The Trump administration has quietly issued a sweeping regulation that would make political ideology, not scientific merit, the deciding factor in federal research and grant funding decisions, according to Richard Besser. The proposal is scheduled to take effect on Oct. 1. If it goes through, medical research and public health programs that affect people across America would be judged on loyalty tests instead of their impact on the nation’s health.
Who Holds the Levers
Besser said the federal government hands out more than $1 trillion in federal grants each year to states, localities, hospitals, universities, nonprofits and other organizations. That money props up research that leads to treatments and cures for illness, powers vaccine clinics and responses to disease outbreaks, supports programs to prevent drug overdose deaths, provides health care to veterans and keeps mothers and babies safe during childbirth. The apparatus is enormous. So is the damage when it gets turned into a political weapon.
He said the current administration is already demolishing the biomedical research system by cutting federal research grants, interfering in what scientists can study and treating immigrants with contempt. The proposed regulation would push that further. It would require federal grant awards to “demonstrably advance the President's policy priorities,” empower federal agency heads to “designate” appointees to review those awards before distribution, and say peer review recommendations should not be “routinely deferred to.”
That’s the hierarchy in plain view. Decisions about research, care and public health would move upward into the hands of political appointees, while the people doing the work, and the people who depend on it, get shoved lower down the chain.
Who Pays for the Power Grab
Besser said grant criteria and selections would be tied directly to the political priorities of this or any other White House, and awards could be terminated simply for ideological reasons. That could end promising research or effective community health programs in their tracks. He said people’s health would suffer and lives would be lost.
The administration has already shown how it uses federal power as leverage. Besser cited wildfires in Southern California in 2025 that destroyed more than 18,000 homes and displaced more than 200,000 residents. He said President Donald Trump repeatedly threatened to condition federal disaster relief on California adopting unrelated policies, such as more stringent voter identification laws. He also said the Federal Emergency Management Agency illegally withheld disaster relief grants from California and other states for months after the devastation, and that it took federal court orders to release those dollars.
That’s not neutral administration. It’s coercion with paperwork.
What the Institutions Are Saying
The American Heart Association said the proposal raises “serious concerns about the independence of science and the future of biomedical and population-based research in the United States.” The Academic Pediatric Association warned that it “could limit federally funded research, training, innovation, care delivery and public health efforts that are essential to enhancing the health and well-being of all children.” Those warnings point to the same basic problem: when power sits above science, science gets bent to serve power.
Susan Collins of Maine, the Republican chair of the Senate Appropriations Committee, predicts the regulation “would harm small and rural communities.” Other detractors warned it could “jeopardize the future of cancer research,” have “a detrimental impact” on preventing and treating diabetes, “discourage and defund” research on health disparities, and create funding insecurity while failing to honor Native American tribal nations. The language changes, but the pattern doesn’t. The people with the least cushion absorb the blow.
Besser said the vast majority of Americans across the political spectrum care deeply about health, and independent analysis shows that the public comments submitted in response to the proposal are overwhelmingly in opposition. Still, he said the administration is barreling ahead to give itself and any future White House the power to reward allies, silence critics and rule by decree at the expense of people’s lives.
He ended by saying health simply cannot be wielded as a political weapon and that a proposal this dangerous, especially in the hands of an authoritarian administration, should never see the light of day. The opinion piece was by Richard Besser, MD, president and chief executive officer of the Robert Wood Johnson Foundation and former acting director of the Centers for Disease Control and Prevention.