Status of FY2023 Labor, Health and Human
December 16, 2022April 27, 2023
Services, and Education Appropriations:
Jessica Tollestrup
In Brief
Specialist in Social Policy
Specialist in Social Policy
This report provides a brief summary of the status of FY2023 Departments of Labor, Health and
This report provides a brief summary of the status of FY2023 Departments of Labor, Health and
Karen E. Lynch
Human Services, and Education, and Related Agencies (LHHS) appropriations as of the cover
Human Services, and Education, and Related Agencies (LHHS) appropriations as of the cover
Specialist in Social Policy
Specialist in Social Policy
date of this report. It also provides background on the scope of the LHHS bill generally and the
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 FY2023
budgetary context for congressional decisionmaking, including the submission of the FY2023
President’s budget request and budget enforcement in the absence of a budget resolution. President’s budget request and budget enforcement in the absence of a budget resolution.
Congress has not yet reached agreement on full-year regular LHHS appropriations. In the interim, FY2023 funding has been provided temporarily through twoFull-year FY2023 appropriations for LHHS were enacted on December 29, 2022, when the Consolidated Appropriations Act, 2023 (FY2023 omnibus; H.R. 2617; P.L. 117-328) was signed into law by the President. Prior to its enactment, the final version of the measure was approved by the Senate on December 22 (68-29). It was approved by the House on December 23 (225-201).
In the interim, FY2023 LHHS funding had been provided temporarily through three continuing resolutions. The first CR was signed into law on September 30, 2022 (Division continuing resolutions. The first CR was signed into law on September 30, 2022 (Division
A of H.R. 6833; P.L. 117-180), providing continuing appropriations for all 12 annual appropriations acts (including LHHS) A of H.R. 6833; P.L. 117-180), providing continuing appropriations for all 12 annual appropriations acts (including LHHS)
through December 16, 2022. The second CR was signed into law on December 16, 2022 (Division A of H.R. 1437; P.L. 117-through December 16, 2022. The second CR was signed into law on December 16, 2022 (Division A of H.R. 1437; P.L. 117-
229), extending appropriations through December 23, 2022. 229), extending appropriations through December 23, 2022.
In general, the CRs fund discretionary programs at the same rate, and under the same conditions, as in FY2022 and funds annually appropriated entitlements at their current law levels. The CRs include several anomalies that are specific to LHHS accounts or related activities. The third CR was signed into law on December 23, 2022 (Division A of H.R. 4373; P.L. 117-264), extending appropriations through December 30, 2022.
Previously, on June 30 2022, the House Appropriations Committee voted to report
Previously, on June 30 2022, the House Appropriations Committee voted to report
theits FY2023 LHHS bill, 32-24; the FY2023 LHHS bill, 32-24; the
measure was subsequently reported to the House on July 5 (H.R. 8295; H.Rept. 117-403). The committee-reported bill would measure was subsequently reported to the House on July 5 (H.R. 8295; H.Rept. 117-403). The committee-reported bill would
increasehave increased regular discretionary LHHS appropriations by an estimated $12.4 billion (+14%) relative to FY2022. Prior to full regular discretionary LHHS appropriations by an estimated $12.4 billion (+14%) relative to FY2022. Prior to full
committee action, the measure was approved in subcommittee, via a voice vote, on June 23, 2022. The committee reported its committee action, the measure was approved in subcommittee, via a voice vote, on June 23, 2022. The committee reported its
initial suballocations for all 12 bills, including LHHS, on June 24, 2022 (H.Rept. 117-390). initial suballocations for all 12 bills, including LHHS, on June 24, 2022 (H.Rept. 117-390).
While the Senate Appropriations Committee
While the Senate Appropriations Committee
hasdid not not
votedvote to report the legislation, the committee chair, Senator Leahy, to report the legislation, the committee chair, Senator Leahy,
released a majority draft of the LHHS bill and accompanying draft report language on July 28, 2022. The Senate majority released a majority draft of the LHHS bill and accompanying draft report language on July 28, 2022. The Senate majority
draft proposal would draft proposal would
increasehave increased regular discretionary LHHS appropriations by about $19.1 billion (+10%) relative to FY2022. regular discretionary LHHS appropriations by about $19.1 billion (+10%) relative to FY2022.
(Also on July 28, 2022, Senator Patty Murray, Chair of the Senate Appropriations LHHS Subcommittee, introduced an (Also on July 28, 2022, Senator Patty Murray, Chair of the Senate Appropriations LHHS Subcommittee, introduced an
FY2023 LHHS bill [S. 4659] that FY2023 LHHS bill [S. 4659] that
appearsappeared to be substantially the same as the majority draft.) to be substantially the same as the majority draft.)
Although full-year regular annual appropriations have not been enacted, the CR provided $2.8 billion in FY2023 emergency-designated appropriations for accounts typically funded in the LHHS bill (Division A of H.R. 6833; P.L. 117-180).
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link to page 4 link to page 6 link to page 6 link to page 6 link to page 8 link to page 8 link to page 8 link to page 9 link to page 10 link to page 10 link to page 10A handful of proposals have been signed into law providing LHHS emergency-designated appropriations for FY2023:
• Division A of the Continuing Appropriations and Ukraine Supplemental Appropriations Act, 2023 (H.R.
6833; P.L. 117-180, September 30, 2022) provided emergency-designated appropriations for two accounts at the HHS Administration for Children and Families (ACF): $1.0 billion for the Low Income Home Energy Assistance Program (§146) and $1.8 billion for expenses to carry out the Unaccompanied Children Program and for certain refugee and entrant assistance activities (§147).
• Division M of H.R. 2617 (P.L. 117-328), the Additional Ukraine Supplemental Appropriations Act, 2023,
provided $2.4 billion in emergency-designated appropriations for the Refugee and Entrant Assistance Account at ACF.
• Division N of H.R. 2617 (P.L. 117-328), the Disaster Relief Supplemental Appropriations Act, 2023,
provided a total of $4.3 billion in emergency-designated appropriations to several HHS accounts and programs.
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link to page 4 link to page 5 link to page 5 link to page 6 link to page 7 link to page 7 link to page 8 link to page 8 link to page 9 link to page 10 link to page 11 link to page 11 link to page 11 link to page 12 Status of FY2023 Labor, Health and Human Services, and Education Appropriations
Contents
Scope of the LHHS Bill ................................................................................................................... 1
Context for FY2023 ......................................................................................................................... 32
FY2023 President’s Budget Submission ................................................................................... 32
FY2023 Discretionary Spending Levels and Appropriations Allocations ................................ 3
FY2023 LHHS Legislative Action .................................................................................................. 5
FY2023 4
FY2023 Consolidated Appropriations Act ................................................................................ 4 FY2023 Continuing Appropriations .......................................................................................... 5
FY2023 Emergency-Designated Appropriations ...................................................................... 5
Prior Congressional Action on an FY2023 Full-Year LHHS Bill ............................................. 6 FY2022 and FY2023 Discretionary Funding Levels .......................................... 6...................... 7
Tables
Table 1. LHHS Discretionary Appropriations: Comparison of FY2022 Enacted with
and FY2023
Enacted with FY2023 House Appropriations Committee Proposal and FY2023 Senate Majority Draft .......... 7.................................................................................................................... 8
Contacts
Author Information .......................................................................................................................... 79
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Status of FY2023 Labor, Health and Human Services, and Education Appropriations
ongress has not yet reached agreement on fullull-year -year
regularFY2023 appropriations for the appropriations for the
Departments of Labor, Health and Human Services, and Education, and Related Agencies Departments of Labor, Health and Human Services, and Education, and Related Agencies
C (LHHS). In the interim, FY2023 funding has been provided temporarily through two
continuing resolutions. The first CR was signed into law on September 30, 2022 (Division A of H.R. 6833; P.L. 117-180), providing continuing appropriations for all 12 annual appropriations acts (including LHHS) through December 16. The second CR was signed into law on December 16, 2022 (Division A of H.R. 1437; P.L. 117-229), extending funding through December 23, 2022. Previously, on June 30, 2022, the House Appropriations Committee voted to report the FY2023 LHHS bill, 32-24; the measure was subsequently reported to the House on July 5 (H.R. 8295; H.Rept. 117-403). While the Senate Appropriations Committee has not voted to report the legislation, the committee chair, Senator Leahy, released a majority draft of the LHHS bill and accompanying draft report language on July 28, 2022.1
(LHHS) appropriations act were enacted on
F December 29, 2022, when the Consolidated Appropriations Act, 2023 (FY2023 omnibus;
H.R. 2617; P.L. 117-328) was signed into law by the President. Previously, FY2023 funding had been provided temporarily through three continuing resolutions (P.L. 117-180, P.L. 117-229, and P.L. 117-264). This report provides a brief summary of the status of LHHS appropriations during the FY2023 This report provides a brief summary of the status of LHHS appropriations during the FY2023
cycle, including relevant congressional actions and a topline comparison of discretionary funding cycle, including relevant congressional actions and a topline comparison of discretionary funding
enacted in FY2022 enacted in FY2022
and FY2023, versus relevant FY2023 legislative proposals as of the cover date of this versus relevant FY2023 legislative proposals as of the cover date of this
report. It also provides background on the scope of the bill and the budgetary context for report. It also provides background on the scope of the bill and the budgetary context for
congressional decisionmaking.congressional decisionmaking.
In addition, it summarizes the FY2023 LHHS emergency-designated appropriations enacted in P.L. 117-180 and P.L. 117-328.
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.
34 trillion in trillion in
FY2022FY2023) 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 • more than a dozen related agencies (RA), including the Social Security
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). 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 FY2023 the Department of Education (ED); and
1 See draft text and explanatory statement linked to Senate Appropriations Committee, “Chairman Leahy Releases Fiscal Year 2023 Senate Appropriations Bills,” July 28, 2022, https://www.appropriations.senate.gov/news/majority/breaking-chairman-leahy-releases-fiscal-year-2023-senate-appropriations-bills. Also on July 28, 2022, Senator Patty Murray, Chair of the Senate Appropriations LHHS Subcommittee, introduced an FY2023 LHHS bill (S. 4659). This bill was referred to the Senate Appropriations Committee. Because S. 4659 has not received any congressional action, this report does not discuss this measure.
2 See the FY2022 Joint Explanatory Statement for LHHS in Joint Explanatory Statement for LHHS in
Congressional Record, daily edition, vol. 168, no. daily edition, vol. 168, no.
42, 198, book II (December 20book IV (March 9, 2022), p. , 2022), p.
H2915S9197. The discretionary funding provided in the LHHS appropriations act is both provided and . 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. controlled by that act. The 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 For definitions of these 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-Terms Used in the Federal 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, 05-734SP. (Terms of interest may include budget authority, appropriated entitlement, direct spending, discretionary,
entitlement authority, and mandatory.) entitlement authority, and mandatory.)
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more than a dozen related agencies (RA), including the Social Security
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). 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 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 FY2023 LHHS appropriations inCRS Report R47345, Labor, Health and Human Services, and Education: FY2023 Appropriations, coordinated by Karen E. Lynch and Jessica Tollestrup.
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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 (e.g., the FY2023 LHHS appropriations (e.g., the FY2023 LHHS appropriations
bil generally would containact contains advance appropriations that advance appropriations that
become available in FY2024 and FY2025 for certain programs and activities). In addition, while new budget become available in FY2024 and FY2025 for certain programs and activities). In addition, while new budget
authority is generally subject to a variety of statutory and congressional rules that are intended to control the authority is generally subject to a variety of statutory and congressional rules that are intended to control the
budget (i.e., budget (i.e.,
budget controls), some budget authority may be effectively exempted from those controls (e.g., budget ), some budget authority may be effectively exempted from those controls (e.g., budget
authority for emergency requirements, health care fraud and abuse control, continuing disability reviews and authority for emergency requirements, health care fraud and abuse control, continuing disability reviews and
redeterminations). redeterminations).
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, such as the 302(b) suballocations (discussed later), the total is based on In some cases, such as the 302(b) suballocations (discussed later), the total is 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 , which is
calculated regardless of the year in which it was first appropriated.calculated regardless of the year in which it was first appropriated.
54 Additionally, budgetary totals may or may not Additionally, budgetary totals may or may not
include Congressional Budget Office (CBO) scorekeeping and other adjustments to reflect budget enforcement include Congressional Budget Office (CBO) scorekeeping and other adjustments to reflect budget enforcement
conventions and special instructions of Congress.conventions and special instructions of Congress.
65 Finally, calculations of LHHS budget authority might include or Finally, calculations of LHHS budget authority might include or
exclude budget authority that is exempted from budget controls. exclude budget authority that is exempted from budget controls.
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 FY2022 LHHS appropriations in CRS Report R47029, Labor, Health and Human Services, and Education: FY2022 Appropriations, pp. 10-12.
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. 5 Such figures exclude advance appropriations for future years, but include advance appropriations from prior years that become available in the given fiscal year.
6 For more information on scorekeeping, see CRS Report 98-560, Baselines and Scorekeeping in the Federal Budget
Process. See also a discussion of key scorekeeping guidelines included in the joint explanatory statement accompanying the conference report to the Balanced Budget Act of 1997 (H.Rept. 105-217, pp. 1007-1014).
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Context for FY2023
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 FY2023 cycle has been affected by a number the congressional budget resolution. However, the FY2023 cycle has been affected by a number
of timing and budgetary issues related to the late submission of the President’s budget and the of timing and budgetary issues related to the late submission of the President’s budget and the
lack of congressional agreement on topline discretionary spending amounts for the appropriations lack of congressional agreement on topline discretionary spending amounts for the appropriations
committees. Background related to these issues is provided below. committees. Background related to these issues is provided below.
FY2023 President’s Budget Submission
The Budget and Accounting Act of 1921 (P.L. 67-13), as amended, requires the President to The Budget and Accounting Act of 1921 (P.L. 67-13), as amended, requires the President to
submit an annual consolidated federal budget to Congress at the beginning of each regular submit an annual consolidated federal budget to Congress at the beginning of each regular
congressional session, not later than the first Monday in February. Many of the proposals in the congressional session, not later than the first Monday in February. Many of the proposals in the
President’s budget would require changes to laws that govern President’s budget would require changes to laws that govern
mandatory spending levels or levels or
policies, which are typically established on a multiyear or permanent basis. policies, which are typically established on a multiyear or permanent basis.
Discretionary
3 Such figures include advance appropriations provided in the bill for future fiscal years, but do not include advance appropriations provided in prior years’ appropriations bills that become available in the current year. 4 Such figures exclude advance appropriations for future years, but include advance appropriations from prior years that become available in the given fiscal year.
5 For more information on scorekeeping, see CRS Report 98-560, Baselines and Scorekeeping in the Federal Budget Process, by Bill Heniff Jr. 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).
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spending, however, which is roughly one-third of the federal budget,6spending, however, which is roughly one-third of the federal budget,7 is decided and controlled is decided and controlled
each fiscal year through the annual appropriations process. While Congress is ultimately not each fiscal year through the annual appropriations process. While Congress is ultimately not
required to adopt the President’s proposals or recommendations, the submission of the President’s required to adopt the President’s proposals or recommendations, the submission of the President’s
budget typically initiates the congressional budget process and informs Congress of the budget typically initiates the congressional budget process and informs Congress of the
President’s recommended spending levels for agencies and programs.President’s recommended spending levels for agencies and programs.
87
The President’s budget request for FY2023 was submitted on March 28, 2022, about seven weeks
The President’s budget request for FY2023 was submitted on March 28, 2022, about seven weeks
after it was due. It was preceded by the enactment of FY2022 full-year annual appropriations after it was due. It was preceded by the enactment of FY2022 full-year annual appropriations
(P.L. 107-103) on March 15, 2022, more than six months into the fiscal year. In some cases, the (P.L. 107-103) on March 15, 2022, more than six months into the fiscal year. In some cases, the
President’s budget request reflected those full-year appropriations amounts that had been enacted President’s budget request reflected those full-year appropriations amounts that had been enacted
two weeks prior. However, in many other cases, the funding requested for LHHS programs and two weeks prior. However, in many other cases, the funding requested for LHHS programs and
activities was based on annualized estimates of the continuing appropriations that were in effect activities was based on annualized estimates of the continuing appropriations that were in effect
at the time the budget was being prepared. As a consequence, many of the underlying at the time the budget was being prepared. As a consequence, many of the underlying
assumptions about funding increases and decreases relative to the prior year that went into the assumptions about funding increases and decreases relative to the prior year that went into the
formulation of the budget were outdated by the time the budget was submitted. formulation of the budget were outdated by the time the budget was submitted.
On June 7, the President submitted amendments to the FY2023 budget that included changes to
On June 7, the President submitted amendments to the FY2023 budget that included changes to
appropriations language requested for DOL and HHS.appropriations language requested for DOL and HHS.
98 The Administration characterized the two The Administration characterized the two
LHHS budget amendments as technical in nature; neither were estimated to affect budget LHHS budget amendments as technical in nature; neither were estimated to affect budget
authority totals on net in the bill. authority totals on net in the bill.
FY2023 Discretionary Spending Levels and Appropriations
Allocations
The congressional budget process generally enforces discretionary spending levels in The congressional budget process generally enforces discretionary spending levels in
appropriations measures via procedural means.appropriations measures via procedural means.
109 This procedural budget enforcement is primarily This procedural budget enforcement is primarily 7 Congressional Budget Office (CBO), The 2022 Long-Term Budget Outlook, July 2022, p. 18, https://www.cbo.gov/system/files/2022-07/57971-LTBO.pdf.
8 For more information, see CRS Report R47019, The Executive Budget Process: An Overview. 9 See the budget amendments package at https://www.whitehouse.gov/wp-content/uploads/2022/06/FY_2023_Budget_Amendments_Package_6-7-22.pdf.
10 Between FY2012 and FY2021, the framework for discretionary spending budget enforcement under the congressional budget process involved both statutory and procedural elements. Those statutory elements included limits
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associated with the budget resolution, which provides a process for the House and the Senate to associated with the budget resolution, which provides a process for the House and the Senate to
agree on budgetary targets ahead of consideration of spending and revenue legislation. agree on budgetary targets ahead of consideration of spending and revenue legislation.
The budget resolution imposes a limit on total discretionary spending available to the
The budget resolution imposes a limit on total discretionary spending available to the
appropriations committees (commonly referred to as a appropriations committees (commonly referred to as a
302(a) allocation) and, subsequently, ) and, subsequently,
limits on spending under the jurisdiction of each appropriations subcommittee are created limits on spending under the jurisdiction of each appropriations subcommittee are created
(referred to as (referred to as
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 the limits). In recent years, adjustments that have been to the 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.
1110
6 Congressional Budget Office (CBO), The 2022 Long-Term Budget Outlook, July 2022, p. 18, https://www.cbo.gov/system/files/2022-07/57971-LTBO.pdf.
7 For more information, see CRS Report R47019, The Executive Budget Process: An Overview, by Dominick A. Fiorentino and Taylor N. Riccard.
8 See the budget amendments package at https://www.whitehouse.gov/wp-content/uploads/2022/06/FY_2023_Budget_Amendments_Package_6-7-22.pdf.
9 Between FY2012 and FY2021, 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). These limits expired at the end of FY2021 and were not renewed.
10 For further information, see Appendix A in CRS Report R47345, Labor, Health and Human Services, and Education: FY2023 Appropriations, coordinated by Karen E. Lynch and Jessica Tollestrup.
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As of the cover date of this report, there has been no House or Senate action on an FY2023
As of the cover date of this report, there has been no House or Senate action on an FY2023
budget resolution. In its absence, on June 8, 2022, the House adopted a resolution (H.Res. 1151) budget resolution. In its absence, on June 8, 2022, the House adopted a resolution (H.Res. 1151)
to provide for 302(a) allocations to the House Appropriations Committee at a specified level, to provide for 302(a) allocations to the House Appropriations Committee at a specified level,
provide limits on advance appropriations,provide limits on advance appropriations,
1211 and allow adjustments to those allocations for and allow adjustments to those allocations for
emergency requirements, health care fraud and abuse control, and continuing disability reviews emergency requirements, health care fraud and abuse control, and continuing disability reviews
and redeterminations (as well as other purposes that do not apply to LHHS).and redeterminations (as well as other purposes that do not apply to LHHS).
1312 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 21. the House Appropriations Committee allocations on June 21.
1413 The Senate The Senate
has not taken similar action to establish Senate Appropriations Committee allocations.has not taken similar action to establish Senate Appropriations Committee allocations.
15 14
Generally, the next step in the appropriations process is for each of the appropriations committees
Generally, the next step in the appropriations process is for each of the appropriations committees
to adopt suballocations from the total amount allocated to them. These 302(b) suballocations to adopt suballocations from the total amount allocated to them. These 302(b) suballocations
provide a limit on current-year (i.e., FY2023) appropriations within each subcommittee’s provide a limit on current-year (i.e., FY2023) appropriations within each subcommittee’s
jurisdiction and incorporate any applicable scorekeeping adjustments made by CBO. The House jurisdiction and incorporate any applicable scorekeeping adjustments made by CBO. The House
Appropriations Committee reported their initial 302(b) suballocations for all 12 subcommittees Appropriations Committee reported their initial 302(b) suballocations for all 12 subcommittees
on June 24 (H.Rept. 117-390).on June 24 (H.Rept. 117-390).
1615 The discretionary budget authority suballocation for LHHS of The discretionary budget authority suballocation for LHHS of
on defense and nondefense discretionary spending established by the Budget Control Act of 2011 (BCA; P.L. 112-25). These limits expired at the end of FY2021 and were not renewed.
11 For further information, see Appendix A in CRS Report R47029, Labor, Health and Human Services, and
Education: FY2022 Appropriations.
12$224.399 billion represented a 14% (+$27.405 billion) increase relative to FY2022. That amount did not include funding subject to adjustments, such as for emergency requirements.
FY2023 LHHS Legislative Action
FY2023 Consolidated Appropriations Act Full-year FY2023 appropriations for LHHS were enacted on December 29, 2022, when the Consolidated Appropriations Act, 2023 (FY2023 omnibus; H.R. 2617; P.L. 117-328) was signed into law by the President. The FY2023 omnibus provided full-year appropriations for all 12 annual appropriations acts in Divisions A-L. (Full-year LHHS appropriations were enacted in Division H.) Prior to its enactment, the final version of the measure was approved by the Senate on December 22 (68-29). It was approved by the House on December 23 (225-201). The FY2023 LHHS appropriations provided in the FY2023 omnibus are summarized in “FY2022 and FY2023 Discretionary Funding Levels.”
11 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 FY2023 LHHS appropriations bill generally would contain advance appropriations for The FY2023 LHHS appropriations bill generally would contain advance appropriations for
FY2024 and FY2025 for certain programs and activities. For further information, see CRS Report R43482, FY2024 and FY2025 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, by Jessica Tollestrup and Megan S. Lynch.
12.
13 H.Res. 1151 also provided a technical clarification: the BCA cap adjustments ( H.Res. 1151 also provided a technical clarification: the BCA cap adjustments (
Section §251(b) of the Balanced 251(b) of the Balanced
Budget and Emergency Deficit Control Act) that applied to discretionary appropriations between FY2012 and FY2021 Budget and Emergency Deficit Control Act) that applied to discretionary appropriations between FY2012 and FY2021
would not apply to allocations established pursuant to that resolution. However, the adjustment for reemployment 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-FY2027 pursuant to services and eligibility assessments would continue to be in effect for FY2022-FY2027 pursuant to
Section §314(g) of 314(g) of
the Congressional Budget Act, subject to specified limits. the Congressional Budget Act, subject to specified limits.
1413 “Publication of Budgetary Material,” “Publication of Budgetary Material,”
Congressional Record, daily edition, Vol. 168, No. 105 (June 21, 2022), pp. , daily edition, Vol. 168, No. 105 (June 21, 2022), pp.
H5731-H5732.H5731-H5732.
15 For a discussion of budget enforcement through methods such as H.Res. 1151, see CRS Report R47175, For a discussion of budget enforcement through methods such as H.Res. 1151, see CRS Report R47175,
Setting
Budgetary Levels: The House’s FY2023 Deeming Resolution. 16, by Megan S. Lynch.
14 In the absence of such actions, the adjustment for emergency requirements that was established in the FY2022 budget resolution (S.Con.Res. 14, §4001) continued to apply in the Senate to the consideration of FY2023 appropriations.
15 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
FY2023, the House Appropriations Committee reported revised suballocations on July 1 (H.Rept. 117-398) to FY2023, the House Appropriations Committee reported revised suballocations on July 1 (H.Rept. 117-398) to
incorporate the cap adjustments where applicable and make an adjustment to outlay levels, but otherwise the incorporate the cap adjustments where applicable and make an adjustment to outlay levels, but otherwise the
suballocation for the LHHS subcommittee was the same as originally reported. suballocation for the LHHS subcommittee was the same as originally reported.
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$224.399 billion represents a 14% (+$27.405 billion) increase relative to FY2022. That amount does not include funding subject to adjustments, such as for emergency requirements.
FY2023 LHHS Legislative Action
FY2023 Continuing Appropriations
FY2023 LHHS regular appropriations are currently beingFY2023 Continuing Appropriations Between the start of FY2023 and the enactment of full-year appropriations, FY2023 LHHS regular appropriations were provided by a series of CRs. The first provided by a series of CRs. The first
CR was signed into law on September 30, 2022 (Division A of H.R. 6833; P.L. 117-180), CR was signed into law on September 30, 2022 (Division A of H.R. 6833; P.L. 117-180),
providing continuing appropriations for all 12 of the annual appropriations acts (including LHHS) providing continuing appropriations for all 12 of the annual appropriations acts (including LHHS)
through December 16, 2022. The measure, which was originally an unrelated vehicle that had through December 16, 2022. The measure, which was originally an unrelated vehicle that had
been passed previously by the House, was taken up by the Senate the week prior to the start of the been passed previously by the House, was taken up by the Senate the week prior to the start of the
fiscal year. The Senate amended the measure to contain the CR, and passed it as amended (72-25) fiscal year. The Senate amended the measure to contain the CR, and passed it as amended (72-25)
on September 29, 2022. The House subsequently took up the measure and agreed to the Senate on September 29, 2022. The House subsequently took up the measure and agreed to the Senate
amendment (230-201) on September 30, 2022. amendment (230-201) on September 30, 2022.
A second CR was signed into law on December 16, 2022 (Division A of H.R. 1437; P.L. 117-
A second CR was signed into law on December 16, 2022 (Division A of H.R. 1437; P.L. 117-
229), extending appropriations through December 23, 2022. The measure, which was originally 229), extending appropriations through December 23, 2022. The measure, which was originally
an unrelated vehicle that had been passed previously by the House and the Senate, was amended an unrelated vehicle that had been passed previously by the House and the Senate, was amended
in the House to contain the CR. The House passed (224-201) the amended bill on December 14. in the House to contain the CR. The House passed (224-201) the amended bill on December 14.
The Senate passed (71-19) the bill on December 15. The Senate passed (71-19) the bill on December 15.
A third CR was signed into law on December 23, 2022 (Division A of H.R. 4373; P.L. 117-264), extending appropriations through December 30, 2022. The measure, which was originally an unrelated appropriations measure that had been passed previously by the House, was amended by the Senate to contain the CR. The Senate passed (voice vote) the amended bill on December 22. The House agreed to the measure pursuant to provisions of H.Res. 1531 on December 23.
In general, the FY2023 CRs fundedIn general, the FY2023 CRs fund discretionary programs at the same rate and under the same discretionary programs at the same rate and under the same
conditions as in FY2022 (§101) and annually appropriated entitlements at their current law levels conditions as in FY2022 (§101) and annually appropriated entitlements at their current law levels
(§111).(§111).
1716 The CRs also The CRs also
includeincluded several anomalies that several anomalies that
arewere specific to LHHS accounts or related specific to LHHS accounts or related
activities (§§101(8), 145-150).activities (§§101(8), 145-150).
1817
FY2023 Emergency-Designated Appropriations
Although full-year regular annual appropriations have not been enacted, one bill has Emergency designated appropriations are effectively exempt from otherwise applicable budget enforcement requirements, such as committee allocations, as described above. A handful of proposals have been signed been signed
into law providing into law providing
FY2023LHHS emergency-designated appropriations for emergency-designated appropriations for
accounts typically funded in the LHHS bill.
FY2023:
• Division A of the Continuing Appropriations and Ukraine Supplemental Division A of the Continuing Appropriations and Ukraine Supplemental
Appropriations Act, 2023 Appropriations Act, 2023
(H.R. 6833; P.L. 117-180, September 30, 2022) provided emergency-designated appropriations (H.R. 6833; P.L. 117-180, September 30, 2022) provided emergency-designated appropriations
for two accounts at the HHS Administration for Children and Families (ACF): $1.0 billion for the for two accounts at the HHS Administration for Children and Families (ACF): $1.0 billion for the
Low Income Home Energy Assistance Program (§146) and $1.8 billion for expenses Low Income Home Energy Assistance Program (§146) and $1.8 billion for expenses
to carry out the Unaccompanied Children Program and for certain refugee and entrant assistance activities (§147).
17
16 For an estimate of the discretionary appropriations contained in Division A of H.R. 6833, see For an estimate of the discretionary appropriations contained in Division A of H.R. 6833, see
Estimated
Discretionary Appropriations Under Division A of Senate Amendment Number 5745 to H.R. 6833H.R. 6833
, the Continuing
Appropriations and Ukraine Supplemental Appropriations Act, 2023, with Adjustments Made in the Senate, September , September
28, 2022, https://www.cbo.gov/system/files/2021-09/57491-CBO-Estimate-for-HR5305.pdf. For an estimate of the 28, 2022, https://www.cbo.gov/system/files/2021-09/57491-CBO-Estimate-for-HR5305.pdf. For an estimate of the
discretionary appropriations contained in Division A of H.R. 1437, see discretionary appropriations contained in Division A of H.R. 1437, see
Estimated Discretionary Appropriations Under
Division A of the Further Continuing Appropriations and Extensions Act, 2023 (Rules Committee Print 117-72, the
House Amendment to the Senate Amendment to H.R. 1437H.R. 1437
) as posted on the Rules Committee Website
(https://rules.house.gov/bill/117/hr1437-sahttps://rules.house.gov/bill/117/hr1437-sa
), with Adjustments Made in the House, December 14, 2022, , December 14, 2022,
https://www.cbo.gov/system/files/2022-12/hr1437%28as_modified%29.pdf.https://www.cbo.gov/system/files/2022-12/hr1437%28as_modified%29.pdf.
1817 The LHHS anomalies are discussed in CRS Report R47283, The LHHS anomalies are discussed in CRS Report R47283,
Overview of Continuing Appropriations for FY2023
(Division A of P.L. 117-180).
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Status of FY2023 Labor, Health and Human Services, and Education Appropriations
to carry out the Unaccompanied Children Program and for certain refugee and entrant assistance activities (§147).18
• Division M of H.R. 2617 (P.L. 117-328), the Additional Ukraine Supplemental
Appropriations Act, 2023, provided $2.40 billion in emergency-designated appropriations for the Refugee and Entrant Assistance Account at ACF.19
• Division N of H.R. 2617 (P.L. 117-328), the Disaster Relief Supplemental
Appropriations Act, 2023, provided a total of $4.25 billion in emergency-designated appropriations to several HHS accounts and programs: • $86 million for CDC-wide Activities and Program Support Account (Centers
for Disease Control and Prevention);
• $2.5 million to the National Institute of Environmental Health Sciences
(National Institutes of Health; NIH);
• $25 million to the Office of the Director (NIH); • $3.5 billion to the Low Income Home Energy Assistance Program (ACF); • $100 million to the Child Care and Development Block Grant (ACF); • $408 million to the Children and Families Services Programs Account (ACF)
for several programs, including $345 million to the Head Start Program; and
• $128.8 million to the Public Health and Social Services Emergency Fund.
Prior Congressional Action on an FY2023 Full-Year LHHS Bill
On June 30 2022, the House Appropriations Committee voted to report the FY2023 LHHS bill, On June 30 2022, the House Appropriations Committee voted to report the FY2023 LHHS bill,
32-24; the measure was subsequently reported to the House on July 5 (H.R. 8295; H.Rept. 117-32-24; the measure was subsequently reported to the House on July 5 (H.R. 8295; H.Rept. 117-
403). Previously, the measure was approved in subcommittee, via a voice vote, on June 23, 2022. 403). Previously, the measure was approved in subcommittee, via a voice vote, on June 23, 2022.
While the Senate Appropriations Committee
While the Senate Appropriations Committee
hasdid not not
votedvote to report to report
its version of the legislation, the committee the legislation, the committee
chair, Senator Leahy, released a majority draft of the LHHS bill and accompanying draft report chair, Senator Leahy, released a majority draft of the LHHS bill and accompanying draft report
language on July 28, 2022.language on July 28, 2022.
19
Table 1 displays the CBO estimate of enacted LHHS discretionary appropriations for FY2022, 20
18 The budgetary effects of §149 related to Afghan parolee eligibility for certain benefits also were emergency-designated. These budgetary effects are not included in this report because the amount of funding was not specified in the provision. For further information, see CBO, Estimated Discretionary Appropriations Under Division A of Senate Amendment Number 5745 to H.R. 6833, the Continuing Appropriations and Ukraine Supplemental Appropriations Act, 2023, September 28, 2022, https://www.cbo.gov/system/files/2022-09/hr6833-CA.pdf.
19 The budgetary effects of §1501 related to Afghan parolee eligibility for certain benefits also were emergency-designated. These budgetary effects are not included in this report because the amount of funding was not specified in the provision. For further information, see CBO, Discretionary Spending in Fiscal Year 2023 Under Divisions A Through L of H.R. 2617 (as modified by Senate Amendment 6552), the Consolidated Appropriations Act, 2023, December 21, 2022, https://www.cbo.gov/system/files/2022-12/HR-2617_div-A%E2%80%93N.pdf.
20 See the draft text and explanatory statement linked to Senate Appropriations Committee, “Chairman Leahy Releases Fiscal Year 2023 Senate Appropriations Bills,” July 28, 2022, https://www.appropriations.senate.gov/news/majority/breaking-chairman-leahy-releases-fiscal-year-2023-senate-appropriations-bills. See also Senate Appropriations Committee, “Shelby: Democrats’ Partisan Bills Threaten FY23 Appropriations Process,” July 28, 2022, https://www.appropriations.senate.gov/news/minority/shelby-democrats-partisan-bills-threaten-fy23-appropriations-process. Also on July 28, 2022, Senator Patty Murray, Chair of the Senate Appropriations LHHS Subcommittee, introduced an FY2023 LHHS bill (S. 4659). This bill was referred to the Senate Appropriations Committee. Because S. 4659 did not received any congressional action, this report does not discuss this measure.
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FY2022 and FY2023 Discretionary Funding Levels Table 1 displays the CBO estimate of enacted LHHS discretionary appropriations for FY2022 and FY2023, the House committee-reported FY2023 discretionary appropriations for LHHS, and those in the the House committee-reported FY2023 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 proposal would increase regular discretionary appropriations for of estimating the bill, the House proposal would increase regular discretionary appropriations for
LHHS relative to FY2022 by 14% (+$27.4 billion), while the Senate majority draft proposal LHHS relative to FY2022 by 14% (+$27.4 billion), while the Senate majority draft proposal
would increase those appropriations by 10% (+19.1 billion).would increase those appropriations by 10% (+19.1 billion).
20 21 Ultimately, the FY2023 enacted amount was an increase in such funding of 5.3% (+10.4 billion).
As previously mentioned, certain LHHS appropriations, such as those allowed for program
As previously mentioned, certain LHHS appropriations, such as those allowed for program
integrity funding or designated for emergency requirements, are effectively exempt from the integrity funding or designated for emergency requirements, are effectively exempt from the
discretionary spending limits. discretionary spending limits.
As was the case for FY2022,FY2023 enacted and the FY2023 House and Senate the FY2023 House and Senate
proposals would provide the proposals would provide the
maximumsame amount amount
allowed for program integrity spending for program integrity spending
under relevant procedures (see discussion in the (see discussion in the
“FY2023 Discretionary Spending Levels and
Appropriations Allocations” section). With regard to new FY2023 funding for emergency section). With regard to new FY2023 funding for emergency
requirements, no such emergency-designated funding was proposed in the House committee bill, requirements, no such emergency-designated funding was proposed in the House committee bill,
but the Senate majority draft would enact such funding in Titles II and VI. The “adjusted but the Senate majority draft would enact such funding in Titles II and VI. The “adjusted
appropriations” total in the table includes these additional funds along with “regular discretionary appropriations” total in the table includes these additional funds along with “regular discretionary
appropriations.” (Note that this table does not include any of the enacted FY2023 emergency funding for LHHS in P.L. 117-180, as this funding was enacted in a different legislative vehicle than those summarized below.)
19 See the draft text and explanatory statement linked to Senate Appropriations Committee, “Chairman Leahy Releases Fiscal Year 2023 Senate Appropriations Bills,” July 28, 2022, https://www.appropriations.senate.gov/news/majority/breaking-chairman-leahy-releases-fiscal-year-2023-senate-appropriations-bills. See also Senate Appropriations Committee, “Shelby: Democrats’ Partisan Bills Threaten FY23 Appropriations Process,” July 28, 2022, https://www.appropriations.senate.gov/news/minority/shelby-democrats-partisan-bills-threaten-fy23-appropriations-process. Also on July 28, 2022, Senator Patty Murray, Chair of the Senate Appropriations LHHS Subcommittee, introduced an FY2023 LHHS bill (S. 4659). This bill was referred to the Senate Appropriations Committee. Because S. 4659 has not received any congressional action, this report does not discuss this measure.
20appropriations.”
21 This CRS estimate of the increase proposed by the Senate majority draft is based on a comparison of the CBO This CRS estimate of the increase proposed by the Senate majority draft is based on a comparison of the CBO
estimate for FY2022 enacted (CBO, estimate for FY2022 enacted (CBO,
Report on the Status of Discretionary Appropriations, Fiscal Year 2022, House of
Representatives, as of May 26, 2022, https://www.cbo.gov/system/files?file=2022-05/FY2022-House-2022-05-26.pdf) , as of May 26, 2022, https://www.cbo.gov/system/files?file=2022-05/FY2022-House-2022-05-26.pdf)
to the total amount of spending listed on page 1 of the Senate majority draft LHHS committee report to the total amount of spending listed on page 1 of the Senate majority draft LHHS committee report
(https://www.appropriations.senate.gov/imo/media/doc/LHHSFY23REPT.pdf). (https://www.appropriations.senate.gov/imo/media/doc/LHHSFY23REPT.pdf).
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1011 link to page 11 Status of FY2023 Labor, Health and Human Services, and Education Appropriations
Table 1. LHHS Discretionary Appropriations: Comparison of FY2022 Enacted with
and FY2023
Enacted with FY2023 House Appropriations Committee Proposal and FY2023
Senate Majority
Draft
(
(
current-year budget authority in billions of dollars) budget authority in billions of dollars)
FY2023 House
Committee
FY2023 Senate
FY2022
Committee Bill
Majority Draft
FY2023
Enacted
(H.R. 8295)
(July 28, 2022)
Enacted
Regular discretionary Regular discretionary
appropriations
196.994
196.994
224.399
224.399
216.079
216.079
appropriations207.4
Adjustmen
Adjustmen
ts:a
Health Care Fraud and
Health Care Fraud and
Abuse
0.556
0.556
0.576
0.576
0.576
0.576
Abuse 0.576
Control Control
Continuing Disability
Continuing Disability
Reviews and
1.435
1.435
1.511
1.511
1.511
1.511
Reviews and 1.511
Redeterminations Redeterminations
Reemployment Services
Reemployment Services
and
0.133
0.133
0.258
0.258
0.258
0.258
and 0.258
Eligibility Assessments Eligibility Assessments
Emergency
Emergency
requirementsrequirementsb
7.831
7.831
—
—
18.500
18.500
9.920
Adjusted appropriations Adjusted appropriations
206.949
206.949
226.744
226.744
236.924
236.924
219.632
Source: The FY2022 Enacted amounts are from CBO, The FY2022 Enacted amounts are from CBO,
Report on the Status of Discretionary Appropriations, Fiscal
Year 2022, House of Representatives, as of May 26, 2022, https://www.cbo.gov/system/files?file=2022-05/FY2022-, as of May 26, 2022, https://www.cbo.gov/system/files?file=2022-05/FY2022-
House-2022-05-26.pdf, and Table 3 in CBO, cost estimate, “The Bipartisan Safer Communities Act would House-2022-05-26.pdf, and Table 3 in CBO, cost estimate, “The Bipartisan Safer Communities Act would
provide funding to encourage enactment of state laws aimed at control ing access to guns and to support a provide funding to encourage enactment of state laws aimed at control ing access to guns and to support a
variety of other initiatives to enhance school safety, mental health programs, and violence prevention,” June 22, variety of other initiatives to enhance school safety, mental health programs, and violence prevention,” June 22,
2022, https://www.cbo.gov/system/files?file=2022-06/S2938.pdf. The FY2023 House Committee Bil amounts are 2022, https://www.cbo.gov/system/files?file=2022-06/S2938.pdf. The FY2023 House Committee Bil amounts are
from page 3 of H.Rept. 117-403 and CRS analysis of H.R. 8295, as reported. FY2023 Senate Majority Draft from page 3 of H.Rept. 117-403 and CRS analysis of H.R. 8295, as reported. FY2023 Senate Majority Draft
amounts are from page 1 of the Senate majority draft LHHS committee report amounts are from page 1 of the Senate majority draft LHHS committee report
(https://www.appropriations.senate.gov/imo/media/doc/LHHSFY23REPT.pdf) and CRS analysis of the Senate (https://www.appropriations.senate.gov/imo/media/doc/LHHSFY23REPT.pdf) and CRS analysis of the Senate
majority draft LHHS bil (https://www.appropriations.senate.gov/download/lhhsfy2023).majority draft LHHS bil (https://www.appropriations.senate.gov/download/lhhsfy2023).
FY2023 Enacted amounts are from CBO, CBO Estimate for Divisions A through N of H.R. 2617 (as modified by S.A. 6552), the Consolidated Appropriations Act, 2023, December 21, 2022, https://www.cbo.gov/publication/58872, and CRS analysis of P.L. 117-180 and P.L. 117-328. Notes: Amounts reflect current-year discretionary budget authority subject to spending limits. “Regular Amounts reflect current-year discretionary budget authority subject to spending limits. “Regular
discretionary appropriations” exclude funds for which special rules apply under the spending limits (e.g., funds for 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 provided under authorities in 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 spending limits. the 21st Century Cures Act (P.L. 114-255) that are effectively exempt from the spending limits.
a. a.
CBO presents theThe FY2022 enacted amounts for these activities are identified via CRS analysis of Division H of P.L. 117-
103. The FY2023 proposed and enacted amounts for these activities are identified via CRS analysis of H.R.
8295, the FY2023 Senate Majority Draft, and Division H of P.L. 117-328. Note that CBO tabulates these adjustments differently based on relevant procedures in CBO, Discretionary Spending in Fiscal Year 2023 Under Divisions A Through L of H.R. 2617 (as modified by Senate Amendment 6552), the Consolidated Appropriations Act, 2023, December 21, 2022, https://www.cbo.gov/system/files/2022-12/HR-2617_div-A%E2%80%93N.pdf. See also CBO, Report on the Status of Discretionary Appropriations, Fiscal Year 2023, House of Representatives, February 10, 2023, https://www.cbo.gov/system/files?file=2023-02/FY2023-House-2022-12-23.pdf; and CBO, Report on the Status of Discretionary Appropriations, Fiscal Year 2023, Senate, February 10, 2023, https://www.cbo.gov/system/files?file=2023-02/FY2023-Senate-2022-12-23.pdf.
b. The budgetary effects of §149 of P.L. 117-180 and §1501 of P.L. 117-328, both of which relate to Afghan
parolee eligibility for certain benefits, also were emergency-designated. These budgetary effects are not included in this report because they did not specify a funding amount. For further information, see CBO, Estimated Discretionary Appropriations Under Division A of Senate Amendment Number 5745 to H.R. 6833, the Continuing Appropriations and Ukraine Supplemental Appropriations Act, 2023, September 28, 2022, https://www.cbo.gov/system/files/2022-09/hr6833-CA.pdf; and CBO, Discretionary Spending in Fiscal Year 2023 Under Divisions A Through L of H.R. 2617 (as modified by Senate Amendment 6552), the Consolidated Appropriations Act, 2023, December 21, 2022, https://www.cbo.gov/system/files/2022-12/HR-2617_div-A%E2%80%93N.pdf.
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8 FY2022 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 $2.124 bil ion. The FY2022 enacted amounts for these activities are identified via CRS analysis of Division H of P.L. 117-103.
Author Information
Jessica Tollestrup
Karen E. Lynch
Specialist in Social Policy
Specialist in Social Policy
Congressional Research Service
7
Status of FY2023 Labor, Health and Human Services, and Education Appropriations
Author Information
Jessica Tollestrup
Karen E. Lynch
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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R47233
R47233
· VERSION 67 · UPDATED
89