Some believe this cut will be covered by the research universities and their associated medical centers. That may be true for a limited time, in a few institutes, for a small set of cases. However, it’s just a cut to medical research, and a deep one at that.<p>Indirect costs support researchers’ needs that the institution provides. For example, who ensures the researcher’s laptop is secure? For basic research, how is lab equipment obtained? Who provides infrastructure to access observational data from an electronic health record system? Categorize these services as you wish, but these services are needed, they have costs, and the expense will need to be covered for medical research to happen. If they can no longer be considered indirect, then they will become itemized and the researcher’s direct budget will have to cover them. For example, laptops permitted to access the institutional network may have a monthly fee that covers system admin time.<p>In the short run, it’ll mean some research simply won’t happen as the researcher doesn’t have budget for new fees the institution charges for equipment/services that were previously “free”. For new grants, it means a greater part of the research budget will have to be itemized with these costs, eg less funding for researcher or graduate assistant effort. Either the overall grant direct costs will have to go up, or less research happens.