Labor, Health and Human Services, and Education: FY2020 Appropriations

Congressional research reportAug 20, 2020

Ask Donna

What actually matters in this document.

Text

Labor, Health and Human Services, and

Education: FY2020 Appropriations

August 20, 2020

Congressional Research Service

https://crsreports.congress.gov

R46492

SUMMARY

Labor, Health and Human Services, and

Education: FY2020 Appropriations

This report offers an overview of actions taken by Congress and the President to provide

FY2020 appropriations for accounts funded by the Departments of Labor, Health and

Human Services, and Education, and Related Agencies (LHHS) appropriations bill. This

bill includes all accounts funded through the annual appropriations process at the

Department of Labor (DOL) and Department of Education (ED). It also provides annual

appropriations for most agencies within the Department of Health and Human Services

(HHS), with certain exceptions (e.g., the Food and Drug Administration is funded via

the Agriculture bill). The LHHS bill also provides funds for more than a dozen related

agencies, including the Social Security Administration (SSA).

This report primarily focuses on regular FY2020 LHHS discretionary funding enacted

during the annual appropriations process. The emergency supplemental funding that was

subsequently enacted for FY2020 is generally not included in the budgetary figures

discussed in the main body of the report. (These appropriations are addressed in the

context of the FY2020 annual cycle in Appendix C.)

Regular Appropriations

FY2020 LHHS Omnibus: On December 19, 2019, the President signed into law the

Further Consolidated Appropriations Act, 2020 (H.R. 1865; P.L. 116-94). This law

contained full-year LHHS appropriations in Division A. Discretionary LHHS

appropriations totaled $195.4 billion. This amount is 3.2% more than FY2019 enacted

and 17.4% more than the FY2020 President’s budget request. The omnibus also

provided $902.3 billion in mandatory funding, for a combined LHHS total of $1.098

trillion. The distribution of discretionary funding was as follows:

DOL: $12.4 billion, 2.4% more than FY2019.

HHS: $94.9 billion, 4.9% more than FY2019.

ED: $72.8 billion, 1.8% more than FY2019.

Related Agencies: $15.4 billion, 0.3% more than FY2019.

R46492

August 20, 2020

Jessica Tollestrup,

Coordinator

Specialist in Social Policy

Karen E. Lynch,

Coordinator

Specialist in Social Policy

David H. Bradley

Specialist in Labor

Economics

Ada S. Cornell

Senior Research Librarian

William R. Morton

Analyst in Income Security

Angela Napili

Senior Research Librarian

Kyle D. Shohfi

Analyst in Education Policy

FY2020 LHHS Senate Action: The FY2020 LHHS bill did not receive subcommittee, full committee, or initial

floor action in the Senate prior to its enactment. With regard to committee consideration, the Senate

Appropriations Committee scheduled a markup for September 10, 2019, but that markup was indefinitely

postponed. (The initial LHHS subcommittee allocation (S.Rept. 116-104) that was adopted by the Senate

Appropriations Committee on September 12, 2019 is discussed in Appendix A.) Senator Blunt, Chair of the

Senate LHHS Subcommittee subsequently released the text of a draft LHHS bill and accompanying committee

report on September 18.

FY2020 LHHS House Action: The House Appropriations Committee’s LHHS subcommittee approved its draft

bill on April 30, 2019, by a voice vote. The full committee markup was held on May 8, 2019, and the bill was

ordered to be reported that same day (30-23). The bill was subsequently reported to the House on May 15 (H.R.

2740, H.Rept. 116-62).

As reported by the full committee, the bill would have provided $204.3 billion in discretionary LHHS funds, a

7.9% increase from FY2019 enacted levels. This amount would have been 22.7% more than the FY2020

President’s request. In addition, the House committee bill would have provided an estimated $902.3 billion in

mandatory funding, for a combined total of $1.107 trillion for LHHS as a whole. The distribution of discretionary

funding was as follows:

Congressional Research Service

Labor, Health and Human Services, and Education: FY2020 Appropriations

DOL: $13.3 billion, 9.9% more than FY2019.

HHS: $99.4 billion, 9.8% more than FY2019.

ED: $75.9 billion, 6.3% more than FY2019.

Related Agencies: $15.7 billion, 2.7% more than FY2019.

The House began consideration of the FY2020 LHHS bill the week of June 10. Of the 73 LHHS amendments

offered, 64 were adopted and the remaining 9 were withdrawn or defeated. The House passed the LHHS omnibus

by a vote of 226-203 on June 19. Because there is no publicly-available source that estimates the account-level

budgetary effects of the amendments adopted to Division A, this report provides analysis of the House Committeereported version of the LHHS bill. For information on the LHHS amendments offered during floor consideration,

see Appendix B.

FY2020 President’s Budget Request: On March 11, 2019, the Trump Administration released the FY2020

President’s budget. The President requested $166.5 billion in discretionary funding for acc ounts funded by the

LHHS bill, which would have been a decrease of 12.1% from FY2019 levels. In addition, the President requested

$900.4 billion in annually appropriated mandatory funding, for a total of $1.067 trillion for LHHS as a whole. The

distribution of discretionary funding was as follows:

DOL: $10.9 billion, 10.0% less than FY2019.

HHS: $78.1 billion, 13.7% less than FY2019.

ED: $64.0 billion, 10.4% less than FY2019.

Related Agencies: $13.5 billion, 11.8% less than FY2019.

Supplemental Appropriations

The legislative response to the global pandemic of Coronavirus Disease 2019 (COVID-19) has included the

enactment of laws to provide authorities and FY2020 supplemental funding to prevent, prepare for, and respond to

the pandemic. As of the date of this report, discretionary LHHS supplemental appropriations for COVID-19

response have been enacted in four supplemental appropriations measures:

Title I, Division B, of the Paycheck Protection Program and Health Care Enhancement Act

(PPPHCEA, P.L. 116-139), enacted on April 24, 2020, provided $100 billion in supplemental

LHHS funds.

Title VIII, Division B, of the Coronavirus Aid, Relief, and Economic Security Act (CARES Act,

P.L. 116-136), enacted on March 27, 2020, provided $172.1 billion in supplemental LHHS funds.

Title V, Division A, of the Families First Coronavirus Response Act (FFCRA, P.L. 116-127),

enacted on March 18, 2020, provided $1.25 billion in supplemental LHHS funds.

Title III, Division A, of the Coronavirus Preparedness and Response Supplemental Appropriations

Act, 2020 (P.L. 116-123), enacted on March 6, 2020, provided approximately $6.4 billion in

supplemental LHHS funds.

In addition, Title IX of the United States-Mexico-Canada Agreement Implementation Act (USMCA, P.L. 116113), enacted on January 29, 2020, provided $210 million in discretionary LHHS supplemental appropriations to

implement the agreement.

See Appendix C of this report for an analysis of the supplemental discretionary LHHS appropriations provided in

these acts. For a detailed discussion of the LHHS COVID-19 response funding, see CRS Report R46353, COVID19: Overview of FY2020 LHHS Supplemental Appropriations.

Congressional Research Service

Labor, Health and Human Services, and Education: FY2020 Appropriations

Contents

Introduction ................................................................................................................... 1

Report Roadmap and Useful Terminology........................................................................... 1

Scope of the Report ................................................................................................... 2

Important Budget Concepts ......................................................................................... 2

Mandatory vs. Discretionary Budget Authority ......................................................... 2

Total Budget Authority Provided in the Bill vs. Total Budget Authority Available

in the Fiscal Year ............................................................................................... 3

Status of FY2020 LHHS Appropriations ............................................................................. 4

FY2020 Supplemental Appropriations .......................................................................... 4

Paycheck Protection Program and Health Care Enhancement Act (PPPHCEA,

Title I, Division B, H.R. 266; P.L. 116-139) ........................................................... 4

Coronavirus Aid, Relief, and Economic Security Act (CARES Act, Title VIII,

Divis ion B, H.R. 748; P.L. 116-136) ..................................................................... 5

Families First Coronavirus Response Act (FFCRA, Title V, Division A, H.R.

6201; P.L. 116-127)............................................................................................ 5

Coronavirus Preparedness and Response Supplemental Appropriations Act, 2020

(Title III, Division A, H.R. 6074; P.L. 116-123)...................................................... 6

United States-Mexico-Canada Agreement Supplemental Appropriations Act, 2019

(USMCA, Title IX, H.R. 5430; P.L. 116-113)......................................................... 6

FY2020 Annual LHHS Appropriations ......................................................................... 7

FY2020 LHHS Omnibus (Division A, Further Consolidated Appropriations Act,

2020, H.R. 1865; P.L. 116-94) ............................................................................. 7

FY2020 Continuing Resolutions (Division A, P.L. 116-59; Division A, P.L. 11669) .................................................................................................................. 8

Earlier Congressional Action on an LHHS Bill ......................................................... 9

FY2020 President’s Budget Request........................................................................... 10

Conclusion of the FY2019 Appropriations Process ....................................................... 10

Summary of FY2020 LHHS Appropriations ...................................................................... 11

Department of Labor (DOL) ........................................................................................... 14

About DOL ............................................................................................................ 15

FY2020 DOL Appropriations Overview ...................................................................... 15

Selected DOL Highlights .......................................................................................... 16

Employment and Training Administration (ETA) .................................................... 16

Bureau of Labor Statistics (BLS) .......................................................................... 17

Bureau of International Labor Affairs (ILAB) ......................................................... 18

Labor-Related General Provisions......................................................................... 18

Department of Health and Human Services (HHS) ............................................................. 21

About HHS............................................................................................................. 21

FY2020 HHS Appropriations Overview ...................................................................... 22

Special Public Health Funding Mechanisms................................................................. 24

Public Health Service Evaluation Tap .................................................................... 24

Prevention and Public Health Fund ....................................................................... 26

Selected HHS Highlights by Agency .......................................................................... 26

HRSA .............................................................................................................. 27

CDC................................................................................................................. 27

NIH.................................................................................................................. 28

Congressional Research Service

Labor, Health and Human Services, and Education: FY2020 Appropriations

SAMHSA ......................................................................................................... 29

AHRQ .............................................................................................................. 30

CMS ................................................................................................................ 30

ACF ................................................................................................................. 31

ACL................................................................................................................. 32

Restrictions Related to Certain Controversial Issues ...................................................... 32

Department of Education (ED) ........................................................................................ 39

About ED ............................................................................................................... 39

FY2020 ED Appropriations Overview ........................................................................ 40

Selected ED Highlights ............................................................................................ 41

School Improvement Programs............................................................................. 41

Student Financial Assistance ................................................................................ 42

Related Agencies .......................................................................................................... 44

FY2020 Related Agencies Appropriations Overview ..................................................... 45

Selected Related Agencies Highlights ......................................................................... 46

SSA Limitation on Administrative Expenses (LAE) ................................................. 46

Corporation for National and Community Service ................................................... 46

National Labor Relations Board (NLRB) ............................................................... 47

Figures

Figure 1. FY2020 Enacted LHHS Appropriations................................................................. 8

Figure 2. FY2020 Enacted LHHS Appropriations by Title ................................................... 14

Figure 3. FY2020 Enacted HHS Appropriations by Agency ................................................. 24

Tables

Table 1. Status of Full-Year LHHS Appropriations Legislation, FY2020 .................................. 7

Table 2. LHHS Appropriations Overview by Bill Title, FY2019-FY2020............................... 12

Table 3. DOL Appropriations Overview............................................................................ 16

Table 4. Detailed DOL Appropriations.............................................................................. 19

Table 5. HHS Appropriations Overview............................................................................ 23

Table 6. HHS Appropriations Totals by Agency ................................................................. 33

Table 7. HHS Discretionary Appropriations for Selected Programs or Activities,

by Agency................................................................................................................. 36

Table 8. ED Appropriations Overview .............................................................................. 40

Table 9. Detailed ED Appropriations ................................................................................ 43

Table 10. Related Agencies Appropriations Overview ......................................................... 45

Table 11. Detailed Related Agencies Appropriations ........................................................... 47

Table A-1. FY2020 LHHS Discretionary House and Senate Initial 302(b) Suballocations,

FY2020 Enacted Levels, and FY2019 Enacted Levels...................................................... 54

Table A-2. LHHS Appropriations Overview, by Bill Title: FY2019-FY2020........................... 55

Table B-1. House Floor Amendments Offered to H.R. 2740 ................................................. 57

Congressional Research Service

Labor, Health and Human Services, and Education: FY2020 Appropriations

Table C-1. Summary of Enacted FY2020 Discretionary Regular and Supplemental

Appropriations ........................................................................................................... 65

Appendixes

Appendix A. Budget Enforcement Activities ..................................................................... 50

Appendix B. House Floor Amendments Offered to H.R. 2740 .............................................. 57

Appendix C. Enacted FY2020 LHHS Supplemental Appropriations...................................... 63

Contacts

Author Information ....................................................................................................... 66

Congressional Research Service

Labor, Health and Human Services, and Education: FY2020 Appropriations

Introduction

This report provides an overview of FY2020

appropriations actions for accounts traditionally funded

in the appropriations bill for the Departments of Labor,

Health and Human Services, and Education, and Related

Agencies (LHHS). This bill provides discretionary and

mandatory appropriations to three federal departments:

the Department of Labor (DOL), the Department of

Health and Human Services (HHS), and the Department

of Education (ED). In addition, the bill provides annual

appropriations for more than a dozen related agencies,

including the Social Security Administration (SSA).

FY2020 Supplemental

Appropriations

This report primarily focuses on regular

FY2020 LHHS discretionary funding

enacted during the annual appropriations

process. The emergency supplemental

funding that was subsequently enacted for

FY2020 is generally not included in the

budgetary figures discussed in the main

body of the report. (These appropriations

are addressed in the context of the

FY2020 annual cycle in Appendix C.)

Discretionary funds represent less than one-fifth of the total funds appropriated in the annual

LHHS bill. Nevertheless, the LHHS bill is typically the largest single source of discretionary

funds for domestic nondefense federal programs among the various appropriations bills. (The

Department of Defense bill is the largest source of discretionary funds among all federal

programs.) Because the appropriations process both provides and controls discretionary funding

(concepts discussed further in “Mandatory vs. Discretionary Budget Authority”), the bulk of this

report is focused on these funds.

The LHHS bill typically is one of the more controversial of the regular appropriations bills

because of the size of its funding and the scope of its programs, as well as various related social

policy issues addressed in the bill, such as restrictions on the use of federal funds for abortion and

for research on human embryos, stem cells, and gun violence.

Congressional clients may consult the LHHS experts list in CRS Report R42638, Appropriations:

CRS Experts, for information on which analysts to contact at the Congressional Research Service

(CRS) with questions on specific agencies and programs funded in the LHHS bill.

Report Roadmap and Useful Terminology

This report is divided into several sections. The opening section provides an explanation of the

scope of the LHHS bill (and hence, the scope of this report) and an introduction to important

terminology and concepts that carry throughout the report. Next is a series of sections describing

major congressional actions on FY2020 appropriations and (for context) a review of the

conclusion of the FY2019 appropriations process. This is followed by a high-level summary and

analysis of enacted and proposed appropriations for FY2020, compared to FY2019 funding

levels. The body of the report concludes with overview sections for each of the major titles of the

bill: DOL, HHS, ED, and Related Agencies (RA). These sections provide selected highlights

from FY2020 enacted and proposed funding levels compared to FY2019. (Note that the

distribution of funds is sometimes illustrated by figures, which in all cases are based on the

FY2020 enacted version of the LHHS bill. 1 )

Appendix A provides a summary of budget enforcement activities for FY2020. This includes

information on the Budget Control Act of 2011 (BCA; P.L. 112-25) and sequestration, budget

1 T he dollars and percentages in each figure also are generally illustrative, except as noted, of the parallel distribution

of funds enacted in FY2019 and proposed by the FY2020 President’s budget, and the House committee -reported and

the Senate-passed bills.

Congressional Research Service

1

Labor, Health and Human Services, and Education: FY2020 Appropriations

enforcement in the absence of an FY2020 budget resolution, subcommittee spending allocations,

and current-year spending levels. This is followed by Appendix B, which provides an overview

of the LHHS-related floor amendments that were offered in the House during its consideration of

H.R. 2740. Appendix C provides an analysis of the supplemental discretionary LHHS

appropriations enacted for FY2020. For a detailed discussion of the FY2020 supplemental LHHS

COVID-19 response funding, see CRS Report R46353, COVID-19: Overview of FY2020 LHHS

Supplemental Appropriations.

Scope of the Report

This report focuses on appropriations to agencies and accounts that are subject to the jurisdiction

of the Labor, Health and Human Services, Education, and Related Agencies subcommittees of the

House and Senate appropriations committees (i.e., accounts traditionally funded via the LHHS

bill). Department “totals” provided in this report do not include funding for accounts or agencies

that are traditionally funded by appropriations bills under the jurisdiction of other subcommittees.

The LHHS bill provides appropriations for the following federal departments and agencies:

the Department of Labor;

most agencies at the Department of Health and Human Services, except for the

Food and Drug Administration (funded through the Agriculture appropriations

bill), the Indian Health Service (funded through the Interior-Environment

appropriations bill), and the Agency for Toxic Substances and Disease Registry

(also funded through the Interior-Environment appropriations bill);

the Department of Education; and

more than a dozen related agencies, including the Social Security Administration,

the Corporation for National and Community Service, the Corporation for Public

Broadcasting, the Institute of Museum and Library Services, the National Labor

Relations Board, and the Railroad Retirement Board.

Note also that funding totals displayed in this report do not reflect amounts provided outside of

the annual appropriations process. Certain direct spending programs, such as Social Security and

parts of Medicare, receive funding directly from their authorizing statutes; such funds are not

reflected in the totals provided in this report because they are not provided through the annual

appropriations process (see related discussion in the “Important Budget Concepts” section).

Important Budget Concepts

Mandatory vs. Discretionary Budget Authority 2

The LHHS bill includes both discretionary and mandatory budget authority. While all

discretionary spending is subject to the annual appropriations process, only a portion of

mandatory spending is provided in appropriations measures.

2 For definitions of these and other budget terms, see U.S. Government Accountability Office (GAO), A Glossary of

Terms Used in the Federal Budget Process, GAO-05-734SP, September 1, 2005, http://www.gao.gov/products/GAO05-734SP. (T erms of interest may include appropriated entitlement, direct spending, discretionary, entitlement

authority, and mandatory.)

Congressional Research Service

2

Labor, Health and Human Services, and Education: FY2020 Appropriations

Mandatory programs funded through the annual appropriations process are commonly referred to

as appropriated entitlements. In general, appropriators have little control over the amounts

provided for appropriated entitlements; rather, the authorizing statute controls the program

parameters (e.g., eligibility rules, benefit levels) that entitle certain recipients to payments. If

Congress does not appropriate the money necessary to meet these commitments, entitled

recipients (e.g., individuals, states, or other entities) may have legal recourse. 3

Most mandatory spending is not provided through the annual appropriations process, but rather

through budget authority provided by the program’s authorizing statute (e.g., Social Security

benefits payments). The funding amounts in this report do not include budget authority provided

outside of the appropriations process. Instead, the amounts reflect only those funds, discretionary

and mandatory, that are provided through appropriations acts.

As displayed in this report, mandatory amounts for the FY2020 President’s budget submission

reflect current-law (or current services) estimates; they generally do not include the President’s

proposed changes to a mandatory spending program’s authorizing statute that might affect total

spending. (In general, such proposals are excluded from this report, as they typically would be

enacted in authorizing legislation.)

The report focuses most closely on discretionary funding. This is because discretionary funding

receives the bulk of attention during the appropriations process. (As noted earlier, although the

LHHS bill includes more mandatory funding than discretionary funding, the appropriators

generally have less flexibility in adjusting mandatory funding levels than discretionary funding

levels.)

Mandatory and discretionary spending is subject to budget enforcement processes that include

sequestration. In general, sequestration involves largely across-the-board reductions that are made

to certain categories of discretionary or mandatory spending. However, the conditions that trigger

sequestration, and how it is carried out, differ for each type of spending. This is discussed further

in Appendix A.

Total Budget Authority Provided in the Bill vs. Total Budget Authority

Available in the Fiscal Year

Budget authority is the amount of money a federal agency is legally authorized to commit or

spend. Appropriations bills may include budget authority that becomes available in the current

fiscal year, in future fiscal years, or some combination. Amounts that become available in future

fiscal years are typically referred to as advance appropriations.

Unless otherwise specified, appropriations levels displayed in this report refer to the total amount

of budget authority provided in an appropriations bill (i.e., “total in the bill”), regardless of the

year in which the funding becomes available. 4 In some cases, the report breaks out current-year

appropriations (i.e., the amount of budget authority available for obligation in a given fiscal year,

regardless of the year in which it was first appropriated). 5

3

Sometimes appropriations measures include amendments to laws authorizing mandatory spending programs and

thereby change the amount of mandatory appropriations needed. Because such amendments are legislative in nature,

they may violate parliamentary rules separating authorizations and appropriations. For more information, see CRS

Report R42388, The Congressional Appropriations Process: An Introduction .

4 Such figures include advance appropriations provided in the bill for future fiscal years, but do not include advance

appropriations provided in prior years’ appropriations bills that become available in the current year.

5 Such figures exclude advance appropriations for future years, but include advance appropriations from prior years that

Congressional Research Service

3

Labor, Health and Human Services, and Education: FY2020 Appropriations

As the annual appropriations process unfolds, the amount of current-year budget authority is

measured against 302(b) allocation ceilings (budget enforcement caps for appropriations

subcommittees that traditionally emerge following the budget resolution process). The process of

measuring appropriations against these spending ceilings takes into account scorekeeping

adjustments, which are made by the Congressional Budget Office (CBO) to reflect conventions

and special instructions of Congress.6 Unless otherwise specified, appropriations levels displayed

in this report do not reflect additional scorekeeping adjustments.

Status of FY2020 LHHS Appropriations

FY2020 Supplemental Appropriations

The legislative response to the global pandemic of Coronavirus Disease 2019 (COVID-19) has

included the enactment of laws to provide authorities and supplemental funding to prevent,

prepare for, and respond to the pandemic. As of the date of this report, LHHS supplemental

appropriations for COVID-19 response have been enacted in four separate supplemental

appropriations measures, discussed below. These are discussed in detail in CRS Report R46353,

COVID-19: Overview of FY2020 LHHS Supplemental Appropriations.

In addition, supplemental discretionary LHHS appropriations to implement the United StatesMexico-Canada Agreement were enacted prior to the COVID-19 outbreak.

See Appendix C for an analysis of the discretionary LHHS appropriations provided in these acts.

Paycheck Protection Program and Health Care Enhancement Act (PPPHCEA,

Title I, Division B, H.R. 266; P.L. 116-139)

In April 2020, Congress and the President came to an agreement on a fourth COVID-19

supplemental appropriations act. Among other provisions, this act provided additional

supplemental appropriations to HHS for the Provider Relief Fund and to support COVID-19

testing. 7 The legislative vehicle that was used for the agreement was H.R. 266, an unrelated

appropriations bill that had been passed previously by the House. On April 21, 2020, the measure

was laid before the Senate by unanimous consent and passed with a substitute amendment by

voice vote. The House adopted the Senate version of the proposal on April 23 by a vote of 388-5. 8

The President signed the bill into law (P.L. 116-139) the following day. 9 The bill provided $100

billion in supplemental LHHS funds for programs and activities at HHS.

become available in the given fiscal year.

6

For more information on scorekeeping, see CRS Report 98-560, Baselines and Scorekeeping in the Federal Budget

Process. See also a discussion of key scorekeeping guidelines included in the joint explanatory statement

accompanying the conference report to the Balanced Budget Act of 1997 ( H.Rept. 105-217, pp. 1007-1014).

T he CARES and PPPHCEA supplemental measures each provided funding for a “Provider Relief Fund” to assist

health care providers and facilities affected by the COVID-19 pandemic. For more information on the new fund, see

HHS, “CARES Act Provider Relief Fund” (the name given to t his fund by HHS), April 22, 2020, https://www.hhs.gov/

provider-relief/index.html.

7

8 House Committee on Appropriations, H.R. 622, Paycheck Protection Program and Health Care Enhancement Act

Division B – Additional Emergency Appropriations for Coronavirus Response, April 21, 2020,

https://appropriations.house.gov/sites/democrats.appropriations.house.gov/files/

Interim%20Emergency%20Package%20Funds%20Hospitals%2C%20Health%20Workers%20and%20Testing.pdf.

9 See CRS Report R46325, Fourth COVID-19 Relief Package (P.L. 116-139): In Brief.

Congressional Research Service

4

Labor, Health and Human Services, and Education: FY2020 Appropriations

Coronavirus Aid, Relief, and Economic Security Act (CARES Act, Title VIII,

Division B, H.R. 748; P.L. 116-136)

On March 17, 2020, the Administration released a second request for FY2020 supplemental

appropriations of $45.8 billion for COVID-19 response, of which $11.1 billion was for LHHS

accounts and activities. 10 Over the next several days, Congress and the Administration negotiated

the scope and scale of this legislative response, leading to enactment of a third COVID-19

response measure.

The legislative vehicle that was ultimately chosen for this package was H.R. 748, an unrelated

measure that had been passed previously by the House. 11 Prior to when a deal was reached

between Congress and the Administration, the Senate voted on March 22 (47-47) and March 23

(49-46) not to invoke cloture on the motion to proceed to H.R. 748. 12 The measure was ultimately

laid before the Senate by unanimous consent and passed with a substitute amendment by a vote of

96-0 on March 25. The House subsequently took up the Senate amendment on March 27, and

agreed to it by a voice vote. The bill was signed into law (P.L. 116-136) by the President that

same day. 13 Among other provisions, the bill provided $172.1 billion in supplemental LHHS

funds for various programs and activities at DOL, HHS, ED, and four LHHS related agencies (the

Corporation for Public Broadcasting, the Institute of Museum and Library Services, the Railroad

Retirement Board, and the Social Security Administration).

Families First Coronavirus Response Act (FFCRA, Title V, Division A, H.R.

6201; P.L. 116-127)

A second COVID-19 response measure was developed by Congress and the Administration soon

after the first (P.L. 116-123) was enacted. Initially, H.R. 6201 was introduced by the Chair of the

House Appropriations Committee on March 11, 2020. 14 The House amended and passed the

measure by a vote of 363-40 on March 14, but further alterations to the final legislative package

were negotiated over the next two days. 15 On March 16, the House (by unanimous consent)

10

With regard to LHHS, the letter also explained that the Administration was seeking to amend its FY2 021 budget

request for CDC and NIH to provide them additional budgetary resources and authorities. Letter from Russell T .

Vought, Acting Director, Office of Management and Budget (OMB), to Vice President Michael Pence, March 17,

2020, https://www.whitehouse.gov/wp-content/uploads/2020/03/Letter-regarding-additional-funding-to-support-theUnited-States-response-to-COVID-19-3.17.2020.pdf.

11 Prior to when H.R. 748 was determined to be the vehicle for the third COVID-19 response measure, the Senate

Majority Leader, Senator McConnell, introduced a proposal on March 19, 2020, that did not include supplemental

emergency-designated discretionary appropriations (S. 3548). Four days later, on March 23, 2020, the House

Appropriations Committee Chair introduced a proposal (H.R. 6379) that did include supplemental appropriations

(including for LHHS).

12 T he Senate Appropriations Committee released a summary of the supplemental appropriations in the measure

(Senate Appropriations Committee, $340 Billion Surge in Emergency Funding to Combat Coronavirus Outbreak,

March 25, 2020, https://www.appropriations.senate.gov/imo/media/doc/

Coronavirus%20Supplemental%20Appropriations%20Summary_FINAL.pdf .)

13

CRS reports on the CARES Act are available on Congress.gov at https://www.congress.gov/bill/116th-congress/

house-bill/748 and https://www.congress.gov/bill/116th-congress/senate-bill/3548.

14 For a summary of the measure, see House Appropriations Comm ittee, H.R. 6201, FAMILIES FIRST

CORONAVIRUS RESPONSE ACT, Title-By-Title Summary, March 11, 2020, https://appropriations.house.gov/sites/

democrats.appropriations.house.gov/files/Families%20First%20Summary%20FINAL.pdf.

15

For background, see John Bresnahan and Marianne Levine, “ Senate to take up coronavirus package after House

passes revised bill,” Politico, March 16, 2020, https://www.politico.com/news/2020/03/16/senate-coronavirusemergency-package-131465. See also “DIRECT ING T HE CLERK OF T HE HOUSE OF REPRESENT AT IVES T O

Congressional Research Service

5

Labor, Health and Human Services, and Education: FY2020 Appropriations

considered and agreed to a resolution (H.Res. 904) that directed the Clerk to make changes to the

legislation when preparing the final, official version of the House-passed bill (engrossment). The

engrossed version was sent to the Senate and ultimately passed without amendment by a vote of

90-8 on March 18. The President signed the bill into law (P.L. 116-127) the same day. 16 The bill

provided $1.25 billion in supplemental LHHS funds for programs and activities at HHS.

Coronavirus Preparedness and Response Supplemental Appropriations Act,

2020 (Title III, Division A, H.R. 6074; P.L. 116-123)

On February 24, 2020, the Trump Administration sent Congress a request for supplemental

appropriations of $1.25 billion for the Public Health and Social Services Emergency Fund

(PHSSEF) at HHS. 17 The request letter included a number of other proposals, largely but not

exclusively related to re-purposing existing funds toward response efforts. All told, the

Administration estimated needing to allocate approximately $2.5 billion toward COVID-19

response efforts. (For the most part, amounts for other LHHS aspects of the request generally

were unspecified in the publicly released request letter.) 18

Several days after the Administration’s request, the Chair of the House Appropriations Committee

introduced H.R. 6074 on March 4, 2020. The measure passed the House that same day by a vote

of 415-2, passed the Senate on March 5 by a vote of 96-1, and was signed into law (P.L. 116-123)

on March 6. 19 The bill provided approximately $6.4 billion in supplemental LHHS funds for

accounts and activities at HHS.

United States-Mexico-Canada Agreement Supplemental Appropriations Act,

2019 (USMCA, Title IX, H.R. 5430; P.L. 116-113)

The United States-Mexico-Canada Agreement (USMCA) was a trade agreement that was

introduced by the House Majority Leader, Representative Hoyer, on December 13, 2019 (H.R.

5430). The measure was passed by the House on December 19, 2019, by a vote of 385-41, and

the Senate on January 16, 2020, by a vote of 89-10. The bill was signed into law on January 29,

2020 (P.L. 116-113).

Supplemental discretionary appropriations carried in Title IX provided $210 million to the

Department of Labor to implement the agreement. 20

MAKE CORRECT IONS IN T HE ENGROSSMENT OF H.R. 6201,” Congressional Record, daily edition, vol. 166,

no. 50 (March 16, 2020), pp. H1698-H1707.

16 CRS Reports on FFCRA are available on Congress.gov at https://www.congress.gov/bill/116th-congress/house-bill/

6201.

17

T he PHSSEF is an account used by the HHS Secretary for one-time or short-term funding such as emergency

supplemental appropriations, and for some ongoing public health preparedness activities.

18 Letter from Russell T . Vought, Acting Director, Office of Management and Budget (OMB), to Vice President

Michael Pence, February 24, 2020, https://www.whitehouse.gov/wp-content/uploads/2020/02/CoronavirusSupplemental-Request-Letter-Final.pdf.

19 A summary of provisions is provided in CRS Report R46285, Coronavirus Preparedness and Response

Supplemental Appropriations Act, 2020 (P.L. 116 -123): First Coronavirus Supplemental.

20 See CBO, “Estimate for H.R. 5430, the United States-Mexico-Canada Agreement Implementation Act, as introduced

on December 13, 2019, December 16, 2020, https://www.cbo.gov/system/files/2019-12/hr5430.pdf.

Congressional Research Service

6

Labor, Health and Human Services, and Education: FY2020 Appropriations

FY2020 Annual LHHS Appropriations

Table 1 provides a timeline of major legislative actions for full-year LHHS proposals, which are

discussed in greater detail below

Table 1. Status of Full-Year LHHS Appropriations Legislation, FY2020

Subcommittee

Approval

House

Senate

Resolution of House and

Senate Differences

Full Committee

Approval

House

4/30/19

H.R. 2740

voice

vote

H.Rept.

116-62

5/15/19

Senate

House

Initial

Passage

Senate

Initial

Passage

Conf.

Report

House

Final

Passage

Senate

Final

Passage

H.R. 2740,

Division A

H.R. 1865, H.R. 1865,

Division A Division A

6/19/19

12/17/19

12/19/19

226-203

297-120

71-23

Public

Law

P.L. 116-94

12/20/19

30-23

Source: CRS Appropriations Status Table.

FY2020 LHHS Omnibus (Division A, Further Consolidated Appropriations

Act, 2020, H.R. 1865; P.L. 116-94)

About one week prior to when the second FY2020 continuing resolution (CR) was scheduled to

expire, the House, Senate, and Trump Administration announced that it had reached a deal that

would fund all 12 appropriations bills in two legislative packages (H.R. 1158 and H.R. 1865);

LHHS was funded in Division A of H.R. 1865. The Further Consolidated Appropriations Act,

2020 was agreed to by the House (297-120) on December 17, 2019, and by the Senate (71-23) on

December 19. The bill was signed into law on December 20 (P.L. 116-94).

LHHS discretionary appropriations in the FY2020 LHHS omnibus totaled $195.4 billion. This

amount is 3.2% more than FY2019 enacted and 17.4% more than the FY2020 President’s budget

request. The omnibus also provided $902.3 billion in mandatory funding, for a combined LHHS

total of $1.098 trillion. (Note that these totals are based only on amounts provided by the FY2020

LHHS omnibus and do not include the supplemental funds, which were provided in addition to

the annual appropriations.)

See Figure 1 for a breakdown of FY2020 discretionary and mandatory LHHS appropriations. 21

21 While the percentages in this figure were calculated based on amounts in the FY20 20 LHHS omnibus, they are

generally also illustrative—within a few percentage points—of the share of mandatory and discretionary funds in

FY2019 and under the various FY2020 proposals (e.g., President’s budget and the House-committee bill).

Congressional Research Service

7

Labor, Health and Human Services, and Education: FY2020 Appropriations

Figure 1. FY2020 Enacted LHHS Appropriations

Source: Amounts in this figure are generally drawn from or calculated based on data contained in the

explanatory statement accompanying the FY2020 LHHS omnibus (P.L. 116-94), available in the Congressional

Record, vol. 165, no. 204, December 17, 2019, pp. H11061-H11161. Enacted totals for FY2020 do not include

emergency-designated appropriations provided by P.L. 116-113, P.L. 116-123, P.L. 116-127, P.L. 116-136, or P.L.

116-139. For consistency with source materials, amounts in this figure generally do not reflect mandatory

spending sequestration. CRS calculations do, however, include LHHS funding provided to HHS pursuant to the

21 st Century Cures Act (P.L. 114-255).

Notes: Details may not add to totals due to rounding. Amounts in this figure (1) reflect all budget authority

appropriated in the bill, regardless of the year in which funds become available (i.e., totals do not include

advances from prior-year appropriations, but do include advances for subsequent years provided in this bill); (2)

have generally not been adjusted to reflect scorekeeping; (3) comprise only those funds provided for agencies

and accounts subject to the jurisdiction of the LHHS subcommittees of the House and Senate appropriations

committees; and (4) do not include appropriations that occur outside of appropriations bills.

FY2020 Continuing Resolutions (Division A, P.L. 116-59; Division A, P.L. 11669)

FY2020 LHHS appropriations were provided by two continuing resolutions (CRs) until the

enactment of the LHHS omnibus (P.L. 116-94) on December 20, 2019. 22

The first CR (Division A of H.R. 4378; P.L. 116-59) was enacted on September 27, 2019. The CR

provided continuing appropriations for all 12 annual appropriations acts (including LHHS)

through November 21, 2019. In general, the CR funded discretionary programs at the same rate

and under the same conditions as in FY2019 (§ 101) and annually appropriated entitlements at

their current law levels (§111). It also included several anomalies that were specific to LHHS

accounts or activities (§§137-139). 23

The second CR (Division A of H.R. 3055; P.L. 116-69) was enacted on November 21, 2019. This

law extended the prior FY2020 CR through December 20, 2019. (None of the few additional

anomalies added by Division A were LHHS-specific.)

22 For an overview of CRs, see CRS Report R42647, Continuing Resolutions: Overview of Components and Practices.

23 For further information on the continuing appropriations provided by P.L. 116-59, see CRS Report R45982,

Overview of Continuing Appropriations for FY2020 (P.L. 116 -59).

Congressional Research Service

8

Labor, Health and Human Services, and Education: FY2020 Appropriations

Earlier Congressional Action on an LHHS Bill

FY2020 LHHS Action in the Senate (Division A, H.R. 2740)

The FY2020 LHHS bill did not receive subcommittee, full committee, or initial floor

consideration in the Senate prior to its enactment.

With regard to committee consideration, the Senate Appropriations Committee scheduled a

markup for September 10, 2019, but that markup was indefinitely postponed prior to when it was

to occur. 24 (The initial LHHS subcommittee allocation (S.Rept. 116-104) that was adopted by the

Senate Appropriations Committee on September 12, 2019 is discussed in Appendix A.) Senator

Blunt, Chair of the Senate LHHS Subcommittee subsequently released the text of a draft LHHS

bill and accompanying committee report on September 18. 25

The Senate Majority Leader, Senator McConnell, presented cloture on the motion to proceed to

H.R. 2740, the House-passed version of the LHHS bill, on September 16. The Senate voted not to

invoke cloture (51-44) on September 18. Cloture was not invoked a second time (51-41) on

October 31.

FY2020 LHHS Action in the House (Division A, H.R. 2740)

The House Appropriations Committee’s LHHS subcommittee approved its draft bill on April 30,

2019, by a voice vote. The full committee markup was held on May 8 and the bill was ordered to

be reported that same day (30-23). The bill was subsequently reported to the House on May 15

(H.R. 2740, H.Rept. 116-62). This is the earliest the LHHS bill (including its predecessor under

prior jurisdictional arrangements) has been reported to the House since the current budget process

was first implemented in FY1976. The FY2020 LHHS bill and FY2020 Military Construction,

Veterans Affairs, and Related Agencies Appropriations bill (H.R. 2745) were the first to be

reported to the House during the FY2020 cycle. The last time LHHS was the first bill reported by

the House Appropriations Committee was FY1980, though in that year the bill was one of three

reported on the same day.

As reported by the full committee, the bill would have provided $204.3 billion in discretionary

LHHS funds, a 7.9% increase from FY2019 enacted levels. This amount would have been 22.7%

more than the FY2020 President’s request. In addition, the House committee bill would have

provided an estimated $902.3 billion in mandatory funding, for a combined total of $1.107 trillion

for LHHS as a whole.

The House began consideration of the FY2020 LHHS bill the week of June 10. To do this, the

House took up the FY2020 LHHS bill reported from committee (H.R. 2740) and amended it into

a four-bill omnibus, with LHHS appropriations in Division A. 26 Of the 73 LHHS amendments

24 Senate Appropriations Committee, “Appropriations Schedule for the Week of September 9, 2019,” September 6,

2019, https://www.appropriations.senate.gov/newsroom/press-releases/appropriations-schedule-for-the-week-ofseptember-9-2019.

25

See Senate Appropriations Committee, “Blunt Releases FY2020 Labor, HHS, & Education Appropriations Bill,”

September 18, 2019, https://www.appropriations.senate.gov/news/fy2020-labor-hhs-and-education-appropriations-billreleased.

26 T he four appropriations acts that received floor consideration via H.R. 2740 were LHHS (Division A); Department

of Defense (Division B); Energy and Water Development and Related Agencies (Division C); and Department of State,

Foreign Operations, and Related Programs (Division D). T wo special rules were adopted that affected the consideration

of LHHS appropriations in Division A: H.Res. 431 and H.Res. 436.

Congressional Research Service

9

Labor, Health and Human Services, and Education: FY2020 Appropriations

offered to Division A, 64 were adopted and the remaining 9 were withdrawn or defeated. The

House passed the LHHS omnibus by a vote of 226-203 on June 19. Because there is no publiclyavailable source that estimates the account-level budgetary effects of the amendments adopted to

Division A, this report provides analysis of the House Committee-reported version of the LHHS

bill. For information on the LHHS amendments offered during floor consideration, see Appendix

B.

FY2020 President’s Budget Request

On March 11, 2019, the Trump Administration released the initial FY2020 President’s budget. 27

The President requested $166.5 billion in discretionary funding for accounts funded by the LHHS

bill, which would have been a decrease of 12.1% from FY2019 levels. In addition, the President

requested $900.4 billion in annually appropriated mandatory funding, for a total of $1.067 trillion

for LHHS as a whole.

Conclusion of the FY2019 Appropriations Process

During the 115th Congress, on September 28, 2018, the President signed into law the Department

of Defense and Labor, Health and Human Services, and Education Appropriations Act, 2019 and

Continuing Appropriations Act, 2019 (H.R. 6157, P.L. 115-245). This was the first occasion since

the FY1997 appropriations cycle that full-year LHHS appropriations were enacted on or before

the start of the fiscal year (October 1). The conference report (H.Rept. 115-952) was adopted by

the Senate on September 18, and the House on September 26. The bill provided regular, full-year

appropriations for the Department of Defense (Division A) and LHHS (Division B)

appropriations acts.

LHHS discretionary appropriations in the FY2019 omnibus totaled $189.4 billion. This amount

was 1.5% more than FY2018 enacted and 8.9% more than the FY2019 President’s budget

request. The omnibus also provided $869.8 billion in mandatory funding, for a combined LHHS

total of $1.059 trillion. (Note that these totals are based only on amounts provided by the FY2019

LHHS omnibus and do not include the supplemental funds, which were provided in addition to

the annual appropriations.)28

27 T he initial set of budget materials was released on March 11, 2019, and additional agency materials were released in

the following weeks, including many on March 18, 2019. In addition, on May 13, the President submitted two budget

amendments that would affect portions of the initial request , though these amendments did not affect the net budget

authority totals proposed in the initial FY2020 request. T he LHHS budget amendments proposed authorizing (1) the

HHS National Institute on Minority Health and Health Disparities to implement a reorganization plan and (2) certain

funds in the HHS General Departmental Management account to be available for specified activities carried out by the

Departmental Appeals Board.

28 For further information, see CRS Report R45869, Labor, Health and Human Services, and Education: FY2019

Appropriations.

Congressional Research Service

10

Labor, Health and Human Services, and Education: FY2020 Appropriations

Summary of FY2020 LHHS Appropriations

Dollars and Percentages in this Report

Amounts displayed in this report are typically rounded to the nearest million or billion (as labeled). Dollar and

percentage changes discussed in the text are based on unrounded amounts.

Unless otherwise specified, appropriations levels displayed in this report refer to the total amount of budget

authority provided in an appropriations bill (i.e., “total in the bill”), regardless of the year in which the funding

becomes available.

Amounts for FY2019 Enacted, FY2020 Request, and FY2020 Enacted are generally drawn from or calculated based

on data contained in the explanatory statement accompanying the FY2020 LHHS omnibus ( P.L. 116-94), available

in the Congressional Record, vol. 165, no. 204, December 17, 2019, pp. H11061 -H11161.

Amounts for the FY2020 House Committee-reported bill are generally drawn from or calculated based on data

contained in the committee report (H.Rept. 116-62) accompanying H.R. 2740. Throughout this report, the

FY2020 House Appropriations Committee-reported LHHS bill is commonly referred to as the House “committee

bill.” (This report does not contain estimates of the House-passed version of H.R. 2740, as there is no publiclyavailable source that estimates the account-level budgetary effects of the adopted amendments. However,

information on the LHHS amendments offered during floor consideration can be found in Appendix B.)

Enacted totals for FY2019 do not include emergency-designated appropriations provided by P.L. 116-20 or P.L.

116-26. Enacted totals for FY2020 do not include emergency-designated appropriations provided by P.L. 116-113,

P.L. 116-123, P.L. 116-127, P.L. 116-136, or P.L. 116-139. For informational purposes, FY2019 and FY2020 enacted

supplemental amounts are displayed separately at the bottom of tables throughout the report and not summed.

One exception to this rule is made in Table A-1, which includes FY2019 and FY2020 enacted supplemental funds

in the “Adjusted Appropriations” totals, as scored by the Congressional Budget Office. In addition, further details

on the FY2020 supplemental appropriations can be found in Appendix C.

For consistency with source materials, the FY2019 and FY2020 numbers in this report generally do not reflect

actual or anticipated postenactment budgetary adjustments, except as noted. 29 CRS calculations do, however,

include LHHS funding provided to HHS pursuant to the 21 st Century Cures Act (P.L. 114-255).

Table 2 displays FY2020 discretionary and mandatory LHHS budget authority provided or

proposed, by bill title, along with FY2019 enacted levels. The amounts shown in this table reflect

total budget authority provided in the annual LHHS bill (i.e., all funds appropriated in the bill,

regardless of the fiscal year in which the funds become available), not total budget authority

available for the current fiscal year. (For a comparable table showing current-year budget

authority, see Table A-2. Note that the totals in this table do not include emergency supplemental

appropriations; amounts provided in supplementals are displayed separately at the bottom of the

table and are in addition to regular appropriations. For a discussion of the FY2020 supplemental

appropriations displayed below the bill totals in Table 2, see Appendix C.)

29 T he general practice for CRS reports on the LHHS bill has been to reflect conventions used in source materials.

T hese conventions have varied over the years. For instance, CRS reports on LHHS appropriations for FY2012-FY2015

generally relied on source materials that adjusted appropriations amounts in the prior -year column to reflect

sequestration, reestimates of mandatory spending, transfers, reprogramming, and other adjustments for compar ability.

However, the FY2016 version of this report broke from that practice due to differing display conventions in source

documents, and did not reflect any such adjustments (except sequestration for the Prevention and Public Health Fund

(PPHF)). T he FY2017 version of this report differed from both of these prior practices, in that it reflected a smaller

subset of transfers (generally concentrated at the National Institutes of Health) and other adjustments for comparability

(e.g., program moves from one account to another), but not reprogramming of funds or mandatory sequestration

(except sequestration of the PPHF). T he FY2108 and FY2019 versions of this report, however, relied on source

materials that generally did not reflect any transfers or other budgetary adjustments pursuant to administrative

authorities except PPHF sequestration. T he source materials used for the FY2020 report version, and thus the numbers

in this report, continue this most recent approach.

Congressional Research Service

11

Labor, Health and Human Services, and Education: FY2020 Appropriations

Table 2. LHHS Appropriations Overview by Bill Title, FY2019-FY2020

(Total budget authority provided in the bill, in billions of dollars)

FY2019

Enacted

FY2020

Request

FY2020

House

Cmte.

(H.R. 2740)

Title I: Labor

13.6

12.3

14.7

13.8

Discretionary

12.1

10.9

13.3

12.4

Mandatory

1.4

1.4

1.4

1.4

Title II: HHS

899.2

916.1

939.3

934.8

Discretionary

90.5

78.1

99.4

94.9

Mandatory

808.7

838.0

840.0

839.9

Title III: Education

75.0

67.6

79.5

76.4

Discretionary

71.4

64.0

75.9

72.8

Mandatory

3.5

3.6

3.6

3.6

71.5

70.9

73.1

72.7

Discretionary

15.3

13.5

15.7

15.4

Mandatory

56.2

57.3

57.3

57.3

Total BA in the Bill

1,059.2

1,066.9

1,106.6

1,097.7

Discretionary

189.4

166.5

204.3

195.4

Mandatory

869.8

900.4

902.3

902.3

P.L. 116-20 (emergency)

0.5

—

—

—

P.L. 116-26 (emergency)

2.9

—

—

—

P.L. 116-113 (emergency)

—

—

—

0.2

P.L. 116-123 (emergency)

—

—

—

6.4

P.L. 116-127 (emergency)

—

—

—

1.3

P.L. 116-136 (emergency)

—

—

—

172.1

P.L. 116-139 (emergency)

—

—

—

100.0

186.7

188.3

189.1

189.1

183.3

186.2

186.7

186.7

-9.4

-24.8

-12.6

-10.5

Bill Title

Title IV: Related Agencies

FY2020

Enacted

(P.L. 116-94)

Memoranda (non-emergency funds only):

Advances for Future Years

(provided in current bill) a

Advances from Prior Years

(for use in current year) a

Additional Scorekeeping Adjustmentsb

Source: Amounts in this table for the FY2019 Enacted, FY2020 Request, and FY2020 Enacted columns are

generally drawn from or calculated based on data contained in the explanatory statement accompanying the

FY2020 LHHS omnibus (P.L. 116-94), available in the Congressional Record, vol. 165, no. 204, December 17, 2019,

pp. H11061-H11161. Amounts in the FY2020 House Committee column are generally drawn from or calculated

based on data contained in the committee report (H.Rept. 116-62) accompanying H.R. 2740. Enacted totals for

FY2019 do not include emergency-designated appropriations provided by P.L. 116-20 or P.L. 116-26. Enacted

totals for FY2020 do not include emergency-designated appropriations provided by P.L. 116-113, P.L. 116-123,

P.L. 116-127, P.L. 116-136, or P.L. 116-139. For consistency with source materials, amounts in this table generally

Congressional Research Service

12

Labor, Health and Human Services, and Education: FY2020 Appropriations

do not reflect mandatory spending sequestration, where applicable, nor do they reflect any transfers or

reprogramming of funds pursuant to executive authorities. CRS calculations do, however, include LHHS funding

provided to HHS pursuant to the 21 st Century Cures Act (P.L. 114-255).

Notes: BA = Budget Authority. Details may not add to totals due to rounding. Amounts in this table (1) reflect

all BA appropriated in the bill, regardless of the year in which funds become available (i.e., totals do not include

advances from prior-year appropriations, but do include advances for subsequent years provided in this bill); (2)

have generally not been adjusted to reflect scorekeeping; (3) comprise only those funds provided (or requested)

for agencies and accounts subject to the jurisdiction of the LHHS subcommittees of the House and Senate

appropriations committees; and (4) do not include appropriations that occur outside of appropriations bills. No

amounts are shown for Title V, because this title consists solely of general provisions.

a.

Totals in this table are based on budget authority provided in the bill (i.e., they exclude advance

appropriations from prior bills and include advance appropriations from this bill made available in future

years). The calculation for total budget authority available in the current year is as follows: Total BA in the

Bill, minus Advances for Future Years, plus Advances from Prior Years.

b.

Totals in this table have generally not been adjusted for further scorekeeping. (To adjust for scorekeeping,

add this line to the total budget authority.)

Figure 2 displays the FY2020 enacted discretionary and mandatory LHHS funding levels, by bill

title. (While the dollars and percentages discussed in this section were calculated based on the

FY2020 enacted amounts, they are generally also illustrative—within several percentage points—

of the share of funds directed to each bill title in FY2019 and under the other FY2020 proposals.)

As this figure demonstrates, HHS accounts for the largest share of total FY2020 LHHS

appropriations: $934.8 billion, or 85.2%. This is due to the large amount of mandatory funding

included in the HHS appropriation, the majority of which is for Medicaid grants to states and

payments to health care trust funds. After HHS, ED and the Related Agencies represent the nextlargest shares of total LHHS funding, accounting for 7.0% and 6.6%, respectively. (The majority

of the ED appropriations each year are discretionary, while the bulk of funding for the Related

Agencies goes toward mandatory payments and administrative costs of the Supplemental Security

Income program at the Social Security Administration.) DOL accounts for the smallest share of

total LHHS funds, 1.3%.

The overall composition of LHHS funding is noticeably different when comparing only

discretionary appropriations. HHS accounts for a comparatively smaller share of total

discretionary appropriations (48.6%), while ED accounts for a relatively larger share (37.2%).

Together, these two departments represent the majority (85.8%) of discretionary LHHS

appropriations. DOL and the Related Agencies account for a roughly even split of the remaining

14.2% of discretionary LHHS funds.

Congressional Research Service

13

Labor, Health and Human Services, and Education: FY2020 Appropriations

Figure 2. FY2020 Enacted LHHS Appropriations by Title

Source: Amounts in this figure are generally drawn from or calculated based on data contained in the

explanatory statement accompanying the FY2020 LHHS omnibus ( P.L. 116-94), available in the Congressional

Record, vol. 165, no. 204, December 17, 2019, pp. H11061 -H11161. Enacted totals for FY2020 do not include

emergency-designated appropriations provided by P.L. 116-113, P.L. 116-123, P.L. 116-127, P.L. 116-136, or P.L.

116-139. For consistency with source materials, amounts in this figure generally do not reflect mandatory

spending sequestration, where applicable, nor do they reflect any transfers or reprogramming of funds pursuant

to executive authorities. CRS calculations do, however, include LHHS funding provided to HHS pursuant to th e

21 st Century Cures Act (P.L. 114-255).

Notes: Details may not add to totals due to rounding. Amounts in this figure (1) reflect all BA appropriated in

the bill, regardless of the year in which funds become available (i.e., totals do not include advances from prioryear appropriations, but do include advances for subsequent years provided in this bill); (2) have generally not

been adjusted to reflect scorekeeping; (3) comprise only those funds provided for agencies and accounts subject

to the jurisdiction of the LHHS subcommittees of the House and Senate appropriations committees; and (4) do

not include appropriations that occur outside of appropriations bills.

Department of Labor (DOL)

Note that all amounts in this section are based on regular LHHS appropriations only. Amounts in

this section do not include mandatory funds provided outside of the annual appropriations process

(e.g., direct appropriations for Unemployment Insurance benefits payments). All amounts in this

section are rounded to the nearest million or billion (as labeled). The dollar changes and

percentage changes discussed in the text are based on unrounded amounts. For consistency with

source materials, amounts do not reflect sequestration or reestimates of mandatory spending

programs, where applicable.

Congressional Research Service

14

Labor, Health and Human Services, and Education: FY2020 Appropriations

About DOL

DOL is a federal department comprised of multiple entities that provide services related to

employment and training, worker protection, income security, and contract enforcement. Annual

LHHS appropriations laws direct funding to all DOL entities (see the text box). 31 The DOL

entities fall primarily into two main functional areas—workforce development and worker

protection. First, there are several DOL

entities that administer workforce employment

DOL Entities Funded via the

and training programs—such as the Workforce

LHHS Appropriations Process

Innovation and Opportunity Act (WIOA) state Employment and Training Administration (ETA)

formula grant programs, Job Corps, and the

Employee Benefits Security Administration (EBSA)

Employment Service—that provide direct

Wage and Hour Division (WHD)

funding for employment activities or

Office of Federal Contract Compliance Programs

administration of income security programs

(OFCCP)

(e.g., for the Unemployment Insurance

Office of Labor-Management Standards (OLMS)

benefits program). Also included in this area is Office of Workers’ Compensation Programs (OWCP)

the Veterans’ Employment and Training

Occupational Safety and Health Administration (OSHA)

Service (VETS), which provides employment

Mine Safety and Health Administration (MSHA)

services specifically for the veteran

Bureau of Labor Statistics (BLS)

population. Second, there are several agencies

Office of Disability Employment Policy (ODEP)

that provide various worker protection

Departmental Management (DM) 30

services. For example, the Occupational

Safety and Health Administration (OSHA),

the Mine Safety and Health Administration (MSHA), and the Wage and Hour Division (WHD)

provide different types of regulation and oversight of working conditions. DOL entities focused

on worker protection provide services to ensure worker safety, adherence to wage and overtime

laws, and contract compliance, among other duties. In addition to these two main functional

areas, DOL’s Bureau of Labor Statistics (BLS) collects data and provides analysis on the labor

market and related labor issues.

FY2020 DOL Appropriations Overview

Table 3 generally displays FY2020 discretionary and mandatory DOL budget authority provided

or proposed, along with FY2019 enacted levels. The totals in this table do not include emergency

supplemental appropriations; amounts provided in supplementals are displayed separately at the

bottom of the table and are in addition to regular appropriations. For a discussion of the FY2020

supplemental appropriations displayed below the bill totals in Table 3, see Appendix C.

The FY2020 LHHS omnibus increased discretionary appropriations for DOL by $291 million

(+2.4%) compared to the FY2019 enacted levels. Discretionary DOL appropriations would have

increased by $1.2 billion (+9.9%) under the FY2020 House committee bill, compared to FY2019,

but would have decreased under the FY2020 President’s budget request by $1.2 billion (-10.0%).

Of the total funding provided in the bill for DOL, roughly 90% is discretionary.

30 Departmental Management includes the DOL salaries and expenses, Veterans Employment and T raining Service

(VET S), IT Modernization, and the Office of the Inspector General.

31 T he Pension Benefit Guaranty Corporation (PBGC) is funded primarily through insurance premiums and related fees

from companies covered by the PBGC.

Congressional Research Service

15

Labor, Health and Human Services, and Education: FY2020 Appropriations

Table 3. DOL Appropriations Overview

(Dollars in billions)

Funding

FY2019

Enacted

FY2020

Request

FY2020

House

Cmte.

(H.R. 2740)

FY2020

Enacted

(P.L.

116-94)

Discretionary

12.1

10.9

13.3

12.4

Mandatory

1.4

1.4

1.4

1.4

Total BA in the Bill

13.6

12.3

14.7

13.8

P.L. 116-20 (emergency)

0.1

—

—

—

P.L. 116-26 (emergency)

—

—

—

—

P.L. 116-113 (emergency)

—

—

—

0.2

P.L. 116-123 (emergency)

—

—

—

—

P.L. 116-127 (emergency)

—

—

—

—

P.L. 116-136 (emergency)

—

—

—

0.4

P.L. 116-139 (emergency)

—

—

—

—

Source: Amounts in this table for the FY2019 Enacted, FY2020 Request, and FY2020 Enacted columns are

generally drawn from or calculated based on data contained in the explanatory statement accompanying the

FY2020 LHHS omnibus (P.L. 116-94), available in the Congressional Record, vol. 165, no. 204, December 17, 2019,

pp. H11061-H11161. Amounts in the FY2020 House Committee column are generally drawn from or calculated

based on data contained in the committee report (H.Rept. 116-62) accompanying H.R. 2740. Enacted totals for

FY2019 do not include emergency-designated appropriations provided by P.L. 116-20 or P.L. 116-26. Enacted

totals for FY2020 do not include emergency-designated appropriations provided by P.L. 116-113, P.L. 116-123,

P.L. 116-127, P.L. 116-136, or P.L. 116-139. For consistency with source materials, amounts in this table generally

do not reflect mandatory spending sequestration, where applicable, nor do they reflect any transfers or

reprogramming of funds pursuant to executive authorities.

Notes: BA = Budget Authority. Details may not add to totals due to rounding. Amounts in this table (1) reflect

all BA appropriated in the bill, regardless of the year in which funds become available (i.e., totals do not include

advances from prior-year appropriations, but do include advances for subsequent years provided in this bill); (2)

have generally not been adjusted to reflect scorekeeping; (3) comprise only those funds provided (or requested)

for agencies and accounts subject to the jurisdiction of the LHHS subcommittees of the House and Senat e

appropriations committees; and (4) do not include appropriations that occur outside of appropriations bills.

Selected DOL Highlights

The following sections present highlights from FY2020 enacted and proposed appropriations

compared to FY2019 enacted appropriations for selected DOL accounts and programs.32

Table 4 displays funding for DOL programs and activities discussed in this section.

Employment and Training Administration (ETA)

ETA administers the primary federal workforce development law, the Workforce Innovation and

Opportunity Act (WIOA, P.L. 113-128). The WIOA, which replaced the Workforce Investment

Act, was signed into law in July 2014 and authorized appropriations for its programs through

FY2020. WIOA’s provisions went into effect in FY2015 and FY2016.

32 DOL budget materials can be found at https://www.dol.gov/general/aboutdol#budget.

Congressional Research Service

16

Labor, Health and Human Services, and Education: FY2020 Appropriations

Title I of WIOA, which authorizes more than half of all funding for the programs authorized by

the four titles of WIOA, includes three state formula grant programs serving Adults, Youth, and

Dislocated Workers. While the FY2020 LHHS omnibus provided a $30 million increase (+1.1%)

for the three WIOA state formula grant programs compared to FY2019, the President’s budget

would have provided level funding and the House committee bill would have increased funding

by $178 million (+6.4%), compared to FY2019 enacted levels.

The FY2020 LHHS omnibus provided $271 million for the Dislocated Workers Activities

National Reserve (DWA National Reserve), which was an increase of $50 million (+22.6%)

compared to the FY2019 enacted level. The FY2020 President’s budget would have reduced

funding for the DWA National Reserve by $86 million (-39.0%) but the House committee bill

would have increased DWA National Reserve funding by $150 million (+67.9%), compared to

the FY2019 enacted level. In addition, the FY2020 LHHS omnibus maintained a provision in that

account (which originated in the FY2018 omnibus and was included in the FY2019 omnibus)

directing $30 million from the DWA National Reserve toward training and employment

assistance for workers dislocated in both the Appalachian and lower Mississippi regions. Finally,

the FY2020 LHHS omnibus included a new provision directing $40 million from the DWA

National Reserve to be used in developing, offering, or improving career training programs at

community colleges.

The FY2020 LHHS omnibus provided $175 million for the Apprenticeship Grant program, which

is $15 million (+9.4%) more than the level enacted in FY2019. The FY2020 President’s budget

would have maintained the same level of funding for the Apprenticeship Grant program as the

FY2019 enacted level and the House committee bill would have increased funding by $90 million

(+56.3%) compared to the FY2019 enacted level.

Four ETA programs for which the FY2020 President’s budget proposed no funding—the Native

Americans program, the Migrant and Seasonal Farmworkers program, the Community Service

Employment for Older Americans (CSEOA) program, and the Workforce Data Quality

Initiative—received FY2020 appropriations at roughly the same level as FY2019.

Bureau of Labor Statistics (BLS)

The FY2020 LHHS omnibus provided $655 million for BLS, which was an increase of $40

million (+6.5%) from the FY2019 enacted level and the same amount requested in the FY2020

President’s budget but $21 million (-3.1%) less than the amount proposed in the House

committee bill. The FY2020 President’s budget indicates that the additional $40 million was

requested, and should remain available until September 30, 2024, for necessary costs associated

with the physical relocation of BLS headquarters to the Suitland Federal Complex. Similarly, the

FY2020 LHHS omnibus directed BLS to use $27 million for costs associated with this move. As

noted in the explanatory statement accompanying the FY2020 LHHS omnibus, the remainder of

the increase ($13 million) is to be used to support an annual supplement to the Current Population

Survey (CPS) to collect data on contingent workers every two years and other topics in the

alternate years, to restore the production of labor market data in the Local Area Unemployment

Statistics (LAUS) program for New England Minor Civil Divisions with populations less than

1,000, and to plan and develop a new National Longitudinal Survey of Youth (NLSY) c ohort. 33

33 Explanatory statement accompanying the FY2020 LHHS omnibus ( P.L. 116-94), available in the Congressional

Record, vol. 165, no. 204, December 17, 2019, pp. H11063.

Congressional Research Service

17

Labor, Health and Human Services, and Education: FY2020 Appropriations

Bureau of International Labor Affairs (ILAB)

The FY2020 LHHS omnibus provided $96 million for ILAB, which was an increase of $10

million (+11.6%) from the FY2019 enacted level. The House committee bill would have provided

$122 million for ILAB, an increase of $36 million (+41.8%) over the FY2019 enacted level. The

FY2020 President’s budget would have decreased funding by $68 million (-78.5%) for ILAB,

which provides research, advocacy, technical assistance, and grants to promote workers’ rights in

different parts of the world. Language in the FY2020 President’s budget indicated that the

proposed reduction reflected a $59.8 million decrease to eliminate new grants and a $7.8 million

decrease to reduce staff levels, with the remaining $19 million to be used on “efforts to make U.S.

trade agreements fair for U.S. workers by monitoring and enforcing the labor provisions of free

trade agreements (FTAs) and trade preference programs to ensure a fair global playing field for

U.S. workers and businesses.”34

Labor-Related General Provisions

Annual LHHS appropriations acts regularly contain general provisions related to certain labor

issues. This section highlights selected DOL general provisions in the FY2020 LHHS omnibus.

The FY2020 LHHS omnibus continued several provisions that have been included in at least one

previous LHHS appropriations act, including provisions that

exempt certain insurance claims adjusters from overtime protection for two years

following a “major disaster” (included since FY2016);35

direct the Secretary of Labor to accept private wage surveys as part of the process

of determining prevailing wages in the H-2B program, even in instances in which

relevant wage data are available from the Bureau of Labor Statistics (included

since FY2016);36

authorize the Secretary of Labor to provide up to $2 million in “excess personal

property” to apprenticeship programs to assist training apprentices (included

since FY2018);37

authorize the Secretary of Labor to employ law enforcement officers or special

agents to provide protection to the Secretary of Labor and certain other

employees and family members at public events and in situations in which there

is a “unique and articulable” threat of physical harm (included since FY2018); 38

and

authorize the Secretary of Labor to dispose of or divest “by any means the

Secretary determines appropriate” all or part of the real property on which the

Treasure Island Job Corps Center is located (included since FY2018). 39

34 See https://www.dol.gov/sites/dolgov/files/general/budget/2020/CBJ-2020-V3-02.pdf, DM-38.

35

See Division A, T itle I, §108 of P.L. 116-94.

36 See Division A, T itle I, §110 of P.L. 116-94. T he H-2B program allows for the temporary employment of foreign

workers in nonagricultural sectors and requires these workers to be paid the “prevailing wage” (i.e., the average wage

paid to similar workers in the local area). Under DOL regulations, private employer surveys may be considered only if

the employer meets certain conditions.

37 See Division A, T itle I, §112 of P.L. 116-94.

38 See Division A, T itle I, §113 of P.L. 116-94.

39 See Division A, T itle I, §114 of P.L. 116-94.

Congressional Research Service

18

Labor, Health and Human Services, and Education: FY2020 Appropriations

Table 4. Detailed DOL Appropriations

(Dollars in millions)

Agency or Selected Program

FY2019

Enacted

FY2020

Request

FY2020

House

Cmte.

(H.R.

2740)

FY2020

Enacted

(P.L. 11694)

ETA—Mandatory a

790

680

680

680

ETA—Discretionary

9,116

7,893

9,934

9,293

Training and Employment Services:

3,503

3,247

3,978

3,611

State Formula Grants:

2,790

2,790

2,967

2,820

Adult Activities Grants to States

846

846

900

855

Youth Activities Grants to States

903

903

964

913

1,041

1,041

1,103

1,052

713

458

1,010

791

DWA National Reserve

221

135

371

271

Native Americans

55

0

55

55

Migrant and Seasonal Farmworkers

89

0

99

92

YouthBuild

90

85

128

95

Reintegration of Ex-Offenders

93

78

100

98

Workforce Data Quality Initiative

6

0

8

6

160

160

250

175

1,719

1,016

1,869

1,744

400

0

464

405

3,336

3,476

3,466

3,375

2,528

2,663

2,630

2,553

Employment Service

683

683

702

690

Foreign Labor Certification

62

71

71

69

One-Stop Career Centers

63

59

63

63

ETA Program Administration

159

154

159

159

Employee Benefits Security Administration

181

194

183

181

Pension Benefit Guaranty Corp, (PBGC) program

level (non-add)b

(445)

(453)

(453)

(453)

Wage and Hour Division

229

233

298

242

Office of Labor-Management Standards

41

49

40

43

Office of Federal Contract Compliance

Programs

103

104

120

106

Discretionary ETA Programs:

Dislocated Worker Activities (DWA)

Grants to States

National Activities:

Apprenticeship Grants

Job Corps

Community Service Employment for Older Americans

State Unemployment Insurance and Employment

Service Operations (SUI/ESO):

Unemployment Compensation

Congressional Research Service

19

Labor, Health and Human Services, and Education: FY2020 Appropriations

Agency or Selected Program

FY2019

Enacted

FY2020

Request

FY2020

House

Cmte.

(H.R.

2740)

FY2020

Enacted

(P.L. 11694)

Office of Workers’ Compensation Programs—

Mandatory c

642

695

695

695

Office of Workers’ Compensation Programs—

Discretionary

118

118

121

118

Occupational Safety & Health Administration

558

558

661

582

Mine Safety & Health Administration

374

376

417

380

Bureau of Labor Statistics

615

655

676

655

Office of Disability Employment Policy

38

27

39

39

Departmental Management

751

700

832

776

Salaries and Expenses

338

267

383

348

86

19

122

96

Veterans Employment and Training

300

306

316

311

IT Modernization

23

37

37

25

Office of the Inspector General

89

90

96

91

Total, DOL BA in the Bill

13,555

12,280

14,696

13,789

Subtotal, Mandatory

1,432

1,375

1,375

1,375

Subtotal, Discretionary

12,123

10,905

13,322

12,414

P.L. 116-20 (emergency)

50

—

—

—

P.L. 116-26 (emergency)

—

—

—

—

P.L. 116-113 (emergency)

—

—

—

210

P.L. 116-123 (emergency)

—

—

—

—

P.L. 116-127 (emergency)

—

—

—

—

P.L. 116-136 (emergency)

—

—

—

360

P.L. 116-139 (emergency)

—

—

—

—

Total, BA Available in Fiscal Year (current year from

any bill)

13,556

12,366

14,696

13,789

Total, BA Advances for Future Years (provided in

current bill)

1,786

1,700

1,786

1,786

Total, BA Advances from Prior Years (for use in

current year)

1,787

1,786

1,786

1,786

International Labor Affairs (non-addd)

Memoranda (non-emergency funds only)

Source: Amounts in this table for the FY2019 Enacted, FY2020 Request, and FY2020 Enacted columns are

generally drawn from or calculated based on data contained in the explanatory statement accompanying the

FY2020 LHHS omnibus (P.L. 116-94), available in the Congressional Record, vol. 165, no. 204, December 17, 2019,

pp. H11061-H11161. Amounts in the FY2020 House Committee column are generally drawn from or calculated

based on data contained in the committee report (H.Rept. 116-62) accompanying H.R. 2740. Enacted totals for

FY2019 do not include emergency-designated appropriations provided by P.L. 116-20 or P.L. 116-26. Enacted

totals for FY2020 do not include emergency-designated appropriations provided by P.L. 116-113, P.L. 116-123,

Congressional Research Service

20

Labor, Health and Human Services, and Education: FY2020 Appropriations

P.L. 116-127, P.L. 116-136, or P.L. 116-139. For consistency with source materials, amounts in this table generally

do not reflect mandatory spending sequestration, where applicable, nor do they reflect any transfers or

reprogramming of funds pursuant to executive authorities.

Notes: BA = Budget Authority. Details may not add to totals due to rounding. Amounts in this table (1) reflect

all BA appropriated in the bill, regardless of the year in which funds become available (i.e., totals do not include

advances from prior-year appropriations, but do include advances for subsequent years provided in this bill); (2)

have generally not been adjusted to reflect scorekeeping; (3) comprise only those funds provided (or requested)

for agencies and accounts subject to the jurisdiction of the LHHS subcommittees of the House and Senate

appropriations committees; and (4) do not include appropriations that occur outside of appropriations bills.

a.

b.

Mandatory funding within ETA goes to Federal Unemployment Benefits and Allowances (FUBA) and

Advances to the Unemployment Trust Fund (UTF), if any. FUBA funds Trade Adjustment Assistance for

Workers (TAA).

PBGC funding is provided outside the LHHS Appropriations Act.

c.

Mandatory programs in the Office of Workers’ Compensation Programs include Special Benefits

(comprising the Federal Employees’ Compensation Benefits and the Longshore and Harbor Workers’

Benefits), Special Benefits for Disabled Coal Miners, Energy Employees Occupational Illness Compensation

(Administrative Expenses), and the Black Lung Disability Trust Fund.

d.

The funding for International Labor Affairs is included in the Salaries and E xpenses total.

Department of Health and Human Services (HHS)

Note that all amounts in this section are based on regular LHHS appropriations only; they do not

include funds for HHS agencies provided through other appropriations bills (e.g., funding for the

Food and Drug Administration) or outside of the annual appropriations process (e.g., direct

appropriations for Medicare or mandatory funds provided by authorizing laws, such as the Patient

Protection and Affordable Care Act [ACA, P.L. 111-148]). 40 All amounts in this section are

rounded to the nearest million or billion (as labeled). The dollar changes and percentage changes

discussed in the text are based on unrounded amounts. For consistency with source materials,

amounts do not reflect sequestration or re-estimates of mandatory spending programs, where

applicable.

About HHS

HHS is a large federal department composed

of multiple agencies working to enhance the

health and well-being of Americans. Annual

LHHS appropriations laws direct funding to

most (but not all) HHS agencies (see text box

for HHS agencies supported by the LHHS

bill). 41 For instance, the LHHS bill directs

funding to five Public Health Service (PHS)

agencies: the Health Resources and Services

Administration (HRSA), Centers for Disease

HHS Agencies Funded via the

LHHS Appropriations Process

Health Resources and Services Administration (HRSA)

Centers for Disease Control and Prevention (CDC)

National Institutes of Health (NIH)

Substance Abuse and Mental Health Services

Administration (SAMHSA)

Agency for Healthcare Research and Quality (AHRQ)

Centers for Medicare & Medicaid Services (CMS)

Administration for Children and Families (ACF)

Administration for Community Living (ACL)

Office of the Secretary (OS)

40 T he ACA was subsequently amended by the Health Care and Education Reconciliation Act ( P.L. 111-152). These

two laws are collectively referred to as the ACA in this report. (Previous CRS reports on the Patient Protection and

Affordable Care Act used the acronym PPACA to refer to the statute, but newer reports will use “ACA,” in

conformance with the more widely used acronym for the law.) For information on funding directly appropriated by the

ACA, see the tables in CRS Report R41301, Appropriations and Fund Transfers in the Affordable Care Act (ACA).

41 T hree HHS public health agencies receive annual funding from appropriations bills other than the LHHS bill: the

Congressional Research Service

21

Labor, Health and Human Services, and Education: FY2020 Appropriations

Control and Prevention (CDC), National Institutes of Health (NIH), Substance Abuse and Mental

Health Services Administration (SAMHSA), and Agency for Healthcare Research and Quality

(AHRQ). 42 These public health agencies support diverse missions, ranging from the provision of

health care services and supports (e.g., HRSA, SAMHSA), to the advancement of health care

quality and medical research (e.g., AHRQ, NIH), to the prevention and control of infectious and

chronic diseases (e.g., CDC). In addition, the LHHS bill provides funding for annually

appropriated components of CMS, 43 which is the HHS agency responsible for the administration

of Medicare, Medicaid, the State Children’s Health Insurance Program (CHIP), and consumer

protections and private health insurance provisions of the ACA.

The LHHS bill also provides funding for two HHS agencies focused primarily on the provision of

social services: the Administration for Children and Families (ACF) and the Administration for

Community Living (ACL). ACF’s mission is to promote the economic and social well-being of

vulnerable children, youth, families, and communities. ACL was formed with a goal of increasing

access to community supports for older Americans and people with disabilities. 44 The LHHS bill

also provides funding for the HHS Office of the Secretary (OS), which encompasses a broad

array of management, research, oversight, and emergency preparedness functions in support of

the entire department.

FY2020 HHS Appropriations Overview

Table 5 displays enacted and proposed FY2020 funding levels for HHS, along with FY2019

levels. Note that the totals in this table do not include emergency supplemental appropriations;

amounts provided in supplementals are displayed separately at the bottom of the table and are in

addition to regular appropriations. For a discussion of the FY2020 supplemental appropriations

displayed below the bill totals in Table 5, see Appendix C.

In general, discretionary funds account for about 10% of HHS appropriations in the LHHS bill.

Compared to the FY2019 funding levels, the FY2020 LHHS omnibus increased HHS

discretionary appropriations by 4.9%. The House committee bill would have increased HHS

discretionary appropriations to a greater degree, by 9.8%, while the President requested a 13.7%

decrease in discretionary HHS funding.

Food and Drug Administration (funded through the Agriculture appropriations bill), the Indian Health Service (funded

through the Interior-Environment appropriations bill), and the Agency for T oxic Substances and Disease Registry

(funded through the Interior-Environment appropriations bill). In addition, while the National Institutes of Health

(NIH) receive the majority of their appropriations fro m the LHHS bill, one NIH institute (the National Institute of

Environmental Health Sciences) receives appropriations from two bills: LHHS and the Interior -Environment bill.

42

For more information on HHS PHS agencies, see CRS Report R44916, Public Health Service Agencies: Overview

and Funding (FY2016-FY2018).

43

Much of the funding for CMS activities is provided through mandatory appropriations in authorizing legislation, and

thus is not subject to the annual appropriations process.

44

ACL was established in 2012 by consolidating the Administration on Aging, the Office of Disability, and the

Administration on Developmental Disabilities (renamed the Administration on Intellectual and Developmental

Disabilities) into one agency. See the HHS Secretary’s press release from April 16, 2012: http://www.hhs.gov/news/

press/2012pres/04/20120416a.html. For more information on the ACL, see http://www.hhs.gov/acl/.

Congressional Research Service

22

Labor, Health and Human Services, and Education: FY2020 Appropriations

Table 5. HHS Appropriations Overview

(Dollars in billions)

FY2019

Enacted

FY2020

Request

FY2020

House Cmte.

(H.R. 2740)

FY2020

Enacted (P.L.

116-94)

Discretionary

90.5

78.1

99.4

94.9

Mandatory

808.7

838.0

840.0

839.9

Total BA in the Bill

899.2

916.1

939.3

934.8

P.L. 116-20 (emergency)

0.3

—

—

—

P.L. 116-26 (emergency)

2.9

—

—

—

P.L. 116-113 (emergency)

—

—

—

—

P.L. 116-123 (emergency)

—

—

—

6.4

P.L. 116-127 (emergency)

—

—

—

1.3

P.L. 116-136 (emergency)

—

—

—

140.4

P.L. 116-139 (emergency)

—

—

—

100

Funding

Source: Amounts in this table for the FY2019 Enacted, FY2020 Request, and FY2020 Enacted columns are

generally drawn from or calculated based on data contained in the explanatory statement accompanying the

FY2020 LHHS omnibus (P.L. 116-94), available in the Congressional Record, vol. 165, no. 204, December 17, 2019,

pp. H11061-H11161. Amounts in the FY2020 House Committee column are generally drawn from or calculated

based on data contained in the committee report (H.Rept. 116-62) accompanying H.R. 2740. Enacted totals for

FY2019 do not include emergency-designated appropriations provided by P.L. 116-20 or P.L. 116-26. Enacted

totals for FY2020 do not include emergency-designated appropriations provided by P.L. 116-113, P.L. 116-123,

P.L. 116-127, P.L. 116-136, or P.L. 116-139. For consistency with source materials, amounts in this table generally

do not reflect mandatory spending sequestration, where applicable, nor do they generally reflect transfers or

reprogramming of funds pursuant to executive authorities. CRS calculations do, however, include LHHS funding

provided to HHS pursuant to the 21 st Century Cures Act (P.L. 114-255).

Notes: BA = Budget Authority. Details may not add to totals due to rounding. Amounts in this table (1) reflect

all BA appropriated in the bill, regardless of the year in which funds become available (i.e., totals do not include

advances from prior-year appropriations, but do include advances for subsequent years provided in this bill); (2)

have generally not been adjusted to reflect scorekeeping; (3) comprise only those funds provided (or requested)

for agencies and accounts subject to the jurisdiction of the LHHS subcommittees of the House and Senate

appropriations committees; and (4) do not include appropriations that occur outside of appropriations bills.

Figure 3 provides an HHS agency-level breakdown of FY2020 enacted appropriations. As this

figure demonstrates, annual HHS appropriations are dominated by mandatory funding, the

majority of which goes to CMS to provide Medicaid benefits and payments to health care trust

funds. When taking into account both mandatory and discretionary funding, CMS accounts for

$828.3 billion, which is 88.6% of all enacted appropriations for HHS. NIH and ACF account for

the next-largest shares of total HHS appropriations, receiving about 4.3% and 4.2% apiece.

By contrast, when looking exclusively at discretionary appropriations, funding for CMS

constitutes about 4.7% of FY2020 enacted HHS appropriations. Instead, the bulk of discretionary

appropriations went to the PHS agencies, which account for 63.4% of discretionary

appropriations provided for HHS. 45 NIH typically receives the largest share of all discretionary

45 For further information about PHS agency funding, see CRS Report R44916, Public Health Service Agencies:

Overview and Funding (FY2016-FY2018).

Congressional Research Service

23

Labor, Health and Human Services, and Education: FY2020 Appropriations

funding among HHS agencies (42.2% in FY2020), with ACF accounting for the second-largest

share (25.8% in FY2020).

Figure 3. FY2020 Enacted HHS Appropriations by Agency

Source: Amounts in this figure are generally drawn from or calculated based on data contained in the

explanatory statement accompanying the FY2020 LHHS omnibus (P.L. 116-94), available in the Congressional

Record, vol. 165, no. 204, December 17, 2019, pp. H11061 -H11161. Enacted totals for FY2020 do not include

emergency-designated appropriations provided by P.L. 116-113, P.L. 116-123, P.L. 116-127, P.L. 116-136, or P.L.

116-139. For consistency with source materials, amounts in this figure generally do not reflect mandatory

spending sequestration, where applicable, nor do they generally reflect transfers or reprogramming of funds

pursuant to executive authorities.

Notes: Details may not add to totals due to rounding. The bar representing the combined mandatory and

discretionary total for CMS has been abbreviated due to space constraints. When taking into account both

mandatory and discretionary funding, CMS receives over 20 times the funding appropriated to either ACF or

NIH in the FY2019 LHHS omnibus. Amounts in this table (1) reflect all BA appropriated in the bill, regardless of

the year in which funds become available (i.e., totals do not include advances from prior-year appropriations, but

do include advances for subsequent years provided in this bill); (2) have generally not been adjusted to reflect

scorekeeping; (3) comprise only those funds provided (or requested) for agencies and accounts subject to the

jurisdiction of the LHHS subcommittees of the House and Senate appropriations committees; and (4) do not

include appropriations that occur outside of appropriations bills.

Special Public Health Funding Mechanisms

Annual appropriations for HHS public health service agencies are best understood in the context

of certain HHS-specific funding mechanisms: the Public Health Service Evaluation Set-Aside,

and the Prevention and Public Health Fund (PPHF). In recent years, LHHS appropriations have

used these funding mechanisms to direct additional support to certain programs and activities.

Public Health Service Evaluation Tap

The PHS Evaluation Set-Aside, also known as the PHS Evaluation Tap, is a unique feature of

HHS appropriations. It is authorized by Section 241 of the Public Health Service Act (PHSA),

and allows the Secretary of HHS, with the approval of appropriators, to redistribute a portion of

eligible PHS agency appropriations across HHS for program evaluation purposes.

Congressional Research Service

24

Labor, Health and Human Services, and Education: FY2020 Appropriations

The PHSA limits the set-aside to not less than 0.2% and not more than 1% of eligible program

appropriations. However, LHHS appropriations acts have commonly established a higher

maximum percentage for the set-aside and have distributed specific amounts of “tap” funding to

selected HHS programs. Since FY2010, and including in FY2020, this higher maximum set-aside

level has been 2.5% of eligible appropriations. 46 (While the House committee bill would also

have maintained the set-aside at 2.5%, the President’s budget proposed to increase the set-aside to

2.9%.)

Display of Evaluation Tap Transfers

Before FY2015, the PHS tap traditionally

provided more than a dozen HHS programs

By convention, tables in this report show only the

amount of PHS Evaluation Tap funds received by an

with funding beyond their annual

agency (i.e., tables do not subtract the amount of the

appropriations and, in some cases, was the

evaluation tap from donor agencies’ appropriations).

sole source of funding for a program or

That is to say, tap amounts shown in the following

activity. However, since FY2015 and

tables are in addition to amounts shown for budget

including in FY2020, LHHS appropriations

authority, but the amounts shown for budget authority

have not been adjusted to reflect potential “transferlaws have directed tap funds to a smaller

out” of funds to the tap.

number of programs or activities within three

HHS agencies (NIH, SAMHSA, and OS) and

have not provided any tap transfers to AHRQ, CDC, and HRSA. This has been particularly

notable for AHRQ, which had been funded primarily through tap transfers from FY2003 to

FY2014, but has received discretionary appropriations since then. 47 The House committee bill

generally would have maintained the current distributional practice for FY2020, except that it

would have also provided tap funding to AHRQ. The President’s budget proposed to expand the

activities and agencies funded by the PHS tap to include the Public Health Scientific Services at

the CDC, while simultaneously proposing to reduce or eliminate tap transfers to some other

activities.

Since FY2015, LHHS appropriations laws have directed the largest share of tap transfers to

NIH. 48 The FY2020 LHHS omnibus provided $1.2 billion in tap transfers to NIH, an $84 million

(+7.3%) increase over the FY2019 level. The FY2020 House committee bill proposed that the

NIH transfers be continued at FY2019 levels ($1.1 billion), whereas the President’s request

proposed that the transfer be reduced by $406 million (-35.4%).

46 See Section 204, Division B, P.L. 116-94 for the FY2020 maximum set -aside level. T he last time that an

appropriations act set the PHS tap percentage at a level other than 2.5% was in FY2009, when it was 2.4% (see P.L.

111-8). T he FY2020 omnibus also retained a change to this provision, first included in the FY2014 omnibus, allowing

tap transfers to be used for the “evaluation and the implementation” of programs funded in the HHS title of the LHHS

appropriations act. Prior to FY2014, such provisions had restricted tap funds to the “evaluation of the implementation”

of programs authorized under the Public Health Service Act.

47 Until FY2015, AHRQ had not received a discretionary appropriation in an annual appropriations act in more than a

decade. FY2009 was the exception to this general pattern, as AHRQ received a supplemental appropriat ion from the

American Recovery and Reinvestment Act that year. In recent years, AHRQ has also received some transfers from the

Prevention and Public Health Fund and the Patient -Centered Outcomes Research T rust Fund, though these transfers

were generally much smaller than the transfers AHRQ received from the tap. For more information, see CRS Report

R44136, The Agency for Healthcare Research and Quality (AHRQ) Budget: Fact Sheet.

48

Prior to FY2015, NIH had traditionally been by far the largest net donor of tap funds, rather than a net recipient. T he

joint explanatory statement accompanying the FY2015 omnibus explained this shift as being intended to ensure that tap

transfers are a “net benefit to NIH rather than a liability” and noted that this change was in response to a growing

concern at the loss of NIH funds to the tap. Joint Explanatory Statement, Proceedings and Debates of the 113 th

Congress, Second Session, Congressional Record, vol. 160, no. 151, Book II, December 11, 2014, p. H9832.

Congressional Research Service

25

Labor, Health and Human Services, and Education: FY2020 Appropriations

Prevention and Public Health Fund

Display of PPHF Transfers

PPHF transfer amounts displayed in the HHS tables in

this report are in addition to amounts shown for

budget authority provided in the bill. For consistency

with source materials, the amounts shown for PPHF

transfers in these tables reflect the estimated effects of

mandatory spending sequestration; this is not the case

for other mandatory spending shown in this report

(also for consistency with source materials).

The ACA both authorized and appropriated

mandatory funding to three funds to support

programs and activities within the PHS

agencies. 49 One of these, the Prevention and

Public Health Fund (PPHF, ACA §4002, as

amended), was given a permanent, annual

appropriation that was intended to provide

support each year to prevention, wellness, and

related public health programs funded through HHS accounts.

The ACA had appropriated $2 billion in mandatory funds to the PPHF for FY2020, but this

amount was reduced by subsequent laws that decreased PPHF funding for FY2020 and other

fiscal years. Under current law, the FY2020 appropriation was $950 million. 50 In addition, this

appropriation was subject to a 5.9% reduction due to sequestration of nonexempt mandatory

spending. (For more information on sequestration, see the budget enforcement discussion in

Appendix A.) After sequestration, the total PPHF appropriation available for FY2020 was $894

million, an increase of $50 million relative to FY2019. Of this amount, the LHHS omnibus

allocated $854 million to CDC, $12 million to SAMHSA, and $28 million to ACL. 51

PPHF funds are intended to supplement (sometimes quite substantially) the funding that selected

programs receive through regular appropriations. Although the PPHF authority instructs the HHS

Secretary to transfer amounts from the fund to HHS agencies, since FY2014 provisions in annual

appropriations acts and accompanying reports have explicitly directed the distribution of PPHF

funds and prohibited the Secretary from making further transfers for those years. 52

CDC commonly receives the largest share of annual PPHF funds. The amount provided to CDC

for FY2020 and proposed by the House committee bill, $854 million, was a $50 million (+6.2%)

increase relative to FY2019. The President’s request proposed increasing the PPHF funding

transferred to CDC to $894 million (+11.1%).

Selected HHS Highlights by Agency

This section begins with a limited selection of FY2020 discretionary funding highlights by HHS

agency. The discussion is largely based on the enacted and proposed appropriations levels for

FY2020, compared to FY2019 enacted levels. 53 These summaries are followed by a brief

overview of significant provisions from annual HHS appropriations laws that restrict spending in

certain controversial areas, such as abortion and stem cell research. The section concludes with

two tables (Table 6 and Table 7) presenting more detailed information on FY2019 enacted and

FY2020 proposed and enacted funding levels for HHS.

49 For more information, see CRS Report R41301, Appropriations and Fund Transfers in the Affordable Care Act

(ACA).

50 42 U.S.C. 300u-11.

51 See explanatory statement accompanying the FY2020 LHHS omnibus (P.L. 116-94), available in the Congressional

Record, vol. 165, no. 204, December 17, 2019, p. H11080, for allocations to specific agency programs and activities.

52 See Division A, §222, P.L. 116-94.

53 HHS budget

materials can be found at http://www.hhs.gov/budget/.

Congressional Research Service

26

Labor, Health and Human Services, and Education: FY2020 Appropriations

HRSA

The FY2020 LHHS omnibus provided $7.0 billion in discretionary budget authority for HRSA.

This was $195 million (+2.8%) more than HRSA’s FY2019 discretionary funding level and $1.2

billion (+20.4%) more than the FY2020 President’s budget request.

The explanatory statement accompanying the FY2020 LHHS omnibus provided $50 million for

the first year of an initiative to reduce HIV transmission under the Primary Health Care account.

These funds are to be used to increase the use of pre-exposure prophylaxis (PrEP) among high

risk groups. 54 Under the Ryan White HIV/AIDS Program appropriation, there is an additional $70

million set aside for the HIV initiative, to be used in high-need jurisdictions to increasing viral

suppression among people with HIV. The explanatory statement also allocates within the Rural

Health account $6 million to be used to develop best practices for HIV treatment through

telehealth. 55

From amounts appropriated to the Health Workforce account, the explanatory statement directed

$102 million (+36%) toward Behavioral Health Workforce Education and Training (BHWET).

Within this amount, the explanatory statement allocated no less than $26.7 million to establish the

Mental and Substance Use Disorder Workforce Training Demonstration, 56 no less than $10

million for experiential training for peer support specialists, 57 and no less than $12 million to

establish the Loan Repayment Program for Substance Use Disorder Treatment Workforce.58

CDC

The FY2020 LHHS omnibus provided $6.8 billion in discretionary budget authority for CDC,

which was $362 million (+5.6%) more than CDC’s FY2019 funding level. The FY2020 LHHS

omnibus did not direct any PHS tap funds to the CDC, continuing the practice started in FY2015.

However, the FY2020 LHHS omnibus did supplement discretionary CDC appropriations with

transfers from two additional sources. First, the FY2020 LHHS omnibus directed $854 million in

PPHF transfers to the CDC, which was $50 million (+6.2%) more than FY2019. 59 Second, the

FY2020 LHHS omnibus directed $225 million from the HHS Nonrecurring Expenses Fund

(NEF)60 to the CDC Buildings and Facilities account to support infrastructure improvements for

the CDC’s Chamblee Campus. 61 Funds transferred into the NEF are generally available to the

54 Congressional Record, December 17, 2019, Vol. 165, No. 204, Book III, p. H11063.

55

Ibid., p. H11064.

56 Authorized under Section 9022 of the 21 st Century Cures Act (P.L. 114-255) and described in Congressional Record,

vol. 165, no. 204, December 17, 2019, p. H11064. See also H.Rept. 116-62, p. 45.

57 As described in Congressional Record, vol. 165, no. 204, December 17, 2019, p. H11064. See also H.Rept. 116-62,

p. 45.

58 Authorized under Section 7071 of the SUPPORT for Patients and Communities Act ( P.L. 115-271) and described in

Congressional Record, vol. 165, no. 204, December 17, 2019, p. H11064. See also H.Rept. 116-62, p. 45.

59 Congressional Record, December 17, 2019, Vol. 165, No. 204, Book III, p. H11065.

60 T he NEF was established by the Consolidated Appropriations Act of 2008 to enable the HHS Secretary to repurpose

certain unobligated balances of expired discretionary funds appropriated to HHS from the General Fund ( P.L. 110-161,

Division G, T itle II, §223). Most accounts in annual appropriations measures receive appropriations from the General

Fund at the U.S. T reasury. T his term refers to all federal money not allocated by law to any other fund account, such as

federal trust funds for Medicare.

61 See Division A, T itle II, §238 of P.L. 116-94. T he $225 million NEF transfer to the CDC Buildings

and Facilities

account was for one-time projects for the CDC’s Chamblee Campus, such as real property, equipment, construction,

demolition, installation, renovation of facilities, and related infrastructure improvements. T he FY2020 LHHS omnibus

separately appropriated $25 million to the CDC Buildings and Facilities account, but did not explicitly direct any of

Congressional Research Service

27

Labor, Health and Human Services, and Education: FY2020 Appropriations

Secretary for capital acquisitions across HHS, including facilities infrastructure and information

technology. Until recently, it has not been common for LHHS appropriations acts to specify that

particular projects are to be funded by the NEF, but there have been a few such cases since

FY2017. 62 All told, this combination of funding represented an increase of $637 million (+8.7%)

from FY2019.

The President’s budget request would have decreased discretionary budget authority by $1.6

billion (-31.2%) relative to FY2019, while requesting that $423 million in tap funds be directed to

the CDC. The President’s budget also requested $894 million in PPHF transfers, which would

have been an $89 million (+11.1%) increase. However, the President’s budget did not request that

any transfers from the NEF be directed to the CDC. All told, this combination of funding would

have represented a decrease of $751 million (-10.2%) from FY2019.

Most programmatic accounts, except Immunization and Respiratory Diseases and Public Health

Preparedness and Response, received increases relative to FY2019. Notable increases were

provided for (1) the HIV/AIDS, Viral Hepatitis, Sexually Transmitted Diseases (STDs), and

Tuberculosis Prevention account, which was funded at an increased level of $1.274 billion

(+13.2% above FY2019), including funding for a new initiative to prevent new HIV infections

($140 million), 63 and (2) the Public Health and Scientific Services account, funded at $555

million (+10.1%), which contained a new initiative on public health data modernization ($50

million). 64 The explanatory statement contained a number of new activities under the Injury

Prevention and Control account, which was funded at $677 million (+4.4%), including funding

for child sexual abuse prevention ($1 million), suicide prevention ($10 million), and adverse

childhood experiences ($4 million). It also included specific funding for a new Firearm Injury and

Mortality Prevention Research program ($12.5 million). 65

NIH

The FY2020 LHHS omnibus provided $40.2 billion in discretionary budget authority for NIH.

This was $2.3 billion (+6.0%) more than FY2019 and $6.8 billion (+20.4%) more than the

President’s FY2020 budget request. The FY2020 LHHS omnibus also directed $225 million from

the HHS Nonrecurring Expenses Fund (NEF) 66 to the NIH Buildings and Facilities account to

implement the recommendations in the 2019 National Academies of Sciences, Engineering, and

these appropriations to the Chamblee project. T he $25 million appropriation to this account represents a $5 million

decrease from FY2019 (-17%), when excluding the NEF funds reserved for the Chamblee project.

62 For instance, a continuing resolution for FY2017 (P.L. 114-254) authorized HHS to transfer up to $300 million (if

certain conditions were met) from the NEF to the HHS Refugee and Entrant Assistance program dedicated to

unaccompanied alien children. For more information, see CRS Report R44723, Overview of Further Continuing

Appropriations for FY2017 (H.R. 2028). In addition, the FY2018 omnibus provision directing $240 million in NEF

funds to the construction of a new CDC laboratory. T he explanatory statement identifies several other priorities for

NEF projects (Congressional Record, March 22, 2018, Vol. 164, No. 50, Book III, p. H2705.)

63 Congressional Record, December 17, 2019, Vol. 165, No. 204, Book III, p. H11065.

64

Ibid, p. H11066. T he explanatory statement notes that these funds are intended to support the initiative as outlined in

an early committee report. For those details, see pp. 71 -72 in H.Rept. 116-62.

65

Ibid, p. H11067. When taking account of the $12.5 million in NIH funding that was reserved for the same purpose,

the total provided for Firearm Injury and Mortality Prevention Research was $25 million.

66

T he NEF was established by the Consolidated Appropriations Act of 2008 to enable the HHS Secretary to repurpose

certain unobligated balances of expired discretionary funds appropriated to HHS from the General Fund ( P.L. 110-161,

Division G, T itle II, §223). Most accounts in annual appropriations measures receive appropriations from the General

Fund at the U.S. T reasury. T his term refers to all federal money not allocated by law to any other fund account, such as

federal trust funds for Medicare.

Congressional Research Service

28

Labor, Health and Human Services, and Education: FY2020 Appropriations

Medicine report Managing the NIH Bethesda Campus’ Capital Assets in a Highly Competitive

Global Biomedical Research Environment. 67 In addition, the FY2020 LHHS omnibus directed

$1.2 billion in PHS tap transfers to NIH, an increase of $84 million (+7.3%) from FY2019. The

entirety of the PHS tap transfer was provided to the National Institute of General Medical

Sciences (NIGMS), and was paired with a discretionary appropriation of $1.7 billion. The

NIGMS discretionary appropriation was $20 million (-1.1%) less than FY2019, but when

combined with the tap transfer, total funding for NIGMS increased by $64 million (+2.2%) from

FY2019.

In line with recent practice, the explanatory statement on the FY2020 LHHS omnibus directed

NIH to reserve a specific dollar amount for a number of purposes, for example, $2.82 billion for

Alzheimer’s disease research, referring to it as an increase of $350 million from FY2019. 68 It also

included a new reservation of funds for Firearm Injury and Mortality Prevention Research ($12.5

million). 69 Reserving a specific dollar amount for a particular disease or area of research at NIH is

a relatively new practice and constitutes a significant departure from past precedent. 70

The FY2020 LHHS omnibus appropriated $492 million to the NIH Innovation Account pursuant

to the 21st Century Cures Act (Cures Act; P.L. 114-255), which was equal to the amount

authorized to be appropriated in that act. The explanatory statement also reiterated the purposes

authorized in the Cures Act, directing that NIH transfer $195 million to the National Cancer

Institute to support cancer research, and $70 million each to the National Institute of Neurological

Disorders and Stroke and the National Institute of Mental Health to support the Brain Research

through Advancing Innovative Neurotechnologies (BRAIN) Initiative. The remaining $157

million was divided between the Precision Medicine Initiative ($149 million) and regenerative

medicine research ($8 million). 71

SAMHSA

The FY2020 LHHS omnibus provided $5.7 billion in discretionary budget authority for

SAMHSA. This amount was $140 million (+2.5%) more than SAMHSA’s FY2019 funding level

and $202 million (+3.6%) more than the President’s FY2020 budget request. The FY2020 LHHS

omnibus also directed $134 million in PHS evaluation tap funding and $12 million in PPHF

funding to SAMHSA, which was the same amount as FY2019.

67 See Division A, T itle II, §237 of P.L. 116-94. For further details, see Congressional Record, December 17, 2019,

Vol. 165, No. 204, Book III, p. H11074.

68 Ibid., p. H11070. For a list of specified funding levels in the explanatory statement accompanying the LHHS

omnibus, see T able A-2 in CRS Report R43341, National Institutes of Health (NIH) Funding: FY1995-FY2021.

69 Ibid., p. H11072. When taking account of the $12.5 million in CDC funding that was reserved for the same purpose,

the total provided for Firearm Injury and Mortality Prevention Research was $25 million.

70 As recently as December 2014, the explanatory statement on the FY2015 omnibus stipulated, “In keeping with

longstanding practice, the agreement does not recommend a specific amount of NIH funding for this purpose

[Alzheimer’s disease] or for any other individual disease. Doing so would establish a dangerous precedent that could

politicize the NIH peer review system. Nevertheless, in recognition that Alzheimer’s disease poses a serious threat to

the Nation’s long-term health and economic stability, the agreement expects that a significant portion of the

recommended increase for NIA should be directed to research on Alzheimer’s. T he exact amount should be determined

by scientific opportunity of additional research on this disease and the quality of grant applications that are submitted

for Alzheimer’s relative to those submitted for other diseases.” See Congressional Record, daily edition, vol. 160, no.

151, Book II (December 11, 2014), p. H9832.

71 Congressional Record, December 17, 2019, Vol. 165, No. 204, Bo ok III, p. H11068.

Congressional Research Service

29

Labor, Health and Human Services, and Education: FY2020 Appropriations

The FY2020 LHHS omnibus included an increase of $50 million (+33.3%) from FY2019 for

Certified Community Behavioral Health Centers. Under the explanatory statement accompanying

the FY2020 LHHS omnibus, funding for Mental Health Programs of Regional and National

Significance (PRNS) received an increase of $65 million (+16.9%) and Substance Abuse

Treatment PRNS received an increase of $19 million (+4.1%) from FY2019. 72 Some of the

increases in PRNS funding are for programs created by the SUPPORT Act (P.L. 115-271), such as

Comprehensive Opioid Recovery Centers ($2 million), Emergency Department Alternatives to

Opioids ($5 million), Peer Support Technical Assistance Center ($1 million), and Treatment,

Recovery, and Workforce Support ($4 million). 73 The State Opioid Response Program continued

to be funded at $1.5 billion, the same amount as FY2019.

AHRQ

The FY2020 LHHS omnibus provided $338 million in discretionary budget authority to AHRQ.

This was the same as the FY2019 level. The FY2020 LHHS omnibus did not direct any PHS tap

transfers to AHRQ, which is in keeping with practices since FY2015 but contrasts with earlier

years (FY2003-FY2014) in which AHRQ had been funded primarily with tap transfers.74 (The

House committee bill proposed $18 million in tap transfers for AHRQ, but this proposal was not

enacted.) The FY2020 LHHS omnibus continued to fund AHRQ as its own operating division,

declining the President’s proposal to consolidate AHRQ into NIH. The FY2020 President’s

budget had requested zero funding for AHRQ, proposing instead to continue funding many of

AHRQ’s activities through a new National Institute for Research on Safety and Quality (NIRSQ)

in the NIH. 75

CMS

The FY2020 LHHS omnibus provided $4.5 billion in discretionary budget authority for CMS.

This was $21 million (+0.5%) more than FY2019 and $84 million (+1.9%) more than the FY2019

President’s budget request. The LHHS omnibus appropriated $786 million for the CMS Health

Care Fraud and Abuse Control (HCFAC) account, 2.7% more than FY2019, and slightly less (0.8%) than the FY2020 President’s request. Of the total amount appropriated for HCFAC, $475

million was effectively exempt from the discretionary budget caps. (See Appendix A for an

explanation of the LHHS budget cap exemptions.)

72 As described in the explanatory statement accompanying the LHHS omnibus ( Congressional Record, vol. 165, no.

204, December 17, 2019, pp. H11074-H11075, and pp. H11116-H11117).

73 Ibid., p. H11075.

74 In addition to funds provided through the annual appropriations process, AHRQ is also scheduled in FY2020 to

receive a transfer of certain mandatory funds that were authorized and appropriated to the Patient-Centered Outcomes

Research T rust Fund (PCORT F) by ACA Section 6301(e), as amended (26 U.S.C. §9511). T ransfers to AHRQ from

the PCORT F are to be used to disseminate the results of patient -centered outcomes research. (PCORT F funds are

generally not displayed in this report, as they are not provided by or modified through annual LHHS appropr iations

bills.) For more information on the PCORT F, see CRS Insight IN11010, Funding for ACA-Established PatientCentered Outcomes Research Trust Fund (PCORTF) Extended Through FY2029 .

75 HHS, NIH, National Institute for Research on Safety and Quality, FY2020 Congressional Justification,

https://www.ahrq.gov/sites/default/files/wysiwyg/cpi/abo ut/mission/budget/2020/FY_2020_CJ_-NIRSQ.pdf. T he

President’s request would have funded NIRSQ at $256 million for FY2020 (not counting transfers from the PCORT F).

A similar proposal was made in the President’s FY2019 and FY2018 requests; see HHS, NIH, National Institute for

Research on Safety and Quality, FY2019 Congressional Justification, https://www.ahrq.gov/sites/default/files/

wysiwyg/cpi/about/mission/budget/2019/NIRSQ.pdf; HHS, NIH, National Institute for Research on Safety and Quality,

FY 2018 Congressional Justification—Budget Estimates for Appropriations Committees, May 23, 2017,

https://www.ahrq.gov/sites/default/files/wysiwyg/cpi/abo ut/mission/budget/2018/NIRSQ.pdf.

Congressional Research Service

30

Labor, Health and Human Services, and Education: FY2020 Appropriations

The LHHS omnibus provided the CMS Program Management account with a flat funding level of

$3.7 billion. This account supports CMS program operations (e.g., claims processing, information

technology investments, provider and beneficiary outreach and education, and program

implementation), in addition to federal administration and other activities related to the

administration of Medicare, Medicaid, the State Children’s Health Insurance Program, and

private health insurance provisions established by the ACA. The FY2020 appropriation was more

than the amount proposed by the President’s budget (+2.5%), but less than the amount proposed

by the House committee bill (-7.9%). The LHHS omnibus maintained a general provision (§227),

included in LHHS appropriations acts since FY2014, authorizing HHS to transfer additional

funds into this account from Medicare trust funds. The terms of the provision required that such

funds be used to support activities specific to the Medicare program, limited the amount of the

transfers to $305 million, and explicitly prohibited such transfers from being used to support or

supplant funding for ACA implementation. The House committee bill would have eliminated this

provision.

ACF

The FY2020 LHHS omnibus provided $24.4 billion in discretionary budget authority for ACF.

This was $1.2 billion (+5.3%) more than FY2019 and $6.1 billion (+33.4%) more than the

FY2020 President’s budget request. The President’s budget would have decreased ACF

discretionary funding by roughly one-fifth relative to the prior year (-21.0%). The President’s

budget would have achieved much of its proposed reduction by eliminating certain programs

within ACF, such as the Low Income Home Energy Assistance Program (LIHEAP), Preschool

Development Grants (PDG), and the Community Services Block Grant (CSBG). Funding for all

three of these programs was increased in the FY2020 LHHS omnibus relative to FY2019:

LIHEAP received $3.7 billion (+1.4%), PDG $275 million (+10.0%), and CSBG $740 million

(+2.1%).

The LHHS omnibus provided $1.9 billion for the Refugee and Entrant Assistance programs

account, an increase of $3 million (+0.2%) relative to FY2019. The LHHS omnibus retained a

provision, included in LHHS appropriations since FY2015, authorizing HHS to augment

appropriations for the Refugee and Entrant Assistance account via transfers from other

discretionary HHS funds. However, it increased the limit on those transfers to 15%, instead of

10% as in previous fiscal years.

The conference report on the omnibus directed the majority of the appropriation for Refugee and

Entrant Assistance programs toward the Unaccompanied Alien Children (UAC) program ($1.3

billion, the same as FY2019). The UAC program provides for the shelter, care, and placement of

unaccompanied alien children who have been apprehended in the United States. The LHHS

omnibus also included several general provisions some of which were similar to those enacted in

FY2019, related to the UAC program. For instance, the law authorized HHS to accept donations

for the care of UACs (§230), limited the use of funds for changes to policy directives related to

the UAC program (§231), limited the use of funds for unlicensed facilities for unaccompanied

alien children (§232), and imposed additional congressional notification requirements prior to the

use of unlicensed facilities (§233), It also prohibited HHS appropriations from being used to

prevent a Member of Congress from visiting a UAC facility for oversight purposes provided that

the Office of Refugee Resettlement (ORR) was notified not less than two business days in

advance to ensure that such visit would not interfere with the operations (including child welfare

and child safety operations) of such facility (§234). A number of reporting requirements related to

the UAC program were also included in the explanatory statement, including public reporting

with respect to children who have been separated from a parent or legal guardian, a report to the

Congressional Research Service

31

Labor, Health and Human Services, and Education: FY2020 Appropriations

appropriations committees related to provider facility violations related to standards of child care

or the wellbeing of children, and a briefing to the committees on plans for children who have

been in ORR custody for extended periods of time. 76

ACL

The FY2020 LHHS omnibus provided $2.2 billion in discretionary budget authority for ACL.

This was $54 million (+2.5%) more than FY2019. In addition, the FY2020 LHHS omnibus

directed $28 million in PPHF transfers to ACL, the same as FY2019. The explanatory statement

accompanying the FY2020 LHHS omnibus specified that the PPHF transfers were for the

Alzheimer’s Disease Program, Chronic Disease Self-Management, and Elder Falls Prevention.

The FY2020 LHHS omnibus did not adopt several ACL proposals made in the President’s budget

submission. These included proposals to consolidate Chronic Disease Self-Management and

Elder Falls Prevention into the Preventive Health Services Program, and to eliminate funding for

the Paralysis Resource Center and the Limb Loss Resource Center. It also did not adopt the

proposal to allow states and tribal organizations to transfer 100% of funds among the home and

community-based supportive services, nutrition, disease prevention and health promotion, and

family caregiver support programs.77

Restrictions Related to Certain Controversial Issues

Annual LHHS appropriations measures regularly contain broad restrictions related to certain

controversial issues. For instance, annual LHHS appropriations acts commonly include provisions

limiting the use of federal funds for abortions, the use of human embryos for research, needle

exchange programs, and gun control advocacy.

Abortions: Since FY1977, annual LHHS appropriations acts have included provisions limiting

the circumstances under which LHHS funds (including Medicaid funds) may be used to pay for

abortions. Early versions of these provisions applied only to HHS, but since FY1994 most

provisions have applied to the entire LHHS bill. Under current provisions, (1) abortions may be

funded only when the life of the mother is endangered or in cases of rape or incest; (2) funds may

not be used to buy a managed care package that includes abortion coverage, except in cases of

rape, incest, or endangerment; and (3) federal programs and state and local governments that

receive LHHS funding are prohibited from discriminating against health care entities that do not

provide or pay for abortions or abortion services. The FY2020 LHHS omnibus retained these

existing restrictions (§§506 and 507). 78

Human Embryo Research: Since FY1996, annual LHHS appropriations have included a

provision prohibiting any LHHS funds (including NIH funds) from being used to create human

76

Congressional Record, vol. 165, no. 204, December 17, 2019, pp. H1107 7-H11078.

Budget of the United States Government, Fiscal Year 2020, Appendix, p. 488, https://www.govinfo.gov/content/pkg/

BUDGET -2020-APP/pdf/BUDGET -2020-APP-1-11.pdf#page=72. A similar proposal was in Budget of the United

States Government, Fiscal Year 2019, Appendix, p. 484, https://www.govinfo.gov/content/pkg/BUDGET -2019-APP/

pdf/BUDGET -2019-APP-1-11.pdf#page=70. During the COVID-19 public health emergency, state and local agencies

on aging have increased flexibility to transfer funds among certain programs; see the discussion of Section 3222 in

CRS Report R46334, Selected Health Provisions in Title III of the CARES Act (P.L. 116 -136).

77

78 T he current provisions are commonly referred to as the Hyde and Weldon Amendments. For additional information,

see CRS Report RL33467, Abortion: Judicial History and Legislative Response.

Congressional Research Service

32

Labor, Health and Human Services, and Education: FY2020 Appropriations

embryos for research purposes or for research in which human embryos are destroyed. The

FY2020 LHHS omnibus retained these existing restrictions (§508). 79

Needle Exchange Programs: Since FY1990, annual LHHS appropriations have generally

included a provision prohibiting any LHHS funds from being used for needle exchange programs

(i.e., programs in which sterile needles or syringes are made available to injection drug users in

exchange for used needles or syringes to mitigate the spread of related infections, such as

Hepatitis and HIV/AIDS). 80 Starting in FY2016, the provision was modified to allow funds to be

used for needle exchange programs under the following conditions: (1) federal funds may not be

used to purchase the needles, but may be used for other aspects of such programs; (2) the state or

local jurisdiction must demonstrate, in consultation with CDC, that they are experiencing, or at

risk for, a significant increase in hepatitis infections or an HIV outbreak due to injection drug use;

and (3) the program must be operating in accordance with state and local law. The FY2020 House

committee bill would have omitted this provision entirely, but the FY2020 LHHS omnibus

retained these existing restrictions and conditions (§527).

Gun Control: Since FY1997, annual LHHS appropriations have included provisions prohibiting

the use of certain funds for activities that advocate or promote gun control. Early versions of

these provisions applied only to CDC; since FY2012, annual appropriations acts also have

included HHS-specific restrictions, in addition to restrictions that apply to all LHHS funds

(including funds transferred from the PPHF). FY2020 omnibus retained these existing restrictions

(§210 [HHS] and §503(c) [all LHHS, plus PPHF transfers]).81

Table 6. HHS Appropriations Totals by Agency

(Dollars in millions)

HHS Agency

HRSA

FY2019

Enacted

FY2020

Request

FY2020

House

Cmte.

(H.R.

2740)

FY2020

Enacted

(P.L. 11694)

7,161

6,138

7,645

7,333

Mandatory BA

308

286

308

286

Discretionary BA

6,853

5,853

7,337

7,047

CDCa

6,533

5,270

7,196

6,895

Mandatory BA

55

55

55

55

Discretionary BA

6,478

5,215

7,141

6,840

0

423

0

0

805

894

854

854

Evaluation Tap Fundingb

PPHF c

79

T he current provision is commonly referred to as the Dickey Amendment. For additional information, see CRS

Report RL33540, Stem Cell Research: Science, Federal Research Funding, and Regulatory Oversight.

80 T he one exception is the FY1992 LHHS appropriations act ( P.L. 102-170), which appears to have included no such

provision. Since the provision’s inception in FY1990, there has been variation in its scope and application during

certain fiscal years. For example, the LHHS appropriations act for FY1998 ( P.L. 105-78) made the ban subject to

action by the HHS Secretary. T he LHHS appropriations acts for FY2010 ( P.L. 111-117, Division D) and FY2011 (P.L.

112-10, Division B) applied the ban only in locations that local authorities determined to be inappropriate.

81 As previously noted, the explanatory statement accompanying the FY2020 LHHS omnibus directed that $12.5

million apiece ($25 million total) be allocated by the CDC and NIH for Firearm Injury and Mortality Prevention

Research (Congressional Record, December 17, 2019, Vol. 165, No. 204, Book III, p. H11067 and H11072).

Congressional Research Service

33

Labor, Health and Human Services, and Education: FY2020 Appropriations

HHS Agency

Nonrecurring Expenses Fund Transferd

FY2019

Enacted

FY2020

House

Cmte.

(H.R.

2740)

FY2020

Request

FY2020

Enacted

(P.L. 11694)

0

0

225

225

37,937

33,410

39,937

40,228

0

0

0

0

37,937

33,410

39,937

40,228

1,147

741

1,147

1,231

0

0

5,597

5,535

5,725

5,737

0

0

0

0

5,597

5,535

5,725

5,737

Evaluation Tap Funding b

134

143

134

134

PPHF c

12

0

12

12

338

0

340

338

Mandatory BA

0

0

0

0

Discretionary BA

338

0

340

338

0

0

18

0

CMS

796,947

828,259

828,658

828,343

Mandatory BA

792,512

823,888

823,888

823,888

Discretionary BA

4,435

4,371

4,771

4,456

ACF

38,413

31,506

43,054

39,523

Mandatory BA

15,202

13,179

15,079

15,079

Discretionary BA

23,210

18,327

27,975

24,444

ACL

2,169

2,033

2,349

2,223

0

0

0

0

Discretionary BA

2,169

2,033

2,349

2,223

PPHF c

28

0

28

28

4,103

3,966

4,423

4,212

Mandatory BA

629

624

624

624

Discretionary BA

3,474

3,342

3,800

3,588

Evaluation Tap Funding b

65

69

125

65

Total, HHS BA in the Bill

899,197

916,117

939,329

934,832

Mandatory

808,707

838,031

839,954

839,931

Discretionary

90,491

78,086

99,376

94,901

P.L. 116-20 (emergency)

321

—

—

—

P.L. 116-26 (emergency)

2,882

—

—

—

NIHa

Mandatory BA

Discretionary BA

Evaluation Tap Funding b

Nonrecurring Expenses Fund Transferd

SAMHSA

Mandatory BA

Discretionary BA

AHRQ e

Evaluation Tap Funding b

Mandatory BA

Office of the Secretary (OS)

Congressional Research Service

225

34

Labor, Health and Human Services, and Education: FY2020 Appropriations

HHS Agency

FY2019

Enacted

FY2020

House

Cmte.

(H.R.

2740)

FY2020

Request

FY2020

Enacted

(P.L. 11694)

P.L. 116-113 (emergency)

—

—

—

—

P.L. 116-123 (emergency)

—

—

—

6,436

P.L. 116-127 (emergency)

—

—

—

1,250

P.L. 116-136 (emergency)

—

—

—

140,389

P.L. 116-139 (emergency)

—

—

—

100,000

Total, BA Available in Fiscal Year (current year

from any bill)

896,013

914,146

937,158

932,661

Total, BA Advances for Future Years (provided in

current bill)

142,132

144,103

144,103

144,303

Total, BA Advances from Prior Years (for use in

current year)

138,948

142,132

142,132

142,132

-8,491

-20,607

-12,477

-9,770

Memoranda (non-emergency funds only)

Total, Additional Scorekeeping Adjustments

Source: Amounts in this table for the FY2019 Enacted, FY2020 Request, and FY2020 Enacted columns are

generally drawn from or calculated based on data contained in the explanatory statement accompanying the

FY2020 LHHS omnibus (P.L. 116-94), available in the Congressional Record, vol. 165, no. 204, December 17, 2019,

pp. H11061-H11161. Amounts in the FY2020 House Committee column are generally drawn from or calculated

based on data contained in the committee report (H.Rept. 116-62) accompanying H.R. 2740. Enacted totals for

FY2019 do not include emergency-designated appropriations provided by P.L. 116-20 or P.L. 116-26. Enacted

totals for FY2020 do not include emergency-designated appropriations provided by P.L. 116-113, P.L. 116-123,

P.L. 116-127, P.L. 116-136, or P.L. 116-139. For consistency with source materials, amounts in this table generally

do not reflect mandatory spending sequestration (except for the estimated tran sfers from the Prevention and

Public Health Fund), nor do they generally reflect transfers or reprogramming of funds pursuant to executive

authorities. CRS calculations do, however, include LHHS funding provided to HHS pursuant to the 21 st Century

Cures Act (P.L. 114-255).

Notes: BA = Budget Authority. Details may not add to totals due to rounding. Amounts in this table (1) reflect

all BA appropriated in the bill, regardless of the year in which funds become available (i.e., totals do not include

advances from prior-year appropriations, but do include advances for subsequent years provided in this bill); (2)

have generally not been adjusted to reflect scorekeeping; (3) comprise only those funds provided (or requested)

for agencies and accounts subject to the jurisdiction of the LHHS subcommittees of the House and Senate

appropriations committees (e.g., department totals do not include funding for the Food and Drug Administration,

the Indian Health Service, or the Agency for Toxic Substances and Disease Registry, all of which are fund ed by

other bills); and (4) do not include appropriations that occur outside of appropriations bills.

a.

Each year, CDC and NIH also receive funding in the Interior-Environment appropriations bill as part of their

overall budget authority.

b.

By convention, this table shows only the amount of PHS Evaluation Tap funds received by an agency, not the

amount of tap funds donated by an agency. That is to say, tap amounts shown in this table are in addition to

amounts shown for budget authority, but the amounts shown for budget authority have not been adjusted

to reflect potential “transfer-out” of funds to the tap.

c.

PPHF funds are not appropriated in the LHHS bill, but are shown here for illustrative purposes as they may

be used to supplement the funding selected agencies and programs receive through the appropriations

process. Amounts shown for PPHF in this table are in addition to amounts shown for budget authority.

The Nonrecurring Expenses Fund (NEF) was established by the Consolidated Appropriations Act of 2008,

to enable the HHS Secretary to repurpose certain unobligated balances of expired discretionary funds

appropriated to HHS from the General Fund. The FY2020 omnibus specified that HHS must transfer $255

d.

Congressional Research Service

35

Labor, Health and Human Services, and Education: FY2020 Appropriations

million apiece from the NEF to the buildings and facilities accounts at CDC and NIH. Amounts shown for

the NEF transfer are in addition to amounts shown for budget authority.

e.

The President’s budget for FY2019 proposed that AHRQ be eliminated, and that certain functions be

transferred to NIH. This proposal was not adopted by the House or the Senate version of the LHHS bill, or

included in FY2020 enacted appropriations.

Table 7. HHS Discretionary Appropriations for Selected

Programs or Activities, by Agency

(Dollars in millions)

Agency or Selected Program

FY2019

Enacted

FY2020

Request

FY2020

House

Cmte.

(H.R.

2740)

FY2020

Enacted

(P.L. 11694)

HRSA

Community Health Centers

1,626

1,626

1,676

1,626

National Health Service Corps

105

105

120

120

Children’s Hospitals Graduate Medical Education

325

0

350

340

Maternal & Child Health Block Grant

678

661

705

688

Autism and Other Developmental Disorders

51

0

53

52

Healthy Start

123

123

131

126

2,319

2,389

2,435

2,389

Organ Transplantation

26

28

32

28

Rural Communities Opioid Response

120

120

100

110

Family Planning (Title X)

286

286

400

286

478

577

500

433

321

153

348

370

1,125

1,318

1,335

1,274

560

372

593

570

52

137

52

52

933

347

1,080

985

255

604

277

255

Birth Defects and Developmental Disabilities

156

112

162

161

Public Health Scientific Services

504

45

604

555

Evaluation Tap Funding b

0

423

0

0

192

157

226

197

17

0

17

17

Injury Prevention and Control

649

629

698

677

National Institute for Occupational Safety and

Health

336

190

346

343

Global Health

496

457

524

571

Ryan White AIDS Programs

CDC

Immunization and Respiratory Diseases

PPHF a

HIV/AIDS, Viral Hepatitis, STDs, TB Prevention

Emerging and Zoonotic Infectious Diseases

PPHF a

Chronic Disease Prevention and Health Promotion

PPHF a

Environmental Health

PPHF a

Congressional Research Service

36

Labor, Health and Human Services, and Education: FY2020 Appropriations

FY2020

Request

FY2020

House

Cmte.

(H.R.

2740)

FY2020

Enacted

(P.L. 11694)

30

30

30

25

0

0

225

225

National Institute of Allergy and Infectious Diseases

5,523

4,754

5,808

5,885

National Institute of General Medical Sciences

1,726

1,732

1,886

1,706

Evaluation Tap Funding

1,147

741

1,147

1,231

National Institute on Aging

3,083

2,654

3,286

3,544

National Institute on Drug Abuse

1,420

1,296

1,489

1,462

711

492

492

492

384

366

433

449

12

0

12

12

Mental Health Block Grant

702

702

737

702

Evaluation Tap Fundingb

21

21

21

21

Certified Community Behavioral Health Clinics

150

150

150

200

Children’s Mental Health

125

125

130

125

Substance Abuse Treatment PRNS

459

430

482

478

Evaluation Tap Funding b

2

0

2

2

Substance Abuse Block Grant

1,779

1,779

1,779

1,779

Evaluation Tap Funding b

79

79

79

79

State Opioid Response Grants

1,500

1,500

1,500

1,500

Substance Abuse Prevention PRNS

205

244

212

206

Health Surveillance and Support

129

97

129

129

Evaluation Tap Funding b

31

42

31

31

Agency or Selected Program

Buildings and Facilities

Nonrecurring Expenses Fund Transferc

FY2019

Enacted

NIH

NIH Innovation Account d

SAMHSA

Mental Health Programs of Regional & National

Significance (PRNS)

PPHF

AHRQ e

Research on Health Costs, Quality, and Outcomes

197

0

197

197

Evaluation Tap Funding b

0

0

18

0

Medical Expenditure Surveys

70

0

72

70

Program Support

71

0

72

71

3,670

3,579

3,985

3,670

765

792

786

786

CMS

CMS Program Management

Health Care Fraud and Abuse Control

ACF

Congressional Research Service

37

Labor, Health and Human Services, and Education: FY2020 Appropriations

Agency or Selected Program

FY2019

Enacted

FY2020

Request

FY2020

House

Cmte.

(H.R.

2740)

FY2020

Enacted

(P.L. 11694)

Low Income Home Energy Assistance Program

Formula Grants

3,690

0

3,840

3,740

Refugee and Entrant Assistance Programs

1,905

1,804

2,412

1,908

Child Care and Development Block Grant

5,276

5,276

7,676

5,826

Head Start

10,063

10,063

11,563

10,613

Preschool Development Grants

250

0

350

275

Child Welfare Services

269

269

269

269

Adoption Opportunities

39

39

42

42

Community Services Block Grant

725

0

760

740

Home & Community-Based Supportive Services

385

385

422

390

Family Caregiver Support Services

181

151

200

186

Nutrition Services Programs

907

907

1,000

937

9

19

13

12

15

0

15

15

State Health Insurance Program (SHIP)

49

36

55

52

Paralysis Resource Center

9

0

9

10

Limb Loss Resource Center

4

0

4

4

Developmental Disabilities Programs

176

133

187

180

WIOA Activities (transferred from ED)

261

231

262

265

60

43

0

60

Evaluation Tap Funding b

0

0

60

0

Office of the Inspector General

80

80

85

80

2,631

2,667

3,008

2,737

ACL

Alzheimer’s Disease Demonstrations

PPHF a

Office of the Secretary

Office of Nat'l Coord. for Health Information

Technology

Public Health and Social Services Emergency Fund

Source: Amounts in this table for the FY2019 Enacted, FY2020 Request, and FY2020 Enacted columns are

generally drawn from or calculated based on data contained in the explanatory statement accompanying the

FY2020 LHHS omnibus (P.L. 116-94), available in the Congressional Record, vol. 165, no. 204, December 17, 2019,

pp. H11061-H11161. Amounts in the FY2020 House Committee column are generally drawn from or calculated

based on data contained in the committee report (H.Rept. 116-62) accompanying H.R. 2740. Enacted totals for

FY2019 do not include emergency-designated appropriations provided by P.L. 116-20 or P.L. 116-26. Enacted

totals for FY2020 do not include emergency-designated appropriations provided by P.L. 116-113, P.L. 116-123,

P.L. 116-127, P.L. 116-136, or P.L. 116-139. For consistency with source materials, amounts in this table generally

do not reflect mandatory spending sequestration (except for the estimated transfers from the Prevention and

Public Health Fund), nor do they reflect any transfers or reprogramming of funds pursuant to executive

authorities. CRS calculations do, however, include LHHS funding provided to HHS pursuant to the 21 st Century

Cures Act (P.L. 114-255).

Notes: BA = Budget Authority. Details may not add to totals due to rounding. Amounts in this table (1) reflect

all BA appropriated in the bill, regardless of the year in which funds become available (i.e., totals do not include

Congressional Research Service

38

Labor, Health and Human Services, and Education: FY2020 Appropriations

advances from prior-year appropriations, but do include advances for subsequent years provided in this bill); (2)

have generally not been adjusted to reflect scorekeeping; (3) comprise only those funds provided (or requested)

for agencies and accounts subject to the jurisdiction of the LHHS subcommittees of the House and Senate

appropriations committees (e.g., department totals do not include funding for the Food and Drug Administration,

the Indian Health Service, or the Agency for Toxic Substances and Disease Registry, all of which are funded by

other bills); and (4) do not include appropriations that occur outside of appropriations bills.

a.

PPHF funds are not appropriated in the LHHS bill, but are shown here for illustrative purposes as they may

be used to supplement the funding selected agencies and programs receive through the appropriations

process. Amounts shown for PPHF in this table are in addition to amounts shown for budget authority.

b.

By convention, this table shows the amount of PHS Evaluation Tap funds received by an agency for a

particular program or activity separately from the budget authority appropriated for that program or

activity. Tap amounts are in addition to amounts shown for budget authority, though the amounts shown for

budget authority have not been adjusted to reflect potential “transfer-out” of funds to the tap.

c.

The NEF was established by the Consolidated Appropriations Act of 2008, to enable the HHS Secretary to

repurpose certain unobligated balances of expired discretionary funds appropriated to HHS from the

General Fund. The FY2020 omnibus specified that HHS must transfer $255 million apiece from the NEF to

the buildings and facilities accounts at CDC and NIH. Amounts shown for the NEF transfer are in addition

to amounts shown for budget authority.

d.

The Cures Act created the NIH Innovation Account and specified that funds in the account must be

appropriated in order to be available for expenditure. In keeping with the purposes and amounts authorized

in the Cures Act, for FY2020, the FY2020 LHHS explanatory statement directed that NIH transfer $195

million to the National Cancer Institute to support cancer research, and $70 million each to the National

Institute of Neurological Disorders and Stroke and the National Institute of Mental Health to support the

Brain Research through Advancing Innovative Neurotechnologies (BRAIN) Initiative. The remaining $157

million was divided between the Precision Medicine Initiative ($14 9 million) and regenerative medicine

research ($8 million).

e.

The President’s budget for FY2020 proposed that AHRQ be eliminated, and that certain functions be

transferred to NIH. This proposal was not adopted by the House or the Senate version of the LHHS bill, or

included in FY2020 enacted appropriations.

Department of Education (ED)

Note that amounts in this section are based on regular LHHS appropriations only. They do not

include mandatory funds provided outside of the annual appropriations process (e.g., direct

appropriations for the Federal Direct Student Loan program and the mandatory portion of the

Federal Pell Grant program). Amounts are rounded to the nearest million or billion (as labeled).

The dollar and percentage changes discussed are based on unrounded amounts. For consistency

with source materials, amounts do not reflect sequestration or reestimates of mandatory spending

programs, where applicable.

About ED

Federal policymakers established the U.S. Department of Education in 1980. 82 Its mission is to

“promote student achievement and preparation for global competitiveness by fostering

educational excellence and ensuring equal access.”83 Typically, about three-quarters of ED’s

discretionary appropriations go either to local educational agencies—which primarily use the

funds to provide educational and related services for economically disadvantaged students and

82 ED in its current incarnation became a department in 1980 pursuant to the Department of Education Organization

Act (enacted on October 17, 1979). However, the department dates its origins to 1867 . See U.S. Department of

Education, “About ED: T he Federal Role in Education,” http://www2.ed.gov/about/overview/fed/role.html.

83 U.S. Department of Education, “About ED,” http://www2.ed.gov/about/landing.jhtml, accessed on November 29,

2018.

Congressional Research Service

39

Labor, Health and Human Services, and Education: FY2020 Appropriations

students with disabilities—or to low-income postsecondary students in the form of Pell Grants,

which help pay for college. The remainder of ED’s discretionary budget provides for a wide

range of activities, including (but not limited to) support for minority-serving institutions;

educational research; and career, technical, and adult education.

The federal government provides roughly 7% of overall funding for elementary and secondary

education in the United States. 84 The majority of school funding—about 84%—comes from states

and local districts, which have primary responsibility for the provision of elementary and

secondary education. With regard to higher education, the federal government provided roughly

62% of undergraduate and graduate student aid in academic year (AY) 2018-2019. 85

FY2020 ED Appropriations Overview

Table 8 displays FY2020 discretionary and mandatory ED budget authority provided and

proposed, along with FY2019 enacted levels. The totals in this table do not include emergency

supplemental appropriations; amounts provided in supplementals are displayed separately at the

bottom of the table and are in addition to regular appropriations. For a discussion of the FY2020

supplemental appropriations displayed below the bill totals in Table 8, see Appendix C.

Discretionary funds represent the majority of ED’s annual appropriations, accounting for roughly

95% of the FY2019 and FY2020 enacted levels. 86 The FY2020 enacted discretionary ED

appropriations were 1.8% higher than FY2019 levels. Proposed discretionary ED appropriations

for FY2020 compared to FY2019 would have decreased under the President’s budget (-10.4%)

and increased under the House committee bill (+6.3%).

Table 8. ED Appropriations Overview

(Dollars in billions)

Funding

FY2019

Enacted

FY2020

Request

FY2020

House Cmte.

(H.R. 2740)

FY2020 Enacted

(P.L. 116-94)

Discretionary

71.4

64.0

75.9

72.8

Mandatory

3.5

3.6

3.6

3.6

Total BA in the Bill

75.0

67.6

79.5

76.4

P.L. 116-20 (emergency)

0.2

—

—

—

P.L. 116-26 (emergency)

—

—

—

—

P.L. 116-113 (emergency)

—

—

—

—

P.L. 116-123 (emergency)

—

—

—

—

P.L. 116-127 (emergency)

—

—

—

—

U.S. Department of Education, “ The FY 2021 Education Budget Summary,” ”Appendix: T otal Expenditures for

Elementary and Secondary Education in the U.S.,” at https://www2.ed.gov/about/overview/budget/budget21/summary/

21summary.pdf.

84

85

For the purposes of this calculation, the federal contribution included $152 billion (grants, loans, work-study, and tax

benefits) out of a total of $246 billion (federal aid, state aid, institutional grants, nonfederal loans, and private and

employer-provided grants). See the College Board’s T rends in Student Aid 2019, p. 9,

https://research.collegeboard.org/pdf/trends-student-aid-2019-full-report.pdf.

86 T he only mandatory ED funding provided in the LHHS Appropriations Act in each of these years is for Vocational

Rehabilitation State Grants.

Congressional Research Service

40

Labor, Health and Human Services, and Education: FY2020 Appropriations

Funding

FY2019

Enacted

FY2020

Request

FY2020

House Cmte.

(H.R. 2740)

FY2020 Enacted

(P.L. 116-94)

P.L. 116-136 (emergency)

—

—

—

30.9

P.L. 116-139 (emergency)

—

—

—

—

Source: Amounts in this table for the FY2019 Enacted, FY2020 Request, and FY2020 Enacted columns are

generally drawn from or calculated based on data contained in the explanatory statement accompanying the

FY2020 LHHS omnibus (P.L. 116-94), available in the Congressional Record, vol. 165, no. 204, December 17, 2019,

pp. H11061-H11161. Amounts in the FY2020 House Committee column are generally drawn from or calculated

based on data contained in the committee report (H.Rept. 116-62) accompanying H.R. 2740. Enacted totals for

FY2019 do not include emergency-designated appropriations provided by P.L. 116-20 or P.L. 116-26. Enacted

totals for FY2020 do not include emergency-designated appropriations provided by P.L. 116-113, P.L. 116-123,

P.L. 116-127, P.L. 116-136, or P.L. 116-139. For consistency with source materials, amounts in this table generally

do not reflect mandatory spending sequestration, where applicable, nor do they reflect any transfers or

reprogramming of funds pursuant to executive authorities.

Notes: BA = Budget Authority. Details may not add to totals due to rounding. Amounts in this table (1) reflect

all BA appropriated in the bill, regardless of the year in which funds become available (i.e., totals do not include

advances from prior-year appropriations, but do include advances for subsequent years provided in this bill); (2)

have generally not been adjusted to reflect scorekeeping; (3) comprise only those funds provid ed (or requested)

for agencies and accounts subject to the jurisdiction of the LHHS subcommittees of the House and Senate

appropriations committees; and (4) do not include appropriations that occur outside of appropriations bills.

Selected ED Highlights

The following sections highlight FY2020 appropriations for selected ED accounts and

programs. 87 Table 9 tracks funding levels for major ED budget and appropriations accounts, and

selected items within those accounts.

School Improvement Programs

The Student Support and Academic Enrichment (SSAE) State Grants, commonly referred to as

the “block grant program,” are funded within the School Improvement Programs account. The

SSAE grants are authorized under Title IV-A of the Elementary and Secondary Education Act

(ESEA), as amended by the Every Student Succeeds Act (ESSA; P.L. 114-95). The program

provides formula grants to state educational agencies (SEAs) and local educational agencies

(LEAs) to provide students with access to a well-rounded education, improve school conditions

for student learning, and improve the use of technology in order to improve the academic

achievement and digital learning of students. LEAs must use allocated funds for three broad

categories, or “buckets,” of activities: (1) supporting well-rounded educational opportunities, (2)

supporting safe and healthy students, and (3) supporting the effective use of technology.

The enacted FY2020 appropriation for the Title IV-A block grant was $1.21 billion, compared to

an FY2019 appropriation level of $1.17 billion (+3.4%). The House committee bill had

recommended a funding level of $1.32 billion for the program, while the President did not request

funds for the program for FY2020. The program is authorized at $1.6 billion for FY2020.

87 ED budget materials can be found at https://www2.ed.gov/about/overview/focus/performance.html.

Congressional Research Service

41

Labor, Health and Human Services, and Education: FY2020 Appropriations

Student Financial Assistance

The Pell Grant program within the Student Financial Assistance account provides need-based

financial aid primarily to low-income undergraduate students to help them cover the cost of

higher education. 88 Pell Grants are the largest single source of federal grant aid for undergraduate

students; they are projected to provide approximately $30.1 billion in aid to roughly 7.3 million

undergraduate students in the 2020-2021 award year. 89 The explanatory statement accompanying

the FY2020 LHHS omnibus directs $22.5 billion in discretionary funding to the Pell Grants

program, which is level funding compared to FY2019. (Additional mandatory funding for the

program is appropriated outside the LHHS bill.) The President’s budget and the House committee

bill both proposed level discretionary funding, as well.

The total maximum Pell Grant award is the sum of the discretionary maximum award level and the

mandatory add-on award level. The discretionary award program costs may be funded through (1)

annual discretionary appropriations; (2) a permanent, definite mandatory appropriation; and (3) the

Pell Grant program surplus.90 The mandatory add-on award program costs are funded by a permanent,

indefinite mandatory appropriation. Both mandatory appropriation sources are provided outside the

annual appropriations process, are authorized by and funded in the Higher Education Act of 1965

(HEA), as amended, and do not appear in Table 9.

The FY2020 LHHS omnibus increased the discretionary maximum Pell Grant award level to

$5,285, which is $150 million (+2.9%) more than the FY2019 level. The House committee bill

recommended the same amount. The President’s budget requested the same discretionary

maximum Pell Grant award level as in FY2019.

As a result of Pell Grant award rules established in the HEA, the increase in the discretionary

maximum Pell Grant award level increases FY2020 program costs, assuming no other changes. In

order to pay for the estimated increase in FY2020 mandatory add-on award program costs, the

LHHS omnibus rescinded $50 million of the FY2020 definite mandatory appropriation. 91 The

House committee bill would have reduced the FY2020 definite mandatory appropriation by the

same amount.

The FY2020 LHHS omnibus implemented another provision related to the Pell Grant program

surplus: it rescinded $500 million of the surplus, which offset the cost of appropriations in the

act. 92

88 For more information about the program, see CRS Report R42446, Federal Pell Grant Program of the Higher

Education Act: How the Program Works and Recent Legislative Changes.

U.S. Department of Education, “ Student Aid Overview,” Justification of Appropriation Estimates to the Congress:

Fiscal Year 2020, pp. N-8–N-9.

90

Because discretionary funds and the base award are appropriated in advance of the award year, they are based on cost

estimates. T his can result in surpluses (or shortfalls) in discretionary appropriations. When annual discretionary

appropriations exceed annual discretionary program costs, the Pell Grant program is able to accumulate a surplus that

remains available to fund discretionary award program costs in subsequent years. T he Congressional Budget Office

(CBO) has estimated a surplus of $10.2 billion at the start of FY2020. See Congressional Budget Office, Pell Grant

Program —CBO’s Baseline as of March 6, 2020, March 2020.

89

91 FY2020 LHHS omnibus, §309.

92 FY2020 LHHS omnibus, §308.

Congressional Research Service

42

Labor, Health and Human Services, and Education: FY2020 Appropriations

Table 9. Detailed ED Appropriations

(Dollars in millions)

Account and Selected Program

FY2019

Enacted

FY2020

Request

FY2020

House

Cmte.

(H.R. 2740)

FY2020

Enacted

(P.L. 11694)

This text is long and has been trimmed here. Open the source document for the complete record.

This is a copy of a public record, reproduced as it was published. It is not legal advice, and it may not be the version a court would rely on. Check the official source before you cite it.

A word about cookies

We need a few to keep you signed in and the library working. The rest help us see which pages people use and where they get stuck. They stay off unless you say yes.