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Trump wants to cut $1.2 billion from medical research ASAP. That’s only the beginning.

The cuts come amid proposed increases in defense spending.

A man at a Trump rally waves a sign that says “I'm ready to work on the wall.” First, Trump will need to find funding.
Aaron P. Bernstein/Getty Images

President Donald Trump’s budget blueprint for 2018 proposed a series of devastating cuts to health research funding and public health programs.

But it seems that assault on medical science and health could be starting much sooner.

According to media reports out today, the Trump White House is proposing to slash $1.2 billion from research grants at the National Institutes of Health and other health and education programs this year.

The $18 billion in total cuts from discretionary spending bills is reportedly offsetting the $30 billion in supplementary increases in defense spending and spending on the border wall with Mexico. (Though it’s not entirely clear that the wall will be part of the supplemental defense budget.)

There have been lots of estimates floating around about how much the wall will cost. Mexico has continued to refuse to foot the bill, but Trump’s been under pressure to deliver on his promise to immediately begin construction. To appease congressional penny pinchers, the money for the increased defense budget and wall has to come from somewhere.

So basically: The Trump White House is ditching investments that would bolster scientific knowledge and health to try to wall off Mexico and marginally increase a defense budget that already outstrips just about every other country on the planet.

How does Trump cut research from the 2017 budget?

You might be wondering: How could Trump slash NIH funding in a fiscal year that’s already underway? He can’t directly. But he does have veto power over Congress. And Congress needs to pass a budget resolution by the end of April to continue funding the government for the rest of the year. If it doesn’t, the government will shut down.

Why, you may ask, does Congress fund the government this way? Because it rarely passes a full, new budget for any fiscal year — that takes too much time and debate. Instead, it often keeps the previous year’s budget framework in place by a temporary measure called a continuing resolution, which has a shorter shelf life.

When it comes time to pass the continuing resolution, Trump could threaten to veto the measure if his budget request isn’t met.

Still, it’s possible the cuts won’t happen. There’s already some pushback underway. Research and health groups like the American Public Health Association and American Society for Biochemistry and Molecular Biology and lawmakers on both sides of the aisle are panning the proposal, particularly after the bipartisan success of the 21st Century Cures Act. The Cures Act aimed to advance medical research and innovation though new funding, and raised the NIH budget by $4.8 billion over 10 years. Asking representatives to vote against the same research center they just funded will be a hard sell.

When NIH funding is cut, the result is simple: fewer scientists get to pursue research

Competition for NIH grants is already intense. Its funding has basically plateaued over the past decade. At the same time, the cost of research keeps increasing, and an ever-growing pool of PhDs is competing for a relatively smaller pile of grant money.

Consider this: In 2000, more than 30 percent of NIH grant applications got approved. Today, it’s closer to 17 percent. It’s not crazy math: The less money there is to go around, the fewer projects get funded.

According to Matt Hourihan — who analyzes budget issues for the AAAS — when the NIH’s budget dropped 5 percent from sequestration cuts, they had to cut around 700 individual grants (out of about 9,000). For 2018, Trump proposed a $5.8 cut to NIH. Hourihan said that could lead to a thousand or more fewer grants.

The requested 2017 cut would put a similar chokehold on the NIH, limiting the institutes’ ability to fund new grants, and may lead to the reduction in funding for exciting new projects.

The effects of these cuts ripple outward. Many researchers rely on federal funding from the NIH or NSF — not just to fund their projects, but also to pay their salaries. The federal government funds some 60 percent of all scientific research in the country. When it becomes less generous, there are fewer opportunities for budding PhDs to start their careers.

As a 2014 piece in Proceedings of the National Academy of Sciences put it: "The current system is in perpetual disequilibrium, because it will inevitably generate an ever-increasing supply of scientists vying for a finite set of research resources and employment opportunities." And that was written while Obama was in office. Now, those resources could be winnowed further.