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

Changes from October 29, 2021 to January 20, 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.

Status of FY2022 Labor, Health and Human
~~October 29, 2021~~January 20, 2022
Services, and Education Appropriations:
Karen E. Lynch
In Brief
Specialist in Social Policy Specialist in Social Policy

This report provides a brief summary of the status of FY2022 appropriations for the Departments This report provides a brief summary of the status of FY2022 appropriations for the Departments
Jessica Tollestrup
of Labor, Health and Human Services, and Education, and Related Agencies (LHHS) as of of Labor, Health and Human Services, and Education, and Related Agencies (LHHS) as of
the Specialist in Social Policy Specialist in Social Policy
~~October 29, 2021~~cover date of this report. It also provides background on the scope of the LHHS bill generally and . It also provides background on the scope of the LHHS bill generally and ~~the~~

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

limits, and the supplemental appropriations provided as part of the legislative response to the limits, and the supplemental appropriations provided as part of the legislative response to the
COVID-19 pandemic. COVID-19 pandemic.
As described below, congressional action has occurred on full-year appropriations for LHHS. Congress has not, however, reached agreement on full-year LHHS appropriations. In the meantime, funding has been provided temporarily through continuing resolutions, and additional emergency spending has been provided through multiple laws. FY2022 LHHS appropriations are currently being provided by a FY2022 LHHS appropriations are currently being provided by a series of continuing continuing ~~resolution (CR) that provides temporary funding~~
~~through December 3~~resolutions (CRs) that provide temporary funding. The first CR (Division A of H.R. 5305; P.L. 117-43) (Division A of H.R. 5305; P.L. 117-43)~~. This CR was signed into law on September 30, 2021~~ extended funding through December 3, 2021. The second CR (Division A of H.R. 6119; P.L. 117-70), extended funding through February 18, 2022. .
With regard to House action on full-year appropriations, FY2022 LHHS appropriations were passed by the House on initial With regard to House action on full-year appropriations, FY2022 LHHS appropriations were passed by the House on initial
consideration (219-208) on July 29, 2021 (Division A, H.R. 4502). Previously, on July 15, 2021, the House Appropriations consideration (219-208) on July 29, 2021 (Division A, H.R. 4502). Previously, on July 15, 2021, the House Appropriations
Committee voted (33-25) to report the LHHS bill; the measure was subsequently reported to the House on July 19 (H.R. Committee voted (33-25) to report the LHHS bill; the measure was subsequently reported to the House on July 19 (H.R.
4502; H.Rept. 117-96). The committee reported its initial suballocations for all 12 appropriations bills, including LHHS, on 4502; H.Rept. 117-96). The committee reported its initial suballocations for all 12 appropriations bills, including LHHS, on
July 1 (H.Rept. 117-78). July 1 (H.Rept. 117-78).
While the Senate Appropriations Committee has not yet voted to report the legislation, the committee chair, Senator Leahy, While the Senate Appropriations Committee has not yet voted to report the legislation, the committee chair, Senator Leahy,
released a majority draft of the LHHS bill and accompanying draft report language on October 18, 2021. released a majority draft of the LHHS bill and accompanying draft report language on October 18, 2021.
Although regular annual appropriations have yet to be enacted, three bills have been signed into law providing LHHS emergency-designated appropriations for FY2022:  Divisions A and C of the Extending Government Funding and Delivering Emergency Assistance Act (H.R. 5305; P.L. 117-43, September 30, 2021), provided a total of $4.2 billion for HHS related to shelter and support services for unaccompanied minors (Division A), and public health and support services for Afghan arrivals and refugees (Division C);  Division J of the Infrastructure Investment and Jobs Act (H.R. 3684; P.L. 117-58, November 15, 2021), provided $100 million in FY2022 for the HHS Low Income Home Energy Assistance Program, and rescinded $353 million in previously enacted emergency funding from the Education Stabilization Fund; and  Division B of the Further Extending Government Funding Act (H.R. 6119; P.L. 117-70, December 3, 2021), provided a total of $1.3 billion for public health and support services for Afghan arrivals and refugees (Division B).
Congressional Research Service Congressional Research Service

Status of FY2022 LHHS Appropriations: In Brief

~~iscal year (FY) 2022 LHHS~~ongressional action has occurred on full-year appropriations for LHHS. Congress has not, however, reached agreement on full-year LHHS appropriations. FY2022 LHHS C appropriations are currently being provided by a appropriations are currently being provided by a ~~continuing~~
~~resolution (CR) that provides temporary funding through December 3~~series of continuing resolutions (CRs) that provide temporary funding. The first CR (Division A of H.R. (Division A of H.R.
F 5305; P.L. 117-43)5305; P.L. 117-43)~~. This CR was signed into law on September 30, 2021~~ extended funding through December 3, 2021. The second CR (Division A of H.R. 6119; P.L. 117-70), extended funding through February 18, 2022. .
Previously, on July 29, 2021, FY2022 LHHS appropriations were passed by the House on initial Previously, on July 29, 2021, FY2022 LHHS appropriations were passed by the House on initial
consideration (219-208) as Division A of H.R. 4502. While the Senate Appropriations Committee consideration (219-208) as Division A of H.R. 4502. While the Senate Appropriations Committee
has not yet voted to report the legislation, the committee chair, Senator Leahy, released a majority has not yet voted to report the legislation, the committee chair, Senator Leahy, released a majority
draft of the LHHS bill and accompanying draft report language on October 18, 2021.1 draft of the LHHS bill and accompanying draft report language on October 18, 2021.1
This report provides a brief summary of the status of LHHS appropriations during the FY2022 This report provides a brief summary of the status of LHHS appropriations during the FY2022
cycle, including relevant congressional actions and a top-line comparison of discretionary funding cycle, including relevant congressional actions and a top-line comparison of discretionary funding
enacted in FY2021, versus relevant FY2022 legislative proposals as of enacted in FY2021, versus relevant FY2022 legislative proposals as of ~~October 29, 2021~~the cover date of this report. It also . It also
provides background on the scope of the bill and the context for congressional decisionmaking.provides background on the scope of the bill and the context for congressional decisionmaking.
In addition, it summarizes the FY2022 LHHS emergency-designated appropriations enacted in P.L. 117-43, P.L. 117-58, and P.L. 117-70. 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 bill. (CRS) with questions on specific agencies and programs funded in the LHHS bill.
Scope of the LHHS Bill
The LHHS bill is the largest ($1.2 trillion in FY2021) of the 12 annual appropriations bills when The LHHS bill is the largest ($1.2 trillion in FY2021) of the 12 annual appropriations bills when
accounting for both mandatory and discretionary funding.2 It provides annually appropriated accounting for both mandatory and discretionary funding.2 It provides annually appropriated
budget authority for the following federal departments and agencies: budget authority for the following federal departments and agencies:
 the Department of Labor (DOL);  the Department of Labor (DOL);
 most agencies at the Department of Health and Human Services (HHS), except  most agencies at the Department of Health and Human Services (HHS), except
for the Food and Drug Administration (funded through the Agriculture for the Food and Drug Administration (funded through the Agriculture
appropriations bill), the Indian Health Service (funded through the Interior-appropriations bill), the Indian Health Service (funded through the Interior-
Environment appropriations bill), and the Agency for Toxic Substances and Environment appropriations bill), and the Agency for Toxic Substances and
Disease Registry (funded through the Interior-Environment appropriations bill); Disease Registry (funded through the Interior-Environment appropriations bill);
 the Department of Education (ED); and  the Department of Education (ED); and
 more than a dozen related agencies ( more than a dozen related agencies (~~RAs~~RA), including the Social Security ), including the Social Security
Administration (SSA), the Corporation for National and Community Service, the Administration (SSA), the Corporation for National and Community Service, the
~~Corporation for Public Broadcasting, the Institute of Museum and Library~~
~~Services, the National Labor Relations Board, and the Railroad Retirement~~
~~Board.~~
~~In general, mandatory funding represents just over 80% of the total LHHS bill, supporting~~
~~annually appropriated entitlements such as Medicaid and Supplemental Security Income (SSI).~~

1 Senate Appropriations Committee majority staff, “Chairman Leahy Releases Remaining Nine Senate Appropriations 1 Senate Appropriations Committee majority staff, “Chairman Leahy Releases Remaining Nine Senate Appropriations
Bills,” October 18, 2021, https://www.appropriations.senate.gov/news/majority/chairman-leahy-releases-remaining-Bills,” October 18, 2021, https://www.appropriations.senate.gov/news/majority/chairman-leahy-releases-remaining-
nine-senate-appropriations-bills. See also “Shelby: Democrats’ Partisan Bills Threaten FY22 Appropriations Process,” nine-senate-appropriations-bills. See also “Shelby: Democrats’ Partisan Bills Threaten FY22 Appropriations Process,”
October 18, 2021, https://www.appropriations.senate.gov/news/shelby-democrats-partisan-bills-threaten-fy22-October 18, 2021, https://www.appropriations.senate.gov/news/shelby-democrats-partisan-bills-threaten-fy22-
appropriations-process. appropriations-process.
2 See CRS Report R46859, 2 See CRS Report R46859, Labor, Health and Human Services, and Education: FY2021 Appropriations. The . The
discretionary funding provided in the LHHS appropriations act is both provided and controlled by that act. The discretionary funding provided in the LHHS appropriations act is both provided and controlled by that act. The
mandatory funding provided in the LHHS act is controlled by provisions in authorizing law. For definitions of these mandatory funding provided in the LHHS act is controlled by provisions in authorizing law. For definitions of these
and other budget terms, see U.S. Government Accountability Office (GAO), A Glossary of Terms Used in the Federal and other budget terms, see U.S. Government Accountability Office (GAO), A Glossary of Terms Used in the Federal
Budget Process, GAO-05-734SP, September 1, 2005, http://www.gao.gov/products/GAO-05-734SP. (Terms of interest Budget Process, GAO-05-734SP, September 1, 2005, http://www.gao.gov/products/GAO-05-734SP. (Terms of interest
may include budget authority, appropriated entitlement, direct spending, discretionary, entitlement authority, and may include budget authority, appropriated entitlement, direct spending, discretionary, entitlement authority, and
mandatory.) mandatory.)
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Status of FY2022 LHHS Appropriations: In Brief

Corporation for Public Broadcasting, the Institute of Museum and Library Services, the National Labor Relations Board, and the Railroad Retirement Board. In general, mandatory funding represents just over 80% of the total LHHS bill, supporting annually appropriated entitlements such as Medicaid and Supplemental Security Income (SSI). Discretionary funds, which account for less than 20% of total funds in the bill, tend to be the Discretionary funds, which account for less than 20% of total funds in the bill, tend to be the
focus of congressional debate during the appropriations process.3 This is because the focus of congressional debate during the appropriations process.3 This is because the
appropriations process generally has little control over the amount of mandatory funding provided appropriations process generally has little control over the amount of mandatory funding provided
for appropriated entitlements; rather, the authorizing statute controls the program parameters for appropriated entitlements; rather, the authorizing statute controls the program parameters
(e.g., eligibility rules, benefit levels) that entitle certain recipients to payments. Consequently, the (e.g., eligibility rules, benefit levels) that entitle certain recipients to payments. Consequently, the
focus of this report generally is on the discretionary spending that has been or would be provided focus of this report generally is on the discretionary spending that has been or would be provided
for LHHS programs and activities under various laws and proposals. for LHHS programs and activities under various laws and proposals.
Even though discretionary appropriations represent a relatively small share of the entire LHHS Even though discretionary appropriations represent a relatively small share of the entire LHHS
bill, the bill is typically the largest single source of nondefense discretionary funding for the bill, the bill is typically the largest single source of nondefense discretionary funding for the
federal government. (The Department of Defense bill is the largest single source of discretionary federal government. (The Department of Defense bill is the largest single source of discretionary
funding overall.) funding overall.)
Calculating Total LHHS Budget Authority
Budget authority is the amount of money a federal agency is legally authorized to commit or spend. Appropriations is the amount of money a federal agency is legally authorized to commit or spend. Appropriations
bil s may include budget authority that becomes available in the current fiscal year, in future fiscal years, or some bil s may include budget authority that becomes available in the current fiscal year, in future fiscal years, or some
combination. Amounts that become available in future fiscal years are typically referred to as combination. Amounts that become available in future fiscal years are typically referred to as advance
appropriations. .
The amount of LHHS budget authority can be tabulated in various ways. The total amount of budget authority The amount of LHHS budget authority can be tabulated in various ways. The total amount of budget authority
provided in an appropriations bil (i.e., provided in an appropriations bil (i.e., total in the bill) would be calculated regardless of the year in which the ) would be calculated regardless of the year in which the
funding becomes available.4 In some cases, however, such as the 302(b) suballocations (discussed later), the total is funding becomes available.4 In some cases, however, such as the 302(b) suballocations (discussed later), the total is
calculated based on calculated based on current-year appropriations (i.e., the amount of appropriations (i.e., the amount of budget authority available for obligation in a given
fiscal year), which is calculated regardless of the year in which it was first appropriated.5 Additionally, budgetary , which is calculated regardless of the year in which it was first appropriated.5 Additionally, budgetary
totals may or may not include Congressional Budget Office (CBO) scorekeeping and other adjustments to reflect totals may or may not include Congressional Budget Office (CBO) scorekeeping and other adjustments to reflect
budget enforcement conventions and special instructions of Congress.6budget enforcement conventions and special instructions of Congress.6
Context for FY2022
Under the congressional budget process, congressional consideration of annual appropriations Under the congressional budget process, congressional consideration of annual appropriations
traditionally is preceded by the submission of the President’s budget request and the adoption of traditionally is preceded by the submission of the President’s budget request and the adoption of
the congressional budget resolution. However, the FY2022 cycle has been affected by a number the congressional budget resolution. However, the FY2022 cycle has been affected by a number
of timing and budgetary issues related to the ongoing COVID-19 pandemic, the presidential of timing and budgetary issues related to the ongoing COVID-19 pandemic, the presidential
transition, and a lack of statutory discretionary spending limits for the first time in a decade. transition, and a lack of statutory discretionary spending limits for the first time in a decade.
Background related to these issues is provided below. Background related to these issues is provided below.

3 For an illustrative discussion of the distribution of funds among the different titles of the bill, and between 3 For an illustrative discussion of the distribution of funds among the different titles of the bill, and between
discretionary and mandatory spending, see the summary of FY2021 LHHS appropriations in CRS Report R46859, discretionary and mandatory spending, see the summary of FY2021 LHHS appropriations in CRS Report R46859,
Labor, Health and Human Services, and Education: FY2021 Appropriations, pp. 12-14. pp. 12-14.
4 Such figures include advance appropriations provided in the bill for future fiscal years, but do not include advance 4 Such figures include advance appropriations provided in the bill for future fiscal years, but do not include advance
appropriations provided in prior years’ appropriations bills that become available in the current year. appropriations provided in prior years’ appropriations bills that become available in the current year.
5 Such figures exclude advance appropriations for future years, but include advance appropriations from prior years that 5 Such figures exclude advance appropriations for future years, but include advance appropriations from prior years that
become available in the given fiscal year. become available in the given fiscal year.
6 For more information on scorekeeping, see CRS Report 98-560, 6 For more information on scorekeeping, see CRS Report 98-560, Baselines and Scorekeeping in the Federal Budget
Process. See also a discussion of key scorekeeping guidelines included in the joint explanatory statement . See also a discussion of key scorekeeping guidelines included in the joint explanatory statement
accompanying the conference report to the Balanced Budget Act of 1997 (H.Rept. 105-217, pp. 1007-1014). accompanying the conference report to the Balanced Budget Act of 1997 (H.Rept. 105-217, pp. 1007-1014).
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COVID-19 Pandemic Supplemental Appropriations for FY2020 and
FY2021
Subsequent to the enactment of annual FY2020 LHHS appropriations and the submission of the Subsequent to the enactment of annual FY2020 LHHS appropriations and the submission of the
President’s FY2021 budget, the effects of the COVID-19 pandemic on communities across the President’s FY2021 budget, the effects of the COVID-19 pandemic on communities across the
world and throughout the United States elicited a legislative response from Congress and the world and throughout the United States elicited a legislative response from Congress and the
President. In the first months of the pandemic, four FY2020 supplemental appropriations were President. In the first months of the pandemic, four FY2020 supplemental appropriations were
part of this legislative response:7 part of this legislative response:7
 Title III, Division A, of the Coronavirus Preparedness and Response  Title III, Division A, of the Coronavirus Preparedness and Response
Supplemental Appropriations Act, 2020 (P.L. 116-123), enacted on March 6, Supplemental Appropriations Act, 2020 (P.L. 116-123), enacted on March 6,
2020, provided approximately $6.4 billion in supplemental LHHS funds8; 2020, provided approximately $6.4 billion in supplemental LHHS funds8;
 Title V, Division A, of the Families First Coronavirus Response Act (FFCRA,  Title V, Division A, of the Families First Coronavirus Response Act (FFCRA,
P.L. 116-127), enacted on March 18, 2020, provided $1.25 billion in P.L. 116-127), enacted on March 18, 2020, provided $1.25 billion in
supplemental LHHS funds; supplemental LHHS funds;
 Title VIII, Division B, of the Coronavirus Aid, Relief, and Economic Security  Title VIII, Division B, of the Coronavirus Aid, Relief, and Economic Security
Act (CARES Act, P.L. 116-136), enacted on March 27, 2020, provided $172.1 Act (CARES Act, P.L. 116-136), enacted on March 27, 2020, provided $172.1
billion in supplemental LHHS funds; and billion in supplemental LHHS funds; and
 Title I, Division B, of the Paycheck Protection Program and Health Care  Title I, Division B, of the Paycheck Protection Program and Health Care
Enhancement Act (PPPHCEA, P.L. 116-139), enacted on April 24, 2020, Enhancement Act (PPPHCEA, P.L. 116-139), enacted on April 24, 2020,
provided $100 billion in supplemental LHHS funds. provided $100 billion in supplemental LHHS funds.
In total, FY2020 supplemental appropriations increased regular FY2020 LHHS enacted funding In total, FY2020 supplemental appropriations increased regular FY2020 LHHS enacted funding
by about 143%. The bulk of the supplemental funding (89%) was directed at HHS. Supplemental by about 143%. The bulk of the supplemental funding (89%) was directed at HHS. Supplemental
HHS funds totaled $248 billion and represented a 261% increase over the agency’s FY2020 HHS funds totaled $248 billion and represented a 261% increase over the agency’s FY2020
regular appropriations funding level. ED received the next largest increase via supplemental regular appropriations funding level. ED received the next largest increase via supplemental
funds (43%), whereas the DOL and funds (43%), whereas the DOL and ~~RAs titles~~RA received the smallest increases relative to their received the smallest increases relative to their
initial FY2020 enacted levels (5% and 3%, respectively). initial FY2020 enacted levels (5% and 3%, respectively).
All of these additional funds were designated as an All of these additional funds were designated as an emergency requirement and thus were and thus were
effectively exempted from otherwise applicable budget enforcement requirements, such as the effectively exempted from otherwise applicable budget enforcement requirements, such as the
discretionary spending limits.9 (See discretionary spending limits.9 (See “FY2022 Discretionary Spending Levels and Appropriations
Allocations” for a further explanation of this issue.) for a further explanation of this issue.)
While annual appropriations for FY2021 were under discussion during the summer and fall of 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 response 2020, Congress and President Trump considered whether any additional COVID-19 response
funding should be enacted.10 Ultimately, the same law (P.L. 116-260) that provided regular annual funding should be enacted.10 Ultimately, the same law (P.L. 116-260) that provided regular annual

7 Other divisions of the acts that provided supplemental LHHS appropriations contained authorization provisions that in 7 Other divisions of the acts that provided supplemental LHHS appropriations contained authorization provisions that in
some cases relate to LHHS programs and activities—for instance, provisions providing a 6.2% increase to the federal some cases relate to LHHS programs and activities—for instance, provisions providing a 6.2% increase to the federal
matching assistance percentage for Medicaid and certain other programs in FFCRA, and provisions modifying student matching assistance percentage for Medicaid and certain other programs in FFCRA, and provisions modifying student
loan subsidy costs in the CARES Act. For further information on the LHHS appropriations provided by these COVID-loan subsidy costs in the CARES Act. For further information on the LHHS appropriations provided by these COVID-
19 supplementals, see CRS Report R46353, 19 supplementals, see CRS Report R46353, COVID-19: Overview of FY2020 LHHS Supplemental Appropriations. .
8 Of the amount shown for P.L. 116-123, $300 million (appropriated to the Public Health and Social Services 8 Of the amount shown for P.L. 116-123, $300 million (appropriated to the Public Health and Social Services
Emergency Fund at HHS) was contingent upon future HHS actions. Emergency Fund at HHS) was contingent upon future HHS actions.
9 For further information, see CRS Report R45778, 9 For further information, see CRS Report R45778, Exceptions to the Budget Control Act’s Discretionary Spending
Limits. .
10 Prior to the enactment of full-year FY2021 LHHS funding, COVID-19-related LHHS provisions were proposed in 10 Prior to the enactment of full-year FY2021 LHHS funding, COVID-19-related LHHS provisions were proposed in
several different appropriations measures for FY2021, including the House-passed full-year LHHS bill (Division E, several different appropriations measures for FY2021, including the House-passed full-year LHHS bill (Division E,
H.R. 7617), a supplemental appropriations package (Division A, H.R. 925), and the FY2021 continuing resolution H.R. 7617), a supplemental appropriations package (Division A, H.R. 925), and the FY2021 continuing resolution
(Division A, P.L. 116-159). While in some cases the budgetary effects of the COVID-19-related provisions were (Division A, P.L. 116-159). While in some cases the budgetary effects of the COVID-19-related provisions were
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LHHS appropriations for FY2021 in Division H also provided FY2021 supplemental LHHS appropriations for FY2021 in Division H also provided FY2021 supplemental
discretionary appropriations in Division M. This law, which was enacted on December 27, 2020, discretionary appropriations in Division M. This law, which was enacted on December 27, 2020,
provided a total of $154.9 billion in supplemental LHHS funds, all of which were designated as provided a total of $154.9 billion in supplemental LHHS funds, all of which were designated as
an emergency requirement (Title III, Division M). This funding was split roughly equally an emergency requirement (Title III, Division M). This funding was split roughly equally
between HHS (48%) and ED (53%). (None was enacted for DOL or between HHS (48%) and ED (53%). (None was enacted for DOL or ~~RAs~~RA.) The ED supplemental .) The ED supplemental
funding budgetary increase of $82 billion was 112% of its FY2021 regular appropriations. HHS funding budgetary increase of $82 billion was 112% of its FY2021 regular appropriations. HHS
regular appropriations were increased by 75% (+$73 billion).11 regular appropriations were increased by 75% (+$73 billion).11
The FY2020 and FY2021 supplemental funding was in many cases provided to LHHS accounts The FY2020 and FY2021 supplemental funding was in many cases provided to LHHS accounts
and activities that also received annual appropriations. Although this funding was generally for and activities that also received annual appropriations. Although this funding was generally for
COVID-19-related response efforts, some of these efforts could include expanding basic COVID-19-related response efforts, some of these efforts could include expanding basic
infrastructure and capacity that would otherwise have been unfunded (or funded through annual infrastructure and capacity that would otherwise have been unfunded (or funded through annual
appropriations had the supplemental funding not been available). As FY2022 LHHS appropriations had the supplemental funding not been available). As FY2022 LHHS
appropriations are being considered, Congress and President Biden appropriations are being considered, Congress and President Biden ~~will need to~~may consider the consider the
extent to which any further funding supporting COVID-19 pandemic response will be enacted as extent to which any further funding supporting COVID-19 pandemic response will be enacted as
regular appropriations subject to the spending limits, or as an emergency requirement. They also regular appropriations subject to the spending limits, or as an emergency requirement. They also
will need to decide whether any program investments or expansions funded via previously will need to decide whether any program investments or expansions funded via previously
enacted COVID-19 supplemental appropriations should be sustained. enacted COVID-19 supplemental appropriations should be sustained.
As of the cover date of this report, the three measures that have been enacted containing emergency-designated funding for FY2022 (totaling about $5 billion) have generally been unrelated to COVID-19 pandemic response. (See “FY2022 Emergency-Designated Appropriations” for a summary of these.) Timing of the FY2022 President’s Budget Submission
The President’s budget request for the upcoming fiscal year is due to be submitted to Congress by The President’s budget request for the upcoming fiscal year is due to be submitted to Congress by
the first Monday in February. However, the FY2022 budget was submitted during a year in which the first Monday in February. However, the FY2022 budget was submitted during a year in which
a presidential transition occurred (on January 20, 2021). Recent Presidents have not submitted a presidential transition occurred (on January 20, 2021). Recent Presidents have not submitted
detailed budget proposals until April or May of their first year in office, although each has detailed budget proposals until April or May of their first year in office, although each has
advised Congress regarding the general contours of their economic and budgetary policies in advised Congress regarding the general contours of their economic and budgetary policies in
special messages submitted to Congress prior to that submission.12 This delay allows time to special messages submitted to Congress prior to that submission.12 This delay allows time to
prepare a proposal that reflects the priorities of the new prepare a proposal that reflects the priorities of the new ~~administration~~Administration. .
On April 9, President Biden submitted to Congress an outline of his discretionary funding On April 9, President Biden submitted to Congress an outline of his discretionary funding
priorities for FY2022.13 This preliminary document provided early highlights for numerous policy priorities for FY2022.13 This preliminary document provided early highlights for numerous policy
areas, including several funded in the LHHS bill. The full budget request was submitted on May areas, including several funded in the LHHS bill. The full budget request was submitted on May
28, almost four months after its due date.14 As a result, the start of annual appropriations 28, almost four months after its due date.14 As a result, the start of annual appropriations
decisionmaking for FY2022 also was delayed to allow time for Congress to consider this request. decisionmaking for FY2022 also was delayed to allow time for Congress to consider this request.
~~FY2022 Discretionary Spending Levels and Appropriations~~
~~Allocations~~
~~For the decade prior to FY2022, the framework for discretionary spending budget enforcement~~
~~under the congressional budget process involved both statutory and procedural elements. Those~~
~~statutory elements included limits on defense and nondefense discretionary spending established~~
~~by the Budget Control Act of 2011 (BCA; P.L. 112-25). LHHS appropriations are classified as~~

designated as an emergency requirement, this was not the case universally. designated as an emergency requirement, this was not the case universally.
11 For further information, see CRS Report R46775, 11 For further information, see CRS Report R46775, Overview of COVID-19 LHHS Supplemental Appropriations:
FY2020 and FY2021. .
12 See CRS Insight IN11655, 12 See CRS Insight IN11655, Budget Submission After a Presidential Transition: Contextualizing the Biden
Administration’s FY2022 Request. .
13 Office of Management and Budget (OMB), 13 Office of Management and Budget (OMB), The President’s FY2022 Discretionary Request, April 9, 2021, , April 9, 2021,
https://www.whitehouse.gov/omb/fy-2022-discretionary-request/. https://www.whitehouse.gov/omb/fy-2022-discretionary-request/.
14 See https://www.whitehouse.gov/omb/budget/. 14 See https://www.whitehouse.gov/omb/budget/.
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Status of FY2022 LHHS Appropriations: In Brief

FY2022 Discretionary Spending Levels and Appropriations Allocations For the decade prior to FY2022, the framework for discretionary spending budget enforcement under the congressional budget process involved both statutory and procedural elements. Those statutory elements included limits on defense and nondefense discretionary spending established by the Budget Control Act of 2011 (BCA; P.L. 112-25). LHHS appropriations are classified as nondefense spending, and the bill has the largest share of such spending compared to the other nondefense spending, and the bill has the largest share of such spending compared to the other
annual appropriations bills. annual appropriations bills.
The procedural elements of budget enforcement are primarily associated with the budget The procedural elements of budget enforcement are primarily associated with the budget
resolution. This provides a limit on total discretionary spending available to the appropriations resolution. This provides a limit on total discretionary spending available to the appropriations
committees (commonly referred to as a committees (commonly referred to as a 302(a) allocation) and allows the appropriations ) and allows the appropriations
committees to create limits on spending under the jurisdiction of each appropriations committees to create limits on spending under the jurisdiction of each appropriations
subcommittee (subcommittee (302(b) suballocations). Certain spending is effectively exempt from these limits ). Certain spending is effectively exempt from these limits
(commonly referred to as(commonly referred to as adjustments to those limits). In recent years, adjustments that have been to those limits). In recent years, adjustments that have been
applied to LHHS appropriations are for applied to LHHS appropriations are for emergency requirements, to accommodate new budget , to accommodate new budget
authority for specified program integrity initiatives at HHS (authority for specified program integrity initiatives at HHS (health care fraud and abuse control) )
and the SSA (and the SSA (continuing disability reviews and redeterminations), and for DOL to fund ), and for DOL to fund
reemployment services and eligibility assessments conducted by the states related to conducted by the states related to
unemployment compensation.15 unemployment compensation.15
The statutory limits on discretionary spending expired at the end of FY2021. This generally The statutory limits on discretionary spending expired at the end of FY2021. This generally
means that, absent the imposition of new statutory limits, discretionary budget enforcement for means that, absent the imposition of new statutory limits, discretionary budget enforcement for
FY2022 will occur via procedural means only. As the FY2022 appropriations cycle progresses, FY2022 will occur via procedural means only. As the FY2022 appropriations cycle progresses,
however, Congress may consider whether to however, Congress may consider whether to ~~re-impose~~reimpose statutory caps, and if so, at what levels statutory caps, and if so, at what levels
and for what number of fiscal years. Absent statutory caps, the amount of FY2022 discretionary and for what number of fiscal years. Absent statutory caps, the amount of FY2022 discretionary
spending—in total and for LHHS—will still need to be determined. In addition, Congress will spending—in total and for LHHS—will still need to be determined. In addition, Congress will
need to determine to what degree any discretionary spending for FY2022 will be effectively need to determine to what degree any discretionary spending for FY2022 will be effectively
exempt from budget enforcement, whether statutory or procedural. exempt from budget enforcement, whether statutory or procedural.
A FY2022 budget resolution has been agreed to by the House and the Senate. S.Con.Res. 14 was A FY2022 budget resolution has been agreed to by the House and the Senate. S.Con.Res. 14 was
adopted by the Senate on August 11, 2021, and by the House (without amendment) on August 24. adopted by the Senate on August 11, 2021, and by the House (without amendment) on August 24.
To provide for 302(a) allocations associated with S.Con.Res. 14, Section 4006 of the budget To provide for 302(a) allocations associated with S.Con.Res. 14, Section 4006 of the budget
resolution provided the Chair of the Senate Budget Committee the authority to enter into the resolution provided the Chair of the Senate Budget Committee the authority to enter into the
Congressional Record allocations consistent with the levels in the budget resolution. Those levels allocations consistent with the levels in the budget resolution. Those levels
were filed in the Senate on September 23were filed in the Senate on September 23~~, 2021~~.16 Section 4006 provided similar authority to the .16 Section 4006 provided similar authority to the
Chair of the House Budget Committee and those allocations were filed on October 27Chair of the House Budget Committee and those allocations were filed on October 27~~, 2021.17~~.17 In addition, S.Con.Res. 14 allowed adjustments to those allocations for emergency requirements, health care fraud and abuse control, continuing disability reviews and redeterminations, and reemployment services and eligibility assessments (as well as other purposes that do not apply to LHHS). With 15 For further information, see CRS Report R45778, Exceptions to the Budget Control Act’s Discretionary Spending Limits. 16 “Publication of Budgetary Material,” Congressional Record, daily edition, Vol. 167, No. 165 (September 23, 2021), pp. S6667-S6668. 17 Publication of Budgetary Material,” Congressional Record, daily edition, Vol. 167, No. 189 (October 27, 2021), pp. H5956-H5957. Congressional Research Service 5 Status of FY2022 LHHS Appropriations: In Brief the exception of emergency requirements, all of these adjustments are subject to limits specified in S.Con.Res. 14.18
Generally, after the budget resolution has been approved by both chambers, the next step in the Generally, after the budget resolution has been approved by both chambers, the next step in the
appropriations process is for each of the appropriations committees to adopt suballocations from appropriations process is for each of the appropriations committees to adopt suballocations from
the total amount allocated to them. These 302(b) suballocations provide a limit on current-year the total amount allocated to them. These 302(b) suballocations provide a limit on current-year
(in this case, FY2022) appropriations within each subcommittee’s jurisdiction and incorporate (in this case, FY2022) appropriations within each subcommittee’s jurisdiction and incorporate
any applicable scorekeeping adjustments made by CBO. Neither the House nor the Senate has any applicable scorekeeping adjustments made by CBO. Neither the House nor the Senate has
filed 302(b) suballocations pursuant to the FY2022 budget resolution. filed 302(b) suballocations pursuant to the FY2022 budget resolution.
However, earlier this year the House provided for budget enforcement in the absence of a budget However, earlier this year the House provided for budget enforcement in the absence of a budget
resolution prior to initial floor consideration of the FY2022 appropriations measures by adopting resolution prior to initial floor consideration of the FY2022 appropriations measures by adopting
a deeming resolution, H.Res. 467 on June 14, 2021.a deeming resolution, H.Res. 467 on June 14, 2021.1819 This resolution provided for 302(a) This resolution provided for 302(a)
allocations to the House Appropriations Committee at a specified level, provided limits on allocations to the House Appropriations Committee at a specified level, provided limits on

~~15 For further information, see CRS Report R45778,~~ ~~Exceptions to the Budget Control Act’s Discretionary Spending~~
~~Limits~~.
~~16 “Publication of Budgetary Material,” Congressional Record, daily edition, Vol. 167, No. 165 (September 23, 2021),~~
~~pp. S6667-S6668.~~
~~17 Publication of Budgetary Material,” Congressional Record, daily edition, Vol. 167, No. 189 (October 27, 2021), pp.~~
~~H5956-H5957.~~
18advance appropriations,20 and allowed adjustments to those allocations for emergency requirements, health care fraud and abuse control, and continuing disability reviews and redeterminations (as well as other purposes that do not apply to LHHS).21 Pursuant to this resolution, the Chair of the House Budget Committee, Representative Yarmuth, published in the Congressional Record the House Appropriations Committee allocations on June 24.22 The House Appropriations Committee reported their initial 302(b) suballocations for all 12 subcommittees on July 1 (H.Rept. 117-78).23 The discretionary budget authority suballocation for LHHS of $237.466 billion represents a 36% (+$63.4 billion) increase relative to FY2021. That amount does not include funding subject to adjustments, such as for emergency requirements. FY2022 LHHS Legislative Action As described below, congressional action has occurred on full-year appropriations for LHHS. Congress has not, however, reached agreement on full-year LHHS appropriations. 18 In addition, Section 4011 of S.Con.Res. 14 provided that the BCA cap adjustments (Section 251(b) of the Balanced Budget and Emergency Deficit Control Act) would not apply to allocations established pursuant to that resolution. Although the FY2022 adjustment for reemployment services and eligibility assessments pursuant to Section 314(g) of the Congressional Budget Act (CBA) continues to be in effect, the limit on that adjustment in the CBA is the same as that provided by S.Con.Res. 14 ($133 million in additional new budget authority). 19 For a discussion of budget enforcement through methods such as H.Res. 467, see CRS Report R44296, For a discussion of budget enforcement through methods such as H.Res. 467, see CRS Report R44296, Deeming
Resolutions: Budget Enforcement in the Absence of a Budget Resolution. .
~~Congressional Research Service~~

5

~~Status of FY2022 LHHS Appropriations: In Brief~~

~~advance appropriations,19 and allowed adjustments to those allocations for emergency~~
~~requirements, health care fraud and abuse control, and continuing disability reviews and~~
~~redeterminations (as well as other purposes that do not apply to LHHS).20 Pursuant to this~~
~~resolution, the Chair of the House Budget Committee, Representative Yarmuth, published in the~~
Congressional Record the House Appropriations Committee allocations on June 24.21 The House
~~Appropriations Committee reported their initial 302(b) suballocations for all 12 subcommittees~~
~~on July 1 (H.Rept. 117-78).22 The discretionary budget authority suballocation for LHHS of~~
~~$237.466 billion represents a 36% (+$63.4 billion) increase relative to FY2021. That amount does~~
~~not include funding subject to adjustments, such as for emergency requirements.~~
~~FY2022 LHHS Legislative Action~~
~~FY2022 Continuing Appropriations~~
~~FY2022 LHHS appropriations are currently being provided by a continuing resolution (CR)~~
20 Advance appropriations become available for obligation one or more fiscal years after the budget year covered by the appropriations act. The FY2022 LHHS appropriations bill generally would contain advance appropriations for FY2023 and FY2024 for certain programs and activities. For further information, see CRS Report R43482, Advance Appropriations, Forward Funding, and Advance Funding: Concepts, Practice, and Budget Process Considerations. 21 H.Res. 467 further provided that the BCA cap adjustments (Section 251(b) of the Balanced Budget and Emergency Deficit Control Act) would not apply to allocations established pursuant to that resolution. However, the adjustment for reemployment services and eligibility assessments would continue to be in effect for FY2022 through FY2027 pursuant to Section 314(g) of the Congressional Budget Act, subject to specified limits. 22 “Publication of Budgetary Material,” Congressional Record, daily edition, Vol. 167, No. 110 (June 24, 2021), p. H3130. 23 Suballocations are commonly adjusted through the appropriations cycle to account for changing priorities. For FY2022, the House Appropriations Committee reported revised suballocations on July 16 (H.Rept. 117-91) to incorporate the cap adjustments where applicable, but otherwise the suballocation for the LHHS subcommittee was the same as originally reported. Congressional Research Service 6 Status of FY2022 LHHS Appropriations: In Brief FY2022 Continuing Appropriations FY2022 LHHS appropriations are currently being provided by a series of continuing resolutions (CRs). The first CR was signed into law on September 30, 2021 (Division A of H.R. 5305; P.L. (Division A of H.R. 5305; P.L. 117-43). The ~~117-43). This CR was signed into law on September 30, 2021. The~~
measure had previously been introduced by the House Appropriations Committee chair, measure had previously been introduced by the House Appropriations Committee chair,
Representative DeLauro, on September 21, and was passed by the House that same day, 220-Representative DeLauro, on September 21, and was passed by the House that same day, 220-
211. On September 30, the Senate took up and passed the measure with an amendment, 65-211. On September 30, the Senate took up and passed the measure with an amendment, 65-35,24 ~~35,23~~
which was subsequently agreed to by the House, 254-175. which was subsequently agreed to by the House, 254-175.
The The first CR provided~~CR provides~~ continuing appropriations for all 12 annual appropriations acts (including continuing appropriations for all 12 annual appropriations acts (including
LHHS) through December 3, 2021. In general, the CR LHHS) through December 3, 2021. In general, the CR ~~funds~~funded discretionary programs at the same discretionary programs at the same
rate and under the same conditions as in FY2020 (§101) and annually appropriated entitlements at rate and under the same conditions as in FY2020 (§101) and annually appropriated entitlements at
their current law levels (§111).their current law levels (§111).2425 It also It also ~~includes~~included several anomalies that are specific to LHHS several anomalies that are specific to LHHS
accounts or related activities (§§138-149). accounts or related activities (§§138-149).
~~Congressional Action on FY2022 Full-Year Appropriations~~
~~The House completed initial floor consideration of FY2022 LHHS appropriations on July 29,~~
~~2021, with the passage (219-208) of H.R. 4502. Those LHHS appropriations were packaged for~~

~~19 Advance appropriations become available for obligation one or more fiscal years after the budget year covered by~~
~~the appropriations act. The FY2022 LHHS appropriations bill generally would contain advance appropriations for~~
~~FY2023 and FY2024 for certain programs and activities. For further information, see CRS Report R43482,~~ ~~Advance~~
~~Appropriations, Forward Funding, and Advance Funding: Concepts, Practice, and Budget Process Considerations~~.
~~20 H.Res. 467 further provided that the BCA cap adjustments (Section 251(b) of the Balanced Budget and Emergency~~
~~Deficit Control Act) would not apply to allocations established pursuant to that resolution. However, the adjustment for~~
~~reemployment services and eligibility assessments would continue to be in effect for FY2022 through FY2027 pursuant~~
~~to Section 314(g) of the Congressional Budget Act, subject to specified limits.~~
~~21 “Publication of Budgetary Material,” Congressional Record, daily edition, Vol. 167, No. 110 (June 24, 2021), p.~~
~~H3130.~~
~~22 Suballocations are commonly adjusted through the appropriations cycle to account for changing priorities. For~~
~~FY2022, the House Appropriations Committee reported revised suballocations on July 16 (H.Rept. 117-91) to~~
~~incorporate the cap adjustments where applicable, but otherwise the suballocation for the LHHS subcommittee was the~~
~~same as originally reported.~~
~~23 No substantive changes were made by the Senate amendment to the CR provisions in Division A of H.R. 5305.~~
24A second CR was enacted extending the provisions of the first CR with some additional anomalies (for LHHS, see Section 162) through February 18, 2022 (Division A of H.R. 6119; P.L. 117-70, December 3, 2021). The measure had previously been introduced by Representative DeLauro on December 2, and passed the House (221-212) and Senate (69-28) that same day. FY2022 Emergency-Designated Appropriations Although full-year regular annual appropriations have yet to be enacted, three bills have been signed into law providing LHHS emergency-designated appropriations for FY2022:  Divisions A and C of the Extending Government Funding and Delivering Emergency Assistance Act (H.R. 5305; P.L. 117-43, September 30, 2021), $4.2 billion, as follows:26  Division A, which contained the first CR for FY2022, provided an additional $2.5 billion in emergency-designated spending (§141) for the HHS Administration for Children and Families (ACF) for support shelter and services for unaccompanied minors referred to HHS, including funding to expand the capacity of state-licensed shelters;  Division C, which contained the Afghanistan Supplemental Appropriations Act, 2022, provided $1.7 billion to ACF for resettlement and other support services for Afghan arrivals and refugees, and $21.5 million to the HHS Centers for Disease Control and Prevention (CDC) for medical support, screening, and related public health activities for Afghan arrivals and refugees;  Division J of the Infrastructure Investment and Jobs Act (H.R. 3684; P.L. 117-58, November 15, 2021), provided $100 million in FY2022 for the HHS Low 24 No substantive changes were made by the Senate amendment to the CR provisions in Division A of H.R. 5305. 25 For an estimate of the discretionary appropriations contained in Division A of H.R. 5305, see Table 1-H and 1-S in For an estimate of the discretionary appropriations contained in Division A of H.R. 5305, see Table 1-H and 1-S in
CBO Estimate for H.R. 5305, the Extending Government Funding and Delivering Emergency Assistance Act as Passed CBO Estimate for H.R. 5305, the Extending Government Funding and Delivering Emergency Assistance Act as Passed
by the House of Representatives on September 21, 2021, https://www.cbo.gov/system/files/2021-09/57491-CBO-by the House of Representatives on September 21, 2021, https://www.cbo.gov/system/files/2021-09/57491-CBO-
Estimate-for-HR5305Estimate-for-HR5305.pdf. 26 See the summary of these provisions from House Appropriations Committee majority staff, H.R. 5305, Extending Government Funding and Delivering Emergency Assistance Act: Section-by-Section Summary, https://appropriations.house.gov/sites/democrats.appropriations.house.gov/files/documents/Summary_0.pdf. Congressional Research Service 7~~.pdf.~~
~~Congressional Research Service~~

6

~~Status of FY2022 LHHS Appropriations: In Brief~~

Status of FY2022 LHHS Appropriations: In Brief Income Home Energy Assistance Program,27 and rescinded $353 million in previously enacted emergency funding from the Education Stabilization Fund; and  Division B of the Further Extending Government Funding Act (H.R. 6119; P.L. 117-70, December 3, 2021), which contained the Additional Afghanistan Supplemental Appropriations Act, 2022:28 $8 million to the CDC for medical support, screening, and related public health activities for Afghan arrivals and refugees, and $1.3 billion to ACF for resettlement and other support services for Afghan arrivals and refugees. Congressional Action on FY2022 Full-Year Appropriations The House completed initial floor consideration of FY2022 LHHS appropriations on July 29, 2021, with the passage (219-208) of H.R. 4502. Those LHHS appropriations were packaged for the purposes of floor consideration with six other appropriations acts, with LHHS appropriations the purposes of floor consideration with six other appropriations acts, with LHHS appropriations
being in Division A of H.R. 4502.being in Division A of H.R. 4502.2529 Floor action was regulated by the terms of a special rule Floor action was regulated by the terms of a special rule
(H.Res. 555). A total of 56 amendments to the LHHS title of the bill were made in order for (H.Res. 555). A total of 56 amendments to the LHHS title of the bill were made in order for
consideration on the floor.consideration on the floor.2630 This rule also provided the authority for the chair of the This rule also provided the authority for the chair of the
Appropriations Committee or her designee to offer any of the amendments made in order en bloc 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).(i.e., in groups of amendments to be disposed of together).2731 All but two LHHS amendments were All but two LHHS amendments were
considered in this manner.considered in this manner.2832 When counted as 56 separate amendments, 47 were adopted and 9 When counted as 56 separate amendments, 47 were adopted and 9
were rejected. were rejected.
Previously, on July 15, 2021, the House Appropriations Committee voted (33-25) to report the Previously, on July 15, 2021, the House Appropriations Committee voted (33-25) to report the
LHHS bill; the measure was subsequently reported to the House on July 19 (H.R. 4502; H.Rept. LHHS bill; the measure was subsequently reported to the House on July 19 (H.R. 4502; H.Rept.
117-96). The measure was approved in subcommittee, via a voice vote, on July 12, 2021. 117-96). The measure was approved in subcommittee, via a voice vote, on July 12, 2021.
While the Senate Appropriations Committee has not yet voted to report the legislation, the While the Senate Appropriations Committee has not yet voted to report the legislation, the
committee chair, Senator Leahy, released a majority draft of the LHHS bill and accompanying committee chair, Senator Leahy, released a majority draft of the LHHS bill and accompanying
draft report language on October 18, 2021.draft report language on October 18, 2021.2933 According to the chair, the purpose of this release is 27 Division J of P.L. 117-58 further provided to the Low Income Home Energy Assistance Program advance appropriations of $100 million for each of FY2023 through FY2026, for a total of $500 million for the program with all fiscal years taken into account. 28 See the summary of these provisions from the House Appropriations Committee majority staff, H.R. 6119, Further Extending Government Funding Act Section-by-Section Summary. 29 ~~According to the chair, the purpose of this release is~~
~~to further negotiations toward enacting all 12 annual appropriations bills prior to when the CR~~
~~expires on December 3.30~~
~~FY2022 LHHS Estimated Discretionary Funding Levels~~
~~Table 1~~ ~~displays the CBO estimate of enacted LHHS discretionary appropriations for FY2021,~~
~~the House committee-reported FY2022 discretionary appropriations for LHHS, and those in the~~
~~Senate majority draft proposal. The amount shown for “regular discretionary appropriations” does~~
~~not include any funding that is subject to program integrity adjustments or emergency~~
~~designations. The amount shown represents current-year budget authority subject to the spending~~
~~limits and takes into account any applicable CBO scorekeeping adjustments. Under this method~~
~~of estimating the bill, the House Committee proposal would increase regular discretionary~~
~~appropriations for LHHS relative to FY2021 by 36% (+$63.4 billion), while the Senate majority~~
~~draft proposal would increase those appropriations by 27% (+46.7 billion).31~~

25 Those appropriations acts were Agriculture and Rural Development, Energy and Water Development, Financial Those appropriations acts were Agriculture and Rural Development, Energy and Water Development, Financial
Services and General Government, Interior and Environment, Military Construction and Veterans Affairs, and Services and General Government, Interior and Environment, Military Construction and Veterans Affairs, and
Transportation and Housing and Urban Development. Transportation and Housing and Urban Development.
2630 For a list of these LHHS amendments (numbered 1-56) and the text of each that was made in order, see pages 8-13 For a list of these LHHS amendments (numbered 1-56) and the text of each that was made in order, see pages 8-13
and 30-38 of H.Rept. 117-109. and 30-38 of H.Rept. 117-109.
2731 For further information about en bloc authority in the context of House floor consideration of appropriations For further information about en bloc authority in the context of House floor consideration of appropriations
measures, see CRS Report R46841, measures, see CRS Report R46841, Changes in the House of Representatives’ Initial Consideration of Regular
Appropriations Measures, 113th-116th Congresses. .
2832 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. 1, 2, 3, and 4 in bloc nos. 1, 2, 3, and 4 in Congressional Record, daily edition, Vol. 167, No. 131 (July 27, 2021), pp. H4055-H4073. , daily edition, Vol. 167, No. 131 (July 27, 2021), pp. H4055-H4073.
2933 On October 25, Senator Patty Murray, Chair of the Senate Appropriations LHHS Subcommittee, introduced an On October 25, Senator Patty Murray, Chair of the Senate Appropriations LHHS Subcommittee, introduced an
FY2022 LHHS bill (S. 3062). This bill was referred to the Senate Appropriations Committee. Because S. 3062 has not FY2022 LHHS bill (S. 3062). This bill was referred to the Senate Appropriations Committee. Because S. 3062 has not
received any congressional action, this report does not discuss this measure. received any congressional action, this report does not discuss this measure.
30Congressional Research Service 8 link to page 13 link to page 8 link to page 8 Status of FY2022 LHHS Appropriations: In Brief to further negotiations toward enacting all 12 annual appropriations bills prior to when the CR expires on December 3.34 FY2022 LHHS Estimated Discretionary Funding Levels Table 1 displays the CBO estimate of enacted LHHS discretionary appropriations for FY2021, the House committee-reported FY2022 discretionary appropriations for LHHS, and those in the Senate majority draft proposal. The amount shown for “regular discretionary appropriations” does not include any funding that is subject to program integrity adjustments or emergency designations. The amount shown represents current-year budget authority subject to the spending limits and takes into account any applicable CBO scorekeeping adjustments. Under this method of estimating the bill, the House Committee proposal would increase regular discretionary appropriations for LHHS relative to FY2021 by 36% (+$63.4 billion), while the Senate majority draft proposal would increase those appropriations by 27% (+46.7 billion).35 As mentioned previously, certain LHHS appropriations, such as those allowed for program integrity funding or designated for emergency requirements, are effectively exempt from the discretionary spending limits. As was the case for FY2021, the FY2022 House Committee and Senate majority draft proposals would provide the maximum amount allowed for program integrity spending under relevant procedures (see discussion in “FY2022 Discretionary Spending Levels and Appropriations Allocations”). With regard to new FY2022 funding for emergency requirements, no such emergency-designated funding has been proposed by the House Committee or the Senate majority draft. (Three bills have been enacted into law that provide emergency-designated funding; the sum of these is listed in table note b to Table 1.) The “adjusted appropriations” total in the table includes the additional program integrity funds along with “regular discretionary appropriations.” 34 The text of the Senate majority draft LHHS bill and accompanying committee report is linked to the press release, The text of the Senate majority draft LHHS bill and accompanying committee report is linked to the press release,
“Chairman Leahy Releases Remaining Nine Senate Appropriations Bills,” October 18, 2021, “Chairman Leahy Releases Remaining Nine Senate Appropriations Bills,” October 18, 2021,
https://www.appropriations.senate.gov/news/majority/chairman-leahy-releases-remaining-nine-senate-appropriations-https://www.appropriations.senate.gov/news/majority/chairman-leahy-releases-remaining-nine-senate-appropriations-
bills. See also “Shelby: Democrats’ Partisan Bills Threaten FY22 Appropriations Process,” October 18, 2021, bills. See also “Shelby: Democrats’ Partisan Bills Threaten FY22 Appropriations Process,” October 18, 2021,
https://www.appropriations.senate.gov/news/shelby-democrats-partisan-bills-threaten-fy22-appropriations-process. https://www.appropriations.senate.gov/news/shelby-democrats-partisan-bills-threaten-fy22-appropriations-process.
3135 This CRS estimate is based on a comparison of the CBO estimate for FY2021 enacted (CBO, This CRS estimate is based on a comparison of the CBO estimate for FY2021 enacted (CBO, Report on the Status of
Discretionary Appropriations, Fiscal Year 2021, House of Representatives, as of July 30, 2021, https://www.cbo.gov/https://www.cbo.gov/
system/files?file=2021-09/FY2021-House.pdf) to the total amount of spending listed on page 1 of the Senate majority system/files?file=2021-09/FY2021-House.pdf) to the total amount of spending listed on page 1 of the Senate majority
~~Congressional Research Service~~

7

~~link to page 7 link to page 7 link to page 11 link to page 11~~ ~~Status of FY2022 LHHS Appropriations: In Brief~~

~~As mentioned previously, certain LHHS appropriations, such as those allowed for program~~
~~integrity funding or designated for emergency requirements, are effectively exempt from the~~
~~discretionary spending limits. As was the case for FY2021, the FY2022 House Committee and~~
~~Senate majority draft proposals would provide the maximum amount allowed for program~~
~~integrity spending under relevant procedures (see discussion in~~ ~~“FY2022 Discretionary Spending~~
~~Levels and Appropriations Allocations”). With regard to new FY2022 funding for emergency~~
~~requirements, no such emergency-designated funding has been proposed by the House Committee~~
~~or the Senate majority draft. The “adjusted appropriations” total in the table includes these~~
~~additional funds along with “regular discretionary appropriations.”~~draft LHHS committee report (posted at https://www.appropriations.senate.gov/news/majority/chairman-leahy-releases-remaining-nine-senate-appropriations-bills). The Senate majority draft LHHS committee report estimates the proposed increase over FY2021 as follows, “The subcommittee’s effective allocation, which includes discretionary funding offset by savings in changes in mandatory programs, is $48,948,000,000 more than the comparable fiscal year 2021 level” (p. 1). Congressional Research Service 9 link to page 13 link to page 13 Status of FY2022 LHHS Appropriations: In Brief
Table 1. LHHS Discretionary Appropriations: Comparison of FY2021 Enacted with
FY2022 House Appropriations Committee and Senate Majority Draft Proposals
(Budget authority in billions of dollars) (Budget authority in billions of dollars)

FY2022 House
FY2022 Senate
FY2021
Committee Bill
Majority Draft
Enacted
(H.R. 4502)
Bill
Regular discretionary Regular discretionary
~~appropriations~~
174.073 174.073
237.466 237.466
220.757 220.757
appropriations AdjustmenAdjustments:a

Health care fraud and Health care fraud and ~~abuse~~
~~control~~
0.496 0.496
0.556 0.556
0.556 0.556
~~Continuing disability reviews~~
~~and redeterminations~~abuse control Continuing disability
1.302 1.302
1.435 1.435
1.435 1.435
~~Reemployment services and~~
~~eligibility assessments~~reviews and redeterminations Reemployment services
0.083 0.083
0.133 0.133
0.133 0.133
~~Emergency requirementsb~~and eligibility assessments Emergency
156.588 156.588
— —
— —
requirementsb Adjusted appropriations Adjusted appropriations
332.542 332.542
239.590 239.590
222.881 222.881
Source: The FY2021 enacted amounts are from CBO, Report on the Status of Discretionary Appropriations, The FY2021 enacted amounts are from CBO, Report on the Status of Discretionary Appropriations,
Fiscal Year 2021, House of Representatives, as of July 30, 2021, https://www.cbo.gov/system/files?file=2021-09/Fiscal Year 2021, House of Representatives, as of July 30, 2021, https://www.cbo.gov/system/files?file=2021-09/
FY2021-House.pdf and CRS analysis of Division H of P.L. 116-260. The FY2022 House amounts are from page 3 FY2021-House.pdf and CRS analysis of Division H of P.L. 116-260. The FY2022 House amounts are from page 3
of H.Rept. 117-96, and CRS analysis of H.R. 4502, as reported. FY2022 Senate amounts are from page 1 of the of H.Rept. 117-96, and CRS analysis of H.R. 4502, as reported. FY2022 Senate amounts are from page 1 of the
Senate majority draft LHHS committee report and CRS analysis of the Senate majority draft LHHS bil posted at Senate majority draft LHHS committee report and CRS analysis of the Senate majority draft LHHS bil posted at
https://www.appropriations.senate.gov/news/majority/chairman-leahy-releases-remaining-nine-senate-https://www.appropriations.senate.gov/news/majority/chairman-leahy-releases-remaining-nine-senate-
appropriations-bil s. “Regular discretionary appropriations” exclude funds for which special rules apply under the appropriations-bil s. “Regular discretionary appropriations” exclude funds for which special rules apply under the
spending limits (e.g., funds for certain program integrity activities and emergency requirements), as well as funds spending limits (e.g., funds for certain program integrity activities and emergency requirements), as well as funds
provided under authorities in the 21st Century Cures Act (P.L. 114-255) that are effectively exempt from the provided under authorities in the 21st Century Cures Act (P.L. 114-255) that are effectively exempt from the
spending limits. spending limits.
Notes: Amounts reflect current-year discretionary budget authority subject to spending limits. Amounts reflect current-year discretionary budget authority subject to spending limits.
a. CBO presents the FY2021 enacted amounts provided for health care fraud and abuse control, continuing a. CBO presents the FY2021 enacted amounts provided for health care fraud and abuse control, continuing
disability reviews and redeterminations, and reemployment services and eligibility assessments as an disability reviews and redeterminations, and reemployment services and eligibility assessments as an
aggregated “program integrity” total of $1.881 bil ion. The FY2021 enacted amounts for these activities are aggregated “program integrity” total of $1.881 bil ion. The FY2021 enacted amounts for these activities are
identified via CRS analysis of Division H of P.L. 116-260. identified via CRS analysis of Division H of P.L. 116-260.
b. b. ~~A total of $4.211 bil ion in FY2022~~ This table does not include $5.228 bil ion in emergency-designated emergency-designated ~~supplemental LHHS~~ FY2022 LHHS annual appropriations appropriations ~~were enacted~~
inthat have been enacted in three measures: Divisions A and C of P.L. 117-43, Division J of P.L. 117-58, and Division B of P.L. 117-70. Total funding enacted in each of these measures was calculated based on an analysis of the statutory text, and estimated budgetary effects in CBO, Estimate for H.R. 5305, the Extending Government Funding and Delivering Emergency Assistance Act as Passed by the House of Representatives on September 21, 2021, https://www.cbo.gov/system/files/2021-09/57491-CBO-Estimate-for-HR5305.pdf; CBO, Senate Amendment 2137 to H.R. 3684, the Infrastructure Investment and Jobs Act, as Proposed on August 1, 2021, Estimated Discretionary Spending Under Division J, Appropriations, https://www.cbo.gov/system/files/2021-08/hr3684_infrastructure.pdf; and CBO, Estimate for H.R. 6119, the Further Extending Government Funding Act, as Posted on the Rules Committee Website on December 2, 2021, https://www.cbo.gov/system/files/2021-12/hr6119.pdf. Congressional Research Service 10 Status of FY2022 LHHS Appropriations: In Brief ~~Divisions A and C of P.L. 117-43. These are not reflected in this table or the FY2022 amounts discussed~~

~~draft LHHS committee report (posted at https://www.appropriations.senate.gov/news/majority/chairman-leahy-~~
~~releases-remaining-nine-senate-appropriations-bills). The Senate majority draft LHHS committee report estimates the~~
~~proposed increase over FY2021 as follows, “The subcommittee’s effective allocation, which includes discretionary~~
~~funding offset by savings in changes in mandatory programs, is $48,948,000,000 more than the comparable fiscal year~~
~~2021 level” (p.1).~~
~~Congressional Research Service~~

8

~~Status of FY2022 LHHS Appropriations: In Brief~~

~~c. in this report. (See pages 374-375 of the Senate majority draft LHHS committee report posted at~~
~~https://www.appropriations.senate.gov/news/majority/chairman-leahy-releases-remaining-nine-senate-~~
~~appropriations-bil s.)~~

Author Information

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

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