The variety of folks receiving remedy on the Nationwide Institutes of Well being Medical Heart — the famend analysis hospital that cares for sufferers with uncommon or life-threatening illnesses — has tumbled beneath the second Trump administration, in line with authorities paperwork and interviews with present and former NIH staff.
NIH paperwork seen by KFF Well being Information present a pronounced decline in sufferers on the 200-bed hospital from February by April, a time that coincides with the Division of Well being and Human Providers’ mass firings of presidency staff, the gutting of scientific analysis, and the administration’s broad crackdown on immigration. The typical variety of sufferers being handled every day throughout that point hovered between 60 and 80, with the April numbers falling to the decrease finish of that vary. Against this, in October, about 80 sufferers a day on common have been on the hospital.
The variety of most cancers medical trial members on the hospital as of July was down about 20% from final yr, one NIH most cancers scientist mentioned. KFF Well being Information agreed to not determine the scientist and others who participated on this article who weren’t approved to talk to the press and feared retaliation.
The numbers “actually don’t look too good,” Pius Aiyelawo, appearing CEO of the medical middle, mentioned throughout a Could 23 assembly of the NIH Medical Heart Analysis Hospital Board.
As of April 30, the common variety of sufferers within the hospital per day had declined by 5.7% from the identical interval a yr in the past.
Adults and kids with most cancers, individuals who want bone marrow transplants, and folks with uncommon illnesses or infections are among the many sufferers who obtain care at no cost on the NIH hospital, in line with former officers. Clinicians there present doubtlessly lifesaving therapies as a part of medical trials, typically to individuals who have run out of choices.
Analysis on the hospital has additionally led to breakthroughs about most cancers, traumatic mind damage, and AIDS, amongst different illnesses. James Gilman, a doctor who was CEO of the medical middle from 2017 till retiring in January, mentioned the middle has pushed essential advances towards illness “that couldn’t have occurred anyplace else.”
Former officers mentioned the drop in sufferers this yr is a consequence of the upheaval the Trump administration has prompted on the NIH, the world’s largest public funder of scientific analysis.
Present and former staff say an exodus of clinicians, scientists, and different staffers has restricted what number of sufferers might be handled. Morale has tanked due to widespread firings and the administration’s cancellation of grants that funded analysis into well being disparities, vaccines, the well being of LGBTQ+ folks, and extra. Contracts have been minimize, and scientists have seen delays in getting important provides for medical analysis.
“Day-after-day appears to be some kind of breaking level,” one NIH employee mentioned.
Through the Could board assembly, a video of which KFF Well being Information seen, Aiyelawo attributed the lower in sufferers coming to the hospital to the departure of NIH investigators — the researchers on research — and fewer affected person recruitment. He additionally famous 11 current departures of medical middle staffers. They included Christine Grady, a nurse who led the middle’s bioethics division and the spouse of Anthony Fauci, the previous head of the NIH’s infectious illnesses institute who grew to become a lightning rod for conservatives in the course of the covid pandemic.
HHS has fired greater than 1,200 NIH staff this yr as a part of its purge of the federal workforce, however the true variety of departures is nearly definitely increased. Others have opted for early retirement or give up as a result of they opposed the Trump administration’s orders.
Gilman mentioned the NIH hospital depends on a “very advanced ecosystem and community to search out sufferers who should not too sick” to doubtlessly be enrolled in a medical trial. When researchers go away, “these sufferers are misplaced,” he mentioned.
The medical middle’s 2025 annual report mentioned there have been roughly 1,500 analysis research underway in 2024, together with research targeted on most cancers, infectious illness, coronary heart and lung circumstances, and blood issues. Medical trials accounted for about half.
The Nationwide Most cancers Institute — which is the biggest of the NIH’s 27 institutes and has been crippled by cuts and chaos this yr — sometimes has probably the most sufferers needing inpatient care, Gilman mentioned.
“What has occurred right here since January has been a fairly traumatic time for that ecosystem,” he mentioned, “and there are items of it that can take a very long time to rebuild, if certainly they get an opportunity to rebuild.”
Through the Could board assembly, Aiyelawo mentioned NIH Director Jay Bhattacharya “may be very conscious” that fewer persons are getting handled on the hospital “and we’re doing all the pieces we will to have the ability to get these numbers up.”
The drop in sufferers this yr isn’t remoted to folks needing inpatient care, NIH paperwork present. As of the tip of April, outpatient visits have been down 8.5% from the identical interval within the prior fiscal yr. The variety of new sufferers total had declined by 6.7%, to about 3,370 folks.
In response to questions, HHS spokesperson Andrew Nixon wrote in an emailed assertion that the medical middle “stays totally operational and continues to supply world-class medical analysis and affected person care. Day-after-day, sufferers from throughout the nation and across the globe come right here to take part in cutting-edge research that drive scientific discovery and enhance well being outcomes.”
“Because the crown jewel of analysis and discovery, the Medical Heart is a prime precedence” beneath Bhattacharya’s management, Nixon mentioned. “We’re dedicated to totally leveraging its capabilities because the nation’s hub for medical analysis innovation. Our focus stays on empowering the analysis group and advancing the crucial mission of creating medical breakthroughs potential proper right here on the NIH campus.”
Even earlier than President Donald Trump started his second time period, the hospital had struggled with lagging affected person numbers. Earlier than the pandemic, it averaged greater than 110 sufferers every day. These numbers plummeted beginning in 2020, authorities paperwork present. Through the 2022 fiscal yr, there have been about 73 sufferers, on common, within the hospital per day.
Whereas yearly figures have elevated since then, they haven’t gone again to pre-pandemic ranges. NIH paperwork present that the hospital noticed a mean of roughly 81 sufferers a day throughout fiscal 2024, which resulted in September. Nonetheless, one NIH employee mentioned: “It is a manufactured disaster. Covid was not.”
The federal authorities has additionally moved to tighten guidelines surrounding guests from overseas, which doubtless limits how many individuals dwelling within the U.S. with out authorized standing would come to the NIH for care.
Earlier than Trump, officers developed a brand new customer coverage for the NIH that required individuals who aren’t U.S. residents or authorized everlasting residents to register on-line earlier than arriving. However its implementation was delayed, Gilman mentioned. It didn’t launch until late January, after President Joe Biden was now not in workplace and across the time the Trump administration started its deportation operation.
The Division of Homeland Safety has carried out widespread raids and arrests and allowed immigration authorities unprecedented entry to numerous federal knowledge sources — together with tax data and Medicaid recipients’ private knowledge — as a part of its immigration enforcement efforts.
The medical middle’s most up-to-date annual report mentioned round 600 sufferers in 2024 have been from overseas.
Now “worldwide sufferers are terrified to come back,” mentioned one just lately departed clinician. “They don’t know what is going to occur to them.”
We’d like to talk with present and former personnel from the Division of Well being and Human Providers or its part businesses who imagine the general public ought to perceive the affect of what’s taking place throughout the federal well being forms. Please message KFF Well being Information on Sign at (415) 519-8778 or get in touch here.