Key takeaways:

• The proposed rule would politicize federal funding for research, experts said.
• It would also make peer review secondary to administration priorities in the grantmaking process.

The Trump administration has proposed what experts are calling “an unprecedented shift” in the way the federal government determines how to distribute grant funding.

The most significant change proposed by the Office of Management and Budget would be a move away from the peer review process to a system that allows political appointees to decide what should be funded. The proposal would also allow federal officials to cancel grant funding at any time.

Image: Sarah Kobrin. Reprinted with permission.

“The overarching goal,” OMB wrote in its proposal, “is to improve transparency, accountability and oversight for how federal taxpayer dollars are used in the context of federal grantmaking.”

The proposal seeks to prevent federal dollars from funding projects related to diversity, equity and inclusion. It explicitly states that federal grants should not be used for projects with “racial preferences ... including activities where race or intentional proxies for race will be used as a selection criterion for employment or program participation,” or research containing “gender ideologies.” It also says grants will not be awarded to studies on chemical and surgical gender transition for children younger than 19 years.

An OMB spokesperson told Healio that the administration proposed the rule to “ensure funding goes toward real science instead of promoting a far-left DEI agenda with things like drag shows in Ecuador and transgender experiments on mice.”

“This rule will bring much-needed transparency to the grantmaking process and ensure taxpayer dollars are spent wisely,” the spokesperson said.

The spokesperson appeared to be referring to a $20,000 grant the State Department awarded to a nonprofit organization in Ecuador in 2022 to fund arts workshops, a short documentary and drag theater performances, which was cited in a fact-check by Newsweek.

The mice comment aligns with a group of studies Trump referenced in an address to Congress last year that evaluated gender-affirming hormone therapy in mouse models, which the Society for Behavioral Neurobiology said benefited transgender and cisgender people who need hormone therapy to treat a variety of conditions.

Alyssa Morrison, JD, a civil rights attorney who specializes in health equity, reproductive rights and constitutional law, told Healio that there is no legal precedent for the changes.

“Although the federal government has changed federal grantmaking regulations in the past, this would create an unprecedented shift in federal grants guidance from flexible ‘guidance’ to binding ‘regulations’ that effectuate the sweeping ideological priorities of this particular presidential administration,” she said. “The proposed rule effectively hands over upward of $1 trillion in annual federal grants to the nearly unfettered discretion of federal agencies and their political appointees.”

Abandoning peer review

The proposal would put senior political appointees in charge of determining who gets grant funding from the NIH and other federal bodies — a departure from the current protocol. Historically, researchers have submitted proposals to federal agencies, which first undergo an administrative review, followed by a peer review from a group of subject matter experts. The peer reviewers give each proposal a priority score, and funding is awarded in order of priority.

The editors of The New England Journal of Medicine explained in an editorial that the current process has very little political interference.

“The NIH leadership and Congress can influence funding by, for example, changing broad budgets or issuing ‘requests for applications,’” they wrote. “However, the decisions are almost entirely driven by science.”

The new system proposed by OMB would make peer review optional, relying instead on political appointees to evaluate the merit of each proposal.

Anna Culbertson, a founding member of the grassroots organization 27 uNIHted, comprised of former NIH staffers, was a probationary scientific program specialist at the agency when she was laid off in early 2025. She worked in the Center for Scientific Review (CSR), where all NIH peer review happens.

According to Culbertson, “there have been a lot of changes to reviewer engagement representation,” as well as “a consolidation of peer review,” the elimination of continuous submissions and the April 2025 disbandment of a CSR advisory council.

“That checks and balances [system] doesn’t exist anymore,” she said. “Separate from peer review, I think the grant screening tool feels the most politically motivated because it is directly looking for specific words and then flagging grants for renegotiation for ‘alignment with administrative priorities.’ But a lot of the [other issues are] still really problematic in that it lends to politicization in different points throughout the process like those impacting peer review.”

Lawrence O. Gostin, JD, a professor at Georgetown Law and founding director of the O’Neill Institute for National and Global Health Law at Georgetown University, told Healio that the new rule “is about politicizing science and public health research,” not “saving taxpayer dollars.”

“Politicians aren’t qualified to evaluate the importance of biomedical research — scientists are,” Gostin said. “The peer review system ensures that research proposals are methodologically sound and serve important public health purposes.”

Canceling projects

Sarah Kobrin, PhD, MPH, who has worked as a program director at the NIH’s National Cancer Institute for more than 22 years, said that her work has “completely changed” since the Trump administration took over.

Speaking to Healio in a strictly personal capacity, Kobrin said that as administrations come and go, they often present new priorities, and “a lot of money is spent and directed towards a new project in hopes of making a faster change in an area that is particularly important to the new administration for whatever reason.”

“And that’s fine, that’s their right,” she added. “What no one has ever done before is try to destroy everything that came before, as well as going forward.”

In addition to changing how grants are awarded, the OMB proposal would also give administrators the ability to pause or cancel funding for projects at any time. Currently, once a proposal receives funding, the only time it may be pulled is if the recipient fails to perform their work within the time specified by the federal agency, according to the NEJM editors.

Unlike previous administrations, which would distribute funding based on their goals, Kobrin said the Trump administration is cutting research projects that do not fit its priorities.

“Nobody’s ever done that before,” she said. “Nobody’s gone backward to say, ‘I don’t want you to be funding these things that were already awarded.’”

Kobrin said she has also seen grants related to the HPV vaccine ended early because the administration “no longer wants to pay for” that research, even though the HPV vaccine reduces the risk for cervical cancer. Notably, at his nomination hearing, HHS Secretary Robert F. Kennedy Jr. declined to renounce his claims that the HPV vaccine is “dangerous and defective” and increases women’s risk for cervical cancer.

“I had to make phone calls to people and say, ‘I’m sorry, but your project has been canceled,’” Kobrin said.

Kobrin said it will be difficult to fully assess the damage caused in a lot of these areas since much of the work is in prevention. “An HPV study that got stopped now is not the kind of thing you can point out and say, ‘See, this person is going to get cervical cancer 50 years from now.’ You know that if she had the vaccine, she wouldn’t, but you can’t say for sure that she will now, and you can’t wait around 50 years to see,” Kobrin said.

Culbertson also noted recent research that showed NIH grant cuts disproportionally impacted women scientists and those from underrepresented racial and ethnic backgrounds.

Deprioritizing DEI

Experts worry that important projects will be passed over because of the administration’s distaste for research related to DEI.

Kobrin focuses on cancer prevention, so she often studies people who are not being screened, usually those from underrepresented populations. According to Kobrin, she was told DEI-related words like “equity,” “HBCU” and “Latinx” indicate poor-quality research.

“There’s no reason to think that an application that includes the word ‘disparity’ is going to [use] lower-quality methods, but that’s the argument that is made,” she said. “But I would challenge anyone to show me the relationship between using these words, which are clearly racially and ethnically linked, to evidence of rigor.”

Paul A. Volberding, MD, professor emeritus of medicine at University of California, San Francisco and a member of the Healio editorial boards for infectious diseases and pediatrics, questioned how far the administration will go to avoid research focused on specific populations.

“If DEI is a threat, can we study diseases like sickle cell anemia that primarily affect African Americans?” Volberding told Healio. “Might veterans’ research also be seen as a problem of DEI limits, as it benefits a subpopulation? Will we block research that is more of a problem in the disadvantaged areas of the world only to see ‘their’ diseases infect ‘real’ Americans and maybe even cause the next pandemic?”

What can you do about this?

The proposal is currently in the public comment phase; OMB proposed that the rule take effect on Oct. 1, 2026. Anyone can submit a comment on or before July 13 at this link.

“Agencies are obligated to review all substantive and relevant comments, and even if your comment does not alter the outcome, it helps create a legal record for future litigation challenging the rule,” Morrison said.

Gostin said he anticipates legal challenges to the rule, although he is unsure how they will fare in the federal court system, especially the Supreme Court.

“If Americans truly want top-quality science to guide research on diseases that affect us all, they will strenuously oppose these new rules,” Gostin said.

In June 2025, Culbertson and Kobrin signed the Bethesda Declaration, an open letter of concern to Congress and top health officials — namely, Kennedy and NIH director Jay Bhattacharya, MD, PhD — that was signed by more than 600 NIH staff and 32,000 others, including the general public, external scientists and patients.

A year later, Kobrin and dozens of current and former NIH workers authored a new declaration, which is still accepting signatures, “to lay out their continuing and deepening concerns at the NIH over the last year,” according to the document. The top concern, they wrote, is that “an anti-science agenda is disrupting research for health advances and cures.”

“NIH is further continuing to be dismantled. It is not going away,” Culbertson said. “Just because NIH is well-liked by Democrats and Republicans, and Jay Bhattacharya is a good speaker, it does not mean that harmful things are not taking place every single day, that the American public’s future treatments are not being impacted every single day and that the marginalized communities are being the most impacted.”

For more information:

Anna Culbertson can be reached at media@27unihted.org.
Lawrence O. Gostin, JD, can be reached at gostin@georgetown.edu.
Sarah Kobrin, PhD, MPH, can be reached at pediatrics@healio.com.
Alyssa Morisson, JD, is a senior staff attorney with Lawyers for Good Government. She can be reached at pediatrics@healio.com.
Paul A. Volberding, MD, can be reached at pediatrics@healio.com.