Labor, Health and Human Services, and Education: FY2023 Appropriations
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Labor, Health and Human Services, and
Education: FY2023 Appropriations
Updated May 22, 2023
Congressional Research Service
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R47345
SUMMARY
Labor, Health and Human Services, and
Education: FY2023 Appropriations
This report offers an overview of actions taken by Congress and the President to provide FY2023
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).
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May 22, 2023
Karen E. Lynch,
Coordinator
Specialist in Social Policy
Jessica Tollestrup,
Coordinator
Specialist in Social Policy
This report primarily focuses on regular FY2023 LHHS discretionary funding enacted during the
annual appropriations process. Totals in the report tables do not include emergency-designated funds.
Regular Appropriations
FY2023 LHHS Omnibus: On December 29, 2022, the Consolidated Appropriations Act, 2023 (FY2023 LHHS omnibus;
H.R. 2617) was signed into law by the President (P.L. 117-328). The FY2023 LHHS omnibus provided full-year
appropriations for all 12 annual appropriations acts in Divisions A-L. Annual discretionary LHHS appropriations totaled
about $225.9 billion. This amount is 5.6% more than FY2022 enacted and 7.8% less than the FY2023 President’s budget
request. The omnibus also provided $1.196 trillion in mandatory funding, for a combined LHHS total of $1.422 trillion. The
distribution of discretionary funding was as follows:
•
•
•
•
DOL: $13.8 billion, 4.9% more than FY2022.
HHS: $115.4 billion, 6.6% more than FY2022.
ED: $79.6 billion, 4.1% more than FY2022.
Related Agencies: $17.0 billion, 6.7% more than FY2022.
FY2023 LHHS Senate Action: The FY2023 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 July 28, 2022. These draft numbers are not presented in this report. Also on July 28,
2022, Senator Patty Murray, chair of the Senate Appropriations LHHS Subcommittee, introduced an FY2023 LHHS bill (S.
4659). This bill was referred to the Senate Appropriations Committee. Because S. 4659 did not receive any congressional
action, this report does not discuss this measure.
FY2023 LHHS House Action: On June 30 2022, the House Appropriations Committee voted to report the FY2023 LHHS
bill, 32-24; the measure was subsequently reported to the House on July 5 (H.R. 8295; H.Rept. 117-403). Previously, the
measure was approved in subcommittee, via a voice vote, on June 23, 2022. As reported by the full committee, the bill would
have provided $243.3 billion in discretionary LHHS funds, a 13.8% increase from FY2022 enacted levels. This amount was
0.6% less than the FY2023 President’s request. In addition, the House committee bill would have provided an estimated
$1.196 trillion in mandatory funding, for a combined total of $1.439 trillion for LHHS as a whole. The distribution of
proposed discretionary funding was as follows:
•
•
•
•
DOL: $15.0 billion, 14.0% more than FY2022.
HHS: $124.2 billion, 14.7% more than FY2022.
ED: $86.7 billion, 13.5% more than FY2022.
Related Agencies: $17.4 billion, 8.8% more than FY2022.
FY2023 President’s Budget Request: The President’s budget request was submitted to Congress on March 28, 2022. The
President requested $244.9 billion in discretionary funding for accounts funded by the LHHS bill, which is an increase of
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Labor, Health and Human Services, and Education: FY2023 Appropriations
14.5% from FY2022 levels. In addition, the President requested $1.196 trillion in annually appropriated mandatory funding,
for a total of $1.441 trillion for LHHS as a whole. The distribution of requested discretionary funding was as follows:
•
•
•
•
DOL: $14.9 billion, 13.0% more than FY2022.
HHS: $123.9 billion, 14.4% more than FY2022.
ED: $88.3 billion, 15.6% more than FY2022.
Related Agencies: $17.7 billion, 11.1% more than FY2022.
Emergency-Designated Appropriations
Three acts have been signed into law providing LHHS emergency-designated appropriations for FY2023:
•
Division A of the Continuing Appropriations and Ukraine Supplemental Appropriations Act, 2023 (H.R.
6833; P.L. 117-180, September 30, 2022) provided emergency-designated appropriations for two accounts
at the HHS Administration for Children and Families (ACF): $1.0 billion for the Low Income Home
Energy Assistance Program (§146) and $1.8 billion for expenses to carry out the Unaccompanied Children
Program and for certain refugee and entrant assistance activities (§147).
•
Division M of H.R. 2617 (P.L. 117-328, December 29, 2022), the Additional Ukraine Supplemental
Appropriations Act, 2023, provided $2.4 billion in emergency-designated appropriations for the Refugee
and Entrant Assistance Account at ACF.
•
Division N of H.R. 2617 (P.L. 117-328, December 29, 2022), the Disaster Relief Supplemental
Appropriations Act, 2023, provided a total of $4.25 billion in emergency-designated appropriations to
several HHS accounts and programs within the Centers for Disease Control and Prevention, the National
Institutes of Health, ACF, and the Public Health and Social Sciences Emergency Fund.
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Labor, Health and Human Services, and Education: FY2023 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 FY2023 LHHS Appropriations ........................................................................................ 4
FY2023 Emergency-Designated Appropriations ...................................................................... 4
FY2023 Annual LHHS Appropriations ..................................................................................... 5
FY2023 Consolidated Appropriations Act ................................................................................ 5
FY2023 Continuing Appropriations .......................................................................................... 6
Prior Congressional Action on an LHHS Bill ..................................................................... 7
FY2023 President’s Budget Request ......................................................................................... 8
FY2022 LHHS Omnibus (Division H, Consolidated Appropriations Act, 2022, H.R.
2471, P.L. 117-103) ................................................................................................................ 8
Summary of FY2023 LHHS Appropriations ................................................................................... 9
Department of Labor (DOL) ......................................................................................................... 12
About DOL ............................................................................................................................. 13
FY2023 DOL Appropriations Overview ................................................................................. 13
Selected DOL Highlights ........................................................................................................ 14
Employment and Training Administration (ETA)............................................................. 14
Employment Service ......................................................................................................... 15
Wage and Hour Division (WHD)...................................................................................... 15
Bureau of Labor Statistics (BLS) ...................................................................................... 15
Bureau of International Labor Affairs (ILAB) .................................................................. 16
Labor-Related General Provisions .................................................................................... 16
Department of Health and Human Services (HHS)....................................................................... 19
About HHS .............................................................................................................................. 19
FY2023 HHS Appropriations Overview ................................................................................. 20
Special Public Health Funding Mechanisms ........................................................................... 23
Public Health Service Evaluation Tap............................................................................... 23
Prevention and Public Health Fund .................................................................................. 24
Selected HHS Highlights by Agency ...................................................................................... 25
Health Resources and Services Administration (HRSA) .................................................. 25
Centers for Disease Control and Prevention (CDC) ......................................................... 26
National Institutes of Health (NIH) .................................................................................. 27
Substance Abuse and Mental Health Services Administration (SAMHSA) ..................... 28
Agency for Healthcare Research and Quality (AHRQ) .................................................... 29
Centers for Medicare & Medicaid Services (CMS) .......................................................... 29
Administration for Children and Families (ACF) ............................................................. 30
Administration for Community Living (ACL) ................................................................. 31
Restrictions Related to Certain Controversial Issues .............................................................. 32
Department of Education (ED) ...................................................................................................... 40
About ED ................................................................................................................................ 40
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Labor, Health and Human Services, and Education: FY2023 Appropriations
FY2023 ED Appropriations Overview.................................................................................... 41
Selected ED Highlights ........................................................................................................... 42
Education for the Disadvantaged ...................................................................................... 42
Safe Schools and Citizenship Education........................................................................... 43
Student Financial Assistance............................................................................................. 43
Related Agencies ........................................................................................................................... 46
FY2023 Related Agencies Appropriations Overview ............................................................. 46
Selected Related Agencies Highlights..................................................................................... 47
SSA Limitation on Administrative Expenses (LAE) ........................................................ 48
Corporation for National and Community Service ........................................................... 48
National Labor Relations Board (NLRB) ......................................................................... 48
Figures
Figure 1. FY2023 Enacted LHHS Appropriations .......................................................................... 6
Figure 2. FY2023 Enacted LHHS Appropriations by Title ........................................................... 12
Figure 3. FY2023 Enacted HHS Appropriations by Agency......................................................... 22
Tables
Table 1. Status of Full-Year LHHS Appropriations Legislation, FY2023 ....................................... 5
Table 2. LHHS Appropriations Overview by Bill Title, FY2022-FY2023 ................................... 10
Table 3. DOL Appropriations Overview ....................................................................................... 14
Table 4. Detailed DOL Appropriations .......................................................................................... 17
Table 5. HHS Appropriations Overview........................................................................................ 21
Table 6. HHS Appropriations Totals and Directed Transfers by Agency ...................................... 34
Table 7. HHS Discretionary Appropriations and Directed Transfers for Selected Programs
or Activities, by Agency ............................................................................................................. 36
Table 8. ED Appropriations Overview .......................................................................................... 41
Table 9. Detailed ED Appropriations ............................................................................................ 44
Table 10. Related Agencies Appropriations Overview .................................................................. 47
Table 11. Detailed Related Agencies Appropriations .................................................................... 49
Table A-1. LHHS Discretionary FY2022 and FY2023 Enacted Levels and FY2023 House
302(b) Suballocations ................................................................................................................. 55
Table A-2. LHHS Appropriations Overview, by Bill Title: FY2022-FY2023............................... 56
Appendixes
Appendix. Budget Enforcement Activities .................................................................................... 51
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Labor, Health and Human Services, and Education: FY2023 Appropriations
Contacts
Author Information........................................................................................................................ 58
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Labor, Health and Human Services, and Education: FY2023 Appropriations
Introduction
This report provides an overview of FY2023
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-Designated and
Mandatory Funding
This report primarily focuses on regular
FY2023 LHHS discretionary funding
enacted during the annual appropriations
process. The emergency discretionary
funding that was enacted for FY2022 or
FY2023 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
FY2022, mandatory appropriations were
enacted for certain LHHS-related
accounts, including in the Inflation
Reduction Act of 2022 (P.L. 117-169).
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 “Mandatory vs. Discretionary Budget Authority”), the bulk of this report is
focused on these funds.
The LHHS bill typically is one of the more controversial of the regular appropriations bills
because of the size of its funding and the scope of its programs, as well as various related social
policy issues addressed in the bill, such as restrictions on the use of federal funds for abortion and
for research on human embryos, stem cells, and gun violence.
Congressional clients may consult the LHHS experts list in CRS Report R42638, Appropriations:
CRS Experts, for information on which analysts to contact at the Congressional Research Service
(CRS) with questions on specific agencies and programs funded in the LHHS bill.
Report Roadmap and Useful Terminology
This report is divided into several sections. The opening section provides an explanation of the
scope of the LHHS bill (and hence, the scope of this report) and an introduction to important
terminology and concepts that carry throughout the report. Next is a series of sections describing
major congressional actions on FY2023 appropriations and (for context) a review of the
conclusion of the FY2022 appropriations process. This is followed by a high-level summary and
analysis of proposed and enacted appropriations for FY2023, compared to FY2022 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 FY2023 proposed and enacted funding levels compared to FY2022. (Note that the
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Labor, Health and Human Services, and Education: FY2023 Appropriations
distribution of funds is sometimes illustrated by figures, which in all cases are based on the
FY2023 enacted version of the LHHS bill.1)
The Appendix provides a summary of budget enforcement activities for FY2023. This includes
information on mandatory spending sequestration pursuant to the Budget Control Act of 2011
(BCA; P.L. 112-25), discretionary spending budget enforcement in the absence of a FY2023
budget resolution, the House LHHS subcommittee spending allocation, and current-year spending
levels.
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 “Mandatory vs. Discretionary Budget
Authority” 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 figures reflect FY2023 enacted, but the distribution of funds (as measured by the relative share of funds going
toward a particular department or agency) is generally illustrative of FY2022 enacted and as proposed by the FY2023
President’s budget and the House committee bill.
2 For definitions of these and other budget terms, see U.S. Government Accountability Office (GAO), A Glossary of
(continued...)
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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 FY2023 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 the Appendix.
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
Terms Used in the Federal Budget Process, GAO-05-734SP, September 1, 2005, http://www.gao.gov/products/GAO05-734SP. (Terms of interest may include appropriated entitlement, direct spending, discretionary, entitlement
authority, and mandatory.)
3 Sometimes appropriations measures include amendments to laws authorizing mandatory spending programs and
thereby change the amount of mandatory appropriations needed. Because such amendments are legislative in nature,
they may violate parliamentary rules separating authorizations and appropriations. For more information, see CRS
Report R42388, The Congressional Appropriations Process: An Introduction.
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 the
Appendix).6 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.7 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 FY2023 LHHS Appropriations
FY2023 Emergency-Designated Appropriations
Three acts have been signed into law providing LHHS emergency-designated appropriations for
FY2023:
•
•
Division A of the Continuing Appropriations and Ukraine Supplemental
Appropriations Act, 2023 (H.R. 6833; P.L. 117-180, September 30, 2022)
provided emergency-designated appropriations for two accounts at the HHS
Administration for Children and Families (ACF): $1.0 billion for the Low
Income Home Energy Assistance Program (§146) and $1.8 billion for expenses
to carry out the Unaccompanied Children Program and for certain refugee and
entrant assistance activities (§147).8
Division M of H.R. 2617 (P.L. 117-328, December 29, 2022), the Additional
Ukraine Supplemental Appropriations Act, 2023, provided $2.4 billion in
emergency-designated appropriations for the Refugee and Entrant Assistance
Account at ACF.9
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 As of the cover date of this report, the House and Senate have not adopted a budget resolution for FY2023. In its
absence, on June 8, 2022, the House adopted a resolution (H.Res. 1151) to provide for House Appropriations
Committee allocations and related purposes. For further information, see the Appendix.
7 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).
8 The budgetary effects of Section 149 related to Afghan parolee eligibility for certain benefits also were emergencydesignated. These budgetary effects are not included in this report because no definite dollar amount was specified. For
further information, see CBO, Estimated Discretionary Appropriations Under Division A of Senate Amendment
Number 5745 to H.R. 6833, the Continuing Appropriations and Ukraine Supplemental Appropriations Act, 2023,
September 28, 2022, https://www.cbo.gov/system/files/2022-09/hr6833-CA.pdf.
9 The budgetary effects of Section 1501 related to Afghan parolee eligibility for certain benefits also were emergencydesignated. These budgetary effects are not included in this report because no definite dollar amount was specified. For
further information, see CBO, Discretionary Spending in Fiscal Year 2023 Under Divisions A Through L of H.R. 2617
(as modified by Senate Amendment 6552), the Consolidated Appropriations Act, 2023, December 21, 2022,
https://www.cbo.gov/system/files/2022-12/HR-2617_div-A%E2%80%93N.pdf.
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•
Division N of H.R. 2617 (P.L. 117-328, December 29, 2022), the Disaster Relief
Supplemental Appropriations Act, 2023, provided a total of $4.25 billion in
emergency-designated appropriations to several HHS accounts and programs:
• $86 million for CDC-wide Activities and Program Support Account (Centers for
Disease Control and Prevention);
•
$3 million to the National Institute of Environmental and Health Sciences (National
Institutes of Health; NIH);
•
•
•
•
$25 million to the Office of the Director (NIH);
•
$129 million to the Public Health and Social Services Emergency Fund.
$3.5 billion to the Low Income Home Energy Assistance Program (ACF);
$100 million to the Child Care and Development Block Grant (ACF);
$408 million to the Children and Families Services Programs Account (ACF) for
several programs, including $345 million to the Head Start program; and
FY2023 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, FY2023
Subcommittee
Approval
House
Senate
6/23/22
voice
vote
—
Full Committee
Approval
House
H.R. 8295
(H.Rept.
117-403)
6/30/22
32-24
Resolution of House and
Senate Differences
Senate
House
Initial
Passage
Senate
Initial
Passage
Conf.
Report
—
—
—
—
House
Final
Passage
Senate
Final
Passage
H.R. 2617,
Division H,
12/23/22
225-201
H.R. 2617,
Division H,
12/22/22
68-29
Public
Law
P.L. 117328
12/29/22
Source: CRS Appropriations Status Table.
FY2023 Consolidated Appropriations Act
Full-year FY2023 appropriations for LHHS were enacted on December 29, 2022, when the
Consolidated Appropriations Act, 2023 (FY2023 omnibus; H.R. 2617, P.L. 117-328) was signed
into law by the President. The FY2023 omnibus provided full-year appropriations for all 12
annual appropriations acts in Divisions A-L. (Full-year LHHS appropriations were enacted in
Division H.) Prior to its enactment, the final version of the measure was approved by the Senate
on December 22 (68-29). It was approved by the House on December 23 (225-201).
See Figure 1 for a breakdown of FY2023 discretionary and mandatory LHHS appropriations
enacted in the FY2023 LHHS omnibus.10 Annual discretionary LHHS appropriations totaled
10 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
FY2022 and under the FY2023 President’s budget and the FY2023 House committee bill.
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$225.9 billion. This amount is 5.6% more than FY2022 enacted and 7.8% less than the FY2023
President’s budget request. The omnibus also provided $1.196 trillion in mandatory funding, for a
combined LHHS total of $1.422 trillion.
Figure 1. FY2023 Enacted LHHS Appropriations
Source: Amounts in this figure are generally drawn from or calculated based on data contained in the
explanatory statement accompanying the FY2023 LHHS omnibus (P.L. 117-328) available in the Congressional
Record, vol. 168, no. 198, book II, December 20, 2022, pp. S8874-S9198. Enacted totals for FY2023 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
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.
FY2023 Continuing Appropriations
Between the start of FY2023 and the enactment of full-year appropriations, FY2023 LHHS
regular appropriations were provided by a series of CRs. The first CR was signed into law on
September 30, 2022 (Division A of H.R. 6833; P.L. 117-180), providing continuing
appropriations for all 12 of the annual appropriations acts (including LHHS) through December
16, 2022. The measure, which was originally an unrelated vehicle that had been passed
previously by the House, was taken up by the Senate the week prior to the start of the fiscal year.
The Senate amended the measure to contain the CR, and passed it as amended (72-25) on
September 29, 2022. The House subsequently took up the measure and agreed to the Senate
amendment (230-201) on September 30, 2022.
A second CR was signed into law on December 16, 2022 (Division A of H.R. 1437; P.L. 117229), extending appropriations through December 23, 2022. The measure, which was originally
an unrelated vehicle that had been passed previously by the House and the Senate, was amended
in the House to contain the CR. The House passed (224-201) the amended bill on December 14.
The Senate passed (71-19) the bill on December 15.
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A third CR was signed into law on December 23, 2022 (Division A of H.R. 4373; P.L. 117-264),
extending appropriations through December 30, 2022. The measure, which was originally an
unrelated appropriations measure that had been passed previously by the House, was amended by
the Senate to contain the CR. The Senate passed (voice vote) the amended bill on December 22.
The House agreed to the measure pursuant to provisions of H.Res. 1531 on December 23.
In general, the FY2023 CRs funded discretionary programs at the same rate and under the same
conditions as in FY2022 (§101) and annually appropriated entitlements at their current law levels
(§111).11 The CRs also included several anomalies that were specific to LHHS accounts or related
activities (§§101(8), 145-150).12
Prior Congressional Action on an LHHS Bill
FY2023 LHHS Action in the Senate
The Senate Appropriations Committee did not report the FY2023 LHHS bill. However, the
committee chair, Senator Leahy, released a majority draft of the LHHS bill and accompanying
draft report language on July 28, 2022.13 These draft numbers are not presented in this report.
Also on July 28, 2022, Senator Patty Murray, chair of the Senate Appropriations LHHS
Subcommittee, introduced an FY2023 LHHS bill (S. 4659).14 Because S. 4659 has not received
any congressional action, this report does not discuss this measure.
FY2023 LHHS Action in the House (H.R. 8295)
On June 30, 2022, the House Appropriations Committee voted to report the FY2023 LHHS bill,
32-24; the measure was subsequently reported to the House on July 5 (H.R. 8295; H.Rept. 117403). Previously, the measure was approved in subcommittee, via a voice vote, on June 23, 2022.
As reported by the full committee, the bill would have provided $243.3 billion in discretionary
LHHS funds, a 13.8% increase from FY2022 enacted levels. This amount was 0.6% less than the
FY2023 President’s request. In addition, the House committee bill would have provided an
estimated $1.196 trillion in mandatory funding, for a combined total of $1.439 trillion for LHHS
as a whole.
11 For an estimate of the discretionary appropriations contained in Division A of H.R. 6833, see CBO, Estimated
Discretionary Appropriations Under Division A of Senate Amendment Number 5745 to H.R. 6833, the Continuing
Appropriations and Ukraine Supplemental Appropriations Act, 2023, with Adjustments Made in the Senate, September
28, 2022, https://www.cbo.gov/system/files/2021-09/57491-CBO-Estimate-for-HR5305.pdf. For an estimate of the
discretionary appropriations contained in Division A of H.R. 1437, see CBO, Estimated Discretionary Appropriations
Under Division A of the Further Continuing Appropriations and Extensions Act, 2023 (Rules Committee Print 117-72,
the House Amendment to the Senate Amendment to H.R. 1437) as posted on the Rules Committee Website
(https://rules.house.gov/bill/117/hr1437-sa), with Adjustments Made in the House, December 14, 2022,
https://www.cbo.gov/system/files/2022-12/hr1437%28as_modified%29.pdf.
12 The LHHS anomalies are discussed in CRS Report R47283, Overview of Continuing Appropriations for FY2023
(Division A of P.L. 117-180).
13 See the draft text and explanatory statement linked to Senate Appropriations Committee, “Chairman Leahy Releases
Fiscal Year 2023 Senate Appropriations Bills,” July 28, 2022,
https://www.appropriations.senate.gov/news/majority/breaking-chairman-leahy-releases-fiscal-year-2023-senateappropriations-bills. See also Senate Appropriations Committee, “Shelby: Democrats’ Partisan Bills Threaten FY23
Appropriations Process,” July 28, 2022, https://www.appropriations.senate.gov/news/minority/shelby-democratspartisan-bills-threaten-fy23-appropriations-process.
14 The text of S. 4659 as introduced was generally the same as the draft LHHS bill released by the chair of the Senate
Appropriations Committee on July 28, discussed above.
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FY2023 President’s Budget Request
The FY2023 President’s budget request was submitted to Congress on March 28, 2022.
Subsequently, on June 7, 2022, the Biden Administration submitted several FY2023 budget
amendments to Congress.15 The Administration characterized the two LHHS budget amendments
as technical in nature; neither were estimated to affect net budget authority totals.16
The President requested $244.9 billion in discretionary funding for accounts funded by the LHHS
bill, which is an increase of 14.5% from FY2022 levels. In addition, the President requested
$1.196 trillion in annually appropriated mandatory funding, for a total of $1.441 trillion for
LHHS as a whole.
FY2022 LHHS Omnibus (Division H, Consolidated Appropriations
Act, 2022, H.R. 2471, P.L. 117-103)
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 fullyear appropriations for all 12 annual appropriations acts in Divisions A-L.17 (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.)18 The bill was approved by the Senate (68-31) on March 10.
Annual discretionary LHHS appropriations in the FY2022 LHHS omnibus 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.19 (Note that these totals are based only on amounts of nonemergency appropriations and do not include emergency-designated or supplemental funds,
which were provided in addition to the annual appropriations.)
15 U.S. President (Biden), “Letter to the Speaker of the House of Representatives on Fiscal Year 2023 Budget
Amendments,” 117th Cong., 2nd sess., June 7, 2022, https://www.whitehouse.gov/wpcontent/uploads/2022/06/FY_2023_Budget_Amendments_Package_6-7-22.pdf.
16 Ibid, p. 14 and p. 20.
17 The FY2022 omnibus was originally intended to carry additional supplemental appropriations related to the COVID19 pandemic in Division M, but Division M was omitted prior to floor consideration.
18 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, and 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, and 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.
19 For a full discussion of the FY2021 LHHS omnibus, see CRS Report R47029, Labor, Health and Human Services,
and Education: FY2022 Appropriations.
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Summary of FY2023 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. These totals include, where applicable, full-year non-emergency appropriations provided in
continuing resolutions.
Throughout this report, the FY2023 House Appropriations Committee-reported LHHS bill is commonly referred
to as the House “committee bill.”
Amounts for the FY2022 Enacted, FY2023 Request, and FY2023 Enacted are generally drawn from or calculated
based on data contained in the explanatory statement accompanying the FY2023 LHHS omnibus (P.L. 117-328),
available in the Congressional Record, vol. 168, no. 198, book II, December 20, 2022, pp. S8874-S9198, unless
otherwise noted. FY2023 House Committee amounts are generally drawn from the committee report (H.Rept.
117-403) accompanying the FY2023 House committee bill (H.R. 8295, as reported), unless otherwise noted.
FY2022 and FY2023 enacted totals (“Total BA in the Bill”) do not include emergency-designated LHHS
appropriations. For informational purposes, FY2022 and FY2023 enacted emergency-designated amounts are
displayed separately at the bottom of tables throughout the report and not summed in that separate display.
Those amounts are based on CRS analysis of the texts of those laws. One exception to this rule is made in the
Appendix, which includes FY2022 and FY2023 enacted emergency-designated funds in the “Adjusted
Appropriations” totals, as scored by the Congressional Budget Office.
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.20 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 FY2023 discretionary and mandatory LHHS budget authority proposed and
enacted, by bill title, along with FY2022 enacted levels. The amounts shown in this table reflect
total budget authority provided in the annual LHHS bill (i.e., all funds appropriated in the bill,
regardless of the fiscal year in which the funds become available), not total budget authority
available for the current fiscal year. (For a comparable table showing current-year budget
20 The general practice for CRS reports on the LHHS bill has been to reflect conventions used in source materials.
These conventions have varied over the years. For instance, CRS reports on LHHS appropriations for FY2012-FY2015
generally relied on source materials that adjusted appropriations amounts in the prior-year column to reflect
sequestration, reestimates of mandatory spending, transfers, reprogramming, and other adjustments for comparability.
However, the FY2016 version of this report broke from that practice due to differing display conventions in source
documents, and did not reflect any such adjustments (except sequestration for the Prevention and Public Health Fund
[PPHF]). The FY2017 version of this report differed from both of these prior practices, in that it reflected a smaller
subset of transfers (generally concentrated at the National Institutes of Health) and other adjustments for comparability
(e.g., program moves from one account to another), but not reprogramming of funds or mandatory sequestration
(except sequestration of the PPHF). The FY2018-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 FY2023, the source materials used for this report continue this most recent approach.
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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, FY2022-FY2023
(total budget authority provided in the bill, in billions of dollars)
Bill Title
Title I: Labor
FY2022
Enacted
FY2023
Request
FY2023
House
Cmte.
(H.R. 8295)
FY2023
Enacted
14.4
16.2
16.3
15.1
Discretionary
13.2
14.9
15.0
13.8
Mandatory
1.2
1.3
1.3
1.3
Title II: HHS
1,147.9
1,255.0
1,255.3
1,246.5
Discretionary
108.3
123.9
124.2
115.4
Mandatory
1,039.6
1,131.1
1,131.1
1,131.1
Title III: Education
80.1
92.3
90.7
83.5
Discretionary
76.4
88.3
86.7
79.6
Mandatory
3.7
3.9
3.9
3.9
73.0
77.4
77.0
76.7
Discretionary
16.0
17.7
17.4
17.0
Mandatory
57.0
59.6
59.6
59.6
Total BA in the Bill
1,315.4
1,440.8
1,439.3
1,421.9
Discretionary
213.9
244.9
243.3
225.9
Mandatory
1,101.5
1,196.0
1,196.0
1,196.0
P.L. 117-43, Divisions A and C
4.2
0.0
0.0
0.0
P.L. 117-58, Division J
0.1
0.0
0.0
0.0
P.L. 117-70, Division B
1.3
0.0
0.0
0.0
P.L. 117-128 , Title IV
1.0
0.0
0.0
0.0
P.L. 117-159, Division B
3.0
0.0
0.0
0.0
P.L. 117-180, Division A
0.0
0.0
0.0
2.8
P.L. 117-328, Division M
0.0
0.0
0.0
2.4
P.L. 117-328, Division N
0.0
0.0
0.0
4.3
Advances for Future Years
(provided in current bill)a
210.7
242.8
242.8
242.8
Advances from Prior Years
(for use in current year)a
197.6
210.7
210.7
210.7
Additional Scorekeeping Adjustmentsb
-14.7
-33.9
-16.5
-16.1
Title IV: Related Agencies
Emergency Funding (not in above totals or
memoranda below)
Memoranda:
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Source: Amounts in this table for the FY2022 Enacted, FY2023 Request, and FY2023 Enacted columns are
generally drawn from or calculated based on data contained in the explanatory statement accompanying the
FY2023 LHHS omnibus (P.L. 117-328) available in the Congressional Record, vol. 168, no. 198, book II, December
20, 2022, pp. S8874-S9198. Amounts in the FY2023 House Committee column are generally drawn from or
calculated based on data contained in the committee report (H.Rept. 117-403) accompanying the FY2023 House
committee bill (H.R. 8295, as reported). Enacted totals (“Total BA in the Bill”) for FY2022 or FY2023 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. 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.
b. 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 FY2023, by bill
title. (While the percentages discussed in this section were calculated based on the FY2023
enacted amounts, they are generally also illustrative—within several percentage points—of the
share of funds directed to each bill title in FY2022, and under the FY2023 President’s budget and
House committee bill.)
As this figure demonstrates, HHS accounts for the largest share of total FY2023 LHHS
appropriations: $1.247 trillion, or 87.7%. 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 5.9% and 5.4%, 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%.
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 (51.1%), while ED accounts for a relatively larger share (35.2%).
Together, these two departments represent the majority (86.3%) of discretionary LHHS
appropriations. DOL and the Related Agencies account for the remaining discretionary funds, at
6.1% and 7.5% of the total, respectively.
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Figure 2. FY2023 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 FY2023 LHHS omnibus (P.L. 117-328), available in the Congressional
Record, vol. 168, no. 198, book II, December 20, 2022, pp. S8874-S9198. Enacted totals for FY2023 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)
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).22 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)21
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.
FY2023 DOL Appropriations Overview
Table 3 displays FY2023 enacted and proposed funding levels for DOL, along with FY2022
levels. Following the conventions in this report, the totals in this table do not include emergencydesignated appropriations; however, note that DOL received no emergency-designated
appropriations in FY2022 or FY2023.
Discretionary funds represent the majority of DOL appropriations, accounting for 92% of
FY2022 and FY2023 enacted levels. The FY2023 LHHS omnibus increased discretionary
appropriations for DOL by $652 million (+4.9%) compared to FY2022 enacted. Relative to
FY2022 enacted, discretionary DOL appropriations would have increased by $1.8 billion
(+14.0%) under the FY2023 House committee bill and $1.7 billion (+13.0%) under the FY2023
President’s budget request.
21 Departmental Management includes the DOL salaries and expenses, Veterans Employment and Training Service
(VETS), IT Modernization, and the Office of the Inspector General.
22 The Pension Benefit Guaranty Corporation (PBGC) is funded primarily through insurance premiums and related fees
from companies covered by the PBGC. For further information, see CRS In Focus IF10492, An Overview of the
Pension Benefit Guaranty Corporation (PBGC).
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Table 3. DOL Appropriations Overview
(in billions of dollars)
FY2022
Enacted
FY2023
Request
FY2023
House
Cmte.
(H.R. 8295)
Discretionary
13.2
14.9
15.0
13.8
Mandatory
1.2
1.3
1.3
1.3
14.4
16.2
16.3
15.1
—
—
—
—
Funding
Total BA in the Bill
Emergency Funding (not in above totals)
FY2023
Enacted
Source: Amounts in this table for the FY2022 Enacted, FY2023 Request, and FY2023 Enacted columns are
generally drawn from or calculated based on data contained in the explanatory statement accompanying the
FY2023 LHHS omnibus (P.L. 117-328), available in the Congressional Record, vol. 168, no. 198, book II, December
20, 2022, pp. S8874-S9198. Amounts in the FY2023 House Committee column are generally drawn from or
calculated based on data contained in the committee report (H.Rept. 117-403) accompanying the FY2023 House
committee bill (H.R. 8295, as reported). Enacted totals (“Total BA in the Bill”) for FY2022 or FY2023 do not
include emergency-designated appropriations. For consistency with source materials, amounts in this table
generally do not reflect mandatory spending sequestration, where applicable, nor do they reflect any transfers or
reprogramming of funds pursuant to executive authorities.
Notes: BA = budget authority. Details may not add to totals due to rounding. Amounts in this table (1) reflect
all BA appropriated in the bill, regardless of the year in which funds become available (i.e., totals do not include
advances from prior-year appropriations, but do include advances for subsequent years provided in this bill); (2)
have generally not been adjusted to reflect scorekeeping; (3) comprise only those funds provided (or requested)
for agencies and accounts subject to the jurisdiction of the LHHS subcommittees of the House and Senate
appropriations committees; and (4) do not include appropriations that occur outside of appropriations bills.
Selected DOL Highlights
The following sections present highlights from FY2023 enacted and proposed appropriations
compared to FY2022 enacted appropriations for selected DOL accounts and programs.23 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, as amended). 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.
Title I of WIOA, which authorizes more than half of all funding for the programs authorized by
the four titles of WIOA, includes three state formula grant programs serving Adults, Youth, and
Dislocated Workers. The FY2023 LHHS omnibus provided a $50 million increase (+1.7%) for
the three WIOA state formula grant programs compared to FY2022. Compared to FY2022
enacted levels, the FY2023 President’s budget would have provided $140 million more (+4.9%)
and the House committee bill would have increased funding by $256 million (+8.9%).
The FY2023 LHHS omnibus provided $326 million for the Dislocated Workers Activities
National Reserve (DWA National Reserve), an increase of $25 million (+8.3%) compared to the
FY2022 enacted level. The House committee bill would have increased funding for the DWA
23 DOL budget materials can be found at https://www.dol.gov/general/aboutdol#budget.
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National Reserve by $157 million (+52.0%), whereas the FY2023 President’s budget would have
increased funding for the DWA National Reserve by $227 million (+75.3%), compared to
FY2022. In addition, the FY2023 LHHS omnibus maintained a provision in that account (which
originated in the FY2018 omnibus) directing $50 million from the DWA National Reserve toward
training and employment assistance for workers dislocated in the Appalachian, lower Mississippi,
and Northern Border Regional Commission regions. The FY2023 LHHS omnibus maintained a
provision that originated in the FY2020 omnibus directing $65 million from the DWA National
Reserve to be used in developing, offering, or improving career training programs at community
colleges.
The FY2023 LHHS omnibus provided $285 million for the Apprenticeship Grant program, which
was $50 million (+21.3%) more than the level enacted in FY2022. The House committee bill and
the FY2023 President’s budget would have increased the level of funding for the Apprenticeship
Grant program by $68 million (+28.9%) compared to the FY2022 enacted level.
Finally, under the pilot and demonstration authority in WIOA (§169), the FY2023 House
committee bill and the FY2023 President’s budget would have provided new funding for a
National Youth Employment Program ($75 million), a Climate Corps ($15 million), and a
Veterans Clean Energy Training program ($10 million). These did not ultimately receive funding
in the FY2023 LHHS omnibus.
Employment Service
The FY2023 LHHS omnibus provided $705 million for the Employment Service (ES), which was
an increase of $5 million (+0.7%) compared to the FY2022 LHHS omnibus. The FY2023 House
committee bill would have provided $749 million for the ES, which would have been an increase
of $49 million (+7.0%) compared to the FY2022 LHHS omnibus and $28 million (+3.8%) more
than requested in the FY2023 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 FY2023 House committee bill included a provision to prohibit DOL from
using any funds provided in the bill to implement or enforce a 2020 final rule allowing the use of
non-merit-staff employees to deliver Employment Service services.24 This provision was not
included in the FY2023 LHHS omnibus.
Wage and Hour Division (WHD)
The FY2023 LHHS omnibus provided $260 million for the WHD, an increase of $9 million
(+3.6%) compared to FY2022 enacted. The FY2023 House committee bill would have provided
$313 million for WHD, an increase of $62 million (+24.6%) compared to the FY2022 enacted
level and $5 million (+1.6%) more than the FY2023 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.
Bureau of Labor Statistics (BLS)
The FY2023 LHHS omnibus provided $698 million for BLS, an increase of $10 million (+1.5%)
compared to FY2022 enacted, whereas the FY2023 House committee bill would have provided a
$38 million increase (+5.6%) and the FY2023 President’s budget proposed a $54 million increase
(+7.8%) relative to FY2022. The explanatory statement accompanying the FY2023 LHHS
omnibus notes that total funding includes $10 million for BLS to implement the National
24 See Section 112.
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Longitudinal Survey of Youth (NLSY) and $14.5 million for BLS to continue planning and
developing the new NLSY established in the FY2020 LHHS act.25
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 FY2023 LHHS omnibus provided $116 million for
ILAB, which was an increase of $10 million (+9.4%) from the FY2022 enacted level. The
FY2023 House committee bill would have increased funding for ILAB by $33 million (+30.9%)
compared to the FY2022 LHHS omnibus, while the FY2023 President’s budget would have
increased funding by $23 million (+21.5%) for ILAB.
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 FY2023 LHHS omnibus.
The FY2023 LHHS omnibus continued several provisions that have been included in at least one
previous LHHS appropriations act, including provisions that
•
•
•
•
•
•
exempted certain insurance claims adjusters from overtime protection for two
years following a “major disaster” (included since FY2016)26;
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)27;
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)28;
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)29;
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)30; and
prohibited annual appropriations from being used to alter the Interagency
Agreement between DOL and the U.S. Department of Agriculture or to close any
25 Congressional Record, December 20, 2022, vol. 168, no. 198, book II, pp. S8874-S8875.
26 See Division H, Title I, §108 of P.L. 117-328.
27 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.
28 See Division H, Title I, §112 of P.L. 117-328
29 See Division H, Title I, §113 of P.L. 117-328.
30 See Division H, Title I, §114 of P.L. 117-328.
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Civilian Conservation Centers unless certain conditions are met (included since
FY2020).31
Table 4. Detailed DOL Appropriations
(in millions of dollars)
Agency or Selected Program
FY2022
Enacted
FY2023
House
Cmte.
(H.R. 8295)
FY2023
Request
FY2023
Enacted
ETA—Mandatorya
540
494
494
494
ETA—Discretionary
9,942
11,076
11,269
10,488
Training and Employment Services:
3,912
4,411
4,598
4,141
State Formula Grants:
2,879
3,019
3,135
2,929
Adult Activities Grants to States
871
900
941
886
Youth Activities Grants to States
933
964
1,033
948
1,076
1,155
1,162
1,096
1,033
1,392
1,462
1,212
DWA National Reserve
301
527
457
326
Native Americans
57
64
64
60
Migrant and Seasonal Farmworkers
95
97
105
97
YouthBuild
99
145
145
105
Reintegration of Ex-Offenders
102
150
150
115
6
6
6
6
Apprenticeship Grants
235
303
303
285
Community Projects
138
0
132
217
National Youth Employment
Program
0
75
75
0
Climate Corps
0
15
15
0
Veterans Clean Energy Training
0
10
10
0
1,749
1,779
1,799
1,760
Community Service Employment for Older
Americans
405
405
450
405
State Unemployment Insurance and
Employment Service Operations (SUI/ESO):
3,711
4,258
4,214
4,009
Unemployment Compensation
2,869
3,353
3,303
3,158
Employment Service
700
721
749
705
Foreign Labor Certification
80
99
95
84
One-Stop Career Centers
63
86
68
63
Discretionary ETA Programs:
Dislocated Worker Activities
(DWA) Grants to States
National Activities:
Workforce Data Quality Initiative
Job Corps
31 See Division H, Title I, §115 of P.L. 117-328.
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Agency or Selected Program
FY2022
Enacted
FY2023
Request
FY2023
House
Cmte.
(H.R. 8295)
FY2023
Enacted
ETA Program Administration
164
223
209
173
Employee Benefits Security
Administration
186
234
234
191
Pension Benefit Guaranty Corp, (PBGC) program
level (non-add) b
(473)
(493)
(493)
(473)
Wage and Hour Division
251
308
313
260
Office of Labor-Management Standards
46
50
46
49
Office of Federal Contract Compliance
Programs
108
147
147
111
Office of Workers’ Compensation
Programs—Mandatoryc
683
756
756
756
Office of Workers’ Compensation
Programs—Discretionary
120
146
146
123
Occupational Safety & Health
Administration
612
701
712
632
Mine Safety & Health Administration
384
423
404
388
Bureau of Labor Statistics
688
742
726
698
Office of Disability Employment Policy
41
59
59
43
Departmental Management
812
1,015
975
859
Salaries and Expenses
368
492
499
392
(106)
(129)
(139)
(116)
Veterans Employment and Training
325
331
339
335
IT Modernization
28
48
38
34
Working Capital Fund
0
36
0
0
Office of the Inspector General
91
108
99
97
Total, DOL BA in the Bill
14,412
16,151
16,281
15,092
Subtotal, Mandatory
1,223
1,250
1,250
1,251
Subtotal, Discretionary
13,189
14,900
15,031
13,841
Total, BA Available in Fiscal Year (current year
from any bill)
14,415
16,151
16,282
15,092
Total, BA Advances for Future Years (provided
in current bill)
1,783
1,782
1,782
1,783
Total, BA Advances from Prior Years (for use
in current year)
1,786
1,783
1,783
1,783
—
—
—
—
International Labor Affairs (non-addd)
Memoranda (non-emergency funds only)
Emergency Funding (not in above totals)
Source: Amounts in this table for the FY2022 Enacted, FY2023 Request, and FY2023 Enacted columns are
generally drawn from or calculated based on data contained in the explanatory statement accompanying the
FY2023 LHHS omnibus (P.L. 117-328), available in the Congressional Record, vol. 168, no. 198, book II, December
20, 2022, pp. S8874-S9198. Amounts in the FY2023 House Committee column are generally drawn from or
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calculated based on data contained in the committee report (H.Rept. 117-403) accompanying the FY2023 House
committee bill (H.R. 8295, as reported). Enacted totals (“Total BA in the Bill”) for FY2022 or FY2023 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.
Department of Health and Human Services (HHS)
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.
HHS Agencies Funded via the
LHHS Appropriations Process
Health Resources and Services Administration (HRSA)
Centers for Disease Control and Prevention (CDC)
National Institutes of Health (NIH)
Substance Abuse and Mental Health Services
Administration (SAMHSA)
Agency for Healthcare Research and Quality (AHRQ)
Centers for Medicare & Medicaid Services (CMS)
Administration for Children and Families (ACF)
Administration for Community Living (ACL)
Office of the Secretary (OS)*
* This report includes funding for the Office of the Assistant
Secretary for Preparedness and Response (ASPR) within OS,
consistent with source materials.
About HHS
HHS is a large federal department composed of multiple agencies working to enhance the health
and well-being of Americans. Annual LHHS appropriations laws direct funding to most (but not
all) HHS agencies (see text box for HHS agencies supported by the LHHS bill).32 For instance,
32 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
(continued...)
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the LHHS bill directs funding to multiple Public Health Service (PHS) agencies, including the
Health Resources and Services Administration (HRSA), the Centers for Disease Control and
Prevention (CDC), the National Institutes of Health (NIH), the Substance Abuse and Mental
Health Services Administration (SAMHSA), and the Agency for Healthcare Research and Quality
(AHRQ). 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). (The HHS Office of the Assistant Secretary for Preparedness and
Response, recently renamed the Administration for Strategic Preparedness and Response [ASPR,
see discussion below], is also a component of the PHS. ASPR funding has historically been
provided within the Office of the Secretary.)
In addition, the LHHS bill provides funding for annually appropriated components of the CMS,33
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, as amended).
The LHHS bill also provides funding for two HHS agencies focused primarily on the provision of
social services: the Administration for Children and Families (ACF) and the Administration for
Community Living (ACL). ACF’s mission is to promote the economic and social well-being of
vulnerable children, youth, families, and communities. ACL was formed with a goal of increasing
access to community supports for older Americans and people with disabilities.
The LHHS bill also provides funding for the HHS Office of the Secretary (OS), which
encompasses a broad array of management, research, oversight, and emergency preparedness
functions in support of the entire department. On July 22, 2022, HHS announced that the Office
of the Assistant Secretary for Preparedness and Response (ASPR) would be renamed the
Administration for Strategic Preparedness and Response (but keep its acronym, ASPR).34
According to the announcement, HHS planned to move ASPR out of OS and, instead, establish
the agency as an HHS operating division (i.e., an organizational level comparable to CDC or
NIH). This reorganization was approved by the HHS Secretary on January 27, 2023, and became
effective on February 11, 2023.35 As the FY2023 President’s budget, House committee bill, and
FY2023 LHHS omnibus were formulated prior to this announcement, this report reflects the
assumptions underlying those proposals in keeping ASPR funding within the OS.
FY2023 HHS Appropriations Overview
Table 5 displays enacted and proposed FY2023 funding levels for HHS, along with FY2022
levels. The totals in this table do not include emergency-designated appropriations. Those
(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.
33 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.
34 HHS Press Office, “HHS Strengthens Country’s Preparedness for Health Emergencies, Announces Administration
for Strategic Preparedness and Response (ASPR),” July 22, 2022, https://www.hhs.gov/about/news/2022/07/22/hhsstrengthens-countrys-preparedness-health-emergencies-announces-administration-for-strategic-preparednessresponse.html.
35 U.S. Department of Health and Human Services, “Statement of Organization, Functions and Delegations of
Authority,” 88 Federal Register 10125-10127, February 16, 2023.
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amounts (if applicable) 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.
In general, discretionary funds account for about 9% of HHS appropriations in the LHHS bill.
Compared to the FY2022 funding levels, the FY2023 LHHS omnibus increased HHS
discretionary appropriations by 6.6%. Both the House committee bill and the President’s request
would have increased HHS discretionary appropriations to a greater degree, by 14.7% and 14.4%,
respectively.
Table 5. HHS Appropriations Overview
(in billions of dollars)
FY2022
Enacted
FY2023
Request
FY2023
House Cmte.
(H.R. 8295)
FY2023
Enacted
Discretionary
108.3
123.9
124.2
115.4
Mandatory
1,039.6
1,131.1
1,131.1
1,131.1
Total BA in the Bill
1,147.9
1,255.0
1,255.3
1,246.5
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
—
—
—
P.L. 117-180, Division A
—
—
—
2.8
P.L. 117-328, Division M
—
—
—
2.4
P.L. 117-328, Division N
—
—
—
4.3
Funding
Emergency Funding (not in above totals)
Sources: Amounts in this table for the FY2022 Enacted, FY2023 Request, and FY2023 Enacted columns are
generally drawn from or calculated based on data contained in the explanatory statement accompanying the
FY2023 LHHS omnibus (P.L. 117-328), available in the Congressional Record, vol. 168, no. 198, book II, December
20, 2022, pp. S8874-S9198. Amounts in the FY2023 House Committee column are generally drawn from or
calculated based on data contained in the committee report (H.Rept. 117-403) accompanying the FY2023 House
committee bill (H.R. 8295, as reported). Enacted totals (“Total BA in the Bill”) for FY2022 or FY2023 do not
include emergency-designated appropriations. For consistency with source materials, amounts in this table
generally do not reflect mandatory spending sequestration, where applicable, nor do they reflect any transfers or
reprogramming of funds pursuant to executive authorities. CRS calculations do, however, include LHHS funding
provided to HHS pursuant to the 21st Century Cures Act (P.L. 114-255), as amended.
Notes: BA = budget authority. Details may not add to totals due to rounding. Amounts in this table (1) reflect
all BA appropriated in the bill, regardless of the year in which funds become available (i.e., totals do not include
advances from prior-year appropriations, but do include advances for subsequent years provided in this bill); (2)
have generally not been adjusted to reflect scorekeeping; (3) comprise only those funds provided (or requested)
for agencies and accounts subject to the jurisdiction of the LHHS subcommittees of the House and Senate
appropriations committees; and (4) do not include appropriations that occur outside of appropriations bills.
Figure 3 provides an HHS agency-level breakdown of FY2023 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
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$1.118 trillion, which is 89.7% of all enacted appropriations for HHS. NIH and ACF account for
the next-largest shares of total HHS appropriations, receiving 3.7% and 3.8% apiece, respectively.
By contrast, when looking exclusively at discretionary appropriations, funding for CMS
constitutes about 4.0% of FY2023 enacted HHS appropriations. The bulk of discretionary
appropriations went to the PHS agencies, which combined to account for 62.0% of discretionary
appropriations provided for HHS.36 NIH typically receives the largest share of all discretionary
funding among HHS agencies (39.9% in FY2023), with ACF accounting for the second-largest
share (26.6% in FY2023).
Figure 3. FY2023 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 FY2023 LHHS omnibus (P.L. 117-328), available in the Congressional
Record, vol. 168, no. 198, book II, December 20, 2022, pp. S8874-S9198. Enacted totals for FY2023 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 FY2023 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.
36 This calculation does not include funding for ASPR, which is included in the totals for the Office of the Secretary, as
per the source materials.
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Special Public Health Funding Mechanisms
Annual appropriations for HHS public health service agencies are best understood in the context
of certain HHS-specific funding mechanisms: the Public Health Service Evaluation Set-Aside,
and the Prevention and Public Health Fund (PPHF). In recent years, LHHS appropriations have
used these funding mechanisms to direct additional support to certain programs and activities.
Public Health Service Evaluation Tap
The PHS Evaluation Set-Aside, also known as the PHS Evaluation Tap, is a unique feature of
HHS appropriations. It is authorized by Section 241 of the Public Health Service Act (PHSA),
and allows the Secretary of HHS 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.
LHHS appropriations acts have commonly established requirements in addition to those
discussed above. These include a higher maximum percentage for the set-aside and directing
specific amounts of tap funding to selected HHS programs. Since FY2010, and including in
FY2023, this higher maximum set-aside level has been 2.5% of eligible appropriations.37 (Both
the House committee bill and the President’s budget would have continued this 2.5% level.)38
Before FY2015, LHHS appropriations acts
Display of PHS Evaluation Tap Transfers
traditionally used the PHS Evaluation Tap to
By convention, appropriations acts direct where
specified PHS Evaluation Tap transfers are to be
provide more than a dozen HHS programs
allocated, but do not specify the PHS funds that are to
with funding beyond their annual
be the sources of those transfers. Thus, tables in this
appropriations; in some cases, this was the
report show only the amount of PHS Evaluation Tap
sole source of funding for a program or
funds received by an agency (i.e., tables do not subtract
activity. However, since FY2015 and
the amount of the evaluation tap from donor agencies’
appropriations). This also means that tap amounts
including in FY2023, LHHS appropriations
shown in the following tables are in addition to
laws have directed tap funds to a smaller
amounts shown for budget authority, but the amounts
number of programs or activities within three
shown for budget authority have not been adjusted to
HHS agencies (NIH, SAMHSA, and OS) and
reflect potential “transfer-out” of funds to the tap.
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.39 Since FY2015, LHHS appropriations laws have directed the largest share of tap
transfers to NIH.
37 See Section 204, Division H, P.L. 117-328, for the FY2023 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 FY2023 omnibus 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.
38 After the LHHS appropriations act allocates this transfer authority to specified programs, any transfer authority that
remains unallocated is available to be used by the HHS Secretary pursuant to the parameters established in law. (Such
post-enactment PHS Evaluation Tap transfers for FY2022 and FY2023 are not within this scope of this report.)
39 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
(continued...)
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Under the FY2023 LHHS omnibus, the amount of PHS Evaluation Tap transfers to SAMHSA
($134 million) were the same as those directed in FY2022. This amount of tap transfers to
SAMHSA was also proposed by the House committee bill and the President’s budget. For the OS,
the FY2023 LHHS omnibus slightly increased the amount of directed tap transfers, by $2 million
(+1.5%), to $131 million. In contrast, the amount of OS tap transfers would have been increased
by $33 million (+25.8%) in the House committee bill, and $60 million (+46.3%) in the
President’s budget. The enacted and proposed tap transfer increases for OS were largely directed
to the Office of the National Coordinator for Health Information Technology, which was solely
funded by tap transfers as of FY2022, and continued to receive no discretionary funding for
FY2023. The FY2023 LHHS omnibus increased NIH tap funding by 7.9% (+$103 million), to
$1.4 billion. Such transfers to NIH would have been increased to a similar degree by the House
committee bill (+$111 million, +8.5%), but would have been decreased under the President’s
budget (-$38 million, -2.9%).
In addition to the transfers to SAMHSA, OS, and NIH, the President’s budget requested that
AHRQ receive a tap transfer of $40 million, for a funding total inclusive of transfers of $416
million. In contrast, the House committee bill would have funded AHRQ at $385 million, and
directed no tap transfers. Ultimately, the FY2023 LHHS omnibus also declined to direct any tap
transfers, and provided AHRQ with $374 million in discretionary appropriations.
The President’s budget proposed expanding the activities and agencies funded by the PHS
Evaluation Tap to include the Public Health Scientific Services and Environmental Health at the
CDC ($151 million), and Paralysis Resource Center, Limb Loss, and Traumatic Brain Injury at
ACL ($28 million). Neither the FY2023 LHHS omnibus nor the House committee bill adopted
these 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.40 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.41
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.
40 For more information, see CRS Report R41301, Appropriations and Fund Transfers in the Affordable Care Act
(ACA).
41 For the FY2023 LHHS omnibus, see Division H, §222, P.L. 117-328 .
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The ACA had appropriated $2 billion in mandatory funds to the PPHF for FY2023, but this
amount was reduced by subsequent laws that decreased PPHF funding for FY2022 and other
fiscal years. Under current law, the FY2023 appropriation is $1.3 billion.42 This appropriation was
subject to a 5.7% reduction due to sequestration of nonexempt mandatory spending.43 (For more
information on sequestration, see the budget enforcement discussion in the Appendix.) After
sequestration, the total PPHF appropriation available for FY2023 was $943 million, the same
amount as FY2022. The FY2023 LHHS omnibus continued the FY2022 allocations of this
funding: $903 million to CDC, $12 million to SAMHSA, and $28 million to ACL. These were
the same as the allocations proposed by the FY2023 House committee bill and the FY2023
President’s budget.
Selected HHS Highlights by Agency
This section begins with a limited selection of
FY2023 discretionary funding highlights by
Display of PPHF Transfers
HHS agency. The discussion is largely based
PPHF transfer amounts displayed in the HHS tables in
on the enacted FY2023 levels as compared to
this report are in addition to amounts shown for
FY2022 enacted levels, and to a limited
budget authority provided in the bill. For consistency
with source materials, the amounts shown for PPHF
degree, the amounts that were proposed by the
transfers in these tables reflect the estimated effects of
FY2023 President’s budget and the House
mandatory spending sequestration; this is not the case
44
committee bill. These summaries are
for other mandatory spending shown in this report
followed by a brief overview of significant
(also for consistency with source materials).
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 FY2022 enacted and FY2023 proposed and enacted funding levels for HHS.
Health Resources and Services Administration (HRSA)
The HRSA mission is focused on delivering health care services to those who are geographically
isolated and economically or medically vulnerable.45 The FY2023 LHHS omnibus provided $9.5
billion in discretionary budget authority for HRSA. This was $912 million (+10.6%) more than
HRSA’s FY2022 discretionary funding level and $961 million (+11.3%) more than the FY2023
President’s budget request.
The FY2023 LHHS omnibus increased funding for a number of maternal health programs,
including an increase of $75 million (+10.0%) compared to the FY2022 LHHS omnibus for the
Maternal and Child Health Block Grant. The FY2023 LHHS House committee report, which
proposed a more substantial increase to the block grant (+$125 million), noted that the “COVID–
19 pandemic has exacerbated maternal mental health conditions, with pregnant and new mothers
experiencing anxiety and depression at a three to four times higher rate than prior to the
pandemic.”46 Within total amounts available for Maternal and Child Health, report language also
directed $15 million ($3 million more than FY2022) for “Alliance for Innovation in Maternal
42 42 U.S.C. §300u-11.
43 OMB, OMB Report to the Congress on the BBEDCA 251A Sequestration for Fiscal Year 2023, March 28, 2022, p. 7
of 16, https://www.whitehouse.gov/wp-content/uploads/2022/03/BBEDCA_251A_Sequestration_Report_FY2023.pdf.
44 HHS budget materials can be found at http://www.hhs.gov/budget/.
45 HRSA, About HRSA, https://www.hrsa.gov/about/index.html.
46 H.Rept. 117-403.
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Health Safety Bundles” and $7 million ($3 million more than FY2022) for the maternal mental
health hotline.47
The FY2023 LHHS omnibus also supported a number of initiatives to improve access to
behavioral health care. For instance, the LHHS omnibus provided $145 million ($10 million more
than FY2022) for the Rural Communities Opioid Response Program (RCORP)48 to continue three
rural centers of excellence and “to address rural tobacco and alcohol addiction.”49 In addition, the
explanatory statement included $153 million ($30 million more than FY2022) for Behavioral
Health Workforce Education and Training (BHWET), which “establishes and expands internships
or field placement programs in behavioral health, serving populations in rural and medically
underserved areas.”50
Centers for Disease Control and Prevention (CDC)
The CDC works to protect public health by providing leadership, information, and scientific
expertise in preventing and controlling diseases, including outbreaks of infectious diseases. The
CDC also works to promote health and quality of life by preventing and controlling injury,
disability, and environmental health threats. The FY2023 LHHS omnibus provided $8.3 billion in
discretionary budget authority for the CDC, which was $760 million (+10.1%) more than the
CDC’s FY2022 funding level. The FY2023 LHHS omnibus did not direct any PHS tap funds to
the CDC, continuing the practice started in FY2015. The FY2023 LHHS omnibus supplemented
discretionary CDC appropriations by directing $903 million in PPHF transfers to the CDC, which
was the same level as in FY2022. Altogether, this combination of funding represented $9.2
billion, an increase of $760 million (+9.1%) relative to FY2022 in budget authority that is
inclusive of directed transfers.
The President’s FY2023 budget request would have increased discretionary budget authority by
$2.1 billion (+28.3%) relative to FY2022, while also requesting that $151 million in tap funds be
directed to the CDC. The President’s budget also requested $903 million in PPHF transfers, the
same as FY2022 enacted. All told, this combination of funding would have totaled $10.7 billion,
representing an increase of $2.3 billion (+27.1%) from FY2022. The FY2023 omnibus provided
$1.5 billion (-14.2%) less than the FY2023 requested amount, inclusive of directed transfers. (The
FY2023 request also included other CDC mandatory spending proposals that were not adopted by
Congress.)
All FY2023 CDC programmatic accounts received increases relative to FY2022 enacted levels,
both in terms of discretionary appropriations and inclusive of directed transfers. Among notable
increases, the CDC’s Public Health Scientific Services account received an increase of $103
million relative to FY2022 enacted, which included an increase of $75 million ($175 million
total) for the CDC’s public health data modernization efforts.51 CDC’s public health data
modernization efforts aim to modernize the technology, systems, and workforce for collecting
47 Congressional Record, vol. 168, no. 198, book II, December 20, 2022, pp. S8876. See also H.Rept. 117-403, p. 8 and
p. 55.
48 Note that this program is referred to as the Rural Communities Overdose Response Program in the LHHS omnibus,
explanatory statement, and House committee report. HRSA documents refer to this as the Rural Communities Opioid
Response Program.
49 Congressional Record, vol. 168, no. 198, book II, December 20, 2022, p. S8877.
50 Congressional Record, vol. 168, no. 198, book II, December 20, 2022, pp. S8875-S8876 and p. S9133. See also
H.Rept. 117-403, p. 54.
51 Congressional Record, vol. 168, no. 198, book II, December 20, 2022, p. S8879; and Congressional Record, vol.
168, no. 42, March 9, 2022, p. H2672.
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public health data at the CDC and at state, territorial, tribal, and local levels. In addition, the
CDC-Wide Activities and Program Support account received an increase of $230 million (+69%)
relative to FY2022 enacted discretionary funding. Within this account, $350 million was provided
for the public health infrastructure and capacity program, an increase of $150 million relative to
FY2022. These funds are intended to support general capabilities of state, territorial, and local
health departments by supporting core functions such as workforce and technology. Furthermore,
the CDC-Wide Activities and Program Support account newly includes a line item for the Center
for Forecasting Epidemics and Outbreak Analytics ($50 million). The Center for Forecasting
Epidemics and Outbreak Analytics was first funded and established by the CDC in 2022 using
American Rescue Plan Act (P.L. 117-2) appropriations.52 The explanatory statement also includes
funding to establish an Office of Rural Health ($5 million), which is intended to “enhance the
implementation of CDC's rural health portfolio, coordinate efforts across CDC programs, and
develop a strategic plan for rural health at CDC that maps the way forward both administratively
and programmatically.”53
National Institutes of Health (NIH)
NIH is the federal government’s lead health and medical research agency. The FY2023 LHHS
omnibus provided $46.0 billion in discretionary budget authority for NIH. This was $2.4 billion
(+5.5%) more than the FY2022 level. In addition, the FY2023 LHHS omnibus directed $1.4
billion in PHS tap transfers to NIH, $103 million (+7.9%) more than FY2022. Inclusive of
directed transfers, NIH received $47.5 billion in the FY2023 omnibus, an increase of $2.5 billion
(+5.6%) relative to FY2022 enacted. The FY2023 omnibus also provided $1.5 billion for the
Advanced Research Projects Agency for Health (ARPA-H) under the HHS Office of the
Secretary—an increase of $500 million (+50.0%) relative to FY2022. ARPA-H is a new agency
focused on high-risk, high-reward health research that was first funded in the FY2022 omnibus.
HHS used these funds to establish ARPA-H as an agency within NIH in March 2022.54 NIH and
ARPA-H together received a total of $49.0 billion in the FY2023 omnibus, an increase of $3.0
billion (+6.5%) relative to the FY2022 level.
The FY2023 President’s budget request for NIH proposed $50.2 billion, comprising $49.0 billion
in discretionary budget authority (including $5.0 billion for ARPA-H) and $1.3 billion in PHS tap
transfers.55 Thus, the FY2023 omnibus provided $1.3 billion (-2.5%) less than the budget
requested amount inclusive of transfers and ARPA-H funding. (The FY2023 request also included
other NIH mandatory spending proposals that were not adopted by Congress.)
All NIH Institute and Center (IC) accounts received increases in FY2023 relative to FY2022,
when accounting for directed transfers. Among the ICs, the National Institute of Minority Health
and Health Disparities (NIMHD) saw the largest percentage increase compared to FY2022
(+14.2%). Of the total $65 million increase for NIMHD, $25 million was directed for health
disparities research in the explanatory statement.56 The explanatory statement also directed
increases for certain diseases and research areas within NIH accounts. For example, a $226
52 CDC, “CDC Launches New Center for Forecasting and Outbreak Analytics,” press release, April 19, 2022,
https://www.cdc.gov/media/releases/2022/p0419-forecasting-center.html.
53 Congressional Record, vol. 168, no. 198, book II, December 20, 2022, p. S8881.
54 See the textbox on the Advanced Research Projects Agency for Health in CRS Report R43341, National Institutes of
Health (NIH) Funding: FY1996-FY2023.
55 The budget request proposed ARPA-H appropriations in an account within NIH. See NIH, FY2023 Congressional
Justification, p. 33,
https://officeofbudget.od.nih.gov/pdfs/FY23/br/Overview%20of%20FY%202023%20Presidents%20Budget.pdf.
56 Congressional Record, vol. 168, no. 198, book II, December 20, 2022, p. S8884.
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million total increase for Alzheimer’s disease and related dementia research across NIH,
including increases specified for the National Institute of Neurological Disorders and Stroke ($75
million) and for the National Institute on Aging ($151 million).57 The explanatory statement also
directed $75 million for implementing the Accelerating Access to Critical Therapies for ALS Act
(ACT for ALS Act; P.L. 117-79), an increase of $50 million, within the Office of the Director
account.58
Substance Abuse and Mental Health Services Administration (SAMHSA)
SAMHSA is the federal agency primarily responsible for supporting community-based mental
health and substance use treatment and prevention services. The SAMHSA mission is focused on
reducing the impacts of substance use and mental illness.59 SAMHSA supports activities that
include education and training, prevention programs, early intervention activities, treatment
services, and technical assistance. The FY2023 LHHS omnibus provided $7.4 billion in
discretionary budget authority for SAMHSA. This amount was $970 million (+15.2%) more than
SAMHSA’s FY2022 funding level and $2.8 billion (-27.3%) less than the President’s FY2023
budget request. The FY2023 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
FY2022. Inclusive of these directed transfers, the LHHS omnibus provided $7.5 billion, or $970
million (+14.8%), more funding than FY2022.
Within the Mental Health Programs of Regional and National Significance account, the FY2023
LHHS omnibus explanatory statement60 included $502 million for the 988 Program (also known
as the 988 Suicide and Crisis Lifeline or the 988 Lifeline), which represents an increase of $400
million (+493.6%) compared to the FY2022 LHHS omnibus.61 In July 2022, the 988 Lifeline
(formerly called the National Suicide Prevention Lifeline) transitioned from a 10-digit number (1800-273-8255) to the 3-digit hotline number (9-8-8). The 988 Lifeline is a national hotline that
provides immediate crisis counseling and referral services for individuals experiencing suicidal
thoughts or other mental distress. The new three-digit number was launched to “make it simpler
for people experiencing a mental health crisis to connect with lifesaving crisis intervention
services.”62 Within the increase for the 988 Lifeline, $10 million is for Spanish speakers seeking
text or chat access and $30 million is for providing capacity and infrastructure for vulnerable
youth.63
Within the Substance Abuse Treatment account, the FY2023 LHHS omnibus provided an increase
of $50 million (+3.3%) for the State Opioid Response (SOR) grants compared to the FY2022
LHHS omnibus. The explanatory statement notes that “large swings in funding between grant
cycles can pose a significant challenge for States seeking to maintain programs that were
instrumental in reducing drug overdose fatalities” and directs SAMHSA to “prevent unusually
large changes” in a state’s allocation.64
57 Congressional Record, vol. 168, no. 198, book II, December 20, 2022, pp. S8882-S8883.
58 Congressional Record, vol. 168, no. 198, book II, December 20, 2022, p. S8885.
59 SAMHSA, About Us, https://www.samhsa.gov/about-us.
60 Congressional Record, vol. 168, no. 198, book II, December 20, 2022, pp. S8887-S8888.
61 Congressional Record, vol. 168, no. 42, book IV, March 9, 2022, pp. H2679-H2680.
62 H.Rept. 117-403, pp. 159-160.
63 Congressional Record, vol. 168, no. 198, book II, December 20, 2022, pp. S8888. See also H.Rept. 117-403, pp.
159-160.
64 Congressional Record, vol. 168, no. 198, book II, December 20, 2022, pp. S8888.
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Agency for Healthcare Research and Quality (AHRQ)
AHRQ conducts research aimed at reducing the costs of health care, promoting patient safety,
measuring the quality of health care, and improving health care services, organization, and
financing. The FY2023 LHHS omnibus provided $374 million in discretionary budget authority
to AHRQ. 65 This amount was $23 million (+6.6%) more than the amount provided by the
FY2022 LHHS omnibus and $3 million (-0.7%) less than the FY2023 President’s discretionary
budget request.66 The FY2023 LHHS omnibus did not adopt the President’s budget proposal to
transfer $40 million in PHS tap funds to AHRQ; the FY2023 LHHS omnibus funding was 10.2%
less than the President’s budget when including this proposed PHS tap transfer and the
discretionary budget request for AHRQ.67
The FY2023 LHHS omnibus funded Health Costs, Quality and Outcomes (HCQO) at $229
million, which was $23 million (+11.2%) more than the FY2022 LHHS omnibus level. The
explanatory statement accompanying the FY2023 LHHS omnibus provided $10 million in new
funding within HCQO for health systems research on Long COVID, including the development
and implementation of new models of patient-centered coordinated care.68 The explanatory
statement also urged AHRQ to fund research on improving maternal health, but did not specify a
dollar amount.69
Centers for Medicare & Medicaid Services (CMS)
CMS is the largest single health payer in the United States.70 The agency administers Medicare,
Medicaid, the State Children’s Health Insurance Program (CHIP), and the federal Marketplace.
The FY2023 LHHS omnibus provided $4.6 billion in discretionary budget authority for CMS,
$20 million (+0.4%) more than FY2022 enacted. Both the President’s budget and the House
committee bill would have provided $703 million (+15.5%) more than in FY2022.
The FY2023 LHHS omnibus provided $893 million for the CMS Health Care Fraud and Abuse
Control (HCFAC) account, 2.3% more than FY2022 and 0.7% less than what was proposed by
the President’s budget and House committee bill. Of this total amount for HCFAC, $576 million
was specified in the LHHS omnibus as being effectively exempt from discretionary budget caps.
(See the Appendix for an explanation of the LHHS budget cap exemptions.)
65 In addition to funds provided through the annual appropriations process, AHRQ is also scheduled in FY2023 to
receive a transfer of certain mandatory funds that were authorized and appropriated to the Patient-Centered Outcomes
Research Trust Fund (PCORTF) by ACA Section 6301(e), as amended (26 U.S.C. §9511). Transfers to AHRQ from
the PCORTF are to be used to disseminate the results of patient-centered outcomes research. (PCORTF funds are
generally not displayed in this report, as they are not provided by or modified through annual LHHS appropriations
bills.) For more information on the PCORTF, see CRS Insight IN11010, Funding for ACA-Established PatientCentered Outcomes Research Trust Fund (PCORTF) Extended Through FY2029.
66 HHS, AHRQ, FY2023 Congressional Justification, p. AHRQ-15,
https://www.ahrq.gov/sites/default/files/wysiwyg/cpi/about/mission/budget/2023/fy2023-cj.pdf. The President’s budget
requested $40 million in PHS tap funds to AHRQ for Research on Health Costs, Quality and Outcomes (HCQO),
which, in addition to the discretionary budget request of $376 million, would have brought AHRQ’s total combined
funding to $416 million (18.7% more than the FY2022 LHHS omnibus level of $350 million). Total AHRQ funding in
the FY2023 LHHS omnibus was 10.2% less than FY2023 President’s budget request (inclusive of requested tap
transfers).
67 Since FY2015, annual LHHS appropriations laws have not directed tap transfers to AHRQ, but in earlier years
(FY2003-FY2014) AHRQ was funded primarily with tap transfers.
68 Congressional Record, vol. 168, no. 198, book II, December 20, 2022, p. S8889.
69 Ibid.
70 FY2023 HHS Budget in Brief, p. 74, https://www.hhs.gov/sites/default/files/fy-2023-budget-in-brief.pdf.
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The FY2023 LHHS omnibus provided the same amount as FY2022 enacted to the CMS Program
Management Account ($3.7 billion). Both the House committee bill and the President’s request
had proposed to increase that account by $677 million (+18.5%). 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 FY2023 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 $455 million (a
$100 million increase relative to the FY2022 limit on such transfers), and explicitly prohibited
such transfers from being used to support or supplant funding for ACA implementation. Both the
President’s budget and the House committee bill would have eliminated this provision.
Administration for Children and Families (ACF)
The ACF mission is focused on promoting the “economic and social well-being of children,
youth, families, and communities.”71 ACF administers a wide array of human services programs,
including Head Start, child care, and various child welfare programs. The FY2023 LHHS
omnibus provided $30.7 billion in discretionary budget authority for ACF, $742 million (+2.5%)
more than FY2022. The President’s budget would have increased funding for ACF relative to
FY2022 enacted, by $3.4 billion (+11.3%), whereas the House committee bill would have
increased funding to a greater degree, by $4.5 billion (+15.0%).
The FY2023 LHHS omnibus provided $6.4 billion for the Refugee and Entrant Assistance
programs account, an increase of $2 million (+0.03%) relative to FY2022.72 The President’s
budget would have decreased this account relative to FY2022, by $97 million (-1.5 %), whereas
the House committee bill would have increased the account by $1.6 billion (+24.2%). The
FY2023 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
FY2022.
The explanatory statement accompanying the FY2023 LHHS omnibus directed $5.5 billion of the
appropriation for Refugee and Entrant Assistance programs toward the Unaccompanied Alien
Children (UAC) program, the same amount as FY2022.73 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 would have decreased this account relative to FY2022, by
$604 million (-11.0 %), while including a mandatory spending proposal for contingency funds as
to help address the “unpredictable fluctuations in program needs,” which it estimated would cost
$1.5 billion.74 The House committee bill would have increased the account by $1.2 billion
(+21.9%), without providing any contingency funds. Ultimately, in addition to the $5.5 billion
noted above, the FY2023 LHHS omnibus included the requested contingency funding, but it was
71 ACF, What We Do, https://www.acf.hhs.gov/about/what-we-do.
72 Of the total amount for FY2022, $1.6 billion was enacted as part of the second CR for FY2022, P.L. 117-70, for the
Unaccompanied Alien Children program.
73 Ibid.
74 ACF, FY2023 Congressional Justification, pp. 41-42, https://www.acf.hhs.gov/sites/default/files/documents/olab/fy2023-congressional-justification.pdf.
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provided as discretionary spending. The FY2023 law directed that the amount of contingency
funding be based on the unaccompanied children in excess of 13,000 that are referred to HHS
under specified authorities for a given month during FY2023. Following the conventions of
congressional source documents, the estimated budgetary cost of this contingency funding ($1.0
billion) is included in the scorekeeping adjustments to the LHHS bill, and not the amounts for the
Refugee and Entrant Assistance programs account.75 (See the Appendix for further information.)
The FY2023 LHHS omnibus also included several general provisions that were enacted in
FY2022 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 included directives for ORR to increase services to children, develop
plans for children who age-out of UAC status, coordinate with DHS to provide an analysis of
case management, expand use of independent legal and mental health services for UACs, and
limit the use of unlicensed facilities, among other things.76 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.”77 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.”78
Administration for Community Living (ACL)
The ACL mission is focused on maximizing the “independence, well-being, and health of older
adults, people with disabilities across the lifespan, and their families and caregivers.”79 The
FY2023 LHHS omnibus provided $2.5 billion in discretionary budget authority for ACL. This
was $220 million (+9.5%) more than the FY2022 LHHS omnibus and $448 million (-15.0%) less
than the President’s request. In addition, the FY2023 LHHS omnibus directed $28 million in
PPHF transfers to ACL, the same as FY2022 and the FY2023 President’s budget.80 The FY2023
LHHS omnibus did not adopt an additional proposal made in the President’s budget for $28
75 Congressional Record, vol. 168, no. 198, book II, December 20, 2022, p. S9198.
76 H.Rept. 117-403, pp. 198-203.
77 Congressional Record, vol. 168, no. 198, book II, December 20, 2022, pp. S8874.
78 Ibid, p. S8890.
79 ACL, About ACL, https://acl.gov/about-acl.
80 The explanatory statement accompanying the FY2023 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 with FY2022 levels. Congressional Record, vol. 168, no. 198, book II, December 20, 2022, p. S8889. The
same PPHF amounts were directed to these ACL programs by the FY2022 LHHS omnibus and accompanying
explanatory statement, Congressional Record, vol. 168, no. 42, March 9, 2022, p. H2685.
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million in evaluation tap funding.81 Accounting for this proposal, the FY2023 LHHS omnibus
enacted $475 million (-15.6%) less than would have been provided in the President’s budget,
which had proposed larger than enacted increases for several ACL programs, including the
Nutrition Services Program and home and community-based supportive services.
For Aging Network Support Activities, the explanatory statement accompanying the FY2023
LHHS omnibus provided $30 million, which is $12 million (+65.0%) more than the FY2022
amount. Within this line item, the explanatory statement funded certain activities that were
authorized by the Supporting Older Americans Act of 2020 (P.L. 116-131),82 but which had not
received funding until the FY2023 LHHS omnibus, including the following:
•
•
$5 million to establish a Research, Demonstration, and Evaluation Center for the
Aging Network with focus on falls prevention programs;
$1 million for an Interagency Coordinating Committee on Healthy Aging and
Age-Friendly Communities with a focus on falls prevention and safe living
environments.83
For Elder Rights Support Activities, the explanatory statement accompanying the FY2023
omnibus provided $34 million, an increase of $15 million (+79.5%) compared to the FY2022
LHHS omnibus. The explanatory statement included a line item of $15 million for an Adult
Protective Services (APS) formula grant program authorized by the Elder Justice Act.84 This was
the first time this APS formula grant has been funded under the regular annual appropriations
process.85
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 FY2023 President’s budget and House
81 HHS, ACL, FY 2023 Congressional Justification, pp. 20, 26, https://acl.gov/sites/default/files/about-acl/2022-
02/FY2023_ACL-BudgetJustification.docx
82 For background, see CRS Report R46439, Older Americans Act: 2020 Reauthorization.
83 Congressional Record, vol. 168, no. 198, December 20, 2022, book II, p. S8891, referring to an earlier FY2023
House Appropriations Committee proposal in H. Rept. 117-403, pp. 214-215.
84 For background, see CRS Report R43707, The Elder Justice Act: Background and Issues for Congress.
85 In FY2021, this APS formula grant program received $276.0 million in mandatory funding through the American
Rescue Plan Act of 2021 (ARPA; P.L. 117-2; see CRS Report R46834, American Rescue Plan Act of 2021 (P.L. 1172): Public Health, Medical Supply Chain, Health Services, and Related Provisions) and $100.0 million in a
supplemental appropriation in the Consolidated Appropriations Act, 2021 (P.L. 116-260, Division M, Coronavirus
Response and Relief Supplemental Appropriations Act, 2021,134 Stat. 1916).
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committee bill would have omitted this provision entirely, but the FY2023 LHHS omnibus
retained these existing restrictions (§§506 and 507).86
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
FY2023 LHHS omnibus retained these existing restrictions (§508).87
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).88 Starting in FY2016, the provision was modified to allow funds to be
used for needle exchange programs under the following conditions: (1) federal funds may not be
used to purchase the needles, but may be used for other aspects of such programs; (2) the state or
local jurisdiction must demonstrate, in consultation with CDC, that they are experiencing, or at
risk for, a significant increase in hepatitis infections or an HIV outbreak due to injection drug use;
and (3) the program must be operating in accordance with state and local law. Both the FY2023
President’s budget and House committee bill would have omitted this provision entirely, but the
FY2023 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). FY2023 omnibus retained these existing restrictions
(§210 [HHS] and §503(c) [all LHHS, plus PPHF transfers]).89
86 The current provisions are commonly referred to as the Hyde Amendment and the Weldon Amendment. For
additional information, see CRS Report RL33467, Abortion: Judicial History and Legislative Response, and CRS In
Focus IF12167, The Hyde Amendment: An Overview.
87 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.
88 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.
89 The FY2023 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. 198,
book II, December 20, 2022, pp. S8880 and S8886). CDC and NIH funding reservations for Firearm Injury and
Mortality Prevention were first included in LHHS explanatory statements in FY2020. The report accompanying
the FY2023 House committee bill had proposed that these amounts be increased to $35 million for the CDC and
$25 million for the NIH ($60 million total) (H.Rept. 117-403).
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Table 6. HHS Appropriations Totals and Directed Transfers by Agency
(in millions of dollars)
FY2023
Request
FY2023
House
Cmte.
(H.R. 8295)
FY2023
Enacted
8,892
8,783
9,575
9,744
Mandatory BA
317
256
256
256
Discretionary BA
8,575
8,526
9,318
9,487
CDCa
7,554
9,676
9,596
8,314
55
55
55
55
7,499
9,621
9,541
8,259
0
151
0
0
903
903
903
903
8,402
10,675
10,444
9,162
43,650
48,962
46,038
46,047
0
0
0
0
HHS Agency
HRSA
Mandatory BA
Discretionary BAb
Evaluation Tap Fundingc
PPHFd
Subtotal (Discretionary BA + Transfers)
NIHa
Mandatory BA
Discretionary BAe
FY2022
Enacted
43,650
48,962
46,038
46,047
Evaluation Tap Fundingc
1,309
1,272
1,421
1,412
Subtotal (Discretionary BA + Transfers)
44,959
50,233
47,459
47,459
6,400
10,137
9,025
7,370
0
0
0
0
6,400
10,137
9,025
7,370
Evaluation Tap Fundingc
134
134
134
134
PPHFd
12
12
12
12
6,546
10,283
9,170
7,516
350
376
385
374
Mandatory BA
0
0
0
0
Discretionary BA
350
376
385
374
0
40
0
0
350
416
385
374
CMS
1,026,793
1,118,314
1,118,314
1,117,630
Mandatory BA
1,022,250
1,113,068
1,113,068
1,113,068
4,543
5,246
5,246
4,563
ACF
46,215
50,317
51,429
47,688
Mandatory BA
16,303
17,034
17,034
17,034
Discretionary BAg
29,912
33,283
34,395
30,654
ACL
2,318
2,986
2,918
2,538
0
0
0
0
SAMHSA
Mandatory BA
Discretionary BAf
Subtotal (Discretionary BA + Transfers)
AHRQ
Evaluation Tap Fundingc
Subtotal (Discretionary BA + Transfers)
Discretionary BA
Mandatory BA
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HHS Agency
Discretionary BA
FY2022
Enacted
FY2023
Request
FY2023
House
Cmte.
(H.R. 8295)
FY2023
Enacted
2,318
2,986
2,918
2,538
Evaluation Tap Fundingc
0
28
0
0
PPHFd
28
28
28
28
2,346
3,041
2,946
2,565
5,697
5,467
8,064
6,838
673
710
710
710
5,024
4,757
7,353
6,128
129
189
162
131
5,153
4,946
7,516
6,259
1,147,869
1,255,018
1,255,343
1,246,542
Mandatory
1,039,599
1,131,124
1,131,124
1,131,124
Discretionary
108,270
123,894
124,219
115,418
Subtotal (Discretionary BA + Transfers)
Office of the Secretary (OS)
Mandatory BA
Discretionary BAe
Evaluation Tap Fundingc
Subtotal (Discretionary BA + Transfers)
Total, HHS BA in the Bill
—
Emergency Funding (not in above totals or memoranda
below)
P.L. 117-58, Division J
500
P.L. 117-70, Division B
1,272
P.L. 117-128 , Title IV
954
P.L. 117-159, Division B
990
P.L. 117-180, Division A
—
P.L. 117-328, Division M
—
P.L. 117-328, Division N
—
—
—
—
—
—
—
—
—
Total, BA Available in Fiscal Year (current year
from any bill)
1,130,779
1,223,159
1,223,484
1,214,684
Total, BA Advances for Future Years (provided in
current bill)
170,222
202,080
202,080
202,080
Total, BA Advances from Prior Years (for use in
current year)
153,132
170,222
170,222
170,222
P.L. 117-43, Divisions A and C
4,209
—
—
—
—
—
—
—
—
—
—
—
—
—
2,775
2.400
4,250
Memoranda
Sources: Amounts in this table for the FY2022 Enacted, FY2023 Request, and FY2023 Enacted columns are
generally drawn from or calculated based on data contained in the explanatory statement accompanying the
FY2023 LHHS omnibus (P.L. 117-328) available in the Congressional Record, vol. 168, no. 198, book II, December
20, 2022, pp. S8874-S9198. Amounts in the FY2023 House Committee column are generally drawn from or
calculated based on data contained in the committee report (H.Rept. 117-403) accompanying the FY2023 House
committee bill (H.R. 8295, as reported). Enacted totals (“Total BA in the Bill”) for FY2022 or FY2023 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.
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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. Of the total FY2022 enacted for Environmental Health, $1.5 million was enacted as part of the first
continuing resolution for FY2022, P.L. 117-43, for the Vessel Sanitation Program.
c. 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.
d. 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.
e. In keeping with source materials, funding for the Advanced Research Projects Agency for Health (ARPA-H)
is included in the NIH discretionary BA total in the FY2023 Request column ($5.0 billion), but is included in
the OS discretionary BA totals in the FY2022 Enacted ($1.0 billion), FY2023 House Committee ($2.8
billion), and FY2023 Enacted ($1.5 billion) columns. For further discussion, see the National Institutes of
Health (NIH section.
f.
Of the total FY2023 enacted for Mental Health Programs of Regional and National Significance, $62 million
was enacted as part of the first continuing resolution for FY2023, P.L. 117-180, for the 988 Suicide and
Crisis Lifeline.
g. 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.
Table 7. HHS Discretionary Appropriations and Directed Transfers for Selected
Programs or Activities, by Agency
(in millions of dollars)
Agency or Selected Program
FY2022
Enacted
FY2023
Request
FY2023
House
Cmte.
(H.R. 8295)
FY2023
Enacted
HRSA
Community Health Centers
1,749
1,839
1,947
1,859
National Health Service Corps
122
210
156
126
Children’s Hospitals Graduate Medical Education
375
350
385
385
Maternal & Child Health Block Grant
748
954
873
823
Autism and Other Developmental Disorders
54
57
57
56
Healthy Start
132
145
145
145
2,495
2,655
2,695
2,571
Organ Transplantation
30
29
31
31
Telehealth
35
0
0
0
Rural Communities Opioid Response
135
165
160
145
Ryan White AIDS Programs
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Labor, Health and Human Services, and Education: FY2023 Appropriations
FY2023
Request
FY2023
House
Cmte.
(H.R. 8295)
FY2023
Enacted
286
400
500
286
449
832
664
500
PPHFa
419
419
419
419
Subtotal (Discretionary BA + Transfers)
868
1,251
1,083
919
HIV/AIDS, Viral Hepatitis, STDs, TB Prevention
1,345
1,471
1,464
1,391
641
651
747
699
PPHFa
52
0
0
0
Subtotal (Discretionary BA + Transfers)
693
651
747
699
1,084
1,357
1,347
1,175
255
255
255
255
Subtotal (Discretionary BA + Transfers)
1,339
1,612
1,602
1,430
Birth Defects and Developmental Disabilities
177
195
225
206
Public Health Scientific Services
652
655
867
754
0
144
0
0
652
799
867
754
Agency or Selected Program
Family Planning (Title X)
FY2022
Enacted
CDC
Immunization and Respiratory Diseases
Emerging and Zoonotic Infectious Diseases
Chronic Disease Prevention and Health Promotion
PPHFa
PPHFa
Subtotal (Discretionary BA + Transfers)
Environmental Healthb
210
378
312
230
PPHFa
17
17
17
17
Evaluation Tap Fundingc
0
7
0
0
227
402
329
247
Injury Prevention and Control
715
1,283
898
761
National Institute for Occupational Safety and
Health
352
345
363
363
Global Health
647
748
758
693
Buildings and Facilities
30
55
55
40
CDC-Wide Activities and Program Support
334
809
959
564
PPHFa
160
160
160
160
Subtotal (Discretionary BA + Transfers)
494
969
1,119
724
National Institute of Allergy and Infectious
Diseases
6,323
6,268
6,643
6,562
National Institute of General Medical Sciences
1,783
1,826
1,779
1,827
Evaluation Tap Fundingc
1,309
1,272
1,421
1,412
Subtotal (Discretionary BA + Transfers)
3,092
3,098
3,200
3,240
National Institute on Aging
4,220
4,011
4,443
4,408
National Institute on Drug Abuse
1,595
1,843
1,713
1,663
Subtotal (Discretionary BA + Transfers)
NIH
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Labor, Health and Human Services, and Education: FY2023 Appropriations
Agency or Selected Program
FY2022
Enacted
FY2023
Request
FY2023
House
Cmte.
(H.R. 8295)
FY2023
Enacted
National Institute on Minority Health and Health
Disparities
459
660
505
524
NIH Innovation Account
150
419
419
419
0
5,000
0
0
587
1,518
1,543
991
PPHFa
12
12
12
12
Subtotal (Discretionary BA + Transfers)
599
1,530
1,555
1,003
Mental Health Block Grant
837
1,632
1,337
987
Evaluation Tap Fundingc
21
21
21
21
Subtotal (Discretionary BA + Transfers)
858
1,653
1,358
1,008
Certified Community Behavioral Health Clinics
315
553
400
385
Children’s Mental Health
125
225
225
130
Substance Abuse Treatment PRNS
520
564
641
572
Evaluation Tap Fundingc
2
2
2
2
522
566
643
574
Substance Abuse Block Grant
1,829
2,929
2,329
1,929
Evaluation Tap Fundingc
79
79
79
79
1,908
3,008
2,408
2,008
1,525
2,000
1,775
1,575
Substance Abuse Prevention PRNS
218
312
248
237
Health Surveillance and Support
260
150
257
302
Evaluation Tap Fundingc
31
31
31
31
Subtotal (Discretionary BA + Transfers)
292
181
289
333
206
229
238
229
0
40
0
0
206
269
238
229
Medical Expenditure Surveys
72
72
72
72
Program Support
73
75
75
73
3,670
4,347
4,347
3,670
873
899
899
893
Advanced Research Projects Agency for Health
(ARPA-H)d
SAMHSA
Mental Health Programs of Regional & National
Significance (PRNS)e
Subtotal (Discretionary BA + Transfers)
Subtotal (Discretionary BA + Transfers)
State Opioid Response Grants
AHRQ
Research on Health Costs, Quality, and Outcomes
Evaluation Tap Fundingc
Subtotal (Discretionary BA + Transfers)
CMS
CMS Program Management
Health Care Fraud and Abuse Control
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Labor, Health and Human Services, and Education: FY2023 Appropriations
Agency or Selected Program
FY2022
Enacted
FY2023
Request
FY2023
House
Cmte.
(H.R. 8295)
FY2023
Enacted
ACF
Low Income Home Energy Assistance Program
Formula Grants
3,800
3,975
4,000
1,500
Refugee and Entrant Assistance Programsf
6,425
6,328
7,979
6,427
Child Care and Development Block Grant
6,165
7,562
7,165
8,021
Head Start
11,037
12,203
12,397
11,997
Preschool Development Grants
290
450
350
315
Child Welfare Services
269
279
274
269
Adoption Opportunities
48
46
50
51
Community Services Block Grant
755
754
800
770
Home & Community-Based Supportive Services
399
500
450
410
Family Caregiver Support Services
194
250
230
205
Nutrition Services Programs
967
1,272
1,260
1,067
Aging Network Support Activities
18
23
37
30
Elder Rights Support Activities
19
77
100
34
State Health Insurance Program (SHIP)
53
55
58
55
Developmental Disabilities Programs
186
232
203
191
WIOA Activities (transferred from ED)
273
323
301
287
0
0
0
0
Evaluation Tap Fundingc
64
104
87
66
Subtotal (Discretionary BA + Transfers)
64
104
87
66
82
106
94
87
Public Health and Social Services Emergency Fund
2,820
3,220
3,145
3,302
Advanced Research Projects Agency for Health
(ARPA-H)d
1,000
0
2,750
1,500
ACL
Office of the Secretary
Office of Nat'l Coord. for Health Information
Technology
Office of the Inspector General
Sources: Amounts in this table for the FY2022 Enacted, FY2023 Request, and FY2023 Enacted columns are
generally drawn from or calculated based on data contained in the explanatory statement accompanying the
FY2023 LHHS omnibus (P.L. 117-328), available in the Congressional Record, vol. 168, no. 198, book II, December
20, 2022, pp. S8874-S9198. Amounts in the FY2023 House Committee column are generally drawn from or
calculated based on data contained in the committee report (H.Rept. 117-403) accompanying the FY2023 House
committee bill (H.R. 8295, as reported). Enacted totals (“Total BA in the Bill”) for FY2022 or FY2023 do not
include emergency-designated appropriations. For consistency with source materials, amounts in this table
generally do not reflect mandatory spending sequestration, where applicable, nor do they reflect any transfers or
reprogramming of funds pursuant to executive authorities. 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
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Labor, Health and Human Services, and Education: FY2023 Appropriations
advances from prior-year appropriations, but do include advances for subsequent years provided in this bill); (2)
have generally not been adjusted to reflect scorekeeping; (3) comprise only those funds provided (or requested)
for agencies and accounts subject to the jurisdiction of the LHHS subcommittees of the House and Senate
appropriations committees (e.g., department totals do not include funding for the Food and Drug Administration,
the Indian Health Service, or the Agency for Toxic Substances and Disease Registry, all of which are funded by
other bills); and (4) do not include appropriations that occur outside of appropriations bills.
a. PPHF funds are not appropriated in the LHHS bill, but are shown here for illustrative purposes as they may
be used to supplement the funding selected agencies and programs receive through the appropriations
process. Amounts shown for PPHF in this table are in addition to amounts shown for budget authority.
b. Of the total FY2022 enacted for Environmental Health, $1.5 million was enacted as part of the first
continuing resolution for FY2022, P.L. 117-43, for the Vessel Sanitation Program.
c. 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.
d. The FY2022 LHHS omnibus funded ARPA-H with $1.0 billion under the HHS Office of the Secretary, but
gave the Secretary the ability to place ARPA-H anywhere in the department. The HHS Secretary placed
ARPA-H within NIH. The President’s FY2023 request for NIH therefore includes proposed funding for
ARPA-H ($5.0 billion) within the NIH total. However, the House Appropriations Committee took the view
that ARPA-H should be established as a separate entity within HHS (apart from NIH), and therefore
proposed FY2023 ARPA-H funding ($2.75 billion) in a separate account under the HHS Secretary. The
FY2023 LHHS omnibus ultimately funded ARPA-H in this manner ($1.5 billion). The numbers in this report
generally follow the committee convention, which is to include ARPA-H funding within the HHS Office of
the Secretary totals for FY2022 enacted, the FY2023 House committee bill, and FY2023 enacted, but within
NIH for the FY2023 President’s request. 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.
e. Of the total FY2023 enacted for Mental Health Programs of Regional and National Significance, $62 million
was enacted as part of the first continuing resolution for FY2023, P.L. 117-180, for the 988 Suicide and
Crisis Lifeline.
f.
Of the total FY2022 enacted for Refugee and Entrant Assistance Programs, $1.6 billion was enacted as part
of the second CR for FY2022, P.L. 117-70, for the Unaccompanied Alien Children Program.
Department of Education (ED)
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 1980.90 Its mission is to
“promote student achievement and preparation for global competitiveness by fostering
educational excellence and ensuring equal access.”91 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 educationally disadvantaged students and
90 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.
91 U.S. Department of Education, “About ED,” http://www2.ed.gov/about/landing.jhtml, accessed on March 23, 2023.
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Labor, Health and Human Services, and Education: FY2023 Appropriations
students with disabilities—or to low-income postsecondary students in the form of Pell Grants,
which help pay for college. The remainder of ED’s discretionary budget provides for a wide range
of activities, including (but not limited to) support for minority-serving institutions; educational
research; and career, technical, and adult education.
The federal government provides roughly 8% of overall funding for elementary and secondary
education in the United States.92 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
56% of undergraduate and graduate student aid in academic year (AY) 2021-2022.93 (A large
share of this aid is provided in the form of student loans that must be repaid.)
FY2023 ED Appropriations Overview
Table 8 displays FY2023 enacted and proposed funding levels for ED, along with FY2022 levels.
The totals in this table do not include emergency-designated appropriations. Those amounts (if
applicable) 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.
Discretionary funds represent the majority of ED’s annual appropriations, accounting for more
than 95% of the FY2022 and FY2023 enacted levels.94 The FY2023 enacted discretionary ED
appropriations were 4.1% higher than FY2022 levels. Proposed discretionary ED appropriations
for FY2023 compared to FY2022 would have increased by 15.6% under the President’s budget,
and by 13.5% under the House committee bill.
Table 8. ED Appropriations Overview
(in billions of dollars)
FY2022
Enacted
FY2023
Request
FY2023
House Cmte.
(H.R. 8295)
FY2023
Enacted
Discretionary
76.4
88.3
86.7
79.6
Mandatory
3.7
3.9
3.9
3.9
Total BA in the Bill
80.1
92.3
90.7
83.5
P.L. 117-58, Division Ja
-0.4
—
—
—-
P.L. 117-159, Division Bb
2.1
—
—
—
Funding
Emergency Funding (not in above totals)
Sources: Amounts in this table for the FY2022 Enacted, FY2023 Request, and FY2023 Enacted columns are
generally drawn from or calculated based on data contained in the explanatory statement accompanying the
FY2023 LHHS omnibus (P.L. 117-328), available in the Congressional Record, vol. 168, no. 198, book II, December
92 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.
93 For the purposes of this calculation, the federal contribution included $131 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 2022, p. 31,
https://research.collegeboard.org/media/pdf/trends-in-college-pricing-student-aid-2022.pdf.
94 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 enacted as part of the
appropriations process.
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20, 2022, pp. S8874-S9198. Amounts in the FY2023 House Committee column are generally drawn from or
calculated based on data contained in the committee report (H.Rept. 117-403) accompanying the FY2023 House
committee bill (H.R. 8295, as reported). Enacted totals (“Total BA in the Bill”) for FY2022 or FY2023 do not
include emergency-designated appropriations. For consistency with source materials, amounts in this table
generally do not reflect mandatory spending sequestration, where applicable, nor do they reflect any transfers or
reprogramming of funds pursuant to executive authorities.
Notes: BA = budget authority. Details may not add to totals due to rounding. Amounts in this table (1) reflect
all BA appropriated in the bill, regardless of the year in which funds become available (i.e., totals do not include
advances from prior-year appropriations, but do include advances for subsequent years provided in this bill); (2)
have generally not been adjusted to reflect scorekeeping; (3) comprise only those funds provided (or requested)
for agencies and accounts subject to the jurisdiction of the LHHS subcommittees of the House and Senate
appropriations committees; and (4) do not include appropriations that occur outside of appropriations bills.
a. 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.
b. 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 FY2023 appropriations for selected ED accounts and
programs.95 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 students, other students attending elementary and secondary schools with
relatively high concentrations of students from low-income families, and eligible students who
live in the areas served by these public schools but attend private schools.96
The enacted FY2023 appropriation for the Education for the Disadvantaged account was $19.1
billion, a 4.7% increase over the enacted FY2022 level of $18.2 billion. Of the $19.1 billion
appropriated for the account, $18.4 billion was provided for Title I-A grants.97 The House
committee bill and accompanying report had recommended a funding level of $21.3 billion for
the account, with $20.5 billion designated for the Title I-A program.98 President Biden’s FY2023
budget requested $21.3 billion in discretionary funding for the Education for the Disadvantaged
Account, of which $20.5 billion would have been provided for Title I-A grants. The President’s
FY2023 budget request also requested $16.0 billion in mandatory funding, which is not included
in Table 9.
95 ED budget materials can be found at https://www2.ed.gov/about/overview/focus/performance.html.
96 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).
97 See the explanatory statement accompanying the LHHS omnibus (Congressional Record, vol. 168, no. 198, Book II,
December 20, 2022, p. S9170).
98 See H.Rept. 117-403, pp. 835-836.
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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.99 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, including Project Prevent and Project
School Emergency Response to Violence (Project SERV). Among ED appropriations accounts,
the Safe Schools and Citizenship Education account received the largest percentage increase
(+26.6%) in the FY2023 LHHS omnibus compared to the FY2022 LHHS omnibus.
The enacted FY2023 appropriation for the Safe Schools and Citizenship Education account was
$457 million, a $96 million increase relative to the enacted level of $361 million in FY2022. The
House committee bill recommended $1.7 billion for the account, and the President’s budget
requested $1.7 billion for the account. Both the House committee bill and the President’s budget
would have designated the majority of funds ($1.0 billion) for school-based mental health
services.100
Student Financial Assistance
The Student Financial Assistance account is the largest ED account funded in the LHHS bill. The
Pell Grant program within the Student Financial Assistance account provides need-based
financial aid primarily to low-income undergraduate students to help them cover the cost of
higher education.101 Pell Grants are the largest single source of federal grant aid for undergraduate
students; ED projected that they would provide approximately $38.7 billion in aid to roughly 6.7
million undergraduate students in FY2023.102 The explanatory statement accompanying the
FY2023 LHHS omnibus directed $22.5 billion in discretionary funding to the Pell Grant program,
which was the same amount as FY2022. (Additional mandatory funding for the program is
appropriated outside the LHHS bill.) The House committee bill proposed the same amount for
Pell Grants, whereas the President’s budget requested $24.3 billion in discretionary funding for
Pell Grants.
The total maximum Pell Grant award is the sum of the discretionary maximum award level and the
mandatory add-on award level. The discretionary award program costs may be funded through
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