Health
How Trump’s Medical Research Cuts Would Hit Colleges and Hospitals in Every State
A proposal by the Trump administration to reduce the size of grants for institutions conducting medical research would have far-reaching effects, and not just for elite universities and the coastal states where many are located.
Also at risk could be grants from the National Institutes of Health to numerous hospitals that conduct clinical research on major diseases, and to state universities across the country. North Carolina, Missouri and Pennsylvania could face disproportionate losses, because of the concentration of medical research in those states.
N.I.H. funding in 2024
Per capita Based on spending in the 2024 fiscal year.
|
Total
In the 2024 fiscal year, the N.I.H. spent at least $32 billion on nearly 60,000 grants, including medical research in areas like cancer, genetics and infectious disease. Of that, $23 billion went to “direct” research costs, such as microscopes and researchers’ salaries, according to an Upshot analysis of N.I.H. grant data.
The other $9 billion went to the institutions’ overhead, or “indirect costs,” which can include laboratory upkeep, utility bills, administrative staff and access to hazardous materials disposal, all of which research institutions say is essential to making research possible.
The N.I.H. proposal, which has been put on hold by a federal court, aims to reduce funding for those indirect costs to a set 15 percent rate that the administration says would save about $4 billion a year. The Upshot analysis estimates that a 15 percent rate would have reduced funding for the grants that received N.I.H. support in 2024 by at least $5 billion. The White House said the savings would be reinvested in more research, but the rate cuts would open up sizable budget holes in most projects at research institutions.
It is not clear whether those organizations can fill the gaps with other funding sources or by shifting how they apply for grants. Instead, many officials at universities and hospitals have said that they may have to pull back on medical or scientific research.
“It’s not an overstatement to say that a slash this drastic in total research funding slows research,” said Heather Pierce, senior director for science policy at the Association of American Medical Colleges, which has sued along with other education and hospital associations to block the policy. And slower scientific progress, she said, would affect anyone who depends on the development of new treatments, medical interventions and diagnostic tools.
We estimate that virtually all universities and hospitals would see fewer funds on similar projects in the future. The 10 institutions that receive the most money from N.I.H. stand to lose more than $100 million per year on average.
To understand how the change would work, let’s look at one grant for about $600,000 sent last year to the University of Alabama at Birmingham to study whether exercise can improve memory for people with epilepsy.
The N.I.H. sent the university this funding in the 2024 fiscal year, as part of a multiyear grant. A majority of the money went to direct costs associated with the study. And an additional 45 percent went to indirect costs supporting the research, like building maintenance and administrative staff. Under the new rules, the university would receive a 15 percent rate on such grants, bringing the total down. That would have been a funding loss of nearly $130,000 on this project alone.
The calculation above, which we have repeated for every grant paid last year, is a bit simplified. In reality, the researchers would lose even more money than we’ve shown, because of the way indirect funding is calculated (see our methodology at the bottom of this article).
Our analysis also makes some other conservative assumptions given the policy’s uncertainty. We assume, for instance, that the new 15 percent rate is a flat rate that all grantees would receive, and not a maximum rate (a distinction left unclear in the N.I.H. guidance). We also assume that the change applies not just to institutions of higher education, but also to all kinds of grantees, including hospitals.
In a statement, the White House indicated it would reserve any savings for additional research grants. “Contrary to the hysteria, redirecting billions of allocated N.I.H. spending away from administrative bloat means there will be more money and resources available for legitimate scientific research, not less,” said Kush Desai, a White House spokesman.
The N.I.H. announcement, however, coincides with the Trump administration’s moves to cut spending across the government, and with the N.I.H.’s withholding of funding for grants — their direct and indirect costs alike — in apparent conflict with separate court orders.
The N.I.H. guidance document includes a number of conflicting statements and statistics the Upshot could not reconcile. The N.I.H. also declined to answer questions about the policy and about its public-facing data tracking grant spending.
The N.I.H. since 1950 has provided these overhead funds in a formulaic way, and since 1965, the government has used a rate individually calculated for each institution. Federal officials review cost summaries, floor plans and other information to determine that rate. That number can be higher for institutions in more expensive parts of the country, or for those that use more energy-intensive equipment. The proposal from the Trump administration would set aside those differences in standardizing the rate at 15 percent for every grantee.
The lists below estimate what would have happened to the 10 universities and hospitals that received the most N.I.H. grant money in the 2024 fiscal year, if the formula change had been in effect then.
University of California, San Francisco San Francisco
Johns Hopkins University
Baltimore
Washington University
St. Louis University of Michigan
Ann Arbor, Mich.
University of Pennsylvania
Philadelphia
University of Pittsburgh Pittsburgh, Pa.
Columbia University Health Sciences
New York
Yale University
New Haven, Conn. Stanford University
Stanford, Calif.
University of Washington
Seattle
Source: National Institutes of Health Based on spending in the 2024 fiscal year.
Massachusetts General Hospital
Boston Vanderbilt University Medical Center
Nashville
Brigham and Women’s Hospital
Boston
Boston Children’s Hospital Boston
University of Texas MD Anderson Cancer Center
Houston
Children’s Hospital of Philadelphia
Philadelphia Dana-Farber Cancer Institute
Boston
Cincinnati Childrens Hospital Medical Center
Cincinnati
Beth Israel Deaconess Medical Center Boston
Cedars-Sinai Medical Center
Los Angeles
Source: National Institutes of Health
Based on spending in the 2024 fiscal year, which extends from Oct. 1 to Sept. 30.Largest N.I.H. grant recipients among colleges, universities and medical schools
Name
Total ’24 Funding
Estimated reduction
$793 mil.
$121 mil.
$788 mil.
$136 mil.
$717 mil.
$108 mil.
$708 mil.
$119 mil.
$652 mil.
$129 mil.
$632 mil.
$115 mil.
$611 mil.
$111 mil.
$602 mil.
$131 mil.
$584 mil.
$107 mil.
$542 mil.
$86 mil.
Largest N.I.H. grant recipients among hospitals
Name
Total ’24 Funding
Estimated reduction
$641 mil.
$98 mil.
$468 mil.
$71 mil.
$364 mil.
$77 mil.
$218 mil.
$54 mil.
$180 mil.
$39 mil.
$162 mil.
$32 mil.
$161 mil.
$35 mil.
$153 mil.
$28 mil.
$117 mil.
$23 mil.
$100 mil.
$23 mil.
If courts allow the change to move forward, some of its consequences are hard to predict.
Advocates for the policy change note that these organizations receive numerous other federal subsidies. Most universities and research hospitals are nonprofits that pay no federal taxes, for example. The N.I.H. announcement also noted that these same institutions often accept grants from charitable foundations that offer much lower overhead rates than the federal government, a signal that universities and hospitals willingly pursue research opportunities with less supplemental funding.
Because the indirect payments are based on broad formulas and not specific line items, critics say institutions may be diverting these federal dollars into unaccountable funds to pay for programs that taxpayers can’t see, such as the kinds of diversity, equity and inclusion programs targeted by the Trump administration.
“That’s how you get things like the ability of administrators to use larger overhead pools of money to build out D.E.I. bureaucracies, or to fund Ph.D. programs in the humanities,” said Jay Greene, a senior research fellow in the Center for Education Policy at the Heritage Foundation, a conservative research group. Mr. Greene was the coauthor of a 2022 article urging the N.I.H. to cut or eliminate indirect grant funding. But he did not have specific examples to cite of research funds being spent in this way.
Researchers say the indirect funds have a branding problem, but are a necessary component of research.
“The term ‘indirect costs’ or the alternative term ‘overhead’ sounds dangerously close to ‘slush fund’ to some people,” said Jeremy Berg, who was the director of the National Institute of General Medical Sciences at the N.I.H. from 2003 to 2011. “There are real costs somebody has to pay for, and heating and cooling university laboratory buildings is a real cost.”
Some grant recipients already receive low overhead payments, but a large majority of them currently receive more than 15 percent, meaning they will need to make budgetary changes to absorb the loss. Among the 2024 grants that we analyzed, institutions that received more than $1 million in N.I.H. support got an average of 40 cents of indirect funding for every dollar of direct funding.
As a share of direct funding
Source: National Institutes of Health
Calculated for 613 institutions that received at least $1 million in funding in fiscal year 2024. Federally negotiated rates are higher than these.
Distribution of overhead funding at N.I.H.-funded institutions in 2024
Universities and hospitals may adjust their overall budgets to keep supporting medical research by cutting back on other things they do. Some might be able to raise money from donors to fill the shortfalls, though most universities are already raising as much philanthropic money as they can.
But many research institutions have said they would adjust by simply doing less medical research, because they would not be able to afford to do as much with less government help.
Universities and hospitals might also shift the kinds of research they do, avoiding areas that require more lab space, regulatory compliance or high-tech equipment, and focusing on types of research that will require them to provide less overhead funding themselves. That may mean disproportionate reductions in complex areas of research like genetics.
Those effects may be spread unevenly across the research landscape, as some organizations find a way to adjust, while others abandon medical research altogether.
We’ve compiled a list of institutions that received at least $1 million in N.I.H. funding in the 2024 fiscal year, along with our estimates of how much less they would have gotten under the new policy. Most of these institutions are universities or hospitals, but there are also some private companies and nonprofit research groups. Our numbers tend to be underestimates of the cuts.
New York
New York New York
New York
New York
Bronx, N.Y.
Rochester, N.Y. Ithaca, N.Y.
Amherst, N.Y.
New York
New York
Stony Brook, N.Y. New York
Buffalo, N.Y.
Manhasset, N.Y.
Cold Spring Harbor, N.Y.
Syracuse, N.Y. New York
Brooklyn, N.Y.
Orangeburg, N.Y.
New York
Albany, N.Y. Binghamton, N.Y.
New York
New York
Albany, N.Y.
New York New York
Syracuse, N.Y.
New York
Troy, N.Y.
New York City, N.Y. New York
New York
Albany, N.Y.
Valhalla, N.Y.
Mineola, N.Y. Rochester, N.Y.
White Plains, N.Y.
Menands, N.Y.
Flushing, N.Y.
New York Upton, N.Y.
New York
Bronx, N.Y.
New York
New York New York
Queens, N.Y.
Potsdam, N.Y.
New York
Buffalo, N.Y. Utica, N.Y.
New York
Niskayuna, N.Y.
New York
New York Jamaica, N.Y.
New York
New York
New York
Old Westbury, N.Y. Clifton Park, N.Y.
Garrison, N.Y.
Other
About our analysis
To estimate changes in funding, we relied on data from RePORT, the N.I.H.’s online registry of grants and projects. We limited our analysis to grants listed within the 50 U.S. states, the District of Columbia or Puerto Rico. We also limited it to grants where the amount of indirect funding was known and where the combined indirect and direct funding was within five percent of the listed total funding. These filters resulted in removing many grants to private organizations such as domestic for-profits. We calculated how much indirect funding each grant would have received under the new guidance by multiplying the listed direct funding amount by 15 percent. We then compared that number to the listed indirect funding amount for each great to estimate the impact of the policy.
There are two reasons our calculations are most likely conservative estimates of true reductions in funding. First, only a portion of the direct funding for each grant is considered to be “eligible” for the purposes of calculating indirect funding. For example, laboratory equipment and graduate student tuition reimbursements are deducted from the direct costs before applying the negotiated overhead rate, whereas our calculations assumed 100 percent of the listed direct costs would be eligible. We performed a more accurate version of our calculations for the 10 universities and 10 hospitals receiving the most N.I.H. funds by inferring their eligible direct costs from their reported negotiated rates. When we did this, we saw an additional increase in losses of about 20 percent.
Second, we applied a 15 percent rate to all grants in the database, including those with an initial indirect rate below 15 percent. An analysis by James Murphy helped inform this approach. According to our analysis, then, some grants would actually receive more money under the new guidance. If the new rate operated more like a cap — and grants with rates currently below 15 percent did not change — the overall reductions in funding would be larger, as the reductions would no longer be offset by some small number of funding increases.
Institution
No. of grants
Total ’24 Funding ▼
Estimated change
1,024
$611 mil.
-$111 mil.
596
$480 mil.
-$63 mil.
714
$453 mil.
-$93 mil.
540
$293 mil.
-$55 mil.
331
$197 mil.
-$54 mil.
311
$184 mil.
-$35 mil.
384
$180 mil.
-$32 mil.
221
$102 mil.
-$21 mil.
204
$83 mil.
-$13 mil.
195
$76 mil.
-$13 mil.
129
$69 mil.
-$17 mil.
176
$64 mil.
-$13 mil.
124
$50 mil.
-$9 mil.
77
$48 mil.
-$9 mil.
61
$39 mil.
-$9 mil.
78
$34 mil.
-$12 mil.
72
$25 mil.
-$5 mil.
49
$24 mil.
-$3 mil.
29
$23 mil.
-$2 mil.
17
$17 mil.
-$3 mil.
20
$14 mil.
-$3 mil.
30
$13 mil.
-$3 mil.
38
$13 mil.
-$2 mil.
28
$12 mil.
-$2 mil.
7
$11 mil.
-$3 mil.
38
$11 mil.
-$2 mil.
13
$11 mil.
-$1 mil.
20
$10 mil.
-$1 mil.
33
$10 mil.
-$2 mil.
25
$10 mil.
-$3 mil.
25
$9 mil.
-$1 mil.
2
$8 mil.
-$1 mil.
2
$8 mil.
+$371k
9
$7 mil.
-$2 mil.
7
$6 mil.
-$1 mil.
17
$6 mil.
-$1 mil.
9
$6 mil.
-$1 mil.
20
$6 mil.
-$759k
10
$5 mil.
-$1 mil.
10
$5 mil.
-$961k
14
$5 mil.
-$540k
9
$5 mil.
-$535k
1
$5 mil.
-$1 mil.
3
$4 mil.
-$1 mil.
10
$3 mil.
-$158k
1
$3 mil.
+$213k
1
$3 mil.
+$144k
9
$3 mil.
-$607k
15
$3 mil.
-$647k
9
$2 mil.
-$270k
13
$2 mil.
-$313k
5
$2 mil.
-$745k
4
$2 mil.
-$738k
4
$2 mil.
-$259k
3
$2 mil.
-$459k
8
$2 mil.
-$142k
6
$1 mil.
-$333k
5
$1 mil.
-$415k
1
$1 mil.
+$113k
3
$1 mil.
-$35k
4
$1 mil.
-$336k
3
$1 mil.
-$199k
3
$1 mil.
-$315k
2
$1 mil.
-$27k
56
$16 mil.
-$1 mil.
Total
5,887
$3.3 bil.
-$618 mil.
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The holidays are known to be a source of stress, between traveling, preparing for family gatherings and indulging in lots of food and drinks.
The uptick of activity can actually put a strain on the heart, a phenomenon known as “holiday heart syndrome.”
Cardiothoracic surgeon Dr. Jeremy London addressed this elevated risk in a recent Instagram post, sharing how heart attacks consistently rise around the holidays.
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“Every year, like clockwork, we see a spike in heart attacks around Christmas and New Year’s,” the South Carolina-based surgeon said. “In fact, Christmas Eve is the highest-risk day of the year.”
This is due to a shift in behavior, specifically drinking and eating too much, moving less and being stressed out, according to London. “Emotional stress, financial stress, the increased pace of the holidays, increased obligations,” he listed.
Cold weather also causes vasoconstriction (narrowing of blood vessels), according to London, which increases the risk of plaque rupture and the potential for heart attack.
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Dr. Glenn Hirsch, chief of the division of cardiology at National Jewish Health in New York, noted in an interview with Fox News Digital that holiday heart syndrome typically refers to the onset of an abnormal heart rhythm, or atrial fibrillation.
This can happen after an episode of binge-drinking alcohol, Hirsch said, which can be exacerbated by holiday celebrations.
Binge-drinking at any time can drive atrial fibrillation, a cardiologist cautioned. (iStock)
“It’s often a combination of overdoing the alcohol intake along with high salt intake and large meals that can trigger it,” he said. “Adding travel, stress and less sleep, and it lowers the threshold to go into that rhythm.”
The biggest risk related to atrial fibrillation, according to Hirsch, is stroke and other complications from blood clots. Untreated atrial fibrillation can lead to heart failure after a long period of time.
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“The risk of atrial fibrillation increases with age, but also underlying cardiovascular disease risk factors increase the risk, such as high blood pressure, obesity, diabetes, sleep apnea and chronic kidney disease,” he added.
Christmas Eve is the “highest risk day of the year” for heart attacks, according to one cardiologist. (iStock)
Preventing a holiday heart event
Holiday heart syndrome is preventable, as Hirsch reminds people that “moderation is key” when celebrating.
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The expert recommends avoiding binge-drinking, overeating (especially salty foods) and dehydration, while managing stress levels and prioritizing adequate sleep.
“Don’t forget to exercise,” he added. “Even getting in at least 5,000 to 10,000 steps during the holiday can help lower risk, [while] also burning some of the additional calories we are often consuming around the holidays.”
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London agreed, stating in his video that “movement is medicine” and encouraging people to get out and move every day.
The various stresses of the holidays can have physical consequences on the body, doctors warn. (iStock)
It’s also important to stay on schedule with any prescribed medications, London emphasized. He encourages setting reminder alerts, even during the holiday break.
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“Prioritize sleep and mindfulness,” he added. “Take care of yourself during this stressful time.”
London also warned that many people delay having certain health concerns checked out until after the holidays, further worsening these conditions.
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“Don’t ignore your symptoms,” he advised. “If you don’t feel right, respond.”
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Flu season is among us, and a new strain has emerged as a major threat.
Influenza A H3N2, or the subclade K variant, has been detected as the culprit in rising global cases, including in the U.S.
In an interview with Fox News Digital, Dr. Neil Maniar, professor of public health practice at Boston’s Northeastern University, shared details on the early severity of this emerging strain.
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“It’s becoming evident that this is a pretty severe variant of the flu,” he said. “Certainly in other parts of the world where this variant has been prevalent, it’s caused some severe illness, and we’re seeing an aggressive flu season already.”
Influenza A H3N2, or the subclade K variant, has been detected as the culprit in rising global cases. (iStock)
The variant seems to differ from prior strains of the flu, with heightened versions of typical symptoms like fever, chills, headache, fatigue, cough, sore throat and runny nose.
Subclade K is the “perfect storm” for an aggressive flu season, Maniar suggested, as vaccination rates overall are down and this year’s flu vaccine does not address this specific strain.
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“The vaccine is very important to get, but because it’s not perfectly aligned with this variant, I think that’s also contributing to some degree to the severity of cases we’re seeing,” he said. “We’re going in [to this flu season] with lower vaccination rates and a variant that in itself seems to be more aggressive.”
“There’s a lot of concern that this could be a particularly difficult flu season, both in terms of the total number of cases [and] the severity of those cases.”
Staying indoors during the colder months increases the risk of exposure to winter illness. (iStock)
Because subclade K is “quite different” from prior variants, Maniar said there is less natural immunity at the community level, further increasing the risk of spread and severity.
Those who are unvaccinated are also at risk of experiencing more severe symptoms, as well as a higher risk of hospitalization, the doctor emphasized.
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In addition to getting vaccinated, the doctor recommends washing hands frequently and properly. While the flu can spread via airborne transmission, a variety of other illnesses, like norovirus, can stick to surfaces for up to two weeks, he added.
The holiday season also boosts the risk of infection, as gatherings, large events, and packed planes, trains and buses can expose people to others who are sick.
The flu vaccine can help to prevent hospitalization and reduce severe symptoms, doctors agree. (iStock)
Those who are not feeling well or exhibiting symptoms should “please stay home,” Maniar advised — “especially if you think you are in that contagious period of the flu or any of these other illnesses that we’re seeing … whether it’s norovirus or COVID or RSV.”
“If you’re not feeling well, stay home. That’s a great way to recover faster and to ensure that you’re not going to get others around you sick.”
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For those who are unsure of their health status or diagnosis, Maniar recommends seeing a healthcare provider to get tested. Some providers may be able to prescribe medication to reduce the severity and duration of the illness.
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“It’s important that everyone stays vigilant and tries to take care of themselves and their families,” he added.
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As snow blanketed parts of the U.S. this week, heart health experts have shared warnings of the physical strain shoveling can take — particularly for older adults.
A 2025 Mayo Clinic review found that just 10 minutes of heavy snow shoveling can push the heart to about 97% of its maximum rate. Exposure to cold air was also found to increase blood pressure and reduce coronary blood flow.
While there isn’t an official age that’s “too old” to shovel, some cardiologists recommend that individuals over 45 should exercise more caution to lower their chances of a cardiac event.
When to take caution
“While there’s no strict age cutoff, generally above the age of mid 40s and above, we tend to be a little more cautious — particularly in people who are less active [without] regular exercise,” Dr. Navjot Kaur Sobti, M.D., an interventional cardiologist at Northwell’s Northern Westchester Hospital in Mount Kisco, New York, told Fox News Digital.
Heart health experts have shared warnings of the physical strain shoveling can take — particularly for older adults. (iStock)
“Certainly in people who are above the age of 65 — and who have risk factors for heart disease, such as high blood pressure, high cholesterol, diabetes, obesity or sedentary lifestyle — we recommend being very, very cautious about shoveling snow,” she advised.
Dr. John Osborne, M.D., a practicing Texas cardiologist and volunteer for the American Heart Association, shared similar guidance for people older than 45, especially males over 65.
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“Unless you are in good cardiovascular shape and conditioned, it may be a good idea to ask someone for help,” he said in an interview with Fox News Digital.
The impact of snow removal is especially concerning for those with existing cardiovascular risks and a history of heart attack or stroke, according to the cardiologist. “People with these characteristics and those who have had bypass surgery or coronary angioplasty simply should not be shoveling snow in any conditions,” he said.
Just 10 minutes of heavy snow shoveling can push the heart to about 97% of its maximum rate, a 2025 Mayo Clinic review found. (iStock)
Osbourne said he often sees cardiac episodes in people who are typically sedentary and sit at a computer most of the day with little or no exercise. “Then once or twice a year, they go out and try to shovel the driveway after a heavy snowfall, and that unexpected exertion can unfortunately lead to tragedy.”
Hidden strain
The stress that is placed on one’s heart while shoveling snow is similar to what occurs during a cardiac stress test, Sobti pointed out, and may even exceed it.
Cold temperatures can cause blood vessels to constrict and blood pressure to spike — which, coupled with existing hypertension and the exertion of lifting snow, can significantly tax the heart, she warned.
“It’s almost like an at-risk person is putting themselves through an unsupervised maximal exertion stress test without a cardiologist actively monitoring them,” Sobti told Fox News Digital.
The stress that is placed on one’s heart while shoveling snow is similar to what occurs during a cardiac stress test. (iStock)
In addition to the exertion of shoveling, frigid temperatures can also strain the heart. Recent research has shown that cold exposure accounts for nearly twice as many cardiovascular deaths as heat exposure, including heat exhaustion.
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That study, published in the Annals of Internal Medicine last month, also found that those over age 65 had higher rates of temperature-related deaths.
“So the risk is very, very high,” Sobti cautioned. “It’s really that sudden rise in blood pressure coupled with the physical stress of snow shoveling itself.”
Safer shoveling tips
The cardiologist said it’s ideal to have someone else help with snow removal — but if you do choose to use a shovel, she recommends pacing yourself and using a “pushing or sweeping” motion instead of heavy lifting.
Recent research has shown that cold exposure accounts for nearly twice as many cardiovascular deaths as heat exposure. (iStock)
To protect against the cold, Sobti also recommends covering your mouth, nose and extremities, wearing a hat and gloves, and using extra caution in windy conditions.
Using an automated snow blower can still raise the heart rate — up to 120 beats per minute, compared to 170 while shoveling, the American Heart Association states on its website.
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It is also important to be aware of any symptoms of a potential cardiac issue while shoveling, Sobti emphasized.
If a person starts to experience warning signs such as chest pain, shortness of breath, a racing heart or palpitations, those should not be ignored.
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Even if the symptoms resolve after a few minutes, a person “could still be experiencing symptoms of a heart attack” and should call 911 for evaluation, Sobti said.
“It’s better really to be safe than sorry.”
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