About a year after the Trump administration slashed $32 billion from NIH’s budget, more than one in four grantees haven’t had a dollar of that funding restored. In a Stat survey of nearly 1,000 U.S.–based NIH researchers, 35% saw full restoration, 26% saw partial, and 27% saw none. Eric Perakslis, now chief science officer at Pluto Health and former FDA informatics chief, says the cuts left labs underfunded, drove young scientists out of research and forced universities to balk at hosting projects that lose money. That talent drain isn’t just academic. Karen Knudsen of the Parker Institute for Cancer Immunotherapy warns that unstable government funding pushes early-career researchers into private roles or out of the country. Those who stay often chase grants from charities with narrow focuses or venture firms that shy away from unproven, early-stage work. Marcel Botha of 10XBeta calls it a “reset,” forcing NIH to justify what it backs and how it compares to global peers—otherwise U.S. science risks falling behind over the next decade. The cutbacks could even cost lives. Knudsen links a 34% decline in cancer deaths since 1991 to steady NIH support and fears today’s pullback will shift money to “safer” projects, edging out bold clinical trials. Rebuilding won’t be quick: Perakslis labels last year’s trimming “reckless” and says you can’t rebuild research infrastructure overnight. But with systems already weakened, he sees a rare chance to redesign how NIH allocates grants and backs the next wave of breakthroughs.