The National Institutes of Health鈥檚 sweeping cuts of grants that fund scientific research are inflicting pain almost universally across the U.S., including in most states that backed President Donald Trump in the 2024 election.
A KFF Health News analysis underscores that the terminations are sparing no part of the country, politically or geographically. About 40% of organizations whose grants the NIH cut in its first month of slashing, which started Feb. 28, are in states like Missouri that Trump won in November.
The Trump administration has singled out Ivy League universities including Columbia and Harvard for broad federal funding cuts. But the spending reductions at the NIH, the nation鈥檚 foremost source of funding for biomedical research, go much further: Of about 220 organizations that had grants terminated, at least 94 were public universities, including flagship state schools in places such as Florida, Georgia, Ohio, Nebraska, and Texas.
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The Trump administration has canceled hundreds of grants supporting research on topics such as vaccination; diversity, equity, and inclusion; and the health of LGBTQ+ populations. Some of the terminations are a result of Trump鈥檚 executive orders to abandon federal work on diversity and equity issues. Others followed the Senate confirmation of anti-vaccine activist Robert F. Kennedy Jr. to lead the Department of Health and Human Services, which oversees the NIH. Many mirror the ambitions laid out in Project 2025鈥檚 鈥淢andate for Leadership,鈥 the conservative playbook for Trump鈥檚 second term.
Affected researchers say Trump administration officials are taking a cudgel to efforts to improve the lives of people who often experience worse health outcomes 鈥 ignoring a scientific reality that diseases and other conditions do not affect all Americans equally.
KFF Health News found that the NIH terminated about 780 grants or parts of grants between Feb. 28 and March 28, based on documents published by the Department of Health and Human Services and a list maintained by academic researchers. Some grants were canceled in full, while in other cases, only supplements 鈥 extra funding related to the main grant, usually for a shorter-term, related project 鈥 were terminated.
Among U.S. recipients, 96 of the institutions that lost grants in the first month are in politically conservative states including Florida, Ohio, and Indiana, where Republicans control the state government or voters reliably support the GOP in presidential campaigns, or in purple states such as North Carolina, Michigan, and Pennsylvania that were presidential battleground states. An additional 124 institutions are in blue states.
Sybil Hosek, a research professor at the University of Illinois-Chicago, helps run a network that focuses on improving care for people 13 to 24 years old who are living with or at risk for HIV. The NIH awarded Florida State University $73 million to lead the HIV project.
鈥淲e never thought they would destroy an entire network dedicated to young Americans,鈥 said Hosek, one of the principal investigators of the Adolescent Medicine Trials Network for HIV/AIDS Interventions. The termination 鈥渄oesn鈥檛 make sense to us.鈥
NIH official Michelle Bulls is director of the Office of Policy for Extramural Research Administration, which oversees grants policy and compliance across NIH institutes. In terminating the grant March 21, Bulls wrote that research 鈥渂ased primarily on artificial and nonscientific categories, including amorphous equity objectives, are antithetical to the scientific inquiry, do nothing to expand our knowledge of living systems, provide low returns on investment, and ultimately do not enhance health, lengthen life, or reduce illness.鈥
Adolescents and young adults ages 13 to 24 accounted for 1 in 5 new HIV infections in the U.S. in 2022, according to the Centers for Disease Control and Prevention.
鈥淚t鈥檚 science in its highest form,鈥 said Lisa Hightow-Weidman, a professor at Florida State University who co-leads the network. 鈥淚 don鈥檛 think we can make America healthy again if we leave youth behind.鈥
HHS spokesperson Emily Hilliard said in an emailed statement that 鈥淣IH is taking action to terminate research funding that is not aligned with NIH and HHS priorities.鈥 The NIH and the White House didn鈥檛 respond to requests for comment.
鈥淎s we begin to Make America Healthy Again, it's important to prioritize research that directly affects the health of Americans. We will leave no stone unturned in identifying the root causes of the chronic disease epidemic as part of our mission to Make America Healthy Again,鈥 Hilliard said.
Harm to HIV, vaccine studies
The NIH, with its nearly $48 billion annual budget, is the largest public funder of biomedical research in the world, awarding nearly 59,000 grants in the 2023 fiscal year. The Trump administration has upended funding for projects that were already underway, stymied money for new applications, and sought to reduce how much recipients can spend on overhead expenses.
Those changes 鈥 plus the firing of 1,200 agency employees as part of mass layoffs across the government 鈥 are alarming scientists and NIH workers, who warn that they will undermine progress in combating diseases and other threats to the nation鈥檚 public health. On April 2, the American Public Health Association, Ibis Reproductive Health, and affected researchers, among others, filed a lawsuit in federal court against the NIH and HHS to halt the grant cancellations.
Two National Cancer Institute employees, who were granted anonymity because they were not authorized to speak to the press and feared retaliation, said its staff receives batches of grants to terminate almost daily. On Feb. 27, the cancer institute had more than 10,800 active projects, the highest share of the NIH鈥檚 roughly two dozen institutes and centers, according to the NIH鈥檚 website. At least 47 grants that NCI awarded were terminated in the first month.
Kennedy has said the NIH should take a years-long pause from funding infectious disease research. In November 2023, he told an anti-vaccine group, 鈥淚鈥檓 gonna say to NIH scientists, 鈥楪od bless you all. Thank you for public service. We鈥檙e going to give infectious disease a break for about eight years,鈥欌 according to NBC News.
For years, Kennedy has peddled falsehoods about vaccines 鈥 including that 鈥渘o vaccine鈥 is 鈥渟afe and effective,鈥 and that 鈥渢here are other studies out there鈥 showing a connection between vaccines and autism, a link that has repeatedly been debunked 鈥 and claimed falsely that HIV is not the only cause of AIDS.
KFF Health News found that grants in blue states were disproportionately affected, making up roughly two-thirds of terminated grants, many of them at Columbia University. The university had more grants terminated than all organizations in politically red states combined. On April 4, Democratic attorneys general in 16 states sued HHS and the NIH to block the agency from canceling funds.
Researchers whose funding was stripped said they stopped clinical trials and other work on improving care for people with HIV, reducing vaping and smoking rates among LGBTQ+ teens and young adults, and increasing vaccination rates for young children. NIH grants routinely span several years.
For example, Hosek said that when the youth HIV/AIDS network鈥檚 funding was terminated, she and her colleagues were preparing to launch a clinical trial examining whether a particular antibiotic that is effective for men to prevent sexually transmitted infections would also work for women.
鈥淭his is a critically important health initiative focused on young women in the United States,鈥 she said. 鈥淲ithout that study, women don鈥檛 have access to something that men have.鈥
Other scientists said they were testing how to improve health outcomes among newborns in rural areas with genetic abnormalities, or researching how to improve flu vaccination rates among Black children, who are more likely to be hospitalized and die from the virus than non-Hispanic white children.
鈥淚t's important for people to know that 鈥 if, you know, they are wondering if this is just a waste of time and money. No, no. It was a beautiful and rare thing that we did,鈥 said Joshua Williams, a pediatric primary care doctor at Denver Health in Colorado who was researching whether sharing stories about harm experienced due to vaccine-preventable diseases 鈥 from missed birthdays to hospitalizations and job loss 鈥 might inspire caregivers to get their children vaccinated against the flu.
He and his colleagues had recruited 200 families, assembled a community advisory board to understand which vaccinations were top priorities, created short videos with people who had experienced vaccine-preventable illness, and texted those videos to half of the caregivers participating in the study.
They were just about to crack open the medical records and see if it had worked: Were the group who received the videos more likely to follow through on vaccinations for their children? That鈥檚 when he got the notice from the NIH.
鈥淚t is the policy of NIH not to prioritize research activities that focuses gaining scientific knowledge on why individuals are hesitant to be vaccinated and/or explore ways to improve vaccine interest and commitment,鈥 the notice read.
Williams said the work was already having an impact as other institutions were using the idea to start projects related to cancer and dialysis.
A hit to rural health
Congress previously tried to ensure that NIH grants also went to states that historically have had less success obtaining biomedical research funding from the government. Now those places aren鈥檛 immune to the NIH鈥檚 terminations.
Sophia Newcomer, an associate professor of public health at the University of Montana, said she had 18 months of work left on a study examining undervaccination among infants, which means they were late in receiving recommended childhood vaccines or didn鈥檛 receive the vaccines at all. Newcomer had been analyzing 10 years of CDC data about children鈥檚 vaccinations and had already found that most U.S. infants from 0 to 19 months old were not adequately vaccinated.
Her grant was terminated March 10, with the NIH letter stating the project 鈥渘o longer effectuates agency priorities,鈥 a phrase replicated in other termination letters KFF Health News has reviewed.
鈥淪tates like Montana don鈥檛 get a lot of funding for health research, and health researchers in rural areas of the country are working on solutions to improve rural health care,鈥 Newcomer said. 鈥淎nd so cuts like this really have an impact on the work we鈥檙e able to do.鈥
Montana is one of 23 states, along with Puerto Rico, that are eligible for the NIH鈥檚 Institutional Development Award program, meant to bolster NIH funding in states that historically have received less investment. Congress established the program in 1993.
The NIH鈥檚 grant terminations hit institutions in 15 of those states, more than half that qualify, plus Puerto Rico.
Researchers can鈥檛 鈥榡ust do it again later鈥
The NIH鈥檚 research funds are deeply entrenched in the U.S. health care system and academia. Rarely does an awarded grant stay within the four walls of a university that received it. One grant鈥檚 money is divvied up among other universities, hospitals, community nonprofits, and other government agencies, researchers said.
Erin Kahle, an infectious disease epidemiologist at the University of Michigan, said she was working with Emory University in Georgia and the CDC as part of her study. She was researching the impact of intimate partner violence on HIV treatment among men living with the virus. 鈥淭hey are relying on our funds, too,鈥 she said.
Kahle said her top priority was to ethically and safely wind down her nationwide study, which included 418 people, half of whom were still participating when her grant was terminated in late March. Kahle said that includes providing resources to participants for whom sharing experiences of intimate partner violence may cause trauma or mental health distress.
Rachel Hess, the co-director of the Clinical & Translational Science Institute at the University of Utah, said the University of Nevada-Reno and Intermountain Health, one of the largest hospital systems in the West, had received funds from a $38 million grant that was awarded to the University of Utah and was terminated March 12.
The institute, which aims to make scientific research more efficient to speed up the availability of treatments for patients, supported over 5,000 projects last year, including 550 clinical trials with 7,000 participants. Hess said that, for example, the institute was helping design a multisite study involving people who have had heart attacks to figure out the ideal mix of medications 鈥渢o keep them alive鈥 before they get to the hospital, a challenge that鈥檚 more acute in rural communities.
After pushback from the university 鈥 the institute鈥檚 projects included work to reduce health care disparities between rural and urban areas 鈥 the NIH restored its grant March 29.
Among the people the Utah center thanked in its announcement about the reversal were the state鈥檚 congressional delegation, which consists entirely of Republican lawmakers. 鈥淲e are grateful to University of Utah leadership, the University of Utah Board of Trustees, our legislative delegation, and the Utah community for their support,鈥 it said.
Hilliard, of HHS, said that 鈥渟ome grants have been reinstated following the appeals process, and the agency will continue to carry out the remaining appeals as planned to determine their alignment.鈥 She declined to say how many had been reinstated, or why the University of Utah grant was among them.
Other researchers haven鈥檛 had the same luck. Kahle, in Michigan, said projects like hers can take a dozen years from start to finish 鈥 applying for and receiving NIH funds, conducting the research, and completing follow-up work.
鈥淓ven if there are changes in the next administration, we鈥檙e looking at at least a decade of setting back the research,鈥 Kahle said. 鈥淚t鈥檚 not as easy as like, 鈥極K, we鈥檒l just do it again later.鈥 It doesn鈥檛 really work that way.鈥
is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF 鈥 the independent source for health policy research, polling, and journalism. It was formerly known as Kaiser Health News.