Lydia Polimeni, National Institutes of Health

NIH stays flat, absorbs three institutes in president’s 2019 budget proposal

Biomedical research funding was one of the budget lines saved from cuts by last-minute adjustments to President Donald Trump’s administration’s 2019 budget proposal released today. Still, advocates say they had hoped for more.

Funding for the National Institutes of Health (NIH), initially slated to be slashed by 27%, instead would total $34.7 billion, roughly unchanged from 2017. That level could end up being a cut, however, after Congress completes work on a bill to fund federal agencies through 2018. The House of Representatives has proposed a $1.1 billion increase and the Senate $2 billion; a budget agreement approved last week promises at least $2 billion for NIH over the next 2 years, adding support for a substantial increase this year.

In the 2019 proposal, NIH’s budget would go up slightly by $538 million over 2017. But that is because it would absorb three Department of Health and Human Services (HHS) agencies that fund research on health care quality, occupational health, and disabilities. They would be separate institutes at first, but their activities could later be integrated into NIH’s existing 27 institutes and centers.

Trump’s 2018 budget request also proposed moving one of these agencies, the Agency for Healthcare Research and Quality (AHRQ), into NIH. The House and Senate resisted that idea, however, and their 2018 spending bills leave AHRQ intact.

The 2019 HHS budget proposal describes two steps meant to “stretch” NIH grant funding. One would limit how much of an investigator’s total salary can be paid by grants to 90%. Some scientific groups have supported such efforts to curb faculty from depending entirely on so-called “soft money” for their salary.

The White House also wants to cut the maximum amount of a salary payable with NIH grant funds from $187,000 to $152,000. In the past, such efforts to reduce the NIH salary cap—usually proposed by Congress—have drawn opposition from academic medical centers.

The HHS plan includes $750 million for NIH from an HHS-wide fund to combat the opioid epidemic that would go in part to a new public-private partnership to find treatments and alternative pain drugs. And the White House plans to streamline administration at NIH. Unlike last year’s proposed budget, however, the proposal does not float the controversial idea—since rejected by Congress—of trimming the overhead payments to institutions that are included in NIH grants.

Biomedical research advocacy groups expressed disappointment with the proposal. “Freezing our national R&D capacity at 2017 levels while China and other competitor nations rush to take the lead in science and technology puts our nation at risk,” said Mary Woolley, president and CEO of Research!America in Arlington, Virginia. The group also calls the proposed AHRQ merger a “strategic mistake” because it “dilutes” the agency’s research on improving patient care.