Labor, Health and Human Services, and Education: FY2024 Appropriations

Labor, Health and Human Services, and
March 8, 2024
Education: FY2024 Appropriations
Jessica Tollestrup,
This report offers an overview of actions taken by Congress and the President to provide FY2024
Coordinator
appropriations for accounts funded by the Departments of Labor, Health and Human Services,
Specialist in Social Policy
and Education, and Related Agencies (LHHS) appropriations bill. This bill includes all accounts

funded through the annual appropriations process at the Department of Labor (DOL) and
Karen E. Lynch,
Department of Education (ED). It also provides annual appropriations for most agencies within
Coordinator
the Department of Health and Human Services (HHS), with certain exceptions (e.g., the Food
Specialist in Social Policy
and Drug Administration is funded via the Agriculture bill). The LHHS bill also provides funds

for more than a dozen related agencies, including the Social Security Administration (SSA).
Ada S. Cornell
This report primarily focuses on regular FY2024 LHHS discretionary funding enacted during the
Senior Research Librarian

annual appropriations process. Totals in the report tables do not include emergency-designated
funds, except as noted.
William R. Morton
Analyst in Income Security
FY2024 Appropriations

Angela Napili
FY2024 Continuing Resolutions: FY2024 LHHS regular appropriations are currently being
Senior Research Librarian
provided by a series of 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
Kavya Sekar
for all 12 annual appropriations acts (including LHHS) through November 17, 2023. In general,
Analyst in Health Policy
the CR funded discretionary programs at the same rate and under the same conditions as in

FY2022 (§101) and annually appropriated entitlements at their current law levels (§111). It also
included several anomalies that are specific to LHHS accounts or related activities (§§101(8),
Kyle D. Shohfi
133). The LHHS funding in the first CR has been extended on three occasions. A second CR
Analyst in Education Policy
(Division A of H.R. 6363; P.L. 118-22) extended LHHS funds through February 2, 2024, and

added one new LHHS-specific provision (§145). LHHS funding was further extended by a third
CR (Division A of H.R. 2872; P.L. 118-35; through March 8, 2024), and fourth CR (Division A

of H.R. 7463; P.L. 118-40; through March 22, 2024), under the same rates and conditions as the
previous CRs.
FY2024 LHHS Senate Action: On July 27, 2023, the Senate Appropriations Committee voted to report the FY2024 LHHS
bill, 26-2; the measure was reported 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 consideration. As reported by the full committee, the bill would provide
$224.5 billion in non-emergency discretionary LHHS funds, a 0.6% decrease from comparable non-emergency FY2023
enacted levels. This amount would be 11.5% less than the FY2024 President’s request. In addition, the Senate committee bill
would provide an estimated $1.217 trillion in mandatory funding, for a combined non-emergency total of $1.442 trillion for
LHHS as a whole. (The Senate committee bill would also provide an additional $4.1 billion in emergency-designated
discretionary appropriations that are not included in the above or below totals; these funds would effectively support regular
operations for a selection of LHHS programs and activities.) The distribution of proposed non-emergency discretionary
funding would be as follows:
• DOL: $13.8 billion, 0.5% less than FY2023.
• HHS: $113.9 billion, 1.3% less than FY2023.
• ED: $79.6 billion, about the same as FY2023.
• Related Agencies: $17.3 billion, 1.4% more than FY2023.
FY2024 LHHS House Action: 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. Subsequently, the House considered an LHHS
bill, but did not vote on final passage. This bill (H.R. 5894), the text of which was substantially the same as the subcommittee
draft bill, had been introduced on October 6, 2023, by Representative Aderholt, chairman of the House Appropriations LHHS
Subcommittee. H.R. 5894 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
Congressional Research Service

---

link to page 68 Labor, Health and Human Services, and Education: FY2024 Appropriations

Committee Print 118-13, which in effect made numerous alterations to the provisions in H.R. 5894 as introduced. The House
considered floor amendments over two days, and then further proceedings were postponed on November 15. Because the
House voted to adopt H.Res. 864, but did not vote on passage of H.R. 5894 as amended on the floor, the “House floor bill”
referred to throughout this report is the text of H.R. 5894 as amended by Rules Committee Print 118-13. Thus, the budget
numbers for the House floor bill presented in this report do not include the effects of any floor amendments. Appendix B
provides a summary of the amendments offered and their disposition.
The House floor bill would provide $196.4 billion in discretionary LHHS funds, a 13.1% decrease from FY2023 enacted
levels. This amount would be 22.6% less than the FY2024 President’s request. In addition, the House floor bill would
provide an estimated $1.217 trillion in mandatory funding, for a combined total of $1.414 trillion for LHHS as a whole. The
distribution of proposed discretionary funding would be as follows:
• DOL: $9.8 billion, 29.1% less than FY2023.
• HHS: $103.7 billion, 10.2% less than FY2023.
• ED: $67.4 billion, 15.3% less than FY2023.
• Related Agencies: $15.5 billion, 9.1% less than FY2023.
FY2024 President’s Budget Request: The President’s budget request was submitted to Congress on March 9, 2023. The
President requested $253.8 billion in discretionary funding for accounts funded by the LHHS bill, which would be an
increase of 12.4% from FY2023 levels. In addition, the President requested $1.217 trillion in annually appropriated
mandatory funding, for a total of $1.471 trillion for LHHS as a whole. The distribution of requested discretionary funding
would be as follows:
• DOL: $15.5 billion, 12.0% more than FY2023.
• HHS: $129.6 billion, 12.3% more than FY2023.
• ED: $90.0 billion, 13.1% more than FY2023.
• Related Agencies: $18.7 billion, 9.8% more than FY2023.

Congressional Research Service

---

link to page 7 link to page 7 link to page 8 link to page 8 link to page 8 link to page 9 link to page 9 link to page 10 link to page 10 link to page 10 link to page 11 link to page 11 link to page 12 link to page 12 link to page 12 link to page 13 link to page 13 link to page 17 link to page 18 link to page 18 link to page 19 link to page 19 link to page 20 link to page 20 link to page 23 link to page 23 link to page 24 link to page 25 link to page 27 link to page 27 link to page 28 link to page 29 link to page 29 link to page 30 link to page 31 link to page 32 link to page 33 link to page 34 link to page 35 link to page 35 link to page 37 link to page 38 link to page 40 link to page 49 link to page 49 Labor, Health and Human Services, and Education: FY2024 Appropriations

Contents
Introduction ..................................................................................................................................... 1
Report Roadmap and Useful Terminology ...................................................................................... 1
Scope of the Report ................................................................................................................... 2
Important Budget Concepts ....................................................................................................... 2
Mandatory vs. Discretionary Budget Authority .................................................................. 2
Total Budget Authority Provided in the Bill vs. Total Budget Authority Available
in the Fiscal Year .............................................................................................................. 3
Status of FY2024 LHHS Appropriations ........................................................................................ 4
FY2024 Annual LHHS Appropriations ..................................................................................... 4
FY2024 Continuing Appropriations .......................................................................................... 4
Prior Congressional Action on an LHHS Bill ........................................................................... 5
FY2024 LHHS Action in the Senate (S. 2624) ................................................................... 5
FY2024 LHHS Action in the House (H.R. 5894, as amended by Rules Committee
Print 118-13) .................................................................................................................... 6
FY2024 President’s Budget Request ......................................................................................... 6
Conclusion of FY2023 Appropriations Process ........................................................................ 7
Summary of FY2024 LHHS Appropriations ................................................................................... 7
Department of Labor (DOL) .......................................................................................................... 11
About DOL ............................................................................................................................. 12
FY2024 DOL Appropriations Overview ................................................................................. 12
Selected DOL Highlights ........................................................................................................ 13
Employment and Training Administration (ETA) ............................................................. 13
Occupational Safety and Health Administration (OSHA) ................................................ 14
Wage and Hour Division (WHD) ...................................................................................... 14
Department of Health and Human Services (HHS) ....................................................................... 17
About HHS .............................................................................................................................. 17
Treatment of Certain HHS Emergency-Designated Funds ..................................................... 18
FY2024 HHS Appropriations Overview ................................................................................. 19
Special Public Health Funding Mechanisms ........................................................................... 21
Public Health Service Evaluation Tap............................................................................... 21
Prevention and Public Health Fund .................................................................................. 22
21st Century Cures Act, NIH Innovation Account ............................................................ 23
Selected HHS Highlights by Agency ...................................................................................... 23
HRSA ................................................................................................................................ 24
CDC .................................................................................................................................. 25
NIH ................................................................................................................................... 26
SAMHSA .......................................................................................................................... 27
AHRQ ............................................................................................................................... 28
CMS .................................................................................................................................. 29
ACF ................................................................................................................................... 29
ACL .................................................................................................................................. 31
ASPR ................................................................................................................................ 32
Restrictions Related to Certain Controversial Issues .............................................................. 34
Department of Education (ED) ...................................................................................................... 43
About ED ................................................................................................................................ 43
Congressional Research Service

---

link to page 49 link to page 50 link to page 50 link to page 51 link to page 54 link to page 54 link to page 55 link to page 56 link to page 56 link to page 57 link to page 11 link to page 17 link to page 26 link to page 10 link to page 15 link to page 19 link to page 21 link to page 25 link to page 42 link to page 45 link to page 45 link to page 50 link to page 52 link to page 54 link to page 57 link to page 64 link to page 64 link to page 66 link to page 68 link to page 60 link to page 68 link to page 68 Labor, Health and Human Services, and Education: FY2024 Appropriations

FY2024 ED Appropriations Overview .................................................................................... 43
Selected ED Highlights ........................................................................................................... 44
Education for the Disadvantaged ...................................................................................... 44
Student Aid Administration ............................................................................................... 45
Related Agencies ........................................................................................................................... 48
FY2024 Related Agencies Appropriations Overview ............................................................. 48
Selected Related Agencies Highlights ..................................................................................... 49
SSA Limitation on Administrative Expenses (LAE) ........................................................ 50
Corporation for National and Community Service (CNCS) ............................................. 50
National Labor Relations Board (NLRB) ......................................................................... 51

Figures
Figure 1. FY2024 Senate Committee-Reported LHHS Appropriations .......................................... 5
Figure 2. FY2024 Senate Committee Bill LHHS Appropriations by Title..................................... 11
Figure 3. FY2024 Enacted HHS Appropriations by Agency ......................................................... 20

Tables
Table 1. Status of Full-Year LHHS Appropriations Legislation, FY2023 ....................................... 4
Table 2. LHHS Appropriations Overview by Bill Title, FY2023-FY2024 ..................................... 9
Table 3. DOL Appropriations Overview ....................................................................................... 13
Table 4. Detailed DOL Appropriations .......................................................................................... 15
Table 5. HHS Appropriations Overview........................................................................................ 19
Table 6. HHS Appropriations Totals and Directed Transfers by Agency ...................................... 36
Table 7. HHS Discretionary Appropriations and Directed Transfers for Selected
Programs or Activities, by Agency ............................................................................................. 39
Table 8. ED Appropriations Overview .......................................................................................... 44
Table 9. Detailed ED Appropriations ............................................................................................ 46
Table 10. Related Agencies Appropriations Overview .................................................................. 48
Table 11. Detailed Related Agencies Appropriations .................................................................... 51

Table A-1. LHHS Discretionary Appropriations: Comparison of FY2023 Enacted, and
FY2024 House and Senate Appropriations Committee Initial 302(b) Suballocations ............... 58
Table A-2. LHHS Appropriations Overview, by Bill Title: FY2023-FY2024 ............................... 60
Table B-1. LHHS House Floor Amendments Offered to H.R. 5894 ............................................. 62

Appendixes
Appendix A. Budget Enforcement Activities ................................................................................ 54
Appendix B. House Floor Amendments Offered to H.R. 5894, as Amended by Rules
Committee Print 118-13 ............................................................................................................. 62

Congressional Research Service

---

link to page 78 Labor, Health and Human Services, and Education: FY2024 Appropriations

Contacts
Author Information ........................................................................................................................ 72

Congressional Research Service

---

link to page 8 Labor, Health and Human Services, and Education: FY2024 Appropriations

Introduction
This report provides an overview of FY2024 proposed
Scope of the Report:
appropriations actions for accounts traditionally funded
Emergency-Designated
in the appropriations bill for the Departments of Labor,
Discretionary Funding
Health and Human Services, and Education, and Related
This report primarily focuses on regular
Agencies (LHHS). This bill provides discretionary and
FY2024 LHHS discretionary funding
mandatory appropriations to three federal departments:
proposed during the annual appropriations
the Department of Labor (DOL), the Department of
process. The emergency discretionary
Health and Human Services (HHS), and the Department
funding that was enacted for FY2023 and
proposed in the Senate for FY2024 is
of Education (ED). In addition, the bill provides annual
generally not included in the budgetary
appropriations for more than a dozen related agencies,
amounts discussed or table totals
including the Social Security Administration (SSA).
presented in the main body of the report.
Such spending is presented below the
Discretionary funds represent less than one-fifth of the
table totals and is in addition to regular
total funds appropriated in the annual LHHS bill.
appropriations. The exceptions to this
Nevertheless, the LHHS bill is typically the largest single
general rule, all within the Department of
Health and Human Services section of this
source of discretionary funds for domestic nondefense
report, are noted.
federal programs among the various appropriations bills.
(The Department of Defense bill is the largest source of discretionary funds among all federal
programs.) Because the appropriations process both provides and controls discretionary funding
(concepts discussed further in the “Mandatory vs. Discretionary Budget Authority” section), the
bulk of this report is focused on these funds.
The LHHS bill typically is one of the more controversial of the regular appropriations bills
because of the size of its funding and the scope of its programs, as well as various related social
policy issues addressed in the bill, such as restrictions on the use of federal funds for abortion and
for research on human embryos, stem cells, and gun violence.
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
(CRS) with questions on specific agencies and programs funded in the LHHS bill.
Report Roadmap and Useful Terminology
This report is divided into several sections. The opening section provides an explanation of the
scope of the LHHS bill (and hence, the scope of this report) and an introduction to important
terminology and concepts that carry throughout the report. Next is a series of sections describing
major congressional actions on FY2024 appropriations and (for context) a review of the
conclusion of the FY2023 appropriations process. This is followed by a high-level summary and
analysis of proposed appropriations for FY2024 compared to FY2023 funding levels. The body of
the report contains overview sections for each of the major titles of the bill: DOL, HHS, ED, and
Related Agencies (RA). These sections provide selected highlights from FY2024 proposed
funding levels compared to FY2023. (Note that the distribution of funds is sometimes illustrated
by figures, which in all cases are based on the FY2024 Senate committee version of the LHHS
bill.1)

1 The figures reflect the FY2024 Senate committee bill, but the distribution of funds (as measured by the relative share
of funds going toward a particular department or agency) is generally illustrative of FY2023 enacted appropriations and
those proposed by the FY2024 President’s budget and the House floor bill.
Congressional Research Service

1

---

link to page 60 link to page 8 Labor, Health and Human Services, and Education: FY2024 Appropriations

Appendix A provides a summary of budget enforcement activities for FY2024. This includes
information on mandatory spending sequestration pursuant to the Budget Control Act of 2011
(BCA; P.L. 112-25), discretionary spending budget enforcement under the Fiscal Responsibility
Act spending limits (FRA; P.L. 118-5), the House draft LHHS subcommittee spending allocation,
the Senate LHHS subcommittee spending allocation, and current-year spending levels.
Scope of the Report
This report focuses on appropriations to agencies and accounts that are subject to the jurisdiction
of the Labor, Health and Human Services, Education, and Related Agencies subcommittees of the
House and Senate appropriations committees (i.e., accounts traditionally funded via the LHHS
bill). Department “totals” provided in this report do not include funding for accounts or agencies
that are traditionally funded by appropriations bills under the jurisdiction of other subcommittees.
The LHHS bill provides appropriations for the following federal departments and agencies:
• the Department of Labor;
• most agencies at the Department of Health and Human Services, except for the
Food and Drug Administration (funded through the Agriculture appropriations
bill), the Indian Health Service (funded through the Interior-Environment
appropriations bill), and the Agency for Toxic Substances and Disease Registry
(also funded through the Interior-Environment appropriations bill);
• the Department of Education; and
• more than a dozen related agencies, including the Social Security Administration,
the Corporation for National and Community Service (sometimes referred to as
AmeriCorps), the Corporation for Public Broadcasting, the Institute of Museum
and Library Services, the National Labor Relations Board, and the Railroad
Retirement Board.
Funding totals displayed in this report do not reflect amounts provided outside of the annual
appropriations process. Certain direct spending programs, such as Social Security and parts of
Medicare, receive funding directly from their authorizing statutes; such funds are not reflected in
the totals provided in this report because they are not provided through the annual appropriations
process (see related discussion in the “Mandatory vs. Discretionary Budget Authority” section).
Important Budget Concepts
Mandatory vs. Discretionary Budget Authority2
The LHHS bill includes both discretionary and mandatory budget authority. While all
discretionary spending is subject to the annual appropriations process, only a portion of
mandatory budget authority is provided in appropriations measures.
Mandatory programs funded through the annual appropriations process are commonly referred to
as appropriated entitlements. In general, appropriators have little control over the amounts
provided for appropriated entitlements; rather, the authorizing statute controls the program
parameters (e.g., eligibility rules, benefit levels) that entitle certain recipients to payments. If

2 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. (Terms of interest may include
appropriated entitlement, direct spending, discretionary, entitlement authority, and mandatory.)
Congressional Research Service

2

---

link to page 60 link to page 60 link to page 60 Labor, Health and Human Services, and Education: FY2024 Appropriations

Congress does not appropriate the money necessary to meet these commitments, entitled
recipients (e.g., individuals, states, or other entities) may have legal recourse.3 Examples of
appropriated entitlements include Medicaid and the Supplemental Security Income program.
Most mandatory spending is not provided through the annual appropriations process, but rather
through budget authority provided by the program’s authorizing statute (e.g., Social Security
benefits payments). The funding amounts in this report do not include budget authority provided
outside of the appropriations process. Instead, the amounts reflect only those funds, discretionary
and mandatory, that are provided through appropriations acts.
As displayed in this report, mandatory amounts for the FY2024 President’s budget submission
reflect current-law (or current services) estimates; they generally do not include the President’s
proposed changes to a mandatory spending program’s authorizing statute that might affect total
spending. (In general, such proposals are excluded from this report, as they typically would be
enacted in authorizing legislation.)
The report focuses most closely on discretionary funding because discretionary funding receives
the bulk of attention during the appropriations process. (While the LHHS bill includes more
mandatory funding than discretionary funding, the appropriators generally have less flexibility in
adjusting mandatory funding levels than discretionary funding levels.)
Mandatory and discretionary spending is subject to budget enforcement processes that include
sequestration. In general, sequestration involves largely across-the-board reductions that are made
to certain categories of discretionary or mandatory spending. However, the conditions that trigger
sequestration, and how it is carried out, differ for each type of spending. This is discussed further
in Appendix A.
Total Budget Authority Provided in the Bill vs. Total Budget Authority
Available in the Fiscal Year
Budget authority is the amount of money a federal agency is legally authorized to commit or
spend. Appropriations bills 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 advance appropriations.
Unless otherwise specified, appropriations levels displayed in this report refer to the total amount
of budget authority provided in an appropriations bill (i.e., “total in the bill”), regardless of the
year in which the funding becomes available.4 In some cases, the report breaks out current-year
appropriations (i.e., the amount of budget authority available for obligation in a given fiscal year,
regardless of the year in which it was first appropriated).5
As the annual appropriations process unfolds, the amount of current-year budget authority is
measured against 302(b) allocation ceilings (budget enforcement caps for appropriations
subcommittees that traditionally emerge following the budget resolution process, see Appendix
A). The process of measuring appropriations against these spending ceilings takes into account

3 Sometimes appropriations measures include amendments to laws authorizing mandatory spending programs and
thereby change the amount of mandatory appropriations needed. Because such amendments are legislative in nature,
they may violate parliamentary rules separating authorizations and appropriations. For more information, see CRS
Report R42388, The Congressional Appropriations Process: An Introduction.
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.
Congressional Research Service

3

---

link to page 15 link to page 10 Labor, Health and Human Services, and Education: FY2024 Appropriations

scorekeeping adjustments, which are made by the Congressional Budget Office (CBO) to reflect
conventions and special instructions of Congress.6 Unless otherwise specified, appropriations
levels displayed in this report do not reflect additional scorekeeping adjustments. (Those
scorekeeping adjustments are displayed at the bottom of Table 2.)
Status of FY2024 LHHS Appropriations
FY2024 Annual LHHS Appropriations
Table 1 provides a timeline of major legislative actions for full-year LHHS proposals, which are
discussed in greater detail below.
Table 1. Status of Full-Year LHHS Appropriations Legislation, FY2023
Subcommittee
Full Committee
Initial Floor
Resolution of House and
Approval
Approval
Consideration
Senate Differences

House
Senate
Conf.
Final
Final
Public
House Senate
House
Senate
House
Senate Report
Passage
Passage
Law
5/18/23 —
—
S. 2624
H.R. 5894 —
—
—
—
—
voice
(S.Rept.
11/15/23
vote
118-84) Chair
7/27/23
Postponed
26-2
Proceedings
Source: CRS Appropriations Status Table.
FY2024 Continuing Appropriations
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
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
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, three
additional CRs were enacted, which extended the provisions of the first CR with some additional
provisions (see Division A of P.L. 118-22, enacted on November 16, 2023; Division A of P.L.
118-35, enacted on January 29, 2024; Division A of P.L. 118-10, enacted on March 1, 2024). The
fourth CR funds LHHS through March 22, 2024.
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 fund
annually appropriated entitlements at their current law levels (§111). The CRs include a few
provisions that are specific to LHHS accounts or related activities. Most of these LHHS-specific

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).
Congressional Research Service

4

---

link to page 11
Labor, Health and Human Services, and Education: FY2024 Appropriations

provisions were included in the first CR and continued in the subsequent CRs (§§101(8), 133);
one new LHHS-specific provision was added in the second CR (§145).7
Prior Congressional Action on an LHHS Bill
FY2024 LHHS Action in the Senate (S. 2624)
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 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
in subcommittee prior to full committee action.
See Figure 1 for a breakdown of FY2024 discretionary and mandatory LHHS appropriations
proposed in the FY2024 Senate committee bill.8 As reported by the full committee, the bill would
provide $224.5 billion in non-emergency discretionary LHHS funds, a 0.6% decrease from
comparable non-emergency FY2023 enacted levels. This amount was 11.5% less than the
FY2024 President’s request. In addition, the Senate committee bill would provide an estimated
$1.217 trillion in mandatory funding, for a combined non-emergency total of $1.442 trillion for
LHHS as a whole.
The Senate committee bill would also provide an additional $4.1 billion in emergency-designated
discretionary appropriations not included in the above totals. These funds would effectively be
available to support regular operations for a selection of LHHS programs and activities, as the bill
would not explicitly target the funds toward needs arising from specific disasters or other events.
These emergency-designated funds would increase the total amount of discretionary funds in the
Senate committee bill by roughly 1.8%.
Figure 1. FY2024 Senate Committee-Reported LHHS Appropriations

Source: Amounts in this figure are generally drawn from or calculated based on data contained in the Senate
Appropriations Committee report accompanying S. 2624 (S.Rept. 118-84). Amounts do not include emergency-

7 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).
8 While the percentages in this figure were calculated based on amounts in the FY2024 Senate committee bill, they are
generally also illustrative—within a few percentage points—of the share of mandatory and discretionary funds in
FY2023 and under the FY2024 President’s budget and the FY2024 House floor bill.
Congressional Research Service

5

---

link to page 68 Labor, Health and Human Services, and Education: FY2024 Appropriations

designated appropriations. For consistency with source materials, amounts in this figure generally do not reflect
mandatory spending sequestration, where applicable, nor do they reflect any transfers or reprogramming of
funds pursuant to executive authorities. CRS calculations do, however, include LHHS funding provided to HHS
pursuant to the 21st Century Cures Act (P.L. 114-255), as amended.
Notes: Details may not add to totals due to rounding. Amounts in this figure (1) reflect all budget authority
appropriated in the bil , regardless of the year in which funds become available (i.e., totals do not include
advances from prior-year appropriations, but do include advances for subsequent years provided in this bil ); (2)
have generally not been adjusted to reflect scorekeeping; (3) comprise only those funds provided for agencies
and accounts subject to the jurisdiction of the LHHS subcommittees of the House and Senate appropriations
committees; and (4) do not include appropriations that occur outside of appropriations bil s.
FY2024 LHHS Action in the House (H.R. 5894, as amended by Rules
Committee Print 118-13)
In the House, the FY2024 LHHS bill was approved in subcommittee on July 14, 2023, by a voice
vote.9 The bill has not been marked up by the full committee.
In November 2023, the House considered an LHHS bill, but did not vote on final passage. This
bill (H.R. 5894), the text of which was substantially the same as the subcommittee draft bill, had
been introduced on October 6, 2023, by Representative Aderholt, Chair of the House
Appropriations LHHS Subcommittee. H.R. 5894 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
Committee Print 118-13, which in effect made numerous alterations to the provisions in H.R.
5894 as introduced.10 The House considered floor amendments over two days, and then further
proceedings were postponed on November 15. Because the House voted to adopt H.Res. 864, but
did not vote on passage of H.R. 5894 as amended on the floor, the “House floor bill” referred to
throughout this report is the text of H.R. 5894 as amended by Rules Committee Print 118-13.
Thus, the budget numbers for the House floor bill presented in this report do not include the
effects of any floor amendments. Appendix B provides a summary of the amendments offered and
their disposition.
The House floor bill would provide $196.4 billion in discretionary LHHS funds, a 13.1%
decrease from FY2023 enacted levels. This amount would be 22.6% less than the FY2024
President’s request. In addition, the House floor bill would provide an estimated $1.217 trillion in
mandatory funding, for a combined total of $1.414 trillion for LHHS as a whole.
FY2024 President’s Budget Request
The President’s budget request was submitted to Congress on March 9, 2023. On May 9, the
President submitted amendments to the FY2024 budget request that included changes to the

9 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/
press-releases/committee-releases-fy24-labor-health-and-human-services-education-and-related.
10 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/
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/
118hr5894ih_to_LHHS%20RCP%20FINAL_xml.pdf. Draft explanatory materials accompanying H.R. 5894 and Rules
Committee Print 118-13 (hereinafter, “House explanatory materials”) were released by the House Appropriations
Committee and posted at https://appropriations.house.gov/sites/republicans.appropriations.house.gov/files/FY24-
LHHS-Explanatory-Materials.pdf.
Congressional Research Service

6

---

Labor, Health and Human Services, and Education: FY2024 Appropriations

amounts requested for specified Department of Education accounts.11 These changes are reflected
in the amounts for the President’s budget that are presented in this report.
The President requested $253.8 billion in discretionary funding for accounts funded by the LHHS
bill, which would be an increase of 12.4% from FY2023 levels. In addition, the President
requested $1.217 trillion in annually appropriated mandatory funding, for a total of $1.471 trillion
for LHHS as a whole.
Conclusion of FY2023 Appropriations Process
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 Division 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, 2022 (68-29). It was approved by the House on December 23, 2022 (225-201).
Annual discretionary LHHS appropriations in the omnibus totaled $225.9 billion. This amount
was 5.6% more than FY2022 enacted and 7.8% less than the FY2023 President’s budget request.
The omnibus also provided $1.196 trillion in mandatory funding, for a combined LHHS total of
$1.422 trillion. (Note that these totals are based only on amounts of non-emergency
appropriations and do not include emergency-designated or supplemental funds, which were
provided in addition to the annual appropriations.)
In addition to regular FY2023 appropriations, several HHS accounts and programs received
emergency-designated appropriations in Divisions N and M of the FY2023 omnibus, as well as
Division A of the first FY2023 CR (P.L. 117-180). All told, these FY2023 LHHS emergency
appropriations totaled $9.4 billion.12 Some of these funds, totaling $750 million, were targeted to
needs arising from particular disasters or events (e.g., Hurricanes Fiona and Ian). In other cases,
the funds were not so targeted, and instead could effectively be used to support regular program
operations, including $4.5 billion for the Low Income Home Energy Assistance Program
(LIHEAP) and $4.2 billion for the Refugee and Entrant Assistance account.
Summary of FY2024 LHHS Appropriations
Dollars and Percentages in this Report
Amounts displayed in this report are typically rounded (e.g., to the nearest mil ion), as labeled. Dol ar and
percentage changes discussed in the text are based on unrounded amounts.
Unless otherwise specified, appropriations levels displayed in this report refer to the total amount of non-
emergency budget authority provided in an appropriations bil (i.e., “total in the bil ”), regardless of the year in
which the funding becomes available. These totals include, where applicable, ful -year non-emergency
appropriations provided in continuing resolutions.
The funding amounts for FY2023 Enacted, FY2024 Request, and FY2024 Senate Committee are generally drawn
from or calculated based on data contained in S.Rept. 118-84, unless otherwise noted. FY2024 House floor
amounts are generally drawn from the explanatory materials accompanying H.R. 5894 and Rules Committee Print
118-13 (hereinafter, “House explanatory materials”) that were released by the House Appropriations Committee

11 See the budget amendments package at https://www.whitehouse.gov/wp-content/uploads/2023/05/
FY_2024_Budget_Amendment_Corrections_5-9-23.pdf.
12 In addition to these amounts, the FY2023 omnibus (Division H) also provided a contingent emergency appropriation
that only became available if certain conditions were met.
Congressional Research Service

7

---

link to page 29 link to page 42 link to page 45 link to page 60 link to page 15 link to page 66 link to page 66 Labor, Health and Human Services, and Education: FY2024 Appropriations

and posted at https://appropriations.house.gov/sites/republicans.appropriations.house.gov/files/FY24-LHHS-
Explanatory-Materials.pdf, unless otherwise noted.
Emergency-designated LHHS appropriations are generally not included in FY2023 and FY2024 totals (“Total BA in
the Bil ”). (For informational purposes, FY2023 enacted and FY2024 proposed emergency-designated amounts are
displayed separately at the bottom of tables throughout the report and not summed in that separate display.
Those amounts are based on CRS analysis of the texts of those laws.) There are two notable exceptions to this
general rule:
•
Funding in the “Selected HHS Highlights by Agency” section includes, as noted, certain emergency-designated
funds that were enacted in FY2023 and proposed in the FY2024 Senate committee bil that effectively could
be used to support regular program operations (i.e., the appropriations did not limit use of funds to activities
associated with a particular disaster or event, such as needs arising from a hurricane). Likewise, Table 6 and
Table 7 also break out FY2023 enacted and FY2024 Senate committee bil emergency funding for regular
program operations for relevant HHS operating divisions, accounts, and budget lines. Al FY2023 and FY2024
emergency-designated funding (for both regular program operations and for specified emergencies) also is
included at the bottom of these HHS tables.
•
Funding in Appendix A includes all FY2023 enacted and FY2024 Senate committee bil emergency-
designated funds in the “Adjusted Appropriations” totals, as scored by the Congressional Budget Office.
Post-enactment adjustments, such as mandatory spending sequestration (where applicable), or transfers and
reprogramming of funds pursuant to executive authorities, are generally not included in this report except as
noted.13 CRS calculations do, however, include LHHS funding provided to HHS pursuant to the 21st Century
Cures Act (P.L. 114-255), as amended.
“Report language,” which Congress may use to further specify funding or to communicate a range of directives to
the agency, is frequently referenced in this CRS report. Each regular appropriations bil reported from committee
is usually accompanied by a written committee report, and the final explanatory text may be used to reconcile any
differences between those reports. For example, earlier report language may address certain issues in ways that
are difficult to reconcile harmoniously with the final enacted text. In these instances, the explanatory text normally
seeks to clarify how the affected agency is to proceed. On the other hand, if the original committee language is
ultimately acceptable to congressional negotiators, the explanatory statement might be silent due to an
expectation that the agency wil fol ow the original directive. For further information, see CRS Report R44124,
Appropriations Report Language: Overview of Development and Components.
Table 2 displays FY2024 proposed discretionary and mandatory LHHS budget authority along
with FY2023 enacted levels, by bill title. The amounts shown in this table reflect total budget
authority provided in the annual LHHS bill (i.e., all funds appropriated in the bill, regardless of
the fiscal year in which the funds become available), not total budget authority available for the
current fiscal year. (For a comparable table showing current-year budget authority, see Table A-
2.) Note that the totals in this table do not include emergency-designated appropriations; those
amounts are displayed separately at the bottom of the table and are in addition to regular
appropriations.

13 The general practice for CRS reports on the LHHS bill has been to reflect conventions used in source materials.
These conventions have varied over the years. For instance, CRS reports on LHHS appropriations for FY2012-FY2015
generally relied on source materials that adjusted appropriations amounts in the prior-year column to reflect
sequestration, reestimates of mandatory spending, transfers, reprogramming, and other adjustments for comparability.
However, the FY2016 version of this report broke from that practice due to differing display conventions in source
documents, and did not reflect any such adjustments (except sequestration for the Prevention and Public Health Fund
[PPHF]). The FY2017 version of this report differed from both of these prior practices, in that it reflected a smaller
subset of transfers (generally concentrated at the National Institutes of Health) and other adjustments for comparability
(e.g., program moves from one account to another), but not reprogramming of funds or mandatory sequestration
(except sequestration of the PPHF). The FY2018-FY2023 versions of this report, however, relied on source materials
that generally did not reflect any transfers or other budgetary adjustments pursuant to administrative authorities except
PPHF sequestration. For FY2024, the source materials used for this report continue this most recent approach.
Congressional Research Service

8

---

link to page 16 link to page 16 link to page 16 link to page 16 Labor, Health and Human Services, and Education: FY2024 Appropriations

Table 2. LHHS Appropriations Overview by Bill Title, FY2023-FY2024
(total budget authority provided in the bill, in billions of dollars)
FY2024
Senate
FY2024
FY2023
FY2024
Cmte.
House Floor
FY2024
Bill Title
Enacted
Request
(S. 2624)
(H.R. 5894)
Enacted
Title I: Labor
15.1
16.8
15.1
11.1
—
Discretionary
13.8
15.5
13.8
9.8
—
Mandatory
1.3
1.3
1.3
1.3
—
Title II: HHS
1,246.5
1,278.7
1,263.0
1,252.8
—
Discretionary
115.4
129.6
113.9
103.7
—
Mandatory
1,131.1
1,149.1
1,149.1
1,149.1
—
Title III: Education
83.5
94.3
83.8
71.7
—
Discretionary
79.6
90.0
79.6
67.4
—
Mandatory
3.9
4.3
4.3
4.3
—
Title IV: Related Agencies
76.7
81.2
79.7
78.0
—
Discretionary
17.0
18.7
17.3
15.5
—
Mandatory
59.6
62.5
62.5
62.5
—
Total BA in the Bill
1,421.9
1,471.0
1,441.7
1,413.5
—
Discretionary
225.9
253.8
224.5
196.4
—
Mandatory
1,196.0
1,217.1
1,217.1
1,217.1
—
Emergency Funding (not in above totals or





memoranda below)a
P.L. 117-180, Division A
2.8
—
—
—
—
P.L. 117-328, Division M
2.4
—
—
—
—
P.L. 117-328, Division N
4.3
—
—
—
—
S. 2624, Title II
—
—
4.1
—
—
Memoranda:





Advances for Future Years
242.8
297.0
297.0
296.5
—
(provided in current bil )b
Advances from Prior Years
210.7
242.8
242.8
242.8
—
(for use in current year)b
Additional Scorekeeping
-16.1
-30.9
-26.5
-47.0
—
Adjustmentsc
Source: Amounts in this table for the FY2023 Enacted, FY2024 Request, and FY2024 Senate Cmte. columns are
generally drawn from or calculated based on data contained in the Senate Appropriations Committee report
accompanying S. 2624 (S.Rept. 118-84). Amounts in this table for the FY2024 House Floor column are generally
drawn from or calculated based on data contained in the explanatory materials accompanying H.R. 5894 posted
at https://appropriations.house.gov/sites/republicans.appropriations.house.gov/files/FY24-LHHS-Explanatory-
Materials.pdf. Totals (“Total BA in the Bil ”) do not include emergency-designated appropriations. CRS
calculations do, however, include LHHS funding provided to HHS pursuant to the 21st Century Cures Act (P.L.
114-255), as amended. For consistency with source materials, amounts in this figure generally do not reflect
mandatory spending sequestration, where applicable, nor do they reflect any transfers or reprogramming of
funds pursuant to executive authorities.
Congressional Research Service

9

---

link to page 17 Labor, Health and Human Services, and Education: FY2024 Appropriations

Notes: BA = Budget Authority. Details may not add to totals due to rounding. Amounts in this table (1) reflect
all BA appropriated in the bil , regardless of the year in which funds become available (i.e., totals do not include
advances from prior-year appropriations, but do include advances for subsequent years provided in this bil ); (2)
have generally not been adjusted to reflect scorekeeping; (3) comprise only those funds provided (or requested)
for agencies and accounts subject to the jurisdiction of the LHHS subcommittees of the House and Senate
appropriations committees; and (4) do not include appropriations that occur outside of appropriations bil s. No
amounts are shown for Title V, because this title consists solely of general provisions.
a. Division H of the FY2023 omnibus included a contingent emergency appropriation for the HHS Refugee and
Entrant Assistance account. The contingent funds were to become available only if certain conditions were
met. The FY2024 President’s request and Senate committee bil s would also provide contingent
appropriations for this account. Consistent with source materials, the estimated amount of the contingent
appropriations is treated as a scorekeeping adjustment and is thus not included in this total. 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 not a definite amount, it is not included in the
tables in this report.
b. Totals in this table are based on budget authority provided in the bil (i.e., they exclude advance
appropriations from prior bil s and include advance appropriations from this bil made available in future
years). The calculation for total budget authority available in a given fiscal year is as fol ows: Total BA in the
Bil , minus Advances for Future Years, plus Advances from Prior Years.
c. Totals in this table have generally not been adjusted for scorekeeping. (To adjust for scorekeeping, add this
line to the total budget authority.)
Figure 2 displays discretionary and mandatory LHHS funding levels proposed by the FY2024
Senate committee bill, by bill title. (While the percentages discussed in this section were
calculated based on the Senate proposal, they are generally also illustrative—within several
percentage points—of the share of funds directed to each bill title in FY2023, and under the
FY2024 President’s budget and House floor bill.)
As this figure demonstrates, HHS accounts for the largest share of total FY2024 LHHS
appropriations: $1.263 trillion, or 87.6%. This is due to the large amount of mandatory funding
included in the HHS appropriation, the majority of which is for Medicaid grants to states and
payments to health care trust funds. After HHS, ED and the Related Agencies represent the next-
largest shares of total LHHS funding, accounting for 5.8% and 5.5%, respectively. (The majority
of the ED appropriations each year are discretionary, while the bulk of funding for the Related
Agencies goes toward mandatory payments and administrative costs of the Supplemental Security
Income program at the Social Security Administration.) DOL accounts for the smallest share of
total LHHS funds, 1.0%.
The overall composition of LHHS funding is noticeably different when comparing only
discretionary appropriations. HHS accounts for a comparatively smaller share of total
discretionary appropriations (50.7%), while ED accounts for a relatively larger share (35.4%).
Together, these two departments represent the majority (86.2%) of discretionary LHHS
appropriations. DOL and the Related Agencies account for the remaining discretionary funds, at
6.1% and 7.7% of the total, respectively.
Congressional Research Service

10

---

Labor, Health and Human Services, and Education: FY2024 Appropriations

Figure 2. FY2024 Senate Committee Bill LHHS Appropriations by Title
(non-emergency budget authority in billions of dollars unless otherwise indicated)

Source: Amounts in this figure are generally drawn from or calculated based on data contained in the Senate
Appropriations Committee report accompanying S. 2624 (S.Rept. 118-84). Totals do not include emergency-
designated appropriations. For consistency with source materials, amounts in this figure generally do not reflect
mandatory spending sequestration, where applicable, nor do they reflect any transfers or reprogramming of
funds pursuant to executive authorities. CRS calculations do, however, include LHHS funding provided to HHS
pursuant to the 21st Century Cures Act (P.L. 114-255), as amended.
Notes: Details may not add to totals due to rounding. Amounts in this figure (1) reflect all BA appropriated in
the bil , regardless of the year in which funds become available (i.e., totals do not include advances from prior-
year appropriations, but do include advances for subsequent years provided in this bil ); (2) have generally not
been adjusted to reflect scorekeeping; (3) comprise only those funds provided for agencies and accounts subject
to the jurisdiction of the LHHS subcommittees of the House and Senate appropriations committees; and (4) do
not include appropriations that occur outside of appropriations bil s.
Department of Labor (DOL)
All amounts in this section are based on regular LHHS appropriations only. Amounts in this
section do not include mandatory funds provided outside of the annual appropriations process
(e.g., direct appropriations for Unemployment Insurance benefits payments). All amounts in this
section are rounded (e.g., to the nearest million), as labeled. The dollar changes and percentage
changes discussed in the text are based on unrounded amounts. For consistency with source
materials, amounts do not reflect sequestration or reestimates of mandatory spending programs,
where applicable.




Congressional Research Service

11

---

link to page 19 Labor, Health and Human Services, and Education: FY2024 Appropriations

About DOL
DOL is a federal department comprising
multiple entities that provide services related
DOL Entities Funded via the
to employment and training, worker
LHHS Appropriations Process
protection, income security, and contract
Employment and Training Administration (ETA)
enforcement. Annual LHHS appropriations
Employee Benefits Security Administration (EBSA)
laws direct funding to all DOL entities (see
Wage and Hour Division (WHD)
the text box).15 The DOL entities fall primarily
Office of Labor-Management Standards (OLMS)
into two main functional areas—workforce
Office of Federal Contract Compliance Programs
development and worker protection. First,
(OFCCP)
several DOL entities administer workforce
Office of Workers’ Compensation Programs (OWCP)
employment and training programs—such as
Occupational Safety and Health Administration (OSHA)
the Workforce Innovation and Opportunity
Mine Safety and Health Administration (MSHA)
Act (WIOA) state formula grant programs,
Bureau of Labor Statistics (BLS)
Job Corps, and the Employment Service—that
Office of Disability Employment Policy (ODEP)
provide direct funding for employment
Departmental Management (DM)14
activities or administration of income security
programs (e.g., for the Unemployment Insurance benefits program). Also included in this area is
the Veterans’ Employment and Training Service (VETS), which provides employment services
specifically for the veteran population. Second, several agencies provide various worker
protection services. For example, the Occupational Safety and Health Administration (OSHA),
the Mine Safety and Health Administration (MSHA), and the Wage and Hour Division (WHD)
provide different types of regulation and oversight of working conditions. DOL entities focused
on worker protection provide services to ensure worker safety, adherence to wage and overtime
laws, and contract compliance, among other duties. In addition to these two main functional
areas, DOL’s Bureau of Labor Statistics (BLS) collects data and provides analysis on the labor
market and related labor issues.
FY2024 DOL Appropriations Overview
Table 3 generally displays proposed FY2024 DOL budget authority, along with FY2023 enacted
levels. Note that the totals in this table do not include emergency-designated appropriations.
Those amounts (if applicable) are displayed separately, along with the law in which they were
enacted, at the bottom of the table and are in addition to regular appropriations. However, no such
appropriations were enacted for the DOL in FY2023, or thus far in FY2024.
The FY2024 Senate committee bill would decrease discretionary appropriations for DOL by $71
million (-0.5%), while the FY2024 House floor bill would decrease appropriations for DOL by
$4.0 billion (-29.1%), and the FY2024 President’s budget request would increase discretionary
appropriations by $1.7 billion (+12.0%) compared to the FY2023 enacted levels.

14 Departmental Management includes the DOL salaries and expenses, Veterans Employment and Training Service
(VETS), IT Modernization, and the Office of the Inspector General.
15 The Pension Benefit Guaranty Corporation (PBGC) is funded primarily through insurance premiums and related fees
from companies covered by the PBGC. For further information, see CRS In Focus IF10492, An Overview of the
Pension Benefit Guaranty Corporation (PBGC).
Congressional Research Service

12

---

link to page 21 Labor, Health and Human Services, and Education: FY2024 Appropriations

Table 3. DOL Appropriations Overview
(in billions of dollars)
FY2024
Senate
FY2024 House
FY2023
FY2024
Cmte.
Floor
FY2024
Funding
Enacted
Request
(S. 2624)
(H.R. 5894)
Enacted
Discretionary
13.8
15.5
13.8
9.8
—
Mandatory
1.3
1.3
1.3
1.3
—
Total, DOL BA in the Bill
15.1
16.8
15.1
11.1
—
Emergency Funding (not in above totals)
—
—
—
—
—
Source: Amounts in this table for the FY2023 Enacted, FY2024 Request, and FY2024 Senate Cmte. columns are
generally drawn from or calculated based on data contained in the Senate Appropriations Committee report
accompanying S. 2624 (S.Rept. 118-84). Amounts in this table for the FY2024 House Floor column are generally
drawn from or calculated based on data contained in the explanatory materials accompanying H.R. 5894 posted
at https://appropriations.house.gov/sites/republicans.appropriations.house.gov/files/FY24-LHHS-Explanatory-
Materials.pdf. Totals (“Total BA in the Bil ”) do not include emergency-designated appropriations.
Notes: BA = Budget Authority. Details may not add to totals due to rounding. Amounts in this table (1) reflect
all BA appropriated in the bil , regardless of the year in which funds become available (i.e., totals do not include
advances from prior-year appropriations, but do include advances for subsequent years provided in this bil ); (2)
have generally not been adjusted to reflect scorekeeping; (3) comprise only those funds provided (or requested)
for agencies and accounts subject to the jurisdiction of the LHHS subcommittees of the House and Senate
appropriations committees; and (4) do not include appropriations that occur outside of appropriations bil s.
Selected DOL Highlights
The following sections present highlights from the FY2024 Senate committee bill, the FY2024
House floor bill, and the President’s FY2024 budget request compared to the FY2023 LHHS
omnibus for selected DOL accounts and programs.16
Table 4 displays funding for DOL programs and activities discussed in this section.
Employment and Training Administration (ETA)
ETA administers federal workforce development programs, including those authorized under Title
I of the Workforce Innovation and Opportunity Act (WIOA; P.L. 113-128, as amended), and
provides oversight to state workforce agencies in the implementation and administration of state
unemployment insurance programs, federal unemployment compensation programs, and other
wage-loss, worker dislocation and adjustment assistance compensation programs. These services
are primarily provided through state workforce agencies and local workforce development
systems.
The FY2024 Senate committee bill would provide $10.4 billion in discretionary budget authority
for the ETA. This is
• $3.4 billion more (+48.8%) than the FY2024 House floor bill ($7.0 billion),
• $1.1 billion less (-9.2%) than the FY2024 President’s request ($11.5 billion), and
• $61 million less (-0.6%) than the FY2023 enacted level ($10.5 billion).

16 DOL budget materials can be found at https://www.dol.gov/general/aboutdol#budget.
Congressional Research Service

13

---

Labor, Health and Human Services, and Education: FY2024 Appropriations

The Senate committee bill would largely maintain ETA funding at the FY2023 level. Among the
largest workforce development programs, the three WIOA formula grant programs (i.e., those
serving Adults, Youth, and Dislocated Workers, respectively) and Job Corps would be funded at
their FY2023 enacted levels.
The House floor bill would reduce discretionary ETA funding by $3.5 billion, or 33.2%, below
the enacted FY2023 levels. The reduction would primarily come from the proposed elimination
of several workforce programs, including Job Corps ($1.8 billion in FY2023), WIOA Youth
Activities ($948 million in FY2023), and Community Service Employment for Older Americans
($405 million in FY2023).
Occupational Safety and Health Administration (OSHA)
OSHA is the federal government’s primary regulator of workplace safety and health. OSHA
promulgates occupational safety and health standards and enforces compliance with these
standards through workplace inspections, abatement orders, and civil monetary penalties. States
may develop their own occupational safety and health systems (“state plans”) that must be “at
least as effective” as OSHA at providing for safe workplaces, and OSHA provides grants to assist
states in funding their state plans. OSHA also provides compliance assistance and education to
employers and enforces 25 federal whistleblower protection laws.17
The FY2024 Senate committee bill would provide $629 million in discretionary budget authority
for OSHA. This is
• $92 million more (+17.1%) than the FY2024 House floor bill ($537 million),
• $110 million less (-14.9%) than the FY2024 President’s request ($739 million),
and
• $4 million less (-0.6%) than the FY2023 enacted level ($632 million).
Both the House and Senate committee recommendations would provide $120 million to support
state plans and include the long-standing provisions limiting OSHA activities related to small
farms and to small businesses in industries with injury rates below national averages.18 Both
recommendations also provide that no less than $3.5 million of the appropriation be for Voluntary
Protection Programs (VPP), part of OSHA’s compliance assistance activities.
Wage and Hour Division (WHD)
WHD is responsible for enforcing the Fair Labor Standards Act (FLSA), the Davis-Bacon Act
(DBA), the Family and Medical Leave Act (FMLA), and other labor standards statutes. The
FY2024 Senate committee bill would provide $265 million in discretionary budget authority for
WHD. This is
• $80 million more (+43.0%) than the FY2024 House floor bill ($185 million),
• $76 million less (-22.4%) than the FY2024 President’s request ($341 million),
and
• $5 million more (+1.7%) than the FY2023 enacted level ($260 million).

17 A list of the federal whistleblower statutes enforced by OSHA is at https://www.whistleblowers.gov/statutes.
18 The $120 million allocations to support state programs are in S.Rept. 118-84, p. 26, and House explanatory materials,
p. 16.
Congressional Research Service

14

---

link to page 23 Labor, Health and Human Services, and Education: FY2024 Appropriations

Table 4. Detailed DOL Appropriations
(in millions of dollars)
FY2024
Senate
FY2024
FY2023
FY2024
Cmte.
House Floor
FY2024
Agency or Selected Program
Enacted Request
(S. 2624)
(H.R. 5894)
Enacted
ETA—Mandatorya
494
31
31
31
—
ETA—Discretionary
10,488
11,479
10,427
7,005
—
Discretionary ETA Programs:





Training and Employment Services:
4,141
4,421
4,017
2,837
—
State Formula Grants:
2,929
3,019
2,929
1,808
—
Adult Activities Grants to States
886
900
886
712
—
Youth Activities Grants to
948
964
948
0
—
States
Dislocated Worker Activities
1,096
1,155
1,096
1,096
—
(DWA) Grants to States
National Activities:
1,212
1,402
1,087
1,029
—
DWA National Reserve
326
364
306
361
—
Native Americans
60
64
60
60
—
Migrant and Seasonal
97
97
97
97
—
Farmworkers
YouthBuild
105
145
105
105
—
Reintegration of Ex-Offenders
115
170
115
115
—
Workforce Data Quality
6
11
6
6
—
Initiative
Apprenticeship Grants
285
335
290
285
—
Community Projects
217
0
108
0
—
Climate Corps
0
15
0
0
—
SECTOR Partnerships
0
200
0
0
—
Job Corps
1,760
1,835
1,760
0
—
Community Service Employment for
405
405
405
0
—
Older Americans
State Unemployment Insurance and
4,009
4,592
4,072
4,006
—
Employment Service Operations
(SUI/ESO):
Unemployment Compensation
3,158
3,680
3,225
3,165
—
Employment Service
705
724
700
705
—
Foreign Labor Certification
84
103
85
73
—
One-Stop Career Centers
63
86
63
63
—
ETA Program Administration
173
225
173
163
—
Employee Benefits Security
191
249
191
153
—
Administration
Congressional Research Service

15

---

link to page 23 link to page 23 link to page 23 Labor, Health and Human Services, and Education: FY2024 Appropriations

FY2024
Senate
FY2024
FY2023
FY2024
Cmte.
House Floor
FY2024
Agency or Selected Program
Enacted Request
(S. 2624)
(H.R. 5894)
Enacted
Pension Benefit Guaranty Corp, (PBGC)
(493)
(513)
(513)
(513)
—
program level (non-add)b
Wage and Hour Division
260
341
265
185
—
Office of Labor-Management
49
53
49
49
—
Standards
Office of Federal Contract
111
151
111
83
—
Compliance Programs
Office of Workers’ Compensation
756
1,249
1,249
1,249
—
Programs—Mandatoryc
Office of Workers’ Compensation
123
152
123
109
—
Programs—Discretionary
Occupational Safety & Health
632
739
629
537
—
Administration
Mine Safety & Health
388
438
388
325
—
Administration
Bureau of Labor Statistics
698
758
698
658
—
Office of Disability Employment
43
61
37
43
—
Policy
Departmental Management
859
1,084
854
661
—
Salaries and Expenses
392
546
393
201
—
International Labor Affairs (non-add)d
(116)
(131)
(116)
(0)
—
Veterans Employment and Training
335
348
335
335
—
IT Modernization
34
79
29
27
—
Office of the Inspector General
97
111
97
97
—
Total, DOL BA in the Bill
15,091
16,785
15,050
11,088
—
Subtotal, Mandatory
1,250
1,280
1,280
1,280
—
Subtotal, Discretionary
13,841
15,505
13,770
9,808
—
Emergency Funding (not in above totals or
—
—
—
—
—
memoranda below)
Memoranda





Total, BA Available in Fiscal Year (current
15,092
16,788
15,053
11,091
—
year from any bil )
Total, BA Advances for Future Years
1,782
1,779
1,779
1,779
—
(provided in current bil )
Total, BA Advances from Prior Years (for
1,782
1,782
1,782
1,782
—
use in current year)
Source: Amounts in this table for the FY2023 Enacted, FY2024 Request, and FY2024 Senate Cmte. columns are
generally drawn from or calculated based on data contained in the Senate Appropriations Committee report
accompanying S. 2624 (S.Rept. 118-84). Amounts in this table for the FY2024 House Floor column are generally
drawn from or calculated based on data contained in the explanatory materials accompanying H.R. 5894 posted
Congressional Research Service

16

---

Labor, Health and Human Services, and Education: FY2024 Appropriations

at https://appropriations.house.gov/sites/republicans.appropriations.house.gov/files/FY24-LHHS-Explanatory-
Materials.pdf. Totals (“Total BA in the Bil ”) do not include emergency-designated appropriations.
Notes: BA = Budget Authority. Details may not add to totals due to rounding. Amounts in this table (1) reflect
all BA appropriated in the bil , regardless of the year in which funds become available (i.e., totals do not include
advances from prior-year appropriations, but do include advances for subsequent years provided in this bil ); (2)
have generally not been adjusted to reflect scorekeeping; (3) comprise only those funds provided (or requested)
for agencies and accounts subject to the jurisdiction of the LHHS subcommittees of the House and Senate
appropriations committees; and (4) do not include appropriations that occur outside of appropriations bil s.
a. Mandatory funding within ETA goes to Federal Unemployment Benefits and Allowances (FUBA) and
Advances to the Unemployment Trust Fund (UTF), if any. FUBA funds Trade Adjustment Assistance for
Workers (TAA).
b. PBGC funding is provided outside the LHHS Appropriations Act.

c. Mandatory programs in the Office of Workers’ Compensation Programs include Special Benefits
(comprising the Federal Employees’ Compensation Benefits and the Longshore and Harbor Workers’
Benefits), Special Benefits for Disabled Coal Miners, Energy Employees Occupational Il ness Compensation
(Administrative Expenses), and the Black Lung Disability Trust Fund.
d. The funding for International Labor Affairs is included in the Salaries and Expenses total.
Department of Health and Human Services (HHS)
All amounts in this section are based on regular LHHS appropriations only; they do not include
funds for HHS agencies provided through other appropriations bills (e.g., funding for the Food
and Drug Administration) or outside of the annual appropriations process (e.g., direct
appropriations for Medicare or mandatory funds provided by authorizing laws). All amounts in
this section are rounded (e.g., to the nearest million), as labeled. The dollar changes and
percentage changes discussed in the text are based on unrounded amounts. For consistency with
source materials, amounts do not reflect sequestration or reestimates of mandatory spending
programs, where applicable.
HHS Agencies Funded via the
About HHS
LHHS Appropriations Process
HHS is a large federal department composed
Health Resources and Services Administration (HRSA)
of multiple agencies working to enhance the
Centers for Disease Control and Prevention (CDC)
health and well-being of Americans. Annual
National Institutes of Health (NIH)
LHHS appropriations laws direct funding to
Substance Abuse and Mental Health Services
most (but not all) HHS agencies (see text box
Administration (SAMHSA)
for HHS agencies supported by the LHHS
Agency for Healthcare Research and Quality (AHRQ)
bill).19
Centers for Medicare & Medicaid Services (CMS)
The LHHS bill directs funding to multiple
Administration for Children and Families (ACF)
Public Health Service (PHS) agencies,
Administration for Community Living (ACL)
including the Health Resources and Services
Administration for Strategic Preparedness & Response
Administration (HRSA), the Centers for
(ASPR)
Disease Control and Prevention (CDC), the
Office of the Secretary (OS)
National Institutes of Health (NIH), the

19 Three HHS public health agencies receive annual funding from appropriations bills other than the LHHS bill: the
Food and Drug Administration (funded through the Agriculture appropriations bill), the Indian Health Service (funded
through the Interior-Environment appropriations bill), and the Agency for Toxic Substances and Disease Registry
(funded through the Interior-Environment appropriations bill). In addition, while the National Institutes of Health
(NIH) receive the majority of their appropriations from the LHHS bill, one NIH institute (the National Institute of
Environmental Health Sciences) receives appropriations from two bills: LHHS and the Interior-Environment bill.
Congressional Research Service

17

---

link to page 25 link to page 25 link to page 25 link to page 42 link to page 45 Labor, Health and Human Services, and Education: FY2024 Appropriations

Substance Abuse and Mental Health Services Administration (SAMHSA), and the Agency for
Healthcare Research and Quality (AHRQ). These public health agencies support diverse
missions, ranging from the provision of health care services and supports (e.g., HRSA,
SAMHSA), to the advancement of health care quality and medical research (e.g., AHRQ, NIH),
to the prevention and control of infectious and chronic diseases (e.g., CDC).
The HHS Administration for Strategic Preparedness and Response (ASPR), is also a component
of the PHS. ASPR was previously the Assistant Secretary for Preparedness and Response within
the Office of the Secretary. Its reorganization as an HHS operating division was approved by the
HHS Secretary on January 27, 2023, and became effective on February 11, 2023.20 For
comparability, the source documents used for this report display FY2023 enacted funding within
ASPR, and not within the Office of the Secretary, and this report follows that convention.
In addition to funding the above PHS agencies, the LHHS bill provides funding for annually
appropriated components of the CMS,21 which is the HHS agency responsible for the
administration of Medicare, Medicaid, the State Children’s Health Insurance Program (CHIP),
and consumer protections and private health insurance provisions of the Affordable Care Act
(ACA; P.L. 111-148, as amended).
The LHHS bill also provides funding for two HHS agencies focused primarily on the provision of
social services: the Administration for Children and Families (ACF) and the Administration for
Community Living (ACL). ACF’s mission is to promote the economic and social well-being of
vulnerable children, youth, families, and communities. ACL was formed with a goal of increasing
access to community supports for older Americans and people with disabilities.
Finally, the LHHS bill also provides funding for the HHS Office of the Secretary (OS), which
encompasses a broad array of management, research, oversight, and emergency preparedness
functions in support of the entire department.
Treatment of Certain HHS Emergency-Designated Funds
The general discussion of total HHS appropriations under the header “FY2024 HHS
Appropriations Overview” follows the convention used throughout the report of excluding
emergency appropriations. (These emergency funds are listed at the bottom of Table 5 and are not
included in the table totals.) However, the remainder of the discussion and tables in the HHS
section offer some analysis that is inclusive of a subset of emergency-designated funds. This
analysis draws a distinction between emergency appropriations that effectively could be used to
support regular program operations from those that would be limited to supporting activities
associated with a particular disaster or event (e.g., needs arising from a hurricane). The analysis
in this section includes, where applicable, the former type of emergency appropriations to offer a
more robust picture of total budgetary resources provided for regular program operations in
FY2023 and the FY2024 Senate committee bill. (The FY2024 President’s budget and the FY2024
House floor bill do not include such funds.) As a result, Table 6 and Table 7 (and the surrounding
discussion) break out FY2023 enacted and FY2024 Senate committee bill emergency funding for
regular program operations for relevant HHS operating divisions, accounts, and budget lines.
Consistent with the rest of the report, all FY2023 and FY2024 emergency-designated funding (for

20 U.S. Department of Health and Human Services, “Statement of Organization, Functions and Delegations of
Authority,” 88 Federal Register, 10125-10127, February 16, 2023.
21 Much of the funding for CMS activities is provided through mandatory appropriations in authorizing legislation, and
thus is not subject to the annual appropriations process.
Congressional Research Service

18

---

link to page 25 link to page 25 Labor, Health and Human Services, and Education: FY2024 Appropriations

both regular program operations and specified emergencies) also is included at the bottom of
these HHS tables.
FY2024 HHS Appropriations Overview
Table 5 displays FY2024 proposed funding levels for HHS, along with FY2023 levels. The totals
in this table do not include emergency-designated appropriations. Those amounts (if applicable)
are displayed separately, along with the law in which they were enacted, at the bottom of the table
and are in addition to regular appropriations.
In general, discretionary funds account for about 9% of HHS appropriations in the LHHS bill.
Compared to the FY2023 funding levels, the FY2024 Senate committee bill would decrease HHS
non-emergency discretionary appropriations by 1.3%. The House floor bill would decrease
funding to a greater degree, by 10.2%, whereas the President’s request would increase HHS
discretionary appropriations by 12.3%.
Table 5. HHS Appropriations Overview
(in billions of dollars)
FY2024
FY2024
FY2023
FY2024
Senate Cmte. House Floor FY2024
Funding
Enacted Request
(S. 2624)
(H.R. 5894)
Enacted
Discretionary
115.4
129.6
113.9
103.7
—
Mandatory
1,131.1
1,149.1
1,149.1
1,149.1
—
Total, HHS BA in the Bill
1,246.5
1,278.7
1,263.0
1,252.8
—
Emergency Funding (not in above totals)a





P.L. 117-180, Division A
2.8
—
—
—
—
P.L. 117-328, Division M
2.4
—
—
—
—
P.L. 117-328, Division N
4.3
—
—
—
—
S. 2624, Title II
—
—
4.1
—
—
Source: Amounts in this table for the FY2023 Enacted, FY2024 Request, and FY2024 Senate Cmte. columns are
generally drawn from or calculated based on data contained in the Senate Appropriations Committee report
accompanying S. 2624 (S.Rept. 118-84). Amounts in this table for the FY2024 House Floor column are generally
drawn from or calculated based on data contained in the explanatory materials accompanying H.R. 5894 posted
at https://appropriations.house.gov/sites/republicans.appropriations.house.gov/files/FY24-LHHS-Explanatory-
Materials.pdf. Totals (“Total BA in the Bil ”) do not include emergency-designated appropriations. CRS
calculations do, however, include LHHS funding provided to HHS pursuant to the 21st Century Cures Act (P.L.
114-255), as amended.
Notes: BA = Budget Authority. Details may not add to totals due to rounding. Amounts in this table (1) reflect
all BA appropriated in the bil , regardless of the year in which funds become available (i.e., totals do not include
advances from prior-year appropriations, but do include advances for subsequent years provided in this bil ); (2)
have generally not been adjusted to reflect scorekeeping; (3) comprise only those funds provided (or requested)
for agencies and accounts subject to the jurisdiction of the LHHS subcommittees of the House and Senate
appropriations committees; and (4) do not include appropriations that occur outside of appropriations bil s.
a. Division H of the FY2023 omnibus included a contingent emergency appropriation for the HHS Refugee and
Entrant Assistance account. The contingent funds were to become available only if certain conditions were
met. The FY2024 President’s request and Senate committee bil s would also provide contingent
appropriations for this account. Consistent with source materials, the estimated amount of the contingent
appropriations is treated as a scorekeeping adjustment and is thus not included in this total. 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
Congressional Research Service

19

---

link to page 26
Labor, Health and Human Services, and Education: FY2024 Appropriations

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 not a definite amount, it is not included in the
tables in this report.
Figure 3 provides an HHS agency-level breakdown of the FY2024 Senate committee bill’s non-
emergency HHS appropriations. As this figure demonstrates, annual HHS appropriations are
dominated by mandatory funding, the majority of which goes to CMS to provide Medicaid
benefits and payments to health care trust funds. When taking into account both mandatory and
discretionary funding, CMS accounts for $1.139 trillion, which is 89.8% of all enacted
appropriations for HHS. ACF and NIH account for the next-largest shares of total HHS
appropriations, receiving 4.0% and 3.7% apiece, respectively.
By contrast, when looking exclusively at discretionary appropriations, funding for CMS
constitutes about 4.0% of FY2024 HHS appropriations proposed in the Senate committee bill.
The bulk of discretionary appropriations would go to the PHS agencies, which combined to
account for 65.5% of discretionary appropriations provided for HHS. NIH typically receives the
largest share of all discretionary funding among HHS agencies (41.4% in the FY2024 Senate
committee bill), with ACF accounting for the second-largest share (27.4%).
Figure 3. FY2024 Enacted HHS Appropriations by Agency
(budget authority in billions of dollars)

Source: Amounts in this figure are generally drawn from or calculated based on data contained in the Senate
Appropriations Committee report accompanying S. 2624 (S.Rept. 118-84). Enacted totals for FY2024 do not
include emergency-designated appropriations. For consistency with source materials, amounts in this figure
generally do not reflect mandatory spending sequestration, where applicable, nor do they reflect any transfers or
reprogramming of funds pursuant to executive authorities. CRS calculations do, however, include LHHS funding
provided to HHS pursuant to the 21st Century Cures Act (P.L. 114-255), as amended.
Notes: Details may not add to totals due to rounding. The bar representing the combined mandatory and
discretionary total for CMS has been abbreviated due to space constraints. When taking into account both
mandatory and discretionary funding, CMS receives over 20 times the funding appropriated to either ACF or
NIH in the FY2023 LHHS omnibus. Amounts in this table (1) reflect all BA appropriated in the bil , regardless of
the year in which funds become available (i.e., totals do not include advances from prior-year appropriations, but
Congressional Research Service

20

---

Labor, Health and Human Services, and Education: FY2024 Appropriations

do include advances for subsequent years provided in this bil ); (2) have generally not been adjusted to reflect
scorekeeping; (3) comprise only those funds provided (or requested) for agencies and accounts subject to the
jurisdiction of the LHHS subcommittees of the House and Senate appropriations committees; and (4) do not
include appropriations that occur outside of appropriations bil s.
Special Public Health Funding Mechanisms
Annual appropriations for HHS Public Health Service agencies are best understood in the context
of certain HHS-specific funding mechanisms, including the Public Health Service Evaluation Set-
Aside, the Prevention and Public Health Fund (PPHF), and 21st Century Cures Act authorities. In
recent years, LHHS appropriations have used these funding mechanisms to direct additional
support to certain programs and activities.
Public Health Service Evaluation Tap
The PHS Evaluation Set-Aside, also known as
the PHS Evaluation Tap, is a unique feature of
Display of PHS Evaluation Tap Transfers
HHS appropriations. It is authorized by
By convention, appropriations acts direct where
Section 241 of the Public Health Service Act
specified PHS Evaluation Tap transfers are to be
(PHSA), and allows the Secretary of HHS to
allocated, but do not specify the PHS funds that are to
redistribute a portion of eligible PHS agency
be the sources of those transfers. Thus, tables in this
report show only the amount of PHS Evaluation Tap
appropriations across HHS for program
funds received by an agency (i.e., tables do not subtract
evaluation purposes. The PHSA limits the set-
the amount of the evaluation tap transfers from donor
aside to not less than 0.2% and not more than
agencies’ appropriations). This also means that tap
1.0% of eligible program appropriations.
amounts shown in the fol owing tables are in addition

to amounts shown for budget authority, but the
LHHS appropriations acts commonly establish
amounts shown for budget authority have not been
requirements in addition to those in statute.
adjusted to reflect the potential transfer out of funds
under the tap.
These include a higher maximum percentage
for the set-aside and directing specific
amounts of tap funding to selected HHS programs.22 Since FY2010, and including in FY2023,
this higher maximum set-aside level has been 2.5% of eligible appropriations.23 The Senate
committee bill would increase the maximum set-aside level to 2.8%. Both the House floor bill
and the President’s budget, however, would continue the 2.5% level.
Although annual LHHS appropriations acts typically direct PHS Evaluation tap transfers to
selected accounts and activities, they do not specify which account is the source of the transfer.
As a result, tables show amounts transferred in, without showing amounts transferred out (see
text box). Before FY2015, LHHS appropriations acts traditionally used the PHS Evaluation Tap
to provide more than a dozen HHS programs with funding beyond their annual appropriations; in
some cases, this was the sole source of funding for a program or activity. However, since FY2015

22 After the LHHS appropriations act allocates this transfer authority to specified programs, any transfer authority that
remains unallocated is available to be used by the HHS Secretary pursuant to the parameters established in law. (Such
post-enactment PHS Evaluation Tap transfers are not within this scope of this report.)
23 See Section 204, Division H, P.L. 117-328, for the FY2023 maximum set-aside level. The last time that an
appropriations act set the PHS tap percentage at a level other than 2.5% was in FY2009, when it was 2.4% (see P.L.
111-8). The FY2023 omnibus retained a change to this provision, first included in the FY2014 omnibus, allowing tap
transfers to be used for the “evaluation … and the implementation” of programs funded in the HHS title of the LHHS
appropriations act. Prior to FY2014, such provisions had restricted tap funds to the “evaluation … of the
implementation” of programs authorized under the Public Health Service Act. The FY2024 President’s budget and the
Senate committee bill would retain the recent phrasing (“and”), while the House floor bill would revert to the older
construction (“of”).
Congressional Research Service

21

---

Labor, Health and Human Services, and Education: FY2024 Appropriations

and including in FY2023, LHHS appropriations acts have directed tap funds to a smaller number
of programs or activities within three HHS agencies (NIH, SAMHSA, and OS). This change has
been particularly notable for AHRQ, which had been funded primarily through tap transfers from
FY2003 to FY2014, but has received discretionary appropriations since then.24 Since FY2015,
LHHS appropriations laws have directed the largest share of tap transfers to NIH.
Under the FY2024 Senate committee bill, the House floor bill, and the President’s budget, the
amount of PHS Evaluation Tap transfers to SAMHSA ($134 million) would be the same as those
directed in FY2023. For the OS, the FY2024 Senate committee bill would increase the amount of
directed tap transfers, by $5 million (+3.8%), to $136 million, whereas the House floor bill would
decrease them by $17 million (-12.8%). The President’s budget, however, proposed that these
transfers be increased by $66 million (+50.2%). The proposed increases for OS were largely
directed to the Office of the National Coordinator for Health Information Technology, which has
been solely funded by tap transfers as of FY2022, and would continue to receive no discretionary
funding for FY2024 under the Senate committee, House floor, and President’s proposals. Finally,
the FY2024 Senate committee bill would keep the amount of NIH tap transfers the same as
FY2023 enacted ($1.4 billion). The House floor bill would decrease these transfers by $85
million (-6.0%), while the President’s budget would increase them by $536 million (37.9%).
In addition to the transfers to SAMHSA, OS, and NIH, the FY2024 Senate committee bill and the
President’s budget proposed expanding the agencies funded by the PHS tap. The CDC would
receive tap transfers, primarily directed to the Public Health Scientific Services, totaling $244
million under the Senate committee bill, and $177 million under the President’s budget. (The
House floor bill proposed no such transfers for the CDC.) The President’s budget also requested
that AHRQ receive a tap transfer of $45 million, for an AHRQ funding total inclusive of transfers
of $448 million. In contrast, the Senate committee bill would fund AHRQ at $371 million, and
direct no tap transfers. (The House floor bill would eliminate AHRQ and transfer its functions to
the NIH.)
Prevention and Public Health Fund
The ACA both authorized and appropriated mandatory funding to three funds to support programs
and activities within the PHS agencies.25 One of these,
the Prevention and Public Health Fund (PPHF, ACA
Display of PPHF Transfers
§4002, as amended), was given a permanent, annual
PPHF transfer amounts displayed in the HHS tables in
appropriation that was intended to provide support
this report are in addition to amounts shown for
each year to prevention, wellness, and related public
budget authority provided in the bil . For consistency
health programs funded through HHS accounts.
with source materials, the amounts shown for PPHF

transfers in these tables reflect the estimated effects of
PPHF funds are intended to supplement (sometimes
mandatory spending sequestration; this is not the case
quite substantially) the funding that selected programs
for other mandatory spending shown in this report
(also for consistency with source materials).
receive through regular appropriations. The PPHF
authority instructs the HHS Secretary to transfer

24 Until FY2015, AHRQ had not received a discretionary appropriation in an annual appropriations act in more than a
decade. FY2009 was the exception to this general pattern, as AHRQ received a supplemental appropriation from the
American Recovery and Reinvestment Act that year. In recent years, AHRQ has also received some transfers from the
Prevention and Public Health Fund and the Patient-Centered Outcomes Research Trust Fund, though these transfers
were generally much smaller than the transfers AHRQ received from the tap. For more information, see CRS Report
R44136, The Agency for Healthcare Research and Quality (AHRQ) Budget: Fact Sheet.
25 For more information, see CRS Report R41301, Appropriations and Fund Transfers in the Affordable Care Act
(ACA).
Congressional Research Service

22

---

link to page 60 link to page 64 link to page 45 Labor, Health and Human Services, and Education: FY2024 Appropriations

amounts from the fund to HHS agencies. However, since FY2014, provisions in annual
appropriations acts and accompanying reports have explicitly directed the distribution of PPHF
funds and prohibited the Secretary from making further transfers for those years.26
The ACA had appropriated $2 billion in mandatory funds to the PPHF for FY2024, but this
amount was reduced by subsequent laws that decreased PPHF funding for FY2024 and other
fiscal years.27 Under current law, the FY2024 appropriation is $1.3 billion.28 This appropriation is
subject to a 5.7% reduction due to sequestration of nonexempt mandatory spending.29 (For more
information on sequestration, see the budget enforcement discussion in the Appendix A.) After
sequestration, the total PPHF appropriation available for FY2024 is $1.2 billion, a $283 million
(+30.0%) increase relative to FY2023. The FY2024 Senate committee bill, House floor bill, and
President’s budget would distribute the entirety of this additional funding to the CDC. In total, the
CDC would receive $1.2 billion, which is 31.3% more than FY2023. These proposals would also
allocate $12 million to SAMHSA and $28 million to ACL (the same as FY2023).
21st Century Cures Act, NIH Innovation Account
The 21st Century Cures Act (P.L. 114-255; hereinafter
referred to as the “Cures Act”) established the NIH
Display of Cures Act Transfers
Innovation Account. The Cures Act transferred funds
For consistency with source materials, the
to the NIH Innovation Account and authorized specific
directed transfers of Cures Act funding
amounts to be appropriated for each of FY2017
shown in Table 7 are in addition to amounts
otherwise appropriated to the accounts.
through FY2026. For FY2024, the amount authorized
is $407 million, which is $678 million (-62.5%) less
than the amount authorized for FY2023. The Cures Act also specifies how the $407 million for
FY2024 is to be distributed: $325 million for the Precision Medicine Initiative and $172 million
for the BRAIN Initiative. Each of the FY2024 proposals would provide the full $407 million for
the account and would distribute the funds as authorized. The committee report and explanatory
materials accompanying the FY2024 Senate committee and House floor bills would direct HHS
to transfer a portion of the funds to two specific NIH institutes. As with the PHS tap and PPHF,
these directed transfers are noted (where applicable) in the discussion and tables that follow.
The Cures Act also specified that amounts appropriated to the NIH Innovation Account (up to the
authorized funding level for the year) are effectively to be excluded from certain budgetary
estimates. For consistency with source documents, the NIH, HHS, and bill-wide totals in this
report generally include funds provided to this account. An exception is that these funds are
excluded from totals in Table A-1, as this table only includes LHHS funds subject to
discretionary spending limits.
Selected HHS Highlights by Agency
This section begins with a limited selection of discretionary funding highlights by HHS agency.
The discussion is largely based on the proposed appropriations levels for FY2024 compared to

26 For the provision in the FY2023 LHHS omnibus, see Division H, §222, P.L. 117-328.
27 For a list of these laws and the amounts that were changed, see CRS Report R47895, Prevention and Public Health
Fund: In Brief.
28 42 U.S.C. §300u-11.
29 OMB Report to the Congress on the BBEDCA 251A Sequestration for Fiscal Year 2024, March 13, 2023, p.6 of 17,
https://www.whitehouse.gov/wp-content/uploads/2023/03/BBEDCA_Sequestration_Report_and_Letter_3-13-
2024.pdf.
Congressional Research Service

23

---

link to page 42 link to page 45 Labor, Health and Human Services, and Education: FY2024 Appropriations

FY2023 enacted levels.30 These summaries are followed by a brief overview of significant
provisions from annual HHS appropriations laws that restrict spending in certain controversial
areas, such as abortion and stem cell research. The section concludes with two tables (Table 6 and
Table 7) presenting more detailed information on FY2023 enacted and FY2024 proposed funding
levels for HHS.
HRSA
The HRSA mission is focused on delivering health care services to those who are geographically
isolated and economically or medically vulnerable.31 The FY2024 Senate committee bill would
provide $8.9 billion in non-emergency discretionary budget authority for HRSA. This is
• $1.6 billion (+22.3%) more than the FY2024 House floor bill ($7.3 billion),
• $328 million (-3.6%) less than the FY2024 President’s request ($9.2 billion), and
• $610 million (-6.4%) less than the FY2023 enacted level ($9.5 billion).
HRSA administers aspects of the HHS-wide Ending the HIV Epidemic (EHE) initiative within
the agency’s Health Centers and Ryan White HIV/AIDS programs, providing HIV care and
treatment services, including Pre-Exposure Prophylaxis (PrEP) services, outreach, and care
coordination. The Senate committee report would maintain HRSA’s EHE funding at FY2023
levels ($157 million for EHE within the Health Centers account and $165 million for EHE within
the Ryan White account).32 The FY2024 House explanatory materials propose eliminating
funding for EHE within both accounts due to “a lack of performance data” and having “not met
its original objectives.”33 Overall, for the Health Centers program, the Senate committee bill and
House floor bill both propose flat funding compared to the FY2023 LHHS omnibus ($1.9
billion). For the Ryan White program, the Senate committee bill proposes flat funding ($2.6
billion) and the House bill proposes $2.3 billion (-9.3% compared to FY2023 enacted).
The Healthy Start program provides funding to review, develop, and evaluate programs that
reduce infant mortality in at-risk communities. The Senate committee report proposes $145
million for this program, which is the same as FY2023 enacted.34 The House explanatory
materials propose eliminating funding for this program, noting that similar activities under the
Maternal, Infant, and Early Childhood Home Visiting (MIECHV) program within HRSA already
receive mandatory funding.35
The Family Planning program, authorized in Title X of the PHSA, supports preventive and
primary health care services. The Senate committee bill proposes $286 million for this program,
which is the same as FY2023 enacted. The House explanatory materials propose eliminating
funding for this program, stating that the committee is “disappointed by the suspension and
termination of Title X grants to projects serving rural and low-income individuals based on the
project’s refusal to refer or counsel for abortion, thereby limiting access to services provided by
such projects.”36

30 HHS budget materials can be found at http://www.hhs.gov/budget/.
31 HRSA, About HRSA, https://www.hrsa.gov/about/index.html.
32 S.Rept. 118-84, p. 37 and Congressional Record, vol. 168, no. 198, book II, December 20, 2022, pp. S8875-S8876.
33 House explanatory materials, pp. 25 and 39.
34 S.Rept. 118-84, p. 47 and Congressional Record, vol. 168, no. 198, book II, December 20, 2022, p. S8876.
35 House explanatory materials, p. 36.
36 House explanatory materials, p. 43.
Congressional Research Service

24

---

Labor, Health and Human Services, and Education: FY2024 Appropriations

Both the Senate committee report and the House explanatory materials highlight the Telehealth
program as a priority for FY2024, both noting the importance of rural access to health care. The
Senate committee report would allocate $38 million for telehealth, which is the same at FY2023
enacted.37 The House explanatory materials propose $45 million for telehealth, an increase of $7
million (+18.4%) compared to FY2023 enacted.38
CDC
The CDC works to protect public health by providing leadership, information, and scientific
expertise in preventing and controlling diseases, including outbreaks of infectious diseases. The
CDC also works to promote health and quality of life by preventing and controlling injury,
disability, and environmental health threats. The FY2024 Senate committee bill would provide
$7.7 billion in non-emergency discretionary budget authority for the CDC (not counting directed
transfers). This amount is
• $1.4 billion (+21.4%) more than the FY2024 House floor bill ($6.4 billion),
• $2.5 billion (-24.5%) less than the FY2024 President’s request ($10.2 billion),
and
• $547 million (-6.6%) less than the FY2023 enacted level ($8.3 billion).
The FY2024 Senate committee bill would supplement its proposed discretionary budget authority
for the CDC with directed transfers of $244 million from the PHS tap (+$244 million from
FY2023 enacted) and $1.2 billion from PPHF (+$283 million from FY2023). Altogether, this
combination of funding in the Senate committee bill would come to $9.1 billion in discretionary
funding (inclusive of directed transfers). This combined amount is
• $1.6 billion (+21.3%) more than comparable levels in the FY2024 House floor
bill ($7.5 billion),
• $2.4 billion (-21.1%) less than comparable levels in the FY2024 President’s
request ($11.6 billion), and
• $20 million (-2.0%) less than the comparable FY2023 enacted level ($9.2
billion).
Inclusive of directed transfers, the FY2024 Senate committee bill would sustain or increase total
funding directed to most CDC accounts, relative to the FY2023 LHHS omnibus. The FY2024
House floor bill, in contrast, would decrease most CDC accounts and numerous CDC programs
within those accounts. For example, the explanatory materials accompanying the House floor bill
would eliminate funding for several HIV programs, including the CDC component of the HHS-
wide Ending the HIV Epidemic Initiative ($220 million in FY2023) and the global HIV/AIDS
program ($129 million in FY2023).39 The House explanatory materials also propose to eliminate
funding lines for tobacco prevention and control programs ($246.5 million in FY2023); the
climate and health program ($10 million in FY2023); youth violence prevention ($18.1 million in
FY2023); firearm injury and mortality prevention ($12.5 million in FY2023); occupational safety
and health research ($115.1 million in FY2023), and all preparedness and response funding aside
from the Public Health Emergency Preparedness cooperative agreement program (decrease of

37 S.Rept. 118-84, p. 55 and Congressional Record, vol. 168, no. 198, book II, December 20, 2022, p. S9140.
38 House explanatory materials, p. 45.
39 House explanatory materials, pp. 48, 62. For FY2023 enacted levels, see Congressional Record, vol. 168, no. 198,
book II, December 20, 2022, pp. S8877, S8881.
Congressional Research Service

25

---

Labor, Health and Human Services, and Education: FY2024 Appropriations

$148.2 million).40 The only account that the House floor bill would increase is the Emerging and
Zoonotic Infectious Diseases (EZID) account. According to the explanatory materials, a $10
million increase (+1.3%, from FY2023 enacted) is directed at mycotic (i.e., fungal) diseases.41
NIH
NIH is the federal government’s lead health and medical research agency. NIH is home to 27
Institutes and Centers, as well as a new agency, the Advanced Research Projects Agency for
Health (ARPA-H). ARPA-H was first established in 2022, and is focused on driving health
breakthroughs and innovations.42 The FY2024 Senate committee bill would provide $47.1 billion
in non-emergency discretionary budget authority for NIH and ARPA-H (not counting directed
transfers). This amount is
• $3.3 billion (+7.6%) more than the FY2024 House floor bill ($43.8 billion),
• $1.7 billion (-3.5%) less than the FY2024 President’s request ($48.8 billion), and
• $413 million (-0.9%) less than the FY2023 enacted level ($47.6 billion).
The FY2024 Senate committee bill would supplement its proposed discretionary budget authority
for the NIH (including ARPA-H) with directed transfers of $1.4 billion from the PHS tap (the
same as FY2023 enacted). In addition, the FY2024 Senate committee bill would also include a
total of $678 million for NIH designated as emergency requirements. Altogether, this combination
of funding in the Senate committee bill would total $49.2 billion in discretionary budget authority
for NIH (inclusive of directed transfers and emergency-designated funds). This amount is
• $4.1 billion (+9.1%) more than comparable levels in the FY2024 House floor bill
($45.1 billion),
• $1.6 billion (-3.0%) less than comparable levels in the FY2024 President’s
request ($50.8 billion), and
• $265 million (+0.5%) more than the comparable FY2023 enacted level ($49.0
billion).
Accounting for the emergency-designated appropriations and transfers, the Senate FY2024
committee bill would sustain or increase the FY2023 enacted funding levels for almost all NIH
accounts. In contrast, several NIH accounts would see decreases under the FY2024 House floor
proposal. The National Institute of Allergy and Infectious Diseases (NIAID) and the Advanced
Research Projects Agency for Health (ARPA-H) would see the largest decreases by dollar
amount: a decrease of $1.5 billion for NIAID (-22.9%) and $1 billion for ARPA-H (-66.7%)
relative to FY2023 enacted levels.
In some cases, the House floor bill would reduce funding where the Senate committee bill would
provide increases relative to FY2023 (accounting for transfers and the emergency-designated
amounts). For example, relative to FY2023 enacted, the House floor bill proposes a decrease of
$216 million for the National Cancer Institute (NCI; -3.0%), whereas the Senate committee bill
would increase NCI by $60 million (+0.8%; with $216 million of the Senate NCI total being
emergency designated). Relative to FY2023 enacted, the National Institute of Mental Health
(NIMH) would see a decrease of $139 million under the FY2024 House floor proposal (-5.9%),

40 House explanatory materials, pp. 50, 58, 59, 60, 61, 63. For FY2023 enacted levels, see Congressional Record, vol.
168, no. 198, book II, December 20, 2022, pp. S8878-S8881.
41 House explanatory materials, p. 50.
42 See CRS Report R47568, Advanced Research Projects Agency for Health (ARPA-H): Overview and Selected Issues.
Congressional Research Service

26

---

Labor, Health and Human Services, and Education: FY2024 Appropriations

whereas NIMH would see an increase of $100 million under the FY2024 Senate committee bill
(+4.3%; with $139 million of the Senate NIMH total being emergency-designated).
SAMHSA
SAMHSA is the federal agency primarily responsible for supporting community-based mental
health and substance abuse treatment and prevention services. The SAMHSA mission is focused
on reducing the impacts of substance abuse and mental illness.43 SAMHSA supports activities
that include education and training, prevention programs, early intervention activities, treatment
services, and technical assistance. The FY2024 Senate committee bill would provide $7.2 billion
in non-emergency discretionary budget authority for SAMHSA (not counting directed transfers).
This is
• $212 million (+3.0%) more than the FY2024 House floor bill ($7.0 billion),
• $3.1 billion (-30.0%) less than the FY2024 President’s request ($10.3 billion),
and
• $183 million (-2.5%) less than the FY2023 enacted level ($7.4 billion).
The FY2024 Senate committee bill, the House floor bill, and the President’s request would
supplement SAMHSA’s proposed discretionary budget authority with directed transfers of $134
million from the PHS tap (the same as FY2023 enacted) and $12 million from the PPHF (the
same as FY2023 enacted). In addition, the Senate committee bill includes a total of $217 million
for SAMHSA designated as an emergency requirement. Accounting for both the emergency-
designated appropriations and the directed transfers, the FY2024 Senate Committee bill would
provide $7.6 billion for SAMHSA. This combined amount is
• $429 million (+6.0%) more than comparable levels in the FY2024 House floor
bill ($7.1 billion),
• $2.9 billion (-27.5%) less than comparable levels in the FY2024 President’s
request ($10.4 billion), and
• $34 million (0.5%) more than the comparable FY2023 enacted level ($7.5
billion).
The State Opioid Response (SOR) grant program, within the Substance Abuse Services account,
supports prevention, treatment, and recovery support services for opioids, as well as other
substances. The House floor and Senate committee bills both propose increases to the SOR grant
program and changes to the tribal set aside. The FY2024 Senate committee proposal would
increase SOR funding by $20 million compared to FY2023 enacted (+1.3%, with $217 million
being emergency-designated). The Senate committee bill would reserve $60 million for tribes, a
$5 million increase over the FY2023 omnibus. The FY2024 House committee bill would increase
funding by $8 million (+0.5%) compared to FY2023 enacted, and would require that not less than
4% be set aside for tribes (i.e., at least $63 million). The Senate committee report continues
language from the FY2023 explanatory statement directing SAMHSA to avoid funding “cliffs”
between states with similar opioid mortality rates; it encourages SAMHSA to apply a weighted
formula, and requests a work plan from SAMHSA about the proposed allocation of funds prior to
awarding.44

43 SAMHSA, About Us, https://www.samhsa.gov/about-us.
44 Congressional Record, vol. 168, no. 198, book II, December 20, 2022, p. S8888; and S.Rept. 118-84, pp. 149-150.
Congressional Research Service

27

---

Labor, Health and Human Services, and Education: FY2024 Appropriations

Within the Mental Health account, the Senate committee bill proposes to increase funding for
Certified Community Behavioral Health Clinics (CCHBCs) by $15 million (+3.9%) relative to
FY2023 enacted. The House bill would continue FY2023 funding levels ($385 million).
AHRQ
AHRQ’s mission is “to produce evidence to make healthcare safer, higher quality, more
accessible, equitable, and affordable, and to work within the U.S. Department of Health and
Human Services and with other partners to make sure that the evidence is understood and used.”
45 AHRQ conducts research aimed at reducing the costs of health care, promoting patient safety,
measuring the quality of health care, and improving health care services, organization, and
financing.
The FY2024 House floor bill would provide no discretionary budget authority for AHRQ. The
FY2024 Senate committee bill would provide $371 million in non-emergency discretionary
budget authority for AHRQ. This amount is
• $32 million (-8.0%) less than the FY2024 President’s request ($403 million), and
• $3 million (-0.8%) less than the FY2023 enacted level ($374 million).
The FY2024 President’s request would supplement its proposed discretionary budget authority
for AHRQ with $45 million in PHS tap transfers. Altogether, this combination of funding in
FY2024 President’s request would come to $448 million for AHRQ (inclusive of directed
transfers), which is $77 million (+17.2%) more than the Senate committee bill.
The FY2024 Senate committee report would fund Research on Health Costs, Quality and
Outcomes (HCQO) at $226 million, which would be $71 million (-24.0%) less than the FY2024
President’s request ($297 million, inclusive of directed transfers), and $3 million (-1.3%) less
than the FY2023 enacted level ($229 million). Within HCQO, the FY2024 Senate committee
report directs $10 million (the same as in FY2023) to support Long COVID research, specifically
health systems research to improve care delivery models, care coordination, and access.46 This
amount would be $9 million (-47.4%) less than the amount requested in the FY2024 President’s
budget ($19 million).47
The FY2024 Senate committee report encourages AHRQ to issue guidance on telehealth,
specifically strategies to engage persons with disabilities and persons with limited English
proficiency. The FY2024 Senate committee report also encourages AHRQ to publish
effectiveness assessments of certain beneficiary telehealth readiness tools, such as digital
navigators and the provision of technology.48

45 AHRQ, Mission and Budget, https://www.ahrq.gov/cpi/about/mission/index.html. In addition to funds provided
through the annual appropriations process, AHRQ is also scheduled in FY2024 to receive a transfer of certain
mandatory funds that were authorized and appropriated to the Patient-Centered Outcomes Research Trust Fund
(PCORTF) by ACA Section 6301(e), as amended (26 U.S.C. §9511). Transfers to AHRQ from the PCORTF are to be
used to disseminate the results of patient-centered outcomes research. (PCORTF funds are generally not displayed in
this report, as they are not provided by or modified through annual LHHS appropriations bills.) These PCORTF
transfers were set at $111 million in FY2023 and $116 million in FY2024. For more information on the PCORTF, see
CRS Insight IN11010, Funding for ACA-Established Patient-Centered Outcomes Research Trust Fund (PCORTF)
Extended Through FY2029.
46 S.Rept. 118-84, pp. 154-155, and Congressional Record, vol. 168, no. 198, book II, December 20, 2022, p. S8889.
47 HHS, AHRQ, FY2024 Congressional Justification, p. AHRQ-39, https://www.ahrq.gov/sites/default/files/wysiwyg/
cpi/about/mission/budget/2024/fy2024-cj.pdf.
48 S.Rept. 118-84, p. 155.
Congressional Research Service

28

---

link to page 60 Labor, Health and Human Services, and Education: FY2024 Appropriations

CMS
CMS is the largest single health payer in the United States.49 The agency administers Medicare,
Medicaid, the Children’s Health Insurance Program (CHIP), and the federal Marketplace. The
FY2024 Senate committee bill would provide $4.6 billion in discretionary budget authority for
CMS. This amount is
• $343 million (+8.1%) more than the FY2024 House floor bill ($4.2 billion),
• $902 million (-16.4%) less than the FY2024 President’s request ($5.5 billion),
and
• $22 million (-0.5%) less than the FY2023 enacted level ($4.6 billion).
Both the Senate committee and House floor proposals would appropriate $915 million for the
CMS Health Care Fraud and Abuse Control (HCFAC) account, 2.5% more than FY2023. Of this
total amount for HCFAC, $604 million would be effectively exempt from the discretionary
budget caps. (See Appendix A for an explanation of the LHHS budget cap exemptions.)
The Senate committee bill would provide the CMS Program Management account with $3.7
billion, which is the same amount that was provided in FY2023.50 The FY2024 House floor bill
would instead provide a $343 million reduction relative to FY2023 (-9.3%), whereas the
President requested an increase of $880 million (+24.0%). This account supports CMS program
operations (e.g., claims processing, information technology investments, provider and beneficiary
outreach and education, and program implementation), in addition to federal administration and
other activities related to the administration of Medicare, Medicaid, the CHIP, and private health
insurance provisions established by the ACA. The Senate committee bill would retain a general
provision (§227 in the FY2023 LHHS omnibus), included in LHHS appropriations acts since
FY2014, authorizing HHS to transfer additional funds into this account from Medicare trust
funds. The terms of the provision would require that such funds be used to support activities
specific to the Medicare program, limit the amount of the transfers to $455 million, and explicitly
prohibit such transfers from being used to support or supplant funding for ACA implementation.
Both the FY2024 House floor bill and the President’s budget would eliminate this provision.
ACF
The ACF mission is focused on promoting the “economic and social well-being of children,
youth, families, and communities.”51 ACF administers a wide array of human services programs,
including Head Start, child care, and various child welfare programs. The FY2024 Senate
committee bill would provide $31.2 billion in non-emergency discretionary budget authority for
ACF. This amount is
• $3.0 billion (+10.6%) more than the FY2024 House floor bill ($28.3 billion),

49 FY2024 HHS Budget in Brief, p. 64, https://www.hhs.gov/sites/default/files/fy-2024-budget-in-brief.pdf.
50 The amounts for the Program Management account in this report do not include $455 million in FY2023 transfers
authorized by, P.L. 117-328, Division H, §227, and proposed for FY2024 in §227 of the Senate committee bill. (See
S.Rept. 118-84, p. 383). The transfers authorized by P.L. 117-328, Division H, §227 are included in how the House
calculates the Program Management account total in its explanatory materials. (See U.S. Congress, House Committee
on Appropriations, Subcommittee on Labor, Health and Human Services, Education, and Related Agencies,
Explanatory Materials for the Departments of Labor, Health and Human Services, and Education, and Related
Agencies Appropriations Bill, 2024, committee print, 118th Cong., 1st sess., November 2, 2023, p. 268.) However, for
consistency with the primary source materials used by this this report (S.Rept. 118-84), the House amounts for this
account has been calculated to exclude this $455 million.
51 ACF, What We Do, https://www.acf.hhs.gov/about/what-we-do.
Congressional Research Service

29

---

Labor, Health and Human Services, and Education: FY2024 Appropriations

• $5.4 billion (-14.7%) less than the FY2024 President’s request ($36.6 billion),
and
• $594 million (+1.9%) more than the FY2023 enacted level ($30.7 billion).
In addition, the FY2024 Senate committee bill also proposes a total of $2.9 billion in emergency-
designated funds for ACF. When accounting for these additional funds, the bill would provide a
combined total of about $34.1 billion in discretionary ACF budget authority (inclusive of
emergency-designated funds). This amount is
• $5.9 billion (+20.6%) more than comparable levels in the FY2024 House floor
bill ($28.3 billion),
• $2.5 billion (-6.9%) less than comparable levels in the FY2024 President’s
request ($36.6 billion), and
• $5.2 billion (-13.3%) less than the comparable FY2023 enacted level ($39.3
billion).52
The FY2024 Senate committee bill would provide $6.4 billion in definite appropriations for the
Refugee and Entrant Assistance account (none of which would be emergency-designated). This is
133.1% more than amount proposed in the House floor bill ($2.8 billion), 11.5% less than the
amount requested in the President’s budget ($7.3 billion), and the same as was provided in non-
emergency appropriations in the FY2023 omnibus. In FY2023, the account received an additional
$4.2 billion in definite emergency-designated appropriations, for a combined total of $10.6
billion.53 When accounting for these definite FY2023 emergency funds, the amount proposed by
the FY2024 Senate committee bill represents a decrease of about 39.5%.
The Senate committee bill would retain a provision, first enacted in the FY2023 omnibus, that
would make additional funds available for the Unaccompanied Alien Children (UAC) program
within the Refugee and Entrant Assistance account, contingent on certain conditions being met.
These additional funds would be emergency-designated. The UAC program provides for the
shelter, care, and placement of unaccompanied alien children who have been apprehended in the
United States. The contingency funding is designed to be responsive to fluctuations in the
monthly number of children referred to the program, with additional funds made available only
when the number of unaccompanied children referred to HHS under specified authorities exceeds
13,000 in a given month. Following conventions of congressional source documents, the
estimated budgetary costs of the emergency-designated contingency funds are included in LHHS
scorekeeping adjustments ($380 million in the Senate committee bill), and not the totals shown
for the Refugee and Entrant Assistance account.54 The President’s budget proposed to retain the

52 The comparable level for FY2023 includes roughly $8.7 billion in emergency-designated funds that effectively could
be used to support regular program operations (i.e., the appropriations did not limit use of funds to activities associated
with a particular disaster or event, such as needs arising from a hurricane). In addition to the $8.7 billion in emergency
funding that could be used for regular program operations, ACF also received $750 million in FY2023 emergency-
designated funds that were targeted to specific disasters. Because these funds were available for more limited purposes,
they are not included in the comparable estimate above. FY2023 emergency-designated appropriations for ACF were
provided in Section 101(8) and Section 147 of Division A of P.L. 117-180 (Continuing Appropriations Act, 2023),
Division M of P.L. 117-328 (Additional Ukraine Supplemental Appropriations Act, 2023), and Division N of P.L. 117-
328 (Disaster Relief Supplemental Appropriations Act, 2023).
53 In FY2023, this account received a total of $4.2 billion in definite emergency designated appropriations in two
different measures, including a combined $2.8 billion spread across Section 101(8) and Section 147 of Division A of
P.L. 117-180 (Continuing Appropriations Act, 2023) and an additional $2.4 billion in Division M of P.L. 117-328.
(Additional Ukraine Supplemental Appropriations Act, 2023.)
54 S.Rept. 118-84, p. 407.
Congressional Research Service

30

---

Labor, Health and Human Services, and Education: FY2024 Appropriations

UAC contingency funds (with some revisions), but the House floor bill proposed that this funding
be eliminated.
The Senate committee bill would also retain several general provisions for the Refugee and
Entrant Assistance account that have been included in annual appropriations acts since at least
FY2020. These provisions would
• authorize HHS to accept donations for the care of UAC arrivals (§230),
• limit the use of funds for unlicensed facilities for unaccompanied alien children
(§231),
• impose additional congressional notification requirements prior to the use of
unlicensed facilities (§232),
• prohibit HHS appropriations from being used to prevent a Member of Congress
from visiting a UAC facility for oversight purposes (§233), and
• impose additional public monthly reporting requirements on the number of
unaccompanied alien children who were separated from their parents or legal
guardians and transferred to the care of the ORR (§234).
The House floor bill would retain each of these general provisions except the provision limiting
use of funds for unlicensed facilities (§231 in the Senate committee bill). The House floor bill
would omit a provision, included in the Refugee and Entrant Assistance account’s appropriations
since FY2015, authorizing HHS to augment the account’s appropriations with transfers from
other discretionary HHS funds. Such transfers were limited to 15% for FY2023. The Senate
committee bill and the President’s budget would each retain this provision.55
ACL
ACL’s mission is focused on maximizing the “independence, well-being, and health of older
adults, people with disabilities across the lifespan, and their families and caregivers.”56 ACL
funds direct services and supports through networks of community-based organizations, as well
as training and research. The FY2024 Senate committee bill would provide $2.5 billion in non-
emergency discretionary budget authority for ACL (not counting directed transfers). This amount
is
• $50 million (+2.0%) more than the FY2024 House floor bill ($2.5 billion),
• $503 million (-16.6%) less than the FY2024 President’s request ($3.0 billion),
and
• $13 million (-0.5%) less than the FY2023 enacted level ($2.5 billion).
In addition, the FY2024 Senate committee bill, the FY2024 House floor bill, and the FY2024
President’s request would supplement their proposed discretionary budget authority for ACL with
directed transfers of $28 million from PPHF (the same as FY2023 enacted).
With regard to the direct care workforce, the FY2024 Senate committee report would direct ACL,
in coordination with DOL and CMS, to report on potential impacts of direct care workforce
shortages.57 The FY2024 House explanatory materials request a briefing on how ACL is using

55 S. 2624, p. 93, and HHS, ACF, FY2024 Congressional Justification, p. 40, https://www.acf.hhs.gov/sites/default/
files/documents/olab/fy-2024-congressional-justification.pdf.
56 ACL, About ACL, https://acl.gov/about-acl.
57 S.Rept. 118-84, pp. 181-182. The direct care workforce includes personal care aides, home health aides, and nursing
assistants who provide long-term services and supports to older adults and persons with disabilities.
Congressional Research Service

31

---

Labor, Health and Human Services, and Education: FY2024 Appropriations

direct care workforce funding from the FY2023 LHHS omnibus.58 Neither of these proposals
would provide the President’s requested $11.5 million increase (distributed as $8.0 million for
Aging Network Support Activities, $3.0 million for Developmental Disabilities Programs, and
$0.5 million for Independent Living) for technical assistance and demonstrations to test
recruitment, retention, and training approaches for the direct care workforce.59
The FY2024 Senate committee report would fund Nutrition Services Programs at $1.059 billion.
These programs are authorized under the Older Americans Act and provide grants to states and
territories to support home-delivered meals (sometimes informally referred to as meals on wheels)
and congregate meals (which are served in group settings such as senior centers). It also funds the
Nutrition Services Incentive Program (NSIP) which provides additional amounts for the purchase
of food for these programs.60 The Senate committee’s proposed funding level for Nutrition
Services Programs would be $8 million (-0.8%) less than FY2023 enacted and the FY2024 House
explanatory statement level, and $226 million (-17.6%) less than the FY2024 President’s request.
The Senate committee report notes that the committee’s recommended increases to home-
delivered and congregate nutrition services as well as state and private funding are expected by
ACL to offset some of the proposed reduction to NSIP.61
The FY2024 Senate committee report would maintain FY2023 funding levels for the Elder Rights
Support Activities at $34 million. This would be $15 million (+79.5%) more than the FY2024
House explanatory statement level and $44 million (-56.2%) less than the FY2024 President’s
request. Within Elder Rights Support Activities, the FY2024 House explanatory statement would
provide no funding (-$15 million from FY2023 enacted) for the State Adult Protective Services
formula grant program, which supports states in investigating allegations of adult maltreatment,
including the abuse, neglect, and exploitation of older adults and adults with disabilities.62 The
FY2024 President’s request would provide State Adult Protective Services formula grants with a
$43 million increase from FY2023 enacted “to allow states to maintain service levels” as certain
prior-year funds from the American Rescue Plan Act of 2021 (ARPA, P.L. 117-2) are exhausted.63
ASPR
New in FY2024, the House floor and Senate committee LHHS appropriations bills include
standalone appropriations for the Administration for Strategic Preparedness and Response
(ASPR). Previously, ASPR was funded as part of the OS Public Health and Social Services
Emergency Fund. ASPR leads the nation’s medical and public health preparedness for, response

58 House explanatory materials, pp. 148-149. The FY2023 LHHS omnibus explanatory statement included $2.0 million
under Aging Network Support Activities for a direct care workforce demonstration project; see Congressional Record,
daily edition, December 22, 2022, p. S8891.
59 ACL, FY2024 Congressional Justification, pp. 12-13, 103, 197, and 205. Note that the President’s budget also
proposes additional increases for other activities within these programs.
60 For details see CRS In Focus IF10633, Older Americans Act: Nutrition Services Program.
61 S.Rept. 118-84, p. 182.
62 FY2023 was the first time the State Adult Protective Services formula grant program was funded by the LHHS
omnibus. Prior to this, the first time these grants received funding was through the Coronavirus Response and Relief
Supplemental Appropriations Act, 2021 (CRRSA, Division M of P.L. 116-260) and then through the American Rescue
Plan Act of 2021 (ARPA, P.L. 117-2). CRRSA appropriated not less than $50 million in emergency funding for Adult
Protective Services (APS) grants to states. ARPA amended Title XX, Subtitle A, of the Social Security Act to add a
new Section 2010. Section 2010 appropriated a total of $276 million for Subtitle B Elder Justice activities in FY2021.
Of this total, ARPA made $88 million available in FY2021 and $188 million available in FY2022. See CRS Report
R46834, American Rescue Plan Act of 2021 (P.L. 117-2): Public Health, Medical Supply Chain, Health Services, and
Related Provisions.
63 ACL, FY2024 Congressional Justification, p. 14.
Congressional Research Service

32

---

Labor, Health and Human Services, and Education: FY2024 Appropriations

to, and recovery from disasters and other public health emergencies.64 ASPR, formerly the Office
of the Assistant Secretary for Preparedness and Response, became an HHS Operating Division
effective February 2023.65 As part of the FY2024 request, the Biden Administration requested a
new separate LHHS appropriations account for ASPR, consistent with other HHS Operating
Divisions.66
The FY2024 Senate committee bill would provide $3.3 billion in non-emergency discretionary
budget authority for the ASPR. This amount is
• $322 million (-8.9%) less than the FY2024 House floor bill ($3.6 billion),
• $973 million (-22.8%) less than the FY2024 President’s request ($4.3 billion),
and
• $331 million (-9.1%) less than the FY2023 enacted level ($3.6 billion).
In addition, the FY2024 Senate committee bill would also include a total of $375 million for
ASPR designated as emergency requirements. Accounting for the emergency-designated
appropriations, the FY2024 Senate committee bill would provide $3.7 billion in discretionary
budget authority for ASPR. This amount is
• $53 million (+1.5%) more than comparable levels in the FY2024 House floor bill
($3.6 billion),
• $598 million (-14.0%) less than comparable levels in the FY2024 President’s
request ($4.3 billion), and
• $44 million (+1.2%) more than the comparable FY2023 enacted level ($3.6
billion).
Accounting for the emergency-designated appropriations, the House floor and Senate committee
FY2024 bills would provide about the same total funding for ASPR as the FY2023 enacted level.
Within ASPR, funding levels in the House floor and Senate committee proposals vary by
program. According to the House explanatory materials, the FY2024 House floor bill would
increase funding for programs that help develop and make available medical products used for
emergencies, including a $150 million increase for the Biomedical Advanced Research and
Development Authority (BARDA) and a $30 million increase for Project BioShield, and a $35
million increase for the Strategic National Stockpile compared to FY2023 enacted levels.67 The
House FY2024 proposal would eliminate funding lines for H-CORE ($75 million in FY2023),
Preparedness and Emergency Operations ($31 million in FY2023), Policy and Planning ($15
million in FY2023) and reduce funding for the Hospital Preparedness Program (HPP) to $155
million, making these funds solely available for formula grants (compared to $305.1 million total
for HPP in FY2023).68 According to the House explanatory materials, these eliminated or reduced

64 Administration for Strategic Preparedness and Response (ASPR), “ASPR Program Offices,” https://aspr.hhs.gov/
AboutASPR/ProgramOffices/Pages/ProgramOffice.aspx.
65 ASPR, HHS, “Statement of Organization, Functions and Delegations of Authority,” 88 Federal Register 10125,
February 11, 2023.
66 ASPR, Congressional Justification FY2024, https://aspr.hhs.gov/AboutASPR/BudgetandFunding/Documents/
FY2024/ASPR-cj.pdf.
67 House explanatory materials, pp. 155, 158.
68 For FY2023 enacted levels, see Congressional Record, vol. 168, no. 198, book II, December 20, 2022, pp. S8893,
S8894.
Congressional Research Service

33

---

Labor, Health and Human Services, and Education: FY2024 Appropriations

funding lines are “outdated legacies of the pandemic response, or which failed to fulfill their
purpose when confronted by the last pandemic.”69
The Senate FY2024 proposal would provide more modest increases and decreases for ASPR
programs. Accounting for the emergency-designated appropriations, the FY2024 Senate
committee bill would provide a $20 million increase for BARDA and $75 million for a new
funding line for Pandemic Preparedness and Biodefense Manufacturing and Production.70 This
new funding line would provide continued funding for activities that first began with COVID-19
relief appropriations, and would be entirely emergency-designated.71 The FY2024 Senate
committee bill would decrease funding for H-CORE, a coordination unit, by $25 million, and for
Pandemic Influenza Preparedness by $26 million, relative to FY2023 enacted.72
Restrictions Related to Certain Controversial Issues
Annual LHHS appropriations measures regularly contain broad restrictions related to certain
controversial issues. For instance, annual LHHS appropriations acts commonly include provisions
limiting the use of federal funds for abortions, the use of human embryos for research, needle
exchange programs, and gun control advocacy.
Abortions: Since FY1977, annual LHHS appropriations acts have included provisions limiting
the circumstances under which LHHS funds (including Medicaid funds) may be used to pay for
abortions. Early versions of these provisions applied only to HHS, but since FY1994 most
provisions have applied to the entire LHHS bill. Under current provisions, (1) abortions may be
funded only when the life of the mother is endangered or in cases of rape or incest; (2) funds may
not be used to buy a managed care package that includes abortion coverage, except in cases of
rape, incest, or life endangerment; and (3) federal programs and state and local governments that
receive LHHS funding are prohibited from discriminating against health care entities that do not
provide or pay for abortions or abortion services. The FY2024 Senate committee bill and the
House floor bill all would retain these existing restrictions (§§506 and 507 in the FY2023 LHHS
omnibus), whereas the President’s budget would eliminate them.73 The FY2024 House floor bill
would additionally amend the Public Health Service Act to establish a right for designated parties
to bring civil action for certain violations of §507(d) in the FY2023 LHHS omnibus “or any
subsequent substantially similar provision” (§246 of the House floor bill). The House floor bill
also proposes two new abortion-related funding restrictions in the HHS title of the bill:
prohibiting funds to specified entities that perform or provide funds to another entity that
performs abortions other than those involving cases of rape, incest, or life endangerment (§239);
and prohibiting funds to support or administer certain abortion-related grants, contracts, or
cooperative agreements (§240). In addition, the House floor bill proposes a bill-wide prohibition
on funds to hospitals and other entities that provide abortion-related training if the training
programs do not satisfy specified requirements (§541).

69 House explanatory materials, pp. 3-4.
70 S.Rept. 118-84, p. 188.
71S.Rept. 118-84, pp. 194-195.
72 S.Rept. 118-84, p. 192. The committee report notes that it additionally “expects the $26,000,000 in unobligated
balances from pandemic influenza supplemental appropriations shall be provided to BARDA for pandemic influenza
activities.”
73 The current provisions are commonly referred to as the Hyde and Weldon Amendments. For additional information,
see CRS Report RL33467, Abortion: Judicial History and Legislative Response, Abortion: Judicial History and
Legislative Response, and CRS In Focus IF12167, The Hyde Amendment: An Overview.
Congressional Research Service

34

---

Labor, Health and Human Services, and Education: FY2024 Appropriations

Human Embryo Research: Since FY1996, annual LHHS appropriations have included a
provision prohibiting any LHHS funds (including NIH funds) from being used to create human
embryos for research purposes or for research in which human embryos are destroyed. The
FY2024 Senate committee bill, House floor bill, and President’s budget all would retain these
existing restrictions (§508 in the FY2023 LHHS omnibus).74 The House floor bill would also
prohibit the use of funds for human fetal tissue research if such tissue was obtained through an
induced abortion (§238).
Needle Exchange Programs: Since FY1990, annual LHHS appropriations have generally
included a provision prohibiting any LHHS funds from being used for needle exchange programs
(i.e., programs in which sterile needles or syringes are made available to injection drug users in
exchange for used needles or syringes to mitigate the spread of related infections, such as
hepatitis and HIV/AIDS).75 Starting in FY2016, the provision was modified to allow funds to be
used for needle exchange programs under the following conditions: (1) federal funds may not be
used to purchase the needles, but may be used for other aspects of such programs; (2) the state or
local jurisdiction must demonstrate, in consultation with CDC, that they are experiencing, or at
risk for, a significant increase in hepatitis infections or an HIV outbreak due to injection drug use;
and (3) the program must be operating in accordance with state and local law. The FY2024
President’s budget would omit this provision entirely, but the Senate committee bill and House
floor bill would retain it (§526 of the FY2023 LHHS omnibus).
Gun Control: Since FY1997, annual LHHS appropriations have included provisions prohibiting
the use of certain funds for activities that advocate or promote gun control. Early versions of
these provisions applied only to CDC; since FY2012, annual appropriations acts also have
included HHS-specific restrictions, in addition to restrictions that apply to all LHHS funds
(including funds transferred from the PPHF). The FY2024 Senate committee bill, the House floor
bill, and the President’s budget all would retain these restrictions (§210 [HHS] and §503(c) [all
LHHS, plus PPHF transfers] of the FY2023 LHHS omnibus).76

74 The current provision is commonly referred to as the Dickey Amendment. For additional information, see CRS
Report RL33540, Stem Cell Research: Science, Federal Research Funding, and Regulatory Oversight.
75 The one exception is the FY1992 LHHS appropriations act (P.L. 102-170), which appears to have included no such
provision. Since the provision’s inception in FY1990, there has been variation in its scope and application during
certain fiscal years. For example, the LHHS appropriations act for FY1998 (P.L. 105-78) made the ban subject to
action by the HHS Secretary. The LHHS appropriations acts for FY2010 (P.L. 111-117, Division D) and FY2011 (P.L.
112-10, Division B) applied the ban only in locations that local authorities determined to be inappropriate.
76 The FY2023 LHHS explanatory statement directed that $12.5 million apiece ($25 million total) be allocated by the
CDC and NIH for Firearm Injury and Mortality Prevention Research (Congressional Record, vol. 168, no. 198, book II,
December 20, 2022, pp. S8880 and S8886). (CDC and NIH funding reservations for Firearm Injury and Mortality
Prevention were first included in LHHS explanatory statements in FY2020.) The report accompanying the FY2024
Senate committee bill (S.Rept. 118-84, pp. 80, 124) would maintain these set-asides, whereas the FY2024 House
explanatory materials would provide no funding. The FY2024 President’s budget requested $35 million for the CDC
and $12.5 million for the NIH ($47.5 million total).
Congressional Research Service

35

---

link to page 44 link to page 44 link to page 44 link to page 44 link to page 44 link to page 44 link to page 44 link to page 44 link to page 44 link to page 44 link to page 44 Labor, Health and Human Services, and Education: FY2024 Appropriations

Table 6. HHS Appropriations Totals and Directed Transfers by Agency
(In millions of dollars)
FY2024
FY2024
House
Senate
Floor
FY2023
FY2024
Cmte.
(H.R.
FY2024
HHS Agency
Enacted
Request
(S. 2624)
5894)
Enacted
HRSA
9,744
9,466
9,139
7,522
—
Mandatory BA
256
261
261
261
—
Discretionary BA
9,487
9,205
8,877
7,260
—
CDCa
8,314
10,273
7,767
6,405
—
Mandatory BA
55
55
55
55
—
Discretionary BA
8,259
10,217
7,712
6,350
—
Evaluation Tap Fundingb
0
177
244
0
—
PPHFc
903
1,186
1,186
1,186
—
Subtotal (Discretionary BA + Transfers)
9,162
11,581
9,142
7,536
—
NIHa
47,547
48,822
47,134
43,795
—
Mandatory BA
0
0
0
0
—
Discretionary BA
47,547
48,822
47,134
43,795
—
Evaluation Tap Fundingb
1,412
1,948
1,412
1,327
—
Emergency (Regular Operations)d
0
0
678
0
—
Subtotal (Discretionary BA + Transfers +
48,959
50,770
49,224
45,123
—
Emergency)
SAMHSA
7,370
10,275
7,188
6,976
—
Mandatory BA
0
0
0
0
—
Discretionary BAe
7,370
10,275
7,188
6,976
—
Evaluation Tap Fundingb
134
134
134
134
—
PPHFc
12
12
12
12
—
Emergency (Regular Operations)d
0
0
217
0
—
Subtotal (Discretionary BA + Transfers +
7,516
10,420
7,550
7,122
—
Emergency)
AHRQ
374
403
371
0
—
Mandatory BA
0
0
0
0
—
Discretionary BA
374
403
371
0
—
Evaluation Tap Fundingb
0
45
0
0
—
Subtotal (Discretionary BA + Transfers)
374
448
371
0
—
CMS
1,117,630
1,134,749
1,133,847
1,133,504
—
Mandatory BA
1,113,068
1,129,262
1,129,262
1,129,262
—
Discretionary BA
4,563
5,487
4,585
4,242
—
ACF
47,688
55,363
49,995
47,012
—
Congressional Research Service

36

---

link to page 44 link to page 44 link to page 44 link to page 44 link to page 44 link to page 44 Labor, Health and Human Services, and Education: FY2024 Appropriations

FY2024
FY2024
House
Senate
Floor
FY2023
FY2024
Cmte.
(H.R.
FY2024
HHS Agency
Enacted
Request
(S. 2624)
5894)
Enacted
Mandatory BA
17,034
18,748
18,748
18,748
—
Discretionary BA
30,654
36,615
31,247
28,264
—
Emergency (Regular Operations)d
8,675f
0
2,850
0
—
Subtotal (Discretionary BA + Emergency)
39,329
36,615
34,097
28,264
—
ACL
2,538
3,028
2,525
2,474
—
Mandatory BA
0
0
0
0
—
Discretionary BA
2,538
3,028
2,525
2,474
—
PPHFc
28
28
28
28
—
Subtotal (Discretionary BA + Transfers)
2,565
3,055
2,552
2,502
—
ASPR
3,630
4,272
3,299
3,621
—
Mandatory BA
0
0
0
0
—
Discretionary BA
3,630
4,272
3,299
3,621
—
Emergency (Regular Operations)d
0
0
375
0
—
Subtotal (Discretionary BA + Emergency)
3,630
4,272
3,674
3,621
—
Office of the Secretary (OS)
1,708
2,096
1,769
1,503
—
Mandatory BA
710
793
793
793
—
Discretionary BA
998
1,303
976
710
—
Evaluation Tap Fundingb
131
197
136
114
—
Subtotal (Discretionary BA + Transfers)
1,129
1,500
1,112
825
—
Total, HHS BA in the Bill
1,246,542
1,278,747
1,263,032
1,252,812
—
Mandatory
1,131,124
1,149,120
1,149,120
1,149,120
—
Discretionary
115,418
129,627
113,912
103,692
—
Emergency Funding (not in above totals or




memoranda below)g
P.L. 117-180, Division A
2,775
—
—
—
—
P.L. 117-328, Division M
2.400
—
—
—
—
P.L. 117-328, Division N
4,250
—
—
—
—
S. 2624, Title II
—
—
4,120
—
—
Memoranda





Total, BA Available in Fiscal Year (current
1,214,684
1,230,447
1,214,732
1,204,512
—
year from any bil )
Total, BA Advances for Future Years
202,080
250,380
250,380
250,380
—
(provided in current bil )
Total, BA Advances from Prior Years (for
170,222
202,080
202,080
202,080
—
use in current year)
Congressional Research Service

37

---

Labor, Health and Human Services, and Education: FY2024 Appropriations

Source: Amounts in this table for the FY2023 Enacted, FY2024 Request, and FY2024 Senate Cmte. columns are
generally drawn from or calculated based on data contained in the Senate Appropriations Committee report
accompanying S. 2624 (S.Rept. 118-84). Amounts in this table for the FY2024 House Floor column are generally
drawn from or calculated based on data contained in the explanatory materials accompanying H.R. 5894 posted
at https://appropriations.house.gov/sites/republicans.appropriations.house.gov/files/FY24-LHHS-Explanatory-
Materials.pdf. Totals (“Total BA in the Bil ”) do not include emergency-designated appropriations. CRS
calculations do, however, include LHHS funding provided to HHS pursuant to the 21st Century Cures Act (P.L.
114-255), as amended.
Notes: BA = Budget Authority. Details may not add to totals due to rounding. Amounts in this table (1) reflect
all BA appropriated in the bil , regardless of the year in which funds become available (i.e., totals do not include
advances from prior-year appropriations, but do include advances for subsequent years provided in this bil ); (2)
have generally not been adjusted to reflect scorekeeping; (3) comprise only those funds provided (or requested)
for agencies and accounts subject to the jurisdiction of the LHHS subcommittees of the House and Senate
appropriations committees (e.g., department totals do not include funding for the Food and Drug Administration,
the Indian Health Service, or the Agency for Toxic Substances and Disease Registry, all of which are funded by
other bil s); and (4) do not include appropriations that occur outside of appropriations bil s.
a. Each year, CDC and NIH also receive funding in the Interior-Environment appropriations bil as part of their
overall budget authority.
b. By convention, this table shows only the amount of PHS Evaluation Tap funds received by an agency, not the
amount of tap funds donated by an agency. That is to say, tap amounts shown in this table are in addition to
amounts shown for budget authority, but the amounts shown for budget authority have not been adjusted
to reflect potential “transfer-out” of funds to the tap.
c. PPHF funds are not appropriated in the LHHS bil , but are shown here for il ustrative purposes as they may
be used to supplement the funding selected agencies and programs receive through the appropriations
process. Amounts shown for PPHF in this table are in addition to amounts shown for budget authority.
d. These table lines include emergency-designated funds that effectively could be used to support regular
program operations (i.e., the appropriations did not limit use of funds to activities associated with a
particular disaster or event, such as needs arising from a hurricane) that were enacted in FY2023 and
proposed in the FY2024 Senate committee bil . Al FY2023 and FY2024 emergency-designated funding (for
both regular program operations and specified emergencies) is listed at the bottom of this table.
e. Of the total FY2023 enacted for Mental Health Programs of Regional and National Significance, $62 mil ion
was enacted as part of the first continuing resolution for FY2023, P.L. 117-180, for the 988 Suicide and
Crisis Lifeline.
f.
For FY2023, $8.7 bil ion in definite emergency-designated funds were enacted that effectively could be used
to support regular program operations (i.e., the appropriations did not limit use of funds to activities
associated with a particular disaster or event, such as needs arising from a hurricane). In addition to the
$8.7 bil ion in emergency funding that could be used for regular program operations, ACF also received
$750 mil ion in FY2023 emergency-designated funds that were targeted to specific disasters. The funds that
were available for more limited purposes are not included in this table line. Finally, ACF also received a
contingent emergency appropriation for which funds were to become available only if certain conditions
were met; consistent with source materials, this contingent appropriation in FY2023 (and as proposed in
the FY2024 President’s request and Senate committee bil ) is treated as a scorekeeping adjustment and is
not included in emergency totals. FY2023 emergency-designated appropriations for ACF were provided in
Section 101(8) and Section 147 of Division A of P.L. 117-180 (Continuing Appropriations Act, 2023), as well
as Division H of P.L. 117-328 (LHHS Appropriations Act, 2023), Division M of P.L. 117-328 (Additional
Ukraine Supplemental Appropriations Act, 2023), and Division N of P.L. 117-328 (Disaster Relief
Supplemental Appropriations Act, 2023).
g. Division H of the FY2023 omnibus included a contingent emergency appropriation for the HHS Refugee and
Entrant Assistance account. The contingent funds were to become available only if certain conditions were
met. The FY2024 President’s budget and Senate committee bil s would also provide contingent
appropriations for this account. Consistent with source materials, the estimated amount of the contingent
appropriations is treated as a scorekeeping adjustment and is thus not included in this total. 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 not a definite amount, it is not included in the
tables in this report.
Congressional Research Service

38

---

link to page 48 link to page 48 link to page 48 link to page 48 link to page 48 Labor, Health and Human Services, and Education: FY2024 Appropriations

Table 7. HHS Discretionary Appropriations and Directed Transfers
for Selected Programs or Activities, by Agency
(in millions of dollars)
FY2024
Senate
FY2024
FY2023
FY2024
Cmte.
House Floor
FY2024
Agency or Selected Program
Enacted
Request
(S. 2624)
(H.R. 5894)
Enacted
HRSA





Community Health Centers
1,858
1,938
1,858
1,858
—
National Health Service Corps
126
176
129
126
—
Children’s Hospitals Graduate Medical
385
385
385
400
—
Education
Maternal & Child Health Block Grant
816
937
813
781
—
Healthy Start
145
185
145
0
—
Ryan White AIDS Programs
2,571
2,696
2,571
2,333
—
Rural Communities Opioid Response
145
165
155
145
—
Family Planning (Title X)
286
512
286
0
—
CDC





HIV/AIDS, Viral Hepatitis, STDs, TB
1,391
1,545
1,395
1,171
—
Prevention
Emerging and Zoonotic Infectious Diseases
699
794
699
709
—
PPHFa
52
52
52
52
—
Subtotal (Discretionary BA + Transfers)
751
846
751
761
—
Chronic Disease Prevention and Health
1,175
1,551
1,180
798
—
Promotion
PPHFa
255
262
255
330
—
Subtotal (Discretionary BA + Transfers)
1,430
1,814
1,435
1,128
—
Environmental Health
230
397
230
131
—
PPHFa
17
17
17
51
—
Evaluation Tap Fundingb
0
7
0
0
—
Subtotal (Discretionary BA + Transfers)
247
421
247
182
—
Injury Prevention and Control
761
1,352
762
731
—
National Institute for Occupational Safety
363
363
363
248
—
and Health
Global Health
693
765
693
371
—
NIH




—
National Cancer Institute
7,104
7,820
7,164
7,104
—
NIH Innovation Account Transfer
216
0
0
0
—
Emergency (Regular Operations)c
0
0
216
0
—
Subtotal (Discretionary BA + NIH
7,320
7,820
7,380
7,104
—
Innovation + Emergency)
Congressional Research Service

39

---

link to page 48 link to page 48 link to page 49 link to page 48 link to page 48 link to page 48 link to page 48 link to page 48 link to page 48 Labor, Health and Human Services, and Education: FY2024 Appropriations

FY2024
Senate
FY2024
FY2023
FY2024
Cmte.
House Floor
FY2024
Agency or Selected Program
Enacted
Request
(S. 2624)
(H.R. 5894)
Enacted
National Institute of Allergy and Infectious
6,562
6,562
6,562
5,062
—
Diseases
National Institute of General Medical
1,827
1,292
1,827
1,827
—
Sciences
Evaluation Tap Fundingb
1,412
1,948
1,412
1,327
—
Subtotal (Discretionary BA + Transfers)
3,240
3,240
3,240
3,155
—
National Institute on Aging
4,408
4,412
4,510
4,408
—
National Institute of Mental Health
2,113
2,456
2,213
2,113
—
NIH Innovation Account Transfer
225
0
86
86
—
Emergency (Regular Operations)c
0
0
139
0
—
Subtotal (Discretionary BA + NIH
2,338
2,456
2,438
2,199
—
Innovation + Emergency)
Advanced Research Projects Agency for
1,500
2,500
1,500
500
—
Health (ARPA-H)



SAMHSA


Mental Health Programs of Regional &
1,053
1,788
1,065
1,004
—
National Significance (PRNS)d
PPHFa
12
12
12
12
—
Subtotal (Discretionary BA + Transfers)
1,065
1,800
1,077
1,016
—
Mental Health Block Grant
987
1,632
1,022
987
—
Evaluation Tap Fundingb
21
21
21
21
—
Subtotal (Discretionary BA + Transfers)
1,008
1,653
1,043
1,008
—
Certified Community Behavioral Health
385
553
400
385
—
Clinics
Children’s Mental Health
130
225
130
130
—
Substance Abuse Treatment PRNS
572
753
574
468
—
Evaluation Tap Fundingb
2
2
2
2
—
Subtotal (Discretionary BA + Transfers)
574
755
576
470
—
Substance Abuse Block Grant
1,929
2,629
1,969
1,929
—
Evaluation Tap Fundingb
79
79
79
79
—
Subtotal (Discretionary BA + Transfers)
2,008
2,708
2,048
2,008
—
State Opioid Response Grants
1,575
2,000
1,378
1,583
—
Emergency (Regular Operations)c
0
0
217
0
—
Subtotal (Discretionary BA + Emergency)
1,575
2,000
1,595
1,583
—
Substance Abuse Prevention PRNS
237
246
237
180
—
Health Surveillance and Support
302
151
212
110
—
Evaluation Tap Fundingb
31
31
31
31
—
Congressional Research Service

40

---

link to page 48 link to page 48 link to page 48 link to page 48 Labor, Health and Human Services, and Education: FY2024 Appropriations

FY2024
Senate
FY2024
FY2023
FY2024
Cmte.
House Floor
FY2024
Agency or Selected Program
Enacted
Request
(S. 2624)
(H.R. 5894)
Enacted
Subtotal (Discretionary BA + Transfers)
333
182
244
141
—



AHRQ


Research on Health Costs, Quality, and
229
252
226
0
—
Outcomes
Evaluation Tap Fundingb
0
45
0
0
—
Subtotal (Discretionary BA + Transfers)
229
297
226
0
—
Medical Expenditure Surveys
72
72
72
0
—
Program Support
73
79
73
0
—



CMS


CMS Program Management
3,670
4,550
3,670
3,327
—
Health Care Fraud and Abuse Control
893
937
915
915
—



ACF


Low Income Home Energy Assistance
1,500
4,111
1,500
4,011
—
Program Formula Grants
Emergency (Regular Operations)c
4,500
0
2,575
0
—
Subtotal (Discretionary BA + Emergency)
6,000
4,111
4,075
4,011
—
Refugee and Entrant Assistance Programs
6,427
7,259
6,427
2,757
—
Emergency (Regular Operations)c
4,175
0
0
0
—
Subtotal (Discretionary BA + Emergency)
10,602
7,259
6,427
2,757
—
Child Care and Development Block Grant
8,021
9,000
8,721
8,021
—
Head Start
11,997
13,112
11,997
11,247
—
Preschool Development Grants
315
360
310
0
—



ACL


Home & Community-Based Supportive
410
500
410
410
—
Services
Family Caregiver Support Services
205
250
210
205
—
Nutrition Services Programs
1,067
1,284
1,059
1,067
—
Aging Network Support Activities
30
40
30
30
—
Elder Rights Support Activities
34
77
34
19
—
Developmental Disabilities Programs
191
214
191
191
—
WIOA Activities (transferred from ED)
287
324
287
287
—
Administration for Strategic





Preparedness and Response
Biomedical Advanced Research and
950
1,015
820
1,100
—
Development Authority (BARDA)
Emergency (Regular Operations)c
0
0
150
0
—
Subtotal (Discretionary BA + Emergency)
950
1,015
970
1,100
—
Congressional Research Service

41

---

link to page 48 link to page 48 Labor, Health and Human Services, and Education: FY2024 Appropriations

FY2024
Senate
FY2024
FY2023
FY2024
Cmte.
House Floor
FY2024
Agency or Selected Program
Enacted
Request
(S. 2624)
(H.R. 5894)
Enacted
Project BioShield
820
830
670
850
—
Emergency (Regular Operations)c
0
0
150
0
—
Subtotal (Discretionary BA + Emergency)
820
830
820
850
—
Strategic National Stockpile
965
995
965
1,000
—
H-CORE
75
83
50
0
—
Pandemic Influenza Preparedness
328
375
302
328
—
Hospital Preparedness Program
305
312
305
155
—
Office of the Secretary





Office of Nat'l Coord. for Health
0
0
0
0
—
Information Technology
Evaluation Tap Fundingb
66
104
71
56
—
Subtotal (Discretionary BA + Transfers)
66
104
71
56
—
Office of the Inspector General
87
117
87
80
—
Public Health and Social Services Emergency
138
278
116
0
—
Fund
Source: Amounts in this table for the FY2023 Enacted, FY2024 Request, and FY2024 Senate Cmte. columns are
generally drawn from or calculated based on data contained in the Senate Appropriations Committee report
accompanying S. 2624 (S.Rept. 118-84). Amounts in this table for the FY2024 House Floor column are generally
drawn from or calculated based on data contained in the explanatory materials accompanying H.R. 5894 posted
at https://appropriations.house.gov/sites/republicans.appropriations.house.gov/files/FY24-LHHS-Explanatory-
Materials.pdf. Totals (“Total BA in the Bil ”) do not include emergency-designated appropriations. CRS
calculations do, however, include LHHS funding provided to HHS pursuant to the 21st Century Cures Act (P.L.
114-255), as amended.
Notes: BA = Budget Authority. Details may not add to totals due to rounding. Amounts in this table (1) reflect
all BA appropriated in the bil , regardless of the year in which funds become available (i.e., totals do not include
advances from prior-year appropriations, but do include advances for subsequent years provided in this bil ); (2)
have generally not been adjusted to reflect scorekeeping; (3) comprise only those funds provided (or requested)
for agencies and accounts subject to the jurisdiction of the LHHS subcommittees of the House and Senate
appropriations committees (e.g., department totals do not include funding for the Food and Drug Administration,
the Indian Health Service, or the Agency for Toxic Substances and Disease Registry, all of which are funded by
other bil s); and (4) do not include appropriations that occur outside of appropriations bil s.
a. PPHF funds are not appropriated in the LHHS bil , but are shown here for il ustrative purposes as they may
be used to supplement the funding selected agencies and programs receive through the appropriations
process. Amounts shown for PPHF in this table are in addition to amounts shown for budget authority.
b. By convention, this table shows the amount of PHS Evaluation Tap funds received by an agency for a
particular program or activity separately from the budget authority appropriated for that program or
activity. Tap amounts are in addition to amounts shown for budget authority, though the amounts shown for
budget authority have not been adjusted to reflect potential “transfer-out” of funds to the tap.
c. These table lines include emergency-designated funds that effectively could be used to support regular
program operations (i.e., the appropriations did not limit use of funds to activities associated with a
particular disaster or event, such as needs arising from a hurricane) that were enacted in FY2023 and
proposed in the FY2024 Senate committee bil . The FY2023 amounts on these lines exclude emergency
funds that were targeted to particular disasters or events. The amounts shown for the Refugee and Entrant
Assistance account do not include contingent emergency appropriations provided in FY2023 or proposed in
the FY2024 President’s request and Senate committee bil . These contingent appropriations are treated as a
scorekeeping adjustment.
Congressional Research Service

42

---

link to page 50 Labor, Health and Human Services, and Education: FY2024 Appropriations

d. Of the total FY2023 enacted for Mental Health Programs of Regional and National Significance, $62 mil ion
was enacted as part of the first continuing resolution for FY2023, P.L. 117-180, for the 988 Suicide and
Crisis Lifeline.
Department of Education (ED)
Amounts in this section are based on regular LHHS appropriations only. They do not include
mandatory funds provided outside of the annual appropriations process (e.g., direct appropriations
for the Federal Direct Student Loan program and the mandatory portion of the Federal Pell Grant
program). Amounts are rounded (e.g., to the nearest million), as labeled. The dollar and
percentage changes discussed are based on unrounded amounts. For consistency with source
materials, amounts do not reflect sequestration or reestimates of mandatory spending programs,
where applicable.
About ED
Federal policymakers established the U.S. Department of Education in 1980.77 Its mission is to
“promote student achievement and preparation for global competitiveness by fostering
educational excellence and ensuring equal access.”78 Typically, about three-quarters of ED’s
discretionary appropriations go either to local educational agencies—which primarily use the
funds to provide educational and related services for educationally disadvantaged students and
students with disabilities—or to low-income postsecondary students in the form of Pell Grants,
which help pay for college. The remainder of ED’s discretionary budget provides for a wide range
of activities, including (but not limited to) support for minority-serving institutions; educational
research; and career, technical, and adult education.
The federal government provides roughly 11% of overall funding for elementary and secondary
education in the United States.79 The majority of school funding—about 89%—comes from states
and local districts, which have primary responsibility for the provision of elementary and
secondary education. With regard to higher education, the federal government provided roughly
55% of undergraduate and graduate student aid in academic year (AY) 2022-2023.80 (A large
share of this aid is provided in the form of student loans that must be repaid.)
FY2024 ED Appropriations Overview
Table 8 displays proposed FY2024 discretionary and mandatory ED budget authority, along with
FY2023 enacted levels. Note that the totals in this table do not include emergency-designated
appropriations. Those amounts are displayed separately, along with the law in which they were

77 ED in its current incarnation became a department in 1980 pursuant to the Department of Education Organization
Act (P.L. 96-88; enacted on October 17, 1979). However, the Department dates its origins to 1867. See U.S.
Department of Education, “About ED: The Federal Role in Education,” http://www2.ed.gov/about/overview/fed/
role.html.
78 U.S. Department of Education, “About ED,” https://www2.ed.gov/about/landing.jhtml?src=ft, accessed on January
12, 2024.
79 U.S. Department of Education, National Center for Education Statistics, Revenues and Expenditures for Public
Elementary and Secondary Education: FY21 (NCES 2023-301), May 2023, https://nces.ed.gov/pubs2023/2023301.pdf.
80 For the purposes of this calculation, the federal contribution included $133 billion (grants, loans, work-study, and tax
benefits) out of a total of $241 billion (federal aid, state aid, institutional grants, and private and employer-provided
grants). See the College Board’s Trends in College Pricing and Student Aid 2023, p. 32,
https://research.collegeboard.org/media/pdf/Trends%20Report%202023%20Updated.pdf.
Congressional Research Service

43

---

link to page 52 Labor, Health and Human Services, and Education: FY2024 Appropriations

enacted, at the bottom of the table and are in addition to regular appropriations. However, no such
appropriations were enacted for ED in FY2023, or thus far in FY2024.
Discretionary funds represent the majority of ED’s annual appropriations, accounting for roughly
95% of ED funding. The FY2024 Senate committee bill would provide about the same
discretionary appropriations for ED as FY2023 enacted, with a decrease of $13 million (-0.0%).
The FY2024 House floor bill would decrease discretionary appropriations for ED by $12.2 billion
(-15.3%), while the FY2024 President’s budget request would increase discretionary
appropriations for ED by $10.4 billion (+13.1%) compared to the FY2023 enacted levels.
Table 8. ED Appropriations Overview
(in billions of dollars)
FY2024 Senate
FY2024 House
FY2023
FY2024
Cmte.
Floor
FY2024
Funding
Enacted
Request
(S. 2624)
(H.R. 5894)
Enacted
Discretionary
79.6
90.0
79.6
67.4
—
Mandatory
4.0
4.3
4.3
4.3
—
Total, ED BA in the Bill
83.5
94.3
83.8
71.7
—
Emergency Funding (not in
—
—
—
—
—
above totals)
Source: Amounts in this table for the FY2023 Enacted, FY2024 Request, and FY2024 Senate Cmte. columns are
generally drawn from or calculated based on data contained in the Senate Appropriations Committee report
accompanying S. 2624 (S.Rept. 118-84). Amounts in this table for the FY2024 House Floor column are generally
drawn from or calculated based on data contained in the explanatory materials accompanying H.R. 5894 posted
at https://appropriations.house.gov/sites/republicans.appropriations.house.gov/files/FY24-LHHS-Explanatory-
Materials.pdf. Totals (“Total BA in the Bil ”) do not include emergency-designated appropriations.
Notes: BA = Budget Authority. Details may not add to totals due to rounding. Amounts in this table (1) reflect
all BA appropriated in the bil , regardless of the year in which funds become available (i.e., totals do not include
advances from prior-year appropriations, but do include advances for subsequent years provided in this bil ); (2)
have generally not been adjusted to reflect scorekeeping; (3) comprise only those funds provided (or requested)
for agencies and accounts subject to the jurisdiction of the LHHS subcommittees of the House and Senate
appropriations committees; and (4) do not include appropriations that occur outside of appropriations bil s.
Selected ED Highlights
The following sections highlight FY2024 appropriations proposals for selected ED accounts and
programs.81 Table 9 tracks funding levels for major ED budget and appropriations accounts, and
selected items within those accounts.
Education for the Disadvantaged
The Education for the Disadvantaged account is the largest account related to elementary and
secondary education and has been the second largest overall within ED based on funding
provided through the annual appropriations process in recent years. Within the account, a
majority of funds are for Grants to Local Educational Agencies, authorized under Title I-A of the
Elementary and Secondary Education Act (ESEA), as amended by the Every Student Succeeds
Act (ESSA; P.L. 114-95). Title I-A grants provide supplementary educational and related services
to low-achieving and other students attending elementary and secondary schools with relatively

81 ED budget materials can be found at https://www2.ed.gov/about/overview/focus/performance.html.
Congressional Research Service

44

---

Labor, Health and Human Services, and Education: FY2024 Appropriations

high concentrations of students from low-income families, as well as eligible students who live in
the areas served by these public schools but attend private schools.82
The FY2024 Senate committee bill would provide $18.6 billion in discretionary budget authority
for ESEA Title I-A Grants to Local Educational Agencies, which is
• $6.2 billion more (+50.2%) than the FY2024 House floor bill ($12.4 billion),
• $2.0 billion less (-9.6%) than the FY2024 President’s request ($20.5 billion), and
• $175 million more (+1.0%) than the FY2023 enacted level ($18.4 billion).
Whereas the FY2024 Senate committee bill would provide a funding level similar to the FY2023
enacted level, the amount in the FY2024 House floor bill would represent a significant decrease.
In addition to providing $6.0 billion less for the Grants to Local Educational Agencies program as
compared to the FY2023 LHHS omnibus, which is reflected in the amount above, the FY2024
House floor bill would also rescind approximately $8.7 billion of the FY2024 advance
appropriations provided under the FY2023 LHHS omnibus and made available on October 1,
2023.83 (That rescission would be in addition to the reduction above.) The House explanatory
materials argue that, due to various factors (including unspent balances from certain one-time
COVID-19-era appropriations), “States do not need additional Federal funding for public
schools.”84
Student Aid Administration
The Student Aid Administration account provides funds to administer the federal student aid
programs authorized under Title IV of the Higher Education Act (HEA) and Title VII-A-I of the
Public Health Service Act. Activities funded under the Student Aid Administration account
include personnel compensation, student loan servicing costs, student aid application processing,
and the disbursement of aid dollars.
The FY2024 Senate committee bill would provide $2.2 billion in discretionary budget authority
for the Student Aid Administration account. This is
• $415 million more (+23.4%) than the FY2024 House floor bill ($1.8 billion),
• $470 million less (-17.7%) than the FY2024 President’s request ($2.7 billion),
and
• $150 million more (+7.4%) than the FY2023 enacted level ($2.0 billion).
Student loan servicing costs account for the largest portion of the spending under the account. ED
uses third-party vendors (i.e., loan servicers) to service the portfolio of ED-held non-defaulted
federal student loans. Loan servicers are responsible for collecting payments on federal student
loans, advising borrowers on resources and benefits to manage their federal student loan
obligations, responding to customer service inquiries, administering loan forgiveness and
discharge benefits, and performing other associated administrative tasks.

82 Although Title I-A funds are used to serve eligible private school students, funds remain under the control of public
school authorities (i.e., they are not transferred to private schools).
83 For further information about the House proposal, see CRS Report R47732, Estimated ESEA Title I-A FY2023 and
FY2024 State Grants Under the House Appropriations Committee Subcommittee-Approved Bill.
84 House explanatory materials, pp. 179-180.
Congressional Research Service

45

---

link to page 54 link to page 54 Labor, Health and Human Services, and Education: FY2024 Appropriations

In April 2023, ED announced that it had awarded new contracts to five student loan servicers as
part of its Unified Servicing and Data Solution (USDS) solicitation.85 ED also extended legacy
servicer contracts through 2024. Both the FY2024 Senate committee bill and the House floor bill
contain similar language to that which has been included in appropriations bills since FY2020
requiring ED to provide quarterly briefings to the committees on its progress related to
solicitations for and implementation of Federal student loan servicing contracts. The President’s
budget states that the requested increase in funds reflects the transition from legacy servicing
contracts to the USDS loan servicing contracts and the return to repayment for millions of
borrowers whose monthly payments had been paused in light of the COVID-19 pandemic.86
Table 9. Detailed ED Appropriations
(in millions of dollars)
FY2024
FY2024
House
Senate
Floor
FY2023
FY2024
Cmte.
(H.R.
FY2024
Account and Selected Program
Enacted
Request
(S. 2624)
5894)
Enacted
Education for the Disadvantageda
19,088
21,255
19,263
13,055
—
Grants to Local Educational Agencies
18,387
20,537
18,562
12,354
—
Impact Aid
1,618
1,618
1,628
1,618
—
School Improvement Programs
5,811
5,890
5,821
4,850
—
Supporting Effective Instruction State Grants
2,190
2,190
2,190
1,681
—
21st Century Community Learning Centers
1,330
1,330
1,330
1,330
—
Student Support and Academic Enrichment
1,380
1,405
1,400
1,380
—
Grants
School Readiness
0
500
0
0
—
Indian Education
195
202
195
195
—
Innovation and Improvement
1,453
1,604
1,237
737
—
Safe Schools and Citizenship Education
457
1,075
437
316
—
English Language Acquisition
890
1,195
897
0
—
Special Education
15,453
18,179
15,662
15,453
—
Part B—Assistance for Education of all
14,614
16,762
14,789
14,614
—
Children with Disabilitiesb
Part C—Infants and Toddlers with
540
932
560
540
—
Disabilities
Rehabilitation Services
4,093
4,406
4,397
4,397
—
Vocational Rehabilitation State Grants
3,950
4,254
4,254
4,254
—
(mandatory)

85 U.S. Department of Education, “U.S. Department of Education’s Office of Federal Student Aid Awards New
Contracts to Five Companies to Serve Borrowers, Reduce Delinquency, and Improve Accountability,” April 24, 2023,
https://www.ed.gov/news/press-releases/us-department-educations-office-federal-student-aid-awards-new-contracts-
five-companies-serve-borrowers-reduce-delinquency-and-improve-accountability.
86 U.S. Department of Education, Student Aid Administration, Fiscal Year 2024 Budget Request, p. 20,
https://www2.ed.gov/about/overview/budget/budget24/justifications/q-saa.pdf.
Congressional Research Service

46

---

link to page 54 link to page 54 Labor, Health and Human Services, and Education: FY2024 Appropriations

FY2024
FY2024
House
Senate
Floor
FY2023
FY2024
Cmte.
(H.R.
FY2024
Account and Selected Program
Enacted
Request
(S. 2624)
5894)
Enacted
Special Institutions for Persons with
301
301
301
301
Disabilities
—
Career, Technical, and Adult Education
2,191
2,448
2,211
2,191
—
Career and Technical Education
1,462
1,689
1,482
1,462
—
Student Financial Assistance
24,615
26,415
24,595
22,475
—
Pell maximum grant (non-add in dollars, not
(6,335)
(6,835)
(6,585)
(6,335)
millions)
—
Federal Pell Grant Program
22,475
24,275
22,475
22,475
—
Student Aid Administration
2,034
2,654
2,184
1,769
—
Free Community College and Tuition
0
500
0
0
Subsidies
—
Higher Education
3,526
3,987
3,260
2,767
—
Howard University
354
347
304
302
—
College Housing & Academic Facilities
0
0
0
0
—
Loansc
HBCU Capital Financing Program
21
21
21
21
—
Account
Institute of Education Sciences
808
871
793
707
—
Departmental Management
634
793
627
515
—
Total, ED BA in the Bill
83,543
94,260
83,834
71,671
—
Subtotal, Mandatory
3,950
4,254
4,254
4,254
—
Subtotal, Discretionary
79,593
90,007
79,580
67,418
—
Emergency Funding (not in above totals or
memoranda below)
—
—
—
—
—
Memoranda





Total, BA Available in Fiscal Year (current
83,543
94,260
83,834
71,671
year from any bil )
—
Total, BA Advances for Future Years
22,597
22,597
22,597
22,597
(provided in current bil )
—
Total, BA Advances from Prior Years (for
22,597
22,597
22,597
22,597d
use in current year)
—
Source: Amounts in this table for the FY2023 Enacted, FY2024 Request, and FY2024 Senate Cmte. columns are
generally drawn from or calculated based on data contained in the Senate Appropriations Committee report
accompanying S. 2624 (S.Rept. 118-84). Amounts in this table for the FY2024 House Floor column are generally
drawn from or calculated based on data contained in the explanatory materials accompanying H.R. 5894 posted
at https://appropriations.house.gov/sites/republicans. appropriations. house.gov/files/FY24-LHHS-Explanatory-
Materials.pdf. Totals (“Total BA in the Bil ”) do not include emergency-designated appropriations.
Notes: BA = Budget Authority. Details may not add to totals due to rounding. Amounts in this table (1) reflect
all BA appropriated in the bil , regardless of the year in which funds become available (i.e., totals do not include
advances from prior year appropriations, but do include advances for subsequent years provided in this bil ); (2)
have generally not been adjusted to reflect scorekeeping; (3) comprise only those funds provided (or requested)
Congressional Research Service

47

---

link to page 54 Labor, Health and Human Services, and Education: FY2024 Appropriations

for agencies and accounts subject to the jurisdiction of the LHHS subcommittees of the House and Senate
appropriations committees; and (4) do not include appropriations that occur outside of appropriations bil s.
Non-add amounts are displayed in italics and parentheses; these amounts are not part of the appropriations
totals.
a. The amount shown in the FY2024 House floor bil column does not reflect the proposed rescission of
advance appropriations for FY2024 provided under the FY2023 LHHS omnibus.
b. Includes Grants to States Part B and Preschool Grants.
c. Amounts for Col ege Housing & Academic Facilities Loans are less than $500,000 for each column, which
round to $0 in mil ions (the unit of measure used in this table). The FY2023 Enacted amount was $298,000;
the FY2024 Request amount was $321,000; FY2024 Senate committee bil amount was $298,000; and the
FY2024 House floor bil amount was $321,000.
d. This amount does not reflect the proposed recissions in the House floor bil . Consistent with source
materials, these rescissions are treated as scorekeeping adjustments and displayed separately.
Related Agencies
All amounts in this section are based on regular LHHS appropriations only; they do not include
funds provided outside of the annual appropriations process (e.g., mandatory appropriations for
Social Security benefit payments). All amounts in this section are rounded (e.g., to the nearest
million), as labeled. The dollar changes and percentage changes in the text are based on
unrounded amounts. For consistency with source materials, amounts do not reflect sequestration
or reestimates of mandatory spending programs, where applicable.
FY2024 Related Agencies Appropriations Overview
Table 10 displays FY2024 proposed funding levels for LHHS Related Agencies, along with
FY2023 enacted levels. The totals in this table do not include emergency-designated
appropriations. Those amounts are generally displayed separately, along with the law in which
they were enacted, at the bottom of the table and are in addition to regular appropriations.
However, no such appropriations were enacted for the Related Agencies in FY2023, or thus far in
FY2024.
In general, discretionary funding constitutes about 22% of total appropriations for LHHS Related
Agencies each year. Compared to FY2023, the Senate committee bill would increase
discretionary appropriations for Related Agencies by 1.4%, the House floor bill would decrease
them by 9.1%, and the President’s budget would increase them by 9.8%.
Table 10. Related Agencies Appropriations Overview
(in billions of dollars)
FY2024
House
FY2024
Floor
FY2023
FY2024
Senate Cmte.
(H.R.
FY2024
Funding
Enacted
Request
(S. 2624)
5894)
Enacted
Discretionary
17.0
18.7
17.3
15.5
—
Mandatory
59.6
62.5
62.5
62.5
—
Congressional Research Service

48

---

link to page 57 link to page 57 link to page 57 Labor, Health and Human Services, and Education: FY2024 Appropriations

FY2024
House
FY2024
Floor
FY2023
FY2024
Senate Cmte.
(H.R.
FY2024
Funding
Enacted
Request
(S. 2624)
5894)
Enacted
Total, Related Agencies BA in the
76.7
81.2
79.7
78.0
—
Bill
Emergency Funding (not in above totals)
—
—
—
—
—
Source: Amounts in this table for the FY2023 Enacted, FY2024 Request, and FY2024 Senate Cmte. columns are
generally drawn from or calculated based on data contained in the Senate Appropriations Committee report
accompanying S. 2624 (S.Rept. 118-84). Amounts in this table for the FY2024 House Floor column are generally
drawn from or calculated based on data contained in the explanatory materials accompanying H.R. 5894 posted
at https://appropriations.house.gov/sites/republicans.appropriations.house.gov/files/FY24-LHHS-Explanatory-
Materials.pdf. Totals (“Total BA in the Bil ”) do not include emergency-designated appropriations.
Notes: BA = Budget Authority. Details may not add to totals due to rounding. Amounts in this table (1) reflect
all BA appropriated in the bil , regardless of the year in which funds become available (i.e., totals do not include
advances from prior-year appropriations, but do include advances for subsequent years provided in this bil ); (2)
have generally not been adjusted to reflect scorekeeping; (3) comprise only those funds provided (or requested)
for agencies and accounts subject to the jurisdiction of the LHHS subcommittees of the House and Senate
appropriations committees; and (4) do not include appropriations that occur outside of appropriations bil s.
The largest share of funding appropriated to Related Agencies in the LHHS bill consistently goes
to the SSA. When taking into account both mandatory and discretionary funding, SSA usually
represents 97% of total appropriations to Related Agencies in the LHHS bill. The bulk of
mandatory funding provided to SSA from the LHHS bill supports the Supplemental Security
Income (SSI) program, which provides means-tested cash assistance to adults and children with
qualifying disabilities and to seniors aged 65 or older.
When looking exclusively at discretionary funding, SSA usually receives about 84% of
discretionary appropriations for LHHS Related Agencies. After SSA, the next-largest related
agency in terms of appropriations is usually the Corporation for National and Community Service
(CNCS), which usually accounts for about 2% of total appropriations and 7% of discretionary
appropriations to LHHS Related Agencies.87 Typically, each of the remaining agencies receives
less than $1 billion from the annual LHHS appropriations bill. For more information, see Table
11.
Selected Related Agencies Highlights
The following sections highlight FY2023 appropriations issues for selected agencies, programs,
or accounts within Related Agencies. Table 11 tracks funding levels for the Related Agencies.

87 In 2020, the Corporation for National and Community Service (CNCS) announced that the agency’s operating name
would become “AmeriCorps,” but that CNCS would remain the agency’s legal name. For additional information, see
“AmeriCorps Unveils New Logo, New Name for Agency,” September 29, 2020, https://americorps.gov/newsroom/
press-release/2020/americorps-unveils-new-logo-new-name-agency. In keeping with source materials, this report
generally uses the legal name, CNCS, when referring to the agency, and uses the term AmeriCorps in reference to
specific programs operated by CNCS.
Congressional Research Service

49

---

link to page 60 Labor, Health and Human Services, and Education: FY2024 Appropriations

SSA Limitation on Administrative Expenses (LAE)
The SSA LAE account consists mainly of funds that are used by SSA to administer the Social
Security and SSI programs and to support CMS in administering portions of Medicare.88 The
account also contains funds that are specifically set aside for certain program integrity activities,
such as continuing disability reviews (CDRs) and SSI nonmedical redeterminations. The FY2024
Senate committee bill proposes $14.4 billion in discretionary funding for the LAE account. This
is
• $465 million (+3.3%) more than the FY2024 House floor bill ($14.0 billion),
• $1.1 billion (-6.9%) less than the FY2024 President’s request ($15.5 billion), and
• $292 million (+2.1%) more than the FY2023 enacted level ($14.1 billion).
Similar to FY2023, the three proposals would dedicate about 13% of total funding for the LAE
account to program integrity activities in FY2024. The program integrity portion of the LAE
account for FY2024 includes $273 million in base funding subject to the discretionary spending
caps established by the Fiscal Responsibility Act of 2023 (P.L. 118-5), as well as additional
funding that is effectively exempt from those caps and subject to an annual limit (adjustment
funding; see Appendix A further information). Both the FY2024 Senate committee bill and the
FY2024 House floor bill would provide almost $1.9 billion in combined program integrity
funding for the LAE account: $273 million in base funding plus $1.6 billion in adjustment
funding, which is the maximum amount of adjustment funding permitted for FY2024 under the
Fiscal Responsibility Act of 2023. The FY2024 President’s request, which was released prior to
the enactment of the Fiscal Responsibility Act of 2023, would provide almost $1.9 billion in
combined program integrity funding for the LAE account: $287 million in base funding plus $1.6
billion in adjustment funding.
Corporation for National and Community Service (CNCS)
The CNCS, operating as AmeriCorps, is an independent federal agency that administers a variety
of national and community service programs.89 The FY2024 Senate committee bill proposes $1.3
billion in discretionary funding for the CNCS. This is
• $602 million (+91.1%) more than the FY2024 House floor bill ($661 million),
• $216 million (-14.6%) less than the FY2024 President’s request ($1.5 billion),
and
• $50 million (-3.8%) less than the FY2023 enacted level ($1.3 billion).
The explanatory materials associated with the House floor bill raise concerns with recent CNCS
audit findings.90 Accordingly, these materials indicate that several CNCS programs would be
reduced or eliminated due to “the lack of oversight for Federal funding.”91

88 See CRS Report R47746, Social Security Administration (SSA): FY2024 Annual Limitation on Administrative
Expenses (LAE) Appropriation: In Brief.
89 See CRS Report RL33931, The Corporation for National and Community Service: Overview of Programs and
Funding, and AmeriCorps, “FAQs: What is CNCS?,” https://americorps.gov/about/faqs.
90 House explanatory materials, p. 220.
91 Ibid.
Congressional Research Service

50

---

Labor, Health and Human Services, and Education: FY2024 Appropriations

National Labor Relations Board (NLRB)
The NLRB is an independent board that enforces provisions in the National Labor Relations Act
(NLRA). The FY2024 Senate committee bill proposes $299 million in discretionary funding for
the NLRB. This is
• $99 million (+49.6%) more than the FY2024 House floor bill ($200 million),
• $77 million (-20.5%) less than the FY2024 President’s request ($376 million),
and
• the same amount as the FY2023 enacted level ($299 million).
The House floor bill also proposes to add a new provision to the LHHS bill that would prohibit
the use of federal funds to change the administration, implementation, or enforcement of the
“Joint Employer Status Under the National Labor Relations Act” final rule (§409).92
Table 11. Detailed Related Agencies Appropriations
(in millions of dollars)
FY2024
FY2024
House
Senate
Floor
FY2023
FY2024
Cmte.
(H.R.
FY2024
Agency, Program, Project, or Activity
Enacted
Request
(S. 2624)
5894)
Enacted
Committee for Purchase from People Who Are
13
15
13
13
—
Blind or Severely Disabled (operating as the U.S.
AbilityOne Commission)
Corporation for National and Community Service
1,313
1,479
1,263
661
—
(CNCS) (operating as AmeriCorps)
Selected CNCS Programs/Initiatives:





Volunteers in Service to America (VISTA)
103
142
103
0
—
National Senior Volunteer Corps
237
262
237
162
—
AmeriCorps State and National Grants
557
651
557
425
—
National Civilian Community Corps
38
43
38
0
—
National Service Trust
230
213
180
0
—
Corporation for Public Broadcasting (CPB)
595
635
595
0
—
Federal Mediation and Conciliation Service
54
56
54
54
—
Federal Mine Safety and Health Review
18
19
18
18
—
Commission
Institute of Museum and Library Services (IMLS)
295
295
290
295
—
Medicaid and CHIP Payment and Access
9
10
9
9
—
Commission (MACPAC)
Medicare Payment Advisory Commission
14
14
14
14
—
(MedPAC)
National Council on Disability
4
4
4
4
—

92 See National Labor Relations Board, “Joint Employer Status Under the National Labor Relations Act,” 85 Federal
Register 11184, February 26, 2020, https://www.federalregister.gov/documents/2020/02/26/2020-03373/joint-
employer-status-under-the-national-labor-relations-act.
Congressional Research Service

51

---

link to page 59 Labor, Health and Human Services, and Education: FY2024 Appropriations

FY2024
FY2024
House
Senate
Floor
FY2023
FY2024
Cmte.
(H.R.
FY2024
Agency, Program, Project, or Activity
Enacted
Request
(S. 2624)
5894)
Enacted
National Labor Relations Board (NLRB)
299
376
299
200
—
National Mediation Board
15
16
15
15
—
Occupational Safety and Health Review
15
16
15
15
—
Commission
Railroad Retirement Board (RRB)
150
160
149
124
—
Dual Benefits (minus tax receipts)
8
7
7
7
—
Federal Payment to RR Retirement Account (mandatory)a
0
0
0
0
—
Limitation on Administration
128
139
128
103
—
Inspector General
14
15
14
14
—
Social Security Administration (SSA)
73,887
78,075
76,999
76,534
—
Payments to Social Security Trust Funds (mandatory)
11
10
10
10
—
Supplemental Security Income (SSI) (mandatory)
59,635
62,456
62,456
62,456
—
Limitation on Administrative Expenses (LAE)
14,126
15,488
14,418
13,953
—
Regular LAE (incl. user fees, non-add)
(12,342)
(13,618)
(12,567)
(12,102)
—
Program Integrity (non-add)
(1,784)
(1,870)
(1,851)
(1,851)
—
Office of Inspector General
115
120
115
115
—
Total, Related Agencies BA in the Bill
76,681
81,169
79,737
77,956
—
Subtotal, Mandatory
59,646
62,466
62,466
62,466
—
Subtotal, Discretionary
17,035
18,703
17,271
15,490
—
Emergency Funding (not in above totals or memoranda below)
—
—
—
—
—
Memoranda





Total, BA Available in Fiscal Year (current year from any
76,421
75,219
73,827
72,581
—
bil )
Total, BA Advances for Future Years (provided in current
16,335
22,275
22,235
21,700
—
bil )
Total, BA Advances from Prior Years (for use in current
16,075
16,325
16,325
16,325
—
year)
Source: Amounts in this table for the FY2023 Enacted, FY2024 Request, and FY2024 Senate Cmte. columns are
generally drawn from or calculated based on data contained in the Senate Appropriations Committee report
accompanying S. 2624 (S.Rept. 118-84). Amounts in this table for the FY2024 House Floor column are generally
drawn from or calculated based on data contained in the explanatory materials accompanying H.R. 5894 posted
at https://appropriations.house.gov/sites/republicans. appropriations. house.gov/files/FY24-LHHS-Explanatory-
Materials.pdf. Totals (“Total BA in the Bil ”) do not include emergency-designated appropriations.
Notes: BA = Budget Authority. Details may not add to totals due to rounding. Amounts in this table (1) reflect
all BA appropriated in the bil , regardless of the year in which funds become available (i.e., totals do not include
advances from prior-year appropriations, but do include advances for subsequent years provided in this bil ); (2)
have generally not been adjusted to reflect scorekeeping; (3) comprise only those funds provided (or requested)
for agencies and accounts subject to the jurisdiction of the LHHS subcommittees of the House and Senate
appropriations committees; and (4) do not include appropriations that occur outside of appropriations bil s.
Congressional Research Service

52

---

Labor, Health and Human Services, and Education: FY2024 Appropriations

a. The actual amount of mandatory federal payments to the Railroad Retirement account is roughly $150,000
in each column, which rounds to $0 in mil ions (the unit of measure used in this table).
Congressional Research Service

53

---

link to page 64 link to page 66 Labor, Health and Human Services, and Education: FY2024 Appropriations

Appendix A. Budget Enforcement Activities
The framework for budget enforcement under the congressional budget process has both statutory
and procedural elements.
The statutory elements relevant to the LHHS bill are primarily the limits on defense and
nondefense discretionary spending in the Balanced Budget and Emergency Deficit Control Act of
1985 (BBEDCA; P.L. 99-177), as amended. LHHS appropriations are classified as nondefense
spending, and the bill has the largest share of such spending compared to the other annual
appropriations bills. In addition, certain funding in the LHHS bill is affected by the mandatory
spending sequester derived from the Budget Control Act of 2011 (BCA; P.L. 112-25) and the
BBEDCA, as amended (most recently by P.L. 117-328, enacted on December 29, 2022).
The procedural elements of budget enforcement for LHHS are primarily associated with the
budget resolution and limit both total discretionary spending and spending under the jurisdiction
of each appropriations subcommittee.
After summarizing the status of budget enforcement for the FY2024 appropriations cycle, this
appendix presents current-year FY2024 LHHS budgetary amounts in Table A-1 and Table A-2.
Statutory Discretionary Spending Limits
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, 2023.93 Prior to the FRA,
statutory limits on discretionary spending had been in effect from FY2012 through FY2021.94 The
FRA amended the BBEDCA to provide limits on 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 nondefense limit. The initial statutory limit on
nondefense discretionary spending for FY2024 is $703.65 billion under the FRA. This represents
a $40.2 billion (-5%) reduction relative to FY2023 enacted nondefense discretionary spending
when accounting for Congressional Budget Office (CBO) scorekeeping, and prior to any
adjustments to the limits pursuant to BBEDCA authorities.95 Under the FRA, the FY2024
spending limits were to be automatically revised in the event a CR is in effect for any budget
account on January 1, 2024.96 The revision would result in an increase in nondefense

93 For more information, see CRS Insight IN12168, Discretionary Spending Caps in the Fiscal Responsibility Act of
2023.
94 During this period, the framework for discretionary spending budget enforcement included statutory limits on
defense and nondefense discretionary spending established by the Budget Control Act of 2011 (BCA; P.L. 112-25).
Further reductions to discretionary spending for FY2013-FY2021 were triggered when the Joint Committee on Deficit
Reduction did not report legislation to achieve a specified amount of budgetary savings. The BCA statutory limits on
discretionary spending expired at the end of FY2021, which meant that discretionary budget enforcement since that
time occurred via procedural means only for FY2022 and FY2023 (CRS Report R46752, Expiration of the
Discretionary Spending Limits: Frequently Asked Questions).
95 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
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. See CRS Insight IN12183, The FRA’s
Discretionary Spending Caps Under a CR: FAQs.
96 Under such a scenario, a sequester order would be issued on April 30, 2024, or fifteen days after enactment of full-
year appropriations. The FRA states that the revised limits would revert to the original FRA limits if full-year
appropriations were enacted before April 30. The FRA includes a similar provision for FY2025 spending. These
(continued...)
Congressional Research Service

54

---

Labor, Health and Human Services, and Education: FY2024 Appropriations

discretionary spending levels and a decrease for defense discretionary spending levels when
compared with the original limits. The revised nondefense discretionary limit would be $736.45
billion, which is roughly $32.8 billion (+5%) more than the original FRA limit for nondefense
discretionary spending.97 The FRA states that the revised limits would revert to the original FRA
limits if full-year appropriations were enacted before April 30.
For LHHS programs and activities, the FRA provides for adjustments to the nondefense spending
limit for health care fraud and abuse control, continuing disability reviews and redeterminations,
and reemployment services and eligibility assessments, up to a specified amount of funding for
each of FY2024 and FY2025.98 The maximum amount of funding allowed for these LHHS
adjustments is $2.447 billion total in FY2024 and $2.531 billion in FY2025. See the report
section, “Exceptions to Budget Enforcement,” for more information about these adjustments.
BCA and Mandatory Sequestration
For deficit-reduction purposes, the BCA (as amended) requires mandatory spending reductions to
occur through sequestration in each of FY2013 through FY2031 (and through FY2032 for
Medicare only).99
On March 13, 2023, concurrent with the release of the President’s budget submission, President
Biden issued the required FY2024 sequestration order, calling for nonexempt mandatory
spending to be reduced on October 1, 2023.100 At that time, the Office of Management and
Budget (OMB) announced that the FY2024 sequestration percentages would equal 2% of
nonexempt Medicare spending and 5.7% of other nonexempt nondefense mandatory spending,
for a total reduction of $26 billion in FY2024.101 (OMB also announced an 8.3% reduction,
totaling $2.0 billion, in nonexempt defense mandatory spending, which does not affect LHHS
funds.)
The BCA includes a number of statutory exemptions to sequestration and other special rules that
are relevant for the appropriated mandatory spending in the LHHS bill. For instance, the LHHS
bill contains several programs that are exempt from sequestration, including Medicaid, payments

provisions have been described as incentivizing Congress to enact regular full-year appropriations legislation instead of
relying on CRs.
97 These calculations are based on P.L. 118-5 and the Congressional Budget Office cost estimate referenced in P.L.
118-5 as “table 1–S of H.R. 2617, published on December 21, 2022.” For more information, see CRS Insight IN12183,
The FRA’s Discretionary Spending Caps Under a CR: FAQs.
98 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).
99 As originally enacted, mandatory sequestration was scheduled to run through FY2021, but this period has
subsequently been incrementally extended to FY2031 by P.L. 113-67, P.L. 113-82, P.L. 114-74, P.L. 115-123, P.L.
116-37, P.L. 116-136, and P.L. 117-58. In addition, P.L. 117-328 extended the sequester through FY2032 for Medicare
only.
100 Sequestration Order for Fiscal Year 2024 Pursuant to Section 251A of the Balanced Budget and Emergency Deficit
Control Act, As Amended, Federal Register Volume 88, No. 51, March 16, 2023, p. 16171, https://www.govinfo.gov/
content/pkg/FR-2023-03-16/pdf/2023-05511.pdf.
101 OMB Report to the Congress on the BBEDCA 251A Sequestration for Fiscal Year 2024, March 13, 2023,
https://www.whitehouse.gov/wp-content/uploads/2023/03/BBEDCA_Sequestration_Report_and_Letter_3-13-
2024.pdf. The BBEDCA, as amended, calls for the sequestration percentages for FY2022-FY2031 to be the same
percentages as in FY2021, so these percentages no longer change year to year. See the report’s appendix for an
itemized list of budget accounts that include mandatory spending subject to sequestration in FY2024, the dollar
amounts subject to sequestration (based on OMB’s current law baseline), the percentage by which they would be
reduced, and the dollar amount of the reduction. While the report displays reductions at the account level, the sequester
itself is implemented at the program, project, or activity level.
Congressional Research Service

55

---

link to page 64 link to page 64 Labor, Health and Human Services, and Education: FY2024 Appropriations

to health care trust funds, Supplemental Security Income, Special Benefits for Disabled Coal
Miners, retirement pay and medical benefits for commissioned Public Health Service officers,
foster care and adoption assistance, and certain family support payments. The LHHS bill also
contains several programs that are subject to special rules under sequestration, such as health
centers and portions of Medicare.102
Budget Resolution, 302(b) Suballocations
The procedural elements of budget enforcement generally stem from requirements under the
Congressional Budget Act of 1974 (P.L. 93-44) that are associated with the adoption of an annual
budget resolution. Through this process, the Appropriations Committee in each chamber receives
a procedural limit on the total amount of discretionary budget authority for the upcoming fiscal
year, referred to as a 302(a) allocation. The Appropriations Committee subsequently divides this
allocation among its 12 subcommittees. These subcommittee-level spending limits are referred to
as 302(b) suballocations. The 302(b) suballocations restrict the amount of budget authority
available to each subcommittee for the agencies, projects, and activities under its jurisdiction,
effectively acting as a cap on each of the 12 regular appropriations bills. Enforcement of the
302(a) allocation and 302(b) suballocations occurs through points of order.103
As of the cover date of this report, there has been no House or Senate action on a FY2024 budget
resolution.104 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
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
Congressional Record as soon as practicable. These were published in the Senate on June 21,
2023, but have not been published in the House.105
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
provide a limit on current-year (i.e., FY2024) appropriations within each subcommittee’s
jurisdiction and incorporate any applicable scorekeeping adjustments made by CBO.106 On June
15, 2023, the House Appropriations Committee voted to approve draft suballocations for all 12
subcommittees, including LHHS (33-27).107 The Senate Appropriations Committee reported its
formal suballocations on June 22, 2023 (15-13).108 These suballocations are displayed in Table A-
1.

102 For more information, see CRS Report R42050, Budget “Sequestration” and Selected Program Exemptions and
Special Rules.
103 For further information, see CRS Report 98-815, Budget Resolution Enforcement.
104 The House Budget Committee voted to report a FY2024 budget resolution on September 20, 2023, but the measure
has not yet been reported.
105 “Budget Enforcement Levels,” Congressional Record, daily edition, vol. 169, no. 108 (June 21, 2023), pp. S2180-
S2181.
106 Such suballocations are commonly revised throughout the appropriations process to reflect changing budgetary
priorities.
107 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/
FY24%20House%20Subcommittee%20Allocations%206.13.23_0.pdf.
108 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.
Congressional Research Service

56

---

Labor, Health and Human Services, and Education: FY2024 Appropriations

Exceptions to Budget Enforcement
For the past several years, certain spending has been made effectively exempt from discretionary
budget enforcement (both the previously mentioned statutory spending caps and 302(a) and
302(b) limits) by a mechanism that is commonly referred to as an adjustment. An adjustment
increases the applicable spending limit to accommodate additional specified funding.
Adjustments to the 302(a) and 302(b) limits are typically specified in the budget resolution. For
the statutory spending limits, these adjustments can be made under Section 251(b) of the
BBEDCA.109 The adjustments that apply to LHHS discretionary funding for the FY2024 budget
cycle are summarized below:
• Emergency requirement. Funding for this adjustment is designated as being
provided for an emergency requirement.110 There are no criteria that would
restrict the use of this adjustment to particular accounts or activities, and no
dollar limit on the amount of appropriations each fiscal year that can be
designated in this manner.
• Continuing disability reviews and redeterminations. Funding for this
adjustment is for the costs associated with conducting continuing disability
reviews, SSI nonmedical redeterminations of eligibility, co-operative disability
investigation units, and the prosecution of fraud in the programs and operations
of the SSA by Special Assistant U.S. Attorneys. For FY2024, the amount of this
adjustment is limited to $1.6 billion in additional new budget authority. However,
at least $273 million must have first been appropriated for these purposes
(sometimes referred to as base funding), subject to the budget resolution limits, in
order for the additional $1.6 billion adjustment to be available.
• Health care fraud and abuse control. Funding for this adjustment is for the
health care fraud abuse control program at CMS (in HHS). For FY2024, the
amount of this adjustment is limited to $604 million in additional new budget
authority. However, at least $311 million must have first been appropriated for
these purposes (sometimes referred to as base funding), subject to the budget
resolution limits, in order for the additional $604 million adjustment to be
available.
• Reemployment services and eligibility assessments. Funding for this
adjustment is for a DOL program providing grants to states under Section 306 of
the Social Security Act for certain claimants of regular Unemployment
Compensation, as defined in such section. For FY2024, the amount of this
adjustment is limited to $265 million in additional new budget authority.
However, at least $117 million must first have been appropriated for these
purposes (sometimes referred to as base funding), subject to the budget resolution
limits, in order for the additional $265 million adjustment to be available.111

109 For further information, see CRS Report R45778, Exceptions to the Budget Control Act’s Discretionary Spending
Limits.
110 In addition to the emergency adjustment that applies to the House in H.Res. 1151, the emergency adjustment that
was established in the FY2022 budget resolution (S.Con.Res. 14, §4001) continues to apply in the Senate during the
consideration of FY2024 appropriations.
111 Unlike the other adjustments, the reemployment services and eligibility assessments adjustment has separately been
established in Section 314(g) of the CBA, which continues to be in effect. However, the FY2023 limit on that
adjustment in the CBA is the same as that provided by the adjustment in S.Con.Res. 14 ($133 million in additional new
budget authority).
Congressional Research Service

57

---

link to page 64 link to page 65 link to page 65 Labor, Health and Human Services, and Education: FY2024 Appropriations

Separate from these cap adjustments, the 21st Century Cures Act (Cures Act, P.L. 114-255), which
was enacted on December 13, 2016, includes additional budget enforcement procedures related to
the discretionary spending limits.112 For the purposes of FY2024 LHHS appropriations, these
procedures apply only to the NIH Innovation Account that was created by the act.113 The Cures
Act provides that discretionary appropriations from this account (up to the amount authorized) are
to be subtracted from any cost estimates provided for purposes of budget controls. Thus, the
Cures Act ensures that appropriations from this account will not count against any spending
limits, such as those associated with the budget resolution for an applicable fiscal year. For
FY2024, these Cures Act funds allowed in the LHHS bill total $407 million.
FY2024 LHHS Spending Subject to Spending Limits
Table A-1 displays LHHS funding subject to budget enforcement for FY2023 (as enacted), along
with the House FY2024 initial suballocations (H.Res. 1151) and the FY2024 Senate committee-
reported bill (S. 2624). Compliance with discretionary spending allocations is evaluated based on
budget authority available in the current fiscal year, adjusted for scorekeeping by CBO. As such,
totals shown in this table may not be comparable to other totals shown in this report. Current-year
budget authority totals exclude advance appropriations for future years, but include advance
appropriations from prior years that become available in the current year. (Advance
appropriations are provided to selected LHHS accounts, generally in order to manage specific
planning concerns and ensure continuity of operations at the start of a new fiscal year.)
The amounts shown in the table also take into account any applicable CBO scorekeeping
adjustments. Under this method of estimating the bill, the House proposal would reduce regular
discretionary appropriations for LHHS by 29% (-$60.3 billion) relative to FY2023. The Senate
proposal would reduce discretionary appropriations for LHHS by 6% (-$12.1 billion) relative to
FY2023.
The table also displays funding for which adjustments may be made to discretionary spending
limits, including funding for certain LHHS program integrity activities and emergency
requirements, where applicable. The “Adjusted Appropriations” total includes this funding.
Table A-1. LHHS Discretionary Appropriations: Comparison of FY2023 Enacted, and
FY2024 House and Senate Appropriations Committee Initial 302(b) Suballocations
(current-year budget authority in billions of dollars)
FY2024
FY2024 Draft
Senate
House
Committee-
FY2023
Committee
Reported Bill
FY2024

Enacted
Suballocationa
(S. 2624)
Enacted
Regular Discretionary Appropriations
207.367
147.096
195.231
—
Adjustments:b



—
Program Integrity
2.345
2.447
2.447


112 These procedures originally applied to two accounts within the scope of the LHHS bill that were created by the
Cures Act: the NIH Innovation Account (FY2017-FY2026) and the Account for the State Response to the Opioid
Abuse Crisis (FY2017-FY2018). These procedures have lapsed for the State Response to the Opioid Abuse Crisis
account as of the end of FY2018, but are still in effect for the NIH Innovation Account through FY2026.
113 The 21st Century Cures Act also created a non-LHHS account—the FDA Innovation Account—and made it subject
to similar budget enforcement-related provisions. For more information, see CRS Report R44720, The 21st Century
Cures Act (Division A of P.L. 114-255).
Congressional Research Service

58

---

link to page 65 link to page 65 link to page 65 Labor, Health and Human Services, and Education: FY2024 Appropriations

FY2024
FY2024 Draft
Senate
House
Committee-
FY2023
Committee
Reported Bill
FY2024

Enacted
Suballocationa
(S. 2624)
Enacted
Health care fraud and abuse
0.576
0.604
0.604
—
control
Continuing disability reviews and
1.511
1.578
1.578
—
redeterminations
Reemployment services and
0.258
0.265
0.265
—
eligibility assessments
Emergency Requirementsc
9.920
—
4.500
—d
Adjusted Appropriations
219.632
149.543
202.178
—
Source: The 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. The FY2024 House Appropriations
Committee initial suballocations are as published at
https://appropriations.house.gov/sites/republicans.appropriations.house.gov/files/documents/FY24%20House%20S
ubcommittee%20Allocations%206.13.23_0.pdf. The program integrity adjustments for the House are from a CRS
analysis of the text of the House floor bil . The FY2024 Senate Committee-reported bil (S. 2624) amounts are
from S.Rept. 118-84, p. 1, and CRS analysis of the text of the Senate committee bil . “Regular discretionary
appropriations” exclude funds for which special rules apply under the spending limits (e.g., funds for certain
program integrity activities and emergency requirements), as well as funds provided under authorities in the 21st
Century Cures Act (P.L. 114-255) that are effectively exempt from the spending limits. Amounts shown in this
table generally reflect scorekeeping adjustments, where applicable.
Notes: It is common for suballocations to be revised over the course of the year to reflect actual action on
appropriations bil s and changes in congressional priorities. Amounts include advance appropriations enacted in
prior fiscal years that first become available in those fiscal years. Regular appropriations reflect current-year
discretionary budget authority subject to the spending limits and exclude funds that are effectively exempt from
these limits. Adjusted appropriations include, where applicable, discretionary funds for which special rules apply
with regard to the spending limits, including certain funds for program integrity activities and funds provided
under certain authorities in the 21st Century Cures Act (P.L. 114-255) that are effectively exempt from
discretionary spending limits. (For FY2023, the Cures Act funds totaled $1.085 bil ion; for FY2024, these funds
totaled $407 mil ion.)
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
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/
republicans.appropriations.house.gov/files/FY24-LHHS-Explanatory-Materials.pdf).
b. 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,
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.
c. Unlike other tables in this report, emergency amounts in this table include estimated costs of contingent
emergency appropriations for the HHS Refugee and Entrant Assistance account, where applicable.
d. 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
Congressional Research Service

59

---

link to page 66 link to page 15 link to page 67 link to page 67 Labor, Health and Human Services, and Education: FY2024 Appropriations

Families (ACF). Because this funding is provided at a rate for operations, and not a definite amount, it is not
included in the tables in this report.
Current-Year Budget Authority
Table A-2 displays the total LHHS current-year budget authority, by title. Unlike the prior table,
the amounts shown here have not been adjusted for congressional scorekeeping. The totals in this
table exclude funds designated as an emergency requirement. The amounts shown reflect total
budget authority available for obligation in the fiscal year, regardless of the year in which it was
first appropriated. (In other words, these amounts exclude advance appropriations for future
years, but include advance appropriations from prior years that became available in the applicable
current year.) Amounts in the FY2023 enacted column include FY2023 advance appropriations
budget authority provided by the FY2021 LHHS omnibus (P.L. 116-260) and the FY2022 LHHS
omnibus (P.L. 117-103). Similarly, the FY2024 President’s budget request, FY2024 Senate Cmte.,
and FY2024 House Floor columns include FY2024 advance appropriations provided by the
FY2022 and FY2023 LHHS omnibuses. (For a comparable table showing total budget authority
in the bill, rather than current-year budget authority, see Table 2 in this report.) As mentioned
above, it is current-year budget authority (adjusted for scorekeeping by CBO) that is used to
determine compliance with discretionary spending allocations.
Table A-2. LHHS Appropriations Overview, by Bill Title: FY2023-FY2024
(current-year budget authority in billions of dollars)
FY2024
FY2024
Senate
House
FY2023
FY2024
Cmte.
Floor
FY2024
Bill Title
Enacted
Request
(S. 2624)
(H.R. 5894)
Enacted
Title I: Labor
15.1
16.8
15.1
11.1
—
Discretionary
13.8
15.5
13.8
9.8
—
Mandatory
1.3
1.3
1.3
1.3
—
Title II: HHS
1,214.7
1,230.4
1,214.7
1,204.5
—
Discretionary
115.4
129.6
113.9
103.7
—
Mandatory
1,099.3
1,100.8
1,100.8
1,100.8
—
Title III: Education
83.5
94.3
83.8
71.7
—
Discretionary
79.6
90.0
79.6
67.4
—
Mandatory
3.9
4.3
4.3
4.3
—
Title IV: Related Agencies
76.4
75.2
73.8
72.6
—
Discretionary
17.0
18.7
17.3
16.0
—
Mandatory
59.4
56.6
56.6
56.6
—
Total Current Year BAa
1,389.7
1,416.7
1,387.4
1,359.9
—
Discretionary
225.8
253.8
224.5
196.9
—
Mandatory
1,163.9
1,162.9
1,162.9
1,162.9
—
Emergency Funding (not in above totals or




—
memoranda below)b
P.L. 117-180, Division A
2.8
—
—
—
—
P.L. 117-328, Division M
2.4
—
—
—
—
Congressional Research Service

60

---

link to page 67 link to page 67 link to page 67 Labor, Health and Human Services, and Education: FY2024 Appropriations

FY2024
FY2024
Senate
House
FY2023
FY2024
Cmte.
Floor
FY2024
Bill Title
Enacted
Request
(S. 2624)
(H.R. 5894)
Enacted
P.L. 117-328, Division N
4.3
—
—
—
—
S. 2624, Title II
—
—
4.1
—
—
Memoranda





Advances for Future Years (provided in
242.8
297.0
297.0
296.5
—
current bil )c
Advances from Prior Years (for use in
210.7
242.8
242.8
242.8
—
current year)c
Additional Scorekeeping Adjustmentsd
-16.1
-30.9
-26.5
-47.0
—
Source: Amounts in this table for the FY2023 Enacted, FY2024 Request, and FY2024 Senate Cmte. columns are
generally drawn from or calculated based on data contained in the Senate Appropriations Committee report
accompanying S. 2624 (S.Rept. 118-84). Amounts in this table for the FY2024 House Floor column are generally
drawn from or calculated based on data contained in the explanatory materials accompanying H.R. 5894 posted
at https://appropriations.house.gov/sites/republicans. appropriations. house.gov/files/FY24-LHHS-Explanatory-
Materials.pdf. Enacted totals (“Total BA in the Bil ”) for FY2023 do not include emergency-designated
appropriations. CRS calculations do, however, include LHHS funding provided to HHS pursuant to the 21st
Century Cures Act (P.L. 114-255), as amended.
Notes: BA = Budget Authority. Details may not add to totals due to rounding. Amounts in this table (1) reflect
current-year budget authority; (2) have generally not been adjusted to reflect scorekeeping; (3) comprise only
those funds provided (or requested) for agencies and accounts subject to the jurisdiction of the LHHS
Subcommittees of the House and the Senate Committees on Appropriations; and (4) do not include
appropriations that occur outside of appropriations bil s. No amounts are shown for Title V, because this title
consists solely of general provisions.
a. Totals in this table are based on current-year budget authority, meaning budget authority that is available
for obligation in a given fiscal year, regardless of the year in which it was first appropriated (i.e., totals
exclude advance appropriations for future years, but include advance appropriations from prior years that
became available in the applicable current year).
b. Division H of the FY2023 omnibus included a contingent emergency appropriation for the HHS Refugee and
Entrant Assistance account. The contingent funds were to become available only if certain conditions were
met. The FY2024 President’s request and Senate committee bil s would also provide contingent
appropriations for this account. Consistent with source materials, the estimated amount of the contingent
appropriations is treated as a scorekeeping adjustment and is thus not included in this total. 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 not a definite amount, it is not included in the
tables in this report. In addition, pursuant to instructions in Section 103 of the FRA, this table does not
include emergency-designated advance appropriations enacted prior to FY2024 (e.g., those in P.L. 117-58,
Division J and P.L. 117-159, Division B).
c. The calculation for total budget authority in the bil (rather than total budget authority available for
obligation in the current fiscal year) is as fol ows: Total Current Year BA minus Advances from Prior Years
plus Advances for Future Years. The amount for both Advances from Prior Years and Advances for Future
Years is the combined total of mandatory and discretionary spending.
d. Totals in this table have generally not been adjusted for further scorekeeping. (To adjust for scorekeeping,
add this line to the total budget authority.)
Congressional Research Service

61

---

link to page 68 Labor, Health and Human Services, and Education: FY2024 Appropriations

Appendix B. House Floor Amendments Offered to
H.R. 5894, as Amended by Rules Committee Print
118-13
Although the House Appropriations Committee LHHS Subcommittee had approved a draft bill on
July 14, 2023, that bill was not marked up by the full committee. Subsequently, the House
considered an LHHS bill, but did not vote on final passage. This bill (H.R. 5894), the text of
which was substantially the same as the subcommittee draft bill, had been introduced on October
6, 2023, by Representative Aderholt, Chair of the House Appropriations LHHS Subcommittee.
H.R. 5894 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 Committee Print 118-13, which in effect made numerous
alterations to the provisions in H.R. 5894 as introduced.114 This rule also provided the authority
for the chair of the Appropriations Committee or her designee to offer any of the amendments
made in order en bloc (i.e., in groups of amendments to be disposed of together);115 a total of 49
amendments were 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
withdrawn.
A summary of each amendment that was offered and its disposition is listed in Table B-1 below.
The summary of each amendment is as published in H.Rept. 118-272, the Rules Committee report
accompanying H.Res. 864. (Note that not all amendments that were made in order were offered.)
Some amendments proposed to increase and decrease funding for the same appropriations
account by identical amounts, thereby having no net budgetary effect. These are commonly called
“plus-minus” amendments.116 While this type of amendment generally would not produce a
budgetary effect, offering the amendment would allow the Member time to speak on the
amendment when the House is considering legislation. This may allow the Member to
communicate preferences related to that specific program or account.
Table B-1. LHHS House Floor Amendments Offered to H.R. 5894
Amdt. No. and Summary from the Rules Committee
En Bloc
Disposition
1. Mil er (IL): Reduces the funds provided to the Occupational Safety and
No
Failed, recorded
Health Administration to $0.
vote: 131 - 300

114 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/
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/118hr5894ih_to_LHHS%20RCP%20FINAL_xml.pdf
. Draft explanatory materials accompanying H.R. 5894 and Rules Committee Print 118-13 also were released by the
House Appropriations Committee and posted at https://appropriations.house.gov/sites/
republicans.appropriations.house.gov/files/FY24-LHHS-Explanatory-Materials.pdf.
115 For further information about en bloc authority in the context of House floor consideration of appropriations
measures, see CRS Report R46841, Changes in the House of Representatives’ Initial Consideration of Regular
Appropriations Measures, 113th-116th Congresses.
116 For more information, see CRS In Focus IF11973, “Plus-Minus” Amendments to Regular Appropriations
Measures.
Congressional Research Service

62

---

Labor, Health and Human Services, and Education: FY2024 Appropriations

Amdt. No. and Summary from the Rules Committee
En Bloc
Disposition
2. Higgins (LA): Reduces the Mine Safety and Health Administration’s Salary
No
Adopted, voice vote
and Expenses account by $1,000,000, attributed to the salary and benefits
cuts of Wil iam O’Dell and Christopher Wil iamson and redirects these
funds to the Department of Labor’s Office of Inspector General’s account.
3. Sherril (NJ): Increases funding for the Department of Education’s Office
Yes
Adopted, voice vote
of Elementary and Secondary Education—Education for the Disadvantaged
account by $5 mil ion to allow K–12 schools to implement and administer
high-impact tutoring programs that wil help students recover from
COVID-related academic challenges. Reduces funding for the Department
of Labor’s Departmental Management—Salaries and Expenses account by
$5 mil ion.
4. Cloud (TX): Strikes a reference to a job corps center on Treasure Island
No
Adopted, voice vote
in Sec. 114 and replaces it with the job corps center located in San Marcos,
Texas.
5. Harris (MD), Murphy (NC), Burgess (TX), Wenstrup (OH): Decreases
Yes
Adopted, voice vote
the Office of the Secretary of HHS by $10,000,000. Increases the HRSA
Health Workforce topline by $9,500,000.
6. Meuser (PA): Provides the Health Workforce Account with an additional
No
Adopted, voice vote
$10 mil ion for the Nurse Corps programs which is offset with a $19
mil ion deduction to the National Institute of Nursing Research.
7. Caraveo (CO): Increases and decreases the Maternal and Child Health
Yes
Adopted, voice vote
Block Grant by $35 mil ion for the purpose of providing support for
maternal and child health care services; prenatal, delivery, and postnatal
care; and screenings, diagnostic and treatment services to improve the
health and well-being of mothers, children, and families.
8. Boebert (CO): Transfers funds from HHS General Department
No
Adopted, voice vote
Management to the Small Rural Hospital Improvement Grant Program.
9. Boebert (CO): Transfers funds from HHS General Department
No
Adopted, voice vote
Management for the purchase and implementation of telehealth services to
improve health care coordination for rural veterans between rural
providers and the Department of Veterans Affairs.
10. Boebert (CO): Transfers funds from HHS General Department
No
Adopted, voice vote
Management to the Rural Emergency Hospital Technical Assistance
Program.
11. Boebert (CO): Transfers funds from HHS General Department
No
Adopted, voice vote
Management to the Rural Residency Planning and Development Program to
support physician workforce expansion in rural areas.
12. Boebert (CO): Transfers funds from HHS General Department
Yes
Adopted, voice vote
Management to suicide prevention research and techniques to combat the
mental health epidemic.
13. Boebert (CO): Transfers funds from HHS General Department
No
Adopted, voice vote
Management to the Inspector General to combat waste, fraud, and abuse.
14. Castor (FL): Increases and decreases funding for the Centers for
Yes
Adopted, voice vote
Disease Control and Prevention in support of the President’s request to
prevent HPV-related cancers through the Cancer Moonshot Initiative.
15. Mil er (WV): Directs $5,000,000 of funding to the CDC’s TGS program
Yes
Adopted, voice vote
to promote early detection of emerging pathogens and infectious diseases
through airport wastewater study. Reduces funding for the Office of the
Secretary of the HHS by the same amount.
Congressional Research Service

63

---

Labor, Health and Human Services, and Education: FY2024 Appropriations

Amdt. No. and Summary from the Rules Committee
En Bloc
Disposition
16. Pfluger (TX): Decreases and increases funds by $1,500,000 within the
Yes
Adopted, voice vote
CDC’s National Center for Emerging and Zoonotic Infectious Diseases for
the purpose of funding grants for research and surveillance activities on the
prevalence of Valley Fever and the health impacts on the population
affected.
17. Murphy (NC): Increases and decreases funding for the U.S. Department
Yes
Adopted, voice vote
of Health and Human Services Office of Disease Prevention and Health
Promotion to support the Presidential Physical Fitness Test.
18. Sherril (NJ): Increases funding by $5 mil ion for the CDC Chronic
Yes
Adopted, voice vote
Disease Prevention and Health Promotion Account to award grants for the
creation of programs to improve prevention, identification, and treatment
of cardiovascular disease in women. The offset of $5 mil ion is from the
Office the Secretary General Departmental Management Account.
19. Mil s (FL): Reduces the appropriated amount for the Public Health
No
Adopted, voice vote
Scientific Services to the FY19 appropriated amount.
20. Gallagher (WI), Crow (CO): Increases funding for the Centers for
Yes
Adopted, voice vote
Disease Control and Prevention ALS Registry by $5,000,000 to support
research to prevent ALS among active military personnel and veterans, and
reduces funding for the Office of the Secretary of General Departmental
Management by $5,000,000.
21. Gottheimer (NJ): Increases and decreases funds by $1,000,000 in the
Yes
Adopted, voice vote
Centers for Disease Control and Prevention’s Environmental Health
account to emphasize the importance of every child having access to
drinking water at school that’s free of lead and dangerous materials.
22. Grothman (WI): Increases and decreases funding in CDC Wide
No
Adopted, voice vote
Activities and Program Support by $1,000,000 to express the intent for the
CDC to conduct a study on the connection between vitamin D deficiencies
and COVID-19 mortality rates in the United States; and the role of vitamin
D in suppressing severe COVID-19 symptoms; and determine whether or
not a recommendation should be made on the supplemental intake of
vitamin D to boost immune health and protect against complications
associated with respiratory il ness and infections.
23. Gottheimer (NJ): Increases and decreases funding by $5 mil ion for the
Yes
Adopted, voice vote
National Cancer Institute to support improved access to lifesaving
screening, diagnostic, and treatment services in an effort to reduce
disparities and advance health equity in breast and cervical cancer.
24. Jackson Lee (TX): Increases funding for the National Cancer Institute by
Yes
Adopted, voice vote
$2,000,000 to research triple negative breast cancer.
25. Murphy (NC), Costa (CA): Transfers $1,000,000 from the Department
Yes
Adopted, voice vote
of Health and Human Services Office of the Secretary to the National
Institute of Neurological Disorders and Stroke to fund a Pediatric-Onset
Epilepsies Consortium to enable cooperative research studies, accelerate
the development of knowledge about the epilepsies, and rapidly advance
therapeutic options and their implementation to improve treatments and
health care outcomes. (10 minutes)
27. Gluesenkamp Perez (WA): Increases and decreases funding for the
Yes
Adopted, voice vote
National Institute of Allergy and Infectious Disease to recognize the
economic burden of Hand, Foot, and Mouth Disease and highlight the
importance of developing a vaccine for its prevention.
28. Good (VA): Transfers $10 mil ion allocated for the Office of Diversity
No
Failed, recorded
in Biomedical Research to the Spending Reduction Account.
vote: 190 - 241
Congressional Research Service

64

---

Labor, Health and Human Services, and Education: FY2024 Appropriations

Amdt. No. and Summary from the Rules Committee
En Bloc
Disposition
29. Caraveo (CO): Increases and decreases the Eunice Kennedy Shriver
Yes
Adopted, voice vote
National Institute of Child Health and Human Development by $10 mil ion,
for the purpose of continued research and training to understand human
development across the lifespan to improve health outcomes and reduce
costs associated with il ness and disability.
30. Gottheimer (NJ): Increases funding by $10 mil ion for the National
Yes
Adopted, voice vote
Institute on Aging to strengthen the Alzheimer’s Disease Education and
Referral (ADEAR) Center’s research on Alzheimer’s disease including
causes, diagnostic tools, treatments, and cures. The offset of $10 mil ion is
from the Office of the Secretary General Departmental Management
Account.
31. Barragan (CA): Increases and decreases funds for the National Institute
Yes
Adopted, voice vote
on Minority Health and Health Disparities (NIMHD) by $1,000,000 to
express the intent that increased funding be included for the NIMHD
Research Endowment Program to provide continued support to existing
grantees, and to expand the number of statutorily eligible institutions
receiving grants through a competitive process.
32. Good (VA): Transfers $524.4 mil ion from the National Institute of
No
Failed, recorded
Minority Health and Health Disparities to the Spending Reduction Account.
vote: 140 - 294
33. Rosendale (MT): Prohibits funding for the John E. Fogarty International
No
Failed, recorded
Center saving approximately $95 mil ion.
vote: 183 - 251
34. Pfluger (TX): Decreases the amount appropriated to the NIH’s Office
No
Adopted, voice vote
of the Director by $3,748,715 to redress the amount of federal funds the
NIH awarded EcoHealth Alliance, Inc. to conduct gain-of-function research
at the Wuhan Institute of Virology.
35. Mil s (FL): Reduces the appropriated amount for the Office of the
No
Failed, recorded
Director, NIH to the FY19 appropriated amount.
vote: 186 - 247
36. Clyde (GA): Reduces funds for the NIH.
No
Adopted, voice vote
37. Steil (WI): Increases the Substance Abuse Mental Health Budget by $18
Yes
Adopted, voice vote
mil ion for the 9–8–8 National Suicide Prevention Lifeline. The offset is
decreasing funding from the NIH Office of the Director.
38. Harris (MD), Burgess (TX): Decreases the appropriation for NIH
No
Adopted, voice vote
buildings and facilities by $59,000,000. Increases the appropriation for
Project BioShield by $50,000,000.
39. Harris (MD), Dunn (FL): Decreases the appropriation for NIH buildings
No
Adopted, voice vote
and facilities by $119,000,000. Increases the appropriation for the Strategic
National Stockpile by $100,000,000.
40. Balint (VT): Increases and decreases funding for the SAMHSA Disaster
Yes
Adopted, voice vote
Response Program to highlight the importance of supporting disaster
survivors’ mental health.
41. Molinaro (NY): Subtracts and adds $10,000,000 to highlight the
Yes
Adopted, voice vote
importance of bolstering 988 infrastructure and care coordination.
42. Murphy (NC): Transfers $2 mil ion from the Office of the Secretary
Yes
Adopted, voice vote
General Departmental Management to the Substance Abuse and Mental
Health Administration to increase available grants to prevent prescription to increase available grants to prevent prescription
drug and il icit opioid overdoses. drug and il icit opioid overdoses.
Congressional Research Service Congressional Research Service

65 65

---

Labor, Health and Human Services, and Education: FY2024 Appropriations

Amdt. No. and Summary from the Rules Committee
En Bloc
Disposition
43. Caraveo (CO): Increases and decreases the National Child Traumatic 43. Caraveo (CO): Increases and decreases the National Child Traumatic
Yes Yes
Adopted, voice vote Adopted, voice vote
Stress Initiative by $7 mil ion for the purpose of raising awareness of the Stress Initiative by $7 mil ion for the purpose of raising awareness of the
impact of traumatic stress on children and adolescents and to increase impact of traumatic stress on children and adolescents and to increase
availability and accessibility of trauma-informed care, services, and availability and accessibility of trauma-informed care, services, and
treatments. treatments.
44. Barr (KY): Increases funding for the Treatment, Recovery, and 44. Barr (KY): Increases funding for the Treatment, Recovery, and
Yes Yes
Adopted, voice vote Adopted, voice vote
Workforce Support Program. Workforce Support Program.
45. Gottheimer (NJ): Increases funding by $10 mil ion for the Assistant 45. Gottheimer (NJ): Increases funding by $10 mil ion for the Assistant
Yes Yes
Adopted, voice vote Adopted, voice vote
Secretary for Mental Health and Substance Use to award grants, contracts, Secretary for Mental Health and Substance Use to award grants, contracts,
and cooperative agreements for planning, establishing, or administering and cooperative agreements for planning, establishing, or administering
programs to prevent and address the misuse of opioids, related drugs, and programs to prevent and address the misuse of opioids, related drugs, and
other drugs commonly used in pain management or injury recovery, as well other drugs commonly used in pain management or injury recovery, as well
as the co-use of one or more such drugs with other substances, by as the co-use of one or more such drugs with other substances, by
students and student athletes. The offset of $10 mil ion is from the Office students and student athletes. The offset of $10 mil ion is from the Office
of the Secretary General Departmental Management Account. of the Secretary General Departmental Management Account.
46. Pettersen (CO): Transfers $2 mil ion from the Office of Secretary 46. Pettersen (CO): Transfers $2 mil ion from the Office of Secretary
Yes Yes
Adopted, voice vote Adopted, voice vote
General Departmental Management Account to the Substance Abuse and General Departmental Management Account to the Substance Abuse and
Mental Health Administration for the purpose of expanding mobile Mental Health Administration for the purpose of expanding mobile
Medication Assisted Treatment (MAT) units in rural communities. Medication Assisted Treatment (MAT) units in rural communities.
47. Molinaro (NY): Subtracts and adds $2,000,000 to specify that SAMHSA 47. Molinaro (NY): Subtracts and adds $2,000,000 to specify that SAMHSA
Yes Yes
Adopted, voice vote Adopted, voice vote
should explore using its funds for crisis stabilization centers that provide should explore using its funds for crisis stabilization centers that provide
walk-in care services for individuals with serious mental health conditions walk-in care services for individuals with serious mental health conditions
and/or substance use disorders as an effective approach to reducing and/or substance use disorders as an effective approach to reducing
emergency department visits, hospitalizations, or incarceration. emergency department visits, hospitalizations, or incarceration.
48. Steube (FL): Increases and decreases funding to the Administration for 48. Steube (FL): Increases and decreases funding to the Administration for
Yes Yes
Adopted, voice vote Adopted, voice vote
Children and Families by $2,000,000 to highlight the need for innovative Children and Families by $2,000,000 to highlight the need for innovative
foster care programming that recognizes the adversities, challenges, and foster care programming that recognizes the adversities, challenges, and
traumas that children and families involved in the foster care system often traumas that children and families involved in the foster care system often
confront in such vulnerable periods. confront in such vulnerable periods.
49. Ramirez (IL): Increases and decreases funding for the Services for 49. Ramirez (IL): Increases and decreases funding for the Services for
Yes Yes
Adopted, voice vote Adopted, voice vote
Survivors of Torture Program. Survivors of Torture Program.
50. Ciscomani (AZ): Increases and decreases funding for Head Start. 50. Ciscomani (AZ): Increases and decreases funding for Head Start.
Yes Yes
Adopted, voice vote Adopted, voice vote
51. Jackson Lee (TX): Increases funds by $2,000,000 for the Head Start Act, 51. Jackson Lee (TX): Increases funds by $2,000,000 for the Head Start Act,
Yes Yes
Adopted, voice vote Adopted, voice vote
including Head Start partnerships. including Head Start partnerships.
52. Molinaro (NY): Increases and decreases funding for the Administration 52. Molinaro (NY): Increases and decreases funding for the Administration
Yes Yes
Adopted, voice vote Adopted, voice vote
of Community Living by $5,000,000 to build up telephone reassurance of Community Living by $5,000,000 to build up telephone reassurance
services to support the mental health and overall well-being of socially services to support the mental health and overall well-being of socially
vulnerable older adults. vulnerable older adults.
53. Dunn (FL), Mil er (WV): Increases and decreases the funding by $400 53. Dunn (FL), Mil er (WV): Increases and decreases the funding by $400
Yes Yes
Adopted, voice vote Adopted, voice vote
mil ion for the Administration for Strategic Preparedness and Response’s mil ion for the Administration for Strategic Preparedness and Response’s
(ASPR) Project Bioshield to highlight the importance of HHS funding oral (ASPR) Project Bioshield to highlight the importance of HHS funding oral
antiviral therapeutics as part of Project NextGen. antiviral therapeutics as part of Project NextGen.
54. Carter (GA), Burgess (TX): Directs $15 mil ion to carry out Section 54. Carter (GA), Burgess (TX): Directs $15 mil ion to carry out Section
No No
Adopted, voice vote Adopted, voice vote
2409 of Public Law 117–328 to allow states to build or maintain their own 2409 of Public Law 117–328 to allow states to build or maintain their own
medical stockpile for their specific and unique needs, while coordinating medical stockpile for their specific and unique needs, while coordinating
with the SNS and ensuring it is robust. with the SNS and ensuring it is robust.
55. Good (VA): Transfers $28 mil ion allocated for Minority AIDS 55. Good (VA): Transfers $28 mil ion allocated for Minority AIDS
No No
Failed, recorded Failed, recorded
prevention to the Spending Reduction Account. prevention to the Spending Reduction Account.
vote: 109 - 324 (Rol vote: 109 - 324 (Rol
no 653) no 653)
Congressional Research Service Congressional Research Service

66 66

---

Labor, Health and Human Services, and Education: FY2024 Appropriations

Amdt. No. and Summary from the Rules Committee
En Bloc
Disposition
56. Hudson (NC): Transfers $2,000,000 from HHS office of the Secretary 56. Hudson (NC): Transfers $2,000,000 from HHS office of the Secretary
Yes Yes
Adopted, voice vote Adopted, voice vote
and transfer it to the Office of Inspector General to support investigation and transfer it to the Office of Inspector General to support investigation
and oversight functions of HHS in disrupting counterfeit medicine. and oversight functions of HHS in disrupting counterfeit medicine.
57. Kiggans (VA): Increases and decreases Medicare Hearings and Appeals 57. Kiggans (VA): Increases and decreases Medicare Hearings and Appeals
Yes Yes
Adopted, voice vote Adopted, voice vote
funding by $196,000,000 to direct CMS to transmit information, either on funding by $196,000,000 to direct CMS to transmit information, either on
the CMS website or on the claim denial notification, to those whose the CMS website or on the claim denial notification, to those whose
Medicare/Medicaid claims are denied about how to effectively appeal their Medicare/Medicaid claims are denied about how to effectively appeal their
denied claims. denied claims.
59. Houchin (IN): Increases and decreases the ESEA account by $1 mil ion 59. Houchin (IN): Increases and decreases the ESEA account by $1 mil ion
Yes Yes
Adopted, voice vote Adopted, voice vote
dol ars to highlight the importance of the Literacy Education for All, Results dol ars to highlight the importance of the Literacy Education for All, Results
for the Nation program under ESEA. for the Nation program under ESEA.
60. Houchin (IN): Increases and decreases the HEA account by $1 mil ion 60. Houchin (IN): Increases and decreases the HEA account by $1 mil ion
Yes Yes
Adopted, voice vote Adopted, voice vote
dol ars to highlight the importance of our future educators teaching the dol ars to highlight the importance of our future educators teaching the
science of reading through a phonics-based curriculum. science of reading through a phonics-based curriculum.
61. Boebert (CO): Transfers funds from the Department of Education 61. Boebert (CO): Transfers funds from the Department of Education
No No
Adopted, voice vote Adopted, voice vote
bureaucracy to Charter School Grants. bureaucracy to Charter School Grants.
62. Boebert (CO): Transfers funds from the Department of Education 62. Boebert (CO): Transfers funds from the Department of Education
No No
Adopted, voice vote Adopted, voice vote
bureaucracy to Rural School Programs. bureaucracy to Rural School Programs.
63. Boebert (CO): Transfers funds from the Department of Education 63. Boebert (CO): Transfers funds from the Department of Education
No No
Adopted, voice vote Adopted, voice vote
bureaucracy to the Office of Indian Education. bureaucracy to the Office of Indian Education.
64. Scott, David (GA): Increases and decreases funding for the Assistance 64. Scott, David (GA): Increases and decreases funding for the Assistance
Yes Yes
Adopted, voice vote Adopted, voice vote
for Arts Education to highlight the need for professional development for for Arts Education to highlight the need for professional development for
arts educators to better include and accommodate students with arts educators to better include and accommodate students with
disabilities. disabilities.
65. Molinaro (NY): Increases and decreases IDEA funding to emphasize the 65. Molinaro (NY): Increases and decreases IDEA funding to emphasize the
Yes Yes
Adopted, voice vote Adopted, voice vote
importance of supporting students with intellectual and developmental importance of supporting students with intellectual and developmental
disabilities. disabilities.
66. Molinaro (NY), Houchin (IN): Increases and decreases IDEA funding to 66. Molinaro (NY), Houchin (IN): Increases and decreases IDEA funding to
Yes Yes
Adopted, voice vote Adopted, voice vote
highlight the importance for school districts to inform parents of their right highlight the importance for school districts to inform parents of their right
to have a third-party advocate in IEP meetings. to have a third-party advocate in IEP meetings.
67. Steil (WI), Grothman (WI): Transfers $5,000,000 from the Department 67. Steil (WI), Grothman (WI): Transfers $5,000,000 from the Department
Yes Yes
Adopted, voice vote Adopted, voice vote
of Education’s Departmental Management Program Administration account of Education’s Departmental Management Program Administration account
to the Department of Education’s Special Education account for the to the Department of Education’s Special Education account for the
purpose of carrying out Part B of the Individuals with Disabilities Education purpose of carrying out Part B of the Individuals with Disabilities Education
Act (IDEA). Act (IDEA).
68. McGarvey (KY): Increases and decreases funding by $2 mil ion to 68. McGarvey (KY): Increases and decreases funding by $2 mil ion to
Yes Yes
Adopted, voice vote Adopted, voice vote
highlight the importance of continued funding for the American Printing highlight the importance of continued funding for the American Printing
House for the Blind and their mission providing accessible and innovative House for the Blind and their mission providing accessible and innovative
reading materials to people who are blind or low vision. reading materials to people who are blind or low vision.
69. Biggs (AZ): Cuts funding for the Student Financial Assistance Program. 69. Biggs (AZ): Cuts funding for the Student Financial Assistance Program.
No No
Failed, recorded Failed, recorded
vote: 85 - 350 vote: 85 - 350
70. Biggs (AZ): Strikes funding to the Student Aid Administration. 70. Biggs (AZ): Strikes funding to the Student Aid Administration.
No No
Failed, recorded Failed, recorded
vote: 81 - 353 vote: 81 - 353
71. Biggs (AZ): Strikes funding to the Higher Education Program. 71. Biggs (AZ): Strikes funding to the Higher Education Program.
No No
Failed, recorded Failed, recorded
vote: 81 - 354 vote: 81 - 354
72. Molinaro (NY): Increases and decreases Department of Education 72. Molinaro (NY): Increases and decreases Department of Education
Yes Yes
Adopted, voice vote Adopted, voice vote
funding to ensure that students are protected against antisemitic activity funding to ensure that students are protected against antisemitic activity
and those students who are affected have access to adequate counseling and those students who are affected have access to adequate counseling
services. services.
Congressional Research Service Congressional Research Service

67 67

---

Labor, Health and Human Services, and Education: FY2024 Appropriations

Amdt. No. and Summary from the Rules Committee
En Bloc
Disposition
73. Moore (WI): Demonstrates the importance of the TRIO program by 73. Moore (WI): Demonstrates the importance of the TRIO program by
Yes Yes
Adopted, voice vote Adopted, voice vote
increase/decrease by $1 mil ion. increase/decrease by $1 mil ion.
74. Ramirez (IL): Increases and decreases funding for Augustus F. Hawkins 74. Ramirez (IL): Increases and decreases funding for Augustus F. Hawkins
Yes Yes
Adopted, voice vote Adopted, voice vote
Centers of Excellence grants. Centers of Excellence grants.
75. Ramirez (IL): Increases and decreases funding for Development 75. Ramirez (IL): Increases and decreases funding for Development
Yes Yes
Adopted, voice vote Adopted, voice vote
Hispanic-Serving Institutions Program. Hispanic-Serving Institutions Program.
76. Biggs (AZ): Strikes funding to the Institute of Education Sciences. 76. Biggs (AZ): Strikes funding to the Institute of Education Sciences.
No No
Failed, recorded Failed, recorded
vote: 118 - 316 vote: 118 - 316
77. Lawler (NY): Increases/decreases funding at the Department of 77. Lawler (NY): Increases/decreases funding at the Department of
Yes Yes
Adopted, voice vote Adopted, voice vote
Education’s Office of Civil Rights to prioritize the investigation of Education’s Office of Civil Rights to prioritize the investigation of
antisemitic incidents on col ege campuses. antisemitic incidents on col ege campuses.
78. Perry (PA): Reduces funding for the National Labor Relations Board by 78. Perry (PA): Reduces funding for the National Labor Relations Board by
No No
Failed, recorded Failed, recorded
$100 mil ion. $100 mil ion.
vote: 169 - 257 vote: 169 - 257
79. Gottheimer (NJ): Increases and decreases funds by $10 mil ion to hire 79. Gottheimer (NJ): Increases and decreases funds by $10 mil ion to hire
Yes Yes
Adopted, voice vote Adopted, voice vote
more Social Security Administration employees in the Office of Hearing more Social Security Administration employees in the Office of Hearing
Operations to reduce hearings backlog and processing times for disability Operations to reduce hearings backlog and processing times for disability
claims. claims.
80. Kiley (CA): Prohibits funds made available under this Act from being 80. Kiley (CA): Prohibits funds made available under this Act from being
No No
Adopted, voice vote Adopted, voice vote
used by the Department of Health and Human Services or any grantee to used by the Department of Health and Human Services or any grantee to
implement a mask mandate for children at Head Start programs implement a mask mandate for children at Head Start programs
81. Boebert (CO): Transfers funds from the Department of Education 81. Boebert (CO): Transfers funds from the Department of Education
No No
Adopted, voice vote Adopted, voice vote
bureaucracy to the Office of the Inspector General to combat Waste, bureaucracy to the Office of the Inspector General to combat Waste,
Fraud, and abuse. Fraud, and abuse.
82. Allen (GA): Restricts any funds made available by this Act to be used to 82. Allen (GA): Restricts any funds made available by this Act to be used to
No No
Adopted, voice vote Adopted, voice vote
finalize, implement, or enforce the proposed rule entitled ‘‘Retirement finalize, implement, or enforce the proposed rule entitled ‘‘Retirement
Security Rule: Definition of an Investment Advice Fiduciary’’ or any Security Rule: Definition of an Investment Advice Fiduciary’’ or any
substantially similar rule. substantially similar rule.
83. Wagner (MO): Prohibits the Department of Labor from using funds to 83. Wagner (MO): Prohibits the Department of Labor from using funds to
No No
Adopted, voice vote Adopted, voice vote
finalize, implement, or enforce proposed amendments to class prohibited finalize, implement, or enforce proposed amendments to class prohibited
transaction exemptions (PTEs) available to investment advice fiduciaries. transaction exemptions (PTEs) available to investment advice fiduciaries.
84. Norman (SC): Prohibits funding to carry out the actions described in 84. Norman (SC): Prohibits funding to carry out the actions described in
No No
Adopted, voice vote Adopted, voice vote
the fact sheet released by the White House related to cracking down on the fact sheet released by the White House related to cracking down on
junk fees in retirement investment advice. junk fees in retirement investment advice.
85. Biggs (AZ): Prohibits the Department of Health and Human Services 85. Biggs (AZ): Prohibits the Department of Health and Human Services
No No
Adopted, voice vote Adopted, voice vote
from making any voluntary contributions to the World Health from making any voluntary contributions to the World Health
Organization. Organization.
86. Biggs (AZ), Roy (TX): Prohibits the use of funds to pay for the salary 86. Biggs (AZ), Roy (TX): Prohibits the use of funds to pay for the salary
No No
Failed, recorded Failed, recorded
and expenses of ORR Director Robin Dunn Marcos. and expenses of ORR Director Robin Dunn Marcos.
vote: 173 - 254 vote: 173 - 254
87. Brecheen (OK): Prohibits funds to finalize, implement, administer, or 87. Brecheen (OK): Prohibits funds to finalize, implement, administer, or
No No
Adopted, voice vote Adopted, voice vote
enforce the proposed rule entitled ‘‘Safe and Appropriate Foster Care enforce the proposed rule entitled ‘‘Safe and Appropriate Foster Care
Placement Requirements for Titles IV–E and IV–B,’ which requires foster Placement Requirements for Titles IV–E and IV–B,’ which requires foster
families to affirm a foster child’s LGBTQI+ identity. families to affirm a foster child’s LGBTQI+ identity.
90. Cammack (FL): Prohibits funds from being used to finalize any rule or 90. Cammack (FL): Prohibits funds from being used to finalize any rule or
No No
Adopted, voice vote Adopted, voice vote
regulation that has resulted in or is likely to result in an annual effect on the regulation that has resulted in or is likely to result in an annual effect on the
economy of $100 mil ion or more. economy of $100 mil ion or more.
92. Crane (AZ): Reduces federal education funding by $37,735,000. 92. Crane (AZ): Reduces federal education funding by $37,735,000.
No No
Failed, recorded Failed, recorded
vote: 151 - 273 vote: 151 - 273
Congressional Research Service Congressional Research Service

68 68

---

Labor, Health and Human Services, and Education: FY2024 Appropriations

Amdt. No. and Summary from the Rules Committee
En Bloc
Disposition
96. Good (VA): Prohibits funds from being used to require universities to 96. Good (VA): Prohibits funds from being used to require universities to
No No
Adopted, voice vote Adopted, voice vote
enforce COVID-19 vaccine requirements for students and faculty. enforce COVID-19 vaccine requirements for students and faculty.
99. Gosar (AZ): Prohibits funding for NIH grant R01AI110964 99. Gosar (AZ): Prohibits funding for NIH grant R01AI110964
No No
Adopted, voice vote Adopted, voice vote
‘ Understanding the Risk of Bat Coronavirus Emergence’’ and Cooperative ‘ Understanding the Risk of Bat Coronavirus Emergence’’ and Cooperative
Agreement U01AI151797 ‘‘Understanding Risk of Zoonotic Virus Agreement U01AI151797 ‘‘Understanding Risk of Zoonotic Virus
Emergence in EID Hotspots of Southeast Asia.’ Emergence in EID Hotspots of Southeast Asia.’
100. Graves (LA): Prohibits the use of funds to promulgate new major rules 100. Graves (LA): Prohibits the use of funds to promulgate new major rules
No No
Adopted, voice vote Adopted, voice vote
if OMB determines that the regulation is likely to result in a significant if OMB determines that the regulation is likely to result in a significant
impact on the economy, a major increase in prices for consumers, or impact on the economy, a major increase in prices for consumers, or
adverse effects on American global competition. adverse effects on American global competition.
101. Greene (GA): Prohibits funding for the implementation of the CDC’s 101. Greene (GA): Prohibits funding for the implementation of the CDC’s
No No
Adopted, voice vote Adopted, voice vote
recommendation to add the COVID vaccine to the child and adolescent recommendation to add the COVID vaccine to the child and adolescent
immunization schedule. immunization schedule.
102. Greene (GA): Prohibits funding for vaccine mandates. 102. Greene (GA): Prohibits funding for vaccine mandates.
No No
Adopted, voice vote Adopted, voice vote
103. Greene (GA), Mil er (IL): Reduces the salary of Rachel Levine, 103. Greene (GA), Mil er (IL): Reduces the salary of Rachel Levine,
No No
Failed, recorded Failed, recorded
Assistant Secretary for Health, to $1. Assistant Secretary for Health, to $1.
vote: 170 - 254, 1 vote: 170 - 254, 1
Present Present
104. Greene (GA), Mil er (IL): Reduces the salary of Miguel Cardona, 104. Greene (GA), Mil er (IL): Reduces the salary of Miguel Cardona,
No No
Failed, recorded Failed, recorded
Secretary of Education, to $1. Secretary of Education, to $1.
vote: 165 - 260, 1 vote: 165 - 260, 1
Present Present
105. Hageman (WY): Prohibits the Department of Labor from providing 105. Hageman (WY): Prohibits the Department of Labor from providing
No No
Adopted, voice vote Adopted, voice vote
climate literacy training. climate literacy training.
106. Hageman (WY): Prohibits the Department of Labor from 106. Hageman (WY): Prohibits the Department of Labor from
No No
Adopted, voice vote Adopted, voice vote
administering environmental justice grant programs. administering environmental justice grant programs.
107. Hageman (WY): Prohibits funds made available by this Act from being 107. Hageman (WY): Prohibits funds made available by this Act from being
No No
Adopted, voice vote Adopted, voice vote
used to implement or carry out the strategies provided by the Department used to implement or carry out the strategies provided by the Department
of Education’s September 2023 report titled ‘‘Strategies for Increasing of Education’s September 2023 report titled ‘‘Strategies for Increasing
Diversity and Opportunity in Higher Education.’ Diversity and Opportunity in Higher Education.’
108. Hageman (WY): Prohibits funds made available by this Act from being 108. Hageman (WY): Prohibits funds made available by this Act from being
No No
Adopted, voice vote Adopted, voice vote
used to carry out educational priorities, including invitational priorities, used to carry out educational priorities, including invitational priorities,
concerning the American History and Civics Education programs, and concerning the American History and Civics Education programs, and
referenced in 86 FR 20348 relating to ‘‘Proposed Priorities—American referenced in 86 FR 20348 relating to ‘‘Proposed Priorities—American
History and Civics Education.’ History and Civics Education.’
109. Harris (MD), Burgess (TX), McCormick (GA), Wenstrup (OH): Limits 109. Harris (MD), Burgess (TX), McCormick (GA), Wenstrup (OH): Limits
No No
Withdrawn Withdrawn
the amount that the National Institutes of Health provides grantees for the amount that the National Institutes of Health provides grantees for
facilities and administrative costs to 30% of the total grant. facilities and administrative costs to 30% of the total grant.
110. Hern (OK): Prohibits funds from being used for a Confucius 110. Hern (OK): Prohibits funds from being used for a Confucius
No No
Adopted, voice vote Adopted, voice vote
Classroom. Classroom.
111. Hern (OK): Ensures the Department of Health and Human Services 111. Hern (OK): Ensures the Department of Health and Human Services
No No
Adopted, recorded Adopted, recorded
implements consumer protections passed in the surprise bil ing law that implements consumer protections passed in the surprise bil ing law that
vote: 411 - 14 vote: 411 - 14
provides patients with an advanced cost estimate for their health care provides patients with an advanced cost estimate for their health care
services. services.
112. Higgins (LA): Reduces the salary of Christopher Wil iamson, Assistant 112. Higgins (LA): Reduces the salary of Christopher Wil iamson, Assistant
No No
Failed, recorded Failed, recorded
Secretary of the Mine Safety and Health Administration, to $1. Secretary of the Mine Safety and Health Administration, to $1.
vote: 148 - 280, 1 vote: 148 - 280, 1
Present Present
113. Higgins (LA): Reduces the salary of Wil iam O’Dell, District Manager in 113. Higgins (LA): Reduces the salary of Wil iam O’Dell, District Manager in
No No
Failed, recorded Failed, recorded
Dallas, Texas, of the Mine Safety and Health Administration, to $1. Dallas, Texas, of the Mine Safety and Health Administration, to $1.
vote: 144 - 279, 1 vote: 144 - 279, 1
Present Present
Congressional Research Service Congressional Research Service

69 69

---

Labor, Health and Human Services, and Education: FY2024 Appropriations

Amdt. No. and Summary from the Rules Committee
En Bloc
Disposition
114. Lawler (NY): Prohibits funding under this Act from going toward 114. Lawler (NY): Prohibits funding under this Act from going toward
No No
Adopted, recorded Adopted, recorded
col eges and universities that authorize, facilitate, provide funding for, or col eges and universities that authorize, facilitate, provide funding for, or
vote: 373 - 54 vote: 373 - 54
otherwise support any event promoting antisemitism on campus. otherwise support any event promoting antisemitism on campus.
115. Massie (KY): Prohibits funds from being used to fund any grant related 115. Massie (KY): Prohibits funds from being used to fund any grant related
No No
Adopted, voice vote Adopted, voice vote
to any transgenic edible vaccine. to any transgenic edible vaccine.
116. Massie (KY), Mil er-Meeks (IA): Prohibits funds from being made 116. Massie (KY), Mil er-Meeks (IA): Prohibits funds from being made
No No
Adopted, voice vote Adopted, voice vote
available to conduct or support gain of function research. available to conduct or support gain of function research.
117. McCormick (GA): Reduces the salary of Xavier Becerra, Secretary of 117. McCormick (GA): Reduces the salary of Xavier Becerra, Secretary of
No No
Failed, recorded Failed, recorded
the Department of Health and Human Services, to $1. the Department of Health and Human Services, to $1.
vote: 162 - 262, 1 vote: 162 - 262, 1
Present Present
118. Mil er (IL): Reduces the salary of Catherine E. Lhamon, Assistant 118. Mil er (IL): Reduces the salary of Catherine E. Lhamon, Assistant
No No
Failed, recorded Failed, recorded
Secretary for Civil Rights at the U.S. Department of Education, to $1. Secretary for Civil Rights at the U.S. Department of Education, to $1.
vote: 157 - 268, 1 vote: 157 - 268, 1
Present Present
119. Mil er (IL): Reduces the salary of Douglas L. Parker, Assistant 119. Mil er (IL): Reduces the salary of Douglas L. Parker, Assistant
No No
Failed, recorded Failed, recorded
Secretary of Labor for Occupational Safety and Health, to $1. Secretary of Labor for Occupational Safety and Health, to $1.
vote: 155 - 270, 1 vote: 155 - 270, 1
Present Present
120. Mil er (IL): Prohibits funds to the World Health Organization. 120. Mil er (IL): Prohibits funds to the World Health Organization.
No No
Adopted, voice vote Adopted, voice vote
121. Mil er (IL): Prohibits funds to Office of Population Affairs. 121. Mil er (IL): Prohibits funds to Office of Population Affairs.
No No
Failed, recorded Failed, recorded
vote: 204 - 224 vote: 204 - 224
122. Mil er (WV), Pfluger (TX), Fleischmann (TN): Prevents funds from 122. Mil er (WV), Pfluger (TX), Fleischmann (TN): Prevents funds from
No No
Adopted, voice vote Adopted, voice vote
being used to finalize, implement, or enforce the proposed rule published being used to finalize, implement, or enforce the proposed rule published
by the Department of Health and Human Services entitled ‘‘Medicaid by the Department of Health and Human Services entitled ‘‘Medicaid
Program; Misclassification of Drugs, Program Administration and Program Program; Misclassification of Drugs, Program Administration and Program
Integrity Updates Under the Medicaid Drug Rebate Program’’ (88 Fed. Reg. Integrity Updates Under the Medicaid Drug Rebate Program’’ (88 Fed. Reg.
34238 (May, 26, 2023)). 34238 (May, 26, 2023)).
123. Mil er-Meeks (IA): Prohibits funding for CDC’s firearm injury and 123. Mil er-Meeks (IA): Prohibits funding for CDC’s firearm injury and
No No
Adopted, recorded Adopted, recorded
mortality prevention research. mortality prevention research.
vote: 216 - 211 vote: 216 - 211
124. Moore (UT), Schneider (IL): Increases and decreases funding for the 124. Moore (UT), Schneider (IL): Increases and decreases funding for the
No No
Adopted, voice vote Adopted, voice vote
U.S. Department of Health and Human Services HRSA Wide Activities and U.S. Department of Health and Human Services HRSA Wide Activities and
Programs Support account to urge HRSA to provide Congress an Programs Support account to urge HRSA to provide Congress an
accounting of unpaid and partially paid claims by HRSA’s COVID-19 accounting of unpaid and partially paid claims by HRSA’s COVID-19
Uninsured Program, an accounting of funding to pay these claims since its Uninsured Program, an accounting of funding to pay these claims since its
initiation, including instances in which funding intended for this program initiation, including instances in which funding intended for this program
was diverted to other activities, and a plan for payment of legitimate claims was diverted to other activities, and a plan for payment of legitimate claims
stil outstanding for services provided under this program. stil outstanding for services provided under this program.
126. Murphy (NC), Hern (OK), Wenstrup (OH), Hageman (WY), Barr 126. Murphy (NC), Hern (OK), Wenstrup (OH), Hageman (WY), Barr
No No
Adopted, voice vote Adopted, voice vote
(KY), Houchin (IN), Rosendale (MT), Burgess (TX), Fischbach (MN): (KY), Houchin (IN), Rosendale (MT), Burgess (TX), Fischbach (MN):
Prohibits funds from being used to finalize, implement, or enforce the Prohibits funds from being used to finalize, implement, or enforce the
proposed rule entitled: ‘‘Medicare and Medicaid Programs: Minimum proposed rule entitled: ‘‘Medicare and Medicaid Programs: Minimum
Staffing Standards for Long-Term Care Facilities and Medicaid Institutional Staffing Standards for Long-Term Care Facilities and Medicaid Institutional
Payment Transparency Reporting (CMS 3442–P).” Payment Transparency Reporting (CMS 3442–P).”
127. Ogles (TN): Prohibits funds from use to impose a COVID-19 mask 127. Ogles (TN): Prohibits funds from use to impose a COVID-19 mask
No No
Adopted, voice vote Adopted, voice vote
mandate. mandate.
128. Ogles (TN): Prohibits funds for Guidance issued by Secretary Becerra 128. Ogles (TN): Prohibits funds for Guidance issued by Secretary Becerra
No No
Adopted, voice vote Adopted, voice vote
regarding mandated use of preferred pronouns. regarding mandated use of preferred pronouns.
129. Perry (PA): Prohibits the use of funds for the Mine Safety and Health 129. Perry (PA): Prohibits the use of funds for the Mine Safety and Health
No No
Adopted, voice vote Adopted, voice vote
Administration to finalize, implement, or enforce the proposed rule Administration to finalize, implement, or enforce the proposed rule
entitled, ‘‘Lowering Miners’ Exposure to Respirable Crystalline Silica and entitled, ‘‘Lowering Miners’ Exposure to Respirable Crystalline Silica and
Improving Respiratory Protection.’ Improving Respiratory Protection.’
Congressional Research Service Congressional Research Service

70 70

---

Labor, Health and Human Services, and Education: FY2024 Appropriations

Amdt. No. and Summary from the Rules Committee
En Bloc
Disposition
130. Perry (PA): Prohibits the use of funds for the NLRB to implement, 130. Perry (PA): Prohibits the use of funds for the NLRB to implement,
No No
Adopted, voice vote Adopted, voice vote
administer, or enforce the ‘ Representation-Case Procedures’’ rule, which administer, or enforce the ‘ Representation-Case Procedures’’ rule, which
imposes ‘‘ambush’ elections. imposes ‘‘ambush’ elections.
131. Perry (PA), Good (VA), Allen (GA): Prohibits the use of funds to 131. Perry (PA), Good (VA), Allen (GA): Prohibits the use of funds to
No No
Adopted, voice vote Adopted, voice vote
implement or enforce the ‘ Cemex’ decision which imposes a back-door implement or enforce the ‘ Cemex’ decision which imposes a back-door
card check system for union elections. card check system for union elections.
132. Pfluger (TX), Burgess (TX), Crenshaw (TX), Weber (TX), Gooden 132. Pfluger (TX), Burgess (TX), Crenshaw (TX), Weber (TX), Gooden
No No
Adopted, voice vote Adopted, voice vote
(TX), Moran (TX), De La Cruz (TX), Babin (TX): Prohibits funding to (TX), Moran (TX), De La Cruz (TX), Babin (TX): Prohibits funding to
finalize, implement or enforce policies in CMS’s policies included in the finalize, implement or enforce policies in CMS’s policies included in the
informational bul etin promulgated by the Centers for Medicare & Medicaid informational bul etin promulgated by the Centers for Medicare & Medicaid
Services Center for Medicaid & CHIP Services on February 17, 2023, and Services Center for Medicaid & CHIP Services on February 17, 2023, and
proposed limitation for state directed payments as stated in the May 3, proposed limitation for state directed payments as stated in the May 3,
2023, proposed rule titled ‘‘Medicaid Program; Medicaid and Children’s 2023, proposed rule titled ‘‘Medicaid Program; Medicaid and Children’s
Health Insurance Program (CHIP) Managed Care Access, Finance, and Health Insurance Program (CHIP) Managed Care Access, Finance, and
Quality.’ Quality.’
133. Rosendale (MT): Prohibits funds made available by this Act from 133. Rosendale (MT): Prohibits funds made available by this Act from
No No
Adopted, voice vote Adopted, voice vote
conducting or supporting any gain-of-function research involving a potential conducting or supporting any gain-of-function research involving a potential
pandemic pathogen by Rocky Mountain Laboratories. pandemic pathogen by Rocky Mountain Laboratories.
134. Rosendale (MT): Reduces the salary of Vincent Munster, Chief, Virus 134. Rosendale (MT): Reduces the salary of Vincent Munster, Chief, Virus
No No
Failed, recorded Failed, recorded
Ecology Section, National Institute of Allergy and Infectious Diseases to $1. Ecology Section, National Institute of Allergy and Infectious Diseases to $1.
vote: 155 - 268, 1 vote: 155 - 268, 1
Present Present
135. Rosendale (MT), Brecheen (OK): Prohibits funds from being used to 135. Rosendale (MT), Brecheen (OK): Prohibits funds from being used to
No No
Withdrawn Withdrawn
implement the proposed rule entitled ‘‘Unaccompanied Children Program implement the proposed rule entitled ‘‘Unaccompanied Children Program
Foundational Rule’’ issued by the Administration for Children and Families. Foundational Rule’’ issued by the Administration for Children and Families.
136. Roy (TX), Cammack (FL): Prohibits funds appropriated by this Act to 136. Roy (TX), Cammack (FL): Prohibits funds appropriated by this Act to
No No
Adopted, voice vote Adopted, voice vote
implement certain executive orders regarding climate change. implement certain executive orders regarding climate change.
137. Santos (NY): Prohibits funds from being used to establish, implement, 137. Santos (NY): Prohibits funds from being used to establish, implement,
No No
Adopted, voice vote Adopted, voice vote
or enforce any vaccine mandate. or enforce any vaccine mandate.
138. Schweikert (AZ): Increases funding for the National Eye Institute by $5 138. Schweikert (AZ): Increases funding for the National Eye Institute by $5
No No
Adopted, voice vote Adopted, voice vote
mil ion for the development of autonomous eye screening for diabetic mil ion for the development of autonomous eye screening for diabetic
retinopathy. Offsets the increase with a decrease in funding of $5 mil ion retinopathy. Offsets the increase with a decrease in funding of $5 mil ion
from the General Departmental Management account under the Office of from the General Departmental Management account under the Office of
the Secretary of Health and Human Services. the Secretary of Health and Human Services.
139. Schweikert (AZ): Increases funding by $2 mil ion for the CDC 139. Schweikert (AZ): Increases funding by $2 mil ion for the CDC
No No
Adopted, voice vote Adopted, voice vote
‘ Emerging Zoonotic and Infectious Disease account with the intention that ‘ Emerging Zoonotic and Infectious Disease account with the intention that
these funds be used for Coccidioidomycosis otherwise known as ‘‘Valley these funds be used for Coccidioidomycosis otherwise known as ‘‘Valley
Fever.’ Offsets the increase with a decrease in funding of $2 mil ion from Fever.’ Offsets the increase with a decrease in funding of $2 mil ion from
the General Departmental Management account under the Office of the the General Departmental Management account under the Office of the
Secretary of Health and Human Services. Secretary of Health and Human Services.
140. Schweikert (AZ): Reduces each amount appropriated or otherwise 140. Schweikert (AZ): Reduces each amount appropriated or otherwise
No No
Failed by voice vote Failed by voice vote
made available by this Act that is not required to be appropriated or made made available by this Act that is not required to be appropriated or made
available by a provision of law by 26.2%, equal to the amount that entities available by a provision of law by 26.2%, equal to the amount that entities
with taxing authority receive in the bil . with taxing authority receive in the bil .
141. Schweikert (AZ), Mil er (WV): Increases and decreases funding of $5 141. Schweikert (AZ), Mil er (WV): Increases and decreases funding of $5
Yes Yes
Adopted, voice vote Adopted, voice vote
mil ion for the National Institute on Drug Abuse to support research on mil ion for the National Institute on Drug Abuse to support research on
cures for synthetic opioids and fentanyl. Offsets the increase with a cures for synthetic opioids and fentanyl. Offsets the increase with a
decrease in funding of $5 mil ion from the General Departmental decrease in funding of $5 mil ion from the General Departmental
Management account under the Office of the Secretary of Health and Management account under the Office of the Secretary of Health and
Human Services. Human Services.
Congressional Research Service Congressional Research Service

71 71

---

Labor, Health and Human Services, and Education: FY2024 Appropriations

142. Smucker (PA), Van Orden (WI): Prohibits ED from using funds to 142. Smucker (PA), Van Orden (WI): Prohibits ED from using funds to
No No
Adopted, voice vote Adopted, voice vote
implement, administer, or enforce a provision of their Oct. 31 final rule implement, administer, or enforce a provision of their Oct. 31 final rule
that would prohibit education and training programs from exceeding their that would prohibit education and training programs from exceeding their
state’s minimum hours requirements. state’s minimum hours requirements.
143. Tenney (NY): Prohibits funding for Executive Order 14019. 143. Tenney (NY): Prohibits funding for Executive Order 14019.
No No
Adopted, voice vote Adopted, voice vote
144. Van Duyne (TX): Prohibits funds from being used to enforce ASC–20 144. Van Duyne (TX): Prohibits funds from being used to enforce ASC–20
No No
Adopted, voice vote Adopted, voice vote
of the Ambulatory Surgical Center Quality Reporting Program (ASCQR) of the Ambulatory Surgical Center Quality Reporting Program (ASCQR)
which requires ASCs to report their COVID-19 Vaccination Coverage which requires ASCs to report their COVID-19 Vaccination Coverage
Among Health Care Personnel data. Among Health Care Personnel data.
146. Lawler (NY), Ciscomani (AZ): Increases funding for Head Start. 146. Lawler (NY), Ciscomani (AZ): Increases funding for Head Start.
No No
Adopted, voice vote Adopted, voice vote
Sources: The amendment numbers and summaries are from pages 3-14 of H.Rept. 118-272. En bloc The amendment numbers and summaries are from pages 3-14 of H.Rept. 118-272. En bloc
consideration and the disposition of all amendments is from consideration and the disposition of all amendments is from Congressional Record, daily edition, Vol. 169, Nos. 188 , daily edition, Vol. 169, Nos. 188
and 189 (November 14, 2023), and and 189 (November 14, 2023), and Congressional Record, daily edition, Vol. 169, No. 190 (November 15, 2023). , daily edition, Vol. 169, No. 190 (November 15, 2023).


Author Information

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


Karen E. Lynch, Coordinator Karen E. Lynch, Coordinator
Kavya Sekar Kavya Sekar
Specialist in Social Policy Specialist in Social Policy
Analyst in Health Policy Analyst in Health Policy


Ada S. Cornell Ada S. Cornell
Kyle D. Shohfi Kyle D. Shohfi
Senior Research Librarian Senior Research Librarian
Analyst in Education Policy Analyst in Education Policy


William R. Morton William R. Morton

Analyst in Income Security Analyst in Income Security



Disclaimer
This document was prepared by the Congressional Research Service (CRS). CRS serves as nonpartisan This document was prepared by the Congressional Research Service (CRS). CRS serves as nonpartisan
shared staff to congressional committees and Members of Congress. It operates solely at the behest of and shared staff to congressional committees and Members of Congress. It operates solely at the behest of and
under the direction of Congress. Information in a CRS Report should not be relied upon for purposes other under the direction of Congress. Information in a CRS Report should not be relied upon for purposes other
than public understanding of information that has been provided by CRS to Members of Congress in than public understanding of information that has been provided by CRS to Members of Congress in
connection with CRS’s institutional role. CRS Reports, as a work of the United States Government, are not connection with CRS’s institutional role. CRS Reports, as a work of the United States Government, are not
subject to copyright protection in the United States. Any CRS Report may be reproduced and distributed in subject to copyright protection in the United States. Any CRS Report may be reproduced and distributed in
its entirety without permission from CRS. However, as a CRS Report may include copyrighted images or its entirety without permission from CRS. However, as a CRS Report may include copyrighted images or
material from a third party, you may need to obtain the permission of the copyright holder if you wish to material from a third party, you may need to obtain the permission of the copyright holder if you wish to
copy or otherwise use copyrighted material. copy or otherwise use copyrighted material.

Congressional Research Service Congressional Research Service
R47936 R47936 · VERSION 5 · UPDATED
72 72

---