NIH Reform

House and Senate Republicans have proposed separate plans to reorganize the National Institutes of Health (NIH), but these efforts are expected to face significant hurdles this Congress. Before the COVID-19 pandemic, the NIH received bipartisan support and consistent funding increases. However, the pandemic highlighted issues such as gain-of-function research and allegations of sexual harassment, prompting renewed scrutiny and calls for reform. 

House Republicans, led by retiring Energy and Commerce Chair Cathy McMorris Rodgers, have introduced a comprehensive plan to consolidate the NIH’s 27 institutes and centers into 15, among other changes. This proposal was included in the fiscal 2025 funding bill, though it has been criticized by some in the scientific community as lacking a scientific basis. 

In contrast, Senate Health, Education, Labor and Pensions Committee ranking member Bill Cassidy is advocating for improvements in the NIH’s grant approval processes and biomedical workforce. Cassidy’s proposals are seen as more collaborative and have not yet been formalized into legislation. 

Despite these proposed changes, both the House and Senate are maintaining or slightly increasing NIH funding levels for the upcoming fiscal year. The House bill proposes steady funding at $48 billion, while the Senate bill includes a modest increase to $50.2 billion, with additional funds for cancer research and new authorities related to addressing sexual harassment. Smaller reforms proposed in the Senate are considered more likely to advance this Congress compared to broader overhauls. 

Appropriations

Congress adjourned for August recess with minimal progress on the 12 annual spending bills necessary to fund government agencies and programs. Federal financing is set to expire on September 30, which could lead to significant disruptions within federal agencies important to ACSM members. 

The Republican-controlled House has passed five appropriations bills, but these include deep budget cuts and contentious cultural provisions, making them unlikely to become law. Meanwhile, the Democratic-controlled Senate has passed seven bills through committee with broad bipartisan support but has yet to vote on them in the full Senate. 

Given the August recess, Congress is expected to rely on a “continuing resolution” (CR) to avoid a government shutdown. The need for such a stopgap measure is anticipated as lawmakers return just before the deadline.  

Key negotiators agree on potentially adding disaster relief funding for areas impacted by recent crises, but significant disagreements remain. Democrats favor a short-term CR extending past the November elections but ending before the year's end, allowing for reevaluation of priorities. House Republicans are open to a longer CR extending into 2025, which could align with hopes of a Republican presidential win and increased conservative control. Both parties are cautious about extending funding too far into the next year, potentially complicating the next president’s budget negotiations.