Labor, Health and Human Services, and Education: FY2022 Appropriations

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Labor, Health and Human Services, and

Education: FY2022 Appropriations

Updated September 13, 2022

Congressional Research Service

https://crsreports.congress.gov

R47029

SUMMARY

Labor, Health and Human Services, and

Education: FY2022 Appropriations

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

FY2022 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).

R47029

September 13, 2022

Jessica Tollestrup,

Coordinator

Specialist in Social Policy

Karen E. Lynch,

Coordinator

Specialist in Social Policy

This report primarily focuses on regular FY2022 LHHS discretionary funding enacted during the annual

appropriations process. Totals in the report tables do not include emergency-designated funds.

Regular Appropriations

FY2022 LHHS Omnibus: On March 15, 2022, the Consolidated Appropriations Act, 2022 (FY2022 LHHS

omnibus; H.R. 2471) was signed into law by the President (P.L. 117-103). The FY2022 LHHS omnibus provided

full-year appropriations for all 12 annual appropriations acts in Divisions A-L. Annual discretionary LHHS

appropriations totaled $214.2 billion. This amount is 7.9% more than FY2021 enacted and 15.7% less than the

FY2022 President’s budget request. The omnibus also provided $1.102 trillion in mandatory funding, for a

combined LHHS total of $1.316 trillion. The distribution of discretionary funding was as follows:

 DOL: $13.2 billion, 5.2% more than FY2021.

 HHS: $108.6 billion, 12.0% more than FY2021.

 ED: $76.4 billion, 3.9% more than FY2021.

 Related Agencies: $16.0 billion, 3.3% more than FY2021.

FY2022 LHHS Senate Action: The FY2022 LHHS bill did not receive subcommittee, full committee, or initial

floor action in the Senate. Senator Leahy, Chair of the Senate Appropriations Committee, released a majority draft

of the LHHS bill and accompanying draft report language on October 18, 2021. These draft numbers are not

presented in this report. In addition, on October 25, Senator Murray, Chair of the Senate Appropriations LHHS

Subcommittee, introduced an FY2022 LHHS bill (S. 3062). This bill was referred to the Senate Appropriations

Committee. Because S. 3062 did not receive any congressional action, this report does not discuss this measure.

FY2022 LHHS House Action: On July 15, 2021, the House Appropriations Committee voted to report the

FY2022 LHHS appropriations bill, 33-25; the measure was subsequently reported to the House on July 19 (H.R.

4502; H.Rept. 117-96). The measure was approved in subcommittee, via voice vote, on July 12, 2021. As reported

by the full committee, the bill would have provided $254.4 billion in discretionary LHHS funds, a 28.1% increase

from FY2021 enacted levels. This amount was 0.2% more than the FY2022 President’s request. In addition, the

House committee bill would have provided an estimated $1.102 trillion in mandatory funding, for a combined

total of $1.356 trillion for LHHS as a whole. The distribution of discretionary funding was as follows:

DOL: $14.7 billion, 17.4% more than FY2021.

HHS: $119.8 billion, 23.6% more than FY2021.

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 ED: $102.8 billion, 39.8% more than FY2021.

 Related Agencies: $17.0 billion, 9.8% more than FY2021.

The House version of LHHS appropriations was initially considered on the floor as part of a consolidated

appropriations package and passed the House (219-208), as amended, on July 31, 2021 (Division A of H.R. 4502).

Of the amendments offered, 47 were adopted and 9 were rejected. Because there is no publicly available source

that estimates the account- or subaccount-level budgetary effects of the amendments adopted to Division A, this

report provides analysis of the House Committee-reported version of the LHHS bill. For information on the LHHS

amendments offered during floor consideration, see Appendix B.

FY2022 President’s Budget Request: The full FY2022 President’s budget request was submitted to Congress on

May 28, 2021. (The President had previously submitted to Congress an outline of his discretionary funding

priorities for FY2022 on April 9, 2021.) The President requested $254.0 billion in discretionary funding for

accounts funded by the LHHS bill, which is an increase of 27.9% from FY2021 levels. In addition, the President

requested $1.102 trillion in annually appropriated mandatory funding, for a total of $1.355 trillion for LHHS as a

whole. The distribution of discretionary funding was as follows:

 DOL: $14.3 billion, 14.2% more than FY2021.

 HHS: $120.0 billion, 23.7% more than FY2021.

 ED: $102.8 billion, 39.8% more than FY2021.

 Related Agencies: $16.9 billion, 9.0% more than FY2021.

Emergency-Designated Appropriations

Over the course of FY2022, five laws were enacted providing FY2022 emergency-designated appropriations for

accounts typically funded in the LHHS bill.

Division B of the Bipartisan Safer Communities Act (S. 2938; P.L. 117-159, June 25, 2022)

provided a total of $1.6 billion in FY2022 for several programs within HHS and ED related to

community mental and behavioral health services, pediatric health care, school attendance and

engagement, and school-based mental health service;

Title IV of the Additional Ukraine Supplemental Appropriations Act, 2022 (H.R. 7691; P.L. 117128, May 21, 2022) provided a total of $1.0 billion to HHS agencies, mostly for resettlement

assistance for eligible Ukrainians in the United States;

Division B of the Further Extending Government Funding Act (H.R. 6119; P.L. 117-70,

December 3, 2021) provided a total of $1.3 billion for public health and support services for

Afghan arrivals and refugees;

Division J of the Infrastructure Investment and Jobs Act (H.R. 3684; P.L. 117-58, November 15,

2021) provided $100 million in FY2022 for the HHS Low Income Home Energy Assistance

Program, and rescinded $353 million in previously enacted emergency funding from the

Education Stabilization Fund; and

Divisions A and C of the Extending Government Funding and Delivering Emergency Assistance

Act (H.R. 5305; P.L. 117-43, September 30, 2021) provided a total of $4.2 billion for HHS

spending related to shelter and support services for unaccompanied minors (Division A), and

public health and support services for Afghan arrivals and refugees (Division C).

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Labor, Health and Human Services, and Education: FY2022 Appropriations

Contents

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

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

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

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

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

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

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

Status of FY2022 LHHS Appropriations ........................................................................................ 4

FY2022 Emergency-Designated Appropriations ...................................................................... 4

FY2022 Annual LHHS Appropriations ..................................................................................... 5

FY2022 Consolidated Appropriations Act .......................................................................... 5

FY2022 Continuing Appropriations ................................................................................... 7

Prior Congressional Action on an LHHS Bill ..................................................................... 7

FY2022 President’s Budget Request......................................................................................... 9

FY2021 LHHS Omnibus (Division H, Consolidated Appropriations Act, 2021, H.R.

133; P.L. 116-260) .................................................................................................................. 9

Summary of FY2022 LHHS Appropriations .................................................................................. 11

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

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

FY2022 DOL Appropriations Overview ................................................................................. 15

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

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

Employment Service ......................................................................................................... 17

Wage and Hour Division (WHD)...................................................................................... 17

Bureau of Labor Statistics (BLS) ...................................................................................... 18

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

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

Department of Health and Human Services (HHS)....................................................................... 22

About HHS .............................................................................................................................. 22

FY2022 HHS Appropriations Overview ................................................................................. 23

Special Public Health Funding Mechanisms ........................................................................... 25

Public Health Service Evaluation Tap............................................................................... 25

Prevention and Public Health Fund .................................................................................. 27

Selected HHS Highlights by Agency ...................................................................................... 28

HRSA ................................................................................................................................ 28

CDC .................................................................................................................................. 28

NIH ................................................................................................................................... 30

SAMHSA .......................................................................................................................... 31

AHRQ ............................................................................................................................... 31

CMS .................................................................................................................................. 32

ACF ................................................................................................................................... 32

ACL .................................................................................................................................. 33

Restrictions Related to Certain Controversial Issues .............................................................. 34

Department of Education (ED) ...................................................................................................... 41

About ED ................................................................................................................................ 41

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Labor, Health and Human Services, and Education: FY2022 Appropriations

FY2022 ED Appropriations Overview .................................................................................... 42

Selected ED Highlights ........................................................................................................... 43

Education for the Disadvantaged ...................................................................................... 43

Safe Schools and Citizenship Education........................................................................... 44

Higher Education .............................................................................................................. 44

Related Agencies ........................................................................................................................... 47

FY2022 Related Agencies Appropriations Overview ............................................................. 47

Selected Related Agencies Highlights..................................................................................... 48

SSA Limitation on Administrative Expenses (LAE) ........................................................ 49

Corporation for National and Community Service ........................................................... 49

National Labor Relations Board (NLRB) ......................................................................... 49

Figures

Figure 1. FY2022 Enacted LHHS Appropriations .......................................................................... 6

Figure 2. FY2022 Enacted LHHS Appropriations by Title ........................................................... 14

Figure 3. FY2022 Enacted HHS Appropriations by Agency......................................................... 25

Tables

Table 1. Status of Full-Year LHHS Appropriations Legislation, FY2022 ....................................... 5

Table 2. LHHS Appropriations Overview by Bill Title, FY2021-FY2022 ................................... 12

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

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

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

Table 6. HHS Appropriations Totals by Agency ........................................................................... 35

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

by Agency .................................................................................................................................. 38

Table 8. ED Appropriations Overview .......................................................................................... 42

Table 9. Detailed ED Appropriations ............................................................................................ 45

Table 10. Related Agencies Appropriations Overview .................................................................. 48

Table 11. Detailed Related Agencies Appropriations .................................................................... 50

Table A-1. LHHS Discretionary FY2021 and FY2022 Enacted Levels, and FY2022

House 302(b) Suballocations ..................................................................................................... 56

Table A-2. LHHS Appropriations Overview, by Bill Title: FY2021-FY2022............................... 57

Table B-1. LHHS House Floor Amendments Offered to H.R. 4502 ............................................. 60

Appendixes

Appendix A. Budget Enforcement Activities ................................................................................ 52

Appendix B. House Floor Amendments Offered to Division A of H.R. 4502 .............................. 60

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Labor, Health and Human Services, and Education: FY2022 Appropriations

Contacts

Author Information........................................................................................................................ 65

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Labor, Health and Human Services, and Education: FY2022 Appropriations

Introduction

This report provides an overview of FY2022

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).

Scope of the Report:

Emergency Funding and

Mandatory Funding Related

to COVID-19

This report primarily focuses on regular

FY2022 LHHS discretionary funding

enacted during the annual appropriations

process. The emergency discretionary

funding that was enacted for FY2021 or

FY2022 is generally not included in the

budgetary figures discussed or table totals

presented in the main body of the report.

(Such spending is presented below the

table totals and is in addition to regular

appropriations.) In addition, during

FY2021, mandatory appropriations were

enacted for 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 also not

included in this report.

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 the “Mandatory vs. Discretionary Budget Authority” section), the bulk of this report is

focused on these funds.

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

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

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

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

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

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

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

Report Roadmap and Useful Terminology

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

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

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

major congressional actions on FY2022 appropriations and (for context) a review of the

conclusion of the FY2021 appropriations process. This is followed by a high-level summary and

analysis of appropriations for FY2022, compared to FY2021 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 FY2022 proposed

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Labor, Health and Human Services, and Education: FY2022 Appropriations

funding levels compared to FY2021. (Note that the distribution of funds is sometimes illustrated

by figures, which in all cases are based on the FY2022 enacted levels.1)

Appendix A provides a summary of budget enforcement activities for FY2022. This includes

information on mandatory spending sequestration pursuant to the Budget Control Act of 2011

(BCA; P.L. 112-25), discretionary spending budget enforcement pursuant to the FY2022 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 floor amendments

that were offered in the House during its consideration of H.R. 4502.

Scope of the Report

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

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

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

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

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

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

the Department of Labor;

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

Food and Drug Administration (funded through the Agriculture appropriations

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

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

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

the Department of Education; and

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

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

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

Relations Board, and the Railroad Retirement Board.

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

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

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

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

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

Important Budget Concepts

Mandatory vs. Discretionary Budget 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 budget authority is provided in appropriations measures.

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

of funds enacted in FY2021 and proposed by the FY2022 President’s budget and in the FY2022 House committee bill.

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/GAO-

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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 FY2022 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.

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

05-734SP. (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.

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.

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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, see Appendix

A). 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 FY2022 LHHS Appropriations

FY2022 Emergency-Designated Appropriations

Over the course of FY2022, five bills were signed into law providing FY2022 emergencydesignated appropriations for accounts typically funded in the LHHS bill.

Division B of the Bipartisan Safer Communities Act (S. 2938, P.L. 117-159, June

25, 2022) provided a total of $1.6 billion in FY2022 for several purposes or

programs within HHS and ED related to community mental and behavioral

health services, pediatric health care, school attendance and engagement, and

school-based mental health services.7

Title IV of the Additional Ukraine Supplemental Appropriations Act, 2022 (H.R.

7691, P.L. 117-128, May 21, 2022) provided $54 million to the CDC for medical

support, screening, and related public health activities related to the situation in

Ukraine, including for populations displaced from Ukraine, and $900 million to

ACF for resettlement assistance for Ukrainian refugees, Ukrainian parolees, and

other eligible Ukrainians in the United States.

Division B of the Further Extending Government Funding Act (H.R. 6119; P.L.

117-70, December 3, 2021) contained the Additional Afghanistan Supplemental

Appropriations Act, 2022, which provided $8 million to the CDC for medical

support, screening, and related public health activities for Afghan arrivals and

refugees, and $1.3 billion to ACF for resettlement assistance for Afghan arrivals

and refugees.8

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).

7 See Table 3 in CBO, cost estimate, “The Bipartisan Safer Communities Act would provide funding to encourage

enactment of state laws aimed at controlling access to guns and to support a variety of other initiatives to enhance

school safety, mental health programs, and violence prevention,” June 22, 2022, https://www.cbo.gov/system/files?

file=2022-06/S2938.pdf.

8 See the summary of these provisions from the House Appropriations Committee majority staff, H.R. 6119, Further

Extending Government Funding Act Section-by-Section Summary, https://appropriations.house.gov/sites/

democrats.appropriations.house.gov/files/

Further%20Extending%20Government%20Funding%20Act%20Summary.pdf.

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Division J of the Infrastructure Investment and Jobs Act (H.R. 3684; P.L. 117-58,

November 15, 2021) provided $100 million in FY2022 for the HHS Low Income

Home Energy Assistance Program,9 and rescinded $353 million in previously

enacted emergency funding from the Education Stabilization Fund.

Divisions A and C of the Extending Government Funding and Delivering

Emergency Assistance Act (H.R. 5305; P.L. 117-43, September 30, 2021)

provided $4.2 billion in emergency-designated funding, as follows:10

 Division A, which contained the first CR for FY2022, provided $2.5 billion

(§141) to the HHS Administration for Children and Families (ACF) for

shelter and support services for unaccompanied minors referred to HHS,

including funding to expand the capacity of state-licensed shelters.

 Division C, which contained the Afghanistan Supplemental Appropriations

Act, 2022, provided $1.7 billion to ACF for resettlement assistance for

Afghan arrivals and refugees, and $21.5 million to the HHS Centers for

Disease Control and Prevention (CDC) for medical support, screening, and

related public health activities for Afghan arrivals and refugees.

FY2022 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, FY2022

Subcommittee

Approval

House

7/12/21

voice

vote

Senate

-

Resolution of House and

Senate Differences

Full Committee

Approval

House

H.R. 4502

H.Rept.

117-96

7/15/21

33-25

Senate

-

House

Initial

Passage

Senate

Initial

Passage

H.R. 4502, Division A

7/29/21

219-208

Conf.

Report

-

House

Final

Passage

Senate

Final

Passage

H.R. 2471,

Division H

3/9/22

361-69

H.R. 2471,

Division H

3/10/22

68-31

Public

Law

P.L. 117103

3/15/22

Source: CRS Appropriations Status Table.

FY2022 Consolidated Appropriations Act

On March 15, 2022, the Consolidated Appropriations Act, 2022 (FY2022 LHHS omnibus; H.R.

2471) was signed into law by the President (P.L. 117-103). The FY2022 omnibus provided full9 Division J of P.L. 117-58 further provided to the Low Income Home Energy Assistance Program advance

appropriations of $100 million for each of FY2023 through FY2026, for a total of $500 million for the program with all

fiscal years taken into account.

10 See the summary of these provisions from House Appropriations Committee majority staff, H.R. 5305, Extending

Government Funding and Delivering Emergency Assistance Act: Section-by-Section Summary,

https://appropriations.house.gov/sites/democrats.appropriations.house.gov/files/documents/Summary_0.pdf.

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year appropriations for all 12 annual appropriations acts in Divisions A-L.11 (Full-year LHHS

appropriations were enacted in Division H.) Prior to its enactment, the final version of the

measure was approved by the House on March 9. (The vote to approve the portion that contained

LHHS appropriations was 260-171.)12 The bill was approved by the Senate (68-31) on March 10.

See Figure 1 for a breakdown of FY2022 discretionary and mandatory LHHS appropriations

enacted in the FY2022 LHHS omnibus.13 Annual discretionary LHHS appropriations totaled

$214.2 billion. This amount is 7.9% more than FY2021 enacted and 15.7% less than the FY2022

President’s budget request. The omnibus also provided $1.102 trillion in mandatory funding, for a

combined LHHS total of $1.316 trillion.

Figure 1. FY2022 Enacted LHHS Appropriations

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

explanatory statement accompanying the FY2022 LHHS omnibus (P.L. 117-103), available in the Congressional

Record, vol. 168, no. 42, book IV, March 9, 2022, pp. H2668-H2915. Enacted totals for FY2022 do not include

emergency-designated appropriations. 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 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

11 The FY2022 omnibus was originally intended to carry additional supplemental appropriations related to the COVID-

19 pandemic in Division M, but Division M was omitted prior to floor consideration.

12 The special rule, H.Res. 973, provided for the consideration of an amendment consisting of the FY2022 omnibus (as

contained in House Rules Committee Print 117-35) to the Senate amendment to H.R. 2471. H.Res. 973 also provided

for the House to adopt the amendment in two votes: the first on Divisions B, C, F, X, Z, titles 2 and 3 of division N, and

the second on the remaining divisions and titles. The House adopted Divisions B, C, F, X, Z, titles 2 and 3 of division

N by a vote of 361-69, and adopted the remaining divisions and titles by a vote of 260-171. The subsequent motion that

the House agree to the Senate amendment with an amendment was agreed to by a voice vote.

13 While the percentages in this figure were calculated based on amounts in the FY2022 LHHS omnibus, they are

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

FY2021 and under the FY2022 President’s budget and the FY2022 House committee bill.

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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.

FY2022 Continuing Appropriations

Between the start of FY2022 and the enactment of full-year annual appropriations, FY2022

LHHS appropriations were provided by a series of CRs. The first CR was signed into law on

September 30, 2021 (Division A of H.R. 5305; P.L. 117-43). The measure had previously been

introduced by the House Appropriations Committee chair, Representative DeLauro, on September

21, and was passed by the House that same day, 220-211. On September 30, the Senate took up

and passed the measure with an amendment, 65-35,14 which was subsequently agreed to by the

House, 254-175.

The first CR provided continuing appropriations for all 12 annual appropriations acts (including

LHHS) through December 3, 2021. In general, the CR funded discretionary programs at the same

rate and under the same conditions as in FY2021 (§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 (§§138-149).

A second CR was enacted extending the provisions of the first CR with some additional

anomalies (for LHHS, see Section 162) through February 18, 2022 (Division A of H.R. 6119; P.L.

117-70, December 3, 2021). The measure had previously been introduced by Representative

DeLauro on December 2, and passed the House (221-212) and the Senate (69-28) that same day.

A third CR was enacted extending the provisions on the second CR with some additional

anomalies (none of which were LHHS-related) through March 11, 2022 (Division A of H.R.

6617; P.L. 117-86, February 18, 2022). The measure had been previously introduced by

Representative DeLauro on February 7. It passed the House (272-182) on February 8 and the

Senate (65-27) on February 17.

A fourth CR was enacted extending the provisions of the third CR with some additional

anomalies (not LHHS-related) through March 15, 2022 (H.J.Res 75; P.L. 117-95, March 11,

2022). The measure had been previously introduced by Representative DeLauro on March 8. It

passed the House (voice vote) on March 8 and the Senate (voice vote) on March 10.

Prior Congressional Action on an LHHS Bill

FY2022 LHHS Action in the Senate

The FY2022 LHHS bill did not receive subcommittee, full committee, or initial floor action in the

Senate. Senator Leahy, Chair of the Senate Appropriations Committee, released a majority draft

of the LHHS bill and accompanying draft report language on October 18, 2021. According to the

chair, the purpose of this release was to further negotiations toward enacting all 12 annual

appropriations bills prior to when the CR was to expire on December 3.16 These draft numbers

are not presented in this report.

14 No substantive changes were made by the Senate amendment to the CR provisions in Division A of H.R. 5305.

15 For an estimate of the discretionary appropriations contained in Division A of H.R. 5305, see Table 1-H and 1-S in

Congressional Budget Office (CBO) Estimate for H.R. 5305, the Extending Government Funding and Delivering

Emergency Assistance Act as Passed by the House of Representatives on September 21, 2021, https://www.cbo.gov/

system/files/2021-09/57491-CBO-Estimate-for-HR5305.pdf.

16 The text of the Senate majority draft LHHS bill and accompanying committee report is linked to the press release,

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In addition, on October 25, Senator Murray, Chair of the Senate Appropriations LHHS

Subcommittee, introduced an FY2022 LHHS bill (S. 3062). This bill was referred to the Senate

Appropriations Committee.17 Because S. 3062 did not receive any congressional action, this

report does not discuss this measure.

FY2022 LHHS Action in the House (Division A, H.R. 2740)

The House LHHS subcommittee approved the draft LHHS bill on July 12, 2021, by a voice vote.

On July 15, 2021, the House Appropriations Committee voted (33-25) to report the LHHS bill;

the measure was subsequently reported to the House on July 19 (H.R. 4502; H.Rept. 117-96).

As reported by the full committee, the bill would provide $254.4 billion in discretionary LHHS

funds, a 28.1% increase from FY2021 enacted levels. This amount would be 0.2% more than the

FY2022 President’s request. In addition, the House committee bill would provide an estimated

$1.102 trillion in mandatory funding, for a combined total of $1.356 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 funds,

which are in addition to the regular annual appropriations.)

Later in July, LHHS appropriations were initially considered on the House floor as part of a

consolidated appropriations package and passed the House (219-208), as amended, on July 29,

2021 (Division A of H.R. 4502). This package would provide appropriations for six other

appropriations acts in addition to LHHS.18 Floor action was regulated by the terms of a special

rule (H.Res. 555). A total of 56 amendments to the LHHS title of the bill were made in order for

consideration on the floor.19 This 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).20 All but two LHHS amendments were

considered in this manner.21 When counted as 56 separate amendments, 47 were adopted and 9

were rejected.

Because there is no publicly available source that estimates the account- or subaccount-level

budgetary effects of the amendments adopted to Division A, this report provides analysis of the

House Committee-reported version of the LHHS bill. For information on the LHHS amendments

offered during floor consideration, see Appendix B.

“Chairman Leahy Releases Remaining Nine Senate Appropriations Bills,” October 18, 2021,

https://www.appropriations.senate.gov/news/majority/chairman-leahy-releases-remaining-nine-senate-appropriationsbills. See also “Shelby: Democrats’ Partisan Bills Threaten FY22 Appropriations Process,” October 18, 2021,

https://www.appropriations.senate.gov/news/shelby-democrats-partisan-bills-threaten-fy22-appropriations-process.

17 The text of S. 3062 as introduced was generally the same as the draft LHHS bill released by the chair of the Senate

Appropriations Committee on October 18, discussed above.

18 Those appropriations acts were Agriculture and Rural Development, Energy and Water Development, Financial

Services and General Government, Interior and Environment, Military Construction and Veterans Affairs, and

Transportation and Housing and Urban Development.

19 For a list of these LHHS amendments (numbered 1-56) and the text of each that was made in order, see pages 8-13

and 30-38 of H.Rept. 117-109.

20 For further information about en bloc authority in the context of House floor consideration of appropriations

measures, see CRS Report R46841, Changes in the House of Representatives’ Initial Consideration of Regular

Appropriations Measures, 113th-116th Congresses.

21 For the en bloc amendments proposing changes to the LHHS division of the bill, see consideration of amendments en

bloc nos. 1, 2, 3, and 4 in Congressional Record, daily edition, Vol. 167, No. 131 (July 27, 2021), pp. H4055-H4073.

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FY2022 President’s Budget Request

The President’s budget request for the upcoming fiscal year is due to be submitted to Congress by

the first Monday in February. However, the FY2022 budget was submitted during a year in which

a presidential transition occurred (on January 20, 2021). Recent Presidents have not submitted

detailed budget proposals until April or May of their first year in office, although each has

advised Congress regarding the general contours of their economic and budgetary policies in

special messages submitted to Congress prior to that submission.22 This delay allows time to

prepare a proposal that reflects the priorities of the new Administration.

On April 9, President Biden submitted to Congress an outline of his discretionary funding

priorities for FY2022.23 This preliminary document provided early highlights for numerous policy

areas, including several funded in the LHHS bill. The full budget request was submitted on May

28, almost four months after its due date.24

The President requested $254.0 billion in discretionary funding for accounts funded by the LHHS

bill, which is an increase of 27.9% from FY2021 levels. In addition, the President requested

$1.102 trillion in annually appropriated mandatory funding, for a total of $1.355 trillion for

LHHS as a whole.

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.25 (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 359-53.26) It was approved by the Senate (92-6) later that

same day.

LHHS discretionary appropriations in the FY2021 LHHS omnibus totaled $198.5 billion. This

amount was 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 non22 See CRS Insight IN11655, Budget Submission After a Presidential Transition: Contextualizing the Biden

Administration’s FY2022 Request.

23 Office of Management and Budget (OMB), The President’s FY2022 Discretionary Request, April 9, 2021,

https://www.whitehouse.gov/omb/fy-2022-discretionary-request/.

24 See https://www.whitehouse.gov/omb/budget/.

25 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,

at 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.

26 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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emergency appropriations provided by the FY2021 LHHS omnibus and do not include

emergency-designated 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, consistent with the conventions for displaying emergencydesignated budget authority in this report.)

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Summary of FY2022 LHHS Appropriations

Dollars and Percentages in this Report

Amounts displayed in this report are typically rounded (e.g., to the nearest million), 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. For FY2022 enacted, amounts for HHS include $1.6 billion in regular discretionary

appropriations enacted as part of the second continuing resolution for FY2022, P.L. 117-70, for the

Unaccompanied Alien Children program.

Throughout this report, the FY2022 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 Division

A of H.R. 4502, as there is no publicly available source that estimates the account- and subaccount-level budgetary

effects of the adopted amendments. However, information on the LHHS amendments offered during floor

consideration can be found in Appendix B.)

Amounts for the FY2021 Enacted, FY2022 Request, and FY2022 Enacted columns are generally drawn from or

calculated based on data contained in the explanatory statement accompanying the FY2022 LHHS omnibus (P.L.

117-103), available in the Congressional Record, vol. 168, no. 42, book IV, March 9, 2022, pp. H2668-H2915.

Amounts in the FY2021 House Committee column are generally drawn from or calculated based on data

contained in the committee report (H.Rept. 117-96) accompanying H.R. 4502. The amounts shown for

emergency-designated appropriations provided in Title II of P.L. 117-31, Divisions A and C of P.L. 117-43, Division

J of P.L. 117-58, Division B of P.L. 117-70, Title IV of P.L. 117-128, and Division B of P.L. 117-159, are based on

CRS analysis of the texts of those laws.

In general, the enacted totals (“Total BA in the Bill”) in this report do not include emergency-designated

appropriations. An exception to this rule is made in Table A-1, which includes FY2021 and FY2022 enacted

emergency-designated funds in the “Adjusted Appropriations” totals, as scored by the Congressional Budget

Office. In addition, as applicable, other tables in this report include, at the bottom, a separate line or lines for

emergency-designated appropriations; these lines are shown for informational purposes and the amounts displayed

are not included in the table totals.

For consistency with source materials, amounts in this report generally do not reflect mandatory spending

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

executive authorities, 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), as amended.

The descriptions of the LHHS appropriations in this report frequently reference “report language,” which

Congress may use to further specify funding or to communicate a range of directives to the agency. Each regular

appropriations bill reported from committee is usually accompanied by a written committee report, and the final

explanatory text may be used to reconcile any differences between those reports. For example, earlier report

language may address certain issues in ways that are difficult to reconcile harmoniously with the final enacted text.

In these instances, the explanatory text normally seeks to clarify how the affected agency is to proceed. On the

other hand, if the original committee language is ultimately acceptable to congressional negotiators, the

explanatory statement might be silent due to an expectation that the agency will follow the original directive. For

further information, see CRS Report R44124, Appropriations Report Language: Overview of Components and

Development.

Table 2 displays FY2022 discretionary and mandatory LHHS budget authority proposed and

enacted, by bill title, along with FY2021 enacted levels. The amounts shown in this table reflect

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

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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

addition to regular appropriations.

Table 2. LHHS Appropriations Overview by Bill Title, FY2021-FY2022

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

FY2021

Enacted

FY2022

Request

FY2022

House

Cmte.

(H.R. 4502)

13.9

15.5

16.0

14.4

Discretionary

12.5

14.3

14.7

13.2

Mandatory

1.4

1.2

1.2

1.2

Title II: HHS

1,016.6

1,159.6

1,159.4

1,148.2

Discretionary

97.0

120.0

119.8

108.6

Mandatory

919.6

1,039.6

1,039.6

1,039.6

Title III: Education

77.2

106.5

106.5

80.1

Discretionary

73.5

102.8

102.8

76.4

Mandatory

3.7

3.7

3.7

3.7

70.8

73.8

74.0

73.0

Discretionary

15.5

16.9

17.0

16.0

Mandatory

55.3

57.0

57.0

57.0

Total BA in the Bill

1,178.5

1,355.5

1,355.9

1,315.7

Discretionary

198.5

254.0

254.4

214.2

Mandatory

980.0

1,101.5

1,101.5

1,101.5

P.L. 116-260, Division H

1.6

—

—

—

P.L. 116-260, Division M

154.9

—

—

—

P.L. 117-31, Title II

0.0a

—

—

—

P.L. 117-43, Divisions A and C

—

—

—

4.2

P.L. 117-58, Division J

—

—

—

0.1

P.L. 117-70, Division B

—

—

—

1.3

P.L. 117-128, Title IV

—

—

—

1.0

P.L. 117-159, Division B

—

—

—

3.0

Bill Title

Title I: Labor

Title IV: Related Agencies

FY2022

Enacted

Emergency Funding (not in above totals)

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-FY2021 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. For FY2022, the source materials used for this report continue this most recent approach.

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FY2021

Enacted

FY2022

Request

FY2022

House

Cmte.

(H.R. 4502)

Advances for Future Years

(provided in current bill)b

197.6

210.7

210.8

210.7

Advances from Prior Years

(for use in current year)b

189.0

197.6

197.6

197.6

Additional Scorekeeping Adjustmentsc

-22.8

-25.4

-14.7

-15.0

Bill Title

FY2022

Enacted

Memoranda (non-emergency funds only):

Source: Amounts in this table for the FY2021 Enacted, FY2022 Request, and FY2022 Enacted columns are

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

FY2022 LHHS omnibus (P.L. 117-103), available in the Congressional Record, vol. 168, no. 42, book IV, March 9,

2022, pp. H2668-H2915. Amounts in the FY2021 House Committee column are generally drawn from or

calculated based on data contained in the committee report (H.Rept. 117-96) accompanying H.R. 4502. Enacted

totals (“Total BA in the Bill”) for FY2021 or FY2022 do not include emergency-designated appropriations. 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. No

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

a. 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).

b. 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 a given fiscal year is as follows: Total BA in the

Bill, minus Advances for Future Years, plus Advances from Prior Years. FY2022 advance appropriations

enacted in prior fiscal years are listed in the FY2022 Request and FY2022 House Cmte. columns.

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

line to the total budget authority.)

Figure 2 displays discretionary and mandatory LHHS funding levels enacted for FY2022, by bill

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

FY2022 enacted amounts, they are generally also illustrative—within several percentage points—

of the share of funds directed to each bill title in FY2021, and under the FY2022 President’s

budget and House committee bill.)

As this figure demonstrates, HHS accounts for the largest share of total FY2022 LHHS

appropriations: $1.148 trillion, or 87.3%. 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 6.1% and 5.5%, 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, 1.1%.

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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 (50.7%), while ED accounts for a relatively larger share (35.7%).

Together, these two departments represent the majority (86.4%) of discretionary LHHS

appropriations. DOL and the Related Agencies account for the remaining discretionary funds, at

6.2% and 7.5% of the total, respectively.

Figure 2. FY2022 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 FY2022 LHHS omnibus (P.L. 117-103), available in the Congressional

Record, vol. 168, no. 42, book IV, March 9, 2022, pp. H2668-H2915. Enacted totals for FY2022 do not include

emergency-designated appropriations. 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 (e.g., to the nearest million), 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.

FY2022 DOL Appropriations Overview

Table 3 displays FY2022 enacted and proposed funding levels for DOL, along with FY2021

levels. The totals in this table do not include emergency supplemental appropriations. Those

amounts are displayed separately, along with the law in which they were enacted, 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.)

Discretionary funds represent the majority of DOL appropriations, accounting for 90% or more of

FY2021 and FY2022 enacted levels. The FY2022 LHHS omnibus increased discretionary

appropriations for DOL by $653 million (+5.2%) compared to the FY2021 LHHS omnibus.

Relative to the FY2021 LHHS omnibus, discretionary DOL appropriations would have increased

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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by $2.2 billion (+17.4%) under the FY2022 House committee bill and $1.8 billion (14.3%) under

the FY2022 President’s budget request.

Table 3. DOL Appropriations Overview

(in billions of dollars)

FY2021

Enacted

FY2022

Request

FY2022

House

Cmte.

(H.R.

4502)

Discretionary

12.5

14.3

14.7

13.2

Mandatory

1.4

1.2

1.2

1.2

13.9

15.5

16.0

14.4

0.9

—

—

—

Funding

Total BA in the Bill

FY2022

Enacted

Emergency Funding (not in above totals)

P.L. 116-260, Division H

Source: Amounts in this table for the FY2021 Enacted, FY2022 Request, and FY2022 Enacted columns are

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

FY2022 LHHS omnibus (P.L. 117-103), available in the Congressional Record, vol. 168, no. 42, book IV, March 9,

2022, pp. H2668-H2915. Amounts in the FY2021 House Committee column are generally drawn from or

calculated based on data contained in the committee report (H.Rept. 117-96) accompanying H.R. 4502. Enacted

totals (“Total BA in the Bill”) for FY2021 or FY2022 do not include emergency-designated appropriations. 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.

Selected DOL Highlights

The following sections present highlights from FY2022 enacted and proposed appropriations

compared to FY2021 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

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) and through FY2022 by the FY2022 LHHS

omnibus (P.L. 117-103, 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

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

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Dislocated Workers. While the FY2022 LHHS omnibus provided a $34 million increase (+1.2%)

for the three WIOA state formula grant programs compared to FY2021, the FY2022 President’s

budget would have provided $174 million more (+6.1%) and the House committee bill would

have increased funding by $250 million (+8.8%), compared to FY2021 enacted levels.

The FY2022 LHHS omnibus provided $301 million for the Dislocated Workers Activities

National Reserve (DWA National Reserve), an increase of $20 million (+7.1%) compared to the

FY2021 enacted level. The House committee bill would have increased funding for the DWA

National Reserve by $155 million (+55.2%), whereas the FY2022 President’s budget would have

increased funding for the DWA National Reserve by $100 million (+35.6%), compared to the

FY2021 LHHS omnibus. In addition, the FY2022 LHHS omnibus maintained a provision in that

account (which originated in the FY2018 omnibus) directing $45 million from the DWA National

Reserve toward training and employment assistance for workers dislocated in both the

Appalachian, lower Mississippi, and Northern Border Regional Commission regions. Finally, the

FY2022 LHHS omnibus maintained a provision that originated in the FY2020 omnibus directing

$50 million from the DWA National Reserve to be used in developing, offering, or improving

career training programs at community colleges.

The FY2022 LHHS omnibus provided $235 million for the Apprenticeship Grant program, which

was $50 million (+27.0%) more than the level enacted in FY2021. The House committee bill and

the FY2022 President’s budget would have increased the level of funding for the Apprenticeship

Grant program by $100 million (+54.1%) compared to the FY2021 enacted level.

Finally, under the pilot and demonstration authority in WIOA (Section 169), the FY2022 House

committee bill and the FY2022 President’s budget would have provided new funding for a

National Youth Employment Program ($50 million) and a Veterans Clean Energy Training

program ($20 million). These did not ultimately receive funding in the FY2022 LHHS omnibus.

Employment Service

The FY2022 LHHS omnibus provided $700 million for the Employment Service (ES), which was

an increase of $8 million (+1.1%) compared to the FY2021 LHHS omnibus. The FY2022 House

committee bill would have provided $771 million for the ES, which would have been an increase

of $79 million (+11.4%) compared to the FY2021 LHHS omnibus and $50 million (+6.9%) more

than requested in the FY2022 President’s budget. The ES is a joint federal-state partnership that

funds staff to provide career counseling, job search services, and administration of the work test

for the UI system. The FY2022 House committee bill included a provision to prohibit DOL from

using any funds provided in the FY2022 LHHS appropriations bill to implement or enforce a

2020 final rule allowing the use of non-merit-staff employees to deliver Employment Service

services.31 This provision was not included in the FY2022 LHHS omnibus.

Wage and Hour Division (WHD)

The FY2022 LHHS omnibus provided $251 million for the WHD, an increase of $5 million

(+2.0%) compared to the FY2021 LHHS omnibus. The FY2022 House committee bill would

have provided $300 million for WHD, an increase of $54 million (+22.0%) compared to the

FY2021 enacted level and $24 million (+8.5%) more than the FY2022 President’s budget. The

WHD is responsible for enforcing the Fair Labor Standards Act (FLSA), the Davis-Bacon Act

(DBA), the Family and Medical Leave Act (FMLA), and other labor standards statutes. The

FY2022 explanatory statement accompanying the FY2022 LHHS omnibus included a

31 See Section 114 and H.Rept. 117-96, p. 24, for further information.

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requirement for the WHD to collect and report annually data on employer participation in the

14(c) program, which allows employers to pay workers with disabilities less than the prevailing

federal minimum wage.32

Bureau of Labor Statistics (BLS)

The FY2022 LHHS omnibus provided $688 million for BLS, an increase of $33 million (+5.0%)

compared to the FY2021 LHHS omnibus, whereas the FY2022 House committee bill and the

FY2022 President’s budget each proposed a $46 million increase (+7.0%) relative to FY2021. As

noted in the explanatory statement accompanying the FY2022 LHHS omnibus, $28.5 million of

the FY2022 appropriation is for costs associated with completing the physical relocation of BLS

headquarters to the Suitland Federal Complex, which was initiated in FY2020.33 Similarly, the

FY2022 House committee report indicated continued support for BLS to continue

implementation of several data projects started in FY2020, including a BLS plan to increase

spending on the new National Longitudinal Survey of Youth (NLSY) cohort to $14.5 million and

for BLS to develop plans to increase the Job Openings and Labor Turnover Survey (JOLTS)

sample and to release JOLTS on a monthly basis, rather than its current quarterly release.34

Bureau of International Labor Affairs (ILAB)

The ILAB provides research, advocacy, technical assistance, and grants to promote workers’

rights in different parts of the world. The FY2022 LHHS omnibus provided $106 million for

ILAB, which was an increase of $10 million (+10.4%) above the FY2021 enacted level. The

FY2022 House committee bill would have increased funding for ILAB by $40 million (+41.5%)

compared to the FY2021 LHHS omnibus, while the FY2022 President’s budget would have

increased funding by $28 million (+28.7%) for ILAB.

Language in the FY2022 explanatory statement accompanying the FY2022 LHHS omnibus

requests ILAB to include the amounts spent on technical assistance grants to combat exploitative

child labor and worker rights issues in future Congressional Budget Justifications.35

In addition, language in the FY2022 House committee report directs ILAB to place additional

labor attachés in strategic countries to assist with promoting worker rights, such as freedom of

association and collective bargaining.36

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 FY2022 LHHS omnibus.

The FY2022 LHHS omnibus continued several provisions that have been included in at least one

previous LHHS appropriations act, including provisions that

32 Congressional Record, March 9, 2022, Vol. 168, No. 42, Book IV, p. H2668.

33 Congressional Record, March 9, 2022, Vol. 168, No. 42, Book IV, p. H2668.

34 See H.Rept. 117-96, p. 36, for further information.

35 Congressional Record, March 9, 2022, Vol. 168, No. 42, Book IV, p. H2668.

36 H.Rept. 117-96, p. 38.

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exempted certain insurance claims adjusters from overtime protection for two

years following a “major disaster” (included since FY2016);37

directed 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);38

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

property” to apprenticeship programs to assist training apprentices (included

since FY2018);39

authorized 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);40

authorized 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);41 and

prohibited annual appropriations 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).42

Table 4. Detailed DOL Appropriations

(in millions of dollars)

Agency or Selected Program

FY2021

Enacted

FY2022

Request

FY2022

House

Cmte.

(H.R. 4502)

FY2022

Enacted

ETA—Mandatorya

634

540

551

540

ETA—Discretionary

9,392

10,708

11,075

9,942

Training and Employment Services:

3,663

4,211

4,407

3,912

State Formula Grants:

2,845

3,019

3,095

2,879

Adult Activities Grants to States

863

900

923

871

Youth Activities Grants to States

921

964

989

933

1,062

1,155

1,184

1,076

Discretionary ETA Programs:

Dislocated Worker Activities

(DWA) Grants to States

37 See Division H, Title I, §108 of P.L. 117-103.

38 See Division H, Title I, §110 of P.L. 117-103. The H-2B program allows for the temporary employment of foreign

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

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

the employer meets certain conditions.

39 See Division H, Title I, §112 of P.L. 117-103.

40 See Division H, Title I, §113 of P.L. 117-103.

41 See Division H, Title I, §114 of P.L. 117-103.

42 See Division H, Title I, §115 of P.L. 117-103.

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Labor, Health and Human Services, and Education: FY2022 Appropriations

Agency or Selected Program

National Activities:

FY2021

Enacted

FY2022

House

Cmte.

(H.R. 4502)

FY2022

Request

FY2022

Enacted

818

1,192

1,312

1,033

DWA National Reserve

281

381

436

301

Native Americans

56

58

58

57

Migrant and Seasonal Farmworkers

94

97

97

95

YouthBuild

97

145

145

99

Reintegration of Ex-Offenders

100

150

150

102

6

6

7

6

Apprenticeship Grants

185

285

285

235

Community Projects

0

0

64

138

National Youth Employment

Program

0

50

50

0

Veterans Clean Energy Training

0

20

20

0

1,749

1,755

1,830

1,749

Community Service Employment for Older

Americans

405

405

450

405

State Unemployment Insurance and

Employment Service Operations (SUI/ESO):

3,417

4,126

4,176

3,711

Unemployment Compensation

2,584

3,243

3,243

2,869

Employment Service

692

721

771

700

Foreign Labor Certification

78

94

94

80

One-Stop Career Centers

63

68

68

63

ETA Program Administration

159

212

212

164

Employee Benefits Security

Administration

181

218

218

186

Pension Benefit Guaranty Corp, (PBGC) program

level (non-add)b

(465)

(473)

(473)

(473)

Wage and Hour Division

246

277

300

251

Office of Labor-Management Standards

44

52

44

46

Office of Federal Contract Compliance

Programs

106

141

141

108

Office of Workers’ Compensation

Programs—Mandatoryc

739

683

683

683

Office of Workers’ Compensation

Programs—Discretionary

118

141

141

120

Occupational Safety & Health

Administration

592

665

692

612

Mine Safety & Health Administration

380

447

405

384

Bureau of Labor Statistics

655

701

701

688

Workforce Data Quality Initiative

Job Corps

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Agency or Selected Program

FY2021

Enacted

FY2022

Request

FY2022

House

Cmte.

(H.R. 4502)

FY2022

Enacted

Office of Disability Employment Policy

39

43

43

41

Departmental Management

784

933

961

812

Salaries and Expenses

349

440

457

368

96

124

136

106

Veterans Employment and Training

316

325

335

325

IT Modernization

27

37

37

28

Working Capital Fund

0

36

36

0

Office of the Inspector General

91

95

95

91

Total, DOL BA in the Bill

13,909

15,548

15,954

14,412

Subtotal, Mandatory

1,373

1,223

1,234

1,223

Subtotal, Discretionary

12,536

14,325

14,720

13,189

925

—

—

—

Total, BA Available in Fiscal Year (current year

from any bill)

13,909

15,551

15,957

14,415

Total, BA Advances for Future Years (provided

in current bill)

1,786

1,783

1,783

1,783

Total, BA Advances from Prior Years (for use

in current year)

1,786

1,786

1,786

1,786

International Labor Affairs (non-addd)

Emergency Funding (not in above totals)

P.L. 116-260, Division H

Memoranda (non-emergency funds only)

Source: Amounts in this table for the FY2021 Enacted, FY2022 Request, and FY2022 Enacted columns are

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

FY2022 LHHS omnibus (P.L. 117-103), available in the Congressional Record, vol. 168, no. 42, book IV, March 9,

2022, pp. H2668-H2915. Amounts in the FY2022 House Committee column are generally drawn from or

calculated based on data contained in the committee report (H.Rept. 117-96) accompanying H.R. 4502. Enacted

totals (“Total BA in the Bill”) for FY2021 or FY2022 do not include emergency-designated appropriations. 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.

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Department of Health and Human Services (HHS)

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

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

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

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

American Rescue Plan Act of 2021 [P.L. 117-2]). All amounts in this section are rounded (e.g., to

the nearest million), 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).43 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).44 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,45

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 Affordable Care Act (ACA; P.L. 111-148).

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

43 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.

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

and Funding (FY2016-FY2018).

45 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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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.

FY2022 HHS Appropriations Overview

Table 5 displays enacted and proposed FY2022 funding levels for HHS, along with FY2021

levels. Note that the totals in this table do not include emergency-designated appropriations.

Those amounts are displayed separately, along with the law in which they were enacted, at the

bottom of the table and are in addition to regular appropriations.46

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

Compared to the FY2021 funding levels, the FY2022 LHHS omnibus increased HHS

discretionary appropriations by 12.0%. Both the House committee bill and the President’s request

would have increased HHS discretionary appropriations to a greater degree, by 23.6% and 23.7%,

respectively.

Table 5. HHS Appropriations Overview

(in billions of dollars)

FY2021

Enacted

FY2022

Request

FY2022

House

Cmte.

(H.R.

4502)

Discretionary

97.0

120.0

119.8

108.6

Mandatory

919.6

1,039.6

1,039.6

1,039.6

1,016.6

1,159.6

1,159.4

1,148.2

P.L. 116-260, Division H

0.6

—

—

—

P.L. 116-260, Division M

72.9

—

—

—

P.L. 117-31, Title IIa

0.0

—

—

—

P.L. 117-43, Divisions A and C

—

—

—

4.2

P.L. 117-58, Division J

—

—

—

0.5

P.L. 117-70, Division B

—

—

—

1.3

P.L. 117-128, Title IV

—

—

—

1.0

P.L. 117-159, Division B

—

—

—

1.0

Funding

Total BA in the Bill

FY2022

Enacted

Emergency Funding (not in above totals)

Sources: Amounts in this table for the FY2021 Enacted, FY2022 Request, and FY2022 Enacted columns are

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

FY2022 LHHS omnibus (P.L. 117-103), available in the Congressional Record, vol. 168, no. 42, book IV, March 9,

2022, pp. H2668-H2915. Amounts in the FY2022 House Committee column are generally drawn from or

calculated based on data contained in the committee report (H.Rept. 117-96) accompanying H.R. 4502. Enacted

totals (“Total BA in the Bill”) for FY2021 and FY2022 do not include emergency-designated appropriations. For

46 For a discussion of the COVID-19-related FY2021 supplemental appropriations in Division M of P.L. 116-260, see

CRS Report R46775, Overview of COVID-19 LHHS Supplemental Appropriations: FY2020 and FY2021.

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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 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. 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 FY2022 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

$1,027.1 billion, which is 89.5% of all enacted appropriations for HHS. ACF and NIH account for

the next-largest shares of total HHS appropriations, receiving 4.0% and 3.8% apiece, respectively.

By contrast, when looking exclusively at discretionary appropriations, funding for CMS

constitutes about 4.5% of FY2022 enacted HHS appropriations. Instead, the bulk of discretionary

appropriations went to the PHS agencies, which combined to account for 61.2% of discretionary

appropriations provided for HHS. NIH typically receives the largest share of all discretionary

funding among HHS agencies (40.2% in FY2022), with ACF accounting for the second-largest

share (27.5% in FY2022).

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Figure 3. FY2022 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 FY2022 LHHS omnibus (P.L. 117-103), available in the Congressional

Record, vol. 168, no. 42, book IV, March 9, 2022, pp. H2668-H2915. Enacted totals (“Total BA in the Bill”) for

FY2022 do not include emergency-designated appropriations. 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 FY2022 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),

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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 1.0% of eligible program

appropriations. However, LHHS appropriations acts have commonly established a higher

maximum percentage for the set-aside and have distributed specific amounts of “tap” funding to

selected HHS programs. Since FY2010, and including in FY2022, this higher maximum set-aside

level has been 2.5% of eligible appropriations.47 (Both the House committee bill and the

President’s budget would have continued this 2.5% level.)

Before FY2015, the PHS tap traditionally

Display of Evaluation Tap Transfers

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 FY2022, 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.48 Since FY2015, LHHS

appropriations laws have directed the largest share of tap transfers to NIH.

The FY2022 LHHS omnibus directed $1.3 billion in tap funds to NIH, which was a small

increase relative to FY2021 (+$38 million, 3.0%). The President’s budget and House committee

bill would have kept the NIH transfers the same as FY2022. With regard to the OS, the FY2022

LHHS omnibus almost doubled the tap transfers to OS (+$64 million, 99.1%) to transition the

Office of the National Coordinator for Health Information Technology to being solely funded by

the PHS tap.49 Both the President’s budget and the House committee bill also proposed that

funding transition, but would have increased the transfers to OS to a greater degree than what was

ultimately enacted for FY2022—$106 million (+163.7%) and $97 million (+149.0%),

respectively. The FY2022 LHHS omnibus, President’s budget, and House committee bill kept the

tap transfers to SAMHSA the same amount as FY2021 ($134 million).

In addition to the transfers to NIH, SAMHSA, and OS, the FY2022 House committee bill

proposed that AHRQ receive $129 million in tap funding, slightly over half the amount that it

proposed for AHRQ’s discretionary funding for FY2022 ($251 million), for a total of $380

47 See Section 204, Division H, P.L. 117-103 for the FY2022 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 FY2022 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.

48 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.

49 Congressional Record, vol. 168, no. 42, book IV, March 9, 2022, pp. H2684.

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million. The FY2022 President’s budget had

requested that AHRQ receive a comparatively

lesser amount of tap funding ($27 million),

with a greater proportion of AHRQ’s funding

in the LHHS bill being derived from

discretionary appropriations ($353 million),

for a total of $380 million. This proposed use

of tap funds was rejected by the FY2022

LHHS omnibus.

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 President’s budget also proposed expanding the activities and agencies funded by the PHS

tap to include the Public Health Scientific Services and Environmental Health at the CDC ($139

million), and Paralysis Resource Center, Limb Loss, and Traumatic Brain Injury at ACL ($17

million). The House committee bill and the FY2022 LHHS omnibus rejected those proposals.

Prevention and Public Health Fund

The ACA both authorized and appropriated mandatory funding to three funds to support programs

and activities within the PHS agencies.50 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.

PPHF funds are intended to supplement (sometimes quite substantially) the funding that selected

programs receive through regular appropriations. The PPHF authority instructs the HHS

Secretary to transfer amounts from the fund to HHS agencies. However, 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.51

The ACA had appropriated $2 billion in mandatory funds to the PPHF for FY2022, but this

amount was reduced by subsequent laws that decreased PPHF funding for FY2022 and other

fiscal years. Under current law, the FY2022 appropriation is $1 billion.52 This appropriation was

subject to a 5.7% reduction due to sequestration of nonexempt mandatory spending. 53 (For more

information on sequestration, see the budget enforcement discussion in Appendix A.) After

sequestration, the total PPHF appropriation available for FY2022 was $943 million, an increase

of $47 million relative to FY2021. Of this amount, the FY2022 LHHS omnibus allocated $903

million to CDC, $12 million to SAMHSA, and $28 million to ACL, the same amounts as

proposed by the House committee bill and the President’s budget.

CDC commonly receives the largest share of annual PPHF funds. The amount that was provided

to CDC by the FY2022 LHHS omnibus, $903 million, was a $47 million (+5.5%) increase

relative to FY2021. The amounts for SAMHSA and ACL were the same as FY2021.

50 For more information, see CRS Report R41301, Appropriations and Fund Transfers in the Affordable Care Act

(ACA).

51 For the FY2022 LHHS omnibus, see Division H, §222, P.L. 117-103.

52 42 U.S.C. §300u-11.

53 OMB Report to the Congress on the BBEDCA 251A Sequestration for Fiscal Year 2022, May 28, 2021, p. 7 of 17,

https://www.whitehouse.gov/wp-content/uploads/2021/05/BBEDCA_251A_Sequestration_Report_FY2022.pdf.

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Selected HHS Highlights by Agency

This section begins with a limited selection of FY2022 discretionary funding highlights by HHS

agency. The discussion is largely based on the enacted and proposed appropriations levels for

FY2022 compared to FY2021 enacted levels.54 These summaries are followed by a brief

overview of significant provisions from annual HHS appropriations laws that restrict spending in

certain controversial areas, such as abortion and stem cell research. The section concludes with

two tables (Table 6 and Table 7) presenting more detailed information on FY2021 enacted and

FY2022 proposed and enacted funding levels for HHS.

HRSA

The FY2022 LHHS omnibus provided $8.6 billion in discretionary budget authority for HRSA.

This was $1.4 billion (+18.8%) more than HRSA’s FY2021 discretionary funding level and $741

million (+9.5%) more than the FY2022 President’s budget request.

Under the Primary Health Care account, the Community Health Centers program received $1.7

billion, an increase of $65 million (+3.9%) relative to FY2021.55 The explanatory statement also

recommended $122.3 million under that same account for the Ending the HIV Epidemic

Initiative.56 Under the Ryan White HIV/AIDS Program appropriation, there is an additional $125

million set aside for this HIV initiative.57

The Maternal and Child Health Block Grant received $748 million, an increase of $35 million

(+4.9%) relative to FY2021. Related to maternal health, the explanatory statement also set aside

$12 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 $29 million for State Maternal Health

Innovation Grants.59 The Rural Communities Opioid Response program received $135 million in

the law, an increase of $25 million (+22.7%) relative to FY2021.60

CDC

The FY2022 LHHS omnibus provided $7.5 billion in discretionary budget authority for CDC,

which was $535 million (+7.7%) more than CDC’s FY2021 funding level. The FY2022 LHHS

omnibus did not direct any PHS tap funds to the CDC, continuing the practice started in FY2015.

The FY2022 LHHS omnibus supplemented discretionary CDC appropriations by directing $903

million in PPHF transfers to the CDC, which was $47 million (+5.5%) more than FY2021.

Altogether, this combination of funding represented an increase of $582 million (+7.4%) from

FY2021 in budget authority that is inclusive of directed transfers.

54 HHS budget materials can be found at http://www.hhs.gov/budget/.

55 The Health Centers program also received significant additional FY2020 and FY2021 funding related to the COVID-

19 pandemic, totaling roughly $2 billion in discretionary funding, and $4 billion in mandatory funding. For a discussion

of this funding, see CRS Report R46711, U.S. Public Health Service: COVID-19 Supplemental Appropriations in the

116th Congress.

56 Congressional Record, March 9, 2022, Vol. 168, No. 42, Book IV, p. H2669.

57 Ibid, p. H2670. This initiative also was supported by funds from other parts of HHS. For more information, see

https://www.hiv.gov/federal-response/ending-the-hiv-epidemic/funding.

58 Ibid, p. H2669. See H.Rept. 117-96 p. 57, for a description of this activity.

59 Ibid, p. H2670.

60 See Ibid, p. H2670, for a description of this activity.

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The President’s FY2022 budget request would have increased discretionary budget authority by

$1.5 billion (+21.4%) relative to FY2021, while also requesting that $139 million in tap funds be

directed to the CDC. The President’s budget also requested $903 million in PPHF transfers, the

same as enacted. All told, this combination of funding would have represented an increase of $1.7

billion (+21.5%) from FY2021. The FY2022 omnibus provided $1.1 billion (-11.5%) less than

the FY2022 requested amount, inclusive of directed transfers.

All but one programmatic account received an increase in discretionary budget authority relative

to FY2021. The Immunization and Respiratory Diseases account was flat-funded in terms of

discretionary budget authority only, but was increased by $47 million (+5.7%) when also

accounting for PPHF transfers. Some notable increases included the HIV/AIDS, Viral Hepatitis,

STI and TB Prevention account, which was funded at an increased level of $1.3 billion (+2.4%

above FY2021), and included $195 million for CDC’s contribution the Ending HIV/AIDS

Initiative;61 the Public Health Scientific Services account, which was funded at $652 million

(+10.1%) above FY2021, and included $100 million for public health data modernization

(+100% above FY2021 funding of $50 million).62 Discretionary funding for the CDC-Wide

Activities and Program Support account was increased by $210 million (+169.9%). When also

accounting for PPHF transfers, which were kept at the same level as FY2021 ($160 million), the

program level for that account was increased by 74.1% relative to FY2021. Of the discretionary

funding, $200 million was designated for public health infrastructure and capacity.63

With regard to the Injury Prevention and Control account, which received $715 million (+4.7%

over FY2021), the explanatory statement included funding for several line items that were first

included in FY2020, including child sexual abuse prevention ($2 million), suicide prevention

($20 million), and adverse childhood experiences (ACEs, $7 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 ($491 million).65

61 Congressional Record, vol. 168, no. 42, March 9, 2022, p. H2670. See also Centers for Disease Control and

Prevention, “Ending the HIV Epidemic,” https://www.cdc.gov/endhiv/index.html.

62 Ibid, p. H2672. For FY2021, see Congressional Record, vol. 166, no. 218 (December 21, 2020), p. H8623.

63 P.L. 117-103, 136 STAT. 448. See also Congressional Record, vol. 168, no. 42, March 9, 2022, p. H2674.

64 Ibid., pp. H2672-H2673. For FY2021 enacted, see Congressional Record, vol. 166, no. 218 (December 21, 2020), p.

H8623.

65 Ibid. 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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NIH

The FY2022 LHHS omnibus provided $43.7 billion in discretionary budget authority for NIH.

This was $2.2 billion (+5.3%) more than FY2021, but $6.8 billion (-13.5%) less than the FY2022

President’s budget request. When adding the $1.0 billion appropriation for the new Advanced

Research Projects Agency for Health (ARPA-H)—which the HHS Secretary has placed within

NIH after enactment of FY2022 LHHS funding—the NIH’s FY2022 discretionary budget

authority was $44.7 billion.66 ARPA-H was originally proposed as a part of President Biden’s

FY2022 NIH budget request with proposed funding of $6.5 billion. The FY2022 enacted NIH

discretionary budget authority, plus the ARPA-H transfer, was $5.8 billion (-11.5%) less than the

President’s FY2022 budget request.

All NIH Institute and Center (IC) accounts received increases in FY2022 relative to FY2021.

Among the ICs, the National Institute of Minority Health and Health Disparities saw the largest

percentage increase compared to FY2021 (+17.4%). In addition, the FY2022 LHHS omnibus

directed $1.3 billion in PHS tap transfers to NIH, $38 million more than FY2021. 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 $1.8 billion. The NIGMS

discretionary appropriation was $63 million (+3.7%) more than FY2021. When combined with

the tap transfer, total funding for NIGMS increased by $101 million (+3.4%) from FY2021. The

Buildings and Facilities account saw a $50 million increase (+25.0%) in discretionary budget

authority relative to FY2021, but a decrease of $175 million (-41.2%) relative to FY2021 when

accounting for the $225 million NEF transfer to that account in FY2021.67

In line with recent practice, the explanatory statement on the FY2022 LHHS omnibus directed

NIH to reserve a specific dollar amount for a number of purposes, for example, an increase of

$289 million for Alzheimer’s disease and related dementia research.68 It also included a

reservation of funds for Firearm Injury and Mortality Prevention Research of $12.5 million, the

same amount as in FY2020 and FY2021.69 Reserving a specific dollar amount for a particular

66 Although the FY2022 President’s budget and FY2022 House committee bill proposed that ARPA-H funding be

appropriated to the NIH, the $1 billion in enacted funding for ARPA-H was ultimately appropriated to the HHS Office

of the Secretary (OS). Those funds were subsequently transferred to the NIH when ARPA-H was placed within that

operating division by the HHS Secretary. The enacted ARPA-H funding is displayed under the OS in Table 7 in

keeping with how it was appropriated in the LHHS omnibus. For background on ARPA-H and its placement, see CRS

Report R47074, Advanced Research Projects Agency for Health (ARPA-H): Congressional Action and Selected Policy

Issues.

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. 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 FY2021 where the LHHS omnibus directed $225 million from the

NEF transfers to the NIH Buildings and Facilities account.

68 Congressional Record, vol. 168, no. 42 (March 9, 2022), p. H2676. 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-FY2023.

69 Ibid., p. H2678. 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 FY2020, FY2021 and

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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.70

SAMHSA

The FY2022 LHHS omnibus provided $6.4 billion in discretionary budget authority for

SAMHSA. This amount was $530 million (+9.0%) more than SAMHSA’s FY2021 funding level

and $3.2 billion (-33.2%) less than the President’s FY2022 budget request. The FY2022 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 FY2021.

The additional funding provided to SAMHSA was spread across several programs in the

explanatory statement. All accounts received discretionary budget authority increases relative to

FY2021. The programs within the Mental Health Programs of Regional and National

Significance (PRNS) received an increase of $112 million (+23.6%), including the increase of

$78 million (+323.4%) to the Suicide Lifeline program to prepare for the launch of a new 988

number for suicide prevention.71 The programs within the Substance Abuse Treatment PRNS

received an increase of $25 million (+5.0%) and the programs within the Substance Abuse

Prevention PRNS received an increase of $10 million (+4.8%). There was also an increase in

funding to the Certified Community Behavioral Health Clinics (CCBHCs)—$65 million

(+26.0%) more than FY2021. The Community Mental Health Services Block Grant (MHBG)

received an increase of $100 million (+13.6%) while the Substance Abuse Prevention and

Treatment Block Grant (SABG) received an increase of $50 million (+2.8%) more than FY2021.

The State Opioid Response (SOR) grant program received an increase of $25 million (+1.7%)

compared to FY2021.

AHRQ

The FY2022 LHHS omnibus provided $350 million in discretionary budget authority to AHRQ.

This amount was $12 million (+3.7%) more than AHRQ’s FY2021 funding level and $3 million

(-0.7%) less than the President’s FY2022 budget request. The FY2022 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.72 (The President’s budget proposed $27 million, and the House bill proposed $129

FY2022.

70 Historically, Congress generally did not specify funding for certain research areas within NIH accounts through the

appropriations process. For example, the explanatory statement on the FY2015 omnibus stipulated, “In keeping with

longstanding practice, the agreement does not recommend a specific amount of NIH funding for this purpose

[Alzheimer’s disease] or for any other individual disease. Doing so would establish a dangerous precedent that could

politicize the NIH peer review system. Nevertheless, in recognition that Alzheimer’s disease poses a serious threat to

the Nation’s long-term health and economic stability, the agreement expects that a significant portion of the

recommended increase for NIA should be directed to research on Alzheimer’s. 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, vol. 160, no. 151

(December 11, 2014), p. H9832.

71 As described in the explanatory statement accompanying the FY2022 LHHS omnibus (Congressional Record, vol.

168, no. 42, March 9, 2022, p. H2680). For the FY2021 amount, see Congressional Record, vol. 166, no. 218

(December 21, 2020), p. H8629.

72 In addition to funds provided through the annual appropriations process, AHRQ is also scheduled in FY2022 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

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million, in tap transfers for AHRQ, but these proposals were not enacted.) Among other

initiatives, the explanatory statement noted increases in funding to establish the Center for

Primary Care Research and to research diagnostic errors and risks to patient safety.73

CMS

The FY2022 LHHS omnibus provided $4.9 billion in discretionary budget authority for CMS,

$421 million (+9.4%) more than FY2021 enacted. (Both the President’s budget and House

committee bill would have provided $712 million (+15.9%) more than FY2021.) The FY2022

LHHS omnibus provided $873 million for the CMS Health Care Fraud and Abuse Control

(HCFAC) account, 8.2% more than FY2021 and the same amount that was proposed by the

President’s budget and House committee bill. Of this total amount for HCFAC, $556 million

would be effectively exempt from the discretionary budget caps. (See Appendix A for an

explanation of the LHHS budget cap exemptions.)

The FY2022 LHHS omnibus provided a $355 million (+9.7%) increase to the CMS Program

Management Account, which was less than the increased proposed by the House committee bill

and the President’s request (+17.6%). 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 FY2022 LHHS

omnibus continued a provision (§227) that has been 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 $355 million, and explicitly prohibited

such transfers from being used to support or supplant funding for ACA implementation. Both the

President’s budget and House committee bill would have eliminated this provision.

ACF

The FY2022 LHHS omnibus provided $29.9 billion in discretionary budget authority for ACF.

This is $5.2 billion (+21.1%) more than FY2021, and $729 less (-$2.4%) than the President’s

budget.

The FY2022 LHHS omnibus provided $6.4 billion for the Refugee and Entrant Assistance

programs account, an increase of $4.5 billion (+236.4%) relative to FY2021.74 The President’s

budget would have increased this account to a lesser degree relative to FY2021, by $2.4 billion

(+130.6%). The FY2022 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 FY2021.

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 CRS Insight IN11010, Funding for ACA-Established PatientCentered Outcomes Research Trust Fund (PCORTF) Extended Through FY2029.

73 See the explanatory statement accompanying the FY2022 LHHS omnibus (Congressional Record, vol. 168, no. 42,

March 9, 2022, p. H2681).

74 Of the total amount for FY2022, $1.6 billion was enacted as part of the second continuing resolution for FY2022,

P.L. 117-70, for the Unaccompanied Alien Children program.

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The explanatory statement accompanying the FY2022 LHHS omnibus directed $5.5 billion of the

appropriation for Refugee and Entrant Assistance programs toward the Unaccompanied Alien

Children (UAC) program, a $4.2 billion (+322.5%) increase over the FY2021 level.75 The UAC

program provides for the shelter, care, and placement of unaccompanied alien children who have

been apprehended in the United States. The President’s budget had proposed $3.3 billion for this

program to “allow [the Office of Refugee Resettlement] ORR to increase the number of statelicensed beds and foster family placements, including both long-term and transitional foster care

placements.”76

The FY2022 LHHS omnibus also included several general provisions that were enacted in

FY2021 related to the UAC program. For instance, the LHHS omnibus

authorized HHS to accept donations for the care of UAC arrivals (§230),

limited the use of funds for unlicensed facilities for unaccompanied alien

children (§231),

imposed additional congressional notification requirements prior to the use of

unlicensed facilities (§232),

prohibited HHS appropriations from being used to prevent a Member of

Congress from visiting a UAC facility for oversight purposes (§233), and

imposed additional public monthly reporting requirements on the number of

unaccompanied alien children who were separated from their parents or legal

guardians and transferred to the care of the ORR (§234).

The House committee report contained additional “directives ... for ORR to reduce its reliance on

large, unlicensed emergency intake sites when capacity is strained; raise standards of care;

expand legal, post-release, and child advocacy services for children; rebuild, support and train

staff on trauma-informed care; establish an independent office to better serve children in ORR’s

care; and increase planning for future humanitarian responses at the border.”77 The explanatory

statement accompanying the LHHS omnibus reiterated that language included in that House

report “should be complied with unless specifically addressed to the contrary in this explanatory

statement.”78 It also contained additional directives, such as that ORR “place siblings in the same

facility, or with the same sponsor, to the extent practicable, and so long as it is appropriate and in

the best interest of the child.”79

ACL

The FY2022 LHHS omnibus provided $2.3 billion in discretionary budget authority for ACL.

This was $60 million (+2.7%) more than FY2021. In addition, the FY2022 LHHS omnibus

directed $28 million in PPHF transfers to ACL, the same as FY2021. The explanatory statement

accompanying the FY2022 LHHS omnibus specified that the PPHF transfers were for the

Alzheimer’s Disease Program, Chronic Disease Self-Management, and Falls Prevention. These

distributions were consistent FY2021 levels, as well as the FY2022 President’s request and House

75 Ibid.

76 HHS, ACF, FY 2022 Congressional Justification, p. 59, https://www.acf.hhs.gov/sites/default/files/documents/olab/

fy_2022_congressional_justification.pdf.

77 H.Rept. 117-96, pp. 208-215.

78 Congressional Record, vol. 168, no. 42, book IV, March 9, 2022, pp. H2682.

79 Ibid.

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committee bill.80 The FY2022 LHHS omnibus did not adopt the proposal made in the President’s

budget for $17 million in evaluation tap funding.81 The FY2022 LHHS omnibus provided $691

million (-23.0%) less in ACL’s discretionary budget authority than the President’s budget, which

had proposed larger increases than what was enacted for several ACL programs including homedelivered meals (part of the Nutrition Services Program) and home and community-based

supportive services.

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. Both the FY2022 President’s budget and House

committee bill would have omitted this provision entirely, but the FY2022 LHHS omnibus

retained these existing restrictions (§§506 and 507).82

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

FY2022 LHHS omnibus retained these existing restrictions (§508).83

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).84 Starting in FY2016, the provision was modified to allow funds to be

80 The same PPHF amounts were directed to these ACL programs by the FY2021 LHHS omnibus and accompanying

explanatory statement.

81 Administration for Community Living, Fiscal Year 2022 Justification of Estimates for Appropriations Committees,

https://acl.gov/sites/default/files/about-acl/2021-06/

FY%202022%20ACL%20Justification%20of%20Estimates%20for%20Appropriations%20Committees_Final.pdf.

82 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 and CRS In Focus IF12167, The Hyde

Amendment: An Overview.

83 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.

84 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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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. Both the FY2022

President’s budget and House committee bill would have omitted this provision entirely, but the

FY2022 LHHS omnibus retained these existing restrictions and conditions (§526).

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). FY2022 omnibus retained these existing restrictions

(§210 [HHS] and §503(c) [all LHHS, plus PPHF transfers]).85

Table 6. HHS Appropriations Totals by Agency

(in millions of dollars)

HHS Agency

HRSA

FY2021

Enacted

FY2022

Request

FY2022

House

Cmte.

(H.R.

4502)

FY2022

Enacted

7,484

8,151

9,062

8,892

Mandatory BA

266

317

317

317

Discretionary BA

7,218

7,834

8,745

8,575

CDCa

7,019

8,510

9,668

7,554

Mandatory BA

55

55

55

55

Discretionary BA

6,963

8,455

9,613

7,499

0

139

0

0

856

903

903

903

41,437

50,461

48,162

43,650

0

0

0

0

41,437

50,461

48,162

43,650

1,272

1,272

1,272

1,309

225

0

0

0

5,870

9,587

9,015

6,400

0

0

0

0

5,870

9,587

9,015

6,400

134

134

134

134

Evaluation Tap Fundingb

PPHFc

NIHa

Mandatory BA

Discretionary BAd

Evaluation Tap Fundingb

Nonrecurring Expenses Fund Transfere

SAMHSA

Mandatory BA

Discretionary BA

Evaluation Tap Fundingb

85 The FY2022 LHHS explanatory statement directs that $12.5 million apiece ($25 million total) be allocated by the

CDC and NIH for Firearm Injury and Mortality Prevention Research (Congressional Record, vol. 168, no. 42, book IV,

March 9, 2022, pp. H2673 and H2678). CDC and NIH funding reservations for Firearm Injury and Mortality

Prevention were first included in LHHS explanatory statements in FY2020. The report accompanying the FY2022

House committee bill had proposed that these amounts be doubled to $25 million apiece ($50 million total) (H.Rept.

117-96).

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FY2021

Enacted

HHS Agency

PPHFc

FY2022

House

Cmte.

(H.R.

4502)

FY2022

Request

FY2022

Enacted

12

12

12

12

338

353

251

350

Mandatory BA

0

0

0

0

Discretionary BA

338

353

251

350

0

27

129

0

CMS

906,627

1,027,439

1,027,439

1,027,148

Mandatory BA

902,150

1,022,250

1,022,250

1,022,250

Discretionary BA

4,477

5,189

5,189

4,898

ACF

41,190

46,944

47,624

46,215

Mandatory BA

16,496

16,303

16,302

16,303

Discretionary BAf

24,695

30,641

31,321

29,912

ACL

2,258

3,009

3,105

2,318

0

0

0

0

AHRQ

Evaluation Tap Fundingb

Mandatory BA

Discretionary BA

2,258

3,009

3,105

2,318

Evaluation Tap Fundingb

0

17

0

0

PPHFc

28

28

28

28

4,359

5,101

5,101

5,697

Mandatory BA

653

657

657

673

Discretionary BA

3,706

4,444

4,445

5,024

65

171

161

129

1,016,583

1,159,555

1,159,426

1,148,224

Mandatory

919,620

1,039,582

1,039,581

1,039,599

Discretionary

96,963

119,973

119,845

108,625

Office of the Secretary (OS)

Evaluation Tap Fundingb

Total, HHS BA in the Bill

Emergency Funding (not in above totals)

P.L. 116-260, Division H

0.6

-

-

-

P.L. 116-260, Division M

72.9

-

-

-

P.L. 117-31g

0.0

-

-

-

P.L. 117-43, Divisions A and C

-

-

-

4.2

P.L. 117-58, Division J

-

-

-

0.5

P.L. 117-70, Division B

-

-

-

1.3

P.L. 117-128, Title IV

-

-

-

1.0

P.L. 117-159, Division B

-

-

-

1.0

Memoranda (non-emergency funds only)

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FY2021

Enacted

FY2022

Request

FY2022

House

Cmte.

(H.R.

4502)

Total, BA Available in Fiscal Year (current year

from any bill)

1,007,753

1,142,465

1,142,337

1,131,134

Total, BA Advances for Future Years (provided in

current bill)

153,132

170,222

170,222

170,222

Total, BA Advances from Prior Years (for use in

current year)

144,303

153,132

153,132

153,132

Total, Additional Scorekeeping Adjustments

-21,748

-25,262

-14,676

-13,790

HHS Agency

FY2022

Enacted

Sources: Amounts in this table for the FY2021 Enacted, FY2022 Request, and FY2022 Enacted columns are

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

FY2022 LHHS omnibus (P.L. 117-103), available in the Congressional Record, vol. 168, no. 42, book IV, March 9,

2022, pp. H2668-H2915. Amounts in the FY2022 House Committee column are generally drawn from or

calculated based on data contained in the committee report (H.Rept. 117-96) accompanying H.R. 4502. Enacted

totals (“Total BA in the Bill”) for FY2021 or FY2022 do not include emergency-designated appropriations. 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 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 (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. Each year, CDC and NIH also receive funding in the Interior-Environment appropriations bill as part of their

overall budget authority.

b. By convention, this table shows only the amount of PHS Evaluation Tap funds received by an agency, not the

amount of tap funds donated by an agency. That is to say, tap amounts shown in this table are in addition to

amounts shown for budget authority, but the amounts shown for budget authority have not been adjusted

to reflect potential “transfer-out” of funds to the tap.

c. PPHF funds are not appropriated in the LHHS bill, but are shown here for illustrative purposes as they may

be used to supplement the funding selected agencies and programs receive through the appropriations

process. Amounts shown for PPHF in this table are in addition to amounts shown for budget authority.

d. When adding the $1.0 billion appropriation for the new Advanced Research Projects Agency for Health

(ARPA-H)—which the HHS Secretary placed within NIH after enactment of FY2022 LHHS funding—the

NIH’s FY2022 discretionary budget authority was $44.7 billion.

e. 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 FY2021 omnibus specified that HHS 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.

f.

Of the total FY2022 enacted for Refugee and Entrant Assistance Programs, $1.6 billion was enacted as part

of the second continuing resolution for FY2022, P.L. 117-70, for the Unaccompanied Alien Children

program.

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).

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Labor, Health and Human Services, and Education: FY2022 Appropriations

Table 7. HHS Discretionary Appropriations for Selected

Programs or Activities, by Agency

(in millions of dollars)

FY2021

Enacted

Agency or Selected Program

FY2022

Request

FY2022

House

Cmte.

(H.R.

4502)

FY2022

Enacted

HRSA

Community Health Centers

1,684

1,734

1,832

1,749

National Health Service Corps

120

185

185

122

Children’s Hospitals Graduate Medical Education

350

350

400

375

Maternal & Child Health Block Grant

713

823

869

748

Autism and Other Developmental Disorders

53

57

57

54

Healthy Start

128

128

145

132

2,424

2,555

2,655

2,495

Organ Transplantation

29

29

34

30

Telehealth

34

37

39

35

Rural Communities Opioid Response

110

165

140

135

Family Planning (Title X)

286

340

400

286

449

527

532

449

372

419

419

419

1,314

1,421

1,502

1,345

596

626

674

641

52

52

52

52

1,022

1,198

1,302

1,084

255

255

255

255

Birth Defects and Developmental Disabilities

168

173

187

177

Public Health Scientific Services

592

610

757

652

Evaluation Tap Fundingb

0

132

0

0

Ryan White AIDS Programs

CDC

Immunization and Respiratory Diseases

PPHFa

HIV/AIDS, Viral Hepatitis, STDs, TB Prevention

Emerging and Zoonotic Infectious Diseases

PPHFa

Chronic Disease Prevention and Health Promotion

PPHFa

Environmental Health

206

309

326

210

PPHFa

17

17

17

17

Evaluation Tap Fundingb

0

7

0

0

Injury Prevention and Control

683

1,103

1,064

715

National Institute for Occupational Safety and

Health

345

345

360

352

Global Health

593

698

843

647

Buildings and Facilities

30

55

55

30

CDC-Wide Activities and Program Support

124

549

1,149

334

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FY2021

Enacted

Agency or Selected Program

FY2022

Request

FY2022

House

Cmte.

(H.R.

4502)

FY2022

Enacted

NIH

National Institute of Allergy and Infectious Diseases

6,070

6,246

6,558

6,323

National Institute of General Medical Sciences

1,720

1,825

1,868

1,783

Evaluation Tap Funding

1,272

1,272

1,272

1,309

National Institute on Aging

3,899

4,036

4,258

4,220

National Institute on Drug Abuse

1,480

1,853

1,860

1,595

National Institute of Minority Health and Health

Disparities

391

652

662

459

NIH Innovation Account

109

150

150

150

0

6,500

3,000

0

475

659

727

587

12

12

12

12

Mental Health Block Grant

737

1,562

1,562

837

Evaluation Tap Fundingb

21

21

21

21

Certified Community Behavioral Health Clinics

250

375

375

315

Children’s Mental Health

125

125

150

125

Substance Abuse Treatment PRNS

495

649

652

520

Evaluation Tap Fundingb

2

2

2

2

Substance Abuse Block Grant

1,779

3,429

2,779

1,829

Evaluation Tap Fundingb

79

79

79

79

State Opioid Response Grants

1,500

2,250

2,000

1,525

Substance Abuse Prevention PRNS

208

217

244

218

Health Surveillance and Support

129

139

212

260

Evaluation Tap Fundingb

31

31

31

31

Advanced Research Projects Agency for Health

(ARPA-H)c

SAMHSA

Mental Health Programs of Regional & National

Significance (PRNS)

PPHFa

AHRQ

Research on Health Costs, Quality, and Outcomes

195

210

106

206

Evaluation Tap Fundingb

0

25

129

0

Medical Expenditure Surveys

72

72

72

72

Program Support

71

71

73

73

3,670

4,316

4,316

4,025

807

873

873

873

CMS

CMS Program Management

Health Care Fraud and Abuse Control

ACF

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FY2021

Enacted

Agency or Selected Program

FY2022

Request

FY2022

House

Cmte.

(H.R.

4502)

FY2022

Enacted

Low Income Home Energy Assistance Program

Formula Grants

3,750

3,850

3,900

3,800

Refugee and Entrant Assistance Programsd

1,910

4,405

4,505

6,425

Child Care and Development Block Grant

5,911

7,377

7,377

6,165

Head Start

10,748

11,932

12,182

11,037

Preschool Development Grants

275

450

450

290

Child Welfare Services

269

275

275

269

Adoption Opportunities

44

46

46

48

Community Services Block Grant

745

754

800

755

Home & Community-Based Supportive Services

393

551

551

399

Family Caregiver Support Services

189

250

250

194

Nutrition Services Programs

952

1,341

1,388

967

Alzheimer’s Disease Demonstrations

13

15

20

15

15

15

15

15

State Health Insurance Program (SHIP)

52

55

57

53

Paralysis Resource Center

10

4

10

10

Evaluation Tap Fundingb

0

7

0

0

Limb Loss Resource Center

4

1

4

4

Evaluation Tap Fundingb

0

3

0

0

Developmental Disabilities Programs

183

206

209

186

WIOA Activities (transferred from ED)

267

311

317

273

62

0

0

0

Evaluation Tap Fundingb

0

87

87

64

Office of the Inspector General

80

100

100

82

2,847

3,523

3,518

3,200

0

0

0

1,000

ACL

PPHFa

Office of the Secretary

Office of Nat'l Coord. for Health Information

Technology

Public Health and Social Services Emergency Fund

Advanced Research Projects Agency for Health

(ARPA-H)c

Sources: Amounts in this table for the FY2021 Enacted, FY2022 Request, and FY2022 Enacted columns are

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

FY2022 LHHS omnibus (P.L. 117-103), available in the Congressional Record, vol. 168, no. 42, book IV, March 9,

2022, pp. H2668-H2915. Amounts in the FY2022 House Committee column are generally drawn from or

calculated based on data contained in the committee report (H.Rept. 117-96) accompanying H.R. 4502. Enacted

totals (“Total BA in the Bill”) for FY2021 or FY2022 do not include emergency-designated appropriations. 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

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Labor, Health and Human Services, and Education: FY2022 Appropriations

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. PPHF funds are not appropriated in the LHHS bill, but are shown here for illustrative purposes as they may

be used to supplement the funding selected agencies and programs receive through the appropriations

process. Amounts shown for PPHF in this table are in addition to amounts shown for budget authority.

b. By convention, this table shows the amount of PHS Evaluation Tap funds received by an agency for a

particular program or activity separately from the budget authority appropriated for that program or

activity. Tap amounts are in addition to amounts shown for budget authority, though the amounts shown for

budget authority have not been adjusted to reflect potential “transfer-out” of funds to the tap.

c. Although the FY2022 President’s budget and FY2022 House committee bill proposed that ARPA-H funding

be appropriated to the NIH, the $1 billion in enacted funding for ARPA-H was ultimately appropriated to

the HHS Office of the Secretary (OS). Those funds were subsequently transferred to the NIH when ARPAH was placed within that operating division by the HHS Secretary. The enacted ARPA-H funding is displayed

under the OS in keeping with how it was appropriated in the LHHS omnibus. For background on ARPA-H

and its placement, see CRS Report R47074, Advanced Research Projects Agency for Health (ARPA-H):

Congressional Action and Selected Policy Issues.

d. Of the total FY2022 enacted for Refugee and Entrant Assistance Programs, $1.6 billion was enacted as part

of the second continuing resolution for FY2022, P.L. 117-70, for the Unaccompanied Alien Children

program.

Department of Education (ED)

Note that amounts in this section are based on regular LHHS appropriations only. They do not

include mandatory funds provided outside of the annual appropriations process (e.g., direct

appropriations for the Federal Direct Student Loan program and the mandatory portion of the

Federal Pell Grant program). Amounts are rounded (e.g., to the nearest million), as labeled. The

dollar and percentage changes discussed are based on unrounded amounts. For consistency with

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

programs, where applicable.

About ED

Federal policymakers established the U.S. Department of Education in 1980.86 Its mission is to

“promote student achievement and preparation for global competitiveness by fostering

educational excellence and ensuring equal access.”87 Typically, about three-quarters of ED’s

discretionary appropriations go either to local educational agencies—which primarily use the

funds to provide educational and related services for economically disadvantaged students and

students with disabilities—or to low-income postsecondary students in the form of Pell Grants,

which help pay for college. The remainder of ED’s discretionary budget provides for a wide

86 ED in its current incarnation became a department in 1980 pursuant to the Department of Education Organization

Act (enacted on October 17, 1979). However, the department dates its origins to 1867. See U.S. Department of

Education, “About ED: The Federal Role in Education,” http://www2.ed.gov/about/overview/fed/role.html.

87 U.S. Department of Education, “About ED,” http://www2.ed.gov/about/landing.jhtml, accessed on June 24, 2022.

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range of activities, including (but not limited to) support for minority-serving institutions;

educational research; and career, technical, and adult education.

The federal government provides roughly 8% of overall funding for elementary and secondary

education in the United States.88 The majority of school funding—about 92%—comes from states

and local districts, which have primary responsibility for the provision of elementary and

secondary education. With regard to higher education, the federal government provided roughly

57% of undergraduate and graduate student aid in academic year (AY) 2020-2021.89

FY2022 ED Appropriations Overview

Table 8 displays FY2022 enacted and proposed funding levels for ED, along with FY2021 levels.

Note that the totals in this table do not include emergency-designated appropriations. Those

amounts are displayed separately, along with the law in which they were enacted, at the bottom of

the table and are in addition to regular appropriations.90

Discretionary funds represent the majority of ED’s annual appropriations, accounting for roughly

95% of the FY2021 and FY2022 enacted levels.91 The FY2022 enacted discretionary ED

appropriations were 3.9% higher than FY2021 levels. Proposed discretionary ED appropriations

for FY2022 compared to FY2021 would have increased 39.8% under both the President’s budget

and House committee bill.

Table 8. ED Appropriations Overview

(in billions of dollars)

FY2021

Enacted

FY2022

Request

FY2022

House

Cmte.

(H.R.

4502)

Discretionary

73.5

102.8

102.8

76.4

Mandatory

3.7

3.7

3.7

3.7

77.2

106.5

106.5

80.1

P.L. 116-260, Division Ma

82.0

—

—

—

P.L. 117-58, Division Jb

—

—

—

-0.4

P.L. 117-159, Division Bc

—

—

—

2.1

Funding

Total BA in the Bill

FY2022

Enacted

Emergency Funding (not in above totals)

88 U.S. Department of Education, National Center for Education Statistics, Revenues and Expenditures for Public

Elementary and Secondary Education: FY20 (NCES 2022-301), May 2022, https://nces.ed.gov/pubs2022/2022301.pdf.

89 For the purposes of this calculation, the federal contribution included $134 billion (grants, loans, work-study, and tax

benefits) out of a total of $235 billion (federal aid, state aid, institutional grants, and private and employer-provided

grants). See the College Board’s Trends in College Pricing and Student Aid 2021, p. 31,

https://research.collegeboard.org/pdf/trends-college-pricing-student-aid-2021.pdf.

90 For a discussion of the COVID-19-related FY2021 supplemental appropriations in Division M of P.L. 116-260, see

CRS Report R46775, Overview of COVID-19 LHHS Supplemental Appropriations: FY2020 and FY2021.

91 The only mandatory ED funding provided in the LHHS Appropriations Act in each of these years is for Vocational

Rehabilitation State Grants. This excludes any rescissions of mandatory appropriations that are used in the

appropriations process.

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Labor, Health and Human Services, and Education: FY2022 Appropriations

Sources: Amounts in this table for the FY2021 Enacted, FY2022 Request, and FY2022 Enacted columns are

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

FY2022 LHHS omnibus (P.L. 117-103), available in the Congressional Record, vol. 168, no. 42, book IV, March 9,

2022, pp. H2668-H2915. Amounts in the FY2022 House Committee column are generally drawn from or

calculated based on data contained in the committee report (H.Rept. 117-96) accompanying H.R. 4502 Enacted

totals (“Total BA in the Bill”) for FY2021 or FY2022 do not include emergency-designated appropriations. 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 Coronavirus Response and Relief Supplemental Appropriations Act (CRRSAA), included in P.L. 116260, provided approximately $82 billion for the Education Stabilization Fund.

b. Section 90007(f)(1) of the Infrastructure Investment and Jobs Act (P.L. 117-58) rescinded $353.4 million of

unobligated balances previously made available for the Education Stabilization Fund.

c. Division B of the Bipartisan Safer Communities Act (P.L. 117-59) provided $1.05 billion for School

Improvement Programs for FY2022 and $200 million for Safe Schools and Citizenship Education for each

fiscal year from FY2022 through FY2026 ($1.0 billion total).

Selected ED Highlights

The following sections highlight FY2022 appropriations for selected ED accounts and

programs.92 Table 9 tracks funding levels for major ED budget and appropriations accounts, and

selected items within those accounts.

Education for the Disadvantaged

The Education for the Disadvantaged account is the largest account related to elementary and

secondary education and has been the second largest overall within ED based on funding

provided through the annual appropriations process in recent years. Within the account, a

majority of funds are for Grants to Local Educational Agencies, authorized under Title I-A of the

Elementary and Secondary Education Act (ESEA), as amended by the Every Student Succeeds

Act (ESSA; P.L. 114-95). Title I-A grants provide supplementary educational and related services

to low-achieving and other students attending elementary and secondary schools with relatively

high concentrations of students from low-income families, as well as eligible students who live in

the areas served by these public schools but attend private schools.93

The enacted FY2022 appropriation for the Education for the Disadvantaged account was $18.2

billion, a 5.8% increase over the enacted FY2021 level of $17.2 billion. Of the $18.2 billion

appropriated for the account, $17.5 billion was provided for Title I-A grants.94 The House

committee bill and accompanying report had recommended a funding level of $36.8 billion for

the account, with $36.0 billion designated for the Title I-A program.95 President Biden’s FY2022

budget requested $37.2 billion for the Education for the Disadvantaged Account, of which $16.5

92 ED budget materials can be found at https://www2.ed.gov/about/overview/focus/performance.html.

93 Although Title I-A funds are used to serve eligible private school students, funds remain under the control of public

school authorities (i.e., they are not transferred to private schools).

94 See the explanatory statement accompanying the LHHS omnibus (Congressional Record, vol. 168, no. 42, March 9,

2022, p. H2887).

95 See p. 499 of H.Rept. 117-96.

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Labor, Health and Human Services, and Education: FY2022 Appropriations

billion would have been provided for Title I-A grants. Of the remaining funds, $20.0 billion

would have been provided for a new Title I Equity Grants program proposed in the President’s

budget. According to the President’s budget, the new program would have been intended to “help

address long-standing funding disparities between under-resourced school districts and their

wealthier counterparts and provide critical new support to advance the President’s commitments

to ensure teachers at Title I schools are paid competitively, ensure equitable access to rigorous

curriculum, expand access to pre-kindergarten and provide meaningful incentives to examine and

address inequalities in school funding systems.”96

Safe Schools and Citizenship Education

The Safe Schools and Citizenship Education account provides funding for activities intended to

improve students’ safety and well-being, enhance the educational and developmental outcomes of

children in distressed communities, and provide comprehensive services for students, their

families, and community members in school settings.97 The account includes several programs

authorized under Title IV-F of the ESEA, as amended: Promise Neighborhoods; Full-Service

Community Schools; and School Safety National Activities, includin

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