Public Access, Open Access, and the Need for NIH Governance | Health Policy | JAMA Internal Medicine | JAMA Network

Abstract:  In July 2025, the National Institutes of Health (NIH) Public Access Policy took effect, marking a landmark commitment to free immediate access to taxpayer-funded research. The policy requires that author accepted manuscripts from NIH-funded research be made publicly available in PubMed Central (PMC) immediately on publication, replacing an earlier policy that allowed publishers a 12-month embargo between publication and free public access.1 Several of the largest publishers have responded by requiring NIH-funded authors to pay open access article processing charges (APCs) to deposit the article in PMC. Although the NIH has stated that compliance does not require APC payment,2 it has not publicly defended this position against publisher practices to the contrary. This Viewpoint examines the resulting confusion between public access and open access, the pay-to-comply publisher practices that conflate the two, and the steps that the NIH must take to fill this gap and promote its public access goals.