Every tool a gastroenterologist reaches for on any given day began as federally funded research, judged on its scientific merit by other scientists and carried from the laboratory into the clinic. A proposed federal rule now threatens this system. And to those AGA members leading the response, the consequences will not stay confined to research. They will impact clinical practice and patient outcomes.
What OMB is proposing
On May 29, the Office of Management and Budget proposed a sweeping revision to the rules that govern how every federal agency awards grants. If finalized, it would require senior political appointees to review each grant before it is awarded and bar them from deferring to expert peer-review panels; allow agencies to terminate grants when political priorities shift; restrict DEI- and gender-related research as a grant condition; prohibit federal funds, including indirect costs, from supporting international scientific collaboration; and make journal publication and open-access fees unallowable by default. The rule is slated to take effect October 1, 2026. Notably, it does not include the 15% cap on indirect-cost reimbursement that many in the research community had feared, a proposal that was blocked separately by Congress.
Public comments on the rule are due July 13, 2026.
For clinicians who might regard grant policy as a researcher's concern, Richard M. Peek Jr., MD, AGAF, AGA president-elect, chair of the AGA GI Researchers Task Force, and director of the division of gastroenterology, hepatology, and nutrition at Vanderbilt University Medical Center, lays out why this one reaches the bedside.
When merit gives way to politics
Dr. Peek's first concern is what happens when expert review is sidelined. “There's much less emphasis on the scientific review of grants — and these are clinical studies, translational studies,” he said. “When those decisions are made more and more by political appointees rather than expert reviewers in the field, it has a high potential to erode the public's trust in the science being funded.”
This has real-world implications, in his view. “If a highly meritorious grant is overlooked because of a political priority, the best science — the kind that translates into the best care for patients — may not get funded.”
Clinical trials and patients at risk
The provision Dr. Peek returns to most concerns the new latitude to stop grants already underway. “There's now essentially carte blanche for grants to be stopped, particularly clinical trials, and that could be very detrimental for patient care,” he said. “If funding for a clinical trial stops, there's a risk of harm to patients, because the trial medications would no longer be available.”
The damage, he noted, would extend well past the patients enrolled. “You lose the scientific workforce, the people employed through those grant mechanisms,” he said. “And you risk voiding the contracts between collaborators. If a study is stopped and there's a contract in place, what happens to the collaborating investigators? That could lead to an unprecedented increase in legal action between investigators.”
The uncertainty may be especially acute for early-career investigators trying to build sustainable research programs.
“The Office of Management and Budget federal grant rule changes could hinder the career development of early career scientists,” said Iboro Umana, MD, PhD, speaking in a personal capacity. “As an early career physician scientist, I have seen firsthand the challenge in building a sustainable research program. The potential for mid-cycle grant cancellation creates uncertainty and impairs investigators’ long-term scientific planning. Ultimately, biomedical innovation could be compromised.”
Editor’s note: Dr. Umana noted that the views expressed are his own and do not represent an official Emory position.
A strain on the community–academic partnership
For practicing clinicians, Dr. Peek's final point may hit closest to home. Much of the work that brings new therapies to patients runs through partnerships between academic centers and community gastroenterologists who help enroll and care for trial participants. Added regulation and funding instability, he warned, “is going to detract from those partnerships — the ones that translate pivotal findings in the lab into clinical practice.”
“NIH-funded clinical trials are at very high risk of incurring harm,” he said, “both for patients and for the relationship between community physicians and the investigators involved in those trials.”
Dr. Peek noted that the rule carries other consequences — tighter limits on conference and journal-subscription funding, for instance — that fall more squarely on academic investigators. He chose to foreground the clinical stakes first.
Take five minutes to make a world of difference
The throughline is that today's standard of care was yesterday's funded science. This rule destabilizes tomorrow's standard of care. The public comment period is the moment clinicians can weigh in, and it closes July 13, 2026.
A comment does not need to be long or technical. A few sentences on the real-world consequences you foresee for your patients carry weight. AGA has set up a tool to make it straightforward.
Act now to protect merit-based science. Submit a comment before July 13.