Centers for Disease Control and Prevention (CDC) Funding Overview
Changes from July 16, 2024 to May 14, 2026
This page shows textual changes in the document between the two versions indicated in the dates above. Textual matter removed in the later version is indicated with red strikethrough and textual matter added in the later version is indicated with blue.
Centers for Disease Control and Prevention
July 16, 2024
(CDC) Funding Overview
Kavya Sekar
The Centers for Disease Control and Prevention (CDC) works to protect public health by
Analyst in Health Policy
(CDC) Funding Overview
Updated May 14, 2026
(R47207)
Jump to Main Text of Report
providing leadership, information, and scientific expertise in preventing and controlling diseases,
including outbreaks of infectious diseases. including outbreaks of infectious diseases. The CDC also works to promote health and quality of CDC also works to promote health and quality of
life, by supporting and undertaking efforts that aim to prevent and control injury, disability, and life, by supporting and undertaking efforts that aim to prevent and control injury, disability, and
For a copy of the full report,
environmental health threats. In addition, the Agency for Toxic Substances and Disease Registry environmental health threats. In addition, the Agency for Toxic Substances and Disease Registry
please call 7-5700 or visit
(ATSDR), headed by the CDC Director, is tasked with identifying potential public health effects (ATSDR), headed by the CDC Director, is tasked with identifying potential public health effects
www.crs.gov.
from exposure to hazardous substances. This CRS report provides an overview of CDCfrom exposure to hazardous substances. This CRS report provides an overview of CDC’'s budget s budget
and appropriations, with a focus on and appropriations, with a focus onFY2024FY2026 enacted appropriations enacted appropriations and the FY2025 President’s budget request, including , including
ATSDR. The report also discusses supplemental appropriations for CDC.ATSDR. The report also discusses supplemental appropriations for CDC.
This report divides CDCThis report divides CDC’'s s program level,, or annual funding from all sources of budget authority, into two categories, with a or annual funding from all sources of budget authority, into two categories, with a
focus on the first:focus on the first:
• A core public health program level that funds most of the agencyA core public health program level that funds most of the agency’'s main public health programs. This is s main public health programs. This is
made up of discretionary and mandatory appropriations that are mostly provided or allocated through the made up of discretionary and mandatory appropriations that are mostly provided or allocated through the
Departments of Labor, Health and Human Services, and Education, and Related Agencies (LHHS) Departments of Labor, Health and Human Services, and Education, and Related Agencies (LHHS)
appropriations act.appropriations act.
•
Other mandatory programs that include several CDC-administered health services, compensation-related, Other mandatory programs that include several CDC-administered health services, compensation-related,
and user fee programs. These include the World Trade Center Health Program and user fees for cruise ship and user fee programs. These include the World Trade Center Health Program and user fees for cruise ship
inspection, among others.inspection, among others.
CDC’s enacted FY2024 (P.L. 117-328)CDC's enacted FY2026 core public health program level is $9. core public health program level is $9.248227 billion, which represents a $21 million billion, which represents a $21 million
(-0.2%) decrease from the (-0.2%) decrease from theFY2023FY2025 final core public health program level. final core public health program level. The Biden Administration has proposed an
FY2025 CDC program level of $9.768 billion, a proposed increase of $520 million over the FY2024 enacted program level.
Accounting for mandatory funding, including new mandatory funding proposed by the Biden Administration for FY2025,
CDC would receive $25.753 billion as requested, an increase of $8.471 billion (+49%) compared with the FY2024 level
inclusive of mandatory funding.
In terms of trends, CDC has seen relatively flat funding until recently: from FY2011 to FY2021, CDC’Accounting for mandatory funding for FY2026, CDC is estimated to receive $16.266 billion in FY2026, a decrease of $459 million (-2.7%) compared with the FY2025 level inclusive of mandatory funding.
funding level remained between approximately $6.5 and $8 billion until the increases provided in FY2022 and FY2023 (not funding level remained between approximately $6.5 and $8 billion until the increases provided in FY2022 and FY2023 (not
adjusted for inflation). adjusted for inflation). Since FY2023, CDC's core public health funding level has remained relatively flat; CDC saw slight decreases in its core public healthCDC saw a decrease in its overall program level in FY2024 program level in FY2024.
and FY2026 relative to the prior year.
CDC also frequently receives one-time supplemental appropriations in response to specific incidents—such as infectious CDC also frequently receives one-time supplemental appropriations in response to specific incidents—such as infectious
disease threats, natural disasters, or screening and health support to refugees. In response to some incidents, such as the disease threats, natural disasters, or screening and health support to refugees. In response to some incidents, such as the
Coronavirus Disease 2019 (COVID-19) pandemic, supplemental appropriations Coronavirus Disease 2019 (COVID-19) pandemic, supplemental appropriationsarehave been substantial and substantial and arewere tied to short-term tied to short-term
funding increases for overall public health capacity at the federal, state, and local level.
Congressional Research Service
link to page 4 link to page 6 link to page 7 link to page 11 link to page 13 link to page 13 link to page 15 link to page 16 link to page 16 link to page 18 link to page 5 link to page 7 link to page 7 link to page 8 link to page 9 link to page 10 link to page 16 link to page 13 link to page 13 link to page 19 link to page 20 Centers for Disease Control and Prevention (CDC) Funding Overview
Contents
Introduction ..................................................................................................................................... 1
Understanding CDC Funding .......................................................................................................... 3
Core Public Health Program Level ........................................................................................... 4
Other Mandatory Programs ....................................................................................................... 8
Proposed Mandatory Programs ............................................................................................... 10
Funding Table ................................................................................................................................ 10
Trends in Core Public Health Program Level................................................................................ 12
CDC Budget in Context ................................................................................................................ 13
Supplemental Appropriations for Public Health Emergencies and Other Incidents ............... 13
CDC Infectious Diseases Rapid Response Reserve Fund ................................................ 15
Figures
Figure 1. Centers for Disease Control and Prevention Organization Chart ..................................... 2
Figure 2. FY2024 Enacted Centers for Disease Control and Prevention Program Level by
Category and Budget Authority .................................................................................................... 4
Figure 3. Example of CDC Appropriation Language ...................................................................... 5
Figure 4. Example of CDC Appropriations Report Language ........................................................ 6
Figure 5. Example of Prevention and Public Health Fund Allocations ........................................... 7
Figure 6. Trends in Core Public Health Program Level ................................................................ 13
Tables
Table 1. Centers for Disease Control and Prevention (CDC) and Agency for Toxic
Substances and Disease Registry (ATSDR) Appropriations, FY2023-FY2025 Request ........... 10
Table 2. Appropriations History to the IDRRRF ........................................................................... 16
Contacts
Author Information ........................................................................................................................ 17
Congressional Research Service
link to page 5 Centers for Disease Control and Prevention (CDC) Funding Overview
Introduction
funding increases for overall public health capacity at the federal, state, and local level.
providing leadership, information, and scientific expertise in preventing and controlling diseases, providing leadership, information, and scientific expertise in preventing and controlling diseases,
including outbreaks of infectious diseases. including outbreaks of infectious diseases.The CDC also works to promote health and quality of CDC also works to promote health and quality of
life, by supporting and undertaking efforts that aim to prevent and control injury, disability, and life, by supporting and undertaking efforts that aim to prevent and control injury, disability, and
environmental health threats. Its stated mission is environmental health threats. Its stated mission isto “protect America from health, safety and
security threats, both foreign and in the [United States].”1"protecting Americans from infectious and communicable diseases and investing in innovation to prevent, detect, and respond to such public health threats."1 In addition to its role supporting In addition to its role supporting
ongoing public health activities, the agency has played a major role in disease outbreaks and ongoing public health activities, the agency has played a major role in disease outbreaks and
public health emergencies, including public health emergencies, including during the federal response to the Coronavirus Disease 2019 the federal response to the Coronavirus Disease 2019
(COVID-19) pandemic. The Agency for Toxic Substances and Disease Registry (ATSDR), a (COVID-19) pandemic. The Agency for Toxic Substances and Disease Registry (ATSDR), a
separate operating division headed by the CDC Director, is tasked with identifying potential separate operating division headed by the CDC Director, is tasked with identifying potential
public health effects from exposure to hazardous substances.public health effects from exposure to hazardous substances.
CDC focuses on supporting science-based disease prevention and health promotion on a CDC focuses on supporting science-based disease prevention and health promotion on a
population-wide basis. CDC also administers some health services and compensation-related population-wide basis. CDC also administers some health services and compensation-related
programs as discussed later in this report. CDC is organized into a number of centers, institutes programs as discussed later in this report. CDC is organized into a number of centers, institutes
and offices (CIOs) as shown and offices (CIOs) as showninin Figure 1. SomeSome of these CIOs focus on specific public health of these CIOs focus on specific public health
challenges (e.g., injury prevention), while others focus on general public health capabilities (e.g., challenges (e.g., injury prevention), while others focus on general public health capabilities (e.g.,
surveillance and laboratory services).surveillance and laboratory services).2
2
CDC was established in 1946 as the Communicable Disease Center.CDC was established in 1946 as the Communicable Disease Center.3 Under authority provided by
congressionally approved reorganization plans3 Through administrative actions, CDC has since been reorganized and renamed. , CDC has since been reorganized and renamed.
Most of CDCMost of CDC’'s programs are authorized in the Public Health Service Act (PHSA). Many CDC s programs are authorized in the Public Health Service Act (PHSA). Many CDC
programs and activities are not explicitly mentioned in the PHSA, but CDC carries out those programs and activities are not explicitly mentioned in the PHSA, but CDC carries out those
programs on the basis of general and permanent statutory authorities granted to the HHS programs on the basis of general and permanent statutory authorities granted to the HHS
Secretary.Secretary.44 Some CDC programs have specific authorizations, mostly in the PHSA. Some CDC programs have specific authorizations, mostly in the PHSA.
Given CDCGiven CDC’'s mix of general and specific authorizations, appropriations play a central role in s mix of general and specific authorizations, appropriations play a central role in
guiding the agencyguiding the agency’'s policy priorities.s policy priorities.
A large portion of CDCA large portion of CDC’'s annual budget is awarded as external financial assistance (typically in s annual budget is awarded as external financial assistance (typically in
the form of grants or cooperative agreements)—especially to the form of grants or cooperative agreements)—especially tostate5state5 and local health departments. and local health departments.6
6 CDC also awards funding to a variety of other entities, including CDC also awards funding to a variety of other entities, includinginternationalforeign governments and governments and
international organizations; tribal governments and organizations; academic and research institutions; and organizations; tribal governments and organizations; academic and research institutions; and
nonprofit organizations.nonprofit organizations.
This report reviews This report reviews the CDC’CDC's budget and appropriations from s budget and appropriations from FY2023 to FY2025FY2024 to FY2026 and its and its
funding history for core public health programs from FY2011 to funding history for core public health programs from FY2011 toFY2025FY2026. It also discusses CDC supplemental and emergency reserve funding. ATSDR appropriations are included within the overall discussion of CDC funding. This CRS report summarizes appropriated budget authority available to CDC in each of the fiscal years covered and does not summarize information on obligations and outlays (or expenditures) from this appropriated budget authority.7
. It also discusses CDC
1 Centers for Disease Control and Prevention (CDC), “Mission, Role, and Pledge,” https://www.cdc.gov/about/
organization/mission.htm.
2 CDC, “Official Mission Statement & Organizational Chart,”
https://www.cdc.gov/about/cdc/?CDC_AAref_Val=https://www.cdc.gov/about/organization/mission.htm.
3 CDC, “Our History-Our Story,” https://www.cdc.gov/museum/history/our-story.html.
4 CRS Report R47981, Centers for Disease Control and Prevention (CDC): History, Overview of Domestic Programs,
and Selected Issues.
5 For the purposes of this report, U.S. territories are included in the term, “state,” consistent with the definition of
“state” in the PHSA (Section 2, 42 U.S.C. §201).
6 In FY2023, CDC obligated more than $12.5 billion in grants for public health programs and research, including more
than $6.7 billion for non-COVID-19 related awards and over $5.8 billion for COVID-19 related awards. See CDC,
“Office of Financial Resources: FY2023 Assistance Snapshot at CDC,”
https://www.cdc.gov/funding/documents/fy2023/fy-2023-ofr-assistance-snapshot-508.pdf.
Congressional Research Service
1
Centers for Disease Control and Prevention (CDC) Funding Overview
supplemental and emergency reserve funding. ATDSR appropriations are included within the
overall discussion of CDC funding.
Figure 1. Centers for Disease Control and Prevention Organization Chart
Source: Adapted by CRS from CDC, “CDC Organization Chart,” https://www.cdc.gov/about/pdf/organization/https://www.cdc.gov/about/pdf/organization/
cdc-org-chart.pdf, updated as of cdc-org-chart.pdf, updated as ofFebruary 23, 2023.
September 13, 2024. Notes: HIV = Human Immunodeficiency Virus; STD = Sexually Transmitted Disease; TB = Tuberculosis; OPDIV HIV = Human Immunodeficiency Virus; STD = Sexually Transmitted Disease; TB = Tuberculosis; OPDIV
= Operating Division.= Operating Division.
Congressional Research Service
2
link to page 7 Centers for Disease Control and Prevention (CDC) Funding Overview
Understanding CDC Funding
Understanding CDC Funding This CRS report divides CDCThis CRS report divides CDC’'s annual s annual program level7 8 into two categories, as shown into two categories, as shown inin Figure 2:
• core public health program level, funded mostly by annual discretionary core public health program level, funded mostly by annual discretionary
Departments of Labor, Health and Human Services, and Education, and Related Departments of Labor, Health and Human Services, and Education, and Related
Agencies (LHHS) appropriations and the mandatory Prevention and Public Agencies (LHHS) appropriations and the mandatory Prevention and Public
Health Fund (PPHF), andHealth Fund (PPHF), and
•
other mandatory programs, including CDC-administered health services, other mandatory programs, including CDC-administered health services,
compensation-related, and user fee programs.compensation-related, and user fee programs.
CRS has divided CDCCRS has divided CDC’'s program level into the two categories to allow for valid year-to-year s program level into the two categories to allow for valid year-to-year
comparisons of programmatic funding levels for the agency. The core public health program level comparisons of programmatic funding levels for the agency. The core public health program level
reflects both (1) funding for the main public health program activities conducted by CDC CIOs reflects both (1) funding for the main public health program activities conducted by CDC CIOs
and ATDSRand ATSDR in support of the agencies in support of the agencies’' core missions, and (2) funding that is largely subject to core missions, and (2) funding that is largely subject to
the annual appropriations process, and therefore reflects the legislative decisions made by the annual appropriations process, and therefore reflects the legislative decisions made by
Congress each year to fund CDC and Congress each year to fund CDC andATDSRATSDR programs. The CDC programs. The CDC “"core public health program core public health program
level”level" in this CRS report aligns with in this CRS report aligns with the “CDC/ATDSRCDC and ATSDR program program level”levels presented in presented in FY2025
CDC budget documents.8
FY2026 explanatory statements accompanying CDC and ATSDR annual appropriations.9
The other mandatory programs excluded from the core public health program level have funding The other mandatory programs excluded from the core public health program level have funding
levels that are mostly controlled by their program authorizations. The two largest programs—the levels that are mostly controlled by their program authorizations. The two largest programs—the
Vaccines for Children (VFC) program and the World Trade Center Health Program (WTCHP)—Vaccines for Children (VFC) program and the World Trade Center Health Program (WTCHP)—
primarily finance specific health services for eligible populations. Changes in annual spending primarily finance specific health services for eligible populations. Changes in annual spending
reflect usage and demand for the program services. These programsreflect usage and demand for the program services. These programs’' funding levels are therefore funding levels are therefore
presented separately from CDCpresented separately from CDC’'s core public health program level and are excluded from analysis s core public health program level and are excluded from analysis
of funding trends for the agencyof funding trends for the agency’'s main programmatic and operating expenses. These other s main programmatic and operating expenses. These other
mandatory programs are also generally presented separately from the rest of CDCmandatory programs are also generally presented separately from the rest of CDC’'s budget in the s budget in the
agency’agency's own budget presentations.10
s own budget presentations.9
7 For the purposes of this report, CDC’s program level is the sum of the agency’s funding for a fiscal year reflecting all
sources of budget authority.
8 See CDC, “FY2025 Budget Detail Table,” https://www.cdc.gov/budget/documents/fy2025/FY-2025-CDC-Budget-
Detail.pdf. CDC changes its budget presentations and categories from year to year.
9 See, for example, CDC, “FY2025 Budget Detail Table,” https://www.cdc.gov/budget/documents/fy2025/FY-2025-
CDC-Budget-Detail.pdf.
Congressional Research Service
3
Centers for Disease Control and Prevention (CDC) Funding Overview
Figure 2. FY2024 Enacted Centers for Disease Control and Prevention Program
Enacted Centers for Disease Control and Prevention Program Level by Category and Budget Authority
Thousands of DollarsThousands of Dollars
Sources: FY2026: FY2024 discretionary amounts are from P.L. discretionary amounts are from P.L. 118-47119-75 and and Congressional Record, vol. vol. 170, no. 51 (March
22, 2024), H2020-H2022, and other mandatory program amount estimates from CDC, “FY2025 Budget Detail
Table,” https://www.cdc.gov/budget/documents/fy2025/FY-2025-CDC-Budget-Detail.pdf.
172, no. 15, book II (January 22, 2026), H1591-H1593; ASTDR discretionary amount from P.L. 119-74; and other mandatory program amount estimates from CDC, "All Purpose Table," FY2027 Congressional Budget Justification, p. 14, Fiscal Year 2027 CDC Congressional Justification. Notes: Amounts reflect some post-appropriations adjustments. Acronyms: CDC = Centers for Disease Control Amounts reflect some post-appropriations adjustments. Acronyms: CDC = Centers for Disease Control
and Prevention.and Prevention.
Core Public Health Program Level
CDCCDC’'s core public health program level funds the main programs that CDC CIOs implement in s core public health program level funds the main programs that CDC CIOs implement in
their efforts to prevent and control disease and to improve public health. Types of funded their efforts to prevent and control disease and to improve public health. Types of funded
activities include but are not limited to developing expertise and best practices in disease activities include but are not limited to developing expertise and best practices in disease
prevention and control; conducting and supporting public health research; supporting and prevention and control; conducting and supporting public health research; supporting and
conducting public health surveillance and data collection; developing and supporting public conducting public health surveillance and data collection; developing and supporting public
health laboratory capacity; supporting and conducting health education and promotion efforts; health laboratory capacity; supporting and conducting health education and promotion efforts;
funding, coordinating, and providing technical assistance to public health programs at the funding, coordinating, and providing technical assistance to public health programs at thestate
Congressional Research Service
4
link to page 8 link to page 9 
Centers for Disease Control and Prevention (CDC) Funding Overview
global, state and local level; supporting some preventive health services programs (e.g., some vaccination and and local level; supporting some preventive health services programs (e.g., some vaccination and
cancer screening programs); and supporting public health emergency preparedness and response cancer screening programs); and supporting public health emergency preparedness and response
efforts. Many of the programs fund and support public health activities at the efforts. Many of the programs fund and support public health activities at thestateglobal, state, and local and local
level.level.10
CDC’11
CDC's core public health program level is made up of (1) discretionary appropriations; (2), s core public health program level is made up of (1) discretionary appropriations; (2),
mandatory funding from the Prevention and Public Health Fund (PPHF); and (3) some other mandatory funding from the Prevention and Public Health Fund (PPHF); and (3) some other
funding sources, such as transfers from other accounts.funding sources, such as transfers from other accounts.
Discretionary Funding ((FY2024: $7.938FY2026: $7.706 billion in LHHS budget authority; $ billion in LHHS budget authority; $8280 million for million for
ATSDR).ATSDR). CDC receives discretionary funding through annual LHHS appropriations, while CDC receives discretionary funding through annual LHHS appropriations, while
ATSDR is separately funded by Interior/Environment appropriations. Within LHHS ATSDR is separately funded by Interior/Environment appropriations. Within LHHS
appropriations, CDC appropriations, CDCreceives funding in several accounts, many of which align with CDC CIOs.
Some accounts fund activities through multiple CIOs (e.g., the Public Health Scientific Services
account). Some CDC accounts are for agency-wide activities, such as the Buildings and Facilities
account and the CDC-Wide Activities and Program Support account.
As an example, the Birth Defects, Developmental Disabilities, Disabilities and Health account
funds activities at CDC’s National Center on Birth Defects and Developmental Disabilities
(NCBDDD). The appropriations act text provides funding to the account with respect to such
activities as authorized by several PHSA titles as shown in Figure 3.
Figure 3. Example of CDC Appropriation Language
From FY2024 LHHS Appropriations
Source: Consolidated Appropriations Act, 2024, P.L. 118-47, Division D, Title II.
Appropriations report language accompanying CDC appropriations generally specifies amounts
for programs or activities funded by CDC accounts in greater detail than the appropriations act
text. Shown below in Figure 4 is the FY2024 report language and funding table accompanying
the Birth Defects and Developmental Disabilities appropriation.11
10 See CDC, “Grant Funding Profiles,” https://fundingprofiles.cdc.gov/.
11 For a general overview of appropriations report language, see CRS Report R44124, Appropriations Report
Language: Overview of Development and Components.
Congressional Research Service
5
link to page 13 link to page 10 
Centers for Disease Control and Prevention (CDC) Funding Overview
Figure 4. Example of CDC Appropriations Report Language
Source: “Explanatory Statement Accompanying Consolidated Appropriations Act, 2024,”funding is specified by the text that is under several headers, which fund thematically aligned program activities.
For example, the appropriations text under the header included in LHHS appropriations language in Figure 3 provides funding for CDC's chronic disease prevention and health promotion budget activities as authorized by several PHSA titles. Many of the headers align with CDC CIOs. The appropriations under the Chronic Disease Prevention and Health Promotion header fund budget activities at CDC's National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP).
Appropriations report language accompanying CDC appropriations has generally specified the amounts for programs or activities funded under CDC headers in greater detail than the appropriations text itself. In this report, appropriations report language refers to any explanatory statement, conference report, or committee report that accompanied CDC appropriations. As shown in Figure 4, the FY2026 LHHS explanatory statement and funding table for the Chronic Disease Prevention and Health Promotion header designates funding amounts for specific budget activities. The funding table also includes amounts from the Prevention and Public Health Fund (PPHF) to be transferred to several budget activities.
vol. vol.170 (March 22, 2024), p. H1889.
This CRS report focuses on account-level funding in Table 1. CDC’s annual Operating Plans
reflect programmatic funding levels within accounts172 (January 22, 2026), p. H1591.
Prior to FY2026, the set-asides specified in report language under CDC headers typically were not enacted into law. In FY2026, however, the LHHS appropriations act contained a general provision (Section 236) that enacted the funding tables in the accompanying explanatory statement under CDC headings by reference.12 In other words, FY2026 LHHS appropriations require that funding provided to CDC under its headings is for the budget activities and funding amounts in the explanatory statement that accompanied the law, such as those illustrated in Figure 4 above.
This CRS report focuses on appropriations provided under each header in Table 1. CDC's annual Operating Plans reflect programmatic funding levels within each of these appropriations as directed by appropriations report as directed by appropriations report
language.language.1213 In addition, the appropriations reports include many directives or recommendations In addition, the appropriations reports include many directives or recommendations
from Congress to CDC regarding funded programs.from Congress to CDC regarding funded programs.
Mandatory Funding from the Prevention and Public Health Fund (PPHF) ((FY2024FY2026 funding: funding:
$1.186$1.398 billion). billion). In recent years, some CDC LHHS accounts have received annual allocations of In recent years, some CDC LHHS accounts have received annual allocations of
the mandatory PPHF as directed in LHHS appropriations laws. In 2010, the Affordable Care Act the mandatory PPHF as directed in LHHS appropriations laws. In 2010, the Affordable Care Act
(ACA; P.L. 111-148, as amended) established the PPHF, which is a permanent, annual (ACA; P.L. 111-148, as amended) established the PPHF, which is a permanent, annual
appropriation that was intended to appropriation that was intended toprovide support prevention, wellness, and related public health support prevention, wellness, and related public health
programs funded through HHS accounts.programs funded through HHS accounts.1314 In recent years, appropriators have directed specific In recent years, appropriators have directed specific
amounts of annual PPHF funding to specific CDC accounts and programs (in addition to other amounts of annual PPHF funding to specific CDC accounts and programs (in addition to other
HHS agencies) through LHHS laws and accompanying report language.HHS agencies) through LHHS laws and accompanying report language.14 15 See Figure 5 for PPHF for PPHF
allocations from FY2024 appropriations.
12 See CDC, Operating Plans, https://www.cdc.gov/budget/operating-plans/index.html.
13 42 U.S.C. §300u-11(a).
14 Prior to FY2014, the HHS Secretary determined uses of the PPHF. See CRS report, CRS Report R47895, Prevention
and Public Health Fund: In Brief.
Congressional Research Service
6
link to page 10 link to page 16 
Centers for Disease Control and Prevention (CDC) Funding Overview
allocations for FY2026 appropriations. Under the authorizing law, overall PPHF appropriations increased from $1.3 billion in FY2025 to $1.525 billion in FY2026. Thus, in FY2026 enacted appropriations,16 Congress was subsequently able to increase overall PPHF funding allocated to CDC from this source by $212 million in FY2026 compared with FY2025.
From FY2024
From FY2026 LHHS Appropriations LHHS Appropriations
Explanatory Statement Source:“"Explanatory Statement Accompanying Consolidated Appropriations Act, Explanatory Statement Accompanying Consolidated Appropriations Act, 2024,”2026," Congressional Record, ,
vol. vol.170 (March 22, 2024), p. H1894.
As shown in172 (January 22, 2026), p. H1597.
As shown in Figure 5, most of the most of the FY2023FY2026 PPHF allocation went to CDC. Additional allocations PPHF allocation went to CDC. Additional allocations
went to the Administration for Community Living (ACL) and the Substance Abuse and Mental went to the Administration for Community Living (ACL) and the Substance Abuse and Mental
Health Services Administration (SAMHSA).Health Services Administration (SAMHSA).
Public Health Service Evaluation Tap ((FY2024FY2026: $43 million). The PHS Evaluation Set-Aside, : $43 million). The PHS Evaluation Set-Aside,
also known as the PHS Evaluation Tap, has the effect of redistributing a certain percentage of also known as the PHS Evaluation Tap, has the effect of redistributing a certain percentage of
eligible appropriations among HHS accounts funded by the LHHS Act (up to 2.5% of eligible eligible appropriations among HHS accounts funded by the LHHS Act (up to 2.5% of eligible
appropriations in appropriations inFY2024).15FY2026).17 Eligible appropriations potentially subject to the transfer include Eligible appropriations potentially subject to the transfer include
any provided for any programs authorized in the programs authorized in the Public Health Service ActPHSA, with some exemptions., with some exemptions.16
18 In recent years, appropriations laws have directed specific amounts of PHS tap funds to specific In recent years, appropriations laws have directed specific amounts of PHS tap funds to specific
agencies. Until FY2024, CDC had not received directed PHS tap transfers since FY2014 (see agencies. Until FY2024, CDC had not received directed PHS tap transfers since FY2014 (see
Figure 6). . By convention, appropriations acts direct where specified PHS tap transfers are to be By convention, appropriations acts direct where specified PHS tap transfers are to be
allocated, but do not specify the accounts that are to be the sources of those transfers. Thus, tables allocated, but do not specify the accounts that are to be the sources of those transfers. Thus, tables
in this report show only the amount of PHS tap funds in this report show only the amount of PHS tap fundsreceived indirected to any CDC account, and not the any CDC account, and not the
amount transferred out of source accounts.amount transferred out of source accounts.
Other funding. CDC sometimes receives funding for its core public health program level CDC sometimes receives funding for its core public health program level
through transfers from other sources, including both discretionary and mandatory appropriations, through transfers from other sources, including both discretionary and mandatory appropriations,
some subject to specific transfer rules.
15 Authorized by Section 241 of the Public Health Service Act (PHSA). The authorizing law allows the HHS Secretary
to redistribute a portion of eligible PHS agency appropriations across HHS for program evaluation purposes. The
PHSA limits the set-aside to not less than 0.2% and not more than 1.0% of eligible program appropriations. In recent
years, annual appropriations laws have established requirements in addition to those in statute. These include a higher
maximum percentage for the set-aside and directing specific amounts of tap funding to selected HHS programs. Since
FY2010, and including in FY2024, this higher maximum set-aside level has been 2.5% of eligible appropriations.
16 Annual appropriations laws have exempted certain appropriations from transfer that would be otherwise eligible. For
example, see in the Substance Abuse and Mental Health Services Administration (SAMHSA) appropriation for mental
health, “none of the funds provided for section 1911 of the PHS Act shall be subject to section 241 of such Act” in P.L.
118-47.
Congressional Research Service
7
link to page 16 link to page 16 link to page 16 Centers for Disease Control and Prevention (CDC) Funding Overview
some subject to specific transfer rules.
Transfers. In some years, CDC has received transfers from other HHS accounts. For example, as In some years, CDC has received transfers from other HHS accounts. For example, as
shown inshown in Figure 6,CDCCDC has received occasional transfers from the Public Health and Social has received occasional transfers from the Public Health and Social
Services Emergency Fund (PHSSEF).Services Emergency Fund (PHSSEF).17
19 CDC has not received a transfer from the PHSSEF since FY2017. Smaller mandatory appropriations for core public health programs. Some smaller CDC public Some smaller CDC public
health programs have been funded by mandatory budget authorities, such as for the Childhood health programs have been funded by mandatory budget authorities, such as for the Childhood
Obesity Demonstration ProjectObesity Demonstration Project,18 as authorized in Social Security Act (SSA) Section
1139A(e)(8).19
.20 Supplemental Appropriations
CDC has also received supplemental appropriations during public health emergencies and other specific incidents, CDC has also received supplemental appropriations during public health emergencies and other specific incidents,
such as during the COVID-19 pandemic, as discussed further insuch as during the COVID-19 pandemic, as discussed further in “ "Supplemental Appropriations for Public Health
Emergencies.” Of note, the recently enacted Emergencies." Of note, the COVID-19 supplemental appropriations and the American Rescue COVID-19 supplemental appropriations and the American Rescue
Plan Act (P.L. 117-2) budget reconciliation measure included several major Plan Act (P.L. 117-2) budget reconciliation measure included several major multiyear funding streams for general public funding streams for general public
health capabilitieshealth capabilities that were not specific to the pandemic, such as for data modernization. These additional appropriations not specific to the pandemic, such as for data modernization. These additional appropriations
are discussed in a separate section in this CRS report to distinguish regular appropriations for CDCare discussed in a separate section in this CRS report to distinguish regular appropriations for CDC’'s annual s annual
operations from these one-time appropriations.operations from these one-time appropriations.
Other Mandatory Programs
CDC also administers several health services and compensation-related programs that are funded CDC also administers several health services and compensation-related programs that are funded
by mandatory budget authorities and are distinct from the agencyby mandatory budget authorities and are distinct from the agency’'s core public health programs. s core public health programs.
In several cases, the programIn several cases, the program’'s authorizing law determines annual funding levels for these s authorizing law determines annual funding levels for these
programs. In addition, CDC receives a small amount of user fees through authorized user fee programs. In addition, CDC receives a small amount of user fees through authorized user fee
programs.programs.
The Vaccines for Children (VFC) program ((FY2024FY2026 estimate: $ estimate: $7.2136.072 billion) provides billion) provides
vaccines to enrolled health care providers to vaccinate eligible children.vaccines to enrolled health care providers to vaccinate eligible children.2021 As authorized in SSA As authorized in SSA
Section 1928 (42 U.S.C. §1396s), the HHS Secretary can purchase vaccines as necessary for Section 1928 (42 U.S.C. §1396s), the HHS Secretary can purchase vaccines as necessary for
eligible children at a federally negotiated discounted price and then distribute vaccines to eligible children at a federally negotiated discounted price and then distribute vaccines to
participating state and local health departments. State and local health departments then distribute participating state and local health departments. State and local health departments then distribute
a portion of the supply to participating health care providers and also administer vaccines through a portion of the supply to participating health care providers and also administer vaccines through
their own programs. In addition, some of the annual VFC funding is awarded to states and other
jurisdictions for program operations and administration.21 their own programs. VFC is financed by a Medicaid VFC is financed by a Medicaid
appropriation within the HHS Centers for Medicare & Medicaid Services (CMS) and is
17 The Public Health and Social Services Emergency Fund is an account of the HHS Secretary that has historically
funded several offices and programs, including the Administration for Strategic Preparedness and Response (ASPR),
the HHS Cybersecurity program, and the Office of National Security. It is also frequently used to provide emergency
supplemental appropriations for transfer by the HHS Secretary to agencies in HHS and elsewhere, according to
legislative direction.
18 Social Security Act (SSA) Section 1139(e)(8).
19 See, for example, funding for the CDC’s Childhood Obesity Research Demonstration (CORD) Project was initially
authorized through the Children’s Health Insurance Program Reauthorization Act of 2009 (CHIPRA; P.L. 111-3), and
the program was extended through several laws until FY2023. CDC, “Report to Congress on the Centers for Disease
Control and Prevention’s Childhood Obesity Research Demonstration Project,” https://www.cdc.gov/obesity/
downloads/strategies/report-to-congress-CORD-508.pdf.
20 VFC is funded by Medicaid appropriations that are transferred annually to CDC. See 42 U.S.C. §1396s.
21 See “State Table: Vaccines for Children” in CDC, FY2025 Congressional Budget Justification, pp. 81-82,
https://www.cdc.gov/budget/documents/fy2025/FY-2025-CDC-congressional-justification.pdf.
Congressional Research Service
8
Centers for Disease Control and Prevention (CDC) Funding Overview
administered by CDC.22appropriation within the HHS Centers for Medicare & Medicaid Services (CMS) and is administered by CDC.22 Like other Medicaid programs, VFC is an appropriated entitlement, Like other Medicaid programs, VFC is an appropriated entitlement,
meaning that VFC funding is provided through LHHS appropriations acts, but the funding level is meaning that VFC funding is provided through LHHS appropriations acts, but the funding level is
determined based on budget projections for meeting the funding needs of the program as required determined based on budget projections for meeting the funding needs of the program as required
by the programby the program’'s authorization law.s authorization law.2323
The Energy Employees Occupational Illness Compensation Program (EEOICP) ( (FY2024
estimateFY2026: $51 million), administered by the Department of Labor (DOL),: $51 million), administered by the Department of Labor (DOL), provides compensation provides compensation
and medical benefits to eligible civilians (or their survivors) who have performed duties related to and medical benefits to eligible civilians (or their survivors) who have performed duties related to
the nuclear weapons production and testing programs of the Department of Energy.the nuclear weapons production and testing programs of the Department of Energy.24 CDC
24 CDC's National Institute for Occupational Safety and Health (NIOSH) provides support to the program by conducting radiation dose estimates, evaluating certain provides support to the program by conducting radiation dose estimates, evaluating certain
petitions, and providing other administrative support. DOL uses these estimates in making petitions, and providing other administrative support. DOL uses these estimates in making
compensation determinations.25compensation determinations.25 Annual funding for these CDC activities is generally provided Annual funding for these CDC activities is generally provided
pursuant to Section 151(b) of Division B, Title I of Consolidated Appropriations Act, 2001 (P.L. pursuant to Section 151(b) of Division B, Title I of Consolidated Appropriations Act, 2001 (P.L.
106-554), which specifies that annual funding pursuant to that section shall be direct spending 106-554), which specifies that annual funding pursuant to that section shall be direct spending
(i.e., mandatory funding).(i.e., mandatory funding).26
26 The World Trade Center Health Program (WTCHP) ((FY2024FY2026 estimated obligations: $ estimated obligations: $768
913 million) provides medical monitoring and treatment to eligible individuals directly affected by the million) provides medical monitoring and treatment to eligible individuals directly affected by the
September 11, 2001 attacks for certain incident-related health conditions. This program also funds September 11, 2001 attacks for certain incident-related health conditions. This program also funds
medical research into health conditions that may develop due to exposure during the attacks.medical research into health conditions that may develop due to exposure during the attacks.27
27 The program is authorized by PHSA Title XXXIII (42 U.S.C. §§300mm et seq.) and funded The program is authorized by PHSA Title XXXIII (42 U.S.C. §§300mm et seq.) and funded
through appropriations provided by PHSA Section 3351 (42 U.S.C. §300mm–61).through appropriations provided by PHSA Section 3351 (42 U.S.C. §300mm–61).
User fee programs ((FY2024FY2026 estimate: $2 estimate: $2.226 million). CDC also receives relatively small million). CDC also receives relatively small
amounts of user fees from authorized user fee programs such as the vessel sanitation program,amounts of user fees from authorized user fee programs such as the vessel sanitation program,28
28 which collects fees from cruise ship owners for public health inspections. In addition, the which collects fees from cruise ship owners for public health inspections. In addition, the
respirator certification program charges fees to respirator manufacturers for certain regulatory respirator certification program charges fees to respirator manufacturers for certain regulatory
activities.29
22 Centers for Medicare & Medicaid Services (CMS), FY2025 Congressional Budget Justification, p. 97,
https://www.cms.gov/files/document/fy2025-cms-congressional-justification-estimates-appropriations-committees.pdf.
23 See CRS Report R42640, Medicaid Financing and Expenditures.
24 CDC, “NIOSH Radiation Dose Reconstruction Program,” https://www.cdc.gov/niosh/ocas/faqsact.html.
25 CDC, “Energy Employees Occupational Illness Compensation Program Act (EEOICPA) Budget Request” in
FY2025 Congressional Budget Justification, p. 360, https://www.cdc.gov/budget/documents/fy2025/FY-2025-CDC-
congressional-justification.pdf.
26 See, for example, in FY2021 LHHS appropriations, 134 STAT 1571 of Division H, Title II, P.L. 116-260.
27 CDC, “World Trade Center Health Program,” https://www.cdc.gov/wtc/.
28 “The Vessel Sanitation Program (VSP) at the Centers for Disease Control and Prevention (CDC) assists the cruise
ship industry to prevent and control the introduction, transmission, and spread of gastrointestinal (GI) illnesses on
cruise ships.” Under authority in in PHSA Section 361; 42 U.S.C. §264. See CDC, “Vessel Sanitation Program,”
https://www.cdc.gov/vessel-sanitation/about/index.html. CDC collects fees from ship owners for operational
inspections, see CDC, “Public Health Operational Inspections,” https://www.cdc.gov/vessel-sanitation/php/age-on-
cruise-ships/public-health-inspections.html.
29 The respirator certification program conducts assessments and NIOSH approval of particulate filtering facepiece
respirators. 42 C.F.R. Part 84. See also CDC, Respirator Certification Fees Schedules,” https://www.cdc.gov/niosh/
npptl/respcertfeescheduletables.html.
Congressional Research Service
9
link to page 13 link to page 13 link to page 13 Centers for Disease Control and Prevention (CDC) Funding Overview
Proposed Mandatory Programs
The Biden Administration proposed new mandatory programs in the FY2025 budget request,
summarized below.30 Estimated amounts for those programs are summarized in Table 1 where
applicable.
• Pandemic Preparedness. For FY2025, President Biden’s budget proposes
$6.100 billion in public health preparedness funding as a transfer to CDC from
$20.000 billion appropriated to the Public Health and Social Services Emergency
Fund, to be made available for five years. The FY2025 proposed public health
preparedness funding is presented as a non-add in the President’s budget and is
therefore not included within the FY2025 total program level for CDC.
• Vaccines for Adults Program. According to the request, CDC submitted a
legislative proposal for mandatory funding of $1.004 billion in FY2025 for a
capped mandatory program to provide vaccines to adults. As requested, $12
billion would be provided for the program over 10 years.
• VFC program modifications. Similar to the FY2024 request, the CDC proposes
some legislative changes to VFC, including expanding eligibility to all children
under 19 years of age enrolled in the Children’s Health Insurance Program
(CHIP). The proposal would also change the fee structure for providers
participating in the program. Both of those changes would affect annual VFC
funding. The FY2025 requested amount for VFC in Table 1 does not reflect all
the proposed program modifications.
• Community Violence Intervention: The request proposes $150 million in
mandatory funding for a Community Violence Intervention Initiative, in addition
to $100 million in discretionary funding. According to CDC, “This investment
will support scaling up existing community violence prevention efforts and
implementing and evaluating programs, policies, and practices based on the best
available evidence for preventing community violence.”31
Funding Table
Table 1 provides an overview of CDC/ATSDR budget and appropriations for FY2023 enacted
through the FY2025 budget requestactivities.29
FY2026 Enacted
As shown in Table 1, in FY2026 enacted appropriations, CDC received a total core public health program level of $9.227 billion, a slight decrease (-$21 million, or -0.2%) from the comparable FY2025 final funding level. Also, as shown in Table 1, most CDC budget activities saw similar funding levels to the prior year funding levels.
Staffing and reorganization. A new provision, Section 239 requires HHS to support staffing levels necessary to fulfill its statutory responsibilities. The section also requires that, 60 days prior to initiating any reorganization of CDC programs or functions to another HHS component, HHS is to submit a detailed plan to the appropriations committees and make such plan public.
Notification of grant terminations and nonrenewals. Section 524 was updated to require HHS (and other LHHS-funded agencies) to notify the appropriations committees at least three days in advance of a termination or noncontinuation of any grant, including a short description of the reason for termination or noncontinuation. CRS analysis of HHS data on grant terminations show that as of May 13, 2026, under the second Trump Administration, HHS had terminated 444 CDC grants totaling $5.78 billion in unliquidated obligations (i.e., funds that had not been spent under the grants).32 Funding Table
Table 1 provides an overview of CDC/ATSDR-enacted appropriations for FY2024 through FY2026, reflecting all sources of regular budget authority (excludes , reflecting all sources of regular budget authority (excludes
supplemental appropriations).supplemental appropriations).
Table 1. Centers for Disease Control and Prevention (CDC) and
Agency for Toxic Substances and Disease Registry (ATSDR) Appropriations,
FY2023-FY2025 Request
FY2024-FY2026
(Millions of Dollars)(Millions of Dollars)
2023
FY2024
FY2024
FY2025
Program or Activity
Final
Request
Enacted
Request
Immunization and Respiratory Diseases
919
1,256
919
969
30 CDC, FY2025 Congressional Budget Justification, pp. 15 and 28,
https://www.cdc.gov/budget/documents/fy2025/FY-2025-CDC-congressional-justification.pdf.
31 CDC, FY2025 Congressional Budget Justification, p. 15, https://www.cdc.gov/budget/documents/fy2025/FY-2025-
CDC-congressional-justification.pdf.
Congressional Research Service
10
link to page 15 link to page 15 Centers for Disease Control and Prevention (CDC) Funding Overview
2023
FY2024
FY2024
FY2025
Program or Activity
Final
Request
Enacted
Request
PPHF Transfer (non-add)
(419)
(505)
(682)
(469)
HIV/AIDS, Viral Hepatitis, STI and TB
1,391
1,545
1,391
1,391
Emerging & Zoonotic Infectious Diseases
751
846
760
781
PPHF Transfer (non-add)
(52)
(52)
(52)
(52)
Chronic Disease Prevention and Health Promotion
1,430
1,814
1,434
1,559
PPHF Transfer (non-add)
(255)
(262)
(241)
(255)
Birth Defects, Developmental Disabilities, Disability
206
223
206
206
and Health
Environmental Health
247
421
243
267
PPHF Transfer (non-add)
(17)
(17)
(51)
(17)
PHS Evaluation Transfer (non-add)
—
(7)
—
—
Injury Prevention and Control
761
1,352
761
943
PHS Evaluation Transfer (non-add)
—
—
—
(100)
Public Health Scientific Services
754
962
754
804
PPHF Transfer (non-add)
—
(140)
—
(183)
PHS Evaluation Transfer (non-add)
—
(170)
(43)
—
Occupational Safety and Health
363
363
363
363
Global Health
693
765
693
694
Public Health Preparedness and Responseb
905
943
938
943
Crosscutting Activities and Program Support
724
1,039
664
724
PPHF Transfer (non-add)
(160)
(160)
(160)
(160)
Office of the Director (non-add)
(129)
(144)
(129)
(129)
Infectious Diseases Rapid Response Reserve Fund (non-add)
(35)
(35)
(25)
(35)
Public Health Infrastructure and Capacity (non-add)
(350)
(600)
(350)
(350)
Center for Forecasting and Analytics (CFA; non-add)
(50)
(50)
—
—
CFA- PPHF Transfer (non-add)
—
(50)
—
(50)
Buildings and Facilities
40
55
40
40
Agency for Toxic Substances and Disease Registry
85
86
82
85
(ATSDR)c
Total, Core Public Health Program Level (CPHPL)
9,269
11,667
9,248
9,769
Less PPHF (mandatory)
-903
-1,186
-1,186
-1,186
Less PHS Evaluation Transfer
—
-177
-43
-100
Total, CDC/ATSDR Discretionary BA
8,366
10,303
8,019
8,482
Less ATSDR
-85
-86
-82
-85
Total, CDC LHHS Discretionary BA
8,281
10,217
7,938
8,397
Vaccines for Children (VFC)
5,217
6,002
7,213
8,040
Congressional Research Service
11
link to page 15 link to page 15 link to page 15 link to page 16 Centers for Disease Control and Prevention (CDC) Funding Overview
2023
FY2024
FY2024
FY2025
Program or Activity
Final
Request
Enacted
Request
Energy Employees Occupational Il ness Compensation
51
51
51
51
Program Act (EEOICPA)d
Agency for Toxic Substances and Disease Registry (ATSDR)a
Energy Employees Occupational Illness Compensation Program Act (EEOICPA)b
Total Other Mandatory Programsc
World Trade Center Health Program (WTCHP)e
710
782
768
788
User Fees
2
2
2
2
Vaccines for Adults (proposed mandatory)
—
1,004
—
1,004
Community Violence Intervention (proposed mandatory)
—
—
—
150
Total Other Mandatory Programsf
5,980
7,841
8,034
10,035
Total, Core Public Health Program Level + Other
15,249
19,508
17,282
19,803
Mandatory
Pandemic Preparedness (proposed mandatory)
—
6,100
—
6,100
Total w/ Pandemic Preparedness
15,249
25,608
17,282
25,753
Source: FY2023 final and FY2025 requested amounts from CDC, “FY2025 Budget Detail Table,”
https://www.cdc.gov/budget/documents/fy2025/FY-2025-CDC-Budget-Detail.pdf. FY2024 request and enacted
amountsMandatory
Source: FY2024 final amounts from CDC, "FY2024 Operating Plan," https://stacks.cdc.gov/view/cdc/177366; FY2025 final amounts from CDC, "FY2026 Operating Plan," https://www.cdc.gov/budget/documents/fy2026/FY-2026-CDC-Operating-Plan.pdf. Enacted amounts for FY2026 are from are from Congressional Record, vol. 172 (January 22, 2026), pp. H1591-H1593; mandatory amounts for FY2024, FY2025, and FY2026 are from FY2027 and FY2026 budget documents, including the congressional justifications for CDC, Administration for a Healthy America, and the Centers for Medicare & Medicaid Services, as well as the President's budget appendix. Amounts shown in table do not account for U.S. Department of State transfers to CDC for global health programs., vol. 170, no. 51 (March 22, 2024), H2020-H2022, and other mandatory
program amounts from CDC, “FY2025 Budget Detail Table,” https://www.cdc.gov/budget/documents/fy2025/FY-
2025-CDC-Budget-Detail.pdf, except where noted below.
Notes: Individual amounts may not add to subtotals or totals due to rounding. Individual amounts may not add to subtotals or totals due to rounding. FY2023 enactedEnacted amounts reflect amounts reflect
some post-appropriations adjustments. Acronyms: some post-appropriations adjustments. Acronyms: BA = Budget Authority; HIV = Human Immunodeficiency Virus; AIDS = Acquired HIV = Human Immunodeficiency Virus; AIDS = Acquired
Immunodeficiency Syndrome; STI = Sexually Transmitted Infection; TB = Tuberculosis; PPHF = Prevention and Immunodeficiency Syndrome; STI = Sexually Transmitted Infection; TB = Tuberculosis; PPHF = Prevention and
Public Health Fund; ATSDR= Agency for Toxic Substances and Disease Registry.
a. The FY2024 request proposed consolidating 13 CDC LHHS discretionary accounts into a single account.
For the sake of comparability, this request is displayed with amounts in the current account structure.
b. This reflects $21 mil ion in appropriations from the Public Health and Social Services Emergency Fund for
CDC activities added to the FY2023 appropriated amount ($883 mil ion).
c. Provided separately in the Interior/Environment Appropriations Act.
d. Per the FY2024 budget request table, all amounts for EEOICPA reflect sequestration and therefore differ
from appropriated funding levels.
e. Amounts reflect federal obligations. FY2023 WTHCP amount does not include the $1 bil ion supplemental
appropriation provided in Consolidated Appropriations Act, 2023 (P.L. 117-328), or from the special fund
enacted in P.L. 118-31.
f.
FY2024 and FY2025 amounts are estimates for VFC, WTCHP, User Fees, and Vaccines for Adults.
Trends in Core Public Health Program Level
As shown in Figure 6, in terms of nominal dollars, from FY2011 to FY2021, CDC’s core public
health program level remained mostly between $6.5 and $8 billion until the increases provided in
FY2022 (+9.0%) and FY2023 (+11.2%; not adjusted for inflation)Public Health Fund; ATSDR= Agency for Toxic Substances and Disease Registry.
a. Provided separately in the Interior/Environment Appropriations Act.
b. Per the FY2024 and FY2026 operation plans, all amounts for EEOICPA reflect sequestration and therefore differ from appropriated funding levels.
c. FY2026 amounts are estimates for VFC, WTCHP, and User Fees.
FY2027 Budget Request: Proposed Funding Changes
National Center for Chemicals and Toxins. The budget also proposes the creation of a new CDC center that would consolidate HHS environmental, toxicological, and chemical programs within a single organizational framework. The center would realign programs, projects, and activities of ATSDR, the National Center for Environmental Health (CDC), the National Institute of Occupational Safety and Health (CDC), National Institute of Environmental Health Sciences (relocated from the National Institutes of Health [NIH]), and National Center for Toxicological Research (relocated from the Food and Drug Administration [FDA]). Trends in Core Public Health Program Level
As shown in Figure 6, in terms of nominal dollars, from FY2011 to FY2021, CDC's core public health program level remained mostly between $6.5 and $8 billion. From FY2011 to FY2021, . From FY2011 to FY2021,
CDC saw annual increases and decreases in its core public health funding level ranging from 1% CDC saw annual increases and decreases in its core public health funding level ranging from 1%
to 6% (except for FY2013). For FY2013—the lowest funding level in the period covered—to 6% (except for FY2013). For FY2013—the lowest funding level in the period covered—
budget sequestration of nonexempt discretionary spending occurred.budget sequestration of nonexempt discretionary spending occurred.3239 CDC saw CDC saw anincreases provided in FY2022 (+9.0%) and FY2023 (+11.2%; not adjusted for inflation). CDC's core public health program level has stayed roughly flat from FY2023 through FY2026. CDC saw a slight overall overall
decrease in its program decrease in its programlevel in FY2024 (-1.8%). The FY2025 request would provide an increase
of 5.6%.
32 CDC, “Fact Sheet: Impact of Sequestration and other Budget Changes on the Centers for Disease Control and
Prevention,” https://www.cdc.gov/budget/documents/fy2013/fy-2013-sequester-impacts.pdf.
Congressional Research Service
12
Centers for Disease Control and Prevention (CDC) Funding Overview
Figure 6. Trends in Core Public Health Program Level
FY2011-FY2024 final, FY2025 request ($ in billions, nominal)
(Figure is interactive in the HTML version of this report.)
Source: CDC Congressional Budget Justifications, and sources in Table 1.
Notes: Amounts are not adjusted for inflation. *President’s budget request; does not reflect proposed
mandatory preparedness funding. levels in FY2024 (-0.22%) and again in FY2026 (-0.23%).
Labor, Health and Human Services, Education, and Related Agencies appropriations Labor, Health and Human Services, Education, and Related Agencies appropriationsbil bill; ATSDR = Agency for ; ATSDR = Agency for
Toxic Substances and Disease Registry; PPHF = Prevention and Public Health Fund; PHSSEF = Public Health and Toxic Substances and Disease Registry; PPHF = Prevention and Public Health Fund; PHSSEF = Public Health and
Social Services Emergency Fund; PHS = Public Health Service; ACA = Affordable Care Act.Social Services Emergency Fund; PHS = Public Health Service; ACA = Affordable Care Act.
CDC Budget in Context
Supplemental Appropriations for Public Health Emergencies and
Other Incidents
CDC CDC has regularly regularlyreceivesreceived supplemental or one-time appropriations in response to public health supplemental or one-time appropriations in response to public health
emergencies and other incidents. For example, since 2019, CDC has received supplemental emergencies and other incidents. For example, since 2019, CDC has received supplemental
appropriations for hurricane and natural disaster response (for example, in P.L. 116-20 and P.L. appropriations for hurricane and natural disaster response (for example, in P.L. 116-20 and P.L.
117-328), the Coronavirus Disease 2019 (COVID-19) pandemic,117-328), the Coronavirus Disease 2019 (COVID-19) pandemic,3340 medical screening and medical screening and
supports for Afghan refugees (P.L. 117-70), and funding for domestic and global activities related supports for Afghan refugees (P.L. 117-70), and funding for domestic and global activities related
to the war in Ukraine (e.g., P.L. 117-128). These amounts are not reflected in the other sections of to the war in Ukraine (e.g., P.L. 117-128). These amounts are not reflected in the other sections of
33 See CRS Report R46711, U.S. Public Health Service: COVID-19 Supplemental Appropriations in the 116th
Congress and CRS Report R46834, American Rescue Plan Act of 2021 (P.L. 117-2): Public Health, Medical Supply
Chain, Health Services, and Related Provisions.
Congressional Research Service
13
Centers for Disease Control and Prevention (CDC) Funding Overview
this report as they are not intended to fund the agencythis report as they are not intended to fund the agency’'s regular operating expenses and programs. s regular operating expenses and programs.
While these supplemental funds While these supplemental fundsarewere, in most cases, primarily intended for the specific incident for , in most cases, primarily intended for the specific incident for
which they which theyarewere appropriated, they appropriated, they arewere sometimes correlated with cycles of funding increases and sometimes correlated with cycles of funding increases and
decreases for overall public health capacity at the federal, state, and local levelsdecreases for overall public health capacity at the federal, state, and local levels. Congress has often appropriated emergency supplemental funding to HHS for purposes that are somewhat general, or with the authority for HHS to transfer those funds, and therefore HHS has decided the final allocation of funds among HHS operating divisions (such as CDC). Final data on HHS supplemental appropriations allocations are not available for all public health emergencies. Large historical . Large historical
supplemental appropriations to the agency and subsequent funding awards to state and local supplemental appropriations to the agency and subsequent funding awards to state and local
agencies includeagencies include
• the following: H1N1 influenza pandemic, 2009. In response to the H1N1 influenza pandemic, In response to the H1N1 influenza pandemic,
CDC spent $600 million on its public health response and also administered $1.4 CDC spent $600 million on its public health response and also administered $1.4
billion through its Public Health Emergency Response grant program to state and billion through its Public Health Emergency Response grant program to state and
local partners.local partners.3441 These funds were made available to CDC from the Supplemental These funds were made available to CDC from the Supplemental
Appropriations Act of 2009 (P.L. 111-32), enacted in June 2009.Appropriations Act of 2009 (P.L. 111-32), enacted in June 2009.
•
Ebola outbreak, 2014-2015. In response to the Ebola outbreak, In response to the Ebola outbreak, the Consolidated Consolidated
and Further Continuing Appropriations Act, 2015 (P.L. 113-235; Division G), and Further Continuing Appropriations Act, 2015 (P.L. 113-235; Division G),
enacted in December 2014, provided CDC with $1.771 billion for both domestic enacted in December 2014, provided CDC with $1.771 billion for both domestic
and international Ebola preparedness and response efforts.and international Ebola preparedness and response efforts.3542 Using these funds, Using these funds,
CDC provided several supplemental grants to state and local agencies, including CDC provided several supplemental grants to state and local agencies, including
$145 million through the Public Health Emergency Preparedness (PHEP) $145 million through the Public Health Emergency Preparedness (PHEP)
cooperative agreement and more than $114 million through the Epidemiology cooperative agreement and more than $114 million through the Epidemiology
and Laboratory Capacity (ELC) grant program.and Laboratory Capacity (ELC) grant program.36
• 43
Zika outbreak, 2016. The Zika Response and Preparedness Appropriations Act, The Zika Response and Preparedness Appropriations Act,
2016 (P.L. 114-223; Division B) provided $394 million to CDC in supplemental 2016 (P.L. 114-223; Division B) provided $394 million to CDC in supplemental
appropriations for preparedness and response to the Zika outbreak, domestically appropriations for preparedness and response to the Zika outbreak, domestically
and internationally.and internationally.3744 CDC obligated a portion of the funding to state and local CDC obligated a portion of the funding to state and local
agencies through several grant programs, including more than $184 million agencies through several grant programs, including more than $184 million
through the ELC grant program.through the ELC grant program.38
• 45
COVID-19 pandemic, 2020-present. Multiple COVID-19 relief laws provided funding directly to CDC or funding that was later transferred to CDC. As reported by GAO, as of As reported by GAO, as of January 2023,
April 2024, CDC has received $CDC has received $26.425.2 billion through billion through the COVID-19 reliefthose appropriations appropriations
measures to the CDC-Wide Activities and Program Support measures to the CDC-Wide Activities and Program SupportAccount.39 Some of
header.46 As part of this total, some of the one-time public health funding for CDC in the American Rescue Plan Act the one-time public health funding for CDC in the American Rescue Plan Act
(ARPA; P.L. 117-2) was not tied to the pandemic, but instead was made available (ARPA; P.L. 117-2) was not tied to the pandemic, but instead was made available
for general public health capabilitiesfor general public health capabilities, see (see the example of the Public Health example of the Public Health
Infrastructure grant program in the textbox belowInfrastructure grant program in the textbox below). In addition, CDC has . In addition, CDC hasreceived
at least $1 billion in transfers and has administered more than $40 billion through administered more than $40 billion through
its grant programs funded by HHS appropriations from the PHSSEF account.40
34 U.S. Government Accountability Office, Influenza Pandemic: Lessons from the H1N1 Pandemic Should be
Incorporated into Future Planning, GAO-11-632, June 2011, pp. 7, 16, https://www.gao.gov/assets/gao-11-632.pdf.
35 P.L. 113-234, 128 Stat. 2520.
36 CDC, “Ebola Funding,” https://web.archive.org/web/20220306103011/https://www.cdc.gov/cpr/readiness/funding-
ebola.htm, and data provided by CDC to CRS on April 22, 2022. See also U.S. Government Accountability Office,
Infectious Disease Threats: Funding and Performance of Key Preparedness and Capacity-Building Programs, May
2018, https://www.gao.gov/assets/gao-18-362.pdf.
37 P.L. 114-223, 130 Stat. 901- 130 Stat. 902.
38 U.S. Government Accountability Office, Zika Supplement: Status of HHS Agencies’ Obligations, Disbursements, and
the Activities Funded, GAO-18-389, May 2018, pp. 33-54, https://www.gao.gov/assets/gao-18-389.pdf, and data
provided by CDC to CRS on April 22, 2022.
39 CDC received funding from five different COVID-19 relief laws: P.L. 116-123, P.L. 116-136, P.L. 116-139, P.L.
116-260, and P.L. 117-2. U.S. Government Accountability Office, COVID-19 Relief: Funding and Spending as of Jan.
31, 2023, GAO- 23-106647, February 2023, https://www.gao.gov/assets/gao-23-106647.pdf.
40 CDC, “Budget: Novel Coronavirus (COVID-19),” https://www.cdc.gov/budget/fact-sheets/covid-19/index.html.
Congressional Research Service
14
Centers for Disease Control and Prevention (CDC) Funding Overview
its grant programs funded by HHS appropriations from the PHSSEF account.47 As a result, of the total appropriated to and administered by CDC, $59.As a result, of the total appropriated to and administered by CDC, $59.525625 billion billion
in CDC COVID-19 grants have been awarded to state, tribal, and local agencies in CDC COVID-19 grants have been awarded to state, tribal, and local agencies
as of September as of September20232024 (amount includes some regular appropriations).48 Some of the COVID relief dollars were ultimately (amount includes some regular appropriations).41 For more
information on CDC funding in the COVID-19 relief laws, see, CRS Report
R46711, U.S. Public Health Service: COVID-19 Supplemental Appropriations in
the 116th Congress and CRS Report R46834, American Rescue Plan Act of 2021
(P.L. 117-2): Public Health, Medical Supply Chain, Health Services, and Related
Provisions.
Some of the COVID relief dollars have since been rescinded. The Congressional Budget Office rescinded. The Congressional Budget Office
estimated that the Fiscal Responsibility Act (P.L. 118-5) rescinded $1.5 billion in CDC budget estimated that the Fiscal Responsibility Act (P.L. 118-5) rescinded $1.5 billion in CDC budget
authority. In addition, FY2024 appropriations authority. In addition, FY2024 appropriations and the FY2025 continuing resolution rescinded certain American Rescue Plan Act rescinded certain American Rescue Plan Act
appropriations for public health; the full impact on CDC is unclear from publicly available appropriations for public health; the full impact on CDC is unclear from publicly available
sources.42
Congress often appropriates emergency supplemental funding to HHS for purposes that are
somewhat general, or with the authority for HHS to transfer those funds, and therefore HHS
decides the final allocation of funds among HHS operating divisions (such as CDC). Final data on
HHS supplemental appropriations allocations are not available for all public health emergencies
listed above.
sources.49 For more information on CDC funding in the COVID-19 relief laws, see, CRS Report R46711, U.S. Public Health Service: COVID-19 Supplemental Appropriations in the 116th Congress and CRS Report R46834, American Rescue Plan Act of 2021 (P.L. 117-2): Public Health, Medical Supply Chain, Health Services, and Related Provisions. Spotlight: Public Health Infrastructure Grant Program
CDC began to fund a new Public Health Infrastructure Grant program beginning in FY2023, drawing from roughly CDC began to fund a new Public Health Infrastructure Grant program beginning in FY2023, drawing from roughly
$3.5 $3.5bil ionbillion provided in the American Rescue Plan Act for public health workforce and data modernization provided in the American Rescue Plan Act for public health workforce and data modernization
programs combined with funding from regular appropriations (GAO-24-105891). Through this program, CDC programs combined with funding from regular appropriations (GAO-24-105891). Through this program, CDC
expects to award $5 expects to award $5bil ionbillion over five years to 107 health departments in all 50 states; Washington, DC; eight over five years to 107 health departments in all 50 states; Washington, DC; eight
territories and freely associated states; and 48 large localities. territories and freely associated states; and 48 large localities. As of December 2025, the award includes $4.6 billion for health departments and roughly $382 million for three national public health partners over the five-year grant period. Recipients are to use this award to hire and retain Recipients are to use this award to hire and retain
public health staff, strengthen organization systems and processes, and modernize public health data systems. State public health staff, strengthen organization systems and processes, and modernize public health data systems. State
health department recipients are expected to distribute a portion of grant funds for public health workforce health department recipients are expected to distribute a portion of grant funds for public health workforce
among local health departments that did not receive direct grant funding from CDC. Given that this five-year among local health departments that did not receive direct grant funding from CDC. Given that this five-year
grant is funded in large part by a one-time appropriation from the ARPA, funds may no longer be available to grant is funded in large part by a one-time appropriation from the ARPA, funds may no longer be available to
support hired staff support hired staffatpast the end of the five-year period the end of the five-year period (November 30, 2027).
.
For further information, see CDC, For further information, see CDC,“"Public Health Infrastructure Grant,Public Health Infrastructure Grant,” " https://www.cdc.gov/infrastructure-https://www.cdc.gov/infrastructure-
phig/about/. phig/about/.
CDC Infectious Diseases Rapid Response Reserve Fund
FY2019 appropriations (P.L. 115-245) established an Infectious Diseases Rapid Response FY2019 appropriations (P.L. 115-245) established an Infectious Diseases Rapid Response
Reserve Fund (IDRRRF) at CDC.Reserve Fund (IDRRRF) at CDC.4350 The IDRRRF is an emergency reserve fund available The IDRRRF is an emergency reserve fund available
specifically for infectious disease emergencies. Funds may be drawn from IDRRRF for an specifically for infectious disease emergencies. Funds may be drawn from IDRRRF for an
infectious disease emergency if the HHS Secretaryinfectious disease emergency if the HHS Secretary
• declares a public health emergency pursuant to PHSA Section 319, ordeclares a public health emergency pursuant to PHSA Section 319, or
•
determines that the infectious disease emergency determines that the infectious disease emergency “"has significant potential to has significant potential to
imminently occur and potential, on occurrence, to affect national security or the imminently occur and potential, on occurrence, to affect national security or the
health, and security of United States citizens, domestically or internationally.health, and security of United States citizens, domestically or internationally.”
41 CDC, “CDC COVID-19 State, Tribal, Local, and Territorial Funding,” data last updated September 5, 2023,
https://www.cdc.gov/budget/fact-sheets/covid-19/funding/index.html.
42 See Section 529 of Division D of P.L. 118-47.
43 Department of Defense and Labor, Health and Human Services, and Education Appropriations Act, 2019 and
Continuing Appropriations Act, 2019, P.L. 115-245, Division B, Title II, Section 231. Codified at 42 U.S.C. §247d-4a.
Congressional Research Service
15
link to page 19 link to page 11 Centers for Disease Control and Prevention (CDC) Funding Overview
"The CDC Director may transfer IDRRRF funds to other CDC accounts as well as to The CDC Director may transfer IDRRRF funds to other CDC accounts as well as to National
Institutes of Health (NIH)NIH accounts or the PHSSEF account. accounts or the PHSSEF account.44
51
Since FY2019, the IDRRRF has received the following regular and supplemental appropriations Since FY2019, the IDRRRF has received the following regular and supplemental appropriations
shown in Table 2.
Table 2. Appropriations History to the IDRRRF
Amount
Fiscal Year
Law and Type of Appropriation
Amount(dollars in millions)
FY2019
P.L. 115-245, regularP.L. 115-245, regular
$50
FY2020
P.L. 116-94, regularP.L. 116-94, regular
$85
P.L. 116-123, supplementalP.L. 116-123, supplemental
$300
P.L. 116-136, supplementalP.L. 116-136, supplemental
$300
FY2021
P.L. 116-260 (Division H), regularP.L. 116-260 (Division H), regular
$10
FY2022
P.L. 117-103, regularP.L. 117-103, regular
$20
FY2023
P.L. 117-328, (Division H), regularP.L. 117-328, (Division H), regular
$35
FY2024
P.L. 118-47, (Division D), regularP.L. 118-47, (Division D), regular
$25
Source: CRS analysis of appropriations laws.
IDRRRF funding has been used for multiple responses, including for recent Ebola outbreaks in IDRRRF funding has been used for multiple responses, including for recent Ebola outbreaks in
Africa, the mpox outbreak in 2022-2023, and for the COVID-19 pandemic response.Africa, the mpox outbreak in 2022-2023, and for the COVID-19 pandemic response.4552 As of As of May
2024March 2026, the IDRRRF has an unobligated balance of $, the IDRRRF has an unobligated balance of $550.5541.3 million available for infectious disease million available for infectious disease
emergencies.emergencies.46
53
Other reserve fund accounts outside of CDC can also support public health emergency response. Other reserve fund accounts outside of CDC can also support public health emergency response.
These include the (1) Public Health Emergency Fund [PHSA Section 319(b), 42 U.S.C. §247d(b)] These include the (1) Public Health Emergency Fund [PHSA Section 319(b), 42 U.S.C. §247d(b)]
and (2) the Disaster Relief Fund at the Department of Homeland Security. (A detailed discussion and (2) the Disaster Relief Fund at the Department of Homeland Security. (A detailed discussion
of these funding sources is outside the scope of this report.) The Public Health Emergency Fund of these funding sources is outside the scope of this report.) The Public Health Emergency Fund
currently has a balance of $56,currently has a balance of $56,500508 and has not received appropriations for many years. and has not received appropriations for many years.47
54 Transfers from the Disaster Relief Fund have funded HHSTransfers from the Disaster Relief Fund have funded HHS’'s response to non-infectious disease s response to non-infectious disease
emergencies, such as for natural disasters, pursuant to authorities in the Robert T. Stafford emergencies, such as for natural disasters, pursuant to authorities in the Robert T. Stafford
Disaster Relief and Emergency Assistance Act (Stafford Act; 42 U.S.C. §§5721 et seq.). Stafford Disaster Relief and Emergency Assistance Act (Stafford Act; 42 U.S.C. §§5721 et seq.). Stafford
Act assistance was not available for HHSAct assistance was not available for HHS’'s response to three recent infectious disease epidemics s response to three recent infectious disease epidemics
prior to the Coronavirus Disease 2019 (COVID-19) pandemic—the H1N1 influenza pandemic in prior to the Coronavirus Disease 2019 (COVID-19) pandemic—the H1N1 influenza pandemic in
44 Per footnote 18, the PHSSEF account historically funded ASPR, the HHS lead operating division for medical and
public health preparedness for, response to, and recovery from disaster and public health emergencies. ASPR oversees
several programs, including the Biomedical Advanced Research and Development Authority and the Strategic National
Stockpile. Beginning in FY2024, ASPR has received its appropriations in separate accounts from the PHSSEF.
45 U.S. Government Accountability Office, Public Health Preparedness: HHS Reserve Funding for Emergencies,
GAO-23-106102, August 2023, https://www.gao.gov/assets/gao-23-106102.pdf.
46 USASpending.gov, “Infectious Diseases Rapid Response Reserve Fund, Centers for Disease Control, Health and
Human Services,” last updated May 20, 2024, https://www.usaspending.gov/federal_account/075-0945.
47 USASpending.gov, “Public Health Emergency Fund, Public Health Services, Office of Assistant Secretary for
Health, Health and Human Services,” https://www.usaspending.gov/federal_account/075-1104.
Congressional Research Service
16
Centers for Disease Control and Prevention (CDC) Funding Overview
2009, the Ebola virus outbreak in 2014, and the Zika virus outbreak in 2016.48 Congress
subsequently established the IDRRRF in 2018.
Author Information
Kavya Sekar
Analyst in Health Policy
Acknowledgments
CRS Research Assistants Joe Angert and John Gorman assisted with this report update. CRS Visual
Information Specialist Jamie Bush provided graphics assistance. Former CRS Analyst in Public Health
Emergency Management Taylor Wyatt and CRS Analyst in Health Policy Hassan Sheikh contributed to an
earlier version of this report.
Disclaimer
This document was prepared by the Congressional Research Service (CRS). CRS serves as nonpartisan
shared staff to congressional committees and Members of Congress. It operates solely at the behest of and
under the direction of Congress. Information in a CRS Report should not be relied upon for purposes other
than public understanding of information that has been provided by CRS to Members of Congress in
connection with CRS’s institutional role. CRS Reports, as a work of the United States Government, are not
subject to copyright protection in the United States. Any CRS Report may be reproduced and distributed in
its entirety without permission from CRS. However, as a CRS Report may include copyrighted images or
material from a third party, you may need to obtain the permission of the copyright holder if you wish to
copy or otherwise use copyrighted material.
482009, the Ebola virus outbreak in 2014, and the Zika virus outbreak in 2016.55 Congress subsequently established the IDRRRF in 2018.
1.
2.
3.
4.
5.
6.
7.
8.
9.
See "Explanatory Statement Accompanying the Consolidated Appropriations Act, 2026," Congressional Record, vol. 172 (January 22, 2026), pp. H1591-H1593; and "Explanatory Statement Accompanying the Commerce, Justice, Science; Energy and Water Development; and Interior and Environment Appropriations Act, 2026," Congressional Record, vol. 172 (January 8, 2026), p. H483.
10.
11.
See, for example, CDC, "Grant Funding Profiles," https://fundingprofiles.cdc.gov/.
12.
13.
14.
15.
16.
17.
18.
19.
20.
21.
22.
23.
24.
25.
26.
27.
CDC, "World Trade Center Health Program," https://www.cdc.gov/wtc/.
28.
29.
30.
31.
32.
33.
34.
35.
36.
37.
38.
39.
40.
41.
42.
43.
44.
45.
46.
47.
48.
49.
50.
51.
52.
U.S. Government Accountability Office, U.S. Government Accountability Office, Public Health Preparedness: HHS Reserve Funding for Emergencies, ,
GAO-23-106102, August 2023, https://www.gao.gov/assets/gao-23-106102.pdfGAO-23-106102, August 2023, https://www.gao.gov/assets/gao-23-106102.pdf.
Congressional Research Service
R47207 · VERSION 7 · UPDATED
17
.
53.
54.
55.
Contents
- Introduction
- Understanding CDC Funding
- Core Public Health Program Level
- Other Mandatory Programs
- FY2026 Enacted
- Funding Table
- FY2027 Budget Request: Proposed Funding Changes
- Trends in Core Public Health Program Level
- CDC Budget in Context
- Supplemental Appropriations for Public Health Emergencies and Other Incidents
- CDC Infectious Diseases Rapid Response Reserve Fund
Figures
- Figure 1. Centers for Disease Control and Prevention Organization Chart
- Figure 2. FY2026 Enacted Centers for Disease Control and Prevention Program Level by Category and Budget Authority
- Figure 3. Example of CDC Appropriations Language
- Figure 4. Example of CDC Appropriations Report Language
- Figure 5. Example of Prevention and Public Health Fund Allocations
- Figure 6. Trends in Core Public Health Program Level
Summary
The Centers for Disease Control and Prevention (CDC) works to protect public health by providing leadership, information, and scientific expertise in preventing and controlling diseases,life, by supporting and undertaking efforts that aim to prevent and control injury, disability, and life, by supporting and undertaking efforts that aim to prevent and control injury, disability, and
and appropriations, with a focus on and appropriations, with a focus on
ATSDR. The report also discusses supplemental appropriations for CDC.ATSDR. The report also discusses supplemental appropriations for CDC.
focus on the first:focus on the first:
Departments of Labor, Health and Human Services, and Education, and Related Agencies (LHHS) Departments of Labor, Health and Human Services, and Education, and Related Agencies (LHHS)
appropriations act.appropriations act.
inspection, among others.inspection, among others.
(-0.2%) decrease from the (-0.2%) decrease from the
The Trump Administration has proposed an FY2027 CDC core public health program level of $5.485 billion and has also proposed to move several CDC programs to different HHS agencies and offices, and to eliminate other CDC programs.
In terms of trends, CDC saw relatively flat funding from FY2011 to FY2021, where CDC's core public health s core public healthfunding level remained between approximately $6.5 and $8 billion until the increases provided in FY2022 and FY2023 (not funding level remained between approximately $6.5 and $8 billion until the increases provided in FY2022 and FY2023 (not
adjusted for inflation). adjusted for inflation). Since FY2023, CDC's core public health funding level has remained relatively flat; CDC saw slight decreases in its core public health
disease threats, natural disasters, or screening and health support to refugees. In response to some incidents, such as the disease threats, natural disasters, or screening and health support to refugees. In response to some incidents, such as the
Coronavirus Disease 2019 (COVID-19) pandemic, supplemental appropriations Coronavirus Disease 2019 (COVID-19) pandemic, supplemental appropriations
funding increases for overall public health capacity at the federal, state, and local level.
Introduction
The Centers for Disease Control and Prevention (CDC) works to protect public health by The Centers for Disease Control and Prevention (CDC) works to protect public health byproviding leadership, information, and scientific expertise in preventing and controlling diseases, providing leadership, information, and scientific expertise in preventing and controlling diseases,
including outbreaks of infectious diseases. including outbreaks of infectious diseases.
life, by supporting and undertaking efforts that aim to prevent and control injury, disability, and life, by supporting and undertaking efforts that aim to prevent and control injury, disability, and
environmental health threats. Its stated mission is environmental health threats. Its stated mission is
ongoing public health activities, the agency has played a major role in disease outbreaks and ongoing public health activities, the agency has played a major role in disease outbreaks and
public health emergencies, including public health emergencies, including during the federal response to the Coronavirus Disease 2019 the federal response to the Coronavirus Disease 2019
(COVID-19) pandemic. The Agency for Toxic Substances and Disease Registry (ATSDR), a (COVID-19) pandemic. The Agency for Toxic Substances and Disease Registry (ATSDR), a
separate operating division headed by the CDC Director, is tasked with identifying potential separate operating division headed by the CDC Director, is tasked with identifying potential
public health effects from exposure to hazardous substances.public health effects from exposure to hazardous substances.
population-wide basis. CDC also administers some health services and compensation-related population-wide basis. CDC also administers some health services and compensation-related
programs as discussed later in this report. CDC is organized into a number of centers, institutes programs as discussed later in this report. CDC is organized into a number of centers, institutes
and offices (CIOs) as shown and offices (CIOs) as shown
challenges (e.g., injury prevention), while others focus on general public health capabilities (e.g., challenges (e.g., injury prevention), while others focus on general public health capabilities (e.g.,
surveillance and laboratory services).surveillance and laboratory services).
Most of CDCMost of CDC
programs and activities are not explicitly mentioned in the PHSA, but CDC carries out those programs and activities are not explicitly mentioned in the PHSA, but CDC carries out those
programs on the basis of general and permanent statutory authorities granted to the HHS programs on the basis of general and permanent statutory authorities granted to the HHS
Secretary.Secretary.
guiding the agencyguiding the agency
the form of grants or cooperative agreements)—especially to the form of grants or cooperative agreements)—especially to
6 CDC also awards funding to a variety of other entities, including CDC also awards funding to a variety of other entities, including
international organizations; tribal governments and organizations; academic and research institutions; and organizations; tribal governments and organizations; academic and research institutions; and
nonprofit organizations.nonprofit organizations.
funding history for core public health programs from FY2011 to funding history for core public health programs from FY2011 to
Figure 1. Centers for Disease Control and Prevention Organization Chart Source: Adapted by CRS from CDC, "CDC Organization Chart,"
cdc-org-chart.pdf, updated as of cdc-org-chart.pdf, updated as of
September 13, 2024. Notes: HIV = Human Immunodeficiency Virus; STD = Sexually Transmitted Disease; TB = Tuberculosis; OPDIV HIV = Human Immunodeficiency Virus; STD = Sexually Transmitted Disease; TB = Tuberculosis; OPDIV
= Operating Division.= Operating Division.
Understanding CDC Funding This CRS report divides CDCThis CRS report divides CDC
Agencies (LHHS) appropriations and the mandatory Prevention and Public Agencies (LHHS) appropriations and the mandatory Prevention and Public
Health Fund (PPHF), andHealth Fund (PPHF), and
comparisons of programmatic funding levels for the agency. The core public health program level comparisons of programmatic funding levels for the agency. The core public health program level
reflects both (1) funding for the main public health program activities conducted by CDC CIOs reflects both (1) funding for the main public health program activities conducted by CDC CIOs
the annual appropriations process, and therefore reflects the legislative decisions made by the annual appropriations process, and therefore reflects the legislative decisions made by
Congress each year to fund CDC and Congress each year to fund CDC and
levels that are mostly controlled by their program authorizations. The two largest programs—the levels that are mostly controlled by their program authorizations. The two largest programs—the
Vaccines for Children (VFC) program and the World Trade Center Health Program (WTCHP)—Vaccines for Children (VFC) program and the World Trade Center Health Program (WTCHP)—
primarily finance specific health services for eligible populations. Changes in annual spending primarily finance specific health services for eligible populations. Changes in annual spending
reflect usage and demand for the program services. These programsreflect usage and demand for the program services. These programs
presented separately from CDCpresented separately from CDC
of funding trends for the agencyof funding trends for the agency
mandatory programs are also generally presented separately from the rest of CDCmandatory programs are also generally presented separately from the rest of CDC
Figure 2. FY2026
Sources: FY2026
172, no. 15, book II (January 22, 2026), H1591-H1593; ASTDR discretionary amount from P.L. 119-74; and other mandatory program amount estimates from CDC, "All Purpose Table," FY2027 Congressional Budget Justification, p. 14, Fiscal Year 2027 CDC Congressional Justification. Notes: Amounts reflect some post-appropriations adjustments. Acronyms: CDC = Centers for Disease Control Amounts reflect some post-appropriations adjustments. Acronyms: CDC = Centers for Disease Control
and Prevention.and Prevention.
CDCCDC
their efforts to prevent and control disease and to improve public health. Types of funded their efforts to prevent and control disease and to improve public health. Types of funded
activities include but are not limited to developing expertise and best practices in disease activities include but are not limited to developing expertise and best practices in disease
prevention and control; conducting and supporting public health research; supporting and prevention and control; conducting and supporting public health research; supporting and
conducting public health surveillance and data collection; developing and supporting public conducting public health surveillance and data collection; developing and supporting public
health laboratory capacity; supporting and conducting health education and promotion efforts; health laboratory capacity; supporting and conducting health education and promotion efforts;
funding, coordinating, and providing technical assistance to public health programs at the funding, coordinating, and providing technical assistance to public health programs at the
cancer screening programs); and supporting public health emergency preparedness and response cancer screening programs); and supporting public health emergency preparedness and response
efforts. Many of the programs fund and support public health activities at the efforts. Many of the programs fund and support public health activities at the
level.level.
mandatory funding from the Prevention and Public Health Fund (PPHF); and (3) some other mandatory funding from the Prevention and Public Health Fund (PPHF); and (3) some other
funding sources, such as transfers from other accounts.funding sources, such as transfers from other accounts.
Discretionary Funding ((
ATSDR).ATSDR). CDC receives discretionary funding through annual LHHS appropriations, while CDC receives discretionary funding through annual LHHS appropriations, while
ATSDR is separately funded by Interior/Environment appropriations. Within LHHS ATSDR is separately funded by Interior/Environment appropriations. Within LHHS
appropriations, CDC appropriations, CDC
Some appropriations provided under certain headers fund programs through multiple CIOs; for example, appropriations provided under the Public Health Scientific Services header fund budget activities for public health surveillance across the agency. Some CDC appropriations provided under other headers are for agency-wide activities, such as the Buildings and Facilities header and the CDC-Wide Activities and Program Support header.
Figure 3. Example of CDC Appropriations Language
From FY2026 LHHS Appropriations
Source: Consolidated Appropriations Act, 2026, P.L. 119-75, Division B, Title II.
Figure 4. Example of CDC Appropriations Report Language
From FY2026 LHHS Appropriations Explanatory Statement
Source: "Explanatory Statement Accompanying Consolidated Appropriations Act, 2026," Congressional Record, ,vol. vol.
language.language.
from Congress to CDC regarding funded programs.from Congress to CDC regarding funded programs.
Mandatory Funding from the Prevention and Public Health Fund (PPHF) ((
the mandatory PPHF as directed in LHHS appropriations laws. In 2010, the Affordable Care Act the mandatory PPHF as directed in LHHS appropriations laws. In 2010, the Affordable Care Act
(ACA; P.L. 111-148, as amended) established the PPHF, which is a permanent, annual (ACA; P.L. 111-148, as amended) established the PPHF, which is a permanent, annual
appropriation that was intended to appropriation that was intended to
programs funded through HHS accounts.programs funded through HHS accounts.
amounts of annual PPHF funding to specific CDC accounts and programs (in addition to other amounts of annual PPHF funding to specific CDC accounts and programs (in addition to other
HHS agencies) through LHHS laws and accompanying report language.HHS agencies) through LHHS laws and accompanying report language.
Figure 5. Example of Prevention and Public Health Fund Allocations
Explanatory Statement Source:
vol. vol.
went to the Administration for Community Living (ACL) and the Substance Abuse and Mental went to the Administration for Community Living (ACL) and the Substance Abuse and Mental
Health Services Administration (SAMHSA).Health Services Administration (SAMHSA).
Public Health Service Evaluation Tap ((
also known as the PHS Evaluation Tap, has the effect of redistributing a certain percentage of also known as the PHS Evaluation Tap, has the effect of redistributing a certain percentage of
eligible appropriations among HHS accounts funded by the LHHS Act (up to 2.5% of eligible eligible appropriations among HHS accounts funded by the LHHS Act (up to 2.5% of eligible
appropriations in appropriations in
18 In recent years, appropriations laws have directed specific amounts of PHS tap funds to specific In recent years, appropriations laws have directed specific amounts of PHS tap funds to specific
agencies. Until FY2024, CDC had not received directed PHS tap transfers since FY2014 (see agencies. Until FY2024, CDC had not received directed PHS tap transfers since FY2014 (see
Figure 6)
allocated, but do not specify the accounts that are to be the sources of those transfers. Thus, tables allocated, but do not specify the accounts that are to be the sources of those transfers. Thus, tables
in this report show only the amount of PHS tap funds in this report show only the amount of PHS tap funds
amount transferred out of source accounts.amount transferred out of source accounts.
Other funding. CDC sometimes receives funding for its core public health program level CDC sometimes receives funding for its core public health program level
through transfers from other sources, including both discretionary and mandatory appropriations, through transfers from other sources, including both discretionary and mandatory appropriations,
Transfers. In some years, CDC has received transfers from other HHS accounts. For example, as In some years, CDC has received transfers from other HHS accounts. For example, as
shown inshown in Figure 6,
Services Emergency Fund (PHSSEF).Services Emergency Fund (PHSSEF).
19 CDC has not received a transfer from the PHSSEF since FY2017. Smaller mandatory appropriations for core public health programs. Some smaller CDC public Some smaller CDC public
health programs have been funded by mandatory budget authorities, such as for the Childhood health programs have been funded by mandatory budget authorities, such as for the Childhood
Obesity Demonstration ProjectObesity Demonstration Project
.20 Supplemental Appropriations
such as during the COVID-19 pandemic, as discussed further insuch as during the COVID-19 pandemic, as discussed further in
Plan Act (P.L. 117-2) budget reconciliation measure included several major Plan Act (P.L. 117-2) budget reconciliation measure included several major multiyear funding streams for general public funding streams for general public
health capabilitieshealth capabilities that were not specific to the pandemic, such as for data modernization. These additional appropriations not specific to the pandemic, such as for data modernization. These additional appropriations
are discussed in a separate section in this CRS report to distinguish regular appropriations for CDCare discussed in a separate section in this CRS report to distinguish regular appropriations for CDC
operations from these one-time appropriations.operations from these one-time appropriations.
CDC also administers several health services and compensation-related programs that are funded CDC also administers several health services and compensation-related programs that are funded
by mandatory budget authorities and are distinct from the agencyby mandatory budget authorities and are distinct from the agency
In several cases, the programIn several cases, the program
programs. In addition, CDC receives a small amount of user fees through authorized user fee programs. In addition, CDC receives a small amount of user fees through authorized user fee
programs.programs.
The Vaccines for Children (VFC) program ((
vaccines to enrolled health care providers to vaccinate eligible children.vaccines to enrolled health care providers to vaccinate eligible children.
Section 1928 (42 U.S.C. §1396s), the HHS Secretary can purchase vaccines as necessary for Section 1928 (42 U.S.C. §1396s), the HHS Secretary can purchase vaccines as necessary for
eligible children at a federally negotiated discounted price and then distribute vaccines to eligible children at a federally negotiated discounted price and then distribute vaccines to
participating state and local health departments. State and local health departments then distribute participating state and local health departments. State and local health departments then distribute
a portion of the supply to participating health care providers and also administer vaccines through a portion of the supply to participating health care providers and also administer vaccines through
meaning that VFC funding is provided through LHHS appropriations acts, but the funding level is meaning that VFC funding is provided through LHHS appropriations acts, but the funding level is
determined based on budget projections for meeting the funding needs of the program as required determined based on budget projections for meeting the funding needs of the program as required
by the programby the program
The Energy Employees Occupational Illness Compensation Program (EEOICP) ( (
and medical benefits to eligible civilians (or their survivors) who have performed duties related to and medical benefits to eligible civilians (or their survivors) who have performed duties related to
the nuclear weapons production and testing programs of the Department of Energy.the nuclear weapons production and testing programs of the Department of Energy.
24 CDC's National Institute for Occupational Safety and Health (NIOSH) provides support to the program by conducting radiation dose estimates, evaluating certain provides support to the program by conducting radiation dose estimates, evaluating certain
petitions, and providing other administrative support. DOL uses these estimates in making petitions, and providing other administrative support. DOL uses these estimates in making
pursuant to Section 151(b) of Division B, Title I of Consolidated Appropriations Act, 2001 (P.L. pursuant to Section 151(b) of Division B, Title I of Consolidated Appropriations Act, 2001 (P.L.
106-554), which specifies that annual funding pursuant to that section shall be direct spending 106-554), which specifies that annual funding pursuant to that section shall be direct spending
(i.e., mandatory funding).(i.e., mandatory funding).
26 The World Trade Center Health Program (WTCHP) ((
913 million) provides medical monitoring and treatment to eligible individuals directly affected by the million) provides medical monitoring and treatment to eligible individuals directly affected by the
September 11, 2001 attacks for certain incident-related health conditions. This program also funds September 11, 2001 attacks for certain incident-related health conditions. This program also funds
medical research into health conditions that may develop due to exposure during the attacks.medical research into health conditions that may develop due to exposure during the attacks.
27 The program is authorized by PHSA Title XXXIII (42 U.S.C. §§300mm et seq.) and funded The program is authorized by PHSA Title XXXIII (42 U.S.C. §§300mm et seq.) and funded
through appropriations provided by PHSA Section 3351 (42 U.S.C. §300mm–61).through appropriations provided by PHSA Section 3351 (42 U.S.C. §300mm–61).
User fee programs ((
amounts of user fees from authorized user fee programs such as the vessel sanitation program,amounts of user fees from authorized user fee programs such as the vessel sanitation program,
28 which collects fees from cruise ship owners for public health inspections. In addition, the which collects fees from cruise ship owners for public health inspections. In addition, the
respirator certification program charges fees to respirator manufacturers for certain regulatory respirator certification program charges fees to respirator manufacturers for certain regulatory
The FY2026 enacted LHHS appropriations law (P.L. 119-75, Division B) also included several new accompanying provisions that address CDC or relate to recent developments at the agency:
Incorporating explanatory statement funding by law. A new provision, Section 236, requires that funding provided to CDC under its headings is for the budget activities and funding amounts as directed in the tables of the explanatory statement that accompanied the law.30 In recent years, Congress has specified funding for over 160 CDC programs in the explanatory statement tables accompanying CDC appropriations (see example under one header in Figure 4). Prior to FY2026, these funding amounts in the explanatory statement were not required by law, but appropriations committees have generally expected agencies to adhere to them.31 The new Section 236 now incorporates these funding levels by law.supplemental appropriations).supplemental appropriations).
Table 1. Centers for Disease Control and Prevention (CDC) and
Program or Activity
FY2024 Final
FY2025 Final
FY2026 Enacted
Immunization and Respiratory Diseases
| 919 |
| 919 |
| 913 |
PPHF Transfer (non-add)
| (682) |
| (682) |
| (596) |
HIV/AIDS, Viral Hepatitis, STI and TB
| 1,391 |
| 1,391 |
| 1,384 |
Emerging & Zoonotic Infectious Diseases
| 760 |
| 760 |
| 781 |
PPHF Transfer (non-add)
| (52) |
| (52) |
| (52) |
Chronic Disease Prevention and Health Promotion
| 1,434 |
| 1,434 |
| 1,433 |
PPHF Transfer (non-add)
| (241) |
| (241) |
| (449) |
Birth Defects, Developmental Disabilities, Disability and Health
| 206 |
| 206 |
| 205 |
Environmental Health
| 243 |
| 243 |
| 243 |
PPHF Transfer (non-add)
| (51) |
| (51) |
| (51) |
PHS Evaluation Transfer (non-add)
| — |
| — |
| — |
Injury Prevention and Control
| 761 |
| 761 |
| 761 |
PHS Evaluation Transfer (non-add)
| — |
| — |
| — |
Public Health Scientific Services
| 754 |
| 754 |
| 767 |
PPHF Transfer (non-add)
| — |
| — |
| — |
PHS Evaluation Transfer (non-add)
| (43) |
| (43) |
| (43) |
Occupational Safety and Health
| 363 |
| 363 |
| 367 |
Global Health
| 693 |
| 693 |
| 693 |
Public Health Preparedness and Response
| 938 |
| 938 |
| 913 |
Crosscutting Activities and Program Support
| 664 |
| 664 |
| 647 |
PPHF Transfer (non-add)
| (160) |
| (160) |
| (160) |
Office of the Director (non-add)
| (129) |
| (129) |
| (102) |
Infectious Diseases Rapid Response Reserve Fund (non-add)
| (25) |
| (25) |
| (25) |
Public Health Infrastructure and Capacity (non-add)
| (350) |
| (350) |
| (360) |
Infrastructure and Capacity PPHF Transfer (non-add)
| — |
| — |
| (90) |
Buildings and Facilities
| 40 |
| 40 |
| 40 |
| 82 |
| 82 |
| 80 |
Total, Core Public Health Program Level (CPHPL)
| 9,248 |
| 9,248 |
| 9,227 |
Less ATSDR
| -82 |
| -82 |
| -80 |
Total, CDC Public Health Program Level (LHHS total)
| 9,167 |
| 9,167 |
| 9,148 |
Less PPHF (mandatory)
| -1,186 |
| -1,186 |
| -1,398 |
Less PHS Evaluation Transfer
| -43 |
| -43 |
| -43 |
Total, CDC LHHS Discretionary BA
| 7,938 |
| 7,938 |
| 7,706 |
Vaccines for Children (VFC)
| 7,239 |
| 6,576 |
| 6,072 |
| 51 |
| 51 |
| 51 |
World Trade Center Health Program (WTCHP)
| 768 |
| 848 |
| 913 |
User Fees
| 2 |
| 2 |
| 2 |
| 8,060 |
| 7,476 |
| 7,038 |
Total, Core Public Health Program Level + Other
| 17,309 |
| 16,725 |
| 16,266 |
some post-appropriations adjustments. Acronyms: some post-appropriations adjustments. Acronyms: BA = Budget Authority; HIV = Human Immunodeficiency Virus; AIDS = Acquired HIV = Human Immunodeficiency Virus; AIDS = Acquired
Immunodeficiency Syndrome; STI = Sexually Transmitted Infection; TB = Tuberculosis; PPHF = Prevention and Immunodeficiency Syndrome; STI = Sexually Transmitted Infection; TB = Tuberculosis; PPHF = Prevention and
The Trump Administration requested a core public health program level of $5.485 billion for CDC in FY2027.33 This proposed level is not directly comparable to the FY2026 enacted level because of significant proposed relocations of CDC programs to other HHS components, as summarized below.34
The Administration also proposed to reduce funding for or entirely eliminate a number of CDC programs, including programs proposed for relocation, in the FY2027 budget request.35
- Eliminate the PPHF. The FY2027 budget request proposes to eliminate the PPHF, a large source of CDC's budget authority, as summarized above. In FY2026, CDC received $1.398 billion from the PPHF to support specific CDC accounts and programs.
- Eliminate CDC programs. The FY2027 budget request proposes to eliminate several CDC programs, including Chronic Disease Prevention and Health Promotion activities except for Cancer Prevention and Control programs and Alzheimer's Disease programs, and the following programs within Injury Prevention and Control: Youth Violence Prevention, Adverse Childhood Experiences, Firearm Injury and Mortality Prevention Research, Elderly Falls, Drowning, Other Injury Prevention Activities, and Injury Control Research Centers.36
As mentioned, the budget also proposes some major HHS reorganizations that would affect CDC programs:
Move CDC Programs to Other HHS Components. The FY2027 budget request proposes to move several major programs and activities out of CDC to the Administration for a Healthy America (AHA), a proposed new operating division within HHS. The activities include those funded under CDC appropriations headers for HIV/AIDS, Viral Hepatitis, Sexually Transmitted Diseases and Tuberculosis Prevention; Chronic Disease Prevention and Health Promotion; Birth Defects, Developmental Disabilities, Disabilities and Health; and Injury Prevention and Control.37 The request also proposes to move the National Center for Health Statistics' funding and activities to a new Office of Strategy within the HHS Office of the Director.38CDC saw annual increases and decreases in its core public health funding level ranging from 1% CDC saw annual increases and decreases in its core public health funding level ranging from 1%
to 6% (except for FY2013). For FY2013—the lowest funding level in the period covered—to 6% (except for FY2013). For FY2013—the lowest funding level in the period covered—
budget sequestration of nonexempt discretionary spending occurred.budget sequestration of nonexempt discretionary spending occurred.
decrease in its program decrease in its program
Figure 6. Trends in Core Public Health Program Level
FY2011-FY2025 final, FY2026 enacted ($ in billions, nominal)(Figure is interactive in the HTML version of this report.) <script type="text/javascript">//Based on IAG in AP 7.4.1 (Revised 20240624) // $(function () { $('#IAG-3749522288').bind('mousedown', function () { /* saveRptHighChartClick(); */ }); //#### HIGHCHART LIBRARIES ####// var files = ["https://code.highcharts.com/highcharts.js","https://code.highcharts.com/highcharts-more.js","https://code.highcharts.com/modules/exporting.js","https://code.highcharts.com/modules/export-data.js","https://code.highcharts.com/modules/accessibility.js"], loaded = 0; if (typeof window["HighchartsEditor"] === "undefined") { window.HighchartsEditor = { ondone: [cl], hasWrapped: false, hasLoaded: false }; include(files[0]); } else { if (window.HighchartsEditor.hasLoaded) { cl(); } else { window.HighchartsEditor.ondone.push(cl); } } function isScriptAlreadyIncluded(src) { var scripts = document.getElementsByTagName("script"); for (var i = 0; i < scripts.length; i++) { if (scripts[i].hasAttribute("src")) { if ((scripts[i].getAttribute("src") || "").indexOf(src) >= 0 || (scripts[i].getAttribute("src") === "http://code.highcharts.com/highcharts.js" && src === "https://code.highcharts.com/stock/highstock.js")) { return true; } } } return false; } function check() { if (loaded === files.length) { for (var i = 0; i < window.HighchartsEditor.ondone.length; i++) { try { window.HighchartsEditor.ondone[i](); } catch (e) { console.error(e); } } window.HighchartsEditor.hasLoaded = true; } } function include(script) { function next() { ++loaded; if (loaded < files.length) { include(files[loaded]); } check(); } if (isScriptAlreadyIncluded(script)) { return next(); } var sc = document.createElement("script"); sc.src = script; sc.type = "text/javascript"; sc.onload = function () { next(); }; document.head.appendChild(sc); } function each(a, fn) { if (typeof a.forEach !== "undefined") { a.forEach(fn); } else { for (var i = 0; i < a.length; i++) { if (fn) { fn(a[i]); } } } } var inc = {}, incl = []; each(document.querySelectorAll("script"), function (t) { inc[t.src.substr(0, t.src.indexOf("?"))] = 1; }); function cl() { if (typeof window["Highcharts"] !== "undefined") { //#### HIGHCHART LIBRARIES END ####// //##### CRS THEME START (v1.2, 20220510)#####// Highcharts.theme = { colors: ['#0C90FC', '#003865', '#F1B434', '#7060A8', '#6CC8BD', '#757048', '#B4C7D0', '#D36127'], chart: {backgroundColor: 'white',}, title: { style: { color: 'black', font: '15px "Calibri", Verdana, sans-serif', fontWeight: 'bold' } }, subtitle: { style: { color: 'black', font: '14px "Calibri", Verdana, sans-serif' }}, credits: { enabled: false }, legend: { itemStyle: { fontFamily: '"Calibri", Verdana, sans-serif', fontSize: '14px', color: 'black', "text-decoration": 'none !important' }, verticalAlign: 'top', itemMarginBottom: 7, }, yAxis: { title: { style: { font: '14px "Calibri", Verdana, sans-serif', fontWeight: 'bold', color: 'black'} }, labels: { style: { font: '14px "Calibri", Verdana,sans-serif', color: 'black'}}, }, xAxis: { title: { style: { font: '14px "Calibri", Verdana, sans-serif', fontWeight: 'bold', color: 'black'}, y: 8 }, labels: { style: { font: '14px "Calibri", Verdana, sans-serif', color: 'black' }, }, lineColor: 'black', lineWidth: 0.5 } }; Highcharts.setOptions(Highcharts.theme); Highcharts.setOptions({ lang: {thousandsSep: ','}, chart: {style: {fontFamily: 'Calibri'}}, exporting: { enabled: false } }); //##### CRS THEME END #####// //#### START chart elements before Highcharts container ####// //#### END chart elements before the Highcharts container ####// var options = { //#### START code inside Highcharts.chart('container', { ####// chart: { type: 'column', }, accessibility: { description: 'Stacked column chart displaying CDC core public health program levels from FY2011 through FY2026. The total for core public health program level includes funding for ATSDR, PHSSEF Transfers, PHS Evaluation Transfers, ACA‑PPHF, and the total LHHS CDC Budget Authority. From FY2011 to FY2021 the total core public health program levels were relatively flat with annual increases and decreases in total core public health funding level ranging from 1% to 6% except for FY2013, for which budget sequestration of nonexempt discretionary spending decreased the core public health funding total. The total core public health program increased in FY2022 and again FY2023. Total core public health program levels have stayed relatively flat following those increases with a slight overall decrease in its program levels in FY2024 and again in FY2026.' }, plotOptions: { column:{ stacking: 'normal', borderRadius: 0, pointPadding:0, borderWidth:0, }, series: { animation:false,} }, title: { text: null }, xAxis: { labels: {rotation: -89.9}, categories: ['FY2011', 'FY2012', 'FY2013', 'FY2014', 'FY2015', 'FY2016', 'FY2017', 'FY2018', 'FY2019', 'FY2020', 'FY2021', 'FY2022', 'FY2023', 'FY2024', 'FY2025', 'FY2026'] }, yAxis: { min: 0, max: 10, title: { text: '$ in billions' }, labels: { formatter: function () { return '$' + Highcharts.numberFormat(this.value, 0); } } }, legend: { reversed: false, align: 'right', layout: 'vertical', symbolRadius:0, itemStyle: { fontFamily: '"Calibri", Verdana, sans-serif', fontSize: '14px', color: 'black', "text-decoration": 'none !important' }, }, tooltip: { useHTML: true, style:{fontSize: '15px'}, shared:true, headerFormat: '{point.category}', pointFormat: '{series.name}: ${point.y:.2f}', //pointFormat: '{series.name}: ${point.y}' footerFormat:'{point.category} Total: ${point.stackTotal}' }, series: [{ name: 'ATSDR', color: '#F05C74', data: [0.08, 0.08, 0.07, 0.07, 0.09, 0.07, 0.07, 0.07, 0.07, 0.08, 0.08, 0.08, 0.09, 0.08, 0.08, 0.08] },{ name: 'PHSSEF Transfer', color: '#F1B434', data: [0.22, 0.03, 0.01, 0.00, 0.02, 0.02, 0.02, 0.00, 0.00, 0.00, 0.00, 0.00, 0.00, 0.00, 0.00, 0.00] },{ name: 'PHS Evaluation Transfers', color: '#0D91FD', data: [0.35, 0.37, 0.38, 0.21, 0.00, 0.00, 0.00, 0.00, 0.00, 0.00, 0.00, 0.00, 0.00, 0.04, 0.04, 0.04] },{ name: 'ACA-PPHF', color: '#AEDAFE', data: [0.61, 0.81, 0.46, 0.83, 0.89, 0.89, 0.89, 0.80, 0.80, 0.85, 0.86, 0.90, 0.90, 1.19, 1.19, 1.40] },{ name: 'Total LHHS CDC Budget Authority', color: '#003865', data: [5.65, 5.66, 5.43, 5.79, 6.00, 6.41, 6.28, 6.82, 6.47, 6.84, 6.94, 7.50, 8.28, 7.94, 7.94, 7.71] }] //#### END container ####// }; new Highcharts.Chart("IAG-3749522288", options); } } }); </script>Source: CDC Congressional Budget Justifications, and sources in Table 1.
Notes: Amounts are not adjusted for inflation. Acronyms: CDC = Centers for Disease Control and Prevention; LHHS = Acronyms: CDC = Centers for Disease Control and Prevention; LHHS =Labor, Health and Human Services, Education, and Related Agencies appropriations Labor, Health and Human Services, Education, and Related Agencies appropriations
Toxic Substances and Disease Registry; PPHF = Prevention and Public Health Fund; PHSSEF = Public Health and Toxic Substances and Disease Registry; PPHF = Prevention and Public Health Fund; PHSSEF = Public Health and
Social Services Emergency Fund; PHS = Public Health Service; ACA = Affordable Care Act.Social Services Emergency Fund; PHS = Public Health Service; ACA = Affordable Care Act.
Supplemental Appropriations for Public Health Emergencies and
Other Incidents
CDC CDC has regularly regularly
emergencies and other incidents. For example, since 2019, CDC has received supplemental emergencies and other incidents. For example, since 2019, CDC has received supplemental
appropriations for hurricane and natural disaster response (for example, in P.L. 116-20 and P.L. appropriations for hurricane and natural disaster response (for example, in P.L. 116-20 and P.L.
117-328), the Coronavirus Disease 2019 (COVID-19) pandemic,117-328), the Coronavirus Disease 2019 (COVID-19) pandemic,
supports for Afghan refugees (P.L. 117-70), and funding for domestic and global activities related supports for Afghan refugees (P.L. 117-70), and funding for domestic and global activities related
to the war in Ukraine (e.g., P.L. 117-128). These amounts are not reflected in the other sections of to the war in Ukraine (e.g., P.L. 117-128). These amounts are not reflected in the other sections of
While these supplemental funds While these supplemental funds
which they which they
decreases for overall public health capacity at the federal, state, and local levelsdecreases for overall public health capacity at the federal, state, and local levels. Congress has often appropriated emergency supplemental funding to HHS for purposes that are somewhat general, or with the authority for HHS to transfer those funds, and therefore HHS has decided the final allocation of funds among HHS operating divisions (such as CDC). Final data on HHS supplemental appropriations allocations are not available for all public health emergencies. Large historical . Large historical
supplemental appropriations to the agency and subsequent funding awards to state and local supplemental appropriations to the agency and subsequent funding awards to state and local
agencies includeagencies include
billion through its Public Health Emergency Response grant program to state and billion through its Public Health Emergency Response grant program to state and
local partners.local partners.
Appropriations Act of 2009 (P.L. 111-32), enacted in June 2009.Appropriations Act of 2009 (P.L. 111-32), enacted in June 2009.
enacted in December 2014, provided CDC with $1.771 billion for both domestic enacted in December 2014, provided CDC with $1.771 billion for both domestic
and international Ebola preparedness and response efforts.and international Ebola preparedness and response efforts.
CDC provided several supplemental grants to state and local agencies, including CDC provided several supplemental grants to state and local agencies, including
$145 million through the Public Health Emergency Preparedness (PHEP) $145 million through the Public Health Emergency Preparedness (PHEP)
cooperative agreement and more than $114 million through the Epidemiology cooperative agreement and more than $114 million through the Epidemiology
and Laboratory Capacity (ELC) grant program.and Laboratory Capacity (ELC) grant program.
appropriations for preparedness and response to the Zika outbreak, domestically appropriations for preparedness and response to the Zika outbreak, domestically
and internationally.and internationally.
agencies through several grant programs, including more than $184 million agencies through several grant programs, including more than $184 million
through the ELC grant program.through the ELC grant program.
measures to the CDC-Wide Activities and Program Support measures to the CDC-Wide Activities and Program Support
header.46 As part of this total, some of the one-time public health funding for CDC in the American Rescue Plan Act the one-time public health funding for CDC in the American Rescue Plan Act
(ARPA; P.L. 117-2) was not tied to the pandemic, but instead was made available (ARPA; P.L. 117-2) was not tied to the pandemic, but instead was made available
for general public health capabilitiesfor general public health capabilities
Infrastructure grant program in the textbox belowInfrastructure grant program in the textbox below). In addition, CDC has . In addition, CDC has
in CDC COVID-19 grants have been awarded to state, tribal, and local agencies in CDC COVID-19 grants have been awarded to state, tribal, and local agencies
as of September as of September
estimated that the Fiscal Responsibility Act (P.L. 118-5) rescinded $1.5 billion in CDC budget estimated that the Fiscal Responsibility Act (P.L. 118-5) rescinded $1.5 billion in CDC budget
authority. In addition, FY2024 appropriations authority. In addition, FY2024 appropriations and the FY2025 continuing resolution rescinded certain American Rescue Plan Act rescinded certain American Rescue Plan Act
appropriations for public health; the full impact on CDC is unclear from publicly available appropriations for public health; the full impact on CDC is unclear from publicly available
sources.49 For more information on CDC funding in the COVID-19 relief laws, see, CRS Report R46711, U.S. Public Health Service: COVID-19 Supplemental Appropriations in the 116th Congress and CRS Report R46834, American Rescue Plan Act of 2021 (P.L. 117-2): Public Health, Medical Supply Chain, Health Services, and Related Provisions. Spotlight: Public Health Infrastructure Grant Program
$3.5 $3.5
programs combined with funding from regular appropriations (GAO-24-105891). Through this program, CDC programs combined with funding from regular appropriations (GAO-24-105891). Through this program, CDC
expects to award $5 expects to award $5
territories and freely associated states; and 48 large localities. territories and freely associated states; and 48 large localities. As of December 2025, the award includes $4.6 billion for health departments and roughly $382 million for three national public health partners over the five-year grant period. Recipients are to use this award to hire and retain Recipients are to use this award to hire and retain
public health staff, strengthen organization systems and processes, and modernize public health data systems. State public health staff, strengthen organization systems and processes, and modernize public health data systems. State
health department recipients are expected to distribute a portion of grant funds for public health workforce health department recipients are expected to distribute a portion of grant funds for public health workforce
among local health departments that did not receive direct grant funding from CDC. Given that this five-year among local health departments that did not receive direct grant funding from CDC. Given that this five-year
grant is funded in large part by a one-time appropriation from the ARPA, funds may no longer be available to grant is funded in large part by a one-time appropriation from the ARPA, funds may no longer be available to
support hired staff support hired staff
For further information, see CDC, For further information, see CDC,
phig/about/. phig/about/.
CDC Infectious Diseases Rapid Response Reserve Fund
Reserve Fund (IDRRRF) at CDC.Reserve Fund (IDRRRF) at CDC.
specifically for infectious disease emergencies. Funds may be drawn from IDRRRF for an specifically for infectious disease emergencies. Funds may be drawn from IDRRRF for an
infectious disease emergency if the HHS Secretaryinfectious disease emergency if the HHS Secretary
health, and security of United States citizens, domestically or internationally.health, and security of United States citizens, domestically or internationally.
shown in Table 2.
Table 2. Appropriations History to the IDRRRF
Fiscal Year
Law and Type of Appropriation
FY2019
$50
FY2020
$85
$300
$300
FY2021
$10
FY2022
$20
FY2023
$35
FY2024
$25
FY2025
P.L. 119-4, (Title IX), regular
$25
FY2026
P.L. 119-75, (Division B), regular
$25
Source: CRS analysis of appropriations laws.
Note: In FY2025, Congress provided appropriations through continuing resolutions, which generally reflected FY2024 appropriations unless otherwise specified.
Africa, the mpox outbreak in 2022-2023, and for the COVID-19 pandemic response.Africa, the mpox outbreak in 2022-2023, and for the COVID-19 pandemic response.
emergencies.emergencies.
These include the (1) Public Health Emergency Fund [PHSA Section 319(b), 42 U.S.C. §247d(b)] These include the (1) Public Health Emergency Fund [PHSA Section 319(b), 42 U.S.C. §247d(b)]
and (2) the Disaster Relief Fund at the Department of Homeland Security. (A detailed discussion and (2) the Disaster Relief Fund at the Department of Homeland Security. (A detailed discussion
of these funding sources is outside the scope of this report.) The Public Health Emergency Fund of these funding sources is outside the scope of this report.) The Public Health Emergency Fund
currently has a balance of $56,currently has a balance of $56,
54 Transfers from the Disaster Relief Fund have funded HHSTransfers from the Disaster Relief Fund have funded HHS
emergencies, such as for natural disasters, pursuant to authorities in the Robert T. Stafford emergencies, such as for natural disasters, pursuant to authorities in the Robert T. Stafford
Disaster Relief and Emergency Assistance Act (Stafford Act; 42 U.S.C. §§5721 et seq.). Stafford Disaster Relief and Emergency Assistance Act (Stafford Act; 42 U.S.C. §§5721 et seq.). Stafford
Act assistance was not available for HHSAct assistance was not available for HHS
prior to the Coronavirus Disease 2019 (COVID-19) pandemic—the H1N1 influenza pandemic in prior to the Coronavirus Disease 2019 (COVID-19) pandemic—the H1N1 influenza pandemic in
CRS Research Assistant Joe Angert assisted with this report update. CRS Visual Information Specialist Amber Wilhelm provided graphics assistance. Former CRS Analyst in Public Health Emergency Management Taylor Wyatt and CRS Analyst in Health Policy Hassan Sheikh contributed to an earlier version of this report.
Footnotes
Centers for Disease Control and Prevention (CDC), "CDC Priorities," https://www.cdc.gov/about/cdc/.
CDC, "CDC Organization and Leadership," January 23, 2025, https://www.cdc.gov/about/organization/index.html.
CDC, "Our History-Our Story," April 19, 2023, https://www.cdc.gov/museum/history/our-story.html.
CRS Report R47981, Centers for Disease Control and Prevention (CDC): History, Overview of Domestic Programs, and Selected Issues.
For the purposes of this report, U.S. territories are included in the term, "state," consistent with the definition of "state" in the PHSA (Section 2, 42 U.S.C. §201).
For example, in FY2023, CDC obligated more than $12.5 billion in grants for public health programs and research, including more than $6.7 billion for non-COVID-19 related awards and over $5.8 billion for COVID-19 related awards. See CDC, "Office of Financial Resources: FY2023 Assistance Snapshot at CDC," https://www.cdc.gov/funding/documents/fy2023/fy-2023-ofr-assistance-snapshot-508.pdf.
For more on the relationship between budget authority, obligations, and outlays, see CRS Report WMR10007, CRS Guide to the Federal Budget Process.
For the purposes of this report, CDC's program level is the sum of the agency's funding for a fiscal year reflecting all sources of budget authority.
See, for example, CDC, "FY2025 Budget Detail Table," https://web.archive.org/web/20250130140026/https://www.cdc.gov/budget/documents/fy2025/FY-2025-CDC-Budget-Detail.pdf.
Specifically, Section 236 of P.L. 119-75, Division B provided that "[f]unds made available in this Act under each of the headings 'Immunization and Respiratory Diseases,' 'HIV/AIDS, Viral Hepatitis, Sexually Transmitted Diseases, and Tuberculosis Prevention,' 'Emerging and Zoonotic Infectious Diseases,' 'Chronic Disease Prevention and Health Promotion,' 'Birth Defects, Developmental Disabilities, Disabilities and Health,' 'Public Health Scientific Services,' 'Environmental Health,' 'Injury Prevention and Control,' 'National Institute for Occupational Safety and Health,' 'Global Health,' 'Public Health Preparedness and Response,' and 'CDC-Wide Activities and Program Support' shall be for the budget activities, and in the amounts specified in the table under each such heading in the explanatory statement." The headings mentioned in this provision include all CDC headings that have funding tables in the explanatory statement that accompanied CDC appropriations; see "Explanatory Statement Accompanying Consolidated Appropriations Act, 2026," Congressional Record, vol. 172 (January 22, 2026), p. H1591-H1593.
See CDC, Operating Plans, https://www.cdc.gov/budget/operating-plans/index.html.
42 U.S.C. §300u-11(a).
Prior to FY2014, the HHS Secretary determined uses of the PPHF. See CRS Report R47895, Prevention and Public Health Fund: In Brief.
The PPHF is subject to sequestration, which reduces overall funding available under the authority. In FY2025, $74 million was sequestered from the FY2025 PPHF appropriation. In FY2026, $87 million was ordered to be sequestered from the PPHF appropriation. See OMB, "Report to the Congress on the BBEDCA 251A Sequestration for Fiscal Year 2026," May 30, 2025, p. 7 of 17, https://www.whitehouse.gov/wp-content/uploads/2025/04/OMB-Report-to-the-Congress-on-the-BBEDCA-251A-Sequestration-for-Fiscal-Year-2026.pdf, and White House, "Sequestration Order for Fiscal Year 2026 Pursuant to Section 251A of the Balanced Budget and Emergency Deficit Control Act, as Amended," Federal Register, vol. 90, no. 107, p. 24045, June 5, 2025.
Authorized by Section 241 of the Public Health Service Act (PHSA). The authorizing law allows the HHS Secretary to redistribute a portion of eligible PHS agency appropriations across HHS for program evaluation purposes. The PHSA limits the set-aside to not less than 0.2% and not more than 1.0% of eligible program appropriations. In recent years, annual appropriations laws have established requirements in addition to those in statute. These include a higher maximum percentage for the set-aside and directing specific amounts of tap funding to selected HHS programs. Since FY2010, and including in FY2026, this higher maximum set-aside level has been 2.5% of eligible appropriations, see Section 204 of Division B, Title II, P.L.119-75.
Annual appropriations laws have exempted certain appropriations from transfer that would be otherwise eligible. For example, see in the Substance Abuse and Mental Health Services Administration (SAMHSA) appropriation for mental health, "none of the funds provided for section 1911 of the PHS Act shall be subject to section 241 of such Act" in P.L. 119-75.
The Public Health and Social Services Emergency Fund is an account of the HHS Secretary that has historically funded several offices and programs, including the Administration for Strategic Preparedness and Response (ASPR), the HHS Cybersecurity program, and the Office of National Security. It is also frequently used to provide emergency supplemental appropriations for transfer by the HHS Secretary to agencies in HHS and elsewhere, according to legislative direction.
42 U.S.C. §1320b-9a(e). Funding for CDC's Childhood Obesity Research Demonstration (CORD) Project was initially authorized through the Children's Health Insurance Program Reauthorization Act of 2009 (CHIPRA; P.L. 111-3), and the program was extended through several laws until FY2023. CDC, "Report to Congress on the Centers for Disease Control and Prevention's Childhood Obesity Research Demonstration Project," https://www.cdc.gov/obesity/downloads/strategies/report-to-congress-CORD-508.pdf.
VFC is funded by Medicaid appropriations that are transferred annually to CDC. See 42 U.S.C. §1396s.
See "How the VFC Program is Funded" at CDC, "About the Vaccines for Children Program," September 30, 2025, https://www.cdc.gov/vaccines-for-children/about/index.html.
See CRS Report R42640, Medicaid Financing and Expenditures.
CDC, "NIOSH Radiation Dose Reconstruction Program," https://www.cdc.gov/niosh/ocas/faqsact.html.
CDC NIOSH, "About DCAS," https://www.cdc.gov/niosh/ocas/ocasabt.html.
P.L. 116-260See, for example, in FY2026 LHHS appropriations, 140 Stat.264 of Division B, Title II, P.L. 119-75.
The Vessel Sanitation Program (VSP) at the Centers for Disease Control and Prevention (CDC) assists the cruise ship industry to prevent and control the introduction, transmission, and spread of gastrointestinal (GI) illnesses on cruise ships. See CDC, "Vessel Sanitation Program," https://www.cdc.gov/vessel-sanitation/about/index.html. Operates under authority provided by PHSA Section 361; 42 U.S.C. §264. CDC collects fees from ship owners for operational inspections, see CDC, "Public Health Operational Inspections," https://www.cdc.gov/vessel-sanitation/php/our-role/public-health-inspections.html.
The respirator certification program conducts assessments and NIOSH approval of particulate filtering facepiece respirators. See also CDC, "Respirator Certification Fees Schedules and STPs," https://www.cdc.gov/niosh/rap/certification-fees/. Based on regulations in 42 C.F.R. Part 84.
Section 236 of P.L. 119-75, Division B provided that "[f]unds made available in this Act under each of the headings 'Immunization and Respiratory Diseases,' 'HIV/AIDS, Viral Hepatitis, Sexually Transmitted Diseases, and Tuberculosis Prevention,' 'Emerging and Zoonotic Infectious Diseases,' 'Chronic Disease Prevention and Health Promotion,' 'Birth Defects, Developmental Disabilities, Disabilities and Health,' 'Public Health Scientific Services,' 'Environmental Health,' 'Injury Prevention and Control,' 'National Institute for Occupational Safety and Health,' 'Global Health,' 'Public Health Preparedness and Response,' and 'CDC-Wide Activities and Program Support' shall be for the budget activities, and in the amounts specified in the table under each such heading in the explanatory statement." The headings mentioned in this provision include all CDC headings that have funding tables in the explanatory statement that accompanied CDC appropriations; see "Explanatory Statement Accompanying Consolidated Appropriations Act, 2026," Congressional Record, vol. 172 (January 22, 2026), p. H1591-H1593.
For more background, see CRS Report R44124, Appropriations Report Language: Overview of Development and Components.
HHS, "HHS Grants Terminated," retrieved from https://taggs.hhs.gov/Content/Data/HHS_Grants_Terminated.pdf.
CDC, FY2027 Congressional Budget Justification, https://www.cdc.gov/budget/documents/fy2027/fy-2027-cdc-cj.pdf.
When compared with the FY2026 core public health program level, the FY2027 budget request proposes a decrease of $3.743 billion (-40.6%) to CDC/ATSDR funding; however, this does not account for the relocations of existing CDC programs to other HHS components. When accounting for the proposed reorganization, the comparable CDC FY2026 funding level is $6.713 billion, and therefore the FY2027 budget request proposes a decrease of $1.228 billion (-18.3%) to this FY2026 comparable level. However, this comparable funding level does not fully account for relocated CDC programs proposed for elimination or funding reductions, as described in this report. FY2026 comparable level from "All Purpose Table" and "Summary of Changes" of CDC, FY2027 Congressional Budget Justification, pp. 13, 15-16, https://www.cdc.gov/budget/documents/fy2027/fy-2027-cdc-cj.pdf.
Administration for a Healthy America (AHA), FY2027 Congressional Budget Justification, https://www.hhs.gov/sites/default/files/fy-2027-aha-cj.pdf, pp. 147-149. AHA is a proposed new operating division within HHS.
HHS, FY2027 Budget in Brief, pp. 44-45, https://www.hhs.gov/sites/default/files/fy-2027-budget-in-brief.pdf.
HHS, FY2027 Budget in Brief, pp. 42-45, https://www.hhs.gov/sites/default/files/fy-2027-budget-in-brief.pdf.
HHS, FY2027 Budget in Brief, pp. 54-57, https://www.hhs.gov/sites/default/files/fy-2027-budget-in-brief.pdf.
CDC, "Fact Sheet: Impact of Sequestration and other Budget Changes on the Centers for Disease Control and Prevention," https://www.cdc.gov/budget/documents/fy2013/fy-2013-sequester-impacts.pdf.
See CRS Report R46711, U.S. Public Health Service: COVID-19 Supplemental Appropriations in the 116th Congress and CRS Report R46834, American Rescue Plan Act of 2021 (P.L. 117-2): Public Health, Medical Supply Chain, Health Services, and Related Provisions.
U.S. Government Accountability Office, Influenza Pandemic: Lessons from the H1N1 Pandemic Should be Incorporated into Future Planning, GAO-11-632, June 2011, pp. 7, 16, https://www.gao.gov/assets/gao-11-632.pdf.
P.L. 113-234, 128 Stat. 2520.
CDC, "Ebola Funding," https://web.archive.org/web/20220306103011/https://www.cdc.gov/cpr/readiness/funding-ebola.htm, and data provided by CDC to CRS on April 22, 2022. See also U.S. Government Accountability Office, Infectious Disease Threats: Funding and Performance of Key Preparedness and Capacity-Building Programs, May 2018, https://www.gao.gov/assets/gao-18-362.pdf.
P.L. 114-223, 130 Stat. 901-130 Stat. 902.
U.S. Government Accountability Office, Zika Supplement: Status of HHS Agencies' Obligations, Disbursements, and the Activities Funded, GAO-18-389, May 2018, pp. 33-54, https://www.gao.gov/assets/gao-18-389.pdf, and data provided by CDC to CRS on April 22, 2022.
CDC received funding from five different COVID-19 relief laws: P.L. 116-123, P.L. 116-136, P.L. 116-139, P.L. 116-260, and P.L. 117-2. U.S. Government Accountability Office, COVID-19: Lessons Can Help Agencies Better Prepare for Emergencies, GAO-24-107175, August 1, 2024, https://www.gao.gov/products/gao-24-107175.
CDC, "Novel Coronavirus (COVID-19," https://www.cdc.gov/budget/covid-19.
CDC, "CDC COVID-19 State, Tribal, Local, and Territorial Funding," website last updated September 4, 2024, https://www.cdc.gov/budget/covid-19-funding/?CDC_AAref_Val=https://www.cdc.gov/budget/fact-sheets/covid-19/funding/index.html.
See Section 529 of Division D of P.L. 118-47 and Section 1101(a)(8) of P.L. 119-4.
Department of Defense and Labor, Health and Human Services, and Education Appropriations Act, 2019 and Continuing Appropriations Act, 2019, P.L. 115-245, Division B, Title II, Section 231. Codified at 42 U.S.C. §247d-4a.
Per footnote 18, the PHSSEF account historically funded ASPR, the HHS lead operating division for medical and public health preparedness for, response to, and recovery from disaster and public health emergencies. ASPR oversees several programs, including the Biomedical Advanced Research and Development Authority and the Strategic National Stockpile. Beginning in FY2024, ASPR has received its appropriations in a separate account from the PHSSEF.
GAO-23-106102, August 2023, https://www.gao.gov/assets/gao-23-106102.pdfGAO-23-106102, August 2023, https://www.gao.gov/assets/gao-23-106102.pdf
.
USASpending.gov, "Infectious Diseases Rapid Response Reserve Fund, Centers for Disease Control, Health and Human Services," last updated March 30, 2026, https://www.usaspending.gov/federal_account/075-0945.
USASpending.gov, "Public Health Emergency Fund, Public Health Services, Office of Assistant Secretary for Health, Health and Human Services," https://www.usaspending.gov/federal_account/075-1104.
U.S. Government Accountability Office, Public Health Preparedness: HHS Reserve Funding for Emergencies, GAO-23-106102, August 2023, https://www.gao.gov/assets/gao-23-106102.pdf.