Department of Health and Human Services: FY2025 Budget Request

Changes from May 1, 2024 to May 23, 2024

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Department of Health and Human Services:
~~April 29~~May 23, 2024 , 2024
FY2025 Budget Request
Jessica Tollestrup
This report provides information about the FY2025 budget request for the U.S. Department of This report provides information about the FY2025 budget request for the U.S. Department of
Specialist in Social Policy Specialist in Social Policy
Health and Human Services (HHS). Historically, HHS has been one of the larger federal Health and Human Services (HHS). Historically, HHS has been one of the larger federal

departments in terms of budgetary resources. Estimates by the Office of Management and Budget departments in terms of budgetary resources. Estimates by the Office of Management and Budget
Karen E. Lynch
(OMB) indicate that HHS has accounted for at least 20% of all federal outlays in each year since (OMB) indicate that HHS has accounted for at least 20% of all federal outlays in each year since
Specialist in Social Policy Specialist in Social Policy
FY1995. Most recently, HHS accounted for 28% of all federal outlays in FY2023. (FY2023 FY1995. Most recently, HHS accounted for 28% of all federal outlays in FY2023. (FY2023

funding levels are generally considered final, whereas FY2024 funding levels in this report are funding levels are generally considered final, whereas FY2024 funding levels in this report are
estimates.) estimates.)
Ada S. Cornell
Senior Research Librarian Senior Research Librarian
The FY2025 President’s budget request was submitted to Congress on March 11, 2024. Under The FY2025 President’s budget request was submitted to Congress on March 11, 2024. Under

this request, HHS would spend an estimated $1.802 trillion in outlays in FY2025. This would be this request, HHS would spend an estimated $1.802 trillion in outlays in FY2025. This would be
$132 billion (+8%) more than $132 billion (+8%) more than estimated HHS outlays in FY2024 and $92 billion (+5%) more HHS outlays in FY2024 and $92 billion (+5%) more

than actual HHS outlays in FY2023. than actual HHS outlays in FY2023.
Mandatory spending typically comprises the majority of the HHS budget. Two mandatory spending programs—Medicare typically comprises the majority of the HHS budget. Two mandatory spending programs—Medicare
and Medicaid—are expected to account for 85% of all estimated HHS outlays in FY2025, according to the President’s budget and Medicaid—are expected to account for 85% of all estimated HHS outlays in FY2025, according to the President’s budget
request. Medicare and Medicaid are request. Medicare and Medicaid are entitlement programs, meaning the federal government is required to make mandatory programs, meaning the federal government is required to make mandatory
payments to individuals, states, or other entities based on criteria established in authorizing law. payments to individuals, states, or other entities based on criteria established in authorizing law.
Proposed FY2025 HHS Outlays by Major Program or Spending Category

Source: Prepared by the Congressional Research Service (CRS) using data on page 17 of the FY2025 HHS Budget in Brief. Prepared by the Congressional Research Service (CRS) using data on page 17 of the FY2025 HHS Budget in Brief.
Notes: Percentages may not sum due to rounding. For mandatory spending, outlays reflect proposed law spending levels, not the Percentages may not sum due to rounding. For mandatory spending, outlays reflect proposed law spending levels, not the
current services baseline. current services baseline.
The amount of mandatory spending is controlled (but not always provided) by authorizing laws. By contrast, for all The amount of mandatory spending is controlled (but not always provided) by authorizing laws. By contrast, for all
discretionary spending the amount is controlled the amount is controlled and provided through the annual appropriations process. Discretionary provided through the annual appropriations process. Discretionary
spending accounts for about 9% of HHS FY2025 outlays in the President’s budget request. Although discretionary spending spending accounts for about 9% of HHS FY2025 outlays in the President’s budget request. Although discretionary spending
represents a relatively small share of the HHS budget, the department nevertheless receives more discretionary money than represents a relatively small share of the HHS budget, the department nevertheless receives more discretionary money than
most federal departments. According to OMB data, HHS accounted for 7% of all discretionary budget authority across the most federal departments. According to OMB data, HHS accounted for 7% of all discretionary budget authority across the
government in FY2023. The Department of Defense was the only federal agency to account for a larger share of all government in FY2023. The Department of Defense was the only federal agency to account for a larger share of all
discretionary budget authority in that year (46%). discretionary budget authority in that year (46%).

Congressional Research Service Congressional Research Service

Department of Health and Human Services: FY2025 Budget Request

About the U.S. Department of Health and Human
Services (HHS)
The mission of HHS is to “enhance the health and well-being of all Americans, by providing for The mission of HHS is to “enhance the health and well-being of all Americans, by providing for
effective health and human services and by fostering sound, sustained advances in the sciences effective health and human services and by fostering sound, sustained advances in the sciences
underlying medicine, public health, and social services.”1 underlying medicine, public health, and social services.”1
HHS is currently organized into 12 main agencies, called HHS is currently organized into 12 main agencies, called operating divisions (listed below).2 (listed below).2
HHS operating divisions are responsible for administering a wide variety of health and human HHS operating divisions are responsible for administering a wide variety of health and human
services programs, and conducting related research. In addition, HHS has a number of services programs, and conducting related research. In addition, HHS has a number of staff
divisions within the Office of the Secretary (OS). These staff divisions fulfill a broad array of within the Office of the Secretary (OS). These staff divisions fulfill a broad array of
management, research, and oversight functions in support of the entire department. management, research, and oversight functions in support of the entire department.
Acronym
HHS Operating Division
ACF
Administration for Children and Families Administration for Children and Families
ACL
Administration for Community Living Administration for Community Living
AHRQ
Agency for Healthcare Research and Quality Agency for Healthcare Research and Quality
ASPR
Administration for Strategic Preparedness and Response Administration for Strategic Preparedness and Response
ATSDR
Agency for Toxic Substances and Disease Registry Agency for Toxic Substances and Disease Registry
CDC
Centers for Disease Control and Prevention Centers for Disease Control and Prevention
CMS
Centers for Medicare & Medicaid Services Centers for Medicare & Medicaid Services
FDA
Food and Drug Administration Food and Drug Administration
HRSA
Health Resources and Services Administration Health Resources and Services Administration
IHS
Indian Health Service Indian Health Service
NIH
National Institutes of Health National Institutes of Health
SAMHSA
Substance Abuse and Mental Health Services Administration3 Substance Abuse and Mental Health Services Administration3
Nine of the HHS operating divisions are part of the U.S. Public Health Service (PHS). PHS Nine of the HHS operating divisions are part of the U.S. Public Health Service (PHS). PHS
agencies have diverse missions in support of public health, including the provision of health care agencies have diverse missions in support of public health, including the provision of health care
services and supports (e.g., IHS, HRSA, SAMHSA); the advancement of health care quality and services and supports (e.g., IHS, HRSA, SAMHSA); the advancement of health care quality and
medical research (e.g., AHRQ, NIH); the prevention and control of disease, injury, and medical research (e.g., AHRQ, NIH); the prevention and control of disease, injury, and
environmental health hazards (e.g., CDC, ATSDR); the preparation for and response to disasters environmental health hazards (e.g., CDC, ATSDR); the preparation for and response to disasters
and public health emergencies (e.g., ASPR); and the regulation of food and drugs (e.g., FDA). and public health emergencies (e.g., ASPR); and the regulation of food and drugs (e.g., FDA).
ASPR is the newest operating division at HHS, established effective February 2023.4 Before this ASPR is the newest operating division at HHS, established effective February 2023.4 Before this
transition, ASPR was a staff division within the HHS Office of the Secretary. transition, ASPR was a staff division within the HHS Office of the Secretary.

1 Introduction to the HHS Strategic Plan FY2022-FY2026, https://www.hhs.gov/about/strategic-plan/2022-2026/ 1 Introduction to the HHS Strategic Plan FY2022-FY2026, https://www.hhs.gov/about/strategic-plan/2022-2026/
introduction/index.html. introduction/index.html.
2 See “HHS Organizational Charts Office of Secretary and Divisions,” last reviewed March 11, 2024, 2 See “HHS Organizational Charts Office of Secretary and Divisions,” last reviewed March 11, 2024,
https://www.hhs.gov/about/agencies/orgchart/index.htmlhttps://www.hhs.gov/about/agencies/orgchart/index.html.
3 The FY2025 HHS budget materials include a legislative proposal to rename the Substance Abuse and Mental Health 3 The FY2025 HHS budget materials include a legislative proposal to rename the Substance Abuse and Mental Health
Services Administration (SAMHSA) as the Substance use And Mental Health Services Administration. Throughout Services Administration (SAMHSA) as the Substance use And Mental Health Services Administration. Throughout
those budget materials, SAMHSA is generally referred to using its proposed name. This report continues to use its those budget materials, SAMHSA is generally referred to using its proposed name. This report continues to use its
statutory name. statutory name.
4 On July 22, 2022, HHS announced that the Office of the Assistant Secretary for Preparedness and Response would be 4 On July 22, 2022, HHS announced that the Office of the Assistant Secretary for Preparedness and Response would be
renamed the Administration for Strategic Preparedness and Response (retaining the ASPR acronym) and be established renamed the Administration for Strategic Preparedness and Response (retaining the ASPR acronym) and be established
(continued...) (continued...)
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The three remaining HHS operating divisions—ACF, ACL, and CMS—are not PHS agencies. The three remaining HHS operating divisions—ACF, ACL, and CMS—are not PHS agencies.
ACF and ACL largely administer human services programs focused on the well-being of ACF and ACL largely administer human services programs focused on the well-being of
vulnerable children, families, older Americans, and individuals with disabilities. CMS—which vulnerable children, families, older Americans, and individuals with disabilities. CMS—which
accounts for the largest share of the HHS budget by far—is responsible for administering accounts for the largest share of the HHS budget by far—is responsible for administering
Medicare, Medicaid, and the State Children’s Health Insurance Program (CHIP), in addition to Medicare, Medicaid, and the State Children’s Health Insurance Program (CHIP), in addition to
certain programs related to private health insurance. certain programs related to private health insurance.
(For a summary of each operating division’s mission and links to agency resources related to the (For a summary of each operating division’s mission and links to agency resources related to the
FY2025 budget request, see tFY2025 budget request, see the Appendix.)
Context for the FY2025 President’s Budget Request
The Budget and Accounting Act of 1921 (P.L. 67-13), as amended and later codified at 31 U.S.C. The Budget and Accounting Act of 1921 (P.L. 67-13), as amended and later codified at 31 U.S.C.
§1105, requires the President to submit an annual consolidated federal budget to Congress at the §1105, requires the President to submit an annual consolidated federal budget to Congress at the
beginning of each regular congressional session, not later than the first Monday in February. beginning of each regular congressional session, not later than the first Monday in February.
Many of the proposals in the President’s budget would require changes to laws that govern Many of the proposals in the President’s budget would require changes to laws that govern
mandatory spending levels or policies, which are typically established on a multiyear or levels or policies, which are typically established on a multiyear or
permanent basis. permanent basis. Discretionary spending, however, which is roughly one-third of the requested , however, which is roughly one-third of the requested
funding, is decided and controlled each fiscal year through the annual appropriations process. funding, is decided and controlled each fiscal year through the annual appropriations process.
While Congress is ultimately not required to adopt the President’s proposals or recommendations, While Congress is ultimately not required to adopt the President’s proposals or recommendations,
the submission of the President’s budget typically initiates the congressional budget process and the submission of the President’s budget typically initiates the congressional budget process and
informs Congress of the President’s recommended spending levels for agencies and programs.5 informs Congress of the President’s recommended spending levels for agencies and programs.5
The President’s budget request for FY2025 was submitted on March 11, 2024, about five weeks The President’s budget request for FY2025 was submitted on March 11, 2024, about five weeks
after it was due.after it was due.6 At the time the FY2025 budget request was being developed, discretionary At the time the FY2025 budget request was being developed, discretionary
funding for FY2024 was being provided by a series of temporary continuing resolutions (CRs), funding for FY2024 was being provided by a series of temporary continuing resolutions (CRs),
instead of full-year appropriations acts. Consequently, both the OMB and HHS budget materials instead of full-year appropriations acts. Consequently, both the OMB and HHS budget materials
use estimates for FY2024 that are derived from two sources: use estimates for FY2024 that are derived from two sources:
• For discretionary spending programs, the materials display annualized estimates • For discretionary spending programs, the materials display annualized estimates
of funding provided under FY2024 CRs (P.L. 118-15, P.L. 118-22, P.L. 118-35, of funding provided under FY2024 CRs (P.L. 118-15, P.L. 118-22, P.L. 118-35,
P.L. 118-40). With limited exceptions, these CRs included a formulaic extension P.L. 118-40). With limited exceptions, these CRs included a formulaic extension
of FY2023 funding levels for discretionary HHS programs and activities. of FY2023 funding levels for discretionary HHS programs and activities.
• For mandatory spending programs, the materials generally display estimates of • For mandatory spending programs, the materials generally display estimates of
the amounts expected to be needed for FY2024 based on criteria outlined in the amounts expected to be needed for FY2024 based on criteria outlined in
authorizing law. (For a related discussion, see the “Budgetary Resources versus authorizing law. (For a related discussion, see the “Budgetary Resources versus
Appropriations” section.) Appropriations” section.)
While the estimates of annualized spending under FY2024 CRs may have informed the While the estimates of annualized spending under FY2024 CRs may have informed the
development of the FY2025 budget request, these estimates should not be treated as FY2024 final development of the FY2025 budget request, these estimates should not be treated as FY2024 final
or enacted levels. For this reason, many prior-year comparisons in this report use FY2023 final or enacted levels. For this reason, many prior-year comparisons in this report use FY2023 final
levels rather than FY2024 estimates. levels rather than FY2024 estimates.
~~FY2024 full-year appropriations were enacted in two omnibus appropriations acts almost six~~
~~months into the fiscal year:~~

as an operating division. This reorganization was approved by the HHS Secretary on January 27, 2023, and became as an operating division. This reorganization was approved by the HHS Secretary on January 27, 2023, and became
effective on February 11, 2023. For more information on this reorganization, see HHS, ASPR, “Statement of effective on February 11, 2023. For more information on this reorganization, see HHS, ASPR, “Statement of
Organization, Functions, and Delegations of Authority,” 88Organization, Functions, and Delegations of Authority,” 88 Federal Register 10125-10127, February 16, 2023, 10125-10127, February 16, 2023,
https://www.govinfo.gov/content/pkg/FR-2023-02-16/pdf/2023-03277.pdf. https://www.govinfo.gov/content/pkg/FR-2023-02-16/pdf/2023-03277.pdf.
5 For more information, see CRS Report R47019, 5 For more information, see CRS Report R47019, The Executive Budget Process: An Overview. .
6 On May 22, 2024, a package of amendments to the FY2025 budget request was submitted by the President to Congress (available at https://www.whitehouse.gov/wp-content/uploads/2024/05/FY-2025-Budget-Amendment-Package.pdf). One amendment made changes to the FDA Salaries and Expenses budget account, without affecting the overall budgetary total for the FDA or HHS as a whole. Congressional Research Service Congressional Research Service

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FY2024 full-year appropriations were enacted in two omnibus appropriations acts almost six months into the fiscal year: • The Consolidated Appropriations Act, 2024 (P.L. 118-42) was enacted on March • The Consolidated Appropriations Act, 2024 (P.L. 118-42) was enacted on March
9, 2024. This act provided full-year funding for several HHS entities, including 9, 2024. This act provided full-year funding for several HHS entities, including
the FDA, IHS, and ATSDR.the FDA, IHS, and ATSDR.67
• The Further Consolidated Appropriations Act, 2024 (P.L. 118-47), was • The Further Consolidated Appropriations Act, 2024 (P.L. 118-47), was
subsequently enacted on March 23, 2024. This act contained full-year funding for subsequently enacted on March 23, 2024. This act contained full-year funding for
all remaining portions of HHS subject to the annual appropriations process. all remaining portions of HHS subject to the annual appropriations process.
The overview chapter (“Building a Healthy America”) of the HHS Budget in Brief (BIB) is the The overview chapter (“Building a Healthy America”) of the HHS Budget in Brief (BIB) is the
main source used for the budget numbers in this report.main source used for the budget numbers in this report.78 For the reasons discussed above, this For the reasons discussed above, this
CRS report generally refers to FY2024 funding levels as CRS report generally refers to FY2024 funding levels as estimates. Amounts for earlier years are . Amounts for earlier years are
called called actual or or final. The most recent fiscal year for which actual or final funding is available is . The most recent fiscal year for which actual or final funding is available is
FY2023. FY2023.
Overview of the FY2025 HHS Budget Request
Under the President’s budget request, HHS would spend an estimated $1.802 trillion in Under the President’s budget request, HHS would spend an estimated $1.802 trillion in ~~outlays8~~outlays9
in FY2025 (sein FY2025 (see Table 1).910 This is $132 billion (+8%) more than estimated HHS outlays in This is $132 billion (+8%) more than estimated HHS outlays in
FY2024 and $92 billion (+5%) more than actual HHS outlays in FY2023. FY2024 and $92 billion (+5%) more than actual HHS outlays in FY2023.
Historical estimates by the Office of Management and Budget (OMB) indicate that HHS has Historical estimates by the Office of Management and Budget (OMB) indicate that HHS has
accounted for at least 20% of all federal outlays in each year since FY1995.accounted for at least 20% of all federal outlays in each year since FY1995.1011 Most recently, HHS Most recently, HHS
accounted for 28% of all federal outlays in FY2023, and would account for a projected 25% of accounted for 28% of all federal outlays in FY2023, and would account for a projected 25% of
outlays if all proposals in the President’s FY2025 budget request were enacted.outlays if all proposals in the President’s FY2025 budget request were enacted.1112
Table 1. FY2025 President’s Budget Request for HHS
(dollars in millions) (dollars in millions)
FY2024
FY2025
Estimate
Request
FY2021
FY2022
FY2023
(Annualized

Actual
Actual
Actual
CR)
Budget Authority Budget Authority
1,676,029 1,676,029
1,635,534 1,635,534
1,800,628 1,800,628
1,701,408 1,701,408
1,843,677 1,843,677
~~Outlays~~
~~1,466,894~~
~~1,643,127~~
~~1,709,408~~
~~1,669,782~~
~~1,801,536~~

6 7 This bill also provided some funding for the National Institute of Environmental Health Sciences within the HHS This bill also provided some funding for the National Institute of Environmental Health Sciences within the HHS
National Institutes of Health. National Institutes of Health.
78 Other sources were consulted, including other chapters of the FY2025 HHS BIB, various volumes of the FY2025 Other sources were consulted, including other chapters of the FY2025 HHS BIB, various volumes of the FY2025
President’s budget published by OMB, and congressional budget justifications published by HHS operating or staff President’s budget published by OMB, and congressional budget justifications published by HHS operating or staff
divisions. However, each of the tables and figures in this report (excepdivisions. However, each of the tables and figures in this report (except Table 2) was developed using data from the was developed using data from the
“Building a Healthy America” chapter of the FY2025 HHS BIB, https://www.hhs.gov/sites/default/files/fy-2025-“Building a Healthy America” chapter of the FY2025 HHS BIB, https://www.hhs.gov/sites/default/files/fy-2025-
budget-in-brief.pdf. budget-in-brief.pdf.
89 Budget authority is the amount of funding a federal agency is legally authorized to commit or spend; an is the amount of funding a federal agency is legally authorized to commit or spend; an outlay occurs occurs
when funds are actually expended from the Treasury. These terms are discussed in the when funds are actually expended from the Treasury. These terms are discussed in the “HHS Budget by Operating
Division” section of this report. section of this report.
910 This does not account for expected reductions to nonexempt mandatory spending due to sequestration. For further This does not account for expected reductions to nonexempt mandatory spending due to sequestration. For further
information, see OMB, information, see OMB, OMB Report to the Congress on the BBEDCA 251A Sequestration for Fiscal Year 2025, March , March
11, 2024, https://www.whitehouse.gov/wp-content/uploads/2024/03/11, 2024, https://www.whitehouse.gov/wp-content/uploads/2024/03/~~BBEDCA_251A_Sequestration_Report_~~
~~FY2025.pdf.~~
10BBEDCA_251A_Sequestration_Report_FY2025.pdf. 11 OMB Historical Tables of the FY2025 President’s Budget, Table 4.2, “Percentage Distribution of Outlays by OMB Historical Tables of the FY2025 President’s Budget, Table 4.2, “Percentage Distribution of Outlays by
Agency: 1962–2029,” https://www.whitehouse.gov/omb/historical-tables/. Agency: 1962–2029,” https://www.whitehouse.gov/omb/historical-tables/.
1112 Ibid. Ibid.
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Department of Health and Human Services: FY2025 Budget Request

FY2024 FY2025 Estimate Request FY2021 FY2022 FY2023 (Annualized Actual Actual Actual CR) Outlays 1,466,894 1,643,127 1,709,408 1,669,782 1,801,536 Sources: For FY2021 actual, see FY2023 HHS BIB, pp. 13-14, https://www.hhs.gov/sites/default/files/fy-2023-For FY2021 actual, see FY2023 HHS BIB, pp. 13-14, https://www.hhs.gov/sites/default/files/fy-2023-
budget-in-brief.pdf. For FY2022 actual, see FY2024 HHS BIB, pp. 11-12, https://www.hhs.gov/sites/default/files/fy-budget-in-brief.pdf. For FY2022 actual, see FY2024 HHS BIB, pp. 11-12, https://www.hhs.gov/sites/default/files/fy-
2024-budget-in-brief.pdf. For FY2023 actual, FY2024 estimate, and FY2025 request, see FY2025 HHS BIB, pp. 13-2024-budget-in-brief.pdf. For FY2023 actual, FY2024 estimate, and FY2025 request, see FY2025 HHS BIB, pp. 13-
14, https://www.hhs.gov/sites/default/files/fy-2025-budget-in-brief.pdf. 14, https://www.hhs.gov/sites/default/files/fy-2025-budget-in-brief.pdf.
Notes: CR = continuing resolution.CR = continuing resolution. Budget authority is the amount of money a federal agency is legal y authorized is the amount of money a federal agency is legal y authorized
to commit or spend; an to commit or spend; an outlay occurs when funds are actually expended from the Treasury. Final appropriations occurs when funds are actually expended from the Treasury. Final appropriations
levels for FY2024 were unknown during the formulation of the FY2025 budget request. Accordingly, amounts levels for FY2024 were unknown during the formulation of the FY2025 budget request. Accordingly, amounts
shown for FY2024 were estimated based on the annualized CR for discretionary programs and current services shown for FY2024 were estimated based on the annualized CR for discretionary programs and current services
baseline estimates for mandatory spending programs. Amounts for FY2025 reflect all proposals in the President’s baseline estimates for mandatory spending programs. Amounts for FY2025 reflect all proposals in the President’s
budget for both mandatory and discretionary spending programs. In keeping with source materials, amounts in budget for both mandatory and discretionary spending programs. In keeping with source materials, amounts in
this table reflect mandatory sequestration in FY2021-FY2024, but do not reflect estimated effects of this table reflect mandatory sequestration in FY2021-FY2024, but do not reflect estimated effects of
sequestration for FY2025. sequestration for FY2025.
Figure 1 displays proposed FY2025 HHS outlays by major program or spending category in the displays proposed FY2025 HHS outlays by major program or spending category in the
President’s request. As this figure shows, mandatory spending typically accounts for the vast President’s request. As this figure shows, mandatory spending typically accounts for the vast
majority of the HHS budget.majority of the HHS budget.1213 Two mandatory spending programs—Medicare and Medicaid—are Two mandatory spending programs—Medicare and Medicaid—are
expected to account for 85% of all estimated HHS spending in FY2025. Medicare and Medicaid expected to account for 85% of all estimated HHS spending in FY2025. Medicare and Medicaid
are are entitlement programs, meaning the federal government is required to make mandatory programs, meaning the federal government is required to make mandatory
payments to individuals, states, or other entities based on criteria established in authorizing law.payments to individuals, states, or other entities based on criteria established in authorizing law.1314
This figure also shows that discretionary spending accounts for about 9% of estimated FY2025 This figure also shows that discretionary spending accounts for about 9% of estimated FY2025
HHS outlays in the President’s request. Although discretionary spending represents a relatively HHS outlays in the President’s request. Although discretionary spending represents a relatively
small share of total HHS spending, the department nevertheless receives more discretionary small share of total HHS spending, the department nevertheless receives more discretionary
funding than most federal departments. According to OMB data, HHS accounted for 7% of all funding than most federal departments. According to OMB data, HHS accounted for 7% of all
discretionary budget authority across the government in FY2023.discretionary budget authority across the government in FY2023.1415 The Department of Defense The Department of Defense
was the only federal agency to account for a larger share of all discretionary budget authority in was the only federal agency to account for a larger share of all discretionary budget authority in
that year (46%). that year (46%).
~~Figure 1. Proposed FY2025 HHS Outlays by Major Program or Spending Category~~

Source: Prepared by the Congressional Research Service (CRS) based on data presented on page 17 of the
~~FY2025 HHS BIB, https://www.hhs.gov/sites/default/files/fy-2025-budget-in-brief.pdf.~~

12 13 The terms The terms mandatory spending and and discretionary spending are discussed in the are discussed in the “Budgetary Resources Versus
Appropriations” section of this report. section of this report.
1314 For more information on how these entitlement programs are financed, see CRS Report R40425, For more information on how these entitlement programs are financed, see CRS Report R40425, Medicare Primer; ;
and CRS Report R42640, and CRS Report R42640, Medicaid Financing and Expenditures. .
1415 OMB Historical Tables of the FY2025 President’s Budget, Table 5.5, “Percentage Distribution of Discretionary OMB Historical Tables of the FY2025 President’s Budget, Table 5.5, “Percentage Distribution of Discretionary
Budget Authority by Agency: 1976–2029,” https://www.whitehouse.gov/omb/historical-tables/. Budget Authority by Agency: 1976–2029,” https://www.whitehouse.gov/omb/historical-tables/.
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Figure 1. Proposed FY2025 HHS Outlays by Major Program or Spending Category Source: Prepared by the Congressional Research Service (CRS) based on data presented on page 17 of the FY2025 HHS BIB, https://www.hhs.gov/sites/default/files/fy-2025-budget-in-brief.pdf. Notes: Percentages may not sum to 100 due to rounding. For mandatory spending, outlays reflect proposed law Percentages may not sum to 100 due to rounding. For mandatory spending, outlays reflect proposed law
spending levels, not the current services baseline. spending levels, not the current services baseline.
Budgetary Resources Versus Appropriations
The HHS budget reflects funding from a broad set of budgetary resources. These include, but are The HHS budget reflects funding from a broad set of budgetary resources. These include, but are
not limited to, amounts provided to HHS through the annual appropriations process. In some not limited to, amounts provided to HHS through the annual appropriations process. In some
cases, amounts shown in FY2025 HHS budget materials (including amounts for prior years) will cases, amounts shown in FY2025 HHS budget materials (including amounts for prior years) will
not match amounts provided to HHS by annual appropriations acts and displayed in not match amounts provided to HHS by annual appropriations acts and displayed in
accompanying congressional documents. There are several reasons for this, discussed briefly accompanying congressional documents. There are several reasons for this, discussed briefly
below. below.
Mandatory and Discretionary Spending
Certain budget documents may show only discretionary spending, while others may also show Certain budget documents may show only discretionary spending, while others may also show
some or all types of mandatory spending. some or all types of mandatory spending. Mandatory spending makes up a large portion of the makes up a large portion of the
HHS budget. Whereas all HHS budget. Whereas all discretionary spending is controlled and provided through the annual is controlled and provided through the annual
appropriations process, all appropriations process, all mandatory spending is controlled by the program’s authorizing statute. is controlled by the program’s authorizing statute.
In most cases, that authorizing statute also provides the funding for the program (e.g., State In most cases, that authorizing statute also provides the funding for the program (e.g., State
Children’s Health Insurance Program). However, the budget authority for some mandatory Children’s Health Insurance Program). However, the budget authority for some mandatory
programs (including Medicaid), while controlled by criteria in the authorizing statute, must still programs (including Medicaid), while controlled by criteria in the authorizing statute, must still
be provided through the annual appropriations process; such programs are commonly referred to be provided through the annual appropriations process; such programs are commonly referred to
as as appropriated entitlements or or appropriated mandatories. .
HHS in the Appropriations Process
The HHS budget request accounts for the department as a whole, while the appropriations process The HHS budget request accounts for the department as a whole, while the appropriations process
divides HHS funding across three different appropriations bills. Most of the department’s divides HHS funding across three different appropriations bills. Most of the department’s
appropriations are provided through the Departments of Labor, Health and Human Services, and appropriations are provided through the Departments of Labor, Health and Human Services, and
Education, and Related Agencies (LHHS) Appropriations Act. However, funding for certain HHS Education, and Related Agencies (LHHS) Appropriations Act. However, funding for certain HHS
agencies and activities is provided in two other bills—the Department of the Interior, agencies and activities is provided in two other bills—the Department of the Interior,
Environment, and Related Agencies Appropriations Act (INT) and the Agriculture, Rural Environment, and Related Agencies Appropriations Act (INT) and the Agriculture, Rural
Congressional Research Service 5 link to page 9 link to page 9 link to page 9 Department of Health and Human Services: FY2025 Budget Request Development, Food and Drug Administration, and Related Agencies Appropriations Act (AG). Development, Food and Drug Administration, and Related Agencies Appropriations Act (AG).
Table 2 lists HHS agencies by appropriations bill. Each of these three appropriations acts lists HHS agencies by appropriations bill. Each of these three appropriations acts
provides discretionary HHS funding. In some cases, these acts also provide the necessary funding provides discretionary HHS funding. In some cases, these acts also provide the necessary funding
for appropriated mandatories at HHS. However, authorizing laws provide funding for other for appropriated mandatories at HHS. However, authorizing laws provide funding for other
mandatory spending programs. mandatory spending programs.
Table 2. HHS Agencies by Appropriations Bill
Appropriations Bill
HHS Agencies Funded in the Bill
Agriculture, Rural Development, Food and Drug Agriculture, Rural Development, Food and Drug
• •
Food and Drug Administration Food and Drug Administration
Administration, and Related Agencies Administration, and Related Agencies (AG) (AG)
Department of the Interior, Environment, and Related Department of the Interior, Environment, and Related
• •
Indian Health Service Indian Health Service
Agencies Agencies (INT(INT)a
• •
Agency for Toxic Substances and Disease Registry Agency for Toxic Substances and Disease Registry
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~~Appropriations Bill~~
~~HHS Agencies Funded in the Bill~~
Departments of Labor, Health and Human Services, and • Departments of Labor, Health and Human Services, and •
Health Resources and Services Administration Health Resources and Services Administration
Education, and Related Agencies Education, and Related Agencies (LHHS)(LHHS)
• •
Centers for Disease Control and Prevention Centers for Disease Control and Prevention
• •
National Institutes of Heal National Institutes of Healtha
• •
Substance Abuse and Mental Health Services Substance Abuse and Mental Health Services
Administration Administration
• •
Agency for Healthcare Research and Quality Agency for Healthcare Research and Quality
• •
Centers for Medicare & Medicaid Services Centers for Medicare & Medicaid Services
• •
Administration for Children and Families Administration for Children and Families
• •
Administration for Community Living Administration for Community Living
• •
Administration for Strategic Preparedness and Administration for Strategic Preparedness and
Response Response
• •
Office of the Secretary Office of the Secretary
Source: CRS. For more information, see CRS Report R40858, CRS. For more information, see CRS Report R40858, Locate an Agency or Program Within Appropriations
Bills. .
a. Funding for NIH comes primarily from the LHHS appropriations bil , with an additional amount for a. Funding for NIH comes primarily from the LHHS appropriations bil , with an additional amount for
Superfund-related activities provided as part of the INT appropriations bil . Superfund-related activities provided as part of the INT appropriations bil .
Proposed Law and Current Law Estimates for Mandatory Programs
HHS budget materials may include two different estimates for mandatory spending programs HHS budget materials may include two different estimates for mandatory spending programs
when appropriate: when appropriate: proposed law and and current law. The . The proposed law estimates take into account estimates take into account
changes in mandatory spending proposed in the FY2025 HHS budget request. Such proposals changes in mandatory spending proposed in the FY2025 HHS budget request. Such proposals
would generally need to be enacted into law to affect the budgetary resources ultimately available would generally need to be enacted into law to affect the budgetary resources ultimately available
to the mandatory spending program.to the mandatory spending program.1516 HHS materials may also show a HHS materials may also show a current law or or current
services estimate for mandatory spending programs. These estimates assume that no changes will estimate for mandatory spending programs. These estimates assume that no changes will
be made to existing policies, and instead estimate mandatory spending for programs based on be made to existing policies, and instead estimate mandatory spending for programs based on
criteria established in current authorizing law. The HHS budget estimates in this report reflect the criteria established in current authorizing law. The HHS budget estimates in this report reflect the
proposed law estimates for mandatory spending programs; readers should be aware that other proposed law estimates for mandatory spending programs; readers should be aware that other
HHS, OMB, or congressional estimates might reflect current law instead. HHS, OMB, or congressional estimates might reflect current law instead.
~~User Fees and Other Types of Collections~~
~~In some cases, agencies within HHS have the authority to expend user fees and other types of~~
~~collections that effectively supplement their appropriations. In addition, agencies may receive~~
~~transfers of budgetary resources from other sources, such as from the Public Health Service~~
~~Evaluation Set-Aside (also referred to as the PHS Tap) or one of the mandatory funds established~~
~~by the Patient Protection and Affordable Care Act (ACA; P.L. 111-148, as amended).16 Budgetary~~
~~totals that account for these sorts of resources in the HHS estimates are often referred to as being~~
~~at the program level. HHS agencies that have historically had notable differences between the~~

15 16 For a list of some HHS legislative proposals for mandatory spending programs in the FY2025 President’s budget, see For a list of some HHS legislative proposals for mandatory spending programs in the FY2025 President’s budget, see
Summary Table S–6 in OMB, Summary Table S–6 in OMB, Budget of the United States Government, Fiscal Year 2025,
https://www.whitehouse.gov/wp-content/uploads/2024/03/budget_fy2025.pdf. This table lists mandatory proposals (but https://www.whitehouse.gov/wp-content/uploads/2024/03/budget_fy2025.pdf. This table lists mandatory proposals (but
not discretionary proposals) by federal department and shows the estimated not discretionary proposals) by federal department and shows the estimated dollar change from current law levels from current law levels
should the proposal be enacted. (The table does not show the actual proposed funding level.) For additional should the proposal be enacted. (The table does not show the actual proposed funding level.) For additional
information, see the applicable operating division chapters of the HHS Budget in Brief or congressional justifications. information, see the applicable operating division chapters of the HHS Budget in Brief or congressional justifications.
~~16 For further information, see CRS Report R47936,~~ ~~Labor, Health and Human Services, and Education: FY2024~~
~~Appropriations~~.
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Congressional Research Service 6 Department of Health and Human Services: FY2025 Budget Request User Fees and Other Types of Collections In some cases, agencies within HHS have the authority to expend user fees and other types of collections that effectively supplement their appropriations. In addition, agencies may receive transfers of budgetary resources from other sources, such as from the Public Health Service Evaluation Set-Aside (also referred to as the PHS Tap) or one of the mandatory funds established by the Patient Protection and Affordable Care Act (ACA; P.L. 111-148, as amended).17 Budgetary totals that account for these sorts of resources in the HHS estimates are often referred to as being at the program level. HHS agencies that have historically had notable differences between the amounts in the appropriations bills and their program level include, for instance, FDA (due to amounts in the appropriations bills and their program level include, for instance, FDA (due to
user fees) and AHRQ (due to transfers).user fees) and AHRQ (due to transfers).1718
Scorekeeping and Display Conventions
The Administration may choose to follow different conventions than those of congressional The Administration may choose to follow different conventions than those of congressional
scorekeepers for its estimates of HHS programs. For example, certain transfers of funding scorekeepers for its estimates of HHS programs. For example, certain transfers of funding
between HHS agencies (or from HHS to other federal agencies) that occurred in prior fiscal years, between HHS agencies (or from HHS to other federal agencies) that occurred in prior fiscal years,
or are expected to occur in the current fiscal year, may be accounted for in the Administration’s or are expected to occur in the current fiscal year, may be accounted for in the Administration’s
estimates but not necessarily in the congressional documents. estimates but not necessarily in the congressional documents.
Sequestration
The Balanced Budget and Emergency Deficit Control Act of 1985 (BBEDCA) provides a The Balanced Budget and Emergency Deficit Control Act of 1985 (BBEDCA) provides a
mechanism (mechanism (sequestration) to reduce mandatory spending in each fiscal year beginning with ) to reduce mandatory spending in each fiscal year beginning with
FY2013 and continuing through FY2032.FY2013 and continuing through FY2032.1819 On March 11, 2024, concurrent with the release of the On March 11, 2024, concurrent with the release of the
President’s budget submission, President Biden issued the required FY2025 sequestration order, President’s budget submission, President Biden issued the required FY2025 sequestration order,
calling for nonexempt mandatory spending to be reduced on October 1, 2024.calling for nonexempt mandatory spending to be reduced on October 1, 2024.1920 FY2025 FY2025
sequestration will equal 2% of nonexempt spending from Medicare and certain other health sequestration will equal 2% of nonexempt spending from Medicare and certain other health
programs and 5.7% of other nonexempt nondefense mandatory spending. OMB calculated that programs and 5.7% of other nonexempt nondefense mandatory spending. OMB calculated that
this will equal a total government-wide reduction in this category of spending of $29.3 billion in this will equal a total government-wide reduction in this category of spending of $29.3 billion in
budget authority in FY2025.budget authority in FY2025.2021 OMB attributed the majority of this amount, $21.8 billion, to HHS OMB attributed the majority of this amount, $21.8 billion, to HHS
reductions to Medicare. (OMB also estimated a reduction of $2.1 billion (-8.3%), in nonexempt reductions to Medicare. (OMB also estimated a reduction of $2.1 billion (-8.3%), in nonexempt
defense mandatory spending, which does not affect HHS funds.) defense mandatory spending, which does not affect HHS funds.)
~~By convention, HHS budget materials for FY2025 generally reflect sequestration for mandatory~~
~~spending programs in prior years (FY2023-FY2024), but do not reflect estimated effects of~~
~~mandatory sequestration for the budget year (FY2025). The numbers in this report reflect this~~
~~convention.~~
~~HHS Budget by Operating Division~~
~~Figure 2~~ ~~provides a breakdown of the FY2025 HHS budget request by operating division. When~~
~~taking into account mandatory and discretionary budget authority (i.e., total budget authority),~~
~~CMS accounts for the largest share of the request at $1.6 trillion. The majority of the CMS budget~~
~~request would go toward mandatory spending programs, such as Medicare and Medicaid. Under~~

17 17 For further information, see CRS Report R47936, Labor, Health and Human Services, and Education: FY2024 Appropriations. 18 The program level for each agency is listed in the table entitled “Composition of the HHS Budget Discretionary The program level for each agency is listed in the table entitled “Composition of the HHS Budget Discretionary
Programs” in the FY2025 HHS BIB. Programs” in the FY2025 HHS BIB.
1819 As originally enacted, mandatory sequestration was scheduled to run through FY2021, but this period has As originally enacted, mandatory sequestration was scheduled to run through FY2021, but this period has
subsequently been incrementally extended. For further information about these extensions, see the Appendix of CRS subsequently been incrementally extended. For further information about these extensions, see the Appendix of CRS
Report R47936, Report R47936, Labor, Health and Human Services, and Education: FY2024 Appropriations. For further information . For further information
about sequestration, see CRS Report R42972, about sequestration, see CRS Report R42972, Sequestration as a Budget Enforcement Process: Frequently Asked
Questions. .
1920 Sequestration Order for Fiscal Year 2025 Pursuant to Section 251A of the Balanced Budget and Emergency Deficit Sequestration Order for Fiscal Year 2025 Pursuant to Section 251A of the Balanced Budget and Emergency Deficit
Control Act, as Amended, Control Act, as Amended, 8889 Federal Register 18531, March 14, 2024, p. 18531, https://www.govinfo.gov/content/ 18531, March 14, 2024, p. 18531, https://www.govinfo.gov/content/
pkg/FR-2024-03-14/pdf/2024-05600.pdf. pkg/FR-2024-03-14/pdf/2024-05600.pdf.
2021 OMB, OMB, OMB Report to the Congress on the BBEDCA 251A Sequestration for Fiscal Year 2025, March 11, 2024, , March 11, 2024,
https://www.whitehouse.gov/wp-content/uploads/2024/03/BBEDCA_251A_Sequestration_Report_FY2025.pdf. See https://www.whitehouse.gov/wp-content/uploads/2024/03/BBEDCA_251A_Sequestration_Report_FY2025.pdf. See
the report’s appendix for an itemized list of budget accounts that include mandatory spending subject to sequestration the report’s appendix for an itemized list of budget accounts that include mandatory spending subject to sequestration
in FY2025, the dollar amounts subject to sequestration (based on OMB’s current law baseline), the percentage by in FY2025, 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 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 level, the sequester itself is implemented at the program,, project,, oror activity level. level.
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link to page 12 Department of Health and Human Services: FY2025 Budget Request By convention, HHS budget materials for FY2025 generally reflect sequestration for mandatory spending programs in prior years (FY2023-FY2024), but do not reflect estimated effects of mandatory sequestration for the budget year (FY2025). The numbers in this report reflect this convention. HHS Budget by Operating Division Figure 2 provides a breakdown of the FY2025 HHS budget request by operating division. When taking into account mandatory and discretionary budget authority (i.e., total budget authority), CMS accounts for the largest share of the request at $1.6 trillion. The majority of the CMS budget request would go toward mandatory spending programs, such as Medicare and Medicaid. Under ~~Department of Health and Human Services: FY2025 Budget Request~~

the President’s budget, spending on Medicare and Medicaid is expected to increase relative to the President’s budget, spending on Medicare and Medicaid is expected to increase relative to
FY2024 levels in terms of current law estimates, and to a slightly greater degree under proposed FY2024 levels in terms of current law estimates, and to a slightly greater degree under proposed
law estimates. However, when looking exclusively at discretionary budget authority, funding for law estimates. However, when looking exclusively at discretionary budget authority, funding for
CMS is comparatively smaller, accounting for $4.3 billion of the HHS discretionary request. CMS is comparatively smaller, accounting for $4.3 billion of the HHS discretionary request.
Discretionary CMS funds primarily support program operations and federal administrative Discretionary CMS funds primarily support program operations and federal administrative
activities, though some funds also go toward efforts to reduce health care fraud and abuse. activities, though some funds also go toward efforts to reduce health care fraud and abuse.
The largest share of the HHS discretionary request would go to the PHS operating divisions: The largest share of the HHS discretionary request would go to the PHS operating divisions:
$86.6 billion in combined public health funding for FDA, HRSA, IHS, CDC, ATSDR, NIH, $86.6 billion in combined public health funding for FDA, HRSA, IHS, CDC, ATSDR, NIH,
SAMHSA, AHRQ, and ASPR. NIH would receive the largest amount of discretionary budget SAMHSA, AHRQ, and ASPR. NIH would receive the largest amount of discretionary budget
authority of any single HHS operating division: $46.4 billion. The majority of the proposed NIH authority of any single HHS operating division: $46.4 billion. The majority of the proposed NIH
budget would support biomedical research performed by hospitals, medical schools, universities, budget would support biomedical research performed by hospitals, medical schools, universities,
and other research institutions around the country.and other research institutions around the country.2122
ACF would receive the second-largest discretionary funding level among the HHS operating ACF would receive the second-largest discretionary funding level among the HHS operating
divisions: $31.4 billion. The majority of the discretionary ACF request (56%) would go to early divisions: $31.4 billion. The majority of the discretionary ACF request (56%) would go to early
childhood care and education programs, such as Head Start and the Child Care and Development childhood care and education programs, such as Head Start and the Child Care and Development
Block Grant.Block Grant.2223

2122 FY2025 HHS BIB, p. 54 FY2025 HHS BIB, p. 54. 23
22 Calculated by CRS based on data presented on pages 129-130 of the FY2025 HHS BIB. Calculated by CRS based on data presented on pages 129-130 of the FY2025 HHS BIB.
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Department of Health and Human Services: FY2025 Budget Request

Figure 2. FY2025 President’s Request for HHS by Operating Division

Source: Prepared by the Congressional Research Service (CRS) based on data presented on pages 13-16 of the Prepared by the Congressional Research Service (CRS) based on data presented on pages 13-16 of the
FY2025 HHS BIB, https://www.hhs.gov/sites/default/files/fy-2025-budget-in-brief.pdf. The amounts displayed as FY2025 HHS BIB, https://www.hhs.gov/sites/default/files/fy-2025-budget-in-brief.pdf. The amounts displayed as
total budget authority include mandatory and discretionary funds. The bar representing the combined mandatory include mandatory and discretionary funds. The bar representing the combined mandatory
and discretionary total for CMS has been abbreviated due to space constraints. (When taking into account both and discretionary total for CMS has been abbreviated due to space constraints. (When taking into account both
mandatory and discretionary funding, CMS receives over 17 times the funding proposed for ACF.) The HHS BIB mandatory and discretionary funding, CMS receives over 17 times the funding proposed for ACF.) The HHS BIB
sources the OMB Budget Appendix for the total budget authority amounts shown above and cautions that these sources the OMB Budget Appendix for the total budget authority amounts shown above and cautions that these
amounts “potentially differ from the levels displayed” elsewhere in the BIB. HHS does not use the same amounts “potentially differ from the levels displayed” elsewhere in the BIB. HHS does not use the same
disclaimer for the discretionary budget authority levels shown in the BIB and above, meaning that the disclaimer for the discretionary budget authority levels shown in the BIB and above, meaning that the
methodology used to calculate and present these numbers may differ from that used by HHS in calculating total methodology used to calculate and present these numbers may differ from that used by HHS in calculating total
budget authority. For this reason, the figure should be viewed as il ustrative. budget authority. For this reason, the figure should be viewed as il ustrative.
Notes: Acronyms listed on page 1 of this report. Amounts for mandatory spending programs are based on the Acronyms listed on page 1 of this report. Amounts for mandatory spending programs are based on the
President’s proposed law baseline, not the current services baseline. Amounts for discretionary spending President’s proposed law baseline, not the current services baseline. Amounts for discretionary spending
programs have not been adjusted to reflect the effects of proposed rescissions or other cancel ations of budget programs have not been adjusted to reflect the effects of proposed rescissions or other cancel ations of budget
authority. Amounts in this figure exclude funding for the HHS staff divisions within the Office of the Secretary authority. Amounts in this figure exclude funding for the HHS staff divisions within the Office of the Secretary
and estimates for several mandatory spending proposals that were listed separately from the operating divisions and estimates for several mandatory spending proposals that were listed separately from the operating divisions
in the HHS BIB. in the HHS BIB.
Table 3 puts the FY2025 request for each HHS operating division and the Office of the Secretary puts the FY2025 request for each HHS operating division and the Office of the Secretary
(OS) into context, displaying it along with estimates of funding provided over the four prior fiscal (OS) into context, displaying it along with estimates of funding provided over the four prior fiscal
years (FY2021-FY2024). These totals are inclusive of both mandatory and discretionary funding. years (FY2021-FY2024). These totals are inclusive of both mandatory and discretionary funding.
The amounts in this table are shown in terms of budget authority (BA) and outlays. The amounts in this table are shown in terms of budget authority (BA) and outlays. BA is the is the
authority provided by federal law to enter into contracts or other financial obligations that will authority provided by federal law to enter into contracts or other financial obligations that will
result in immediate or future expenditures involving federal government funds. result in immediate or future expenditures involving federal government funds. Outlays occur occur
when funds are actually expended from the Treasury; they could be the result of either new when funds are actually expended from the Treasury; they could be the result of either new
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budget authority enacted in the current fiscal year or unexpended budget authority that was budget authority enacted in the current fiscal year or unexpended budget authority that was
enacted in previous fiscal years. The rate at which outlays occur often is dependent on the enacted in previous fiscal years. The rate at which outlays occur often is dependent on the
purpose of the funding and the timeline for which expenditures are to occur. (For example, purpose of the funding and the timeline for which expenditures are to occur. (For example,
outlays for salaries and expenses tend to happen at a more rapid rate than those for multiyear outlays for salaries and expenses tend to happen at a more rapid rate than those for multiyear
projects.) In addition, as outlays over the course of a fiscal year may occur from funds enacted projects.) In addition, as outlays over the course of a fiscal year may occur from funds enacted
over a series of fiscal years, they may be more or less than the amount of budget authority newly over a series of fiscal years, they may be more or less than the amount of budget authority newly
enacted for that fiscal year. As a consequence, the BA and outlays in this table represent two enacted for that fiscal year. As a consequence, the BA and outlays in this table represent two
different ways of accounting for the funding that is provided to each HHS agency through the different ways of accounting for the funding that is provided to each HHS agency through the
federal budget process. For examplefederal budget process. For example, Table 3 shows $16.6 billion in FY2025 BA for HRSA, but shows $16.6 billion in FY2025 BA for HRSA, but
an estimated $18.8 billion in FY2025 HRSA outlays, reflecting the expected expenditure of funds an estimated $18.8 billion in FY2025 HRSA outlays, reflecting the expected expenditure of funds
previously provided to the agency in addition to some funds that are expected to be newly enacted previously provided to the agency in addition to some funds that are expected to be newly enacted
in FY2025. in FY2025.
Amounts shown for the OS were calculated using funding levels in HHS BIBs for several staff Amounts shown for the OS were calculated using funding levels in HHS BIBs for several staff
divisions, accounts, and activities under the OS.divisions, accounts, and activities under the OS.2324 They also include estimates for several They also include estimates for several
mandatory spending proposals that were listed separately from the operating divisions in the front mandatory spending proposals that were listed separately from the operating divisions in the front
tables of the HHS BIB, such as the Defense Production Act Medical Supplies Enhancement, PrEP tables of the HHS BIB, such as the Defense Production Act Medical Supplies Enhancement, PrEP
Delivery Program to End the HIV Epidemic, Mental Health Transformation Fund, Public Health Delivery Program to End the HIV Epidemic, Mental Health Transformation Fund, Public Health
Resilience, National Hepatitis C Elimination Program, Antimicrobial Subscriptions, and Resilience, National Hepatitis C Elimination Program, Antimicrobial Subscriptions, and
Customer Experience. Customer Experience.
Table 3. HHS Budget by Operating and Staff Division
(mandatory and discretionary spending combined, dollars in millions) (mandatory and discretionary spending combined, dollars in millions)
FY2024
Estimate
FY2021
FY2022
FY2023
(Annualized
FY2025
Operating Division
Actual
Actual
Actual
CR)a
Request
FDA

Budget Authority (BA) Budget Authority (BA)
3,765 3,765
4,379 4,379
2,706 2,706
3,644 3,644
3,806 3,806
Outlays Outlays
3,303 3,303
4,588 4,588
2,882 2,882
4,573 4,573
3,973 3,973
HRSA

BA BA
21,733 21,733
13,566 13,566
14,584 14,584
16,465 16,465
16,640 16,640
Outlays Outlays
14,232 14,232
16,128 16,128
15,883 15,883
15,953 15,953
18,790 18,790
IHS

BA BA
13,794 13,794
7,442 7,442
7,881 7,881
13,287 13,287
8,931 8,931
Outlays Outlays
9,866 9,866
6,507 6,507
7,292 7,292
8,415 8,415
9,424 9,424
CDCb

BA BA
28,511 28,511
9,156 9,156
9,672 9,672
10,588 10,588
11,507 11,507
Outlays Outlays
11,269 11,269
16,526 16,526
12,278 12,278
14,697 14,697
15,658 15,658

2324 These include Departmental Management, Nonrecurring Expenses Fund, Office of Medicare Hearings and Appeals, These include Departmental Management, Nonrecurring Expenses Fund, Office of Medicare Hearings and Appeals,
Office of the National Coordinator for Health Information Technology, Office for Civil Rights, Office of Inspector Office of the National Coordinator for Health Information Technology, Office for Civil Rights, Office of Inspector
General, Public Health and Social Services Emergency Fund, Program Support Center (including retirement pay, General, Public Health and Social Services Emergency Fund, Program Support Center (including retirement pay,
medical benefits, and miscellaneous trust funds), the No Surprises Implementation Fund, and certain collections medical benefits, and miscellaneous trust funds), the No Surprises Implementation Fund, and certain collections
credited to that office or the department. credited to that office or the department.
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FY2024
Estimate
FY2021
FY2022
FY2023
(Annualized
FY2025
Operating Division
Actual
Actual
Actual
CR)a
Request
NIH

BA BA
42,186 42,186
45,415 45,415
48,927 48,927
47,669 47,669
49,790 49,790
Outlays Outlays
38,868 38,868
40,623 40,623
46,507 46,507
46,419 46,419
46,638 46,638
SAMHSA

BA BA
13,674 13,674
6,724 6,724
7,567 7,567
7,545 7,545
8,158 8,158
Outlays Outlays
5,910 5,910
7,384 7,384
8,261 8,261
9,235 9,235
9,813 9,813
AHRQ

BA BA
337 337
350 350
374 374
374 374
387 387
Outlays Outlays
329 329
339 339
349 349
381 381
375 375
CMSc

BA BA
1,296,727 1,296,727
1,471,167 1,471,167
1,634,038 1,634,038
1,518,687 1,518,687
1,603,501 1,603,501
Outlays Outlays
1,240,623 1,240,623
1,370,675 1,370,675
1,490,112 1,490,112
1,458,603 1,458,603
1,580,706 1,580,706
ACF

BA BA
122,521 122,521
73,556 73,556
78,371 78,371
71,172 71,172
91,755 91,755
Outlays Outlays
70,079 70,079
85,702 85,702
88,739 88,739
82,979 82,979
89,979 89,979
ACL

BA BA
4,221 4,221
2,293 2,293
2,524 2,524
2,509 2,509
2,579 2,579
Outlays Outlays
2,662 2,662
2,720 2,720
3,013 3,013
3,489 3,489
3,104 3,104
ASPRd

BA BA
- -
- -
- -
- -
3,768 3,768
Outlays Outlays
- -
- -
- -
- -
926 926
Office of the Secretarye

BA BA
128,560 128,560
1,486 1,486
-6,016 -6,016
9,468 9,468
42,855 42,855
Outlays Outlays
69,753 69,753
91,935 91,935
34,092 34,092
25,038 25,038
22,150 22,150
Total, HHS

BA
1,676,029
1,635,534
1,800,628
1,701,408
1,843,677
Outlays
1,466,894
1,643,127
1,709,408
1,669,782
1,801,536
Sources: For FY2021 actual, see FY2023 HHS BIB, pp. 13-14, https://www.hhs.gov/sites/default/files/fy-2023-For FY2021 actual, see FY2023 HHS BIB, pp. 13-14, https://www.hhs.gov/sites/default/files/fy-2023-
budget-in-brief.pdf. For FY2022 actual, see FY2024 HHS BIB, pp. 11-12, https://www.hhs.gov/sites/default/files/fy-budget-in-brief.pdf. For FY2022 actual, see FY2024 HHS BIB, pp. 11-12, https://www.hhs.gov/sites/default/files/fy-
2024-budget-in-brief.pdf. For FY2023 actual, FY2024 estimate, and FY2025 request, see FY2025 HHS BIB, pp. 13-16, 2024-budget-in-brief.pdf. For FY2023 actual, FY2024 estimate, and FY2025 request, see FY2025 HHS BIB, pp. 13-16,
https://www.hhs.gov/sites/default/files/fy-2025-budget-in-brief.pdf. https://www.hhs.gov/sites/default/files/fy-2025-budget-in-brief.pdf.
Notes: Totals are as reported in HHS BIBs.Totals are as reported in HHS BIBs. The HHS BIBs source the Budget Appendix prepared by the Office The HHS BIBs source the Budget Appendix prepared by the Office
of Management and Budget for the BA amounts shown in these particular BIB tables. HHS cautions that these of Management and Budget for the BA amounts shown in these particular BIB tables. HHS cautions that these
amounts “potentially differ from the levels displayed in the individual Operating or Staff Division Chapters.” amounts “potentially differ from the levels displayed in the individual Operating or Staff Division Chapters.”
Totals may not sum due to rounding and, in prior years, may reflect some adjustments for comparability. Totals may not sum due to rounding and, in prior years, may reflect some adjustments for comparability.
Amounts for FY2025 reflect all proposals in the President’s budget for both mandatory and discretionary Amounts for FY2025 reflect all proposals in the President’s budget for both mandatory and discretionary
spending programs. In keeping with source materials, amounts in this table reflect sequestration for mandatory spending programs. In keeping with source materials, amounts in this table reflect sequestration for mandatory
spending programs in FY2021-FY2024, but do not reflect estimated effects of mandatory sequestration for spending programs in FY2021-FY2024, but do not reflect estimated effects of mandatory sequestration for
FY2025. FY2025.
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a. FY2024 funding levels in the FY2025 BIB are annualized estimates of funding provided by FY2024 continuing a. FY2024 funding levels in the FY2025 BIB are annualized estimates of funding provided by FY2024 continuing
resolutions for programs and activities funded by the annual appropriations process. For mandatory resolutions for programs and activities funded by the annual appropriations process. For mandatory
spending provided outside the annual appropriations process, funding levels generally reflect amounts spending provided outside the annual appropriations process, funding levels generally reflect amounts
provided by authorizing law. In cases where ful -year funding had not yet been provided in authorizing law, provided by authorizing law. In cases where ful -year funding had not yet been provided in authorizing law,
these levels are based on annualized amounts provided in the most recent short-term funding extension in these levels are based on annualized amounts provided in the most recent short-term funding extension in
effect at the time that the budget formulation process was completed. effect at the time that the budget formulation process was completed.
b. By HHS convention, the amounts shown for CDC include funding for ATSDR. b. By HHS convention, the amounts shown for CDC include funding for ATSDR.
c. Per source materials, the budget authority for CMS includes non-CMS budget authority for Hospital c. Per source materials, the budget authority for CMS includes non-CMS budget authority for Hospital
Insurance and Supplementary Medical Insurance for the Social Security Administration and the Medicare Insurance and Supplementary Medical Insurance for the Social Security Administration and the Medicare
Payment Advisory Commission (MedPAC). Payment Advisory Commission (MedPAC).
d. On February 11, 2023, HHS established ASPR as an operating division named the Administration for d. On February 11, 2023, HHS established ASPR as an operating division named the Administration for
Strategic Preparedness and Response. Funding for the prior entity within the HHS Office of the Secretary, Strategic Preparedness and Response. Funding for the prior entity within the HHS Office of the Secretary,
the Office of the Assistant Secretary for Preparedness and Response, is included in the Office of the the Office of the Assistant Secretary for Preparedness and Response, is included in the Office of the
Secretary funding listed in this table for FY2021-FY2024. Secretary funding listed in this table for FY2021-FY2024.
e. Amounts shown for the OS include estimates for several mandatory spending proposals that were listed e. Amounts shown for the OS include estimates for several mandatory spending proposals that were listed
separately from the operating divisions in the HHS BIB, such as the Defense Production Act Medical separately from the operating divisions in the HHS BIB, such as the Defense Production Act Medical
Supplies Enhancement, PrEP Delivery Program to End the HIV Epidemic, Mental Health Transformation Supplies Enhancement, PrEP Delivery Program to End the HIV Epidemic, Mental Health Transformation
Fund, National Hepatitis C Elimination Program, Antimicrobial Subscriptions, and Customer Experience. Fund, National Hepatitis C Elimination Program, Antimicrobial Subscriptions, and Customer Experience.
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Appendix. HHS Operating Divisions: Missions and
FY2025 Budget Resources
This appendix provides for each operating division a brief summary of its mission,This appendix provides for each operating division a brief summary of its mission,2425 the the
applicable appropriations bill, the FY2025 budget request level, and links to additional resources applicable appropriations bill, the FY2025 budget request level, and links to additional resources
related to that request. related to that request.
Food and Drug Administration (FDA)
The FDA mission is focused on regulating the safety and labeling of human foods, dietary The FDA mission is focused on regulating the safety and labeling of human foods, dietary
supplements, cosmetics, and animal foods; and the safety and effectiveness of human drugs, supplements, cosmetics, and animal foods; and the safety and effectiveness of human drugs,
biological products (e.g., vaccines), medical devices, radiation-emitting products, and animal biological products (e.g., vaccines), medical devices, radiation-emitting products, and animal
drugs. It also regulates tobacco products.drugs. It also regulates tobacco products.2526
Appropriations Bill:
• Agriculture, Rural Development, Food and Drug Administration, and Related • Agriculture, Rural Development, Food and Drug Administration, and Related
Agencies Agencies (AG) (AG)
FY2025 Request:
• BA: $3.806 billion • BA: $3.806 billion
• Outlays: $3.973 billion • Outlays: $3.973 billion
Additional Resources:
• Congressional Justification (all-purpose table on p. 15), https://www.fda.gov/ • Congressional Justification (all-purpose table on p. 15), https://www.fda.gov/
media/176925/download media/176925/download
• BIB chapter (p. 18), https://www.hhs.gov/sites/default/files/fy-2025-budget-in- • BIB chapter (p. 18), https://www.hhs.gov/sites/default/files/fy-2025-budget-in-
brief.pdf#page=24 brief.pdf#page=24
Health Resources and Services Administration (HRSA)
The HRSA mission is focused on providing “equitable health care to people who are The HRSA mission is focused on providing “equitable health care to people who are
geographically isolated and economically or medically vulnerable.”geographically isolated and economically or medically vulnerable.”2627 Among its many programs Among its many programs
and activities, HRSA supports health care workforce training; the National Health Service Corps; and activities, HRSA supports health care workforce training; the National Health Service Corps;
and the federal health centers program, which provides grants to nonprofit entities that provide and the federal health centers program, which provides grants to nonprofit entities that provide
primary care services to people who experience financial, geographic, cultural, or other barriers to primary care services to people who experience financial, geographic, cultural, or other barriers to
health care. health care.
Appropriations Bill:
• LHHS • LHHS
FY2025 Request:
• BA: $16.640 billion • BA: $16.640 billion

2425 The mission summaries below exclude the Office of the Secretary, which comprises multiple staff divisions whose The mission summaries below exclude the Office of the Secretary, which comprises multiple staff divisions whose
goals are to “provide leadership, direction, and policy guidance to the Department.” See HHS Strategic Plan FY2022-goals are to “provide leadership, direction, and policy guidance to the Department.” See HHS Strategic Plan FY2022-
2026, Introduction: About HHS, https://www.hhs.gov/about/strategic-plan/2022-2026/overview/index.html. 2026, Introduction: About HHS, https://www.hhs.gov/about/strategic-plan/2022-2026/overview/index.html.
2526 FDA, FDA, What Does FDA Do, https://www.fda.gov/about-fda/what-we-do. , https://www.fda.gov/about-fda/what-we-do.
2627 HRSA, HRSA, About HRSA, https://www.hrsa.gov/about/index.html. , https://www.hrsa.gov/about/index.html.
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• Outlays: $18.790 billion • Outlays: $18.790 billion
Additional Resources:
• Congressional Justification (all-purpose table on p. 19), https://www.hrsa.gov/ • Congressional Justification (all-purpose table on p. 19), https://www.hrsa.gov/
sites/default/files/hrsa/about/budget/budget-justification-fy2025.pdf sites/default/files/hrsa/about/budget/budget-justification-fy2025.pdf
• BIB chapter (p. 25), https://www.hhs.gov/sites/default/files/fy-2025-budget-in- • BIB chapter (p. 25), https://www.hhs.gov/sites/default/files/fy-2025-budget-in-
brief.pdf#page=31 brief.pdf#page=31
Indian Health Service (IHS)
The IHS mission is to provide “federal health services to American Indians and Alaska Natives” The IHS mission is to provide “federal health services to American Indians and Alaska Natives”
and “raise the physical, mental, social, and spiritual health of American Indians and Alaska and “raise the physical, mental, social, and spiritual health of American Indians and Alaska
Natives to the highest level.”Natives to the highest level.”2728 IHS provides health care for approximately 2.6 million eligible IHS provides health care for approximately 2.6 million eligible
American Indians and Alaska Natives through a system of programs and facilities located on or American Indians and Alaska Natives through a system of programs and facilities located on or
near Indian reservations, and through contractors in certain urban areas.near Indian reservations, and through contractors in certain urban areas.2829
Appropriations Bill:
• Department of the Interior, Environment, and Related Agencies (INT) • Department of the Interior, Environment, and Related Agencies (INT)
FY2025 Request:
• BA: $8.931 billion • BA: $8.931 billion
• Outlays: $9.424 billion • Outlays: $9.424 billion
Additional Resources:
• Congressional Justification (all-purpose table on p. 11), https://www.ihs.gov/ • Congressional Justification (all-purpose table on p. 11), https://www.ihs.gov/
sites/budgetformulation/themes/responsive2017/display_objects/documents/FY- sites/budgetformulation/themes/responsive2017/display_objects/documents/FY-
2025-IHS-CJ030824.pdf 2025-IHS-CJ030824.pdf
• BIB chapter (p. 34), https://www.hhs.gov/sites/default/files/fy-2025-budget-in- • BIB chapter (p. 34), https://www.hhs.gov/sites/default/files/fy-2025-budget-in-
brief.pdf#page=40 brief.pdf#page=40
Centers for Disease Control and Prevention (CDC) and Agency for
Toxic Substances and Disease Registry (ATSDR)
The CDC mission is focused on “developing and applying disease prevention and control, The CDC mission is focused on “developing and applying disease prevention and control,
environmental health, and health promotion and health education activities designed to improve environmental health, and health promotion and health education activities designed to improve
the health of the people of the United States.”the health of the people of the United States.”2930 CDC is organized into a number of centers, CDC is organized into a number of centers,
institutes, and offices, some focused on specific public health challenges (e.g., injury prevention) institutes, and offices, some focused on specific public health challenges (e.g., injury prevention)
and others focused on general public health capabilities (e.g., surveillance and laboratory and others focused on general public health capabilities (e.g., surveillance and laboratory
services). services).
In addition, the ATSDR is headed by the CDC director. For that reason, the ATSDR budget is In addition, the ATSDR is headed by the CDC director. For that reason, the ATSDR budget is
often shown within CDC. Following the conventions of the FY2025 HHS BIB, ATSDR’s budget often shown within CDC. Following the conventions of the FY2025 HHS BIB, ATSDR’s budget
request is included in the CDC totals shown in this report. ATSDR’s work is focused on request is included in the CDC totals shown in this report. ATSDR’s work is focused on

2728 IHS, IHS, Agency Overview, https://www.ihs.gov/aboutihs/overview/. , https://www.ihs.gov/aboutihs/overview/.
2829 IHS, IHS, About IHS, https://www.ihs.gov/aboutihs/. , https://www.ihs.gov/aboutihs/.
2930 CDC, CDC, Official Mission/Function Statement, updated 1/24/2023, https://www.cdc.gov/about/pdf/organization/iod-, https://www.cdc.gov/about/pdf/organization/iod-
mission-statement.pdf. mission-statement.pdf.
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preventing or mitigating adverse effects resulting from exposure to hazardous substances in the preventing or mitigating adverse effects resulting from exposure to hazardous substances in the
environment.environment.3031
Appropriations Bills:
• LHHS (CDC) • LHHS (CDC)
• INT (ATSDR) • INT (ATSDR)
FY2025 Request (CDC and ATSDR combined):
• BA: $11.507 billion • BA: $11.507 billion
• Outlays: $15.658 billion • Outlays: $15.658 billion
Additional Resources:
• CDC Congressional Justification (all-purpose table on p. 30), • CDC Congressional Justification (all-purpose table on p. 30),
https://www.cdc.gov/budget/documents/fy2025/FY-2025-CDC-congressional- https://www.cdc.gov/budget/documents/fy2025/FY-2025-CDC-congressional-
justification.pdf justification.pdf
• ATSDR Congressional Justification, https://www.cdc.gov/budget/documents/ • ATSDR Congressional Justification, https://www.cdc.gov/budget/documents/
fy2025/FY-2025-ATSDR-congressional-justification.pdf fy2025/FY-2025-ATSDR-congressional-justification.pdf
• BIB chapter (p. 44), https://www.hhs.gov/sites/default/files/fy-2025-budget-in- • BIB chapter (p. 44), https://www.hhs.gov/sites/default/files/fy-2025-budget-in-
brief.pdf#page=50 brief.pdf#page=50
National Institutes of Health (NIH)
The NIH mission is focused on conducting and supporting research “in the causes, diagnosis, The NIH mission is focused on conducting and supporting research “in the causes, diagnosis,
prevention, and cure of human diseases” and “in directing programs for the collection, prevention, and cure of human diseases” and “in directing programs for the collection,
dissemination, and exchange of information in medicine and health.”dissemination, and exchange of information in medicine and health.”3132 NIH is organized into 27 NIH is organized into 27
research institutes and centers, headed by the NIH Director.research institutes and centers, headed by the NIH Director.3233 In addition, FY2022 appropriations In addition, FY2022 appropriations
called for HHS to establish a new entity: the Advanced Research Projects Agency for Health called for HHS to establish a new entity: the Advanced Research Projects Agency for Health
(ARPA-H). HHS subsequently placed this entity within NIH. (ARPA-H). HHS subsequently placed this entity within NIH.
Appropriations Bill:
• LHHS • LHHS
FY2025 Request:
• BA: $49.790 billion • BA: $49.790 billion
• Outlays: $46.638 billion • Outlays: $46.638 billion
Additional Resources:
• Congressional Justification (all-purpose table on p. 39), • Congressional Justification (all-purpose table on p. 39),
https://officeofbudget.od.nih.gov/pdfs/FY25/br/ https://officeofbudget.od.nih.gov/pdfs/FY25/br/
Overview%20of%20FY%202025%20Presidents%20Budget.Overview%20of%20FY%202025%20Presidents%20Budget.~~pdf33~~pdf34

3031 ASTDR, ASTDR, Official Mission/Function Statement, effective 1/9/2020, https://www.cdc.gov/about/pdf/organization/atsdr-, https://www.cdc.gov/about/pdf/organization/atsdr-
mission-statement.pdf. mission-statement.pdf.
3132 NIH, NIH, Mission and Goals, https://www.nih.gov/about-nih/what-we-do/mission-goals. , https://www.nih.gov/about-nih/what-we-do/mission-goals.
3233 NIH, NIH, Organization, https://www.nih.gov/about-nih/who-we-are/organization. , https://www.nih.gov/about-nih/who-we-are/organization.
3334 NIH’s individual institutes/centers also submit justifications, available at https://officeofbudget.od.nih.gov/ NIH’s individual institutes/centers also submit justifications, available at https://officeofbudget.od.nih.gov/
insti_center_subs.html. insti_center_subs.html.
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• BIB chapter (p. 52), https://www.hhs.gov/sites/default/files/fy-2025-budget-in- • BIB chapter (p. 52), https://www.hhs.gov/sites/default/files/fy-2025-budget-in-
brief.pdf#page=58 brief.pdf#page=58
Substance Abuse and Mental Health Services Administration
(SAMHSA)3435
SAMHSA is the federal agency primarily responsible for supporting community-based mental 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 health and substance abuse treatment and prevention services. The SAMHSA mission is focused
on reducing the impacts of substance use disorder and mental illness.on reducing the impacts of substance use disorder and mental illness.3536 SAMHSA supports SAMHSA supports
activities that include education and training, prevention programs, early intervention activities, activities that include education and training, prevention programs, early intervention activities,
treatment services, and technical assistance. treatment services, and technical assistance.
Appropriations Bill:
• LHHS • LHHS
FY2025 Request:
• BA: $8.158 billion • BA: $8.158 billion
• Outlays: $9.813 billion • Outlays: $9.813 billion
Additional Resources:
• Congressional Justification (all-purpose table on p. 10), https://www.samhsa.gov/ • Congressional Justification (all-purpose table on p. 10), https://www.samhsa.gov/
sites/default/files/samhsa-fy-2025-cj.pdf sites/default/files/samhsa-fy-2025-cj.pdf
• BIB chapter (p. 59), https://www.hhs.gov/sites/default/files/fy-2025-budget-in- • BIB chapter (p. 59), https://www.hhs.gov/sites/default/files/fy-2025-budget-in-
brief.pdf#page=65 brief.pdf#page=65
Agency for Healthcare Research and Quality (AHRQ)
The AHRQ mission is focused on research to “make health care safer, higher quality, more The AHRQ mission is focused on research to “make health care safer, higher quality, more
accessible, equitable, and affordable.”accessible, equitable, and affordable.”3637 Specific AHRQ research efforts are aimed at reducing the Specific AHRQ research efforts are aimed at reducing the
costs of care, promoting patient safety, measuring the quality of health care, and improving health costs of care, promoting patient safety, measuring the quality of health care, and improving health
care services, organization, and financing. care services, organization, and financing.
Appropriations Bill:
• LHHS • LHHS
FY2025 Request:
• BA: $0.387 billion • BA: $0.387 billion
• Outlays: $0.375 billion • Outlays: $0.375 billion
Additional Resources:
• Congressional Justification (all-purpose table on p. 15), https://www.ahrq.gov/ • Congressional Justification (all-purpose table on p. 15), https://www.ahrq.gov/
sites/default/files/wysiwyg/cpi/about/mission/budget/2025/fy2025-cj.pdf sites/default/files/wysiwyg/cpi/about/mission/budget/2025/fy2025-cj.pdf

3435 The FY2025 HHS BIB and SAMHSA congressional justification refer to SAMHSA as the Substance use And The FY2025 HHS BIB and SAMHSA congressional justification refer to SAMHSA as the Substance use And
Mental Health Services Administration, while other sources, including the SAMHSA website and appropriations bills, Mental Health Services Administration, while other sources, including the SAMHSA website and appropriations bills,
continue to use Substance Abuse and Mental Health Services Administration. continue to use Substance Abuse and Mental Health Services Administration.
3536 SAMHSA, SAMHSA, About Us, https://www.samhsa.gov/about-us. , https://www.samhsa.gov/about-us.
3637 AHRQ, AHRQ, About AHRQ, https://www.ahrq.gov/cpi/about/index.html. , https://www.ahrq.gov/cpi/about/index.html.
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• BIB chapter (p. 65), https://www.hhs.gov/sites/default/files/fy-2025-budget-in- • BIB chapter (p. 65), https://www.hhs.gov/sites/default/files/fy-2025-budget-in-
brief.pdf#page=71 brief.pdf#page=71
Centers for Medicare & Medicaid Services (CMS)
The CMS mission is focused on “advancing health equity, expanding coverage, and improving The CMS mission is focused on “advancing health equity, expanding coverage, and improving
health outcomes.”health outcomes.”3738 The President’s budget estimates that in FY2025, “over 160 million, or The President’s budget estimates that in FY2025, “over 160 million, or
roughly 1 in 2 Americans, will rely on the programs CMS administers or oversees including roughly 1 in 2 Americans, will rely on the programs CMS administers or oversees including
Medicare, Medicaid, the Children’s Health Insurance Program (CHIP), and the Marketplaces.”Medicare, Medicaid, the Children’s Health Insurance Program (CHIP), and the Marketplaces.”3839
Appropriations Bill:
• LHHS • LHHS
FY2025 Request:
• BA: $1,603.501 billion • BA: $1,603.501 billion
• Outlays: $1,580.706 billion • Outlays: $1,580.706 billion
Additional Resources:
• Congressional Justification (all-purpose table on p. 7), https://www.cms.gov/ • Congressional Justification (all-purpose table on p. 7), https://www.cms.gov/
files/document/fy2025-cms-congressional-justification-estimates-appropriations- files/document/fy2025-cms-congressional-justification-estimates-appropriations-
committees.pdf committees.pdf
• BIB chapter (p. 71), https://www.hhs.gov/sites/default/files/fy-2025-budget-in- • BIB chapter (p. 71), https://www.hhs.gov/sites/default/files/fy-2025-budget-in-
brief.pdf#page=77 brief.pdf#page=77
Administration for Children and Families (ACF)
The ACF mission is focused on promoting the “economic and social well-being of families, The ACF mission is focused on promoting the “economic and social well-being of families,
children, individuals and communities.”children, individuals and communities.”3940 ACF administers a wide array of human services ACF administers a wide array of human services
programs, including Temporary Assistance for Needy Families (TANF), Head Start, child care, programs, including Temporary Assistance for Needy Families (TANF), Head Start, child care,
the Social Services Block Grant (SSBG), and various child welfare programs. the Social Services Block Grant (SSBG), and various child welfare programs.
Appropriations Bill:
• LHHS • LHHS
FY2025 Request:
• BA: $91.755 billion • BA: $91.755 billion
• Outlays: $89.979 billion • Outlays: $89.979 billion
Additional Resources:
• Congressional Justification (all-purpose table on p. 5), https://www.acf.hhs.gov/ • Congressional Justification (all-purpose table on p. 5), https://www.acf.hhs.gov/
sites/default/files/documents/olab/fy-2025-congressional-justification.pdf sites/default/files/documents/olab/fy-2025-congressional-justification.pdf
• BIB chapter (p. 129), https://www.hhs.gov/sites/default/files/fy-2025-budget-in- • BIB chapter (p. 129), https://www.hhs.gov/sites/default/files/fy-2025-budget-in-
brief.pdf#page=135 brief.pdf#page=135

3738 CMS, CMS, Fiscal Year 2025 Justification of Estimates for Appropriations Committees, March 2024, , March 2024,
https://www.cms.gov/files/document/fy2025-cms-congressional-justification-estimates-appropriations-committees.pdf. https://www.cms.gov/files/document/fy2025-cms-congressional-justification-estimates-appropriations-committees.pdf.
3839 CMS, CMS, Fiscal Year 2025 Justification of Estimates for Appropriations Committees, March 2024, , March 2024,
https://www.cms.gov/files/document/fy2025-cms-congressional-justification-estimates-appropriations-committees.pdf. https://www.cms.gov/files/document/fy2025-cms-congressional-justification-estimates-appropriations-committees.pdf.
3940 ACF, ACF, What We Do, https://www.acf.hhs.gov/about/what-we-do. , https://www.acf.hhs.gov/about/what-we-do.
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Administration for Community Living (ACL)
The ACL mission is focused on maximizing the “independence, well-being, and health of older The ACL 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.”adults, people with disabilities across the lifespan, and their families and caregivers.”4041 ACL ACL
administers a number of programs targeted at older Americans and people with disabilities, administers a number of programs targeted at older Americans and people with disabilities,
including Home and Community-Based Supportive Services and State Councils on including Home and Community-Based Supportive Services and State Councils on
Developmental Disabilities. Developmental Disabilities.
Appropriations Bill:
• LHHS • LHHS
FY2025 Request:
• BA: $2.579 billion • BA: $2.579 billion
• Outlays: $3.104 billion • Outlays: $3.104 billion
Additional Resources:
• Congressional Justification (all-purpose table on p. 16), https://acl.gov/sites/ • Congressional Justification (all-purpose table on p. 16), https://acl.gov/sites/
default/files/about-acl/2024-03/FY2025ACL-CJ-508.docx default/files/about-acl/2024-03/FY2025ACL-CJ-508.docx
• BIB chapter (p. 146), https://www.hhs.gov/sites/default/files/fy-2025-budget-in- • BIB chapter (p. 146), https://www.hhs.gov/sites/default/files/fy-2025-budget-in-
brief.pdf#page=152 brief.pdf#page=152
Administration for Strategic Preparedness and Response (ASPR)4142
The ASPR mission is to lead “the nation’s medical and public health preparedness for, response The ASPR mission is to lead “the nation’s medical and public health preparedness for, response
to, and recovery from disasters and other public health emergencies.”to, and recovery from disasters and other public health emergencies.”4243 ASPR “serves as the ASPR “serves as the
principal advisor to the HHS Secretary on issues related to public health and medical emergency principal advisor to the HHS Secretary on issues related to public health and medical emergency
preparedness and response. ASPR has operational responsibilities for the advanced research, preparedness and response. ASPR has operational responsibilities for the advanced research,
development and stockpiling of medical countermeasures as well as the coordination of the development and stockpiling of medical countermeasures as well as the coordination of the
federal public health and medical response to emergencies and disasters.”federal public health and medical response to emergencies and disasters.”4344
Appropriations Bill:
• LHHS • LHHS
FY2025 Request:
• BA: $3.768 billion • BA: $3.768 billion
• Outlays: $0.926 billion • Outlays: $0.926 billion
Additional Resources:
• Congressional Justification (all-purpose table on p. 16), https://aspr.hhs.gov/ • Congressional Justification (all-purpose table on p. 16), https://aspr.hhs.gov/
AboutASPR/BudgetandFunding/Documents/FY2025/ASPR-cj.pdf AboutASPR/BudgetandFunding/Documents/FY2025/ASPR-cj.pdf

4041 ACL, ACL, About ACL, https://acl.gov/about-acl. , https://acl.gov/about-acl.
4142 The Administration for Strategic Preparedness and Response (ASPR) was established as an HHS operating division, The Administration for Strategic Preparedness and Response (ASPR) was established as an HHS operating division,
effective February 11, 2023. It was formerly the “Office of the Assistant Secretary for Preparedness and Response,” effective February 11, 2023. It was formerly the “Office of the Assistant Secretary for Preparedness and Response,”
within the HHS Office of the Secretary. For more information on this reorganization, see HHS, ASPR, “Statement of within the HHS Office of the Secretary. For more information on this reorganization, see HHS, ASPR, “Statement of
Organization, Functions, and Delegations of Authority,” 88Organization, Functions, and Delegations of Authority,” 88 Federal Register 10125-10127, February 16, 2023, 10125-10127, February 16, 2023,
https://www.govinfo.gov/content/pkg/FR-2023-02-16/pdf/2023-03277.pdf. https://www.govinfo.gov/content/pkg/FR-2023-02-16/pdf/2023-03277.pdf.
4243 ASPR, ASPR, ASPR Program Offices, https://aspr.hhs.gov/AboutASPR/ProgramOffices/Pages/ProgramOffice.aspx. , https://aspr.hhs.gov/AboutASPR/ProgramOffices/Pages/ProgramOffice.aspx.
4344 ASPR, ASPR, ASPR Budget and Funding, https://aspr.hhs.gov/AboutASPR/BudgetandFunding/Pages/default.aspx. , https://aspr.hhs.gov/AboutASPR/BudgetandFunding/Pages/default.aspx.
Congressional Research Service Congressional Research Service

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Department of Health and Human Services: FY2025 Budget Request

• BIB chapter (p. 155), https://www.hhs.gov/sites/default/files/fy-2025-budget-in- • BIB chapter (p. 155), https://www.hhs.gov/sites/default/files/fy-2025-budget-in-
brief.pdf#page=161 brief.pdf#page=161

Author Information

Jessica Tollestrup Jessica Tollestrup
Ada S. Cornell Ada S. Cornell
Specialist in Social Policy Specialist in Social Policy
Senior Research Librarian Senior Research Librarian

Karen E. Lynch Karen E. Lynch

Specialist in Social Policy Specialist in Social Policy

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