Labor, Health and Human Services, and Education: FY2021 Appropriations
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Labor, Health and Human Services, and
Education: FY2021 Appropriations
Updated January 10, 2022
Congressional Research Service
https://crsreports.congress.gov
R46859
SUMMARY
Labor, Health and Human Services, and
Education: FY2021 Appropriations
This report offers an overview of actions taken by Congress and the President to provide FY2021
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 FY2021 LHHS discretionary funding enacted during the
annual appropriations process. The emergency-designated discretionary funding that was
subsequently enacted for FY2021 is generally not included in the budgetary figures discussed in
the main body of the report. (The FY2021 emergency supplemental discretionary appropriations
enacted for COVID-19 pandemic response are addressed in the context of the FY2021 annual
cycle in Appendix C.)
Regular Appropriations
FY2021 LHHS Omnibus: On December 27, 2020, the Consolidated Appropriations Act, 2021
(FY2021 LHHS omnibus; H.R. 133) was signed into law by President Trump as P.L. 116-260.
The FY2021 LHHS omnibus provided full-year appropriations for all 12 annual appropriations
acts in Divisions A-L. Annual discretionary LHHS appropriations totaled $198.5 billion. This
amount is 1.6% more than FY2020 enacted and 11.0% more than the FY2021 President’s budget
request. The omnibus also provided $980.0 billion in mandatory funding, for a combined LHHS
total of $1.178 trillion. The distribution of discretionary funding was as follows:
R46859
January 10, 2022
Karen E. Lynch,
Coordinator
Specialist in Social Policy
Jessica Tollestrup,
Coordinator
Specialist in Social Policy
Kyle D. Shohfi
Analyst in Education Policy
David H. Bradley
Specialist in Labor
Economics
Angela Napili
Senior Research Librarian
William R. Morton
Analyst in Income Security
DOL: $12.5 billion, 1.0% more than FY2020.
HHS: $97.0 billion, 2.2% more than FY2020.
ED: $73.54 billion, 1.1% more than FY2020.
Related Agencies: $15.5 billion, 0.6% more than FY2020.
FY2021 LHHS Senate Action: The FY2021 LHHS bill did not receive subcommittee, full committee, or initial floor action
in the Senate prior to its enactment. The chair of the Senate Committee on Appropriations, Senator Richard Shelby, released
drafts of all 12 annual appropriations bills along with draft accompanying committee reports on November 10, 2020, which
was intended to further negotiations on annual appropriations between the House and the Senate. These draft numbers are not
presented in this report.
FY2021 LHHS House Action: On July 13, 2020, the House Appropriations Committee voted to report the FY2021 LHHS
appropriations bill, 30-22; the measure was subsequently reported to the House on July 15 (H.R. 7614; H.Rept. 116-450).
This was preceded by subcommittee approval of the draft bill on July 7, by a vote of 9-6.
As reported by the full committee, the bill would have provided $198.1 billion in discretionary LHHS funds, a 1.3% increase
from FY2020 enacted levels. This amount would have been 10.8% more than the FY2021 President’s request. In addition,
the House committee bill would have provided an estimated $980.0 billion in mandatory funding, for a combined total of
$1.178 trillion for LHHS as a whole. The distribution of discretionary funding was as follows:
DOL: $12.7 billion, 2.0% more than FY2020.
HHS: $96.4 billion, 1.5% more than FY2020.
ED: $73.47 billion, 1.0% more than FY2020.
Related Agencies: $15.6 billion, 1.4% more than FY2020.
Congressional Research Service
Labor, Health and Human Services, and Education: FY2021 Appropriations
The House version of LHHS appropriations was initially considered on the floor as part of a consolidated appropriations
package and passed the House (217-197), as amended, on July 31, 2020 (Division E of H.R. 7617). Of the amendments
offered, 84 were adopted and 8 were rejected. Because there is no publicly available source that estimates the account-level
budgetary effects of the amendments adopted to Division E, 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.
FY2021 President’s Budget Request: The President’s FY2021 budget request was submitted to Congress on February 10,
2020. On March 17, 2020, President Trump submitted a letter to Congress about FY2021 budget amendments (along with a
supplemental appropriations request for FY2020) related to the response to the COVID-19 pandemic. These budget
amendments affected the FY2021 President’s requested levels for Centers for Disease Control and Prevention (CDC) and
National Institutes of Health (NIH) accounts at HHS. Amounts shown for the President’s request in the source materials
consulted for this report generally appear to reflect these budget amendments.
The President requested $178.8 billion in discretionary funding for accounts funded by the LHHS bill, which would have
been a decrease of 8.5% from FY2020 levels. In addition, the President requested $978.3 billion in annually appropriated
mandatory funding, for a total of $1.157 trillion for LHHS as a whole. The distribution of discretionary funding was as
follows:
DOL: $11.1 billion, 10.5% less than FY2020.
HHS: $87.0 billion, 8.3% less than FY2020.
ED: $66.6 billion, 8.5% less than FY2020.
Related Agencies: $14.1 billion, 8.2% less than FY2020.
Supplemental Appropriations
Several acts have been signed into law providing FY2020 and FY2021 supplemental discretionary appropriations for LHHS
programs and activities related to the COVID-19 pandemic. For FY2021, the same law that provided “regular” annual LHHS
appropriations for FY2021 in Division H also provided supplemental discretionary appropriations in a separate division
(Coronavirus Response and Relief Supplemental Appropriations Act, 2021; CRRSA). This law, which was enacted on
December 27, 2020, provided a total of $154.9 billion in supplemental LHHS funds (Title III, Division M, of P.L. 116-260).
In addition, prior to the end of FY2021, a second supplemental appropriations act containing LHHS appropriations was
enacted (P.L. 117-31) on July 30, 2021. This law provided $25 million in supplemental appropriations for the Refugee and
Entrant Assistance account at HHS for specified purposes related to Afghan special immigrants.
In total, FY2021 supplemental appropriations increased regular discretionary FY2021 LHHS enacted funding by about
78.1%. This funding was split roughly equally between HHS (48.1%) and ED (52.9%). (None was enacted for DOL or RA.)
The ED budgetary increase due to its supplemental funding was 111.5% (+82.0 billion) more than its FY2021 regular
discretionary appropriations. HHS regular discretionary appropriations were increased by 75.2% (+$72.9 billion).
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 pandemic response funding, see CRS Report R46775, Overview of
COVID-19 LHHS Supplemental Appropriations: FY2020 and FY2021.
Congressional Research Service
Labor, Health and Human Services, and Education: FY2021 Appropriations
Contents
Introduction ..................................................................................................................................... 1
Report Roadmap and Useful Terminology ...................................................................................... 1
Scope of the Report ................................................................................................................... 2
Important Budget Concepts....................................................................................................... 3
Mandatory vs. Discretionary Budget Authority .................................................................. 3
Total Budget Authority Provided in the Bill vs. Total Budget Authority Available
in the Fiscal Year.............................................................................................................. 4
Status of FY2021 LHHS Appropriations ........................................................................................ 4
FY2021 Supplemental Appropriations ...................................................................................... 4
Emergency Security Supplemental Appropriations Act, 2021 (H.R. 3237; P.L.
117-31) ............................................................................................................................. 5
The Coronavirus Response and Relief Supplemental Appropriations (CRRSA)
Act, 2021 (Division M of H.R. 133; P.L. 116-260, “5th COVID”) .................................. 5
FY2021 Annual LHHS Appropriations ..................................................................................... 6
FY2021 LHHS Omnibus (Division H, Consolidated Appropriations Act, 2021,
H.R. 133; P.L. 116-260) ................................................................................................... 6
FY2021 Continuing Resolutions (Division A of H.R. 8337; P.L. 116-159) ....................... 8
Earlier Congressional Action on an LHHS Bill .................................................................. 8
FY2021 President’s Budget Request......................................................................................... 9
Conclusion of the FY2020 Appropriations Process and FY2020 Supplemental
Appropriations ..................................................................................................................... 10
Summary of FY2021 LHHS Appropriations ................................................................................. 12
Department of Labor (DOL) ......................................................................................................... 15
About DOL ............................................................................................................................. 16
FY2021 DOL Appropriations Overview ................................................................................. 16
Selected DOL Highlights ........................................................................................................ 17
Employment and Training Administration (ETA)............................................................. 17
Office of Foreign Labor Certification (OFLC) ................................................................. 18
Bureau of Labor Statistics (BLS) ...................................................................................... 19
Bureau of International Labor Affairs (ILAB) .................................................................. 19
Labor-Related General Provisions .................................................................................... 19
Department of Health and Human Services (HHS)....................................................................... 22
About HHS .............................................................................................................................. 23
FY2021 HHS Appropriations Overview ................................................................................. 24
Special Public Health Funding Mechanisms ........................................................................... 26
Public Health Service Evaluation Tap............................................................................... 26
Prevention and Public Health Fund .................................................................................. 28
Selected HHS Highlights by Agency ...................................................................................... 28
HRSA ................................................................................................................................ 29
CDC .................................................................................................................................. 29
NIH ................................................................................................................................... 31
SAMHSA .......................................................................................................................... 32
AHRQ ............................................................................................................................... 32
CMS .................................................................................................................................. 33
ACF ................................................................................................................................... 33
ACL .................................................................................................................................. 34
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Labor, Health and Human Services, and Education: FY2021 Appropriations
Restrictions Related to Certain Controversial Issues .............................................................. 35
Department of Education (ED) ...................................................................................................... 42
About ED ................................................................................................................................ 42
FY2021 ED Appropriations Overview .................................................................................... 43
Selected ED Highlights ........................................................................................................... 44
Education for the Disadvantaged ...................................................................................... 44
Student Financial Assistance............................................................................................. 45
Related Agencies ........................................................................................................................... 47
FY2021 Related Agencies Appropriations Overview ............................................................. 48
Selected Related Agencies Highlights..................................................................................... 49
SSA Limitation on Administrative Expenses (LAE) ........................................................ 49
Corporation for National and Community Service ........................................................... 50
National Labor Relations Board (NLRB) ......................................................................... 50
Figures
Figure 1. FY2021 Enacted LHHS Appropriations .......................................................................... 7
Figure 2. FY2021 Enacted LHHS Appropriations by Title ........................................................... 15
Figure 3. FY2021 Enacted HHS Appropriations by Agency......................................................... 26
Tables
Table 1. Status of Full-Year LHHS Appropriations Legislation, FY2021 ....................................... 6
Table 2. LHHS Appropriations Overview by Bill Title, FY2020-FY2021 ................................... 13
Table 3. DOL Appropriations Overview ....................................................................................... 17
Table 4. Detailed DOL Appropriations .......................................................................................... 20
Table 5. HHS Appropriations Overview........................................................................................ 24
Table 6. HHS Appropriations Totals by Agency ........................................................................... 36
Table 7. HHS Discretionary Appropriations for Selected Programs or Activities,
by Agency .................................................................................................................................. 39
Table 8. ED Appropriations Overview .......................................................................................... 43
Table 9. Detailed ED Appropriations ............................................................................................ 46
Table 10. Related Agencies Appropriations Overview .................................................................. 48
Table 11. Detailed Related Agencies Appropriations .................................................................... 50
Table A-1. LHHS Discretionary FY2020 Enacted Levels, FY2021 House 302(b)
Suballocations, and FY2021 Enacted Levels ............................................................................. 57
Table A-2. LHHS Appropriations Overview, by Bill Title: FY2020-FY2021............................... 58
Table B-1. LHHS House Floor Amendments Offered to H.R. 7617 ............................................. 60
Table C-1. Summary of Enacted FY2021 Discretionary Regular and Supplemental
Appropriations............................................................................................................................ 70
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Labor, Health and Human Services, and Education: FY2021 Appropriations
Appendixes
Appendix A. Budget Enforcement Activities ................................................................................ 53
Appendix B. House Floor Amendments Offered to H.R. 7617 ..................................................... 60
Appendix C. Enacted FY2021 LHHS Supplemental Appropriations ........................................... 69
Contacts
Author Information........................................................................................................................ 71
Congressional Research Service
Labor, Health and Human Services, and Education: FY2021 Appropriations
Introduction
This report provides an overview of FY2021
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).
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.
Scope of the Report:
Emergency and Mandatory
Funding Related to COVID-19
This report primarily focuses on regular
FY2021 LHHS discretionary funding
enacted during the annual appropriations
process. The emergency discretionary
funding that was enacted for FY2020, or
proposed and enacted for FY2021, is
generally not included in the budgetary
figures discussed or table totals presented
in the main body of the report. (Note that
while emergency-designated spending,
including that proposed and enacted in the
context of annual LHHS appropriations, is
presented below the table totals, it is not
included in them. Also, the FY2021
emergency supplemental appropriations
enacted for COVID-19 pandemic response
and other purposes are addressed in the
context of the FY2021 annual cycle in
Appendix C.) In addition, during FY2020
and FY2021, mandatory appropriations
were enacted to certain LHHS-related
accounts for COVID-19 pandemic
response, including in the American Rescue
Plan Act of 2021 (P.L. 117-2). These
mandatory funds are beyond the scope of
this report.
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 FY2021 appropriations and (for context) a review of the
conclusion of the FY2020 appropriations process. This is followed by a high-level summary and
analysis of enacted and proposed appropriations for FY2021, compared to FY2020 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 FY2021 enacted and proposed funding levels compared to FY2020. (Note that the
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Labor, Health and Human Services, and Education: FY2021 Appropriations
distribution of funds is sometimes illustrated by figures, which in all cases are based on the
FY2021 enacted version of the LHHS bill.1)
Appendix A provides a summary of budget enforcement activities for FY2021. This includes
information on the Budget Control Act of 2011 (BCA; P.L. 112-25) and sequestration, budget
enforcement in the absence of an FY2021 budget resolution, the House LHHS subcommittee
spending allocation, 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. 7617. Appendix C provides an analysis of the supplemental
discretionary LHHS appropriations enacted for FY2021. For a detailed discussion of the FY2021
supplemental LHHS COVID-19 pandemic response funding, see CRS Report R46775, Overview
of COVID-19 LHHS Supplemental Appropriations: FY2020 and FY2021.
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).
1 The dollars and percentages in each figure also are generally illustrative, except as noted, of the parallel distribution
of funds enacted in FY2020 and proposed by the FY2021 President’s budget and the House committee bill.
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Labor, Health and Human Services, and Education: FY2021 Appropriations
Important Budget Concepts
Mandatory vs. Discretionary Budget Authority2
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.
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 FY2021 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 because discretionary funding receives
the bulk of attention during the appropriations process. (While 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.
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. (Terms of interest may include appropriated entitlement, direct spending, discretionary, entitlement
authority, and mandatory.)
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.
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Labor, Health and Human Services, and Education: FY2021 Appropriations
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
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. (Those scorekeeping
adjustments are displayed at the bottom of Table 2.)
Status of FY2021 LHHS Appropriations
FY2021 Supplemental Appropriations
The legislative response to the global COVID-19 pandemic has included the enactment of laws to
provide authorities and supplemental funding to prevent, prepare for, and respond to the
pandemic. LHHS supplemental appropriations for COVID-19 pandemic response were enacted in
four FY2020 measures, and one FY2021 measure. All five of these supplementals are discussed
in detail in CRS Report R46775, Overview of COVID-19 LHHS Supplemental Appropriations:
FY2020 and FY2021.
In addition, prior to the end of FY2021, a second supplemental appropriations act containing
LHHS appropriations was enacted (P.L. 117-31) on July 30, 2021. This law provided $25 million
in supplemental appropriations for the Refugee and Entrant Assistance account at HHS for
specified purposes related to Afghan special immigrants.
See Appendix C for an analysis of the regular and supplemental discretionary LHHS
appropriations enacted for FY2021.
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
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).
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Labor, Health and Human Services, and Education: FY2021 Appropriations
Emergency Security Supplemental Appropriations Act, 2021 (H.R. 3237; P.L.
117-31)
H.R. 3237 was introduced as a supplemental appropriations bill by the chair of the House
Appropriations Committee, Representative DeLauro, on May 14, 2021. Both as introduced and as
passed by the House (213-212, 3 present) on May 20, 2021, the bill did not contain LHHS
funding. Subsequently, the Senate added $25 million in supplemental appropriations for the
Refugee and Entrant Assistance account at HHS for specified purposes related to Afghan special
immigrants, among other changes. The bill passed the Senate, as amended (98-0), on July 29,
2021. The House agreed to the Senate-passed version (416-11) on July 30, 2021, and the bill was
signed into law (P.L. 117-31) by President Biden that same day.
According to CBO, the $25 million in supplemental LHHS appropriations provided by P.L. 11731 was about 1% of the $2.1 billion in FY2021 discretionary appropriations provided by the law. 7
The Coronavirus Response and Relief Supplemental Appropriations (CRRSA)
Act, 2021 (Division M of H.R. 133; P.L. 116-260, “5th COVID”)
While annual appropriations for FY2021 were under discussion during the summer and fall of
2020, Congress and President Trump considered whether any additional COVID-19 pandemic
response funding should be enacted in separate supplemental appropriations measures or
packaged with the FY2021 annual funding. (Four COVID-19 pandemic response FY2020
supplemental appropriations acts had previously been enacted; see discussion in “Conclusion of
the FY2020 Appropriations Process and FY2020 Supplemental Appropriations”.) In addition,
policymakers had the option of making further COVID-19 pandemic response funding subject to
the limit on FY2021 nondefense discretionary spending, or providing that funding instead as
emergency appropriations (effectively exempt from that limit).8 Ultimately, additional FY2021
appropriations for COVID-19 pandemic relief were enacted as part of H.R. 133. (Regular
FY2021 LHHS annual appropriations were provided in Division H, referred to in this report as
“the FY2021 LHHS omnibus”; emergency supplemental funding for COVID-19 pandemic
response was provided in Division M.) On December 21, 2020, the final version of H.R. 133 was
approved by the House. (The vote to approve the portion that contained Division M was 359-53.9)
The measure was approved by the Senate (92-6) later that same day, and signed into law (P.L.
116-260) by President Trump on December 27.
7 CBO, Discretionary Spending: Senate Amendment 2123, July 29, 2021, https://www.cbo.gov/system/files/2021-07/
EmergencySecuritySupplementalAppropriationsAct2021.pdf.
8 Prior to the enactment of full year FY2021 LHHS funding, COVID-19 pandemic-related LHHS provisions were
proposed in several different appropriations measures for FY2021, including the House-passed full-year LHHS bill
(Division E, H.R. 7617), a supplemental appropriations package (Division A, H.R. 925), and the FY2021 continuing
resolution (Division A, P.L. 116-159). While in some cases, the budgetary effects of the COVID-19 pandemic-related
provisions were designated as an emergency requirement, that was not the case universally.
9 The special rule, H.Res. 1271, provided for the consideration of an amendment consisting of the final text for
enactment (as contained in House Rules Committee Print 116-68) to the Senate amendment to H.R. 133. H.Res. 1271
also provided for the House to adopt the amendment in two votes: the first on Divisions B, C, E, and F, and the second
on the remaining divisions. The House adopted Divisions B, C, E, and F by a vote of 327-85, and adopted the
remaining divisions by a vote of 359-53. The subsequent motion that the House agree to the Senate amendment with an
amendment was agreed to without objection.
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Labor, Health and Human Services, and Education: FY2021 Appropriations
According to CBO, P.L. 116-260 provided about $184.3 billion in supplemental appropriations in
Division M, of which $155 billion (approximately 84%) was for LHHS accounts and activities.10
Funding was provided for various programs and activities at HHS and ED.
FY2021 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, FY2021
Subcommittee
Approval
House
Senate
7/7/2020
9-6
Resolution of House and
Senate Differences
Full Committee
Approval
House
H.R. 7614
H.Rept.
116-450
7/13/20
30-22
Senate
House
Initial
Passage
H.R. 7617,
Division E
7/31/20
217-197
Senate
Initial
Passage
Conf.
Report
House
Final
Passage
Senate
Final
Passage
H.R. 133,
Division H
12/21/20
359-53
H.R. 133,
Division H
12/21/20
96-2
Public
Law
P.L. 116260
12/27/20
Source: CRS Appropriations Status Table.
FY2021 LHHS Omnibus (Division H, Consolidated Appropriations Act, 2021,
H.R. 133; P.L. 116-260)
On December 27, 2020, the Consolidated Appropriations Act, 2021 was signed into law by the
President (H.R. 133, P.L. 116-260). P.L. 116-260 provided full-year appropriations for all 12
annual appropriations acts in Divisions A-L, and supplemental appropriations for COVID-19
pandemic relief in Division M.11 (Full-year LHHS appropriations were enacted in Division H,
referred to as “the FY2021 LHHS omnibus.”) Prior to its enactment, the final version of the
measure was approved by the House on December 21. (The vote to approve the portion that
contained LHHS appropriations was 359-53.12) It was approved by the Senate (92-6) later that
same day.
10 The total amount of supplemental appropriations in Division M is from CBO, Discretionary Spending Under
Division M, the Coronavirus Response and Relief Supplemental Appropriations Act, 2021, December 22, 2020, p. 1,
https://www.cbo.gov/publication/56916. The total amount of LHHS supplemental appropriations in Title III of
Division M was calculated by CRS (see Table 2 of this report), and does not include funding appropriated in Title III to
the Food and Drug Administration (FDA) Salaries and Expenses account, as this funding is generally not under the
purview of the LHHS Appropriations Act.
11 P.L. 116-260 also contained additional COVID-19 pandemic response provisions in Division N, but this division is
considered authorizing legislation, rather than appropriations legislation, and is thus beyond the scope of this report.
For further discussion, see the Congressional Budget Office cost estimate for Division N, released on January 14, 2021,
https://www.cbo.gov/system/files/2021-01/PL_116-260_div_N.pdf. In addition, Divisions O-FF of P.L. 116-260
contained miscellaneous authorizing provisions that are also beyond the scope of this report.
12 The special rule, H.Res. 1271, provided for the consideration of an amendment consisting of the final text for
enactment (as contained in House Rules Committee Print 116-68) to the Senate amendment to H.R. 133. H.Res. 1271
also provided for the House to adopt the amendment in two votes: the first on Divisions B, C, E, and F, and the second
on the remaining divisions. The House adopted Divisions B, C, E, and F by a vote of 327-85, and adopted the
remaining divisions by a vote of 359-53. The subsequent motion that the House agree to the Senate amendment with an
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Labor, Health and Human Services, and Education: FY2021 Appropriations
LHHS discretionary appropriations in the FY2021 LHHS omnibus totaled $198.5 billion. This
amount is 1.6% more than FY2020 enacted and 11.0% more than the FY2021 President’s budget
request. The omnibus also provided $980.0 billion in mandatory funding, for a combined LHHS
total of $1.178 trillion. (Note that these totals are based only on amounts of non-emergency
appropriations provided by the FY2021 LHHS omnibus and do not include emergencydesignated or supplemental funds, which were provided in addition to the annual appropriations.
Division H also enacted $1.6 billion in emergency-designated budget authority, of which $925
million was for DOL in Title I, and $638 million was for HHS in Title II, which is not reflected in
the above figures.)
See Figure 1 for a breakdown of FY2021 discretionary and mandatory LHHS appropriations.13
Figure 1. FY2021 Enacted LHHS Appropriations
Source: Amounts in this figure are generally drawn from or calculated based on data contained in the
explanatory statement accompanying the FY2021 LHHS omnibus (P.L. 116-260), available in the Congressional
Record, vol. 166, no. 218, book IV, December 21, 2020, pp. H8619-H8711. Enacted totals (“Total BA in the Bill”)
for FY2021 do not include emergency-designated appropriations provided in Division H or M of P.L. 116-260, or
P.L. 117-31. 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
21st Century Cures Act (P.L. 114-255), as amended.
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.
amendment was agreed to without objection.
13 While the percentages in this figure were calculated based on amounts in the FY2021 LHHS omnibus, they are
generally also illustrative—within a few percentage points—of the share of mandatory and discretionary funds in
FY2020 and under the various FY2021 proposals (e.g., President’s budget and the House-committee bill).
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Labor, Health and Human Services, and Education: FY2021 Appropriations
FY2021 Continuing Resolutions (Division A of H.R. 8337; P.L. 116-159)
Between the start of the fiscal year on October 1, 2020, and the enactment of the annual LHHS
appropriations on December 27, 2020, LHHS programs and activities were provided temporary
FY2021 funding via a series of continuing resolutions (CRs).
The first CR providing temporary funding for LHHS programs and activities was signed into law
on October 1 (Division A of H.R. 8337; P.L. 116-159). The measure had previously been
introduced by the House Appropriations Committee chair, Representative Lowey, on September
22, and had passed the House that same day, 359-57.14 The Senate subsequently took up and
passed the measure without amendment, 84-10, on September 30.
The CR provided continuing appropriations for all 12 annual appropriations acts (including
LHHS) through December 11, 2020. In general, the CR funded discretionary programs at the
same rate and under the same conditions as in FY2020 (§101) and annually appropriated
entitlements at their current law levels (§111).15 It also included several anomalies that are
specific to LHHS accounts or related activities (§§149-156).
This first CR was extended by four subsequent CRs:
P.L. 116-215 (Division A), which extended LHHS funding through December 18;
P.L. 116-225, which extended LHHS funding through December 20;
P.L. 116-226, which extended LHHS funding through December 21; and
P.L. 116-246, which extended LHHS funding through December 28.
Earlier Congressional Action on an LHHS Bill
FY2021 LHHS Action in the Senate
Senate Appropriations Committee action on the FY2021 LHHS bill did not occur during the
FY2021 cycle. The chair of the Senate Committee on Appropriations, Senator Richard Shelby,
released drafts of all 12 annual appropriations bills along with draft accompanying committee
reports on November 10, 2020, which was intended to further negotiations on annual
appropriations between the House and the Senate.16 These draft numbers are not presented in this
report.
14 For further information about the continuing appropriations in H.R. 8337, see House Appropriations Committee,
“House Democrats File Bipartisan Continuing Resolution,” press release, September 22, 2020,
https://appropriations.house.gov/news/press-releases/house-democrats-file-bipartisan-continuing-resolution.
Previously, the chairwoman had introduced H.R. 8319, which included a similar CR in Division A, but that measure
did not receive House floor consideration. For further information about the continuing appropriations in H.R. 8319,
see House Appropriations Committee, “House Democrats Introduce Continuing Resolution,” press release, September
21, 2020, https://appropriations.house.gov/news/press-releases/house-democrats-introduce-continuing-resolution-1.
15 For an estimate of the discretionary appropriations contained in Division A of H.R. 8337, see CBO, “CBO’s Estimate
for H.R. 8337, the Continuing Appropriations Act, 2021 and Other Extensions Act, as Passed by the House of
Representatives on September 22, 2020,” September 23, 2020, https://www.cbo.gov/system/files/2020-09/hr8337.pdf.
16 See linked draft bill and report language text in the Senate Appropriations Committee majority press release,
“Committee Releases FY21 Bills in Effort to Advance Process, Produce Bipartisan Results,” November 10, 2020,
https://www.appropriations.senate.gov/news/committee-releases-fy21-bills-in-effort-to-advance-process-producebipartisan-results. See also the statement from the Senate Appropriations Committee Vice Chair, Senator Patrick
Leahy, at https://www.appropriations.senate.gov/news/minority/senate-approps-vice-chair-leahy-statement-on-therelease-of-the-fy-2021-senate-appropriations-bills-.
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Labor, Health and Human Services, and Education: FY2021 Appropriations
FY2021 LHHS Action in the House (Division A, H.R. 2740)
The House LHHS subcommittee approved the draft LHHS bill on July 7, by a vote of 9-6. On
July 13, 2020, the House Appropriations Committee voted to report the FY2021 LHHS
appropriations bill, 30-22; the measure was subsequently reported to the House on July 15 (H.R.
7614; H.Rept. 116-450).
As reported by the full committee, the bill would have provided $198.1 billion in discretionary
LHHS funds, a 1.3% increase from FY2020 enacted levels. This amount would have been 10.8%
more than the FY2021 President’s request. In addition, the House committee bill would have
provided an estimated $980.0 billion in mandatory funding, for a combined total of $1.178 trillion
for LHHS as a whole. (Note that these totals are based only on amounts of non-emergency
appropriations that would have been provided by the House committee bill and do not include
emergency-designated or supplemental funds, which were provided in addition to the annual
appropriations. The House committee bill included a total of $19.4 billion in emergencydesignated budget authority in Title VI, of which $925 million was for DOL and $18.5 billion
was for HHS, which is not reflected in the above figures.)
Later in July, LHHS appropriations were initially considered on the House floor as part of a
consolidated appropriations package and passed the House (217-197), as amended, on July 31,
2020 (Division E of H.R. 7617). This package would have provided appropriations for five other
appropriations acts in addition to LHHS: Department of Defense; Commerce, Justice, Science;
Energy and Water Development; Financial Services and General Government; and
Transportation, Housing, and Urban Development.17 Floor action on H.R. 7617 was regulated by
the terms of a special rule (H.Res. 1067) that made in order 92 amendments to the LHHS title of
the bill.18 That rule also provided the authority for the chair of the Appropriations Committee or
her designee to offer any of the amendments made in order en bloc (i.e., in groups of amendments
to be disposed of together). All but three LHHS amendments were considered in this manner.19
When counted as 92 separate amendments, 84 were adopted and 8 were rejected.
Because there is no publicly available source that estimates the account-level budgetary effects of
the amendments adopted to Division E, 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.
FY2021 President’s Budget Request
The President’s FY2021 budget request was submitted to Congress on February 10, 2020.20 On
March 17, 2020, President Trump submitted a letter to Congress about FY2021 budget
17 H.R. 7617 was initially expected to provide appropriations for the act funding the Department of Homeland Security,
but that division was ultimately omitted under the terms of the special rule that regulated floor consideration (H.Res.
1067).
18 For a list of these LHHS amendments (numbered 218-309) and the text of each that was made in order, see H.Rept.
116-461, pp. 23-32 and 89-108. Readers should note that LHHS amendments were keyed to Division F of what was to
be the base text for amendment (Rules Committee Print 116–60). The LHHS division was redesignated as Division E
after House passage due to the omission of the Department of Homeland Security division from the bill.
19 For the en bloc amendments proposing changes to the LHHS division of the bill, see consideration of amendments en
bloc nos. 3, 4, and 5 in Congressional Record, daily edition, Vol. 166, No. 135 (July 30, 2020), pp. H4134-H4139,
H4143-H4169.
20 For further information on the HHS budget request, see CRS Report R46321, Department of Health and Human
Services: FY2021 Budget Request. Note that the report covers the FY2021 President’s request for HHS in its entirety,
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Labor, Health and Human Services, and Education: FY2021 Appropriations
amendments (along with a supplemental appropriations request for FY2020) related to the
response to the COVID-19 pandemic.21 These budget amendments affected the FY2021
President’s requested levels for CDC and NIH accounts at HHS.22
The President requested $178.8 billion in discretionary funding for accounts funded by the LHHS
bill, which would have been a decrease of 8.5% from FY2020 levels. In addition, the President
requested $978.3 billion in annually appropriated mandatory funding, for a total of $1.157 trillion
for LHHS as a whole.
Conclusion of the FY2020 Appropriations Process and FY2020
Supplemental Appropriations
FY2020 regular appropriations for LHHS were enacted as part of the Further Consolidated
Appropriations Act, 2020, on December 20, 2019 (FY2020 LHHS omnibus; P.L. 116-94). The
FY2020 LHHS omnibus 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.23
On January 29, 2020, supplemental appropriations of $210 million in additional funding to DOL
to carry out the United States-Mexico-Canada Agreement (USMCA) were enacted (P.L. 116113).24
Subsequent to the enactment of annual FY2020 LHHS discretionary appropriations and the
submission of the President’s budget, the effects of the COVID-19 global pandemic on
communities across the world and throughout the United States elicited a legislative response
from Congress and the President during the remainder of FY2020. Four FY2020 supplemental
appropriations were part of this legislative response:25
not just the components of the agency funded through the annual LHHS bill.
21 Executive Office of the President, Office of Management and Budget, Letter from Acting Director Russell T. Vought
to The Honorable Michael R. Pence, March 17, 2020, https://www.whitehouse.gov/wp-content/uploads/2020/03/Letterregarding-additional-funding-to-support-the-United-States-response-to-COVID-19-3.17.2020.pdf.
22 Amounts shown for the President’s request in the source materials consulted for this report generally appear to reflect
these budget amendments. The source materials used for the President’s request are drawn from or calculated based on
the explanatory statement accompanying the FY2021 LHHS omnibus (P.L. 116-260), available in the Congressional
Record, vol. 166, no. 218, book IV, December 21, 2020, pp. H8619-H8711.
23 For further information, see CRS Report R46492, Labor, Health and Human Services, and Education: FY2020
Appropriations.
24 Title IX of the United States-Mexico-Canada Agreement Supplemental Appropriations Act, 2019, (USMCA, P.L.
116-113). The USMCA supplemental appropriations of $210 million for DOL were for the Bureau of International
Labor Affairs (ILAB) to support the implementation and enforcement of the USMCA. The labor-related provisions in
the USMCA, which are associated with ILAB’s role, are discussed in CRS Report R44981, The United States-MexicoCanada Agreement (USMCA), pp. 32-33.
25 Other divisions of the acts that provided supplemental LHHS appropriations contained authorization provisions that
in some cases relate to LHHS programs and activities—for instance, provisions providing a 6.2% increase to the
federal matching assistance percentage for Medicaid and certain other programs in FFCRA, and provisions modifying
student loan subsidy costs in the CARES Act. The mandatory spending budgetary effects of such provisions are outside
the scope of this report. For further information on the LHHS appropriations provided by these COVID-19 pandemic
response supplementals, see CRS Report R46353, COVID-19: Overview of FY2020 LHHS Supplemental
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Labor, Health and Human Services, and Education: FY2021 Appropriations
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 funds26 (“1st
COVID”);
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 (“2nd COVID”);
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 (“3rd COVID”); and
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 (“4th COVID”).
In total, FY2020 supplemental appropriations increased regular FY2020 LHHS enacted funding
by about 143%. The bulk of the supplemental funding (89%) was directed at HHS. The $248
billion in supplemental HHS funds represented a 261% increase over the agency’s FY2020
regular appropriations funding level. ED received the next largest increase via supplemental
funds (43%), whereas DOL and RA received the smallest increases relative to their initial
FY2020 enacted levels (5% and 3%, respectively).
Appropriations.
26 Of the amount shown for P.L. 116-123, $300 million (appropriated to the Public Health and Social Services
Emergency Fund at HHS) was contingent upon future HHS actions.
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Labor, Health and Human Services, and Education: FY2021 Appropriations
Summary of FY2021 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 the FY2020 Enacted, FY2021 Request, and FY2021 Enacted are generally drawn from or calculated
based on data contained in the explanatory statement accompanying the FY2021 LHHS omnibus (P.L. 116-260),
available in the Congressional Record, vol. 166, no. 218, book IV, December 21, 2020, pp. H8619-H8711. (The
amount for P.L. 117-31 is from CBO, Discretionary Spending: Senate Amendment 2123, July 29, 2021,
https://www.cbo.gov/system/files/2021-07/EmergencySecuritySupplementalAppropriationsAct2021.pdf.)
Amounts for the FY2021 House Committee-reported bill are generally drawn from or calculated based on data
contained in the committee report (H.Rept. 116-450) accompanying H.R. 7614. Throughout this report, the
FY2021 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. 7617, as there is no publicly
available 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 (“Total BA in the Bill”) for FY2020 do not include emergency-designated appropriations provided in
P.L. 116-113, P.L. 116-123, P.L. 116-127, P.L. 116-136, or P.L. 116-139. House committee bill totals (“Total BA in
the Bill”) for FY2021 do not include emergency-designated appropriations proposed in Title VI of H.R. 7614.
Enacted totals (“Total BA in the Bill”) for FY2021 do not include emergency-designated appropriations provided in
Division H or M of P.L. 116-260, or P.L. 117-31. For informational purposes, FY2020 enacted, and FY2021
proposed and enacted, emergency-designated amounts are displayed separately at the bottom of tables
throughout the report and not summed. One exception is made in Table A-1, which includes FY2020 and
FY2021 enacted emergency-designated funds in the “Adjusted Appropriations” totals, as scored by the
Congressional Budget Office. In addition, further details on the FY2021 supplemental appropriations can be found
in Appendix C.
For consistency with source materials, the FY2020 and FY2021 numbers in this report generally do not reflect
actual or anticipated post-enactment budgetary adjustments, except as noted.27 CRS calculations do, however,
include LHHS funding provided to HHS pursuant to the 21st Century Cures Act (P.L. 114-255).
Table 2 displays FY2021 discretionary and mandatory LHHS budget authority provided or
proposed, by bill title, along with FY2020 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-designated
appropriations; those amounts are displayed separately at the bottom of the table and are in
27 The general practice for CRS reports on the LHHS bill has been to reflect conventions used in source materials.
These 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 comparability.
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)). The 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). The FY2018, FY2019, and FY2020 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. The source materials used for the FY2021 report version, and thus the numbers
in this report, continue this most recent approach.
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Labor, Health and Human Services, and Education: FY2021 Appropriations
addition to regular appropriations. For a discussion of the FY2021 supplemental appropriations
displayed below the bill totals in Table 2, see Appendix C.)
Table 2. LHHS Appropriations Overview by Bill Title, FY2020-FY2021
(Total budget authority provided in the bill, in billions of dollars)
FY2020
Enacted
FY2021
Request
FY2021
House
Cmte.
(H.R. 7614)
13.8
12.5
14.0
13.9
Discretionary
12.4
11.1
12.7
12.5
Mandatory
1.4
1.4
1.4
1.4
Title II: HHS
934.8
1,005.0
1,016.0
1016.6
Discretionary
94.9
87.0
96.4
97.0
Mandatory
839.9
917.9
919.6
919.6
Title III: Education
76.4
70.2
77.1
77.2
Discretionary
72.8
66.6
73.5
73.5
Mandatory
3.6
3.7
3.7
3.7
72.7
69.4
70.9
70.8
Discretionary
15.4
14.1
15.6
15.5
Mandatory
57.3
55.3
55.3
55.3
Total BA in the Bill
1,097.7
1,157.1
1,178.0
1,178.5
Discretionary
195.4
178.8
198.1
198.5
Mandatory
902.3
978.3
980.0
980.0
USMCA (P.L. 116-113)
0.2
-
-
-
1st COVID (P.L. 116-123)
6.4
-
-
-
2nd COVID (P.L. 116-127)
1.3
-
-
-
3rd COVID (P.L. 116-136)
172.1
-
-
-
4th COVID (P.L. 116-139)
100.0
-
-
-
Emergency Funding in Annual LHHSa
-
-
19.4
1.6
5th COVID (Division M, P.L. 116-260)
-
-
-
154.9
Afghan special immigrants (P.L. 117-31)
-
-
-
0.0b
Advances for Future Years
(provided in current bill)c
189.1
197.1
197.6
197.6
Advances from Prior Years
(for use in current year)c
186.7
188.6
189.0
189.0
Additional Scorekeeping Adjustmentsd
-10.5
-9.9
-13.2
-22.5
Bill Title
Title I: Labor
Title IV: Related Agencies
FY2021
Enacted
(P.L. 116260)
Emergency Funding (not included in above totals)
Memoranda (non-emergency funds only):
Source: Amounts in this table for the FY2020 Enacted, FY2021 Request, and FY2021 Enacted columns are
generally drawn from or calculated based on data contained in the explanatory statement accompanying the
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Labor, Health and Human Services, and Education: FY2021 Appropriations
FY2021 LHHS omnibus (P.L. 116-260), available in the Congressional Record, vol. 166, no. 218, book IV, December
21, 2020, pp. H8619-H8711. (The amount for P.L. 117-31 is from CBO, Discretionary Spending: Senate Amendment
2123, July 29, 2021, https://www.cbo.gov/system/files/2021-07/
EmergencySecuritySupplementalAppropriationsAct2021.pdf.) Amounts in the FY2021 House Committee column
are generally drawn from or calculated based on data contained in the committee report (H.Rept. 116-450)
accompanying H.R. 7614. Enacted totals (“Total BA in the Bill”) for FY2020 do not include emergency-designated
appropriations provided in P.L. 116-113, P.L. 116-123, P.L. 116-127, P.L. 116-136, or P.L. 116-139. House
committee bill totals (“Total BA in the Bill”) for FY2021 do not include emergency-designated appropriations
proposed in Title VI of H.R. 7614. Enacted totals (“Total BA in the Bill”) for FY2021 do not include emergencydesignated appropriations provided in Division H or M of P.L. 116-260, or P.L. 117-31. 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 the 21st Century Cures Act (P.L.
114-255), as amended.
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. The FY2021 House committee bill included a total of $19.4 billion in emergency-designated budget
authority in Title VI, of which $925 million was for DOL and $18.5 billion was for HHS. Subsequently,
Division H of P.L. 116-260 enacted $1.6 billion in emergency-designated budget authority, of which $925
million was for DOL in Title I, and $638 million was for HHS in Title II.
b. P.L. 117-31 provided $25 million in supplemental appropriations for the Refugee and Entrant Assistance
account at HHS for specified purposes related to Afghan special immigrants, which rounds to $0.0 in billions
(the unit of measure used in this table).
c. 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.
d. 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 FY2021 enacted discretionary and mandatory LHHS funding levels, by bill
title. (While the dollars and percentages discussed in this section were calculated based on the
FY2021 enacted amounts, they are generally also illustrative—within several percentage points—
of the share of funds directed to each bill title in FY2020 and under the other FY2021 proposals.)
As this figure demonstrates, HHS accounts for the largest share of total FY2021 LHHS
appropriations: $1,017 billion, or 86.3%. 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 6.6% and 6.0%, 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, 1.2%.
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 (48.8%), while ED accounts for a relatively larger share (37.0%).
Together, these two departments represent the majority (85.9%) of discretionary LHHS
appropriations. DOL and the Related Agencies account for a roughly even split of the remaining
14.1% of discretionary LHHS funds.
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Figure 2. FY2021 Enacted LHHS Appropriations by Title
(Budget authority in billions of dollars [unless otherwise indicated])
Source: Amounts in this figure are generally drawn from or calculated based on data contained in the
explanatory statement accompanying the FY2021 LHHS omnibus (P.L. 116-260), available in the Congressional
Record, vol. 166, no. 218, book IV, December 21, 2020, pp. H8619-H8711. Enacted totals (“Total BA in the Bill”)
for FY2021 do not include emergency-designated appropriations provided in Division H or M of P.L. 116-260, or
P.L. 117-31. 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 the
21st Century Cures Act (P.L. 114-255), as amended.
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.
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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).29 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)28
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.
FY2021 DOL Appropriations Overview
Table 3 generally displays FY2021 discretionary and mandatory DOL budget authority provided
or proposed, along with FY2020 enacted levels. The totals in this table do not include emergency
supplemental appropriations; amounts provided in supplemental appropriations are displayed
separately at the bottom of the table and are in addition to regular appropriations. (Although not
technically supplemental appropriations, the bottom of the table also includes emergencydesignated discretionary funding proposed or enacted in annual LHHS measures.)
The FY2021 LHHS omnibus increased discretionary appropriations for DOL by $122 million
(+1.0%) compared to the FY2020 enacted levels. Discretionary DOL appropriations would have
increased by $254 million (+2.0%) under the FY2021 House committee bill, compared to
FY2020 enacted, but would have decreased under the FY2021 President’s budget request by $1.3
billion (-10.5%). Of the total funding provided in the bill for DOL, roughly 90% is discretionary.
28 Departmental Management includes the DOL salaries and expenses, Veterans Employment and Training Service
(VETS), IT Modernization, and the Office of the Inspector General.
29 The Pension Benefit Guaranty Corporation (PBGC) is funded primarily through insurance premiums and related fees
from companies covered by the PBGC. For further information, see CRS In Focus IF10492, An Overview of the
Pension Benefit Guaranty Corporation (PBGC).
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Table 3. DOL Appropriations Overview
(In billions of dollars)
FY2020
Enacted
FY2021
Request
FY2021
House
Cmte.
(H.R.
7614)
Discretionary
12.4
11.1
12.7
12.5
Mandatory
1.4
1.4
1.4
1.4
13.8
12.5
14.0
13.9
USMCA (P.L. 116-113)
0.2
—
—
—
3rd COVID (P.L. 116-136)
0.4
—
—
—
Emergency Funding in Annual
LHHSa
—
—
0.9
0.9
Funding
Total BA in the Bill
FY2021
Enacted
(P.L. 116260)
Emergency Funding (not included in above
totals)
Source: Amounts in this table for the FY2020 Enacted, FY2021 Request, and FY2021 Enacted columns are
generally drawn from or calculated based on data contained in the explanatory statement accompanying the
FY2021 LHHS omnibus (P.L. 116-260), available in the Congressional Record, vol. 166, no. 218, book IV, December
21, 2020, pp. H8619-H8711. Amounts in the FY2021 House Committee column are generally drawn from or
calculated based on data contained in the committee report (H.Rept. 116-450) accompanying H.R. 7614. Enacted
totals (“Total BA in the Bill”) for FY2020 do not include emergency-designated appropriations provided in P.L.
116-113, P.L. 116-123, P.L. 116-127, P.L. 116-136, or P.L. 116-139. House committee bill totals (“Total BA in the
Bill”) for FY2021 do not include emergency-designated appropriations proposed in Title VI of H.R. 7614. Enacted
totals (“Total BA in the Bill”) for FY2021 do not include emergency-designated appropriations provided in
Division H or M of P.L. 116-260, or P.L. 117-31. 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.
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. The FY2021 House committee bill included a total of $19.4 billion in emergency-designated budget
authority in Title VI, of which $925 million was for DOL. Subsequently, Division H of P.L. 116-260 enacted
$1.6 billion in emergency-designated budget authority, of which $925 million was for DOL.
Selected DOL Highlights
The following sections present highlights from FY2021 enacted and proposed appropriations
compared to FY2020 enacted appropriations for selected DOL accounts and programs. 30
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 statute, the Workforce Innovation
and Opportunity Act (WIOA, P.L. 113-128). The WIOA, which replaced the Workforce
30 DOL budget materials can be found at https://www.dol.gov/general/aboutdol#budget.
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Investment Act, was enacted in July 2014 and authorized appropriations for its programs and
activities from FY2015 through FY2020. Authorization of appropriations for WIOA programs
and activities expired at the end of FY2020 but was extended through FY2021 by the FY2021
LHHS omnibus (P.L. 116-260, Division H, Title I).
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 FY2021 LHHS omnibus provided a $26 million increase (+0.9%)
for the three WIOA state formula grant programs compared to FY2020, the FY2021 President’s
budget would have provided level funding and the House committee bill would have increased
funding by $50 million (+1.8%), compared to FY2020 enacted levels.
The FY2021 LHHS omnibus provided $281 million for the Dislocated Workers Activities
National Reserve (DWA National Reserve), which was an increase of $10 million (+3.7%)
compared to the FY2020 enacted level. This was the same amount that was proposed by the
House committee bill, whereas the FY2021 President’s budget would have reduced funding for
the DWA National Reserve by $110 million (-40.6%). In addition, the FY2021 LHHS omnibus
maintained a provision in that account (which originated in the FY2018 omnibus and has been
included since then) directing $35 million from the DWA National Reserve toward training and
employment assistance for workers dislocated in both the Appalachian and lower Mississippi
regions. Finally, the FY2021 LHHS omnibus maintained a provision that originated in the
FY2020 omnibus directing $45 million from the DWA National Reserve to be used in developing,
offering, or improving career training programs at community colleges.
The FY2021 LHHS omnibus provided $185 million for the Apprenticeship Grant program, which
was $10 million (+5.7%) more than the level enacted in FY2020 and the same that the House
committee bill would have provided. The FY2021 President’s budget would have increased the
level of funding for the Apprenticeship Grant program by $25 million (+14.3%) compared to the
FY2020 enacted level.
Four ETA programs for which the FY2021 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 FY2021 appropriations at roughly the same level as FY2020.
Office of Foreign Labor Certification (OFLC)
The FY2021 LHHS omnibus provided $78 million for OFLC, which was an increase of $9
million (+13.1%) compared to the FY2020 enacted level and the same amount that was proposed
by the House committee bill. This FY2021 enacted level was $2 million less (-2.6%) than the
amount requested in the FY2021 President’s budget. The OFLC, which is part of ETA, is
responsible for labor certification applications for employment-based and immigration and guest
worker programs. Of the $9 million increase, $3 million was for national administration and $6
million was for grants to states. As noted in the FY2021 House committee report, the $6 million
increase in OFLC grants to states was proposed partly in response to an increase in the number of
H-2A applications that resulted in requests from states for additional resources for reviewing,
processing, recruitment of potential domestic agricultural workers, and contract oversight.31
31 H.Rept. 116-450, pp. 20-21.
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Bureau of Labor Statistics (BLS)
The FY2021 LHHS omnibus provided $655 million for BLS, the same level as FY2020 enacted
The House committee bill had previously proposed level funding, whereas the FY2021
President’s budget had proposed a $3 million increase (+0.5%) relative to FY2020. As noted in
the explanatory statement accompanying the FY2021 LHHS omnibus, $13 million of the FY2021
appropriation was for necessary costs associated with the physical relocation of BLS headquarters
to the Suitland Federal Complex, which was initiated in FY2020.32 Similarly, the FY2021 House
committee report indicated continued support for BLS to continue implementation of several data
projects started in FY2020, including work to implement 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) cohort.33
Bureau of International Labor Affairs (ILAB)
The FY2021 LHHS omnibus provided $96 million for ILAB, which was the same as the FY2020
enacted level and the same amount that the House committee bill would have provided. The
FY2021 President’s budget would have decreased funding by $77 million (-80.6%) for ILAB,
which provides research, advocacy, technical assistance, and grants to promote workers’ rights in
different parts of the world. Language in the FY2021 President’s budget indicated that the
proposed reduction reflected a $67.3 million decrease to eliminate new grants and a $10.3 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 FY2021 LHHS omnibus.
The FY2021 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
32 Congressional Record, December 21, 2020, Vol. 166, No. 218, Book IV, p. H8619.
33 H.Rept. 116-450, pp. 31-32.
34 See DOL, FY2021 Congressional Budget Justification, Departmental Management, p. DM-41, https://www.dol.gov/
sites/dolgov/files/general/budget/2021/CBJ-2021-V3-02.pdf.
35 See Division H, Title I, §108 of P.L. 116-260.
36 See Division H, Title I, §110 of P.L. 116-260. The H-2B program allows for the temporary employment of foreign
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Labor, Health and Human Services, and Education: FY2021 Appropriations
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
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 and
prohibit any funds from the FY2021 omnibus from being used to alter the
Interagency Agreement between DOL and USDA or to close any Civilian
Conservation Centers unless certain conditions are met (included since
FY2020).40
Table 4. Detailed DOL Appropriations
(In millions of dollars)
Agency or Selected Program
FY2020
Enacted
FY2021
Request
FY2021
House
Cmte.
(H.R.
7614)
FY2021
Enacted
(P.L. 116260)
ETA—Mandatorya
680
634
634
634
ETA—Discretionary
9,293
8,043
9,527
9,392
Training and Employment Services:
3,611
3,358
3,697
3,663
State Formula Grants:
2,820
2,820
2,870
2,845
Adult Activities Grants to States
855
855
865
863
Youth Activities Grants to States
913
913
925
921
1,052
1,052
1,080
1,062
791
538
827
818
DWA National Reserve
271
161
281
281
Native Americans
55
0
56
56
Migrant and Seasonal Farmworkers
92
0
96
94
YouthBuild
95
85
101
97
Reintegration of Ex-Offenders
98
93
103
100
Discretionary ETA Programs:
Dislocated Worker Activities (DWA)
Grants to States
National Activities:
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 H, Title I, §112 of P.L. 116-260.
38 See Division H, Title I, §113 of P.L. 116-260.
39 See Division H, Title I, §114 of P.L. 116-260.
40 See Division H, Title I, §116 of P.L. 116-260.
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FY2021
Request
FY2021
House
Cmte.
(H.R.
7614)
FY2021
Enacted
(P.L. 116260)
6
0
6
6
175
200
185
185
1,744
1,016
1,756
1,749
405
0
410
405
3,375
3,497
3,506
3,417
2,553
2,665
2,668
2,584
Employment Service
690
688
698
692
Foreign Labor Certification
69
80
78
78
One-Stop Career Centers
63
65
63
63
ETA Program Administration
159
172
159
159
Employee Benefits Security Administration
181
193
181
181
Pension Benefit Guaranty Corp, (PBGC) program
level (non-add)b
(453)
(465)
(465)
(465)
Wage and Hour Division
242
244
246
246
Office of Labor-Management Standards
43
50
42
44
Office of Federal Contract Compliance
Programs
106
106
106
106
Office of Workers’ Compensation Programs—
Mandatoryc
695
739
739
739
Office of Workers’ Compensation Programs—
Discretionary
118
119
118
118
Occupational Safety & Health Administration
582
577
594
592
Mine Safety & Health Administration
380
382
380
380
Bureau of Labor Statistics
655
658
655
655
Office of Disability Employment Policy
39
27
39
39
Departmental Management
776
714
780
784
Salaries and Expenses
348
272
349
349
96
19
96
96
Veterans Employment and Training
311
312
314
316
IT Modernization
25
37
25
27
Office of the Inspector General
91
93
92
91
Total, DOL BA in the Bill
13,789
12,488
14,041
13,909
Subtotal, Mandatory
1,375
1,373
1,373
1,373
Subtotal, Discretionary
12,414
11,114
12,668
12,536
Agency or Selected Program
Workforce Data Quality Initiative
Apprenticeship Grants
Job Corps
Community Service Employment for Older Americans
State Unemployment Insurance and Employment
Service Operations (SUI/ESO):
Unemployment Compensation
International Labor Affairs (non-addd)
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Enacted
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Labor, Health and Human Services, and Education: FY2021 Appropriations
Agency or Selected Program
FY2020
Enacted
FY2021
Request
FY2021
House
Cmte.
(H.R.
7614)
FY2021
Enacted
(P.L. 116260)
Emergency Funding (not included in above totals)
USMCA (P.L. 116-113)
210
—
—
—
3rd COVID (P.L. 116-136)
360
—
—
—
Emergency Funding in Annual LHHSe
—
—
925
925
Total, BA Available in Fiscal Year (current year from
any bill)
13,789
12,548
14,041
13,909
Total, BA Advances for Future Years (provided in
current bill)
1,786
1,726
1,786
1,786
Total, BA Advances from Prior Years (for use in
current year)
1,786
1,786
1,786
1,786
Memoranda (non-emergency funds only)
Source: Amounts in this table for the FY2020 Enacted, FY2021 Request, and FY2021 Enacted columns are
generally drawn from or calculated based on data contained in the explanatory statement accompanying the
FY2021 LHHS omnibus (P.L. 116-260), available in the Congressional Record, vol. 166, no. 218, book IV, December
21, 2020, pp. H8619-H8711. Amounts in the FY2021 House Committee column are generally drawn from or
calculated based on data contained in the committee report (H.Rept. 116-450) accompanying H.R. 7614. Enacted
totals (“Total BA in the Bill”) for FY2020 do not include emergency-designated appropriations provided in P.L.
116-113, P.L. 116-123, P.L. 116-127, P.L. 116-136, or P.L. 116-139. House committee bill totals (“Total BA in the
Bill”) for FY2021 do not include emergency-designated appropriations proposed in Title VI of H.R. 7614. Enacted
totals (“Total BA in the Bill”) for FY2021 do not include emergency-designated appropriations provided in
Division H or M of P.L. 116-260, or P.L. 117-31. 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.
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. 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).
b. 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 Expenses total.
e. The FY2021 House committee bill included a total of $19.4 billion in emergency-designated budget
authority in Title VI, of which $925 million was for DOL. Subsequently, Division H of P.L. 116-260 enacted
$1.6 billion in emergency-designated budget authority, of which $925 million was for DOL.
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
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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]). 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 Agencies Funded via the
HHS is a large federal department composed
LHHS Appropriations Process
of multiple agencies working to enhance the
Health Resources and Services Administration (HRSA)
health and well-being of Americans. Annual
Centers for Disease Control and Prevention (CDC)
LHHS appropriations laws direct funding to
National Institutes of Health (NIH)
most (but not all) HHS agencies (see text box
Substance Abuse and Mental Health Services
for HHS agencies supported by the LHHS
Administration (SAMHSA)
bill).41 For instance, the LHHS bill directs
Agency for Healthcare Research and Quality (AHRQ)
funding to five Public Health Service (PHS)
Centers for Medicare & Medicaid Services (CMS)
agencies: the Health Resources and Services
Administration for Children and Families (ACF)
Administration (HRSA), Centers for Disease
Administration for Community Living (ACL)
Control and Prevention (CDC), National
Office of the Secretary (OS)
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. 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.
41 Three HHS public health agencies receive annual funding from appropriations bills other than the LHHS bill: 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
(funded through the Interior-Environment appropriations bill). In addition, while the National Institutes of Health
(NIH) receive the majority of their appropriations from 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.
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FY2021 HHS Appropriations Overview
Table 5 displays enacted and proposed FY2021 funding levels for HHS, along with FY2020
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. (Although not technically supplemental appropriations, the
bottom of the table also includes emergency-designated discretionary funding proposed or
enacted in annual LHHS measures.) For a discussion of the FY2021 supplemental appropriations
in Division M of P.L. 116-260 and P.L. 117-31, see Appendix C.
In general, discretionary funds account for about 10% of HHS appropriations in the LHHS bill.
Compared to the FY2020 funding levels, the FY2021 LHHS omnibus increased HHS
discretionary appropriations by 2.2%. The House committee bill would have increased HHS
discretionary appropriations to a lesser degree, by 1.5%, while the President requested an 8.3%
decrease in discretionary HHS funding.
Table 5. HHS Appropriations Overview
(In billions of dollars)
FY2020
Enacted
FY2021
Request
FY2021
House
Cmte.
(H.R.
7614)
Discretionary
94.9
87.0
96.4
97.0
Mandatory
839.9
917.9
919.6
919.6
Total BA in the Bill
934.8
1,005.0
1,016.0
1,016.6
1st COVID (P.L. 116-123)
6.4
—
—
—
2nd COVID (P.L. 116-127)
1.3
—
—
—
3rd COVID (P.L. 116-136)
140.4
—
—
—
4th COVID (P.L. 116-139)
100.0
—
—
—
Emergency Funding in Annual LHHSa
—
—
18.5
0.6
5th COVID (Division M, P.L. 116-260)
—
—
—
72.9
Afghan special immigrants (P.L. 117-31)
-
-
-
0.0b
Funding
FY2021
Enacted
(P.L.
116-260)
Emergency Funding (not included in above
totals)
Sources: Amounts in this table for the FY2020 Enacted, FY2021 Request, and FY2021 Enacted columns are
generally drawn from or calculated based on data contained in the explanatory statement accompanying the
FY2021 LHHS omnibus (P.L. 116-260), available in the Congressional Record, vol. 166, no. 218, book IV, December
21, 2020, pp. H8619-H8711. (The amount for P.L. 117-31 is from CBO, Discretionary Spending: Senate Amendment
2123, July 29, 2021, https://www.cbo.gov/system/files/2021-07/
EmergencySecuritySupplementalAppropriationsAct2021.pdf.) Amounts in the FY2021 House Committee column
are generally drawn from or calculated based on data contained in the committee report (H.Rept. 116-450)
accompanying H.R. 7614. Enacted totals (“Total BA in the Bill”) for FY2020 do not include emergency-designated
appropriations provided in P.L. 116-113, P.L. 116-123, P.L. 116-127, P.L. 116-136, or P.L. 116-139. House
committee bill totals (“Total BA in the Bill”) for FY2021 do not include emergency-designated appropriations
proposed in Title VI of H.R. 7614. Enacted totals (“Total BA in the Bill”) for FY2021 do not include emergencydesignated appropriations provided in Division H or M of P.L. 116-260, or P.L. 117-31. For consistency with
source materials, amounts in this figure generally do not reflect mandatory spending sequestration, where
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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), as amended.
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. The FY2021 House committee bill included a total of $19.4 billion in emergency-designated budget
authority in Title VI, of $18.5 billion was for HHS. Subsequently, Division H of P.L. 116-260 enacted $1.6
billion in emergency-designated budget authority, of which $638 million was for HHS in Title II.
b. P.L. 117-31 provided $25 million in supplemental appropriations for the Refugee and Entrant Assistance
account at HHS for specified purposes related to Afghan special immigrants, which rounds to $0.0 in billions
(the unit of measure used in this table).
Figure 3 provides an HHS agency-level breakdown of FY2021 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
$906.6 billion, which is 89.2% of all enacted appropriations for HHS. NIH and ACF account for
the next-largest shares of total HHS appropriations, receiving about 4.1% apiece.
By contrast, when looking exclusively at discretionary appropriations, funding for CMS
constitutes about 4.6% of FY2021 enacted HHS appropriations. Instead, the bulk of discretionary
appropriations went to the PHS agencies, which combined to account for 63.8% of discretionary
appropriations provided for HHS.44 NIH typically receives the largest share of all discretionary
funding among HHS agencies (42.7% in FY2021), with ACF accounting for the second-largest
share (25.5% in FY2021).
44 For further information about PHS agency funding, see CRS Report R44916, Public Health Service Agencies:
Overview and Funding (FY2016-FY2018).
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Figure 3. FY2021 Enacted HHS Appropriations by Agency
(Budget authority in billions of dollars)
Source: Amounts in this figure are generally drawn from or calculated based on data contained in the
explanatory statement accompanying the FY2021 LHHS omnibus (P.L. 116-260), available in the Congressional
Record, vol. 166, no. 218, book IV, December 21, 2020, pp. H8619-H8711. Enacted totals (“Total BA in the Bill”)
for FY2021 do not include emergency-designated appropriations provided in Division H or M of P.L. 116-260, or
P.L. 117-31. 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 the
21st Century Cures Act (P.L. 114-255), as amended.
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 FY2021 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.
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
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maximum percentage for the set-aside and have distributed specific amounts of “tap” funding to
selected HHS programs. Since FY2010, and including in FY2021, this higher maximum set-aside
level has been 2.5% of eligible appropriations.45 (The President’s budget proposed to increase the
set-aside to 2.9%, while the House committee bill would have increased it to 3.0%.)
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.46 The House committee bill
generally would have maintained the current distributional practice for FY2021, 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 and to supplemental funding for organ transplantation activities at HRSA, while
simultaneously proposing to reduce tap transfers to the NIH.
Since FY2015, LHHS appropriations laws have directed the largest share of tap transfers to
NIH.47 The FY2021 LHHS omnibus provided $1.3 billion in tap transfers to NIH, a $41 million
(+3.3%) increase over the FY2020 level. The FY2021 House committee bill proposed that the
NIH transfers be increased by $110 million (+9.0%), whereas the President’s request proposed
that the transfers be reduced by $490 million (-39.8%).
45 See Section 204, Division H, P.L. 116-260 for the FY2021 maximum set-aside level. The 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). The FY2021 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.
46 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 appropriation 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 Trust 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.
47 Prior to FY2015, NIH had traditionally been by far the largest net donor of tap funds, rather than a net recipient. The
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.
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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.48 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 FY2021, but this
amount was reduced by subsequent laws that decreased PPHF funding for FY2021 and other
fiscal years. Under current law, the FY2021 appropriation was $950 million.49 In addition, this
appropriation was subject to a 5.7% reduction due to sequestration of nonexempt mandatory
spending.50 (For more information on sequestration, see the budget enforcement discussion in
Appendix A.) After sequestration, the total PPHF appropriation available for FY2021 was $896
million, an increase of $2 million relative to FY2020. Of this amount, the LHHS omnibus
allocated $856 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 FY2021 and proposed by the House committee bill, $854 million, was a $2 million (+0.2%)
increase relative to FY2020. The President’s request proposed increasing the PPHF funding
transferred to CDC to $894 million (+4.6%), and providing no mandated transfers to SAMHSA
or ACL.
Selected HHS Highlights by Agency
This section begins with a limited selection of FY2021 discretionary funding highlights by HHS
agency. The discussion is largely based on the enacted and proposed appropriations levels for
FY2021, compared to FY2020 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
48 For more information, see CRS Report R41301, Appropriations and Fund Transfers in the Affordable Care Act
(ACA).
49 42 U.S.C. §300u-11.
50 OMB Report to the Congress on the Joint Committee Reductions for Fiscal Year 2021, February 10, 2020, p. 7 of 17,
https://www.whitehouse.gov/wp-content/uploads/2020/02/JC-sequestration_report_FY21_2-10-20.pdf.
51 See explanatory statement accompanying the FY2021 LHHS omnibus (P.L. 116-260), available in the Congressional
Record, December 21, 2020, Vol. 166, No. 218, Book IV, p. H8634, for allocations to specific agency programs and
activities.
52 See Division H, §222, P.L. 116-260.
53 HHS budget materials can be found at http://www.hhs.gov/budget/.
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two tables (Table 6 and Table 7) presenting more detailed information on FY2020 enacted and
FY2021 proposed and enacted funding levels for HHS.
HRSA
The FY2021 LHHS omnibus provided $7.2 billion in discretionary budget authority for HRSA.
This was $171 million (+2.4%) more than HRSA’s FY2020 discretionary funding level and $913
million (+14.5%) more than the FY2021 President’s budget request.
Under the Primary Health Care account, the Community Health Centers program received $1.683
billion, an increase of $57 million (+3.5%) relative to FY2020.54 The explanatory statement also
recommended $102.5 million under that same account for the second year of the Ending the HIV
Epidemic Initiative, which is focused on reducing HIV transmission via increased use of preexposure prophylaxis (PrEP) among high risk groups.55 Under the Ryan White HIV/AIDS
Program appropriation, there is an additional $105 million set aside for this HIV initiative, an
increase of $35 million relative to FY2020. The explanatory statement also “encourages the
acceleration of the development of oral, ultra-long-acting, sustained-release therapies” as part of
this initiative.56
The explanatory statement provided $34 million for telehealth within the Rural Health account, a
$5 million (+17.2%) increase relative to FY2020. Within this amount, $6.5 million was provided
for the Telehealth Centers of Excellence (COE) and $1 million was provided for an evaluation of
nationwide telehealth investments in rural areas and populations.57 It also directed HHS and
HRSA to “continue to utilize the expertise of the COEs in the Ending the HIV Epidemic initiative
to develop best practices for utilizing telehealth in HIV prevention, care, and treatment.”
The Maternal and Child Health (MCH) Block Grant received $713 million, an increase of $25
million (+3.6%) relative to FY2020. Related to maternal health, the explanatory statement set
aside $9 million for the Alliance for Maternal Health Safety Bundles, which are “a set of targeted
and evidence-based best practices that, when implemented, improve patient outcomes and reduce
maternal mortality and severe maternal morbidity,”58 and provided $5 million for State Maternal
Health Innovation Grants. Within the Health Workforce account, the explanatory statement
designated $2.5 million for midwife training “to address the national shortage of maternity care
providers and the lack of diversity in the maternity care workforce.”59
CDC
The FY2021 LHHS omnibus provided $7.0 billion in discretionary budget authority for CDC,
which was $123 million (+1.8%) more than CDC’s FY2020 funding level. The FY2021 LHHS
omnibus did not direct any PHS tap funds to the CDC, continuing the practice started in FY2015.
54 The Health Centers program also received significant additional FY2020 and FY2021 funding related to the COVID-
19 pandemic, totaling roughly $2 billion. For a discussion of this funding, see CRS Report R46711, U.S. Public Health
Service: COVID-19 Supplemental Appropriations in the 116th Congress.
55 Congressional Record, December 21, 2020, Vol. 166, No. 218, Book IV, p. H8620. An amount of $50 million was
set aside in FY2020 for the first year of this initiative (see Congressional Record, December 17, 2019, Vol. 165, No.
204, Book III, p. H11063).
56 Ibid, p. H8621.
57 Ibid, p. H8620. See H.Rept. 116-450, pp. 58-59, for further information.
58 Ibid, p. H8620. See H.Rept. 116-450, p. 51, for a description of this activity.
59 Ibid, p. H8620.
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It also did not direct the transfer of funds from the HHS Nonrecurring Expenses Fund (NEF) to
the CDC (unlike FY2020).60 However, the FY2021 LHHS omnibus did supplement discretionary
CDC appropriations by directing $856 million in PPHF transfers to the CDC, which was $2
million (+0.2%) more than FY2020. All told, this combination of funding—compared to FY2020
funding from discretionary appropriations and directed transfers from the PPHF and NEF—
represented a decrease of $100 million (-1.3%) from FY2020 in budget authority that is inclusive
of directed transfers.
The President’s budget request would have increased discretionary budget authority by $54
million (+0.8%) relative to FY2020, while also requesting that $542 million in tap funds be
directed to the CDC. The President’s budget also requested $894 million in PPHF transfers,
which would have been a $40 million (+4.6%) increase. 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 an increase of $410 million (+5.1%) from FY2020.
All programmatic accounts received increases relative to FY2020 except Public Health
Preparedness and Response and CDC-Wide Activities and Program Support. Among these
increases: (1) the HIV/AIDS, Viral Hepatitis, STI and TB Prevention account, which was funded
at an increased level of $1.3 billion (+3.2% above FY2020) included a $35 million increase for
the Ending HIV/AIDS Initiative;61 and (2) the Emerging and Zoonotic Infectious Diseases
(EZID) account, which was funded at an increased level of $596 million (+4.5% above FY2020),
included $10 million in funding for a new pilot program that would award competitive grants for
the development of Social Determinants of Health Accelerator Plans62. Other increases included
the Environmental Health account, funded at $206 million (+4.6%)63, and the Public Health
Scientific Services account, funded at $592 million (+6.6%).
With regard to the Injury Prevention and Control account, which received $683 million (+0.8%),
the explanatory statement included funding for several line items that were first included in
FY2020, including child sexual abuse prevention ($1.5 million), suicide prevention ($12 million),
and adverse childhood experiences (ACEs, $5 million).64 The explanatory statement also included
specific funding for Firearm Injury and Mortality Prevention Research program ($12.5 million)
and Opioid Overdose Prevention and Surveillance ($476 million).65
60 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 (P.L. 110-161,
Division G, Title II, §223). Most accounts in annual appropriations measures receive appropriations from the General
Fund at the U.S. Treasury. This term refers to all federal money not allocated by law to any other fund account, such as
federal trust funds for Medicare. Funds transferred into the NEF are generally available to the 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, including in FY2020 where the LHHS omnibus directed $225 million from the
NEF to the CDC Buildings and Facilities account to support infrastructure improvements for the CDC’s Chamblee
Campus (Congressional Record, December 17, 2019, Vol. 165, No. 204, Book III, p. H11065.)
61 Centers for Disease Control and Prevention, “Ending the HIV Epidemic,” https://www.cdc.gov/endhiv/index.html.
62 Congressional Record, December 21, 2020, Vol. 166, No. 218, Book IV, p. H8623. See H.Rept. 116-450, pp. 76-77,
for a description of this activity.
63 This amount does not include the PPHF transfer of $17 million that was directed to the Environmental Health
account each of FY2020 and FY2021.
64 Ibid., p. H8623.
65 Ibid., p. H8623. 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.
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The Infectious Disease Rapid Response Reserve Fund (IDRRRF) within the CDC-Wide
Activities and Program Support account received $10 million in the explanatory statement.66 The
IDRRRF was established in 2018 by P.L. 115-245 and is codified at 42 U.S.C. §247d-4a as an
emergency reserve account. Funds can be made available for infectious disease emergencies as
declared by the HHS Secretary (PHSA §319), or if an infectious disease outbreak has the
potential to affect national security or the health and security of U.S. citizens, as specified. Funds
may be used to carry out activities related to the research, public health prevention, and response
for infectious disease emergencies.
NIH
The FY2021 LHHS omnibus provided $41.4 billion in discretionary budget authority for NIH.
This was $1.2 billion (+3.0%) more than FY2020 and $3.4 billion (+8.8%) more than the
President’s FY2021 budget request.
As was the case in FY2020, the FY2021 LHHS omnibus directed $225 million from the HHS
Nonrecurring Expenses Fund (NEF)67 to the NIH Buildings and Facilities account to implement
the recommendations in the 2019 National Academies of Sciences, Engineering, and Medicine
report Managing the NIH Bethesda Campus’ Capital Assets in a Highly Competitive Global
Biomedical Research Environment.68 In addition, the FY2021 LHHS omnibus directed $1.3
billion in PHS tap transfers to NIH, an increase of $41 million (+3.3%) from FY2020. 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 $14 million (+0.8%) more than FY2020, but when
combined with the tap transfer, total funding for NIGMS increased by $54 million (+1.8%) from
FY2020.
In line with recent practice, the explanatory statement on the FY2021 LHHS omnibus directed
NIH to reserve a specific dollar amount for a number of purposes, for example, $3.1 billion for
Alzheimer’s disease research at the National Institute on Aging.69 It also included a reservation of
funds for Firearm Injury and Mortality Prevention Research of $12.5 million, the same amount as
FY2020.70 Reserving a specific dollar amount for a particular disease or area of research at NIH is
a relatively new practice that has expanded since 2015; still, most NIH funding is not designated
for particular diseases or areas of research.71
66 Ibid., p. H8624.
67 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 (P.L. 110-161,
Division G, Title II, §223). Most accounts in annual appropriations measures receive appropriations from the General
Fund at the U.S. Treasury. This term refers to all federal money not allocated by law to any other fund account, such as
federal trust funds for Medicare.
68 See Division H, Title II, §238 of P.L. 116-260. For further details, see Congressional Record, December 21, 2020,
Vol. 166, No. 218, Book IV, p. H8629. (See also Congressional Record, December 17, 2019, Vol. 165, No. 204, Book
III, p. H11074.)
69 Ibid., p. H8626. For a list of specified funding levels in the explanatory statement accompanying the LHHS omnibus,
see Table A-2 in CRS Report R43341, National Institutes of Health (NIH) Funding: FY1996-FY2022.
70 Ibid., p. H8627. 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 in both FY2020 and FY2021.
71 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
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The FY2021 LHHS omnibus appropriated $404 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 $50 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 $109
million was for the Precision Medicine Initiative.72
SAMHSA
The FY2021 LHHS omnibus provided $5.9 billion in discretionary budget authority for
SAMHSA. This amount was $133 million (+2.3%) more than SAMHSA’s FY2020 funding level
and $272 million (+4.9%) more than the President’s FY2021 budget request. The FY2021 LHHS
omnibus also directed $134 million in PHS evaluation tap funding and $12 million in PPHF
funding to SAMHSA, which were the same amounts as FY2019 and FY2020.
The additional funding provided to SAMHSA was spread across several programs in the
explanatory statement. The programs within the Mental Health Programs of Regional and
National Significance (PRNS) received an increase of $26 million (+5.9%) and the programs
within the Substance Abuse Treatment PRNS received an increase of $17 million (+3.6%). Nearly
all Mental Health and Substance Abuse Treatment PRNS programs received level funding or
modest increases from FY2020. The largest increase was provided to the Certified Community
Behavioral Health Clinics (CCBHCs)—$50 million (+25.0%) more than FY2020. The
Community Mental Health Block Grant (MHBG) received an increase of $35 million (+5.0%)
while the Substance Abuse Prevention and Treatment Block Grant (SABG) received the same
amount as FY2020. The State Opioid Response (SOR) grant program continued to be funded at
$1.5 billion, the same amount as FY2019 and FY2020.
AHRQ
The FY2021 LHHS omnibus provided $338 million in discretionary budget authority to AHRQ.
This was the same as the FY2020 level. The FY2021 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.73 (The
House bill proposed $200 million in tap transfers for AHRQ, but this proposal was not enacted.)
The FY2021 LHHS omnibus continued to fund AHRQ as its own operating division, declining
the President’s proposal to consolidate AHRQ into NIH. The FY2021 President’s budget had
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. The 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.
72 Congressional Record, December 21, 2020, Vol. 166, No. 218, Book IV, p. H8624.
73 In addition to funds provided through the annual appropriations process, AHRQ is also scheduled in FY2021 to
receive a transfer of certain mandatory funds that were authorized and appropriated to the Patient-Centered Outcomes
Research Trust Fund (PCORTF) by ACA Section 6301(e), as amended (26 U.S.C. §9511). Transfers to AHRQ from
the PCORTF are to be used to disseminate the results of patient-centered outcomes research. (PCORTF funds are
generally not displayed in this report, as they are not provided by or modified through annual LHHS appropriations
bills.) For more information on the PCORTF, see HHS, Office of the Assistant Secretary for Planning and Evaluation,
Patient-Centered Outcomes Research Trust Fund, https://aspe.hhs.gov/patient-centered-outcomes-research-trust-fund.
Congressional Research Service
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Labor, Health and Human Services, and Education: FY2021 Appropriations
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.74
CMS
The FY2021 LHHS omnibus provided $4.5 billion in discretionary budget authority for CMS.
This was $21 million (+0.5%) more than FY2020 and $30 million (-0.7%) less than the FY2021
President’s budget request. The LHHS omnibus appropriated $807 million for the CMS Health
Care Fraud and Abuse Control (HCFAC) account, 2.7% more than FY2020, and less (-0.7%) than
the FY2021 President’s request. Of the total amount appropriated for HCFAC, $496 million was
effectively exempt from the discretionary budget caps. (See Appendix A for an explanation of
the LHHS budget cap exemptions.)
The LHHS omnibus provided the CMS Program Management account with $3.7 billion, which
was the same amount provided in FY2020 and FY2019. 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 FY2021
appropriation was less than the amount proposed by the President’s budget (-0.6%) and 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 FY2021 LHHS omnibus provided $24.7 billion in discretionary budget authority for ACF.
This was $251 million (+1.0%) more than FY2020 and $4.5 billion (+22.3%) more than the
FY2020 President’s budget request. The President’s budget would have decreased ACF
discretionary funding by almost one-fifth relative to the prior year (-17.4%). 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 sustained or increased in the FY2021 LHHS omnibus relative to
FY2020: LIHEAP received $3.8 billion (+0.3%), PDG $275 million (+0.0%), and CSBG $745
million (+0.7%).
74 HHS, NIH, National Institute for Research on Safety and Quality, FY2021 Congressional Justification,
https://www.ahrq.gov/sites/default/files/wysiwyg/cpi/about/mission/budget/2021/FY_2021_CJ_NIRSQ.pdf. The
President’s request would have funded NIRSQ at $257 million for FY2021 (not counting transfers from the PCORTF).
A similar proposal was made in the President’s FY2020, FY2019, and FY2018 requests; see HHS, NIH, National
Institute for Research on Safety and Quality, FY2021 Congressional Justification, https://www.ahrq.gov/sites/default/
files/wysiwyg/cpi/about/mission/budget/2020/FY_2020_CJ_-NIRSQ.pdf; 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, https://www.ahrq.gov/sites/default/files/wysiwyg/cpi/about/mission/budget/2018/
NIRSQ.pdf.
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Labor, Health and Human Services, and Education: FY2021 Appropriations
The LHHS omnibus provided $1.9 billion for the Refugee and Entrant Assistance programs
account, an increase of $2 million (+0.1%) relative to FY2020. 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. The 15% limit on those transfers was the same as FY2020.
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 FY2020 and 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 that were enacted in FY2020 related to
the UAC program. For instance, the law authorized HHS to accept donations for the care of UAC
arrivals (§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 or carried by reference in the explanatory statement, such as a
monthly report to the appropriations committees that includes estimates of UAC arrivals and any
changes in funding needs as a result of these arrivals, public reporting with respect to children
who have been separated from a parent or legal guardian, a report to the appropriations
committees related to provider facility violations related to standards of child care or the
wellbeing of children, and a semiannual report related to number of children in ORR custody in
residential treatment centers.75
ACL
The FY2021 LHHS omnibus provided $2.3 billion in discretionary budget authority for ACL.
This was $35 million (+1.6%) more than FY2020. In addition, the FY2021 LHHS omnibus
directed $28 million in PPHF transfers to ACL, the same as FY2020. The explanatory statement
accompanying the FY2021 LHHS omnibus specified that the PPHF transfers were for the
Alzheimer’s Disease Program, Chronic Disease Self-Management, and Elder Falls Prevention.
The FY2021 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 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.76
75 Congressional Record, vol. 165, no. 204, December 17, 2019, pp. H11077-H11078. The explanatory statement
included language related to the UACs that noted “The agreement notes that the front matter of this explanatory
statement establishes that language included in House Report 116–450 should be complied with unless specifically
addressed to the contrary in this explanatory statement. In cases where the House Report addresses an issue not
addressed in this joint explanatory statement, the House Report language is deemed to carry the same emphasis as
language included in this explanatory statement.” See H.Rept. 116-450, pp. 177-188 for UAC-related language.
76 Budget of the United States Government, Fiscal Year 2021, Appendix, p. 502, https://www.govinfo.gov/content/pkg/
BUDGET-2021-APP/pdf/BUDGET-2021-APP.pdf#page=506. A similar proposal was made in the President’s FY2020
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Labor, Health and Human Services, and Education: FY2021 Appropriations
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 FY2021 LHHS omnibus retained these
existing restrictions (§§506 and 507).77
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
embryos for research purposes or for research in which human embryos are destroyed. The
FY2021 LHHS omnibus retained these existing restrictions (§508).78
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).79 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 FY2021 House
and FY2019 requests; see, 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; and Budget
of the United States Government, Fiscal Year 2019, Appendix, p. 484, https://www.govinfo.gov/content/pkg/BUDGET2019-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).
Furthermore, P.L. 116-260, Division N, Section 732 provides that of the home-delivered and congregate nutrition
services program funds that they receive in FY2021, state and local agencies on aging may transfer up to 100% of the
funds between the two programs without prior approval.
77 The 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.
78 The 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.
79 The 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. The 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.
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Labor, Health and Human Services, and Education: FY2021 Appropriations
committee bill would have omitted this provision entirely, but the FY2021 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). FY2021 omnibus retained these existing restrictions
(§210 [HHS] and §503(c) [all LHHS, plus PPHF transfers]).80
Table 6. HHS Appropriations Totals by Agency
(In millions of dollars)
HHS Agency
HRSA
FY2020
Enacted
FY2021
Request
FY2021
House
Cmte.
(H.R.
7614)
FY2021
Enacted
(P.L. 116260)
7,333
6,571
7,472
7,484
Mandatory BA
286
266
266
266
Discretionary BA
7,047
6,305
7,206
7,218
0
13
0
0
6,895
6,949
7,126
7,019
Mandatory BA
55
55
55
55
Discretionary BA
6,840
6,894
7,070
6,963
0
542
0
0
PPHFc
854
894
856
856
Nonrecurring Expenses Fund Transferd
225
0
0
0
40,228
38,070
40,618
41,437
0
0
0
0
40,228
38,070
40,618
41,437
1,231
741
1,341
1,272
225
0
0
225
5,737
5,598
5,833
5,870
0
0
0
0
5,737
5,598
5,833
5,870
Evaluation Tap Fundinga
134
143
134
134
PPHFc
12
0
12
12
338
0
143
338
Evaluation Tap Fundinga
CDCb
Evaluation Tap Fundinga
NIHb
Mandatory BA
Discretionary BA
Evaluation Tap Fundinga
Nonrecurring Expenses Fund Transferd
SAMHSA
Mandatory BA
Discretionary BA
AHRQe
80 As previously noted, the explanatory statement accompanying the FY2021 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 21, 2020, Vol. 166, No. 218, Book IV, pp. H8623 and H8627.). These
CDC and NIH funding reservations for Firearm Injury and Mortality Prevention were first included in LHHS
explanatory statements in FY2020.
Congressional Research Service
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Labor, Health and Human Services, and Education: FY2021 Appropriations
HHS Agency
FY2020
Enacted
FY2021
Request
FY2021
House
Cmte.
(H.R.
7614)
FY2021
Enacted
(P.L. 116260)
Mandatory BA
0
0
0
0
Discretionary BA
338
0
143
338
0
0
200
0
CMS
828,343
906,657
906,942
906,627
Mandatory BA
823,888
902,150
902,150
902,150
Discretionary BA
4,456
4,507
4,792
4,477
ACF
39,523
34,994
41,256
41,190
Mandatory BA
15,079
14,796
16,496
16,496
Discretionary BA
24,444
20,198
24,760
24,695
ACL
2,223
2,108
2,280
2,258
0
0
0
0
Discretionary BA
2,223
2,108
2,280
2,258
PPHFc
28
0
28
28
4,212
4,009
4,309
4,359
Mandatory BA
624
653
653
653
Discretionary BA
3,588
3,356
3,656
3,706
65
74
65
65
934,832
1,004,955
1,015,978
1,016,583
Mandatory
839,931
917,920
919,620
919,620
Discretionary
94,901
87,036
96,358
96,963
1st COVID (P.L. 116-123)
6.4
—
—
—
2nd COVID (P.L. 116-127)
1.3
—
—
—
3rd COVID (P.L. 116-136)
140.4
—
—
—
4th COVID (P.L. 116-139)
100.0
—
—
—
Emergency Funding in Annual LHHSf
—
—
18.5
0.6
5th COVID (Division M, P.L. 116-260)
—
—
—
72.9
Afghan special immigrants (P.L. 117-31)
-
-
-
0.0g
Total, BA Available in Fiscal Year (current year
from any bill)
932,661
996,126
1,007,149
1,007,753
Total, BA Advances for Future Years (provided in
current bill)
144,303
153,132
153,132
153,132
Total, BA Advances from Prior Years (for use in
current year)
142,132
144,303
144,303
144,303
Evaluation Tap Fundinga
Mandatory BA
Office of the Secretary (OS)
Evaluation Tap Fundinga
Total, HHS BA in the Bill
Emergency Funding (not included in above totals)
Memoranda (non-emergency funds only)
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Labor, Health and Human Services, and Education: FY2021 Appropriations
HHS Agency
Total, Additional Scorekeeping Adjustments
FY2020
Enacted
-9,420
FY2021
Request
-9,163
FY2021
House
Cmte.
(H.R.
7614)
-12,124
FY2021
Enacted
(P.L. 116260)
-21,068
Sources: Amounts in this table for the FY2020 Enacted, FY2021 Request, and FY2021 Enacted columns are
generally drawn from or calculated based on data contained in the explanatory statement accompanying the
FY2021 LHHS omnibus (P.L. 116-260), available in the Congressional Record, vol. 166, no. 218, book IV, December
21, 2020, pp. H8619-H8711. (The amount for P.L. 117-31 is from CBO, Discretionary Spending: Senate Amendment
2123, July 29, 2021, https://www.cbo.gov/system/files/2021-07/
EmergencySecuritySupplementalAppropriationsAct2021.pdf.) Amounts in the FY2021 House Committee column
are generally drawn from or calculated based on data contained in the committee report (H.Rept. 116-450)
accompanying H.R. 7614. Enacted totals (“Total BA in the Bill”) for FY2020 do not include emergency-designated
appropriations provided in P.L. 116-113, P.L. 116-123, P.L. 116-127, P.L. 116-136, or P.L. 116-139. House
committee bill totals (“Total BA in the Bill”) for FY2021 do not include emergency-designated appropriations
proposed in Title VI of H.R. 7614. Enacted totals (“Total BA in the Bill”) for FY2021 do not include emergencydesignated appropriations provided in Division H or M of P.L. 116-260, or P.L. 117-31. 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 the 21st Century Cures Act (P.L.
114-255), as amended.
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 funded by
other bills); and (4) do not include appropriations that occur outside of appropriations bills.
a. 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.
b. Each year, CDC and NIH also receive funding in the Interior-Environment appropriations bill as part of their
overall budget authority.
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.
d. 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 $225
million apiece from the NEF to the buildings and facilities accounts at CDC and NIH. The FY2021 omnibus
specified that HHS must transfer $225 million to the building and facilities account at NIH. Amounts shown
for the NEF transfer are in addition to amounts shown for budget authority.
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.
f.
The FY2021 House committee bill included a total of $19.4 billion in emergency-designated budget
authority in Title VI, of which $18.5 billion was for HHS. Subsequently, Division H of P.L. 116-260 enacted
$1.6 billion in emergency-designated budget authority, of which $638 million was for HHS in Title II.
g. P.L. 117-31 provided $25 million in supplemental appropriations for the Refugee and Entrant Assistance
account at HHS for specified purposes related to Afghan special immigrants, which rounds to $0.0 in billions
(the unit of measure used in this table).
Congressional Research Service
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Labor, Health and Human Services, and Education: FY2021 Appropriations
Table 7. HHS Discretionary Appropriations for Selected
Programs or Activities, by Agency
(In millions of dollars)
Agency or Selected Program
FY2020
Enacted
FY2021
Request
FY2021
House
Cmte.
(H.R.
7614)
FY2021
Enacted
(P.L. 116260)
HRSA
Community Health Centers
1,626
1,728
1,651
1,683
National Health Service Corps
120
120
120
120
Children’s Hospitals Graduate Medical Education
340
0
340
350
Maternal & Child Health Block Grant
688
761
713
713
Autism and Other Developmental Disorders
52
0
53
53
Healthy Start
126
126
131
128
2,389
2,484
2,414
2,424
Organ Transplantation
28
17
33
29
Telehealth
29
29
42
34
Rural Communities Opioid Response
110
110
110
110
Family Planning (Title X)
286
286
286
286
433
577
470
449
370
303
370
372
1,274
1,553
1,288
1,314
Emerging and Zoonotic Infectious Diseases
570
599
594
596
Chronic Disease Prevention and Health Promotion
985
962
1,050
1,022
255
454
257
255
Birth Defects and Developmental Disabilities
161
112
163
168
Public Health Scientific Services
555
115
593
592
Environmental Health
197
182
220
206
17
0
17
17
Injury Prevention and Control
677
730
695
683
National Institute for Occupational Safety and
Health
343
111
345
345
0
79
0
0
Global Health
571
621
573
593
Buildings and Facilities
25
30
30
30
225
0
0
0
5,885
5,885
6,013
6,070
Ryan White AIDS Programs
CDC
Immunization and Respiratory Diseases
PPHFa
HIV/AIDS, Viral Hepatitis, STDs, TB Prevention
PPHFa
PPHFa
Evaluation Tap Fundingb
Nonrecurring Expenses Fund Transferc
NIH
National Institute of Allergy and Infectious Diseases
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Labor, Health and Human Services, and Education: FY2021 Appropriations
FY2021
Request
FY2021
House
Cmte.
(H.R.
7614)
FY2021
Enacted
(P.L. 116260)
1,706
1,931
1,631
1,720
Evaluation Tap Funding
1,231
741
1,341
1,272
National Institute on Aging
3,544
3,226
3,609
3,899
National Institute on Drug Abuse
1,462
1,432
1,475
1,480
492
404
404
404
449
441
469
475
12
0
12
12
Mental Health Block Grant
702
737
737
737
Evaluation Tap Fundingb
21
21
21
21
Certified Community Behavioral Health Clinics
200
225
225
250
Children’s Mental Health
125
125
125
125
Substance Abuse Treatment PRNS
478
365
488
495
Evaluation Tap Fundingb
79
79
79
79
Substance Abuse Block Grant
1,779
1,779
1,779
1,779
Evaluation Tap Fundingb
79
79
79
79
State Opioid Response Grants
1,500
1,585
1,500
1,500
Substance Abuse Prevention PRNS
206
97
209
208
Health Surveillance and Support
129
97
129
129
Evaluation Tap Fundingb
31
42
31
31
197
0
0
197
Evaluation Tap Fundingb
0
0
200
0
Medical Expenditure Surveys
70
0
72
70
Program Support
71
0
71
71
3,670
3,694
3,985
3,670
786
813
807
807
Low Income Home Energy Assistance Program
Formula Grants
3,740
0
3,765
3,750
Refugee and Entrant Assistance Programs
1,908
2,456
1,911
1,910
Child Care and Development Block Grant
5,826
5,826
5,926
5,911
Head Start
10,613
10,613
10,763
10,748
Agency or Selected Program
National Institute of General Medical Sciences
NIH Innovation Accountd
FY2020
Enacted
SAMHSA
Mental Health Programs of Regional & National
Significance (PRNS)
PPHF
AHRQe
Research on Health Costs, Quality, and Outcomes
CMS
CMS Program Management
Health Care Fraud and Abuse Control
ACF
Congressional Research Service
40
Labor, Health and Human Services, and Education: FY2021 Appropriations
Agency or Selected Program
FY2020
Enacted
FY2021
Request
FY2021
House
Cmte.
(H.R.
7614)
FY2021
Enacted
(P.L. 116260)
Preschool Development Grants
275
0
300
275
Child Welfare Services
269
269
269
269
Adoption Opportunities
42
42
42
44
Community Services Block Grant
740
0
750
745
Home & Community-Based Supportive Services
390
390
400
393
Family Caregiver Support Services
186
151
194
189
Nutrition Services Programs
937
937
957
952
Alzheimer’s Disease Demonstrations
12
27
12
13
15
0
15
15
State Health Insurance Program (SHIP)
52
36
54
52
Paralysis Resource Center
10
10
10
10
Limb Loss Resource Center
4
4
4
4
Developmental Disabilities Programs
180
136
184
183
WIOA Activities (transferred from ED)
265
236
265
267
Office of Nat'l Coord. for Health Information
Technology
60
51
60
62
Office of the Inspector General
80
90
80
80
2,737
2,641
2,827
2,847
ACL
PPHFa
Office of the Secretary
Public Health and Social Services Emergency Fund
Sources: Amounts in this table for the FY2020 Enacted, FY2021 Request, and FY2021 Enacted columns are
generally drawn from or calculated based on data contained in the explanatory statement accompanying the
FY2021 LHHS omnibus (P.L. 116-260), available in the Congressional Record, vol. 166, no. 218, book IV, December
21, 2020, pp. H8619-H8711. Amounts in the FY2021 House Committee column are generally drawn from or
calculated based on data contained in the committee report (H.Rept. 116-450) accompanying H.R. 7614. Enacted
totals (“Total BA in the Bill”) for FY2020 do not include emergency-designated appropriations provided in P.L.
116-113, P.L. 116-123, P.L. 116-127, P.L. 116-136, or P.L. 116-139. House committee bill totals (“Total BA in the
Bill”) for FY2021 do not include emergency-designated appropriations proposed in Title VI of H.R. 7614. Enacted
totals (“Total BA in the Bill”) for FY2021 do not include emergency-designated appropriations provided in
Division H or M of P.L. 116-260, or P.L. 117-31. 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 the 21st Century Cures Act (P.L. 114-255), as amended.
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 funded by
other bills); and (4) do not include appropriations that occur outside of appropriations bills.
Congressional Research Service
41
Labor, Health and Human Services, and Education: FY2021 Appropriations
a.
b.
c.
d.
e.
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.
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.
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 required that HHS transfer $225 million apiece from the NEF to the
buildings and facilities accounts at CDC and NIH. The FY2021 omnibus required that $225 million be
transferred to NIH. Amounts shown for the NEF transfer are in addition t
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