As the battle over Elon Musk's DOGE-directed cuts to federal medical research continues, institutions already are freezing hiring, cutting back on the number of Ph.D. students they'll accept and making other contingencies.

Why it matters: Capping how much NIH covers the schools' overhead costs could lead to billions of dollars in cuts to scientific research funding and widespread economic fallout.

Driving the news: An economic analysis by software company Implan on Tuesday estimates proposed cuts could lead to a loss of $6.1 billion in the nation's gross domestic product and more than 46,000 jobs.

• "There's going to be impacts on real estate," said Bjorn Markeson, academic divisional director and economist at Implan. "There's going to be impacts on legal services. There's going to be impacts on services to buildings, office, administration."

Between the lines: While federal courts have temporarily frozen plans to slash the rate NIH pays for "indirect costs" and the administration's temporary "pause" on federally funded grants, universities are already feeling real pain.

• Institutions have also reported delays of NIH grant reviews, in what some legal scholars call a "backdoor" approach to freezing funding, Nature reported.

Zoom in: Maryland is among the states that could be hit hardest, with potential annual losses exceeding $2 billion due to Johns Hopkins University and its robust research corridor, Terry Clower, director of the Center for Regional Analysis at George Mason University, told Axios.

• By his calculations, there could be 2,000 to 3,000 jobs eliminated in the state.

The bottom line: The future of research talent and scientific advancements could be at stake with these looming cuts.

• "There will be knock-on effects in the economy in future years," Clower said.

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A narrowly divided U.S. House late Tuesday laid the groundwork for a possible major overhaul of Medicaid to help pay for an extension of Trump tax cuts, by adopting a GOP budget resolution in a 217-215 vote, Victoria Knight and Peter Sullivan wrote first on Pro.

Why it matters: The safety net program emerged as a prime target after House Republican budget writers instructed the Energy and Commerce Committee to find $880 billion in cuts.

• That put moderate Republicans in a bind, concerned that reduced federal Medicaid dollars could force painful trade-offs for states and lead to significant coverage losses.
• House Republican leaders argued Medicaid isn't technically mentioned in the budget blueprint, and that any of those details can be worked out later. They also said they would focus on "fraud, waste and abuse" in the program.

Driving the news: Conservative holdouts who complained about how much the resolution would increase the deficit ended up caving to leadership's pressure and voting to pass the resolution.

• Reps. Warren Davidson (R-Ohio), Victoria Spartz (R-Ind.) and Tim Burchett (R-Tenn.), who had all cited concerns with the spending levels, flipped their votes to "yes."

What they're saying: Patient groups like the American Cancer Society Cancer Action Network had called on lawmakers to oppose the budget, saying it is "severing the lifeline Medicaid provides for cancer patients and those at risk for cancer."

What's next: The House still has to reconcile its budget plan with the Senate, which is on a very different page, with a slimmed-down blueprint focused on border policy and energy.

If you need smart, quick intel on health care policy for your job, get Axios Pro Policy.

President Trump used an executive order on Tuesday to direct three federal agencies to enforce the health care price transparency regulations he rolled out during his first term.

The big picture: Trump didn't unveil new pricing policies but the order indicates it's still a priority for him — and it could signal more enforcement against noncompliant hospitals and insurers going forward.

Flashback: The first Trump administration finalized rules requiring hospitals to post their negotiated prices for different health care services online, and for health insurers to post their negotiated rates for services.

• The idea was that making prices transparent would give patients more of a say in their care and bring down health care costs.

Where it stands: Hospitals have been slow to comply. Less than a quarter satisfied all of the requirements as of November, according to a report from an advocacy group.

• The Biden administration took enforcement action against 18 hospitals between 2022 and 2025, online records show.

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A new type of bone marrow transplant can cure sickle cell disease with only half of the donor's cell proteins matching, according to new clinical trial results published in the New England Journal of Medicine.

Why it matters: The procedure would greatly expand the pool of potential donors, in addition to costing less than one-quarter of the price of innovative gene therapies for the condition that have earned FDA approval in recent years.

Context: Sickle cell anemia is considered a rare disease, but it's the most common inherited blood disorder. It affects about 100,000 people in the U.S. and 8 million people across the world.

What they did: The new transplant method uses bone marrow from "half-matched donors," who have some but not all of the same cell proteins as the patient.

• Nearly every person on the planet has a half match, said Robert Brodsky, a professor at Johns Hopkins University School of Medicine and a co-author of the study.

Zoom out: Researchers calculated the median cost of the transplant to be $467,747 per patient.

• Meanwhile, sickle cell gene therapies Casgevy and Lyfgenia cost $2.2 million and $3.1 million, respectively.

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💰 Senate Judiciary Committee Chair Chuck Grassley launched an inquiry into UnitedHealth's Medicare billing practices. (WSJ)

👉 Eli Lilly is selling higher-dose vials of Zepbound at a lower price to boost weight-loss drug access. (CNBC)

💻 One year later, UnitedHealth still sending breach notices from the massive hack at its Change Healthcare unit. (Minnesota Star Tribune)