Experts say that though the National Institutes of Health’s total budget suggests that little has changed for the agency and its grantees, that top line masks deeper disruptions.

Eva Revolver for NPR

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Eva Revolver for NPR

The National Institutes of Health (NIH) wields a $47.5 billion budget. More than 80% of its funds go out the door as grants to answer pressing biomedical questions. Over the decades, those grants have helped decipher the human genome, eliminate the polio virus in the U.S. and turn AIDS from a death sentence to a survivable illness.

But experts say this kind of fundamental science is coming up against an administration that has delayed funding and rerouted billions of dollars in research, resulting in chaos for researchers and patients alike. Trump officials say the administration’s practices serve to further the agency’s goals.

“NIH is committed to responsible stewardship of taxpayer dollars and to advancing rigorous, high-impact science that improves health outcomes for the American people,” Emily Hilliard, a spokesperson for the Department of Health and Human Services, which oversees the NIH, wrote in an August email.

More political oversight may be coming to how those funds get dispersed, according to recent reports. For now, court cases have restored funding, and Congress has preserved it in successive budget bills. But for the scientists who have had to scrap time-sensitive experiments or have seen their labs shuttered, those top-line numbers do not tell the full story.

Here are six graphics that highlight some of the less visible impacts of changes in research funding at the NIH.

The Trump administration proposed cutting the NIH budget by 41%, or by about $19.6 billion, for 2026. It also asked to restructure 27 institutes to eight — eliminating four outright — in its request. Congress did neither; in fact, it maintained both the existing institutes and a budget that was on par with previous years’ appropriations.

But experts say that though the total amount of funding suggests that little has changed, it masks a deeper disruption in the way that money moves.

The numbers behind the numbers 

Once money is appropriated by Congress, it then has to be obligated by the NIH — committing the funds to specific projects via grants. Those grants are generally doled out at a fairly consistent rate throughout the year. But since President Trump’s inauguration in 2025, that process has slowed to a crawl. In fiscal year 2025, the NIH ran roughly 44 days behind the average pace of 2021 to 2024; through early July 2026, it ran 42 days behind.

Heather Pierce tracks NIH obligations for the Association of American Medical Colleges. She pointed out that as of July — three-quarters of the way through the fiscal year — the NIH had obligated roughly half its budget, with billions of dollars still left on the table.

Jennifer Troyer, a former director of extramural operations for the NIH’s National Human Genome Research Institute, oversaw billions of dollars in grants awarded over her tenure until she resigned at the end of 2025. She ticked through some of the reasons for these delays.

Grants are peer-reviewed and prepared by the NIH staff to get funded, stepping through different “statuses” in the process, says Troyer — but now, they are undergoing another level of review that she calls a “black hole.”

“There’s a status called Status 19 I didn’t, even as the director, I did not know existed until things started getting stuck,” says Troyer, “because it was something that [grants] would blip through for, like, a few minutes.” Awards she had signed would go out and come back stopped, she says, flagged by the Department of Health and Human Services, by the Office of Management and Budget or by the White House “as not acceptable.”