Contents

• NIH Funding: FY1996-FY2026 Request
• Funding Sources
• NIH Funding: FY2025-FY2026 Request
• FY2025 Final
• FY2026 Request
• Trends

Summary

This report details the National Institutes of Health (NIH) budget and appropriations process with a focus on FY2025 and FY2026 request. NIH is the primary federal agency charged with conducting and supporting medical, health, and behavioral research. It consists of 27 Institutes and Centers (ICs) plus the Office of the Director (OD). In addition, the Advanced Research Projects Agency for Health (ARPA-H), first funded in FY2022, is established as an independent agency housed within NIH to advance "high-potential, high-impact" biomedical and health research. Nearly 82% of the NIH budget funds extramural research through grants, contracts, and other awards to universities and other research institutions. About 11% 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 the Department of Interior, Environment, and Related Agencies (INT) Appropriations Act and a mandatory budget authority for type 1 diabetes research.

FY2025 Enacted and FY2026 Request

In FY2025, NIH was primarily funded by the FY2025 full-year continuing resolution (CR; Division A of P.L. 119-4). The CR, for the most part, provided NIH with full-year FY2025 funding at the same levels and subject to the same conditions as provided in FY2024 appropriations (P.L. 118-47). The main exception was for the NIH Innovation Account; a provision in the FY2025 CR reduced the FY2025 NIH Innovation Account appropriation to the level authorized in the 21st Century Cures Act for FY2025 (a $280 million decrease to precision medicine and brain research). Accounting for transfers, NIH received a total program funding level of $46.995 billion in FY2025, $357 million (-0.8%) less than the FY2024 final level. Accounting for an ARPA-H appropriation of $1.5 billion, the final NIH and ARPA-H FY2025 funding level is $48.495 billion, or 0.7% less than the FY2024 NIH and ARPA-H funding level.

The FY2026 budget request proposes an NIH program level of $27.915 billion, a decrease of $19.1 billion (-40.6%) from the FY2025 enacted level. The FY2026 budget request also proposes to restructure NIH. Four ICs would be eliminated, while 19 would be consolidated into eight restructured ICs. Two NIH components would be moved out of NIH to other parts of HHS: the National Institute of Environmental Health Sciences and ARPA-H. In FY2026, all eight proposed ICs would see funding decreases (ranging from -21% to -44%) from comparable FY2025 levels.

Trends

NIH has seen periods of high and low funding growth during the years covered by this report, as illustrated in Figure 2. From 1998 through 2003, 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 17%. From FY2003 to FY2015, NIH funding increased more gradually in nominal dollars. In some years (FY2006, FY2011, and FY2013), agency funding decreased in nominal dollars. From FY2016 through FY2023, NIH saw funding increases each year ranging from 3% to 9%. NIH saw slight decreases in both FY2024 (-0.7%) and FY2025 (-0.8%) from the prior year's enacted funding level.

When looking at NIH funding adjusted for inflation (in preliminary constant FY2024 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 (at a rate higher than inflation, as measured by the BRDPI) in each of FY2016 through FY2023. In FY2025, the inflation-adjusted NIH program level based on BRDPI projections, is estimated to be 8.8% less than the FY2003 peak level. The FY2026 request would provide an inflation-adjusted NIH program that is 47.3% below the FY2003 peak level.

NIH Funding: FY1996-FY2026 Request

The National Institutes of Health (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 Human Services (HHS), a group of federal agencies engaged in public health activities.¹ 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 these, 24 ICs and OD support research programs and three provide support services. 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, the Advanced Research Projects Agency for Health (ARPA-H), first funded in FY2022, is established as an independent agency housed within NIH to advance "high-potential, high-impact" biomedical and health research.² This report details the NIH budget with a focus on FY2025 enacted funding and the FY2026 request. As of the date of publication, the FY2026 continuing resolution (P.L. 119-37) has funded NIH until January 30, 2026 at FY2025 enacted levels. This report does not summarize this temporary FY2026 funding.

NIH activities cover a wide range of basic, clinical, and translational research, focused on particular diseases, areas of human health and development, or more fundamental aspects of biology and behavior. Its mission also includes research training and health information collection and dissemination.³ As of FY2023, nearly 82% of the NIH budget funded extramural research (i.e., external) through grants, contracts, and other awards. which supported research performed by more than 300,000 individuals who work at over 2,500 hospitals, medical schools, universities, and other research institutions around the country.⁴ In addition, as of FY2023, about 11% of the agency's budget supported intramural research (i.e., internal) conducted by nearly 6,000 NIH physicians and scientists, most of whom are located on the NIH campus in Bethesda, MD.⁵ The remaining 6% of the budget supported administration, construction, maintenance, and operations.⁶

Funding Sources

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 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."⁷

Discretionary budget authority. The majority of NIH's discretionary budget authority has come primarily from the annual Department of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act (LHHS), with an additional smaller amount from the Department of the Interior, Environment, and Related Agencies Appropriations Act (INT). The LHHS Act has typically provided NIH funding under headers that align with its 24 research ICs, OD, ARPA-H, and a Buildings and Facilities account. Three support centers are funded through transfers from other accounts. The INT Act has provided funding specifically for the National Institute of Environmental Health Science's Hazardous Substance Basic Research and Training Program (Superfund Research Program), which supports research and training related to the health effects of hazardous substances.⁸

PHS Evaluation Set-Aside. The PHS Evaluation Set-Aside, also known as the PHS Evaluation Tap, has the effect of redistributing a certain percentage of eligible appropriations among HHS accounts funded by the LHHS Act (up to 2.5% of eligible appropriations in FY2025).⁹ Eligible appropriations potentially subject to the transfer include any programs authorized in the Public Health Service Act, with some exemptions.¹⁰ In recent years, appropriations laws have directed specific amounts of PHS tap funds to specific agencies. NIH has received a large share of PHS Evaluation Tap transfers in recent years, specifically to the National Institute of General Medical Sciences (NIGMS). By convention, appropriations acts have directed where specified PHS Evaluation Tap transfers are to be allocated but do not specify the accounts that are to be the sources of those transfers. Thus, tables in this report show only the amount of PHS Evaluation Tap funds received in any NIH account.

Mandatory Type I Diabetes Funding. In addition, NIH has received mandatory funding provided in Public Health Service Act (PHSA) Section 330B for a special program on type 1 diabetes research. For FY2025, funding was primarily extended to September 30, 2025, by Division B of the Full-Year Continuing Appropriations and Extensions Act, 2025 (P.L. 119-4).¹¹

21^st 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, which was created by the 21^st Century Cures Act ("the Cures Act," P.L. 114-255). The NIH Innovation Account funds programs authorized by the Cures act for FY2017 through FY2026, as shown in Table 1.¹² Amounts appropriated to the account—up the limit authorized for each fiscal year—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.¹³ 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. Innovation Account appropriations are available until expended, unlike most discretionary funding NIH receives, which has typically been made available for one year. All amounts authorized by the Cures Act have been fully appropriated to the Innovation Account from FY2017 to FY2025, including $127 million for FY2025.¹⁴

NIH Funding: FY2025-FY2026 Request

Table 2 provides an overview of recent year NIH funding from FY2024 final appropriations to proposed amounts in the FY2026 budget request. The first section of the table summarizes discretionary funding to each of NIH's accounts in annual LHHS appropriations, ending with the total discretionary amount enacted or proposed in LHHS each year. Next, the table summarizes funding by other sources (see previous section) and then summarizes the total NIH program level for each year accounting for all sources of funds. In this table, ARPA-H funding is presented separately from the rest of NIH, and thus a separate "NIH and ARPA-H" program level is shown.

The following discussion provides a summary of enacted and proposed NIH funding in FY2025 and FY2026, respectively, with a discussion of highlighted changes in each year.

FY2025 Final

In FY2025, NIH was primarily funded by the FY2025 full-year CR (Division A of P.L. P.L. 119-4).¹⁵ The CR, for the most part, provided NIH with full-year FY2025 funding at the same levels and subject to the same conditions as funding provided in FY2024 appropriations (P.L. 118-47). The one exception was for the NIH Innovation Account; as previously mentioned, a provision in the FY2025 CR reduced the FY2025 NIH Innovation Account appropriation to the level authorized in the 21^st Century Cures Act for FY2025 (a $280 million scheduled decrease to the Precision Medicine Initiative (PMI) and the Brain Research Through Advancing Innovative Neurotechnologies (BRAIN) Initiative).

As shown in Table 2, accounting for transfers and funding from other sources (e.g., mandatory appropriations), NIH received a total program funding level of $46.995 billion in FY2025. Accounting for an ARPA-H appropriation of $1.5 billion, the final NIH and ARPA-H FY2025 funding level is $48.495 billion. This final FY2025 total funding level is $357 million less than the comparable FY2024 final level. This year-to-year decrease is primarily because of the decrease in authorized (and appropriated) funding for the NIH Innovation Account (a $280 million decrease) and because of differences in total funding provided for the mandatory type 1 diabetes research program in FY2025 compared to FY2024 (a $76.7 million decrease). Otherwise, all other NIH accounts saw the same funding level in FY2025 as in FY2024.¹⁶

In FY2024, through an accompanying explanatory statement, Congress specified funding for certain programs and activities within NIH accounts, such as funding for Alzheimer's disease research and mental health research (see Appendix A).¹⁷ Besides these limited specific directives, Congress has not typically directed NIH funding for specific diseases or projects. Instead, Congress has allocated funding among NIH's ICs accounts, giving the ICs flexibility to determine overall funding levels for specific programs and research areas. The FY2025 CR was not accompanied by an explanatory statement or report. As of the cover date of this report, the post-enactment allocations for particular programs, projects, and activities are not consistently available through public executive branch sources.

This report focuses on annual appropriations levels, or the annual level of regular budget authority available to NIH for obligation and spending. This report does not focus on NIH's obligations and expenditures from these appropriations. While not a focus of this report, in August 2025, the Government Accountability Office (GAO) determined that publicly available data showed a decline in FY2025 obligations and expenditures relative to prior fiscal years. Between February and June 2025, NIH obligated $8 billion less than it had in the same time period for FY2024, and roughly 62%-64% of what the agency had obligated in the same time period in FY2023 and FY2024.¹⁸ Since GAO published this report, in November 2025, CRS analyzed available NIH budget data and found that the agency obligated almost all of its FY2025 discretionary budget authority by the end of FY2025. The agency's total obligations in FY2025 were similar to FY2024. All NIH accounts funded by one-year discretionary appropriations had obligated close to 100% of available FY2025 appropriations.¹⁹

FY2026 Request

For FY2026, President Trump requests a total NIH program level of $27.915 billion from all funding sources. This represents a 40.6% reduction from the comparable FY2025 NIH program level of $46.995 billion (excluding ARPA-H).

NIH Restructuring

Significantly, the President's FY2026 budget proposes to reduce NIH's 24 current research ICs to eight research ICs. Four ICs would be eliminated, while 19 would be consolidated into eight restructured ICs as shown in Figure 1. Two NIH components would be moved out of NIH to other parts of HHS: the National Institute of Environmental Health Sciences (NIEHS) and ARPA-H (see next section). According to the budget request, the "restructuring will create efficiencies within NIH that will allow the agency to focus on true science, and coordinate research to make the best use of federal funds."²⁰ Table 2 provides a comparison of the FY2026 total proposed NIH funding with FY2024 final and FY2025 enacted funding. It displays funding organized by the proposed new ICs for FY2024, FY2025, and FY2026, along with FY2024 and FY2025 funding as enacted based on the prior IC structure (shown as non-adds in the table). The table also shows NIH funding data for certain transfers or other budget authorities as summarized earlier. In FY2026, all eight proposed ICs would see decreases from prior comparable FY2024 and FY2025 levels (ranging from -21% to -44%).

Figure 1. Proposed NIH Reorganization for FY2026

Source: HHS, Budget in Brief FY2026, p. 22, https://www.hhs.gov/sites/default/files/fy-2026-budget-in-brief.pdf Notes: The President's FY2026 request proposes to eliminate the National Institutes for Nursing Research, National Center for Complementary and Integrative Health, Fogarty International Center, and the National Institute on Minority Health and Health Disparities.

ARPA-H

In FY2022 Congress established ARPA-H within NIH to support milestone-based research aimed at driving health innovation. ARPA-H is an independent agency and is not considered an NIH IC.²¹ However, ARPA-H is placed within NIH by statute and has received appropriations in an NIH account for both FY2024 and FY2025 as shown in Table 2.²² The FY2026 budget proposes moving ARPA-H out of NIH under a new Assistant Secretary for a Healthy Future (ASHF) with a FY2026 funding level of $945 million (compared to $1.5 billion in FY2025).²³ Therefore, the FY2026 requested funding level for ARPA-H is not reflected in Table 2.

Potential Impact on Funded Research

NIH estimates that the FY2026 funding level would support 4,312 new competing research grants, a decrease of 29.3% from the number of competing grants supported by the FY2025 funding level (6,095 grants) and an even greater decrease from the FY2024 level of 10,086 competing grants.²⁴ This decrease is explained by both an overall proposed funding level decrease and NIH's new multiyear grants funding policy which results in fewer, but larger, grant awards (see next section for further explanation). All other categories of research would also see decreases compared to FY2025 funding levels ranging from 27% to 43%, including NIH's support of research centers, training, and intramural research.²⁵

Policy Proposals

The FY2026 request also includes several policy proposals for NIH, specifically:

• Indirect costs rate cap: The FY2026 request proposes to continue an NIH policy announced in February 2025 to cap the amount of NIH grant funds that can pay for facilities and administrative (F&A, or indirect) costs at 15% of the applicable direct cost base for each award. The request also proposes to eliminate an annual provision in LHHS appropriations acts that limits NIH's ability to modify its indirect costs rate policy. As of the date of publication, NIH's implementation of the February 2025 indirect costs policy was permanently enjoined (i.e., paused) by a Massachusetts federal court in April 2025.²⁶ Currently, most NIH-funded research institutions have a separate indirect cost rate that is applied to a portion of the direct research costs supported by any research grant the institution receives. According to a 2025 economics study based on data from 354 NIH-funded institutions, most institutions' negotiated rates were between 50% and 70%, averaging 58%. However, effective indirect costs rates, meaning the amount of the grant that has effectively covered indirect costs, ranged between 25% and 45% and averaged 42%.²⁷ According the budget request, the policy change will "maximize the impact of NIH research investments" by increasing the share of each grant that is directly spent on research.²⁸ For further background on NIH indirect costs policy, see CRS Insight IN12516, NIH Indirect Costs Policy for Research Grants: Recent Developments.
• Multiyear grants: The FY2026 NIH budget request also proposes to continue a FY2025 policy to reserve half of NIH's budget allocation for competing research project grants for awards that fully fund the grant across multiple years. Under recent practice, most NIH research project grants are committed for multiple years, but funding for the grant is obligated each year of the grant period as a noncompeting grant continuation.²⁹ To illustrate, under this policy, FY2026 appropriations might be used to fully fund a three-year project spanning FY2026-FY2028, instead of funding such a project with a combination of funds appropriated in each of those three years. According to the request, the new policy will "increase NIH budget flexibility by no longer encumbering large portions of each year's appropriation for the continuation of research projects that were initiated in previous years."³⁰ For more information, see CRS In Focus IF13131, NIH Grants Policy Under the Second Trump Administration

Trends

Table 3 outlines NIH program level funding from FY1996 to the FY2026 request. Figure 2 illustrates funding trends in both current (also called nominal dollars) and preliminary constant (i.e., inflation-adjusted) FY2024 dollars (funding shown is total budget authority). These figures reflect NIH's program level without ARPA-H 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, Congress and the President doubled the NIH budget to $27.167 billion in FY2003 (often referred to as the NIH budget doubling period). In each of FY1999 through FY2003, NIH received annual funding increases of 14.0% to 16.5%. From FY2003 to FY2015, NIH funding increased more gradually in nominal dollars.³¹ In some years, (FY2006, FY2011, and FY2013) funding for the agency decreased in nominal dollars.³² From FY2016 through FY2023, NIH received funding increases each year. The largest annual percentage increase was from FY2017 to FY2018, where the program level increased by $3.010 billion (+8.8%), making this the largest single-year percentage increase since FY2003. Both the FY2024 and FY2025 program levels saw slight decreases from the prior years (-0.7% and -0.8%). The FY2026 budget request would provide a 40.6% decrease from the FY2025 enacted level.

The lower half of Figure 2 shows NIH funding adjusted for inflation (in preliminary constant FY2024 dollars) using the Biomedical Research and Development Price Index (BRDPI).³³ It shows that the purchasing power of NIH funding initially peaked in FY2003 (the last year of the five-year doubling period) and then has not reached the same inflation-adjusted program level as in FY2003 even with the year-to-year increases provided (in nominal terms) from FY2016 through FY2024. Although inflation adjusted funding levels in recent years have come close to those peak levels. The FY2026 request would provide an inflation-adjusted (based on BRDPI projections) NIH program funding level that is estimated to be 47.3% below the FY2003 peak level.

Figure 2. NIH Funding, FY1996-FY2026 Request Program Level Funding in Current and Preliminary Constant (FY2024) Dollars.

Sources: Sources used for the FY2024, FY2025, and proposed FY2026 program levels are in Table 2. The FY2023 (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 June 2025, at https://officeofbudget.od.nih.gov/gbiPriceIndexes.html. Notes: Funding levels do not include ARPA-H funding. 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 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). PB = President's budget.

Appendix A. NIH Funding Details

Program-Specific Funding

For the most part, Congress has not specified NIH funding for particular diseases or research topics through appropriations and instead has allowed the ICs to award funding within their mission areas based on their own strategic planning and priority-setting processes. NIH has generally awarded research funding on a flexible and competitive basis through various funding allocation mechanisms intended to balance scientific and health priorities.³⁴

However, in some cases, Congress and the President have specified funding levels for programs or research areas within NIH accounts throughout the budget and appropriations process. Congress has used appropriations report language to designate funding for specified purposes. This practice has expanded since FY2015.³⁵

In FY2024, Congress used appropriations report language to specify a certain amount of IC funding for designated purposes, as summarized in Table A-1. Most of these amounts were specified in the explanatory statement accompanying enacted appropriations.³⁶ In a few cases, amounts specified in the Senate appropriations report (S.Rept. 118-84) were incorporated by reference.³⁷ Sometimes the language specified a certain amount for a certain purpose; in other cases, the language provided increased or additional funding.

As mentioned, the FY2025 CR provided NIH, for the most part, with full-year FY2025 funding at the same levels and subject to the same conditions as funding provided in FY2024 appropriations (P.L. 118-47). The FY2025 CR was not accompanied by a similar explanatory statement or congressional report as in FY2024 appropriations. As of the cover date of this report, the post-enactment allocations for NIH programs, projects, and activities are not consistently available through public executive branch sources. CRS has included Table A-1 showing amounts in the FY2024 explanatory statement for reference purposes.

Appendix B. Acronyms and Abbreviations

Footnotes