“It’s gone from being a sort of manageable system to a system that clearly is out of control,” Gingrich said of the government’s health-science grantmaking apparatus. “I think it deserves a substantial overhaul. And I don’t mind putting some financial pressure on it to start getting that overhaul. I don’t think we have an obligation to just continue to throw money at something.”
Gingrich, who led the GOP back to House control in 1994 after 40 years in the minority, remains an éminence grise capable of influencing lawmakers’ post-pandemic perspective. But he’s moved along with the party.
It’s a major change. Rewind to the late 1990s, and it was a Gingrich-led Congress that passed funding increases leading to a doubling of the National Institutes of Health’s budget, upping it by 14 to 16 percent each year for half a decade.
As recently as 2015, the Georgia Republican was calling for another doubling, again arguing that it was an investment fiscal conservatives should embrace.
But the pandemic — and GOP anger at government efforts to stem Covid’s spread and Anthony Fauci — changed everything. House Republicans last week proposed the 8 percent budget cut, and even Gingrich now wants to take a cleaver to the NIH.
Gingrich’s affection for the NIH was tested during the Covid pandemic — and did not withstand that test. He said he’s grown disillusioned with an agency that was “so awash in money that they were giving it to the Chinese to do research, which had an enormous military capability,” citing coronavirus research grant subcontracts that went to the Wuhan Institute of Virology.
For that, he blames Fauci, who was during the pandemic, as he was during Gingrich’s speakership, the director of the NIH’s National Institute of Allergy and Infectious Diseases.
The proposed budget cut would need to get past the Democratic-controlled Senate and President Joe Biden before taking effect. The NIH budget is now “four times bigger than when I became speaker,” Gingrich said. But that doesn’t account for inflation — something Gingrich was cognizant of when he was advocating for another big budget increase in 2015.
Naturally, many scientists disagree with Gingrich’s new views.
The proposed budget cut is a “blow to the mission of the National Institutes of Health,” according to United For Medical Research, a coalition of research institutions, health and patient advocates and companies that advocates for increased NIH funding. “The NIH and the entire biomedical research community has for the last several years been catching up from a decade of flat funding,” the coalition said in a statement.
When adjusted for inflation, the 2023 NIH budget is $47.6 billion, compared to $46.7 billion in 2003, the last year of Congress’ double-digit NIH budget increases, according to a Congressional Research Service report from May.
For his part, Biden’s NIH budget proposed an $811 million bump, an increase of 1.7 percent. Biden then agreed to a freeze in his June agreement with House Republicans to raise the country’s debt ceiling.
When the House Appropriations Committee considered the NIH funding bill last week, ranking member Rosa DeLauro (D-Conn.) bemoaned the “dreadful cuts to the National Institutes of Health” and cited the legislation’s potential to stifle biomedical innovation.
Erik Fatemi, a principal at lobbying firm Cornerstone Government Affairs and former Democratic staffer on the Senate Appropriations subcommittee with authority over NIH funding, said of the proposed cuts: “That would be a huge blow, not only for the agency, but for our international competitiveness, our economic development, and of course, for patients.” Even flat funding could pose challenges to the biomedical research enterprise, he said.
At the same time, he added, there’s zero chance Congress will pass the House bill, calling it “the opening salvo in a long process that will take a lot of twists and turns, and might even include a government shutdown.” Ultimately he thinks Congress will give the NIH at least as much money as lawmakers gave the agency this year.
Senate Appropriations Committee leaders, Democratic and Republican, have agreed to add $2 billion in emergency funding to their version of the health care funding bill that includes NIH — above what Biden agreed to in the debt ceiling deal.
That’s likely a strategy to create a higher bar for negotiations, so that they can keep funding NIH flat, or could result in a small bump in funding, according to Ellie Dehoney, senior vice president at Research!America, a research advocacy organization.
Dehoney views the House version as a messaging bill signaling anger from a segment of the right toward the NIH and Fauci, rather than a sign Republicans have permanently soured on the agency.
“I think that NIH is going to remain a bipartisan priority and that the champions are still strong,” she said, adding, “this was actually a post-pandemic wave of anger more than a change in direction.”
Former Missouri Sen. Roy Blunt, an appropriator who was among the NIH’s biggest Republican champions, acknowledged that every health agency took a reputational hit during Covid.
In his view, the NIH isn’t being singled out. “The House is looking for places to cut spending and very few things are protected in that environment,” said Blunt, who retired at the end of the last Congress.
At the same time, he pointed to personalized medicine, immunotherapy and Alzheimer’s treatments as areas of rapid health care transformation. It would be a mistake for the U.S. not to lead the effort toward finding new cures for diseases, he added.
“We want those things to happen in our country, and to have the earliest benefit of those things. And one of the ways to see that that happens is a vibrant NIH,” Blunt said.