A proposed rule that would reshape how federal grants are awarded across nearly every federal agency could threaten the physical therapy profession's capacity to advance care delivery and improve population health.

The Office of Management and Budget's sweeping 2026 proposed rule to revise existing guidance governing federal financial assistance would change how grants, cooperative agreements, loans, and loan guarantees are designed, reviewed, awarded, monitored, and terminated across nearly every federal agency. These changes, which would take effect on Oct. 1, could significantly weaken the physical therapy profession by slowing research growth, increasing burdens on education, limiting access to scientific knowledge, reducing global collaboration, and threatening scientific independence.