President Donald Trump is considering an executive order that would place a new White House-linked board between the National Institutes of Health and researchers seeking federal grants, according to reports published Sunday. The proposal would give a small panel including Office of Management and Budget Director Russell Vought and NIH Director Jay Bhattacharya the power to approve awards only by unanimous consent, Reuters reported, citing Politico.

The order itself was not public as of Sunday night, and neither the White House nor the Department of Health and Human Services had confirmed its final language. That uncertainty matters: the scope of the board, the grants it would review, the standards it would apply and whether it would operate before or after NIH advisory councils are all unresolved. Still, the reported unanimity requirement would amount to a significant new veto point in the country’s largest public biomedical research system.

The immediate issue is not whether elected officials may set research priorities. Federal law already leaves room for the health secretary and NIH institutes to choose among scientifically recommended projects. The harder question is whether a political panel could reject grants for ideological reasons without disrupting the statutory peer-review process, violating existing regulations or discriminating against protected viewpoints.

How NIH grant review works now

NIH, an HHS agency made up of 27 institutes and centers, does not award most competitive research grants through a single scientific score. It uses two formal levels of review followed by programmatic and administrative decisions.

At the first level, a scientific review group—often called a study section—assesses an application’s likely effect on its field. NIH says these groups are composed primarily of nonfederal scientists selected for relevant expertise. At least three reviewers generally prepare critiques and preliminary scores, after which eligible panelists discuss and score competitive applications. Reviewers also assess human-subject protections, inclusion plans, animal welfare, biohazards and budget issues. The agency’s current review guidance describes the goal as a fair and timely process that strives to be free of bias.

The second level is conducted by the advisory council or board of the institute or center that could make the award. NIH program staff weigh peer-review scores, percentile rankings, written critiques and the institute’s priorities, then prepare a funding plan. The council advises the institute or center director, who makes the final funding decision, according to NIH’s process description.

That structure separates scientific evaluation from policy and portfolio choices without pretending that funding is purely mechanical. A top score does not guarantee an award, and agencies may favor one disease area, research stage or public-health need over another. The reported board would be different because it appears to add centralized political approval after, or alongside, those established steps.

Congress has written core peer-review requirements into law. Under 42 U.S.C. §289a-1, NIH generally may not fund research subject to technical and scientific peer review unless it has been reviewed and recommended by the relevant scientific body and advisory council. The same statute allows the health secretary to establish priorities among projects that have cleared review.

Federal regulations reinforce that framework. Part 52h of Title 42 requires peer-review groups to be built around scientific or technical qualifications and sets conflict-of-interest rules. It also makes an important distinction: peer reviewers’ recommendations are advisory rather than binding on the official who ultimately awards funds. In other words, existing law does not compel NIH to finance every meritorious proposal, but it does prescribe how scientific merit must enter the decision.

That leaves room for a president to direct broad executive-branch policy, but not an unlimited license to replace scientific review with political screening. A lawful board might review portfolio balance, spending priorities or compliance after peer review. A board that effectively excluded research because officials disapproved of the researchers’ lawful expression or a field’s viewpoint would invite different constitutional and administrative-law challenges.

The reported proposal also raises procedural questions. NIH’s own policy summary says the two-level system is grounded in the Public Health Service Act, federal advisory-committee law and review regulations. An executive order cannot repeal a statute. Any implementation would have to fit within delegated authority, and some changes could require public rulemaking rather than an internal directive.

The plan arrives during an active court fight

The proposal is emerging as researchers challenge an existing NIH grant-screening system. A class-action complaint filed last week alleges that the administration used a list of 235 words or phrases—including terms associated with race, gender, climate and health disparities—to flag, delay or terminate research. The plaintiffs argue that the system penalizes disfavored viewpoints and violates the First Amendment and federal administrative law. Those are allegations, not judicial findings.

The complaint, brought by individual scientists and professional organizations, asks a federal court to block the alleged screening practices and restore lawful review. Reuters described the case as a challenge to what the plaintiffs call ideological review of biomedical grants. The government will have the opportunity to contest both the facts and the legal theory.

The new board could intensify that litigation if it formalizes criteria resembling those alleged in the lawsuit. It could also produce a separate dispute over whether the board’s decisions are reviewable, whether applicants receive reasons for rejection and what administrative record a court could examine. If the board instead applies written, field-neutral standards tied to appropriations and agency priorities, the legal analysis would be different.

Research institutions face a planning problem

For universities, hospitals and nonprofit laboratories, uncertainty can matter before any grant is formally denied. Researchers typically invest months in preliminary work, compliance planning and applications. Institutions plan hiring, laboratory space and clinical-study infrastructure around expected award cycles. Adding an undefined review layer could lengthen decisions, make outcomes less predictable and discourage proposals in politically sensitive areas even without an explicit ban.

A unanimity rule would amplify that effect because any member could stop an award. It could also concentrate responsibility: unlike a study section, which produces documented critiques and numerical scores, a small policy board might operate without a comparable scientific record unless the order requires transparency. The Guardian reported that administration officials discussed the plan Friday while criticizing NIH support for initiatives they characterized as politically misaligned.

Supporters of tighter White House control are likely to argue that NIH spends taxpayer money and should reflect the elected administration’s priorities. That argument has a legitimate democratic premise: appropriations, public-health needs and program goals shape every federal research portfolio. The counterargument is that disease mechanisms, trial design and scientific feasibility require expert review insulated from partisan preference. The existing system attempts to combine both forms of accountability rather than choose one exclusively.

What the evidence does—and does not—show

No public evidence yet establishes how many grants the proposed board would review, which subjects it would target, how quickly it would act or whether it would disclose explanations. There is also no public text showing that the board would cancel awards already made. Reports about discussions and draft orders can change before a president signs them.

That limits what can responsibly be concluded. The proposal is a governance change, not a clinical finding, and its health effects cannot be measured in advance. Delayed or redirected grants could affect the pace and composition of research, but any claim that a specific treatment or discovery would be lost is necessarily speculative. Conversely, there is no evidence yet that another approval layer would improve scientific quality, reduce waste or correct a documented failure in peer review.

The decisive facts will be the order’s final text, its criteria and its interaction with Congress’s two-stage review requirements. Until those are public, the strongest conclusion is narrower: the administration is weighing a mechanism that could give senior political officials direct veto power over NIH awards after scientists and advisory councils have evaluated them. That would shift authority toward the White House, and it would almost certainly be tested against the legal protections that govern federal biomedical research.