Amy Waterman, a health researcher at Houston Methodist Hospital in Texas, has spent the past three years developing a program that she hoped would transform kidney care. With a team of scientists and clinicians, she created a method to identify people at the highest risk for kidney failure and built tools to better inform patients and families about the effectiveness of early kidney transplants.
The program was all set to launch in several California clinics. But on July 15, Dr. Waterman learned that her work would no longer be funded.
“We really believe that our work will matter to improving care,” she said. Now, she added, “it’s totally uncertain if we can even continue.”
Dr. Waterman is one of dozens of scientists whose active grants were discontinued by the Agency for Healthcare Research and Quality, an arm of the U.S. Department of Health and Human Services. The targeted grants range in scope, from reducing the overuse of antibiotics to improving children’s asthma treatments, according to AcademyHealth, an organization tracking the grants.
“This is real work that affects people,” said Dr. Aaron Carroll, the organization’s president. “When these investments stop, health system clinicians and patients feel it, not just the researchers.”
The discontinuation of active grant funding is part of a broader trend across the federal government, which has sought to change the way science is funded and conducted since the Trump administration took office.
A.H.R.Q. is a small agency that funds research to make quality health care in the United States more affordable and accessible. It awards grants through a competitive review process and generally disburses funds for multiyear awards in installments. Researchers are required to submit regular progress reports for the grants to renew each year.
According to Dr. Carroll, a vast majority of projects continue to receive funding. “Once in a while, a grant is terminated midstream,” he said. “But usually it’s for cause, or for a very specific purpose, and you would know what that is.”
Scientists who spoke to The New York Times said that they had submitted reports last summer, and had been waiting months for the next installment of their grant funds. Last week, they received letters from A.H.R.Q. stating that the grants would be discontinued.
Specific reasoning was not provided in the letters. Instead, the letters said that the agency was adjusting its award portfolio “in order to better prioritize agency resources,” and listed priorities including patient safety, preventing antibiotic resistance and the use of digital tools to improve health, according to documents reviewed by The Times.
Several scientists who received the notice said that their work fell within the agency’s priorities. (A federal judge in Massachusetts recently ruled that funding agencies could not terminate active grants in certain states by citing a shift in priorities, although that restriction could change with the passing of a new White House proposal.)
Emily Hilliard, a spokeswoman for the Department of Health and Human Services, said in an email that the A.H.R.Q. grants “were not terminated — they were not awarded continued funding.” She added that the agency’s director was under statute to determine “whether continuation funding is in the best interest of the federal government.”
The discontinuation of funding comes after a sharp reduction in staff at A.H.R.Q., followed by a decline in grantmaking and managing. “We don’t know who is making these decisions,” Stephanie Garlock, an attorney at Public Citizen Litigation Group, said of the notices. The law firm, which filed suit against the agency last year, was evaluating the recent development, Ms. Garlock added.
Grants focused on training the next generation of health services researchers were also discontinued, despite being a stated priority for the agency. One program targeted has been running continuously at Brown University since 1986, but it is no longer recruiting new trainees.
According to Grant Witness, an crowdsourced online database, at least 150 active grants have been discontinued by the agency, totaling $229 million. Many of the affected researchers said that they were taken by surprise, despite sweeping changes at the agency.
“Nothing like this has ever happened before,” said Dr. Nora Becker, a physician-scientist at the University of Michigan who was three years into an award supporting her studies on the financial burden experienced by Covid-19 patients. Dr. Becker stopped receiving the funds last fall. Since then, she has devoted most of her time “frantically applying” to any other grant opportunities she could find, she said.
Others are doing the same. Some have received interim support from their institutions or are hoping to secure funds through private foundations. The National Institutes of Health offers an alternative federal avenue but focuses more on basic research and discovery, which is distinct from A.H.R.Q.’s purpose.
“A lot of research from N.I.H. happens in academic medical centers,” said Dr. Sebastian Tong, a researcher at the University of Washington. “A.H.R.Q. was the final bridge bringing it to the public, especially in remote communities.”
Dr. Tong was halfway through a project supported by the agency that focused on improving care for substance abuse at primary care centers when his funding was cut. The last half of the project was going to be the most important, he said: Programs run in a handful of medical centers were going to be evaluated and published, and then scaled up to include dozens of clinics.
Now the scope is limited, Dr. Tong said, and some patients and clinicians have asked if they could continue the work for free. “We were initially hoping that the funds would return,” he added. “At this point, we have stopped all work on this.”
