The United States Congress has officially passed a comprehensive funding bill for the Department of Health and Human Services (HHS) for fiscal year (FY) 2026, marking a significant legislative milestone for the biomedical research community. The final appropriations package includes an increase of approximately $415 million for the National Institutes of Health (NIH), a move that directly defies earlier administrative proposals for drastic budget reductions. Among the specific allocations, the bill provides a $10 million increase specifically earmarked for diabetes research, alongside critical legislative language designed to safeguard the operational integrity of the NIH. This development follows a year of intensive advocacy led by the Endocrine Society, which mobilized a broad coalition of medical professionals and patient advocates to protect federal investment in endocrine-related scientific discovery.
Legislative Victory Amidst Budgetary Uncertainty
The passage of the FY 2026 funding bill represents a stark reversal of the fiscal trajectory initially proposed by the administration. In early budget drafts, the executive branch had advocated for a 40% reduction in NIH research funding—a cut that experts warned would have devastated the American biomedical enterprise. These proposed cuts were accompanied by the cancellation of thousands of active research grants and a radical plan to restructure the NIH’s internal organization. Such a restructuring, which proposed consolidating the current 28 Institutes and Centers (ICs) into just nine entities, was viewed by the Endocrine Society as a potential disruption to specialized endocrine research that might have seen its focus diluted under a more generalized administrative umbrella.
The final bill not only restores the funding but also implements several "guardrail" provisions that the Endocrine Society championed to ensure fiscal stability for researchers. Key among these is the limitation of "multi-year funding" maneuvers. While multi-year funding allows the NIH to commit several years of funding at once, it can also lock up current-year appropriations, reducing the flexibility to fund new, innovative projects in subsequent years. By limiting this practice, Congress has ensured a more consistent flow of resources for new grant cycles.
Furthermore, the legislation prohibits the imposition of arbitrary caps on indirect cost rates. Indirect costs cover the essential overhead of research—such as laboratory utilities, administrative support, and equipment maintenance—that universities and research institutions rely on to keep their doors open. The bill also introduces a strict efficiency requirement, mandating that approved grants be paid within five business days, a move intended to prevent bureaucratic delays from stalling critical laboratory work. Collectively, these measures represent a reassertion of congressional authority over federal spending, ensuring that the NIH remains a robust and independent engine of scientific progress.
The Reauthorization of the Special Diabetes Program
In a parallel legislative success, Congress passed, and the president signed into law, a vital reauthorization of the Special Diabetes Program (SDP) in February. This legislation was embedded within a larger appropriations package that provides essential funding for several health-related agencies. The new law funds the SDP at $200 million per program, per year, reflecting a $40 million annual increase for each of the program’s two primary components.
The SDP is a cornerstone of federal efforts to combat diabetes, consisting of two distinct but complementary branches. The first branch supports Type 1 diabetes research conducted through the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), a division of the NIH. This research is instrumental in developing new therapies, such as continuous glucose monitors and artificial pancreas systems, which have revolutionized the management of the disease. The second branch focuses on prevention, education, and treatment programs for indigenous communities across the United States, administered through the Indian Health Service (IHS). Indigenous populations experience some of the highest rates of Type 2 diabetes in the world, making the SDP’s community-based interventions a matter of public health urgency.
The Endocrine Society worked in close coordination with a bipartisan group of congressional leaders to secure this funding. Key champions included Senators Susan Collins (R-ME) and Jeanne Shaheen (D-NH), the co-chairs of the Senate Diabetes Caucus, as well as Representatives Diana DeGette (D-CO) and Michael Bilirakis (R-FL), who lead the House Diabetes Caucus. The increase in funding is expected to accelerate clinical trials and expand the reach of preventative services in underserved regions, potentially lowering long-term healthcare costs associated with diabetes complications.
Telehealth Coverage and the Future of Medicare Access
The February legislative package also included a two-year extension of Medicare telehealth waivers. These waivers, originally introduced as emergency measures during the COVID-19 pandemic, have allowed Medicare beneficiaries to receive care from their physicians via telehealth from the safety and convenience of their homes. For endocrinology, the extension is particularly impactful; data indicates that endocrinologists are among the most frequent users of telehealth services within the Medicare system.
Endocrine disorders, such as diabetes, thyroid disease, and osteoporosis, often require frequent monitoring and consultation. Telehealth has proven to be an effective tool for maintaining continuity of care, especially for patients in rural or medically underserved areas who face significant travel barriers. The Endocrine Society has been a leading voice in the push to make these flexibilities permanent, arguing that the modern healthcare system must evolve to meet patients where they are. The two-year extension provides a critical window for policymakers to evaluate the long-term benefits of telehealth and develop a permanent framework for its integration into standard Medicare coverage.
Congressional Oversight and the Debate on NIH Modernization
While the funding increase is a victory, the future structure and mission of the NIH remain subjects of intense debate on Capitol Hill. The Senate Committee on Health, Education, Labor, and Pensions (HELP) recently held a hearing focused on "modernizing" the agency. During this hearing, NIH Director Jayanta Bhattacharya faced questioning from senators on a wide array of topics, including drug pricing, vaccine scheduling, and the ethics of "gain-of-function" research.
The hearing highlighted deep concerns regarding the stability of the biomedical workforce. Senator Susan Collins (R-ME) specifically raised alarms about how previous cuts to diversity, equity, and inclusion (DEI) initiatives have negatively impacted research into women’s health and health disparities. Furthermore, she noted that the current climate of funding uncertainty is discouraging early-career scientists from remaining in the research field, potentially leading to a "brain drain" that could hamper American scientific competitiveness for decades.
Other committee members, including Senators Lisa Murkowski (R-AK) and Tammy Baldwin (D-WI), pointed to leadership gaps within the NIH’s various Institutes and Centers. Senator Baldwin pressed Director Bhattacharya on the importance of including external scientists in the search process for new IC directors, a requirement that the Endocrine Society has strongly supported to ensure that the agency remains guided by peer-reviewed scientific expertise rather than purely administrative concerns.
Director Bhattacharya reiterated his commitment to restoring public trust in science and ensuring that the NIH remains focused on the health of the American people. Addressing the controversial cancellation of clinical trials under previous budget proposals, he stated that he has instructed researchers to prioritize continuity of care for patients currently enrolled in trials, though he clarified that the ultimate responsibility for this care rests with the individual research institutions rather than the federal government.
Obesity and Liver Disease: Educating the Next Generation of Policymakers
Beyond the halls of the NIH, the Endocrine Society is actively working to educate lawmakers on the evolving landscape of metabolic health. On January 22, the Society partnered with the American Association for the Study of Liver Diseases (AASLD) to host a congressional briefing titled “GLP-1s: A Game Changer for the Treatment of Liver Disease.”
The briefing featured former Endocrine Society President Dale Abel, MD, PhD, who provided congressional staff with an in-depth look at the mechanics of GLP-1 (glucagon-like peptide-1) receptor agonists. These medications, originally developed for diabetes, have shown remarkable efficacy in treating obesity and its related complications, including Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD), formerly known as non-alcoholic fatty liver disease.
Dr. Abel’s presentation emphasized that obesity is not merely a lifestyle issue but a complex chronic disease that drives a multitude of other conditions. Following the briefing, Dr. Abel met with congressional leadership to discuss policy options for improving access to obesity treatments. These efforts are part of a broader initiative to elevate the Society’s role as an authoritative voice in metabolic health, ensuring that future legislation regarding drug coverage and public health interventions is grounded in the latest endocrine science.
Chronology of Advocacy and the Road to FY 2027
The legislative wins of early 2026 are the culmination of a year-long advocacy cycle. The Endocrine Society’s strategy involved a multi-pronged approach:
- Early 2025: Mobilization began in response to the administration’s proposed 40% NIH budget cut. The Society launched online advocacy campaigns and coordinated "Hill Days," where members met directly with congressional staff.
- Late 2025: The Society convened a coalition of over 140 professional medical societies and patient advocacy groups, culminating in a joint letter to congressional leadership that emphasized the economic and societal value of NIH-funded research.
- January 2026: Targeted educational briefings, such as the GLP-1 session, were held to provide staff with technical expertise on emerging health crises.
- February 2026: Passage of the SDP reauthorization and the Medicare telehealth extension.
- March 2026: Finalization of the FY 2026 HHS funding bill and the beginning of the FY 2027 budget cycle.
The focus now shifts to the upcoming fiscal year. President Trump is expected to release his FY 2027 budget proposal in mid-March, and early indications suggest it may again include proposals to scale back research spending. In response, the Endocrine Society has scheduled a virtual Hill Day for March 13, allowing its members to engage with congressional offices remotely.
The Society remains committed to advocating for steady, sustainable increases in NIH funding. The goal is to move away from the "boom-and-bust" cycles of the past and toward a predictable funding environment that allows researchers to pursue long-term, high-risk, high-reward projects. As the FY 2027 debate begins, the Endocrine Society will continue to urge its members and the public to add their voices to the campaign, ensuring that the momentum gained in 2026 is not lost in the coming year. Through these efforts, the Society aims to protect the future of endocrine research and the health of the millions of patients who depend on its discoveries.