Hill Republicans are expressing concern about NIH's abrupt decision to cap payments for overhead at universities and medical research centers, signaling growing pressure to alter the policy, Victoria and Peter report.

Why it matters: The change affects billions of dollars for universities in red states and could be an early barometer of how much resistance there is to Elon Musk's broader "DOGE" efforts.

What they're saying: Sen. Katie Britt, one of the first GOP senators to speak out, told reporters today that she had a call with HHS Secretary-designee Robert F. Kennedy Jr.

• Britt didn't elaborate on what was said but previously said she wanted to talk to Kennedy about being efficient with taxpayer dollars while maintaining "the research capabilities that we need."
• "I know what happens at UAB, at the University of Alabama. It's tremendous. They do incredible work, they do incredible research, and it has yielded tremendous results that have saved lives across the country," Britt said. "We want to make sure that can continue."

House Appropriations Labor-HHS subcommittee chair Robert Aderholt also told Axios that he had been hearing feedback and concerns, including from the University of Alabama and Auburn University.

• "I support NIH, I think they do a lot of great work over there," he said. "So I obviously don't want to cut all the funding to NIH, but I think there's ways we can tweak it, to make it make sense."
• "We want to look at it, and work with the president and the administration and figure out how to cut the waste out, but make the mission still the same."

Senate HELP Chair Bill Cassidy also said he had spoken to research institutions in Louisiana that said it will be "very difficult" for universities that don't have big endowments to conduct research.

• "Of course I want people in Louisiana to benefit from research dollars, and for them to not only go to Massachusetts and California," Cassidy said.
• Sen. Shelley Moore Capito, who chairs the Senate Appropriations Labor-HHS subcommittee, expressed some concern and said she is "hearing from my institutions."
• She said she wanted to avoid such a "dramatic reduction" in funding, adding, "I'm sure it'll be determined in the court."

State of play: Yesterday, 22 state attorneys general sued the Trump administration to block the policy from taking effect, arguing that the action violated the Administrative Procedure Act and was "arbitrary and capricious."

• A federal judge in Massachusetts ordered a nationwide freeze late yesterday while legal arguments play out.

The bottom line: Lawmakers have a variety of options at their disposal that they could use to try to stop the policy from going into effect, but haven't reached a consensus on how or whether to act.

• It's possible that they could ask Kennedy to change the policy once he's confirmed.
• They could also address it in a government funding bill, with the latest CR due to expire March 14.

Speaker Mike Johnson said today that House Republicans are focused on fraud and work requirements in Medicaid, not benefit cuts, as they look for savings in a reconciliation package.

• But that doesn't necessarily mean that sweeping changes to the safety net program like per capita caps are off the table, as lawmakers need to hit major budget cut targets, Peter and Victoria report.

Why it matters: Johnson is seeking to make reassurances amid fears Republicans may have to embrace Medicaid coverage losses to help pay for an extension of tax policies and other priorities.

• The House Budget Committee has noticed a markup for Thursday on a budget resolution.

Driving the news: "Medicaid has never been on the chopping block," Johnson said at a press conference. "It's non-benefit related reforms to the program. Medicaid is infamous for fraud, waste and abuse."

• He also pointed to the prospect of adding work requirements for "able-bodied workers."

Yes, but: If House Republicans' budget resolution calls for massive spending cuts, the math could dictate cutting deeper into Medicaid.

• A Johnson spokesperson would not rule out block grants or per capita caps. "We will just stick with the speaker's comments at the press conference for now," the spokesperson told Axios.
• Earlier today, House Majority Leader Steve Scalise also did not rule out going further on Medicaid, though he likewise said the focus is on "fraud" and work requirements in the program.
• "We're looking at a lot of different things, but we're talking with the White House, we're talking with our members," he told Axios when asked about per capita caps. "The committees will decide those details once we get past the budget."

Between the lines: There is a question about how far the White House will want to go on Medicaid, given Trump's comments on not wanting to "affect" benefits.

• "I think no one really had talked to the president about it. It's been reported he said Medicaid is off the table. I don't think that's true," said Rep. Ralph Norman.
• Norman also said that lawmakers can't do deficit reduction "any other way" and they've "got to have Medicaid."
• "I think we lay it out to the president again, work requirements, block grants," said Norman, though he added that lawmakers were still trying to get clarification on Trump's Medicaid comment.

What's next: The budget resolution's instructions to the Energy and Commerce Committee, which could be in the hundreds of billions, will say a lot about how far lawmakers need to go on Medicaid.

• The Budget Committee is supposed to release text 24 hours before the markup, so more should be known tomorrow.
• "The focus is on what are the most conservative policies that can get to 218," said a senior GOP aide.

1. RFK Jr. claims: The HHS secretary-designate has repeatedly claimed that vaccines are not tested rigorously enough and has called for an alternative type of testing that experts say would be unethical, WaPo reports.
2. AI prescribing: A House bill would clarify that AI and machine learning technologies can be used to prescribe drugs to patients, if authorized by the state involved and approved by the FDA, per MedPage.
3. Super Bowl backlash: A nonprofit New York medical system is getting heat in health circles for spending big on a Super Bowl ad, Axios' Maya Goldman reports.