Status of FY2022 Labor, Health and Human
JanuaryApril 20, 2022 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 the
of Labor, Health and Human Services, and Education, and Related Agencies (LHHS) as of the
Specialist in Social Policy
Specialist in Social Policy
cover date of this report. It also provides background on the scope of the LHHS bill generally and
cover date of this report. It also provides background on the scope of the LHHS bill generally and
the budgetary context for congressional decisionmaking, including the submission of the FY2022
the 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 series of continuing resolutions (CRs) that provide temporary fundingFull-year FY2022 appropriations for LHHS were enacted on March 15, 2022, when the Consolidated Appropriations Act, 2022 (FY2022 omnibus; H.R. 2471; P.L. 117-103) was signed into law by the President. Prior to its enactment, the final version of the measure was approved by the House on March 9. (The vote to approve the portion that contained LHHS appropriations was 260-171.) It was approved by the Senate (68-31) on March 10.
Previously, FY2022 LHHS appropriations were temporarily provided by a series of continuing resolutions (CRs). The first CR (Division A of H.R. 5305; P.L. 117-43) extended funding through December 3, 2021. The . The first CR (Division A of H.R. 5305; P.L. 117-43) 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.second CR (Division A of H.R. 6119; P.L. 117-70), extended funding through February 18, 2022.
The third CR (Division A of H.R. 6617; P.L. 117-86) extended funding through March 11, 2022. The fourth CR (H.J.Res. 75; P.L. 117-95) extended funding through March 15, 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 19Committee voted (33-25) to report the LHHS bill; the measure was subsequently reported to the House on July 19
, 2021 (H.R. (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 1July 1
, 2021 (H.Rept. 117-78). (H.Rept. 117-78).
While the Senate Appropriations Committee
While the Senate Appropriations Committee
has not yet voteddid not vote to report to report
the legislationits version of the legislation prior to the enactment of FY2022 full-year appropriations, the committee chair, Senator Leahy, , 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 enactedIn addition, three bills have been signed into law providing LHHS , three bills have been signed into law providing LHHS
emergency-designated appropriations for FY2022: emergency-designated appropriations for FY2022:
Divisions A and C of the Extending Government Funding and Delivering Emergency Assistance Act (H.R.
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
5305; P.L. 117-43, September 30, 2021), provided a total of $4.2 billion for HHS
spending related to shelter and related to shelter and
support services for unaccompanied minors (Division A), and public health and support services for support services for unaccompanied minors (Division A), and public health and support services for
Afghan arrivals and refugees (Division C); 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),
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
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; rescinded $353 million in previously enacted emergency funding from the Education Stabilization Fund;
and and
Division B of the Further Extending Government Funding Act (H.R. 6119; P.L. 117-70, December 3,
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
2021), provided a total of $1.3 billion for public health and support services for Afghan arrivals and
refugees (Division B). refugees (Division B).
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Status of FY2022 LHHS Appropriations: In Brief
Contents
Scope of the LHHS Bill ................................................................................................................... 1
Context for FY2022 ......................................................................................................................... 2
COVID-19 Pandemic Supplemental Appropriations for FY2020 and FY2021 ........................ 32
Timing of the FY2022 President’s Budget Submission ............................................................ 4
FY2022 Discretionary Spending Levels and Appropriations Allocations ................................ 5
FY2022 LHHS Legislative Action .................................................................................................. 6
FY2022 Consolidated Appropriations Act ................................................................................ 6 FY2022 Continuing Appropriations .......................................................................................... 7
FY2022 Emergency-Designated Appropriations ...................................................................... 7
8 Prior Congressional Action on FY2022 Full-Year Appropriations .................................................... 8
8 FY2021 and FY2022 LHHS Estimated Discretionary Funding Levels ......................................................... 9
Tables
Table 1. LHHS Discretionary Appropriations: Comparison of FY2021FY2022 Enacted with
FY2022 House Appropriations Committee andBill, FY2022 Senate Majority Draft Proposals Bill, and FY2021 Enacted .................................................................................................................. 10
Contacts
Author Information ......................................................................................................................... 11
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Status of FY2022 LHHS Appropriations: In Brief
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 series of continuing resolutions (CRs)
that provide temporary funding. The first CR (Division A of H.R. 5305; P.L. 117-43) 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 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 draft of the LHHS bill and accompanying draft report language on October 18, 2021.1
ull year FY2022 appropriations for LHHS were enacted on March 15, 2022, when the Consolidated Appropriations Act, 2022 (FY2022 omnibus; H.R. 2471, P.L. 117-103) was
F signed into law by the President. Previously, FY2022 LHHS appropriations had been
temporarily provided by a series of continuing resolutions (P.L. 117-43, P.L. 117-70, P.L. 117-86, and P.L. 117-95). 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 FY2021enacted in FY2021
and FY2022, versus relevant FY2022 legislative , versus relevant FY2022 legislative
proposalsproposals as of the cover date of this report. It also provides background on the scope of the bill and the context for congressional . It also provides background on the scope of the bill and the context for congressional
decisionmaking. In addition, it summarizes the FY2022 LHHS emergency-designated 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. appropriations enacted in P.L. 117-43, P.L. 117-58, and P.L. 117-70.
For a more detailed analysis of the FY2022 LHHS bill, see CRS Report R47029, Labor, Health and Human Services, and Education: FY2022 Appropriations.
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.The LHHS bill is the largest ($1.
23 trillion in trillion in
FY20212022) of the 12 annual appropriations bills when ) of the 12 annual appropriations bills when
accounting for both mandatory and discretionary funding.accounting for both mandatory and discretionary funding.
21 It provides annually appropriated 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 (RA), including the Social Security more than a dozen related agencies (RA), including the Social Security
Administration (SSA), the Corporation for National and Community Service, the
Administration (SSA), the Corporation for National and Community Service, the
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-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-appropriations-process.
2 See CRS Report R46859, Labor, Health and Human Services, and Education: FY2021 Appropriations. 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). 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.2 This is because the appropriations process generally has little control over the amount of mandatory funding provided 1 See the FY2022 Joint Explanatory Statement for LHHS in Congressional Record, daily edition, vol. 168, no. 42, book iv (March 9, 2022), p. H2915. 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.)
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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 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 mandatory.)
2 For an illustrative discussion of the distribution of funds among the different titles of the bill, and between discretionary and mandatory spending, see the summary of FY2021 LHHS appropriations in CRS Report R46859, Labor, Health and Human Services, and Education: FY2021 Appropriations, pp. 12-14.
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Status of FY2022 LHHS Appropriations: In Brief
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.funding becomes available.
43 In some cases, however, such as the 302(b) suballocations (discussed later), the total is 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., which is calculated regardless of the year in which it was first appropriated.
54 Additionally, budgetary 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.budget enforcement conventions and special instructions of Congress.
65
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 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.
4
COVID-19 Pandemic Supplemental Appropriations for FY2020 and FY2021 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 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 part of this legislative response:6
3 Such figures include advance appropriations provided in the bill for future fiscal years, but do not include advance 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
4 Such figures exclude advance appropriations for future years, but include advance appropriations from prior years that 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.
65 For more information on scorekeeping, see CRS Report 98-560, 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 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 President. In the first months of the pandemic, four FY2020 supplemental appropriations were part of this legislative response:76 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
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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 2020, provided approximately $6.4 billion in supplemental LHHS
funds8funds7; ;
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 RA received the smallest increases relative to their initial funds (43%), whereas the DOL and RA received the smallest increases relative to their initial
FY2020 enacted levels (5% and 3%, respectively). 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.discretionary spending limits.
98 (See (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.funding should be enacted.
109 Ultimately, the same law (P.L. 116-260) that provided regular annual 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 some cases relate to LHHS programs and activities—for instance, provisions providing a 6.2% increase to the federal 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, 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 between HHS (48%) and ED (53%). (None was enacted for DOL or RA.) The ED supplemental funding budgetary increase of $82 billion was 112% of its FY2021 regular appropriations. HHS regular appropriations were increased by 75% (+$73 billion).10
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. .
87 Of the amount shown for P.L. 116-123, $300 million (appropriated to the Public Health and Social Services 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.
98 For further information, see CRS Report R45778, For further information, see CRS Report R45778,
Exceptions to the Budget Control Act’s Discretionary Spending
Limits. .
109 Prior to the enactment of full-year FY2021 LHHS funding, COVID-19-related LHHS provisions were proposed in 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 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 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 RA.) The ED supplemental funding budgetary increase of $82 billion was 112% of its FY2021 regular appropriations. HHS regular appropriations were increased by 75% (+$73 billion).11
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 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 appropriations had the supplemental funding not been available). As FY2022 LHHS appropriations are being considered, Congress and President Biden may consider the 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 will need to decide whether any program investments or expansions funded via previously 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 designated as an emergency requirement, this was not the case universally.
10 For further information, see CRS Report R46775, Overview of COVID-19 LHHS Supplemental Appropriations: FY2020 and FY2021.
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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 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 appropriations had the supplemental funding not been available).
Congress has debated whether additional emergency-designated funds are needed to address the COVID-19 pandemic or for other purposes. For instance, in March 2022 the White House submitted a request for supplemental funds related to COVID-19 and for other purposes.11 While the FY2022 omnibus was originally intended to carry additional supplemental LHHS appropriations related to COVID-19 in Division M, this division was ultimately omitted from the bill prior to floor consideration.12 In addition, emergency-designated LHHS funding for FY2022 (totaling about $5 billion) funding for FY2022 (totaling about $5 billion)
have generally been has been provided for purposes that are generally unrelated to COVID-19 pandemic response. (See unrelated to COVID-19 pandemic response. (See
“FY2022 Emergency-Designated
Appropriations” for a summary of these.) 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.special messages submitted to Congress prior to that submission.
1213 This delay This delay
allowsallowed time to time to
prepare a proposal that reflects the priorities of the new Administration. prepare a proposal that reflects the priorities of the new Administration.
On April 9,
On April 9,
2021, President Biden submitted to Congress an outline of his discretionary funding President Biden submitted to Congress an outline of his discretionary funding
priorities for FY2022.priorities for FY2022.
1314 This preliminary document provided early highlights for numerous policy 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.28, almost four months after its due date.
1415 As a result, the start of annual appropriations 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.
designated as an emergency requirement, this was not the case universally.
11 For further information, see CRS Report R46775, Overview of COVID-19 LHHS Supplemental Appropriations:
FY2020 and FY2021.
12 Later in the fiscal year, in March 2022, the President submitted a supplemental budget request for emergency-designated funds to provide assistance to Ukraine and for “near-term prevention and response activities to address SARS-CoV-2, its future variants, and the COVID-19 disease.”16
11 Letter from Shalanda D. Young, Acting Director of the Office of Management and Budget, to the Honorable Nancy Pelosi, Speaker of the House of Representatives, March 2, 2022, https://www.whitehouse.gov/wp-content/uploads/2022/03/COVID-and-Ukraine-Supplemental-Funding-Request-Pelosi.pdf. (Identical letters were sent to other recipients.)
12 For a summary of the funding that would have been contained in Division M, see the Senate Appropriations Committee majority, Summary of Emergency Supplemental Funding to Continue Efforts to Combat COVID, March 9, 2022, https://www.appropriations.senate.gov/imo/media/doc/COVID%20Supp%20Summary.pdf.
13 See CRS Insight IN11655, See CRS Insight IN11655,
Budget Submission After a Presidential Transition: Contextualizing the Biden
Administration’s FY2022 Request. .
1314 Office of Management and Budget (OMB), 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/.
1415 See https://www.whitehouse.gov/omb/budget/. 16 Letter from Shalanda D. Young, Acting Director of the Office of Management and Budget, to the Honorable Nancy Pelosi, Speaker of the House of Representatives, March 2, 2022, https://www.whitehouse.gov/wp-content/uploads/2022/03/COVID-and-Ukraine-Supplemental-Funding-Request-Pelosi.pdf. (Identical letters were sent to other recipients.) 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 For the decade prior to FY2022, the framework for discretionary spending budget enforcement
under the congressional budget process involved both statutory and procedural elements. Those under the congressional budget process involved both statutory and procedural elements. Those
statutory elements included limits on defense and nondefense discretionary spending established statutory elements included limits on defense and nondefense discretionary spending established
by the Budget Control Act of 2011 (BCA; P.L. 112-25). LHHS appropriations are classified as by the Budget Control Act of 2011 (BCA; P.L. 112-25). LHHS appropriations are classified as
nondefense spending, and the 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 statutory limits on discretionary spending expired at the end of FY2021, and therefore did not restrict FY2022 appropriations. As a result, discretionary budget enforcement for FY2022 occurred via procedural means only.
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.unemployment compensation.
15
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 FY2022 will occur via procedural means only. As the FY2022 appropriations cycle progresses, however, Congress may consider whether to reimpose statutory caps, and if so, at what levels 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 need to determine to what degree any discretionary spending for FY2022 will be effectively exempt from budget enforcement, whether statutory or procedural. 17
A FY2022 budget resolution
A FY2022 budget resolution
has beenwas agreed to by the House and the Senate. S.Con.Res. 14 was 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 23.were filed in the Senate on September 23.
1618 Section 4006 provided similar authority to the Chair Section 4006 provided similar authority to the Chair
of the House Budget Committee and those allocations were filed on October 27.of the House Budget Committee and those allocations were filed on October 27.
1719 In addition, In addition,
S.Con.Res. 14 allowed adjustments to those allocations for emergency requirements, health care 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 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 services and eligibility assessments (as well as other purposes that do not apply to LHHS). With
the exception of emergency requirements, all of these adjustments are subject to limits specified in S.Con.Res. 14.20
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
1517 For further information, see CRS Report R45778, For further information, see CRS Report R45778,
Exceptions to the Budget Control Act’s Discretionary Spending
Limits. .
1618 “Publication of Budgetary Material,” “Publication of Budgetary Material,”
Congressional Record, daily edition, Vol. 167, No. 165 (September 23, 2021), , daily edition, Vol. 167, No. 165 (September 23, 2021),
pp. S6667-S6668. pp. S6667-S6668.
1719 Publication of Budgetary Material,” Publication of Budgetary Material,”
Congressional Record, daily edition, Vol. 167, No. 189 (October 27, 2021), pp. , daily edition, Vol. 167, No. 189 (October 27, 2021), pp.
H5956-H5957. H5956-H5957.
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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 appropriations process is for each of the appropriations committees to adopt suballocations from 20 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).
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Status of FY2022 LHHS Appropriations: In Brief
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
However, earlier
this yearin 2021, the House provided for budget enforcement in the absence of a budget 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.
1921 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
advance appropriations,advance appropriations,
2022 and allowed adjustments to those allocations for emergency and allowed adjustments to those allocations for emergency
requirements, health care fraud and abuse control, and continuing disability reviews and requirements, health care fraud and abuse control, and continuing disability reviews and
redeterminations (as well as other purposes that do not apply to LHHS).redeterminations (as well as other purposes that do not apply to LHHS).
2123 Pursuant to this Pursuant to this
resolution, the Chair of the House Budget Committee, Representative Yarmuth, published in the resolution, the Chair of the House Budget Committee, Representative Yarmuth, published in the
Congressional Record the House Appropriations Committee allocations on June 24. the House Appropriations Committee allocations on June 24.
2224 The House The House
Appropriations Committee reported their initial 302(b) suballocations for all 12 subcommittees Appropriations Committee reported their initial 302(b) suballocations for all 12 subcommittees
on July 1 (H.Rept. 117-78).on July 1 (H.Rept. 117-78).
2325 The discretionary budget authority suballocation for LHHS of The discretionary budget authority suballocation for LHHS of
$237.466 billion $237.466 billion
representsrepresented a 36% (+$63.4 billion) increase relative to FY2021. That amount a 36% (+$63.4 billion) increase relative to FY2021. That amount
doesdid not include funding subject to adjustments, such as for emergency requirements. not include funding subject to adjustments, such as for emergency requirements.
FY2022 LHHS Legislative Action
As described below, congressional 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).
19occurred on short-term appropriations in continuing resolutions (CRs) and supplemental appropriations prior to the enactment of full-year FY2022 appropriations for LHHS on March 15, 2022. The legislative history of those full-year appropriations also is summarized.
FY2022 Consolidated Appropriations Act On March 15, 2022, the Consolidated Appropriations Act, 2022 (FY2022 omnibus; H.R. 2471) was signed into law by the President (P.L. 117-103). The FY2022 omnibus provided full-year appropriations for all 12 annual appropriations acts in Divisions A-L.26 (Full-year LHHS appropriations were enacted in Division H.) Prior to its enactment, the final version of the
21 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. .
2022 Advance appropriations become available for obligation one or more fiscal years after the budget year covered by become available for obligation one or more fiscal years after the budget year covered by
the appropriations actthe appropriations act
. The FY2022 LHHS appropriations The FY2022 LHHS appropriations
billact generally generally
would containcontains advance appropriations for advance appropriations for
FY2023 and FY2024 for certain programs and activities. For further information, see CRS Report R43482, FY2023 and FY2024 for certain programs and activities. For further information, see CRS Report R43482,
Advance
Appropriations, Forward Funding, and Advance Funding: Concepts, Practice, and Budget Process Considerations. .
2123 H.Res. 467 further provided that the BCA cap adjustments (Section 251(b) of the Balanced Budget and Emergency H.Res. 467 further provided that the BCA cap adjustments (Section 251(b) of the Balanced Budget and Emergency
Deficit Control Act) would not apply to allocations established pursuant to that resolution. However, the adjustment for Deficit Control Act) would not apply to allocations established pursuant to that resolution. However, the adjustment for
reemployment services and eligibility assessments reemployment services and eligibility assessments
wouldwill continue to be in effect for FY2022 through FY2027 pursuant continue to be in effect for FY2022 through FY2027 pursuant
to Section 314(g) of the Congressional Budget Act, subject to specified limits. to Section 314(g) of the Congressional Budget Act, subject to specified limits.
2224 “Publication of Budgetary Material,” “Publication of Budgetary Material,”
Congressional Record, daily edition, Vol. 167, No. 110 (June 24, 2021), p. , daily edition, Vol. 167, No. 110 (June 24, 2021), p.
H3130. H3130.
2325 Suballocations are commonly adjusted through the appropriations cycle to account for changing priorities. For Suballocations are commonly adjusted through the appropriations cycle to account for changing priorities. For
FY2022, the House Appropriations Committee reported revised suballocations on July 16 (H.Rept. 117-91) to FY2022, the House Appropriations Committee reported revised suballocations on July 16 (H.Rept. 117-91) to
incorporate the cap adjustments where applicable, but otherwise the suballocation for the LHHS subcommittee was the incorporate the cap adjustments where applicable, but otherwise the suballocation for the LHHS subcommittee was the
same as originally reported. same as originally reported.
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Status of FY2022 LHHS Appropriations: In Brief
FY2022 Continuing Appropriations
FY2022 LHHS appropriations are currently being provided by a series of continuing resolutions (CRs)26 The FY2022 omnibus was originally intended to carry additional supplemental appropriations related to the COVID-19 pandemic in Division M, but Division M was omitted prior to floor consideration.
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measure was approved by the House on March 9. (The vote to approve the portion that contained LHHS appropriations was 260-171.)27 The bill was approved by the Senate (68-31) on March 10. The FY2022 LHHS appropriations provided in the FY2022 omnibus are summarized in “FY2021 and FY2022 LHHS Discretionary Funding Levels.”
FY2022 Continuing Appropriations Between the start of FY2022 and the enactment of full-year annual appropriations, FY2022 LHHS appropriations were provided by a series of CRs. The first CR was signed into law on September 30, 2021 (Division A of H.R. 5305; P.L. . The first CR was signed into law on September 30, 2021 (Division A of H.R. 5305; P.L.
117-43). The measure had previously been introduced by the House Appropriations Committee 117-43). The measure had previously been introduced by the House Appropriations Committee
chair, Representative DeLauro, on September 21, and was passed by the House that same day, chair, Representative DeLauro, on September 21, and was passed by the House that same day,
220-211. On September 30, the Senate took up and passed the measure with an amendment, 65-220-211. On September 30, the Senate took up and passed the measure with an amendment, 65-
35,2435,28 which was subsequently agreed to by the House, 254-175. which was subsequently agreed to by the House, 254-175.
The first CR provided continuing appropriations for all 12 annual appropriations acts (including
The first CR provided continuing appropriations for all 12 annual appropriations acts (including
LHHS) through December 3, 2021. In general, the CR funded discretionary programs at the same LHHS) through December 3, 2021. In general, the CR funded 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).
2529 It also included several anomalies that are specific to LHHS It also included several anomalies that are specific to LHHS
accounts or related activities (§§138-149). accounts or related activities (§§138-149).
AThe second CR was enacted extending the provisions of the first CR with some additional 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. 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 117-70, December 3, 2021). The measure had previously been introduced by Representative
DeLauro on December 2, and passed the House (221-212) and DeLauro on December 2, and passed the House (221-212) and
the Senate (69-28) that same day.
The third CR was enacted extending the provisions on the second CR with some additional anomalies (none of which were LHHS-related) through March 11, 2022 (Division A of H.R. 6617; P.L. 117-86, February 18, 2022). The measure had previously been introduced by Representative DeLauro on February 7. It passed the House (272-182) on February 8 and the Senate (65-27) on February 17.
The fourth CR was enacted extending the provisions of the third CR with some additional anomalies (not LHHS-related) through March 15, 2022 (H.J.Res. 75; P.L. 117-95, March 11, 2022). The measure had previously been introduced by Representative DeLauro on March 8. It passed the House (voice vote) on March 8 and the Senate (voice vote) on March 10.
27 The special rule, H.Res. 973, provided for the consideration of an amendment consisting of the FY2022 omnibus (as contained in House Rules Committee Print 117-35) to the Senate amendment to H.R. 2471. H.Res. 973 also provided for the House to adopt the amendment in two votes: the first on Divisions B, C, F, X, Z, and Titles 2 and 3 of Division N; and the second on the remaining divisions and titles. The House adopted Divisions B, C, F, X, Z, and Titles 2 and 3 of Division N by a vote of 361-69, and adopted the remaining divisions and titles by a vote of 260-171. The subsequent motion that the House agree to the Senate amendment with an amendment was agreed to by a voice vote.
28 No substantive changes were made by the Senate amendment to the CR provisions in Division A of H.R. 5305. 29Senate (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-HR5305.pdf. Estimate-for-HR5305.pdf.
26 See the summary of these provisions from House Appropriations Committee majority staff, H.R. 5305,Congressional Research Service
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Status of FY2022 LHHS Appropriations: In Brief
FY2022 Emergency-Designated Appropriations Emergency designated appropriations are effectively exempt from otherwise applicable budget enforcement requirements, such as committee allocations, as described above. 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:30
Division A, which contained the first CR for FY2022, provided an
additional $2.5 billion in emergency-designated spending (§141) to the HHS Administration for Children and Families (ACF) for supporting 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 Income Home Energy Assistance Program,31Emergency Assistance Act: Section-by-Section Summary, https://appropriations.house.gov/sites/democrats.appropriations.house.gov/files/documents/Summary_0.pdf.
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Status of FY2022 LHHS Appropriations: In Brief
Income Home Energy Assistance Program,27 and rescinded $353 million in and rescinded $353 million in
previously enacted emergency funding from the Education Stabilization Fund; previously enacted emergency funding from the Education Stabilization Fund;
and and
Division B of the Further Extending Government Funding Act (H.R. 6119; P.L.
Division B of the Further Extending Government Funding Act (H.R. 6119; P.L.
117-70, December 3, 2021), which contained the Additional Afghanistan
117-70, December 3, 2021), which contained the Additional Afghanistan
Supplemental Appropriations Act, 2022:Supplemental Appropriations Act, 2022:
2832 $8 million to the CDC for medical $8 million to the CDC for medical
support, screening, and related public health activities for Afghan arrivals and 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 refugees, and $1.3 billion to ACF for resettlement and other support services for
Afghan arrivals and refugees. Afghan arrivals and refugees.
Prior Congressional Action on FY2022 Full-Year Appropriations
Prior to the start of the fiscal year, the House took action on full-year LHHS appropriations. The The House completed initial floor consideration of FY2022 LHHS appropriations on July 29, 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 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.
2933 Floor action was regulated by the terms of a special rule
30 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.
31 Floor action was regulated by the terms of a special rule (H.Res. 555). A total of 56 amendments to the LHHS title of the bill were made in order for consideration on the floor.30 This rule also provided the authority for the chair of the Appropriations Committee or her designee to offer any of the amendments made in order en bloc (i.e., in groups of amendments to be disposed of together).31 All but two LHHS amendments were considered in this manner.32 When counted as 56 separate amendments, 47 were adopted and 9 were rejected.
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. 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 committee chair, Senator Leahy, released a majority draft of the LHHS bill and accompanying draft report language on October 18, 2021.33 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 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 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. fiscal years taken into account.
2832 See the summary of these provisions from the House Appropriations Committee majority staff, H.R. 6119, Further 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. Extending Government Funding Act Section-by-Section Summary.
2933 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.
30 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.
31 For further information about en bloc authority in the context of House floor consideration of appropriations measures, see CRS Report R46841, Changes in the House of Representatives’ Initial Consideration of Regular
Appropriations Measures, 113th-116th Congresses.
32 For the en bloc amendments proposing changes to the LHHS division of the bill, see consideration of amendments en bloc nos. 1, 2, 3, and 4 in Congressional Record, daily edition, Vol. 167, No. 131 (July 27, 2021), pp. H4055-H4073.
33 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 received any congressional action, this report does not discuss this measure.
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(H.Res. 555). A total of 56 amendments to the LHHS title of the bill were made in order for consideration on the floor.34 This rule also provided the authority for the chair of the Appropriations Committee or her designee to offer any of the amendments made in order en bloc (i.e., in groups of amendments to be disposed of together).35 All but two LHHS amendments were considered in this manner.36 When counted as 56 separate amendments, 47 were adopted and 9 were rejected.
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. 117-96). The measure was approved in subcommittee, via a voice vote, on July 12, 2021.
While the Senate Appropriations Committee did not vote to report its version of the legislation , the committee chair, Senator Leahy, released a majority draft of the LHHS bill and accompanying draft report language on October 18, 2021.37 According to the chair, the purpose of this release was to further negotiations toward enacting all 12 annual appropriations bills prior to when the CR to further negotiations toward enacting all 12 annual appropriations bills prior to when the CR
expires on December 3.expires on December 3.
34
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FY2021 and FY2022 LHHS Estimated Discretionary Funding Levels
Table 1 displays the CBO estimate of enacted LHHS discretionary appropriations for FY2021displays the CBO estimate of enacted LHHS discretionary appropriations for FY2021
, and FY2022, the House committee-reported FY2022 discretionary appropriations for LHHS, and those in the 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 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 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 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 limits and takes into account any applicable CBO scorekeeping adjustments. Under this method
of estimating the bill, the House Committee proposal would of estimating the bill, the House Committee proposal would
increasehave increased regular discretionary regular discretionary
appropriations for LHHS relative to FY2021 by 36% (+$63.4 billion), while the Senate majority appropriations for LHHS relative to FY2021 by 36% (+$63.4 billion), while the Senate majority
draft proposal would draft proposal would
increasehave increased those appropriations by 27% (+46.7 those appropriations by 27% (+46.7
billion).39 Ultimately, the FY2022 enacted amount was an increase in such funding of 13% (+$22.9 billion) relative to FY2021.
Transportation and Housing and Urban Development.
34 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.
35 For further information about en bloc authority in the context of House floor consideration of appropriations measures, see CRS Report R46841, Changes in the House of Representatives’ Initial Consideration of Regular Appropriations Measures, 113th-116th Congresses.
36 For the en bloc amendments proposing changes to the LHHS division of the bill, see consideration of amendments en bloc nos. 1, 2, 3, and 4 in Congressional Record, daily edition, Vol. 167, No. 131 (July 27, 2021), pp. H4055-H4073.
37 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 received any congressional action, this report does not discuss this measure.
38billion).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.
35 This CRS estimate is39 The CRS estimates are based on a comparison of the CBO estimate for FY2021 enacted (CBO, 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 listedsystem/files?file=2021-09/FY2021-House.pdf) to the total amount of spending listed
on, respectively, on page 3 of H.Rept. 117-96 and page 1 of the Senate majority page 1 of the Senate majority
draft LHHS committee report (posted at https://www.appropriations.senate.gov/news/majority/chairman-leahy-draft LHHS committee report (posted at https://www.appropriations.senate.gov/news/majority/chairman-leahy-
releases-remaining-nine-senate-appropriations-releases-remaining-nine-senate-appropriations-
bills). Other estimates may vary depending on source materials and methods used.
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link to page 8 link to page 8 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, FY2022 enacted (and the two proposals) provides 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, $5.2 billion has been enacted. The “adjusted appropriations” total in the table includes the additional program integrity and emergency-designated funds along with “regular discretionary 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).
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link to page 13 link to page 13 Status of FY2022 LHHS Appropriations: In Brief
Table 1. LHHS Discretionary Appropriations: Comparison of FY2021FY2022 Enacted with
FY2022 House Appropriations Committee andBill, FY2022 Senate Majority Draft ProposalsBill,
and FY2021 Enacted
(Budget authority in billions of dollars)
(Budget authority in billions of dollars)
FY2022 House
FY2022 Senate
FY2021
Committee Bill
Majority Draft
FY2022
Enacted
(H.R. 4502)
Bill
Enacted
Regular discretionary Regular discretionary
174.073
174.073
237.466
237.466
220.757
220.757
appropriations
Adjustments:a 196.994
appropriations
Adjustments:
Health care fraud and
Health care fraud and
0.496
0.496
0.556
0.556
0.556
0.556
0.556
abuse control abuse control
Continuing disability
Continuing disability
1.302
1.302
1.435
1.435
1.435
1.435
1.435
reviews and
reviews and
redeterminations redeterminations
Reemployment services
Reemployment services
0.083
0.083
0.133
0.133
0.133
0.133
0.133
and eligibility and eligibility
assessments assessments
Emergency
Emergency
requirements
156.588
156.588
—
—
—
—
requirementsb5.228
Adjusted appropriations
Adjusted appropriations
332.542
332.542
239.590
239.590
222.881
222.881
204.346
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. appropriations-bil s.
The FY2022 enacted amounts are from CBO, Estimate for H.R. 2471, the Consolidated Appropriations Act, 2022, as Cleared by the Congress on March 10, 2022, https://www.cbo.gov/system/files/2022-03/HR2471_As_Cleared_by_the_Congress.pdf, and CRS analysis of Division H of P.L. 117-103. “Regular discretionary appropriations” exclude funds for which special rules apply under the “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. Notes: 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
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 identified via CRS analysis of Division H of P.L. 116-260.
b. This table does not include $5.228 bil ion in emergency-designated FY2022 LHHS annual appropriations that
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. spending limits. Notes: Amounts reflect current-year discretionary budget authority subject to spending limits.
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Status of FY2022 LHHS Appropriations: In Brief
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
Disclaimer
This document was prepared by the Congressional Research Service (CRS). CRS serves as nonpartisan
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