Status of FY2022 Labor, Health and Human Services, and Education Appropriations: In Brief

Changes from July 21, 2021 to July 23, 2021

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Status of FY2022 Labor, Health and Human
July July 2123, 2021 , 2021
Services, and Education Appropriations: In
Karen E. Lynch
Brief
Specialist in Social Policy Specialist in Social Policy

This report provides a brief summary of the status of FY2022 appropriations for the Departments This report provides a brief summary of the status of FY2022 appropriations for the Departments
Jessica Tollestrup
of Labor, Health and Human Services, and Education, and Related Agencies (LHHS) as of July of Labor, Health and Human Services, and Education, and Related Agencies (LHHS) as of July
Specialist in Social Policy Specialist in Social Policy
23, 2021. It also provides background on the scope of the LHHS bill generally and the budgetary 23, 2021. It also provides background on the scope of the LHHS bill generally and the budgetary

context for congressional decisionmaking, including the submission of the FY2022 President’s context for congressional decisionmaking, including the submission of the FY2022 President’s
budget request, budget enforcement in the absence of statutory discretionary spending limits, and budget request, budget enforcement in the absence of statutory discretionary spending limits, and

the supplemental appropriations provided as part of the legislative response to the COVID-19 the supplemental appropriations provided as part of the legislative response to the COVID-19
pandemic. pandemic.
With regard to House action on full-year appropriations, on July 15, 2021, the House Appropriations Committee voted (33- With regard to House action on full-year appropriations, on July 15, 2021, the House Appropriations Committee voted (33-
25) to report the LHHS bill; the measure was subsequently reported to the House on July 19 (H.R. 4502; H.Rept. 117-96). 25) to report the LHHS bill; the measure was subsequently reported to the House on July 19 (H.R. 4502; H.Rept. 117-96).
Previously, the measure was approved in subcommittee, via a voice vote, on July 12, 2021. The committee reported its initial Previously, the measure was approved in subcommittee, via a voice vote, on July 12, 2021. The committee reported its initial
suballocations for all 12 appropriations bills, including LHHS, on July 1 (H.Rept. 117-78). suballocations for all 12 appropriations bills, including LHHS, on July 1 (H.Rept. 117-78).
Senate Appropriations Committee action on the LHHS bill has not yet occurred during the FY2022 cycle. Senate Appropriations Committee action on the LHHS bill has not yet occurred during the FY2022 cycle.

Congressional Research Service Congressional Research Service

Status of FY2022 LHHS Appropriations: In Brief

n July 15, 2021, the House Appropriations Committee voted (33-25) to report the FY2022 n July 15, 2021, the House Appropriations Committee voted (33-25) to report the FY2022
appropriations bil for the Departments of Labor, Health and Human Services, and appropriations bil for the Departments of Labor, Health and Human Services, and
O Education, and Related Agencies (LHHS); the measure was subsequently reported to the O Education, and Related Agencies (LHHS); the measure was subsequently reported to the
House on July 19 (H.R. 4502; H.Rept. 117-96). Previously, the measure was approved in House on July 19 (H.R. 4502; H.Rept. 117-96). Previously, the measure was approved in
subcommittee, via a voice vote, on July 12, 2021. subcommittee, via a voice vote, on July 12, 2021.
This report provides a brief summary of the status of LHHS appropriations during the FY2022 This report provides a brief summary of the status of LHHS appropriations during the FY2022
cycle, including relevant congressional actions and a top-line comparison of discretionary funding cycle, including relevant congressional actions and a top-line comparison of discretionary funding
enacted in FY2021, versus relevant FY2022 legislative proposals as of July 23, 2021. It also enacted in FY2021, versus relevant FY2022 legislative proposals as of July 23, 2021. It also
provides background on the scope of the bil and the context for congressional decisionmaking. provides background on the scope of the bil and the context for congressional decisionmaking.
Congressional clients may consult the LHHS experts list in CRS Report R42638, 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 , for information on which analysts to contact at the Congressional Research Service
(CRS) with questions on specific agencies and programs funded in the LHHS bil . (CRS) with questions on specific agencies and programs funded in the LHHS bil .
Scope of the LHHS Bill
The LHHS bil is the largest ($1.2 tril ion in FY2021) of the 12 annual appropriations bil s when The LHHS bil is the largest ($1.2 tril ion in FY2021) of the 12 annual appropriations bil s when
accounting for both mandatory and discretionary funding.1 It provides annual y appropriated accounting for both mandatory and discretionary funding.1 It provides annual y appropriated
budget authority for the following federal departments and agencies: budget authority for the following federal departments and agencies:
 the Department of Labor (DOL);  the Department of Labor (DOL);
 most agencies at the Department of Health and Human Services (HHS), except  most agencies at the Department of Health and Human Services (HHS), except
for the Food and Drug Administration (funded through the Agriculture for the Food and Drug Administration (funded through the Agriculture
appropriations bil ), the Indian Health Service (funded through the Interior-appropriations bil ), the Indian Health Service (funded through the Interior-
Environment appropriations bil ), and the Agency for Toxic Substances and Environment appropriations bil ), and the Agency for Toxic Substances and
Disease Registry (funded through the Interior-Environment appropriations bil ); Disease Registry (funded through the Interior-Environment appropriations bil );
 the Department of Education (ED); and  the Department of Education (ED); and
 more than a dozen related agencies (RAs), including the Social Security  more than a dozen related agencies (RAs), including the Social Security
Administration (SSA), the Corporation for National and Community Service, the Administration (SSA), the Corporation for National and Community Service, the
Corporation for Public Broadcasting, the Institute of Museum and Library Corporation for Public Broadcasting, the Institute of Museum and Library
Services, the National Labor Relations Board, and the Railroad Retirement Services, the National Labor Relations Board, and the Railroad Retirement
Board. Board.
In general, mandatory funding represents just over 80% of the total LHHS bil , supporting In general, mandatory funding represents just over 80% of the total LHHS bil , supporting
annual y appropriated entitlements such as Medicaid and Supplemental Security Income (SSI). annual y appropriated entitlements such as Medicaid and Supplemental Security Income (SSI).
Discretionary funds, which account for less than 20% of total funds in the bil , tend to be the Discretionary funds, which account for less than 20% of total funds in the bil , tend to be the
focus of congressional debate during the appropriations process.2 This is because the focus of congressional debate during the appropriations process.2 This is because the
appropriations process general y has little control over the amount of mandatory funding provided appropriations process general y has little control over the amount of mandatory funding provided
for appropriated entitlements; rather, the authorizing statute controls the program parameters for appropriated entitlements; rather, the authorizing statute controls the program parameters
(e.g., eligibility rules, benefit levels) that entitle certain recipients to payments. Consequently, the (e.g., eligibility rules, benefit levels) that entitle certain recipients to payments. Consequently, the

1 T he FY2021 total is drawn from the 1 T he FY2021 total is drawn from the Congressional Record, Vol. 166, No. 218, Book IV, December 17, 2019, pp. , Vol. 166, No. 218, Book IV, December 17, 2019, pp.
H8709, https://www.congress.gov/116/crec/2020/12/21/CREC-2020-12-21.pdf-bk4. T he discretionary funding H8709, https://www.congress.gov/116/crec/2020/12/21/CREC-2020-12-21.pdf-bk4. T he discretionary funding
provided in the LHHS appropriations act is both provided and controlled by that act. T he mandatory funding provided provided in the LHHS appropriations act is both provided and controlled by that act. T he mandatory funding provided
in the LHHS act is controlled by provisions in authorizing law. For definitions of these and other budget terms, see U.S. in the LHHS act is controlled by provisions in authorizing law. For definitions of these and other budget terms, see U.S.
Government Accountability Office (GAO), Government Accountability Office (GAO), A Glossary of Term s Used in the Federal Budget Process, GAO-05-734SP, , GAO-05-734SP,
September 1, 2005, http://www.gao.gov/products/GAO-05-734SP. (T erms of interest may include budget authority, September 1, 2005, http://www.gao.gov/products/GAO-05-734SP. (T erms of interest may include budget authority,
appropriated entitlement, direct spending, discretionary, entitlement authority, and mandatory.) appropriated entitlement, direct spending, discretionary, entitlement authority, and mandatory.)
2 For an illustrative discussion of the distribution of funds among the different titles of the bill, and between 2 For an illustrative discussion of the distribution of funds among the different titles of the bill, and between
discretionary and mandatory spending, see the summary of FY2020 LHHS a ppropriations in CRS Report R46492, discretionary and mandatory spending, see the summary of FY2020 LHHS a ppropriations in CRS Report R46492,
Labor, Health and Hum an Services, and Education: FY2020 Appropriations, pp. 11-14. , pp. 11-14.
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Status of FY2022 LHHS Appropriations: In Brief

focus of this report general y is on the discretionary spending that has been or would be provided focus of this report general y is on the discretionary spending that has been or would be provided
for LHHS programs and activities under various laws and proposals. for LHHS programs and activities under various laws and proposals.
Even though discretionary appropriations represent a relatively smal share of the entire LHHS Even though discretionary appropriations represent a relatively smal share of the entire LHHS
bil , the bil is typical y the largest single source of nondefense discretionary funding for the bil , the bil is typical y the largest single source of nondefense discretionary funding for the
federal government. (The Department of Defense bil is the largest single source of discretionary federal government. (The Department of Defense bil is the largest single source of discretionary
funding overal .) funding overal .)
Calculating Total LHHS Budget Authority
Budget authority is the amount of money a federal agency is legal y authorized to commit or spend. Appropriations is the amount of money a federal agency is legal y authorized to commit or spend. Appropriations
bil s may include budget authority that becomes available in the current fiscal year, in future fiscal years, or some bil s 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 typical y referred to as combination. Amounts that become available in future fiscal years are typical y referred to as advance
appropriations. .
The amount of LHHS budget authority can be tabulated in various ways. The total amount of budget authority The amount of LHHS budget authority can be tabulated in various ways. The total amount of budget authority
provided in an appropriations bil (i.e., provided in an appropriations bil (i.e., total in the bil ) would be calculated regardless of the year in which the ) would be calculated regardless of the year in which the
funding becomes available.3 In some cases, however, such as the 302(b) subal ocations (discussed later), the total is funding becomes available.3 In some cases, however, such as the 302(b) subal ocations (discussed later), the total is
calculated based on calculated based on current-year appropriations (i.e., the amount of appropriations (i.e., the amount of budget authority available for obligation in a given
fiscal year), which is calculated regardless of the year in which it was first appropriated.4 Additional y, budgetary , which is calculated regardless of the year in which it was first appropriated.4 Additional y, budgetary
totals may or may not include Congressional Budget Office (CBO) scorekeeping and other adjustments to reflect totals may or may not include Congressional Budget Office (CBO) scorekeeping and other adjustments to reflect
budget enforcement conventions and special instructions of Congress.5 budget enforcement conventions and special instructions of Congress.5
Context for FY2022
Under the congressional budget process, congressional consideration of annual appropriations Under the congressional budget process, congressional consideration of annual appropriations
traditional y is preceded by the submission of the President’s budget request and the adoption of traditional y is preceded by the submission of the President’s budget request and the adoption of
the congressional budget resolution. However, the FY2022 cycle has been affected by a number the congressional budget resolution. However, the FY2022 cycle has been affected by a number
of timing and budgetary issues related to the ongoing COVID-19 pandemic, the presidential of timing and budgetary issues related to the ongoing COVID-19 pandemic, the presidential
transition, and a lack of statutory discretionary spending limits for the first time in a decade. transition, and a lack of statutory discretionary spending limits for the first time in a decade.
Background related to these issues is provided below. Background related to these issues is provided below.
COVID-19 Pandemic Supplemental Appropriations for FY2020 and
FY2021
Subsequent to the enactment of annual FY2020 LHHS appropriations and the submission of the Subsequent to the enactment of annual FY2020 LHHS appropriations and the submission of the
President’s FY2021 budget, the effects of the COVID-19 pandemic on communities across the President’s FY2021 budget, the effects of the COVID-19 pandemic on communities across the
world and throughout the United States elicited a legislative response from Congress and the world and throughout the United States elicited a legislative response from Congress and the
President. In the first months of the pandemic, four FY2020 supplemental appropriations were President. In the first months of the pandemic, four FY2020 supplemental appropriations were
part of this legislative response:6 part of this legislative response:6

3 Such figures include advance appropriations provided in the bill for future fiscal years, but do not include advance 3 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. appropriations provided in prior years’ appropriations bills that become available in the current year.
4 Such figures exclude advance appropriations for future years, but include advance appropriations from prior years that 4 Such figures exclude advance appropriations for future years, but include advance appropriations from prior years that
become available in the given fiscal year. become available in the given fiscal year.
5 For more information on scorekeeping, see CRS Report 98-560, 5 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 . 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). accompanying the conference report to the Balanced Budget Act of 1997 ( H.Rept. 105-217, pp. 1007-1014).
6 Other divisions of the acts that provided supplemental LHHS appropriations contained authorization provisions that in 6 Other divisions of the acts that provided supplemental LHHS appropriations contained authorization provisions that in
some cases relate to LHHS programs and activities—for instance, provisions providing a 6.2% increase to the federal some cases relate to LHHS programs and activities—for instance, provisions providing a 6.2% increase to the federal
matching assistance percentage for Medicaid and certain other programs in FFCRA, and provisions modifying student matching assistance percentage for Medicaid and certain other programs in FFCRA, and provisions modifying student
loan subsidy costs in the CARES Act. For further information on the LHHS appropriation s provided by these COVID-loan subsidy costs in the CARES Act. For further information on the LHHS appropriation s provided by these COVID-
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link to page 7 link to page 7 link to page 7 link to page 7 Status of FY2022 LHHS Appropriations: In Brief

 Title III, Division A, of the Coronavirus Preparedness and Response  Title III, Division A, of the Coronavirus Preparedness and Response
Supplemental Appropriations Act, 2020 (P.L. 116-123), enacted on March 6, Supplemental Appropriations Act, 2020 (P.L. 116-123), enacted on March 6,
2020, provided approximately $6.4 bil ion in supplemental LHHS funds7; 2020, provided approximately $6.4 bil ion in supplemental LHHS funds7;
 Title V, Division A, of the Families First Coronavirus Response Act (FFCRA,  Title V, Division A, of the Families First Coronavirus Response Act (FFCRA,
P.L. 116-127), enacted on March 18, 2020, provided $1.25 bil ion in P.L. 116-127), enacted on March 18, 2020, provided $1.25 bil ion in
supplemental LHHS funds; supplemental LHHS funds;
 Title VIII, Division B, of the Coronavirus Aid, Relief, and Economic Security  Title VIII, Division B, of the Coronavirus Aid, Relief, and Economic Security
Act (CARES Act, P.L. 116-136), enacted on March 27, 2020, provided $172.1 Act (CARES Act, P.L. 116-136), enacted on March 27, 2020, provided $172.1
bil ion in supplemental LHHS funds; and bil ion in supplemental LHHS funds; and
 Title I, Division B, of the Paycheck Protection Program and Health Care  Title I, Division B, of the Paycheck Protection Program and Health Care
Enhancement Act (PPPHCEA, P.L. 116-139), enacted on April 24, 2020, Enhancement Act (PPPHCEA, P.L. 116-139), enacted on April 24, 2020,
provided $100 bil ion in supplemental LHHS funds. provided $100 bil ion in supplemental LHHS funds.
In total, FY2020 supplemental appropriations increased regular FY2020 LHHS enacted funding In total, FY2020 supplemental appropriations increased regular FY2020 LHHS enacted funding
by about 143%. The bulk of the supplemental funding (89%) was directed at HHS. Supplemental by about 143%. The bulk of the supplemental funding (89%) was directed at HHS. Supplemental
HHS funds totaled $248 bil ion and represented a 261% increase over the agency’s FY2020 HHS funds totaled $248 bil ion and represented a 261% increase over the agency’s FY2020
regular appropriations funding level. ED received the next largest increase via supplemental regular appropriations funding level. ED received the next largest increase via supplemental
funds (43%), whereas the DOL and RA titles received the smal est increases relative to their funds (43%), whereas the DOL and RA titles received the smal est increases relative to their
initial FY2020 enacted levels (5% and 3%, respectively). initial FY2020 enacted levels (5% and 3%, respectively).
Al of these additional funds were designated as an Al of these additional funds were designated as an emergency requirement and thus were and thus were
effectively exempted from otherwise applicable budget enforcement requirements, such as the effectively exempted from otherwise applicable budget enforcement requirements, such as the
discretionary spending limits.8 (See discretionary spending limits.8 (See “FY2022 Discretionary Spending Levels and Appropriations
Al ocations” for a further explanation of this issue.) for a further explanation of this issue.)
While annual appropriations for FY2021 were under discussion during the summer and fal of While annual appropriations for FY2021 were under discussion during the summer and fal of
2020, Congress and President Trump considered whether any additional COVID-19 response 2020, Congress and President Trump considered whether any additional COVID-19 response
funding should be enacted.9 Ultimately, the same law (P.L. 116-260) that provided regular annual funding should be enacted.9 Ultimately, the same law (P.L. 116-260) that provided regular annual
LHHS appropriations for FY2021 in Division H also provided FY2021 supplemental LHHS appropriations for FY2021 in Division H also provided FY2021 supplemental
discretionary appropriations in Division M. This law, which was enacted on December 27, 2020, discretionary appropriations in Division M. This law, which was enacted on December 27, 2020,
provided a total of $154.9 bil ion in supplemental LHHS funds, al of which were designated as provided a total of $154.9 bil ion in supplemental LHHS funds, al of which were designated as
an emergency requirement (Title III, Division M). This funding was split roughly equal y an emergency requirement (Title III, Division M). This funding was split roughly equal y
between HHS (48%) and ED (53%). (None was enacted for DOL or RA.) The ED supplemental between HHS (48%) and ED (53%). (None was enacted for DOL or RA.) The ED supplemental
funding budgetary increase of $82 bil ion was 112% of its FY2021 regular appropriations. HHS funding budgetary increase of $82 bil ion was 112% of its FY2021 regular appropriations. HHS
regular appropriations were increased by 75% (+$73 bil ion).10 regular appropriations were increased by 75% (+$73 bil ion).10
The FY2020 and FY2021 supplemental funding was in many cases provided to LHHS accounts The FY2020 and FY2021 supplemental funding was in many cases provided to LHHS accounts
and activities that also received annual appropriations. Although this funding was general y for and activities that also received annual appropriations. Although this funding was general y for
COVID-19-related response efforts, some of these efforts could include expanding basic COVID-19-related response efforts, some of these efforts could include expanding basic

19 supplementals, see CRS Report R46353, 19 supplementals, see CRS Report R46353, COVID-19: Overview of FY2020 LHHS Supplem ental Appropriations. .
7 Of the amount shown for P.L. 116-123, $300 million (appropriated to the Public Health and Social Services 7 Of the amount shown for P.L. 116-123, $300 million (appropriated to the Public Health and Social Services
Emergency Fund at HHS) was contingent upon future HHS actions. Emergency Fund at HHS) was contingent upon future HHS actions.
8 For further information, see CRS Report R45778, 8 For further information, see CRS Report R45778, Exceptions to the Budget Control Act’s Discretionary Spending
Lim its. .
9 Prior to the enactment of full-year FY2021 LHHS funding, COVID-19-related LHHS provisions were proposed in 9 Prior to the enactment of full-year FY2021 LHHS funding, COVID-19-related LHHS provisions were proposed in
several different appropriations measures for FY20 21, including the House-passed full-year LHHS bill (Division E, several different appropriations measures for FY20 21, including the House-passed full-year LHHS bill (Division E,
H.R. 7617), a supplemental appropriations package (Division A, H.R. 925), and the FY2021 continuing resolution H.R. 7617), a supplemental appropriations package (Division A, H.R. 925), and the FY2021 continuing resolution
(Division A, P.L. 116-159). While in some cases the budgetary effects of the COVID-19-related provisions were (Division A, P.L. 116-159). While in some cases the budgetary effects of the COVID-19-related provisions were
designated as an emergency requirement, this was not the case universally. designated as an emergency requirement, this was not the case universally.
10 For further information, see CRS Report R46775, 10 For further information, see CRS Report R46775, Overview of COVID-19 LHHS Supplemental Appropriations:
FY2020 and FY2021. .
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Status of FY2022 LHHS Appropriations: In Brief

infrastructure and capacity that would otherwise have been unfunded (or funded through annual infrastructure and capacity that would otherwise have been unfunded (or funded through annual
appropriations had the supplemental funding not been available). As FY2022 LHHS appropriations had the supplemental funding not been available). As FY2022 LHHS
appropriations are being considered in the coming months, Congress and President Biden wil appropriations are being considered in the coming months, Congress and President Biden wil
need to consider the extent to which any further funding supporting COVID-19 pandemic need to consider the extent to which any further funding supporting COVID-19 pandemic
response wil be enacted as regular appropriations subject to the spending limits, or as an response wil be enacted as regular appropriations subject to the spending limits, or as an
emergency requirement. They also wil need to decide whether any program investments or emergency requirement. They also wil need to decide whether any program investments or
expansions funded via previously enacted COVID-19 supplemental appropriations should be expansions funded via previously enacted COVID-19 supplemental appropriations should be
sustained. sustained.
Timing of the FY2022 President’s Budget Submission
The President’s budget request for the upcoming fiscal year is due to be submitted to Congress by The President’s budget request for the upcoming fiscal year is due to be submitted to Congress by
the first Monday in February. However, the FY2022 budget was submitted during a year in which the first Monday in February. However, the FY2022 budget was submitted during a year in which
a presidential transition occurred (on January 20, 2021). Recent Presidents have not submitted a presidential transition occurred (on January 20, 2021). Recent Presidents have not submitted
detailed budget proposals until April or May of their first year in office, although each has detailed budget proposals until April or May of their first year in office, although each has
advised Congress regarding the general contours of their economic and budgetary policies in advised Congress regarding the general contours of their economic and budgetary policies in
special messages submitted to Congress prior to that submission.11 This delay al ows time to special messages submitted to Congress prior to that submission.11 This delay al ows time to
prepare a proposal that reflects the priorities of the new administration. prepare a proposal that reflects the priorities of the new administration.
On April 9, President Biden submitted to Congress an outline of his discretionary funding On April 9, President Biden submitted to Congress an outline of his discretionary funding
priorities for FY2022.12 This preliminary document provided early highlights for numerous policy priorities for FY2022.12 This preliminary document provided early highlights for numerous policy
areas, including several funded in the LHHS bil . The full budget request was submitted on May areas, including several funded in the LHHS bil . The full budget request was submitted on May
28, almost four months after its due date.13 As a result, the start of annual appropriations 28, almost four months after its due date.13 As a result, the start of annual appropriations
decisionmaking for FY2022 also was delayed to al ow time for Congress to consider this request. decisionmaking for FY2022 also was delayed to al ow time for Congress to consider this request.
FY2022 Discretionary Spending Levels and Appropriations
Allocations
For the decade prior to FY2022, the framework for discretionary spending budget enforcement For the decade prior to FY2022, the framework for discretionary spending budget enforcement
under the congressional budget process involved both statutory and procedural elements. Those under the congressional budget process involved both statutory and procedural elements. Those
statutory elements included limits on defense and nondefense discretionary spending established statutory elements included limits on defense and nondefense discretionary spending established
by the Budget Control Act of 2011 (BCA; P.L. 112-25). LHHS appropriations are classified as by the Budget Control Act of 2011 (BCA; P.L. 112-25). LHHS appropriations are classified as
nondefense spending, and the bil has the largest share of such spending compared to the other nondefense spending, and the bil has the largest share of such spending compared to the other
annual appropriations bil s. annual appropriations bil s.
The procedural elements of budget enforcement are primarily associated with the budget The procedural elements of budget enforcement are primarily associated with the budget
resolution. This provides a limit on total discretionary spending available to the appropriations resolution. This provides a limit on total discretionary spending available to the appropriations
committees (commonly referred to as a committees (commonly referred to as a 302(a) allocation) and limits on spending under the ) and limits on spending under the
jurisdiction of each appropriations subcommittee (jurisdiction of each appropriations subcommittee (302(b) suballocations). Certain spending is ). Certain spending is
effectively exempt from these limits (commonly referred to aseffectively exempt from these limits (commonly referred to as adjustments to those limits). In to those limits). In
recent years, adjustments that have been applied to LHHS appropriations are for recent years, adjustments that have been applied to LHHS appropriations are for emergency
requirements, to accommodate new budget authority for specified program integrity initiatives at , to accommodate new budget authority for specified program integrity initiatives at
HHS (HHS (health care fraud and abuse control) and the SSA () and the SSA (continuing disability reviews and

11 See CRS Insight IN11655, 11 See CRS Insight IN11655, Budget Submission After a Presidential Transition: Contextualizing the Biden
Administration’s FY2022 Request. .
12 Office of Management and Budget (OMB), 12 Office of Management and Budget (OMB), The President’s FY2022 Discretionary Request, April 9, 2021, , April 9, 2021,
https://www.whitehouse.gov/omb/fy-2022-discretionary-request/. https://www.whitehouse.gov/omb/fy-2022-discretionary-request/.
13 See https://www.whitehouse.gov/omb/budget/. 13 See https://www.whitehouse.gov/omb/budget/.
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Status of FY2022 LHHS Appropriations: In Brief

redeterminations), and for DOL to fund ), and for DOL to fund reemployment services and eligibility assessments
conducted by the states related to unemployment compensation.14 conducted by the states related to unemployment compensation.14
Under current law, the statutory limits on discretionary spending expire at the end of FY2021. Under current law, the statutory limits on discretionary spending expire at the end of FY2021.
This general y means that, absent the imposition of new statutory limits, discretionary budget This general y means that, absent the imposition of new statutory limits, discretionary budget
enforcement for FY2022 wil occur via procedural means only. As the FY2022 appropriations enforcement for FY2022 wil occur via procedural means only. As the FY2022 appropriations
cycle progresses, however, Congress may consider whether to re-impose statutory caps, and if so, cycle progresses, however, Congress may consider whether to re-impose statutory caps, and if so,
at what levels and for what number of fiscal years. Absent statutory caps, the amount of FY2022 at what levels and for what number of fiscal years. Absent statutory caps, the amount of FY2022
discretionary spending—in total and for LHHS—wil stil need to be determined. In addition, discretionary spending—in total and for LHHS—wil stil need to be determined. In addition,
Congress wil need to determine to what degree any discretionary spending for FY2022 wil be Congress wil need to determine to what degree any discretionary spending for FY2022 wil be
effectively exempt from budget enforcement, whether statutory or procedural. effectively exempt from budget enforcement, whether statutory or procedural.
As of the date of this report, there has been no House or Senate action on a FY2022 budget As of the date of this report, there has been no House or Senate action on a FY2022 budget
resolution. In its absence, on June 14, 2021, the House adopted a resolution (H.Res. 467) to resolution. In its absence, on June 14, 2021, the House adopted a resolution (H.Res. 467) to
provide for 302(a) al ocations to the House Appropriations Committee at a specified level, to provide for 302(a) al ocations to the House Appropriations Committee at a specified level, to
provide limits on advance appropriations,15 and to al ow adjustments to those al ocations for provide limits on advance appropriations,15 and to al ow adjustments to those al ocations for
emergency requirements, health care fraud and abuse control, and continuing disability reviews emergency requirements, health care fraud and abuse control, and continuing disability reviews
and redeterminations (as wel as other purposes that do not apply to LHHS).16 Pursuant to this and redeterminations (as wel as other purposes that do not apply to LHHS).16 Pursuant to this
resolution, the Chair of the House Budget Committee, Representative Yarmuth, published in the resolution, the Chair of the House Budget Committee, Representative Yarmuth, published in the
Congressional Record the House Appropriations Committee al ocations on June 24.17 The Senate the House Appropriations Committee al ocations on June 24.17 The Senate
has not taken similar action to establish Senate Appropriations Committee al ocations.18 has not taken similar action to establish Senate Appropriations Committee al ocations.18
General y, the next step in the appropriations process is for each of the appropriations committees General y, the next step in the appropriations process is for each of the appropriations committees
to adopt subal ocations from the total amount al ocated to them. These 302(b) subal ocations to adopt subal ocations from the total amount al ocated to them. These 302(b) subal ocations
provide a limit on current-year (in this case, FY2022) appropriations within each subcommittee’s provide a limit on current-year (in this case, FY2022) appropriations within each subcommittee’s
jurisdiction and incorporate any applicable scorekeeping adjustments made by CBO. The House jurisdiction and incorporate any applicable scorekeeping adjustments made by CBO. The House
Appropriations Committee reported their initial 302(b) subal ocations for al 12 subcommittees Appropriations Committee reported their initial 302(b) subal ocations for al 12 subcommittees
on July 1 (H.Rept. 117-78).19 The discretionary budget authority subal ocation for LHHS of on July 1 (H.Rept. 117-78).19 The discretionary budget authority subal ocation for LHHS of
$237.466 bil ion represents a 36% (+$63.4 bil ion) increase relative to FY2021. That amount does $237.466 bil ion represents a 36% (+$63.4 bil ion) increase relative to FY2021. That amount does
not include funding subject to adjustments, such as for emergency requirements. not include funding subject to adjustments, such as for emergency requirements.

14 For further information, see CRS Report R45778, 14 For further information, see CRS Report R45778, Exceptions to the Budget Control Act’s Discretionary Spending
Lim its. .
15 15 Advance appropriations become available for obligation one or more fiscal years after the budget year covered by become available for obligation one or more fiscal years after the budget year covered by
the appropriations act the appropriations act . T he FY2022 LHHS appropriations bill generally would contain advance appropriations for T he FY2022 LHHS appropriations bill generally would contain advance appropriations for
FY2023 and FY2024 for certain programs and activities. For further information, see CRS Report R43482, FY2023 and FY2024 for certain programs and activities. For further information, see CRS Report R43482, Advance
Appropriations, Forward Funding, and Advance Funding: Concepts, Practice, and Budget Process Considerations . .
16 H.Res. 467 further provided that the BCA cap adjustments (Section 251(b) of the Balanced Budget and Emergency 16 H.Res. 467 further provided that the BCA cap adjustments (Section 251(b) of the Balanced Budget and Emergency
Deficit Control Act) would not apply to allocations established pursuant to that resolution. However, the adjustment for Deficit Control Act) would not apply to allocations established pursuant to that resolution. However, the adjustment for
reemployment services and eligibility assessments would continue to be in effect for FY2022 through FY2027 pursuant reemployment services and eligibility assessments would continue to be in effect for FY2022 through FY2027 pursuant
to Section 314(g) of the Congressional Budget Act, subject to specified limits. to Section 314(g) of the Congressional Budget Act, subject to specified limits.
17 “Publication of Budgetary Material,” 17 “Publication of Budgetary Material,” Congressional Record, daily edition, Vol. 167, No. 110 (June 24, 2021), p. , daily edition, Vol. 167, No. 110 (June 24, 2021), p.
H3130. H3130.
18 For a discussion of budget enforcement through methods such as H.Res. 467, see CRS Report R44296, 18 For a discussion of budget enforcement through methods such as H.Res. 467, see CRS Report R44296, Deeming
Resolutions: Budget Enforcem ent in the Absence of a Budget Resolution. .
19 Suballocations are commonly adjusted through the appropriations cycle to account for changing priorities. For 19 Suballocations are commonly adjusted through the appropriations cycle to account for changing priorities. For
FY2022, the House Appropriations Committee reported revised suballocations on July 16 ( H.Rept. 117-91) to FY2022, the House Appropriations Committee reported revised suballocations on July 16 ( H.Rept. 117-91) to
incorporate the cap adjustments where applicable, but otherwise the suballocation for the LHHS subcommittee was the incorporate the cap adjustments where applicable, but otherwise the suballocation for the LHHS subcommittee was the
same as originally reported. same as originally reported.
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link to page 9 link to page 7 link to page 10 link to page 9 link to page 7 link to page 10 Status of FY2022 LHHS Appropriations: In Brief

FY2022 LHHS Legislative Action
On July 15, 2021, the House Appropriations Committee voted (33-25) to report the LHHS bil ; On July 15, 2021, the House Appropriations Committee voted (33-25) to report the LHHS bil ;
the measure was subsequently reported to the House on July 19 (H.R. 4502; H.Rept. 117-96). the measure was subsequently reported to the House on July 19 (H.R. 4502; H.Rept. 117-96).
Previously, the measure was approved in subcommittee, via a voice vote, on July 12, 2021. Previously, the measure was approved in subcommittee, via a voice vote, on July 12, 2021.
Senate Appropriations Committee action on the FY2022 LHHS bil has not yet occurred. Senate Appropriations Committee action on the FY2022 LHHS bil has not yet occurred.
Table 1 displays the CBO estimate of enacted LHHS discretionary appropriations for FY2021, displays the CBO estimate of enacted LHHS discretionary appropriations for FY2021,
and the House committee-reported FY2022 discretionary appropriations for LHHS. The amount and the House committee-reported FY2022 discretionary appropriations for LHHS. The amount
shown for “regular discretionary appropriations” does not include any funding that is subject to shown for “regular discretionary appropriations” does not include any funding that is subject to
program integrity adjustments or emergency designations. The amount shown represents current-program integrity adjustments or emergency designations. The amount shown represents current-
year budget authority subject to the spending limits and takes into account any applicable CBO year budget authority subject to the spending limits and takes into account any applicable CBO
scorekeeping adjustments. Under this method of estimating the bil , the House proposal would scorekeeping adjustments. Under this method of estimating the bil , the House proposal would
increase regular discretionary appropriations for LHHS relative to FY2021 by 36% (+$63.4 increase regular discretionary appropriations for LHHS relative to FY2021 by 36% (+$63.4
bil ion). bil ion).
As mentioned previously, certain LHHS appropriations, such as those al owed for program As mentioned previously, certain LHHS appropriations, such as those al owed for program
integrity funding or designated for emergency requirements, are effectively exempt from the integrity funding or designated for emergency requirements, are effectively exempt from the
discretionary spending limits. As was the case for FY2021, the FY2022 House proposal would discretionary spending limits. As was the case for FY2021, the FY2022 House proposal would
provide the maximum amount al owed for program integrity spending under relevant procedures provide the maximum amount al owed for program integrity spending under relevant procedures
(see discussion in (see discussion in “FY2022 Discretionary Spending Levels and Appropriations Al ocations”). .
With regard to new FY2022 funding for emergency requirements, no such emergency-designated With regard to new FY2022 funding for emergency requirements, no such emergency-designated
funding has been proposed by the House. The “adjusted appropriations” total in the table includes funding has been proposed by the House. The “adjusted appropriations” total in the table includes
these additional funds along with “regular discretionary appropriations.” these additional funds along with “regular discretionary appropriations.”
Table 1. LHHS Discretionary Appropriations: Comparison of FY2021 Enacted with
FY2022 House Appropriations Committee Proposal
(Budget authority in bil ions of dol ars) (Budget authority in bil ions of dol ars)

FY2022 House
Committee
FY2021
Bill
Enacted
(H.R. 4502)
Regular discretionary Regular discretionary
appropriations appropriations
174.073 174.073
237.466 237.466
Adjustments Adjustments:a

Health care fraud and Health care fraud and
abuse control abuse control
0.496 0.496
0.556 0.556
Continuing disability Continuing disability
reviews and reviews and
1.302 1.302
1.435 1.435
redeterminations redeterminations
Reemployment services Reemployment services
and eligibility assessments and eligibility assessments
0.083 0.083
0.133 0.133
Emergency requirements Emergency requirements
156.563 156.563
— —
Adjusted appropriations Adjusted appropriations
332.517 332.517
239.590 239.590
Source: The FY2021 enacted amounts are from CBO, The FY2021 enacted amounts are from CBO, Report on the Status of Discretionary Appropriations, Fiscal
Year 2021, House of Representatives, as of December 27, 2020, https://www.cbo.gov/system/files?file=2021-02/, https://www.cbo.gov/system/files?file=2021-02/
FY2021-House-2021-02-01.pdf, and CRS analysis of Division H of P.L. 116-260. The FY2022 House amounts are FY2021-House-2021-02-01.pdf, and CRS analysis of Division H of P.L. 116-260. The FY2022 House amounts are
from page 3 of H.Rept. 117-96, and CRS analysis of H.R. 4502, as reported. “Regular discretionary from page 3 of H.Rept. 117-96, and CRS analysis of H.R. 4502, as reported. “Regular discretionary
appropriations” exclude funds for which special rules apply under the spending limits (e.g., funds for certain appropriations” exclude funds for which special rules apply under the spending limits (e.g., funds for certain
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Status of FY2022 LHHS Appropriations: In Brief

program integrity activities and emergency requirements), as wel as funds provided under authorities in the 21 st program integrity activities and emergency requirements), as wel as funds provided under authorities in the 21 st
Century Cures Act (P.L. 114-255) that are effectively exempt from the spending limits. Century Cures Act (P.L. 114-255) that are effectively exempt from the spending limits.
Notes: Amounts reflect current-year discretionary budget authority subject to spending limits. Amounts reflect current-year discretionary budget authority subject to spending limits.
a. CBO presents the FY2021 enacted amounts provided for health care fraud and abuse control, continuing a. CBO presents the FY2021 enacted amounts provided for health care fraud and abuse control, continuing
disability reviews and redeterminations, and reemployment services and eligibility assessments as an disability reviews and redeterminations, and reemployment services and eligibility assessments as an
aggregated “program integrity” total of $1.881 bil ion. The FY2021 enacted amounts for these activities are aggregated “program integrity” total of $1.881 bil ion. The FY2021 enacted amounts for these activities are
identified via CRS analysis of Division H of P.L. 116-260. identified via CRS analysis of Division H of P.L. 116-260.

Author Information

Karen E. Lynch Karen E. Lynch
Jessica Tollestrup Jessica Tollestrup
Specialist in Social Policy Specialist in Social Policy
Specialist in Social Policy Specialist in Social Policy

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