Sciences (NCATS) Advancing Translational Sciences (NCATS)
$ $~~882~~
~~$874~~874 $923
$923 $923
Office of Director Office of Director (OD)d
$2, $2,~~629~~315
$2, $2,~~315~~647
$2, $2,~~656~~898
(Common Fund)
($~~657)~~
~~($646)~~
~~($772)~~646)
(Office for Research on Women’s Health)
($5953) )
~~($53)~~
~~($76)~~
Innovation Accoun Innovation Accounte
$ $~~150~~419
$419 $419
$ $~~419~~235
Buildings and Facilities (B&F) Buildings and Facilities (B&F)
$ $~~250~~
~~$300~~300 $350 $350 Subtotal, NIH (LHHS Discretionary $43,962 $46,042 $46,317 BA) PHS Program Evaluation (provided to $1,272 $1,412 $1,948 NIGMS) Superfund (Interior approp. to NIEHS)g $83 $83 $83 Mandatory type 1 diabetes funds (to $141 $141 $250i NIDDK)h
~~$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
~~FY2023~~FY2024
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~~Request Enacted Request NIH Program Level $45,458 $47,678 $48,598 Advanced Research Projects Agency for $5,000 $1,500 $2,500 Health (ARPA-H)f NIH and ARPA-H Program Level $50,458 $49,178 $51,098 Pandemic Preparedness (proposed $12,050 — $2,690 mandatory)j Total w/ Pandemic Preparedness $62,508 $49,178 $53,788 Source: The FY2024 Request and FY2023 Enacted program levels are from NIH, Congressional Justification: FY2024, “Supplementary Tables,” March 9, 2023, p. 100-102, https://officeofbudget.od.nih.gov/pdfs/FY24/br/Overview%20of%20FY%202024%20Supplementary%20Tables.pdf. FY2023 request amounts are from amounts are from Congressional Record, vol. , vol.
168, no. 198, Book II, December 20, 2022, pp. S9145-S9147, S8853.168, no. 198, Book II, 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 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 h). a. Amounts for the NIDDK do not include mandatory funding for type 1 diabetes research (see note h).
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 g). (see note g).
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 P.L. 113-94). 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~~: $496 mil~~ ($1.085 bil ion for ion for ~~FY2022; $1.085 bil~~FY2023; $407 mil ion for ion for ~~FY2023~~FY2024 proposed). The remaining . The remaining funds for funds for
this account are reflected, where applicable, this account are reflected, where applicable, ~~into~~in the totals for other ICs. For the totals for other ICs. For ~~FY2022~~FY2023, this includes , this includes ~~$194~~
$216 mil ion to NCI for cancer research and $mil ion to NCI for cancer research and $76225 mil ion to each of NINDS and NIMH for the BRAIN Initiative mil ion to each of NINDS and NIMH for the BRAIN Initiative
~~($152~~($450 mil ion total mil ion total ~~for BRAIN). For FY2023, this includes $216 mil ion to NCI for cancer research and $225~~
~~mil ion to each~~). For FY2024, this includes a total of $172 to both of NINDS and NIMH for the BRAIN Initiative of NINDS and NIMH for the BRAIN Initiative ~~($450 mil ion total).~~
. NIH, Overview of FY2024 President’s Budget, March 9, 2023, p. 56. f. f.
ARPA-H was funded under a separate account under the Office of the Secretary in ARPA-H was funded under a separate account under the Office of the Secretary in ~~both FY2022 and~~
~~FY2023. In FY2022, a proviso accompanying the appropriation gave HHS Secretary Becerra the ability to~~
~~transfer the new agency anywhere within the department within 30 days of enactment. On March 30, 2022,~~
~~HHS Secretary Becerra submitted a notice to the appropriations committees that ARPA-H is to reside~~
~~within the NIH; therefore, ARPA-H is shown within NIH in this table. For FY2023, ARPA-H authorizing~~
~~legislation in Division FF (P.L. 117-328) established it as a component~~FY2023. For FY2023, ARPA-H authorizing legislation in Division FF (P.L. 117-328) established it as a component of NIH. In addition, both the FY2023 and FY2024 budgets proposed ARPA-H funding as a part of NIH. Therefore, ARPA-H is shown of NIH. Therefore, ARPA-H is shown
within the NIH program level in this report.within the NIH program level in this report.
g. This is a separate account in the Interior/Environment appropriations for NIEHS research activities related g. This is a separate account in the Interior/Environment appropriations for NIEHS research activities related
to Superfund research. to Superfund research.
h. Mandatory funds are available to NIDDK for type 1 diabetes research under PHSA Section 330Bm, which h. 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). The Division BB, Title II). The ~~FY2022 and~~ FY2023 amounts for the type I diabetes research program ($141 FY2023 amounts for the type I diabetes research program ($141
mil ion) are lower than the enacted funding mil ion) are lower than the enacted funding ~~levels for FY2022 and~~ level for FY2023 ($150 mil ion). According to the FY2023 ($150 mil ion). According to the
budget request, the budget request, the ~~FY2022 and FY2023 amounts reflect~~amount reflects sequestration of $8.55 mil ion. See “Budget sequestration of $8.55 mil ion. See “Budget
Mechanism Table,” p. 44 in https://officeofbudget.od.nih.gov/pdfs/FY23/br/Mechanism Table,” p. 44 in https://officeofbudget.od.nih.gov/pdfs/FY23/br/
Overview%20of%20FY%202023%20Presidents%20Budget.pdf. Overview%20of%20FY%202023%20Presidents%20Budget.pdf.
i. i.
Proposed amount. j. The FY2023 request proposed new mandatory funding for pandemic preparedness to be available for five The FY2023 request proposed new mandatory funding for pandemic preparedness to be available for five
years. The request proposed an HHS-wide total of $81.7 bil ion for pandemic preparedness, with $12.05 years. The request proposed 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.
~~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~~
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~~purposes, whereas the President proposes amounts in his annual budget request.22 This is a~~
~~relatively new practice that has expanded since FY2015.23~~ The FY2024 request proposes new mandatory funding for pandemic preparedness to be available for five years. The request proposes an HHS-wide total of proposes an HHS-wide total of $20 bil ion for pandemic preparedness with $2.69 bil ion of the total designated for NIH. This amount is shown as a non-add in the request. NIH, Overview of FY2024 President’s Budget, March 9, 2023, p. 7. Congressional Research Service 12 link to page 16 National Institutes of Health (NIH) Funding: FY1996-FY2024 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.30 This practice has expanded since FY2015.31 For the most part, Congress does not For the most part, Congress does not
specify NIH funding for particular diseases or specify NIH funding for particular diseases or ~~areas of research~~research topics in the appropriations process and 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.2432
In FY2023, Congress used appropriations report language to specify a certain amount of IC In FY2023, 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 Most of these amounts are
specified in the explanatory statement accompanying enacted appropriations;specified in the explanatory statement accompanying enacted appropriations;2533 in a few cases, in a few cases,
amounts specified in the House Appropriations report (H.Rept. 117-96) are incorporated by amounts specified in the House Appropriations report (H.Rept. 117-96) are incorporated by
reference.reference.2634 Sometimes the language specifies a certain amount for a certain purpose; in other Sometimes the language specifies a certain amount for a certain purpose; in other
cases, the language provides increased or additional funding. The appropriations reports also cases, the language provides increased or additional funding. The appropriations reports also
include many include many ~~additional~~general statements statements ~~directing~~recommending the agency to the agency to ~~prioritize~~fund certain programs or areas of certain programs or areas of
research, as well as statements expressing the opinion or concerns of Congress regarding NIH. research, as well as statements expressing the opinion or concerns of Congress regarding NIH.
These broad statements are not summarized here. These broad statements are not summarized here.
Table A-2. Specified NIH Funding Levels in FY2023 Explanatory Statement
Institute/Center
Program/Activity
Amount
National Cancer Institute National Cancer Institute
Childhood Cancer Data Initiative (CCDI) Childhood Cancer Data Initiative (CCDI)
No less than $50 mil ion No less than $50 mil ion
(NCI) (NCI)
including no less than $750 including no less than $750
thousand to continue to thousand to continue to
support enhancement of the support enhancement of the
CCDI Molecular CCDI Molecular
Characterization Initiative. Characterization Initiative.
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
(including $2 mil ion for cancer (including $2 mil ion for cancer
registry case capture efforts for registry case capture efforts for
childhood and adolescent childhood and adolescent
cancers.*) cancers.*)
NCI Paylines NCI Paylines
An increase of $150 mil ion 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 30 For a general overview, see CRS Report R44124, For a general overview, see CRS Report R44124, Appropriations Report Language: Overview of ~~Components and~~
~~Development~~,Development and Components and CRS Report R47019, and CRS Report R47019, The Executive Budget Process: An Overview. .
~~23 As recently as~~31 For example, in December 2014, the explanatory statement on the FY2015 omnibus stipulated, “In keeping with 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.
2432 CRS Report R41705, CRS Report R41705, The National Institutes of Health (NIH): Background and Congressional Issues. .
2533 Congressional Record, vol. 168, no. 198, Book II, December 20, 2022, pp. S8881-S8887, S8853. , vol. 168, no. 198, Book II, December 20, 2022, pp. S8881-S8887, S8853.
2634 House report amounts cited where not superseded by the explanatory statement per direction in the explanatory 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 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 included in this explanatory statement and should be complied with unless specifically addressed to the contrary in this
explanatory statement” (explanatory statement” (Congressional Record, vol. 168, no. 198, Book II, December 20, 2022, p. S8874). , vol. 168, no. 198, Book II, December 20, 2022, p. S8874).
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Institute/Center
Program/Activity
Amount
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 Valvular Heart Disease Research Valvular Heart Disease Research
$20 mil ion $20 mil ion
National Institute of National Institute of
Pain Management Researc Pain Management Researcha
An increase of $9 mil ion An increase of $9 mil ion
Dental and Craniofacial Dental and Craniofacial
Research (NIDCR) Research (NIDCR)
National Institute of National Institute of
Special Diabetes Program Special Diabetes Program
$8.55 mil ion to restore cuts $8.55 mil ion to restore cuts
Diabetes and Digestive Diabetes and Digestive
for SDP from sequestration for SDP from sequestration
and Kidney Diseases and Kidney Diseases
Pain Management Research Pain Management Research
An increase of $5 mil ion An increase of $5 mil ion
(NIDDK) (NIDDK)
National Institute of National Institute of
Alzheimer’s Disease and Alzheimer’s Disease Alzheimer’s Disease and Alzheimer’s Disease
An increase in $75 mil ion for An increase in $75 mil ion for
Neurological Disorders Neurological Disorders
Related Dementias (AD/ADRD) Related Dementias (AD/ADRD)
NINDS out of the $226 NINDS out of the $226
mil ion and Stroke (NINDS) and Stroke (NINDS)
increase for AD/ADRD across increase for AD/ADRD across
NIH NIH
HEAL Initiative (opioids, stimulants, and pain HEAL Initiative (opioids, stimulants, and pain
No less than $280.295 mil ion, No less than $280.295 mil ion,
management) management)
an increase of $10 mil ion an increase of $10 mil ion
Undiagnosed Diseases Network (UDN) Undiagnosed Diseases Network (UDN)
$18 mil ion $18 mil ion
National Institute of National Institute of
Consortium of Food Allergy Research Consortium of Food Allergy Research
$12.1 mil ion, an increase of $3 $12.1 mil ion, an increase of $3
Allergy and Infectious Allergy and Infectious
(CoFAR) (CoFAR)
mil ion mil ion
Diseases (NIAID) Diseases (NIAID)
Regional biocontainment laboratories (RBL) Regional biocontainment laboratories (RBL)
$52 mil ion of which $52 mil ion of which ~~non~~not less less
than $1 mil ion shall be than $1 mil ion shall be
provided to each of the 12 provided to each of the 12
RBLs to support the RBLs to support the
maintenance of a capable maintenance of a capable
research workforce, facilities, research workforce, facilities,
and equipment. and equipment.
Centers for AIDS Research (CFARS Centers for AIDS Research (CFARS)a
$71 mil ion $71 mil ion
Responding to infectious diseases/Antimicrobial Responding to infectious diseases/Antimicrobial
No less than $565 mil ion, an No less than $565 mil ion, an
Resistance Resistance
increase of $25 mil ion increase of $25 mil ion
Universal flu vaccine Universal flu vaccine
No less than $270 mil ion, an No less than $270 mil ion, an
increase of $25 mil ion increase of $25 mil ion
Health Disparities Resear Health Disparities Researcha
$10 mil ion $10 mil ion
National Institute of National Institute of
Health Disparities Research Health Disparities Research
An increase of $5 mil ion An increase of $5 mil ion
General Medical Sciences General Medical Sciences
Increasing diversity in biomedical research Increasing diversity in biomedical research
An increase of $10 mil ion An increase of $10 mil ion
(NIGMS) (NIGMS)
Institutional Development Award (IDeA) Program $425.956 mil ion, an increase of Institutional Development Award (IDeA) Program $425.956 mil ion, an increase of
$15.503 mil ion $15.503 mil ion
Eunice Kennedy Shriver
Heath Impacts on Children of Technology and Heath Impacts on Children of Technology and
$15 mil ion $15 mil ion
National Institute of Child Social Media Use National Institute of Child Social Media Use
Health and Human Health and Human
Impact of COVID–19 on children Impact of COVID–19 on children
An increase of $2.5 mil ion An increase of $2.5 mil ion
Development (NICHD) Development (NICHD)
Impact of COVID-19 on Pregnant and Lactating Impact of COVID-19 on Pregnant and Lactating
An increase of $3 mil ion An increase of $3 mil ion
Women Women
Implementing a Maternal Health and Pregnancy Implementing a Maternal Health and Pregnancy
No less than $43.4 mil ion No less than $43.4 mil ion
Outcomes Vision for Everyone (IMPROVE) Outcomes Vision for Everyone (IMPROVE)
Initiative Initiative
National Institute of National Institute of
Additional Research Additional Research
An increase of $40 mil ion An increase of $40 mil ion
Environmental Health Environmental Health
Sciences (NIEHS) Sciences (NIEHS)
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Institute/Center
Program/Activity
Amount
National Institute on National Institute on
Alzheimer’s disease and related dementias Alzheimer’s disease and related dementias
An increase in $151 mil ion for An increase in $151 mil ion for
Aging (NIA) Aging (NIA)
~~NINDS~~NIA out of the $226 out of the $226
mil ion increase for AD/ADRD, increase for AD/ADRD,
including $1.5 mil ion for a including $1.5 mil ion for a
National Academies of National Academies of
Sciences, Engineering, and Sciences, Engineering, and
Medicine (NASEM) report on Medicine (NASEM) report on
research priorities on research priorities on
AD/ADRD informed by an AD/ADRD informed by an
expert panel. expert panel.
National Institute of National Institute of
Opioids and pain/pain management Opioids and pain/pain management ~~researcha~~research
An increase of $5 mil ion An increase of $5 mil ion
Arthritis and Arthritis and
Musculoskeletal and Skin Musculoskeletal and Skin
Diseases (NIAMS) Diseases (NIAMS)
National Institute on National Institute on
HEAL Initiative (opioids, stimulants, and pain HEAL Initiative (opioids, stimulants, and pain
No less than $355.295 mil ion No less than $355.295 mil ion
Drug Abuse (NIDA) Drug Abuse (NIDA)
management) management)
Pain and pain management Pain and pain management
Additional $10 mil ion Additional $10 mil ion
Youth and Perinatal Marijuana Us Youth and Perinatal Marijuana Usea
$2 mil ion to enter into $2 mil ion to enter into
contract with NASEM to study contract with NASEM to study
youth and perinatal marijuana youth and perinatal marijuana
use use
National Institute of National Institute of
Impact of COVID on mental health Impact of COVID on mental health
An increase of $5 mil ion An increase of $5 mil ion
Mental Health (NIMH) Mental Health (NIMH)
Mental Health Treatment Research Mental Health Treatment Research
An increase of $5 mil ion An increase of $5 mil ion
National Institute of National Institute of
Health disparities research Health disparities research
An increase of $10 mil ion An increase of $10 mil ion
Nursing Research (NINR) Nursing Research (NINR)
National Institute on National Institute on
Chronic Disease Centers Chronic Disease Centers
An additional $11 mil ion An additional $11 mil ion
Minority Health and Minority Health and
Health disparities research Health disparities research
An increase of $25 mil ion An increase of $25 mil ion
Health Disparities Health Disparities
Research Centers in Minority Institutions Research Centers in Minority Institutions
$88.765 mil ion $88.765 mil ion
(NIMHD) (NIMHD)
Coordination Network Coordination Network
Research Endowment Program Research Endowment Program
$12 mil ion $12 mil ion
National Center for National Center for
Pain and pain management Pain and pain management ~~researcha~~research
An additional $5 mil ion An additional $5 mil ion
Complementary and Complementary and
Integrative Health Integrative Health
(NCCIH) (NCCIH)
National Center for National Center for
Clinical and Translational Science Awards Clinical and Translational Science Awards
$629.56 mil ion, an increase of $629.56 mil ion, an increase of
Advancing Translational Advancing Translational
(CTSAs) (CTSAs)
$22.914 mil ion $22.914 mil ion
Sciences (NCATS) Sciences (NCATS)
Cures Acceleration Network (CAN) Cures Acceleration Network (CAN)
$70 mil ion $70 mil ion
John E. Fogarty John E. Fogarty
Health disparities researc Health disparities researcha
An increase of $5 mil ion An increase of $5 mil ion
International Center (FIC) International Center (FIC)
Office of the Director Office of the Director
Administration Offices Administration Offices
$4.55 mil ion $4.55 mil ion
(OD)/ Multi-Institute (OD)/ Multi-Institute
Amyotrophic lateral sclerosis (ALS) Amyotrophic lateral sclerosis (ALS)
$75 mil ion for implementation $75 mil ion for implementation
Research Initiatives 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), an increase of (P.L. 117-79), an increase of
$50 mil ion. $50 mil ion.
All of Us Precision Medicine InitiatiPrecision Medicine Initiativea
$541 mil ion, including $419 $541 mil ion, including $419
mil ion from the Innovation mil ion from the Innovation
Account Account
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Institute/Center
Program/Activity
Amount
Artificial Intelligence/Machine Learning (AI/ML) Artificial Intelligence/Machine Learning (AI/ML)
$135 mil ion including $85 $135 mil ion including $85
mil ion for Office of Data mil ion for Office of Data
Science Strategy (an increase of Science Strategy (an increase of
$15 mil ion), $50 mil ion for $15 mil ion), $50 mil ion for
AI/ML focused investment, and AI/ML focused investment, and
$3 mil ion for the Office of $3 mil ion for the Office of
Portfolio Analysis Portfolio Analysis
Autoimmune Diseases $10 mil ion to establish an Office of Autoimmune Disease Research (OADR) within the Office of Research on Women’s Health (ORWH). Grants for biomedical research facilities Grants for biomedical research facilities
$80 mil ion $80 mil ion
Brain Research through Advancing Innovative Brain Research through Advancing Innovative
$680 mil io $680 mil ion,b including $95 including $95
Neurotechnologies (BRAIN) Initiative Neurotechnologies (BRAIN) Initiative
mil ion for the Human Brain mil ion for the Human Brain
Cell Atlas, $10 mil ion for the Cell Atlas, $10 mil ion for the
Armamentarium for Brain Cell Armamentarium for Brain Cell
Access, and $30 mil ion for the Access, and $30 mil ion for the
Brain Connectivity Map Brain Connectivity Map
Foreign Threats to Research Foreign Threats to Research
$5 mil ion transferred from $5 mil ion transferred from
NIH to the Inspector General NIH to the Inspector General
to conduct investigation into to conduct investigation into
foreign threats to research* foreign threats to research*
Common Fund Common Fund
Increase of $65 mil ion Increase of $65 mil ion
Office of Nutrition Research (ONR Office of Nutrition Research (ONR)a
$40 mil ion $40 mil ion
Cybersecurity Cybersecurity
$265 mil ion $265 mil ion, an increase of $40 an increase of $40
mil ion mil ion
~~Development~~Developmental Delays Delays
$ $~~100~~10 mil ion mil ion
Environmental Influences on Child Health Environmental Influences on Child Health
$180 mil ion, the same level as $180 mil ion, the same level as
Outcomes (ECHO Outcomes (ECHO)a
FY2022 FY2022
Firearm injury and mortality prevention research Firearm injury and mortality prevention research
$12.5 mil ion, the same level as $12.5 mil ion, the same level as
FY2022 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
NASEM Study on Heritable Genetic Information NASEM Study on Heritable Genetic Information
$1.3 mil ion $1.3 mil ion
Investigation of Co-Occurring Conditions Across Investigation of Co-Occurring Conditions Across
No less than $90 mil ion No less than $90 mil ion
the Lifespan to Understand Down Syndrome the Lifespan to Understand Down Syndrome
(INCLUDE) (INCLUDE)
Office of AIDS Research, for HIV/AIDS research Office of AIDS Research, for HIV/AIDS research
An increase of $100 mil ion An increase of $100 mil ion
Congressional Research Service 16 link to page 16 link to page 21 National Institutes of Health (NIH) Funding: FY1996-FY2024 Institute/Center Program/Activity Amount Office of Research on Women’~~Office of Research on Women'~~s Health (ORWH) s Health (ORWH)
$76.48 mil ion, including $5 $76.48 mil ion, including $5
mil ion, an increase of $1 mil ion, an increase of $1
mil ion, for the Building mil ion, for the Building
Interdisciplinary Research Interdisciplinary Research
Careers in Women’s Health Careers in Women’s Health
(BIRCWH) program. (BIRCWH) program.

$10 mil ion to establish an $10 mil ion to establish an
Office of Autoimmune Disease Office of Autoimmune Disease
Research (OADR)Research (OADR) (mentioned earlier). .

$2 mil ion to contract NASEM $2 mil ion to contract NASEM
on a study on gaps in on a study on gaps in
knowledge of women’s health. knowledge of women’s health.
Office of the Chief Officer for Scientific Office of the Chief Officer for Scientific
$22.415 mil ion $22.415 mil ion
Workforce Diversity (COSWD) Workforce Diversity (COSWD)
Source: Congressional Record, vol. 168, no. 198, Book II, December 20, 2022, pp. S8881-S8887, S8853. House , vol. 168, no. 198, Book II, December 20, 2022, pp. S8881-S8887, S8853. House
report amounts cited where not superseded by the explanatory statement per direction in the explanatory 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 statement, “Unless otherwise noted, the language set forth in H.Rept. 117-403 carries the same weight as
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language included in this explanatory statement and should be complied with unless specifically addressed to the language included in this explanatory statement and should be complied with unless specifically addressed to the
contrary in this explanatory statement” (p. S8874). contrary in this explanatory statement” (p. S8874).
Notes: Table does not include amounts already shown inTable does not include amounts already shown in Table A-2. Dol ar amounts are at the level of detail Dol ar amounts are at the level of detail
used in the appropriations report text. used in the appropriations report text.
a. From H.Rept. 117-96a. From H.Rept. 117-96.
b. Amount includes $450 mil ion from the Innovation Account for the BRAIN Initiative as authorized by the b. Amount includes $450 mil ion from the Innovation Account for the BRAIN Initiative as authorized by the
Cures Act (split between NINDS and NIMH in Cures Act (split between NINDS and NIMH in ~~FY2022~~FY2023 appropriations). appropriations).
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~~National Institutes of Health (NIH) Funding: FY1996-FY2023~~Table A-3. Specified NIH Funding Levels in the FY2024 HHS Budget in Brief Institute/Center Program/Activity Amount National Cancer Institute Cancer Moonshot $716 mil ion total, an (NCI) increase of $500 mil ion Office of the Director Nutrition research $121 mil ion (OD)/Office of Nutrition Research Several ICs All of Us Precision Medicine Initiative and Brain Additional $462 mil ion for Research Through Advancing Innovative total of $1.2 bil ion for Neurotechnologies (BRAIN) both initiativesa (same funding level as FY2023) Several ICs Opioids, stimulant and pain research $1.8 bil ion (same as FY2023 enacted), including $636 mil ion for the Helping to End Addiction Long-term (HEAL) Initiative National Institute on Health disparities and inequities research $95 mil ion Minority Health and Health Disparities (NIMHD) and other ICs National Institute of Developing a universal influenza vaccine $270 mil ion Allergy and Infectious Ending the HIV epidemic in the United States $26 mil ion (same as FY23 Diseases (NIAID) and enacted) other ICs Congressional Research Service 17 link to page 16 National Institutes of Health (NIH) Funding: FY1996-FY2024 Institute/Center Program/Activity Amount Eunice Kennedy Shriver Impact of COVID-19 on pregnant and lactating $3 mil ion National Institute of Child women Health and Human Development (NICHD) National Institute of Innovating mental health research and treatment, An increase of $200 mil ion Mental Health (NIMH) including to support better diagnostics, improved treatments, and enhanced precision of care for mental health. Not specified Impact of climate change on human health An increase of $25 mil ion Buildings and Facilities Address NIH’s backlog of maintenance and repair on $350 mil ion its intramural campus Source: HHS, Budget in Brief: FY2024, pp. 46-51, https://www.hhs.gov/sites/default/files/fy-2024-budget-in-brief.pdf. Notes: Table does not include amounts already shown in Table A-2. Dol ar amounts are at the level of detail used in the budget request and are presented in the order they appear in the budget in brief. a. Total amount includes $407 mil ion from the Innovation Account for the BRAIN Initiative and PMI as authorized by the Cures Act. Congressional Research Service 18 National Institutes of Health (NIH) Funding: FY1996-FY2024

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:2735
• First Measure: Division A of the Coronavirus Preparedness and Response Division A of the Coronavirus Preparedness and Response
Supplemental Appropriations Act, 2020 (P.L. 116-123), enacted on March 6, Supplemental Appropriations Act, 2020 (P.L. 116-123), enacted on March 6,
2020. 2020.
• Second Measure: Division B of the Coronavirus Aid, Relief, and Economic Division B of the Coronavirus Aid, Relief, and Economic
Security Act (CARES Act, P.L. 116-136), enacted on March 27, 2020. Security Act (CARES 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 Act (PPPHCEA, P.L. 116-139), enacted on April 24, 2020. Care Enhancement 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 December 27, 2020. 116-260), enacted on December 27, 2020.
NIH received a total of $3.031 billion to NIH IC accounts, along with directed transfers from the 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.

27 35 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. $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 and fifth measures, NIH In the fourth and fifth measures, NIH
received funding for specific purposes related to diagnostic test R&D. This funding was directed received funding for specific purposes related to diagnostic test R&D. This funding was directed
to NIH as “not less than” transfers from the PHSSEF account in the fourth measure, and directly to NIH as “not less than” transfers from the PHSSEF account in the fourth measure, and directly
to the OD account in the fifth measure. These amounts included the following: to the OD account in the fifth measure. These amounts included the following:
• National Cancer Institute (NCI): Transfer of not less than $306 million from 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 fourth measure. testing and associated technologies” in the fourth 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 fourth measure. rapid testing related to coronavirus” in the fourth 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 fourth measure. In the fifth measure, not less than $100 million of entities” in the fourth measure. 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 the $1.250 billion total provided to the OD account is for “the Rapid Acceleration
of Diagnostics.” of 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.2836
Long-Term Studies of COVID-19. The fifth measure directed $1.15 billion of the total $1.25 The fifth measure directed $1.15 billion of the total $1.25
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 Long Enhance Recovery (RECOVER) Initiative, a large coordinated research initiative to study Long
COVID.COVID.2937 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).

28 36 CRS communication with NIH, July 24, 2020. CRS communication with NIH, July 24, 2020.
2937 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 “Appendix: HHS COVID-19 Funding,” GAO-22-105397). NIH’s RECOVER Unaccompanied Children Program (see “Appendix: HHS COVID-19 Funding,” GAO-22-105397). NIH’s RECOVER
website states that “the primary funding source for RECOVER has changed to the American Rescue Plan (ARP) Act of website states that “the primary funding source for RECOVER has changed to the American Rescue Plan (ARP) Act of
2021 (Sec. 2401), the $1.15 billion budget remains and NIH RECOVER research activities have neither stopped nor 2021 (Sec. 2401), the $1.15 billion budget remains and NIH RECOVER research activities have neither stopped nor
had any delays.” 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 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 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 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-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 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 HHS Secretary can allocate a portion of these funds to NIH accounts at his discretion. In addition, NIH has
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 (see ~~footnote~~footnote 27). 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

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Author Information

Kavya Sekar Kavya Sekar

Analyst in Health Policy Analyst in Health Policy

Acknowledgments
CRS Research Assistant John Gorman provided assistance for this report. CRS Research Assistant John Gorman provided assistance 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
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Congressional Research Service Congressional Research Service
R43341 R43341 · VERSION 4547 · UPDATED
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