In his first joint address to Congress in 2021, President Joe Biden asked lawmakers to greenlight a new initiative: a health research agency focused on speeding to market innovative technologies for diseases like cancer and Alzheimer’s.

Shortly thereafter, a lobbying campaign was born.

Now, cities and states across the nation are jostling to become the site of the Advanced Research Projects Agency for Health by forming coalitions, hiring external lobbyists and recruiting lawmakers to the cause. The opportunity promises to be a potentially major economic boon to the winner.

Congressional delegations in at least seven states have organized letters outlining the benefits of their districts to Health and Human Services Secretary Xavier Becerra and acting ARPA-H Deputy Director Adam Russell, with more likely to follow. The campaigns have created strange bedfellows across the ideological spectrum, like conservative Sen. Josh Hawley, R-Mo., and progressive Rep. Cori Bush, D-Mo.  

But the details of the new agency are still very much up in the air. Congress officially enacted ARPA-H with $1 billion in the fiscal 2022 omnibus spending package, but competing bills in the House and Senate would fill in the details of how the agency would operate, how it would be organized, how much more funding it would receive and where it could be located. 

Republican Richard M. Burr of North Carolina, one of the key authors of the Senate ARPA-H bill, said he signed on to a letter with other North Carolina lawmakers “only because it seemed like every other state had a letter out there.”

“We don’t even have ARPA-H passed yet,” he said, referring to the competing bills.

While Becerra is housing ARPA-H under the National Institutes of Health, the director will report to Becerra directly. The House bill seeks to make the agency completely independent of NIH. And both bills would prohibit the agency from being physically located on an NIH campus. The Senate bill would also ban the agency from being located in the Washington, D.C., area.

California and Massachusetts are often the first places that come to mind for thriving biotech industries. But they’re facing fierce competition from the likes of Illinois, Georgia, Maryland, Missouri, North Carolina, Ohio, Pennsylvania and Texas. 

Industry executives and public officials in those states are hyping the benefits of their respective life science communities, including the diversity and education of their workforces, reputation of their universities, proximity to major airports, available real estate and job opportunities for staff transitioning into and out of ARPA-H. Centrally located states are also touting their location as a convenient home base for officials who will be constantly jetting around the country. 

Among the first states to make a bid for the new agency was Texas. Not long after Congress began working on Biden’s request for ARPA-H, a colleague asked Wayne Roberts, CEO of the Cancer Prevention and Research Institute of Texas, the second largest cancer research foundation in the world, whether the state was preparing a bid.

“We made some phone calls to some folks in the life science industry that we thought would be knowledgeable about it,” Roberts said. “And very quickly a small group of people came together.”

Texas is home to Brooke Army Medical Center, the nation’s largest military hospital, and “the only Biosafety Level 4 (BSL-4) lab co-located with a national primate center,” according to a letter led by Texas Reps. Lizzie Fletcher and Colin Allred, both Democrats. The state is also one of the fastest-growing in the country.

“If you want to be where the cool kids are gonna be in 10 to 15 years, you come to Texas,” Roberts said.

Atlanta is home to both the Centers for Disease Control and Prevention and the world’s busiest airport. Russell Medford, CEO of cardiac medtech company Covanos and chair of the ARPA-H Georgia Coalition, also noted the lower cost of living compared with coastal cities.

“Where do you want to put your money, into the research or into the real estate requirements?” he said.

State groups are also lining up powerful friends to advocate on their behalf. Pennsylvania, where Drew Weissman and Katalin Karikó first discovered the messenger RNA technology used in COVID-19 vaccines, is also the home state of HHS Assistant Secretary for Health Rachel Levine.

Chris Molineaux, president and CEO of Life Sciences Pennsylvania, said Levine’s office has been “very receptive” to headquartering ARPA-H in the Philadelphia area. Rep. John Joyce, R-Pa., is another enthusiastic supporter, Molineaux added.

“To have other physicians lined up, like Dr. Levine, Dr. Joyce, others who know the potential of the life sciences industry in Philadelphia, what the industry has already developed and delivered — those are very important voices at the table,” he said.

Levine’s office said she has “made no commitments” since the decision will be up to Becerra and the ARPA-H director. Joyce’s office did not respond to requests for comment.

Massachusetts is represented by Democratic Rep. Richard E. Neal, who chairs the powerful House Ways and Means Committee.

And California is home to Speaker Nancy Pelosi and House Minority Leader Kevin McCarthy. Rep. Anna G. Eshoo, the Silicon Valley Democrat who chairs the House Energy and Commerce Health Subcommittee and sponsored the House bill, has emerged as the biggest champion of ARPA-H being completely independent of NIH. 

But she said pitching California as ARPA-H headquarters just yet would be “putting the cart before the horse.”

“What thrills me is there’s such a competition for it,” Eshoo said. “It’s very exciting.”

It’s unclear whether bad blood will keep some states out of consideration. In Texas, GOP Gov. Greg Abbott has been waging a war with the Biden administration over care for transgender children. Abbott’s office did not respond to a request for comment.  

Thomas Graham, a spokesman for the Coalition for Health Advancement and Research in Texas, downplayed the concerns, noting that Texas secured a critical federal contract to launch a vaccine facility — the Texas A&M Center for Innovation in Advanced Development and Manufacturing — during the administrations of former GOP Gov. Rick Perry and former President Barack Obama. 

“There’s history of states setting politics aside, and the nation and the federal government setting politics aside, to ensure that best assets are united for the state of Texas,” he said.

Geographic restrictions could also shorten the list of candidates. A desire to distance the new agency from the NIH and the District of Columbia, for instance, could undermine Maryland’s bid. But Sen. Chris Van Hollen, D-Md., argued it should be considered an asset.

“It should be a plus because we have a great ecosystem that’s in place,” he said.

HHS isn’t showing its cards thus far. The department has yet to name a permanent ARPA-H director and is also likely to wait on choosing a final location until Congress finalizes the agency’s remaining details. 

“We are in the process of standing up the new agency and are developing plans for its operations and functions,” Becerra wrote in a response to Georgia lawmakers earlier this month. 

“Currently, no commitments as to the physical location of ARPA-H have been made. We will continue to engage in a thoughtful process, but the decision will ultimately be up to the inaugural director in consultation with me.”