https://www.notus.org/health-science/nih-holding-up-medical-research-funding-status-19

Hundreds of grants, including for maternal health, contraceptives and drug abuse, are in limbo, subject to political reviews.

The Trump administration is implementing more political oversight of grants. Alex Brandon/AP

By Paige Winfield Cunningham

August 17, 2026 06:00 a.m.

It used to be that once a National Institutes of Health grant award hit “status 19,” the money was about to go out the door.

That’s not the case anymore. The Trump administration has enacted an unprecedented political review process, pushing hundreds of awards into limbo. Status 19 — an administrative code describing awards with senior leadership sign-off — is being used as the holding cell.

Current and former career staff say this extra review by senior leaders is occurring after grants have undergone peer review, been approved by multiple offices in NIH, and screened for red-flag words around race, gender or other behavioral and social sciences. The extra political reviews are required not only for newly funded grants but also for annual payment installments for previously awarded projects.

As a result, some grants are lingering in status 19 for weeks or even months, gumming up the works as grant officers try to get awards out the door ahead of the new fiscal year starting in October. Flagged grants reviewed by NOTUS had to do with maternal health, contraceptive use, aging, dementia and opioid abuse.

“The notion that Francis Collins or Mike Lauer would ever have reviewed individual grants like this is so beyond the realm of comprehension,” a senior career staffer said, referring to the former directors of NIH and its Office of Extramural Research. “It’s laughable to me.”

A second senior NIH official called status 19 a “graveyard for grants.” The NIH staffers were granted anonymity because they weren’t authorized to speak to the media.

As one of the largest grant funders in the federal government, NIH’s process is a prime example of how the Trump administration is implementing more political oversight of grants across a wide swath of agencies, even as its efforts to formalize those reviews face pushback.

Senate Republicans voted to temporarily block a White House regulation to formalize political review, which has already led to delays in posting and awarding grants at the Centers for Disease Control and Prevention, the Substance Abuse and Mental Health Services Administration, the Department of Interior and other agencies.

Researchers, patient advocates and biotech companies are outraged by the proposed regulation, which the White House is seeking to implement by Oct. 1 but could be blocked until December if the House also approves a delay.

Senior NIH leaders sent around a new agency review flowchart in May outlining additional steps once an award hits status 19. The flowchart, viewed by NOTUS, mandates a review by the NIH Office of Extramural Research (OER) and an HHS counselor before grantees are given a notice of award. There are no political appointees at OER, but its director reports to NIH Director and Trump appointee Jay Bhattacharya.

As a result of the extra reviews, the number of grants sitting for weeks in status 19 have surged. Around 8% of new grant awards are sitting in status 19 for anywhere from two to seven weeks, according to internal data shared with NOTUS.

In past years, around 11% of first-time awards had been released to the recipients within a week. This year, it’s 2%.

The delays are even more pronounced for annual payment installments for ongoing grants. The vast majority previously left status 19 within three days; now it takes 53 days to get 90% of payments out the door.

Lauer, who served as NIH’s extramural research director from 2015 to February 2025, said he couldn’t recall a time when a political appointee — including the NIH director — halted awarding of a research grant after it had gone through the review and approval process.

“Status 19 was not something I thought about,” Lauer told NOTUS.

NIH career staff stress that by the time grant awards reach status 19, they have been through dozens of editing and review steps. They’ve undergone peer review and a second look by an advisory council. Grant officers have gone through a checklist, including confirming that women and racial minorities have been appropriately included, something required by statute.

In grants reviewed by NOTUS, HHS or EOR staff flagged words including “diverse,” “equity,” “structural” and “underrepresented” and asked for clarification about what the researchers meant by them. In one project, a staffer wrote that the word “structural” could include concepts that are inconsistent with NIH priorities.

They asked for more clarification in projects that focused on health disparities or racial groups. Officials wrote that focusing on specific racial groups required more justification. In one project that expressed support for scholars and researchers from a variety of backgrounds, an official responded that the language could raise legal concerns if interpreted as targeting people based on demographics.

In multiple flagged grants, officials expressed concerns that they weren’t worth funding because their only practical use might be to support the writing of new laws.

HHS spokeswoman Emily Hilliard disputed the notion that status 19 is being used to hold up grants under extra political reviews. She said grants can remain in status 19 for five to 10 days while they are given final review by the Office of Extramural Research.

“There is no political appointee review stage in the NIH grant review process,” Hilliard said in a statement. “OER’s review is a longstanding part of NIH’s grant review process.”

Lauer said releasing grant money might face occasional delays, but it was almost always because Congress had failed to pass a budget for NIH, leading to uncertainty about how much total grant funding would be available.

Trump appointees are also conducting extra layers of review to the notices posted by the government to let researchers know money is available for specific projects or programs. Researchers say they’ve seen more delays in posting those notices — another obstacle in getting grant funding out the door.

“It’s this black box of HHS review,” said Colleen Kelley, an associate dean for research at Emory University.

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Author

Paige Winfield Cunningham is a reporter at NOTUS.