For nearly two years, the Trump administration has tried to shrink the National Institutes of Health through the front door: a proposed 40% budget cut, a cap on the overhead payments that keep university labs running, and a plan to abolish the institute that studies why minority patients get sicker and die younger. Congress declined to enact the deep cuts. Courts blocked the overhead cap. So now, according to a Reuters report Saturday citing Politico, the president is trying a different door entirely: taking control of the grant decisions themselves.
Politico reported, and Reuters confirmed, that Trump has directed his budget director, Russ Vought, to draft an executive order creating a board that would decide which grants the NIH funds. The board would include NIH Director Jay Bhattacharya and Vought, and it would have to reach unanimous decisions on grant awards. Unanimity sounds collegial. In practice, it hands the White House budget office a veto over every dollar of congressionally appropriated medical research money.
The reported trigger is telling. On Friday, in an Oval Office meeting, Trump asked Bhattacharya to cut Harvard University's funding, administration officials told Politico. Bhattacharya refused. The board proposal surfaced after that refusal. The Washington Post, which also reported on the meeting, said Vought led the criticism of the NIH, accusing the agency of funding "woke" initiatives that ran against Trump's agenda.
Read that sequence again. The president's own NIH director, a close ally of Health Secretary Robert F. Kennedy Jr. and hardly a member of the resistance, declined to weaponize research grants against a university the administration has been fighting in court since last year. A federal judge ruled in September 2025 that the administration's freeze of more than $2 billion in Harvard research funding amounted to unconstitutional retaliation. The government's appeal is still pending. The proposed board looks like a solution to a specific problem: a science agency whose leader still thinks some decisions belong to science.
None of this arrived out of nowhere. In August 2025, Trump signed an executive order declaring that political appointees would review all federal grants, with the power to cancel work not "consistent with agency priorities," and that senior officials should not "routinely defer" to peer reviewers, the outside scientists who have scored research proposals for roughly eight decades. Bhattacharya followed with an internal memo stating that institutes should not rely on scientific merit rankings in setting their final funding plans. Program officers have since told KFF Health News that applications are screened for words like "diversity" and "climate change," and that self-censorship is now part of the job. As one officer put it, when a grant says "health equity," it gets terminated.
The administration has also lost, repeatedly, when it pushed further. Its proposed budget would have slashed NIH funding from about $48 billion to $27.5 billion and consolidated its institutes, but final fiscal 2026 appropriations kept money flowing and explicitly barred unilateral changes to indirect cost rates. The First Circuit upheld a ruling that the NIH cannot cap those rates at 15%, and the Justice Department let its deadline to seek Supreme Court review lapse this spring, leaving the injunction permanent. Nature reported in February that the budget office responded by slow-walking the release of research grants Congress had already authorized. Congress holds the power of the purse on paper. The fight now is over whether that paper means anything.
For Black communities, the stakes have a particular edge. The administration's budget eliminates the National Institute on Minority Health and Health Disparities, a roughly $534 million cut targeting the one NIH institute whose entire mission is research into why diseases hit minority patients harder. The Supreme Court has already let the administration terminate more than 1,700 grants, worth $783 million, that officials deemed tied to diversity or "gender ideology," grants that included research on heart disease, HIV and AIDS, Alzheimer's, and substance abuse. A politicized grant board on top of that means research into the conditions that shorten Black life expectancy could face a second screening: not for scientific merit, but for vocabulary and politics.
Institutions with thin financial cushions, including historically Black colleges and universities that train a large share of Black physicians and researchers, would have the least room to absorb delayed or politically denied grants. Harvard can litigate for years. Most schools cannot.
The administration's stated rationale is that peer review funds too much "unfocused research of marginal social utility" and that federal science spending must be politically accountable. There is a real debate buried in there about overhead rates and duplication, and even some NIH veterans concede parts of the system are ripe for reform. But political accountability for an entire research portfolio is a polite phrase for a simple arrangement: the president's budget chief decides which diseases get studied.
The White House, the budget office, and HHS did not immediately respond to Reuters' requests for comment. The executive order, as of this weekend, is still a draft. What happens next depends on whether the courts treat control of grantmaking the same way they treated the cuts, and whether Congress decides the power of the purse is worth defending with specific protective language or is willing to let it leak away one mechanism at a time.
Free Game Takeaway
Watch three things. First, the text of the executive order itself: a unanimity requirement means Vought alone can block any grant, so look for who else sits on the board and whether career scientists have any binding role. Second, the legal response: universities and state attorneys general have won nearly every round of this fight, and an order letting political appointees override peer review of congressionally appropriated funds will be sued on day one. Third, the fiscal 2027 budget: the elimination of the National Institute on Minority Health and Health Disparities and the 15% overhead cap are still administration asks, and Congress has so far rejected both. If you work in research, medicine, or at a university, expect continued delays and screening of grant language. If your community relies on research into conditions like heart disease, hypertension, HIV, or maternal mortality, understand that the pipeline for that science is being rerouted through a political office. The signal to track is whether appropriators write explicit peer-review protections into the next funding bill, or stay quiet and let the executive branch keep the pen.