H.R. 3491: DeOndra Dixon INCLUDE Project Act of 2025

Introduced May 19, 202518 cosponsors

Sponsor

Diana DeGette

Diana DeGette

Democrat · CO-1

Down syndrome research gets a permanent NIH home

3 min readLast updated September 12, 2026

Why it matters

Every 2 years, NIH would have to show Congress what Down syndrome research it is actually funding and what evidence it is producing. H.R. 3491 turns the INCLUDE Project into a standing federal program and pushes research beyond childhood to daily living, Alzheimer’s, dementia, and autoimmunity.

H.R. 3491 would write the NIH INCLUDE Project into federal law, making Down syndrome research a permanent named program instead of an initiative that depends on agency priorities.

The bill tells NIH to study Down syndrome across the full lifespan. That includes basic science on trisomy 21, cohort studies that follow people over time, and more clinical trials that include people with Down syndrome or are designed specifically for them.

It also points NIH toward the health issues families often worry about most: co-occurring conditions, biomarkers, diagnosis, treatment, and quality of life. The bill specifically names Alzheimer’s disease, related dementias, and autoimmunity, and it allows research on therapies that help with activities of daily living.

Just as important, NIH would have to coordinate this work across its institutes instead of leaving it fragmented. The agency would be told to prioritize research that does not duplicate what NIH is already doing and to consult patient advocates and other stakeholders when setting priorities.

Congress would then get a report every 2 years showing which NIH institutes did the work, whether they collaborated, and what real-world evidence came out of it. That does not guarantee new funding, but it does create a clearer paper trail for whether this research is actually happening.

Bill Progress

IntroducedMay 19
Committee 
Pass HouseJul 20
Pass Senate 
Signed 
Law 

Latest Action · Jul 21, 2026

1/3

Passed the House, received in Senate

H.R. 3491 Bill Summary

What H.R. 3491 actually does.

1

Down syndrome research becomes a standing NIH program

H.R. 3491 formally establishes the INCLUDE Project at NIH as an ongoing program for research, training, and investigation related to Down syndrome.

2

Research follows people across their whole lives

NIH would be directed to support studies across the lifespan, including cohort research designed to improve understanding of Down syndrome and related conditions over time.

3

More clinical trials can be built for Down syndrome patients

The bill supports expanding clinical trials that include people with Down syndrome or are expressly designed for them, including biomedical, drug, and daily-living therapies.

4

Alzheimer’s, dementia, and autoimmunity are explicitly included

The research agenda specifically covers co-occurring conditions, including Alzheimer’s disease, related dementias, and autoimmunity, along with diagnosis, treatment, and biomarker work.

5

NIH has to coordinate instead of duplicating work

NIH would have to coordinate Down syndrome research through the Director's office and prioritize projects that do not duplicate existing NIH research activities.

6

Congress gets a recurring scorecard

Every 2 years, NIH would have to report to key House and Senate health and appropriations committees on what research was done, which institutes were involved, and what real-world evidence resulted.

Who benefits from H.R. 3491?

People with Down syndrome

They are the focus of the bill's clinical trials, diagnosis, treatment, biomarker, and co-occurring-condition research — including studies that follow health needs from childhood through aging.

Families caring for someone with Down syndrome

The bill includes research on quality of life and therapies that support activities of daily living, reflecting the practical questions families face outside a lab.

Doctors and researchers who need better evidence

More coordinated NIH studies and biennial reporting could make it easier to see which institutes are producing usable data for clinical care and where research gaps remain.

Patient advocates

NIH would be expected to consult stakeholders, including patient advocates, when carrying out the program, giving advocates a formal opening to shape research priorities.

Who is affected by H.R. 3491?

National Institutes of Health

NIH would have to run the INCLUDE Project as a formal program, coordinate work across institutes, consult stakeholders, and send Congress a report every 2 years.

NIH institutes and centers

Institutes working on Down syndrome and related conditions would face more coordination and more visibility because reports must identify who did the research and whether multiple institutes worked together.

Congressional health and spending committees

Key House and Senate committees would receive regular reports that let lawmakers track whether NIH is producing distinct, usable Down syndrome research.

Researchers seeking NIH support

Projects that add something new may have an advantage because the bill tells NIH to prioritize nonduplicative research.

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On the Record

What Congress Is Saying

H.R. 3491 has come up 12 times in the Congressional Record so far.

H.R. 3491 also appeared in 1 more House floor reference and 7 routine cosponsor filings.

HR3491 Legislative Journey

5 actions

Committee Action

Jul 21, 2026

Received in the Senate and Read twice and referred to the Committee on Health, Education, Labor, and Pensions.

House: Vote: 4649-4650

Jul 20, 2026

4649-4650

On motion to suspend the rules and pass the bill Agreed to by voice vote. (text: CR H4649-4650)

House: Committee Action

Jul 2, 2026

119-722

Reported by the Committee on Energy and Commerce. H. Rept. 119-722.

House: Vote: 46-0

May 21, 2026

46-0

Ordered to be Reported by the Yeas and Nays: 46 - 0.

House: Committee Action

May 19, 2025

Referred to the House Committee on Energy and Commerce.

About the Sponsor

Diana DeGette

Diana DeGette

Democrat, Colorado's 1st congressional district · 29 years in Congress

Committees: Energy and Commerce

View full profile →

Cosponsors (18)

No new cosponsors in 180 days — momentum stalled

This bill has 18 cosponsors: 12 Democrats, 6 Republicans, reflecting bipartisan support. Cosponsors represent 11 states: Colorado, Connecticut, District of Columbia, and 8 more.

12Democrats6Republicans·11 statesBipartisan

Committee Sponsors

Health, Education, Labor, and Pensions Committee

10D12R1I
|0 signed23 not yet

0 of 23 committee members cosponsored

No committee members have cosponsored this bill

Energy and Commerce Committee

24D30R
|2 signed52 not yet

2 of 54 committee members cosponsored

33 Democrats across these committees haven't cosponsored yet. Mobilize their constituents

H.R. 3491 Quick Facts

Cosponsors
18
Richard Hudson
Rosa DeLauro
Tom Cole
Eleanor Norton
Pete Stauber
+13 more
Committee
Health, Education, Labor, and Pensions
Chamber
House
Policy
Health
Introduced
May 19, 2025

Passed the House, received in Senate

Jul 21, 2026

Constituent Resources

Get notified when this bill moves

Official Sources

H.R. 3491 on Congress.gov

Official bill status, text, actions, and summaries for the DeOndra Dixon INCLUDE Project Act of 2025.

NIH INCLUDE Project

Official NIH overview of the INCLUDE Project that H.R. 3491 would write into federal law as a standing program.

NIH Clinical Research Trials and You

Official NIH explainer on clinical trials, relevant because the bill seeks to expand trials inclusive of or expressly for people with Down syndrome.

Public Health Service Act on GovInfo

Official government-hosted text of the Public Health Service Act, which H.R. 3491 would amend by adding new section 409K.

H.R. 3491 Common Questions

What does H.R. 3491 actually do?

It makes the NIH INCLUDE Project a formal federal program for Down syndrome research, training, and investigation instead of leaving it as an internal initiative.

Does H.R. 3491 cover adults with Down syndrome or just children?

Adults too. The bill tells NIH to support research across the lifespan, including long-term cohort studies and work on aging-related conditions.

Would this bill expand clinical trials for people with Down syndrome?

Yes. H.R. 3491 supports more clinical trials that include people with Down syndrome or are designed specifically for them.

Does the bill include Alzheimer's and dementia research?

Yes. It specifically includes research on co-occurring conditions such as Alzheimer's disease and related dementias in people with Down syndrome.

Does H.R. 3491 mention autoimmunity?

Yes. The bill explicitly includes research on the increased prevalence of autoimmunity in people with Down syndrome and possible treatment approaches.

Would NIH have to listen to patient advocates under H.R. 3491?

Yes, as much as feasible. The bill says NIH should consult relevant stakeholders, including patient advocates, when carrying out the program.

Does H.R. 3491 provide new funding for Down syndrome research?

Not directly. The bill sets up the program in law, but it does not include a specific dollar amount for funding.

How often would NIH have to report to Congress?

Every 2 years. Those reports must show which NIH institutes did the research, whether they worked together, and what real-world evidence came from it.

Based on H.R. 3491 bill text

H.R. 3491 Bill Text

To amend the Public Health Service Act to authorize the Secretary of Health and Human Services to carry out a program of research, training, and investigation related to Down syndrome, and for other purposes.

Source: U.S. Government Publishing Office

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