Status of FY2024 Labor, Health and Human Services, and Education Appropriations: In Brief

Changes from December 19, 2023 to January 26, 2024

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

Status of FY2024 Labor, Health and Human
~~December 19, 2023~~January 26, 2024
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 FY2024 Labor, Health and Human This report provides a brief summary of the status of FY2024 Labor, Health and Human
Jessica Tollestrup
Services, and Education (LHHS) appropriations as of the cover date of this report. It also Services, and Education (LHHS) appropriations as of the cover date of this report. It also
Specialist in Social Policy Specialist in Social Policy
provides background on the scope of the LHHS bill generally and the context for congressional provides background on the scope of the LHHS bill generally and the context for congressional

appropriations decisions, including the submission of the FY2024 President’s budget request and appropriations decisions, including the submission of the FY2024 President’s budget request and
budget enforcement in the absence of a budget resolution. budget enforcement in the absence of a budget resolution.

Congress has not reached agreement on full-year regular FY2024 LHHS appropriations. In the interim, FY2024 funding has Congress has not reached agreement on full-year regular FY2024 LHHS appropriations. In the interim, FY2024 funding has
been provided temporarily through been provided temporarily through ~~two~~three continuing resolutions (CRs). The first CR was signed into law on September 30, continuing resolutions (CRs). The first CR was signed into law on September 30,
2023 (Division A of H.R. 5860; P.L. 118-15), providing continuing appropriations for all 12 annual appropriations acts 2023 (Division A of H.R. 5860; P.L. 118-15), providing continuing appropriations for all 12 annual appropriations acts
(including LHHS) through November 17, 2023. Subsequently, (including LHHS) through November 17, 2023. Subsequently, ~~a second CR, which generally~~ two additional CRs were enacted, which extended the provisions of the extended the provisions of the
first CRfirst CR~~, was~~ with some additional provisions (see Division A of P.L. 118-22, enacted on November 16, 2023 enacted on November 16, 2023; and (Division ADivision A, of P.L. 118- P.L. 118-~~22).~~ 35, enacted on January 19, 2024). The third CR provides LHHS appropriations through March 8. In general, the CRs fund discretionary programs at In general, the CRs fund discretionary programs at
the same rate, and under the same conditions, as in FY2023 and funds annually appropriated entitlements at their current law the same rate, and under the same conditions, as in FY2023 and funds annually appropriated entitlements at their current law
levels. The CRs include a few provisions that are specific to LHHS accounts or related activities. Most of these LHHS-levels. The CRs include a few provisions that are specific to LHHS accounts or related activities. Most of these LHHS-
specific provisions were included in the first CR and continued in specific provisions were included in the first CR and continued in ~~the second~~subsequent CRs; one new LHHS-specific provision was added ; one new LHHS-specific provision was added
in the second CR. in the second CR.
On July 27, 2023, the Senate Appropriations Committee voted to report the FY2024 LHHS bill, 26-2; the measure was On July 27, 2023, the Senate Appropriations Committee voted to report the FY2024 LHHS bill, 26-2; the measure was
subsequently reported to the Senate that same day (S. 2624; S.Rept. 118-84). The Senate committee bill would reduce subsequently reported to the Senate that same day (S. 2624; S.Rept. 118-84). The Senate committee bill would reduce
discretionary appropriations for LHHS by 6% (-$12.1 billion) relative to FY2023 and by 1% (-$1.8 billion) relative to discretionary appropriations for LHHS by 6% (-$12.1 billion) relative to FY2023 and by 1% (-$1.8 billion) relative to
FY2022. The measure was not formally marked up in subcommittee prior to full committee consideration. The Senate FY2022. The measure was not formally marked up in subcommittee prior to full committee consideration. The Senate
Appropriations Committee reported its initial suballocations for all 12 subcommittees, including LHHS, on June 22, 2023 Appropriations Committee reported its initial suballocations for all 12 subcommittees, including LHHS, on June 22, 2023
(15-13). (15-13).
While the House Appropriations Committee did not report its version of the LHHS bill, a draft bill was approved in While the House Appropriations Committee did not report its version of the LHHS bill, a draft bill was approved in
subcommittee on July 14, 2023, by a voice vote. Previously, on June 15, 2023, the House Appropriations Committee subcommittee on July 14, 2023, by a voice vote. Previously, on June 15, 2023, the House Appropriations Committee
approved draft suballocations (33-27), which would reduce regular discretionary appropriations for LHHS by 29% (-$60.3 approved draft suballocations (33-27), which would reduce regular discretionary appropriations for LHHS by 29% (-$60.3
billion) relative to FY2023 and by 25% (-$49.9 billion) relative to FY2022. billion) relative to FY2023 and by 25% (-$49.9 billion) relative to FY2022.
The LHHS bill also has received some House floor consideration, but the House did not vote on passage of the bill. On The LHHS bill also has received some House floor consideration, but the House did not vote on passage of the bill. On
October 6, 2023, Representative Aderholt, Chair of the House Appropriations LHHS Subcommittee, introduced an LHHS October 6, 2023, Representative Aderholt, Chair of the House Appropriations LHHS Subcommittee, introduced an LHHS
bill (H.R. 5894); the text of H.R. 5894 was substantially the same as the subcommittee draft bill. The bill was brought to the bill (H.R. 5894); the text of H.R. 5894 was substantially the same as the subcommittee draft bill. The bill was brought to the
House floor for consideration on November 14, under the terms of a special rule (H.Res. 864). The special rule specified the House floor for consideration on November 14, under the terms of a special rule (H.Res. 864). The special rule specified the
amendments that were to be in order, and provided that the text of the bill would be Rules Committee Print 118-13, which in amendments that were to be in order, and provided that the text of the bill would be Rules Committee Print 118-13, which in
effect made numerous alterations to the provisions in H.R. 5894 as introduced. Floor amendments were considered on effect made numerous alterations to the provisions in H.R. 5894 as introduced. Floor amendments were considered on
November 14 and 15, with a total of 109 being adopted. November 14 and 15, with a total of 109 being adopted.

Congressional Research Service Congressional Research Service

Status of FY2024 LHHS Appropriations: In Brief

ongress has not reached agreement on full-year regular FY2024 appropriations for the ongress has not reached agreement on full-year regular FY2024 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, FY2024 funding has been provided temporarily through C (LHHS). In the interim, FY2024 funding has been provided temporarily through ~~two~~
March 8, 2024, via three continuing resolutions (CRs). The first CR was signed into law on September 30, 2023 (Division continuing resolutions (CRs). The first CR was signed into law on September 30, 2023 (Division
A of H.R. 5860; P.L. 118-15), providing continuing appropriations for all 12 annual A of H.R. 5860; P.L. 118-15), providing continuing appropriations for all 12 annual
appropriations acts (including LHHS)appropriations acts (including LHHS) ~~through November 17, 2023. Subsequently, a second CR~~. Subsequently, two additional CRs were enacted, ,
which generally extended the provisions of the first CRwhich generally extended the provisions of the first CR~~, was enacted on November 16, 2023~~
~~(Division A, P.L. 118-22).~~
(Division A, P.L. 118-22 and Division A of P.L. 118-35). Previously, on July 27, 2023, the Senate Appropriations Committee voted to report the FY2024 Previously, on July 27, 2023, the Senate Appropriations Committee voted to report the FY2024
LHHS bill, 26-2 (S. 2624; S.Rept. 118-84). While the House Appropriations Committee did not LHHS bill, 26-2 (S. 2624; S.Rept. 118-84). While the House Appropriations Committee did not
reported its version of the FY2024 LHHS bill, a draft bill was approved in subcommittee on July reported its version of the FY2024 LHHS bill, a draft bill was approved in subcommittee on July
14, 2023, by a voice vote.1 The LHHS bill also received some House floor consideration on 14, 2023, by a voice vote.1 The LHHS bill also received some House floor consideration on
November 14 and 15, 2023, but the House did not vote on passage of the bill (H.R. 5894).2 November 14 and 15, 2023, but the House did not vote on passage of the bill (H.R. 5894).2
This report provides a brief summary of the status of Labor, Health and Human Services, and This report provides a brief summary of the status of Labor, Health and Human Services, and
Education (LHHS) appropriations during the FY2024 appropriations cycle, including relevant Education (LHHS) appropriations during the FY2024 appropriations cycle, including relevant
congressional actions and a top-line comparison of discretionary funding enacted in FY2023 congressional actions and a top-line comparison of discretionary funding enacted in FY2023
versus relevant FY2024 legislative proposals as of the cover date of this report. It also provides versus relevant FY2024 legislative proposals as of the cover date of this report. It also provides
background on the scope of the bill and the context for congressional appropriations decisions. background on the scope of the bill and the context for congressional appropriations decisions.
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 of the 12 annual appropriations bills when accounting for both The LHHS bill is the largest of the 12 annual appropriations bills when accounting for both
mandatory and discretionary funding ($1.4 trillion in FY2023).3 It provides annually appropriated mandatory and discretionary funding ($1.4 trillion in FY2023).3 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);

1 See draft text linked to House Appropriations Committee, “Committee Releases FY24 Labor, Health and Human 1 See draft text linked to House Appropriations Committee, “Committee Releases FY24 Labor, Health and Human
Services, Education, and Related Agencies Appropriations Bill,” July 13, 2023, https://appropriations.house.gov/news/Services, Education, and Related Agencies Appropriations Bill,” July 13, 2023, https://appropriations.house.gov/news/
press-releases/committee-releases-fy24-labor-health-and-human-services-education-and-related. press-releases/committee-releases-fy24-labor-health-and-human-services-education-and-related.
2 The bill was brought to the House floor for consideration on November 14, under the terms of a special rule (H.Res. 2 The bill was brought to the House floor for consideration on November 14, under the terms of a special rule (H.Res.
864) that specified the amendments that would be in order and provided that the text of the bill would be Rules 864) that specified the amendments that would be in order and provided that the text of the bill would be Rules
Committee Print 118-13, which in effect made numerous alterations to the provisions in H.R. 5894 as introduced. The Committee Print 118-13, which in effect made numerous alterations to the provisions in H.R. 5894 as introduced. The
text of Rules Committee Print 118-13 is posted at https://rules.house.gov/sites/republicans.rules118.house.gov/files/text of Rules Committee Print 118-13 is posted at https://rules.house.gov/sites/republicans.rules118.house.gov/files/
LHHS%20RCP%20FINAL_xml.pdf. A comparative print of H.R. 5894 and the Rules Committee Print 118-13 is LHHS%20RCP%20FINAL_xml.pdf. A comparative print of H.R. 5894 and the Rules Committee Print 118-13 is
posted at https://rules.house.gov/sites/republicans.rules118.house.gov/files/posted at https://rules.house.gov/sites/republicans.rules118.house.gov/files/
118hr5894ih_to_LHHS%20RCP%20FINAL_xml.pdf. Draft explanatory materials accompanying H.R. 5894 and Rules 118hr5894ih_to_LHHS%20RCP%20FINAL_xml.pdf. Draft explanatory materials accompanying H.R. 5894 and Rules
Committee Print 118-13 have also been released by the House Appropriations Committee and posted at Committee Print 118-13 have also been released by the House Appropriations Committee and posted at
https://appropriations.house.gov/sites/republicans.appropriations.house.gov/files/FY24-LHHS-Explanatory-https://appropriations.house.gov/sites/republicans.appropriations.house.gov/files/FY24-LHHS-Explanatory-
Materials.pdf. The Rules Committee Print does not reflect amendments adopted on the floor. Materials.pdf. The Rules Committee Print does not reflect amendments adopted on the floor.
3 Calculated based on the explanatory statement accompanying the FY2023 LHHS omnibus (P.L. 117-328) available in 3 Calculated based on the explanatory statement accompanying the FY2023 LHHS omnibus (P.L. 117-328) available in
the the Congressional Record, vol. 168, no. 198, book II, December 20, 2022, pp. S8874-S9198. The discretionary funding , vol. 168, no. 198, book II, December 20, 2022, pp. S8874-S9198. The discretionary funding
provided in the LHHS appropriations act is both provided and controlled by that act. The mandatory funding provided 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 and other budget terms, see U.S. in the LHHS act is controlled by provisions in authorizing law. For definitions of these and other budget terms, see U.S.
Government Accountability Office (GAO), A Glossary of Terms Used in the Federal Budget Process, GAO-05-734SP, 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 may include 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 , and mandatory.) .)
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Status of FY2024 LHHS Appropriations: In Brief

• 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), Corporation for National and Community Service, Administration (SSA), Corporation for National and Community Service,
Corporation for Public Broadcasting, Institute of Museum and Library Services, Corporation for Public Broadcasting, Institute of Museum and Library Services,
National Labor Relations Board, and Railroad Retirement Board. National Labor Relations Board, and Railroad Retirement Board.
In general, mandatory funding represents more than 80% of the total LHHS bill, supporting In general, mandatory funding represents more than 80% of the total LHHS bill, supporting
annually appropriated entitlements such as Medicaid and Supplemental Security Income (SSI). annually appropriated entitlements such as Medicaid and Supplemental Security Income (SSI).
Discretionary funds, which account for less than 20% of total funds in the bill, tend to be the Discretionary funds, which account for less than 20% of total funds in the bill, tend to be the
focus of congressional debate during the appropriations process.4 This is because the focus of congressional debate during the appropriations process.4 This is because the
appropriations process generally has little control over the amount of mandatory funding provided appropriations process generally has little control over the amount of mandatory funding provided
for appropriated entitlements; rather, the authorizing statute controls the program parameters for appropriated entitlements; rather, the authorizing statute controls the program parameters
(e.g., eligibility rules, benefit levels) that entitle certain recipients to payments. Consequently, the (e.g., eligibility rules, benefit levels) that entitle certain recipients to payments. Consequently, the
focus of this report generally is on the discretionary spending that has been or would be provided focus of this report generally is on the discretionary spending that has been or would be provided
for LHHS programs and activities under various laws and proposals. for LHHS programs and activities under various laws and proposals.
Even though discretionary appropriations represent a relatively small share of the entire LHHS Even though discretionary appropriations represent a relatively small share of the entire LHHS
bill, the bill is typically the largest single source of nondefense discretionary funding for the bill, the bill is typically the largest single source of nondefense discretionary funding for the
federal government. (The Department of Defense bill is the largest single source of discretionary federal government. (The Department of Defense bill is the largest single source of discretionary
funding overall.) funding overall.)
Calculating Total LHHS Budget Authority
Budget authority is the amount of money a federal agency is legally authorized to commit or spend. Appropriations is the amount of money a federal agency is legally authorized to commit or spend. Appropriations
bil s may include budget authority that becomes available in the current fiscal year, in future fiscal years, or some bil s may include budget authority that becomes available in the current fiscal year, in future fiscal years, or some
combination. Amounts that become available in future fiscal years are typically referred to as combination. Amounts that become available in future fiscal years are typically referred to as advance
appropriations (e.g., the FY2024 LHHS appropriations act generally would contain advance appropriations that (e.g., the FY2024 LHHS appropriations act generally would contain advance appropriations that
become available in FY2025 and FY2026 for certain programs and activities). In addition, while new budget become available in FY2025 and FY2026 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, including ), some budget authority may be effectively exempted from those controls, including
budget authority for emergency requirements, health care fraud and abuse control, and continuing disability budget authority for emergency requirements, health care fraud and abuse control, and continuing disability
reviews and redeterminations. reviews and 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.5 In some cases, such as the 302(b) suballocations (discussed later), the total is based on funding becomes available.5 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.6 Additionally, budgetary totals may or may not calculated regardless of the year in which it was first appropriated.6 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

4 For an illustrative discussion of the distribution of funds among the different titles of the bill, and between 4 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 in CRS Report R47345, discretionary and mandatory spending, see the summary of FY2023 LHHS appropriations in CRS Report R47345,
Labor, Health and Human Services, and Education: FY2023 Appropriations. .
5 Such figures include advance appropriations provided in the bill for future fiscal years, but do not include advance 5 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.
6 Such figures typically exclude advance appropriations for future years, but include advance appropriations from prior 6 Such figures typically exclude advance appropriations for future years, but include advance appropriations from prior
years that become available in the given fiscal year. years that become available in the given fiscal year.
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Status of FY2024 LHHS Appropriations: In Brief

conventions and special instructions of Congress.7 Finally, calculations of LHHS budget authority might include or conventions and special instructions of Congress.7 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.
Context for FY2024
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 FY2024 cycle has been affected by a number the congressional budget resolution. However, the FY2024 cycle has been affected by a number
of issues, including the circumstances affecting the timing of the President’s budget and the of issues, including the circumstances affecting the timing of the President’s budget and the
recent imposition of statutory discretionary spending limits on defense and nondefense spending. recent imposition of statutory discretionary spending limits on defense and nondefense spending.
Background related to these issues is provided below. Background related to these issues is provided below.
FY2024 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
spending, however, which is roughly one-third of the federal budget,8 is decided and controlled , however, which is roughly one-third of the federal budget,8 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.9 President’s recommended spending levels for agencies and programs.9
The President’s budget request for FY2024 was submitted on March 9, 2023, about five weeks The President’s budget request for FY2024 was submitted on March 9, 2023, about five weeks
after it was due. It was preceded by the enactment of FY2023 full-year annual appropriations after it was due. It was preceded by the enactment of FY2023 full-year annual appropriations
(P.L. 117-328) on December 29, 2022, about three months into the fiscal year. The delay of the (P.L. 117-328) on December 29, 2022, about three months into the fiscal year. The delay of the
budget submission allowed the FY2023 funding amounts displayed in the budget materials budget submission allowed the FY2023 funding amounts displayed in the budget materials
generally to reflect the annual appropriations in December. generally to reflect the annual appropriations in December.
On May 9, the President submitted amendments to the FY2024 budget request that included On May 9, the President submitted amendments to the FY2024 budget request that included
changes to the amounts requested for specified Department of Education accounts.10 In addition, changes to the amounts requested for specified Department of Education accounts.10 In addition,
two supplemental appropriations proposals made since that time have included requests for two supplemental appropriations proposals made since that time have included requests for
LHHS-related discretionary funding. The request for “critical national security funding needs” LHHS-related discretionary funding. The request for “critical national security funding needs”

7 For more information on scorekeeping, see CRS Report 98-560, 7 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).
8 Congressional Budget Office (CBO), 8 Congressional Budget Office (CBO), The 2022 Long-Term Budget Outlook, July 2022, p. 18, https://www.cbo.gov/, July 2022, p. 18, https://www.cbo.gov/
system/files/2022-07/57971-LTBO.pdf. system/files/2022-07/57971-LTBO.pdf.
9 For more information, see CRS Report R47019, 9 For more information, see CRS Report R47019, The Executive Budget Process: An Overview. .
10 See the budget amendments package at https://www.whitehouse.gov/wp-content/uploads/2023/05/10 See the budget amendments package at https://www.whitehouse.gov/wp-content/uploads/2023/05/
FY_2024_Budget_Amendment_Corrections_5-9-23.pdf. FY_2024_Budget_Amendment_Corrections_5-9-23.pdf.
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Status of FY2024 LHHS Appropriations: In Brief

made on October 20 included funding for HHS and DOL accounts.11 The request for “critical made on October 20 included funding for HHS and DOL accounts.11 The request for “critical
domestic needs” made on October 25 included funding for HHS and ED accounts.12 domestic needs” made on October 25 included funding for HHS and ED accounts.12
FY2024 Discretionary Spending Levels and Appropriations
Allocations
For FY2024, the discretionary spending levels in appropriations measures are enforceable by both For FY2024, the discretionary spending levels in appropriations measures are enforceable by both
statutory and procedural means. Statutory budget enforcement is through the discretionary statutory and procedural means. Statutory budget enforcement is through the discretionary
spending limits in the Balanced Budget and Emergency Deficit Control Act of 1985 (BBEDCA; spending limits in the Balanced Budget and Emergency Deficit Control Act of 1985 (BBEDCA;
P.L. 99-177), as amended. These statutory limits are enforced through P.L. 99-177), as amended. These statutory limits are enforced through sequestration: largely : largely
across-the-board reductions made to the category of spending that is in excess of the limit across-the-board reductions made to the category of spending that is in excess of the limit
(defense or nondefense), to eliminate the excess spending.13 Procedural budget enforcement is (defense or nondefense), to eliminate the excess spending.13 Procedural budget enforcement is
primarily associated with the budget resolution, which provides a process for the House and primarily associated with the budget resolution, which provides a process for the House and
Senate to agree on budgetary targets ahead of consideration of spending and revenue legislation. Senate to agree on budgetary targets ahead of consideration of spending and revenue legislation.
These targets are enforced through points of order. These targets are enforced through points of order.
Certain spending is effectively exempt from these limits (commonly referred to as Certain spending is effectively exempt from these limits (commonly referred to as adjustments to to
those limits). In recent years, adjustments that have been applied to LHHS appropriations are for those limits). In recent years, adjustments that have been applied to LHHS appropriations are for
emergency requirements, to accommodate new budget authority for specified “program integrity” , to accommodate new budget authority for specified “program integrity”
initiatives at HHS (initiatives at HHS (health care fraud and abuse control), the SSA (), 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 unemployment compensation.14 conducted by the states related to unemployment compensation.14
Statutory Spending Limits
The statutory limits on discretionary spending that are currently in effect were enacted as part of The statutory limits on discretionary spending that are currently in effect were enacted as part of
the Fiscal Responsibility Act of 2023 (FRA; P.L. 118-5) on June 3, 2023.15 Prior to the FRA, the Fiscal Responsibility Act of 2023 (FRA; P.L. 118-5) on June 3, 2023.15 Prior to the FRA,
statutory limits on discretionary spending had been in effect from FY2012 through FY2021 statutory limits on discretionary spending had been in effect from FY2012 through FY2021
(having expired at the end of FY2021).16 The FRA amended the BBEDCA to provide limits on (having expired at the end of FY2021).16 The FRA amended the BBEDCA to provide limits on
defense discretionary (all spending under budget function 050) and nondefense discretionary (all defense discretionary (all spending under budget function 050) and nondefense discretionary (all
other spending) for FY2024 and FY2025. All funding in the LHHS bill is subject to the other spending) for FY2024 and FY2025. All funding in the LHHS bill is subject to the
nondefense limit. The statutory limit on nondefense discretionary spending for FY2024 is nondefense limit. The statutory limit on nondefense discretionary spending for FY2024 is
$703.65 billion. This would be a $40.2 billion (-5%) reduction relative to FY2023 enacted $703.65 billion. This would be a $40.2 billion (-5%) reduction relative to FY2023 enacted

11 See Executive Office of the President (EOP), Office of Management and Budget (OMB), “Letter Regarding Critical 11 See Executive Office of the President (EOP), Office of Management and Budget (OMB), “Letter Regarding Critical
National Security Funding Needs for FY 2024,” October 20, 2023, https://www.whitehouse.gov/omb/briefing-room/National Security Funding Needs for FY 2024,” October 20, 2023, https://www.whitehouse.gov/omb/briefing-room/
2023/10/20/letter-regarding-critical-national-security-funding-needs-for-fy-2024/. 2023/10/20/letter-regarding-critical-national-security-funding-needs-for-fy-2024/.
12 See EOP, OMB, “FACT SHEET: White House Calls on Congress to Support Critical Domestic Needs,” October 25, 12 See EOP, OMB, “FACT SHEET: White House Calls on Congress to Support Critical Domestic Needs,” October 25,
2023, https://www.whitehouse.gov/briefing-room/statements-releases/2023/10/25/fact-sheet-white-house-calls-on-2023, https://www.whitehouse.gov/briefing-room/statements-releases/2023/10/25/fact-sheet-white-house-calls-on-
congress-to-support-critical-domestic-needs/; and EOP, OMB, “Funding Request to meet Critical Needs,” undated, congress-to-support-critical-domestic-needs/; and EOP, OMB, “Funding Request to meet Critical Needs,” undated,
https://www.whitehouse.gov/wp-content/uploads/2023/10/Funding-Request-to-Meet-Critical-Needs.pdf. https://www.whitehouse.gov/wp-content/uploads/2023/10/Funding-Request-to-Meet-Critical-Needs.pdf.
13 The Fiscal Responsibility Act of 2023 (FRA; P.L. 118-5) also contains procedures by which these limits might be 13 The Fiscal Responsibility Act of 2023 (FRA; P.L. 118-5) also contains procedures by which these limits might be
temporarily or permanently adjusted in the case of a continuing resolution. For a summary of these adjustments, see temporarily or permanently adjusted in the case of a continuing resolution. For a summary of these adjustments, see
CRS Insight IN12168, CRS Insight IN12168, Discretionary Spending Caps in the Fiscal Responsibility Act of 2023. .
14 For further information on how these generally function, see Appendix A in CRS Report R47345, 14 For further information on how these generally function, see Appendix A in CRS Report R47345, Labor, Health and
Human Services, and Education: FY2023 Appropriations. .
15 For more information, see CRS Insight IN12168, 15 For more information, see CRS Insight IN12168, Discretionary Spending Caps in the Fiscal Responsibility Act of
2023. .
16 These limits were initially established in 2011 by the amendments made by the Budget Control Act of 2011 (BCA; 16 These limits were initially established in 2011 by the amendments made by the Budget Control Act of 2011 (BCA;
P.L. 112-25) to the BBEDCA, but they were subsequently revised several times over the course of their effective P.L. 112-25) to the BBEDCA, but they were subsequently revised several times over the course of their effective
period. For a summary of these changes, see CRS Insight IN11148, period. For a summary of these changes, see CRS Insight IN11148, The Bipartisan Budget Act of 2019: Changes to the
BCA and Debt Limit. .
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nondefense discretionary spending when accounting for Congressional Budget Office (CBO) nondefense discretionary spending when accounting for Congressional Budget Office (CBO)
scorekeeping, and prior to any adjustments to the limits pursuant to BBEDCA authorities.17 For scorekeeping, and prior to any adjustments to the limits pursuant to BBEDCA authorities.17 For
LHHS programs and activities, the FRA also provided for adjustments to the nondefense LHHS programs and activities, the FRA also provided for adjustments to the nondefense
spending limit for health care fraud and abuse control, continuing disability reviews and spending limit for health care fraud and abuse control, continuing disability reviews and
redeterminations, and reemployment services and eligibility assessments, up to a specified redeterminations, and reemployment services and eligibility assessments, up to a specified
amount of funding for each of FY2024 and FY2025.18 The maximum amount of funding allowed amount of funding for each of FY2024 and FY2025.18 The maximum amount of funding allowed
for these LHHS adjustments is $2.447 billion total in FY2024 and $2.531 billion in FY2025. for these LHHS adjustments is $2.447 billion total in FY2024 and $2.531 billion in FY2025.
Appropriations Allocations Under the Budget Resolution
The budget resolution process dates back to the Congressional Budget Act of 1974, and is used The budget resolution process dates back to the Congressional Budget Act of 1974, and is used
each year to impose a limit on total discretionary spending available to the appropriations each year to impose 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 subsequently, limits on spending ) and subsequently, limits on spending
under the jurisdiction of each appropriations subcommittee (referred to as under the jurisdiction of each appropriations subcommittee (referred to as 302(b)
suballocations).19 ).19
As of the cover date of this report, there has been no House or Senate action on a FY2024 budget As of the cover date of this report, there has been no House or Senate action on a FY2024 budget
resolution.20 For the purposes of providing 302(a) allocations and budgetary aggregates for the resolution.20 For the purposes of providing 302(a) allocations and budgetary aggregates for the
consideration of FY2024 appropriations, as well as other matters that would have been consideration of FY2024 appropriations, as well as other matters that would have been
traditionally associated with the budget resolution, the FRA directed the Chairs of the House traditionally associated with the budget resolution, the FRA directed the Chairs of the House
Budget Committee and the Senate Budget Committee to enter those amounts into the Budget Committee and the Senate Budget Committee to enter those amounts into the
Congressional Record as soon as practicable. These were published in the Senate on June 21, as soon as practicable. These were published in the Senate on June 21,
2023, but have not been published in the House.21 2023, but have not been published in the House.21
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., FY2024) appropriations within each subcommittee’s provide a limit on current-year (i.e., FY2024) appropriations within each subcommittee’s
jurisdiction and incorporate any applicable scorekeeping adjustments made by CBO.22 On June jurisdiction and incorporate any applicable scorekeeping adjustments made by CBO.22 On June
15, 2023, the House Appropriations Committee voted to approve draft suballocations for all 12 15, 2023, the House Appropriations Committee voted to approve draft suballocations for all 12

17 These calculations are based on CBO, 17 These calculations are based on CBO, Report on the Status of Discretionary Appropriations, Fiscal Year 2023, U.S.
Senate, February 10, 2023, https://www.cbo.gov/system/files?file=2023-02/FY2023-Senate-2022-12-23.pdf. Note that , https://www.cbo.gov/system/files?file=2023-02/FY2023-Senate-2022-12-23.pdf. Note that
CBO tabulates a slightly different amount of funding using House conventions in CBO, CBO tabulates a slightly different amount of funding using House conventions in CBO, Report on the Status of
Discretionary Appropriations, Fiscal Year 2023, U.S. House of Representatives, February 10, 2023, ,
https://www.cbo.gov/system/files?file=2023-02/FY2023-House-2022-12-23.pdf. The FRA includes a provision https://www.cbo.gov/system/files?file=2023-02/FY2023-House-2022-12-23.pdf. The FRA includes a provision
described as incentivizing Members to enact regular full-year appropriations legislation. The FRA states that in the described as incentivizing Members to enact regular full-year appropriations legislation. The FRA states that in the
event that a continuing resolution (CR) is in effect on January 1 of 2024 or 2025 for any budget account, the event that a continuing resolution (CR) is in effect on January 1 of 2024 or 2025 for any budget account, the
discretionary spending limits for that fiscal year are automatically revised. The revision would result in an increase in discretionary spending limits for that fiscal year are automatically revised. The revision would result in an increase in
nondefense discretionary budget authority and a decrease for defense discretionary spending levels when compared nondefense discretionary budget authority and a decrease for defense discretionary spending levels when compared
with the original levels. Under such a scenario, a sequester order would be issued on April 30 of either 2024 or 2025. with the original levels. Under such a scenario, a sequester order would be issued on April 30 of either 2024 or 2025.
The FRA states that the revised limits would revert to the original FRA limits if full-year appropriations were enacted The FRA states that the revised limits would revert to the original FRA limits if full-year appropriations were enacted
before April 30. For more information, see CRS Insight IN12183, before April 30. For more information, see CRS Insight IN12183, The FRA’s Discretionary Spending Caps Under a
CR: FAQs. .
18 The FRA also provided for a designation for emergency requirements, which would generally be available for 18 The FRA also provided for a designation for emergency requirements, which would generally be available for
funding under the purview of any appropriations act (not just LHHS). funding under the purview of any appropriations act (not just LHHS).
19 For further information, see CRS Report 98-815, 19 For further information, see CRS Report 98-815, Budget Resolution Enforcement. .
20 The House Budget Committee voted to report a FY2024 budget resolution on September 20, 2023, but the measure 20 The House Budget Committee voted to report a FY2024 budget resolution on September 20, 2023, but the measure
has not yet been reported. has not yet been reported.
21 “Budget Enforcement Levels,” 21 “Budget Enforcement Levels,” Congressional Record, daily edition, vol. 169, no. 108 (June 21, 2023), pp. S2180-, daily edition, vol. 169, no. 108 (June 21, 2023), pp. S2180-
S2181. S2181.
22 Such suballocations are commonly revised throughout the appropriations process to reflect changing budgetary 22 Such suballocations are commonly revised throughout the appropriations process to reflect changing budgetary
priorities. priorities.
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subcommittees, including LHHS (33-27).23 Subsequently, the Senate Appropriations Committee subcommittees, including LHHS (33-27).23 Subsequently, the Senate Appropriations Committee
reported its suballocations on June 22, 2023 (15-13).24 These suballocations are displayed in reported its suballocations on June 22, 2023 (15-13).24 These suballocations are displayed in
Table 1.
FY2024 LHHS Legislative Action
FY2024 Continuing Appropriations
FY2024 LHHS regular appropriations are currently being provided by a series of CRs. The first FY2024 LHHS regular appropriations are currently being provided by a series of CRs. The first
CR was signed into law on September 30, 2023 (Division A of H.R. 5860; P.L. 118-15). It CR was signed into law on September 30, 2023 (Division A of H.R. 5860; P.L. 118-15). It
provided continuing appropriations for all 12 of the annual appropriations acts (including LHHS) provided continuing appropriations for all 12 of the annual appropriations acts (including LHHS)
through November 17, 2023. H.R. 5860 was introduced by Representative Granger, the House through November 17, 2023. H.R. 5860 was introduced by Representative Granger, the House
Appropriations Committee Chair, on September 30, 2023. That same day, the measure was passed Appropriations Committee Chair, on September 30, 2023. That same day, the measure was passed
by both the House (335-91) and the Senate (88-9), and signed into law. Subsequently, by both the House (335-91) and the Senate (88-9), and signed into law. Subsequently, ~~a second~~
CRtwo additional CRs were enacted, which extended the provisions of the first CR with some additional , which extended the provisions of the first CR with some additional ~~provisions, was~~provisions (see Division A of P.L. 118-22, enacted enacted
on November 16, 2023on November 16, 2023; and (Division ADivision A, of P.L. 118- P.L. 118-~~22)~~35, enacted on January 19, 2024). The third CR provides LHHS appropriations through March 8. .
In general, the FY2024 CRs fund discretionary programs at the same rate and under the same In general, the FY2024 CRs fund discretionary programs at the same rate and under the same
conditions as in FY2023 annual appropriations acts (§101), with specified exceptions, and funds conditions as in FY2023 annual appropriations acts (§101), with specified exceptions, and funds
annually appropriated entitlements at their current law levels (§111).25 The CRs include a few annually appropriated entitlements at their current law levels (§111).25 The CRs include a few
provisions that are specific to LHHS accounts or related activities. Most of these LHHS-specific provisions that are specific to LHHS accounts or related activities. Most of these LHHS-specific
provisions were included in the first CR and continued in the second (§§101(8), 133); one new provisions were included in the first CR and continued in the second (§§101(8), 133); one new
LHHS-specific provision was added in the second CR (§145).26 LHHS-specific provision was added in the second CR (§145).26
Congressional Action on an LHHS Bill
In the Senate, the FY2024 LHHS bill has been reported out of the Senate Appropriations In the Senate, the FY2024 LHHS bill has been reported out of the Senate Appropriations
Committee, but has not received floor consideration. On July 27, 2023, the Senate Appropriations Committee, but has not received floor consideration. On July 27, 2023, the Senate Appropriations
Committee voted to report the FY2024 LHHS bill, 26-2; the measure was subsequently reported Committee voted to report the FY2024 LHHS bill, 26-2; the measure was subsequently reported
to the Senate that same day (S. 2624; S.Rept. 118-84). The measure was not formally marked up to the Senate that same day (S. 2624; S.Rept. 118-84). The measure was not formally marked up
in subcommittee prior to full committee action. in subcommittee prior to full committee action.

23 The House Appropriations Committee suballocations have not been formally reported, but they have been published 23 The House Appropriations Committee suballocations have not been formally reported, but they have been published
by the committee at https://appropriations.house.gov/sites/republicans.appropriations.house.gov/files/documents/by the committee at https://appropriations.house.gov/sites/republicans.appropriations.house.gov/files/documents/
FY24%20House%20Subcommittee%20Allocations%206.13.23_0.pdf. FY24%20House%20Subcommittee%20Allocations%206.13.23_0.pdf.
24 S.Rept. 118-45. These suballocations were subsequently revised in S.Rept. 118-57, S.Rept. 118-69, S.Rept. 118-78, 24 S.Rept. 118-45. These suballocations were subsequently revised in S.Rept. 118-57, S.Rept. 118-69, S.Rept. 118-78,
S.Rept. 118-98, and S.Rept. 118-108. S.Rept. 118-98, and S.Rept. 118-108.
25 For an estimate of the discretionary appropriations contained in Division A of H.R. 6833, see 25 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. 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. 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.
26 The LHHS-specific provisions in the first CR (§§101(8) and 133) are discussed in CRS Report R47749, 26 The LHHS-specific provisions in the first CR (§§101(8) and 133) are discussed in CRS Report R47749, Overview of
Continuing Appropriations for FY2024 (Division A of P.L. 118-15). .
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In the House, the FY2024 LHHS bill has received some House Appropriations Committee In the House, the FY2024 LHHS bill has received some House Appropriations Committee
consideration, but was not marked up by the full committee. The draft bill was approved in consideration, but was not marked up by the full committee. The draft bill was approved in
subcommittee on July 14, 2023, by a voice vote.27 subcommittee on July 14, 2023, by a voice vote.27
The LHHS bill has also received some House floor consideration, but the House has not voted on The LHHS bill has also received some House floor consideration, but the House has not voted on
passage of the bill. On October 6, 2023, Representative Aderholt, Chair of the House passage of the bill. On October 6, 2023, Representative Aderholt, Chair of the House
Appropriations LHHS Subcommittee, introduced an LHHS bill (H.R. 5894); the text of H.R. Appropriations LHHS Subcommittee, introduced an LHHS bill (H.R. 5894); the text of H.R.
5894 as introduced was substantially the same as the subcommittee draft. The bill was brought to 5894 as introduced was substantially the same as the subcommittee draft. The bill was brought to
the House floor for consideration on November 14, under the terms of a special rule (H.Res. 864), the House floor for consideration on November 14, under the terms of a special rule (H.Res. 864),
that specified the amendments that would be in order and provided that the text of the bill would that specified the amendments that would be in order and provided that the text of the bill would
be Rules Committee Print 118-13, which in effect made numerous alterations to the provisions in be Rules Committee Print 118-13, which in effect made numerous alterations to the provisions in
H.R. 5894 as introduced.28 This rule also provided the authority for the chair of the H.R. 5894 as introduced.28 This rule also provided the authority for the chair of the
Appropriations Committee or her designee to offer any of the amendments made in order en bloc Appropriations Committee or her designee to offer any of the amendments made in order en bloc
(i.e., in groups of amendments to be disposed of together)29; a total of 49 amendments were (i.e., in groups of amendments to be disposed of together)29; a total of 49 amendments were
considered in this manner. When counting amendments considered en bloc as separate considered in this manner. When counting amendments considered en bloc as separate
amendments, 109 amendments were adopted, 23 were rejected, and 2 were offered and amendments, 109 amendments were adopted, 23 were rejected, and 2 were offered and
withdrawn. withdrawn.
Table 1 displays the CBO estimate of enacted LHHS discretionary appropriations for FY2022 displays the CBO estimate of enacted LHHS discretionary appropriations for FY2022
and FY2023, alongside the FY2024 draft House suballocation for LHHS30 and the FY2024 and FY2023, alongside the FY2024 draft House suballocation for LHHS30 and the FY2024
Senate committee-reported bill (S. 2624). The amounts shown for “regular discretionary Senate committee-reported bill (S. 2624). The amounts shown for “regular discretionary
appropriations” do not include any funding that is subject to program integrity adjustments or appropriations” do not include any funding that is subject to program integrity adjustments or
emergency designations. The amounts shown represent current-year budget authority subject to emergency designations. The amounts shown represent current-year budget authority subject to
the spending limits and take into account any applicable CBO scorekeeping adjustments. Under the spending limits and take into account any applicable CBO scorekeeping adjustments. Under
this method of estimating the bill, the House proposal would reduce regular discretionary this method of estimating the bill, the House proposal would reduce regular discretionary
appropriations for LHHS by 29% (-$60.3 billion) relative to FY2023 and by 25% (-$49.9 billion) appropriations for LHHS by 29% (-$60.3 billion) relative to FY2023 and by 25% (-$49.9 billion)

27 See draft text linked to House Appropriations Committee, “Committee Releases FY24 Labor, Health and Human 27 See draft text linked to House Appropriations Committee, “Committee Releases FY24 Labor, Health and Human
Services, Education, and Related Agencies Appropriations Bill,” July 13, 2023, https://appropriations.house.gov/news/Services, Education, and Related Agencies Appropriations Bill,” July 13, 2023, https://appropriations.house.gov/news/
press-releases/committee-releases-fy24-labor-health-and-human-services-education-and-related. press-releases/committee-releases-fy24-labor-health-and-human-services-education-and-related.
28 See the Rules Committee report accompanying H.Res. 864 for the text of the amendments made in order (H.Rept. 28 See the Rules Committee report accompanying H.Res. 864 for the text of the amendments made in order (H.Rept.
118-272). The text of Rules Committee Print 118-13 is posted at https://rules.house.gov/sites/118-272). The text of Rules Committee Print 118-13 is posted at https://rules.house.gov/sites/
republicans.rules118.house.gov/files/LHHS%20RCP%20FINAL_xml.pdf. A comparative print of H.R. 5894 and the republicans.rules118.house.gov/files/LHHS%20RCP%20FINAL_xml.pdf. A comparative print of H.R. 5894 and the
Rules Committee Print 118-13 is posted at https://rules.house.gov/sites/republicans.rules118.house.gov/files/Rules Committee Print 118-13 is posted at https://rules.house.gov/sites/republicans.rules118.house.gov/files/
118hr5894ih_to_LHHS%20RCP%20FINAL_xml.pdf. Draft explanatory materials accompanying H.R. 5894 and Rules 118hr5894ih_to_LHHS%20RCP%20FINAL_xml.pdf. Draft explanatory materials accompanying H.R. 5894 and Rules
Committee Print 118-13 have also been released by the House Appropriations Committee and posted at Committee Print 118-13 have also been released by the House Appropriations Committee and posted at
https://appropriations.house.gov/sites/republicans.appropriations.house.gov/files/FY24-LHHS-Explanatory-https://appropriations.house.gov/sites/republicans.appropriations.house.gov/files/FY24-LHHS-Explanatory-
Materials.pdf. Materials.pdf.
29 For further information about en bloc authority in the context of House floor consideration of appropriations 29 For further information about en bloc authority in the context of House floor consideration of appropriations
measures, see CRS Report R46841, measures, see CRS Report R46841, Changes in the House of Representatives’ Initial Consideration of Regular
Appropriations Measures, 113th-116th Congresses. .
30 The House Appropriations Committee majority summary of the subcommittee draft LHHS bill indicated that total 30 The House Appropriations Committee majority summary of the subcommittee draft LHHS bill indicated that total
discretionary funding in the draft aligns with the draft subcommittee allocation. (See bill summary linked at House discretionary funding in the draft aligns with the draft subcommittee allocation. (See bill summary linked at House
Appropriations Committee majority, “Committee Releases FY24 Labor, Health and Human Services, Education, and Appropriations Committee majority, “Committee Releases FY24 Labor, Health and Human Services, Education, and
Related Agencies Appropriations Bill,” July 13 2023, https://appropriations.house.gov/news/press-releases/committee-Related Agencies Appropriations Bill,” July 13 2023, https://appropriations.house.gov/news/press-releases/committee-
releases-fy24-labor-health-and-human-services-education-and-related.) According to page 2 of the draft explanatory releases-fy24-labor-health-and-human-services-education-and-related.) According to page 2 of the draft explanatory
materials released by the House Appropriations Committee, the LHHS appropriations in H.R. 5894 (and presumably as materials released by the House Appropriations Committee, the LHHS appropriations in H.R. 5894 (and presumably as
proposed in Rules Committee Print 118-13) align with the draft subcommittee suballocation. proposed in Rules Committee Print 118-13) align with the draft subcommittee suballocation.
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relative to FY2022.31 The Senate proposal would reduce discretionary appropriations for LHHS relative to FY2022.31 The Senate proposal would reduce discretionary appropriations for LHHS
by 6% (-$12.1 billion) relative to FY2023 and by 1% (-$1.8 billion) relative to FY2022.32 by 6% (-$12.1 billion) relative to FY2023 and by 1% (-$1.8 billion) relative to FY2022.32
As mentioned previously, certain LHHS appropriations, such as those allowed for program As mentioned previously, certain LHHS appropriations, such as those allowed for program
integrity funding or designated as for emergency requirements, are effectively exempt from the integrity funding or designated as for emergency requirements, are effectively exempt from the
discretionary spending limits. (The “adjusted appropriations” total in the table includes funding discretionary spending limits. (The “adjusted appropriations” total in the table includes funding
under these adjustments, plus “regular discretionary appropriations.”) The draft House under these adjustments, plus “regular discretionary appropriations.”) The draft House
Appropriations Committee report on FY2024 suballocations for LHHS presents an aggregate Appropriations Committee report on FY2024 suballocations for LHHS presents an aggregate
total for the three “program integrity” adjustments ($2.4 billion), which matches the maximum total for the three “program integrity” adjustments ($2.4 billion), which matches the maximum
aggregate amount available for the three LHHS “program integrity” adjustments under the aggregate amount available for the three LHHS “program integrity” adjustments under the
FY2024 statutory spending limits (see discussion in the FY2024 statutory spending limits (see discussion in the “FY2024 Discretionary Spending Levels
and Appropriations Allocations” section). The House suballocations for LHHS do not include any section). The House suballocations for LHHS do not include any
FY2024 funding for emergency requirements. The FY2024 Senate committee-reported LHHS bill FY2024 funding for emergency requirements. The FY2024 Senate committee-reported LHHS bill
would provide the same total amount proposed by the House in program integrity adjustments, would provide the same total amount proposed by the House in program integrity adjustments,
and $4.5 billion in emergency-designated discretionary funding.33 and $4.5 billion in emergency-designated discretionary funding.33
Table 1. LHHS Discretionary Appropriations: Comparison of FY2022 Enacted,
FY2023 Enacted, and FY2024 House and Senate Appropriations Committee Initial
302(b) Suballocations
(Budget authority in billions of dollars) (Budget authority in billions of dollars)

FY2024 Draft
FY2024 Senate
House
Committee-
FY2022
FY2023
Committee
Reported Bill
Enacted
Enacted
Suballocationa
(S. 2624)
Regular discretionary Regular discretionary
196.994 196.994
207.367 207.367
147.096 147.096
195.231 195.231
appropriations appropriations
Adjustmen Adjustments:b

Program Integrity Program Integrity
2.124 2.124
2.345 2.345
2.447 2.447
2.447 2.447
Health Care Fraud and
0.556
0.576
—
0.604
Abuse Control (non-add)
Continuing Disability
1.435
1.511
—
1.578
Reviews and
Redeterminations (non-
add)
Reemployment Services
0.133
0.258
—
0.265
and Eligibility
Assessments (non-add)

31 This CRS estimate is based on a comparison of the CBO estimate for FY2022 enacted (CBO, 31 This CRS estimate is based on a comparison of the 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/, https://www.cbo.gov/
system/files?file=2022-05/FY2022-House-2022-05-26.pdf) to the total discretionary spending budget authority system/files?file=2022-05/FY2022-House-2022-05-26.pdf) to the total discretionary spending budget authority
allocation. allocation.
32 An alternative way of calculating the amount of the Senate-proposed reductions was provided in the committee 32 An alternative way of calculating the amount of the Senate-proposed reductions was provided in the committee
report accompanying S. 2624. The subcommittee’s effective base discretionary funding allocation, which includes report accompanying S. 2624. The subcommittee’s effective base discretionary funding allocation, which includes
discretionary funding offset by savings in changes in mandatory programs and other similar adjustments is discretionary funding offset by savings in changes in mandatory programs and other similar adjustments is
$1,218,000,000 below the comparable fiscal year 2023 level ( S.Rept. 118-84, p. 1). With regard to the House-proposed $1,218,000,000 below the comparable fiscal year 2023 level ( S.Rept. 118-84, p. 1). With regard to the House-proposed
reductions, it cannot be determined based on the suballocations alone the extent to which these reductions would be reductions, it cannot be determined based on the suballocations alone the extent to which these reductions would be
achieved via rescissions to previously enacted funding and other related budgetary mechanisms, versus reducing the achieved via rescissions to previously enacted funding and other related budgetary mechanisms, versus reducing the
amount of LHHS funding that would be newly enacted for FY2024. amount of LHHS funding that would be newly enacted for FY2024.
33 Emergency-designed funding in S. 2624 was proposed for a total of 11 accounts under the Health and Human 33 Emergency-designed funding in S. 2624 was proposed for a total of 11 accounts under the Health and Human
Services (Title II) and Related Agencies (Title IV) titles in the bill. Services (Title II) and Related Agencies (Title IV) titles in the bill.
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FY2024 Draft
FY2024 Senate
House
Committee-
FY2022
FY2023
Committee
Reported Bill
Enacted
Enacted
Suballocationa
(S. 2624)
Emergency Emergency ~~requirements~~requirementsc
7.831
9.920
—
4.500
Adjusted appropriations Adjusted appropriations
206.949 206.949
219.632 219.632
149.543 149.543
202.178 202.178
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-, 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.2022, https://www.cbo.gov/system/files?file=2022-06/S2938.pdf. TheThe FY2023 Enacted amounts are from CBO, 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. , December 21, 2022, https://www.cbo.gov/publication/58872; and CRS analysis of P.L. 117-180 and P.L.
117-328. The FY2024 House Appropriations Committee initial suballocations are as published at 117-328. The FY2024 House Appropriations Committee initial suballocations are as published at
https://appropriations.house.gov/sites/republicans.appropriations.house.gov/files/documents/https://appropriations.house.gov/sites/republicans.appropriations.house.gov/files/documents/
FY24%20House%20Subcommittee%20Allocations%206.13.23_0.pdf. The FY2024 Senate Committee-reported bill FY24%20House%20Subcommittee%20Allocations%206.13.23_0.pdf. The FY2024 Senate Committee-reported bill
(S. 2624) amounts are from S.Rept. 118-84, p. 1, and CRS analysis of the text of S. 2624. “Regular discretionary (S. 2624) amounts are from S.Rept. 118-84, p. 1, and CRS analysis of the text of S. 2624. “Regular discretionary
appropriations” exclude funds for which special rules apply under the spending limits (e.g., funds for certain appropriations” exclude funds for which special rules apply under the spending limits (e.g., funds for certain
program integrity activities and emergency requirements), as well as funds provided under authorities in the 21st 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. Century Cures Act (P.L. 114-255) that are effectively exempt from the spending limits.
Notes: Amounts reflect current-year discretionary budget authority subject to spending limits. Amounts reflect current-year discretionary budget authority subject to spending limits.
a. According to page 2 of the draft explanatory materials released by the House Appropriations Committee, a. According to page 2 of the draft explanatory materials released by the House Appropriations Committee,
the LHHS appropriations in H.R. 5894 (and presumably as proposed in Rules Committee Print 118-13) align the LHHS appropriations in H.R. 5894 (and presumably as proposed in Rules Committee Print 118-13) align
with the draft subcommittee suballocation (House Appropriations Committee, draft explanatory materials with the draft subcommittee suballocation (House Appropriations Committee, draft explanatory materials
timestamped 03:26 on November 2, 2023, p. 2, https://appropriations.house.gov/sites/timestamped 03:26 on November 2, 2023, p. 2, https://appropriations.house.gov/sites/
republicans.appropriations.house.gov/files/FY24-LHHS-Explanatory-Materials.pdf). republicans.appropriations.house.gov/files/FY24-LHHS-Explanatory-Materials.pdf).
b. The FY2022 enacted amounts for these activities are identified via CRS analysis of Division H of P.L. 117- b. The FY2022 enacted amounts for these activities are identified via CRS analysis of Division H of P.L. 117-
103. The FY2023 enacted amounts for these activities are identified via CRS analysis of Division H of P.L. 103. The FY2023 enacted amounts for these activities are identified via CRS analysis of Division H of P.L.
117-328. Note that CBO tabulates these adjustments differently based on relevant procedures in CBO, 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/, December 21, 2022, https://www.cbo.gov/
system/files/2022-12/HR-2617_div-A%E2%80%93N.pdf. See also CBO, 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/, February 10, 2023, https://www.cbo.gov/system/
files?file=2023-02/FY2023-House-2022-12-23.pdf; and CBO, 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/, February 10, 2023, https://www.cbo.gov/system/files?file=2023-02/
FY2023-Senate-2022-12-23.pdf. FY2023-Senate-2022-12-23.pdf.
c. Division A of the Continuing Appropriations Act, 2024 and Other Extensions Act (H.R. 5860; P.L. 118-15, September 30, 2023) provided a rate for operations of $2.5 bil ion in emergency-designated appropriations for Low Income Home Energy Assistance Program (§101(8)) at the HHS Administration for Children and Families (ACF). Because this funding is provided at a rate for operations, and is not a definite amount, it is not included in this table.

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

Congressional Research Service Congressional Research Service

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Status of FY2024 LHHS Appropriations: In Brief

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