Labor, Health and Human Services, and Education: FY2021 Appropriations

Changes from July 26, 2021 to January 10, 2022

This page shows textual changes in the document between the two versions indicated in the dates above. Textual matter removed in the later version is indicated with ~~red strikethrough~~ and textual matter added in the later version is indicated with blue.

Labor, Health and Human Services, and
~~July 26, 2021~~January 10, 2022
Education: FY2021 Appropriations
Karen E. Lynch,
This report offers an overview of actions taken by Congress and the President to provide FY2021 This report offers an overview of actions taken by Congress and the President to provide FY2021
Coordinator
appropriations for accounts funded by the Departments of Labor, Health and Human Services, appropriations for accounts funded by the Departments of Labor, Health and Human Services,
Specialist in Social Policy Specialist in Social Policy
and Education, and Related Agencies (LHHS) appropriations bill. This bill includes all accounts 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 funded through the annual appropriations process at the Department of Labor (DOL) and
Jessica Tollestrup,
Department of Education (ED). It also provides annual appropriations for most agencies within Department of Education (ED). It also provides annual appropriations for most agencies within
Coordinator
the Department of Health and Human Services (HHS), with certain exceptions (e.g., the Food the Department of Health and Human Services (HHS), with certain exceptions (e.g., the Food
Specialist in Social Policy Specialist in Social Policy
and Drug Administration is funded via the Agriculture bill). The LHHS bill also provides funds 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). for more than a dozen related agencies, including the Social Security Administration (SSA).
Kyle D. Shohfi
This report primarily This report primarily ~~focus es~~focuses on regular FY2021 LHHS discretionary funding enacted during the on regular FY2021 LHHS discretionary funding enacted during the
Analyst in Education Policy Analyst in Education Policy
annual appropriations process. The emergency-designated discretionary funding that was annual appropriations process. The emergency-designated discretionary funding that was

subsequently enacted for FY2021 is generally not included in the budgetary figures discussed in subsequently enacted for FY2021 is generally not included in the budgetary figures discussed in
David H. Bradley
the main body of the report. (The FY2021 emergency supplemental discretionary appropriations the main body of the report. (The FY2021 emergency supplemental discretionary appropriations
Specialist in Labor Specialist in Labor
enacted for COVID-19 pandemic response are addressed in the context of the FY2021 annual enacted for COVID-19 pandemic response are addressed in the context of the FY2021 annual
Economics Economics
cycle cycle inin Appendix C.)

Angela Napili
Regular Appropriations
Senior Research Librarian Senior Research Librarian

FY2021 LHHS Omnibus: On December 27, 2020, the Consolidated Appropriations Act, 2021 On December 27, 2020, the Consolidated Appropriations Act, 2021
(FY2021(FY2021 LHHS omnibus; H.R. 133) was signed into law by President Trump as P.L. 116-260. LHHS omnibus; H.R. 133) was signed into law by President Trump as P.L. 116-260.
William R. Morton
The FY2021 The FY2021 LHHS omnibus provided full-year appropriations for all 12 annual appropriations LHHS omnibus provided full-year appropriations for all 12 annual appropriations
Analyst in Income Security Analyst in Income Security
acts in Divisions A-L. Annual discretionary LHHS appropriations totaled $198.5 billion. This acts in Divisions A-L. Annual discretionary LHHS appropriations totaled $198.5 billion. This

amount is 1.6% more than FY2020 enacted and 11.0% more than the FY2021 President’s budget amount is 1.6% more than FY2020 enacted and 11.0% more than the FY2021 President’s budget
request. The omnibus also provided $980.0 billion in mandatory funding, for a combined LHHS request. The omnibus also provided $980.0 billion in mandatory funding, for a combined LHHS

total of $1.178 trillion. The distribution of discretionary funding was as follows: total of $1.178 trillion. The distribution of discretionary funding was as follows:
  DOL: $12.5 $12.5 billion, 1.0% more than FY2020. billion, 1.0% more than FY2020.
  HHS: $97.0 billion, 2.2% more than FY2020. $97.0 billion, 2.2% more than FY2020.
  ED: $73.54 billion, 1.1% more than FY2020. $73.54 billion, 1.1% more than FY2020.
  Related Agencies: $15.5 billion, 0.6% more than FY2020. $15.5 billion, 0.6% more than FY2020.
FY2021 LHHS Senate Action: The FY2021 The FY2021 LHHS bill did not receive subcommittee, full committee, or initial floor action LHHS bill did not receive subcommittee, full committee, or initial floor action
in the Senate prior to its enactment. The chair of the Senate Committee on Appropriations, Senator Richard Shelby, released in the Senate prior to its enactment. The chair of the Senate Committee on Appropriations, Senator Richard Shelby, released
drafts of all 12 annual appropriations bills along with draft accompanying committee reports on November 10, 2020,drafts of all 12 annual appropriations bills along with draft accompanying committee reports on November 10, 2020, which which
was intended to further negotiations on annual appropriations between the House and the Senate. was intended to further negotiations on annual appropriations between the House and the Senate. These draft numbers are not
presented in this report.
FY2021 LHHS House Action: On July 13, 2020, the House Appropriations Committee voted to report the FY2021 LHHS On July 13, 2020, the House Appropriations Committee voted to report the FY2021 LHHS
appropriations bill, 30-22; the measure was subsequently reported to the House on July 15 (H.R. 7614; H.Rept. 116-450). appropriations bill, 30-22; the measure was subsequently reported to the House on July 15 (H.R. 7614; H.Rept. 116-450).
This was preceded by subcommittee approval of the draft bill on July 7, by a vote of 9-6. This was preceded by subcommittee approval of the draft bill on July 7, by a vote of 9-6.
As reported by the full committee, the bill would have provided $198.1 billion in discretionary LHHS funds, a 1.3% increase As reported by the full committee, the bill would have provided $198.1 billion in discretionary LHHS funds, a 1.3% increase
from FY2020from FY2020 enacted levels. This amount would have been 10.8% more than the FY2021 President’s request. In addition, enacted levels. This amount would have been 10.8% more than the FY2021 President’s request. In addition,
the House committee bill would have provided an estimated $980.0 billion in mandatory funding, for a combined total of the House committee bill would have provided an estimated $980.0 billion in mandatory funding, for a combined total of
$1.178$1.178 trillion for LHHS as a whole. The distribution of discretionary funding was as follows: trillion for LHHS as a whole. The distribution of discretionary funding was as follows:
  DOL: $12.7 $12.7 billion, 2.0% more than FY2020. billion, 2.0% more than FY2020.
  HHS: $96.4 billion, 1.5% more than FY2020. $96.4 billion, 1.5% more than FY2020.
  ED: $73.47 billion, 1.0% more than FY2020. $73.47 billion, 1.0% more than FY2020.
  Related Agencies: $15.6 billion, 1.4% more than FY2020. $15.6 billion, 1.4% more than FY2020.
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Appropriations
The House version of LHHS appropriations was initially considered on the floor as part of a consolidated appropriations The House version of LHHS appropriations was initially considered on the floor as part of a consolidated appropriations
package and passed the House (217-197), as amended, on July 31, 2020 (Division E of H.R. 7617).package and passed the House (217-197), as amended, on July 31, 2020 (Division E of H.R. 7617). Of the amendments Of the amendments
offered, 84 were adopted and 8 were rejected. offered, 84 were adopted and 8 were rejected. Because there is no publicly available source that estimates the account-level
budgetary effects of the amendments adopted to Division E, this report provides analysis of the House Committee-reported
version of the LHHS bill. For information on the LHHS amendments offered during floor consideration, For information on the LHHS amendments offered during floor consideration, seesee Appendix B.
FY2021 President’s Budget Request: The President’s FY2021 budget request was submitted to Congress on February 10, The President’s FY2021 budget request was submitted to Congress on February 10,
2020. On March 17, 2020, President Trump submitted a letter to Congress about FY2021 budget amendments (2020. On March 17, 2020, President Trump submitted a letter to Congress about FY2021 budget amendments (~~alo ng~~along with a with a
supplemental appropriations request for FY2020) related to the response to the COVID-19 pandemic. These budget supplemental appropriations request for FY2020) related to the response to the COVID-19 pandemic. These budget
amendments affected the FY2021 President’s requested levels for Centers for Disease Control and Prevention (CDC) and amendments affected the FY2021 President’s requested levels for Centers for Disease Control and Prevention (CDC) and
National Institutes of Health (NIH) accounts at HHS. Amounts shown for the President’s request in the source materials National Institutes of Health (NIH) accounts at HHS. Amounts shown for the President’s request in the source materials
consulted for this report generally appear to reflect these budget amendments. consulted for this report generally appear to reflect these budget amendments.
The President requested $178.8 billion in discretionary funding for accounts funded by the LHHS bill, which would have The President requested $178.8 billion in discretionary funding for accounts funded by the LHHS bill, which would have
been a decrease of 8.5% from FY2020been a decrease of 8.5% from FY2020 levels. In addition, the President requested $978.3 billion in annually appropriated levels. In addition, the President requested $978.3 billion in annually appropriated
mandatory funding, for a total of $1.157 trillion for LHHS as a whole. The distribution of discretionary funding was as mandatory funding, for a total of $1.157 trillion for LHHS as a whole. The distribution of discretionary funding was as
follows: follows:
  DOL: $11.1 $11.1 billion, 10.5% less than FY2020. billion, 10.5% less than FY2020.
  HHS: $87.0 billion, 8.3% less than FY2020. $87.0 billion, 8.3% less than FY2020.
  ED: $66.6 billion, 8.5% less than FY2020. $66.6 billion, 8.5% less than FY2020.
  Related Agencies: $14.1 billion, 8.2% less than FY2020.$14.1 billion, 8.2% less than FY2020.

Supplemental Appropriations
Several acts have been signed into law providing FY2020 and FY2021 supplemental discretionary appropriations for LHHS Several acts have been signed into law providing FY2020 and FY2021 supplemental discretionary appropriations for LHHS
programs and activities related to the COVID-19 pandemic. For FY2021,programs and activities related to the COVID-19 pandemic. For FY2021, the same law that provided “regular” annual LHHS the same law that provided “regular” annual LHHS
appropriations for FY2021 in Division H also provided supplemental discretionary appropriations in a separate division appropriations for FY2021 in Division H also provided supplemental discretionary appropriations in a separate division
(Coronavirus Response and Relief Supplemental Appropriations Act, 2021; CRRSA). This law, which was enacted on (Coronavirus Response and Relief Supplemental Appropriations Act, 2021; CRRSA). This law, which was enacted on
December 27, 2020, provided a total of $154.9 billion in supplemental LHHS funds (Title III, Division M, of P.L. 116-260).December 27, 2020, provided a total of $154.9 billion in supplemental LHHS funds (Title III, Division M, of P.L. 116-260).
In addition, prior to the end of FY2021, a second supplemental appropriations act containing LHHS appropriations was enacted (P.L. 117-31) on July 30, 2021. This law provided $25 million in supplemental appropriations for the Refugee and Entrant Assistance account at HHS for specified purposes related to Afghan special immigrants. In total, FY2021 supplemental appropriations increased regular discretionary FY2021 LHHS enacted funding by about In total, FY2021 supplemental appropriations increased regular discretionary FY2021 LHHS enacted funding by about
78.1%. This funding was split roughly equally between HHS (48.1%) and ED (52.9%). (None was enacted for DOL or RA.) 78.1%. This funding was split roughly equally between HHS (48.1%) and ED (52.9%). (None was enacted for DOL or RA.)
The ED budgetary increase due to its supplemental funding was 111.5% (+82.0 billion) more than its FY2021 regular The ED budgetary increase due to its supplemental funding was 111.5% (+82.0 billion) more than its FY2021 regular
discretionary appropriations. HHS regular discretionary appropriations were increased by 75.2% (+$72.9 billion). discretionary appropriations. HHS regular discretionary appropriations were increased by 75.2% (+$72.9 billion).
SeeSee Appendix C of this report for an analysis of the supplemental discretionary LHHS appropriations provided in these acts. of this report for an analysis of the supplemental discretionary LHHS appropriations provided in these acts.
For a detailed discussion of the LHHS COVID-19For a detailed discussion of the LHHS COVID-19 pandemic response funding, see CRS Report R46775, pandemic response funding, see CRS Report R46775, Overview of
COVID-19 LHHS Supplemental Appropriations: FY2020 and FY2021. .
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Appropriations
Introduction
This report provides an overview of FY2021 This report provides an overview of FY2021
Scope of the Report:
appropriations actions for accounts appropriations actions for accounts ~~traditional y~~traditionally funded funded
Emergency and Mandatory
in the appropriations in the appropriations ~~bil~~ bill for the Departments of Labor, for the Departments of Labor,
Funding Related to COVID-19
Health and Human Services, and Education, and Related Health and Human Services, and Education, and Related
This report primarily This report primarily focuses on regular focuses on regular
Agencies (LHHS). This Agencies (LHHS). This ~~bil~~ bill provides discretionary and provides discretionary and
FY2021 LHHS discretionary FY2021 LHHS discretionary funding funding
mandatory appropriations to three federal departments: mandatory appropriations to three federal departments:
enacted during the annual appropriations enacted during the annual appropriations
the Department of Labor (DOL), the Department of the Department of Labor (DOL), the Department of
process. process. The emergency discretionary The emergency discretionary
funding that was enacted for FY2020, or funding that was enacted for FY2020, or
Health and Human Services (HHS), and the Department Health and Human Services (HHS), and the Department
proposed and enacted for FY2021, is proposed and enacted for FY2021, is
of Education (ED). In addition, the of Education (ED). In addition, the ~~bil~~ bill provides annual provides annual
~~general y~~generally not included in the budgetary not included in the budgetary
appropriations for more than a dozen related agencies, appropriations for more than a dozen related agencies,
figures discussed or table totals presented figures discussed or table totals presented
including the Social Security Administration (SSA). including the Social Security Administration (SSA).
in the main body of the report. in the main body of the report. (Note that (Note that
while emergency-designatedwhile emergency-designated spending, spending,
Discretionary funds represent less than one-fifth of the Discretionary funds represent less than one-fifth of the
including that proposed and enacted in the including that proposed and enacted in the
total funds appropriated in the annual LHHS total funds appropriated in the annual LHHS ~~bil~~ bill. .
context of annual LHHS appropriations, is context of annual LHHS appropriations, is
Nevertheless, the LHHS Nevertheless, the LHHS ~~bil is typical y~~bill is typically the largest the largest
presented below the table totals, it is not presented below the table totals, it is not
included in them. Also,included in them. Also, the FY2021 the FY2021
single source of discretionary funds for domestic single source of discretionary funds for domestic
emergency emergency supplemental appropriations supplemental appropriations
nondefense federal programs among the various nondefense federal programs among the various
enacted for COVID-19 pandemic response enacted for COVID-19 pandemic response
appropriations appropriations ~~bil s~~bills. (The Department of Defense . (The Department of Defense ~~bil is~~
bill is and other purposes are addressed in the are addressed in the ~~context of the~~
the largest source of discretionary funds among the largest source of discretionary funds among al
~~FY2021 annual cycle i~~n ~~Appendix~~ all context of the FY2021 annual cycle in federal programs.) Because the appropriations process Appendix C.) In In
addition, during FY2020 addition, during FY2020 and FY2021, mandatory appropriations~~and FY2021,~~
~~federal programs.) Because the appropriations process~~
~~mandatory appropriations were enacted to~~
both both provides and and controls discretionary funding discretionary funding
were enacted to certain LHHS-related certain LHHS-related ~~accounts for~~
(concepts discussed further in (concepts discussed further in “Mandatory vs.
accounts for COVID-19 pandemic COVID-19 pandemic ~~response, including in~~
Discretionary Budget Authority”)), the bulk of this report , the bulk of this report
~~the American Rescue Plan Act of 2021~~response, including in the American Rescue
is focused on these funds. is focused on these funds.
Plan Act of 2021 (P.L. 117-2). These (P.L. 117-2). These mandatory funds are mandatory funds are
beyond the scope of beyond the scope of ~~this report.~~
The LHHS The LHHS ~~bil typical y~~bill typically is one of the more controversial is one of the more controversial this report.
of the regular appropriations of the regular appropriations ~~bil s~~bills because of the size of its funding and the scope of its programs, because of the size of its funding and the scope of its programs,
~~as wel~~ as well as various related social policy issues addressed in the as various related social policy issues addressed in the ~~bil~~ bill, such as restrictions on the use , such as restrictions on the use
of federal funds for abortion and for research on human embryos, stem of federal funds for abortion and for research on human embryos, stem ~~cel s~~cells, and gun violence. , and gun violence.
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 (CRS) with questions on specific agencies and programs funded in the LHHS ~~bil~~ bill. .
Report Roadmap and Useful Terminology
This report is divided into several sections. The opening section provides an explanation of the This report is divided into several sections. The opening section provides an explanation of the
scope of the LHHS scope of the LHHS ~~bil~~ bill (and hence, the scope of this report) and an introduction to important (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 terminology and concepts that carry throughout the report. Next is a series of sections describing
major congressional actions on FY2021 appropriations and (for context) a review of the major congressional actions on FY2021 appropriations and (for context) a review of the
conclusion of the FY2020 appropriations process. This is followed by a high-level summary and conclusion of the FY2020 appropriations process. This is followed by a high-level summary and
analysis of enacted and proposed appropriations for FY2021, compared to FY2020 funding analysis of enacted and proposed appropriations for FY2021, compared to FY2020 funding
levels. The body of the report concludes with overview sections for each of the major titles of the levels. The body of the report concludes with overview sections for each of the major titles of the
~~bil :~~ bill: DOL, HHS, ED, and Related Agencies (RA). These sections provide selected highlights DOL, HHS, ED, and Related Agencies (RA). These sections provide selected highlights
from FY2021 enacted and proposed funding levels compared to FY2020. (Note that the from FY2021 enacted and proposed funding levels compared to FY2020. (Note that the
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Appropriations
distribution of funds is sometimes distribution of funds is sometimes ~~il ustrated~~illustrated by figures, which in by figures, which in al all cases are based on the cases are based on the
FY2021 enacted version of the LHHS FY2021 enacted version of the LHHS ~~bil~~ bill.1) .1)
Appendix A provides a summary of budget enforcement activities for FY2021. This includes provides a summary of budget enforcement activities for FY2021. This includes
information on the Budget Control Act of 2011 (BCA;information on the Budget Control Act of 2011 (BCA; P.L. 112-25) and sequestration, budget P.L. 112-25) and sequestration, budget
enforcement in the absence of an FY2021 budget resolution, the House LHHSenforcement in the absence of an FY2021 budget resolution, the House LHHS subcommittee subcommittee
spending spending ~~al ocation~~allocation, and current-year spending levels. This is followed , and current-year spending levels. This is followed byby Appendix B, ~~which~~ which
provides an overview of the LHHS-related floor amendments that were offered in the House provides an overview of the LHHS-related floor amendments that were offered in the House
during its consideration of H.R. 7617during its consideration of H.R. 7617. Appendix C provides an analysis of the supplemental provides an analysis of the supplemental
discretionary LHHS appropriations enacted for FY2021. For a detailed discussion of the FY2021 discretionary LHHS appropriations enacted for FY2021. For a detailed discussion of the FY2021
supplemental LHHS COVID-19 pandemic response funding, see CRS Report R46775, supplemental LHHS COVID-19 pandemic response funding, see CRS Report R46775, Overview
of COVID-19 LHHS Supplemental Appropriations: FY2020 and FY2021. .
Scope of the Report
This report focuses on appropriations to agencies and accounts that are subject to the jurisdiction 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 of the Labor, Health and Human Services, Education, and Related Agencies subcommittees of the
House and Senate appropriations committees (i.e., accounts House and Senate appropriations committees (i.e., accounts ~~traditional y~~traditionally funded via the LHHS funded via the LHHS
~~bil~~ bill). Department “totals” provided in this report do not include funding for accounts or agencies ). Department “totals” provided in this report do not include funding for accounts or agencies
that are that are ~~traditional y~~ traditionally funded by appropriations funded by appropriations ~~bil s~~bills under the jurisdiction of other subcommittees. under the jurisdiction of other subcommittees.
The LHHS The LHHS ~~bil~~ bill provides appropriations for the following federal departments and agencies: provides appropriations for the following federal departments and agencies:
 the Department of Labor;  the Department of Labor;
 most agencies at the Department of Health and Human Services, except for the  most agencies at the Department of Health and Human Services, except for the
Food and Drug Administration (funded through the Agriculture appropriations Food and Drug Administration (funded through the Agriculture appropriations
~~bil~~ bill), the Indian Health Service (funded through the Interior-Environment ), the Indian Health Service (funded through the Interior-Environment
appropriations appropriations ~~bil~~ bill), and the Agency for Toxic Substances and Disease Registry ), and the Agency for Toxic Substances and Disease Registry
(also funded through the Interior-Environment appropriations (also funded through the Interior-Environment appropriations ~~bil~~ bill); );
 the Department of Education; and  the Department of Education; and
 more than a dozen related agencies, including the Social Security Administration,  more than a dozen related agencies, including the Social Security Administration,
the Corporation for National and Community Service, the Corporation for Public the Corporation for National and Community Service, the Corporation for Public
Broadcasting, the Institute of Museum and Library Services, the National Labor Broadcasting, the Institute of Museum and Library Services, the National Labor
Relations Board, and the Railroad Retirement Board. Relations Board, and the Railroad Retirement Board.
Note also that funding totals displayed in this report do not reflect amounts provided outside of 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 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 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 reflected in the totals provided in this report because they are not provided through the annual
appropriations process (see related discussion in the appropriations process (see related discussion in the “Important Budget Concepts~~” section).~~

~~1 T he~~” section). 1 The dollars and percentages in each figure dollars and percentages in each figure also are generally illustrative, except as noted, of the parallel distribution also are generally illustrative, except as noted, of the parallel distribution
of fundsof funds enacted in FY2020 and proposed by the FY2021 President’s budget and the House committee bill.enacted in FY2020 and proposed by the FY2021 President’s budget and the House committee bill.
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Appropriations
Important Budget Concepts
Mandatory vs. Discretionary Budget Authority2
The LHHS The LHHS ~~bil~~ bill includes both discretionary and mandatory budget authority. While includes both discretionary and mandatory budget authority. While al
all discretionary spending is subject to the annual appropriations process, only a portion of discretionary spending is subject to the annual appropriations process, only a portion of
mandatory spending is provided in appropriations measures. mandatory spending is provided in appropriations measures.
Mandatory programs funded through the annual appropriations process are commonly referred to Mandatory programs funded through the annual appropriations process are commonly referred to
as as appropriated entitlements. In general, appropriators have little control over the amounts . In general, appropriators have little control over the amounts
provided for appropriated entitlements; rather, the authorizing statute controls the program 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 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 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 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 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 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 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 outside of the appropriations process. Instead, the amounts reflect only those funds, discretionary
and mandatory, that are provided through appropriations acts. and mandatory, that are provided through appropriations acts.
As displayed in this report, mandatory amounts for the FY2021 President’s budget submission As displayed in this report, mandatory amounts for the FY2021 President’s budget submission
reflect current-law (or current services) estimates; they reflect current-law (or current services) estimates; they ~~general y~~generally do not include the President’s do not include the President’s
proposed changes to a mandatory spending program’s authorizing statute that might affect total 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 spending. (In general, such proposals are excluded from this report, as they ~~typical y~~typically would be would be
enacted in authorizing legislation.) enacted in authorizing legislation.)
The report focuses most closely on discretionary funding because discretionary funding receives The report focuses most closely on discretionary funding because discretionary funding receives
the bulk of attention during the appropriations process. (While the LHHS the bulk of attention during the appropriations process. (While the LHHS ~~bil~~ bill includes more includes more
mandatory funding than discretionary funding, the appropriators mandatory funding than discretionary funding, the appropriators ~~general y~~generally have less flexibility have less flexibility in in
adjusting mandatory funding levels than discretionary funding levels.) adjusting mandatory funding levels than discretionary funding levels.)
Mandatory and discretionary spending is subject to budget enforcement processes that include 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 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 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 sequestration, and how it is carried out, differ for each type of spending. This is discussed further
iin Appendix A.

2 For definitions of these and other budget2 For definitions of these and other budget terms, see U.S. Government Accountability Office (GAO), terms, see U.S. Government Accountability Office (GAO), A Glossary of
~~Term s~~Terms Used in the Federal Budget Process, GAO-05-734SP, September 1, 2005, http://www.gao.gov/products/GAO-, GAO-05-734SP, September 1, 2005, http://www.gao.gov/products/GAO-
05-734SP. (05-734SP. (~~T erms~~Terms of interest may include appropriated entitlement, direct spending, discretionary, entitlement of interest may include appropriated entitlement, direct spending, discretionary, entitlement
authority, and mandatory.) authority, and mandatory.)
3 Sometimes appropriations measures include 3 Sometimes appropriations measures include amendments to lawsamendments to laws authorizing mandatory spending programs and authorizing mandatory spending programs and
thereby change the amount of mandatory appropriations needed. Becausethereby change the amount of mandatory appropriations needed. Because such amendments are legislative in nature, such amendments are legislative in nature,
they may violate parliamentary rules separating authorizations and appropriations. For more information, see CRS they may violate parliamentary rules separating authorizations and appropriations. For more information, see CRS
Report R42388, Report R42388, The Congressional Appropriations Process: An Introduction . .
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Appropriations
Total Budget Authority Provided in the Bill vs. Total Budget Authority
Available in the Fiscal Year
Budget authority is the amount of money a federal agency is Budget authority is the amount of money a federal agency is ~~legal y~~legally authorized to commit or authorized to commit or
spend. Appropriations spend. Appropriations ~~bil s~~bills may include budget authority that becomes available in the current 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 year, in future fiscal years, or some combination. Amounts that become available in future
fiscal years are fiscal years are ~~typical y~~typically referred to as referred to as advance appropriations. .
Unless otherwise specified, appropriations levels displayed in this report refer to the total amount Unless otherwise specified, appropriations levels displayed in this report refer to the total amount
of of budget authority provided in an appropriations bill (i.e., “total in the (i.e., “total in the ~~bil~~ bill”), regardless of the ”), regardless of the
year in which the funding becomes available.4 In some cases, the report breaks out year in which the funding becomes available.4 In some cases, the report breaks out current-year
appropriations (i.e., the amount of 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 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 As the annual appropriations process unfolds, the amount of current-year budget authority is
measured against 302(b) measured against 302(b) ~~al ocation~~allocation ceilings (budget enforcement caps for appropriations ceilings (budget enforcement caps for appropriations
subcommittees that subcommittees that ~~traditional y~~traditionally emerge following the budget resolution process). The process of emerge following the budget resolution process). The process of
measuring appropriations against these spending ceilings takes into account measuring appropriations against these spending ceilings takes into account scorekeeping
adjustments, which are made by the Congressional Budget Office (CBO) to reflect conventions , which are made by the Congressional Budget Office (CBO) to reflect conventions
and special instructions of Congress.6 Unless otherwise specified, appropriations levels displayed and special instructions of Congress.6 Unless otherwise specified, appropriations levels displayed
in this report do not reflect additional scorekeeping adjustments. (Those scorekeeping in this report do not reflect additional scorekeeping adjustments. (Those scorekeeping
adjustments are displayed at the bottom adjustments are displayed at the bottom ofof Table 2.)
Status of FY2021 LHHS Appropriations
FY2021 Supplemental Appropriations
The legislativeThe legislative response to the global COVID-19 pandemic has included the enactment of laws to response to the global COVID-19 pandemic has included the enactment of laws to
provide authorities and supplemental funding to prevent, prepare for, and respond to the provide authorities and supplemental funding to prevent, prepare for, and respond to the
pandemic. pandemic. ~~As of the date of this report,~~ LHHS supplemental appropriations for COVID-19 LHHS supplemental appropriations for COVID-19
pandemic response pandemic response ~~have been~~were enacted in four FY2020 measures, and one FY2021 measure. enacted in four FY2020 measures, and one FY2021 measure. Al
All five of these supplementals are discussed in detail in CRS Report R46775, five of these supplementals are discussed in detail in CRS Report R46775, Overview of COVID-
19 LHHS Supplemental Appropriations: FY2020 and FY2021. In addition, prior to the end of FY2021, a second supplemental appropriations act containing LHHS appropriations was enacted (P.L. 117-31) on July 30, 2021. This law provided $25 million in supplemental appropriations for the Refugee and Entrant Assistance account at HHS for specified purposes related to Afghan special immigrants. See Appendix C for an analysis of the regular and supplemental discretionary LHHS appropriations enacted for FY2021. 4 Such figures include advance appropriations provided in the bill for future fiscal years, but ~~FY2020 and FY2021. See Appendix C for an analysis of~~
~~the regular and supplemental discretionary LHHS appropriations enacted for FY2021.~~
~~The Coronavirus Response and Relief Supplemental Appropriations (CRRSA)~~
~~Act, 2021 (Division M of H.R. 133; P.L. 116-260, “5th COVID”)~~
~~While annual appropriations for FY2021 were under discussion during the summer and fal of~~
~~2020, Congress and President Trump considered whether any additional COVID-19 pandemic~~
~~response funding should be enacted in separate supplemental appropriations measures or~~
~~packaged with the FY2021 annual funding. (Four COVID-19 pandemic response FY2020~~
~~supplemental appropriations acts had previously been enacted, see discussion in~~ ~~“Conclusion of~~

~~4 Such figures include advance appropriations provided in the bill for future fiscal years, but~~ do not include advance 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.
5 Such5 Such ~~figures exclude~~ figures exclude advance appropriations for future years, but includeadvance appropriations for future years, but include advance appropriations from prior years that advance appropriations from prior years that
become available in the given fiscal year. become available in the given fiscal year.
6 For more information on scorekeeping, see CRS 6 For more information on scorekeeping, see CRS Report 98-560, Report 98-560, Baselines and Scorekeeping in the Federal Budget
Process. See. See also a discussionalso a discussion of key scorekeeping guidelinesof key scorekeeping guidelines ~~included~~ included in the joint explanatory statement in the joint explanatory statement
accompanying the conference report to the Balanced Budgetaccompanying the conference report to the Balanced Budget Act of 1997 (H.Rept. 105-217, pp. 1007-1014). Act of 1997 (H.Rept. 105-217, pp. 1007-1014).
Congressional Research Service Congressional Research Service

4 4

link to page 16 link to page link to page 16 link to page 1116 Labor, Health and Human Services, and Education: FY2021 ~~Appropriations~~

Appropriations Emergency Security Supplemental Appropriations Act, 2021 (H.R. 3237; P.L. 117-31) H.R. 3237 was introduced as a supplemental appropriations bill by the chair of the House Appropriations Committee, Representative DeLauro, on May 14, 2021. Both as introduced and as passed by the House (213-212, 3 present) on May 20, 2021, the bill did not contain LHHS funding. Subsequently, the Senate added $25 million in supplemental appropriations for the Refugee and Entrant Assistance account at HHS for specified purposes related to Afghan special immigrants, among other changes. The bill passed the Senate, as amended (98-0), on July 29, 2021. The House agreed to the Senate-passed version (416-11) on July 30, 2021, and the bill was signed into law (P.L. 117-31) by President Biden that same day. According to CBO, the $25 million in supplemental LHHS appropriations provided by P.L. 117-31 was about 1% of the $2.1 billion in FY2021 discretionary appropriations provided by the law. 7 The Coronavirus Response and Relief Supplemental Appropriations (CRRSA) Act, 2021 (Division M of H.R. 133; P.L. 116-260, “5th COVID”) While annual appropriations for FY2021 were under discussion during the summer and fall of 2020, Congress and President Trump considered whether any additional COVID-19 pandemic response funding should be enacted in separate supplemental appropriations measures or packaged with the FY2021 annual funding. (Four COVID-19 pandemic response FY2020 supplemental appropriations acts had previously been enacted; see discussion in “Conclusion of the FY2020 Appropriations Process and FY2020 Supplemental Appropriations”..) In addition, ) In addition,
policymakers had the option of making further COVID-19 pandemic response funding subject to policymakers had the option of making further COVID-19 pandemic response funding subject to
the limitthe limit on FY2021 nondefense discretionary spending, or providing that funding instead as on FY2021 nondefense discretionary spending, or providing that funding instead as
emergency appropriations (effectively exempt from that limit).emergency appropriations (effectively exempt from that limit).78 Ultimately, additional Ultimately, additional FY2021 FY2021
appropriations for COVID-19 pandemic relief were enacted as part of H.R. 133. (Regular appropriations for COVID-19 pandemic relief were enacted as part of H.R. 133. (Regular
FY2021 LHHS annual appropriations were provided in Division H, referred to in this report as FY2021 LHHS annual appropriations were provided in Division H, referred to in this report as
“the FY2021 LHHS omnibus”; emergency supplemental funding for COVID-19 pandemic “the FY2021 LHHS omnibus”; emergency supplemental funding for COVID-19 pandemic
response was provided in Division M.) On December 21, 2020, the final version of H.R. 133 was response was provided in Division M.) On December 21, 2020, the final version of H.R. 133 was
approved by the House. (The vote to approve the portion that contained Division M was 359-53.approved by the House. (The vote to approve the portion that contained Division M was 359-53.89) )
The measure was approved by the Senate (92-6) later that same day, and signed into law (P.L. The measure was approved by the Senate (92-6) later that same day, and signed into law (P.L.
~~116-260) by President Trump on December 27.~~
~~According to CBO, P.L. 116-260 provided about $184.3 bil ion in supplemental appropriations in~~
~~Division M, of which $155 bil ion (approximately 84%) was for LHHS accounts and activities. 9~~
~~Funding was provided for various programs and activities at HHS and ED.~~
~~FY2021 Annual LHHS Appropriations~~
~~Table 1~~ ~~provides a timeline of major legislative actions for full-year LHHS proposals, which are~~
~~discussed in greater detail below~~
~~Table 1. Status of Full-Year LHHS Appropriations Legislation, FY2021~~
~~Subcommittee~~
~~Full Committee~~
~~Resolution of House and~~
~~Approval~~
~~Approval~~

~~Senate Differences~~

~~House~~
~~Senate~~
~~House~~
~~Senate~~
~~Initial~~
~~Initial~~
~~Conf.~~
~~Final~~
~~Final~~
~~Public~~
~~House~~
~~Senate~~
~~House~~
~~Senate Passage~~
~~Passage~~
~~Report~~
~~Passage~~
~~Passage~~
~~Law~~

~~7/7/2020~~
~~H.R. 7614~~
~~H.R. 7617,~~

~~H.R. 133,~~
~~H.R. 133,~~
~~P.L. 116-~~
~~9-6~~
~~H.Rept.~~
~~Division E~~
~~Division H Division H~~
~~260~~
~~116-450~~
~~7/31/20~~
~~12/21/20~~
~~12/21/20~~
~~12/27/20~~
~~7/13/20~~
~~217-197~~
~~359-53~~
~~96-2~~
~~30-22~~
Source: CRS Appropriations Status Table.

7116-260) by President Trump on December 27. 7 CBO, Discretionary Spending: Senate Amendment 2123, July 29, 2021, https://www.cbo.gov/system/files/2021-07/EmergencySecuritySupplementalAppropriationsAct2021.pdf. 8 Prior to the enactment of full year FY2021 LHHS Prior to the enactment of full year FY2021 LHHS funding,funding, COVID-19 pandemic-related LHHSCOVID-19 pandemic-related LHHS provisions were provisions were
proposed in several different appropriations measures for FY2021, includingproposed in several different appropriations measures for FY2021, including the House-passedthe House-passed full-year LHHSfull-year LHHS bill bill
(Division E, H.R. 7617), a supplemental appropriations package (Division A, H.R. 925), and the FY2021 continuing (Division E, H.R. 7617), a supplemental appropriations package (Division A, H.R. 925), and the FY2021 continuing
resolution (Division A, P.L. 116-159). While in some cases, the budgetary effects of the COVID-19 pandemic-related resolution (Division A, P.L. 116-159). While in some cases, the budgetary effects of the COVID-19 pandemic-related
provisions were designatedprovisions were designated as an emergency requirement, that was not the case universally.as an emergency requirement, that was not the case universally.
~~8 T he~~ 9 The special rule, H.Res. special rule, H.Res. 1271, provided for the consideration of an amendment consisting of the final text for 1271, provided for the consideration of an amendment consisting of the final text for
enactmentenactment (as contained in House Rules(as contained in House Rules Committee Print 116-68) to the Senate amendment to H.R. 133. H.Res. 1271 Committee Print 116-68) to the Senate amendment to H.R. 133. H.Res. 1271
also provided for the House to adopt the amendment in two votes: the first on Divisions B, C, E, and F, and the second also provided for the House to adopt the amendment in two votes: the first on Divisions B, C, E, and F, and the second
on the remaining divisions. on the remaining divisions. ~~T he~~The House adopted Divisions B, C, E, and F by a vote of 327-85, and adopted the House adopted Divisions B, C, E, and F by a vote of 327-85, and adopted the
remaining divisionsremaining divisions by a vote of 359-53. The subsequent motion that the House agree to the Senate amendment with an by a vote of 359-53. The subsequent motion that the House agree to the Senate amendment with an
amendment wasamendment was agreed to without objection. Congressional Research Service 5 link to page 12 Labor, Health and Human Services, and Education: FY2021 Appropriations According to CBO, P.L. 116-260 provided about $184.3 billion in supplemental appropriations in Division M, of which $155 billion (approximately 84%) was for LHHS accounts and activities.10 Funding was provided for various programs and activities at HHS and ED. FY2021 Annual LHHS Appropriations Table 1 provides a timeline of major legislative actions for full-year LHHS proposals, which are discussed in greater detail below. Table 1. Status of Full-Year LHHS Appropriations Legislation, FY2021 Subcommittee Full Committee Resolution of House and Approval Approval Senate Differences House Senate House Senate Initial Initial Conf. Final Final Public House Senate House Senate Passage Passage Report Passage Passage Law 7/7/2020 H.R. 7614 H.R. 7617, H.R. 133, H.R. 133, P.L. 116- 9-6 H.Rept. Division E Division H Division H 260 116-450 7/31/20 12/21/20 12/21/20 12/27/20 7/13/20 217-197 359-53 96-2 30-22 Source: CRS Appropriations Status Table.~~agreed to without objection.~~
~~9 T he total amount of supplemental appropriations in Division M is from CBO,~~ ~~Discretionary Spending Under Division~~
~~M, the Coronavirus Response and Relief Supplem ental Appropriations Act, 2021~~ ~~, December 22, 2020, p. 1,~~
~~https://www.cbo.gov/publication/56916. T he total amount of LHHS supplemental appropriations in T itle III of~~
~~Division M was calculated by CRS (see T able 2 of this report), and does not include funding appropriated in T itle III to~~
~~the Food and Drug Administration (FDA) Salaries and Expenses account, as this funding is generally not under the~~
~~purview of the LHHS Appropriations Act.~~
~~Congressional Research Service~~

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~~link to page 13~~ ~~Labor, Health and Human Services, and Education: FY2021 Appropriations~~

FY2021 LHHS Omnibus (Division H, Consolidated Appropriations Act, 2021,
H.R. 133; P.L. 116-260)
On December 27, 2020, the Consolidated Appropriations Act, 2021 was signed into law by the On December 27, 2020, the Consolidated Appropriations Act, 2021 was signed into law by the
President (H.R. 133, P.L. 116-260). P.L. 116-260 provided full-year appropriations for President (H.R. 133, P.L. 116-260). P.L. 116-260 provided full-year appropriations for al all 12 12
annual appropriations acts in Divisions A-L, and supplemental appropriations for COVID-19 annual appropriations acts in Divisions A-L, and supplemental appropriations for COVID-19
pandemic relief in Division M.pandemic relief in Division M.1011 (Full-year LHHS appropriations were enacted in Division H, (Full-year LHHS appropriations were enacted in Division H,
referred to as “the FY2021 LHHS omnibus.”) Prior to its enactment, the final version of the referred to as “the FY2021 LHHS omnibus.”) Prior to its enactment, the final version of the
measure was approved by the House on December 21. (The vote to approve the portion that measure was approved by the House on December 21. (The vote to approve the portion that
contained LHHS appropriations was 359-53.contained LHHS appropriations was 359-53.1112) It was approved by the Senate (92-6) later that ) It was approved by the Senate (92-6) later that
~~same day.~~
~~LHHS discretionary appropriations in the FY2021 LHHS omnibus totaled $198.5 bil ion. This~~
~~amount is 1.6% more than FY2020 enacted and 11.0% more than the FY2021 President’s budget~~
~~request. The omnibus also provided $980.0 bil ion in mandatory funding, for a combined LHHS~~
~~total of $1.178 tril ion. (Note that these totals are based only on amounts of non-emergency~~
~~appropriations provided by the FY2021 LHHS omnibus and do not include emergency-~~
~~designated or supplemental funds, which were provided in addition to the annual appropriations.~~
~~Division H also enacted $1.6 bil ion in emergency-designated budget authority, of which $925~~
~~mil ion was for DOL in Title I, and $638 mil ion was for HHS in Title II, which is not reflected in~~
~~the above figures.)~~
~~See Figure 1 for a breakdown of FY2021 discretionary and mandatory LHHS appropriations.12~~

10same day. 10 The total amount of supplemental appropriations in Division M is from CBO, Discretionary Spending Under Division M, the Coronavirus Response and Relief Supplemental Appropriations Act, 2021, December 22, 2020, p. 1, https://www.cbo.gov/publication/56916. The total amount of LHHS supplemental appropriations in Title III of Division M was calculated by CRS (see Table 2 of this report), and does not include funding appropriated in Title III to the Food and Drug Administration (FDA) Salaries and Expenses account, as this funding is generally not under the purview of the LHHS Appropriations Act. 11 P.L. 116-260 also contained additional COVID-19 pandemic response provisions in Division N, but this division is P.L. 116-260 also contained additional COVID-19 pandemic response provisions in Division N, but this division is
consideredconsidered authorizing legislation, rather than appropriations legislation, and is thus beyond the scope of this report. authorizing legislation, rather than appropriations legislation, and is thus beyond the scope of this report.
For further discussion,For further discussion, ~~see~~ see the Congressional Budgetthe Congressional Budget Office cost estimate for Division N, released on January 14, 2021, Office cost estimate for Division N, released on January 14, 2021,
https://www.cbo.gov/system/files/2021-01/PL_116-260_div_N.pdf. In addition, Divisions O-FF of P.L. 116-260 https://www.cbo.gov/system/files/2021-01/PL_116-260_div_N.pdf. In addition, Divisions O-FF of P.L. 116-260
contained miscellaneous authorizing provisions that are also beyond the scope of this report.contained miscellaneous authorizing provisions that are also beyond the scope of this report.
~~11 T he~~ 12 The special rule, H.Res. special rule, H.Res. 1271, provided for the consideration of an amendment consisting of the final text for 1271, provided for the consideration of an amendment consisting of the final text for
enactmentenactment (as contained in House Rules(as contained in House Rules Committee Print 116-68) to the Senate amendment to H.R. 133. H.Res. 1271 Committee Print 116-68) to the Senate amendment to H.R. 133. H.Res. 1271
also provided for the House to adopt the amendment in two votes: the first on Divisions B, C, E, and F, and the second also provided for the House to adopt the amendment in two votes: the first on Divisions B, C, E, and F, and the second
on the remaining divisions. on the remaining divisions. ~~T he~~The House adopted Divisions B, C, E, and F by a vote of 327-85, and adopted the House adopted Divisions B, C, E, and F by a vote of 327-85, and adopted the
remaining divisionsremaining divisions by a vote of 359-53. The subsequent motion that the House agree to the Senate amendment with an by a vote of 359-53. The subsequent motion that the House agree to the Senate amendment with an
~~amendment was agreed to without objection.~~
~~12 While the percentages in this figure were calculated based on amounts in the FY2021 LHHS omnibus, they are~~
~~generally also illustrative—within a few percentage points—of the share of mandatory and discretionary funds in~~
~~FY2020 and under the various FY2021 proposals (e.g., President’s budget and the House-committee bill).~~
~~Congressional Research Service~~

6

~~Labor, Health and Human Services, and Education: FY2021 Appropriations~~

~~Figure 1. FY2021 Enacted LHHS Appropriations~~

~~Source:~~ ~~Amounts in this figure are general y~~ Congressional Research Service 6 link to page 13 Labor, Health and Human Services, and Education: FY2021 Appropriations LHHS discretionary appropriations in the FY2021 LHHS omnibus totaled $198.5 billion. This amount is 1.6% more than FY2020 enacted and 11.0% more than the FY2021 President’s budget request. The omnibus also provided $980.0 billion in mandatory funding, for a combined LHHS total of $1.178 trillion. (Note that these totals are based only on amounts of non-emergency appropriations provided by the FY2021 LHHS omnibus and do not include emergency-designated or supplemental funds, which were provided in addition to the annual appropriations. Division H also enacted $1.6 billion in emergency-designated budget authority, of which $925 million was for DOL in Title I, and $638 million was for HHS in Title II, which is not reflected in the above figures.) See Figure 1 for a breakdown of FY2021 discretionary and mandatory LHHS appropriations.13 Figure 1. FY2021 Enacted LHHS Appropriations Source: Amounts in this figure are generally drawn from or calculated based on data contained in the drawn from or calculated based on data contained in the
explanatory statement accompanying the FY2021 LHHS omnibus (P.L. 116-260), available in the explanatory statement accompanying the FY2021 LHHS omnibus (P.L. 116-260), available in the Congressional
Record,, vol. 166, no. 218, book IV, Decembervol. 166, no. 218, book IV, December 21, 2020, pp. H8619-H8711. Enacted totals (“Total BA in the Bil ”) 21, 2020, pp. H8619-H8711. Enacted totals (“Total BA in the Bil ”)
for FY2021 do not include emergency-designatedfor FY2021 do not include emergency-designated appropriations provided in Divisionappropriations provided in Division H or M of P.L.H or M of P.L. 116-260, or P.L. 117-31. ~~116-260.~~
For consistency with source materials,For consistency with source materials, amounts in this figure amounts in this figure ~~general y~~generally do not reflect mandatory spending do not reflect mandatory spending
sequestration. CRS calculations do, however,sequestration. CRS calculations do, however, include LHHSinclude LHHS funding provided to HHS pursuant to the funding provided to HHS pursuant to the ~~21 st~~
21st Century Cures Act (P.L. 114-255), as amended. Century Cures Act (P.L. 114-255), as amended.
Notes: Details Details may not add to totals due to rounding. Amounts in this figure (1) reflect may not add to totals due to rounding. Amounts in this figure (1) reflect al all budget authority budget authority
appropriated in the bil ,appropriated in the bil , ~~regardless~~ regardless of the year in which funds become available (i.e.,of the year in which funds become available (i.e., totals do not include totals do not include
advances from prior-year appropriations,advances from prior-year appropriations, but do include advances for subsequent years provided in this bil ); (2) but do include advances for subsequent years provided in this bil ); (2)
have have ~~general y~~generally not been adjusted to reflect not been adjusted to reflect scorekeeping; (3) comprisescorekeeping; (3) comprise only those funds provided for agencies only those funds provided for agencies
and accounts subject to the jurisdiction of the LHHSand accounts subject to the jurisdiction of the LHHS ~~subcommittees~~ subcommittees of the House and Senate appropriations of the House and Senate appropriations
committees;committees; and (4) do not include appropriations that occur outside of appropriations bil s. and (4) do not include appropriations that occur outside of appropriations bil s.
amendment was agreed to without objection. 13 While the percentages in this figure were calculated based on amounts in the FY2021 LHHS omnibus, they are generally also illustrative—within a few percentage points—of the share of mandatory and discretionary funds in FY2020 and under the various FY2021 proposals (e.g., President’s budget and the House-committee bill). Congressional Research Service 7 Labor, Health and Human Services, and Education: FY2021 Appropriations FY2021 Continuing Resolutions (Division A of H.R. 8337; P.L. 116-159)
Between the start of the fiscal year on October 1, 2020, and the enactment of the annual LHHS Between the start of the fiscal year on October 1, 2020, and the enactment of the annual LHHS
appropriations on December 27, 2020, LHHS programs and activities were provided temporary appropriations on December 27, 2020, LHHS programs and activities were provided temporary
FY2021 funding via a series of continuing resolutions (CRs). FY2021 funding via a series of continuing resolutions (CRs).
The first CR providing temporary funding for LHHS programs and activities was signed into law The first CR providing temporary funding for LHHS programs and activities was signed into law
on October 1 (Division A of H.R. 8337; P.L. 116-159). The measure had previously been on October 1 (Division A of H.R. 8337; P.L. 116-159). The measure had previously been
introduced by the House Appropriations Committee chair, Representative Lowey, on September introduced by the House Appropriations Committee chair, Representative Lowey, on September
22, and had passed the House that same day, 359-57.22, and had passed the House that same day, 359-57.1314 The Senate subsequently took up and The Senate subsequently took up and
passed the measure without amendment, 84-10, on September 30. passed the measure without amendment, 84-10, on September 30.
The CR provided continuing appropriations for The CR provided continuing appropriations for al all 12 annual appropriations acts (including 12 annual appropriations acts (including
~~LHHS) through December 11, 2020. In general, the CR funded discretionary programs at the~~

~~13 For further information about the continuing appropriations in H.R. 8337, see House Appropriations Committee,~~
~~“House Democrats File Bipartisan Continuing Resolution,” press release, September 22, 2020,~~
~~https://appropriations.house.gov/news/press-releases/house-democrats-file-bipartisan-continuing-resolution.~~
~~Previously, the chairwoman had introduced H.R. 8319, which included a similar CR in Division A, but that measure~~
~~did not receive House floor consideration. For further information about the continuing appropriations in H.R. 8319,~~
~~see House Appropriations Committee, “ House Democrats Introduce Continuing Resolution,” press release, September~~
~~21, 2020, https://appropriations.house.gov/news/press-releases/house-democrats-introduce-continuing-resolution-1.~~
~~Congressional Research Service~~

7

~~Labor, Health and Human Services, and Education: FY2021 Appropriations~~

LHHS) through December 11, 2020. In general, the CR funded discretionary programs at the same rate and under the same conditions as in FY2020 (§101) and same rate and under the same conditions as in FY2020 (§101) and ~~annual y~~annually appropriated appropriated
entitlements at their current law levels (§111).entitlements at their current law levels (§111).1415 It also included several anomalies that are It also included several anomalies that are
specific to LHHS accounts or related activities (§§149-156). specific to LHHS accounts or related activities (§§149-156).
This first CR was extended by four subsequent CRs: This first CR was extended by four subsequent CRs:
 P.L. 116-215 (Division A), which extended LHHS funding through December 18;  P.L. 116-215 (Division A), which extended LHHS funding through December 18;
 P.L. 116-225, which extended LHHS funding through December 20;  P.L. 116-225, which extended LHHS funding through December 20;
 P.L. 116-226, which extended LHHS funding through December 21; and  P.L. 116-226, which extended LHHS funding through December 21; and
 P.L. 116-246, which extended LHHS funding through December 28.  P.L. 116-246, which extended LHHS funding through December 28.
Earlier Congressional Action on an LHHS Bill
FY2021 LHHS Action in the Senate
Senate Appropriations Committee action on the FY2021 LHHS Senate Appropriations Committee action on the FY2021 LHHS ~~bil~~ bill did not occur during the did not occur during the
FY2021 cycle. The chair of the Senate Committee on Appropriations, Senator Richard Shelby, FY2021 cycle. The chair of the Senate Committee on Appropriations, Senator Richard Shelby,
released drafts of released drafts of al all 12 annual appropriations 12 annual appropriations ~~bil s~~bills along with draft accompanying committee along with draft accompanying committee
reports on November 10, 2020, which was intended to further negotiations on annual reports on November 10, 2020, which was intended to further negotiations on annual
appropriations between the House and the Senate.appropriations between the House and the Senate.1516 These draft numbers are not presented in this
~~report.~~
~~FY2021 LHHS Action in the House (Division A, H.R. 2740)~~
~~The House LHHS subcommittee approved the draft LHHS bil on July 7, by a vote of 9-6. On~~
~~July 13, 2020, the House Appropriations Committee voted to report the FY2021 LHHS~~
~~appropriations bil , 30-22; the measure was subsequently reported to the House on July 15 (H.R.~~
~~7614; H.Rept. 116-450).~~
~~As reported by the full committee, the bil would have provided $198.1 bil ion in discretionary~~
~~LHHS funds, a 1.3% increase from FY2020 enacted levels. This amount would have been 10.8%~~
~~more than the FY2021 President’s request. In addition, the House committee bil would have~~
~~provided an estimated $980.0 bil ion in mandatory funding, for a combined total of $1.178 tril ion~~
~~for LHHS as a whole. (Note that these totals are based only on amounts of non-emergency~~
~~appropriations that would have been provided by the House committee bil and do not include~~
~~emergency-designated or supplemental funds, which were provided in addition to the annual~~
~~appropriations. The House committee bil included a total of $19.4 bil ion in emergency-~~
~~designated budget authority in Title VI, of which $925 mil ion was for DOL and $18.5 bil ion~~
~~was for HHS, which is not reflected in the above figures.)~~
~~Later in July, LHHS appropriations were initial y considered on the House floor as part of a~~
~~consolidated appropriations package and passed the House (217-197), as amended, on July 31,~~

~~14 For an estimate of the discretionary appropriations contained in Division A of H.R. 8337, see CBO, “ CBO’s Estimate~~
~~for H.R. 8337, the Continuing Appropriations Act, 2021 and Other Extensions Act, as Passed by the House of~~
~~Representatives on September 22, 2020,” September 23, 2020, https://www.cbo.gov/system/files/2020-09/hr8337.pdf.~~
~~15 See linked draft bill and report language text in the Senate Appropriations Committee majority press release,~~
~~“Committee Releases FY21 Bills in Effort to Advance Process, Produce Bipartisan Results,” November 10, 2020,~~
~~https://www.appropriations.senate.gov/news/committee-releases-fy21-bills-in-effort-to-advance-process-produce-~~
~~bipartisan-results. See also the statement from the Senate Appropriations Committee Vice Chair, Senator Patrick~~
~~Leahy, at https://www.appropriations.senate.gov/news/minority/senate-approps-vice-chair-leahy-statement-on-the-~~
~~release-of-the-fy-2021-senate-appropriations-bills-.~~
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~~link to page 65~~ ~~Labor, Health and Human Services, and Education: FY2021 Appropriations~~

~~2020 (Division E of H.R. 7617). This package would have provided appropriations for five other~~
~~appropriations acts in addition to LHHS: Department of Defense; Commerce, Justice, Science;~~
~~Energy and Water Development; Financial Services and General Government; and~~
~~Transportation, Housing, and Urban Development.16 Floor action on H.R. 7617 was regulated by~~
~~the terms of a special rule (H.Res. 1067) that made in order 92 amendments to the LHHS title of~~
~~the bil .17 That rule also provided the authority for the chair of the Appropriations Committee or~~
~~her designee to offer any of the amendments made in order en bloc (i.e., in groups of amendments~~
~~to be disposed of together). Al but three LHHS amendments were considered in this manner.18~~
~~When counted as 92 separate amendments, 84 were adopted and 8 were rejected.~~
report. 14 For further information about the continuing appropriations in H.R. 8337, see House Appropriations Committee, “House Democrats File Bipartisan Continuing Resolution,” press release, September 22, 2020, https://appropriations.house.gov/news/press-releases/house-democrats-file-bipartisan-continuing-resolution. Previously, the chairwoman had introduced H.R. 8319, which included a similar CR in Division A, but that measure did not receive House floor consideration. For further information about the continuing appropriations in H.R. 8319, see House Appropriations Committee, “House Democrats Introduce Continuing Resolution,” press release, September 21, 2020, https://appropriations.house.gov/news/press-releases/house-democrats-introduce-continuing-resolution-1. 15 For an estimate of the discretionary appropriations contained in Division A of H.R. 8337, see CBO, “CBO’s Estimate for H.R. 8337, the Continuing Appropriations Act, 2021 and Other Extensions Act, as Passed by the House of Representatives on September 22, 2020,” September 23, 2020, https://www.cbo.gov/system/files/2020-09/hr8337.pdf. 16 See linked draft bill and report language text in the Senate Appropriations Committee majority press release, “Committee Releases FY21 Bills in Effort to Advance Process, Produce Bipartisan Results,” November 10, 2020, https://www.appropriations.senate.gov/news/committee-releases-fy21-bills-in-effort-to-advance-process-produce-bipartisan-results. See also the statement from the Senate Appropriations Committee Vice Chair, Senator Patrick Leahy, at https://www.appropriations.senate.gov/news/minority/senate-approps-vice-chair-leahy-statement-on-the-release-of-the-fy-2021-senate-appropriations-bills-. Congressional Research Service 8 link to page 66 Labor, Health and Human Services, and Education: FY2021 Appropriations FY2021 LHHS Action in the House (Division A, H.R. 2740) The House LHHS subcommittee approved the draft LHHS bill on July 7, by a vote of 9-6. On July 13, 2020, the House Appropriations Committee voted to report the FY2021 LHHS appropriations bill, 30-22; the measure was subsequently reported to the House on July 15 (H.R. 7614; H.Rept. 116-450). As reported by the full committee, the bill would have provided $198.1 billion in discretionary LHHS funds, a 1.3% increase from FY2020 enacted levels. This amount would have been 10.8% more than the FY2021 President’s request. In addition, the House committee bill would have provided an estimated $980.0 billion in mandatory funding, for a combined total of $1.178 trillion for LHHS as a whole. (Note that these totals are based only on amounts of non-emergency appropriations that would have been provided by the House committee bill and do not include emergency-designated or supplemental funds, which were provided in addition to the annual appropriations. The House committee bill included a total of $19.4 billion in emergency-designated budget authority in Title VI, of which $925 million was for DOL and $18.5 billion was for HHS, which is not reflected in the above figures.) Later in July, LHHS appropriations were initially considered on the House floor as part of a consolidated appropriations package and passed the House (217-197), as amended, on July 31, 2020 (Division E of H.R. 7617). This package would have provided appropriations for five other appropriations acts in addition to LHHS: Department of Defense; Commerce, Justice, Science; Energy and Water Development; Financial Services and General Government; and Transportation, Housing, and Urban Development.17 Floor action on H.R. 7617 was regulated by the terms of a special rule (H.Res. 1067) that made in order 92 amendments to the LHHS title of the bill.18 That rule also provided the authority for the chair of the Appropriations Committee or her designee to offer any of the amendments made in order en bloc (i.e., in groups of amendments to be disposed of together). All but three LHHS amendments were considered in this manner.19 When counted as 92 separate amendments, 84 were adopted and 8 were rejected. Because there is no publicly available source that estimates the account-level budgetary effects of
the amendments adopted to Division E, this report provides analysis of the House Committee-
reported version of the LHHS bill. For information on the LHHS amendments offered during For information on the LHHS amendments offered during
floor consideration, sefloor consideration, see Appendix B.
FY2021 President’s Budget Request
The President’s FY2021 budget request was submitted to Congress on February 10, 2020.The President’s FY2021 budget request was submitted to Congress on February 10, 2020.1920 On On
March 17, 2020, President Trump submitted a letter to Congress about FY2021 budget March 17, 2020, President Trump submitted a letter to Congress about FY2021 budget
~~amendments (along with a supplemental appropriations request for FY2020) related to the~~
~~response to the COVID-19 pandemic.20 These budget amendments affected the FY2021~~
~~President’s requested levels for CDC and NIH accounts at HHS.21~~
~~The President requested $178.8 bil ion in discretionary funding for accounts funded by the LHHS~~
~~bil , which would have been a decrease of 8.5% from FY2020 levels. In addition, the President~~
~~requested $978.3 bil ion in annual y appropriated mandatory funding, for a total of $1.157 tril ion~~
~~for LHHS as a whole.~~

16 17 H.R. 7617 was initially expected to provide appropriations for the act funding the Department of Homeland Security, H.R. 7617 was initially expected to provide appropriations for the act funding the Department of Homeland Security,
but that division wasbut that division was ultimately omitted under the terms of the special ruleultimately omitted under the terms of the special rule that regulated floor consideration (that regulated floor consideration ( H.Res. H.Res.
1067). 1067).
1718 For a list of these LHHS For a list of these LHHS amendments (numbered 218-309) and the text of each that was made in order, see H.Rept. amendments (numbered 218-309) and the text of each that was made in order, see H.Rept.
116-461, pp. 23-32 and 89-108. Readers should note that LHHS amendments were keyed to Division F of what was116-461, pp. 23-32 and 89-108. Readers should note that LHHS amendments were keyed to Division F of what was to to
be the basebe the base text for amendment (Rules Committee Print 116–60). The LHHS division wastext for amendment (Rules Committee Print 116–60). The LHHS division was ~~redesignated~~ redesignated as Division E as Division E
after House passageafter House passage ~~due~~ due to the omission of the Department of Homeland Security division to the omission of the Department of Homeland Security division ~~fro m~~from the bill. the bill.
1819 For the en bloc amendments proposing changes to the LHHS division of the bill, see consideration of amendments en For the en bloc amendments proposing changes to the LHHS division of the bill, see consideration of amendments en
bloc nos. 3, 4, and 5 in bloc nos. 3, 4, and 5 in Congressional Record, daily edition, Vol. 166, No. 135 (July 30, 2020), pp. H4134daily edition, Vol. 166, No. 135 (July 30, 2020), pp. H4134 -H4139, -H4139,
H4143-H4169. H4143-H4169.
1920 For further information on the HHS budget For further information on the HHS budget request, see CRSrequest, see CRS Report R46321, Report R46321, Department of Health and Human
Services: FY2021 Budget Request. Note that the report covers the FY2021 President’s request for HHS. Note that the report covers the FY2021 President’s request for HHS ~~in its entirety,~~
~~not just the components of the agency funded through the annual LHHS bill.~~
~~20 Executive Office of the President, Office of Management and Budget, Letter from Acting Director Russell T . Vought~~
~~to T he Honorable Michael R. Pence, March 17, 2020, https://www.whitehouse.gov/wp-content/uploads/2020/03/Letter-~~
~~regarding-additional-funding-to-support -the-United-States-response-to-COVID-19-3.17.2020.pdf.~~
~~21 Amounts shown for the President’s request in the source materials consulted for this report generally appear to reflect~~
~~these budget amendments. T he source materials used for the President’s request are drawn from or calculated based on~~
~~the explanatory statement accompanying the FY2021 LHHS omnibus ( P.L. 116-260), available in the~~ ~~Congressional~~
~~Record, vol. 166, no. 218, book IV, December 21, 2020, pp. H8619 -H8711.~~
~~Congressional Research Service~~

9

~~Labor, Health and Human Services, and Education: FY2021 Appropriations~~
in its entirety, Congressional Research Service 9 Labor, Health and Human Services, and Education: FY2021 Appropriations amendments (along with a supplemental appropriations request for FY2020) related to the response to the COVID-19 pandemic.21 These budget amendments affected the FY2021 President’s requested levels for CDC and NIH accounts at HHS.22 The President requested $178.8 billion in discretionary funding for accounts funded by the LHHS bill, which would have been a decrease of 8.5% from FY2020 levels. In addition, the President requested $978.3 billion in annually appropriated mandatory funding, for a total of $1.157 trillion for LHHS as a whole.
Conclusion of the FY2020 Appropriations Process and FY2020
Supplemental Appropriations
FY2020 regular appropriations for LHHS were enacted as part of the Further Consolidated FY2020 regular appropriations for LHHS were enacted as part of the Further Consolidated
Appropriations Act, 2020, on December 20, 2019 (FY2020 LHHS omnibus; P.L. 116-94). The Appropriations Act, 2020, on December 20, 2019 (FY2020 LHHS omnibus; P.L. 116-94). The
FY2020 LHHS omnibus was agreed to by the House (297-120) on December 17, 2019, and by FY2020 LHHS omnibus was agreed to by the House (297-120) on December 17, 2019, and by
the Senate (71-23) on December 19. The the Senate (71-23) on December 19. The ~~bil~~ bill was signed into law on December 20 (P.L. 116-94). was signed into law on December 20 (P.L. 116-94).
LHHS discretionary appropriations in the FY2020 LHHS LHHS discretionary appropriations in the FY2020 LHHS omnibus totaled $195.4 omnibus totaled $195.4 ~~bil ion~~billion. This . This
amount is 3.2% more than FY2019 enacted and 17.4% more than the FY2020 President’s budget amount is 3.2% more than FY2019 enacted and 17.4% more than the FY2020 President’s budget
request. The omnibus also provided $902.3 request. The omnibus also provided $902.3 ~~bil ion~~billion in mandatory funding, for a combined LHHS in mandatory funding, for a combined LHHS
total of $1.098 total of $1.098 ~~tril ion.22~~trillion.23
On January 29, 2020, supplemental appropriations of $210 On January 29, 2020, supplemental appropriations of $210 ~~mil ion~~million in additional in additional funding to DOL funding to DOL
to carry out the United States-Mexico-Canada Agreement (USMCA) were enacted (P.L. 116-to carry out the United States-Mexico-Canada Agreement (USMCA) were enacted (P.L. 116-
113).113).2324
Subsequent to the enactment of annual FY2020 LHHS discretionary appropriations and the Subsequent to the enactment of annual FY2020 LHHS discretionary appropriations and the
submission of the President’s budget, the effects of the COVID-19 global pandemic on submission of the President’s budget, the effects of the COVID-19 global pandemic on
communities across the world and throughout the United States elicited a legislativecommunities across the world and throughout the United States elicited a legislative response response
from Congress and the President during the remainder of FY2020. Four FY2020 supplemental from Congress and the President during the remainder of FY2020. Four FY2020 supplemental
appropriations were part of this legislative response:appropriations were part of this legislative response:24
~~ Title III, Division A, of the Coronavirus Preparedness and Response~~
~~Supplemental Appropriations Act, 2020 (P.L. 116-123), enacted on March 6,~~
~~2020, provided approximately $6.4 billion in supplemental LHHS funds25 (“1st~~
~~COVID”);~~
~~ Title V, Division A, of the Families First Coronavirus Response Act (FFCRA,~~
~~P.L. 116-127), enacted on March 18, 2020, provided $1.25 bil ion in~~
~~supplemental LHHS funds (“2nd COVID”);~~
~~ Title VIII, Division B, of the Coronavirus Aid, Relief, and Economic Security~~
~~Act (CARES Act, P.L. 116-136), enacted on March 27, 2020, provided $172.1~~
~~bil ion in supplemental LHHS funds (“3rd COVID”); and~~

~~22 For further information, see CRS Report R46492,~~ ~~Labor, Health and Human Services, and Education: FY2020~~
~~Appropriations~~.
~~23 T itle~~25 not just the components of the agency funded through the annual LHHS bill. 21 Executive Office of the President, Office of Management and Budget, Letter from Acting Director Russell T. Vought to The Honorable Michael R. Pence, March 17, 2020, https://www.whitehouse.gov/wp-content/uploads/2020/03/Letter-regarding-additional-funding-to-support-the-United-States-response-to-COVID-19-3.17.2020.pdf. 22 Amounts shown for the President’s request in the source materials consulted for this report generally appear to reflect these budget amendments. The source materials used for the President’s request are drawn from or calculated based on the explanatory statement accompanying the FY2021 LHHS omnibus (P.L. 116-260), available in the Congressional Record, vol. 166, no. 218, book IV, December 21, 2020, pp. H8619-H8711. 23 For further information, see CRS Report R46492, Labor, Health and Human Services, and Education: FY2020 Appropriations. 24 Title IX of the United States-Mexico-Canada Agreement Supplemental Appropriations Act, 2019, (USMCA, P.L. IX of the United States-Mexico-Canada Agreement Supplemental Appropriations Act, 2019, (USMCA, P.L.
116-113). 116-113). ~~T he~~The USMCA supplemental appropriations of $210 million for DOL were for the Bureau USMCA supplemental appropriations of $210 million for DOL were for the Bureau of International of International
Labor Affairs (ILAB) to support the implementation and enforcement of the USMCA. Labor Affairs (ILAB) to support the implementation and enforcement of the USMCA. ~~T he~~The labor labor -related provisions in -related provisions in
the USMCA,the USMCA, which are associated with ILAB’s role, are discussedwhich are associated with ILAB’s role, are discussed in CRSin CRS Report R44981, Report R44981, The United States-Mexico-
Canada ~~Agreem ent~~Agreement (USMCA), pp. 32-33. , pp. 32-33.
2425 Other divisions of the acts that provided supplemental LHHS appropriations contained authorization provisions that Other divisions of the acts that provided supplemental LHHS appropriations contained authorization provisions that
in some casesin some cases relate to LHHS programs and relate to LHHS programs and ~~act ivities~~activities—for instance, provisions providing a 6.2% increase to the —for instance, provisions providing a 6.2% increase to the
federal matching assistance percentage for Medicaid and certain other programs in FFCRA,federal matching assistance percentage for Medicaid and certain other programs in FFCRA, and provisions modifying and provisions modifying
student loan subsidystudent loan subsidy costs in the CAREScosts in the CARES Act. Act. ~~T he~~The mandatory spending mandatory spending ~~budgetar y~~ budgetary effects of such provisions are outside effects of such provisions are outside
the scope of this report. For further information on the LHHS appropriations provided by these COVID-19 pandemic the scope of this report. For further information on the LHHS appropriations provided by these COVID-19 pandemic
response supplementals, see CRSresponse supplementals, see CRS Report R46353, Report R46353, COVID-19: Overview of FY2020 LHHS Supplemental Congressional Research Service 10 Labor, Health and Human Services, and Education: FY2021 Appropriations  Title III, Division A, of the Coronavirus Preparedness and Response Supplemental Appropriations Act, 2020 (P.L. 116-123), enacted on March 6, 2020, provided approximately $6.4 billion in supplemental LHHS funds26 (“1st COVID”);  Title V, Division A, of the Families First Coronavirus Response Act (FFCRA, P.L. 116-127), enacted on March 18, 2020, provided $1.25 billion in supplemental LHHS funds (“2nd COVID”);  Title VIII, Division B, of the Coronavirus Aid, Relief, and Economic Security Act (CARES Act, P.L. 116-136), enacted on March 27, 2020, provided $172.1 billion in supplemental LHHS funds (“3rd COVID”); and ~~of FY2020 LHHS Supplem ental~~
~~Appropriations~~.
~~25 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.~~
~~Congressional Research Service~~

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~~link to page 65 link to page 62 link to page 74 link to page 18~~ ~~Labor, Health and Human Services, and Education: FY2021 Appropriations~~

 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 provided $100 ~~bil ion~~ billion in supplemental LHHSin supplemental LHHS funds (“4th COVID”). funds (“4th COVID”).
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. The $248 by about 143%. The bulk of the supplemental funding (89%) was directed at HHS. The $248
~~bil ion~~ billion in supplemental HHS funds represented a 261% increase over the agency’s FY2020 in supplemental HHS funds represented a 261% increase over the agency’s FY2020
regular appropriations funding level. ED received the next largest increase via supplemental regular appropriations funding level. ED received the next largest increase via supplemental
funds (43%), whereas DOL and RA received the funds (43%), whereas DOL and RA received the ~~smal est~~smallest increases relative to their initial increases relative to their initial
~~FY2020 enacted levels (5% and 3%, respectively).~~
FY2020 enacted levels (5% and 3%, respectively). Appropriations. 26 Of the amount shown for P.L. 116-123, $300 million (appropriated to the Public Health and Social Services Emergency Fund at HHS) was contingent upon future HHS actions. Congressional Research Service 11 link to page 66 link to page 63 link to page 75 link to page 19 link to page 64 Labor, Health and Human Services, and Education: FY2021 Appropriations Summary of FY2021 LHHS Appropriations
Dollars and Percentages in this Report
Amounts displayed in this report are Amounts displayed in this report are ~~typical y~~typically rounded to the nearest mil ion rounded to the nearest mil ion or bil ionor bil ion (as labeled). Dol ar(as labeled). Dol ar and and
percentage changes discussed in the text are based on unrounded amounts. percentage changes discussed in the text are based on unrounded amounts.
Unless otherwiseUnless otherwise specified,specified, appropriations levelsappropriations levels displayed in this report refer to the total amount of budget displayed in this report refer to the total amount of budget
authority provided in an appropriations bil (i.e.,authority provided in an appropriations bil (i.e., “total in the bil ”), regardless“total in the bil ”), regardless of the year in which the funding of the year in which the funding
becomesbecomes available. available.
Amounts for the FY2020 Enacted, FY2021 Request, and FY2021 Enacted are Amounts for the FY2020 Enacted, FY2021 Request, and FY2021 Enacted are ~~general y~~ generally drawn from or calculated drawn from or calculated
based on data contained in the explanatory statement accompanying the FY2021 LHHS omnibus (based on data contained in the explanatory statement accompanying the FY2021 LHHS omnibus ( P.L. 116-260), P.L. 116-260),
available in the available in the Congressional Record, vol., vol. 166, no. 218, book IV, December166, no. 218, book IV, December 21, 2020, pp. H8619-H8711. (The amount for P.L. 117-31 is from CBO, Discretionary Spending: Senate Amendment 2123, July 29, 2021, https://www.cbo.gov/system/files/2021-07/EmergencySecuritySupplementalAppropriationsAct2021.pdf.) ~~21, 2020, pp. H8619-H8711.~~
Amounts for the FY2021 House Committee-reportedAmounts for the FY2021 House Committee-reported bil are bil are ~~general y~~generally drawn from or calculated based on data drawn from or calculated based on data
contained in the committeecontained in the committee report (H.Rept. 116-450) accompanying H.R. 7614. Throughout this report, the report (H.Rept. 116-450) accompanying H.R. 7614. Throughout this report, the
FY2021 House Appropriations Committee-reportedFY2021 House Appropriations Committee-reported LHHS bil is commonlyLHHS bil is commonly ~~referred~~ referred to as the House “committee to as the House “committee
bil .” (This report does not contain estimatesbil .” (This report does not contain estimates of the House-passed versionof the House-passed version of H.R. 7617, as there is no publicly of H.R. 7617, as there is no publicly
available source that estimatesavailable source that estimates the account-level budgetary effects of the adopted amendments.the account-level budgetary effects of the adopted amendments. However, However,
information on the LHHS amendments offered during floor consideration can be found ininformation on the LHHS amendments offered during floor consideration can be found in Appendix B.)
Enacted totals (“Total BA in the Bil ”) for FY2020 do not include emergency-designated appropriations provided in Enacted totals (“Total BA in the Bil ”) for FY2020 do not include emergency-designated appropriations provided in
P.L. 116-113, P.L. 116-123, P.L. 116-127, P.L. 116-136, or P.L. 116-139. House committeeP.L. 116-113, P.L. 116-123, P.L. 116-127, P.L. 116-136, or P.L. 116-139. House committee ~~bil~~ bil totals (“Total BA in totals (“Total BA in
the Bil ”) for FY2021 do not include emergency-designated appropriations proposed in Title VI of H.R. 7614. the Bil ”) for FY2021 do not include emergency-designated appropriations proposed in Title VI of H.R. 7614.
Enacted totals (“Total BA in the Bil ”) for FY2021 do not include emergency-designated appropriations provided in Enacted totals (“Total BA in the Bil ”) for FY2021 do not include emergency-designated appropriations provided in
DivisionDivision H or M of P.L.H or M of P.L. ~~116-260~~ 116-260, or P.L. 117-31. For informational purposes, FY2020 enacted, and FY2021 proposed and enacted, . For informational purposes, FY2020 enacted, and FY2021 proposed and enacted,
emergency-designated amounts are displayed separately at the bottom of tables throughout the report and not emergency-designated amounts are displayed separately at the bottom of tables throughout the report and not
summed.summed. One exceptionOne exception ~~to this rule~~ is made in is made in Table A-1, ~~which~~which includes FY2020 and FY2021 enacted includes FY2020 and FY2021 enacted
emergency-designated funds in the “Adjusted Appropriations” totals, as scoredemergency-designated funds in the “Adjusted Appropriations” totals, as scored ~~by the Congressional~~ by the Congressional Budget Budget
Office. In addition, further details on the FY2021 supplemental appropriations can be found inOffice. In addition, further details on the FY2021 supplemental appropriations can be found in Appendix C.
For consistency with source materials,For consistency with source materials, the FY2020 and FY2021 numbers in this report the FY2020 and FY2021 numbers in this report ~~general y~~ generally do not reflect do not reflect
actual or anticipated post-enactment budgetary adjustments, except as noted.actual or anticipated post-enactment budgetary adjustments, except as noted.2627 CRS calculations do, however, CRS calculations do, however,
include LHHSinclude LHHS funding provided to HHS pursuant to the 21st Century Cures Act (P.L. 114-255). funding provided to HHS pursuant to the 21st Century Cures Act (P.L. 114-255).
Table 2 displays FY2021 discretionary and mandatory LHHS budget authority provided or displays FY2021 discretionary and mandatory LHHS budget authority provided or
proposed, by proposed, by ~~bil~~ bill title, along with FY2020 enacted levels. The amounts shown in this table reflect title, along with FY2020 enacted levels. The amounts shown in this table reflect

~~26 T he general practice for CRS reports on the LHHS bill has been to reflect conventions used in source materials.~~
~~T hese conventions have varied over the years. For instance, CRS reports on LHHS app ropriations~~total budget authority provided in the annual LHHS bill (i.e., all funds appropriated in the bill, regardless of the fiscal year in which the funds become available), not total budget authority available for the current fiscal year. (For a comparable table showing current-year budget authority, see Table A-2. Note that the totals in this table do not include emergency-designated appropriations; those amounts are displayed separately at the bottom of the table and are in 27 The general practice for CRS reports on the LHHS bill has been to reflect conventions used in source materials. These conventions have varied over the years. For instance, CRS reports on LHHS appropriations for FY2012-FY2015 for FY2012-FY2015
generally relied on source materials that adjusted appropriations amounts in the priorgenerally relied on source materials that adjusted appropriations amounts in the prior -year column to reflect -year column to reflect
sequestration, reestimates of mandatory spending, transfers, reprogramming, and other adjustments for comparability.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 However, the FY2016 version of this report broke from that practice due to differing display conventions in source
documents, and diddocuments, and did not reflect any such adjustments (except sequestration for the Prevention and Public Health Fund not reflect any such adjustments (except sequestration for the Prevention and Public Health Fund
(PPHF)). (PPHF)). ~~T he~~The FY2017 version of this report differed from both of these prior practices, in that it reflected a smaller FY2017 version of this report differed from both of these prior practices, in that it reflected a smaller
subsetsubset of transfers (generally concentrated at the National Institutes of Health) and other adjustments for comparability of transfers (generally concentrated at the National Institutes of Health) and other adjustments for comparability
(e.g., program moves from one account (e.g., program moves from one account ~~t o~~to another), but not reprogramming of funds or mandatory sequestration (except sequestration of the PPHF). The FY2018, FY2019, and FY2020 versions of this report, however, relied on source materials that generally did not reflect any transfers or other budgetary adjustments pursuant to administrative authorities except PPHF sequestration. The source materials used for the FY2021 report version, and thus the numbers in this report, continue this most recent approach. Congressional Research Service 12 link to page 19 link to page 75 link to page 20 link to page 20 link to page 20 link to page 20 link to page 20 Labor, Health and Human Services, and Education: FY2021 Appropriations ~~another), but not reprogramming of funds or mandatory sequestration~~
~~Congressional Research Service~~

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~~link to page 63 link to page 18 link to page 74 link to page 19~~ ~~Labor, Health and Human Services, and Education: FY2021 Appropriations~~

~~total budget authority provided in the annual LHHS bil (i.e., al funds appropriated in the bil ,~~
~~regardless of the fiscal year in which the funds become available), not total budget authority~~
~~available for the current fiscal year. (For a comparable table showing current-year budget~~
~~authority, see Table A-2. Note that the totals in this table do not include emergency-designated~~
~~appropriations; those amounts are displayed separately at the bottom of the table and are in~~
addition to regular appropriations. For a discussion of the FY2021 supplemental appropriations addition to regular appropriations. For a discussion of the FY2021 supplemental appropriations
displayed below the displayed below the ~~bil~~ bill totals itotals in Table 2, se see Appendix C.)
Table 2. LHHS Appropriations Overview by Bill Title, FY2020-FY2021
(Total budget authority provided in the (Total budget authority provided in the ~~bil , in bil ions of dol ars~~bill, in billions of dollars) )
FY2021
FY2021
House
Enacted
FY2020
FY2021
Cmte.
(P.L. 116-
Bill Title
Enacted
Request
(H.R. 7614)
260)
Title I: Labor
13.8
12.5
14.0
13.9
Discretionary Discretionary
12.4 12.4
11.1 11.1
12.7 12.7
12.5 12.5
Mandatory Mandatory
1.4 1.4
1.4 1.4
1.4 1.4
1.4 1.4
Title II: HHS
934.8
1,005.0
1,016.0
1016.6
Discretionary Discretionary
94.9 94.9
87.0 87.0
96.4 96.4
97.0 97.0
Mandatory Mandatory
839.9 839.9
917.9 917.9
919.6 919.6
919.6 919.6
Title III: Education
76.4
70.2
77.1
77.2
Discretionary Discretionary
72.8 72.8
66.6 66.6
73.5 73.5
73.5 73.5
Mandatory Mandatory
3.6 3.6
3.7 3.7
3.7 3.7
3.7 3.7
Title IV: Related Agencies
72.7
69.4
70.9
70.8
Discretionary Discretionary
15.4 15.4
14.1 14.1
15.6 15.6
15.5 15.5
Mandatory Mandatory
57.3 57.3
55.3 55.3
55.3 55.3
55.3 55.3
Total BA in the Bill
1,097.7
1,157.1
1,178.0
1,178.5
Discretionary
195.4
178.8
198.1
198.5
Mandatory
902.3
978.3
980.0
980.0
Emergency Funding (not included in above totals)

USMCA (P.L. 116-113) USMCA (P.L. 116-113)
0.2 0.2
- -
- -
- -
1st COVID (P.L. 116-123) 1st COVID (P.L. 116-123)
6.4 6.4
- -
- -
- -
2nd COVID (P.L. 116-127) 2nd COVID (P.L. 116-127)
1.3 1.3
- -
- -
- -
3rd COVID (P.L. 116-136) 3rd COVID (P.L. 116-136)
172.1 172.1
- -
- -
- -
4th COVID (P.L. 116-139) 4th COVID (P.L. 116-139)
100.0 100.0
- -
- -
- -
Emergency Funding in Annual LHH Emergency Funding in Annual LHHSa
- -
- -
19.4 19.4
1.6 1.6
5th COVID (Division 5th COVID (Division M, P.L.M, P.L. 116-260) - - - 154.9 Afghan special immigrants (P.L. 117-31) - - - 0.0b Memoranda (non-emergency funds ~~116-260)~~
-
-
-
~~154.9~~

~~(except sequestration of the PPHF). T he FY2018, FY2019, and FY2020 versions of this report, however, relied on~~
~~source materials that generally did not reflect any transfers or other budgetary adjustments pursuant to administrative~~
~~authorities except PPHF sequestration. T he source materials used for the FY2021 report version, and thus the numbers~~
~~in this report, continue this most recent approach.~~
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~~link to page 19 link to page 19 link to page 19 link to page 20~~ ~~Labor, Health and Human Services, and Education: FY2021 Appropriations~~

~~FY2021~~
~~FY2021~~
~~House~~
~~Enacted~~
~~FY2020~~
~~FY2021~~
~~Cmte.~~
~~(P.L. 116-~~
~~Bill Title~~
~~Enacted~~
~~Request~~
~~(H.R. 7614)~~
~~260)~~
~~Memoranda (non-emergency funds~~ only):

Advances for Future Years Advances for Future Years
189.1 189.1
197.1 197.1
197.6 197.6
197.6 197.6
(provided in current bil (provided in current bil )bc
Advances from Advances from Prior Years Prior Years
186.7 186.7
188.6 188.6
189.0 189.0
189.0 189.0
(for use in current year (for use in current year)bc
Additional Scorekeeping Additional Scorekeeping ~~Adjustment~~sc Adjustmentsd
-10.5 -10.5
-9.9 -9.9
-13.2 -13.2
-22.5 -22.5
Source: Amounts in this table for the FY2020 Enacted, FY2021 Request, and FY2021 Enacted columns are Amounts in this table for the FY2020 Enacted, FY2021 Request, and FY2021 Enacted columns are
~~general y~~generally drawn from drawn from or calculated based on data contained in the explanatory statement accompanying the or calculated based on data contained in the explanatory statement accompanying the
Congressional Research Service 13 link to page 21 Labor, Health and Human Services, and Education: FY2021 Appropriations FY2021 LHHS omnibus (P.L. 116-260), available in the FY2021 LHHS omnibus (P.L. 116-260), available in the Congressional Record, vol., vol. 166, no. 218, book IV, December 166, no. 218, book IV, December
21, 2020, pp. H8619-H8711. 21, 2020, pp. H8619-H8711. (The amount for P.L. 117-31 is from CBO, Discretionary Spending: Senate Amendment 2123, July 29, 2021, https://www.cbo.gov/system/files/2021-07/EmergencySecuritySupplementalAppropriationsAct2021.pdf.) Amounts in the FY2021 House CommitteeAmounts in the FY2021 House Committee column column are generally~~are general y~~ drawn from or drawn from or
calculated based on data contained in the committeecalculated based on data contained in the committee report (H.Rept. 116-450) accompanying H.R. 7614. Enacted report (H.Rept. 116-450) accompanying H.R. 7614. Enacted
totals (“Total BA in the Bil ”) for FY2020 do not include emergency-designated appropriations provided in P.L. totals (“Total BA in the Bil ”) for FY2020 do not include emergency-designated appropriations provided in P.L.
116-113, P.L. 116-123, P.L. 116-127, P.L. 116-136, or P.L. 116-139. House 116-113, P.L. 116-123, P.L. 116-127, P.L. 116-136, or P.L. 116-139. House ~~committee~~ committee bil totals (“Total BA in the bil totals (“Total BA in the
Bil ”) for FY2021 do not include emergency-designated appropriations proposed in Title VI of H.R. 7614. Enacted Bil ”) for FY2021 do not include emergency-designated appropriations proposed in Title VI of H.R. 7614. Enacted
totals (“Total BA in the Bil ”) for FY2021 do not include emergency-designated appropriations provided in totals (“Total BA in the Bil ”) for FY2021 do not include emergency-designated appropriations provided in
~~Division~~ Division H or M of P.L.H or M of P.L. ~~116-260~~ 116-260, or P.L. 117-31. For consistency with source materials,. For consistency with source materials, amounts in this figure amounts in this figure ~~general y~~ generally do not do not
reflect mandatory spending sequestration, wherereflect mandatory spending sequestration, where applicable, nor do they reflect any transfers or reprogramming applicable, nor do they reflect any transfers or reprogramming
of funds pursuant to executive authorities. CRS calculations do, however, include LHHS funding provided to 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. HHS pursuant to the 21st Century Cures Act (P.L. 114-255), as amended.
Notes: BA = Budget Authority. DetailsBA = Budget Authority. Details may not add to totals due to rounding. Amounts in this table (1) reflect may not add to totals due to rounding. Amounts in this table (1) reflect
al all BA appropriated in the bil ,BA appropriated in the bil , ~~regardless~~ regardless of the year in which funds become available (i.e.,of the year in which funds become available (i.e., totals do not include totals do not include
advances from prior-year appropriations,advances from prior-year appropriations, but do include advances for subsequent years provided in this bil ); (2) but do include advances for subsequent years provided in this bil ); (2)
have have ~~general y~~generally not been adjusted to reflect not been adjusted to reflect scorekeeping; (3) comprisescorekeeping; (3) comprise only those funds provided (or requested) only those funds provided (or requested)
for agencies and accounts subject to the jurisdictionfor agencies and accounts subject to the jurisdiction of the LHHS subcommitteesof the LHHS subcommittees of the House and Senate of the House and Senate
appropriations committees;appropriations committees; and (4) do not include appropriations that occur outside of appropriations bil s.and (4) do not include appropriations that occur outside of appropriations bil s. No No
amounts are shown for Title V, because this title consists solelyamounts are shown for Title V, because this title consists solely of generalof general provisions.provisions.
a. The FY2021 House committeea. The FY2021 House committee bil included a total of $19.4 bil ion in emergency-designatedbil included a total of $19.4 bil ion in emergency-designated budget budget
authority in Title VI, of which $925 mil ion authority in Title VI, of which $925 mil ion was for DOL and $18.5 bil ion was for HHS. Subsequently, was for DOL and $18.5 bil ion was for HHS. Subsequently,
DivisionDivision H of P.L. 116-260 enacted $1.6 bil ion in emergency-designated budget authority, of which $925 H of P.L. 116-260 enacted $1.6 bil ion in emergency-designated budget authority, of which $925
mil ionmil ion was for DOLwas for DOL in Title I, and $638 mil ionin Title I, and $638 mil ion was for HHS in Title II. b. P.L. 117-31 provided $25 mil ion in supplemental appropriations for the Refugee and Entrant Assistance account at HHS for specified purposes related to Afghan special immigrants, which rounds to $0.0 in bil ions (the unit of measure used in this table). c~~was for HHS in Title II.~~
b. Totals in this table are based on budget authority provided in the bil. Totals in this table are based on budget authority provided in the bil (i.e.,(i.e., they exclude advance they exclude advance
appropriations from prior bil s appropriations from prior bil s and include advance appropriations from this bil made available in future and include advance appropriations from this bil made available in future
years). The calculation for total budget authority available in the current year is as fol ows:years). The calculation for total budget authority available in the current year is as fol ows: Total BA in the Total BA in the
Bil ,Bil , minus Advances for Future Years,minus Advances for Future Years, plus Advances fromplus Advances from Prior Years.Prior Years.
c d. Totals in this table have . Totals in this table have ~~general y~~generally not been adjusted for further scorekeeping. not been adjusted for further scorekeeping. (To adjust for scorekeeping, (To adjust for scorekeeping,
add this line to the total budget authority.) add this line to the total budget authority.)
Figure 2 displays the FY2021 enacted discretionary and mandatory LHHS funding levels, by displays the FY2021 enacted discretionary and mandatory LHHS funding levels, by ~~bil~~
bill title. (While the dollars and percentages discussed in this section were calculated based on the title. (While the dollars and percentages discussed in this section were calculated based on the
FY2021 enacted amounts, they are FY2021 enacted amounts, they are ~~general y also il ustrative~~generally also illustrative—within several percentage points——within several percentage points—
of the share of funds directed to each of the share of funds directed to each ~~bil~~ bill title in FY2020 and under the other FY2021 proposals.) title in FY2020 and under the other FY2021 proposals.)
As this figure demonstrates, HHS accounts for the largest share of total FY2021 LHHS As this figure demonstrates, HHS accounts for the largest share of total FY2021 LHHS
appropriations: $1,017 appropriations: $1,017 ~~bil ion~~billion, or 86.3%. This is due to the large amount of mandatory funding , or 86.3%. This is due to the large amount of mandatory funding
included in the HHS appropriation, the majority of which is for Medicaid grants to states and 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 next-payments to health care trust funds. After HHS, ED and the Related Agencies represent the next-
largest shares of total LHHS funding, accounting for 6.6% and 6.0%, respectively. (The majority largest shares of total LHHS funding, accounting for 6.6% and 6.0%, respectively. (The majority
of the ED appropriations each year are discretionary, while the bulk of funding for the Related 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 Agencies goes toward mandatory payments and administrative costs of the Supplemental Security
~~Congressional Research Service~~

13

~~Labor, Health and Human Services, and Education: FY2021 Appropriations~~

Income program at the Social Security Administration.) DOL accounts for the Income program at the Social Security Administration.) DOL accounts for the ~~smal est~~smallest share of share of
total LHHS funds, 1.2%. total LHHS funds, 1.2%.
The The ~~overal~~ overall composition of LHHS funding is noticeably different when comparing only composition of LHHS funding is noticeably different when comparing only
discretionary appropriations. HHS accounts for a comparatively discretionary appropriations. HHS accounts for a comparatively ~~smal er~~smaller share of total share of total
discretionary appropriations (48.8%), while ED accounts for a relatively larger share (37.0%). discretionary appropriations (48.8%), while ED accounts for a relatively larger share (37.0%).
Together, these two departments represent the majority (85.9%) of discretionary LHHS Together, these two departments represent the majority (85.9%) of discretionary LHHS
appropriations. DOL and the Related Agencies account for a roughly even split of the remaining appropriations. DOL and the Related Agencies account for a roughly even split of the remaining
14.1% of discretionary LHHS funds. 14.1% of discretionary LHHS funds.
Congressional Research Service 14 Labor, Health and Human Services, and Education: FY2021 Appropriations Figure 2. FY2021 Enacted LHHS Appropriations by Title
(Budget authority in Budget authority in ~~bil ions of dol ars (~~billions of dollars [unless otherwise indicatedunless otherwise indicated]) )

Source: Amounts in this figure are Amounts in this figure are ~~general y~~generally drawn from or calculated based on data contained in the drawn from or calculated based on data contained in the
explanatory statement accompanying the FY2021 LHHS omnibus (P.L. 116-260), available in the explanatory statement accompanying the FY2021 LHHS omnibus (P.L. 116-260), available in the Congressional
Record,, vol. 166, no. 218, book IV, Decembervol. 166, no. 218, book IV, December 21, 2020, pp. H8619-H8711. Enacted totals (“Total BA in the Bil ”) 21, 2020, pp. H8619-H8711. Enacted totals (“Total BA in the Bil ”)
for FY2021 do not include emergency-designatedfor FY2021 do not include emergency-designated appropriations provided in Divisionappropriations provided in Division H or M of P.L.H or M of P.L. 116-260, or P.L. 117-31. ~~116-260.~~
For consistency with source materials,For consistency with source materials, amounts in this figure amounts in this figure ~~general y~~generally do not reflect mandatory spending do not reflect mandatory spending
sequestration, where applicable, nor do they reflectsequestration, where applicable, nor do they reflect any transfers or reprogrammingany transfers or reprogramming of funds pursuant to of funds pursuant to
executive authorities. CRS calculations do, however,executive authorities. CRS calculations do, however, include LHHS funding provided to HHS pursuant to the include LHHS funding provided to HHS pursuant to the ~~21 st~~
21st Century Cures Act (P.L. 114-255), as amended. Century Cures Act (P.L. 114-255), as amended.
Notes: Details Details may not add to totals due to rounding. Amounts in this figure (1) reflect may not add to totals due to rounding. Amounts in this figure (1) reflect al all BA appropriated in BA appropriated in
the bil ,the bil , ~~regardless~~ regardless of the year in which funds become available (i.e.,of the year in which funds become available (i.e., totals do not include advances fromtotals do not include advances from prior-prior-
year appropriations, but do include advances for subsequent years provided in this bil ); (2) have year appropriations, but do include advances for subsequent years provided in this bil ); (2) have ~~general y~~ generally not not
been adjusted to reflect scorekeeping;been adjusted to reflect scorekeeping; (3) comprise(3) comprise only those funds provided for agencies and accounts subject only those funds provided for agencies and accounts subject
to the jurisdictionto the jurisdiction of the LHHS subcommitteesof the LHHS subcommittees of the House and Senate appropriations committees;of the House and Senate appropriations committees; and (4) do and (4) do
not include appropriations that occur outside of appropriations bil s. not include appropriations that occur outside of appropriations bil s.
Department of Labor (DOL)
Note that Note that al all amounts in this section are based on regular LHHS appropriations only. Amounts in 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 this section do not include mandatory funds provided outside of the annual appropriations process
(e.g., direct appropriations for Unemployment Insurance benefits payments). (e.g., direct appropriations for Unemployment Insurance benefits payments). Al All amounts in this amounts in this
section are rounded to the nearest section are rounded to the nearest ~~mil ion or bil ion~~ million or billion (as labeled). The dollar changes and (as labeled). The dollar changes and
percentage changes discussed in the text are based on unrounded amounts. For consistency with 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 source materials, amounts do not reflect sequestration or reestimates of mandatory spending
programs, where applicable. programs, where applicable.
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link to page link to page 2223 Labor, Health and Human Services, and Education: FY2021 ~~Appropriations~~
Appropriations
About DOL
DOL is a federal department comprised of multiple entities that provide services related to 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 employment and training, worker protection, income security, and contract enforcement. Annual
LHHS appropriations laws direct funding to LHHS appropriations laws direct funding to al all DOL entities (see the text box).DOL entities (see the text box).2829 The DOL The DOL
entities entities ~~fal~~ fall primarily into two main functional areas—workforce development and worker primarily into two main functional areas—workforce development and worker
protection. First, there are several DOL protection. First, there are several DOL
entities that administer workforce employment entities that administer workforce employment
DOL Entities Funded via the
and training programs—such as the Workforce and training programs—such as the Workforce
LHHS Appropriations Process
Innovation and Opportunity Act (WIOA) state Innovation and Opportunity Act (WIOA) state
Employment and Training Administration Employment and Training Administration (ETA) (ETA)
formula grant programs, Job Corps, and the formula grant programs, Job Corps, and the
Employee Benefits Employee Benefits Security AdministrationSecurity Administration (EBSA) (EBSA)
Employment Service—that provide direct Employment Service—that provide direct
Wage and Hour Division Wage and Hour Division (WHD) (WHD)
funding for employment activities or funding for employment activities or
Office of Federal Office of Federal Contract Compliance Programs Contract Compliance Programs
administration of income security programs administration of income security programs
(OFCCP) (OFCCP)
(e.g., for the Unemployment Insurance (e.g., for the Unemployment Insurance
Office of Labor-Management Standards (OLMS) Office of Labor-Management Standards (OLMS)
benefits program). Also included in this area is benefits program). Also included in this area is
Office of Workers’ Office of Workers’ Compensation ProgramsCompensation Programs (OWCP) (OWCP)
the Veterans’ Employment and Training the Veterans’ Employment and Training
Occupational Safety and Health Administration Occupational Safety and Health Administration (OSHA) (OSHA)
Service (VETS), which provides employment Service (VETS), which provides employment
Mine Safety and Health Administration Mine Safety and Health Administration (MSHA) (MSHA)
services services ~~specifical y~~specifically for the veteran for the veteran
population. Second, there are several agencies population. Second, there are several agencies
Bureau of Labor Statistics (BLS) Bureau of Labor Statistics (BLS)
that provide various worker protection that provide various worker protection
Office of Disability Office of Disability Employment Policy (ODEP) Employment Policy (ODEP)
services. For example, the Occupational services. For example, the Occupational
Departmental Management (DM) Departmental Management (DM)2728
Safety and Health Administration (OSHA), Safety and Health Administration (OSHA),
the Mine Safety and Health Administration (MSHA), and the Wage and Hour Division (WHD) 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 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 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 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 areas, DOL’s Bureau of Labor Statistics (BLS) collects data and provides analysis on the labor
market and related labor issues. market and related labor issues.
FY2021 DOL Appropriations Overview
Table 3 ~~general y~~generally displays FY2021 discretionary and mandatory DOL budget authority provided displays FY2021 discretionary and mandatory DOL budget authority provided
or proposed, along with FY2020 enacted levels. The totals in this table do not include emergency or proposed, along with FY2020 enacted levels. The totals in this table do not include emergency
supplemental appropriations; amounts provided in supplemental appropriations are displayed supplemental appropriations; amounts provided in supplemental appropriations are displayed
separately at the bottom of the table and are in addition to regular appropriations. (Although not separately at the bottom of the table and are in addition to regular appropriations. (Although not
~~technical y~~technically supplemental appropriations, the bottom of the table also includes emergency- supplemental appropriations, the bottom of the table also includes emergency-
designated discretionary funding proposed or enacted in annual LHHS measures.) designated discretionary funding proposed or enacted in annual LHHS measures.)
The FY2021 LHHS The FY2021 LHHS omnibus increased discretionary appropriations for DOL by $122 omnibus increased discretionary appropriations for DOL by $122 ~~mil ion~~million
(+1.0%) compared to the FY2020 enacted levels. Discretionary DOL appropriations would have (+1.0%) compared to the FY2020 enacted levels. Discretionary DOL appropriations would have
increased by $254 increased by $254 ~~mil ion~~ million (+2.0%) under the FY2021 House committee (+2.0%) under the FY2021 House committee ~~bil~~ bill, compared to , compared to
FY2020 enacted, but would have decreased under the FY2021 President’s budget request by $1.3 FY2020 enacted, but would have decreased under the FY2021 President’s budget request by $1.3
~~bil ion~~ billion (-10.5%). Of the total funding provided in the (-10.5%). Of the total funding provided in the ~~bil~~ bill for DOL, roughly 90% is discretionary. for DOL, roughly 90% is discretionary.

27 28 Departmental Management includes the DOL salaries Departmental Management includes the DOL salaries and expenses, Veterans Employment and and expenses, Veterans Employment and ~~T raining~~Training Service Service
((~~VET S~~VETS), IT), IT Modernization, and the Office of the Inspector General.Modernization, and the Office of the Inspector General.
~~28 T he~~ 29 The Pension Benefit Guaranty Corporation (PBGC) is funded Pension Benefit Guaranty Corporation (PBGC) is funded primarily through insurance premiums and related fees primarily through insurance premiums and related fees
from companies covered by the PBGC.from companies covered by the PBGC. For further information, see CRSFor further information, see CRS In Focus IF10492, In Focus IF10492, An Overview of the
Pension Benefit Guaranty Corporation (PBGC). .
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Appropriations
Table 3. DOL Appropriations Overview
(In (In ~~bil ions of dol ars~~billions of dollars) )
FY2021
House
FY2021
Cmte.
Enacted
FY2020
FY2021
(H.R.
(P.L. 116-
Funding
Enacted
Request
7614)
260)
Discretionary Discretionary
12.4 12.4
11.1 11.1
12.7 12.7
12.5 12.5
Mandatory Mandatory
1.4 1.4
1.4 1.4
1.4 1.4
1.4 1.4
Total BA in the Bill
13.8
12.5
14.0
13.9 13.9
Emergency Funding (not included in above
~~totals)~~

totals) USMCA (P.L. 116-113) USMCA (P.L. 116-113)
0.2 0.2
— —
— —
— —
3rd COVID (P.L. 116-136) 3rd COVID (P.L. 116-136)
0.4 0.4
— —
— —
— —
Emergency Funding in Annual Emergency Funding in Annual
~~LHHSa~~
— —
— —
0.9 0.9
0.9 0.9
LHHSa Source: Amounts in this table for the FY2020 Enacted, FY2021 Request, and FY2021 Enacted columns are Amounts in this table for the FY2020 Enacted, FY2021 Request, and FY2021 Enacted columns are
~~general y~~generally drawn from drawn from or calculated based on data contained in the explanatory statement accompanying the or calculated based on data contained in the explanatory statement accompanying the
FY2021 LHHS omnibus (P.L. 116-260), available in the FY2021 LHHS omnibus (P.L. 116-260), available in the Congressional Record, vol., vol. 166, no. 218, book IV, December 166, no. 218, book IV, December
21, 2020, pp. H8619-H8711. Amounts in the FY2021 House Committee21, 2020, pp. H8619-H8711. Amounts in the FY2021 House Committee column are column are ~~general y~~generally drawn from or drawn from or
calculated based on data contained in the committeecalculated based on data contained in the committee report (H.Rept. 116-450) accompanying H.R. 7614. Enacted report (H.Rept. 116-450) accompanying H.R. 7614. Enacted
totals (“Total BA in the Bil ”) for FY2020 do not include emergency-designated appropriations provided intotals (“Total BA in the Bil ”) for FY2020 do not include emergency-designated appropriations provided in P.L. P.L.
116-113, P.L. 116-123, P.L. 116-127, P.L. 116-136, or P.L. 116-139. House committee116-113, P.L. 116-123, P.L. 116-127, P.L. 116-136, or P.L. 116-139. House committee bil totals (“Total BA in the bil totals (“Total BA in the
Bil ”) for FY2021 do not include emergency-designated appropriations proposed in Title VI of H.R. 7614. Enacted Bil ”) for FY2021 do not include emergency-designated appropriations proposed in Title VI of H.R. 7614. Enacted
totals (“Total BA in the Bil ”) for FY2021 do not include emergency-designated appropriations provided in totals (“Total BA in the Bil ”) for FY2021 do not include emergency-designated appropriations provided in
DivisionDivision H or M of P.L.H or M of P.L. ~~116-260~~ 116-260, or P.L. 117-31. For consistency with source materials,. For consistency with source materials, amounts in this figure amounts in this figure ~~general y~~ generally do not do not
reflect mandatory spending sequestration, wherereflect mandatory spending sequestration, where applicable, nor do they reflect any transfers or reprogramming applicable, nor do they reflect any transfers or reprogramming
of funds pursuant to executive authorities.of funds pursuant to executive authorities.
Notes: BA = Budget Authority. DetailsBA = Budget Authority. Details may not add to totals due to rounding. Amounts in this table (1) reflect may not add to totals due to rounding. Amounts in this table (1) reflect
al all BA appropriated in the bil ,BA appropriated in the bil , ~~regardless~~ regardless of the year in which funds become available (i.e.,of the year in which funds become available (i.e., totals do not include totals do not include
advances from prior-year appropriations,advances from prior-year appropriations, but do include advances for subsequent years provided in this bil ); (2) but do include advances for subsequent years provided in this bil ); (2)
have have ~~general y~~generally not been adjusted to reflect not been adjusted to reflect scorekeeping; (3) comprisescorekeeping; (3) comprise only those funds provided (or requested) only those funds provided (or requested)
for agencies and accounts subject to the jurisdictionfor agencies and accounts subject to the jurisdiction of the LHHS subcommitteesof the LHHS subcommittees of the House and Senate of the House and Senate
appropriations committees;appropriations committees; and (4) do not include appropriationsand (4) do not include appropriations that occur outside of appropriations bil s. that occur outside of appropriations bil s.
a. The FY2021 House committeea. The FY2021 House committee bil included a total of $19.4 bil ion in emergency-designatedbil included a total of $19.4 bil ion in emergency-designated budget budget
authority in Title VI, of which $925 mil ion authority in Title VI, of which $925 mil ion was for DOL. Subsequently, Divisionwas for DOL. Subsequently, Division H of P.L. 116-260 enacted H of P.L. 116-260 enacted
$1.6 bil ion in emergency-designated budget authority, of which $925 mil ion$1.6 bil ion in emergency-designated budget authority, of which $925 mil ion was for DOL.was for DOL.
Selected DOL Highlights
The following sections present highlights from FY2021 enacted and proposed appropriations The following sections present highlights from FY2021 enacted and proposed appropriations
compared to FY2020 enacted appropriations for selected DOL accounts and programs.compared to FY2020 enacted appropriations for selected DOL accounts and programs.2930
Table 4 displays funding for DOL programs and activities discussed in this section. 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 ETA administers the primary federal workforce development statute, the Workforce Innovation
and Opportunity Act (WIOA, P.L. 113-128). The WIOA, which replaced the Workforce and Opportunity Act (WIOA, P.L. 113-128). The WIOA, which replaced the Workforce

~~29 DOL budget~~ 30 DOL budget materials can be found at https://www.dol.gov/general/aboutdol#budget. materials can be found at https://www.dol.gov/general/aboutdol#budget.
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Labor, Health and Human Services, and Education: FY2021 ~~Appropriations~~
Appropriations
Investment Act, was enacted in July 2014 and authorized appropriations for its programs and Investment Act, was enacted in July 2014 and authorized appropriations for its programs and
activities from FY2015 through FY2020. Authorization of appropriations for WIOA programs activities from FY2015 through FY2020. Authorization of appropriations for WIOA programs
and activities expired at the end of FY2020 but was extended through FY2021 by the FY2021 and activities expired at the end of FY2020 but was extended through FY2021 by the FY2021
LHHS omnibus (P.L. 116-260, Division H, Title I). LHHS omnibus (P.L. 116-260, Division H, Title I).
Title I of WIOA, which authorizes more than half of Title I of WIOA, which authorizes more than half of al all funding for the programs authorized by funding for the programs authorized by
the four titles of WIOA, includes three state formula grant programs serving Adults, Youth, and the four titles of WIOA, includes three state formula grant programs serving Adults, Youth, and
Dislocated Workers. While the FY2021 LHHS omnibus provided a $26 Dislocated Workers. While the FY2021 LHHS omnibus provided a $26 ~~mil ion~~ million increase (+0.9%) increase (+0.9%)
for the three WIOA state formula grant programs compared to FY2020, the FY2021 President’s for the three WIOA state formula grant programs compared to FY2020, the FY2021 President’s
budget would have provided levelbudget would have provided level funding and the House committee funding and the House committee ~~bil~~ bill would have increased would have increased
funding by $50 funding by $50 ~~mil ion~~ million (+1.8%), compared to FY2020 enacted levels. (+1.8%), compared to FY2020 enacted levels.
The FY2021 LHHS The FY2021 LHHS omnibus provided $281 omnibus provided $281 ~~mil ion~~ million for the Dislocated Workers Activities for the Dislocated Workers Activities
National Reserve (DWA National Reserve), which was an increase of $10 National Reserve (DWA National Reserve), which was an increase of $10 ~~mil ion~~million (+3.7%) (+3.7%)
compared to the FY2020 enacted level. This was the same amount that was proposed by the compared to the FY2020 enacted level. This was the same amount that was proposed by the
House committee House committee ~~bil~~ bill, whereas the FY2021 President’s budget would have reduced funding for , whereas the FY2021 President’s budget would have reduced funding for
the DWA National Reserve by $110 the DWA National Reserve by $110 ~~mil ion~~ million (-40.6%). In addition, the FY2021 LHHS omnibus (-40.6%). In addition, the FY2021 LHHS omnibus
maintained a provision in that account (which originated in the FY2018 omnibus and has been maintained a provision in that account (which originated in the FY2018 omnibus and has been
included since then) directing $35 included since then) directing $35 ~~mil ion~~ million from the DWA National Reserve toward training and from the DWA National Reserve toward training and
employment assistance for workers dislocated in both the Appalachian and lower Mississippi employment assistance for workers dislocated in both the Appalachian and lower Mississippi
regions. regions. ~~Final y~~Finally, the FY2021 LHHS omnibus maintained a provision that originated in the , the FY2021 LHHS omnibus maintained a provision that originated in the
FY2020 omnibus directing $45 FY2020 omnibus directing $45 ~~mil ion~~ million from the DWA National Reserve to be used in developing, from the DWA National Reserve to be used in developing,
offering, or improving career training programs at community colleges. offering, or improving career training programs at community colleges.
The FY2021 LHHS The FY2021 LHHS omnibus provided $185 omnibus provided $185 ~~mil ion~~ million for the Apprenticeship Grant program, which for the Apprenticeship Grant program, which
was $10 was $10 ~~mil ion~~million (+5.7%) more than the level enacted in FY2020 and the same that the House (+5.7%) more than the level enacted in FY2020 and the same that the House
committee committee ~~bil~~ bill would have provided. The FY2021 President’s budget would have increased the would have provided. The FY2021 President’s budget would have increased the
level of funding for the Apprenticeship Grant program by $25 level of funding for the Apprenticeship Grant program by $25 ~~mil ion~~million (+14.3%) compared to the (+14.3%) compared to the
FY2020 enacted level. FY2020 enacted level.
Four ETA programs for which the FY2021 President’s budget proposed no funding—the Native Four ETA programs for which the FY2021 President’s budget proposed no funding—the Native
Americans program, the Migrant and Seasonal Farmworkers program, the Community Service Americans program, the Migrant and Seasonal Farmworkers program, the Community Service
Employment for Older Americans (CSEOA) program, and the Workforce Data Quality Employment for Older Americans (CSEOA) program, and the Workforce Data Quality
Initiative—received FY2021 appropriations at roughly the same level as FY2020. Initiative—received FY2021 appropriations at roughly the same level as FY2020.
Office of Foreign Labor Certification (OFLC)
The FY2021 LHHS The FY2021 LHHS omnibus provided $78 omnibus provided $78 ~~mil ion~~ million for OFLC, which was an increase of $9 for OFLC, which was an increase of $9
~~mil ion~~ million (+13.1%) compared to the FY2020 enacted level and the same amount that was proposed (+13.1%) compared to the FY2020 enacted level and the same amount that was proposed
by the House committee by the House committee ~~bil~~ bill. This FY2021 enacted level was $2 . This FY2021 enacted level was $2 ~~mil ion~~ million less (-2.6%) than the less (-2.6%) than the
amount requested in the FY2021 President’s budget. The OFLC, which is part of ETA, is amount requested in the FY2021 President’s budget. The OFLC, which is part of ETA, is
responsible for labor certification applications for employment-based and immigration and guest responsible for labor certification applications for employment-based and immigration and guest
worker programs. Of the $9 worker programs. Of the $9 ~~mil ion~~million increase, $3 increase, $3 ~~mil ion~~million was for national administration and $6 was for national administration and $6
~~mil ion~~ million was for grants to states. As noted in the FY2021 House committee report, the $6 was for grants to states. As noted in the FY2021 House committee report, the $6 ~~mil ion~~million
increase in OFLC grants to states was proposed partly in response to an increase in the number of increase in OFLC grants to states was proposed partly in response to an increase in the number of
H-2A applications that resulted in requests from states for additional resources for reviewing, H-2A applications that resulted in requests from states for additional resources for reviewing,
processing, recruitment of potential domestic agricultural workers, and contract oversight.processing, recruitment of potential domestic agricultural workers, and contract oversight.30

3031 31 H.Rept. 116-450, pp. 20-21. H.Rept. 116-450, pp. 20-21.
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Appropriations
Bureau of Labor Statistics (BLS)
The FY2021 LHHS The FY2021 LHHS omnibus provided $655 omnibus provided $655 ~~mil ion~~ million for BLS, the same level as FY2020 enacted for BLS, the same level as FY2020 enacted
The House committee The House committee ~~bil~~ bill had previously proposed level funding, whereas the FY2021 had previously proposed level funding, whereas the FY2021
President’s budget had proposed a $3 President’s budget had proposed a $3 ~~mil ion~~million increase (+0.5%) relative to FY2020. As noted in increase (+0.5%) relative to FY2020. As noted in
the explanatory statement accompanying the FY2021 LHHS omnibus, $13 the explanatory statement accompanying the FY2021 LHHS omnibus, $13 ~~mil ion~~ million of the FY2021 of the FY2021
appropriation was for necessary costs associated with the physical relocation of BLS headquarters appropriation was for necessary costs associated with the physical relocation of BLS headquarters
to the Suitland Federal Complex, which was initiated in FY2020.to the Suitland Federal Complex, which was initiated in FY2020.3132 Similarly, the FY2021 House Similarly, the FY2021 House
committee report indicated continued support for BLS to continue implementation of several data committee report indicated continued support for BLS to continue implementation of several data
projects started in FY2020, including work to implement an annual supplement to the Current projects started in FY2020, including work to implement an annual supplement to the Current
Population Survey (CPS) to collect data on contingent workers every two years and other topics Population Survey (CPS) to collect data on contingent workers every two years and other topics
in the alternate years, to restore the production of labor market data in the Local Area in the alternate years, to restore the production of labor market data in the Local Area
Unemployment Statistics (LAUS) program for New England Minor Civil Divisions with Unemployment Statistics (LAUS) program for New England Minor Civil Divisions with
populations less than 1,000, and to plan and develop a new National Longitudinalpopulations less than 1,000, and to plan and develop a new National Longitudinal Survey of Survey of
Youth (NLSY) cohort.Youth (NLSY) cohort.3233
Bureau of International Labor Affairs (ILAB)
The FY2021 LHHS The FY2021 LHHS omnibus provided $96 omnibus provided $96 ~~mil ion~~ million for ILAB, which was the same as the FY2020 for ILAB, which was the same as the FY2020
enacted level and the same amount that the House committee enacted level and the same amount that the House committee ~~bil~~ bill would have provided. The would have provided. The
FY2021 President’s budget would have decreased funding by $77 FY2021 President’s budget would have decreased funding by $77 ~~mil ion~~million (-80.6%) for ILAB, (-80.6%) for ILAB,
which provides research, advocacy, technical assistance, and grants to promote workers’ rights in which provides research, advocacy, technical assistance, and grants to promote workers’ rights in
different parts of the world. Language in the FY2021 President’s budget indicated that the different parts of the world. Language in the FY2021 President’s budget indicated that the
proposed reduction reflected a $67.3 proposed reduction reflected a $67.3 ~~mil ion~~million decrease to eliminate new grants and a $10.3 decrease to eliminate new grants and a $10.3 ~~mil ion~~
million decrease to reduce staff levels, with the remaining $19 decrease to reduce staff levels, with the remaining $19 ~~mil ion~~ million to be used on “efforts to make U.S. to be used on “efforts to make U.S.
trade agreements fair for U.S. workers by monitoring and enforcing the labor provisions of free trade agreements fair for U.S. workers by monitoring and enforcing the labor provisions of free
trade agreements (FTAs) and trade preference programs to ensure a fair global playing field for trade agreements (FTAs) and trade preference programs to ensure a fair global playing field for
U.S. workers and businesses.”U.S. workers and businesses.”3334
Labor-Related General Provisions
Annual LHHS appropriations acts regularly contain general provisions related to certain labor Annual LHHS appropriations acts regularly contain general provisions related to certain labor
issues. This section highlights selected DOL general provisions in the FY2021 LHHS omnibus. issues. This section highlights selected DOL general provisions in the FY2021 LHHS omnibus.
The FY2021 LHHS The FY2021 LHHS omnibus continued several provisions that have been included in at least one omnibus continued several provisions that have been included in at least one
previous LHHS appropriations act, including provisions that previous LHHS appropriations act, including provisions that
 exempt certain insurance claims adjusters from overtime protection for two years  exempt certain insurance claims adjusters from overtime protection for two years
following a “major disaster” (included since FY2016); following a “major disaster” (included since FY2016);3435
 direct the Secretary of Labor to accept private wage surveys as part of the process  direct the Secretary of Labor to accept private wage surveys as part of the process
of determining prevailing wages in the H-2B program, even in instances in which of determining prevailing wages in the H-2B program, even in instances in which
relevant wage data are availablerelevant wage data are available from the Bureau of Labor Statistics (included from the Bureau of Labor Statistics (included
since FY2016);since FY2016);35

3136 32 Congressional Record, December 21, 2020, Vol. 166, No. 218, Book IV, p. H8619. , December 21, 2020, Vol. 166, No. 218, Book IV, p. H8619.
3233 H.Rept. 116-450, pp. 31-32. H.Rept. 116-450, pp. 31-32.
3334 See See DOL, DOL, FY2021 Congressional Budget Justification, Departmental Management, p. DM-41, https://www.dol.gov/, p. DM-41, https://www.dol.gov/
sites/dolgov/files/general/budget/2021/CBJ-2021-V3-02.pdf. sites/dolgov/files/general/budget/2021/CBJ-2021-V3-02.pdf.
3435 See See Division H, Division H, ~~T itle~~Title I, §108 of P.L. 116-260. I, §108 of P.L. 116-260.
3536 See See Division H, Division H, ~~T itle~~Title I, §110 of P.L. 116-260. I, §110 of P.L. 116-260. ~~T he~~The H-2B program allows for the temporary employment of foreign H-2B program allows for the temporary employment of foreign
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Appropriations
 authorize the Secretary of Labor to provide up to $2  authorize the Secretary of Labor to provide up to $2 ~~mil ion~~ million in “excess personal in “excess personal
property” to apprenticeship programs to assist training apprentices (included property” to apprenticeship programs to assist training apprentices (included
since FY2018);since FY2018);3637
 authorize the Secretary of Labor to employ law enforcement officers or special  authorize the Secretary of Labor to employ law enforcement officers or special
agents to provide protection to the Secretary of Labor and certain other 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 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);is a “unique and articulable” threat of physical harm (included since FY2018);3738
 authorize the Secretary of Labor to dispose of or divest “by any means the  authorize the Secretary of Labor to dispose of or divest “by any means the
Secretary determines appropriate” Secretary determines appropriate” al all or part of the real property on which the or part of the real property on which the
Treasure Island Job Corps Center is located (included since FY2018);Treasure Island Job Corps Center is located (included since FY2018);3839 and and
 prohibit any funds from the FY2021 omnibus from being used to alter the  prohibit any funds from the FY2021 omnibus from being used to alter the
Interagency Agreement between DOL and USDA or to close any Civilian Interagency Agreement between DOL and USDA or to close any Civilian
Conservation Centers unless certain conditions are met (included since Conservation Centers unless certain conditions are met (included since
FY2020).FY2020).3940
Table 4. Detailed DOL Appropriations
(In (In ~~mil ions of dol ars~~millions of dollars) )
FY2021
House
FY2021
Cmte.
Enacted
FY2020
FY2021
(H.R.
(P.L. 116-
Agency or Selected Program
Enacted
Request
7614)
260)
ETA—Mandatorya
680
634
634
634
ETA—Discretionary
9,293
8,043
9,527
9,392
Discretionary Discretionary ETA Programs: ETA Programs:

Training and Employment Training and Employment Services: Services:
3,611 3,611
3,358 3,358
3,697 3,697
3,663 3,663
State Formula State Formula Grants: Grants:
2,820 2,820
2,820 2,820
2,870 2,870
2,845 2,845
Adult Activities Adult Activities Grants to States Grants to States
855 855
855 855
865 865
863 863
Youth Activities Youth Activities Grants to States Grants to States
913 913
913 913
925 925
921 921
Dislocated Dislocated ~~Worker Activities~~ Worker Activities (DWA) (DWA)
Grants to States Grants to States
1,052 1,052
1,052 1,052
1,080 1,080
1,062 1,062
National Activities: National Activities:
791 791
538 538
827 827
818 818
DWA DWA National Reserve National Reserve
271 271
161 161
281 281
281 281
Native Americans Native Americans
55 55
0 0
56 56
56 56
Migrant and Seasonal Farmworkers Migrant and Seasonal Farmworkers
92 92
0 0
96 96
94 94
YouthBuild YouthBuild
95 95
85 85
101 101
97 97
Reintegration of Ex-Offenders Reintegration of Ex-Offenders
98 98
93 93
103 103
100 100

workers in nonagricultural sectors and requiresworkers in nonagricultural sectors and requires these workers to be paid the “these workers to be paid the “ prevailing wage”prevailing wage” (i.e., the average wage (i.e., the average wage
paid to similar workers in the local area). Under DOL regulations, private employer surveys may be consideredpaid to similar workers in the local area). Under DOL regulations, private employer surveys may be considered only if only if
the employer meets certain conditions. the employer meets certain conditions.
36 37 See See Division H, Division H, ~~T itle~~Title I, §112 of P.L. 116-260. I, §112 of P.L. 116-260.
3738 See See Division H, Division H, ~~T itle~~Title I, §113 of P.L. 116-260. I, §113 of P.L. 116-260.
3839 See See Division H, Division H, ~~T itle~~Title I, §114 of P.L. 116-260. I, §114 of P.L. 116-260.
3940 See See Division H, Division H, ~~T itle~~Title I, §116 of P.L. 116-260. I, §116 of P.L. 116-260.
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Appropriations
FY2021
House
FY2021
Cmte.
Enacted
FY2020
FY2021
(H.R.
(P.L. 116-
Agency or Selected Program
Enacted
Request
7614)
260)
Workforce Workforce Data Quality Initiative Data Quality Initiative
6 6
0 0
6 6
6 6
Apprenticeship Grants Apprenticeship Grants
175 175
200 200
185 185
185 185
Job Corps Job Corps
1,744 1,744
1,016 1,016
1,756 1,756
1,749 1,749
Community Service Community Service Employment for Older Americans Employment for Older Americans
405 405
0 0
410 410
405 405
State Unemployment Insurance and Employment State Unemployment Insurance and Employment
ServiceService Operations (SUI/ESO):Operations (SUI/ESO):
3,375 3,375
3,497 3,497
3,506 3,506
3,417 3,417
Unemployment Compensation Unemployment Compensation
2,553 2,553
2,665 2,665
2,668 2,668
2,584 2,584
Employment Service Employment Service
690 690
688 688
698 698
692 692
Foreign Labor Certification Foreign Labor Certification
69 69
80 80
78 78
78 78
One-Stop Career Centers One-Stop Career Centers
63 63
65 65
63 63
63 63
ETA Program Administration ETA Program Administration
159 159
172 172
159 159
159 159
Employee Benefits Security Administration
181
193
181
181
Pension Benefit Guaranty Corp, (PBGC) program
~~level (non-add)~~b (453)
(~~453)~~465)
(465)
(465)
~~(465)~~level (non-add)b
Wage and Hour Division
242
244
246
246
Office of Labor-Management ~~Standards~~
Standards 43
50
42
44
Office of Federal Contract Compliance
106
106
106
106
Programs
Office of Workers’ Compensation Programs—
~~Mandatory~~c
~~695~~ 695 739
739
739
~~739~~Mandatoryc
Office of Workers’ Compensation Programs—
118
119
118
118
Discretionary
Occupational Safety & Health Administration
582
577
594
592
Mine Safety & Health Administration
380
382
380
380
Bureau of Labor Statistics
655
658
655
655
Office of Disability Employment Policy
39
27
39
39
Departmental Management
776
714
780
784
Salaries Salaries and Expenses and Expenses
348 348
272 272
349 349
349 349
International Labor Affairs (non-addd)
96
19
96
96
Veterans Employment and Training Veterans Employment and Training
311 311
312 312
314 314
316 316
IT Modernization IT Modernization
25 25
37 37
25 25
27 27
Office of the Inspector General Office of the Inspector General
91 91
93 93
92 92
91 91
Total, DOL BA in the Bill
13,789
12,488
14,041
13,909
Subtotal, Mandatory
1,375
1,373
1,373
1,373
Subtotal, Discretionary
12,414
11,114
12,668
12,536
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Appropriations
FY2021
House
FY2021
Cmte.
Enacted
FY2020
FY2021
(H.R.
(P.L. 116-
Agency or Selected Program
Enacted
Request
7614)
260)
Emergency Funding (not included in above totals)

USMCA (P.L. 116-113) USMCA (P.L. 116-113)
210 210
— —
— —
— —
3rd COVID (P.L. 116-136) 3rd COVID (P.L. 116-136)
360 360
— —
— —
— —
Emergency Funding in Annual LHH Emergency Funding in Annual LHHSe
— —
— —
925 925
925 925
Memoranda (non-emergency funds only)

Total, BA Available in Fiscal Total, BA Available in Fiscal Year (current year from Year (current year from
any bil ) any bil )
13,789 13,789
12,548 12,548
14,041 14,041
13,909 13,909
Total, BA Advances for Future Years Total, BA Advances for Future Years (provided in (provided in
current bil ) current bil )
1,786 1,786
1,726 1,726
1,786 1,786
1,786 1,786
Total, BA Advances from Prior Total, BA Advances from Prior Years (for use in Years (for use in
current year) current year)
1,786 1,786
1,786 1,786
1,786 1,786
1,786 1,786
Source: Amounts in this table for the FY2020 Enacted, FY2021 Request, and FY2021 Enacted columns are Amounts in this table for the FY2020 Enacted, FY2021 Request, and FY2021 Enacted columns are
~~general y~~generally drawn from drawn from or calculated based on data contained in the explanatory statement accompanying the or calculated based on data contained in the explanatory statement accompanying the
FY2021 LHHS omnibus (P.L. 116-260), available in the FY2021 LHHS omnibus (P.L. 116-260), available in the Congressional Record, vol., vol. 166, no. 218, book IV, December 166, no. 218, book IV, December
21, 2020, pp. H8619-H8711. Amounts in the FY2021 House Committee21, 2020, pp. H8619-H8711. Amounts in the FY2021 House Committee column are column are ~~general y~~generally drawn from or drawn from or
calculated based on data contained in the committeecalculated based on data contained in the committee report (H.Rept. 116-450) accompanying H.R. 7614. Enacted report (H.Rept. 116-450) accompanying H.R. 7614. Enacted
totals (“Total BA in the Bil ”) for FY2020 do not include emergency-designated appropriations provided intotals (“Total BA in the Bil ”) for FY2020 do not include emergency-designated appropriations provided in P.L. P.L.
116-113, P.L. 116-123, P.L. 116-127, P.L. 116-136, or P.L. 116-139. House committee116-113, P.L. 116-123, P.L. 116-127, P.L. 116-136, or P.L. 116-139. House committee bil totals (“Total BA in the bil totals (“Total BA in the
Bil ”) for FY2021 do not include emergency-designated appropriations proposed in Title VI of H.R. 7614. Enacted Bil ”) for FY2021 do not include emergency-designated appropriations proposed in Title VI of H.R. 7614. Enacted
totals (“Total BA in the Bil ”) for FY2021 do not include emergency-designated appropriations provided in totals (“Total BA in the Bil ”) for FY2021 do not include emergency-designated appropriations provided in
DivisionDivision H or M of P.L.H or M of P.L. ~~116-260~~ 116-260, or P.L. 117-31. For consistency with source materials,. For consistency with source materials, amounts in this figure amounts in this figure ~~general y~~ generally do not do not
reflect mandatory spending sequestration, wherereflect mandatory spending sequestration, where applicable, nor do they reflect any transfers or reprogramming applicable, nor do they reflect any transfers or reprogramming
of funds pursuant to executive authorities.of funds pursuant to executive authorities.
Notes: BA = Budget Authority. DetailsBA = Budget Authority. Details may not add to totals due to rounding. Amounts in this table (1) reflect may not add to totals due to rounding. Amounts in this table (1) reflect
al all BA appropriated in the bil ,BA appropriated in the bil , ~~regardless~~ regardless of the year in which funds become available (i.e.,of the year in which funds become available (i.e., totals do not include totals do not include
advances from prior-year appropriations,advances from prior-year appropriations, but do include advances for subsequent years provided in this bil ); (2) but do include advances for subsequent years provided in this bil ); (2)
have have ~~general y~~generally not been adjusted to reflect not been adjusted to reflect scorekeeping; (3) comprisescorekeeping; (3) comprise only those funds provided (or requested) only those funds provided (or requested)
for agencies and accounts subject to the jurisdictionfor agencies and accounts subject to the jurisdiction of the LHHS subcommitteesof the LHHS subcommittees of the House and Senate of the House and Senate
appropriations committees;appropriations committees; and (4) do not include appropriations that occur outside of appropriations bil s. and (4) do not include appropriations that occur outside of appropriations bil s.
a. Mandatory funding within ETA goes to Federala. Mandatory funding within ETA goes to Federal Unemployment Benefits and Unemployment Benefits and ~~Al owances~~ Allowances (FUBA) and (FUBA) and
Advances to the Unemployment Advances to the Unemployment Trust Fund (UTF), if any. FUBATrust Fund (UTF), if any. FUBA funds Trade Adjustment Assistancefunds Trade Adjustment Assistance for for
WorkersWorkers (TAA). (TAA).
b. PBGC funding is provided outside the LHHS b. PBGC funding is provided outside the LHHS Appropriations Act. Appropriations Act.

c. Mandatory programs c. Mandatory programs in the Office of Workers’in the Office of Workers’ Compensation ProgramsCompensation Programs include Special Benefits include Special Benefits
(comprising the Federal (comprising the Federal Employees’Employees’ Compensation Benefits and the LongshoreCompensation Benefits and the Longshore and Harbor Workers’ and Harbor Workers’
Benefits), Special Benefits for Disabled Coal Miners,Benefits), Special Benefits for Disabled Coal Miners, Energy Employees Occupational Il nessEnergy Employees Occupational Il ness Compensation Compensation
(Administrative(Administrative Expenses), and the Black Lung DisabilityExpenses), and the Black Lung Disability Trust Fund. Trust Fund.
d. The funding for International Labor Affairs is included in the Salaries d. The funding for International Labor Affairs is included in the Salaries and Expenses total. and Expenses total.
e. The FY2021 House committeee. The FY2021 House committee bil included a total of $19.4 bil ion in emergency-designatedbil included a total of $19.4 bil ion in emergency-designated budget budget
authority in Title VI, of which $925 mil ion authority in Title VI, of which $925 mil ion was for DOL. Subsequently, Divisionwas for DOL. Subsequently, Division H of P.L. 116-260 enacted H of P.L. 116-260 enacted
$1.6 bil ion in emergency-designated budget authority, of which $925 mil ion$1.6 bil ion in emergency-designated budget authority, of which $925 mil ion was for DOL.was for DOL.
Department of Health and Human Services (HHS)
Note that Note that al all amounts in this section are based on regular LHHS appropriations only; they do not amounts in this section are based on regular LHHS appropriations only; they do not
include funds for HHS agencies provided through other appropriations include funds for HHS agencies provided through other appropriations ~~bil s~~bills (e.g., funding for the (e.g., funding for the
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Appropriations
Food and Drug Administration) or outside of the annual appropriations process (e.g., direct Food and Drug Administration) or outside of the annual appropriations process (e.g., direct
appropriations for Medicare or mandatory funds provided by authorizing laws, such as the Patient appropriations for Medicare or mandatory funds provided by authorizing laws, such as the Patient
Protection and Affordable Care Act [ACA, P.L. 111-148]). Protection and Affordable Care Act [ACA, P.L. 111-148]). Al All amounts in this section are rounded amounts in this section are rounded
to the nearest to the nearest ~~mil ion or bil ion~~ million or billion (as labeled). The dollar changes and percentage changes discussed (as labeled). The dollar changes and percentage changes discussed
in the text are based on unrounded amounts. For consistency with source materials, amounts do 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. not reflect sequestration or re-estimates of mandatory spending programs, where applicable.
About HHS
HHS Agencies Funded via the
HHS is a large federal department composed HHS is a large federal department composed
LHHS Appropriations Process
of multiple agencies working to enhance the of multiple agencies working to enhance the
Health Resources Health Resources and Servicesand Services ~~Administration~~ Administration (HRSA) (HRSA)
health and health and ~~wel~~ well-being of Americans. Annual -being of Americans. Annual
Centers for Disease Centers for Disease Control and Prevention (CDC) Control and Prevention (CDC)
LHHS appropriations laws direct funding to LHHS appropriations laws direct funding to
National Institutes of Health (NIH) National Institutes of Health (NIH)
most (but not most (but not al all) HHS agencies (see text box ) HHS agencies (see text box
Substance Abuse and Mental Health Services Substance Abuse and Mental Health Services
for HHS agencies supported by the LHHS for HHS agencies supported by the LHHS
Administration Administration (SAMHSA) (SAMHSA)
~~bil ).40~~bill).41 For instance, the LHHS For instance, the LHHS ~~bil~~ bill directs directs
Agency for Healthcare Research and Quality (AHRQ) Agency for Healthcare Research and Quality (AHRQ)
funding to five Public Health Service (PHS) funding to five Public Health Service (PHS)
Centers for Medicare & Medicaid Services Centers for Medicare & Medicaid Services (CMS) (CMS)
agencies: the Health Resources and Services agencies: the Health Resources and Services
Administration Administration for Children and Familiesfor Children and Families (ACF) (ACF)
Administration (HRSA), Centers for Disease Administration (HRSA), Centers for Disease
Administration Administration for Community Living (ACL) for Community Living (ACL)
Control and Prevention (CDC), National Control and Prevention (CDC), National
Office of the Secretary (OS) Office of the Secretary (OS)
Institutes of Health (NIH), Substance Abuse Institutes of Health (NIH), Substance Abuse
and Mental Health Services Administration and Mental Health Services Administration
(SAMHSA), and Agency for Healthcare Research and Quality (AHRQ).(SAMHSA), and Agency for Healthcare Research and Quality (AHRQ).4142 These public health These public health
agencies support diverse missions, ranging from the provision of health care services and 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 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). (e.g., AHRQ, NIH), to the prevention and control of infectious and chronic diseases (e.g., CDC).
In addition, the LHHS billIn addition, the LHHS bill provides funding for provides funding for ~~annual y~~annually appropriated components of CMS, appropriated components of CMS,4243
which is the HHS agency responsible for the administration of Medicare, Medicaid, the State which is the HHS agency responsible for the administration of Medicare, Medicaid, the State
Children’s HealthChildren’s Health Insurance Program (CHIP), and consumer protections and private health Insurance Program (CHIP), and consumer protections and private health
insurance provisions of the ACA. insurance provisions of the ACA.
The LHHS The LHHS ~~bil~~ bill also provides funding for two HHS agencies focused primarily on the provision of 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 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 Community Living (ACL). ACF’s mission is to promote the economic and social ~~wel~~ well-being of -being of
vulnerable children, youth, families, and communities. ACL was formed with a goal of increasing 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 access to community supports for older Americans and people with disabilities. The LHHS ~~bil~~
bill also provides funding for the HHS Office of the Secretary (OS), which encompasses a broad 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 array of management, research, oversight, and emergency preparedness functions in support of
the entire department. the entire department.

~~40 T hree HHS public~~ 41 Three HHS public health agencies receive annual fundinghealth agencies receive annual funding from appropriations bills other than the LHHS bill:from appropriations bills other than the LHHS bill: the the
Food and DrugFood and Drug Administration (funded through the Agriculture appropriations bill), the Indian Health Service (funded Administration (funded through the Agriculture appropriations bill), the Indian Health Service (funded
through the Interior-Environment appropriations bill), and the Agency for through the Interior-Environment appropriations bill), and the Agency for ~~T oxic~~Toxic Substances Substances and Diseaseand Disease Registry Registry
(funded(funded through the Interior-Environment appropriations bill). In addition, whilethrough the Interior-Environment appropriations bill). In addition, while the National Institutes of Health the National Institutes of Health
(NIH) receive the majority of their appropriations from the LHHS bill,(NIH) receive the majority of their appropriations from the LHHS bill, one NIH institute (the National Institute of one NIH institute (the National Institute of
Environmental Health Sciences) receives appropriations from two bills: LHHSEnvironmental Health Sciences) receives appropriations from two bills: LHHS and the Interiorand the Interior -Environment bill. -Environment bill.
4142 For more information on HHS PHS For more information on HHS PHS agencies, see CRSagencies, see CRS Report R44916, Report R44916, Public Health Service Agencies: Overview
and Funding (FY2016-FY2018). .
42 43 Much of the funding for CMS Much of the funding for CMS activities is provided through mandatory appropriations in authorizing legislation, and activities is provided through mandatory appropriations in authorizing legislation, and
thus is not subject to the annual appropriations process. thus is not subject to the annual appropriations process.
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link to page link to page 2930 link to page 75 link to page link to page 7431 link to page link to page 3031 Labor, Health and Human Services, and Education: FY2021 ~~Appropriations~~
Appropriations
FY2021 HHS Appropriations Overview
Table 5 displays enacted and proposed FY2021 funding levels for HHS, along with FY2020 displays enacted and proposed FY2021 funding levels for HHS, along with FY2020
levels. Note that the totals in this table do not include emergency supplemental appropriations; levels. Note that the totals in this table do not include emergency supplemental appropriations;
amounts provided in supplementals are displayed separately at the bottom of the table and are in amounts provided in supplementals are displayed separately at the bottom of the table and are in
addition to regular appropriations. (Although not addition to regular appropriations. (Although not ~~technical y~~technically supplemental appropriations, the supplemental appropriations, the
bottom of the table also includes emergency-designated discretionary funding proposed or bottom of the table also includes emergency-designated discretionary funding proposed or
enacted in annual LHHS measures.) For a discussion of the FY2021 supplemental appropriations enacted in annual LHHS measures.) For a discussion of the FY2021 supplemental appropriations
in Division M of P.L. 116-260in Division M of P.L. 116-260 and P.L. 117-31, se, see Appendix C.
In general, discretionary funds account for about 10% of HHS appropriations in the LHHS In general, discretionary funds account for about 10% of HHS appropriations in the LHHS ~~bil~~ bill. .
Compared to the FY2020 funding levels, the FY2021 LHHS omnibus increased HHS Compared to the FY2020 funding levels, the FY2021 LHHS omnibus increased HHS
discretionary appropriations by 2.2%. The House committee discretionary appropriations by 2.2%. The House committee ~~bil~~ bill would have increased HHS would have increased HHS
discretionary appropriations to a lesser degree, by 1.5%, while the President requested an 8.3% discretionary appropriations to a lesser degree, by 1.5%, while the President requested an 8.3%
decrease in discretionary HHS funding. decrease in discretionary HHS funding.
Table 5. HHS Appropriations Overview
(In (In ~~bil ions of dol ars~~billions of dollars) )
FY2021
House
FY2021
Cmte.
Enacted
FY2020
FY2021
(H.R.
(P.L.
Funding
Enacted
Request
7614)
116-260)
Discretionary Discretionary
94.9 94.9
87.0 87.0
96.4 96.4
97.0 97.0
Mandatory Mandatory
839.9 839.9
917.9 917.9
919.6 919.6
919.6 919.6
Total BA in the Bill
934.8
1,005.0
1,016.0
1,016.6
Emergency Funding (not included in above
totals)

1st COVID (P.L. 116-123) 1st COVID (P.L. 116-123)
6.4 6.4
— —
— —
— —
2nd COVID (P.L. 116-127) 2nd COVID (P.L. 116-127)
1.3 1.3
— —
— —
— —
3rd COVID (P.L. 116-136) 3rd COVID (P.L. 116-136)
140.4 140.4
— —
— —
— —
4th COVID (P.L. 116-139) 4th COVID (P.L. 116-139)
100.0 100.0
— —
— —
— —
Emergency Funding in Annual LHH Emergency Funding in Annual LHHSa
— —
— —
18.5 18.5
0.6 0.6
5th COVID (Division 5th COVID (Division M, P.L.M, P.L. 116-260) 116-260)
— —
— —
— —
72.9 72.9
~~Source~~Afghan special immigrants (P.L. 117-31) - - - 0.0b Sources: Amounts in this table for the FY2020 Enacted, FY2021 Request, and FY2021 Enacted columns are Amounts in this table for the FY2020 Enacted, FY2021 Request, and FY2021 Enacted columns are
~~general y~~generally drawn from drawn from or calculated based on data contained in the explanatory statement accompanying the or calculated based on data contained in the explanatory statement accompanying the
FY2021 LHHS omnibus (P.L. 116-260), available in the FY2021 LHHS omnibus (P.L. 116-260), available in the Congressional Record, vol., vol. 166, no. 218, book IV, December 166, no. 218, book IV, December
21, 2020, pp. H8619-H8711. 21, 2020, pp. H8619-H8711. (The amount for P.L. 117-31 is from CBO, Discretionary Spending: Senate Amendment 2123, July 29, 2021, https://www.cbo.gov/system/files/2021-07/EmergencySecuritySupplementalAppropriationsAct2021.pdf.) Amounts in the FY2021 House CommitteeAmounts in the FY2021 House Committee column column are generally~~are general y~~ drawn from or drawn from or
calculated based on data contained in the committeecalculated based on data contained in the committee report (H.Rept. 116-450) accompanying H.R. 7614. Enacted report (H.Rept. 116-450) accompanying H.R. 7614. Enacted
totals (“Total BA in the Bil ”) for FY2020 do not include emergency-designated appropriations provided intotals (“Total BA in the Bil ”) for FY2020 do not include emergency-designated appropriations provided in P.L. P.L.
116-113, P.L. 116-123, P.L. 116-127, P.L. 116-136, or P.L. 116-139. House 116-113, P.L. 116-123, P.L. 116-127, P.L. 116-136, or P.L. 116-139. House ~~committee~~ committee bil totals (“Total BA in the bil totals (“Total BA in the
Bil ”) for FY2021 do not include emergency-designated appropriations proposed in Title VI of H.R. 7614. Enacted Bil ”) for FY2021 do not include emergency-designated appropriations proposed in Title VI of H.R. 7614. Enacted
totals (“Total BA in the Bil ”) for FY2021 do not include emergency-designated appropriations provided in totals (“Total BA in the Bil ”) for FY2021 do not include emergency-designated appropriations provided in
~~Division~~ Division H or M of P.L.H or M of P.L. ~~116-260~~ 116-260, or P.L. 117-31. For consistency with source materials,. For consistency with source materials, amounts in this figure amounts in this figure ~~general y~~ generally do not do not
reflect mandatory spending sequestration, wherereflect mandatory spending sequestration, where Congressional Research Service 24 link to page 32 Labor, Health and Human Services, and Education: FY2021 Appropriations applicable, nor do they reflect any transfers or reprogramming applicable, nor do they reflect any transfers or reprogramming
of funds pursuant to executive authorities. CRS calculations do, however, include LHHS funding provided to 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. HHS pursuant to the 21st Century Cures Act (P.L. 114-255), as amended. ~~114-255), as amended.~~
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~~Labor, Health and Human Services, and Education: FY2021 Appropriations~~

Notes: BA = Budget Authority. DetailsBA = Budget Authority. Details may not add to totals due to rounding. Amounts in this table (1) reflect may not add to totals due to rounding. Amounts in this table (1) reflect
al all BA appropriated in the bil ,BA appropriated in the bil , ~~regardless~~ regardless of the year in which funds become available (i.e.,of the year in which funds become available (i.e., totals do not include totals do not include
advances from prior-year appropriations,advances from prior-year appropriations, but do include advances for subsequent years provided in this bil ); (2) but do include advances for subsequent years provided in this bil ); (2)
have have ~~general y~~generally not been adjusted to reflect not been adjusted to reflect scorekeeping; (3) comprisescorekeeping; (3) comprise only those funds provided (or requested) only those funds provided (or requested)
for agencies and accounts subject to the jurisdictionfor agencies and accounts subject to the jurisdiction of the LHHS subcommitteesof the LHHS subcommittees of the House and Senate of the House and Senate
appropriations committees;appropriations committees; and (4) do not include appropriations that occur outside of appropriations bil s. and (4) do not include appropriations that occur outside of appropriations bil s.
a. The FY2021 House committeea. The FY2021 House committee bil included a total of $19.4 bil ion in emergency-designatedbil included a total of $19.4 bil ion in emergency-designated budget budget
authority in Title VI, of $18.5 bil ion was for HHS. Subsequently, Division authority in Title VI, of $18.5 bil ion was for HHS. Subsequently, Division H of P.L. 116-260 enacted $1.6 H of P.L. 116-260 enacted $1.6
bil ion in emergency-designated budget authority, of which $638 mil ionbil ion in emergency-designated budget authority, of which $638 mil ion was for HHS in Title II. b. P.L. 117-31 provided $25 mil ion in supplemental appropriations for the Refugee and Entrant Assistance account at HHS for specified purposes related to Afghan special immigrants, which rounds to $0.0 in bil ions (the unit of measure used in this table). ~~was for HHS in Title II.~~
Figure 3 provides an HHS agency-level breakdown of FY2021 enacted appropriations. As this provides an HHS agency-level breakdown of FY2021 enacted appropriations. As this
figure demonstrates, annual HHS appropriations are dominated by mandatory funding, the 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 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 funds. When taking into account both mandatory and discretionary funding, CMS accounts for
$906.6 $906.6 ~~bil ion~~billion, which is 89.2% of , which is 89.2% of al all enacted appropriations for HHS. NIH and ACF account for enacted appropriations for HHS. NIH and ACF account for
the next-largest shares of total HHS appropriations, receiving about 4.1% apiece. the next-largest shares of total HHS appropriations, receiving about 4.1% apiece.
By contrast, when looking exclusively at discretionary appropriations, funding for CMS By contrast, when looking exclusively at discretionary appropriations, funding for CMS
constitutes about 4.6% of FY2021 enacted HHS appropriations. Instead, the bulk of discretionary constitutes about 4.6% of FY2021 enacted HHS appropriations. Instead, the bulk of discretionary
appropriations went to the PHS agencies, which combined to account for 63.8% of discretionary appropriations went to the PHS agencies, which combined to account for 63.8% of discretionary
appropriations provided for HHS.appropriations provided for HHS.~~43 NIH typical y~~44 NIH typically receives the largest share of receives the largest share of al all discretionary discretionary
funding among HHS agencies (42.7% in FY2021), with ACF accounting for the second-largest funding among HHS agencies (42.7% in FY2021), with ACF accounting for the second-largest
~~share (25.5% in FY2021).~~
share (25.5% in FY2021). 44 For further information about PHS agency funding, see CRS Report R44916, Public Health Service Agencies: Overview and Funding (FY2016-FY2018). Congressional Research Service 25 Labor, Health and Human Services, and Education: FY2021 Appropriations Figure 3. FY2021 Enacted HHS Appropriations by Agency
(Budget authority in Budget authority in ~~bil ions of dol ars~~billions of dollars)

Source: Amounts in this figure are Amounts in this figure are ~~general y~~generally drawn from or calculated based on data contained in the drawn from or calculated based on data contained in the
explanatory statement accompanying the FY2021 LHHS omnibus (P.L. 116-260), available in the explanatory statement accompanying the FY2021 LHHS omnibus (P.L. 116-260), available in the Congressional
Record,, vol. 166, no. 218, book IV, Decembervol. 166, no. 218, book IV, December 21, 2020, pp. H8619-H8711. Enacted totals (“Total BA in the Bil ”) 21, 2020, pp. H8619-H8711. Enacted totals (“Total BA in the Bil ”)
for FY2021 do not include emergency-designatedfor FY2021 do not include emergency-designated appropriations provided in Divisionappropriations provided in Division H or M of P.L.H or M of P.L. 116-260, or P.L. 117-31. ~~116-260.~~
For consistency with source materials,For consistency with source materials, amounts in this figure amounts in this figure ~~general y~~generally do not reflect mandatory spending do not reflect mandatory spending
sequestration, where applicable, nor do they reflectsequestration, where applicable, nor do they reflect any transfers or reprogrammingany transfers or reprogramming of funds pursuant of funds pursuant to to

~~43 For further information about PHS agency funding, see CRS Report R44916,~~ ~~Public Health Service Agencies:~~
~~Overview and Funding (FY2016-FY2018)~~.
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~~Labor, Health and Human Services, and Education: FY2021 Appropriations~~

executive authorities. CRS calculations do, however,executive authorities. CRS calculations do, however, include LHHS funding provided to HHS pursuant to the include LHHS funding provided to HHS pursuant to the ~~21 st~~
21st Century Cures Act (P.L. 114-255), as amended. Century Cures Act (P.L. 114-255), as amended.
Notes: Details Details may not add to totals due to rounding. The bar representing the combined mandatory and may not add to totals due to rounding. The bar representing the combined mandatory and
discretionarydiscretionary total for CMS has been abbreviated due to space constraints. When taking into account both total for CMS has been abbreviated due to space constraints. When taking into account both
mandatory and discretionarymandatory and discretionary funding, CMS receivesfunding, CMS receives over 20 timesover 20 times the funding appropriated to either ACF or the funding appropriated to either ACF or
NIH in the FY2021 LHHS omnibus. Amounts in this table (1) reflect NIH in the FY2021 LHHS omnibus. Amounts in this table (1) reflect al all BA appropriated in the bil , regardlessBA appropriated in the bil , regardless of of
the year in which funds become available (i.e.,the year in which funds become available (i.e., totals do not include advances fromtotals do not include advances from prior-year appropriations, but prior-year appropriations, but
do include advances for subsequent years provided in this bil ); (2) have do include advances for subsequent years provided in this bil ); (2) have ~~general y~~generally not been adjusted to reflect not been adjusted to reflect
scorekeeping;scorekeeping; (3) comprise(3) comprise only those funds provided (or requested) for agencies and accounts subject to the only those funds provided (or requested) for agencies and accounts subject to the
jurisdictionjurisdiction of the LHHS subcommitteesof the LHHS subcommittees of the House and Senate appropriations committees;of the House and Senate appropriations committees; and (4) do not and (4) do not
include appropriations that occur outside of appropriations bil s. include appropriations that occur outside of appropriations bil s.
Special Public Health Funding Mechanisms
Annual appropriations for HHS public health service agencies are best understood in the context 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, 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 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. 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 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), HHS appropriations. It is authorized by Section 241 of the Public Health Service Act (PHSA),
~~and al ows~~and allows the Secretary of HHS, with the approval of appropriators, to redistribute a portion of the Secretary of HHS, with the approval of appropriators, to redistribute a portion of
~~eligible~~ eligible PHS agency appropriations across HHS for program evaluation purposes. PHS agency appropriations across HHS for program evaluation purposes.
The PHSA limits the set-aside to not less than 0.2% and not more than 1% of eligible program The PHSA limits the set-aside to not less than 0.2% and not more than 1% of eligible program
appropriations. However, LHHS appropriations acts have commonly established a higher appropriations. However, LHHS appropriations acts have commonly established a higher
Congressional Research Service 26 Labor, Health and Human Services, and Education: FY2021 Appropriations maximum percentage for the set-aside and have distributed specific amounts of “tap” funding to maximum percentage for the set-aside and have distributed specific amounts of “tap” funding to
selected HHS programs. Since FY2010, and including in FY2021, this higher maximum set-aside selected HHS programs. Since FY2010, and including in FY2021, this higher maximum set-aside
level has been 2.5% of eligiblelevel has been 2.5% of eligible appropriations.appropriations.4445 (The President’s budget proposed to increase the (The President’s budget proposed to increase the
set-aside to 2.9%, while the House committee set-aside to 2.9%, while the House committee ~~bil~~ bill would have increased it to 3.0%.) would have increased it to 3.0%.)
Before FY2015, the PHS tap Before FY2015, the PHS tap ~~traditional y~~traditionally
Display of Evaluation Tap Transfers
provided more than a dozen HHS programs provided more than a dozen HHS programs
By convention, tables in this report show only the By convention, tables in this report show only the
with funding beyond their annual with funding beyond their annual
amount of PHS Evaluation Tap funds received amount of PHS Evaluation Tap funds received by an by an
appropriations and, in some cases, was the appropriations and, in some cases, was the
agency (i.e., agency (i.e., tables do not subtract the amount of the tables do not subtract the amount of the
sole source of funding for a program or sole source of funding for a program or
evaluation tap from evaluation tap from donor agencies’ appropriations). donor agencies’ appropriations).
That is to say, tap amounts shown in the fol owing That is to say, tap amounts shown in the fol owing
activity. However, since FY2015 and activity. However, since FY2015 and
tables are in addition to amounts shown for budget tables are in addition to amounts shown for budget
including in FY2020, LHHS appropriations including in FY2020, LHHS appropriations
authority, but the amounts shown for budget authority authority, but the amounts shown for budget authority
laws have directed tap funds to a laws have directed tap funds to a ~~smal er~~smaller
have not been adjusted to reflect potential “transfer- have not been adjusted to reflect potential “transfer-
number of programs or activities within three number of programs or activities within three
out” of funds to the tap. out” of funds to the tap.
HHS agencies (NIH, SAMHSA, and OS) and HHS agencies (NIH, SAMHSA, and OS) and
have not provided any tap transfers to AHRQ, CDC, and HRSA. This has been particularly 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~~

~~44 See Section 204, Division H, P.L. 116-260 for the FY2021 maximum set -aside level. T he last time that an~~
~~appropriations act set the PHS tap percentage at a level other than 2.5% was in FY2009, when it was 2.4% (see P.L.~~
~~111-8). T he FY2021 omnibus also retained a change to this provision, first included in the FY2014 omnibus, allowing~~
~~tap transfers to be used for the “ evaluation and the implementation” of programs funded in the HHS title of the LHHS~~
~~appropriations act. Prior to FY2014, such provisions had restricted tap funds to the “evaluation of the implementation”~~
~~of programs authorized under the Public Health Serv ice Act.~~
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notable for AHRQ, which had been funded primarily through tap transfers from FY2003 to FY2014, but has received discretionary appropriations since then.FY2014, but has received discretionary appropriations since then.4546 The House committee The House committee ~~bil~~
~~general y~~bill generally would have maintained the current distributional practice for FY2021, except that it would have maintained the current distributional practice for FY2021, except that it
would have also provided tap funding to AHRQ. The President’s budget proposed to expand the would have also provided tap funding to AHRQ. The President’s budget proposed to expand the
activities and agencies funded by the PHS tap to include the Public Health Scientific Services at activities and agencies funded by the PHS tap to include the Public Health Scientific Services at
the CDC and to supplemental funding for organ transplantation activities at HRSA, while the CDC and to supplemental funding for organ transplantation activities at HRSA, while
simultaneously proposing to reduce tap transfers to the NIH. simultaneously proposing to reduce tap transfers to the NIH.
Since FY2015, LHHS appropriations laws have directed the largest share of tap transfers to Since FY2015, LHHS appropriations laws have directed the largest share of tap transfers to
NIH.NIH.4647 The FY2021 LHHS The FY2021 LHHS omnibus provided $1.3 omnibus provided $1.3 ~~bil ion~~ billion in tap transfers to NIH, a $41 in tap transfers to NIH, a $41 ~~mil ion~~
million (+3.3%) increase over the FY2020 level. The FY2021 House committee (+3.3%) increase over the FY2020 level. The FY2021 House committee ~~bil~~ bill proposed that the proposed that the
NIH transfers be increased by $110 NIH transfers be increased by $110 ~~mil ion~~million (+9.0%), whereas the President’s request proposed (+9.0%), whereas the President’s request proposed
that the transfers be reduced by $490 that the transfers be reduced by $490 ~~mil ion~~million (-39.8%). 45 See Section 204, Division H, P.L. 116-260 for the FY2021 maximum set-aside level. The last time that an appropriations act set the PHS tap percentage at a level other than 2.5% was in FY2009, when it was 2.4% (see P.L. 111-8). The FY2021 omnibus also retained a change to this provision, first included in the FY2014 omnibus, allowing tap transfers to be used for the “evaluation and the implementation” of programs funded in the HHS title of the LHHS appropriations act. Prior to FY2014, such provisions had restricted tap funds to the “evaluation of the implementation” of programs authorized under the Public Health Service Act. 46 ~~(-39.8%).~~
~~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.47 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, wel ness, and related public health programs funded~~
~~through HHS accounts.~~
~~The ACA had appropriated $2 bil ion in mandatory funds to the PPHF for FY2021, but this~~
~~amount was reduced by subsequent laws that decreased PPHF funding for FY2021 and other~~
~~fiscal years. Under current law, the FY2021 appropriation was $950 mil ion.48 In addition, this~~
~~appropriation was subject to a 5.7% reduction due to sequestration of nonexempt mandatory~~
~~spending.49 (For more information on sequestration, see the budget enforcement discussion in~~
Appendix A.) After sequestration, the total PPHF appropriation available for FY2021 was $896
~~mil ion, an increase of $2 mil ion relative to FY2020. Of this amount, the LHHS omnibus~~
~~al ocated $856 mil ion to CDC, $12 mil ion to SAMHSA, and $28 mil ion to ACL.50~~

45 Until FY2015, AHRQ had not received a discretionary appropriation in an annual appropriations act in more than a Until FY2015, AHRQ had not received a discretionary appropriation in an annual appropriations act in more than a
decade.decade. FY2009 wasFY2009 was the exception to this general pattern, as AHRQ received a supplemental appropriation from the 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 American Recovery and Reinvestment Act that year. In recent years, AHRQ has also received some transfers from the
Prevention and Public Health FundPrevention and Public Health Fund and the Patientand the Patient -Centered Outcomes Research -Centered Outcomes Research ~~T rust~~Trust Fund, though these transfers Fund, though these transfers
werewere generally much smaller than the transfers AHRQ received from the tap. For more information, see CRSgenerally much smaller than the transfers AHRQ received from the tap. For more information, see CRS Report Report
R44136, R44136, The Agency for Healthcare Research and Quality (AHRQ) Budget: Fact Sheet. .
46 47 Prior to FY2015, NIH had traditionally been by far the largest net donor of tap funds, rather than a net recipient. Prior to FY2015, NIH had traditionally been by far the largest net donor of tap funds, rather than a net recipient. ~~T he~~The
joint explanatory statement accompanying the FY2015 omnibus explained this shift as beingjoint explanatory statement accompanying the FY2015 omnibus explained this shift as being intended to ensure that tap intended to ensure that tap
transfers are a “net benefit to NIH rather than a liability” and noted that this change was in response to a growing transfers are a “net benefit to NIH rather than a liability” and noted that this change was in response to a growing
concern at the loss of NIH fundsconcern at the loss of NIH funds to the tap. Joint Explanatory Statement, Proceedings and Debatesto the tap. Joint Explanatory Statement, Proceedings and Debates of the of the ~~113 th~~113th
Congress, SecondCongress, Second Session,Session, Congressional Record, vol. 160, no. 151, Book II, December 11, 2014, p. H9832. Congressional Research Service 27 link to page 59 Labor, Health and Human Services, and Education: FY2021 Appropriations Prevention and Public Health Fund Display of PPHF Transfers The ACA both authorized and appropriated PPHF transfer amounts displayed in the HHS tables in mandatory funding to three funds to support this report are in addition to amounts shown for budget authority provided in the bil . For consistency programs and activities within the PHS with source materials, the amounts shown for PPHF agencies.48 One of these, the Prevention and transfers in these tables reflect the estimated effects of Public Health Fund (PPHF, ACA §4002, as mandatory spending sequestration; this is not the case amended), was given a permanent, annual for other mandatory spending shown in this report appropriation that was intended to provide (also for consistency with source materials). support each year to prevention, wellness, and related public health programs funded through HHS accounts. The ACA had appropriated $2 billion in mandatory funds to the PPHF for FY2021, but this amount was reduced by subsequent laws that decreased PPHF funding for FY2021 and other fiscal years. Under current law, the FY2021 appropriation was $950 million.49 In addition, this appropriation was subject to a 5.7% reduction due to sequestration of nonexempt mandatory spending.50 (For more information on sequestration, see the budget enforcement discussion in Appendix A.) After sequestration, the total PPHF appropriation available for FY2021 was $896 million, an increase of $2 million relative to FY2020. Of this amount, the LHHS omnibus allocated $856 million to CDC, $12 million to SAMHSA, and $28 million to ACL.51 PPHF funds are intended to supplement (sometimes quite substantially) the funding that selected programs receive through regular appropriations. Although the PPHF authority instructs the HHS Secretary to transfer amounts from the fund to HHS agencies, since FY2014 provisions in annual appropriations acts and accompanying reports have explicitly ~~Congressional Record, vol. 160, no. 151, Book II, December 11, 2014, p. H9832.~~
~~47 For more information, see CRS Report R41301,~~ ~~Appropriations and Fund Transfers in the Affordable Care Act~~
~~(ACA)~~.
~~48 42 U.S.C. §300u-11.~~
~~49 OMB Report to the Congress on the Joint Committee Reductio ns for Fiscal Year 2021, February 10, 2020, p. 7 of 17,~~
~~https://www.whitehouse.gov/wp-content/uploads/2020/02/JC-sequestration_report_FY21_2-10-20.pdf.~~
~~50 See explanatory statement accompanying the FY2021 LHHS omnibus (P.L. 116-260), available in the~~ ~~Congressional~~
~~Record, December 21, 2020, Vol. 166, No. 218, Book IV, p. H8634, for allocations to specific agency programs and~~
~~activities.~~
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~~link to page 40 link to page 43~~ ~~Labor, Health and Human Services, and Education: FY2021 Appropriations~~

~~PPHF funds are intended to supplement~~
~~Display of PPHF Transfers~~
~~(sometimes quite substantial y) the funding~~
~~that selected programs receive through regular~~
~~PPHF transfer amounts displayed in the HHS tables in~~
~~this report are in addition to amounts shown for~~
~~appropriations. Although the PPHF authority~~
~~budget authority provided in the bil . For consistency~~
~~instructs the HHS Secretary to transfer~~
~~with source materials, the amounts shown for PPHF~~
~~amounts from the fund to HHS agencies, since~~
~~transfers in these tables reflect the estimated effects of~~
~~FY2014 provisions in annual appropriations~~
~~mandatory spending sequestration; this is not the case~~
~~acts and accompanying reports have explicitly~~
~~for other mandatory spending shown in this report~~
~~(also for consistency with source materials).~~
directed the distribution of PPHF funds and directed the distribution of PPHF funds and
prohibited the Secretary from making further prohibited the Secretary from making further
transfers for those years.transfers for those years.51
52 CDC commonly receives the largest share of annual PPHF funds. The amount provided to CDC CDC commonly receives the largest share of annual PPHF funds. The amount provided to CDC
for FY2021 and proposed by the House committee for FY2021 and proposed by the House committee ~~bil~~ bill, $854 , $854 ~~mil ion~~million, was a $2 , was a $2 ~~mil ion~~ million (+0.2%) (+0.2%)
increase relative to FY2020. The President’s request proposed increasing the PPHF funding increase relative to FY2020. The President’s request proposed increasing the PPHF funding
transferred to CDC to $894 transferred to CDC to $894 ~~mil ion~~million (+4.6%), and providing no mandated transfers to SAMHSA (+4.6%), and providing no mandated transfers to SAMHSA
or ACL. or ACL.
Selected HHS Highlights by Agency
This section begins with a limited selection of FY2021 discretionary funding highlights by HHS This section begins with a limited selection of FY2021 discretionary funding highlights by HHS
agency. The discussion is largely based on the enacted and proposed appropriations levels for agency. The discussion is largely based on the enacted and proposed appropriations levels for
FY2021, compared to FY2020 enacted levels.FY2021, compared to FY2020 enacted levels.5253 These summaries are followed by a brief These summaries are followed by a brief
overview of significant provisions from annual HHS appropriations laws that restrict spending in overview of significant provisions from annual HHS appropriations laws that restrict spending in
certain controversial areas, such as abortion and stem certain controversial areas, such as abortion and stem ~~cel~~ cell research. The section concludes with research. The section concludes with
~~two tables (Table 6 and Table 7) presenting more detailed information on FY2020 enacted and~~
~~FY2021 proposed and enacted funding levels for HHS.~~
~~HRSA~~
~~The FY2021 LHHS omnibus provided $7.2 bil ion in discretionary budget authority for HRSA.~~
~~This was $171 mil ion (+2.4%) more than HRSA’s FY2020 discretionary funding level and $913~~
~~mil ion~~ 48 For more information, see CRS Report R41301, Appropriations and Fund Transfers in the Affordable Care Act (ACA). 49 42 U.S.C. §300u-11. 50 OMB Report to the Congress on the Joint Committee Reductions for Fiscal Year 2021, February 10, 2020, p. 7 of 17, https://www.whitehouse.gov/wp-content/uploads/2020/02/JC-sequestration_report_FY21_2-10-20.pdf. 51 See explanatory statement accompanying the FY2021 LHHS omnibus (P.L. 116-260), available in the Congressional Record, December 21, 2020, Vol. 166, No. 218, Book IV, p. H8634, for allocations to specific agency programs and activities. 52 See Division H, §222, P.L. 116-260. 53 HHS budget materials can be found at http://www.hhs.gov/budget/. Congressional Research Service 28 link to page 42 link to page 45 Labor, Health and Human Services, and Education: FY2021 Appropriations two tables (Table 6 and Table 7) presenting more detailed information on FY2020 enacted and FY2021 proposed and enacted funding levels for HHS. HRSA The FY2021 LHHS omnibus provided $7.2 billion in discretionary budget authority for HRSA. This was $171 million (+2.4%) more than HRSA’s FY2020 discretionary funding level and $913 million (+14.5%) more than the FY2021 President’s budget request. (+14.5%) more than the FY2021 President’s budget request.
Under the Primary Health Care account, the Community Health Centers program received $1.683 Under the Primary Health Care account, the Community Health Centers program received $1.683
~~bil ion,~~ billion, an increase of $57 an increase of $57 ~~mil ion~~ million (+3.5%) relative to FY2020.(+3.5%) relative to FY2020.5354 The explanatory statement also The explanatory statement also
recommended $102.5 recommended $102.5 ~~mil ion~~million under that same account for the second year of the Ending the HIV under that same account for the second year of the Ending the HIV
Epidemic Initiative, which is focused on reducing HIV transmission via increased use of pre-Epidemic Initiative, which is focused on reducing HIV transmission via increased use of pre-
exposure prophylaxis (PrEP) among high risk groups.exposure prophylaxis (PrEP) among high risk groups.5455 Under the Ryan White HIV/AIDS Under the Ryan White HIV/AIDS
Program appropriation, there is an additional $105 Program appropriation, there is an additional $105 ~~mil ion~~ million set aside for this HIV initiative,set aside for this HIV initiative, an an
increase of $35 increase of $35 ~~mil ion~~ million relative to FY2020. The explanatory statement also “encourages the ~~relative to FY2020. The explanatory statement also “encourages the~~

~~51 See Division H, §222, P.L. 116-260.~~
~~52 HHS budget materials can be found at http://www.hhs.gov/budget/.~~
~~53 T he Health Centers program also received significant additional FY2020 and FY2021 funding related to the COVID -~~
~~19 pandemic, totaling roughly $2 billion. For a discussion of this funding, see CRS Report R46711,~~ ~~U.S. Public Health~~
~~Service: COVID-19 Supplem ental Appropriations in the 116th Congress~~.
~~54 Congressional Record, December 21, 2020, Vol. 166, No. 218, Book IV, p. H8620. An amount of $50 million was~~
~~set aside in FY2020 for the first year of this init iative (see Congressional Record, December 17, 2019, Vol. 165, No.~~
~~204, Book III, p. H11063).~~
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acceleration of the development of oral, ultra-long-acting, sustained-release therapies” as part of acceleration of the development of oral, ultra-long-acting, sustained-release therapies” as part of
this initiative.this initiative.5556
The explanatory statement provided $34 The explanatory statement provided $34 ~~mil ion~~ million for telehealth within the Rural Health account, a for telehealth within the Rural Health account, a
~~$5 mil ion~~ $5 million (+17.2%) increase relative to FY2020. Within this amount, $6.5 (+17.2%) increase relative to FY2020. Within this amount, $6.5 ~~mil ion~~million was provided was provided
for the Telehealth Centers of for the Telehealth Centers of ~~Excel ence~~Excellence (COE) and $1 (COE) and $1 ~~mil ion~~ million was provided for an evaluation of was provided for an evaluation of
nationwide telehealth investments in rural areas and populations.nationwide telehealth investments in rural areas and populations.5657 It also directed HHS and It also directed HHS and
HRSA to “continue to utilize the expertise of the COEs in the Ending the HIV Epidemic initiative HRSA to “continue to utilize the expertise of the COEs in the Ending the HIV Epidemic initiative
to develop best practices for utilizing telehealth in HIV prevention, care, and treatment.”to develop best practices for utilizing telehealth in HIV prevention, care, and treatment.”
The Maternal and Child Health (MCH) Block Grant received $713 The Maternal and Child Health (MCH) Block Grant received $713 ~~mil ion,~~ million, an increase of $25 an increase of $25
~~mil ion~~ million (+3.6%) relative to FY2020. Related to maternal health, the explanatory statement set (+3.6%) relative to FY2020. Related to maternal health, the explanatory statement set
aside $9 aside $9 ~~mil ion for the Al iance~~ million for the Alliance for Maternal Health Safety Bundles, which are “a set of targeted for Maternal Health Safety Bundles, which are “a set of targeted
and evidence-based best practices that, when implemented, improve patient outcomes and reduce and evidence-based best practices that, when implemented, improve patient outcomes and reduce
maternal mortality and severe maternal morbidity,”maternal mortality and severe maternal morbidity,”5758 and provided $5 and provided $5 ~~mil ion~~ million for State Maternal for State Maternal
Health Innovation Grants. Within the Health Workforce account, the explanatory statement Health Innovation Grants. Within the Health Workforce account, the explanatory statement
designated $2.5 designated $2.5 ~~mil ion~~ million for midwife training “to address the national shortage of maternity care for midwife training “to address the national shortage of maternity care
providers and the lack of diversity in the maternity care workforce.”providers and the lack of diversity in the maternity care workforce.”5859
CDC
The FY2021 LHHS The FY2021 LHHS omnibus provided $7.0 omnibus provided $7.0 ~~bil ion~~ billion in discretionary budget authority for CDC, in discretionary budget authority for CDC,
which was $123 which was $123 ~~mil ion~~million (+1.8%) more than CDC’s FY2020 funding level. The FY2021 LHHS (+1.8%) more than CDC’s FY2020 funding level. The FY2021 LHHS
omnibus did not direct any PHS tap funds to the CDC, continuing the practice started in FY2015. omnibus did not direct any PHS tap funds to the CDC, continuing the practice started in FY2015.
~~It also did not direct the transfer of funds from the HHS Nonrecurring Expenses Fund (NEF) to~~
~~the CDC (unlike FY2020).59 However, the FY2021 LHHS omnibus did supplement discretionary~~
~~CDC appropriations by directing $856 mil ion in PPHF transfers to the CDC, which was $2~~
~~mil ion (+0.2%) more than FY2020. Al told, this combination of funding—compared to FY2020~~
~~funding from discretionary appropriations and directed transfers from the PPHF and NEF—~~
~~represented a decrease of $100 mil ion (-1.3%) from FY2020 in budget authority that is inclusive~~
~~of directed transfers.~~
~~The President’s budget request would have increased discretionary budget authority by $54~~
~~mil ion (+0.8%) relative to FY2020, while also requesting that $542 mil ion in tap funds be~~
~~directed to the CDC. The President’s budget also requested $894 million in PPHF transfers,~~
~~which would have been a $40 mil ion (+4.6%) increase. The President’s budget did not request~~

~~55 Ibid, p. H8621.~~
~~56 Ibid, p. H8620. See H.Rept. 116-450, pp. 58-59, for further information.~~
~~57 Ibid, p. H8620. See H.Rept. 116-450, p. 51, for a description of this activity.~~
~~58 Ibid, p. H8620.~~
~~59 T he NEF was established by the Consolidated Appropriations Act of 2008 to enable the HHS Secretary to repurpose~~
~~certain unobligated balances of expired discretionary funds appropriated to HHS from the General Fund ( P.L. 110-161,~~
~~Division G, T itle II, §223). Most accounts in annual appropriations measures receive appropriations from the General~~
~~Fund at the U.S. T reasury. T his term refers to all federal money not allocated by law to any other fund account, such as~~
~~federal trust funds for Medicare. Funds transferred into the NEF are generally available to the Secretary for capital~~
~~acquisitions across HHS, including facilities infrastructure and information technology. Until recently, it has not been~~
~~common for LHHS appropriations acts to specify that particular projects are to be funded by the NEF, but there have~~
~~been a few such cases since FY2017, including in FY2020 where the LHHS omnibus directed $225 million from the~~
~~NEF to the CDC Buildings and Facilities account to support infr astructure improvements for the CDC’s Chamblee~~
~~Campus (Congressional Record, December 17, 2019, Vol. 165, No. 204, Book III, p. H11065.)~~
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~~that any transfers from the NEF be directed to the CDC. Al told, this combination of funding~~
~~would have represented an increase of $410 mil ion (+5.1%) from FY2020.~~
~~Al programmatic accounts received increases relative to FY2020 except Public Health~~
~~Preparedness and Response and CDC-Wide Activities and Program Support. Among these~~
~~increases: (1) the HIV/AIDS, Viral Hepatitis, STI and TB Prevention account, which was funded~~
~~at an increased level of $1.3 bil ion (+3.2% above FY2020) included a $35 mil ion increase for~~
~~the Ending HIV/AIDS Initiative;60 and (2) the Emerging and Zoonotic Infectious Diseases~~
~~(EZID) account, which was funded at an increased level of $596 mil ion (+4.5% above FY2020),~~
~~included $10 mil ion in funding for a new pilot program that would award competitive grants for~~
~~the development of Social Determinants of Health Accelerator Plans61. Other increases included~~
~~the Environmental Health account, funded at $206 mil ion (+4.6%)62, and the Public Health~~
~~Scientific Services account, funded at $592 mil ion (+6.6%).~~
~~With regard to the Injury Prevention and Control account, which received $683 mil ion (+0.8%),~~
~~the explanatory statement included funding for several line items that were first included in~~
~~FY2020, including child sexual abuse prevention ($1.5 mil ion), suicide prevention ($12 mil ion),~~
~~and adverse childhood experiences (ACEs, $5 mil ion).63 The explanatory statement also included~~
~~specific funding for Firearm Injury and Mortality Prevention Research program ($12.5 mil ion)~~
~~and Opioid Overdose Prevention and Surveil ance ($476 mil ion).64~~
~~The Infectious Disease Rapid Response Reserve Fund (IDRRRF) within the CDC-Wide~~
~~Activities and Program Support account received $10 mil ion in the explanatory statement.65 The~~
~~IDRRRF was established in 2018 by P.L. 115-245 and is codified at 42 U.S.C. §247d-4a as an~~
~~emergency reserve account. Funds can be made available for infectious disease emergencies as~~
~~declared by the HHS Secretary (PHSA §319), or if an infectious disease outbreak has the~~
~~potential to affect national security or the health and security of U.S. citizens, as specified. Funds~~
~~may be used to carry out activities related to the research, public health prevention, and response~~
~~for infectious disease emergencies.~~
~~NIH~~
~~The FY2021 LHHS omnibus provided $41.4 bil ion in discretionary budget authority for NIH.~~
~~This was $1.2 bil ion (+3.0%) more than FY2020 and $3.4 bil ion (+8.8%) more than the~~
~~President’s FY2021 budget request.~~
~~As was the case in FY2020, the FY2021 LHHS omnibus directed $225 mil ion from the HHS~~
~~Nonrecurring Expenses Fund (NEF)66 to the NIH Buildings and Facilities account to implement~~

~~60 Centers for Disease Control and Prevention, “Ending the HIV Epidemic,” https://www.cdc.gov/endhiv/index.html.~~
~~61 Congressional Record, December 21, 2020, Vol. 166, No. 218, Book IV, p. H8623. See H.Rept. 116-450, pp. 76-77,~~
~~for a description of this activity.~~
~~62 T his amount does not include the PPHF transfer of $17 million that was directed to the Environmental Health~~
~~account each of FY2020 and FY2021.~~
~~63 Ibid., p. H8623.~~
~~64 Ibid., p. H8623. When taking account of the $12.5 million in NIH funding that was reserved for the same purpose,~~
~~the total provided for Firearm Injury and Mortality Prevention Research was $25 million.~~
~~65 Ibid., p. H8624.~~
~~66 T he NEF was established by the Consolidated Appropriations Act of 2008 to enable the HHS Secretary to repurpose~~
~~certain unobligated balances of expired discretionary funds appropriated to HHS from the General Fund ( P.L. 110-161,~~
~~Division G, T itle II, §223). Most accounts in annual appropriations measures receive appropriations from the General~~
~~Fund at the U.S. T reasury. T his term refers to all federal money not allocated by law to any other fund account, such as~~
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~~the recommendations in the 2019 National Academies of Sciences, Engineering, and Medicine~~
~~report~~ ~~Managing the NIH Bethesda Campus’ Capital Assets in a Highly Competitive Global~~
~~Biomedical Research Environment.67 In addition, the FY2021 LHHS omnibus directed $1.3~~
~~bil ion in PHS tap transfers to NIH, an increase of $41 mil ion (+3.3%) from FY2020. The~~
~~entirety of the PHS tap transfer was provided to the National Institute of General Medical~~
~~Sciences (NIGMS), and was paired with a discretionary appropriation of $1.7 bil ion. The~~
~~NIGMS discretionary appropriation was $14 mil ion (+0.8%) more than FY2020, but when~~
~~combined with the tap transfer, total funding for NIGMS increased by $54 mil ion (+1.8%) from~~
~~FY2020.~~
~~In line with recent practice, the explanatory statement on the FY2021 LHHS omnibus directed~~
~~NIH to reserve a specific dollar amount for a number of purposes, for example, $3.1 bil ion for~~
~~Alzheimer’s disease research at the National Institute on Aging.68 It also included a reservation of~~
~~funds for Firearm Injury and Mortality Prevention Research of $12.5 mil ion, the same amount as~~
~~FY2020.69 Reserving a specific dollar amount for a particular disease or area of research at NIH is~~
~~a relatively new practice that has expanded since 2015; stil , most NIH funding is not designated~~
~~for particular diseases or areas of research.70~~
~~The FY2021 LHHS omnibus appropriated $404 mil ion to the NIH Innovation Account pursuant~~
~~to the 21st Century Cures Act (Cures Act; P.L. 114-255), which was equal to the amount~~
~~authorized to be appropriated in that act. The explanatory statement also reiterated the purposes~~
~~authorized in the Cures Act, directing that NIH transfer $195 mil ion to the National Cancer~~
~~Institute to support cancer research, and $50 mil ion each to the National Institute of Neurological~~
~~Disorders and Stroke and the National Institute of Mental Health to support the Brain Research~~
~~through Advancing Innovative Neurotechnologies (BRAIN) Initiative. The remaining $109~~
~~mil ion was for the Precision Medicine Initiative.71~~
~~SAMHSA~~
~~The FY2021 LHHS omnibus provided $5.9 bil ion in discretionary budget authority for~~
~~SAMHSA. This amount was $133 mil ion (+2.3%) more than SAMHSA’s FY2020 funding level~~
~~and $272 mil ion (+4.9%) more than the President’s FY2021 budget request. The FY2021 LHHS~~
~~omnibus also directed $134 mil ion in PHS evaluation tap funding and $12 mil ion in PPHF~~
~~funding to SAMHSA, which were the same amounts as FY2019 and FY2020.~~

~~federal trust funds for Medicare.~~
~~67 See Division H, T itle II, §238 of P.L. 116-260. For further details, see Congressional Record, December 21, 2020,~~
~~Vol. 166, No. 218, Book IV, p. H8629. (See also Congressional Record, December 17, 2019, Vol. 165, No. 204, Book~~
~~III, p. H11074.)~~
~~68 Ibid., p. H8626. For a list of specified funding levels in the explanatory statement accompanying the LHHS omnibus,~~
~~see T able A-2 in CRS Report R43341, National Institutes of Health (NIH) Funding: FY1996 -FY2022.~~
~~69 Ibid., p. H8627. When taking account of the $12.5 million in CDC funding that was reserved for the same purpose,~~
~~the total provided for Firearm Injury and Mortality Prevention Research was $25 million in both FY2020 and FY2021.~~
~~70 As recently as December 2014, the explanatory statement on the FY2015 omnibus stipulated, “In keeping with~~
~~longstanding practice, the agreement does not recommend a specific amount of NIH funding for this purpose~~
~~[Alzheimer’s disease] or for any other individual disease. Doing so would establish a dangerous precedent that could~~
~~politicize the NIH peer review system. Nevertheless, in recognition that Alzheimer’s disease po ses a serious threat to~~
~~the Nation’s long-term health and economic stability, the agreement expects that a significant portion of the~~
~~recommended increase for NIA should be directed to research on Alzheimer’s. T he exact amount should be determined~~
~~by scientific opportunity of additional research on this disease and the quality of grant applications that are submitted~~
~~for Alzheimer’s relative to those submitted for other diseases.” See Congressional Record, daily edition, vol. 160, no.~~
~~151, Book II (December 11, 2014), p. H9832.~~
~~71 Congressional Record, December 21, 2020, Vol. 166, No. 218, Book IV, p. H8624.~~
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~~link to page 58~~ ~~Labor, Health and Human Services, and Education: FY2021 Appropriations~~

~~The additional funding provided to SAMHSA was spread across several programs in the~~
~~explanatory statement. The programs within the Mental Health Programs of Regional and~~
~~National Significance (PRNS) received an increase of $26 mil ion (+5.9%) and the programs~~
~~within the Substance Abuse Treatment PRNS received an increase of $17 mil ion (+3.6%). Nearly~~
~~al Mental Health and Substance Abuse Treatment PRNS programs received level funding or~~
~~modest increases from FY2020. The largest increase was provided to the Certified Community~~
~~Behavioral Health Clinics (CCBHCs)—$50 mil ion (+25.0%) more than FY2020. The~~
~~Community Mental Health Block Grant (MHBG) received an increase of $35 mil ion (+5.0%)~~
~~while the Substance Abuse Prevention and Treatment Block Grant (SABG) received the same~~
~~amount as FY2020. The State Opioid Response (SOR) grant program continued to be funded at~~
~~$1.5 bil ion, the same amount as FY2019 and FY2020.~~
~~AHRQ~~
~~The FY2021 LHHS omnibus provided $338 mil ion in discretionary budget authority to AHRQ.~~
~~This was the same as the FY2020 level. The FY2021 LHHS omnibus did not direct any PHS tap~~
~~transfers to AHRQ, which is in keeping with practices since FY2015 but contrasts with earlier~~
~~years (FY2003-FY2014) in which AHRQ had been funded primarily with tap transfers.72 (The~~
~~House bil proposed $200 mil ion in tap transfers for AHRQ, but this proposal was not enacted.)~~
~~The FY2021 LHHS omnibus continued to fund AHRQ as its own operating division, declining~~
~~the President’s proposal to consolidate AHRQ into NIH. The FY2021 President’s budget had~~
~~requested zero funding for AHRQ, proposing instead to continue funding many of AHRQ’s~~
~~activities through a new National Institute for Research on Safety and Quality (NIRSQ) in the~~
~~NIH.73~~
~~CMS~~
~~The FY2021 LHHS omnibus provided $4.5 bil ion in discretionary budget authority for CMS.~~
~~This was $21 mil ion (+0.5%) more than FY2020 and $30 mil ion (-0.7%) less than the FY2021~~
~~President’s budget request. The LHHS omnibus appropriated $807 mil ion for the CMS Health~~
~~Care Fraud and Abuse Control (HCFAC) account, 2.7% more than FY2020, and less (-0.7%) than~~
~~the FY2021 President’s request. Of the total amount appropriated for HCFAC, $496 mil ion was~~
~~effectively exempt from the discretionary budget caps. (See Appendix A for an explanation of~~
~~the LHHS budget cap exemptions.)~~

~~72 In addition to funds provided through the annual appropriations process, AHRQ is also scheduled in FY2021 to~~
~~receive a transfer of certain mandatory funds that were authorized and appropriated to the Patient-Centered Outcomes~~
~~Research T rust Fund (PCORT F) by ACA Section 6301(e), as amended (26 U.S.C. §9511). T ransfers to AHRQ from~~
~~the PCORT F are to be used to disseminate the results of patient -centered outcomes research. (PCORT F funds are~~
~~generally not displayed in this report, as they are not provided by or modified through annual LHHS appropriations~~
~~bills.) For more information on the PCORT F, see HHS, Office of the Assistant Secretary for Planning and Ev aluation,~~
Patient-Centered Outcom es Research Trust Fund, https://aspe.hhs.gov/patient-centered-outcomes-research-trust-fund.
~~73 HHS, NIH, National Institute for Research on Safety and Quality, FY2021 Congressional Justification,~~
~~https://www.ahrq.gov/sites/default/files/wysiwyg/cpi/abo ut/mission/budget/2021/FY_2021_CJ_NIRSQ.pdf. T he~~
~~President ’s request would have funded NIRSQ at $257 million for FY2021 (not counting transfers from the PCORT F).~~
~~A similar proposal was made in the President’s FY2020, FY2019, and FY2018 requests; see HHS, NIH, National~~
~~Institute for Research on Safety and Quality, FY2021 Congressional Justification, https://www.ahrq.gov/sites/default/~~
~~files/wysiwyg/cpi/about/mission/budget/2020/FY_2020_CJ_-NIRSQ.pdf; HHS, NIH, National Institute for Research~~
~~on Safety and Quality, FY2019 Congressional Justification, https://www.ahrq.gov/sites/default/files/wysiwyg/cpi/~~
~~about/mission/budget/2019/NIRSQ.pdf; HHS, NIH, National Institute for Research on Safety and Quality,~~ ~~FY 2018~~
~~Congressional Justification, https://www.ahrq.gov/sites/default/files/wysiwyg/cpi/about/mission/budget/2018/~~
~~NIRSQ.pdf.~~
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~~The LHHS omnibus provided the CMS Program Management account with $3.7 bil ion, which~~
~~was the same amount provided in FY2020 and FY2019. This account supports CMS program~~
~~operations (e.g., claims processing, information technology investments, provider and beneficiary~~
~~outreach and education, and program implementation), in addition to federal administration and~~
~~other activities related to the administration of Medicare, Medicaid, the State Children’s Health~~
~~Insurance Program, and private health insurance provisions established by the ACA. The FY2021~~
~~appropriation was less than the amount proposed by the President’s budget (-0.6%) and the House~~
~~committee bil (-7.9%). The LHHS omnibus maintained a general provision (§227), included in~~
~~LHHS appropriations acts since FY2014, authorizing HHS to transfer additional funds into this~~
~~account from Medicare trust funds. The terms of the provision required that such funds be used to~~
~~support activities specific to the Medicare program, limited the amount of the transfers to $305~~
~~mil ion, and explicitly prohibited such transfers from being used to support or supplant funding~~
~~for ACA implementation. The House committee bil would have eliminated this provision.~~
~~ACF~~
~~The FY2021 LHHS omnibus provided $24.7 bil ion in discretionary budget authority for ACF.~~
~~This was $251 mil ion (+1.0%) more than FY2020 and $4.5 bil ion (+22.3%) more than the~~
~~FY2020 President’s budget request. The President’s budget would have decreased ACF~~
~~discretionary funding by almost one-fifth relative to the prior year (-17.4%). The President’s~~
~~budget would have achieved much of its proposed reduction by eliminating certain programs~~
~~within ACF, such as the Low Income Home Energy Assistance Program (LIHEAP), Preschool~~
~~Development Grants (PDG), and the Community Services Block Grant (CSBG). Funding for al~~
~~three of these programs was sustained or increased in the FY2021 LHHS omnibus relative to~~
~~FY2020: LIHEAP received $3.8 bil ion (+0.3%), PDG $275 mil ion (+0.0%), and CSBG $745~~
~~mil ion (+0.7%).~~
~~The LHHS omnibus provided $1.9 billion for the Refugee and Entrant Assistance programs~~
~~account, an increase of $2 mil ion (+0.1%) relative to FY2020. The LHHS omnibus retained a~~
~~provision, included in LHHS appropriations since FY2015, authorizing HHS to augment~~
~~appropriations for the Refugee and Entrant Assistance account via transfers from other~~
~~discretionary HHS funds. The 15% limit on those transfers was the same as FY2020.~~
~~The conference report on the omnibus directed the majority of the appropriation for Refugee and~~
~~Entrant Assistance programs toward the Unaccompanied Alien Children (UAC) program ($1.3~~
~~bil ion, the same as FY2020 and FY2019). The UAC program provides for the shelter, care, and~~
~~placement of unaccompanied alien children who have been apprehended in the United States. The~~
~~LHHS omnibus also included several general provisions that were enacted in FY2020 related to~~
~~the UAC program. For instance, the law authorized HHS to accept donations for the care of UAC~~
~~arrivals (§230), limited the use of funds for changes to policy directives related to the UAC~~
~~program (§231), limited the use of funds for unlicensed facilities for unaccompanied alien~~
~~children (§232), and imposed additional congressional notification requirements prior to the use~~
~~of unlicensed facilities (§233). It also prohibited HHS appropriations from being used to prevent~~
~~a Member of Congress from visiting a UAC facility for oversight purposes provided that the~~
~~Office of Refugee Resettlement (ORR) was notified not less than two business days in advance to~~
~~ensure that such visit would not interfere with the operations (including child welfare and child~~
~~safety operations) of such facility (§234). A number of reporting requirements related to the UAC~~
~~program were also included in or carried by reference in the explanatory statement, such as a~~
~~monthly report to the appropriations committees that includes estimates of UAC arrivals and any~~
~~changes in funding needs as a result of these arrivals, public reporting with respect to children~~
~~who have been separated from a parent or legal guardian, a report to the appropriations~~
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32

~~Labor, Health and Human Services, and Education: FY2021 Appropriations~~

~~committees related to provider facility violations related to standards of child care or the~~
~~wel being of children, and a semiannual report related to number of children in ORR custody in~~
~~residential treatment centers.74~~
~~ACL~~
~~The FY2021 LHHS omnibus provided $2.3 bil ion in discretionary budget authority for ACL.~~
~~This was $35 mil ion (+1.6%) more than FY2020. In addition, the FY2021 LHHS omnibus~~
~~directed $28 mil ion in PPHF transfers to ACL, the same as FY2020. The explanatory statement~~
~~accompanying the FY2021 LHHS omnibus specified that the PPHF transfers were for the~~
~~Alzheimer’s Disease Program, Chronic Disease Self-Management, and Elder Falls Prevention.~~
~~The FY2021 LHHS omnibus did not adopt several ACL proposals made in the President’s budget~~
~~submission. These included proposals to consolidate Chronic Disease Self-Management and~~
~~Elder Fal s Prevention into the Preventive Health Services Program, and to al ow states and tribal~~
~~organizations to transfer 100% of funds among the home and community-based supportive~~
~~services, nutrition, disease prevention and health promotion, and family caregiver support~~
~~programs.75~~
~~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 bil . 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~~

~~74 Congressional Record, vol. 165, no. 204, December 17, 2019, pp. H1107 7-H11078. T he explanatory statement~~
~~included language related to the UACs that noted “T he agreement notes that the front matter of this explanatory~~
~~statement establishes that language included in House Report 116–450 should be complied with unless specifically~~
~~addressed to the contrary in this explanatory statement. In cases where the House Report addresses an issue not~~
~~addressed in this joint explanatory statement, the House Report language is deemed to carry the same emphasis as~~
~~language included in this explanatory statement.” See H.Rept. 116-450, pp. 177-188 for UAC-related language.~~
~~75 Budget of the United States Government, Fiscal Year 2021, Appendix, p. 502, https://www.govinfo.gov/content/pkg/~~
~~BUDGET -2021-APP/pdf/BUDGET -2021-APP.pdf#page=506. A similar proposal was made in the President’s FY2020~~
~~and FY2019 requests; see, Budget of the United States Governm ent, Fiscal Year 2020, Appendix, p. 488,~~
~~https://www.govinfo.gov/content/pkg/BUDGET -2020-APP/pdf/BUDGET -2020-APP-1-11.pdf#page=72; and~~ ~~Budget~~
~~of the United States Governm ent, Fiscal Year 2019, Appendix, p. 484, https://www.govinfo.gov/content/pkg/BUDGET -~~
~~2019-APP/pdf/BUDGET -2019-APP-1-11.pdf#page=70. During the COVID-19 public health emergency, state and~~
~~local agencies on aging have increased flexibility to transfer funds among certain programs; see the discussion of~~
~~Section 3222 in CRS Report R46334, Selected Health Provisions in Title III of the CARES Act (P.L. 116 -136).~~
~~Furthermore, P.L. 116-260, Division N, Section 732 provides that of the home-delivered and congregate nutrition~~
~~services program funds that they receive in FY2021, state and local agencies on aging may transfer up to 100% of the~~
~~funds between the two programs without prior approval.~~
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33

~~Labor, Health and Human Services, and Education: FY2021 Appropriations~~

~~provide or pay for abortions or abortion services. The FY2021 LHHS omnibus retained these~~
~~existing restrictions (§§506 and 507).76~~
Human Embryo Research: Since FY1996, annual LHHS appropriations have included a
~~provision prohibiting any LHHS funds (including NIH funds) from being used to create human~~
~~embryos for research purposes or for research in which human embryos are destroyed. The~~
~~FY2021 LHHS omnibus retained these existing restrictions (§508).77~~
Needle Exchange Programs: Since FY1990, annual LHHS appropriations have general y
~~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).78 Starting in FY2016, the provision was modified to al ow funds to be~~
~~used for needle exchange programs under the following conditions: (1) federal funds may not be~~
~~used to purchase the needles, but may be used for other aspects of such programs; (2) the state or~~
~~local jurisdiction must demonstrate, in consultation with CDC, that they are experiencing, or at~~
~~risk for, a significant increase in hepatitis infections or an HIV outbreak due to injection drug use;~~
~~and (3) the program must be operating in accordance with state and local law. The FY2021 House~~
~~committee bil would have omitted this provision entirely, but the FY2021 LHHS omnibus~~
~~retained these existing restrictions and conditions (§527).~~
Gun Control: Since FY1997, annual LHHS appropriations have included provisions prohibiting
~~the use of certain funds for activities that advocate or promote gun control. Early versions of~~
~~these provisions applied only to CDC; since FY2012, annual appropriations acts also have~~
~~included HHS-specific restrictions, in addition to restrictions that apply to al LHHS funds~~
~~(including funds transferred from the PPHF). FY2021 omnibus retained these existing restrictions~~
~~(§210 [HHS] and §503(c) [al LHHS, plus PPHF transfers]).79~~
~~Table 6. HHS Appropriations Totals by Agency~~
~~(In mil ions of dol ars)~~
~~FY2021~~
~~House~~
~~FY2021~~
~~Cmte.~~
~~Enacted~~
~~FY2020~~
~~FY2021~~
~~(H.R.~~
~~(P.L. 116-~~
~~HHS Agency~~
~~Enacted~~
~~Request~~
~~7614)~~
~~260)~~
~~HRSA~~
~~7,333~~
~~6,571~~
~~7,472~~
~~7,484~~
~~Mandatory BA~~
~~286~~
~~266~~
~~266~~
~~266~~

~~76 T he current provisions are commonly referred to as the Hyde and Weldon Amendments. For additional information,~~
~~see CRS Report RL33467, Abortion: Judicial History and Legislative Response.~~
~~77 T he current provision is commonly referred to as the Dickey Amendment. For additional information, see CRS~~
~~Report RL33540, Stem Cell Research: Science, Federal Research Funding, and Regulatory Oversight.~~
~~78 T he one exception is the FY1992 LHHS appropriations act (P.L. 102-170), which appears to have included no such~~
~~provision. Since the provision’s inception in FY1990, there has been variation in its scope and application during~~
~~certain fiscal years. For example, the LHHS appropriations act for FY1998 ( P.L. 105-78) made the ban subject to~~
~~action by the HHS Secretary. T he LHHS appropriations acts for FY2010 ( P.L. 111-117, Division D) and FY2011 (P.L.~~
~~112-10, Division B) applied the ban only in locations that lo cal authorities determined to be inappropriate.~~
~~79 As previously noted, the explanatory statement accompanying the FY2021 LHHS omnibus directed that $12.5~~
~~million apiece ($25 million total) be allocated by the CDC and NIH for Firearm Injury and Mortality Prevention~~
~~Research (Congressional Record, December 21, 2020, Vol. 166, No. 218, Book IV, pp. H8623 and H8627.). T hese~~
~~CDC and NIH funding reservations for Firearm Injury and Mortality Prevention were first included in LHHS~~
~~explanatory statements in FY2020.~~
~~Congressional Research Service~~

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link to page 42 link to page 43 link to page 42 link to page 43 link to page 43 link to page 43 link to page 42 link to page 43 link to page 42 link to page 43 link to page 43 link to page 42 link to page 43 ~~Labor, Health and Human Services, and Education: FY2021 Appropriations~~

~~FY2021~~
~~House~~
~~FY2021~~
~~Cmte.~~
~~Enacted~~
~~FY2020~~
~~FY2021~~
~~(H.R.~~
~~(P.L. 116-~~
~~HHS Agency~~
~~Enacted~~
~~Request~~
~~7614)~~
~~260)~~
~~Discretionary BA~~
~~7,047~~
~~6,305~~
~~7,206~~
~~7,218~~
Evaluation Tap Fundinga
0
13
0
0
CDCb
~~6,895~~
~~6,949~~
~~7,126~~
~~7,019~~
~~Mandatory BA~~
55
55
55
55
~~Discretionary BA~~
~~6,840~~
~~6,894~~
~~7,070~~
~~6,963~~
Evaluation Tap Fundinga
0
~~542~~
0
0
PPHFc
~~854~~
~~894~~
~~856~~
~~856~~
Nonrecurring Expenses Fund Transferd
~~225~~
0
0
0
NIHb
~~40,228~~
~~38,070~~
~~40,618~~
~~41,437~~
~~Mandatory BA~~
0
0
0
0
~~Discretionary BA~~
~~40,228~~
~~38,070~~
~~40,618~~
~~41,437~~
Evaluation Tap Fundinga
~~1,231~~
~~741~~
~~1,341~~
~~1,272~~
Nonrecurring Expenses Fund Transferd
~~225~~
0
0
~~225~~
~~SAMHSA~~
~~5,737~~
~~5,598~~
~~5,833~~
~~5,870~~
~~Mandatory BA~~
0
0
0
0
~~Discretionary BA~~
~~5,737~~
~~5,598~~
~~5,833~~
~~5,870~~
Evaluation Tap Fundinga
~~134~~
~~143~~
~~134~~
~~134~~
PPHFc
12
0
12
12
AHRQe
~~338~~
0
~~143~~
~~338~~
~~Mandatory BA~~
0
0
0
0
~~Discretionary BA~~
~~338~~
0
~~143~~
~~338~~
Evaluation Tap Fundinga
0
0
~~200~~
0
~~CMS~~
~~828,343~~
~~906,657~~
~~906,942~~
~~906,627~~
~~Mandatory BA~~
~~823,888~~
~~902,150~~
~~902,150~~
~~902,150~~
~~Discretionary BA~~
~~4,456~~
~~4,507~~
~~4,792~~
~~4,477~~
~~ACF~~
~~39,523~~
~~34,994~~
~~41,256~~
~~41,190~~
~~Mandatory BA~~
~~15,079~~
~~14,796~~
~~16,496~~
~~16,496~~
~~Discretionary BA~~
~~24,444~~
~~20,198~~
~~24,760~~
~~24,695~~
~~ACL~~
~~2,223~~
~~2,108~~
~~2,280~~
~~2,258~~
~~Mandatory BA~~
0
0
0
0
~~Discretionary BA~~
~~2,223~~
~~2,108~~
~~2,280~~
~~2,258~~
PPHFc
28
0
28
28
~~Office of the Secretary (OS)~~
~~4,212~~
~~4,009~~
~~4,309~~
~~4,359~~
~~Mandatory BA~~
~~624~~
~~653~~
~~653~~
~~653~~
~~Discretionary BA~~
~~3,588~~
~~3,356~~
~~3,656~~
~~3,706~~
~~Congressional Research Service~~

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~~link to page 42 link to page 43~~ ~~Labor, Health and Human Services, and Education: FY2021 Appropriations~~

~~FY2021~~
~~House~~
~~FY2021~~
~~Cmte.~~
~~Enacted~~
~~FY2020~~
~~FY2021~~
~~(H.R.~~
~~(P.L. 116-~~
~~HHS Agency~~
~~Enacted~~
~~Request~~
~~7614)~~
~~260)~~
Evaluation Tap Fundinga
65
74
65
65
~~Total, HHS BA in the Bill~~
~~934,832~~
~~1,004,955~~
~~1,015,978~~
~~1,016,583~~
~~Mandatory~~
~~839,931~~
~~917,920~~
~~919,620~~
~~919,620~~
~~Discretionary~~
~~94,901~~
~~87,036~~
~~96,358~~
~~96,963~~
~~Emergency Funding (not included in above totals)~~

~~1st COVID (P.L. 116-123)~~
~~6.4~~
—
—
—
~~2nd COVID (P.L. 116-127)~~
~~1.3~~
—
—
—
~~3rd COVID (P.L. 116-136)~~
~~140.4~~
—
—
—
~~4th COVID (P.L. 116-139)~~
~~100.0~~
—
—
—
~~Emergency Funding in Annual LHHSf~~
—
—
~~18.5~~
~~0.6~~
~~5th COVID (Division M, P.L. 116-260)~~
—
—
—
~~72.9~~
~~Memoranda (non-emergency funds only)~~

~~Total, BA Available in Fiscal Year (current year~~
~~932,661~~
~~996,126~~
~~1,007,149~~
~~1,007,753~~
~~from any bil )~~
~~Total, BA Advances for Future Years (provided in~~
~~144,303~~
~~153,132~~
~~153,132~~
~~153,132~~
~~current bil )~~
~~Total, BA Advances from Prior Years (for use in~~
~~142,132~~
~~144,303~~
~~144,303~~
~~144,303~~
~~current year)~~
~~Total, Additional Scorekeeping Adjustments~~
~~-9,420~~
~~-9,163~~
~~-12,124~~
~~-21,068~~
Source: Amounts in this table for the FY2020 Enacted, FY2021 Request, and FY2021 Enacted columns are
~~general y drawn from or calculated based on data contained in the explanatory statement accompanying the~~
~~FY2021 LHHS omnibus (P.L. 116-260), available in the Congressional Record, vol. 166, no. 218, book IV, December~~
~~21, 2020, pp. H8619-H8711. Amounts in the FY2021 House Committee column are general y drawn from or~~
~~calculated based on data contained in the committee report (H. Rept. 116-450) accompanying H.R. 7614.~~
54 The Health Centers program also received significant additional FY2020 and FY2021 funding related to the COVID-19 pandemic, totaling roughly $2 billion. For a discussion of this funding, see CRS Report R46711, U.S. Public Health Service: COVID-19 Supplemental Appropriations in the 116th Congress. 55 Congressional Record, December 21, 2020, Vol. 166, No. 218, Book IV, p. H8620. An amount of $50 million was set aside in FY2020 for the first year of this initiative (see Congressional Record, December 17, 2019, Vol. 165, No. 204, Book III, p. H11063). 56 Ibid, p. H8621. 57 Ibid, p. H8620. See H.Rept. 116-450, pp. 58-59, for further information. 58 Ibid, p. H8620. See H.Rept. 116-450, p. 51, for a description of this activity. 59 Ibid, p. H8620. Congressional Research Service 29 Labor, Health and Human Services, and Education: FY2021 Appropriations It also did not direct the transfer of funds from the HHS Nonrecurring Expenses Fund (NEF) to the CDC (unlike FY2020).60 However, the FY2021 LHHS omnibus did supplement discretionary CDC appropriations by directing $856 million in PPHF transfers to the CDC, which was $2 million (+0.2%) more than FY2020. All told, this combination of funding—compared to FY2020 funding from discretionary appropriations and directed transfers from the PPHF and NEF—represented a decrease of $100 million (-1.3%) from FY2020 in budget authority that is inclusive of directed transfers. The President’s budget request would have increased discretionary budget authority by $54 million (+0.8%) relative to FY2020, while also requesting that $542 million in tap funds be directed to the CDC. The President’s budget also requested $894 million in PPHF transfers, which would have been a $40 million (+4.6%) increase. The President’s budget did not request that any transfers from the NEF be directed to the CDC. All told, this combination of funding would have represented an increase of $410 million (+5.1%) from FY2020. All programmatic accounts received increases relative to FY2020 except Public Health Preparedness and Response and CDC-Wide Activities and Program Support. Among these increases: (1) the HIV/AIDS, Viral Hepatitis, STI and TB Prevention account, which was funded at an increased level of $1.3 billion (+3.2% above FY2020) included a $35 million increase for the Ending HIV/AIDS Initiative;61 and (2) the Emerging and Zoonotic Infectious Diseases (EZID) account, which was funded at an increased level of $596 million (+4.5% above FY2020), included $10 million in funding for a new pilot program that would award competitive grants for the development of Social Determinants of Health Accelerator Plans62. Other increases included the Environmental Health account, funded at $206 million (+4.6%)63, and the Public Health Scientific Services account, funded at $592 million (+6.6%). With regard to the Injury Prevention and Control account, which received $683 million (+0.8%), the explanatory statement included funding for several line items that were first included in FY2020, including child sexual abuse prevention ($1.5 million), suicide prevention ($12 million), and adverse childhood experiences (ACEs, $5 million).64 The explanatory statement also included specific funding for Firearm Injury and Mortality Prevention Research program ($12.5 million) and Opioid Overdose Prevention and Surveillance ($476 million).65 60 The NEF was established by the Consolidated Appropriations Act of 2008 to enable the HHS Secretary to repurpose certain unobligated balances of expired discretionary funds appropriated to HHS from the General Fund (P.L. 110-161, Division G, Title II, §223). Most accounts in annual appropriations measures receive appropriations from the General Fund at the U.S. Treasury. This term refers to all federal money not allocated by law to any other fund account, such as federal trust funds for Medicare. Funds transferred into the NEF are generally available to the Secretary for capital acquisitions across HHS, including facilities infrastructure and information technology. Until recently, it has not been common for LHHS appropriations acts to specify that particular projects are to be funded by the NEF, but there have been a few such cases since FY2017, including in FY2020 where the LHHS omnibus directed $225 million from the NEF to the CDC Buildings and Facilities account to support infrastructure improvements for the CDC’s Chamblee Campus (Congressional Record, December 17, 2019, Vol. 165, No. 204, Book III, p. H11065.) 61 Centers for Disease Control and Prevention, “Ending the HIV Epidemic,” https://www.cdc.gov/endhiv/index.html. 62 Congressional Record, December 21, 2020, Vol. 166, No. 218, Book IV, p. H8623. See H.Rept. 116-450, pp. 76-77, for a description of this activity. 63 This amount does not include the PPHF transfer of $17 million that was directed to the Environmental Health account each of FY2020 and FY2021. 64 Ibid., p. H8623. 65 Ibid., p. H8623. When taking account of the $12.5 million in NIH funding that was reserved for the same purpose, the total provided for Firearm Injury and Mortality Prevention Research was $25 million. Congressional Research Service 30 Labor, Health and Human Services, and Education: FY2021 Appropriations The Infectious Disease Rapid Response Reserve Fund (IDRRRF) within the CDC-Wide Activities and Program Support account received $10 million in the explanatory statement.66 The IDRRRF was established in 2018 by P.L. 115-245 and is codified at 42 U.S.C. §247d-4a as an emergency reserve account. Funds can be made available for infectious disease emergencies as declared by the HHS Secretary (PHSA §319), or if an infectious disease outbreak has the potential to affect national security or the health and security of U.S. citizens, as specified. Funds may be used to carry out activities related to the research, public health prevention, and response for infectious disease emergencies. NIH The FY2021 LHHS omnibus provided $41.4 billion in discretionary budget authority for NIH. This was $1.2 billion (+3.0%) more than FY2020 and $3.4 billion (+8.8%) more than the President’s FY2021 budget request. As was the case in FY2020, the FY2021 LHHS omnibus directed $225 million from the HHS Nonrecurring Expenses Fund (NEF)67 to the NIH Buildings and Facilities account to implement the recommendations in the 2019 National Academies of Sciences, Engineering, and Medicine report Managing the NIH Bethesda Campus’ Capital Assets in a Highly Competitive Global Biomedical Research Environment.68 In addition, the FY2021 LHHS omnibus directed $1.3 billion in PHS tap transfers to NIH, an increase of $41 million (+3.3%) from FY2020. The entirety of the PHS tap transfer was provided to the National Institute of General Medical Sciences (NIGMS), and was paired with a discretionary appropriation of $1.7 billion. The NIGMS discretionary appropriation was $14 million (+0.8%) more than FY2020, but when combined with the tap transfer, total funding for NIGMS increased by $54 million (+1.8%) from FY2020. In line with recent practice, the explanatory statement on the FY2021 LHHS omnibus directed NIH to reserve a specific dollar amount for a number of purposes, for example, $3.1 billion for Alzheimer’s disease research at the National Institute on Aging.69 It also included a reservation of funds for Firearm Injury and Mortality Prevention Research of $12.5 million, the same amount as FY2020.70 Reserving a specific dollar amount for a particular disease or area of research at NIH is a relatively new practice that has expanded since 2015; still, most NIH funding is not designated for particular diseases or areas of research.71 66 Ibid., p. H8624. 67 The NEF was established by the Consolidated Appropriations Act of 2008 to enable the HHS Secretary to repurpose certain unobligated balances of expired discretionary funds appropriated to HHS from the General Fund (P.L. 110-161, Division G, Title II, §223). Most accounts in annual appropriations measures receive appropriations from the General Fund at the U.S. Treasury. This term refers to all federal money not allocated by law to any other fund account, such as federal trust funds for Medicare. 68 See Division H, Title II, §238 of P.L. 116-260. For further details, see Congressional Record, December 21, 2020, Vol. 166, No. 218, Book IV, p. H8629. (See also Congressional Record, December 17, 2019, Vol. 165, No. 204, Book III, p. H11074.) 69 Ibid., p. H8626. For a list of specified funding levels in the explanatory statement accompanying the LHHS omnibus, see Table A-2 in CRS Report R43341, National Institutes of Health (NIH) Funding: FY1996-FY2022. 70 Ibid., p. H8627. When taking account of the $12.5 million in CDC funding that was reserved for the same purpose, the total provided for Firearm Injury and Mortality Prevention Research was $25 million in both FY2020 and FY2021. 71 As recently as December 2014, the explanatory statement on the FY2015 omnibus stipulated, “In keeping with longstanding practice, the agreement does not recommend a specific amount of NIH funding for this purpose [Alzheimer’s disease] or for any other individual disease. Doing so would establish a dangerous precedent that could politicize the NIH peer review system. Nevertheless, in recognition that Alzheimer’s disease poses a serious threat to Congressional Research Service 31 Labor, Health and Human Services, and Education: FY2021 Appropriations The FY2021 LHHS omnibus appropriated $404 million to the NIH Innovation Account pursuant to the 21st Century Cures Act (Cures Act; P.L. 114-255), which was equal to the amount authorized to be appropriated in that act. The explanatory statement also reiterated the purposes authorized in the Cures Act, directing that NIH transfer $195 million to the National Cancer Institute to support cancer research, and $50 million each to the National Institute of Neurological Disorders and Stroke and the National Institute of Mental Health to support the Brain Research through Advancing Innovative Neurotechnologies (BRAIN) Initiative. The remaining $109 million was for the Precision Medicine Initiative.72 SAMHSA The FY2021 LHHS omnibus provided $5.9 billion in discretionary budget authority for SAMHSA. This amount was $133 million (+2.3%) more than SAMHSA’s FY2020 funding level and $272 million (+4.9%) more than the President’s FY2021 budget request. The FY2021 LHHS omnibus also directed $134 million in PHS evaluation tap funding and $12 million in PPHF funding to SAMHSA, which were the same amounts as FY2019 and FY2020. The additional funding provided to SAMHSA was spread across several programs in the explanatory statement. The programs within the Mental Health Programs of Regional and National Significance (PRNS) received an increase of $26 million (+5.9%) and the programs within the Substance Abuse Treatment PRNS received an increase of $17 million (+3.6%). Nearly all Mental Health and Substance Abuse Treatment PRNS programs received level funding or modest increases from FY2020. The largest increase was provided to the Certified Community Behavioral Health Clinics (CCBHCs)—$50 million (+25.0%) more than FY2020. The Community Mental Health Block Grant (MHBG) received an increase of $35 million (+5.0%) while the Substance Abuse Prevention and Treatment Block Grant (SABG) received the same amount as FY2020. The State Opioid Response (SOR) grant program continued to be funded at $1.5 billion, the same amount as FY2019 and FY2020. AHRQ The FY2021 LHHS omnibus provided $338 million in discretionary budget authority to AHRQ. This was the same as the FY2020 level. The FY2021 LHHS omnibus did not direct any PHS tap transfers to AHRQ, which is in keeping with practices since FY2015 but contrasts with earlier years (FY2003-FY2014) in which AHRQ had been funded primarily with tap transfers.73 (The House bill proposed $200 million in tap transfers for AHRQ, but this proposal was not enacted.) The FY2021 LHHS omnibus continued to fund AHRQ as its own operating division, declining the President’s proposal to consolidate AHRQ into NIH. The FY2021 President’s budget had the Nation’s long-term health and economic stability, the agreement expects that a significant portion of the recommended increase for NIA should be directed to research on Alzheimer’s. The exact amount should be determined by scientific opportunity of additional research on this disease and the quality of grant applications that are submitted for Alzheimer’s relative to those submitted for other diseases.” See Congressional Record, daily edition, vol. 160, no. 151, Book II (December 11, 2014), p. H9832. 72 Congressional Record, December 21, 2020, Vol. 166, No. 218, Book IV, p. H8624. 73 In addition to funds provided through the annual appropriations process, AHRQ is also scheduled in FY2021 to receive a transfer of certain mandatory funds that were authorized and appropriated to the Patient-Centered Outcomes Research Trust Fund (PCORTF) by ACA Section 6301(e), as amended (26 U.S.C. §9511). Transfers to AHRQ from the PCORTF are to be used to disseminate the results of patient-centered outcomes research. (PCORTF funds are generally not displayed in this report, as they are not provided by or modified through annual LHHS appropriations bills.) For more information on the PCORTF, see HHS, Office of the Assistant Secretary for Planning and Evaluation, Patient-Centered Outcomes Research Trust Fund, https://aspe.hhs.gov/patient-centered-outcomes-research-trust-fund. Congressional Research Service 32 link to page 59 Labor, Health and Human Services, and Education: FY2021 Appropriations requested zero funding for AHRQ, proposing instead to continue funding many of AHRQ’s activities through a new National Institute for Research on Safety and Quality (NIRSQ) in the NIH.74 CMS The FY2021 LHHS omnibus provided $4.5 billion in discretionary budget authority for CMS. This was $21 million (+0.5%) more than FY2020 and $30 million (-0.7%) less than the FY2021 President’s budget request. The LHHS omnibus appropriated $807 million for the CMS Health Care Fraud and Abuse Control (HCFAC) account, 2.7% more than FY2020, and less (-0.7%) than the FY2021 President’s request. Of the total amount appropriated for HCFAC, $496 million was effectively exempt from the discretionary budget caps. (See Appendix A for an explanation of the LHHS budget cap exemptions.) The LHHS omnibus provided the CMS Program Management account with $3.7 billion, which was the same amount provided in FY2020 and FY2019. This account supports CMS program operations (e.g., claims processing, information technology investments, provider and beneficiary outreach and education, and program implementation), in addition to federal administration and other activities related to the administration of Medicare, Medicaid, the State Children’s Health Insurance Program, and private health insurance provisions established by the ACA. The FY2021 appropriation was less than the amount proposed by the President’s budget (-0.6%) and the House committee bill (-7.9%). The LHHS omnibus maintained a general provision (§227), included in LHHS appropriations acts since FY2014, authorizing HHS to transfer additional funds into this account from Medicare trust funds. The terms of the provision required that such funds be used to support activities specific to the Medicare program, limited the amount of the transfers to $305 million, and explicitly prohibited such transfers from being used to support or supplant funding for ACA implementation. The House committee bill would have eliminated this provision. ACF The FY2021 LHHS omnibus provided $24.7 billion in discretionary budget authority for ACF. This was $251 million (+1.0%) more than FY2020 and $4.5 billion (+22.3%) more than the FY2020 President’s budget request. The President’s budget would have decreased ACF discretionary funding by almost one-fifth relative to the prior year (-17.4%). The President’s budget would have achieved much of its proposed reduction by eliminating certain programs within ACF, such as the Low Income Home Energy Assistance Program (LIHEAP), Preschool Development Grants (PDG), and the Community Services Block Grant (CSBG). Funding for all three of these programs was sustained or increased in the FY2021 LHHS omnibus relative to FY2020: LIHEAP received $3.8 billion (+0.3%), PDG $275 million (+0.0%), and CSBG $745 million (+0.7%). 74 HHS, NIH, National Institute for Research on Safety and Quality, FY2021 Congressional Justification, https://www.ahrq.gov/sites/default/files/wysiwyg/cpi/about/mission/budget/2021/FY_2021_CJ_NIRSQ.pdf. The President’s request would have funded NIRSQ at $257 million for FY2021 (not counting transfers from the PCORTF). A similar proposal was made in the President’s FY2020, FY2019, and FY2018 requests; see HHS, NIH, National Institute for Research on Safety and Quality, FY2021 Congressional Justification, https://www.ahrq.gov/sites/default/files/wysiwyg/cpi/about/mission/budget/2020/FY_2020_CJ_-NIRSQ.pdf; HHS, NIH, National Institute for Research on Safety and Quality, FY2019 Congressional Justification, https://www.ahrq.gov/sites/default/files/wysiwyg/cpi/about/mission/budget/2019/NIRSQ.pdf; HHS, NIH, National Institute for Research on Safety and Quality, FY 2018 Congressional Justification, https://www.ahrq.gov/sites/default/files/wysiwyg/cpi/about/mission/budget/2018/NIRSQ.pdf. Congressional Research Service 33 Labor, Health and Human Services, and Education: FY2021 Appropriations The LHHS omnibus provided $1.9 billion for the Refugee and Entrant Assistance programs account, an increase of $2 million (+0.1%) relative to FY2020. The LHHS omnibus retained a provision, included in LHHS appropriations since FY2015, authorizing HHS to augment appropriations for the Refugee and Entrant Assistance account via transfers from other discretionary HHS funds. The 15% limit on those transfers was the same as FY2020. The conference report on the omnibus directed the majority of the appropriation for Refugee and Entrant Assistance programs toward the Unaccompanied Alien Children (UAC) program ($1.3 billion, the same as FY2020 and FY2019). The UAC program provides for the shelter, care, and placement of unaccompanied alien children who have been apprehended in the United States. The LHHS omnibus also included several general provisions that were enacted in FY2020 related to the UAC program. For instance, the law authorized HHS to accept donations for the care of UAC arrivals (§230), limited the use of funds for changes to policy directives related to the UAC program (§231), limited the use of funds for unlicensed facilities for unaccompanied alien children (§232), and imposed additional congressional notification requirements prior to the use of unlicensed facilities (§233). It also prohibited HHS appropriations from being used to prevent a Member of Congress from visiting a UAC facility for oversight purposes provided that the Office of Refugee Resettlement (ORR) was notified not less than two business days in advance to ensure that such visit would not interfere with the operations (including child welfare and child safety operations) of such facility (§234). A number of reporting requirements related to the UAC program were also included in or carried by reference in the explanatory statement, such as a monthly report to the appropriations committees that includes estimates of UAC arrivals and any changes in funding needs as a result of these arrivals, public reporting with respect to children who have been separated from a parent or legal guardian, a report to the appropriations committees related to provider facility violations related to standards of child care or the wellbeing of children, and a semiannual report related to number of children in ORR custody in residential treatment centers.75 ACL The FY2021 LHHS omnibus provided $2.3 billion in discretionary budget authority for ACL. This was $35 million (+1.6%) more than FY2020. In addition, the FY2021 LHHS omnibus directed $28 million in PPHF transfers to ACL, the same as FY2020. The explanatory statement accompanying the FY2021 LHHS omnibus specified that the PPHF transfers were for the Alzheimer’s Disease Program, Chronic Disease Self-Management, and Elder Falls Prevention. The FY2021 LHHS omnibus did not adopt several ACL proposals made in the President’s budget submission. These included proposals to consolidate Chronic Disease Self-Management and Elder Falls Prevention into the Preventive Health Services Program, and to allow states and tribal organizations to transfer 100% of funds among the home and community-based supportive services, nutrition, disease prevention and health promotion, and family caregiver support programs.76 75 Congressional Record, vol. 165, no. 204, December 17, 2019, pp. H11077-H11078. The explanatory statement included language related to the UACs that noted “The agreement notes that the front matter of this explanatory statement establishes that language included in House Report 116–450 should be complied with unless specifically addressed to the contrary in this explanatory statement. In cases where the House Report addresses an issue not addressed in this joint explanatory statement, the House Report language is deemed to carry the same emphasis as language included in this explanatory statement.” See H.Rept. 116-450, pp. 177-188 for UAC-related language. 76 Budget of the United States Government, Fiscal Year 2021, Appendix, p. 502, https://www.govinfo.gov/content/pkg/BUDGET-2021-APP/pdf/BUDGET-2021-APP.pdf#page=506. A similar proposal was made in the President’s FY2020 Congressional Research Service 34 Labor, Health and Human Services, and Education: FY2021 Appropriations Restrictions Related to Certain Controversial Issues Annual LHHS appropriations measures regularly contain broad restrictions related to certain controversial issues. For instance, annual LHHS appropriations acts commonly include provisions limiting the use of federal funds for abortions, the use of human embryos for research, needle exchange programs, and gun control advocacy. Abortions: Since FY1977, annual LHHS appropriations acts have included provisions limiting the circumstances under which LHHS funds (including Medicaid funds) may be used to pay for abortions. Early versions of these provisions applied only to HHS, but since FY1994 most provisions have applied to the entire LHHS bill. Under current provisions, (1) abortions may be funded only when the life of the mother is endangered or in cases of rape or incest; (2) funds may not be used to buy a managed care package that includes abortion coverage, except in cases of rape, incest, or endangerment; and (3) federal programs and state and local governments that receive LHHS funding are prohibited from discriminating against health care entities that do not provide or pay for abortions or abortion services. The FY2021 LHHS omnibus retained these existing restrictions (§§506 and 507).77 Human Embryo Research: Since FY1996, annual LHHS appropriations have included a provision prohibiting any LHHS funds (including NIH funds) from being used to create human embryos for research purposes or for research in which human embryos are destroyed. The FY2021 LHHS omnibus retained these existing restrictions (§508).78 Needle Exchange Programs: Since FY1990, annual LHHS appropriations have generally included a provision prohibiting any LHHS funds from being used for needle exchange programs (i.e., programs in which sterile needles or syringes are made available to injection drug users in exchange for used needles or syringes to mitigate the spread of related infections, such as Hepatitis and HIV/AIDS).79 Starting in FY2016, the provision was modified to allow funds to be used for needle exchange programs under the following conditions: (1) federal funds may not be used to purchase the needles, but may be used for other aspects of such programs; (2) the state or local jurisdiction must demonstrate, in consultation with CDC, that they are experiencing, or at risk for, a significant increase in hepatitis infections or an HIV outbreak due to injection drug use; and (3) the program must be operating in accordance with state and local law. The FY2021 House and FY2019 requests; see, Budget of the United States Government, Fiscal Year 2020, Appendix, p. 488, https://www.govinfo.gov/content/pkg/BUDGET-2020-APP/pdf/BUDGET-2020-APP-1-11.pdf#page=72; and Budget of the United States Government, Fiscal Year 2019, Appendix, p. 484, https://www.govinfo.gov/content/pkg/BUDGET-2019-APP/pdf/BUDGET-2019-APP-1-11.pdf#page=70. During the COVID-19 public health emergency, state and local agencies on aging have increased flexibility to transfer funds among certain programs; see the discussion of Section 3222 in CRS Report R46334, Selected Health Provisions in Title III of the CARES Act (P.L. 116-136). Furthermore, P.L. 116-260, Division N, Section 732 provides that of the home-delivered and congregate nutrition services program funds that they receive in FY2021, state and local agencies on aging may transfer up to 100% of the funds between the two programs without prior approval. 77 The current provisions are commonly referred to as the Hyde and Weldon Amendments. For additional information, see CRS Report RL33467, Abortion: Judicial History and Legislative Response. 78 The current provision is commonly referred to as the Dickey Amendment. For additional information, see CRS Report RL33540, Stem Cell Research: Science, Federal Research Funding, and Regulatory Oversight. 79 The one exception is the FY1992 LHHS appropriations act (P.L. 102-170), which appears to have included no such provision. Since the provision’s inception in FY1990, there has been variation in its scope and application during certain fiscal years. For example, the LHHS appropriations act for FY1998 (P.L. 105-78) made the ban subject to action by the HHS Secretary. The LHHS appropriations acts for FY2010 (P.L. 111-117, Division D) and FY2011 (P.L. 112-10, Division B) applied the ban only in locations that local authorities determined to be inappropriate. Congressional Research Service 35 link to page 44 link to page 44 link to page 44 link to page 44 link to page 44 link to page 44 link to page 44 link to page 44 link to page 44 link to page 44 link to page 44 Labor, Health and Human Services, and Education: FY2021 Appropriations committee bill would have omitted this provision entirely, but the FY2021 LHHS omnibus retained these existing restrictions and conditions (§527). Gun Control: Since FY1997, annual LHHS appropriations have included provisions prohibiting the use of certain funds for activities that advocate or promote gun control. Early versions of these provisions applied only to CDC; since FY2012, annual appropriations acts also have included HHS-specific restrictions, in addition to restrictions that apply to all LHHS funds (including funds transferred from the PPHF). FY2021 omnibus retained these existing restrictions (§210 [HHS] and §503(c) [all LHHS, plus PPHF transfers]).80 Table 6. HHS Appropriations Totals by Agency (In millions of dollars) FY2021 House FY2021 Cmte. Enacted FY2020 FY2021 (H.R. (P.L. 116- HHS Agency Enacted Request 7614) 260) HRSA 7,333 6,571 7,472 7,484 Mandatory BA 286 266 266 266 Discretionary BA 7,047 6,305 7,206 7,218 Evaluation Tap Fundinga 0 13 0 0 CDCb 6,895 6,949 7,126 7,019 Mandatory BA 55 55 55 55 Discretionary BA 6,840 6,894 7,070 6,963 Evaluation Tap Fundinga 0 542 0 0 PPHFc 854 894 856 856 Nonrecurring Expenses Fund Transferd 225 0 0 0 NIHb 40,228 38,070 40,618 41,437 Mandatory BA 0 0 0 0 Discretionary BA 40,228 38,070 40,618 41,437 Evaluation Tap Fundinga 1,231 741 1,341 1,272 Nonrecurring Expenses Fund Transferd 225 0 0 225 SAMHSA 5,737 5,598 5,833 5,870 Mandatory BA 0 0 0 0 Discretionary BA 5,737 5,598 5,833 5,870 Evaluation Tap Fundinga 134 143 134 134 PPHFc 12 0 12 12 AHRQe 338 0 143 338 80 As previously noted, the explanatory statement accompanying the FY2021 LHHS omnibus directed that $12.5 million apiece ($25 million total) be allocated by the CDC and NIH for Firearm Injury and Mortality Prevention Research (Congressional Record, December 21, 2020, Vol. 166, No. 218, Book IV, pp. H8623 and H8627.). These CDC and NIH funding reservations for Firearm Injury and Mortality Prevention were first included in LHHS explanatory statements in FY2020. Congressional Research Service 36 link to page 44 link to page 44 link to page 44 link to page 44 link to page 44 Labor, Health and Human Services, and Education: FY2021 Appropriations FY2021 House FY2021 Cmte. Enacted FY2020 FY2021 (H.R. (P.L. 116- HHS Agency Enacted Request 7614) 260) Mandatory BA 0 0 0 0 Discretionary BA 338 0 143 338 Evaluation Tap Fundinga 0 0 200 0 CMS 828,343 906,657 906,942 906,627 Mandatory BA 823,888 902,150 902,150 902,150 Discretionary BA 4,456 4,507 4,792 4,477 ACF 39,523 34,994 41,256 41,190 Mandatory BA 15,079 14,796 16,496 16,496 Discretionary BA 24,444 20,198 24,760 24,695 ACL 2,223 2,108 2,280 2,258 Mandatory BA 0 0 0 0 Discretionary BA 2,223 2,108 2,280 2,258 PPHFc 28 0 28 28 Office of the Secretary (OS) 4,212 4,009 4,309 4,359 Mandatory BA 624 653 653 653 Discretionary BA 3,588 3,356 3,656 3,706 Evaluation Tap Fundinga 65 74 65 65 Total, HHS BA in the Bill 934,832 1,004,955 1,015,978 1,016,583 Mandatory 839,931 917,920 919,620 919,620 Discretionary 94,901 87,036 96,358 96,963 Emergency Funding (not included in above totals) 1st COVID (P.L. 116-123) 6.4 — — — 2nd COVID (P.L. 116-127) 1.3 — — — 3rd COVID (P.L. 116-136) 140.4 — — — 4th COVID (P.L. 116-139) 100.0 — — — Emergency Funding in Annual LHHSf — — 18.5 0.6 5th COVID (Division M, P.L. 116-260) — — — 72.9 Afghan special immigrants (P.L. 117-31) - - - 0.0g Memoranda (non-emergency funds only) Total, BA Available in Fiscal Year (current year 932,661 996,126 1,007,149 1,007,753 from any bil ) Total, BA Advances for Future Years (provided in 144,303 153,132 153,132 153,132 current bil ) Total, BA Advances from Prior Years (for use in 142,132 144,303 144,303 144,303 current year) Congressional Research Service 37 Labor, Health and Human Services, and Education: FY2021 Appropriations FY2021 House FY2021 Cmte. Enacted FY2020 FY2021 (H.R. (P.L. 116- HHS Agency Enacted Request 7614) 260) Total, Additional Scorekeeping Adjustments -9,420 -9,163 -12,124 -21,068 Sources: Amounts in this table for the FY2020 Enacted, FY2021 Request, and FY2021 Enacted columns are generally drawn from or calculated based on data contained in the explanatory statement accompanying the FY2021 LHHS omnibus (P.L. 116-260), available in the Congressional Record, vol. 166, no. 218, book IV, December 21, 2020, pp. H8619-H8711. (The amount for P.L. 117-31 is from CBO, Discretionary Spending: Senate Amendment 2123, July 29, 2021, https://www.cbo.gov/system/files/2021-07/EmergencySecuritySupplementalAppropriationsAct2021.pdf.) Amounts in the FY2021 House Committee column are generally drawn from or calculated based on data contained in the committee report (H.Rept. 116-450) accompanying H.R. 7614. Enacted totals (“Total BA in the Bil ”) for FY2020 do not include emergency-designated appropriations provided Enacted totals (“Total BA in the Bil ”) for FY2020 do not include emergency-designated appropriations provided
in P.L.in P.L. 116-113, P.L. 116-123, P.L. 116-127, P.L. 116-136, or P.L. 116-139. House 116-113, P.L. 116-123, P.L. 116-127, P.L. 116-136, or P.L. 116-139. House ~~committee~~ committee bil totals (“Total BA bil totals (“Total BA
in the Bil ”) for FY2021 do not include emergency-designated appropriations proposed in Title VI of H.R. 7614. in the Bil ”) for FY2021 do not include emergency-designated appropriations proposed in Title VI of H.R. 7614.
Enacted totals (“Total BA in the Bil ”) for FY2021 do not include emergency-designated appropriations provided Enacted totals (“Total BA in the Bil ”) for FY2021 do not include emergency-designated appropriations provided
in Divisionin Division H or M of P.L.H or M of P.L. ~~116-260~~ 116-260, or P.L. 117-31. For consistency with . For consistency with ~~source~~ source materials,materials, amounts in this figure amounts in this figure ~~general y~~generally do not do not
reflect mandatory spending sequestration, wherereflect mandatory spending sequestration, where applicable, nor do they reflect any transfers or reprogramming applicable, nor do they reflect any transfers or reprogramming
of funds pursuant to executive authorities. CRS calculations do, however, include LHHS funding provided to 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. HHS pursuant to the 21st Century Cures Act (P.L. 114-255), as amended.
Notes: BA = Budget Authority. DetailsBA = Budget Authority. Details may not add to totals due to rounding. Amounts in this table (1) reflect may not add to totals due to rounding. Amounts in this table (1) reflect
al all BA appropriated in the bil ,BA appropriated in the bil , ~~regardless~~ regardless of the year in which funds become available (i.e.,of the year in which funds become available (i.e., totals do not include totals do not include
advances from prior-year appropriations,advances from prior-year appropriations, but do include advances for subsequent years provided in this bil ); (2) but do include advances for subsequent years provided in this bil ); (2)
have have ~~general y~~generally not been adjusted to reflect not been adjusted to reflect scorekeeping; (3) comprisescorekeeping; (3) comprise only those funds provided (or requested) only those funds provided (or requested)
for agencies and accounts subject to the jurisdictionfor agencies and accounts subject to the jurisdiction of the LHHS subcommitteesof the LHHS subcommittees of the House and Senate of the House and Senate
appropriations committeesappropriations committees (e.g.,(e.g., department totals do not include funding for the Food and Drug Administration, department totals do not include funding for the Food and Drug Administration,
the Indian Health Service,the Indian Health Service, or the Agency for Toxic Substances and Diseaseor the Agency for Toxic Substances and Disease Registry, Registry, al all of which are funded by of which are funded by
other bil s); and (4) do not include appropriations that occur outside of appropriations bil s.other bil s); and (4) do not include appropriations that occur outside of appropriations bil s.
a. By convention, this table shows only the amount of PHS Evaluation Tap funds receiveda. By convention, this table shows only the amount of PHS Evaluation Tap funds received by an agency, not the by an agency, not the
amount of tap funds donated by an agency. That is to say, tap amounts shown in this table are amount of tap funds donated by an agency. That is to say, tap amounts shown in this table are in addition to ~~in addition to~~
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amounts shown for budget authority, but the amounts shown for budget authority have not been adjusted 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.to reflect potential “transfer-out” of funds to the tap.
b. Each year, CDC and NIH also receive b. Each year, CDC and NIH also receive funding in the Interior-Environment appropriations bil as part of their funding in the Interior-Environment appropriations bil as part of their
~~overal~~ overall budget authority. budget authority.
c. PPHF funds are not appropriated in the LHHS bil , c. PPHF funds are not appropriated in the LHHS bil , but are shown here for il ustrativebut are shown here for il ustrative purposes as they may purposes as they may
be used to supplement the funding selected agencies and programs be used to supplement the funding selected agencies and programs ~~receive~~ receive through the appropriations through the appropriations
process.process. Amounts shown for PPHF in this table areAmounts shown for PPHF in this table are in addition to amounts shown for budget authority. amounts shown for budget authority.
d. The Nonrecurring Expenses Fund (NEF) was established by the Consolidated Appropriations Act of 2008, d. The Nonrecurring Expenses Fund (NEF) was established by the Consolidated Appropriations Act of 2008,
to enable the HHS Secretary to repurpose certain unobligated balances of expired discretionary to enable the HHS Secretary to repurpose certain unobligated balances of expired discretionary funds funds
appropriated to HHS from the Generalappropriated to HHS from the General Fund. The FY2020 omnibus specified that HHS must transfer $Fund. The FY2020 omnibus specified that HHS must transfer $~~2 25~~225
mil ionmil ion apiece from the NEF to the buildings and facilitiesapiece from the NEF to the buildings and facilities accounts at CDC and NIH. The FY2021 omnibus accounts at CDC and NIH. The FY2021 omnibus
specified that HHS must transfer $225 mil ionspecified that HHS must transfer $225 mil ion to the building and facilitiesto the building and facilities account at NIH. Amounts shown account at NIH. Amounts shown
for the NEF transfer are for the NEF transfer are in addition to amounts shown for budget authority. amounts shown for budget authority.
e. The President’s e. The President’s budget for FY2020 proposed that AHRQ be eliminated,budget for FY2020 proposed that AHRQ be eliminated, and that certain functions be and that certain functions be
transferred to NIH. This proposal was not adopted by the House or the Senate version of the LHHS bil , transferred to NIH. This proposal was not adopted by the House or the Senate version of the LHHS bil , or or
included in FY2020 enacted appropriations.included in FY2020 enacted appropriations.
f. f.
The FY2021 House committee The FY2021 House committee bil included a total of $19.4 bil ion in emergency-designatedbil included a total of $19.4 bil ion in emergency-designated budget budget
authority in Title VI, of which $18.5 bil ion was for HHS. Subsequently, Divisionauthority in Title VI, of which $18.5 bil ion was for HHS. Subsequently, Division H of P.L. 116-260 enacted H of P.L. 116-260 enacted
$1.6 bil ion in emergency-designated budget authority, of which $638 mil ion$1.6 bil ion in emergency-designated budget authority, of which $638 mil ion was for HHS in Title II.was for HHS in Title II.
~~Table 7. HHS Discretionary Appropriations for Selected~~
~~Programs or Activities, by Agency~~
~~(In mil ions of dol ars~~ g. P.L. 117-31 provided $25 mil ion in supplemental appropriations for the Refugee and Entrant Assistance account at HHS for specified purposes related to Afghan special immigrants, which rounds to $0.0 in bil ions (the unit of measure used in this table). Congressional Research Service 38 link to page 48 link to page 48 link to page 48 link to page 48 link to page 48 Labor, Health and Human Services, and Education: FY2021 Appropriations Table 7. HHS Discretionary Appropriations for Selected Programs or Activities, by Agency (In millions of dollars) )
FY2021
House
FY2021
Cmte.
Enacted
FY2020
FY2021
(H.R.
(P.L. 116-
Agency or Selected Program
Enacted
Request
7614)
260)
HRSA

Community Health Centers Community Health Centers
1,626 1,626
1,728 1,728
1,651 1,651
1,683 1,683
National Health Service National Health Service Corps Corps
120 120
120 120
120 120
120 120
Children’s Children’s Hospitals Graduate Medical Education Hospitals Graduate Medical Education
340 340
0 0
340 340
350 350
Maternal & Child Health Block Maternal & Child Health Block Grant Grant
688 688
761 761
713 713
713 713
Autism and Other Developmental Autism and Other Developmental Disorders Disorders
52 52
0 0
53 53
53 53
Healthy Start Healthy Start
126 126
126 126
131 131
128 128
Ryan White AIDS Programs Ryan White AIDS Programs
2,389 2,389
2,484 2,484
2,414 2,414
2,424 2,424
Organ Transplantation Organ Transplantation
28 28
17 17
33 33
29 29
Telehealth Telehealth
29 29
29 29
42 42
34 34
Rural Communities Rural Communities Opioid Response Opioid Response
110 110
110 110
110 110
110 110
Family Family Planning (Title X) Planning (Title X)
286 286
286 286
286 286
286 286
CDC

Immunization and Respiratory Diseases Immunization and Respiratory Diseases
433 433
577 577
470 470
449 449
PPHFa
370
303
370
372
HIV/AIDS, Viral HIV/AIDS, Viral Hepatitis, STDs, TB PreventionHepatitis, STDs, TB Prevention
1,274 1,274
1,553 1,553
1,288 1,288
1,314 1,314
Emerging and Zoonotic Infectious Diseases Emerging and Zoonotic Infectious Diseases
570 570
599 599
594 594
596 596
Chronic Disease Chronic Disease Prevention and Health PromotionPrevention and Health Promotion
985 985
962 962
1,050 1,050
1,022 1,022
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~~FY2021~~
~~House~~
~~FY2021~~
~~Cmte.~~
~~Enacted~~
~~FY2020~~
~~FY2021~~
~~(H.R.~~
~~(P.L. 116-~~
~~Agency or Selected Program~~
~~Enacted~~
~~Request~~
~~7614)~~
~~260)~~
PPHFa
255
454
257
255
Birth Defects and Developmental Birth Defects and Developmental DisabilitiesDisabilities
161 161
112 112
163 163
168 168
Public Health Scientific Services Public Health Scientific Services
555 555
115 115
593 593
592 592
Environmental Health Environmental Health
197 197
182 182
220 220
206 206
PPHFa
17
0
17
17
Injury Prevention and Control Injury Prevention and Control
677 677
730 730
695 695
683 683
National Institute for Occupational Safety and National Institute for Occupational Safety and
343 343
111 111
345 345
345 345
Health Health
Evaluation Tap Fundingb
0
79
0
0
Global Health Global Health
571 571
621 621
573 573
593 593
Buildings and Facilities Buildings and Facilities
25 25
30 30
30 30
30 30
Nonrecurring Expenses Fund ~~Transfer~~Transf erc
225
0
0
0
NIH

National Institute of National Institute of ~~Al ergy~~ Allergy and Infectious Diseases 5,885 5,885 6,013 6,070 Congressional Research Service 39 link to page 48 link to page 48 link to page 48 link to page 48 link to page 48 link to page 48 link to page 48 Labor, Health and Human Services, and Education: FY2021 Appropriations FY2021 House FY2021 Cmte. Enacted FY2020 FY2021 (H.R. (P.L. 116- Agency or Selected Program Enacted Request 7614) 260)~~and Infectious Diseases~~
~~5,885~~
~~5,885~~
~~6,013~~
~~6,070~~
National Institute of General Medical Sciences National Institute of General Medical Sciences
1,706 1,706
1,931 1,931
1,631 1,631
1,720 1,720
Evaluation Tap Funding
1,231 1,231
741 741
1,341 1,341
1,272 1,272
National Institute on Aging National Institute on Aging
3,544 3,544
3,226 3,226
3,609 3,609
3,899 3,899
National Institute on Drug Abuse National Institute on Drug Abuse
1,462 1,462
1,432 1,432
1,475 1,475
1,480 1,480
NIH Innovation Accoun NIH Innovation Accountd
492 492
404 404
404 404
404 404
SAMHSA

Mental Health Programs Mental Health Programs of Regional & National of Regional & National
449 449
441 441
469 469
475 475
Significance (PRNS) Significance (PRNS)
PPHF
12
0
12
12
Mental Health Block Mental Health Block GrantGrant
702 702
737 737
737 737
737 737
Evaluation Tap Fundingb
21
21
21
21
Certified Certified Community Behavioral Health Clinics Community Behavioral Health Clinics
200 200
225 225
225 225
250 250
Children’s Children’s Mental HealthMental Health
125 125
125 125
125 125
125 125
Substance Abuse Treatment PRNS Substance Abuse Treatment PRNS
478 478
365 365
488 488
495 495
Evaluation Tap Fundingb
79
79
79
79
Substance Abuse Block Grant Substance Abuse Block Grant
1,779 1,779
1,779 1,779
1,779 1,779
1,779 1,779
Evaluation Tap Fundingb
79
79
79
79
State Opioid Response Grants State Opioid Response Grants
1,500 1,500
1,585 1,585
1,500 1,500
1,500 1,500
Substance Abuse Prevention PRNS Substance Abuse Prevention PRNS
206 206
97 97
209 209
208 208
Health Health ~~Surveil ance~~ Surveillance and Support and Support
129 129
97 97
129 129
129 129
Evaluation Tap Funding b 31 42 31 31 ~~Tap Funding~~b
31
42
31
31
~~Congressional Research Service~~

38

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~~FY2021~~
~~House~~
~~FY2021~~
~~Cmte.~~
~~Enacted~~
~~FY2020~~
~~FY2021~~
~~(H.R.~~
~~(P.L. 116-~~
~~Agency or Selected Program~~
~~Enacted~~
~~Request~~
~~7614)~~
~~260)~~
AHRQe

Research on Health Costs, Quality, and Outcomes Research on Health Costs, Quality, and Outcomes
197 197
0 0
0 0
197 197
Evaluation Tap Fundingb
0
0
200
0
Medical Expenditure Surveys Medical Expenditure Surveys
70 70
0 0
72 72
70 70
Program Support Program Support
71 71
0 0
71 71
71 71
CMS

CMS Program Management CMS Program Management
3,670 3,670
3,694 3,694
3,985 3,985
3,670 3,670
Health Care Fraud and Abuse Control Health Care Fraud and Abuse Control
786 786
813 813
807 807
807 807
ACF

Low Income Home Energy Assistance Low Income Home Energy Assistance Program Program
3,740 3,740
0 0
3,765 3,765
3,750 3,750
Formula Formula GrantsGrants
Refugee and Entrant Assistance Programs Refugee and Entrant Assistance Programs
1,908 1,908
2,456 2,456
1,911 1,911
1,910 1,910
Child Care and Development Child Care and Development ~~Block~~ Block Grant Grant
5,826 5,826
5,826 5,826
5,926 5,926
5,911 5,911
Head Start Head Start
10,613 10,613
10,613 10,613
10,763 10,763
10,748 10,748 Congressional Research Service 40 link to page 48 Labor, Health and Human Services, and Education: FY2021 Appropriations FY2021 House FY2021 Cmte. Enacted FY2020 FY2021 (H.R. (P.L. 116- Agency or Selected Program Enacted Request 7614) 260) Preschool Development
~~Preschool Development~~ Grants Grants
275 275
0 0
300 300
275 275
Child Welfare Child Welfare Services Services
269 269
269 269
269 269
269 269
Adoption Opportunities Adoption Opportunities
42 42
42 42
42 42
44 44
Community Services Community Services ~~Block~~ Block Grant Grant
740 740
0 0
750 750
745 745
ACL

Home Home & Community-Based Supportive Services& Community-Based Supportive Services
390 390
390 390
400 400
393 393
Family Family ~~Caregiver~~ Caregiver Support Services Support Services
186 186
151 151
194 194
189 189
Nutrition Services Nutrition Services Programs Programs
937 937
937 937
957 957
952 952
Alzheimer’s Alzheimer’s ~~Disease~~ Disease Demonstrations Demonstrations
12 12
27 27
12 12
13 13
PPHFa
15
0
15
15
State Health Insurance Program (SHIP) State Health Insurance Program (SHIP)
52 52
36 36
54 54
52 52
Paralysis Resource Paralysis Resource Center Center
10 10
10 10
10 10
10 10
Limb Loss Limb Loss Resource Center Resource Center
4 4
4 4
4 4
4 4
Developmental Developmental ~~Disabilities~~ Disabilities Programs Programs
180 180
136 136
184 184
183 183
WIOA Activities WIOA Activities (transferred from(transferred from ED) ED)
265 265
236 236
265 265
267 267
Office of the Secretary

Office of Nat'l Coord. for Health Information Office of Nat'l Coord. for Health Information
60 60
51 51
60 60
62 62
Technology Technology
Office of the Inspector General Office of the Inspector General
80 80
90 90
80 80
80 80
Public Health and Social Services Public Health and Social Services Emergency Fund Emergency Fund
2,737 2,737
2,641 2,641
2,827 2,827
2,847 2,847
~~Congressional Research Service~~

39

~~Labor, Health and Human Services, and Education: FY2021 Appropriations~~

~~Source~~Sources: Amounts in this table for the FY2020 Enacted, FY2021 Request, and FY2021 Enacted columns are Amounts in this table for the FY2020 Enacted, FY2021 Request, and FY2021 Enacted columns are
~~general y~~generally drawn from drawn from or calculated based on data contained in the explanatory statement accompanying the or calculated based on data contained in the explanatory statement accompanying the
FY2021 LHHS omnibus (P.L. 116-260), available in the FY2021 LHHS omnibus (P.L. 116-260), available in the Congressional Record, vol., vol. 166, no. 218, book IV, December 166, no. 218, book IV, December
21, 2020, pp. H8619-H8711. Amounts in the FY2021 House Committee21, 2020, pp. H8619-H8711. Amounts in the FY2021 House Committee column are generally drawn from or column are generally drawn from or
calculated based on data contained in the committeecalculated based on data contained in the committee report (H.Rept. 116-450) accompanying H.R. 7614. Enacted report (H.Rept. 116-450) accompanying H.R. 7614. Enacted
totals (“Total BA in the Bil ”) for FY2020 do not include emergency-designated appropriations provided intotals (“Total BA in the Bil ”) for FY2020 do not include emergency-designated appropriations provided in P.L. P.L.
116-113, P.L. 116-123, P.L. 116-127, P.L. 116-136, or P.L. 116-139. House committee116-113, P.L. 116-123, P.L. 116-127, P.L. 116-136, or P.L. 116-139. House committee bil totals (“Total BA in the bil totals (“Total BA in the
Bil ”) for FY2021 do not include emergency-designated appropriations proposed in Title VI of H.R. 7614. Enacted Bil ”) for FY2021 do not include emergency-designated appropriations proposed in Title VI of H.R. 7614. Enacted
totals (“Total BA in the Bil ”) for FY2021 do not include emergency-designated appropriations provided in totals (“Total BA in the Bil ”) for FY2021 do not include emergency-designated appropriations provided in
DivisionDivision H or M of P.L.H or M of P.L. ~~116-260~~ 116-260, or P.L. 117-31. For consistency with source materials,. For consistency with source materials, amounts in this figure amounts in this figure ~~general y~~ generally do not do not
reflect mandatory spending sequestration, wherereflect mandatory spending sequestration, where applicable, nor do they reflect any transfers or reprogramming applicable, nor do they reflect any transfers or reprogramming
of funds pursuant to executive authorities. CRS calculations do, however, include LHHS funding provided to 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. HHS pursuant to the 21st Century Cures Act (P.L. 114-255), as amended.
Notes: BA = Budget Authority. DetailsBA = Budget Authority. Details may not add to totals due to rounding. Amounts in this table (1) reflect may not add to totals due to rounding. Amounts in this table (1) reflect
al all BA appropriated in the bil ,BA appropriated in the bil , ~~regardless~~ regardless of the year in which funds become available (i.e.,of the year in which funds become available (i.e., totals do not include totals do not include
advances from prior-year appropriations,advances from prior-year appropriations, but do include advances for subsequent years provided in this bil ); (2) but do include advances for subsequent years provided in this bil ); (2)
have have ~~general y~~generally not been adjusted to reflect not been adjusted to reflect scorekeeping; (3) comprisescorekeeping; (3) comprise only those funds provided (or requested) only those funds provided (or requested)
for agencies and accounts subject to the jurisdictionfor agencies and accounts subject to the jurisdiction of the LHHS subcommitteesof the LHHS subcommittees of the House and Senate of the House and Senate
appropriations committeesappropriations committees (e.g.,(e.g., department totals do not include funding for the Food and Drug Administration, department totals do not include funding for the Food and Drug Administration,
the Indian Health Service,the Indian Health Service, or the Agency for Toxic Substances and Diseaseor the Agency for Toxic Substances and Disease Registry, Registry, al all of which are funded by of which are funded by
other bil s); and (4) do not include appropriations that occur outside of appropriations bil s.other bil s); and (4) do not include appropriations that occur outside of appropriations bil s.
Congressional Research Service 41 Labor, Health and Human Services, and Education: FY2021 Appropriations a. PPHF funds are not appropriated in the LHHS bil ,a. PPHF funds are not appropriated in the LHHS bil , but are shown here for il ustrativebut are shown here for il ustrative purposes as they may purposes as they may
be used to supplement the funding selected agencies and programs be used to supplement the funding selected agencies and programs ~~receive~~ receive through the appropriations through the appropriations
process.process. Amounts shown for PPHF in this table areAmounts shown for PPHF in this table are in addition to amounts shown for budget authority. amounts shown for budget authority.
b. By convention, this table shows the amount of PHS Evaluation Tap funds received b. By convention, this table shows the amount of PHS Evaluation Tap funds received by an agency for a by an agency for a
particular program particular program or activity separately from the budget authority appropriated for that program or or activity separately from the budget authority appropriated for that program or
activity. Tap amounts are activity. Tap amounts are in addition to amounts shown for budget authority, though the amounts shown for 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. budget authority have not been adjusted to reflect potential “transfer-out” of funds to the tap.
c. The NEF was established by the Consolidated Appropriations c. The NEF was established by the Consolidated Appropriations Act of 2008, to enable the HHS SecretaryAct of 2008, to enable the HHS Secretary to to
repurpose certain unobligated balances of expired discretionary repurpose certain unobligated balances of expired discretionary funds appropriated to HHS from the funds appropriated to HHS from the
GeneralGeneral Fund. The FY2020 omnibus required that HHS transfer $225 mil ionFund. The FY2020 omnibus required that HHS transfer $225 mil ion apiece from the NEF to the apiece from the NEF to the
buildings and facilitiesbuildings and facilities accounts at CDC and NIH.accounts at CDC and NIH. The FY2021 omnibus required that $225 mil ionThe FY2021 omnibus required that $225 mil ion be be
transferred to NIH. Amounts shown for the NEF transfer are in addition to amounts shown for budget transferred to NIH. Amounts shown for the NEF transfer are in addition to amounts shown for budget
authority. authority.
d. The Cures Act created the NIH Innovation Account and specified that funds in the account must be d. The Cures Act created the NIH Innovation Account and specified that funds in the account must be
appropriated in order appropriated in order to be available for expenditure. In keeping with the purposes and amounts authorized to be available for expenditure. In keeping with the purposes and amounts authorized
in the Cures Act, for FY2021, the FY2021 LHHS explanatory statement directed that NIH transfer $195 in the Cures Act, for FY2021, the FY2021 LHHS explanatory statement directed that NIH transfer $195
mil ionmil ion to the National Cancer Institute to support cancer research,to the National Cancer Institute to support cancer research, and $50 mil ionand $50 mil ion each to the National each to the National
Institute of Neurological DisordersInstitute of Neurological Disorders and Stroke and the National Institute of Mental Health to support the and Stroke and the National Institute of Mental Health to support the
Brain Research through Advancing Innovative NeurotechnologiesBrain Research through Advancing Innovative Neurotechnologies (BRAIN) Initiative. The remaining(BRAIN) Initiative. The remaining $109 $109
mil ionmil ion was for the Precisionwas for the Precision Medicine Initiative. Medicine Initiative.
e. The President’s e. The President’s budget for FY2021 proposed that AHRQ be eliminated,budget for FY2021 proposed that AHRQ be eliminated, and that certain functions be and that certain functions be
transferred to NIH. This proposal was not adopted by the House or the Senate version of the LHHS bil , transferred to NIH. This proposal was not adopted by the House or the Senate version of the LHHS bil , or or
included in FY2021 enacted appropriations. included in FY2021 enacted appropriations.
Department of Education (ED)
Note that amounts in this section are based on regular LHHS appropriations only. They do not Note that amounts in this section are based on regular LHHS appropriations only. They do not
include mandatory funds provided outside of the annual appropriations process (e.g., direct 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 appropriations for the Federal Direct Student Loan program and the mandatory portion of the
Federal Federal ~~Pel~~ Pell Grant program). Amounts are rounded to the nearest Grant program). Amounts are rounded to the nearest ~~mil ion or bil ion~~ million or billion (as labeled). (as labeled).
The dollar and percentage changes discussed are based on unrounded amounts. For consistency 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 with source materials, amounts do not reflect sequestration or reestimates of mandatory spending
programs, where applicable. programs, where applicable.
~~Congressional Research Service~~

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About ED
Federal policymakers established the U.S. Department of Education in 1980.Federal policymakers established the U.S. Department of Education in 1980.8081 Its mission is to Its mission is to
“promote student achievement and preparation for global competitiveness by fostering “promote student achievement and preparation for global competitiveness by fostering
educational educational ~~excel ence~~excellence and ensuring equal access.” and ensuring equal access.”~~81 Typical y~~82 Typically, about three-quarters of ED’s , about three-quarters of ED’s
discretionary appropriations go either to local educational agencies—which primarily use the discretionary appropriations go either to local educational agencies—which primarily use the
funds to provide educational and related services for funds to provide educational and related services for ~~economical y~~economically disadvantaged students and disadvantaged students and
students with disabilities—or to low-income postsecondary students in the form of students with disabilities—or to low-income postsecondary students in the form of ~~Pel~~ Pell Grants, Grants,
which help pay for college. The remainder of ED’s discretionary budget provides for a wide 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; range of activities, including (but not limited to) support for minority-serving institutions;
~~educational research; and career, technical, and adult education.~~
~~The federal government provides roughly 7% of overal funding for elementary and secondary~~
~~education in the United States.82~~educational research; and career, technical, and adult education. 81 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. 82 U.S. Department of Education, “About ED,” http://www2.ed.gov/about/landing.jhtml, accessed on June 9, 2021. Congressional Research Service 42 link to page 49 link to page 75 Labor, Health and Human Services, and Education: FY2021 Appropriations The federal government provides roughly 7% of overall funding for elementary and secondary education in the United States.83 The majority of school funding—about 84%—comes from states The majority of school funding—about 84%—comes from states
and local districts, which have primary responsibility for the provision of elementary and 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 secondary education. With regard to higher education, the federal government provided roughly
59% of undergraduate and graduate student aid in academic year (AY) 2019-2020.59% of undergraduate and graduate student aid in academic year (AY) 2019-2020.8384
FY2021 ED Appropriations Overview
Table 8 displays FY2021 discretionary and mandatory ED budget authority provided and displays FY2021 discretionary and mandatory ED budget authority provided and
proposed, along with FY2020 enacted levels. The totals in this table do not include emergency proposed, along with FY2020 enacted levels. The totals in this table do not include emergency
supplemental appropriations; amounts provided in supplementals are displayed separately at the supplemental appropriations; amounts provided in supplementals are displayed separately at the
bottom of the table and are in addition to regular appropriations. For a discussion of the FY2021 bottom of the table and are in addition to regular appropriations. For a discussion of the FY2021
supplemental appropriations in Division M of P.L. 116-260supplemental appropriations in Division M of P.L. 116-260~~, se~~e and P.L. 117-31, see Appendix C.
Discretionary funds represent the majority of ED’s annual appropriations, accounting for roughly Discretionary funds represent the majority of ED’s annual appropriations, accounting for roughly
95% of the FY2020 and FY2021 enacted levels.95% of the FY2020 and FY2021 enacted levels.8485 The FY2021 enacted discretionary ED The FY2021 enacted discretionary ED
appropriations were 1.1% higher than FY2020 levels. Proposed discretionary ED appropriations appropriations were 1.1% higher than FY2020 levels. Proposed discretionary ED appropriations
for FY2021 compared to FY2020 would have decreased under the President’s budget (-8.5%) and for FY2021 compared to FY2020 would have decreased under the President’s budget (-8.5%) and
increased under the House committee increased under the House committee ~~bil (+1.0%).~~

~~80 ED in its current incarnation became a department in 1980 pursuant to the Department of Education Organization~~
~~Act (enacted on October 17, 1979). However, the department dates its origins to 1867. See U.S. Department of~~
~~Education, “About ED: T he Federal Role in Education,” http://www2.ed.gov/about/overview/fed/role.html.~~
~~81 U.S. Department of Education, “About ED,” http://www2.ed.gov/about/landing.jhtml, accessed on June 9, 2021.~~
~~82 U.S. Department of Education, “ The FY 2021 Education Budget Summary,” ”Appendix: T otal Expenditures for~~
~~Elementary and Secondary Education in the U.S.,” at https://www2.ed.gov/about/overview/budget/budget21/summary/~~
~~21summary.pdf.~~
~~83 For the purposes of this calculation, the federal contribution included $143 billion (grants, loans, work -study, and tax~~
~~benefits) out of a total of $242 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 2020, p. 30,~~
~~https://research.collegeboard.org/pdf/trends-college-pricing-student-aid-2020.pdf.~~
~~84 T he only mandatory ED funding provided in the LHHS Appropriations Act in each of these years is for Vocational~~
~~Rehabilitation State Grants. T his excludes any rescissions of mandatory appropriations that are used in the~~
~~appropriations process.~~
~~Congressional Research Service~~

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bill (+1.0%). Table 8. ED Appropriations Overview
(In (In ~~bil ions of dol ars~~billions of dollars) )
FY2021
FY2021
House
Enacted
Cmte.
(P.L.
FY2020
FY2021
(H.R.
116-
Funding
Enacted
Request
7614)
260)
Discretionary Discretionary
72.8 72.8
66.6 66.6
73.5 73.5
73.5 73.5
Mandatory Mandatory
3.6 3.6
3.7 3.7
3.7 3.7
3.7 3.7
Total BA in the Bill
76.4
70.2
77.1
77.2
Emergency Funding (not included in above totals)

3rd COVID (P.L. 116-136) 3rd COVID (P.L. 116-136)
30.9 30.9
— —
— —
— —
5th COVID (Division 5th COVID (Division M, P.L.M, P.L. 116-260) 116-260)
— —
— —
— —
82.0 82.0
~~Source~~Sources: Amounts in this table for the FY2020 Enacted, FY2021 Request, and FY2021 Enacted columns are Amounts in this table for the FY2020 Enacted, FY2021 Request, and FY2021 Enacted columns are
~~general y~~generally drawn from drawn from or calculated based on data contained in the explanatory statement accompanying the or calculated based on data contained in the explanatory statement accompanying the
FY2021 LHHS omnibus (P.L. 116-260), available in the FY2021 LHHS omnibus (P.L. 116-260), available in the Congressional Record, vol., vol. 166, no. 218, book IV, December 166, no. 218, book IV, December
21, 2020, pp. H8619-H8711. Amounts in the FY2021 House Committee21, 2020, pp. H8619-H8711. Amounts in the FY2021 House Committee column are column are ~~general y~~generally drawn from or drawn from or
calculated based on data contained in the committeecalculated based on data contained in the committee report (H.Rept. 116-450) accompanying H.R. 7614. Enacted report (H.Rept. 116-450) accompanying H.R. 7614. Enacted
totals (“Total BA in the Bil ”) for FY2020 do not include emergency-designated appropriations provided intotals (“Total BA in the Bil ”) for FY2020 do not include emergency-designated appropriations provided in ~~P.L.~~
~~116-113, P.L. 116-123, P.L. 116-127, P.L. 116-136, or P.L. 116-139. House committee~~ P.L. 83 U.S. Department of Education, “The FY 2021 Education Budget Summary,” ”Appendix: Total Expenditures for Elementary and Secondary Education in the U.S.,” at https://www2.ed.gov/about/overview/budget/budget21/summary/21summary.pdf. 84 For the purposes of this calculation, the federal contribution included $143 billion (grants, loans, work-study, and tax benefits) out of a total of $242 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 2020, p. 30, https://research.collegeboard.org/pdf/trends-college-pricing-student-aid-2020.pdf. 85 The only mandatory ED funding provided in the LHHS Appropriations Act in each of these years is for Vocational Rehabilitation State Grants. This excludes any rescissions of mandatory appropriations that are used in the appropriations process. Congressional Research Service 43 link to page 52 Labor, Health and Human Services, and Education: FY2021 Appropriations 116-113, P.L. 116-123, P.L. 116-127, P.L. 116-136, or P.L. 116-139. House committee bil totals (“Total BA in the bil totals (“Total BA in the
Bil ”) for FY2021 do not include emergency-designated appropriations proposed in Title VI of H.R. 7614. Enacted Bil ”) for FY2021 do not include emergency-designated appropriations proposed in Title VI of H.R. 7614. Enacted
totals (“Total BA in the Bil ”) for FY2021 do not include emergency-designated appropriations provided in totals (“Total BA in the Bil ”) for FY2021 do not include emergency-designated appropriations provided in
DivisionDivision H or M of P.L.H or M of P.L. ~~116-260~~ 116-260, or P.L. 117-31. For consistency with source materials,. For consistency with source materials, amounts in this figure amounts in this figure ~~general y~~ generally do not do not
reflect mandatory spending sequestration, wherereflect mandatory spending sequestration, where applicable, nor do they reflect any transfers or reprogramming applicable, nor do they reflect any transfers or reprogramming
of funds pursuant to executive authorities. of funds pursuant to executive authorities.
Notes: BA = Budget Authority. DetailsBA = Budget Authority. Details may not add to totals due to rounding. Amounts in this table (1) reflect may not add to totals due to rounding. Amounts in this table (1) reflect
al all BA appropriated in the bil ,BA appropriated in the bil , ~~regardless~~ regardless of the year in which funds become available (i.e.,of the year in which funds become available (i.e., totals do not include totals do not include
advances from prior-year appropriations,advances from prior-year appropriations, but do include advances for subsequent years provided in this bil ); (2) but do include advances for subsequent years provided in this bil ); (2)
have have ~~general y~~generally not been adjusted to reflect not been adjusted to reflect scorekeeping; (3) comprisescorekeeping; (3) comprise only those funds provided (or requested) only those funds provided (or requested)
for agencies and accounts subject to the jurisdictionfor agencies and accounts subject to the jurisdiction of the LHHS subcommitteesof the LHHS subcommittees of the House and Senate of the House and Senate
appropriations committees;appropriations committees; and (4) do not include appropriations that occur outside of appropriations bil s. and (4) do not include appropriations that occur outside of appropriations bil s.
Selected ED Highlights
The following sections highlight FY2021 appropriations for selected ED accounts and The following sections highlight FY2021 appropriations for selected ED accounts and
programs.programs.8685 Table 9 tracks funding levels for major ED budget and appropriations accounts, and tracks funding levels for major ED budget and appropriations accounts, and
selected items within those accounts. selected items within those accounts.
Education for the Disadvantaged
The Education for the Disadvantaged account is the largest account related to elementary and The Education for the Disadvantaged account is the largest account related to elementary and
secondary education and the third largest secondary education and the third largest ~~overal~~ overall within ED based on funding provided through within ED based on funding provided through
the annual appropriations process. Within the account, a majority of funds are appropriated for the annual appropriations process. Within the account, a majority of funds are appropriated for
Grants to Local Educational Agencies, authorized under Title I-A of the Elementary and 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. 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 low114-95). Title I-A grants provide supplementary educational and related services to low -achieving -achieving
and other students attending elementary and secondary schools with relatively high and other students attending elementary and secondary schools with relatively high

~~85 ED budget materials can be found at https://www2.ed.gov/about/overview/focus/performance.html.~~
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42

~~Labor, Health and Human Services, and Education: FY2021 Appropriations~~

concentrations of students from low-income families, as concentrations of students from low-income families, as ~~wel~~ well as eligibleas eligible students who live in the students who live in the
areas served by these public schools but attend private schools.areas served by these public schools but attend private schools.86
87 The enacted FY2021 appropriation for Title I-A grants was $16.5 The enacted FY2021 appropriation for Title I-A grants was $16.5 ~~bil ion~~billion, compared to an FY2020 , compared to an FY2020
appropriation level of $16.3 appropriation level of $16.3 ~~bil ion~~billion (+1.4%). The House committee (+1.4%). The House committee ~~bil~~ bill had recommended a had recommended a
funding level of $16.6 funding level of $16.6 ~~bil ion~~ billion for the program. President Trump’s FY2021 budget requested no for the program. President Trump’s FY2021 budget requested no
new funding for the Education for the Disadvantaged account, but proposed to consolidate the new funding for the Education for the Disadvantaged account, but proposed to consolidate the
Title I-A program, along with 28 other competitive and formula grant programs,Title I-A program, along with 28 other competitive and formula grant programs,8788 into a single into a single
Elementary and Secondary Education for the Disadvantaged Block Grant under a new Elementary and Secondary Education for the Disadvantaged Block Grant under a new
“Improving Elementary and Secondary Education” account. Under the proposal, block grants “Improving Elementary and Secondary Education” account. Under the proposal, block grants
would have been would have been ~~al ocated~~allocated to state educational agencies and local educational agencies by to state educational agencies and local educational agencies by
formula and could have been used for any purpose of the consolidated programs.formula and could have been used for any purpose of the consolidated programs.88
~~Student Financial Assistance~~
~~The Pel 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.89 Pel~~ 89 86 ED budget materials can be found at https://www2.ed.gov/about/overview/focus/performance.html. 87 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). 88 ED budget materials propose $19.3 billion in new budget authority for this block grant (including $6.8 billion to become available in FY2021 and an advance appropriation of $12.5 billion to become available in FY2022. For a full list of programs that would be combined into a single block grant under the proposal, see Budget of the United States Government, Fiscal Year, 2021, Major Savings and Reforms, p. 20, https://www.govinfo.gov/content/pkg/BUDGET-2021-MSV/pdf/BUDGET-2021-MSV.pdf. 89 For more information about the legislative proposal, see U.S. Department of Education, “Improving Elementary and Secondary Education,” Justification of Appropriation Estimates to the Congress: Fiscal Year 2021, https://www2.ed.gov/about/overview/budget/budget21/justifications/a-iese.pdf. Congressional Research Service 44 link to page 52 link to page 52 Labor, Health and Human Services, and Education: FY2021 Appropriations Student Financial Assistance The Pell Grant program within the Student Financial Assistance account provides need-based financial aid primarily to low-income undergraduate students to help them cover the cost of higher education.90 Pell Grants are the largest single source of federal grant aid for undergraduate Grants are the largest single source of federal grant aid for undergraduate
students; ED projected that they would provide approximately $30.3 students; ED projected that they would provide approximately $30.3 ~~bil ion~~ billion in aid to roughly 7.1 in aid to roughly 7.1
~~mil ion~~ million undergraduate students in FY2021.undergraduate students in FY2021.9091 The explanatory statement accompanying the The explanatory statement accompanying the
FY2021 LHHS Omnibus directed $22.5 FY2021 LHHS Omnibus directed $22.5 ~~bil ion~~billion in discretionary funding to the in discretionary funding to the ~~Pel~~ Pell Grant Grant
program, which was level funding compared to FY2020. (Additional mandatory funding for the program, which was level funding compared to FY2020. (Additional mandatory funding for the
program is appropriated outside the LHHS program is appropriated outside the LHHS ~~bil~~ bill.) The President’s budget and the House committee .) The President’s budget and the House committee
~~bil~~ bill both proposed level discretionary funding, as both proposed level discretionary funding, as ~~wel~~ well. .
The total maximum The total maximum ~~Pel~~ Pell Grant award is the sum of the discretionary maximum award level and the Grant award is the sum of the discretionary maximum award level and the
mandatory add-on award level. The discretionary award program costs may be funded through (1) mandatory add-on award level. The discretionary award program costs may be funded through (1)
annual discretionary appropriations; (2) a permanent, definite mandatory appropriation; and (3) the annual discretionary appropriations; (2) a permanent, definite mandatory appropriation; and (3) the
~~Pel~~ Pell Grant program surplus.Grant program surplus.9192 The mandatory add-on award program costs are funded by a permanent, The mandatory add-on award program costs are funded by a permanent,
indefinite mandatory appropriation. Both mandatory indefinite mandatory appropriation. Both mandatory appropriation sources are provided outside the annual appropriations process, are authorized by and funded in the Higher Education Act of 1965 (HEA), as amended, and do not appear in Table 9. The FY2021 LHHS omnibus increased the discretionary maximum Pell Grant award level to $5,435, which is $150 (+2.8%) more than the FY2020 level. The House committee bill recommended the same amount. The President’s budget requested the same discretionary maximum Pell Grant award level as in FY2020. As a result of Pell Grant award rules established in the HEA, the increase in the discretionary maximum Pell Grant award level increases FY2021 program costs, assuming no other changes. In order to pay for the estimated increase in FY2021 mandatory add-on award program costs, the FY2021 LHHS omnibus rescinded $28 million of the FY2021 definite mandatory appropriation.93 The House committee bill would have reduced the FY2020 definite mandatory appropriation by the same amount. The FY2021 LHHS omnibus implemented another provision related to the Pell Grant program surplus: it rescinded $500 million of the surplus, which offset the cost of appropriations in the act.94 90 For more information about the program, see CRS Report R45418, Federal Pell Grant Program of the Higher Education Act: Primer. 91 U.S. ~~appropriation sources are provided outside the~~

~~86 Although T itle 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).~~
~~87 ED budget materials propose $19.3 billion in new budget authority for this block grant (including $6.8 billion to~~
~~become available in FY2021 and an advance appropriation of $12.5 billion to become available in FY2022. For a full~~
~~list of programs that would be combined into a single block grant under the proposal, see~~ ~~Budget of the United States~~
~~Governm ent, Fiscal Year, 2021, Major Savings and Reform s, p. 20, https://www.govinfo.gov/content/pkg/BUDGET -~~
~~2021-MSV/pdf/BUDGET -2021-MSV.pdf.~~
~~88 For more information about the legislative proposal, see U.S. Department of Education, “Improving Elementary and~~
~~Secondary Education,” Justification of Appropriation Estim ates to the Congress: Fiscal Year 2021,~~
~~https://www2.ed.gov/about/overview/budget/budget21/justifications/a-iese.pdf.~~
~~89 For more information about the program, see CRS Report R45418,~~ ~~Federal Pell Grant Program of the Higher~~
~~Education Act: Prim er~~.
~~90 U.S.~~ Department of Education, “Student Aid Overview,” Department of Education, “Student Aid Overview,” Justification of Appropriation Estimates to the Congress:
Fiscal Year 2021, pp. O-6–O-7, https://www2.ed.gov/about/overview/budget/budget21/justifications/o-sao.pdf. , pp. O-6–O-7, https://www2.ed.gov/about/overview/budget/budget21/justifications/o-sao.pdf.
9192 Because Because discretionary funds anddiscretionary funds and the base awardthe base award are appropriated in advance of the awardare appropriated in advance of the award year, they are year, they are ~~base d~~ based on cost on cost
estimates. estimates. ~~T his~~This can result in surpluses can result in surpluses (or shortfalls) in discretionary appropriations. When annual discretionary funding (or shortfalls) in discretionary appropriations. When annual discretionary funding
available exceedsavailable exceeds annual discretionary program costs, the Pell Grant program is able to accumulate a surplusannual discretionary program costs, the Pell Grant program is able to accumulate a surplus that that
remains availableremains available to fund discretionary awardto fund discretionary award program costs in subsequentprogram costs in subsequent years. years. ~~T he~~The Congressional Budget Congressional Budget Office Office
(CBO) has estimated a surplus(CBO) has estimated a surplus of $12.5 billion at the start of FY2021. See Congressional Budgetof $12.5 billion at the start of FY2021. See Congressional Budget Office, Office, Pell Grant
Program —CBO’s February 2021 Baseline, p. 2, https://www.cbo.gov/system/files/2021-02/51304-2021-02-, p. 2, https://www.cbo.gov/system/files/2021-02/51304-2021-02-
pellgrant.pdf. pellgrant.pdf.
93 P.L. 116-260, Division H, §309. 94 P.L. 116-260, Division H, §308. Congressional Research Service Congressional Research Service

4345

link to page link to page 5053 link to page link to page 5253 link to page link to page 5253 link to page link to page 5253 link to page link to page 5253 link to page link to page 5253 link to page link to page 5253 link to page link to page 5253 link to page link to page 5253 link to page link to page 5253 Labor, Health and Human Services, and Education: FY2021 Appropriations Table 9. Detailed ED Appropriations (In millions of dollars ~~Labor, Health and Human Services, and Education: FY2021 Appropriations~~

~~annual appropriations process, are authorized by and funded in the Higher Education Act of 1965~~
~~(HEA), as amended, and do not appear in Table 9.~~
~~The FY2021 LHHS omnibus increased the discretionary maximum Pel Grant award level to~~
~~$5,435, which is $150 (+2.8%) more than the FY2020 level. The House committee bil~~
~~recommended the same amount. The President’s budget requested the same discretionary~~
~~maximum Pel Grant award level as in FY2020.~~
~~As a result of Pel Grant award rules established in the HEA, the increase in the discretionary~~
~~maximum Pel Grant award level increases FY2021 program costs, assuming no other changes. In~~
~~order to pay for the estimated increase in FY2021 mandatory add-on award program costs, the~~
~~FY2021 LHHS omnibus rescinded $28 mil ion of the FY2021 definite mandatory appropriation.92~~
~~The House committee bil would have reduced the FY2020 definite mandatory appropriation by~~
~~the same amount.~~
~~The FY2021 LHHS omnibus implemented another provision related to the Pel Grant program~~
~~surplus: it rescinded $500 mil ion of the surplus, which offset the cost of appropriations in the~~
~~act.93~~
~~Table 9. Detailed ED Appropriations~~
~~(In mil ions of dol ars~~) )
FY2021
FY2021
House
Enacted
FY2020
FY2021
Cmte.
(P.L. 116-
Account and Selected Program
Enacted
Request
(H.R. 7614)
260)
Education ~~for the Disadvantaged~~
for the Disadvantaged 16,997
0a
17,258
17,227
Grants to Local Grants to Local Educational Agencies Educational Agencies
16,310 16,310
0a
16,564 16,564
16,537 16,537
Comprehensive Comprehensive ~~Literacy Development~~ Literacy Development Grants Grants
192 192
0a
192 192
192 192
Impact Aid
1,486
1,411
1,491
1,501
School Improvement Programs
5,405
392
5,454
5,444
Supporting Effective Instruction State Grants Supporting Effective Instruction State Grants
2,132 2,132
0a
2,154 2,154
2,143 2,143
21st Century Community Learning Centers 21st Century Community Learning Centers
1,250 1,250
0a
1,263 1,263
1,260 1,260
Student Support and Academic Student Support and Academic Enrichment Grants Enrichment Grants
1,210 1,210
0a
1,220 1,220
1,220 1,220
Indian Education
181
181
181
181
Innovation and Improvement
1,104
0a
1,075
1,114
Safe Schools and Citizenship Education
210
0a
218
217
English Language ~~Acquisition~~
Acquisition 787
0a
797
797
Special Education
13,885
13,985
14,093
14,071
Part B—Assistance Part B—Assistance for Education of for Education of al all Children with Children with
~~Disabilities~~
13,159 13,159
13,259 13,259
13,356 13,356
13,335 13,335
Disabilities Part C—Infants and Toddlers with Disabilities Part C—Infants and Toddlers with Disabilities
477 477
477 477
482 482
482 482
Rehabilitation ~~Services~~
Services 3,748
3,783
3,828
3,814
Vocational Rehabilitation State Grants (mandatory) Vocational Rehabilitation State Grants (mandatory)
3,610 3,610
3,668 3,668
3,668 3,668
3,675 3,675

~~92 P.L. 116-260, Division H, §309.~~
~~93 P.L. 116-260, Division H, §308.~~
~~Congressional Research Service~~

44

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~~FY2021~~
~~FY2021~~
~~House~~
~~Enacted~~
~~FY2020~~
~~FY2021~~
~~Cmte.~~
~~(P.L. 116-~~
~~Account and Selected Program~~
~~Enacted~~
~~Request~~
~~(H.R. 7614)~~
~~260)~~
~~Special Institutions~~ Special Institutions for Persons with Disabilities
249
249
254
256
Career, Technical, and Adult Education
1,961
2,723
1,986
2,031
Career Career and Technical Education and Technical Education
1,290 1,290
2,053 2,053
1,308 1,308
1,342 1,342
Student Financial Assistance
24,520
22,975
24,565
24,545
~~Pel maximum~~ Pell maximum grant (non-add)
5,285
5,285
5,435
5,435
Federal Federal ~~Pel~~ Pell Grant Program Grant Program
22,475 22,475
22,475 22,475
22,475 22,475
22,475 22,475
Federal Direct Student Loan Program Account
50
0
50
50
Student Aid Administration
1,769
1,883
1,769
1,854
Higher Education
2,476
1,789
2,557
2,542
Federal Federal TRIO Programs TRIO Programs
1,090 1,090
950 950
1,100 1,100
1,097 1,097
Howard University
240
240
254
251
College Housing & Academic Facilities Loansb
0
0
0
0
HBCU Capital ~~Financing~~ Financing Program Account
46
40
48
48
Institute of Education Sciences
623
565
630
642
Departmental ~~Management~~
Management 623
647
626
624
Total, ED BA in the Bill
76,361
70,228
77,135
77,212
Congressional Research Service 46 Labor, Health and Human Services, and Education: FY2021 Appropriations FY2021 FY2021 House Enacted FY2020 FY2021 Cmte. (P.L. 116- Account and Selected Program Enacted Request (H.R. 7614) 260) Subtotal, ~~Subtotal,~~ Mandatory
3,610
3,668
3,668
3,675
Subtotal, Discretionary
72,751
66,561
73,467
73,537
Emergency Funding (not included in above totals)

3rd COVID (P.L. 116-136) 3rd COVID (P.L. 116-136)
30,925 30,925
— —
— —
— —
5th COVID (Division 5th COVID (Division M, P.L.M, P.L. 116-260) 116-260)
— —
— —
— —
82,000 82,000
Memoranda (non-emergency funds only)

Total, BA Available in Fiscal Total, BA Available in Fiscal Year (current year from Year (current year from
~~any bil )~~
76,225 76,225
70,228 70,228
77,135 77,135
77,212 77,212
any bil ) Total, BA Advances for Future Years (provided in Total, BA Advances for Future Years (provided in
~~current bil )~~
22,597 22,597
22,597 22,597
22,597 22,597
22,597 22,597
current bil ) Total, BA Advances from PriorTotal, BA Advances from Prior Years (for use in Years (for use in
22,597 22,597
22,597 22,597
22,597 22,597
22,597 22,597
current year) current year)
~~Source~~Sources: Amounts in this table for the FY2020 Enacted, FY2021 Request, and FY2021 Enacted columns are Amounts in this table for the FY2020 Enacted, FY2021 Request, and FY2021 Enacted columns are
~~general y~~generally drawn from drawn from or calculated based on data contained in the explanatory statement accompanying the or calculated based on data contained in the explanatory statement accompanying the
FY2021 LHHS omnibus (P.L. 116-260 ), available in the FY2021 LHHS omnibus (P.L. 116-260 ), available in the Congressional Record,, vol. 166, no. 218, book IV, vol. 166, no. 218, book IV,
DecemberDecember 21, 2020, pp. H8619-H8711. Amounts in the FY2021 House Committee21, 2020, pp. H8619-H8711. Amounts in the FY2021 House Committee column are column are ~~general y~~ generally drawn drawn
from or calculated based on data contained in the committeefrom or calculated based on data contained in the committee report (H.report (H. Rept. 116-450) accompanying H.R. Rept. 116-450) accompanying H.R.
7614. Enacted totals (“Total BA in the Bil ”) for FY2020 do not include emergency-designated appropriations 7614. Enacted totals (“Total BA in the Bil ”) for FY2020 do not include emergency-designated appropriations
provided in P.L. 116-113, P.L. 116-123, P.L. 116-127, P.L. 116-136, or P.L. 116-139. House committeeprovided in P.L. 116-113, P.L. 116-123, P.L. 116-127, P.L. 116-136, or P.L. 116-139. House committee bil totals bil totals
(“Total BA (“Total BA in the Bil ”) for FY2021 do not include emergency-designatedin the Bil ”) for FY2021 do not include emergency-designated appropriations proposed in Title VI of appropriations proposed in Title VI of
H.R. 7614. Enacted totals (“Total BA in the Bil ”) for FY2021 do not include emergency-designated H.R. 7614. Enacted totals (“Total BA in the Bil ”) for FY2021 do not include emergency-designated
appropriations provided in Divisionappropriations provided in Division H or M of P.L. 116-260H or M of P.L. 116-260, or P.L. 117-31. For consistency with source materials,. For consistency with source materials, amounts in amounts in
this figure this figure ~~general y~~generally do not reflect mandatory spending sequestration, do not reflect mandatory spending sequestration, where applicable, nor do they reflect any where applicable, nor do they reflect any
transfers or transfers or ~~reprogramming~~ reprogramming of funds pursuant to executive authorities.of funds pursuant to executive authorities.
~~Congressional Research Service~~

45

~~link to page 52~~ ~~Labor, Health and Human Services, and Education: FY2021 Appropriations~~

Notes: BA = Budget Authority. DetailsBA = Budget Authority. Details may not add to totals due to rounding. Amounts in this table (1) reflect may not add to totals due to rounding. Amounts in this table (1) reflect
al all BA appropriated in the bil ,BA appropriated in the bil , ~~regardless~~ regardless of the year in which funds become available (i.e.,of the year in which funds become available (i.e., totals do not include totals do not include
advances from prior year appropriations, but do include advances for subsequent years provided in this bil ); (2) advances from prior year appropriations, but do include advances for subsequent years provided in this bil ); (2)
have have ~~general y~~generally not been adjusted to reflect not been adjusted to reflect scorekeeping; (3) comprisescorekeeping; (3) comprise only those funds provided (or requested) only those funds provided (or requested)
for agencies and accounts subject to the jurisdictionfor agencies and accounts subject to the jurisdiction of the LHHS subcommitteesof the LHHS subcommittees of the House and Senate of the House and Senate
appropriations committees;appropriations committees; and (4) do not include appropriations that occur outside of appropriations bil s. and (4) do not include appropriations that occur outside of appropriations bil s.
Non-add amounts are displayed in italicsNon-add amounts are displayed in italics and parentheses; these amounts are not part of the appropriations and parentheses; these amounts are not part of the appropriations
totals. totals.
a. The President’sa. The President’s FY2021 budget proposed to eliminateFY2021 budget proposed to eliminate funding for this program and to consolidate it into a funding for this program and to consolidate it into a
new Elementary and Secondary Education for the Disadvantaged Block new Elementary and Secondary Education for the Disadvantaged Block Grant. The amount proposed for Grant. The amount proposed for
that Block Grant is not reflectedthat Block Grant is not reflected in the source materialsin the source materials described above; as such, it is not reflecteddescribed above; as such, it is not reflected this this
table. ED budget materialstable. ED budget materials propose $19.3 bil ion in new budget authority for this block grant (including $6.8 propose $19.3 bil ion in new budget authority for this block grant (including $6.8
bil ion to become available in FY2021 and an advance appropriation of $12.5 bil ion to becomebil ion to become available in FY2021 and an advance appropriation of $12.5 bil ion to become available in available in
FY2022. For moreFY2022. For more information about the legislativeinformation about the legislative proposal, see U.S.proposal, see U.S. Department of Education, “Improving Department of Education, “Improving
Elementary and Secondary Education,” Elementary and Secondary Education,” Justification of Appropriation Estimates to the Congress: Fiscal Year 2021, ,
https://www2.ed.gov/about/overview/budget/budget21/justifications/a-iese.pdf.https://www2.ed.gov/about/overview/budget/budget21/justifications/a-iese.pdf.
b. Actual amount for Col ege Housing & Academic Facilities b. Actual amount for Col ege Housing & Academic Facilities Loans is $435,000 in each column, which rounds Loans is $435,000 in each column, which rounds
to $0 in mil ions to $0 in mil ions (the unit of measure(the unit of measure used in this table). used in this table).
Related Agencies
Note that Note that al all amounts in this section are based on regular LHHS appropriations only; they do not amounts in this section are based on regular LHHS appropriations only; they do not
include funds provided outside of the annual appropriations process (e.g., mandatory include funds provided outside of the annual appropriations process (e.g., mandatory
Congressional Research Service 47 link to page 54 Labor, Health and Human Services, and Education: FY2021 Appropriations appropriations for Social Security benefit payments). appropriations for Social Security benefit payments). Al All amounts in this section are rounded to amounts in this section are rounded to
the nearest the nearest ~~mil ion or bil ion~~ million or billion (as labeled). The dollar changes and percentage changes in the text (as labeled). The dollar changes and percentage changes in the text
are based on unrounded amounts. For consistency with source materials, amounts do not reflect are based on unrounded amounts. For consistency with source materials, amounts do not reflect
sequestration or re-estimates of mandatory spending programs, where applicable. sequestration or re-estimates of mandatory spending programs, where applicable.
FY2021 Related Agencies Appropriations Overview
Table 10 displays FY2021 proposed and enacted funding levels for LHHS related agencies, along displays FY2021 proposed and enacted funding levels for LHHS related agencies, along
with FY2020 enacted levels. Totals in this table do not include emergency supplemental with FY2020 enacted levels. Totals in this table do not include emergency supplemental
appropriations; amounts provided in supplementals are displayed separately at the bottom of the appropriations; amounts provided in supplementals are displayed separately at the bottom of the
table and are in addition to regular appropriations. table and are in addition to regular appropriations.
In general, discretionary funding constitutes about 20% of total appropriations for LHHS related In general, discretionary funding constitutes about 20% of total appropriations for LHHS related
agencies each year. The FY2021 LHHS omnibus increased discretionary appropriations for agencies each year. The FY2021 LHHS omnibus increased discretionary appropriations for
related agencies by about 0.6% compared to FY2020. The President’s budget would have related agencies by about 0.6% compared to FY2020. The President’s budget would have
decreased discretionary appropriations for related agencies by about 8.2%, while the House decreased discretionary appropriations for related agencies by about 8.2%, while the House
committee committee ~~bil~~ bill would have increased such appropriations by 1.4%. would have increased such appropriations by 1.4%.
Table 10. Related Agencies Appropriations Overview
(In (In ~~bil ions of dol ars~~billions of dollars) )
FY2021
House
FY2021
Cmte.
Enacted
FY2020
FY2021
(H.R.
(P.L.
Funding
Enacted
Request
7614)
116-260)
Discretionary Discretionary
15.4 15.4
14.1 14.1
15.6 15.6
15.5 15.5
Mandatory Mandatory
57.3 57.3
55.3 55.3
55.3 55.3
55.3 55.3
Total BA in the Bill
72.7
69.4
70.9
70.8
~~Congressional Research Service~~

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~~FY2021~~
~~House~~
~~FY2021~~
~~Cmte.~~
~~Enacted~~
~~FY2020~~
~~FY2021~~
~~(H.R.~~
~~(P.L.~~
~~Funding~~
~~Enacted~~
~~Request~~
~~7614)~~
~~116-260)~~
~~Emergency Funding (not included in above~~
~~totals)~~

Emergency Funding (not included in above totals) 3rd COVID (P.L. 116-136) 3rd COVID (P.L. 116-136)
0.4 0.4
— —
— —
— —
~~Source~~Sources: Amounts in this table for the FY2020 Enacted, FY2021 Request, and FY2021 Enacted columns are Amounts in this table for the FY2020 Enacted, FY2021 Request, and FY2021 Enacted columns are
~~general y~~generally drawn from drawn from or calculated based on data contained in the explanatory statement accompanying the or calculated based on data contained in the explanatory statement accompanying the
FY2021 LHHS omnibus (P.L. 116-260), available in the FY2021 LHHS omnibus (P.L. 116-260), available in the Congressional Record, vol., vol. 166, no. 218, book IV, December 166, no. 218, book IV, December
21, 2020, pp. H8619-HH8711. Amounts in the FY2021 House Committee21, 2020, pp. H8619-HH8711. Amounts in the FY2021 House Committee column are column are ~~general y~~generally drawn from or drawn from or
calculated based on data contained in the committeecalculated based on data contained in the committee report (H.Rept. 116-450) accompanying H.R. 7614. Enacted report (H.Rept. 116-450) accompanying H.R. 7614. Enacted
totals (“Total BA in the Bil ”) for FY2020 do not include emergency-designated appropriations provided intotals (“Total BA in the Bil ”) for FY2020 do not include emergency-designated appropriations provided in P.L. P.L.
116-113, P.L. 116-123, P.L. 116-127, P.L. 116-136, or P.L. 116-139. House committee116-113, P.L. 116-123, P.L. 116-127, P.L. 116-136, or P.L. 116-139. House committee bil totals (“Total BA in the bil totals (“Total BA in the
Bil ”) for FY2021 do not include emergency-designated appropriations proposed in Title VI of H.R. 7614. Enacted Bil ”) for FY2021 do not include emergency-designated appropriations proposed in Title VI of H.R. 7614. Enacted
totals (“Total BA in the Bil ”) for FY2021 do not include emergency-designated appropriations provided in totals (“Total BA in the Bil ”) for FY2021 do not include emergency-designated appropriations provided in
DivisionDivision H or M of P.L.H or M of P.L. ~~116-260~~ 116-260, or P.L. 117-31. For consistency with source materials,. For consistency with source materials, amounts in thisamounts in this ~~table general y~~ table generally do not do not
reflect mandatory spending sequestration, wherereflect mandatory spending sequestration, where applicable, nor do they reflect any transfers or reprogramming applicable, nor do they reflect any transfers or reprogramming
of funds pursuant to executive authorities. of funds pursuant to executive authorities.
Notes: BA = Budget Authority. DetailsBA = Budget Authority. Details may not add to totals due to rounding. Amounts in this table (1) reflect may not add to totals due to rounding. Amounts in this table (1) reflect
al all BA appropriated in the bil ,BA appropriated in the bil , ~~regardless~~ regardless of the year in which funds become available (i.e.,of the year in which funds become available (i.e., totals do not include totals do not include
advances from prior-year appropriations,advances from prior-year appropriations, but do include advances for subsequent years provided in this bil ); (2) but do include advances for subsequent years provided in this bil ); (2)
have have ~~general y~~generally not been adjusted to reflect not been adjusted to reflect scorekeeping; (3) comprisescorekeeping; (3) comprise only those funds provided (or requested) only those funds provided (or requested)
for agencies and accounts subject to the jurisdictionfor agencies and accounts subject to the jurisdiction of the LHHS subcommitteesof the LHHS subcommittees of the House and Senate of the House and Senate
appropriations committees;appropriations committees; and (4) do not include appropriations that occur outside of appropriations bil s. and (4) do not include appropriations that occur outside of appropriations bil s.
Congressional Research Service 48 link to page 56 link to page 56 link to page 59 Labor, Health and Human Services, and Education: FY2021 Appropriations The largest share of funding appropriated to related agencies in the LHHSThe largest share of funding appropriated to related agencies in the LHHS ~~bil~~ bill consistently goes consistently goes
to the SSA. When taking into account both mandatory and discretionary funding, SSA to the SSA. When taking into account both mandatory and discretionary funding, SSA ~~usual y~~
usually represents roughly 97% of total appropriations to related agencies in the LHHS represents roughly 97% of total appropriations to related agencies in the LHHS ~~bil~~ bill. The bulk of . The bulk of
mandatory funding provided to SSA from the LHHS mandatory funding provided to SSA from the LHHS ~~bil~~ bill supports the Supplemental Security supports the Supplemental Security
Income (SSI) program, which provides means-tested cash assistance to disabled adults and Income (SSI) program, which provides means-tested cash assistance to disabled adults and
children and to seniors aged 65 or older. children and to seniors aged 65 or older.
When looking exclusively at discretionary funding, SSA received 84.3% of discretionary When looking exclusively at discretionary funding, SSA received 84.3% of discretionary
appropriations for LHHS related agencies in the FY2021 LHHSappropriations for LHHS related agencies in the FY2021 LHHS omnibus. After SSA, the next-omnibus. After SSA, the next-
largest related agency in terms of appropriations is largest related agency in terms of appropriations is ~~usual y~~usually the Corporation for National and the Corporation for National and
Community Service (CNCS), which accounted for about 1.6% of total appropriations and 7.3% of Community Service (CNCS), which accounted for about 1.6% of total appropriations and 7.3% of
discretionary appropriations to LHHS related agencies in FY2021. discretionary appropriations to LHHS related agencies in FY2021. ~~Typical y~~Typically, each of the , each of the
remaining related agencies receives less than $1 remaining related agencies receives less than $1 ~~bil ion~~ billion from the annual LHHSfrom the annual LHHS appropriations appropriations
~~bil~~ bill. For more information, se. For more information, see Table 11.
Selected Related Agencies Highlights
The following sections highlight FY2021 appropriations issues for selected related agencies. The following sections highlight FY2021 appropriations issues for selected related agencies.
Table 11 tracks funding levels for these related agencies. tracks funding levels for these related agencies.
SSA Limitation on Administrative Expenses (LAE)
The SSA LAE account consists mainly of funds that are used by SSA to administer the Social The SSA LAE account consists mainly of funds that are used by SSA to administer the Social
Security and SSI programs and to support CMS in administering portions of Medicare. The Security and SSI programs and to support CMS in administering portions of Medicare. The
account also contains funds that are account also contains funds that are ~~specifical y~~specifically set aside for certain program integrity activities, set aside for certain program integrity activities,
such as continuing disability reviews (CDRs) and SSI nonmedical redeterminations. The FY2021 such as continuing disability reviews (CDRs) and SSI nonmedical redeterminations. The FY2021
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~~link to page 58 link to page 55~~ ~~Labor, Health and Human Services, and Education: FY2021 Appropriations~~

~~LHHS omnibus provided $12.9 bil ion~~ LHHS omnibus provided $12.9 billion to the LAE account, which was an increase of $60 to the LAE account, which was an increase of $60 ~~mil ion~~million
(+0.5%) relative to the FY2020 enacted level. The President’s request would have provided about (+0.5%) relative to the FY2020 enacted level. The President’s request would have provided about
$480 $480 ~~mil ion~~ million (+3.7%) more for the LAE account relative to FY2020, while the House committee (+3.7%) more for the LAE account relative to FY2020, while the House committee
~~bil~~ bill would have increased LAE funding by $100 would have increased LAE funding by $100 ~~mil ion~~ million (+0.8%). (+0.8%).
Of the $12.9 Of the $12.9 ~~bil ion~~ billion provided to the LAE account for FY2021, nearly $1.6 provided to the LAE account for FY2021, nearly $1.6 ~~bil ion~~billion (12.2% of this (12.2% of this
total) was dedicated to program integrity activities. The program integrity portion of the LAE total) was dedicated to program integrity activities. The program integrity portion of the LAE
account included $273 account included $273 ~~mil ion~~million in base funding subject to the discretionary spending caps in base funding subject to the discretionary spending caps
established by the Budget Control Act of 2011, as established by the Budget Control Act of 2011, as ~~wel~~ well as additional funding that was effectively as additional funding that was effectively
exempt from those caps and subject to an annual limit (exempt from those caps and subject to an annual limit (cap adjustment funding; se; see Appendix A
for further information). The FY2021 LHHS omnibus provided $1.3 for further information). The FY2021 LHHS omnibus provided $1.3 ~~bil ion~~ billion in cap adjustment in cap adjustment
funding, which was the maximum amount permitted for FY2021.funding, which was the maximum amount permitted for FY2021.9495 Federal law Federal law ~~al owed~~allowed slightly slightly
more cap adjustment funding for FY2020 than for FY2021, and additional FY2021 funds to more cap adjustment funding for FY2020 than for FY2021, and additional FY2021 funds to
sustain the prior year level of funding were subject to the cap. The combined amount of program sustain the prior year level of funding were subject to the cap. The combined amount of program
integrity funding enacted for FY2021 was $7 integrity funding enacted for FY2021 was $7 ~~mil ion~~million (-0.4%) less than the combined amount (-0.4%) less than the combined amount
enacted for FY2020, reflecting the reduction to the cap adjustment funding permitted for FY2021 enacted for FY2020, reflecting the reduction to the cap adjustment funding permitted for FY2021
relative to FY2020. Both the FY2021 President’s budget and the House committee relative to FY2020. Both the FY2021 President’s budget and the House committee ~~bil~~ bill would would
have also provided the maximum amount of cap adjustment funding permitted for FY2021. have also provided the maximum amount of cap adjustment funding permitted for FY2021.
95 See 2 U.S.C. §901(b)(2)(B). Congressional Research Service 49 link to page 58 link to page 56 Labor, Health and Human Services, and Education: FY2021 Appropriations Corporation for National and Community Service
The CNCS is an independent federal agency that administers a variety of national and community The CNCS is an independent federal agency that administers a variety of national and community
service programs, such as AmeriCorps and the National Senior Volunteer Corps.service programs, such as AmeriCorps and the National Senior Volunteer Corps.9596 The FY2021 The FY2021
LHHS omnibus provided $1.1 LHHS omnibus provided $1.1 ~~bil ion~~ billion in total CNCS funding, a $17 in total CNCS funding, a $17 ~~mil ion~~ million (+1.5%) increase (+1.5%) increase
from the FY2020 enacted level. The FY2021 President’s budget had requested $92 from the FY2020 enacted level. The FY2021 President’s budget had requested $92 ~~mil ion~~million (- (-
91.7%) for CNCS,91.7%) for CNCS,9697 noting that these funds would be used to execute an orderly shutdown of noting that these funds would be used to execute an orderly shutdown of
CNCS operations, with the agency’s closure slated to be complete by the end of FY2021.CNCS operations, with the agency’s closure slated to be complete by the end of FY2021.9798 The The
House committee House committee ~~bil~~ bill declined the President’s proposal, proposing instead to increase CNCS declined the President’s proposal, proposing instead to increase CNCS
funding by $50 funding by $50 ~~mil ion~~ million (+4.5%) compared to the FY2020 enacted level. (+4.5%) compared to the FY2020 enacted level.
National Labor Relations Board (NLRB)
The NLRB is an independent board that enforces provisions in the National Labor Relations Act The NLRB is an independent board that enforces provisions in the National Labor Relations Act
(NLRA). The FY2021 LHHS omnibus maintained the FY2020 funding levels for the NLRB of (NLRA). The FY2021 LHHS omnibus maintained the FY2020 funding levels for the NLRB of
$274 $274 ~~mil ion~~million. The FY2021 President’s budget would have decreased funding for the NLRB by . The FY2021 President’s budget would have decreased funding for the NLRB by
$27 $27 ~~mil ion~~ million (-10.0%) compared to the FY2020 enacted level, while the House committee (-10.0%) compared to the FY2020 enacted level, while the House committee ~~bil~~
bill would have increased funding for the NLRB by $4 would have increased funding for the NLRB by $4 ~~mil ion (+1.3%).~~

~~94 See 2 U.S.C. §901(b)(2)(B).~~
~~95 See CRS~~ million (+1.3%). The FY2021 LHHS omnibus retained a provision that has been included in the LHHS bill since FY2012 that prohibits any funds appropriated to the NLRB in the bill, or any prior appropriations act, from being used to issue a directive or regulation to provide employees a means of voting through any electronic method in an election determining representation for collective bargaining (§407). Table 11. Detailed Related Agencies Appropriations (In millions of dollars) FY2021 FY2021 House Enacted Cmte. (P.L. FY2020 FY2021 (H.R. 116- Agency, Program, Project, or Activity Enacted Request 7614) 260) Committee for Purchase from People Who Are Blind or Severely Disabled (U.S. AbilityOne Commission) 10 14 10 11 Corporation for National and Community Service (CNCS) 1,104 92a 1,154 1,121 Selected CNCS Programs/Initiatives: Volunteers in Service to America (VISTA) 93 5 95 97 96 See CRS Report RL33931, Report RL33931, The Corporation for National and Community Service: Overview of Programs and
Funding. .
~~96 T his~~97 This report uses the figure report uses the figure that was publishedthat was published in the FY2021 LHHS omnibusin the FY2021 LHHS omnibus explanatory statement, which is the explanatory statement, which is the
source document usedsource document used by this report for the FY2021 request. (See the Source notes foby this report for the FY2021 request. (See the Source notes for Table 11 for further for further
information.) According to the Corporation for National and Community Service (CNCS)information.) According to the Corporation for National and Community Service (CNCS) FY2021 budgetFY2021 budget justification, justification,
the total amount requested for CNCSthe total amount requested for CNCS ~~was~~ was $82 million (see CNCS,$82 million (see CNCS, FY2021 Congressional BudgetFY2021 Congressional Budget Justification, Justification,
February 10, 2020, p. 2, https://americorps.gov/sites/default/files/documents/February 10, 2020, p. 2, https://americorps.gov/sites/default/files/documents/
CNCS%20FY%202021%20Congressional%20Budget%20Justification%20w%20IG%20Message%20%28Final%29_5CNCS%20FY%202021%20Congressional%20Budget%20Justification%20w%20IG%20Message%20%28Final%29_5
08.pdf). 08.pdf).
~~97 T he budget~~ 98 The budget request indicated that the elimination of CNCSrequest indicated that the elimination of CNCS ~~would~~ would return the “responsibility to fund national return the “responsibility to fund national ~~serv ice~~service
and volunteerism to the private and nonprofit sectors.” See ibid.and volunteerism to the private and nonprofit sectors.” See ibid. Previous President’s budgetsPrevious President’s budgets for FY2018, FY2019, for FY2018, FY2019,
and FY2020 had also proposed an elimination of CNCS. and FY2020 had also proposed an elimination of CNCS.
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link to page link to page ~~56 link to page 56~~58 link to page link to page 5658 link to page link to page 5258 Labor, Health and Human Services, and Education: FY2021 Appropriations FY2021 FY2021 House Enacted Cmte. (P.L. FY2020 FY2021 (H.R. 116- Agency, Program, Project, or Activity Enacted Request 7614) 260) National Senior Volunteer Corps 221 0b 239 225 AmeriCorps ~~Labor, Health and Human Services, and Education: FY2021 Appropriations~~

~~The FY2021 LHHS omnibus retained a provision that has been included in the LHHS bil since~~
~~FY2012 that prohibits any funds appropriated to the NLRB in the bil , or any prior appropriations~~
~~act, from being used to issue a directive or regulation to provide employees a means of voting~~
~~through any electronic method in an election determining representation for collective bargaining~~
~~(§407).~~
~~Table 11. Detailed Related Agencies Appropriations~~
~~(In mil ions of dol ars)~~
~~FY2021~~
~~FY2021~~
~~House~~
~~Enacted~~
~~Cmte.~~
~~(P.L.~~
~~FY2020~~
~~FY2021~~
~~(H.R.~~
~~116-~~
~~Agency, Program, Project, or Activity~~
~~Enacted~~
~~Request~~
~~7614)~~
~~260)~~
~~Committee for Purchase from People Who Are Blind or~~
~~Severely Disabled (U.S. AbilityOne Commission)~~
10
14
10
11
~~Corporation for National and Community Service~~
~~(CNCS)~~
~~1,104~~
~~92a~~
~~1,154~~
~~1,121~~
~~Selected CNCS Programs/Initiatives:~~

~~Volunteers in Service to America (VISTA)~~
93
5
95
97
~~National Senior Volunteer Corps~~
~~221~~
0b
~~239~~
~~225~~
~~AmeriCorps~~ State and National Grants State and National Grants
429 429
2 2
447 447
455 455
National Civilian Community Corps National Civilian Community Corps
33 33
23 23
35 35
34 34
National Service National Service Trust Trust
208 208
10c
212 212
185 185
Corporation for Public Broadcasting (CPB)
485
0
535
495
Federal Mediation and Conciliation Service
47
49
49
49
Federal Mine Safety and Health Review Commission
17
17
17
17
Institute of Museum and Library Services (IMLS)
252
23
257
257
Medicare Payment Advisory Commission (MedPAC)
13
14
13
13
Medicaid and CHIP Payment and Access Commission
(MACPAC)
9
9
9
9
National Council on Disability
3
3
3
3
National Labor Relations Board (NLRB)
274
247
278
274
National Mediation Board
14
14
14
14
Occupational Safety and Health Review Commission
13
14
13
13
Railroad Retirement Board (RRB)
150
144
150
147
Dual Benefits Dual Benefits (minus tax receipts)(minus tax receipts)
15 15
12 12
12 12
12 12
Federal Federal Payment to RR RetirementPayment to RR Retirement Account (Account (~~mandatory~~)0mandator y)d
0 0
0 0
0 0
0 0
Limitation Limitation on Administrationon Administration
124 124
120 120
127 127
124 124
Inspector General Inspector General
11 11
11 11
11 11
12 12
Social Security Administration (SSA)
70,314
68,759
68,369
68,329
Payments to Social Payments to Social Security Trust Funds (mandatory) Security Trust Funds (mandatory)
11 11
11 11
11 11
11 11
Supplemental Security Income (SSI) (mandatory) Supplemental Security Income (SSI) (mandatory)
57,328 57,328
55,282 55,282
55,282 55,282
55,282 55,282
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~~FY2021~~
~~FY2021~~
~~House~~
~~Enacted~~
~~Cmte.~~
~~(P.L.~~
~~FY2020~~
~~FY2021~~
~~(H.R.~~
~~116-~~
~~Agency, Program, Project, or Activity~~
~~Enacted~~
~~Request~~
~~7614)~~
~~260)~~
~~Limitation~~ Limitation on Administrativeon Administrative Expenses (LAE) Expenses (LAE)
12,870 12,870
13,349 13,349
12,970 12,970
12,930 12,930
Regular LAE (incl. user fees, non-add)
11,288
11,774
11,395
11,355
Program Integrity (non-add)
1,582
1,575
1,575
1,575
Office of Inspector General Office of Inspector General
106 106
116 116
106 106
106 106
Total, Related Agencies BA in the Bill
72,706
69,398
70,871
70,752
Subtotal, Mandatory
57,339
55,294
55,294
55,294
Subtotal, Discretionary
15,367
14,104
15,577
15,459
Emergency Funding (not included in above totals)

3rd COVID (P.L. 116-136) 3rd COVID (P.L. 116-136)
430 430
— —
— —
— —
Memoranda (non-emergency funds only)

Total, BA Available in Fiscal Total, BA Available in Fiscal Year (current year from any bil ) Year (current year from any bil )
72,486 72,486
69,728 69,728
71,101 71,101
71,022 71,022
Total, BA Advances for Future Years (provided in current bil ) Total, BA Advances for Future Years (provided in current bil )
20,365 20,365
19,600 19,600
20,115 20,115
20,075 20,075 Congressional Research Service 51 Labor, Health and Human Services, and Education: FY2021 Appropriations FY2021 FY2021 House Enacted Cmte. (P.L. FY2020 FY2021 (H.R. 116- Agency, Program, Project, or Activity Enacted Request 7614) 260) Total, BA Advances from Prior
~~Total, BA Advances from Prior~~ Years (for use in current year) Years (for use in current year)
20,145 20,145
19,930 19,930
20,345 20,345
20,345 20,345
~~Source~~Sources: Amounts in this table for the FY2020 Enacted, FY2021 Request, and FY2021 Enacted columns are Amounts in this table for the FY2020 Enacted, FY2021 Request, and FY2021 Enacted columns are
~~general y~~generally drawn from drawn from or calculated based on data contained in the explanatory statement accompanying the or calculated based on data contained in the explanatory statement accompanying the
FY2021 LHHS omnibus (P.L. 116-260), available in the FY2021 LHHS omnibus (P.L. 116-260), available in the Congressional Record, vol., vol. 166, no. 218, book IV, December 166, no. 218, book IV, December
21, 2020, pp. H8619-HH8711. Amounts in the FY2021 House Committee21, 2020, pp. H8619-HH8711. Amounts in the FY2021 House Committee column are column are ~~general y~~generally drawn from or drawn from or
calculated based on data contained in the committeecalculated based on data contained in the committee report (H.Rept. 116-450) accompanying H.R. 7614. Enacted report (H.Rept. 116-450) accompanying H.R. 7614. Enacted
totals (“Total BA in the Bil ”) for FY2020 do not include emergency-designated appropriations provided intotals (“Total BA in the Bil ”) for FY2020 do not include emergency-designated appropriations provided in P.L. P.L.
116-113, P.L. 116-123, P.L. 116-127, P.L. 116-136, or P.L. 116-139. House committee116-113, P.L. 116-123, P.L. 116-127, P.L. 116-136, or P.L. 116-139. House committee bil totals (“Total BA in the bil totals (“Total BA in the
Bil ”) for FY2021 do not include emergency-designated appropriations proposed in Title VI of H.R. 7614. Enacted Bil ”) for FY2021 do not include emergency-designated appropriations proposed in Title VI of H.R. 7614. Enacted
totals (“Total BA in the Bil ”) for FY2021 do not include emergency-designated appropriations provided in totals (“Total BA in the Bil ”) for FY2021 do not include emergency-designated appropriations provided in
DivisionDivision H or M of P.L.H or M of P.L. ~~116-260~~ 116-260, or P.L. 117-31. For consistency with source materials,. For consistency with source materials, amounts in this figure amounts in this figure ~~general y~~ generally do not do not
reflect mandatory spending sequestration, wherereflect mandatory spending sequestration, where applicable, nor do they reflect any transfers or reprogramming applicable, nor do they reflect any transfers or reprogramming
of funds pursuant to executive authorities. of funds pursuant to executive authorities.
Notes: BA = Budget Authority. DetailsBA = Budget Authority. Details may not add to totals due to rounding. Amounts in this table (1) reflect may not add to totals due to rounding. Amounts in this table (1) reflect
al all BA appropriated in the bil ,BA appropriated in the bil , ~~regardless~~ regardless of the year in which funds become available (i.e.,of the year in which funds become available (i.e., totals do not include totals do not include
advances from prior-year appropriations,advances from prior-year appropriations, but do include advances for subsequent years provided in this bil ); (2) but do include advances for subsequent years provided in this bil ); (2)
have have ~~general y~~generally not been adjusted to reflect not been adjusted to reflect scorekeeping; (3) comprisescorekeeping; (3) comprise only those funds provided (or requested) only those funds provided (or requested)
for agencies and accounts subject to the jurisdictionfor agencies and accounts subject to the jurisdiction of the LHHS subcommitteesof the LHHS subcommittees of the House and Senate of the House and Senate
appropriations committees;appropriations committees; and (4) do not include appropriations that occur outside of appropriations bil s.and (4) do not include appropriations that occur outside of appropriations bil s.
a. This report uses the figure that was published in the FY2021 LHHS omnibus explanatory statementa. This report uses the figure that was published in the FY2021 LHHS omnibus explanatory statement , which , which
is the source document used by this report for the FY2021 request. (See the Source notes for further is the source document used by this report for the FY2021 request. (See the Source notes for further
information.) According to the Corporation for National and Community Serviceinformation.) According to the Corporation for National and Community Service (CNCS) FY2021 budget (CNCS) FY2021 budget
justification, the total amount requested for CNCS was $82 mil ionjustification, the total amount requested for CNCS was $82 mil ion (see CNCS, FY2021 Congressional (see CNCS, FY2021 Congressional
Budget Justification, February 10, 2020, p. 2, https://americorps.gov/sites/default/files/documents/Budget Justification, February 10, 2020, p. 2, https://americorps.gov/sites/default/files/documents/
CNCS%20FY%202021%20Congressional%20Budget%20Justification%20w%20IG%20Message%20%28Final%2CNCS%20FY%202021%20Congressional%20Budget%20Justification%20w%20IG%20Message%20%28Final%2
9_508.pdf).9_508.pdf).
b. The actual amount requested is roughly $333,000, which rounds to $0 in mil ions b. The actual amount requested is roughly $333,000, which rounds to $0 in mil ions (the unit of measure(the unit of measure used used
in this table). in this table).
c. This report uses the figure that was published in the FY2021 LHHS omnibus explanatory statement, which c. This report uses the figure that was published in the FY2021 LHHS omnibus explanatory statement, which
is the source document used by this report for the FY2021 request. (See the “Source” notes for further is the source document used by this report for the FY2021 request. (See the “Source” notes for further
information.) According to the CNCS FY2021 budget justification, the total amount requested for the information.) According to the CNCS FY2021 budget justification, the total amount requested for the
National ServiceNational Service Trust was $0 (see CNCS, FY2021 CongressionalTrust was $0 (see CNCS, FY2021 Congressional Budget Justification, February 10, 2020, p. Budget Justification, February 10, 2020, p.
2, https://americorps.gov/sites/default/files/documents/2, https://americorps.gov/sites/default/files/documents/
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CNCS%20FY%202021%20Congressional%20Budget%20Justification%20w%20IG%20Message%20%28Final%2CNCS%20FY%202021%20Congressional%20Budget%20Justification%20w%20IG%20Message%20%28Final%2
9_508.pdf). 9_508.pdf).
d. The actual amount of mandatory federal d. The actual amount of mandatory federal payments to the Railroad Retirementpayments to the Railroad Retirement account is roughly $150,000 account is roughly $150,000
in each column, which rounds to $0 in mil ions in each column, which rounds to $0 in mil ions (the unit of measure(the unit of measure used in this table). used in this table).
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Appropriations
Appendix A. Budget Enforcement Activities
The framework for budget enforcement under the congressional budget process has both statutory The framework for budget enforcement under the congressional budget process has both statutory
and procedural elements. The statutory elements include the discretionary spending limits and and procedural elements. The statutory elements include the discretionary spending limits and
mandatory spending sequester derived from the Budget Control Act of 2011 (BCA;mandatory spending sequester derived from the Budget Control Act of 2011 (BCA; P.L. 112-25) P.L. 112-25)
and the Balanced Budget and Emergency Deficit Control Act of 1985 (BBEDCA;and the Balanced Budget and Emergency Deficit Control Act of 1985 (BBEDCA; P.L. 99-177), P.L. 99-177),
as amended. The procedural elements are primarily associated with the budget resolution and as amended. The procedural elements are primarily associated with the budget resolution and
limit both total discretionary spending and spending under the jurisdiction of each appropriations limit both total discretionary spending and spending under the jurisdiction of each appropriations
subcommittee. subcommittee.
Statutory budget enforcement requirements that apply to FY2021 discretionary spending were Statutory budget enforcement requirements that apply to FY2021 discretionary spending were
altered prior to the start of the fiscal year by the Bipartisan Budget Act of 2019 (BBAaltered prior to the start of the fiscal year by the Bipartisan Budget Act of 2019 (BBA 2019; P.L. 2019; P.L.
116-37) which was enacted on August 2, 2019. This law increased the defense and nondefense 116-37) which was enacted on August 2, 2019. This law increased the defense and nondefense
discretionary spending limits for FY2020 and FY2021, and extended mandatory spending discretionary spending limits for FY2020 and FY2021, and extended mandatory spending
sequestration through FY2029.sequestration through FY2029.9899 Subsequently, mandatory spending sequestration was further Subsequently, mandatory spending sequestration was further
extended through FY2030 by the CARES Act (P.L. 116-136), enacted on March 27, 2020. extended through FY2030 by the CARES Act (P.L. 116-136), enacted on March 27, 2020.
Budget Control Act and Sequestration
The BCAThe BCA provides budget process mechanisms to reduce mandatory spending and further reduce provides budget process mechanisms to reduce mandatory spending and further reduce
discretionary spending over an extended period.discretionary spending over an extended period.99100 For mandatory spending, reductions are to For mandatory spending, reductions are to
occur through sequestration in each of fiscal years between FY2013-FY2030.occur through sequestration in each of fiscal years between FY2013-FY2030.~~100~~101 For discretionary For discretionary
spending, reductions occurred through sequestration in FY2013, but were to be achieved through spending, reductions occurred through sequestration in FY2013, but were to be achieved through
lower discretionary spending limits for each of the fiscal years between FY2014-FY2021. (At this lower discretionary spending limits for each of the fiscal years between FY2014-FY2021. (At this
time, there are no statutory discretionary spending limits in place for FY2022 or future years.) time, there are no statutory discretionary spending limits in place for FY2022 or future years.)
The BCAThe BCA does not require a sequester of discretionary spending in FY2014-FY2021 unless one or does not require a sequester of discretionary spending in FY2014-FY2021 unless one or
both of the statutory discretionary spending limits (on “defense” and “nondefense” spending) is both of the statutory discretionary spending limits (on “defense” and “nondefense” spending) is
breached. Only discretionary spending subject to a given spending limitbreached. Only discretionary spending subject to a given spending limit would be affected by a would be affected by a
breach of that limit, and the LHHSbreach of that limit, and the LHHS ~~bil~~ bill only includes funding in the nondefense category. only includes funding in the nondefense category.
FY2021 Mandatory Spending Sequestration
On February 10, 2020, concurrent with the release of the President’s budget submission, On February 10, 2020, concurrent with the release of the President’s budget submission,
President Trump issued the required FY2021 sequestration order, President Trump issued the required FY2021 sequestration order, ~~cal ing~~calling for nonexempt for nonexempt
mandatory spending to be reduced on October 1, 2020.mandatory spending to be reduced on October 1, 2020.~~101~~102 At that time, the Office of Management At that time, the Office of Management
and Budget (OMB) estimated that the FY2021 sequestration percentages would equal 2% of and Budget (OMB) estimated that the FY2021 sequestration percentages would equal 2% of

98 99 For a discussion For a discussion of how these discretionary spending requirements for FY2014of how these discretionary spending requirements for FY2014 -FY2019 were modified by the -FY2019 were modified by the
Bipartisan BudgetBipartisan Budget Act of 2013, the Bipartisan Budget Act of 2015, and the Bipartisan BudgetAct of 2013, the Bipartisan Budget Act of 2015, and the Bipartisan Budget Act of 2018, seeAct of 2018, see CRS CRS
Report R43236, Report R43236, Labor, Health and ~~Hum an~~Human Services, and Education: FY2014 Appropriations; and CRS; and CRS Report Report
R44287, R44287, Labor, Health and ~~Hum an~~Human Services, and Education: FY2016 Appropriations, and CRS, and CRS Report R45083, Report R45083, Labor,
Health and ~~Hum an~~Human Services, and Education: FY2018 Appropriations. .
~~99 T he~~100 The BCA initially imposed limits on discretionary spending for each of FY2012 BCA initially imposed limits on discretionary spending for each of FY2012 -FY2021. Further reductions to -FY2021. Further reductions to
discretionary spending werediscretionary spending were triggered when the Joint Committee on Deficit Reduction didtriggered when the Joint Committee on Deficit Reduction did not report legislation to not report legislation to
achieve a specified amount of budgetaryachieve a specified amount of budgetary savings. savings.
~~100~~ 101 As originally enacted, mandatory sequestration was scheduled As originally enacted, mandatory sequestration was scheduled to run through FY2021, but this period has to run through FY2021, but this period has
subsequentlysubsequently been incrementally extended to FY2030 by P.L. 113-67, P.L. 113-82, P.L. 114-74, P.L. 115-123, P.L. been incrementally extended to FY2030 by P.L. 113-67, P.L. 113-82, P.L. 114-74, P.L. 115-123, P.L.
116-37, and P.L. 116-136. 116-37, and P.L. 116-136.
~~101~~102 Sequestration Order for Fiscal Sequestration Order for Fiscal Year 2021 Pursuant to Section 251A of the Balanced BudgetYear 2021 Pursuant to Section 251A of the Balanced Budget and Emergency Deficit and Emergency Deficit
Control Act, As Amended,Control Act, As Amended, Federal RegisterFederal Register ~~Volume~~ Volume 85, No. 30, February 13, 2020, p. 8129, https://www.govinfo.gov/85, No. 30, February 13, 2020, p. 8129, https://www.govinfo.gov/
content/pkg/FR-2020-02-13/pdf/2020-03044.pdf. content/pkg/FR-2020-02-13/pdf/2020-03044.pdf.
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Appropriations
nonexempt Medicare spending and 5.7% of other nonexempt nondefense mandatory spending, nonexempt Medicare spending and 5.7% of other nonexempt nondefense mandatory spending,
for a total reduction of $21 for a total reduction of $21 ~~bil ion~~ billion in FY2021.in FY2021.~~102~~103 (OMB also estimated an 8.3% reduction, (OMB also estimated an 8.3% reduction,
totaling $924 totaling $924 ~~mil ion,~~ million, in nonexempt defense mandatory spending, which does not affect LHHS in nonexempt defense mandatory spending, which does not affect LHHS
funds.) funds.)
On March 27, 2020, over a month after President Trump issued the sequestration order for On March 27, 2020, over a month after President Trump issued the sequestration order for
FY2021 and OMB released the sequester report, the CARES Act (P.L. 116-136) was enacted. FY2021 and OMB released the sequester report, the CARES Act (P.L. 116-136) was enacted.
This law included a provision temporarily suspending Medicare sequestration from May 1, 2020, This law included a provision temporarily suspending Medicare sequestration from May 1, 2020,
through December 31, 2020. Subsequent laws (P.L. 116-260 and P.L. 117-7) extended this through December 31, 2020. Subsequent laws (P.L. 116-260 and P.L. 117-7) extended this
suspension through December 31, 2021. A result of these combined provisions is that Medicare suspension through December 31, 2021. A result of these combined provisions is that Medicare
sequestration was effectively required to be suspended throughout the entirety of FY2021 sequestration was effectively required to be suspended throughout the entirety of FY2021
(October 2020 through September 2021). (October 2020 through September 2021).
FY2021 Statutory Discretionary Spending Limits
With regard to discretionary spending, the FY2021 statutory spending limits that were in effect With regard to discretionary spending, the FY2021 statutory spending limits that were in effect
were $672 were $672 ~~bil ion~~billion for defense spending and $627 for defense spending and $627 ~~bil ion~~ billion for nondefense spending.for nondefense spending.~~103~~104 Relative to Relative to
FY2020, the defense and nondefense limits FY2020, the defense and nondefense limits ~~al owed~~allowed for an increase in spending subject to each for an increase in spending subject to each
respective limit of $5 respective limit of $5 ~~bil ion~~ billion apiece. Once apiece. Once al all regular annual appropriations acts were enacted for regular annual appropriations acts were enacted for
FY2021 and FY2021 and ~~al owable~~allowable adjustments to the spending limits (discussed below) were made, OMB adjustments to the spending limits (discussed below) were made, OMB
determined that those appropriations did not violate either of the spending limits, and thus no determined that those appropriations did not violate either of the spending limits, and thus no
sequestration of discretionary spending would be required.sequestration of discretionary spending would be required.~~104~~
105 Cap Adjustments, Exemptions, and Special Rules
The BCA The BCA ~~al ows~~ allows for certain adjustments to the discretionary spending limits for FY2012- for certain adjustments to the discretionary spending limits for FY2012-
FY2021.FY2021.~~105~~106 An adjustment effectively raises the applicable spending limit An adjustment effectively raises the applicable spending limit when funding subject when funding subject
to that adjustment is enacted. In addition to the LHHS-specific adjustments that are discussed in to that adjustment is enacted. In addition to the LHHS-specific adjustments that are discussed in
the paragraph below, the BCA includes an adjustment for funding designated as an “emergency the paragraph below, the BCA includes an adjustment for funding designated as an “emergency
requirement.” The BCA includes no dollar limitrequirement.” The BCA includes no dollar limit to the amount of appropriations each fiscal year to the amount of appropriations each fiscal year
that can be designated in this manner, and no criteria that would restrict the use of this adjustment that can be designated in this manner, and no criteria that would restrict the use of this adjustment
to certain accounts or activities. to certain accounts or activities. Al All FY2021 LHHS supplemental discretionary appropriations FY2021 LHHS supplemental discretionary appropriations
(totaling $155 (totaling $155 ~~bil ion)~~ billion) were designated as an emergency requirement, as were a were designated as an emergency requirement, as were a ~~smal~~ small portion of portion of
annual LHHS appropriations ($1.6 annual LHHS appropriations ($1.6 ~~bil ion~~billion). ).
The BCA The BCA also provides adjustments that are also provides adjustments that are ~~specifical y~~specifically for LHHS accounts and activities, for LHHS accounts and activities, al all of of
which are subject to dollar limits each fiscal year. As which are subject to dollar limits each fiscal year. As ~~original y~~ originally enacted, the BCA enacted, the BCA ~~al owed~~
allowed increases to the nondefense limit (up to a point) to accommodate new budget authority for increases to the nondefense limit (up to a point) to accommodate new budget authority for

~~102~~ 103 OMB Report to the Congress on the Joint Committee Reductions for Fiscal Year 2021 , February 10, 2020, , February 10, 2020,
https://www.whitehouse.gov/wp-content/uploads/2020/02/JC-sequestration_report_FY21_2-10-20.pdf. See the report’s https://www.whitehouse.gov/wp-content/uploads/2020/02/JC-sequestration_report_FY21_2-10-20.pdf. See the report’s
appendix for an itemized list of budgetappendix for an itemized list of budget accounts that include mandatory spending subjectaccounts that include mandatory spending subject to sequestration in FY2021, to sequestration in FY2021,
the dollar amounts subject to sequestration (basedthe dollar amounts subject to sequestration (based on OMB’son OMB’s current law baseline),current law baseline), the percentage by which they the percentage by which they
wouldwould be reduced,be reduced, and the dollar amount of the reduction. While the report displays reductions at the and the dollar amount of the reduction. While the report displays reductions at the account level, the level, the
sequestersequester itself is implemented at the itself is implemented at the program , project, or activity level. level.
~~103~~ 104 OMB Sequestration Preview Report to the President and Congress for Fiscal Year 2021 , February 10, 2020, , February 10, 2020,
https://www.whitehouse.gov/wp-content/uploads/2020/02/Sequestration_Preview_2-10-20.pdf. https://www.whitehouse.gov/wp-content/uploads/2020/02/Sequestration_Preview_2-10-20.pdf.
~~104~~105 OMB, Budget OMB, Budget Enforcement Act Report (Enforcement Act Report (Seven-Day-After), Consolidated Appropriations Act, 2021, January 15, , January 15,
2021, https://www.whitehouse.gov/wp-content/uploads/2021/01/7_Day_After_Report_Omni_1-15-21.pdf. 2021, https://www.whitehouse.gov/wp-content/uploads/2021/01/7_Day_After_Report_Omni_1-15-21.pdf.
~~105~~106 For further information, see CRS For further information, see CRS Report R45778, Report R45778, Exceptions to the Budget Control Act’s Discretionary Spending
~~Lim its~~Limits. .
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specified program integrity initiatives specified program integrity initiatives at HHS and the Social Security Administration (SSA).at HHS and the Social Security Administration (SSA).~~106~~107
The Bipartisan Budget Act of 2015 (P.L. 114-74) amended the list of SSA activities covered by The Bipartisan Budget Act of 2015 (P.L. 114-74) amended the list of SSA activities covered by
this “cap adjustment” to include costs associated with work-related continuing disability reviews, this “cap adjustment” to include costs associated with work-related continuing disability reviews,
Cooperative Disability Investigations, and fraud prosecutions by Special Assistant U.S. Attorneys, Cooperative Disability Investigations, and fraud prosecutions by Special Assistant U.S. Attorneys,
and revised the amount of the and revised the amount of the ~~al owable~~allowable SSA adjustment amounts to be more generous in SSA adjustment amounts to be more generous in
FY2017-FY2019 compared to what was previously FY2017-FY2019 compared to what was previously ~~al owed~~allowed, but less generous in FY2021., but less generous in FY2021.~~107~~108 The The
~~BBA~~ BBA 2018 then added a new cap to accommodate new budget authority for the DOL to help fund 2018 then added a new cap to accommodate new budget authority for the DOL to help fund
the reemployment services and eligibilitythe reemployment services and eligibility assessments conducted by the states related to assessments conducted by the states related to
unemployment compensation.unemployment compensation.~~108~~
109 Separate from these cap adjustments, the 21st Century Cures Act (Cures Act, P.L. 114-255), which Separate from these cap adjustments, the 21st Century Cures Act (Cures Act, P.L. 114-255), which
was enacted on December 13, 2016, includes additional budget enforcement procedures related to was enacted on December 13, 2016, includes additional budget enforcement procedures related to
the discretionary spending limits.the discretionary spending limits.~~109~~110 For the purposes of FY2021 LHHS appropriations, these For the purposes of FY2021 LHHS appropriations, these
procedures apply only to the NIH Innovation Account that was created by the act.procedures apply only to the NIH Innovation Account that was created by the act.~~110~~111 The Cures The Cures
Act provides that discretionary appropriations from this account (up to the amount authorized) are Act provides that discretionary appropriations from this account (up to the amount authorized) are
to be subtracted from any cost estimates provided for purposes of budget controls. Thus, the to be subtracted from any cost estimates provided for purposes of budget controls. Thus, the
Cures Act ensures that appropriations from this account Cures Act ensures that appropriations from this account ~~wil~~ will not count against any spending not count against any spending
limits, such as the statutory discretionary spending limits imposed by the BCA.limits, such as the statutory discretionary spending limits imposed by the BCA.
An additional An additional set of statutory exemptions and special rules that apply to sequestration are relevant set of statutory exemptions and special rules that apply to sequestration are relevant
for the LHHS for the LHHS ~~bil .~~ bill. The LHHS The LHHS ~~bil~~ bill contains several programs that are exempt from sequestration, contains several programs that are exempt from sequestration,
including Medicaid, payments to health care trust funds, Supplemental Security Income, Special including Medicaid, payments to health care trust funds, Supplemental Security Income, Special
Benefits for Disabled Coal Miners, retirement pay and medical benefits for commissioned Public Benefits for Disabled Coal Miners, retirement pay and medical benefits for commissioned Public
Health Service officers, foster care and adoption assistance, and certain family support payments. Health Service officers, foster care and adoption assistance, and certain family support payments.
The LHHS The LHHS ~~bil~~ bill also contains several programs that are subject to special rules under also contains several programs that are subject to special rules under
sequestration, such as unemployment compensation, certain student loans, health centers, and sequestration, such as unemployment compensation, certain student loans, health centers, and
portions of Medicare.portions of Medicare.~~111~~112
Budget Resolution and 302(b) Suballocations
The procedural elements of budget enforcement The procedural elements of budget enforcement ~~general y~~generally stem from requirements under the stem from requirements under the
Congressional Budget Act of 1974 (P.L. 93-44) that are associated with the adoption of an annual Congressional Budget Act of 1974 (P.L. 93-44) that are associated with the adoption of an annual
budget resolution. Through this process, the Appropriations Committee in each chamber receives budget resolution. Through this process, the Appropriations Committee in each chamber receives
a procedural limit on the total amount of discretionary budget authority for the upcoming fiscal a procedural limit on the total amount of discretionary budget authority for the upcoming fiscal

~~106~~ 107 For further information about the allowable FY2018 adjustments, see For further information about the allowable FY2018 adjustments, see OMB Sequestration Preview Report to the
President and Congress for Fiscal Year 2018 , May 23, 2017, https://www.whitehouse.gov/sites/whitehouse.gov/files/, May 23, 2017, https://www.whitehouse.gov/sites/whitehouse.gov/files/
omb/sequestration_reports/2018_preview_report_may2017_potus.pdf. omb/sequestration_reports/2018_preview_report_may2017_potus.pdf.
~~107~~ 108 For further information, see CRS For further information, see CRS Report R44250, Report R44250, Social Security and Social Security Disability Insurance (SSDI)
Provisions in the Bipartisan Budget Act of 2015 . .
~~108~~109 For information on the programmatic changes associated with this cap adjustment that were also included For information on the programmatic changes associated with this cap adjustment that were also included in the in the
BBABBA 2018, see CRS2018, see CRS Report R44836, Report R44836, ~~Unem ployment~~Unemployment Insurance: Legislative Issues in the 115th Congress. .
~~109 T hese~~110 These procedures originally applied to two accounts within the scope of the LHHS procedures originally applied to two accounts within the scope of the LHHS ~~bill~~ bill that were created bythat were created by the the
CuresCures ~~Act~~ Act: the NIH Innovation Account: the NIH Innovation Account (FY2017-FY2026) and the Account for the State Response to the Opioid (FY2017-FY2026) and the Account for the State Response to the Opioid
AbuseAbuse ~~Crisis~~ Crisis (FY2017-FY2018). (FY2017-FY2018). ~~T hese~~These procedures have lapsed for the State Response to the Opioid Abuse procedures have lapsed for the State Response to the Opioid Abuse Crisis Crisis
account as of the end of FY2018, but are still in effect for the NIH Innovation Accountaccount as of the end of FY2018, but are still in effect for the NIH Innovation Account through FY2026. through FY2026.
~~110 T he~~111 The 21st Century Cures Act also created a non-LHHS account—the FDA Innovation Account 21st Century Cures Act also created a non-LHHS account—the FDA Innovation Account —and made it subject —and made it subject
to similar budgetto similar budget ~~enforcement~~ enforcement-related provisions. For more information, see CRS-related provisions. For more information, see CRS Report R44720, Report R44720, The 21st Century
Cures Act (Division A of P.L. 114-255). .
~~111~~112 For more information, see CRS For more information, see CRS Report R42050, Report R42050, Budget “Sequestration” and Selected Program Exemptions and
Special Rules. .
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year, referred to as a 302(a) year, referred to as a 302(a) ~~al ocation~~allocation. The Appropriations Committee subsequently divides this . The Appropriations Committee subsequently divides this
~~al ocation~~allocation among its 12 subcommittees. These subcommittee-level spending limits are referred to among its 12 subcommittees. These subcommittee-level spending limits are referred to
as 302(b) as 302(b) ~~subal ocations~~suballocations. The 302(b) . The 302(b) ~~subal ocations~~suballocations restrict the amount of budget authority restrict the amount of budget authority
availableavailable to each subcommittee for the agencies, projects, and activities under its jurisdiction, to each subcommittee for the agencies, projects, and activities under its jurisdiction,
effectively acting as a cap on each of the 12 regular appropriations effectively acting as a cap on each of the 12 regular appropriations ~~bil s~~bills. Enforcement of the . Enforcement of the
302(a) 302(a) ~~al ocation~~allocation and 302(b) and 302(b) ~~subal ocations~~suballocations occurs through points of order. occurs through points of order.
For the FY2021 appropriations cycle, the House and the Senate relied on alternate mechanisms For the FY2021 appropriations cycle, the House and the Senate relied on alternate mechanisms
provided by BBAprovided by BBA 2019 to provide the basis for the Appropriations Committees spending 2019 to provide the basis for the Appropriations Committees spending
~~al ocations.112~~allocations.113 These procedures These procedures ~~al owed~~allowed those spending those spending ~~al ocations~~allocations to be established via to be established via
statements submitted to the statements submitted to the Congressional Record by the chairs of the House and Senate budget by the chairs of the House and Senate budget
committees, without the adoption of a budget resolution.committees, without the adoption of a budget resolution.~~113~~114 Among other requirements, these Among other requirements, these
spending spending ~~al ocations~~allocations were required to be consistent with the levels established by the statutory were required to be consistent with the levels established by the statutory
discretionary spending limits. The FY2021 committee-level spending discretionary spending limits. The FY2021 committee-level spending ~~al ocations~~allocations were submitted were submitted
in the House on May 1, and in the Senate on May 4, 2020.in the House on May 1, and in the Senate on May 4, 2020.~~114~~115 The House Appropriations The House Appropriations
Committee subsequently adopted 302(b) Committee subsequently adopted 302(b) ~~subal ocations~~suballocations for each of its 12 subcommittees on July for each of its 12 subcommittees on July
9.9.~~115~~116 The House initial The House initial ~~LHHS discretionary subal ocation~~ LHHS discretionary suballocation for FY2021 was $182.9 for FY2021 was $182.9 ~~bil ion.116~~billion.117 The The
Senate Appropriations Committee did not Senate Appropriations Committee did not ~~formal y adopt subal ocations~~formally adopt suballocations prior to the enactment of prior to the enactment of
full-year appropriations for FY2021, although a majority proposal for these full-year appropriations for FY2021, although a majority proposal for these ~~subal ocations was~~
suballocations was released on November 10, 2020.released on November 10, 2020.~~117~~
118 For current-year LHHS discretionary For current-year LHHS discretionary ~~fundi~~ngfunding, Table A-1 displays FY2020 enacted levels, the displays FY2020 enacted levels, the
House FY2021 initialHouse FY2021 initial ~~subal ocations~~ suballocations, and enacted FY2021 LHHS appropriations. The table , and enacted FY2021 LHHS appropriations. The table
shows that the House would have decreased regular LHHS discretionary appropriations by about shows that the House would have decreased regular LHHS discretionary appropriations by about
~~$128 mil ion~~ $128 million (-0.1%) compared to the prior fiscal year. Final enacted appropriations were about (-0.1%) compared to the prior fiscal year. Final enacted appropriations were about
$9 $9 ~~bil ion~~ billion (-4.9%) lower than the prior fiscal year. However, readers should note that the LHHS (-4.9%) lower than the prior fiscal year. However, readers should note that the LHHS
funding amounts calculated via this method are the net of funding amounts calculated via this method are the net of ~~bil ions~~ billions of dollars in offsets included in of dollars in offsets included in
each proposal, such as certain rescissions of previously enacted funding and each proposal, such as certain rescissions of previously enacted funding and changes in
mandatory program spending (CHIMPS). When those offsets are excluded from this calculation, (CHIMPS). When those offsets are excluded from this calculation,
FY2021 regular discretionary appropriations in the House committee FY2021 regular discretionary appropriations in the House committee ~~bil~~ bill and those that were and those that were
~~ultimately~~ ultimately enacted represent an increase to LHHS funding relative to FY2020.enacted represent an increase to LHHS funding relative to FY2020.~~118~~

~~112~~119 113 For a discussion For a discussion of budgetof budget enforcement mechanisms that may be adopted in the absence of a budgetenforcement mechanisms that may be adopted in the absence of a budget resolution, see resolution, see
CRSCRS Report R44296, Report R44296, ~~Deem ing~~Deeming Resolutions: Budget ~~Enforcem ent~~Enforcement in the Absence of a Budget Resolution ; and CRS ; and CRS
Report R43535, Report R43535, Provisions in the Bipartisan Budget Act of 2013 as an Alternative to a Traditional Budget Resolution . .
~~113~~114 Ibid. Ibid. For a general discussionFor a general discussion of budgetof budget enforcement mechanisms that may be adopted in the absence of a budget enforcement mechanisms that may be adopted in the absence of a budget
resolution, see CRSresolution, see CRS Report R44296, Report R44296, ~~Deem ing~~Deeming Resolutions: Budget Enforcement in the Absence of a Budget Resolution . .
~~114~~ 115 “Publication of Budgetary Material,” “Publication of Budgetary Material,” Congressional Record, daily edition, Vol., daily edition, Vol. 166, No. 82 (May 1, 2020), pp. 166, No. 82 (May 1, 2020), pp.
H1968-H1969. “H1968-H1969. “ Budget Enforcement Levels for Fiscal Year 2021,” Budget Enforcement Levels for Fiscal Year 2021,” Congressional Record, daily edition, Vol. 166, No. , daily edition, Vol. 166, No.
83 (May 4, 2020), pp. S2205-S2206. 83 (May 4, 2020), pp. S2205-S2206.
~~115~~116 House Appropriations Committee, “Appropriations Committee Approves FY2021 Subcommittee Allocations,” July House Appropriations Committee, “Appropriations Committee Approves FY2021 Subcommittee Allocations,” July
9, 2020, press release, https://appropriations.house.gov/news/press-releases/appropriations-committee-approves-fy-9, 2020, press release, https://appropriations.house.gov/news/press-releases/appropriations-committee-approves-fy-
2021-subcommittee-allocations. 2021-subcommittee-allocations.
~~116~~ 117 H.Rept. 116-443. H.Rept. 116-443. ~~T he~~The House Appropriations Committee subsequently reported revised 302(b) suballocations House Appropriations Committee subsequently reported revised 302(b) suballocations
(H.Rept. 116-454, July 16, 2020), although the LHHS discretionary suballocation was(H.Rept. 116-454, July 16, 2020), although the LHHS discretionary suballocation was ~~unchanged f rom~~ unchanged from the initial the initial
amount. amount.
~~117~~118 See See linked draft 302(b) suballocation text in the Senate Appropriations Committee majority press release, linked draft 302(b) suballocation text in the Senate Appropriations Committee majority press release,
“Committee Releases FY21 Bills“Committee Releases FY21 Bills in Effort to Advance Process, Produce Bipartisan Results,”in Effort to Advance Process, Produce Bipartisan Results,” November 10, 2020, November 10, 2020,
https://www.appropriations.senate.gov/news/committee-releases-fy21-bills-in-effort-to-advance-process-produce-https://www.appropriations.senate.gov/news/committee-releases-fy21-bills-in-effort-to-advance-process-produce-
bipartisan-results. bipartisan-results.
~~118 See~~ 119 See the funding totals and scorekeeping adjustments ithe funding totals and scorekeeping adjustments in Table A-2. For the FY2021 House committee bill, seeFor the FY2021 House committee bill, see also also
the House Appropriations Committee, “the House Appropriations Committee, “ Appropriations Committee Releases Fiscal Year 2021 LaborAppropriations Committee Releases Fiscal Year 2021 Labor -HHS-Education -HHS-Education
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The table also displays funding for which adjustments may be made to the discretionary spending The table also displays funding for which adjustments may be made to the discretionary spending
limits under the BCA, including funding for certain LHHS program integrity activities and limits under the BCA, including funding for certain LHHS program integrity activities and
emergency requirements, where applicable. The “Adjusted Appropriations” total includes this emergency requirements, where applicable. The “Adjusted Appropriations” total includes this
funding. funding.
Compliance with discretionary spending Compliance with discretionary spending ~~al ocations~~allocations is evaluated based on budget authority is evaluated based on budget authority
available in the current fiscal year, adjusted for scorekeeping by CBO. As such, totals shown in , adjusted for scorekeeping by CBO. As such, totals shown in
this table may not be comparable to other totals shown in this report. Current-year budget this table may not be comparable to other totals shown in this report. Current-year budget
authority totals exclude advance appropriations for future years, but include advance authority totals exclude advance appropriations for future years, but include advance
appropriations from prior years that become available in the current year. (Advance appropriations from prior years that become available in the current year. (Advance
appropriations are provided to selected LHHS accounts, appropriations are provided to selected LHHS accounts, ~~general y~~generally in order to manage specific in order to manage specific
planning concerns and ensure continuity of operations at the start of a new fiscal year.) planning concerns and ensure continuity of operations at the start of a new fiscal year.)
Table A-1. LHHS Discretionary FY2020 Enacted Levels, FY2021 House 302(b)
Suballocations, and FY2021 Enacted Levels
(Budget authority in (Budget authority in ~~bil ions of dol ars~~billions of dollars) )
FY2020
FY2021 Initial
FY2021

Enacted
House 302(b)
Enacted
Regular Appropriations Regular Appropriations
183.042 183.042
182.914 182.914
174.073 174.073
Adjustments: Adjustments:

Program Integrity Program Integrity
1.842 1.842
1.881 1.881
1.881 1.881
Emergency Emergency
RequirementRequirementsa
280.000 280.000
— —
156. 156.~~563~~588
Adjusted Appropriations Adjusted Appropriations
464.884 464.884
184.795 184.795
332. 332.~~517~~
~~Source~~542 Sources: Table prepared by Table prepared by ~~the Congressional Research Service (CRS)~~CRS. Amounts shown for FY2020 Enacted are . Amounts shown for FY2020 Enacted are
as scored by CBO (see as scored by CBO (see Fiscal Year 2020 House Current ~~Status of Discretionary Appropriations~~ Status of Discretionary Appropriations as of April 24, 2020,
https://www.cbo.gov/system/files?file=2020-05/FY2020-House-2020-4-24.pdf). The House Initial 302(b) is as https://www.cbo.gov/system/files?file=2020-05/FY2020-House-2020-4-24.pdf). The House Initial 302(b) is as
reported in H.Rept. 116-443 on July 13, 2020. Amounts shown for FY2021 Enacted are as scored by CBO (reported in H.Rept. 116-443 on July 13, 2020. Amounts shown for FY2021 Enacted are as scored by CBO (Report on the Status of Discretionary Appropriations, Fiscal
Year 2021, House of Representatives, as of July 30, 2021, ~~House Current Status of Discretionary Appropriations as of December 27, 2020,~~ https://www.cbo.gov/ https://www.cbo.gov/
system/files?file=2021-system/files?file=2021-0209/FY2021-House/FY2021-House~~-2021-02-01.pdf.)~~.pdf).
Notes: It is common for It is common for ~~subal ocations~~suballocations to be revised over the course of the year to reflect to be revised over the course of the year to reflect actual action on actual action on
appropriations bil s and changes in congressionalappropriations bil s and changes in congressional priorities.priorities. Regular appropriations reflect currentRegular appropriations reflect current -year -year
discretionarydiscretionary budget authority subject to the spending limits.budget authority subject to the spending limits. Adjusted appropriations include, where applicable, Adjusted appropriations include, where applicable,
discretionarydiscretionary funds for which special rulesfunds for which special rules apply with regard to the spending limits,apply with regard to the spending limits, including certain funds for including certain funds for
program integrity activities.program integrity activities. Enacted appropriations include advance appropriations enacted in priorEnacted appropriations include advance appropriations enacted in prior fiscal years fiscal years
that first become available in those fiscal years. They also include the enacted LHHS appropriations that were that first become available in those fiscal years. They also include the enacted LHHS appropriations that were
designated as emergencydesignated as emergency ~~requirements~~ requirements in FY2020 (P.L. 116-113, P.L. 116-123, P.L. 116-127, P.L. 116-136, and in FY2020 (P.L. 116-113, P.L. 116-123, P.L. 116-127, P.L. 116-136, and
P.L. 116-139) and FY2021 (Divisions H and M of P.L. 116-260P.L. 116-139) and FY2021 (Divisions H and M of P.L. 116-260, and P.L. 117-31). Enacted amounts do not include, where ). Enacted amounts do not include, where
applicable, funds provided under certain authorities in the 21st Century Cures Act (P.L. 114-255) that are applicable, funds provided under certain authorities in the 21st Century Cures Act (P.L. 114-255) that are
effectively exempt from discretionaryeffectively exempt from discretionary spending limits.spending limits. (For FY2020, these funds totaled $492 mil ion;(For FY2020, these funds totaled $492 mil ion; for FY2021, for FY2021,
these funds totaled $404 mil ion.)these funds totaled $404 mil ion.)
a. The House initial 302(b) for LHHSa. The House initial 302(b) for LHHS did not include an did not include an ~~al ocation~~allocation for the $19.4 bil ion for the $19.4 bil ion in emergency-in emergency-
designated appropriations subsequently proposed in Title VI of the House committee designated appropriations subsequently proposed in Title VI of the House committee ~~bil (H.R. 7614).~~

~~Funding Bill,”~~ bil (H.R. 7614). Funding Bill,” press release, July 6, 2020, https://appropriations.house.gov/news/press-releases/appropriations-press release, July 6, 2020, https://appropriations.house.gov/news/press-releases/appropriations-
committee-releases-fiscal-year-2021-labor-hhs-education-funding. For FY2021 enacted, see also Senate Appropriations committee-releases-fiscal-year-2021-labor-hhs-education-funding. For FY2021 enacted, see also Senate Appropriations
Committee Vice Chair, Senator Patrick Leahy, “Committee Vice Chair, Senator Patrick Leahy, “ Summary, Labor, Health and Human Services, Education, and Related Summary, Labor, Health and Human Services, Education, and Related
AgenciesAgencies Fiscal Year 2021 Appropriations Bill,” December 21, 2020, p. 1, https://www.appropriations.senate.gov/imo/Fiscal Year 2021 Appropriations Bill,” December 21, 2020, p. 1, https://www.appropriations.senate.gov/imo/
media/doc/LHHS.pdf. media/doc/LHHS.pdf.
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Appropriations
Current-Year Budget Authority
Table A-2 displays the total LHHSdisplays the total LHHS current-year budget authority, by title. The amounts shown in current-year budget authority, by title. The amounts shown in
this table reflect total budget authority availablethis table reflect total budget authority available for obligation in the fiscal year, regardless of the for obligation in the fiscal year, regardless of the
year in which it was first appropriated. (In other words, these amounts exclude advance year in which it was first appropriated. (In other words, these amounts exclude advance
appropriations for future years, but include advance appropriations from prior years that became appropriations for future years, but include advance appropriations from prior years that became
availableavailable in the applicable current year.) Amounts in the FY2020 enacted column include FY2020 in the applicable current year.) Amounts in the FY2020 enacted column include FY2020
budget authority provided by the FY2018 omnibus (P.L. 115-141) and FY2019 omnibus (P.L. budget authority provided by the FY2018 omnibus (P.L. 115-141) and FY2019 omnibus (P.L.
116-94). Similarly, the FY2021 President’s budget, House committee, and enacted columns 116-94). Similarly, the FY2021 President’s budget, House committee, and enacted columns
include FY2021 budget authority provided by the FY2019 and FY2020 omnibuses. (For a include FY2021 budget authority provided by the FY2019 and FY2020 omnibuses. (For a
comparable table showing total budget authority in the comparable table showing total budget authority in the ~~bil~~ bill, rather than current-year budget , rather than current-year budget
authority, seauthority, see Table 2 in this report.) As mentioned above, it is current-year budget authority in this report.) As mentioned above, it is current-year budget authority
(adjusted for scorekeeping by CBO) that is used to determine compliance with discretionary (adjusted for scorekeeping by CBO) that is used to determine compliance with discretionary
spending spending ~~al ocations~~allocations. .
Table A-2. LHHS Appropriations Overview, by Bill Title: FY2020-FY2021
(Current-year budget authority in (Current-year budget authority in ~~bil ions of dol ars~~billions of dollars) )
FY2021
FY2021
Enacted
FY2020
FY2021
House Cmte.
(P.L. 116-
Bill Title
Enacted
Request
(H.R. 7614)
260)
Title I: Labor
13.8
12.5
14.0
13.9
Discretionary Discretionary
12.4 12.4
11.2 11.2
12.7 12.7
12.5 12.5
Mandatory Mandatory
1.4 1.4
1.4 1.4
1.4 1.4
1.4 1.4
Title II: HHS
932.7
996.1
1007.1
1007.8
Discretionary Discretionary
94.9 94.9
87.0 87.0
96.4 96.4
97.0 97.0
Mandatory Mandatory
837.8 837.8
909.1 909.1
910.8 910.8
910.8 910.8
Title III: Education
76.4
70.2
77.1
77.2
Discretionary Discretionary
72.8 72.8
66.6 66.6
73.5 73.5
73.5 73.5
Mandatory Mandatory
3.6 3.6
3.7 3.7
3.7 3.7
3.7 3.7
Title IV: Related Agencies
72.5
69.7
71.1
71.0
Discretionary Discretionary
15.3 15.3
14.1 14.1
15.5 15.5
15.4 15.4
Mandatory Mandatory
57.1 57.1
55.6 55.6
55.6 55.6
55.6 55.6
Total Current ~~Year BA~~ Year BAa
1,095.3
1,148.6
1,169.4
1,169.9
Discretionary
195.4
178.9
198.0
198.5
Mandatory
899.9
969.7
971.4
971.4
Emergency Funding (not included in above totals)

USMCA (P.L. 116-113) USMCA (P.L. 116-113)
0.2 0.2
- -
- -
- -
1st COVID (P.L. 116-123) 1st COVID (P.L. 116-123)
6.4 6.4
- -
- -
- -
2nd COVID (P.L. 116-127) 2nd COVID (P.L. 116-127)
1.3 1.3
- -
- -
- -
3rd COVID (P.L. 116-136) 3rd COVID (P.L. 116-136)
172.1 172.1
- -
- -
- -
4th COVID (P.L. 116-139) 4th COVID (P.L. 116-139)
100.0 100.0
- -
- -
- -
Emergency Funding in Annual LHH Emergency Funding in Annual LHHSb
- -
- -
19.4 19.4
1.6 1.6
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link to page link to page 6465 link to page link to page 6465 link to page link to page 6465 link to page 65 Labor, Health and Human Services, and Education: FY2021 ~~Appropriations~~
Appropriations
FY2021
FY2021
Enacted
FY2020
FY2021
House Cmte.
(P.L. 116-
Bill Title
Enacted
Request
(H.R. 7614)
260)
5th COVID (Division 5th COVID (Division M, P.L.M, P.L. 116-260) 116-260)
- -
- -
- -
154.9 154.9
Afghan special immigrants (P.L. 117-31) - - - 0.0c Memoranda:

Advances for Future Years (provided in current Advances for Future Years (provided in current
189.1 189.1
197.1 197.1
197.6 197.6
197.6 197.6
bil bil )c
d Advances from Advances from Prior Years (for use in current Prior Years (for use in current
186.7 186.7
188.6 188.6
189.0 189.0
189.0 189.0
year year)cd
Additional Scorekeeping Additional Scorekeeping ~~Adjustment~~sd Adjustmentse
-10.5 -10.5
-9.9 -9.9
-13.2 -13.2
-22.5 -22.5
~~Source~~Sources: Amounts in this table for the FY2020 Enacted, FY2021 Request, and FY2021 Enacted columns are Amounts in this table for the FY2020 Enacted, FY2021 Request, and FY2021 Enacted columns are
~~general y~~generally drawn from drawn from or calculated based on data contained in the explanatory statement accompanying the or calculated based on data contained in the explanatory statement accompanying the
FY2021 LHHS omnibus (P.L. 116-260), available in the FY2021 LHHS omnibus (P.L. 116-260), available in the Congressional Record, vol., vol. 166, no. 218, book IV, December 166, no. 218, book IV, December
21, 2020, pp. H8619-H8711. 21, 2020, pp. H8619-H8711. (The amount for P.L. 117-31 is from CBO, Discretionary Spending: Senate Amendment 2123, July 29, 2021, https://www.cbo.gov/system/files/2021-07/EmergencySecuritySupplementalAppropriationsAct2021.pdf.) Amounts in the FY2021 House CommitteeAmounts in the FY2021 House Committee column column are generally~~are general y~~ drawn from or drawn from or
calculated based on data contained in the committeecalculated based on data contained in the committee report (H.Rept. 116-450) accompanying H.R. 7614. Enacted report (H.Rept. 116-450) accompanying H.R. 7614. Enacted
totals (“Total BA in the Bil ”) for FY2020 do not include emergency-designated appropriations provided intotals (“Total BA in the Bil ”) for FY2020 do not include emergency-designated appropriations provided in P.L. P.L.
116-113, P.L. 116-123, P.L. 116-127, P.L. 116-136, or P.L. 116-139. House 116-113, P.L. 116-123, P.L. 116-127, P.L. 116-136, or P.L. 116-139. House ~~committee~~ committee bil totals (“Total BA in the bil totals (“Total BA in the
Bil ”) for FY2021 do not include emergency-designated appropriations proposed in Title VI of H.R. 7614. Enacted Bil ”) for FY2021 do not include emergency-designated appropriations proposed in Title VI of H.R. 7614. Enacted
totals (“Total BA in the Bil ”) for FY2021 do not include emergency-designated appropriations provided in totals (“Total BA in the Bil ”) for FY2021 do not include emergency-designated appropriations provided in
~~Division~~ Division H or M of P.L.H or M of P.L. ~~116-260~~ 116-260, or P.L. 117-31. For consistency with source materials,. For consistency with source materials, amounts in this figure amounts in this figure ~~general y~~ generally do not do not
reflect mandatory spending sequestration, wherereflect mandatory spending sequestration, where applicable, nor do they reflect any transfers or reprogramming applicable, nor do they reflect any transfers or reprogramming
of funds pursuant to executive authorities. of funds pursuant to executive authorities.
Notes: BA = Budget Authority. DetailsBA = Budget Authority. Details may not add to totals due to rounding. Amounts in this table (1) reflect may not add to totals due to rounding. Amounts in this table (1) reflect
current-year budget authority; (2) have current-year budget authority; (2) have ~~general y~~generally not been adjusted to reflect scorekeeping; not been adjusted to reflect scorekeeping; (3) comprise(3) comprise only only
those funds provided (or requested) for agencies and accounts subject to the jurisdictionthose funds provided (or requested) for agencies and accounts subject to the jurisdiction of the LHHS of the LHHS
SubcommitteesSubcommittees of the House and the Senate Committeesof the House and the Senate Committees on Appropriations; and (4) do not include on Appropriations; and (4) do not include
appropriations that occur outside of appropriations bil s.appropriations that occur outside of appropriations bil s. No amounts are shown for Title V, because this title No amounts are shown for Title V, because this title
consists solelyconsists solely of general provisions. of general provisions.
a. Totals in this table are based on current-year budget authority, meaning budget authority that is available a. Totals in this table are based on current-year budget authority, meaning budget authority that is available
for obligation in a given fiscal year, regardless for obligation in a given fiscal year, regardless of the year in which it was first appropriated (i.e.,of the year in which it was first appropriated (i.e., totals totals
exclude advance appropriations for future years, but include advance appropriations fromexclude advance appropriations for future years, but include advance appropriations from prior years that prior years that
became available in the applicable current year). became available in the applicable current year).
b. The FY2021 House committee b. The FY2021 House committee bil included a total of $19.4 bil ion in emergency-designatedbil included a total of $19.4 bil ion in emergency-designated budget budget
authority in Title VI, of which $925 mil ion authority in Title VI, of which $925 mil ion was for DOL and $18.5 bil ion was for HHS. Subsequently, was for DOL and $18.5 bil ion was for HHS. Subsequently,
DivisionDivision H of P.L. 116-260 enacted $1.6 bil ion in emergency-designated budget authority, of which $925 H of P.L. 116-260 enacted $1.6 bil ion in emergency-designated budget authority, of which $925
mil ionmil ion was for DOLwas for DOL in Title I, and $638 mil ionin Title I, and $638 mil ion was for HHS in Title II. c. P.L. 117-31 provided $25 mil ion in supplemental appropriations for the Refugee and Entrant Assistance account at HHS for specified purposes related to Afghan special immigrants, which rounds to $0.0 in bil ions (the unit of measure used in this table). d~~was for HHS in Title II.~~
c. The calculation for total budget authority in the bil (rather than total budget authority available for . The calculation for total budget authority in the bil (rather than total budget authority available for
obligation in the current fiscal year) is as fol ows: obligation in the current fiscal year) is as fol ows: Total Current Year BA minus Advances from PriorTotal Current Year BA minus Advances from Prior Years Years
plus Advances for Future Years.plus Advances for Future Years. The amount for both Advances fromThe amount for both Advances from Prior Years and Advances for Future Prior Years and Advances for Future
Years is the combined total of mandatory and discretionaryYears is the combined total of mandatory and discretionary spending. spending.
de. Totals in this table have . Totals in this table have ~~general y~~generally not been adjusted for further scorekeeping. not been adjusted for further scorekeeping. (To adjust for scorekeeping, (To adjust for scorekeeping,
add this line to the total budget authority.) add this line to the total budget authority.)
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Appropriations
Appendix B. House Floor Amendments Offered to
H.R. 7617
The House began its initialThe House began its initial floor consideration of FY2021 LHHS appropriations on July 30, 2020. floor consideration of FY2021 LHHS appropriations on July 30, 2020.
Those appropriations were Those appropriations were ~~initial y~~initially considered on the floor as part of a consolidated considered on the floor as part of a consolidated
appropriations package and passed the House (217-197), as amended, on July 31, 2020 (Division appropriations package and passed the House (217-197), as amended, on July 31, 2020 (Division
E of H.R. 7617). This package would have provided appropriations for five other appropriations E of H.R. 7617). This package would have provided appropriations for five other appropriations
acts in addition to LHHS:acts in addition to LHHS: Department of Defense; Commerce, Justice, Science; Energy and Department of Defense; Commerce, Justice, Science; Energy and
Water Development; Financial Services and General Government; and Transportation, Housing, Water Development; Financial Services and General Government; and Transportation, Housing,
and Urban Development.and Urban Development.~~119~~120 LHHS amendments were keyed to Division F of what was to be the LHHS amendments were keyed to Division F of what was to be the
base text for amendment (Rules Committee Print 116–60). The LHHS division was redesignated base text for amendment (Rules Committee Print 116–60). The LHHS division was redesignated
as Division E after House passage due to the omission of the Department of Homeland Security as Division E after House passage due to the omission of the Department of Homeland Security
division from the division from the ~~bil~~ bill. .
Floor action on H.R. 7617 was regulated by the terms of a special rule (H.Res. 1067) that made in Floor action on H.R. 7617 was regulated by the terms of a special rule (H.Res. 1067) that made in
order 92 amendments to the LHHS title of the order 92 amendments to the LHHS title of the ~~bil .120~~bill.121 That rule also provided the authority for the That rule also provided the authority for the
chair of the Appropriations Committee or her designee to offer any of the amendments made in chair of the Appropriations Committee or her designee to offer any of the amendments made in
order en blocorder en bloc (i.e., in groups of amendments to be disposed of together). (i.e., in groups of amendments to be disposed of together). Al All but three LHHS but three LHHS
amendments were considered in this manner.amendments were considered in this manner.~~121~~122 When counted as 92 separate amendments, 84 When counted as 92 separate amendments, 84
were adopted and 8 were rejected. were adopted and 8 were rejected.
Al All of the amendments that were offered and their dispositions are listed iof the amendments that were offered and their dispositions are listed in Table B-1 below.below.
Table B-1. LHHS House Floor Amendments Offered to H.R. 7617
En
Bloc
Amdt. No. and Summary from the Rules Committee
No.
Disposition
218. Adams 218. Adams (NC): Prohibits the use of funds for the enforcement(NC): Prohibits the use of funds for the enforcement of WHD Fieldof WHD Field Bul etinBul etin
5 5
Adopted, Adopted,
No. 2020-2, which attempts to limit No. 2020-2, which attempts to limit liquidated damages for violationsliquidated damages for violations of minimumof minimum wage wage
Voice Voice
and overtime and overtime protections. protections.
219. 219. ~~Al en~~ Allen (GA): Reduces funds made available in Division(GA): Reduces funds made available in Division F (LHHS) by 5 F (LHHS) by 5
percent. NA NA
Rejected, Rejected,
~~percent.~~
123-292 123-292
220. Bera 220. Bera (CA): Increases and decreases(CA): Increases and decreases the School Improvement Account by $500,000 the School Improvement Account by $500,000
4 4
Adopted, Adopted,
with the intent of directing the Department of Education to col ect and share best with the intent of directing the Department of Education to col ect and share best
Voice Voice
practices for offering online classroom practices for offering online classroom instruction with local education agencies, instruction with local education agencies,
including resourcesincluding resources from the What Worksfrom the What Works Clearinghouse and lessonsClearinghouse and lessons learned by learned by
schools from the transition to online learning this past school year as a resultschools from the transition to online learning this past school year as a result of of
COVID-19. COVID-19.

~~119~~ 120 H.R. 7617 was initially expected to provide appropriations for the act funding the Department of Homeland H.R. 7617 was initially expected to provide appropriations for the act funding the Department of Homeland
Security, but that division wasSecurity, but that division was ultimately omitted under ultimately omitted under ~~th e~~the terms of the special rule that regulated floor consideration terms of the special rule that regulated floor consideration
(H.Res. 1067). (H.Res. 1067).
~~120~~121 For a list of these LHHS For a list of these LHHS amendments (numbered 218-309) and the text of each that was made in order, see H.Rept. amendments (numbered 218-309) and the text of each that was made in order, see H.Rept.
116-461, pp. 23-32 and 89-108. 116-461, pp. 23-32 and 89-108.
~~121~~ 122 For the en bloc For the en bloc ~~amendment s~~amendments proposing changes to the LHHS division of the bill, see consideration of amendments proposing changes to the LHHS division of the bill, see consideration of amendments
en blocen bloc nos. 3, 4, and 5 in nos. 3, 4, and 5 in Congressional Record, daily edition, Vol.daily edition, Vol. 166, No. 135 (July 30, 2020), pp. H4134166, No. 135 (July 30, 2020), pp. H4134 -H4139, -H4139,
H4143-H4169. H4143-H4169.
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Appropriations
En
Bloc
Amdt. No. and Summary from the Rules Committee
No.
Disposition
221. Bera 221. Bera (CA): Decreases(CA): Decreases and increasesand increases funds by $1 mil ionfunds by $1 mil ion in the CDC Public Health in the CDC Public Health
5 5
Adopted, Adopted,
Preparedness and Response account to urge CDC to Preparedness and Response account to urge CDC to integrate early warning integrate early warning
Voice Voice
~~surveil ance~~ surveillance data, such as network-connected devices likedata, such as network-connected devices like smart thermometerssmart thermometers and and
pulse oximeterspulse oximeters or symptom surveys,or symptom surveys, into its COVID-19 syndromic into its COVID-19 syndromic ~~surveil ance~~ surveillance to help to help
identify potential hotspots even before individuals present to a health care facility. identify potential hotspots even before individuals present to a health care facility.
222. Bera 222. Bera (CA): Decreases(CA): Decreases and increasesand increases funds by $1 mil ionfunds by $1 mil ion in the CDC Immunization in the CDC Immunization
5 5
Adopted, Adopted,
and Respiratory and Respiratory ~~Diseases~~ Diseases account to urge CDC to prioritizeaccount to urge CDC to prioritize assistance to State, local, assistance to State, local,
Voice Voice
tribal, and territorial tribal, and territorial health departments regarding Immunization Information Systemshealth departments regarding Immunization Information Systems to to
best prepare for management and distribution of seasonal influenza and COVID-19 best prepare for management and distribution of seasonal influenza and COVID-19
vaccines and to support mass vaccination efforts.vaccines and to support mass vaccination efforts.
223. Beyer 223. Beyer (VA): Increases and decreases(VA): Increases and decreases funds by $500,000 to highlight the need for a funds by $500,000 to highlight the need for a
4 4
Adopted, Adopted,
GAO study on standardized tests for col ege admissions, GAO study on standardized tests for col ege admissions, the accountability and the accountability and
Voice Voice
oversight of the organizations managing such tests, efficacy of such tests, impact in oversight of the organizations managing such tests, efficacy of such tests, impact in
admissionsadmissions decisions,decisions, and economicand economic impact on col egeimpact on col ege applicants. applicants.
224. Beyer 224. Beyer (VA): Requires the National Academies(VA): Requires the National Academies of Sciences Engineering and Medicine of Sciences Engineering and Medicine
5 5
Adopted, Adopted,
do to a holistic review do to a holistic review of the U.S. coronavirusof the U.S. coronavirus response and offer recommendations, response and offer recommendations,
Voice Voice
including but not limited including but not limited to how to build public health security and pandemic to how to build public health security and pandemic
preparedness.preparedness.
225. Bishop, 225. Bishop, Dan (NC): RestrictsDan (NC): Restricts any of the funds in the Act from being used to any of the funds in the Act from being used to
3 3
Rejected, Rejected,
withdraw the rule withdraw the rule ~~al owing~~allowing Health Reimbursement Health Reimbursement ~~Arrangements~~ Arrangements to be used to to be used to
voice voice
purchase individual market purchase individual market coverage.coverage.
226. Burgess 226. Burgess (TX): Increases(TX): Increases and decreasesand decreases funds by $100 mil ionfunds by $100 mil ion in the Public Health in the Public Health
4 4
Adopted, Adopted,
and Social Services and Social Services Emergency fund to highlight the need for manufacturing process Emergency fund to highlight the need for manufacturing process
Voice Voice
improvements improvements to increase yieldsto increase yields of Immunoglobulin G in plasma manufacturing in the of Immunoglobulin G in plasma manufacturing in the
United States. United States.
227. Cárdenas (CA): Increases funding for the National Child Traumatic Stress 227. Cárdenas (CA): Increases funding for the National Child Traumatic Stress Initiative Initiative
4 4
Adopted, Adopted,
by $1 mil ion by $1 mil ion and decreasesand decreases funding for HHS’s Generalfunding for HHS’s General Departmental Management Departmental Management
Voice Voice
account by $1 mil ion. account by $1 mil ion.
228. Cohen (TN): Prohibits the use of funds to enter into any new contract, grant, or 228. Cohen (TN): Prohibits the use of funds to enter into any new contract, grant, or
5 5
Adopted, Adopted,
cooperative agreement cooperative agreement with any Trump relatedwith any Trump related business listedbusiness listed in the President Trump’s in the President Trump’s
Voice Voice
Annual Financial Disclosure Annual Financial Disclosure Report submitted to the Office of Government Ethics as Report submitted to the Office of Government Ethics as
~~wel~~ well as certain Trump related propertiesas certain Trump related properties listed on the Trump Organization’s website. listed on the Trump Organization’s website.
The specific business are listed in the amendment.The specific business are listed in the amendment.
229. Crow (CO): Increases 229. Crow (CO): Increases the carve-out for Project SERV fromthe carve-out for Project SERV from $5 mil ion$5 mil ion to $6 to $6
4 4
Adopted, Adopted,
mil ion, mil ion, which funds grants to local education agencies for mental health, counseling, and which funds grants to local education agencies for mental health, counseling, and
Voice Voice
technical assistance in the wake of traumatic events at schools that are disruptive to technical assistance in the wake of traumatic events at schools that are disruptive to
learning—such as natural disasters,learning—such as natural disasters, violence at school, or pandemics.violence at school, or pandemics.
230. Davis, 230. Davis, Danny K. (IL), Burgess (TX): Increases funding to the account of Birth Danny K. (IL), Burgess (TX): Increases funding to the account of Birth
4 4
Adopted, Adopted,
Defects, Defects, ~~Development Disabilities, Disabilities~~ Development Disabilities, Disabilities and Health by $2,000,000, and decreases and Health by $2,000,000, and decreases
Voice Voice
the administration account in the Office of the Secretary of Health and Human Services the administration account in the Office of the Secretary of Health and Human Services
by $2,000,000. Currently under this account, there are zero dol ars by $2,000,000. Currently under this account, there are zero dol ars ~~al ocated~~allocated for the for the
Public Health Approach to Blood DisordersPublic Health Approach to Blood Disorders ~~Program for Sickle Cel Disease~~ Program for Sickle Cell Disease that wil that wil
support the CDC's sicklesupport the CDC's sickle ~~cel disease surveil ance~~ cell disease surveillance program to better identify affected program to better identify affected
individuals, to understand their health outcomes,individuals, to understand their health outcomes, and to evaluate strategiesand to evaluate strategies to prevent to prevent
complicationscomplications and riskand risk factors that affect individuals living with this disease.factors that affect individuals living with this disease.
231. DeSaulnier 231. DeSaulnier (CA): Increases and decreases(CA): Increases and decreases the Department of Labor budget by $2 the Department of Labor budget by $2
4 4
Adopted, Adopted,
mil ion mil ion with the intention of funding a study that examines the cost savings of with the intention of funding a study that examines the cost savings of
Voice Voice
teleworking/telecommuting, teleworking/telecommuting, ~~specifical y~~ specifically as it relates as it relates to workerto worker productivity, cost savings productivity, cost savings
to the employer,to the employer, transportation emissiontransportation emission reductions, child care costs,reductions, child care costs, etc. etc.
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Appropriations
En
Bloc
Amdt. No. and Summary from the Rules Committee
No.
Disposition
232. DeSaulnier 232. DeSaulnier (CA), Thompson, Glenn (PA): Increases funding for(CA), Thompson, Glenn (PA): Increases funding for Statewide Family Statewide Family
4 4
Adopted, Adopted,
Engagement Centers at the Department of Education by $1 mil ion. Engagement Centers at the Department of Education by $1 mil ion.
Voice Voice
233. Escobar (TX): Increases and decreases 233. Escobar (TX): Increases and decreases funding by $1 mil ionfunding by $1 mil ion in the Substance Abuse 4 in the Substance Abuse 4
Adopted, Adopted,
and Mental Health Administration and Mental Health Administration (SAMHSA) account to encourage the agency to (SAMHSA) account to encourage the agency to
Voice Voice
streamline streamline the application processthe application process for SAMHSAfor SAMHSA grants. grants.
234. Escobar (TX), Torres 234. Escobar (TX), Torres ~~Smal ,~~ Small, Xochitl (NM), Jackson LeeXochitl (NM), Jackson Lee (TX): Increases and (TX): Increases and
5 5
Adopted, Adopted,
decreases decreases funding by $1 mil ionfunding by $1 mil ion in the Office of the Secretary account to urge the U.S.-in the Office of the Secretary account to urge the U.S.-
Voice Voice
Mexico Border Health Commission Mexico Border Health Commission to develop and implementto develop and implement a bi-national strategy to a bi-national strategy to
address COVID-19 in the border region.address COVID-19 in the border region.
235. Escobar (TX): Prohibits funds from being used to implement 235. Escobar (TX): Prohibits funds from being used to implement or enforce the or enforce the
5 5
Adopted, Adopted,
restrictions restrictions under the rule entitled, ‘ Orderunder the rule entitled, ‘ Order Under Sections 362 and 365 of the Public Under Sections 362 and 365 of the Public
Voice Voice
Health Service Health Service Act; Order Suspending Introduction of Certain Persons FromAct; Order Suspending Introduction of Certain Persons From Countries Countries
WhereWhere a Communicable Diseasea Communicable Disease ~~Exists~~ Exists (42 U.S.C. 265, 268)’ at the U.S. borders with (42 U.S.C. 265, 268)’ at the U.S. borders with
Canada and Mexico. Canada and Mexico.
236. Espail at (NY), Jackson Lee (TX): Increases and decreases 236. Espail at (NY), Jackson Lee (TX): Increases and decreases by $10,000,000 to by $10,000,000 to
4 4
Adopted, Adopted,
support greater minority support greater minority patient outreach and minoritypatient outreach and minority candidate inclusion by the candidate inclusion by the
Voice Voice
National Institute of National Institute of ~~Al ergy~~ Allergy and Infectious Diseasesand Infectious Diseases in clinical trial participation for any in clinical trial participation for any
vaccine or therapeutics to treat the novel Coronavirus 2019 (COVID-19).vaccine or therapeutics to treat the novel Coronavirus 2019 (COVID-19).
237. Espail at (NY): Prohibits the Office 237. Espail at (NY): Prohibits the Office of Refugee Resettlementof Refugee Resettlement and the U.S. and the U.S.
5 5
Adopted, Adopted,
Department of Health and Human Services Department of Health and Human Services from contracting with any for-profit from contracting with any for-profit
Voice Voice
contractor for the purposes of housing unaccompanied children (UAC). contractor for the purposes of housing unaccompanied children (UAC).
238. Espail at (NY), Grijalva 238. Espail at (NY), Grijalva (AZ): Increases and decreases(AZ): Increases and decreases funds by $10 mil ionfunds by $10 mil ion in Part A in Part A
4 4
Adopted, Adopted,
of Title III of the ESEA to highlight the need for English Language Acquisition (ELA) of Title III of the ESEA to highlight the need for English Language Acquisition (ELA)
Voice Voice
grants and technical assistance to local education agencies supporting the education of grants and technical assistance to local education agencies supporting the education of
English learnersEnglish learners (ELs). (ELs).
239. Finkenauer 239. Finkenauer (IA): Increases funding for endometriosis(IA): Increases funding for endometriosis research at the National research at the National
NA NA
Adopted, Adopted,
Institute of Child Health and Human Development Institute of Child Health and Human Development to $26 mil ion,to $26 mil ion, doubling funding for doubling funding for
Voice Voice
endometriosis endometriosis ~~research~~ research over FY 19 level. over FY 19 level.
240. Finkenauer 240. Finkenauer (IA), Mul in (OK): Increases funding by $5 mil ion(IA), Mul in (OK): Increases funding by $5 mil ion for Certified for Certified
4 4
Adopted, Adopted,
Community Behavioral Community Behavioral Health Clinics,Health Clinics, ~~decreases~~ decreases $5 mil ion$5 mil ion from the Office of the from the Office of the
Voice Voice
Secretary account. Secretary account.
241. Foster 241. Foster ~~(IL), Kel y, Mike~~ (IL), Kelly, Mike (PA): Strikes(PA): Strikes Section 510, thereby removingSection 510, thereby removing a a
NA NA
Adopted, Adopted,
ban on HHS promulgating rules ban on HHS promulgating rules on unique patient identifiers.on unique patient identifiers.
Voice Voice
242. Foxx (NC), Flores 242. Foxx (NC), Flores (TX), Walden (OR): Prohibits the delay or weakening of the (TX), Walden (OR): Prohibits the delay or weakening of the
3 3
Rejected, Rejected,
November November 27, 2019 rule relating to price transparency requirements27, 2019 rule relating to price transparency requirements for hospitals. for hospitals.
voice voice
243. Gomez 243. Gomez (CA): Provides(CA): Provides an additional $5 mil ionan additional $5 mil ion for the NIH's National Institute on for the NIH's National Institute on
4 4
Adopted, Adopted,
Minority Health and Health Disparities Minority Health and Health Disparities (NIMHD), decreases(NIMHD), decreases $5 mil ion$5 mil ion from the Office from the Office
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of the Secretary account. of the Secretary account.
244. Gomez 244. Gomez (CA): Provides(CA): Provides an additional $5 mil ionan additional $5 mil ion for the Health Centersfor the Health Centers program, program,
4 4
Adopted, Adopted,
decreases decreases $5 mil ion$5 mil ion from the Office of the Secretaryfrom the Office of the Secretary account. account.
Voice Voice
245. Gottheimer 245. Gottheimer (NJ): Increases and decreases funds by $1,000,000 in the Centers For (NJ): Increases and decreases funds by $1,000,000 in the Centers For
4 4
Adopted, Adopted,
Disease Disease Control And Prevention Environmental Health account to emphasize the Control And Prevention Environmental Health account to emphasize the
Voice Voice
importance of every child having access to drinking water at school that’s free of lead importance of every child having access to drinking water at school that’s free of lead
and dangerous materials.and dangerous materials.
246. Gottheimer 246. Gottheimer (NJ): Increases and decreases the Public Health Emergency(NJ): Increases and decreases the Public Health Emergency Fund by $1 Fund by $1
4 4
Adopted, Adopted,
mil ion mil ion to highlight the need for al Membersto highlight the need for al Members of Congress to have access to the weekly of Congress to have access to the weekly
Voice Voice
updates on the Strategic National Stockpile from updates on the Strategic National Stockpile from the Secretary of HHS provided to the Secretary of HHS provided to
House and Senate AppropriationsHouse and Senate Appropriations Committees.Committees.
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Appropriations
En
Bloc
Amdt. No. and Summary from the Rules Committee
No.
Disposition
247. Hastings (FL): Provides an additional $500,000 for civics education, split 247. Hastings (FL): Provides an additional $500,000 for civics education, split ~~equal y~~equally
4 4
Adopted, Adopted,
between American between American ~~History~~ History and Civics Academies,and Civics Academies, and Americanand American ~~History~~ History and Civics and Civics
Voice Voice
National Activities. National Activities.
248. Hil , 248. Hil , French (AR): StrikesFrench (AR): Strikes guidance requiring $100 mil ionguidance requiring $100 mil ion to be obligated to carry to be obligated to carry
3 3
Rejected, Rejected,
out the ACA navigator program. out the ACA navigator program.
voice voice
249. Hil , 249. Hil , French (AR): Transfers $2.6 mil ionFrench (AR): Transfers $2.6 mil ion from the National Labor Relations Board from the National Labor Relations Board
3 3
Rejected, Rejected,
(NLRB) account to the Office of Labor Management Standards (OLMS) account. (NLRB) account to the Office of Labor Management Standards (OLMS) account.
voice voice
250. Hudson (NC): Increase Impact Aid 7003(b) by $1,000,000 and decrease 250. Hudson (NC): Increase Impact Aid 7003(b) by $1,000,000 and decrease
4 4
Adopted, Adopted,
Department of Education Departmental Management Program Department of Education Departmental Management Program ~~Administration~~ Administration fund by fund by
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$1,000,000 $1,000,000
251. Jackson Lee (TX): Increases and decreases 251. Jackson Lee (TX): Increases and decreases funds by $10,000,000 increase in fundingfunds by $10,000,000 increase in funding 4 4
Adopted, Adopted,
to support greater diversity to support greater diversity in the pool of diabetes researchin the pool of diabetes research ~~professionals~~ professionals and patients and patients
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participating in clinical trials. participating in clinical trials.
252. Jackson Lee (TX): Increases and decreases 252. Jackson Lee (TX): Increases and decreases funds by $10,000,000 with the intent of funds by $10,000,000 with the intent of
4 4
Adopted, Adopted,
supporting programs that provide outreach and support services supporting programs that provide outreach and support services targeting program targeting program
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participants at greatest risk participants at greatest risk of not completing a col egeof not completing a col ege degree due to COVID-19 degree due to COVID-19
education disruption. education disruption.
253. Jayapal (WA), Hayes (CT), Moulton (MA), Kennedy (MA), Trahan (MA): Prohibits 253. Jayapal (WA), Hayes (CT), Moulton (MA), Kennedy (MA), Trahan (MA): Prohibits
5 5
Adopted, Adopted,
use of funds to implement use of funds to implement or enforce Secretary DeVos'or enforce Secretary DeVos' Interim Final Rule entitled Interim Final Rule entitled
Voice Voice
“CARES Act Programs; Equitable Services “CARES Act Programs; Equitable Services to interpretation of the CARES Act to divert to interpretation of the CARES Act to divert
federal emergencyfederal emergency aid dol arsaid dol ars intended for public schools to private school students. intended for public schools to private school students.
Students and Teachers in Non-Public Schools,"Students and Teachers in Non-Public Schools," an unlawful an unlawful
254. Keating (MA): Increases the Bureau of Health Workforce 254. Keating (MA): Increases the Bureau of Health Workforce account by $5 mil ionaccount by $5 mil ion to to
4 4
Adopted, Adopted,
go toward the Nurse Corps Loan Repayment Program, go toward the Nurse Corps Loan Repayment Program, ~~decreases~~ decreases the Office of the the Office of the
Voice Voice
Secretary account by $5 mil ion. Secretary account by $5 mil ion.
255. Keating (MA): Increases the NIH budget by $2 mil ion 255. Keating (MA): Increases the NIH budget by $2 mil ion to go towards a study and a to go towards a study and a
4 4
Adopted, Adopted,
report to Congress reviewing report to Congress reviewing the increased use of opioids during the COVID-19 the increased use of opioids during the COVID-19
Voice Voice
pandemic. pandemic.
256. 256. ~~Kel y,~~ Kelly, Robin (IL): Increases CDC firearmRobin (IL): Increases CDC firearm injury and mortality prevention research injury and mortality prevention research
5 5
Adopted, Adopted,
by $5,000,000. by $5,000,000.
Voice Voice
257. Lee, 257. Lee, Susie (NV): Increases funding for the Ful -ServiceSusie (NV): Increases funding for the Ful -Service Community Schools ProgramCommunity Schools Program
4 4
Adopted, Adopted,
(FSCS) by $1 mil ion. (FSCS) by $1 mil ion. This Department of Education program helps provide This Department of Education program helps provide
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comprehensive comprehensive wrap-around serviceswrap-around services in schools. in schools.
258. Lee, 258. Lee, Susie (NV), Thompson, Glenn (PA): ProvidesSusie (NV), Thompson, Glenn (PA): Provides an additional $1,000,000 to Area an additional $1,000,000 to Area
4 4
Adopted, Adopted,
Health Education Centers (AHEC) within HRSA’s Health Education Centers (AHEC) within HRSA’s Bureau of Health WorkforceBureau of Health Workforce account account
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to address shortages and increase to address shortages and increase diversity in communities’diversity in communities’ health workforcehealth workforce pipelines pipelines
by developing education and training networksby developing education and training networks among local academic institutions and among local academic institutions and
community-based organizations. Makes corresponding reduction in the General community-based organizations. Makes corresponding reduction in the General
Departmental Management sub-account of HHS’sDepartmental Management sub-account of HHS’s Office of the Secretary.Office of the Secretary.
259. Levin, 259. Levin, Andy (MI): IncreasesAndy (MI): Increases and decreasesand decreases by $1 mil ionby $1 mil ion for ILABfor ILAB funding with the funding with the
5 5
Adopted, Adopted,
intent that the funds support workers’ intent that the funds support workers’ rights and capacity to organize independent rights and capacity to organize independent
Voice Voice
unions in Mexico. unions in Mexico.
260. Levin, 260. Levin, Andy (MI): Prohibits any of the funds made available by this Act to be used Andy (MI): Prohibits any of the funds made available by this Act to be used
5 5
Adopted, Adopted,
by the Department of Education for Education Freedom by the Department of Education for Education Freedom Scholarship private school Scholarship private school
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vouchers. vouchers.
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Appropriations
En
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Amdt. No. and Summary from the Rules Committee
No.
Disposition
261. Lujan (NM), Pappas (NH), Guthrie (KY): Increases funding for Comprehensive 261. Lujan (NM), Pappas (NH), Guthrie (KY): Increases funding for Comprehensive
4 4
Adopted, Adopted,
Opioid Recovery Centers (CORCs) under the SAMHSA Opioid Recovery Centers (CORCs) under the SAMHSA Mental Health account by $8 Mental Health account by $8
Voice Voice
mil ion, mil ion, bringing total funding for CORCsbringing total funding for CORCs to the ful $10 mil ionto the ful $10 mil ion authorized by the authorized by the
SUPPORT Act. Offset by a corresponding reduction to HHS Office of the Secretary.SUPPORT Act. Offset by a corresponding reduction to HHS Office of the Secretary.
262. Maloney, Sean (NY): Increases and decreases 262. Maloney, Sean (NY): Increases and decreases funding by $10 mil ionfunding by $10 mil ion in the Institute in the Institute
4 4
Adopted, Adopted,
of Museum and Library Services of Museum and Library Services account to highlight the need for technological account to highlight the need for technological
Voice Voice
advancements, like Wi-Fi advancements, like Wi-Fi and computers,and computers, in Libraries,in Libraries, especial yespecial y those in communities those in communities
that are that are ~~economical y~~ economically distressed.distressed.
263. McAdams (UT): Increases funding for the Suicide Lifeline 263. McAdams (UT): Increases funding for the Suicide Lifeline program under the program under the
4 4
Adopted, Adopted,
SAMHSA Mental Health account by $4 mil ion SAMHSA Mental Health account by $4 mil ion with offsets. with offsets.
Voice Voice
264. McBath (GA): Increases funding for CDC 264. McBath (GA): Increases funding for CDC Injury Prevention and Control fund by Injury Prevention and Control fund by
5 5
Adopted, Adopted,
$5,000,000, decreases $5,000,000, decreases the General Departmentalthe General Departmental Management fund under the office of Management fund under the office of
Voice Voice
the HHS Secretary by $5,000,000. the HHS Secretary by $5,000,000.
265. McBath (GA), Speier (CA), 265. McBath (GA), Speier (CA), ~~Dingel~~ Dingell (MI), Moore (WI), Kuster (NH): Increase (MI), Moore (WI), Kuster (NH): Increase ~~overal~~
overall 4 4
Adopted, Adopted,
budget for Children and Family budget for Children and Family ~~Services~~ Services by $5,000,000, thereby increasing the budget by $5,000,000, thereby increasing the budget
Voice Voice
for FVPSA by $5,000,000. Decrease for FVPSA by $5,000,000. Decrease the Generalthe General Departmental Management fund under Departmental Management fund under
the Office of the HHS Secretarythe Office of the HHS Secretary by $5,000,000.by $5,000,000.
266. McKinley 266. McKinley (WV), (WV), ~~Pascrel~~ Pascrell (NJ): Provides an additional $1 mil ion(NJ): Provides an additional $1 mil ion to the Alternatives to the Alternatives
4 4
Adopted, Adopted,
to Opioids in the Emergency Department which is to Opioids in the Emergency Department which is authorized in Section 7091 of the authorized in Section 7091 of the
Voice Voice
SUPPORT for Patients and Communities SUPPORT for Patients and Communities Act, P.L.Act, P.L. 115-271. 115-271.
267. McKinley 267. McKinley (WV), Doyle (PA): Funds Sec. 7081 of the SUPPORT Act, preventing (WV), Doyle (PA): Funds Sec. 7081 of the SUPPORT Act, preventing
4 4
Adopted, Adopted,
overdoses overdoses while in emergencywhile in emergency ~~rooms~~ rooms by creating a coordinated care model.by creating a coordinated care model.
Voice Voice
268. Newhouse (WA): Strikes 268. Newhouse (WA): Strikes Section 247 of Title II, which prohibits the use of funds toSection 247 of Title II, which prohibits the use of funds to
3 3
Rejected, Rejected,
implement, implement, enforce, or otherwiseenforce, or otherwise give effect to the revisiongive effect to the revision to section 447.10 of title 42, to section 447.10 of title 42,
voice voice
Code of Federal Regulations, contained in the final rule entitled ‘ Code of Federal Regulations, contained in the final rule entitled ‘ ‘Medicaid Program; Medicaid Program;
Reassignment of Medicaid Provider Claims’Reassignment of Medicaid Provider Claims’ (84 Fed. Reg. 19718 (May 6, 2019)). (84 Fed. Reg. 19718 (May 6, 2019)).
269. Norcross 269. Norcross (NJ): Increases and decreases(NJ): Increases and decreases OSHA by $5 mil ionOSHA by $5 mil ion with the intent of with the intent of
5 5
Adopted, Adopted,
directing them to issue directing them to issue a comprehensivea comprehensive emergency temporaryemergency temporary standard to protect standard to protect
Voice Voice
workers, workers, employers,employers, and customersand customers from the COVID19 pandemic.from the COVID19 pandemic.
270. Norcross 270. Norcross (NJ): Increases and decreases(NJ): Increases and decreases the Public Health and Social Services the Public Health and Social Services
5 5
Adopted, Adopted,
Emergency Fund by $5 mil ion Emergency Fund by $5 mil ion with the intention of directingwith the intention of directing the Department to the Department to
Voice Voice
establish a nationwide standard for diagnostic testing and contact tracing related to establish a nationwide standard for diagnostic testing and contact tracing related to
COVID-19. The standard should focus on child care facilities,COVID-19. The standard should focus on child care facilities, child care providers, child care providers,
parents, and anyone who may come in contact with a child care setting. parents, and anyone who may come in contact with a child care setting.
271. Norcross 271. Norcross (NJ), Hartzler (MO): Appropriates $11.5 mil ion(NJ), Hartzler (MO): Appropriates $11.5 mil ion for militaryfor military and civilian and civilian
4 4
Adopted, Adopted,
partnership for trauma readiness partnership for trauma readiness grants as authorized by section 204 of the Pandemic grants as authorized by section 204 of the Pandemic
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and and Al All-Hazards Preparedness-Hazards Preparedness and Advancing Innovation Act of 2019.and Advancing Innovation Act of 2019.
272. Omar 272. Omar (MN): Transfers $1 mil ion(MN): Transfers $1 mil ion to the CDC with the intention that the agency to the CDC with the intention that the agency
4 4
Adopted, Adopted,
use the funds to conduct a study on the health impacts of mercury use the funds to conduct a study on the health impacts of mercury exposure caused by exposure caused by
Voice Voice
the use of commercial the use of commercial skin lightening products. skin lightening products.
273. Panetta (CA), Yarmuth (KY), Davis, Danny K. (IL), Hastings (FL): Increases and 273. Panetta (CA), Yarmuth (KY), Davis, Danny K. (IL), Hastings (FL): Increases and
4 4
Adopted, Adopted,
decreases decreases School Improvement ProgramsSchool Improvement Programs funding by $1 mil ionfunding by $1 mil ion to emphasize the need to emphasize the need
Voice Voice
for additional funding for the McKinney Vento Homeless for additional funding for the McKinney Vento Homeless ~~Assistance~~ Assistance Act’s Education for Act’s Education for
HomelessHomeless Children and Youth programChildren and Youth program (EHCY). (EHCY).
274. Pappas (NH), Gooden (TX), Suozzi (NY), Kustoff (TN), Brindisi 274. Pappas (NH), Gooden (TX), Suozzi (NY), Kustoff (TN), Brindisi (NY), Trone (MD): (NY), Trone (MD):
4 4
Adopted, Adopted,
Increases and decreases Increases and decreases by $4,000,000 funding for NIH Office of the Directorby $4,000,000 funding for NIH Office of the Director in order in order
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to establish a pilot program to support research and development to establish a pilot program to support research and development jointly with Israel for jointly with Israel for
effective responseseffective responses to COVID-19 to COVID-19
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Appropriations
En
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Amdt. No. and Summary from the Rules Committee
No.
Disposition
275. 275. ~~Pascrel~~ Pascrell (NJ), Bacon (NE): Decreases(NJ), Bacon (NE): Decreases the Generalthe General Departmental Management Departmental Management
4 4
Adopted, Adopted,
funding by $1 mil ion funding by $1 mil ion and provides funding $1 mil ionand provides funding $1 mil ion for the National Concussion for the National Concussion
Voice Voice
~~Surveil ance~~ Surveillance System within the Centers for DiseaseSystem within the Centers for Disease Control and Prevention, authorized Control and Prevention, authorized
by 42 U.S.C.by 42 U.S.C. 280b-3. 280b-3.
276. Perlmutter 276. Perlmutter (CO), Wilson,(CO), Wilson, Joe (SC), Lujan (NM), Crow (CO): IncreasesJoe (SC), Lujan (NM), Crow (CO): Increases the Energy the Energy
4 4
Adopted, Adopted,
Employees Employees Occupational Il nessOccupational Il ness Program by $2 mil ionProgram by $2 mil ion in orderin order to fund the Department to fund the Department
Voice Voice
of Labor Office of the Ombudsman through Fiscal of Labor Office of the Ombudsman through Fiscal Year 2021.Year 2021.
277. Perlmutter 277. Perlmutter (CO): Increases(CO): Increases the Energy Employeesthe Energy Employees Occupational Il ness ProgramOccupational Il ness Program by by
4 4
Adopted, Adopted,
$300,000 to fund a support contractor for the Advisory Board on Toxic Substances and $300,000 to fund a support contractor for the Advisory Board on Toxic Substances and
Voice Voice
Worker Worker Health and help the Board fulfilHealth and help the Board fulfil its legislativeits legislative mandate. mandate.
278. Porter 278. Porter (CA): Ensures that ACA(CA): Ensures that ACA open enrol mentopen enrol ment data is disaggregated by race, data is disaggregated by race,
5 5
Adopted, Adopted,
ethnicity, preferred language, age, and sex to support better understanding of ethnicity, preferred language, age, and sex to support better understanding of
Voice Voice
enrol ment enrol ment information.information.
279. Porter 279. Porter (CA): Increases funding to provide $500,000 for the Maternal Mental Health (CA): Increases funding to provide $500,000 for the Maternal Mental Health
4 4
Adopted, Adopted,
Hotline. Hotline.
Voice Voice
280. Porter 280. Porter (CA): Increases funding to provide $55,500,000 for the Child Care(CA): Increases funding to provide $55,500,000 for the Child Care Access Access
4 4
Adopted, Adopted,
Means Parents in School Program (CCAMPIS). Means Parents in School Program (CCAMPIS).
Voice Voice
281. Pressley 281. Pressley (MA): Increases funding by $5 (MA): Increases funding by $5 ~~mil ion~~ million for the National Institute of Arthritis for the National Institute of Arthritis
4 4
Adopted, Adopted,
and Musculoskeletal and Musculoskeletal and Skin Diseases,and Skin Diseases, which conducts research for alopecia areata, by which conducts research for alopecia areata, by
Voice Voice
decreasing the General decreasing the General Departmental Management budget for the Department of Departmental Management budget for the Department of
Health and Human Services'Health and Human Services' Office of the Secretary.Office of the Secretary.
282. Richmond (LA): Increases and decreases 282. Richmond (LA): Increases and decreases Student Support and Academic Student Support and Academic
4 4
Adopted, Adopted,
Enrichment State Grants by $1 mil ion Enrichment State Grants by $1 mil ion to focus additional efforts on comprehensive to focus additional efforts on comprehensive
Voice Voice
dropout prevention programs dropout prevention programs including those with experientialincluding those with experiential learning components. learning components.
283. Schakowsky (IL): Providing $1,000,000 in funding for an interagency Col ege 283. Schakowsky (IL): Providing $1,000,000 in funding for an interagency Col ege
5 5
Adopted, Adopted,
Campus Task Force on mental and behavioral health and $1,000,000 for efforts aimed at Campus Task Force on mental and behavioral health and $1,000,000 for efforts aimed at
Voice Voice
reducing the stigma associated with mental health services reducing the stigma associated with mental health services to ensure that students at to ensure that students at
institutions of higher education have the support they need to successful yinstitutions of higher education have the support they need to successful y complete complete
their education, as authorized in the 21st Century Cures Act (P.L. 114-255). their education, as authorized in the 21st Century Cures Act (P.L. 114-255).
284. Schrier 284. Schrier (WA): Increases funding for vaccines by $2 mil ion(WA): Increases funding for vaccines by $2 mil ion and reduce by $2 mil ion and reduce by $2 mil ion
5 5
Adopted, Adopted,
the Office of the Secretary of Health and Human Services the Office of the Secretary of Health and Human Services to ensure that the Centers to ensure that the Centers
Voice Voice
for Disease for Disease Control and Prevention (CDC) has the resourcesControl and Prevention (CDC) has the resources to disaggregate,to disaggregate, detailed detailed
vaccination acceptance data by race and ethnicity. vaccination acceptance data by race and ethnicity.
285. Schrier 285. Schrier (WA): Increases then decrease by $200 mil ion(WA): Increases then decrease by $200 mil ion funding to promote funding to promote
4 4
Adopted, Adopted,
innovation in antibacterial research innovation in antibacterial research and developmentand development by funding the CARB-X program by funding the CARB-X program
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that develops products directly supporting the government-wide National Action Plan that develops products directly supporting the government-wide National Action Plan
for Combating AntibioticResistant Bacteria. for Combating AntibioticResistant Bacteria.
286. Sherril 286. Sherril (NJ): Increases and decreases(NJ): Increases and decreases funds by $20,000,000 to highlight the need for 5 funds by $20,000,000 to highlight the need for 5
Adopted, Adopted,
the Mental and Substance Use Disorder the Mental and Substance Use Disorder ~~Workforce~~ Workforce Training DemonstrationTraining Demonstration Program Program
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under HRSA Health Workforce. under HRSA Health Workforce.
287. Sherril 287. Sherril (NJ): Increases the National Institute of Mental health budget by $5,000,000(NJ): Increases the National Institute of Mental health budget by $5,000,000 4 4
Adopted, Adopted,
to address youth mental health disparities. to address youth mental health disparities.
Voice Voice
288. Slotkin 288. Slotkin (MI): Increases and decreases the Institute of Education Sciences by (MI): Increases and decreases the Institute of Education Sciences by
5 5
Adopted, Adopted,
$1,000,000 to highlight the need for academic research on issues $1,000,000 to highlight the need for academic research on issues of racial inequality. of racial inequality.
Voice Voice
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Appropriations
En
Bloc
Amdt. No. and Summary from the Rules Committee
No.
Disposition
289. Smith, 289. Smith, Christopher (NJ), Peterson (MN), Stefanik (NY), Delgado (NY), Rose, Max Christopher (NJ), Peterson (MN), Stefanik (NY), Delgado (NY), Rose, Max
4 4
Adopted, Adopted,
(NY): Redirects (NY): Redirects $4 mil ion$4 mil ion from Generalfrom General Departmental Management at the Department Departmental Management at the Department
Voice Voice
of Health and Human Services of Health and Human Services to Emerging Zoonotic and Infectious Diseasesto Emerging Zoonotic and Infectious Diseases at the at the
Centers for DiseaseCenters for Disease Control, for Lyme DiseaseControl, for Lyme Disease and other Vector-Borneand other Vector-Borne Diseases.Diseases. (10 (10
minutes) minutes)
290. Smith, 290. Smith, Jason (MO): Increases and decreasesJason (MO): Increases and decreases funds by $1 mil ionfunds by $1 mil ion to highlight the to highlight the
4 4
Adopted, Adopted,
need for the Secretary of HHS, in col aboration with the HHS Assistant Secretary need for the Secretary of HHS, in col aboration with the HHS Assistant Secretary for for
Voice Voice
Preparedness and Response, the FDA Commissioner, Preparedness and Response, the FDA Commissioner, the CDC Director,the CDC Director, and the and the
Secretary for Homeland Security, to determine,Secretary for Homeland Security, to determine, ~~and annual y~~ and annually update, a list of 300-400 update, a list of 300-400
medications for which it is criticalmedications for which it is critical that the Federal government ensure availability in the that the Federal government ensure availability in the
event of a public health emergency.event of a public health emergency.
291. Speier 291. Speier (CA), (CA), ~~Dingel~~ Dingell (MI), Moore (WI), McBath (GA), Haaland (NM): Increases (MI), Moore (WI), McBath (GA), Haaland (NM): Increases
4 4
Adopted, Adopted,
funding for the Rape, Prevention and Education program funding for the Rape, Prevention and Education program by $5.25 mil ionby $5.25 mil ion to ensure that to ensure that
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diverse diverse stakeholders,stakeholders, including educational institutions, rape crisisincluding educational institutions, rape crisis centers, community centers, community
organizations and state agency partners have sufficient resourcesorganizations and state agency partners have sufficient resources to implementto implement their their
programmingprogramming to prevent sexual violence.to prevent sexual violence.
292. Speier 292. Speier (CA), Jayapal (WA), Jackson Lee (TX), Rice, Kathleen (NY), Tlaib(CA), Jayapal (WA), Jackson Lee (TX), Rice, Kathleen (NY), Tlaib
5 5
Adopted, Adopted,
(MI): Increases (MI): Increases funding for OSHA’sfunding for OSHA’s ~~Whistleblower~~ Whistleblower Protection ProgramProtection Program by $1,436,000 in by $1,436,000 in
Voice Voice
order to ensure the office that enforces over 20 whistleblower order to ensure the office that enforces over 20 whistleblower laws has the funding laws has the funding
needed to respond to the increase in complaints related to the COVID-19 pandemic. needed to respond to the increase in complaints related to the COVID-19 pandemic.
DecreasesDecreases funding for the Office of the Secretary by $2,436,000.funding for the Office of the Secretary by $2,436,000.
293. Stauber (MN), Young (AK): Increases SAMHSA for American 293. Stauber (MN), Young (AK): Increases SAMHSA for American Indian and Alaska Indian and Alaska
4 4
Adopted, Adopted,
Native Suicide Prevention by $2,869,000 to combat the rampant suicide of Native Native Suicide Prevention by $2,869,000 to combat the rampant suicide of Native
Voice Voice
Americans. Americans.
294. Stevens (MI), Wasserman 294. Stevens (MI), Wasserman Schultz (FL): Reduces and increasesSchultz (FL): Reduces and increases funds by $5 mil ionfunds by $5 mil ion in in
4 4
Adopted, Adopted,
the CDC's Injury Prevention and Control account to highlight the need to fund the the CDC's Injury Prevention and Control account to highlight the need to fund the
Voice Voice
CDC's work on drowning prevention. CDC's work on drowning prevention.
295. Taylor (TX), Shalala (FL): Requires the Secretary of the Department of Health and 295. Taylor (TX), Shalala (FL): Requires the Secretary of the Department of Health and
4 4
Adopted, Adopted,
Human Services Human Services to enter into an agreement with the National Academiesto enter into an agreement with the National Academies of Science, of Science,
Voice Voice
Engineering, and Medicine to commission Engineering, and Medicine to commission a report on the differences between state, a report on the differences between state,
local, and federal vital statistics and death reporting standards; to provide local, and federal vital statistics and death reporting standards; to provide
recommendationsrecommendations on how to harmonizeon how to harmonize these standards; and provide information on these standards; and provide information on
the feasibilitythe feasibility of establishing and implementingof establishing and implementing national standards for vital statistics and national standards for vital statistics and
death reporting.death reporting.
296. Taylor (TX): Increases and decreases 296. Taylor (TX): Increases and decreases funds by $1 mil ionfunds by $1 mil ion with the intention of with the intention of
3 3
Rejected, Rejected,
requiring the Inspector General requiring the Inspector General of the Department of Laborof the Department of Labor to report on the Bureau of to report on the Bureau of
voice voice
Labor Statistics (BLS) media lock-ups, including a comparison to the Federal Labor Statistics (BLS) media lock-ups, including a comparison to the Federal Reserve’s Reserve’s
media lock-up and best practices for marketmedia lock-up and best practices for market moving informationmoving information from the Federal from the Federal
ReserveReserve and BLS,and BLS, examine the ability of the Federalexamine the ability of the Federal ~~Reserve to release more~~ Reserve to release more market market
moving information such as the BLSmoving information such as the BLS economic data, if discontinuing mediaeconomic data, if discontinuing media lock-ups pose lock-ups pose
a single point of failure security risk,a single point of failure security risk, ~~determine~~ determine best practices to ensure equal access by best practices to ensure equal access by
traders,traders, determine best practices to enable media access to examine data priordetermine best practices to enable media access to examine data prior to to
releases,releases, and determineand determine if lock-ups pose a cybersecurity concern. if lock-ups pose a cybersecurity concern.
297. Trahan (MA), Jayapal (WA): Increases and decreases 297. Trahan (MA), Jayapal (WA): Increases and decreases funding under Title I of the funding under Title I of the
5 5
Adopted, Adopted,
Elementary and Secondary Education Act of 1965 (referred Elementary and Secondary Education Act of 1965 (referred to in this Act as ‘ ESEA’to in this Act as ‘ ESEA’ ’) to ) to
Voice Voice
underscore congressional underscore congressional intent that funding designated as emergencyintent that funding designated as emergency aid during the aid during the
COVID-19 pandemic not be redirectedCOVID-19 pandemic not be redirected by the Secretary of Education away from public by the Secretary of Education away from public
elementaryelementary and secondary schools to private schools unless and secondary schools to private schools unless ~~specifical y~~specifically authorized under authorized under
such Acts, the ESEA, IDEA, or other law in effect priorsuch Acts, the ESEA, IDEA, or other law in effect prior to the enactment of this Act.to the enactment of this Act.
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298. Trahan (MA), Correa (CA): Increases and decreases 298. Trahan (MA), Correa (CA): Increases and decreases the Program Administration the Program Administration
5 5
Adopted, Adopted,
account at the Department of Education to il ustrate the serious account at the Department of Education to il ustrate the serious consequences of using consequences of using
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federal funding to coerce schools federal funding to coerce schools into resuming in-person instruction as they reopen into resuming in-person instruction as they reopen
during the COVID-19 pandemic. during the COVID-19 pandemic.
299. Trahan (MA): Increases and decreases 299. Trahan (MA): Increases and decreases funding at the HHS Office of the Secretary funding at the HHS Office of the Secretary
5 5
Adopted, Adopted,
General General Management account for the intention of directing the Secretary to engage the Management account for the intention of directing the Secretary to engage the
Voice Voice
National Academies National Academies of Sciences, Engineering, and Mathematics to study the health of Sciences, Engineering, and Mathematics to study the health
effects and injury impacts caused by the use of kinetic impact projectiles.effects and injury impacts caused by the use of kinetic impact projectiles.
300. Trone (MD), 300. Trone (MD), ~~Gal agher~~Gallagher (WI): Increases funding by $1 mil ion (WI): Increases funding by $1 mil ion for SAMHSA’sfor SAMHSA’s mental mental
4 4
Adopted, Adopted,
health programs to implement health programs to implement an Interagency Task Forcean Interagency Task Force on Trauma-Informed Care to on Trauma-Informed Care to
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identify and disseminate identify and disseminate evidence based approaches on prevention and identification of evidence based approaches on prevention and identification of
trauma, community-based practices to support children and their families,trauma, community-based practices to support children and their families, and and
opportunities for state- and local-levelopportunities for state- and local-level partnerships, as authorized by the SUPPORT for partnerships, as authorized by the SUPPORT for
Patients and CommunitiesPatients and Communities Act. DecreasesAct. Decreases by $1 mil ionby $1 mil ion the Office of the Secretary - the Office of the Secretary -
GeneralGeneral Departmental Management. Departmental Management.
301. Velázquez (NY): Prevents funds from 301. Velázquez (NY): Prevents funds from this this ~~act~~Act from being used to reject from being used to reject grant grant
5 5
Adopted, Adopted,
applications due to the use of the term “vulnerable," "entitlement," applications due to the use of the term “vulnerable," "entitlement," "diversity," "diversity,"
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"transgender," "fetus," "evidence-based", or "science-based”. "transgender," "fetus," "evidence-based", or "science-based”.
302. Waters 302. Waters (CA), Schakowsky (IL), (CA), Schakowsky (IL), ~~Dingel~~ Dingell (MI): Prohibits the use of funds to (MI): Prohibits the use of funds to
5 5
Adopted, Adopted,
implement implement the Administration’sthe Administration’s July 2019 proposed rule,July 2019 proposed rule, ~~‘ Medicare~~ ‘‘Medicare and Medicaid and Medicaid
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Programs; Requirements Programs; Requirements for Long-Termfor Long-Term Care Facilities:Care Facilities: Regulatory 5 ProvisionsRegulatory 5 Provisions To To
PromotePromote Efficiency, and Transparency” which deregulates nursing homesEfficiency, and Transparency” which deregulates nursing homes and weakens and weakens
infection prevention standards in nursing homes.infection prevention standards in nursing homes.
303. Waters 303. Waters (CA), Watson Coleman (NJ): Prohibits the use of funds to require (CA), Watson Coleman (NJ): Prohibits the use of funds to require
5 5
Adopted, Adopted,
hospitals, hospital laboratories, hospitals, hospital laboratories, and acute care facilitiesand acute care facilities to report COVID-19 data using to report COVID-19 data using
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the “teletracking.protect.hhs.gov” the “teletracking.protect.hhs.gov” website that was announced by the Department of website that was announced by the Department of
Health and Human ServicesHealth and Human Services in the document entitled “COVID-19 Guidance for Hospital in the document entitled “COVID-19 Guidance for Hospital
Reporting and FAQs for Hospitals, Hospital Laboratory,Reporting and FAQs for Hospitals, Hospital Laboratory, and Acute Care Facility Data and Acute Care Facility Data
Reporting Updated July 10, 2020”, instead of the CDC.Reporting Updated July 10, 2020”, instead of the CDC.
304. Waters 304. Waters (CA), Lee,(CA), Lee, Barbara (CA), Chu (CA): Increases funds for the Minority AIDS Barbara (CA), Chu (CA): Increases funds for the Minority AIDS
4 4
Adopted, Adopted,
Initiative by $5 mil ion Initiative by $5 mil ion and reduces remaining funds for the Office of the Secretary,and reduces remaining funds for the Office of the Secretary, HHS, HHS,
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General General Departmental Management, by the same amount. Departmental Management, by the same amount.
305. Waters 305. Waters (CA), Smith,(CA), Smith, Christopher (NJ): Increases funds for the BOLD Christopher (NJ): Increases funds for the BOLD
4 4
Adopted, Adopted,
Infrastructure for Alzheimer’s Infrastructure for Alzheimer’s Act, within the CDC’s “Chronic DiseaseAct, within the CDC’s “Chronic Disease Prevention and Prevention and
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Health Promotion” Health Promotion” account, by $5 mil ionaccount, by $5 mil ion and reducesand reduces funds for the Office of the funds for the Office of the
Secretary,Secretary, HHS, GeneralHHS, General Departmental Management, by the same amount. Departmental Management, by the same amount.
306. Waters 306. Waters (CA), Schakowsky (IL): Increases funds for the (CA), Schakowsky (IL): Increases funds for the ~~Al iance~~ Alliance for Innovation on for Innovation on
4 4
Adopted, Adopted,
Maternal Health (AIM) within HRSA’s Maternal Health (AIM) within HRSA’s Maternal and Child Health account by $5 mil ion Maternal and Child Health account by $5 mil ion
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and reduces funds for the Office of the Secretary, and reduces funds for the Office of the Secretary, HHS, General Departmental HHS, General Departmental
Management, by the same amount. Management, by the same amount.
307. Watson Coleman (NJ): Increases and decreases 307. Watson Coleman (NJ): Increases and decreases funds by $500,000 to highlight the funds by $500,000 to highlight the
5 5
Adopted, Adopted,
need for a GAO study examining: need for a GAO study examining: 1) whether public health entities are including racial 1) whether public health entities are including racial
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and ethnic demographic data when reporting COVID–19 cases & deaths, identifying and ethnic demographic data when reporting COVID–19 cases & deaths, identifying
~~chal enges~~challenges, and recommendations, and recommendations for improvement;for improvement; and 2) whether changes after July and 2) whether changes after July
10 to HHS reporting requirements10 to HHS reporting requirements ~~make~~ make it moreit more difficult to report demographic data. difficult to report demographic data.
308. Watson Coleman (NJ): Increases and decreases 308. Watson Coleman (NJ): Increases and decreases funds by $5,000,000 to highlight funds by $5,000,000 to highlight
5 5
Adopted, Adopted,
the need for a GAO study auditing hiring, retention, and promotion the need for a GAO study auditing hiring, retention, and promotion practices at CDC practices at CDC
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to evaluate whether current policies to evaluate whether current policies equitably support staff of color,equitably support staff of color, and identifying and identifying
recommendationsrecommendations to remedyto remedy disparities.disparities.
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309. Wright (TX), Foxx (NC): Strikes 309. Wright (TX), Foxx (NC): Strikes Sec.Sec. 114 in division F, removing114 in division F, removing the prohibition the prohibition
3 3
Rejected, Rejected,
against DOL OFCCP's rule Implementing Legal against DOL OFCCP's rule Implementing Legal ~~Requirements~~ Requirements Regarding the Equal Regarding the Equal
voice voice
Opportunity Clause’s Opportunity Clause’s ~~Religious~~ Religious Exemption from taking effect. Exemption from taking effect.
~~Source~~Sources: The amendment numbers and summariesThe amendment numbers and summaries are from H.Rept. 116-461. En bloc amendment numbers are are from H.Rept. 116-461. En bloc amendment numbers are
from from Congressional Record,, daily edition, Vol. 166, No. 135 (July 30, 2020), pp. H4134-H4139, H4143-H4169. The daily edition, Vol. 166, No. 135 (July 30, 2020), pp. H4134-H4139, H4143-H4169. The
amendment dispositions are from Congress.gov. amendment dispositions are from Congress.gov.
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link to page link to page 7576 link to page link to page 7576 Labor, Health and Human Services, and Education: FY2021 ~~Appropriations~~
Appropriations
Appendix C. Enacted FY2021 LHHS Supplemental
Appropriations
Five appropriations acts have been signed into law related to the COVID-19 pandemic. Four of Five appropriations acts have been signed into law related to the COVID-19 pandemic. Four of
these provided FY2020 supplemental discretionary appropriations for LHHS programs and these provided FY2020 supplemental discretionary appropriations for LHHS programs and
activities, and one provided FY2021 supplemental discretionary appropriations. activities, and one provided FY2021 supplemental discretionary appropriations. Al All five of these five of these
are summarized in CRS Report R46775, are summarized in CRS Report R46775, Overview of COVID-19 LHHS Supplemental
Appropriations: FY2020 and FY2021..
For FY2021, the same law that provided “regular” annual LHHS appropriations for FY2021 in For FY2021, the same law that provided “regular” annual LHHS appropriations for FY2021 in
Division H also provided supplemental discretionary appropriations in Division M (H.R. 133, Division H also provided supplemental discretionary appropriations in Division M (H.R. 133,
P.L. 116-260). This law, which was enacted on December 27, 2020, provided a total of $154.9 P.L. 116-260). This law, which was enacted on December 27, 2020, provided a total of $154.9
~~bil ion~~ billion in supplemental LHHSin supplemental LHHS funds (Title III, Coronavirus Response and Relief Supplemental funds (Title III, Coronavirus Response and Relief Supplemental
Appropriations Act, 2021; CRRSA).Appropriations Act, 2021; CRRSA).~~122~~123 Unlike Unlike the regular discretionary appropriations in the regular discretionary appropriations in
Division H, however, these additional funds were designated as an “emergency requirement” and Division H, however, these additional funds were designated as an “emergency requirement” and
thus were effectively exempted from otherwise applicable budget enforcement requirements thus were effectively exempted from otherwise applicable budget enforcement requirements
(such as the statutory discretionary spending limits).(such as the statutory discretionary spending limits).~~123~~124 In addition, prior to the end of FY2021, a second supplemental appropriations act containing LHHS appropriations was enacted (P.L. 117-31) on July 30, 2021. This law provided $25 million in supplemental appropriations for the Refugee and Entrant Assistance account at HHS for specified purposes related to Afghan special immigrants.
The FY2021 discretionary regular and supplemental LHHS appropriations are summarized in The FY2021 discretionary regular and supplemental LHHS appropriations are summarized in
Table C-1. In In total, FY2021 supplemental appropriations increased regular FY2021 LHHS total, FY2021 supplemental appropriations increased regular FY2021 LHHS
enacted funding by about 78%. This funding was split roughly enacted funding by about 78%. This funding was split roughly ~~equal y~~equally between HHS (48%) and between HHS (48%) and
ED (53%). (None was enacted for DOL or RA.) The ED supplemental funding budgetary increase ED (53%). (None was enacted for DOL or RA.) The ED supplemental funding budgetary increase
of $82 of $82 ~~bil ion~~ billion was 112% of its FY2021 regular appropriations. HHS regular appropriations were was 112% of its FY2021 regular appropriations. HHS regular appropriations were
increased by 75% (+$73 increased by 75% (+$73 ~~bil ion).124~~billion).125
The majority of HHS funds (66%) in the FY2021 supplemental appropriations measure were The majority of HHS funds (66%) in the FY2021 supplemental appropriations measure were
appropriated to the Public Health and Social Services Emergency Fund (PHSSEF) within the appropriated to the Public Health and Social Services Emergency Fund (PHSSEF) within the
Office of the Secretary. The PHSSEF account is used by the HHS Secretary for one-time or short-Office of the Secretary. The PHSSEF account is used by the HHS Secretary for one-time or short-
term funding, such as emergency supplemental appropriations, and for some ongoing public term funding, such as emergency supplemental appropriations, and for some ongoing public
health preparedness activities in the Office of the HHS Assistant Secretary for Preparedness and health preparedness activities in the Office of the HHS Assistant Secretary for Preparedness and
Response.Response.
Accounts at the CDC received approximately 12% of the supplemental HHS appropriations Accounts at the CDC received approximately 12% of the supplemental HHS appropriations
provided in the FY2021 supplemental measure, which more than doubled its discretionary provided in the FY2021 supplemental measure, which more than doubled its discretionary
funding level for FY2021. The FY2021 supplemental appropriations also increased SAMHSA funding level for FY2021. The FY2021 supplemental appropriations also increased SAMHSA
funding by 72%, and ACF funding by 42%. Remaining supplemental appropriations to NIH and funding by 72%, and ACF funding by 42%. Remaining supplemental appropriations to NIH and
~~ACL augmented total agency funding levels to a lesser extent. No FY2021 supplemental funds~~
~~were appropriated to HRSA, CMS, or AHRQ.~~
~~The majority of ED funds ($81.9 bil ion or 99.9%) in the FY2021 supplemental appropriations~~
~~measure were for the Education Stabilization Fund (ESF). The ESF supports three emergency~~
~~relief funding streams: (1) a Governor’s Emergency Education Relief (GEER) Fund, (2) an~~

~~122 T his~~ 123 This amount excludes funding amount excludes funding appropriated in appropriated in ~~T itle~~Title III to the Food and Drug III to the Food and Drug Administration (FDA) SalariesAdministration (FDA) Salaries and and
Expenses account, as this fundingExpenses account, as this funding is generally not under the purview of the LHHSis generally not under the purview of the LHHS appropriations act.appropriations act. It also does not It also does not
includeinclude ~~funds~~ funds provided in other titles and divisions of this law.provided in other titles and divisions of this law. For instance, $175 million in mandatory funds provided For instance, $175 million in mandatory funds provided
to ACL Agingto ACL Aging and Disability Servicesand Disability Services Programs for nutrition services provided in Programs for nutrition services provided in ~~T itle~~Title VII of Division N. VII of Division N.
~~123~~124 Division H also included Division H also included $1.6 billion in emergency-designated funding,$1.6 billion in emergency-designated funding, but these are not considered to be “regular” but these are not considered to be “regular”
annual appropriations. annual appropriations. ~~T hese~~These are thus excluded are thus excluded from the “regular appropriations” numbers from the “regular appropriations” numbers inin Table C-1.. 125
~~124~~ For a discussion For a discussion of the FY2020 and FY2021 COVID-19-related supplemental appropriations for the Public Health of the FY2020 and FY2021 COVID-19-related supplemental appropriations for the Public Health
ServiceService Agencies at HHS,Agencies at HHS, see CRSsee CRS Report R46711, Report R46711, U.S. Public Health Service: COVID-19 ~~Supplem ental~~Supplemental
Appropriations in the 116th Congress. .
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Appropriations ACL augmented total agency funding levels to a lesser extent. No FY2021 supplemental funds were appropriated to HRSA, CMS, or AHRQ. The majority of ED funds ($81.9 billion or 99.9%) in the FY2021 supplemental appropriations measure were for the Education Stabilization Fund (ESF). The ESF supports three emergency relief funding streams: (1) a Governor’s Emergency Education Relief (GEER) Fund, (2) an Elementary and Secondary School Emergency Relief (ESSER) Fund, and (3) a Higher Education Elementary and Secondary School Emergency Relief (ESSER) Fund, and (3) a Higher Education
Emergency Relief Fund (HEERF). The ESF is not Emergency Relief Fund (HEERF). The ESF is not ~~typical y~~typically funded in regular appropriations acts. funded in regular appropriations acts.
Remaining FY2021 supplemental funds for ED, which combined to account for 0.1% of ED’s Remaining FY2021 supplemental funds for ED, which combined to account for 0.1% of ED’s
FY2021 supplemental funds, went to accounts that FY2021 supplemental funds, went to accounts that ~~typical y~~typically receive regular appropriations, receive regular appropriations,
including accounts for Student Aid Administration, the Institute for Education Sciences, Special including accounts for Student Aid Administration, the Institute for Education Sciences, Special
Institutions for People with Disabilities, Howard University, and Departmental Management. Institutions for People with Disabilities, Howard University, and Departmental Management.
Table C-1. Summary of Enacted FY2021 Discretionary Regular and Supplemental
Appropriations
(Budget authority in (Budget authority in ~~mil ions of dol ars~~millions of dollars) )
FY2021
CRRSA,
P.L. 117- Grand

Regular
Title III
31 Total
Department of Labor
12,536
-
- 12,536
Department of Health and Human Services
96,963
72,945
25 169,933~~169,908~~
HRSA HRSA
7,218 7,218
- -
- 7,218 7,218
CDC CDC
6,963 6,963
8,750 8,750
- 15,713 15,713
NIH NIH
41,437 41,437
1,250 1,250 -
42,687 42,687
SAMHSA SAMHSA
5,870 5,870
4,250 4,250 -
10,120 10,120
AHRQ AHRQ
338 338
- -
- 338 338
CMS CMS
4,477 4,477 -
- -
4,477 4,477
ACF ACF
24,695 24,695
10,250 10,250 25
34, 34,~~945~~970
ACL ACL
2,258 2,258
100 100
- 2,358 2,358
OS OS
3,706 3,706
48,345 48,345 -
52,051 52,051
Department of Education
73,537
82,000
- 155,537
Related Agencies
15,459
-
- 15,459
LHHS Total:
198,494
154,945
25 353,464 Sources~~353,439~~
~~Source~~: CompiledCompiled by CRS fromby CRS from LHHS amounts specified in P.L. 116-260, Divisions H and Title III of MLHHS amounts specified in P.L. 116-260, Divisions H and Title III of M, and P.L. 117-31. This . This
report excludes funding appropriated to the Food and Drug Administrationreport excludes funding appropriated to the Food and Drug Administration (FDA) Salaries(FDA) Salaries and Expenses account and Expenses account
in Title III (P.L. 116-260, Division M), as this funding is in Title III (P.L. 116-260, Division M), as this funding is ~~general y~~generally not under the purview of the LHHS not under the purview of the LHHS
appropriations act. This table does not include the $1.6 bil ion in emergency-designatedappropriations act. This table does not include the $1.6 bil ion in emergency-designated funding enacted in funding enacted in
DivisionDivision H of P.L. 116-260, as these H of P.L. 116-260, as these ~~general y~~generally are not considered to be “regular appropriations.” Funds provided are not considered to be “regular appropriations.” Funds provided
in other titles and divisionsin other titles and divisions of this law are beyond the scope of this report and are excluded fromof this law are beyond the scope of this report and are excluded from the table. (For the table. (For
instance, the table does not include $175 mil ioninstance, the table does not include $175 mil ion in mandatory funds provided to ACL Aging and Disability in mandatory funds provided to ACL Aging and Disability
ServicesServices ~~Programs~~ Programs for nutrition servicesfor nutrition services provided in Title VII of Divisionprovided in Title VII of Division N, P.L. 116-260N, P.L. 116-260)..) FY2021 regular FY2021 regular
amounts include LHHSamounts include LHHS funding provided to HHS pursuant to the 21st Century Cures Act (P.L. 114-255).funding provided to HHS pursuant to the 21st Century Cures Act (P.L. 114-255).
Notes: Al All supplemental funds are designated as an emergencysupplemental funds are designated as an emergency requirement.requirement. The display of funds in this table is The display of funds in this table is
based on the accounts in which they werebased on the accounts in which they were appropriated. When the supplemental bil text appropriated. When the supplemental bil text ~~cal s~~calls for transfers, for transfers,
funds are tabulated based on the account to which they were appropriated, not on the account to which they funds are tabulated based on the account to which they were appropriated, not on the account to which they
are to be transferred.are to be transferred. For further information about how these funds wereFor further information about how these funds were distributed, see CRS Report R46775, distributed, see CRS Report R46775,
Overview of COVID-19 LHHS Supplemental Appropriations: FY2020 and FY2021. .

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Author Information

Karen E. Lynch, Coordinator Karen E. Lynch, Coordinator
David H. Bradley David H. Bradley
Specialist in Social Policy Specialist in Social Policy
Specialist in Labor Economics Specialist in Labor Economics

Jessica Tollestrup, Coordinator Jessica Tollestrup, Coordinator
Angela Napili Angela Napili
Specialist in Social Policy Specialist in Social Policy
Senior Research Librarian Senior Research Librarian

Kyle D. Shohfi Kyle D. Shohfi
William R. Morton William R. Morton
Analyst in Education Policy Analyst in Education Policy
Analyst in Income Security Analyst in Income Security

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