Radiology Researchers Navigate NIH Funding and Policy Changes
A look at policy whiplash, vanishing pay lines and the impact of intensified advocacy efforts
When the Trump Administration assumed office in January 2025 and implemented new funding policies and processes at the NIH, radiology found itself caught in the same turmoil that affected the wider research community.
“The NIH is the main source of funding for health care‑related research and has always been the strongest supporter of research in the health care arena,” said Elizabeth Krupinski, PhD, professor and vice chair for research in the Department of Radiology and Imaging Science at the Emory School of Medicine in Atlanta.
At some research institutions, grants were canceled or drastically curtailed; others experienced long holds before grant funding was released. The combination of funding cuts, grant terminations, NIH staff reductions, changes to the agency’s grant proposal review process and delays in communication presented researchers and their institutions with an unprecedented level of uncertainty.
The Chaos of Uncertainty
“The biomedical research enterprise generally works well in stable conditions,” said Eve Granatosky, PhD, a principal at Lewis-Burke Associates, a federal government relations firm that represents universities, scientific societies and research organizations. “Science is a long-term enterprise, and you have to be able to count on funding for your research and for hiring students and technicians.”
In its budget proposal for fiscal year (FY) 2026, the Trump Administration proposed cutting the NIH budget by roughly 40% and reorganizing or eliminating certain institutes and centers. These changes were ultimately rejected by a bipartisan Congress in the appropriations process.
For radiology, that rejection had concrete implications. “It prevented the National Institute of Biomedical Imaging and Bioengineering (NIBIB) from being folded into other parts of the NIH in ways that didn’t make sense and would be harmful for the community, potentially diluting resources and expertise specific to imaging research,” Dr. Granatosky explained.
David Mankoff, MD, PhD, professor of radiology and vice chair for research at the Perelman School of Medicine at the University of Pennsylvania in Philadelphia, said the final FY 2026 NIH budget, roughly flat with a small real decrease after inflation, is far better than the 40% cut that was initially proposed by the Trump Administration. Lawmakers also blocked a proposed cut in indirect cost rates on research grants—typically 50% or more—to just 15%.
“That would have been a disaster, not only for departments but for entire institutions that rely on indirect cost funding to sustain research infrastructure,” Dr. Mankoff said.
Beyond Budget Cuts and Policy Changes
Much of the disruption was driven less by topline NIH dollar cuts and more by how existing funds were—or were not—allowed to flow.
“Many grants were abruptly terminated, not because of a reduced NIH budget but because projects were deemed out of step with the administration’s priorities,” Dr. Granatosky said. “A lot of grants that had anything to do with diversity, equity and inclusion or health equity were terminated, and health disparities work was hit particularly hard.”
Dr. Krupinski was just one of the many researchers affected. One of her grants at Northwestern University in Chicago was not reinstated, forcing her to find other sources of funding to compensate. “Impacts on individual researchers were largely dependent on the institution and the specific research portfolios,” she said.
The NIH’s unified funding strategy, implemented in late 2025 by new NIH director Jay Bhattacharya, MD, PhD, moved away from traditional pay lines—the numeric score thresholds that gave investigators a reasonable expectation of what would and would not be funded. For example, in the past, if an NIH institute had a 15% pay line, investigators knew that applications scoring in the top 10% to 15% had a strong chance of funding.
“Removing pay lines takes away some planning ability for faculty,” Dr. Granatosky said. “More importantly, it leaves more room for political influence, geographic factors and alignment with administration priorities to influence award decisions after peer review.”
Dr. Krupinski added that hyper‑competitive pay lines as low as 4% would make funding seem almost unattainable, especially to young investigators, who would have fewer opportunities to submit grant applications to help cover their academic salaries.
Impact on Radiology Leadership and Ongoing Threats
Changes at the NIH represent daily operational stress for Dr. Mankoff and many vice chairs of research. Many NIH employees were fired or retired, including some institute directors, leaving investigators without program officers and slowing the grant review and award processes.
“The abrupt changes have turned the usual ups and downs of grants into a large‑scale funding crisis,” he said.
Dr. Mankoff credits RSNA’s Government Relations team with providing the Society’s vice chair group with early intelligence on federal actions and clarifying rumors versus confirmed policy calls throughout this tumultuous time.
“Because of our regular calls with RSNA and the Academy of Radiology and Biomedical Imaging Research, vice chairs were sometimes better informed than their own institutional leadership about impending changes at NIH,” he said.
Unfortunately, the FY 2027 budget proposal, released by the Trump Administration on April 3, once again threatens to cut NIH funding, merge some of its 27 institutes and reinstate the 15% indirect cost rate cap. Dr. Mankoff is, however, cautiously optimistic about the biomedical research community’s ability to prevail, given the strong advocacy efforts it marshalled over the last year and a half.
“The relatively good outcome on the 2026 budget required organized pressure and education of lawmakers,” he said. “Through RSNA and the Academy, there have been coordinated campaigns to contact members of Congress and expanded ‘radiology days’ in D.C. These efforts helped convey that NIH funding and stable indirect cost structures are non‑negotiable for maintaining a vibrant research ecosystem.”
The Importance of Advocacy
For the radiology and broader biomedical community, sustained vigilance and active advocacy will be essential to ensure that NIH funding continues to prioritize the best possible science.
In late May 2026, The Trump Administration’s Office of Management and Budget proposed new rule changes that could significantly reshape the policies and processes governing federal grantmaking, including biomedical research grants issued by the NIH. RSNA submitted comments in advance of the July 13 submission deadline.
Dr. Granatosky urges imaging departments and radiology investigators to systematically document grant terminations, hiring freezes, project delays and other concrete impacts tied to NIH policies.
“Policymakers are not closely tracking exactly what grants have been canceled or the number of staff that can’t be hired because of these changes,” she said. “Capturing these stories and funneling them to their institutions’ government relations offices, professional societies like RSNA, and directly to congressional delegations can help lawmakers conduct meaningful oversight.”
“Members of Congress can’t go and fight for more NIH funding if they don’t know why it’s important and what its impacts are,” Dr. Granatosky said.
For More Information
Read previous RSNA News stories on radiology research advocacy:
Breaking Down the Unified Funding Strategy
For radiology residents navigating the research landscape, the National Institutes of Health (NIH) Unified Funding Strategy (UFS) represents a meaningful shift in how grants are awarded and how you should think about your work.
In the past, funding decisions were largely driven by a numeric cutoff: score well enough, and your project was likely funded. Under the UFS, that rigid system is gone. Instead, NIH leaders now take a broader view, weighing not just scientific merit but also how a project fits into larger priorities. These initiatives may include supporting early-career investigators, advancing emerging areas, such as imaging AI, or balancing the overall research portfolio.
For residents, this means success is no longer just about achieving a top score. It’s about clearly communicating why your research matters now, how it fills a gap and how it aligns with bigger-picture goals in radiology and medicine.
Will that shift influence the wider funding ecosystem? Organizations like RSNA and the Society of Interventional Radiology (SIR) are watching closely and considering whether to adapt their own approaches.
The takeaway? Strong science still matters—but in today’s environment, context, clarity and alignment may matter just as much.