National Institutes of Health (NIH) Funding:
May 20, 2022
FY1996-FY2023
Kavya Sekar
This report details the National Institutes of Health (NIH) budget and appropriations
Analyst in Health Policy
process with a focus on FY2022 and FY2023. NIH is the primary federal agency

charged with conducting and supporting medical, health, and behavioral research, and it
is made up of 27 Institutes and Centers and the Office of the Director (OD). About 80%

of the NIH budget funds extramural research through grants, contracts, and other
awards. About 10% of NIH funding goes to intramural researchers at NIH-operated facilities. Almost all of NIH’s
funding is provided in the annual Departments of Labor, Health and Human Services, and Education, and Related
Agencies (LHHS) Appropriations Act. NIH also receives smaller amounts of funding from Interior/Environmental
(INT) appropriations and a mandatory budget authority for type 1 diabetes research.
The FY2022 NIH program level of $46.183 billion represents a $3.146 billion increase (+7.3%) relative to
FY2021-enacted program level. The FY2022 enacted total for NIH is also $5.775 billion (-11.1%) less than the
FY2022 budget request and $3.404 billion (-6.9%) less than the program level proposed by the House-passed
LHHS and INT bills. In FY2022, all Institute and Center (IC) accounts received an increase relative to FY2021
funding levels (see Table A-1).
Additionally, the Biden Administration’s FY2022 budget request had proposed the creation of a new Advanced
Research Projects Agency for Health (ARPA-H) within NIH with an initial funding level of $6.5 billion to be
available for three years. FY2022 appropriations (P.L. 117-103; Division H) provided $1 billion in funding for
ARPA-H in a new LHHS account (available for three years) and allowed for the Department of Health and
Human Services (HHS) Secretary to transfer ARPA-H to any agency or office of the Department of Health and
Human Services (including NIH) within 30 days of enactment. On March 30, 2022, HHS Secretary Xavier
Becerra submitted a notice to the appropriations committees that ARPA-H is to reside within the NIH, while the
ARPA-H Director is to report directly to the HHS Secretary. Appropriations for ARPA-H are therefore included
within the NIH FY2022 program level in this report.
The Biden Administration’s FY2023 budget request proposes an FY2023 program level of $62.503 billion—a
$16.320 billion increase (+35.3%) from the FY2022 program level. Within the total, the request proposes $5
billion for ARPA-H, an increase of $4 billion from the FY2022-enacted level. The FY2023 request total also
includes $12.05 billion in new mandatory appropriations for pandemic preparedness.
NIH has seen periods of high and low funding growth during the period covered by this report, as illustrated in
Figure 1. Between FY1996 and FY1998, funding for NIH grew from $11.928 billion to $13.675 billion (nominal
dollars). Over the next five years, Congress and the President doubled the NIH budget to $27.167 billion in
FY2003. In each of FY1999 through FY2003, NIH received annual funding increases of 14% to 16%. From
FY2003 to FY2015, NIH funding increased more gradually in nominal dollars. In some years (FY2006, FY2011,
and FY2013), funding for the agency decreased in nominal dollars. From FY2016 through FY2022, NIH has seen
funding increases each year. The largest increase was from FY2017 to FY2018, where the program level
increased by $3.0 billion (+8.8%), making this the largest single-year nominal dollar increase since FY2003. The
proposed funding increase in the FY2023 budget request would be a single-year nominal dollar increase of
$16.320 billion (+35.3%), which would represent the largest funding increase in the period covered in this report.
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 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 FY2022. The FY2022 program level is 0.6%
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greater than the peak FY2003 program level. The FY2023 budget request would provide a program level that is a
32.8% increase relative to the peak FY2003 program level.
This CRS report details NIH budget and appropriations for FY2022 and FY2023 and provides an overview of
funding trends in regular appropriations to the agency from FY1996 to FY2023. Coronavirus supplemental
funding for NIH is discussed in Appendix B of the report but is generally not included in the budgetary figures
elsewhere in the report. Appendix A includes funding tables by account and program-specific funding levels for
FY2021, FY2022, and FY2023. Appendix C provides a list of acronyms and abbreviations used in the report.

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NIH Funding: FY1996-FY2023
This report provides a historical overview of federal funding provided to the National Institutes of
Health (NIH) between FY1996 and FY2023. It also provides a brief explanation of the
discretionary spending funding sources for NIH associated with the annual appropriations process
(via the Labor, HHS, and Education and Interior/Environment Appropriations Acts) and the
mandatory funding for special program on type 1 diabetes research.1
NIH is the primary federal agency for medical, health, and behavioral research. It is the largest of
the eight health-related agencies that make up the Public Health Service (PHS) within the
Department of Health and Human Services (HHS).2 NIH consists of the Office of the Director
(OD) and 27 Institutes and Centers (ICs) that focus on aspects of health, human development, and
biomedical science. The OD sets overall policy for NIH and coordinates the programs and
activities of all NIH components, particularly in areas of research that involve multiple institutes.
In addition, FY2022 appropriations established a new entity that has been placed within NIH: the
Advanced Research Projects Agency for Health (ARPA-H), as discussed further in this report.
NIH activities cover a wide range of basic,
Supplemental Funding for NIH
clinical, and translational research, focused on
In FY2021 and prior years, NIH received supplemental
particular diseases, areas of human health and
appropriations provided as an emergency requirement.
development, or more fundamental aspects of
Given that this report examines trends in regular
biology and behavior. Its mission also includes
annual appropriations to NIH enacted by Congress and
the President for the normal operations of the agency,
research training and health information
amounts provided to NIH pursuant to an emergency
collection and dissemination.3 More than 80%
requirement are generally excluded from this report. In
of the NIH budget funds extramural research
some years, supplemental funding to NIH was
(i.e., external) through grants, contracts, and
substantial, such as the over $10 bil ion in
other awards. This funding supports research
appropriations provided in the American Recovery and
Reinvestment Act of 2009 (ARRA; P.L. 111-5), which
performed by more than 300,000 individuals
was a 33% increase to the regular FY2009
who work at over 2,500 hospitals, medical
appropriations NIH received. NIH has also received
schools, universities, and other research
supplemental appropriations during several infectious
institutions around the country.4 About 10% of
disease emergencies, such as for the Ebola and Zika
the agency’s budget supports intramural
outbreaks. Given current interest, a summary of the
FY2020 and FY2021 amounts for the COVID-19
research (i.e., internal) conducted by nearly
pandemic is provided in Appendix B.
6,000 NIH physicians and scientists, most of
whom are located on the NIH campus in Bethesda, MD.5

1 “Mandatory spending” is controlled by authorization acts; “discretionary spending” is controlled by appropriations
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
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
Indian Health Service (IHS), and the Agency for Toxic Substances and Disease Registry (ATSDR).
3 For further information on the National Institutes of Health (NIH), see CRS Report R41705, The National Institutes of
Health (NIH): Background and Congressional Issues.
4 NIH, “What We Do - Budget,” June 29, 2020, at https://www.nih.gov/about-nih/what-we-do/budget.
5 Ibid.
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Funding Sources
The vast majority of NIH funding comes from annual discretionary appropriations bills. NIH
additionally receives some mandatory funding and some funding due to unique transfer or
budgetary rules, as explained below. The total funding available for NIH activities, taking account
of add-ons and PHS tap transfers, is referred to as the NIH “program level.”6
Discretionary budget authority: NIH’s discretionary budget authority comes primarily from
annual Labor, HHS, and Education (LHHS) Appropriations Acts, with an additional smaller
amount for the Superfund Research Program and related activities from the Interior/Environment
(INT) Appropriations Act.7
PHS Evaluation Set-Aside: 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
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
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
Appropriations Acts have commonly established a higher maximum percentage for the set-aside
and have appropriated specific amounts of “tap” funding to selected HHS programs—in the
context of NIH, these appropriations have been made to National Institute of General Medical
Sciences in recent years.9 Since FY2010, and including in FY2022, this higher maximum set-
aside level has been 2.5% of eligible appropriations.10 Readers should note that totals in this
report and NIH source documents include amounts “transferred in” pursuant to PHS tap but do
not include any amounts “transferred out” under this same authority.
21st Century Cures Act Innovation Account: NIH also receives funding through LHHS
appropriations, subject to different budget enforcement rules than the rest of the NIH funding in
the act—appropriations to the NIH Innovation Account created by the 21st Century Cures Act

6 NIH program levels in this report reflect total funding for all Institutes and Centers (ICs), the Office of the Director
(OD), the PHS Evaluation Set-Aside (“PHS Evaluation Tap”), the Superfund Research Program, mandatory type I
diabetes research (provided in Public Health Service Act [PHSA] Section 330B), the nonrecurring expenses fund
(NEF), and, when applicable, the Patient-Centered Outcomes Research Trust Fund (PCORTF) and mandatory
pandemic preparedness funding proposed in the FY2023 budget.
7 The Hazardous Substance Basic Research and Training Program (Superfund Research Program) funds research on the
health effects of exposures to hazardous substances and related solutions at the National Institute of Environmental
Health Sciences. It is authorized by 311(a) of the Comprehensive Environmental Response, Compensation, and
Liability Act of 1980 (42 U.S.C. §9660(a)) and Section 126(g) of the Superfund Amendments and Reauthorization Act
of 1986.
8 For more information on the PHS Evaluation Tap, or PHS Evaluation Set-Aside, see discussion in CRS Report
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
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
concern at the loss of NIH funds to the tap. Joint Explanatory Statement, Proceedings and Debates of the
113th Congress, Second Session, Congressional Record, vol. 160, no. 151, Book II, December 11, 2014, p. H9832.
10 See Section 204 of Division H, Title II, of P.L. 117-103 for the FY2022 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.
111-8). The FY2022 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
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.
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(“the 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 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 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 specified in the Cures Act. If the NIH Director determines that the funds for any of
the four Innovation Projects are not necessary, the amounts may be transferred back to the NIH
Innovation Account. All amounts authorized by the Cures Act have been fully appropriated to the
Innovation Account from FY2017 to FY2022, including $496 million for FY2022. For FY2023,
$1.085 billion is authorized to be appropriated.
Mandatory Type I Diabetes Funding: 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
program on type 1 diabetes research, most recently extended through FY2023 by the
Consolidated Appropriations Act, 2021 (P.L. 116-260; Division BB, Title III).
Nonrecurring expenses fund (NEF): The NEF permits HHS to transfer unobligated balances of
expired discretionary funds from FY2008 and subsequent years into the NEF account. Statute
authorizes use of the funds for capital acquisitions, including information technology (IT) and
facilities infrastructure (42 U.S.C. §3514a), and appropriators can direct the funds to certain
accounts through appropriations acts. As shown in Table A-1, appropriations directed specific
amounts from the NEF to the NIH Building and Facilities account in FY2020 and FY2021.
Appropriators did not direct a NEF transfer in FY2022.
FY2022 Proposed and Enacted Funding
President Biden’s FY2022 budget request (May 28, 2021) proposed that NIH be provided with a
total program level of $51.958 billion, an increase of $8.92 billion (+20.7%) from the FY2021
program level. The proposed FY2022 program level would have been made up of13
 $50.461 billion in discretionary LHHS budget authority (nontransfer);
 $1.272 billion pursuant to the PHS program evaluation transfer;
 $84 million for the Superfund research program and related activities from
Interior/Environment appropriations; and
 $141 million in annual funding for the mandatory type 1 diabetes research
program.14

11 See section on 21st Century Cures Act in CRS Report R41705, The National Institutes of Health (NIH): Background
and Congressional Issues.
12 CRS Report R45778, Exceptions to the Budget Control Act’s Discretionary Spending Limits.
13 Based mostly on budget request numbers in Congressional Record, vol. 168, no. 42, Book IV, March 9, 2022, pp.
H2862-H2865, except where noted.
14 The FY2022 request amount for the mandatory type 1 diabetes research program differs from the already enacted
amount for FY2022 of $150 million in PHSA Section 330B, as amended in P.L. 116-260, Division BB, Title III.
According to the budget request, the FY2022 request amount reflects sequestration of $8.55 million. See “Budget
Request by IC,” p. 1, at https://officeofbudget.od.nih.gov/pdfs/FY21/br/
2022%20CJ%20Overview%20Volume%20Supplementary%20Tables%20May%2028_corrections%20Oct%204%20an
notated.pdf
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Under this request, all existing IC accounts, except for the OD, would have received an increase
compared with FY2021-enacted levels (see Appendix A). The proposed funding level for the OD
($2.25 billion) would have been $163 million less (-6.7%) than the FY2021-enacted level. The
Buildings and Facilities (B&F) account would have received an increase of $51 million (+25.4%)
in LHHS discretionary budget authority, but an overall decrease of $174 million (-41.1%) when
accounting for the additional NEF transfer of $225 million directed to the B&F account in
FY2021 appropriations.15
The FY2022 budget request also proposed the creation of an Advanced Research Projects Agency
for Health (ARPA-H) within NIH. The budget request included $6.5 billion, available through
September 30, 2024, for ARPA-H “to build platforms and capabilities to deliver cures for cancer,
Alzheimer’s disease, diabetes, and other diseases.”16 The $6.5 billion for ARPA-H accounted for
72.9% of the FY2022 budget request’s proposed $8.92 billion increase from FY2021-enacted
levels. Further information on the ARPA-H proposal is provided in the text box below.
In July 2021, the House passed a consolidated appropriations bill, H.R. 4502, with proposed
FY2022 funding levels for NIH accounts in Division A (LHHS appropriations) and Division E
(Interior/Environment appropriations). The House-passed appropriations bill would have
provided NIH with a FY2022 estimated program level of $49.587 billion, an increase of $6.550
billion (+15.2%) from FY2021-enacted levels and a decrease of $2.371 billion (-4.6%) from the
FY2022 budget request. The House-proposed FY2022 program level would have included the
following amounts:17
 $48.082 billion in discretionary LHHS budget authority (nontransfer);
 $1.272 billion pursuant to the PHS program evaluation transfer;
 $84 million for the Superfund research program and related activities from
Interior/Environment appropriations; and
 $150 million in annual funding for the mandatory type 1 diabetes research
program.
House-passed appropriations would have provided increases to all existing IC accounts compared
with FY2021 funding levels. Compared with the FY2022 budget request, House-passed
appropriations would have provided increases to all existing IC accounts except for the National
Institute of Child Health and Human Development (-$252 million), the National Institute of
Environmental Health Sciences (-$79 million), and the National Institute of Arthritis and
Musculoskeletal and Skin Diseases (-$1 million). The House-passed measure also included $3.0
billion for ARPA-H available through September 30, 2024, a decrease of $3.5 billion (-53.8%)
compared with the FY2022 budget request, and provided that funding would have been available
only if legislation specifically establishing ARPA-H is enacted into law. The Senate
Appropriations Committee LHHS and INT subcommittee chairs introduced regular
appropriations bills (S. 3062 and S. 3034, respectively) that would have provided funding for
NIH; the Senate did not consider these measures in committee or on the floor.

15 Accounting for the directed NEF transfer, the Buildings and Facilities account has a total FY2021 funding level of
$424 million. This total account amount is not reflected in budget request documents.
16 NIH, Congressional Justification: FY2022, May 28, 2021, p. 10, at https://officeofbudget.od.nih.gov/pdfs/FY22/br/
2022%20CJ%20Overview%20Volume%20May%2028.pdf.
17 H.Rept. 117-96, Departments of Labor, Health and Human Services, and Education, and Related Agencies
Appropriations Bill, 2022, July 19, 2021, pp. 475-477, at https://www.congress.gov/117/crpt/hrpt96/CRPT-
117hrpt96.pdf. The FY2022 House numbers incorporate the budgetary effects of the amendments to H.R. 4502 that
were adopted by the House on July 29, 2021.
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On March 15, 2022, Congress and President Biden finalized NIH FY2022 appropriations by
enacting the Consolidated Appropriations Act, 2022 (P.L. 117-103), which includes final FY2022
LHHS appropriations in Division H and Interior/Environment appropriations in Division G. The
enacted FY2022 NIH program level is made up of the following:
 $43.65 billion in discretionary LHHS budget authority;
 $1.309 billion pursuant to the PHS program evaluation transfer;
 $83 million for the Superfund research program and related activities from
Interior/Environment appropriations; and
 $141 million in annual funding for the mandatory type 1 diabetes research
program.18
In total, the NIH FY2022 program level as enacted is $45.183 billion. In addition, the law
provided $1 billion for the Advanced Research Projects Agency for Health to a new account
under the Office of the Secretary. The law allowed the HHS Secretary to place the new agency
anywhere within the department within 30 days of enactment. On March 30, 2022, HHS
Secretary Xavier Becerra submitted a notice to the appropriations committees that ARPA-H is to
reside within the NIH.
Accounting for the ARPA-H transfer, the NIH FY2022-enacted program level is $46.183 billion.
This FY2022 NIH program level represents a $3.146 billion increase (+7.3%) relative to the
FY2021-enacted program level of $43.037 billion. The FY2022 enacted total for NIH is also
$5.775 billion (-11.1%) less than the FY2022 budget request. In FY2022, all IC accounts received
an increase relative to FY2021 funding levels. For the Innovation Account, the full amount
authorized by the 21st Century Cures Act ($496 million) is appropriated. The Buildings and
Facilities (B&F) account receives an increase of $51 million (+25.4%) in LHHS discretionary
budget authority, but an overall decrease of $174 million (-41.1%) when accounting for the
additional NEF transfer of $225 million directed to the B&F account in FY2021 appropriations.
Advanced Research Projects Agency for Health (ARPA-H)
President Biden’s FY2022 budget request to Congress proposed the creation of an Advanced Research Projects
Agency for Health (ARPA-H) within the National Institutes of Health (NIH). The budget request included $6.5
bil ion for ARPA-H “to build platforms and capabilities to deliver cures for cancer, Alzheimer’s disease, diabetes,
and other diseases.” Funding was requested for a period of three years to “allow for both scale-up in FY 2022 and
redeployment of resources in the next two years if projects fail to meet performance milestones.” The vast
majority of funding would support extramural research, with a small amount of funding reserved for staffing and
administrative functions. Unlike NIH Institutes and Centers (ICs), ARPA-H would not have its own intramural
research program.
As proposed, ARPA-H is modeled after the Defense Advanced Research Projects Agency (DARPA), which works
primarily with the Department of Defense (DOD), and would contain several “DARPA model” characteristics,
including a flat and nimble organizational structure, tenure-limited program managers with a high degree of
autonomy to select and fund projects, and a milestone-based contract approach. While this organizational
structure would be “operationally unique” from NIH ICs, ARPA-H would stil coordinate research and activities
with NIH ICs and other HHS agencies.

18 The FY2022-enacted amount for the mandatory type 1 diabetes research program differs from the amount for
FY2022 of $150 million in PHSA Section 330B, as amended in P.L. 116-260 , Division BB, Title III. According to the
budget request, the FY2023 amount reflects sequestration of $8.55 million. See “Budget Mechanism Table,” p. 44, at
https://officeofbudget.od.nih.gov/pdfs/FY23/br/Overview%20of%20FY%202023%20Presidents%20Budget.pdf.
18 HHS, Budget in Brief: FY2023, pp. 53-54, https://www.hhs.gov/sites/default/files/fy-2023-budget-in-brief.pdf.

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The FY2022 budget request describes four broad project areas that ARPA-H would fund:

tackling bold challenges requiring large-scale, sustained, cross-sector coordination;

creating new capabilities (e.g., technologies, data resources, disease models);

supporting high-risk exploration that could establish entirely new paradigms; and

overcoming market failures through critical solutions, including financial incentives.
Most ARPA-H awards would be given to industry, universities, and nonprofit research institutions, and may
involve some agreements with other federal agencies.19
The Consolidated Appropriations Act, 2022 (P.L. 117-103), provides $1 bil ion to HHS to establish the Advanced
Research Projects Agency for Health (ARPA-H). The law created a new ARPA-H account at HHS, with funding
available until September 30, 2024, and allowed the HHS Secretary to place the new agency anywhere within the
department within 30 days of enactment. On March 30, 2022, HHS Secretary Xavier Becerra submitted a notice
to the appropriations committees that ARPA-H is to reside within the NIH, while the ARPA-H Director is to
report directly to the HHS Secretary.
For further information and analysis regarding ARPA-H, see CRS Report R47074, Advanced Research Projects Agency
for Health (ARPA-H): Congressional Action and Selected Policy Issues.
FY2023 Budget Request
President Biden’s FY2023 budget request proposes that NIH be provided with a total program
level of $62.503 billion, an increase of $16.320 billion (+35.3%) from FY2022-enacted levels.
The proposed FY2023 program level would be made up of20
 $48.957 billion in discretionary LHHS budget authority (nontransfer);
 $1.272 billion pursuant to the PHS program evaluation transfer;
 $83 million for the Superfund research program and related activities from
Interior/Environment appropriations;
 $141 million in annual funding for the mandatory type 1 diabetes research
program;21and
 $12.05 billion in new mandatory appropriations for pandemic preparedness.22
Under this request, approximately half of existing IC accounts would receive increases compared
with FY2022-enacted levels (see Appendix A). Funding for the National Institute on Minority
Health and Health Disparities (NIMHD) would increase by the greatest percentage amount
(+$201 million, +43.7%), and funding for OD would decrease by the greatest amount (-$319

19 NIH, Congressional Justification: FY2022, May 28, 2021, pp. 10-11, at https://officeofbudget.od.nih.gov/pdfs/FY22/
br/2022%20CJ%20Overview%20Volume%20May%2028.pdf and HHS, “FY2022 Budget in Brief,” pp. 59-60, at
https://www.hhs.gov/sites/default/files/fy-2022-budget-in-brief.pdf.
20 NIH, Congressional Justification: FY2023, “Budget Request by IC (Summary Table),” March 28, 2022, p. 86, at
https://officeofbudget.od.nih.gov/pdfs/FY23/br/Overview%20of%20FY%202023%20Presidents%20Budget.pdf.
21 This proposed amount for the mandatory type 1 diabetes research program differs from the already enacted amount
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.

22 The FY2023 budget request proposes an HHS-wide total of $81.7 billion for pandemic preparedness to “transform
U.S. capabilities to prepare for and respond rapidly and effectively to future pandemics and other high consequence
biological threats.” The $12.05 billion directed to NIH is for “NIH research and development of vaccines, diagnostics,
and therapeutics against high priority viral families, biosafety and biosecurity, and to expand laboratory capacity and
clinical trial infrastructure.” See HHS, Budget in Brief: FY2023, p. 55, https://www.hhs.gov/sites/default/files/fy-2023-
budget-in-brief.pdf.
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million, -12.2%). In addition, the full amount ($1.085 billion) authorized by the 21st Century
Cures Act for FY2023 (P.L. 114-255) would be appropriated to the Innovation Account. The
FY2023 budget request also proposes $5 billion for ARPA-H, an increase of $4 billion from the
FY2022-enacted level.23
Under the pandemic preparedness proposal, NIH would be provided $12.05 billion in new
mandatory appropriations available for five years. This new appropriation makes up 73.8% of the
proposed increase of $16.32 billion relative to FY2022-enacted program level. The pandemic
preparedness proposal generally does not designate specific amounts for NIH ICs but describes a
number of activities the new funding would support, including vaccine and therapeutic
development, diagnostic test development and innovation, research infrastructure for clinical
trials, and laboratory biosafety and biosecurity.24 If enacted, these mandatory appropriations
generally would be controlled outside the annual appropriations process by authorizing law.
Trends
Table 1 outlines NIH program level funding from FY1996 until the FY2023 request. Figure 1
illustrates funding trends in both current (also called nominal dollars) and projected constant (i.e.,
inflation-adjusted) FY2022 dollars (funding shown is total budget authority).
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,
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 more gradually in nominal dollars.25 In some years, (FY2006,
FY2011, and FY2013) funding for the agency decreased in nominal dollars.26 From FY2016
through FY2022, 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
the largest single-year nominal dollar increase since FY2003. The proposed funding increase in
the FY2023 budget request would be a single-year nominal dollar increase of $16.320 billion
(+35.3%)—it would represent the largest single-year increase in the period covered by this report.
The lower half of Figure 1 shows NIH funding adjusted for inflation (in projected constant
FY2023 dollars) using the Biomedical Research and Development Price Index (BRDPI).27 It

23 NIH, Congressional Justification: FY2023, “Budget Request by IC (Summary Table),” March 28, 2022, p. 86, at
https://officeofbudget.od.nih.gov/pdfs/FY23/br/Overview%20of%20FY%202023%20Presidents%20Budget.pdf.
24 NIH, Congressional Justification: FY2023, pp. 17-20, https://officeofbudget.od.nih.gov/pdfs/FY23/br/
Overview%20of%20FY%202023%20Presidents%20Budget.pdf.
25 Amounts shown in Table 1 include appropriations for the Global Fund to Fight AIDS, TB, and Malaria (FY2002-
FY2011) that were subject to transfer-out. As of FY2012, NIH no longer receives appropriations for the National
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
“Supplemental Appropriation Data Table” for “History of Congressional Appropriations, Fiscal Years 2000-2012” at
http://officeofbudget.od.nih.gov/approp_hist.html.
26 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-
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
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.
27 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
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shows that the purchasing power of NIH funding initially peaked in FY2003 (the last year of the
five-year doubling period) and then declined fairly steadily for more than a decade until
consecutive funding increases were provided in each of FY2016 through FY2022. The FY2022
program level is 0.6% greater than the peak FY2003 program level. The FY2023 budget request
would provide a program level that is 32.8% relative to the peak FY2003 program level.
Figure 1. NIH Funding, FY1996-FY2023
Program Level Funding in Current and Projected Constant (FY2023) Dollars.

Source: Sources used for FY2023 request, FY2022, and FY2021 program levels are in Table A-1. The FY2020
(and earlier) program levels are from NIH Budget Office, Appropriations History by Institute/Center (1938 to
Present), at http://officeofbudget.od.nih.gov/approp_hist.html. Inflation adjustment reflects the Biomedical
Research and Development Price Index (BRDPI), updated March 2022, at https://officeofbudget.od.nih.gov/
gbiPriceIndexes.html.

equipment. It indicates how much the NIH budget must change to maintain purchasing power. See “NIH Price
Indexes,” at https://officeofbudget.od.nih.gov/gbiPriceIndexes.html.
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Notes: By convention, program level totals include amounts “transferred in” pursuant to PHS tap but do not
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
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
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).
Table 1. NIH Funding, FY1996-FY2023
Program Level Funding in Current and Constant (FY2023) Dollars (Billions)
Program Level
Program Level Projected
% Relative to
Fiscal Year
Current $
% Change
Constant FY2023 $
FY2003a
1996
11.928
5.6%
25.045

1997
12.741
6.8%
26.028

1998
13.675
7.3%
27.020

1999
15.629
14.3%
29.934

2000
17.841
14.1%
32.942

2001
20.459
14.7%
36.561

2002
23.321
14.0%
40.340

2003
27.167
16.5%
45.396

2004
28.037
3.2%
45.167
-0.5%
2005
28.594
2.0%
44.341
-2.3%
2006
28.560
-0.1%
42.328
-6.8%
2007
29.179
2.2%
41.664
-8.2%
2008
29.607
1.5%
40.385
-11.0%
2009
30.545
3.2%
40.480
-10.8%
2010
31.238
2.3%
40.176
-11.5%
2011
30.916
-1.0%
38.657
-14.8%
2012
30.861
-0.2%
38.099
-16.1%
2013
29.316
-5.0%
35.526
-21.7%
2014
30.143
2.8%
35.760
-21.2%
2015
30.311
0.6%
35.243
-22.4%
2016
32.311
6.6%
36.769
-19.0%
2017
34.301
6.2%
38.044
-16.2%
2018
37.311
8.8%
40.375
-11.1%
2019
39.313
5.4%
41.661
-8.2%
2020
41.690
6.0%
45.018
-4.4%
2021
43.037
3.2%
45.498
-3.3%
2022
46.183
7.3%
47.363
+0.6%
2023PB
62.503
35.3%
62.503
+32.8%
Sources: Sources used for FY2023 request, FY2022, and FY2021 program levels are in Table A-1. The FY2020
(and earlier) program levels are from NIH Budget Office, Appropriations History by Institute/Center (1938 to
Present), at http://officeofbudget.od.nih.gov/approp_hist.html. Inflation adjustment reflects the Biomedical
Research and Development Price Index (BRDPI), updated March 2022, at https://officeofbudget.od.nih.gov/
gbiPriceIndexes.html.
Notes: By convention, budget tables, such as Table 1, 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
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authority, including appropriations for the Global Fund to Fight AIDS, TB, and Malaria (FY2002-FY2011) that
were subject to transfer-out. As of FY2012, NIH no longer receives appropriations for the National Institute of
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
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 denotes “President’s Budget.”
a. FY2003 was the year that NIH received the most program level funding (prior to FY2022) in 2023 constant
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)
FY2021
FY2022
FY2022
FY2023
Institutes/Centers
Final
Request
Enacted
Request
Cancer Institute (NCI)
$6,540
$6,733
$6,913
$6,714
Heart, Lung, and Blood Institute (NHLBI)
$3,654
$3,846
$3,808
$3,823
Dental/Craniofacial Research (NIDCR)
$483
$516
$501
$513
Diabetes/Digestive/Kidney (NIDDK)a
$2,126
$2,219
$2,204
$2,206
Neurological Disorders/Stroke (NINDS)
$2,504
$2,783
$2,611
$2,768
Allergy/Infectious Diseases (NIAID)
$6,049
$6,246
$6,323
$6,268
General Medical Sciences (NIGMS)b
$1,715
$1,825
$1,783
$1,826
Child Health/Human Development (NICHD)
$1,588
$1,942
$1,683
$1,675
National Eye Institute (NEI)
$833
$859
$864
$853
Environmental Health Sciences (NIEHS)c
$812
$937
$842
$932
National Institute on Aging (NIA)
$3,888
$4,036
$4,220
$4,011
Arthritis/Musculoskeletal/Skin Diseases
$632
$680
$656
$676
(NIAMS)
Deafness/Communication Disorders
$497
$512
$515
$509
(NIDCD)
Alcohol Abuse/Alcoholism (NIAAA)
$553
$570
$574
$567
Nursing Research (NINR)
$174
$200
$181
$199
National Institute on Drug Abuse (NIDA)
$1,476
$1,853
$1,595
$1,843
National Institute of Mental Health (NIMH)
$2,100
$2,214
$2,217
$2,211
Human Genome Research Institute (NHGRI)
$614
$633
$639
$629
Biomedical Imaging/Bioengineering (NIBIB)
$409
$422
$425
$419
Complementary/Integrative Health (NCCIH)
$154
$184
$159
$183
Minority Health/Health Disparities (NIMHD)
$390
$652
$459
$660
Fogarty International Center (FIC)
$84
$96
$87
$96
National Library of Medicine (NLM)
$461
$475
$479
$472
Advancing Translational Sciences (NCATS)
$853
$879
$882
$874
Office of Director (OD)d
$2,413
$2,250
$2,629
$2,310
Innovation Accounte
$109
$150
$150
$419
Buildings and Facilities (B&F)f
$199
$250
$250
$300
Research Quality
—
—
—
—
ARPA-H
—
$6,500
$1,000g
$5,000
Subtotal, NIH (LHHS Discretionary
$41,309
$50,461
$44,650
$48,957
BA)
PHS Program Evaluation (provided to
$1,272
$1,272
$1,309
$1,272
NIGMS)
Superfund (Interior approp. to NIEHS)h
$82
$84
$83
$83
Mandatory type 1 diabetes funds (to
$150
$141
$141
$141j
NIDDK)i
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FY2021
FY2022
FY2022
FY2023
Institutes/Centers
Final
Request
Enacted
Request
Pandemic Preparednessk (proposed
—
—
—
$12,050
mandatory)
Nonrecurring Expenses Fund (NEF) Transfer
$225
—
—
—
(to Buildings and Facilities)l
NIH Program Level
$43,037
$51,958
$46,183
$62,503
Source: The FY2023 Request and FY2021 program levels are from NIH, Congressional Justification: FY2023,
“Budget Request by IC (Summary Table),” March 28, 2022, p. 86, at https://officeofbudget.od.nih.gov/pdfs/FY23/
br/Overview%20of%20FY%202023%20Presidents%20Budget.pdf. The FY2022 and FY2022 Request program
levels are from Congressional Record, vol. 168, no. 42, Book IV, March 9, 2022, pp. H2862-H2865, except where
noted below.
Notes: Totals may differ from the sum of the components due to rounding. Amounts in table may differ from
actuals in many cases. By convention, budget tables such as Table A-1 do not subtract the amount of transfers
to the evaluation tap from the agencies’ appropriation. In general, amounts provided to NIH for emergency
requirements are excluded from these totals (e.g., FY2021 amounts do not include the amounts provided in the
coronavirus supplemental appropriations acts, summarized in Appendix B).
a. Amounts for the NIDDK do not include mandatory funding for type 1 diabetes research (see note j).
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
(see note i).
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.
e. The amount shown for the NIH Innovation Account in each column represents only a portion of the total
appropriation to the account ($404 mil ion for FY2021: $496 mil ion for FY2022; $1.085 bil ion for FY2023.
The remaining funds for this account are reflected, where applicable, into the totals for other ICs. For
FY2022, this includes $194 mil ion to NCI for cancer research and $76 mil ion to each of NINDS and NIMH
for the BRAIN Initiative ($152 mil ion total for BRAIN). For FY2023, this includes $216 mil ion to NCI for
cancer research and $225 mil ion to each of NINDS and NIMH for the BRAIN Initiative ($450 mil ion total).
f.
Amounts for the Building and Facilities account do not include directed transfers from the nonrecurring
expenses fund in FY202-enacted appropriations (see note l).
g. Funding for ARPA-H in P.L. 117-103 was provided to a new ARPA-H account under the HHS Office of the
Secretary. A proviso accompanying the appropriation gave HHS Secretary Becerra the ability to transfer the
new agency anywhere within the department within 30 days of enactment. On March 30, 2022, HHS
Secretary Xavier Becerra submitted a notice to the appropriations committees that ARPA-H is to reside
within the NIH; therefore, ARPA-H is shown within NIH in this table presentation.
h. This is a separate account in the Interior/Environment appropriations for NIEHS research activities related
to Superfund research.
i.
Mandatory funds are available to NIDDK for type 1 diabetes research under PHSA Section 330Bm, which
was most recently extended through FY2023 by the Consolidated Appropriations Act, 2021 (P.L. 116-260;
Division BB, Title II).
j.
The FY2022 and FY2023 amounts for the type I diabetes research program ($141 mil ion) are lower than
the enacted funding levels for FY2022 and FY2023 ($150 mil ion). According to the budget request, the
FY2022 and FY2023 amounts reflect sequestration of $8.55 mil ion. See “Budget Mechanism Table,” p. 44 in
https://officeofbudget.od.nih.gov/pdfs/FY23/br/Overview%20of%20FY%202023%20Presidents%20Budget.pdf.
k. The FY2023 request proposes new mandatory funding for pandemic preparedness to be available for five
years. The request proposes an HHS-wide total of $81.7 bil ion for pandemic preparedness, with $12.05
bil ion of the total designated for NIH.
l.
The nonrecurring expenses fund (NEF) permits HHS to transfer unobligated balances of expired
discretionary funds from FY2008 and subsequent years into the NEF account. Congress and the President
authorized use of the funds for capital acquisitions, including information technology (IT) and facilities
infrastructure (42 U.S.C. §3514a), and can direct the funds to certain accounts through appropriations acts.
NEF transfers are shown as non-add in this budget presentation as these amounts were not reflected in
FY2023 budget request tables.
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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.28 This is a
relatively new practice that has expanded since FY2015.29 For the most part, Congress does not
specify NIH funding for particular diseases or areas of research in the appropriations process and
instead allows the ICs to award funding within their mission areas based on their own strategic
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
priorities.30
In FY2022, Congress used appropriations report language to specify a certain amount of IC
funding for designated purposes, as summarized in Table A-2. 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 include many additional statements directing
the agency to prioritize certain programs or areas of research, as well as statements expressing the
opinion or concerns of Congress regarding NIH; these broad statements are not summarized here.
In addition, the President has proposed broad funding increases for certain research and other
areas in his FY2023 budget request, as summarized in Table A-3.
Table A-2. Specified NIH Funding Levels in FY2022 Explanatory Statement
Institute/Center
Program/Activity
Amount

Childhood Cancer Data Initiative (CCDI)
$50 mil ion
Childhood Cancer Survivorship, Treatment
No less than $30 mil ion
Access, and Research (STAR) Act
Cancer success rates
An additional $150 mil ion
National Heart, Lung, and
Community Engagement Alliance Against
$20 mil ion
Blood Institute (NHLBI)
COVID–19 Disparities (CEAL) Initiative
Health disparities research*
An increase of $50 mil ion
National Institute of
Opioids and pain/pain management research*
An increase of $18 mil ion
Dental and Craniofacial
Research (NIDCR)
National Institute of
Opioids and pain/pain management research*
An increase of $20 mil ion
Diabetes and Digestive
and Kidney Diseases
(NIDDK)
HEAL Initiative (opioids, stimulants, and pain
No less than the FY2021
management)
funding level ($270 mil ion)

28 For a general overview, see CRS Report R44124, Appropriations Report Language: Overview of Components and
Development and CRS Report R47019, The Executive Budget Process: An Overview.
29 As recently as December 2014, the explanatory statement on the FY2015 omnibus stipulated, “In keeping with
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
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
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
for Alzheimer’s relative to those submitted for other diseases.” See Congressional Record, daily edition, vol. 160, no.
151, Book II (December 11, 2014), p. H9832.
30 CRS Report R41705, The National Institutes of Health (NIH): Background and Congressional Issues.
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Institute/Center
Program/Activity
Amount
National Institute of
Basic research related to opioids and pain*
An additional $43 mil ion
Neurological Disorders
and Stroke (NINDS)
National Institute of
Centers for AIDS Research
$71 mil ion, an increase of $10
Allergy and Infectious
mil ion
Diseases (NIAID)
Consortium of Food Allergy Research
$9.1 mil ion, an increase of $3
(CoFAR)
mil ion
Lyme disease and other tick-borne diseases
An increase of $18 mil ion
Regional biocontainment laboratories (RBL)
$52 mil ion
Responding to infectious diseases
No less than $540 mil ion, an
increase of $15 mil ion
Rapid vaccine development platforms for
$50 mil ion
emerging infectious disease*
SARS–CoV–2–Immunity: understanding diversity
$5 mil ion
and addressing disparity
Universal flu vaccine
No less than $245 mil ion, an
increase of $25 mil ion
National Institute of
Increasing diversity in biomedical research
An increase of $6.36 mil ion
General Medical Sciences
Institutional Development Award (IDeA) Program $410 mil ion, an increase of
(NIGMS)
$13.4 mil ion
Eunice Kennedy Shriver
Impact of COVID–19 on children
An increase of $7.5 mil ion
National Institute of Child Implementing a Maternal Health and Pregnancy
$43 mil ion, an increase of $30
Health and Human
Outcomes Vision for Everyone (IMPROVE)
mil ion
Development (NICHD)
Initiative
Research in pregnant and lactating
$1.5 mil ion
women- National Academies of Science,
Education, and Medicine (NASEM) panel
National Institute of
Climate change research*
An increase of $100 mil ion
Environmental Health
Sciences (NIEHS)
National Institute on
Alzheimer’s disease and related dementias
An increase of $289 mil ion
Aging (NIA)
Center on Exposome Studies in Alzheimer’s
$15 mil ion
Disease and Related Dementias (ADRD)
Opioids and pain/pain management research*
An increase of $29 mil ion
National Institute of
Opioids and pain/pain management research*
An increase of $24 mil ion
Arthritis and
Musculoskeletal and Skin
Diseases (NIAMS)
National Institute on
HEAL Initiative (opioids, stimulants, and pain
No less than $345 mil ion
Drug Abuse (NIDA)
management)
Underage and perinatal marijuana use- NASEM
$2 mil ion
panel*
National Institute of
Impact of COVID on mental health
An increase of $20 mil ion
Mental Health (NIMH)
National Institute of
Health disparities research*
An increase of $20 mil ion
Nursing Research (NINR)
National Human Genome
Emerging Centers of Excellence in Genomic
No less than $15 mil ion
Research Institute
Sciences
(NHGRI)
National Institute on
Health disparities research
An increase of $50 mil ion
Minority Health and
Research Centers in Minority Institutions
$5 mil ion
Health Disparities
Coordination Network
(NIMHD)
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Institute/Center
Program/Activity
Amount
National Center for
Pain and pain management research*
An increase of $26 mil ion
Complementary and
Integrative Health
(NCCIH)
National Center for
Clinical and Translational Science Awards
$606.7 mil ion, an increase of
Advancing Translational
(CTSAs)
$19.8 mil ion
Sciences (NCATS)
Cures Acceleration Network (CAN)
$60 mil ion
John E. Fogarty
Health disparities research*
An increase of $10 mil ion
International Center (FIC)
Office of the Director
All of Us Precision Medicine Initiative
$541 mil ion, an increase of $41
(OD)/ Multi-Institute
mil iona
Research Initiatives
Amyotrophic lateral sclerosis (ALS)
$25 mil ion for implementation
of the Accelerating Access to
Critical Therapies for ALS Act
(P.L. 117-79).
$1 mil ion for NASEM study “to
identify and recommend actions
for the public, private, and
nonprofit sectors to undertake
to make ALS a livable disease
within a decade.”
Grants for biomedical research facilities
$60 mil ion
Brain Research through Advancing Innovative
$620 mil ion,b including $70
Neurotechnologies (BRAIN) Initiative
mil ion for the Human Brain
Cell Atlas, $30 mil ion for the
Armamentarium for Brain Cell
Access, and $10 mil ion for the
Brain Connectivity Map
Cybersecurity
An increase of $40 mil ion
Environmental Influences on Child Health
$180 mil ion
Outcomes (ECHO)*
Firearm injury and mortality prevention research
$12.5 mil ion
HHS Office of Extramural Research allocation for
$2.5 mil ion
foreign influence investigations
IDeA States Pediatric Clinical Trials Network
No less than the FY2021
funding level ($15 mil ion)
Investigation of Co-Occurring Conditions Across
No less than $75 mil ion, an
the Lifespan to Understand Down Syndrome
increase of $10 mil ion
(INCLUDE)
Office of AIDS Research, for HIV/AIDS research
No less than $3.2 bil ion
Office of Research on Women's Health (ORWH)
$59.5 mil ion, including $4
mil ion for the Building
Interdisciplinary Research
Careers in Women’s Health
(BIRCWH) program
Office of Behavioral and Social Sciences Research
$38.9 mil ion
(OBSSR)
Office of the Chief Officer for Scientific
$16.2 mil ion
Workforce Diversity (COSWD)
Source: Congressional Record, vol. 168, no. 42, Book IV, March 9, 2022, pp. H2674-H2679, and H.Rept. 117-96,
pp. 108-166. House report amounts cited where not superseded by the explanatory statement per direction in
the explanatory statement, “Unless otherwise noted, the language set forth in H.Rept. 117-96 carries the same
weight as language included in this explanatory statement and should be complied with unless specifically
addressed to the contrary in this explanatory statement” (p. H2668).
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Notes: Table does not include amounts already shown in Table A-2. Asterisks (*) denote amounts from
H.Rept. 117-96.
a. Amount includes $150 mil ion from the Innovation Account as authorized in the Cures Act.
b. Amount includes $152 mil ion from the Innovation Account for the BRAIN Initiative as authorized by the
Cures Act (split between NINDS and NIMH in FY2022 appropriations).
Table A-3. Specified NIH Funding Levels in FY2023 Budget Request
Program/Activity
Amount
Opioid, stimulant, and pain research
$2.6 bil ion—$811 mil ion for the Helping to End
Addiction Long-term (HEAL) Initiative and $1.8 bil ion
to support ongoing research across ICs
Health disparities and inequities research
An increase of $350 mil ion—$210 mil ion for the
National Institute on Minority Health and Health
Disparities (NIMHD)
Office of Nutrition Research—to promote health and
$97 mil ion
reduce the burden of diet-related diseases.
Universal influenza vaccine
$260 mil ion, an increase of $15 mil ion above enacted
Centers for AIDS Research
$26 mil ion
Maternal Health and Pregnancy Outcomes Vision for
$30 mil ion
Everyone (IMPROVE) Initiative
Research on effects of COVID-19 on pregnant and
additional $3 mil ion
lactating women (National Institute of Child Health and
Human Development [NICHD])
Studies of the social media impact on mental health
$5 mil ion
(National Institute of Mental Health [NIMH])
Studies to inform mental health treatment approaches,
$5 mil ion
service delivery, and system transformation (NIMH)
Center for Sexual Orientation and Gender Identity
$2 mil ion
(SOGI) research
Source: HHS, “FY2023 Budget in Brief,” pp. 55-58, at https://www.hhs.gov/sites/default/files/fy-2023-budget-in-
brief.pdf. In several cases, the budget request does not specify funding amounts by institute/center or account.
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Appendix B. Coronavirus Supplemental
Appropriations (FY2020 and FY2021) and Additional
American Rescue Plan Act funding
NIH received FY2020 and FY2021 emergency supplemental appropriations to several IC
accounts and as transfers from the Public Health and Social Services Emergency Fund (PHSSEF)
account as provided by four coronavirus supplemental appropriations acts:31
 Division A of the Coronavirus Preparedness and Response Supplemental
Appropriations Act, 2020 (P.L. 116-123), enacted on March 6, 2020.
 Division B of the Coronavirus Aid, Relief, and Economic Security Act (CARES
Act, P.L. 116-136), enacted on March 27, 2020.
 Division B of the Paycheck Protection Program and Health Care Enhancement
Act (PPPHCEA, P.L. 116-139), enacted on April 24, 2020.
 Division M of Consolidated Appropriations Act, 2021 (P.L. 116-260), enacted on
December 27, 2020.
NIH received a total of $3.031 billion to NIH IC accounts, along with directed transfers from the
PHSSEF account to NIH accounts totaling not less than $1.806 billion. Accounting for transfers,
NIH received a total of at least $4.837 billion (see text box below for information on American
Rescue Plan Act funding). All appropriations to NIH accounts are available until September 30,
2024, and all transfers from the PHSSEF are available until expended. This funding was primarily
provided in three categories:
Broadly Available Funding. In the first (P.L. 116-123) and third measure (CARES Act; P.L. 116-
136), funding was made available to several NIH IC accounts “to prevent, prepare for and
respond to coronavirus, domestically and internationally.” NIH IC accounts that received broadly
available funds and their totals include the following:
 National Institute of Allergy and Infectious Diseases (NIAID): $1.542 billion,
including $836 million in the first measure and $706 million in the CARES Act.
Some transfers or set-asides were directed for specific purposes in the NIAID
appropriations. The first measure directed a transfer of not less than $10 million
to the National Institute of Environmental Health Sciences (NIEHS) for “worker-
based training to prevent and reduce exposure of hospital employees, emergency
first responders, and other workers who are at risk of exposure to coronavirus
through their work duties.” The third measure set aside not less than $156 million
of the total for “the study of, construction of, demolition of, renovation of, and
acquisition of equipment for, vaccine and infectious diseases research facilities of
or used by NIH, including the acquisition of real property.”
 National Heart, Lung, and Blood Institute (NHLBI): $103 million in the
CARES Act.
 National Institute of Biomedical Imaging and Bioengineering (NIBIB): $60
million in the CARES Act.
 National Library of Medicine (NLM): $10 million in the CARES Act.

31 NIH did not receive supplemental appropriations from the Families First Coronavirus Response Act (FFCRA, P.L.
116-127), enacted on March 18, 2020.
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 National Center for Advancing Translational Sciences (NCATS): $36 million
in the CARES Act.
 Office of the Director (OD): $30 million in the CARES Act.
Diagnostic Testing Research and Development (R&D). In the fourth (Paycheck Protection
Program and Health Care Enhancement Act; PPPHCEA, P.L. 116-139) and fifth measure
(Division M of P.L. 116-260), NIH received funding for specific purposes related to diagnostic
test R&D. This funding was directed to NIH as “not less than” transfers from the PHSSEF
account in the fourth measure, and directly to the OD account in the fifth measure. These amounts
included the following:
 National Cancer Institute (NCI): Transfer of not less than $306 million from
PHSSEF to NCI “to develop, validate, improve, and implement serological
testing and associated technologies” in the PPPHCEA.
 NIBIB: Transfer of not less than $500 million from PHSSEF to NIBIB “to
accelerate research, development, and implementation of point of care and other
rapid testing related to coronavirus” in the PPPHCEA.
 OD: Transfer of not less than $1 billion from PHSSEF to OD “to develop,
validate, improve, and implement testing and associated technologies; to
accelerate research, development, and implementation of point of care and other
rapid testing; and for partnerships with governmental and non-governmental
entities” in the PPPHCEA. In the fifth measure, not less than $100 million of the
$1.250 billion total provided to the OD account is for “the Rapid Acceleration of
Diagnostics.”
NIH’s Rapid Acceleration of Diagnostics (RADx) initiative is an effort to innovate and scale up
COVID-19 diagnostic technologies. As communicated to CRS, the $1.5 billion total for NIBIB
and OD in the fourth measure was used to support RADx initially, with additional funds in the
fifth measure as specified above.32
Long-Term Studies of COVID-19. The fifth measure directed $1.15 billion of the total $1.250
billion provided to the OD account “for research and clinical trials related to long-term studies of
COVID-19.” The $1.15 billion has since been directed toward NIH’s REsearching COVID to
Enhance Recovery (RECOVER) Initiative, a large coordinated research initiative to study long
COVID. 33 The fifth measure also allows the total $1.25 billion appropriation to OD to be
transferred to other IC accounts (in addition to other HHS transfer authorities in the law).
American Rescue Plan Act of 2021 (ARPA; P.L. 117-2) Appropriations
The ARPA did not provide any mandatory appropriations directly to NIH but made available several
appropriations that could be allocated to NIH. For example, $6.05 bil ion was provided to the HHS Secretary in
mandatory appropriations (i.e., direct appropriations) for research, development, manufacturing, production, and
the purchase of vaccines, therapeutics, and ancil ary medical products and supplies—available to address COVID-
19, SARS-CoV-2 or its variants, and any disease with potential for creating a pandemic (Title II, Section 2303). The
HHS Secretary can allocate a portion of these funds to NIH accounts at his discretion. In addition, NIH has

32 CRS communication with NIH, July 24, 2020.
33 See “How is RECOVER being paid for” at RECOVER: Frequently Asked Questions, https://recovercovid.org/
faqs#paid. As reported by the Government Accountability Office (GA)-22-105497), HHS transferred $1,063.5 million
of the $1.25 appropriation for NIH OD in the fifth measure to the Administration for Children and Families’
Unaccompanied Children Program (see Appendix: HHS COVID-19 Funding). NIH’s RECOVER website states that
“the primary funding source for RECOVER has changed to the American Rescue Plan (ARP) Act of 2021 (Sec. 2401),
the $1.15 billion budget remains and NIH RECOVER research activities have neither stopped nor had any delays.”
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reported that the HHS Secretary has allocated other ARPA funding in Section 2401 toward the RECOVER
Initiative (see above) after an initial transfer of $1,063.5 from NIH to HHS’s Administration for Children and
Families’ Unaccompanied Children Program of the original appropriation for that program in the fifth measure
(see footnote 31).

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Appendix C. Acronyms and Abbreviations
Acronym/
Abbreviation
Organization/Term
ARPA-H
Advanced Research Projects Agency for Health
DARPA
Defense Advanced Research Projects Agency
DOD
Department of Defense
FIC
Fogarty International Center
FY
Fiscal Year
IC
Institutes and Centers
NASEM
National Academies of Sciences, Engineering, and Medicine
NCATS
National Center for Advancing Translational Sciences
NCCIH
National Center for Complementary and Integrative Health
NCI
National Cancer Institute
NEF
Nonrecurring Expenses Fund
NEI
National Eye Institute
NHGRI
National Human Genome Research Institute
NHLBI
National Heart, Lung, and Blood Institute
NIA
National Institute on Aging
NIAAA
National Institute on Alcohol Abuse and Alcoholism
NIAID
National Institute of Allergy and Infectious Diseases
NIAMS
National Institute of Arthritis and Musculoskeletal and Skin Diseases
NIBIB
National Institute of Biomedical Imaging and Bioengineering
NICHD
National Institute of Child Health and Human Development
NIDA
National Institute on Drug Abuse
NIDCD
National Institute on Deafness and Other Communication Disorders
NIDCR
National Institute of Dental and Craniofacial Research
NIDDK
National Institute of Diabetes and Digestive and Kidney Diseases
NIEHS
National Institute of Environmental Health Sciences
NIGMS
National Institute of General Medical Sciences
NIMH
National Institute of Mental Health
NIMHD
National Institute on Minority Health and Health Disparities
NINDS
National Institute of Neurological Disorders and Stroke
NINR
National Institute of Nursing Research
NLM
National Library of Medicine
OD
NIH Office of the Director
PHS
Public Health Service

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Author Information

Kavya Sekar

Analyst in Health Policy

Acknowledgments
CRS Research Assistants Isaac Nicchitta and John Gorman provided valuable assistance in analysis and
writing for this report.

Disclaimer
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
under the direction of Congress. Information in a CRS Report should not be relied upon for purposes other
than public understanding of information that has been provided by CRS to Members of Congress in
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Congressional Research Service
R43341 · VERSION 43 · UPDATED
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