Labor, Health and Human Services, and
December 16, 2022
Education: FY2023 Appropriations
Karen E. Lynch,
This report offers an overview of actions taken by Congress and the President to provide FY2023
Coordinator
appropriations for accounts funded by the Departments of Labor, Health and Human Services,
Specialist in Social Policy
and Education, and Related Agencies (LHHS) appropriations bill. This bill includes all accounts

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

for more than a dozen related agencies, including the Social Security Administration (SSA).

This report primarily focuses on regular FY2023 LHHS discretionary funding enacted during the
annual appropriations process. Note that the totals in report tables do not include emergency-designated appropriations.
Those amounts are displayed separately and are in addition to regular appropriations.
FY2023 Continuing Resolution: FY2023 LHHS regular appropriations are currently being provided by a series of
continuing resolutions (CRs). The first CR was signed into law on September 30, 2022 (Division A of H.R. 6833; P.L. 117-
180), providing continuing appropriations for all 12 annual appropriations acts (including LHHS) through December 16,
2022. In general, the CR funded discretionary programs at the same rate and under the same conditions as in FY2022 (§101)
and annually appropriated entitlements at their current law levels (§111). It also included several anomalies that are specific
to LHHS accounts or related activities (§§101(8), 145-150). The LHHS funding in the first CR was subsequently extended
through December 23, 2022, through the enactment of P.L. 117-229 (H.R. 1437), a second FY2023 CR.
Regular Appropriations
FY2023 LHHS Senate Action: The FY2023 LHHS bill has not received subcommittee, full committee, or initial floor
action in the Senate. Senator Leahy, Chair of the Senate Appropriations Committee, released a majority draft of the LHHS
bill and accompanying draft report language on July 28, 2022. These draft numbers are not presented in this report.
Also on July 28, 2022, Senator Patty Murray, Chair of the Senate Appropriations LHHS Subcommittee, introduced an
FY2023 LHHS bill (S. 4659). This bill was referred to the Senate Appropriations Committee. Because S. 4659 has not
received any congressional action, this report does not discuss this measure.
FY2023 LHHS House Action: On June 30 2022, the House Appropriations Committee voted to report the FY2023 LHHS
bill, 32-24; the measure was subsequently reported to the House on July 5 (H.R. 8295; H.Rept. 117-403). Previously, the
measure was approved in subcommittee, via a voice vote, on June 23, 2022.
As reported by the full committee, the bill would provide $243.3 billion in discretionary LHHS funds, a 13.6% increase from
FY2022 enacted levels. This amount is $1.5 billion (-0.6%) less than the FY2023 President’s request. In addition, the House
committee bill would provide an estimated $1.196 trillion in mandatory funding, for a combined total of $1.439 trillion for
LHHS as a whole. The distribution of discretionary funding is as follows:
 DOL: $15.0 billion, 14.0% more than FY2022.
 HHS: $124.2 billion, 14.4% more than FY2022.
 ED: $86.7 billion, 13.5% more than FY2022.
 Related Agencies: $17.4 billion, 8.8% more than FY2022.
The House committee bill has not received floor consideration as of the cover date of this report.
FY2023 President’s Budget Request: The FY2023 President’s budget request was submitted to Congress on March 28,
2022. Subsequently, on June 7, 2022, the Biden Administration submitted several FY2023 budget amendments to Congress.
Congressional Research Service

Labor, Health and Human Services, and Education: FY2023 Appropriations

The Administration characterized the two LHHS budget amendments as technical in nature; neither was estimated to affect
net budget authority totals.
The President requested $244.9 billion in discretionary funding for accounts funded by the LHHS bill, which is an increase of
14.3% from FY2022 levels. In addition, the President requested $1.196 trillion in annually appropriated mandatory funding,
for a total of $1.441 trillion for LHHS as a whole. The distribution of discretionary funding is as follows:
 DOL: $14.9 billion, 13.0% more than FY2022.
 HHS: $123.9 billion, 14.1% more than FY2022.
 ED: $88.3 billion, 15.6% more than FY2022.
 Related Agencies: $17.7 billion, 11.1% more than FY2022.
Emergency-Designated Appropriations
Although full-year regular annual appropriations have yet to be enacted, one bill has been signed into law providing FY2023
emergency-designated appropriations for accounts typically funded in the LHHS bill.
Division A of the Continuing Appropriations and Ukraine Supplemental Appropriations Act, 2023 (H.R. 6833; P.L. 117-180,
September 30, 2022) provided emergency-designated appropriations for two accounts at the HHS Administration for
Children and Families (ACF): $1.0 billion for the Low Income Home Energy Assistance Program (§146) and $1.8 billion for
expenses to carry out the Unaccompanied Children (UC) Program and for certain refugee and entrant assistance activities
(§147).

Congressional Research Service

Labor, Health and Human Services, and Education: FY2023 Appropriations

Congressional Research Service

link to page 8 Labor, Health and Human Services, and Education: FY2023 Appropriations

Introduction
This report provides an overview of FY2023
Scope of the Report:
appropriations actions for accounts traditionally funded
Emergency-Designated and
in the appropriations bill for the Departments of Labor,
Mandatory Funding
Health and Human Services, and Education, and Related
This report primarily focuses on regular
Agencies (LHHS). This bill provides discretionary and
FY2023 LHHS discretionary funding
mandatory appropriations to three federal departments:
enacted during the annual appropriations
the Department of Labor (DOL), the Department of
process. The emergency discretionary
funding that was enacted for FY2022 or
Health and Human Services (HHS), and the Department
FY2023 is generally not included in the
of Education (ED). In addition, the bill provides annual
budgetary figures discussed or table totals
appropriations for more than a dozen related agencies,
presented in the main body of the report.
including the Social Security Administration (SSA).
(Such spending is presented below the
table totals and is in addition to regular
Discretionary funds represent less than one-fifth of the
appropriations.) In addition, during
total funds appropriated in the annual LHHS bill.
FY2022 mandatory appropriations were
Nevertheless, the LHHS bill is typically the largest single
enacted for certain LHHS-related
accounts, including in P.L. 117-169,
source of discretionary funds for domestic nondefense
commonly referred to as the Inflation
federal programs among the various appropriations bills.
Reduction Act of 2022. These mandatory
(The Department of Defense bill is the largest source of
funds are also not included in this report.
discretionary funds among all federal programs.)
Because the appropriations process both provides and controls discretionary funding (concepts
discussed further in “Mandatory vs. Discretionary Budget Authority”), the bulk of this report is
focused on these funds.
The LHHS bill typically is one of the more controversial of the regular appropriations bills
because of the size of its funding and the scope of its programs, as well as various related social
policy issues addressed in the bill, such as restrictions on the use of federal funds for abortion and
for research on human embryos, stem cells, and gun violence.
Congressional clients may consult the LHHS experts list in CRS Report R42638, Appropriations:
CRS Experts, for information on which analysts to contact at the Congressional Research Service
(CRS) with questions on specific agencies and programs funded in the LHHS bill.
Report Roadmap and Useful Terminology
This report is divided into several sections. The opening section provides an explanation of the
scope of the LHHS bill (and hence, the scope of this report) and an introduction to important
terminology and concepts that carry throughout the report. Next is a series of sections describing
major congressional actions on FY2023 appropriations and (for context) a review of the
conclusion of the FY2022 appropriations process. This is followed by a high-level summary and
analysis of proposed appropriations for FY2023, compared to FY2022 funding levels. The body
of the report concludes with overview sections for each of the major titles of the bill: DOL, HHS,
ED, and Related Agencies (RA). These sections provide selected highlights from FY2023
proposed funding levels compared to FY2022. (Note that the distribution of funds is sometimes
Congressional Research Service

1

link to page 55 link to page 8 Labor, Health and Human Services, and Education: FY2023 Appropriations

illustrated by figures, which in all cases are based on the FY2023 House committee-reported
version of the LHHS bill.1)
The Appendix provides a summary of budget enforcement activities for FY2023. This includes
information on mandatory spending sequestration pursuant to the Budget Control Act of 2011
(BCA; P.L. 112-25), discretionary spending budget enforcement in the absence of a FY2023
budget resolution, the House LHHS subcommittee spending allocation, and current-year spending
levels.
Scope of the Report
This report focuses on appropriations to agencies and accounts that are subject to the jurisdiction
of the Labor, Health and Human Services, Education, and Related Agencies subcommittees of the
House and Senate appropriations committees (i.e., accounts traditionally funded via the LHHS
bill). Department “totals” provided in this report do not include funding for accounts or agencies
that are traditionally funded by appropriations bills under the jurisdiction of other subcommittees.
The LHHS bill provides appropriations for the following federal departments and agencies:
 the Department of Labor;
 most agencies at the Department of Health and Human Services, except for the
Food and Drug Administration (funded through the Agriculture appropriations
bill), the Indian Health Service (funded through the Interior-Environment
appropriations bill), and the Agency for Toxic Substances and Disease Registry
(also funded through the Interior-Environment appropriations bill);
 the Department of Education; and
 more than a dozen related agencies, including the Social Security Administration,
the Corporation for National and Community Service, the Corporation for Public
Broadcasting, the Institute of Museum and Library Services, the National Labor
Relations Board, and the Railroad Retirement Board.
Note also that funding totals displayed in this report do not reflect amounts provided outside of
the annual appropriations process. Certain direct spending programs, such as Social Security and
parts of Medicare, receive funding directly from their authorizing statutes; such funds are not
reflected in the totals provided in this report because they are not provided through the annual
appropriations process (see related discussion in the “Important Budget Concepts” section).
Important Budget Concepts
Mandatory vs. Discretionary Budget Authority2
The LHHS bill includes both discretionary and mandatory budget authority. While all
discretionary spending is subject to the annual appropriations process, only a portion of
mandatory budget authority is provided in appropriations measures.

1 The dollars and percentages in each figure also are generally illustrative, except as noted, of the parallel distribution
of funds enacted in FY2022 and proposed by the FY2023 President’s budget.
2 For definitions of these and other budget terms, see U.S. Government Accountability Office (GAO), A Glossary of
Terms Used in the Federal Budget Process, GAO-05-734SP, September 1, 2005, http://www.gao.gov/products/GAO-
05-734SP. (Terms of interest may include appropriated entitlement, direct spending, discretionary, entitlement
Congressional Research Service

2

link to page 55 Labor, Health and Human Services, and Education: FY2023 Appropriations

Mandatory programs funded through the annual appropriations process are commonly referred to
as appropriated entitlements. In general, appropriators have little control over the amounts
provided for appropriated entitlements; rather, the authorizing statute controls the program
parameters (e.g., eligibility rules, benefit levels) that entitle certain recipients to payments. If
Congress does not appropriate the money necessary to meet these commitments, entitled
recipients (e.g., individuals, states, or other entities) may have legal recourse.3
Most mandatory spending is not provided through the annual appropriations process, but rather
through budget authority provided by the program’s authorizing statute (e.g., Social Security
benefits payments). The funding amounts in this report do not include budget authority provided
outside of the appropriations process. Instead, the amounts reflect only those funds, discretionary
and mandatory, that are provided through appropriations acts.
As displayed in this report, mandatory amounts for the FY2023 President’s budget submission
reflect current-law (or current services) estimates; they generally do not include the President’s
proposed changes to a mandatory spending program’s authorizing statute that might affect total
spending. (In general, such proposals are excluded from this report, as they typically would be
enacted in authorizing legislation.)
The report focuses most closely on discretionary funding because discretionary funding receives
the bulk of attention during the appropriations process. (While the LHHS bill includes more
mandatory funding than discretionary funding, the appropriators generally have less flexibility in
adjusting mandatory funding levels than discretionary funding levels.)
Mandatory and discretionary spending is subject to budget enforcement processes that include
sequestration. In general, sequestration involves largely across-the-board reductions that are made
to certain categories of discretionary or mandatory spending. However, the conditions that trigger
sequestration, and how it is carried out, differ for each type of spending. This is discussed further
in the Appendix.
Total Budget Authority Provided in the Bill vs. Total Budget Authority
Available in the Fiscal Year
Budget authority is the amount of money a federal agency is legally authorized to commit or
spend. Appropriations bills may include budget authority that becomes available in the current
fiscal year, in future fiscal years, or some combination. Amounts that become available in future
fiscal years are typically referred to as advance appropriations.
Unless otherwise specified, appropriations levels displayed in this report refer to the total amount
of budget authority provided in an appropriations bill (i.e., “total in the bill”), regardless of the
year in which the funding becomes available.4 In some cases, the report breaks out current-year
appropriations (i.e., the amount of budget authority available for obligation in a given fiscal year,
regardless of the year in which it was first appropriated).5

authority, and mandatory.)
3 Sometimes appropriations measures include amendments to laws authorizing mandatory spending programs and
thereby change the amount of mandatory appropriations needed. Because such amendments are legislative in nature,
they may violate parliamentary rules separating authorizations and appropriations. For more information, see CRS
Report R42388, The Congressional Appropriations Process: An Introduction.
4 Such figures include advance appropriations provided in the bill for future fiscal years, but do not include advance
appropriations provided in prior years’ appropriations bills that become available in the current year.
5 Such figures exclude advance appropriations for future years, but include advance appropriations from prior years that
Congressional Research Service

3

link to page 55 link to page 14 Labor, Health and Human Services, and Education: FY2023 Appropriations

As the annual appropriations process unfolds, the amount of current-year budget authority is
measured against 302(b) allocation ceilings (budget enforcement caps for appropriations
subcommittees that traditionally emerge following the budget resolution process, see the
Appendix). The process of measuring appropriations against these spending ceilings takes into
account scorekeeping adjustments, which are made by the Congressional Budget Office (CBO) to
reflect conventions and special instructions of Congress.6 Unless otherwise specified,
appropriations levels displayed in this report do not reflect additional scorekeeping adjustments.
(Those scorekeeping adjustments are displayed at the bottom of Table 2.)
Status of FY2023 LHHS Appropriations
FY2023 Continuing Appropriations
FY2023 LHHS regular appropriations are currently being provided by a series of continuing
resolutions (CRs). The first CR was signed into law on September 30, 2022 (Division A of H.R.
6833; P.L. 117-180). The measure, which was originally an unrelated vehicle that had been
previously passed by the House, was taken up by the Senate the week prior to the start of the
fiscal year. The Senate amended the measure to contain the CR, and passed it as amended (72-25)
on September 29, 2022. The House subsequently took up the measure and agreed to the Senate
amendment (230-201) on September 30, 2022.
That first CR provided continuing appropriations for all 12 annual appropriations acts (including
LHHS) through December 16, 2022. In general, the CR funded discretionary programs at the
same rate and under the same conditions as in FY2022 (§101) and annually appropriated
entitlements at their current law levels (§111).7 It also included several anomalies that are specific
to LHHS accounts or related activities (§§101(8), 145-150).8
The LHHS funding in the first CR was subsequently extended through December 23, 2022,
through the enactment of P.L. 117-229 (H.R. 1437), a second FY2023 CR.
FY2023 Emergency-Designated Appropriations
Although full-year regular annual appropriations have yet to be enacted, one bill has been signed
into law providing FY2023 emergency-designated appropriations for accounts typically funded in
the LHHS bill.
Division A of the Continuing Appropriations and Ukraine Supplemental Appropriations Act, 2023
(H.R. 6833; P.L. 117-180, September 30, 2022) provided emergency-designated appropriations
for two accounts at the HHS Administration for Children and Families (ACF): $1.0 billion for the
Low Income Home Energy Assistance Program (§146) and $1.8 billion for expenses to carry out

become available in the given fiscal year.
6 For more information on scorekeeping, see CRS Report 98-560, Baselines and Scorekeeping in the Federal Budget
Process. See also a discussion of key scorekeeping guidelines included in the joint explanatory statement
accompanying the conference report to the Balanced Budget Act of 1997 (H.Rept. 105-217, pp. 1007-1014).
7 For an estimate of the discretionary appropriations contained in Division A of H.R. 6833, see Estimated Discretionary
Appropriations Under Division A of Senate Amendment Number 5745 to H.R. 6833, the Continuing Appropriations
and Ukraine Supplemental Appropriations Act, 2023, with Adjustments Made in the Senate, September 28, 2022,
https://www.cbo.gov/system/files/2021-09/57491-CBO-Estimate-for-HR5305.pdf.
8 The LHHS anomalies are discussed in CRS Report R47283, Overview of Continuing Appropriations for FY2023
(Division A of P.L. 117-180).
Congressional Research Service

4

link to page 11 Labor, Health and Human Services, and Education: FY2023 Appropriations

the Unaccompanied Children (UC) Program and for certain refugee and entrant assistance
activities (§147).
FY2023 Annual LHHS Appropriations
Table 1 provides a timeline of major legislative actions for full-year LHHS proposals, which are
discussed in greater detail below:
Table 1. Status of Full-Year LHHS Appropriations Legislation, FY2023
Subcommittee
Full Committee
Resolution of House and
Approval
Approval

Senate Differences

House
Senate
House
Senate
Initial
Initial
Conf.
Final
Final
Public
House
Senate
House
Senate Passage
Passage
Report
Passage
Passage
Law

6/23/22
H.R. 8295

voice
(H.Rept.
vote
117-403)
6/30/22
32-24
Source: CRS Appropriations Status Table.
Congressional Action on an LHHS Bill
FY2023 LHHS Action in the Senate
While the Senate Appropriations Committee has not yet voted to report the legislation, the
committee chair, Senator Leahy, released a majority draft of the LHHS bill and accompanying
draft report language on July 28, 2022.9 These draft numbers are not presented in this report.
Also on July 28, 2022, Senator Patty Murray, Chair of the Senate Appropriations LHHS
Subcommittee, introduced an FY2023 LHHS bill (S. 4659).10 Because S. 4659 has not received
any congressional action, this report does not discuss this measure.
FY2023 LHHS Action in the House (H.R. 8295)
On June 30, 2022, the House Appropriations Committee voted to report the FY2023 LHHS bill,
32-24; the measure was subsequently reported to the House on July 5 (H.R. 8295; H.Rept. 117-
403). Previously, the measure was approved in subcommittee, via a voice vote, on June 23, 2022.

9 See draft text and explanatory statement linked to Senate Appropriations Committee, “Chairman Leahy Releases
Fiscal Year 2023 Senate Appropriations Bills,” July 28, 2022, https://www.appropriations.senate.gov/news/majority/
breaking-chairman-leahy-releases-fiscal-year-2023-senate-appropriations-bills. See also Senate Appropriations
Committee, “Shelby: Democrats’ Partisan Bills Threaten FY23 Appropriations Process,” July 28, 2022,
https://www.appropriations.senate.gov/news/minority/shelby-democrats-partisan-bills-threaten-fy23-appropriations-
process.
10 The text of S. 4659 as introduced was generally the same as the draft LHHS bill released by the chair of the Senate
Appropriations Committee on July 28, discussed above.
Congressional Research Service

5

link to page 12

Labor, Health and Human Services, and Education: FY2023 Appropriations

See Figure 1 for a breakdown of FY2023 discretionary and mandatory LHHS appropriations
proposed in the House committee bill.11 As reported by the full committee, the bill would provide
$243.3 billion in discretionary LHHS funds, a 13.6% increase from FY2022 enacted levels. This
amount would be 0.6% less than the FY2023 President’s request. In addition, the House
committee bill would provide an estimated $1.196 trillion in mandatory funding, for a combined
total of $1.439 trillion for LHHS as a whole. (Note that these totals are based only on amounts of
non-emergency appropriations that would be provided by the House committee bill and do not
include emergency-designated funds, which are in addition to the regular annual appropriations.)
Figure 1. FY2023 House Committee-Reported LHHS Appropriations

Source: Amounts in this figure are generally drawn from or calculated based on data contained in the
committee report (H.Rept. 117-403) accompanying the FY2023 House committee bil (H.R. 8295, as reported).
FY2023 House committee totals (“Total BA in the Bil ”) do not include emergency-designated LHHS
appropriations. For consistency with source materials, amounts in this figure generally do not reflect mandatory
spending sequestration. CRS calculations do, however, include LHHS funding provided to HHS pursuant to the
21st Century Cures Act (P.L. 114-255), as amended.
Notes: Details may not add to totals due to rounding. Amounts in this figure (1) reflect all budget authority
appropriated in the bil , regardless of the year in which funds become available (i.e., totals do not include
advances from prior-year appropriations, but do include advances for subsequent years provided in this bil ); (2)
have generally not been adjusted to reflect scorekeeping; (3) comprise only those funds provided for agencies
and accounts subject to the jurisdiction of the LHHS subcommittees of the House and Senate appropriations
committees; and (4) do not include appropriations that occur outside of appropriations bil s.
FY2023 President’s Budget Request
The FY2023 President’s budget request was submitted to Congress on March 28, 2022.
Subsequently, on June 7, 2022, the Biden Administration submitted several FY2023 budget

11 While the percentages in this figure were calculated based on amounts in the FY2023 House committee bill, they are
generally also illustrative—within a few percentage points—of the share of mandatory and discretionary funds in
FY2022 and under the FY2023 President’s budget.
Congressional Research Service

6

Labor, Health and Human Services, and Education: FY2023 Appropriations

amendments to Congress.12 The Administration characterized the two LHHS budget amendments
as technical in nature; neither were estimated to affect net budget authority totals.13
The President requested $244.9 billion in discretionary funding for accounts funded by the LHHS
bill, which is an increase of 14.3% from FY2022 levels. In addition, the President requested
$1.196 trillion in annually appropriated mandatory funding, for a total of $1.441 trillion for
LHHS as a whole.
FY2022 LHHS Omnibus (Division H, Consolidated Appropriations Act, 2022,
H.R. 2471, P.L. 117-103)
On March 15, 2022, the Consolidated Appropriations Act, 2022 (FY2022 LHHS omnibus; H.R.
2471) was signed into law by the President (P.L. 117-103). The FY2022 omnibus provided full-
year appropriations for all 12 annual appropriations acts in Divisions A-L.14 (Full-year LHHS
appropriations were enacted in Division H.) Prior to its enactment, the final version of the
measure was approved by the House on March 9. (The vote to approve the portion that contained
LHHS appropriations was 260-171.)15 The bill was approved by the Senate (68-31) on March 10.
Annual discretionary LHHS appropriations in the FY2022 LHHS omnibus totaled $214.2 billion.
This amount is 7.9% more than FY2021 enacted and 15.7% less than the FY2022 President’s
budget request. The omnibus also provided $1.102 trillion in mandatory funding, for a combined
LHHS total of $1.316 trillion.16 (Note that these totals are based only on amounts of non-
emergency appropriations and do not include emergency-designated or supplemental funds,
which were provided in addition to the annual appropriations.)

12 U.S. President (Biden), “Letter to the Speaker of the House of Representatives on Fiscal Year 2023 Budget
Amendments,” 117th Cong., 2nd sess., June 7, 2022, https://www.whitehouse.gov/wp-content/uploads/2022/06/
FY_2023_Budget_Amendments_Package_6-7-22.pdf.
13 Ibid, pp. 14, 20.
14 The FY2022 omnibus was originally intended to carry additional supplemental appropriations related to the COVID-
19 pandemic in Division M, but Division M was omitted prior to floor consideration.
15 The special rule, H.Res. 973, provided for the consideration of an amendment consisting of the FY2022 omnibus (as
contained in House Rules Committee Print 117-35) to the Senate amendment to H.R. 2471. H.Res. 973 also provided
for the House to adopt the amendment in two votes: the first on Divisions B, C, F, X, Z, and titles 2 and 3 of division N,
and the second on the remaining divisions and titles. The House adopted Divisions B, C, F, X, Z, and titles 2 and 3 of
division N by a vote of 361-69, and adopted the remaining divisions and titles by a vote of 260-171. The subsequent
motion that the House agree to the Senate amendment with an amendment was agreed to by a voice vote.
16 For a full discussion of the FY2021 LHHS omnibus, see CRS Report R47029, Labor, Health and Human Services,
and Education: FY2022 Appropriations.
Congressional Research Service

7

link to page 60 link to page 14 link to page 60 link to page 60 Labor, Health and Human Services, and Education: FY2023 Appropriations

Summary of FY2023 LHHS Appropriations
Dollars and Percentages in this Report
Amounts displayed in this report are typically rounded (e.g., to the nearest mil ion), as labeled. Dol ar and
percentage changes discussed in the text are based on unrounded amounts.
Unless otherwise specified, appropriations levels displayed in this report refer to the total amount of budget
authority provided in an appropriations bil (i.e., “total in the bil ”), regardless of the year in which the funding
becomes available.
Throughout this report, the FY2023 House Appropriations Committee-reported LHHS bil is commonly referred
to as the “House committee bil .”
Amounts for the FY2022 Enacted, FY2023 Request, and FY2023 House Cmte. columns in the tables are generally
drawn from the committee report (H.Rept. 117-403) accompanying the FY2023 House committee bil (H.R. 8295,
as reported), unless otherwise noted. FY2022 enacted totals (“Total BA in the Bil ”) do not include emergency-
designated LHHS appropriations. For informational purposes, FY2022 and FY2023 enacted emergency-designated
amounts are displayed separately at the bottom of tables throughout the report and not summed. Those amounts
are based on CRS analysis of the texts of those laws. One exception to this rule is made in Table A-2, which
includes FY2022 and FY2023 enacted emergency-designated funds in the “Adjusted Appropriations” totals, as
scored by the Congressional Budget Office.
For consistency with source materials, amounts in this report generally do not reflect mandatory spending
sequestration, where applicable, nor do they reflect any transfers or reprogramming of funds pursuant to
executive authorities, except as noted.17 CRS calculations do, however, include LHHS funding provided to HHS
pursuant to the 21st Century Cures Act (P.L. 114-255), as amended.
Table 2 displays FY2023 discretionary and mandatory LHHS budget authority proposed, by bill
title, along with FY2022 enacted levels. The amounts shown in this table reflect total budget
authority provided in the annual LHHS bill (i.e., all funds appropriated in the bill, regardless of
the fiscal year in which the funds become available), not total budget authority available for the
current fiscal year. (For a comparable table showing current-year budget authority, see Table A-
2.) Note that the totals in this table do not include emergency-designated appropriations; those
amounts are displayed separately at the bottom of the table and are in addition to regular
appropriations.
Table 2. LHHS Appropriations Overview by Bill Title, FY2022-FY2023
(total budget authority provided in the bill, in billions of dollars)
FY2023
FY2022
FY2023
House Cmte.
FY2023
Bill Title
Enacted
Request
(H.R. 8295)
Enacted
Title I: Labor
14.4
16.2
16.3
—
Discretionary
13.2
14.9
15.0
—

17 The general practice for CRS reports on the LHHS bill has been to reflect conventions used in source materials.
These conventions have varied over the years. For instance, CRS reports on LHHS appropriations for FY2012-FY2015
generally relied on source materials that adjusted appropriations amounts in the prior-year column to reflect
sequestration, reestimates of mandatory spending, transfers, reprogramming, and other adjustments for comparability.
However, the FY2016 version of this report broke from that practice due to differing display conventions in source
documents, and did not reflect any such adjustments (except sequestration for the Prevention and Public Health Fund
[PPHF]). The FY2017 version of this report differed from both of these prior practices, in that it reflected a smaller
subset of transfers (generally concentrated at the National Institutes of Health) and other adjustments for comparability
(e.g., program moves from one account to another), but not reprogramming of funds or mandatory sequestration
(except sequestration of the PPHF). The FY2018-FY2022 versions of this report, however, relied on source materials
that generally did not reflect any transfers or other budgetary adjustments pursuant to administrative authorities except
PPHF sequestration. For FY2023, the source materials used for this report continue this most recent approach.
Congressional Research Service

8

link to page 16 link to page 16 link to page 16 Labor, Health and Human Services, and Education: FY2023 Appropriations

FY2023
FY2022
FY2023
House Cmte.
FY2023
Bill Title
Enacted
Request
(H.R. 8295)
Enacted
Mandatory
1.2
1.3
1.3
—
Title II: HHS
1,148.2
1,255.0
1,255.3
—
Discretionary
108.6
123.9
124.2
—
Mandatory
1,039.6
1,131.1
1,131.1
—
Title III: Education
80.1
92.3
90.7
—
Discretionary
76.4
88.3
86.7
—
Mandatory
3.7
3.9
3.9
—
Title IV: Related Agencies
73.0
77.4
77.0
—
Discretionary
16.0
17.7
17.4
—
Mandatory
57.0
59.6
59.6
—
Total BA in the Bill
1,315.7
1,440.8
1,439.3
—
Discretionary
214.2
244.9
243.3
—
Mandatory
1,101.5
1,196.0
1,196.0
—
Emergency Funding (not in above totals)

P.L. 117-43, Divisions A and C
4.2
—
—
—
P.L. 117-58, Division J
0.1
—
—
—
P.L. 117-70, Division B
1.3
—
—
—
P.L. 117-128, Title IV
1.0
—
—
—
P.L. 117-158, Division B
3.0
—
—
—
P.L. 117-180, Division A
—
—
—
2.8
Memoranda (non-emergency funds only):

Advances for Future Years
210.7
242.8
242.8
—
(provided in current bil )a
Advances from Prior Years
197.6
210.7
210.7
—
(for use in current year)a
Additional Scorekeeping Adjustmentsb
-15.0
-33.9
-16.5
—
Source: Amounts in this table for the FY2022 Enacted, FY2023 Request, and FY2023 House Cmte. columns are
generally drawn from the committee report (H.Rept. 117-403) accompanying the FY2023 House committee bil
(H.R. 8295, as reported). Enacted totals (“Total BA in the Bil ”) for FY2022 do not include emergency-designated
appropriations. Amounts shown for emergency-designated appropriations are based on CRS analysis of the
specified laws. For consistency with source materials, amounts in this table generally do not reflect mandatory
spending sequestration, where applicable, nor do they reflect any transfers or reprogramming of funds pursuant
to executive authorities.
Notes: BA = budget authority. Details may not add to totals due to rounding. Amounts in this table (1) reflect
all BA appropriated in the bil , regardless of the year in which funds become available (i.e., totals do not include
advances from prior-year appropriations, but do include advances for subsequent years provided in this bil ); (2)
have generally not been adjusted to reflect scorekeeping; (3) comprise only those funds provided (or requested)
for agencies and accounts subject to the jurisdiction of the LHHS subcommittees of the House and Senate
appropriations committees; and (4) do not include appropriations that occur outside of appropriations bil s. No
amounts are shown for Title V, because this title consists solely of general provisions.
Congressional Research Service

9

link to page 16

Labor, Health and Human Services, and Education: FY2023 Appropriations

a. Totals in this table are based on budget authority provided in the bil (i.e., they exclude advance
appropriations from prior bil s and include advance appropriations from this bil made available in future
years). The calculation for total budget authority available in a given fiscal year is as fol ows: Total BA in the
Bil , minus Advances for Future Years, plus Advances from Prior Years.
b. Totals in this table have generally not been adjusted for scorekeeping. (To adjust for scorekeeping, add this
line to the total budget authority.)
Figure 2 displays the House committee bill discretionary and mandatory LHHS funding levels
proposed for FY2023, by bill title. (While the dollars and percentages discussed in this section
were calculated based on the FY2023 House committee bill, they are generally also illustrative—
within several percentage points—of the share of funds directed to each bill title in FY2022 and
under the FY2023 President’s budget.)
As this figure demonstrates, HHS accounts for the largest share of total FY2023 LHHS
appropriations: $1.255 trillion, or 87.2%. This is due to the large amount of mandatory funding
included in the HHS appropriation, the majority of which is for Medicaid grants to states and
payments to health care trust funds. After HHS, ED and the Related Agencies represent the next-
largest shares of total LHHS funding, accounting for 6.3% and 5.4%, respectively. (The majority
of the ED appropriations each year are discretionary, while the bulk of funding for the Related
Agencies goes toward mandatory payments and administrative costs of the Supplemental Security
Income program at the Social Security Administration.) DOL accounts for the smallest share of
total LHHS funds, 1.1%.
The overall composition of LHHS funding is noticeably different when comparing only
discretionary appropriations. HHS accounts for a comparatively smaller share of total
discretionary appropriations (51.0%), while ED accounts for a relatively larger share (35.6%).
Together, these two departments represent the majority (86.7%) of discretionary LHHS
appropriations. DOL and the Related Agencies account for a roughly even split of the remaining
13.3% of discretionary LHHS funds.
Figure 2. FY2023 House Committee-Reported LHHS Appropriations by Title
(budget authority in billions of dollars unless otherwise indicated)

Source: Amounts in this figure are generally drawn from or calculated based on data contained in the
committee report (H.Rept. 117-403) accompanying the FY2023 House committee bil (H.R. 8295, as reported).
FY2023 House committee totals (“Total BA in the Bil ”) do not include emergency-designated LHHS
appropriations. For consistency with source materials, amounts in this figure generally do not reflect mandatory
Congressional Research Service

10

Labor, Health and Human Services, and Education: FY2023 Appropriations

spending sequestration, nor do they reflect any transfers or reprogramming of funds pursuant to executive
authorities. CRS calculations do, however, include LHHS funding provided to HHS pursuant to the 21st Century
Cures Act (P.L. 114-255), as amended.
Notes: Details may not add to totals due to rounding. Amounts in this figure (1) reflect all BA appropriated in
the bil , regardless of the year in which funds become available (i.e., totals do not include advances from prior-
year appropriations, but do include advances for subsequent years provided in this bil ); (2) have generally not
been adjusted to reflect scorekeeping; (3) comprise only those funds provided for agencies and accounts subject
to the jurisdiction of the LHHS subcommittees of the House and Senate appropriations committees; and (4) do
not include appropriations that occur outside of appropriations bil s.
Department of Labor (DOL)
All amounts in this section are based on regular LHHS appropriations only. Amounts in this
section do not include mandatory funds provided outside of the annual appropriations process
(e.g., direct appropriations for Unemployment Insurance benefits payments). All amounts in this
section are rounded (e.g., to the nearest million), as labeled. The dollar changes and percentage
changes discussed in the text are based on unrounded amounts. For consistency with source
materials, amounts do not reflect sequestration or reestimates of mandatory spending programs,
where applicable.
About DOL
DOL is a federal department comprising multiple entities that provide services related to
employment and training, worker protection, income security, and contract enforcement. Annual
LHHS appropriations laws direct funding to all DOL entities (see the text box).19 The DOL
entities fall primarily into two main functional areas—workforce development and worker
protection. First, there are several DOL
entities that administer workforce employment
DOL Entities Funded via the
and training programs—such as the Workforce
LHHS Appropriations Process
Innovation and Opportunity Act (WIOA) state
Employment and Training Administration (ETA)
formula grant programs, Job Corps, and the
Employee Benefits Security Administration (EBSA)
Employment Service—that provide direct
Wage and Hour Division (WHD)
funding for employment activities or
Office of Federal Contract Compliance Programs
administration of income security programs
(OFCCP)
(e.g., for the Unemployment Insurance
Office of Labor-Management Standards (OLMS)
benefits program). Also included in this area is
Office of Workers’ Compensation Programs (OWCP)
the Veterans’ Employment and Training
Occupational Safety and Health Administration (OSHA)
Service (VETS), which provides employment
Mine Safety and Health Administration (MSHA)
services specifically for the veteran
population. Second, there are several agencies
Bureau of Labor Statistics (BLS)
that provide various worker protection
Office of Disability Employment Policy (ODEP)
services. For example, the Occupational
Departmental Management (DM)18
Safety and Health Administration (OSHA),
the Mine Safety and Health Administration (MSHA), and the Wage and Hour Division (WHD)
provide different types of regulation and oversight of working conditions. DOL entities focused

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

11

link to page 18 Labor, Health and Human Services, and Education: FY2023 Appropriations

on worker protection provide services to ensure worker safety, adherence to wage and overtime
laws, and contract compliance, among other duties. In addition to these two main functional
areas, DOL’s Bureau of Labor Statistics (BLS) collects data and provides analysis on the labor
market and related labor issues.
FY2022 DOL Appropriations Overview
Table 3 generally displays FY2023 discretionary and mandatory DOL budget authority proposed,
along with FY2022 enacted levels. Note that the totals in this table do not include emergency-
designated appropriations. Those amounts (if applicable) are displayed separately, along with the
law in which they were enacted, at the bottom of the table and are in addition to regular
appropriations.
The FY2023 House committee bill would increase discretionary appropriations for DOL by $1.8
billion (+14.0%), while the FY2023 President’s budget request would increase discretionary
appropriations by $1.7 billion (+13.0%) compared to the FY2022 enacted levels. Of the total
funding provided in the bill for DOL, roughly 92% is discretionary.
Table 3. DOL Appropriations Overview
(in billions of dollars)
FY2023
House
Cmte.
FY2022
FY2023
(H.R.
FY2023
Funding
Enacted
Request
8295)
Enacted
Discretionary
13.2
14.9
15.0
—
Mandatory
1.2
1.3
1.3
—
Total BA in the Bill
14.4
16.2
16.3
—
Emergency Funding (not in above totals)
—
—
—
—
Source: Amounts in this table for the FY2022 Enacted, FY2023 Request, and FY2023 House Cmte. columns are
generally drawn from the committee report (H.Rept. 117-403) accompanying the FY2023 House committee bil
(H.R. 8295, as reported). Enacted totals (“Total BA in the Bil ”) for FY2022 do not include emergency-designated
appropriations. For consistency with source materials, amounts in this table generally do not reflect mandatory
spending sequestration, where applicable, nor do they reflect any transfers or reprogramming of funds pursuant
to executive authorities.
Notes: BA = budget authority. Details may not add to totals due to rounding. Amounts in this table (1) reflect
all BA appropriated in the bil , regardless of the year in which funds become available (i.e., totals do not include
advances from prior-year appropriations, but do include advances for subsequent years provided in this bil ); (2)
have generally not been adjusted to reflect scorekeeping; (3) comprise only those funds provided (or requested)
for agencies and accounts subject to the jurisdiction of the LHHS subcommittees of the House and Senate
appropriations committees; and (4) do not include appropriations that occur outside of appropriations bil s.
Selected DOL Highlights
The following sections present highlights from the FY2023 House committee bill and the
President’s FY2023 budget request compared to the FY2022 LHHS omnibus for selected DOL
accounts and programs.20

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

12

link to page 21 Labor, Health and Human Services, and Education: FY2023 Appropriations

Table 4 displays funding for DOL programs and activities discussed in this section.
Employment and Training Administration (ETA)
Title I of WIOA, which authorizes more than half of all WIOA funding, includes three state
formula grant programs serving Adults, Youth, and Dislocated Workers. For the three WIOA state
formula grant programs, the FY2023 House committee bill would provide a $256 million increase
(+8.9%) compared to FY2022 enacted levels and a $116 million increase (+3.8%) compared to
the level requested in the FY2023 President’s budget.
The FY2023 House committee bill would provide $457 million for the Dislocated Workers
Activities National Reserve (DWA National Reserve), which would be an increase of $157
million (+52.0%) compared to the FY2022 enacted level of $301 million but a decrease of $70
million (-13.3%) compared to the FY2023 President’s budget request of $527 million. In
addition, the FY2023 House committee bill would maintain a provision in that account, which
originated in the FY2020 LHHS omnibus, directing that funds ($100 million for FY2023, an
increase of $50 million relative to FY2022 enacted) from the DWA National Reserve be used in
developing, offering, or improving career training programs at community colleges. The FY2023
House committee bill and the FY2023 President’s budget request would direct $50 million and
$100 million, respectively, from the DWA National Reserve for training and employment
assistance to workers in communities experiencing dislocations in the fossil fuel extraction and
energy production industries.21
The FY2023 House committee bill and the FY2023 President’s budget would provide $145
million for the YouthBuild program and $150 million for ex-offender activities, increases of
46.4% and 46.9%, respectively, compared to the levels enacted in the FY2022 LHHS omnibus.
The FY2023 House committee bill and the FY2023 President’s budget would provide $303
million for the Apprenticeship Grant program, which would be $68 million (+28.9%) more than
the level enacted in the FY2022 LHHS omnibus.
Finally, under the pilot and demonstration authority in WIOA (Section 169), the FY2023 House
committee bill and the FY2023 President’s budget would provide new funding for a National
Youth Employment Program ($75 million), a Climate Corps program ($15 million), and a
Veterans Clean Energy Training program ($10 million). In addition, the FY2023 House
committee bill would provide $132 million in funding for community projects for dislocated
workers, adults, and youth.
Employment Service
The FY2023 House committee bill would provide $749 million for the Employment Service,
which would be an increase of $49 million (+7.0%) compared to the FY2022 enacted level and
$28 million (+3.8%) more than requested in the FY2023 President’s budget. The Employment
Service is a joint federal-state partnership that funds staff to provide career counseling, job search
services, and administration of the work test for the Unemployment Insurance (UI) system. The
FY2023 House committee bill would prohibit DOL from using any funds provided in the FY2023
LHHS appropriations bill to implement or enforce a 2020 final rule allowing the use of non-
merit-staff employees to deliver services for the Employment Service.22

21 DOL, FY2023 Congressional Budget Justification, Employment and Training Administration, Training and
Employment Services, p. 6, https://www.dol.gov/sites/dolgov/files/general/budget/2023/CBJ-2023-V1-03.pdf.
22 See §112 of H.R. 8295 and H.Rept. 117-403 p. 19-20.
Congressional Research Service

13

Labor, Health and Human Services, and Education: FY2023 Appropriations

Wage and Hour Division (WHD)
The FY2023 House committee bill would provide $313 million for WHD, an increase of $62
million (+24.6%) compared to the FY2022 enacted level and $5 million (+1.6%) more than the
FY2023 President’s budget. The WHD is responsible for enforcing the Fair Labor Standards Act
(FLSA), the Davis-Bacon Act (DBA), the Family and Medical Leave Act (FMLA), as well as
other labor standards statutes. As noted in the accompanying report, the additional $62 million in
the FY2023 appropriations for WHD would be to support additional investigators to implement
strategic enforcement and, as required by the bill, to establish a national hotline to support
domestic workers reporting wage and hour violations.23
Office of Disability Employment Policy (ODEP)
The FY2023 House committee bill would provide $59 million for ODEP, an increase of $18
million (+44.6%) compared to the FY2022 enacted level and the same as proposed in the FY2023
President’s budget. The ODEP is responsible for developing and influencing policies and
practices to increase labor market opportunities for individuals with disabilities. The House
committee report expresses support for the FY2023 President’s budget proposal to use additional
ODEP funding to plan and implement Equitable Transition Model (ETM) projects to enable low-
income youth with disabilities to transition to employment.24
Bureau of International Labor Affairs (ILAB)
The FY2023 House committee bill would provide $139 million for ILAB, an increase of $33
million (+30.9%) compared to the FY2022 enacted level and $10 million (+7.8%) more than the
FY2023 President’s budget request.25 ILAB provides research, advocacy, technical assistance,
and grants to promote workers’ rights in different parts of the world. Language in the FY2023
House committee report directs ILAB to place additional labor attachés in strategic countries,
including but not limited to Honduras, to assist with promoting worker rights, such as freedom of
association and collective bargaining.26
Labor-Related General Provisions
Annual LHHS appropriations acts regularly contain general provisions related to certain labor
issues. This section highlights selected DOL general provisions in the FY2023 House committee
bill.
The FY2023 House committee bill would add new provisions and continue several provisions
that have been included in at least one previous LHHS appropriations act, including provisions
that would
 authorize the Secretary of Labor to employ law enforcement officers or special
agents to provide protection to the Secretary of Labor and certain other

23 H.Rept. 117-403 p. 24-26.
24 H.Rept. 117-403 p. 35.
25 This level is specified in H.Rept. 117-403 p. 35.
26 H.Rept. 117-403 p. 35.
Congressional Research Service

14

link to page 23 Labor, Health and Human Services, and Education: FY2023 Appropriations

employees and family members at public events and in situations in which there
is a “unique and articulable” threat of physical harm (included since FY2018);27
 authorize the Secretary of Labor to dispose of or divest “by any means the
Secretary determines appropriate” all or part of the real property on which the
Treasure Island Job Corps Center (California) is located (included since
FY2018);28
 prohibit any funds from the bill from being used to alter the Interagency
Agreement between DOL and the Department of Agriculture or to close any
Civilian Conservation Centers unless certain conditions are met (included since
FY2020);29
 prohibit any funds from the bill from being used to implement or enforce the
final rule on “Wagner-Peyser Act Staffing Flexibility” (included since FY2022);30
and
 prohibit any funds from the bill from being used to implement or enforce
Industry Recognized Apprentice Programs (included since FY2022).31
Table 4. Detailed DOL Appropriations
(in millions of dollars)
FY2023
House
FY2022
FY2023
Cmte.
FY2023
Agency or Selected Program
Enacted
Request
(H.R. 8295)
Enacted
ETA—Mandatorya
540
494
494
—
ETA—Discretionary
9,942
11,076
11,269
—
Discretionary ETA Programs:

—
Training and Employment Services:
3,912
4,411
4,598
—
State Formula Grants:
2,879
3,019
3,135
—
Adult Activities Grants to States
871
900
941
—
Youth Activities Grants to States
933
964
1,033
—
Dislocated Worker Activities
1,076
1,155
1,162
—
(DWA) Grants to States
National Activities:
1,033
1,392
1,462
—
DWA National Reserve
301
527
457
—
Native Americans
57
64
64
—
Migrant and Seasonal Farmworkers
95
97
105
—
YouthBuild
99
145
145
—
Reintegration of Ex-Offenders
102
150
150
—
Workforce Data Quality Initiative
6
6
6
—

27 Division A, Title I, §109 of H.R. 8295.
28 Division A, Title I, §110 of H.R. 8295.
29 Division A, Title I, §111 of H.R. 8295.
30 Division A, Title I, §112 of H.R. 8295.
31 Division A, Title I, §113 of H.R. 8295.
Congressional Research Service

15

link to page 23 link to page 23 link to page 23 Labor, Health and Human Services, and Education: FY2023 Appropriations

FY2023
House
FY2022
FY2023
Cmte.
FY2023
Agency or Selected Program
Enacted
Request
(H.R. 8295)
Enacted
Apprenticeship Grants
235
303
303
—
Community Projects
138
0
132
—
National Youth Employment
0
75
75
—
Program
Climate Corps
0
15
15
—
Veterans Clean Energy Training
0
10
10
—
Job Corps
1,749
1,779
1,799
—
Community Service Employment for Older
405
405
450
—
Americans
State Unemployment Insurance and
3,711
4,258
4,214
—
Employment Service Operations (SUI/ESO):
Unemployment Compensation
2,869
3,353
3,303
—
Employment Service
700
721
749
—
Foreign Labor Certification
80
99
95
—
One-Stop Career Centers
63
86
68
—
ETA Program Administration
164
223
209
—
Employee Benefits Security
186
234
234
—
Administration
Pension Benefit Guaranty Corp, (PBGC) program
473
493
493
—
level (non-add)b
Wage and Hour Division
251
308
313
—
Office of Labor-Management Standards
46
50
46
—
Office of Federal Contract Compliance
108
147
147
—
Programs
Office of Workers’ Compensation
683
756
756
—
Programs—Mandatoryc
Office of Workers’ Compensation
120
146
146
—
Programs—Discretionary
Occupational Safety & Health
612
701
712
—
Administration
Mine Safety & Health Administration
384
423
404
—
Bureau of Labor Statistics
688
742
726
—
Office of Disability Employment Policy
41
59
59
—
Departmental Management
812
1,015
975
—
Salaries and Expenses
368
492
499
—
International Labor Affairs (non-addd)
106
129
139
—
Veterans Employment and Training
325
331
339
—
IT Modernization
28
48
38
—
Congressional Research Service

16

Labor, Health and Human Services, and Education: FY2023 Appropriations

FY2023
House
FY2022
FY2023
Cmte.
FY2023
Agency or Selected Program
Enacted
Request
(H.R. 8295)
Enacted
Working Capital Fund
0
36
0
—
Office of the Inspector General
91
108
99
—
Total, DOL BA in the Bill
14,412
16,151
16,281
—
Subtotal, Mandatory
1,223
1,250
1,250
—
Subtotal, Discretionary
13,189
14,900
15,031
—
Emergency Funding (not in above totals)
—
—
—
—
Memoranda (non-emergency funds only)

—
Total, BA Available in Fiscal Year (current year
14,415
16,151
16,282
—
from any bil )
Total, BA Advances for Future Years (provided
1,783
1,782
1,782
—
in current bil )
Total, BA Advances from Prior Years (for use
1,786
1,783
1,783
—
in current year)
Source: Amounts in this table for the FY2022 Enacted, FY2023 Request, and FY2023 House Cmte. columns are
generally drawn from the committee report (H.Rept. 117-403) accompanying the FY2023 House committee bil
(H.R. 8295, as reported). Enacted totals (“Total BA in the Bil ”) for FY2022 do not include emergency-designated
appropriations. For consistency with source materials, amounts in this figure generally do not reflect mandatory
spending sequestration, where applicable, nor do they reflect any transfers or reprogramming of funds pursuant
to executive authorities.
Notes: BA = budget authority. Details may not add to totals due to rounding. Amounts in this table (1) reflect
all BA appropriated in the bil , regardless of the year in which funds become available (i.e., totals do not include
advances from prior-year appropriations, but do include advances for subsequent years provided in this bil ); (2)
have generally not been adjusted to reflect scorekeeping; (3) comprise only those funds provided (or requested)
for agencies and accounts subject to the jurisdiction of the LHHS subcommittees of the House and Senate
appropriations committees; and (4) do not include appropriations that occur outside of appropriations bil s.
a. Mandatory funding within ETA goes to Federal Unemployment Benefits and Allowances (FUBA) and
Advances to the Unemployment Trust Fund (UTF), if any. FUBA funds Trade Adjustment Assistance for
Workers (TAA).
b. PBGC funding is provided outside the LHHS Appropriations Act.

c. Mandatory programs in the Office of Workers’ Compensation Programs include Special Benefits
(comprising the Federal Employees’ Compensation Benefits and the Longshore and Harbor Workers’
Benefits), Special Benefits for Disabled Coal Miners, Energy Employees Occupational Il ness Compensation
(Administrative Expenses), and the Black Lung Disability Trust Fund.
d. The funding for International Labor Affairs is included in the Salaries and Expenses total.
Department of Health and Human Services (HHS)
All amounts in this section are based on regular LHHS appropriations only; they do not include
funds for HHS agencies provided through other appropriations bills (e.g., funding for the Food
and Drug Administration) or outside of the annual appropriations process (e.g., direct
appropriations for Medicare or mandatory funds provided by authorizing laws, such as the
American Rescue Plan Act of 2021 [P.L. 117-2]). All amounts in this section are rounded (e.g., to
the nearest million), as labeled. The dollar changes and percentage changes discussed in the text
are based on unrounded amounts. For consistency with source materials, amounts do not reflect
sequestration or re-estimates of mandatory spending programs, where applicable.
Congressional Research Service

17

Labor, Health and Human Services, and Education: FY2023 Appropriations

About HHS
HHS is a large federal department composed
HHS Agencies Funded via the
of multiple agencies working to enhance the
LHHS Appropriations Process
health and well-being of Americans. Annual
Health Resources and Services Administration (HRSA)
LHHS appropriations laws direct funding to
Centers for Disease Control and Prevention (CDC)
most (but not all) HHS agencies (see text box
National Institutes of Health (NIH)
for HHS agencies supported by the LHHS
Substance Abuse and Mental Health Services
bill).32 For instance, the LHHS bill directs
Administration (SAMHSA)
funding to multiple Public Health Service
Agency for Healthcare Research and Quality (AHRQ)
(PHS) agencies, including the Health
Centers for Medicare & Medicaid Services (CMS)
Resources and Services Administration
Administration for Children and Families (ACF)
(HRSA), Centers for Disease Control and
Administration for Community Living (ACL)
Prevention (CDC), National Institutes of
Office of the Secretary (OS)*
Health (NIH), Substance Abuse and Mental
Health Services Administration (SAMHSA),
* This report includes funding for the Office of the Assistant
Secretary for Preparedness and Response (ASPR) within OS,
and Agency for Healthcare Research and
consistent with source materials.
Quality (AHRQ). These public health agencies
support diverse missions, ranging from the provision of health care services and supports (e.g.,
HRSA, SAMHSA), to the advancement of health care quality and medical research (e.g., AHRQ,
NIH), to the prevention and control of infectious and chronic diseases (e.g., CDC). (The HHS
Office of the Assistant Secretary for Preparedness and Response [ASPR] is also a component of
the PHS, but funding for this office has historically been provided within the Office of the
Secretary.)
In addition, the LHHS bill provides funding for annually appropriated components of CMS,33
which is the HHS agency responsible for the administration of Medicare, Medicaid, the State
Children’s Health Insurance Program (CHIP), and consumer protections and private health
insurance provisions of the Affordable Care Act (ACA; P.L. 111-148).
The LHHS bill also provides funding for two HHS agencies focused primarily on the provision of
social services: the Administration for Children and Families (ACF) and the Administration for
Community Living (ACL). ACF’s mission is to promote the economic and social well-being of
vulnerable children, youth, families, and communities. ACL was formed with a goal of increasing
access to community supports for older Americans and people with disabilities.
The LHHS bill also provides funding for the HHS Office of the Secretary (OS), which
encompasses a broad array of management, research, oversight, and emergency preparedness
functions in support of the entire department. On July 22, 2022, HHS announced that the Office
of the Assistant Secretary for Preparedness and Response (ASPR) would be renamed the
Administration for Strategic Preparedness and Response (but keep its acronym, ASPR).34

32 Three HHS public health agencies receive annual funding from appropriations bills other than the LHHS bill: the
Food and Drug Administration (funded through the Agriculture appropriations bill), the Indian Health Service (funded
through the Interior-Environment appropriations bill), and the Agency for Toxic Substances and Disease Registry
(funded through the Interior-Environment appropriations bill). In addition, while the National Institutes of Health
(NIH) receive the majority of their appropriations from the LHHS bill, one NIH institute (the National Institute of
Environmental Health Sciences) receives appropriations from two bills: LHHS and the Interior-Environment bill.
33 Much of the funding for CMS activities is provided through mandatory appropriations in authorizing legislation, and
thus is not subject to the annual appropriations process.
34 HHS Press Office, “HHS Strengthens Country’s Preparedness for Health Emergencies, Announces Administration
for Strategic Preparedness and Response (ASPR),” July 22, 2022, https://www.hhs.gov/about/news/2022/07/22/hhs-
Congressional Research Service

18

link to page 25 Labor, Health and Human Services, and Education: FY2023 Appropriations

According to the announcement, HHS planned to move ASPR out of OS and, instead, establish
the agency as an HHS operating division (i.e., an organizational level comparable to CDC or
NIH). As the FY2023 President’s budget and House committee bill were formulated prior to this
announcement, this report reflects the assumptions underlying those proposals in keeping ASPR
funding within the OS.
FY2023 HHS Appropriations Overview
Table 5 displays proposed FY2023 funding levels for HHS, along with FY2022 enacted levels.
Note that the totals in this table do not include emergency-designated appropriations. Those
amounts are displayed separately, along with the law in which they were enacted, at the bottom of
the table and are in addition to regular appropriations.
In general, discretionary funds account for about 10% of HHS appropriations in the LHHS bill.
Compared to the FY2022 funding levels, the FY2023 House committee bill would increase HHS
discretionary appropriations by 14.4%. The FY2023 President’s request proposed increasing HHS
discretionary appropriations to a similar degree, by 14.1%.
Table 5. HHS Appropriations Overview
(in billions of dollars)
FY2023
FY2022
FY2023
House Cmte.
FY2023
Funding
Enacted
Request
(H.R. 8295)
Enacted
Discretionary
108.6
123.9
124.2
—
Mandatory
1,039.6
1,131.1
1,131.1
—
Total BA in the Bill
1,148.2
1,255.0
1,255.3
—
Emergency Funding (not in above totals)

P.L. 117-43, Divisions A and C
4.2
—
—
—
P.L. 117-58, Division J
0.5
—
—
—
P.L. 117-70, Division B
1.3
—
—
—
P.L. 117-128, Title IV
1.0
—
—
—
P.L. 117-159, Division B
1.0
—
—
—
P.L. 117-180, Division A
—
—
—
2.8
Source: Amounts in this table for the FY2022 Enacted, FY2023 Request, and FY2023 House Cmte. columns are
generally drawn from the committee report (H.Rept. 117-403) accompanying the FY2023 House committee bil
(H.R. 8295, as reported). Enacted totals (“Total BA in the Bil ”) for FY2022 do not include emergency-designated
appropriations. Amounts shown for emergency-designated appropriations are based on CRS analysis of the
specified laws. For consistency with source materials, amounts in this table generally do not reflect mandatory
spending sequestration, where applicable, nor do they reflect any transfers or reprogramming of funds pursuant
to executive authorities.
Notes: BA = budget authority. Details may not add to totals due to rounding. Amounts in this table (1) reflect
all BA appropriated in the bil , regardless of the year in which funds become available (i.e., totals do not include
advances from prior-year appropriations, but do include advances for subsequent years provided in this bil ); (2)
have generally not been adjusted to reflect scorekeeping; (3) comprise only those funds provided (or requested)

strengthens-countrys-preparedness-health-emergencies-announces-administration-for-strategic-preparedness-
response.html.
Congressional Research Service

19

link to page 26

Labor, Health and Human Services, and Education: FY2023 Appropriations

for agencies and accounts subject to the jurisdiction of the LHHS subcommittees of the House and Senate
appropriations committees; and (4) do not include appropriations that occur outside of appropriations bil s.
Figure 3 provides an HHS agency-level breakdown of FY2023 appropriations proposed by the
House Appropriations Committee. As this figure demonstrates, annual HHS appropriations are
dominated by mandatory funding, the majority of which goes to CMS to provide Medicaid
benefits and payments to health care trust funds. When taking into account both mandatory and
discretionary funding, CMS accounts for $1.118 trillion in the House committee bill, which is
89.1% of all proposed appropriations for HHS. ACF and NIH account for the next-largest shares
of total HHS appropriations, receiving about 4.1% and 3.7% apiece, respectively.
By contrast, when looking exclusively at discretionary appropriations, funding for CMS
constitutes about 4.2% of FY2023 HHS appropriations proposed by the House committee.
Instead, the bulk of discretionary appropriations would go to five PHS agencies (HRSA, CDC,
SAMHSA, NIH, and AHRQ), accounting for a combined 59.8% of discretionary appropriations
proposed for HHS. NIH typically receives the largest share of all discretionary funding among
HHS agencies (37.1% in the FY2023 House committee proposal), with ACF accounting for the
second-largest share (27.7%).
Figure 3. FY2023 House Committee-Reported HHS Appropriations by Agency
(budget authority in billions of dollars)

Source: Amounts in this figure are generally drawn from or calculated based on data contained in the
committee report (H.Rept. 117-403) accompanying the FY2023 House committee bil (H.R. 8295, as reported).
FY2023 House committee totals (“Total BA in the Bil ”) do not include emergency-designated LHHS
appropriations. For consistency with source materials, amounts in this figure generally do not reflect mandatory
spending sequestration, nor do they reflect any transfers or reprogramming of funds pursuant to executive
authorities. CRS calculations do, however, include LHHS funding provided to HHS pursuant to the 21st Century
Cures Act (P.L. 114-255), as amended.
Notes: Details may not add to totals due to rounding. The bar representing the combined mandatory and
discretionary total for CMS has been abbreviated due to space constraints. When taking into account both
Congressional Research Service

20

Labor, Health and Human Services, and Education: FY2023 Appropriations

mandatory and discretionary funding, CMS receives more than 20 times the funding appropriated to either ACF
or NIH in the FY2022 House committee bil . Amounts in this table (1) reflect all BA appropriated in the bil ,
regardless of the year in which funds become available (i.e., totals do not include advances from prior-year
appropriations, but do include advances for subsequent years provided in this bil ); (2) have generally not been
adjusted to reflect scorekeeping; (3) comprise only those funds provided (or requested) for agencies and
accounts subject to the jurisdiction of the LHHS subcommittees of the House and Senate appropriations
committees; and (4) do not include appropriations that occur outside of appropriations bil s.
Special Public Health Funding Mechanisms
Annual appropriations for HHS public health service agencies are best understood in the context
of certain HHS-specific funding mechanisms: the Public Health Service Evaluation Set-Aside,
and the Prevention and Public Health Fund (PPHF). In recent years, LHHS appropriations laws
have used these funding mechanisms to direct additional support to certain programs and
activities.
Public Health Service Evaluation Tap
The PHS Evaluation Set-Aside, also known as the PHS Evaluation Tap, is a unique feature of
HHS appropriations. It is authorized by Section 241 of the Public Health Service Act (PHSA),
and allows the Secretary of HHS, with the approval of appropriators, 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% of eligible program
appropriations. However, LHHS appropriations acts have commonly established a higher
maximum percentage for the set-aside and have distributed specific amounts of “tap” funding to
selected HHS programs. In regular LHHS appropriations enacted between FY2010-FY2022, this
higher maximum set-aside level was 2.5% of eligible appropriations.35 Both the House committee
bill and the President’s budget would continue this 2.5% level.
Before FY2015, the PHS tap traditionally
Display of Evaluation Tap Transfers
provided more than a dozen HHS programs
By convention, tables in this report show only the
with funding beyond their annual
amount of PHS Evaluation Tap funds received by an
appropriations and, in some cases, was the
agency (i.e., tables do not subtract the amount of the
sole source of funding for a program or
tap from donor agencies’ appropriations). That is to
say, tap amounts shown in the fol owing tables are in
activity. However, since FY2015 and
addition to amounts shown for budget authority, but
including in FY2022, LHHS appropriations
the amounts shown for budget authority have not been
laws have directed tap funds to a smaller
adjusted to reflect potential “transfer-out” of funds to
number of programs or activities within three
the tap.
HHS agencies (NIH, SAMHSA, and OS) and
have not provided any tap transfers to AHRQ, CDC, and HRSA. This has been particularly
notable for AHRQ, which had been funded primarily through tap transfers from FY2003 to

35 See Section 204, Division H, P.L. 117-103 for the FY2022 maximum set-aside level. The last time that an
appropriations act set the PHS tap percentage at a level other than 2.5% was in FY2009, when it was 2.4% (see P.L.
111-8). The House committee bill also retained a change to this provision, first included in the FY2014 omnibus,
allowing tap transfers to be used for the “evaluation and the implementation” of programs funded in the HHS title of
the LHHS appropriations act. Prior to FY2014, such provisions had restricted tap funds to the “evaluation of the
implementation” of programs authorized under the Public Health Service Act.
Congressional Research Service

21

Labor, Health and Human Services, and Education: FY2023 Appropriations

FY2014, but has received discretionary appropriations since then.36 Since FY2015, LHHS
appropriations laws have directed the largest share of tap transfers to NIH.37
Under both the House committee bill and the President’s budget, the amount of tap transfers to
SAMHSA ($134 million) would be the same as those directed in FY2022. In contrast, the amount
of tap transfers to OS would be increased by $33 million (+25.8%) in the House committee bill,
and $60 million (+46.3%) in the President’s budget. The bulk of these proposed increases would
be directed to the Office of the National Coordinator for Health Information Technology, which
was solely funded by tap transfers as of FY2022. Finally, NIH tap funding would be increased by
the House committee bill by $111 million (+8.5%), but decreased under the President’s budget by
$38 million (-2.9%).
In addition to the transfers to NIH, SAMHSA, and OS, the President’s budget requested that
AHRQ receive a tap transfer of $40 million, for a funding total inclusive of transfers of $416
million. In contrast, the House would fund AHRQ at $385 million, and direct no tap transfers. If
final appropriations were to adopt the President’s proposal, it would be the first time since
FY2014 that the LHHS bill would direct tap funds to AHRQ.
The President’s budget also proposed expanding the activities and agencies funded by the PHS
tap to include the Public Health Scientific Services and Environmental Health at the CDC ($151
million), and Paralysis Resource Center, Limb Loss, and Traumatic Brain Injury at ACL ($28
million). The House committee bill would not adopt those proposals.
Prevention and Public Health Fund
The ACA both authorized and appropriated mandatory funding to three funds to support programs
and activities within the PHS agencies.38 One of these, the Prevention and Public Health Fund
(PPHF, ACA §4002, as amended), was given a permanent, annual appropriation that was intended
to provide support each year to prevention, wellness, and related public health programs funded
through HHS accounts.
PPHF funds are intended to supplement (sometimes quite substantially) the funding that selected
programs receive through regular appropriations. The PPHF authority instructs the HHS
Secretary to transfer amounts from the fund to HHS agencies. However, since FY2014,
provisions in annual appropriations acts and accompanying reports have explicitly directed the
distribution of PPHF funds and prohibited the Secretary from making further transfers for those
years.39

36 Until FY2015, AHRQ had not received a discretionary appropriation in an annual appropriations act in more than a
decade. FY2009 was the exception to this general pattern, as AHRQ received a supplemental appropriation from the
American Recovery and Reinvestment Act that year. In recent years, AHRQ has also received some transfers from the
Prevention and Public Health Fund and the Patient-Centered Outcomes Research Trust Fund, though these transfers
were generally much smaller than the transfers AHRQ received from the tap. For more information, see CRS Report
R44136, The Agency for Healthcare Research and Quality (AHRQ) Budget: Fact Sheet.
37 Prior to FY2015, NIH had traditionally been by far the largest net donor of tap funds, rather than a net recipient. The
joint explanatory statement accompanying the FY2015 omnibus explained this shift as being intended to ensure that tap
transfers are a “net benefit to NIH rather than a liability” and noted that this change was in response to a growing
concern at the loss of NIH funds to the tap. Joint Explanatory Statement, Proceedings and Debates of the 113th
Congress, Second Session, Congressional Record, vol. 160, no. 151, Book II, December 11, 2014, p. H9832.
38 For more information, see CRS Report R41301, Appropriations and Fund Transfers in the Affordable Care Act
(ACA).
39 For the FY2022 LHHS omnibus, see Division H, §222, P.L. 117-103.
Congressional Research Service

22

link to page 55 link to page 39 link to page 42 Labor, Health and Human Services, and Education: FY2023 Appropriations

The ACA had appropriated $2 billion in
Display of PPHF Transfers
mandatory funds to the PPHF for FY2023, but
initial PPHF appropriations have been affected
PPHF transfer amounts displayed in the HHS tables in
this report are in addition to amounts shown for
by subsequent amendments.40 Under current
budget authority provided in the bil . For consistency
law, the FY2023 appropriation is $1 billion.41
with source materials, the amounts shown for PPHF
In addition, this appropriation was subject to a
transfers in these tables reflect the estimated effects of
5.7% reduction due to sequestration of
mandatory spending sequestration; this is not the case
nonexempt mandatory spending.
for other mandatory spending shown in this report
42 (For more
(also for consistency with source materials).
information on sequestration, see the budget
enforcement discussion in the Appendix.)
After sequestration, the total PPHF appropriation available for FY2023 was $943 million, the
same amount as FY2022. Of this amount, the House committee bill and the President’s budget
would allocate $903 million to CDC, $12 million to SAMHSA, and $28 million to ACL, the same
amounts as FY2022 for all three operating divisions.
Selected HHS Highlights by Agency
This section begins with a limited selection of discretionary funding highlights by HHS agency.
The discussion is largely based on the proposed appropriations levels for FY2023 compared to
FY2022 enacted levels.43 These summaries are followed by a brief overview of significant
provisions from annual HHS appropriations laws that restrict spending in certain controversial
areas, such as abortion and stem cell research. The section concludes with two tables (Table 7 and
Table 8) presenting more detailed information on FY2022 enacted and FY2023 proposed funding
levels for HHS.
HRSA
The HRSA mission is focused on delivering health care services to those who are geographically
isolated and economically or medically vulnerable.44 The FY2023 House committee bill proposes
$9.3 billion in discretionary budget authority for HRSA. This is $743 million (+8.7%) more than
HRSA’s discretionary funding level in the FY2022 LHHS omnibus and $792 million (+9.3%)
more than the FY2023 President’s budget request.
The House committee bill proposes a number of increases for contraceptive programs compared
to the FY2022 LHHS omnibus. For the Family Planning program authorized in Title X of the
PHSA, the House committee bill proposes $500 million, an increase of $214 million (+74.5%)
compared to FY2022 enacted. The House committee report notes that the bill requires that “all
recipients of funds under this heading offer services consistent with the best available evidence-
based standards, including the Quality Family Planning guidelines from the CDC and the Office
of Population Affairs (OPA).”45 The House committee report also directs the Secretary of HHS to
“continue the process of revising” the CDC guidelines to incorporate the latest evidence and

40 P.L. 112-96, P.L. 114-255, P.L. 115-96, and P.L. 115-123.
41 42 U.S.C. §300u-11.
42 OMB Report to the Congress on the BBEDCA 251A Sequestration for Fiscal Year 2023, March 28, 2022, p. 7 of 16,
https://www.whitehouse.gov/wp-content/uploads/2022/03/BBEDCA_251A_Sequestration_Report_FY2023.pdf.
43 HHS budget materials can be found at http://www.hhs.gov/budget/.
44 HRSA, About HRSA, https://www.hrsa.gov/about/index.html.
45 H.Rept. 117-403, p. 66.
Congressional Research Service

23

Labor, Health and Human Services, and Education: FY2023 Appropriations

“support comprehensive reproductive and sexual health needs of all people.”46 Also, one of the
proposed increases to the Health Centers program is an increase of $25 million specifically to
“support grants for training and quality improvement efforts to make available patient-centered
contraceptive care within health center primary care settings.”47
The House committee report also proposes increased funding for a number of maternal health
programs, including an increase of $125 million (+16.7%) compared to FY2022 enacted for the
Maternal and Child Health Block Grant. This increase would also include additional funds for
maternal and child health projects of regional and national significance. For instance, the
committee report proposes a new $10 million innovation fund for “community-based
organizations to support reducing maternal mortality and adverse maternal outcomes, as
described in the fiscal year 2023 budget request.”48 The committee report also recommends $15
million ($3 million more than FY2022 enacted) “to support continued implementation of the
Alliance for Innovation on Maternal Health program’s maternal safety bundles.”49 In addition, the
committee report would reserve $7 million ($3 million more than FY2022 enacted) for the
maternal mental health hotline, noting that the “COVID–19 pandemic has exacerbated maternal
mental health conditions, with pregnant and new mothers experiencing anxiety and depression at
a three to four times higher rate than prior to the pandemic.”50
The House committee bill includes a number of initiatives in behavioral health care, including an
increase of $25 million for the Rural Communities Opioid Response Program (RCORP)51 which
allows for “the expanded focus on behavioral health care, including SUD [substance use
disorder], needs in rural communities;”52 an increase of $10 million for “loan repayment for
mental and behavioral health providers” under National Health Service Corps (NHSC)53; and an
increase of $62 million for the Behavioral Health Workforce Education and Training (BHWET)
to increase placements in rural and medically underserved areas.54
CDC
CDC develops and supports community-based and population-wide programs and systems to
promote health-related quality of life and to prevent the leading causes of disease, injury,
disability, and death—both domestically and globally. For CDC, the FY2023 House committee
bill proposes $9.5 billion in discretionary budget authority. This is $2.0 billion (+27.2%) more
than CDC’s discretionary funding level in the FY2022 LHHS omnibus ($7.5 billion) and $80
million (-0.8%) less than the FY2023 President’s discretionary budget request ($9.6 billion). The
President’s discretionary budget request represents a $2.1 billion increase (+28.3%) relative to the
FY2022 LHHS omnibus. In addition to discretionary budget authority, CDC often receives a large
portion of annual PPHF allocations. Both the House committee bill and the President’s budget
propose directing $903 million in PPHF funding to CDC, the same amount as in the FY2022

46 H.Rept. 117-403, p. 66.
47 H.Rept. 117-403, p. 44.
48 H.Rept. 117-403, p. 59.
49 H.Rept. 117-403, p. 55.
50 H.Rept. 117-403, p. 57.
51 Note that this program is referred to as the Rural Communities Overdose Response Program in the House committee
report and as the Rural Communities Opioid Response Program in HRSA documents.
52 H.Rept. 117-403, p. 65.
53 H.Rept. 117-403, p. 47.
54 H.Rept. 117-403, p. 50
Congressional Research Service

24

Labor, Health and Human Services, and Education: FY2023 Appropriations

omnibus. Similar to recent practice (since FY2015), the House committee bill would not direct
PHS tap funds to CDC. The President’s budget requested $151 million in PHS tap funds to CDC.
Inclusive of discretionary budget authority and directed transfers, CDC would receive a total of
$10.4 billion in the FY2023 House committee bill, which is $2.0 billion (+24.3%) more than the
FY2022 LHHS omnibus ($8.4 billion) and $231 million (-2.2%) less than the President’s budget
request ($10.7 billion).
The FY2023 House committee bill proposes funding increases to all discretionary CDC accounts
relative to the FY2022 LHHS omnibus. Congress generally designates funding for specific CDC
programs in appropriations report language (rather than bill text). Many of the proposed increases
in the FY2023 House committee bill focus on bolstering “core capacities” at CDC and CDC-
funded state and local public health agencies.55 For example, the FY2023 House committee bill
proposes $750 million for public health infrastructure and capacity in the CDC-Wide Activities
and Program Support account, a $550 million increase from the FY2022 enacted level and $150
million more than the President’s requested amount ($600 million).56 These funds are intended to
support general capabilities of state, territorial and local health departments by supporting core
functions such as workforce and technology. The FY2023 House committee bill also proposes
$250 million for the Public Health Data Modernization initiative in the Public Health Scientific
Services account, an increase of $150 million from the FY2022 enacted level ($100 million) and
$50 more than the President’s requested amount ($200 million).57 This initiative aims to
modernize the technology, systems, and workforce for collecting public health data at the CDC
and state, territorial, and local level.
NIH
NIH is the federal government’s lead health and medical research agency. For NIH, the FY2023
House committee bill proposes $46.0 billion in discretionary budget authority. This is $2.4 billion
(+5.5%) more than the FY2022 LHHS omnibus ($43.7 billion) and $2.9 billion (-6.0%) less than
the President’s discretionary budget request ($49.0 billion; includes $5 billion in funding for the
Advanced Research Projects Agency for Health, see next paragraph). For PHS tap funds, the
House committee bill would direct $1.4 billion to NIH, which is $111 million (+8.5%) more than
the amount in the FY2022 omnibus ($1.3 billion) and $149 million (+11.7%) more than in the
President’s budget request ($1.3 billion). Inclusive of discretionary budget authority and directed
PHS tap transfers, NIH would receive a total of $47.5 billion under the House committee bill,
which is $2.5 billion (+5.6%) more than the FY2022 LHHS omnibus ($45.0 billion) and $2.8
billion (-5.5%) less than the President’s budget request (includes ARPA-H funding).
Funding for the Advanced Research Projects Agency for Health (ARPA-H) complicates analysis
of NIH appropriations for FY2022 and FY2023. ARPA-H is a new agency with a focus on high-
risk, high-reward health research.58 The FY2022 LHHS omnibus funded ARPA-H with $1.0
billion under the HHS Office of the Secretary, but gave the Secretary the ability to place ARPA-H
anywhere in the department. The HHS Secretary subsequently chose to place ARPA-H within
NIH. The Biden Administration’s FY2023 budget request for NIH therefore includes proposed

55 H.Rept. 117-403, p. 6
56 H.Rept. 117-403, pp. 94-95; and CDC, “FY2023: President’s Budget detail table,” https://www.cdc.gov/budget/
documents/fy2023/FY-2023-CDC-Budget-Detail.pdf.
57 H.Rept. 117-403, p. 85; and CDC, “FY2023: President’s Budget detail table,” https://www.cdc.gov/budget/
documents/fy2023/FY-2023-CDC-Budget-Detail.pdf.
58 For more information on ARPA-H, see CRS Report R47074, Advanced Research Projects Agency for Health
(ARPA-H): Congressional Action and Selected Policy Issues.
Congressional Research Service

25

link to page 32 Labor, Health and Human Services, and Education: FY2023 Appropriations

funding for ARPA-H ($5.0 billion) within the NIH total. However, the House Appropriations
Committee has taken the view that ARPA-H should be established as a separate entity within
HHS (apart from NIH)59 and has therefore proposed FY2023 ARPA-H funding ($2.75 billion) in
a separate account under the HHS Secretary. The numbers in this report generally follow the
committee convention, which is to include ARPA-H funding within the HHS Office of the
Secretary totals for FY2022 enacted ($1.0 billion) and the FY2023 House committee bill ($2.8
billion), but within NIH ($5.0 billion) for the FY2023 President’s request. The final placement of
ARPA-H remains uncertain as Congress considers bills to formally authorize ARPA-H.60 The
following table shows NIH funding totals with and without ARPA-H to allow for further
comparisons among the enacted and proposed amounts.
Table 6. NIH LHHS Totals with and without ARPA-H
(in millions of dollars)
FY2023
FY2022
FY2023
House Cmte.

Enacted
Request
(H.R. 8295)
ARPA-H total
1,000
5,000
2,750
NIH LHHS total (Discretionary BA + Transfers) with ARPA-H
45,959
50,252
50,209
NIH LHHS total (Discretionary BA + Transfers) without ARPA-H
44,959
45,233
47,459
Source: All amounts from H.Rept. 117-403.
As shown in Table 6, the House committee bill would provide $2.8 billion for ARPA-H, an
increase of $1.8 billion (+175.0%) from the FY2022 LHHS omnibus and a decrease of $2.3
billion (-45.0%) from the President’s request. Looking at total amounts for NIH (inclusive of
directed transfers), when including ARPA-H funding within the NIH total, the House committee
bill would provide $50.2 billion, which is $24 million (-0.05%) less than the amount proposed in
the President’s budget request ($50.2 billion). When excluding ARPA-H from the NIH total, the
House committee bill would provide $47.5 billion, an increase of $2.2 billion (+4.9%) relative to
the President’s requested amount. In other words, much of the difference between the FY2023
House committee bill and the President’s request for NIH is driven by differences in proposed
amounts for ARPA-H.
All NIH accounts would receive increases (when accounting for transfers) under the House
committee bill, except for the Office of the Director account. For example, the House committee
bill would provide $7.4 billion for the National Cancer Institute, the principal NIH institute tasked
with conducting and funding cancer research and training. This amount would be an increase of
$466 million (+6.7%) from the FY2022 omnibus ($6.9 billion) and $665 million (+9.9%) from
the President’s request ($6.7 billion).
For the most part, Congress does not specify funding levels for research areas within NIH
accounts, thereby allowing NIH Institutes and Centers to award research funding on a competitive
basis through their priority setting and scientific review processes. However, in recent years,
Congress has specified funding levels for certain high priority areas through appropriations report

59 H.Rept. 117-403, p. 242.
60 For more information, see CRS Report R47074, Advanced Research Projects Agency for Health (ARPA-H):
Congressional Action and Selected Policy Issues.
Congressional Research Service

26

Labor, Health and Human Services, and Education: FY2023 Appropriations

language. For instance, the House committee report recommends an increase of $200 million for
Alzheimer’s disease and related dementias research.61
SAMHSA62
SAMHSA is the federal agency primarily responsible for supporting community-based mental
health and substance abuse treatment and prevention services. The SAMHSA mission is focused
on reducing the impacts of substance abuse and mental illness.63 SAMHSA supports activities
that include education and training, prevention programs, early intervention activities, treatment
services, and technical assistance.
The FY2023 House committee bill proposes $9.0 billion in discretionary budget authority for
SAMHSA. This is $2.6 billion (+41.0%) more than SAMHSA’s discretionary funding level in the
FY2022 LHHS omnibus and $1.1 billion (-11.0%) less than the FY2023 President’s budget
request. PHS tap funding ($134 million) and PPHF funding ($12 million) would be the same as
the FY2022 LHHS omnibus under both the House committee bill and the President’s budget
proposal. Inclusive of discretionary budget authority and directed transfers, SAMHSA would
receive a total of $9.2 billion in the FY2023 House committee bill, which is $2.7 billion (+40.1%)
more than the FY2022 LHHS omnibus ($6.5 billion) and $1.1 billion (-10.8%) less than the
President’s budget request ($10.3 billion).
Within the Mental Health account, the House committee report recommends $747 million for the
988 Suicide and Crisis Lifeline (988 Lifeline, referred to in the accompanying report as the 988
Program), which represents an increase of $640 million (+600.5%) compared to the FY2022
LHHS omnibus.64 In July 2022, the 988 Lifeline (formerly the National Suicide Prevention
Lifeline) transitioned from a 10-digit number (1-800-273-8255) to the 3-digit hotline number (9-
8-8). The 988 Lifeline is a national hotline that provides immediate crisis counseling and referral
services for individuals experiencing suicidal thoughts or other mental distress. The new three
digit number was launched to “make it simpler for people experiencing a mental health crisis to
connect with lifesaving crisis intervention services.”65 The proposed funding would support
implementation of the new three-digit hotline, in anticipation of higher call volume among other
reasons. Of the above funding for the 988 Lifeline, $30 million would be reserved for providing
specialized services for LGBTQI+ youths.66
Also within the Mental Health account, the House committee bill and report propose increased
funding for mental health crisis response. For example, the committee recommends an increase of
$50 million for “mobile crisis response teams that divert the response for mental health crises
from law enforcement to behavioral health teams.”67 The committee bill proposes an increase of
$85 million (+27.0%) for Certified Community Behavioral Health Clinics (CCHBCs), with the

61 H.Rept. 117-403, p. 124-5.
62 Section 244 of the House committee bill proposes to amend the Public Health Service Act to rename SAMHSA the
“Substance Use and Mental Health Administration,” and would make conforming changes to SAMHSA entities to
replace “abuse” with “use.” The House committee bill also proposes to rename several SAMHSA accounts and lines
(e.g., rename the “Substance Abuse Prevention” account as “Substance Use Prevention”). This report uses the current
names for these entities—those that are in effect as of the FY2022 enacted version of the LHHS bill.
63 SAMHSA, About Us, https://www.samhsa.gov/about-us.
64 Congressional Record, vol. 168, no. 42, book IV, March 9, 2022, pp. H2679-H2680.
65 H.Rept. 117-403, pp. 159-160.
66 H.Rept. 117-403, p. 160.
67 H.Rept. 117-403, pp. 161-162.
Congressional Research Service

27

Labor, Health and Human Services, and Education: FY2023 Appropriations

report noting that “CCBHCs are required to partner with local agencies, and this often includes
partnering with law enforcement to develop safe and effective crisis response.”68 Additionally, the
House committee bill would increase—from 5% to 10%—the set-aside within the Mental Health
Block Grant (MHBG) for evidence-based crisis care programs. The purpose of the increase would
be “to address the needs of individuals with serious mental illnesses and children with serious
mental and emotional disturbances.”69
Within the Substance Abuse Services account, the House committee bill and report focus on
addressing the opioid and substance use disorder (SUD) crises. For instance, the committee bill
would provide an increase of $250 million (+16.4%) for the State Opioid Response (SOR) grants
compared to FY2022 enacted. The committee report expresses support for using SOR grants to
expand treatment access to SUD treatments in rural and underserved communities.70 Within the
Substance Abuse Prevention and Treatment Block Grant (SABG), the House committee report
would establish a 10% Recovery Set-Aside for “the provision of evidence-informed SUD non-
clinical recovery supports and services.”71
AHRQ
AHRQ conducts research aimed at reducing the costs of health care, promoting patient safety,
measuring the quality of health care, and improving health care services, organization, and
financing. For AHRQ, the FY2023 House committee bill proposes $385 million in discretionary
budget authority. This is $35 million (+9.9%) more than AHRQ’s discretionary funding level in
the FY2022 LHHS omnibus ($350 million) and $9 million (+2.4%) more than the FY2023
President’s discretionary budget request ($376 million). The President’s discretionary budget
request represents a $26 million increase (+7.3%) relative to the FY2022 LHHS omnibus. In
keeping with practices since FY2015, the FY2023 House committee bill would not direct PHS
tap funds to AHRQ.72 The President’s budget requested $40 million in PHS tap funds to AHRQ
for Research on Health Costs, Quality and Outcomes (HCQO), which, in addition to the
discretionary budget request, would bring AHRQ’s total combined funding to $416 million
(18.7% more than FY2022).
The House committee report would fund HCQO at $238 million, which would be $32 million
(+15.7%) more than the FY2022 LHHS omnibus level, but $31 million (-11.5%) less than the
FY2023 President’s budget request (inclusive of requested tap transfers). Within HCQO, the
President’s FY2023 budget proposed $19 million in new funding for health systems research on
Long COVID, including how to use digital health and telehealth, support Long COVID clinics in
smaller communities, and enable primary care providers to use emerging evidence.73 The House
committee report expressed support for the budget’s proposed Long COVID efforts, but did not
specify a dollar amount.74

68 H.Rept. 117-403, p. 163.
69 H.Rept. 117-403, p. 163.
70 H.Rept. 117-403, p. 171.
71 H.Rept. 117-403, p. 172.
72 Since FY2015, annual LHHS appropriations laws have not directed tap transfers to AHRQ, but in earlier years
(FY2003-FY2014) AHRQ was funded primarily with tap transfers.
73 HHS, AHRQ, FY20203 Congressional Justification, pp. 61-62, https://www.ahrq.gov/sites/default/files/wysiwyg/cpi/
about/mission/budget/2023/fy2023-cj.pdf.
74 H.Rept. 117-403, pp. 176-177.
Congressional Research Service

28

link to page 55 Labor, Health and Human Services, and Education: FY2023 Appropriations

Also within HCQO, the President’s FY2023 budget proposed $7 million in new funding to
improve maternal health.75 The House committee report expressed support for maternal health
efforts, specifically to improve timely and accurate maternal morbidity and mortality state and
local data, and to develop person-reported quality measures that capture birthing people’s
experiences of maternity care and inequities.76 The committee report did not specify a dollar
amount for maternal health.
CMS
CMS is the largest single health payer in the United States.77 The agency administers Medicare,
Medicaid, the Children’s Health Insurance Program (CHIP), and the federal Marketplace. The
FY2023 House committee bill and FY2023 President’s budget request would provide $5.2 billion
in discretionary budget authority for CMS. This is $348 million (+7.1%) more than the FY2022
enacted level. Both proposals would appropriate $899 million for the CMS Health Care Fraud
and Abuse Control (HCFAC) account, 3.0% more than FY2022. Of this total amount for HCFAC,
$576 million would be effectively exempt from the discretionary budget caps. (See the Appendix
for an explanation of the LHHS budget cap exemptions.)
Both the House committee bill and the President’s request would provide the CMS Program
Management account with $4.3 billion, which is 8.0% (+$322 million) more than the amount
provided in FY2022 ($4.0 billion).78 This account supports CMS program operations (e.g., claims
processing, information technology investments, provider and beneficiary outreach and
education, and program implementation), in addition to federal administration and other activities
related to the administration of Medicare, Medicaid, the State Children’s Health Insurance
Program, and private health insurance provisions established by the ACA. The House committee
bill and the President’s budget would eliminate a general provision (§227 in the FY2022 LHHS
omnibus), included in LHHS appropriations acts since FY2014, authorizing HHS to transfer
additional funds into this account from Medicare trust funds. The terms of the provision required
that such funds be used to support activities specific to the Medicare program, limited the amount
of the transfers to $355 million, and explicitly prohibited such transfers from being used to
support or supplant funding for Affordable Care Act implementation.
ACF
The ACF mission is focused on promoting the “economic and social well-being of children,
youth, families, and communities.”79 ACF administers a wide array of human services programs,
including Head Start, child care, the Social Services Block Grant (SSBG), and various child
welfare programs. The FY2023 House committee bill would provide $34.4 billion in
discretionary budget authority for ACF. This is $4.5 billion (+15.0%) more than FY2022 and $1.1
billion (+3.3%) more than the FY2023 President’s budget request of $33.3 billion.

75 HHS, AHRQ, FY2023 Congressional Justification, pp. 54-56, https://www.ahrq.gov/sites/default/files/wysiwyg/cpi/
about/mission/budget/2023/fy2023-cj.pdf.
76 H.Rept. 117-403, pp. 176-177.
77 FY2023 HHS Budget in Brief, p. 74, https://www.hhs.gov/sites/default/files/fy-2023-budget-in-brief.pdf.
78 The FY2022 amount includes $355 million in transfers authorized by P.L. 117-103, Division H, §227. The $355
million is amount is included in the FY2022 account total on page 179 of H.Rept. 117-403, but is displayed separately
as a scorekeeping adjustment on page 860 of H.Rept. 117-403.
79 HHS, ACF, What We Do, https://www.acf.hhs.gov/about/what-we-do.
Congressional Research Service

29

Labor, Health and Human Services, and Education: FY2023 Appropriations

The FY2023 House committee bill would provide $8.0 billion for the Refugee and Entrant
Assistance account, an increase of $1.6 billion (+24.2%) relative to FY2022. In contrast, the
President’s budget would slightly decrease this account relative to FY2022, by $97 million (-
1.5%). The House committee bill would omit a provision, included in LHHS appropriations since
FY2015, authorizing HHS to augment appropriations for the Refugee and Entrant Assistance
account via transfers from other discretionary HHS funds. The limit on those transfers enacted for
FY2022 was 15%. The President’s budget proposed to retain this provision.80
The House committee report would direct $6.7 billion of the appropriation for Refugee and
Entrant Assistance programs toward the Unaccompanied Alien Children (UAC) program, a $1.2
billion (21.9%) increase over the FY2022 level of $5.5 billion.81 The UC program provides for
the shelter, care, and placement of unaccompanied alien children who have been apprehended at
the U.S.-Mexico border. The President’s budget would provide $4.9 billion for this program to
allow the Office of Refugee Resettlement (ORR) to “continue to effectively care for children
referred by the Department of Homeland Security [DHS], support processing centers along the
Southwest Border co-operated by DHS and HHS, and implement service expansions.”82
The FY2023 LHHS committee bill included several general provisions that were enacted in prior
fiscal years related to the UAC program (sometimes with alterations to them). For instance, the
House committee bill would
 authorize HHS to accept donations for the care of UAC arrivals (with new
authority to accept monetary donations) (§228),
 limit the use of funds for unlicensed facilities for unaccompanied children (with
modifications to the conditions on use) (§229),
 impose additional congressional notification requirements prior to the use of
unlicensed facilities (§230),
 prohibit HHS appropriations from being used to prevent a Member of Congress
from visiting a UC facility for oversight purposes (with the omission of the prior
notice requirement) (§231), and
 impose additional public monthly reporting requirements on the number of
unaccompanied alien children who were separated from their parents or legal
guardians and transferred to the care of the ORR (§232).
The FY2023 House committee bill also contains general provisions that were previously
proposed in the same or similar form by the FY2022 House committee bill, but were not enacted
in FY2022. These provisions would prohibit the use of funds for sharing any information
pertaining to unaccompanied alien children for use or reference in removal proceedings or
immigration enforcement (§233), require HHS to make efforts to place sibling unaccompanied
alien children together (§234), and require HHS to submit a detailed spend plan for the account

80 HHS, ACF, FY2023 Congressional Justification, p. 33, https://www.acf.hhs.gov/sites/default/files/documents/olab/
fy-2023-congressional-justification.pdf.
81 The UAC program is also sometimes referred to as the Unaccompanied Children (UC) program. The $5.5 billion in
funding enacted for the UAC program in FY2022 includes $1.6 billion that was enacted as part of the second FY2022
CR (P.L. 117-70), but does not include $2.5 billion in emergency-designated funds enacted as part of the first FY2022
CR (P.L. 117-43). The latter funds are excluded from the FY2022 total above on the basis of their emergency
designation. The committee accounts for these additional dollars in discussing their funding decisions on page 198 of
H.Rept. 117-403.
82 HHS, ACF, FY2023 Congressional Justification, p. 37, https://www.acf.hhs.gov/sites/default/files/documents/olab/
fy-2023-congressional-justification.pdf.
Congressional Research Service

30

Labor, Health and Human Services, and Education: FY2023 Appropriations

(§235). The FY2023 House committee bill also proposes a new general provision allowing funds
provided to this account (in FY2023 and future years) to be used for children, parents, and legal
guardians who were separated at the United States-Mexico border in connection with the Zero-
Tolerance Policy (§236). The House committee report includes directives for ORR to increase
services to children, develop plans for children who age-out of UAC status, coordinate with DHS
to provide an analysis of case management, expand use of independent legal and mental health
services for UACs, and limit the use of unlicensed facilities, among other things.83
ACL
The ACL mission is focused on maximizing the “independence, well-being, and health of older
adults, people with disabilities across the lifespan, and their families and caregivers.”84 For ACL,
the FY2023 House committee bill proposes $2.9 billion in discretionary budget authority. This is
$600 million (+25.9%) more than ACL’s discretionary funding level in the FY2022 LHHS
omnibus ($2.3 billion) and $68 million (-2.3%) less than the FY2023 President’s discretionary
budget request ($3.0 billion). The President’s discretionary budget request represents a $668
million increase (+28.8%) relative to the FY2022 LHHS omnibus. Both the House committee bill
and the President’s budget request propose directing $28 million in PPHF funding to ACL, the
same as in the FY2022 LHHS omnibus. The House committee bill would not direct PHS tap
funds to ACL, in keeping with the FY2022 LHHS omnibus. The President’s budget requested $28
million in PHS tap funds to ACL. Inclusive of discretionary budget authority and directed
transfers, ACL would receive a total of $2.9 billion under the House committee bill, which is
$600 million (+25.6%) more than the FY2022 LHHS omnibus ($2.3 billion) and $95 million
(-3.1%) less than the President’s budget request.
For Nutrition Services Programs, the FY2023 House committee report proposes $1.3 billion. This
would be $293 million (+30.3%) more than the FY2022 LHHS omnibus ($967 million), and $12
million (-1.0%) less than the FY2023 President’s discretionary budget request ($1.3 billion). The
President’s budget justification proposed the increased funding to meet a “sustained increase in
demand” for services.85
For Aging Network Support Activities, the House committee report proposes $37 million, which
would be $19 million (100.2%) more than the FY2022 LHHS omnibus, and $14 million
(+61.1%) more than the President’s discretionary budget request. Within this line item, the House
committee report would fund several activities that were authorized by the Supporting Older
Americans Act of 2020 (P.L. 116-131),86 but which have not received funding to date and for
which the President’s FY2023 budget did not request funds:
 $10.0 million to establish a Research, Demonstration, and Evaluation Center for
the Aging Network with focus on falls prevention programs;
 $1.0 million for an Interagency Coordinating Committee on Healthy Aging and
Age-Friendly Communities with a focus on falls prevention and safe living
environments; and

83 H.Rept. 117-403, pp. 198-203.
84 ACL, About ACL, https://acl.gov/about-acl.
85 HHS, ACL, FY2023 Congressional Justification, p. 5, https://acl.gov/about-acl/budget.
86 For background, see CRS Report R46439, Older Americans Act: 2020 Reauthorization.
Congressional Research Service

31

Labor, Health and Human Services, and Education: FY2023 Appropriations

 $3.0 million for a Direct Care Workforce Demonstration project.87
For Elder Rights Support Activities, the House committee report proposes $100 million, which
would be an increase of $81 million (+429.8%) compared to the FY2022 LHHS omnibus, and an
increase of $23 million (+29.2%) compared to the President’s budget request. The House
committee report includes in this line item $80 million for an Adult Protective Services (APS)
formula grant program authorized by the Elder Justice Act.88 This would be the first time this APS
formula grant would be funded under the regular annual appropriations process.89
Restrictions Related to Certain Controversial Issues
Annual LHHS appropriations measures regularly contain broad restrictions related to certain
controversial issues. For instance, annual LHHS appropriations acts commonly include provisions
limiting the use of federal funds for abortions, the use of human embryos for research, needle
exchange programs, and gun control advocacy.
Abortions: Since FY1977, annual LHHS appropriations acts have included provisions limiting
the circumstances under which LHHS funds (including Medicaid funds) may be used to pay for
abortions. Early versions of these provisions applied only to HHS, but since FY1994 most
provisions have applied to the entire LHHS bill. Under current provisions, (1) abortions may be
funded only when the life of the mother is endangered or in cases of rape or incest; (2) funds may
not be used to buy a managed care package that includes abortion coverage, except in cases of
rape, incest, or endangerment; and (3) federal programs and state and local governments that
receive LHHS funding are prohibited from discriminating against health care entities that do not
provide or pay for abortions or abortion services. Both the FY2023 House committee bill and the
President’s budget would eliminate these existing restrictions (§§506 and 507 in the FY2022
LHHS omnibus90).
Human Embryo Research: Since FY1996, annual LHHS appropriations have included a
provision prohibiting any LHHS funds (including NIH funds) from being used to create human
embryos for research purposes or for research in which human embryos are destroyed. Both the
FY2023 House committee bill and the President’s budget would retain these existing restrictions
(§506 of the House committee bill).91
Needle Exchange Programs: Since FY1990, annual LHHS appropriations have generally
included a provision prohibiting any LHHS funds from being used for needle exchange programs
(i.e., programs in which sterile needles or syringes are made available to injection drug users in
exchange for used needles or syringes to mitigate the spread of related infections, such as
hepatitis and HIV/AIDS).92 Starting in FY2016, the provision was modified to allow funds to be

87 H.Rept. 117-96, pp. 214-215.
88 For background, see CRS Report R43707, The Elder Justice Act: Background and Issues for Congress.
89 In FY2021, this APS formula grant program received $276.0 million in mandatory funding through the American
Rescue Plan Act of 2021 (ARPA; P.L. 117-2; see CRS Report R46834, American Rescue Plan Act of 2021 (P.L. 117-
2): Public Health, Medical Supply Chain, Health Services, and Related Provisions) and $100.0 million in a
supplemental appropriation in the Consolidated Appropriations Act, 2021 (P.L. 116-260, Division M, Coronavirus
Response and Relief Supplemental Appropriations Act, 2021,134 Stat. 1916).
90 These provisions are commonly referred to as the Hyde and Weldon Amendments. For additional information, see
CRS Report RL33467, Abortion: Judicial History and Legislative Response.
91 The current provision is commonly referred to as the Dickey Amendment. For additional information, see CRS
Report RL33540, Stem Cell Research: Science, Federal Research Funding, and Regulatory Oversight.
92 The one exception is the FY1992 LHHS appropriations act (P.L. 102-170), which appears to have included no such
Congressional Research Service

32

link to page 41 link to page 41 link to page 41 link to page 41 link to page 41 link to page 41 Labor, Health and Human Services, and Education: FY2023 Appropriations

used for needle exchange programs under the following conditions: (1) federal funds may not be
used to purchase the needles, but may be used for other aspects of such programs; (2) the state or
local jurisdiction must demonstrate, in consultation with CDC, that they are experiencing, or at
risk for, a significant increase in hepatitis infections or an HIV outbreak due to injection drug use;
and (3) the program must be operating in accordance with state and local law. Both the FY2023
House committee bill and the President’s budget would omit this provision entirely (§526 in the
FY2022 LHHS omnibus).
Gun Control: Since FY1997, annual LHHS appropriations have included provisions prohibiting
the use of certain funds for activities that advocate or promote gun control. Early versions of
these provisions applied only to CDC; since FY2012, annual appropriations acts also have
included HHS-specific restrictions, in addition to restrictions that apply to all LHHS funds
(including funds transferred from the PPHF). Both the FY2023 House committee bill and the
President’s budget would retain these existing restrictions (§210 [HHS] and §503(c) [all LHHS,
plus PPHF transfers]).93
Table 7. HHS Appropriations Totals by Agency
(in millions of dollars)
FY2023
House
Cmte.
FY2022
FY2023
(H.R.
FY2023
HHS Agency
Enacted
Request
8295)
Enacted
HRSA
8,892
8,783
9,575
—
Mandatory BA
317
256
256
—
Discretionary BA
8,575
8,526
9,318
—
CDCa
7,554
9,676
9,596
—
Mandatory BA
55
55
55
—
Discretionary BA
7,499
9,621
9,541
—
Evaluation Tap Fundingb
0
151
0
—
PPHFc
903
903
903
—
Subtotal (Discretionary BA + Transfers)
8,402
10,675
10,444
—
NIHa
43,650
48,962
46,038
—
Mandatory BA
0
0
0
—
Discretionary BAd
43,650
48,962
46,038
—
Evaluation Tap Fundingb
1,309
1,272
1,421
—
Subtotal (Discretionary BA + Transfers)
44,959
50,233
47,459
—
SAMHSA
6,400
10,137
9,025
—

provision. Since the provision’s inception in FY1990, there has been variation in its scope and application during
certain fiscal years. For example, the LHHS appropriations act for FY1998 (P.L. 105-78) made the ban subject to
action by the HHS Secretary. The LHHS appropriations acts for FY2010 (P.L. 111-117, Division D) and FY2011 (P.L.
112-10, Division B) applied the ban only in locations that local authorities determined to be inappropriate.
93 The FY2023 House committee report directs that $30 million apiece ($60 million total) be allocated by the CDC and
NIH for Firearm Injury and Mortality Prevention Research (H.Rept. 117-403). CDC and NIH funding reservations for
Firearm Injury and Mortality Prevention were first included in LHHS explanatory statements in FY2020.
Congressional Research Service

33

link to page 41 link to page 41 link to page 41 link to page 41 link to page 41 link to page 41 link to page 41 Labor, Health and Human Services, and Education: FY2023 Appropriations

FY2023
House
Cmte.
FY2022
FY2023
(H.R.
FY2023
HHS Agency
Enacted
Request
8295)
Enacted
Mandatory BA
0
0
0
—
Discretionary BA
6,400
10,137
9,025
—
Evaluation Tap Fundingb
134
134
134
—
PPHFc
12
12
12
—
Subtotal (Discretionary BA + Transfers)
6,546
10,283
9,170
—
AHRQ
350
376
385
—
Mandatory BA
0
0
0
—
Discretionary BA
350
376
385
—
Evaluation Tap Fundingb
0
40
0
—
Subtotal (Discretionary BA + Transfers)
350
416
385
—
CMS
1,027,148 1,118,314
1,118,314
—
Mandatory BA
1,022,250
1,113,068
1,113,068
—
Discretionary BA
4,898
5,246
5,246
—
ACF
46,215
50,317
51,429
—
Mandatory BA
16,303
17,034
17,034
—
Discretionary BAe
29,912
33,283
34,395
—
ACL
2,318
2,986
2,918
—
Mandatory BA
0
0
0
—
Discretionary BA
2,318
2,986
2,918
—
Evaluation Tap Fundingb
0
28
0
—
PPHFc
28
28
28
—
Subtotal (Discretionary BA + Transfers)
2,346
3,041
2,946
—
Office of the Secretary (OS)
5,697
5,467
8,064
—
Mandatory BA
673
710
710
—
Discretionary BA
5,024
4,757
7,353
—
Evaluation Tap Fundingb
129
189
162
—
Subtotal (Discretionary BA + Transfers)
5,153
4,946
7,516
—
Total, HHS BA in the Bill
1,148,224 1,255,018
1,255,343
—
Mandatory
1,039,599
1,131,124
1,131,124
—
Discretionary
108,625
123,894
124,219
—
Emergency Funding (not in above totals)

—
P.L. 117-43, Divisions A and C
4,209
—
—
—
P.L. 117-58, Division J
500
—
—
—
P.L. 117-70, Division B
1,272
—
—
—
Congressional Research Service

34

link to page 31 Labor, Health and Human Services, and Education: FY2023 Appropriations

FY2023
House
Cmte.
FY2022
FY2023
(H.R.
FY2023
HHS Agency
Enacted
Request
8295)
Enacted
P.L. 117-128, Title IV
954
—
—
—
P.L. 117-159, Division B
990
—
—
—
P.L. 117-180, Division A
—
—
—
2,775
Memoranda (non-emergency funds only)

Total, BA Available in Fiscal Year (current year
1,131,134
1,223,159
1,223,484
—
from any bil )
Total, BA Advances for Future Years (provided in
170,222
202,080
202,080
—
current bil )
Total, BA Advances from Prior Years (for use in
153,132
170,222
170,222
—
current year)
Sources: Amounts in this table for the FY2022 Enacted, FY2023 Request, and FY2023 House Cmte. columns
are generally drawn from the committee report (H.Rept. 117-403) accompanying the FY2023 House committee
bil (H.R. 8295, as reported). Enacted totals (“Total BA in the Bil ”) for FY2022 do not include emergency-
designated appropriations. Amounts shown for emergency-designated appropriations are based on CRS analysis
of the specified laws. For consistency with source materials, amounts in this table generally do not reflect
mandatory spending sequestration, where applicable, nor do they reflect any transfers or reprogramming of
funds pursuant to executive authorities.
Notes: BA = budget authority. Details may not add to totals due to rounding. Amounts in this table (1) reflect
all BA appropriated in the bil , regardless of the year in which funds become available (i.e., totals do not include
advances from prior-year appropriations, but do include advances for subsequent years provided in this bil ); (2)
have generally not been adjusted to reflect scorekeeping; (3) comprise only those funds provided (or requested)
for agencies and accounts subject to the jurisdiction of the LHHS subcommittees of the House and Senate
appropriations committees (e.g., department totals do not include funding for the Food and Drug Administration,
the Indian Health Service, or the Agency for Toxic Substances and Disease Registry, all of which are funded by
other bil s); and (4) do not include appropriations that occur outside of appropriations bil s.
a. Each year, CDC and NIH also receive funding in the Interior-Environment appropriations bil as part of their
overall budget authority.
b. By convention, this table shows only the amount of PHS Evaluation Tap funds received by an agency, not the
amount of tap funds donated by an agency. That is to say, tap amounts shown in this table are in addition to
amounts shown for budget authority, but the amounts shown for budget authority have not been adjusted
to reflect potential “transfer-out” of funds to the tap.
c. PPHF funds are not appropriated in the LHHS bil , but are shown here for il ustrative purposes as they may
be used to supplement the funding selected agencies and programs receive through the appropriations
process. Amounts shown for PPHF in this table are in addition to amounts shown for budget authority.
d. In keeping with source materials, funding for the Advanced Research Projects Agency for Health (ARPA-H)
is included in the NIH discretionary BA total in the FY2023 Request column ($5.0 bil ion), but is included in
the OS discretionary BA totals in the FY2022 Enacted ($1.0 billion) and FY2023 House Cmte. ($2.8 bil ion)
columns. For further discussion, see the “NIH” section.
e. Of the total FY2022 enacted for Refugee and Entrant Assistance Programs, $1.6 bil ion was enacted as part
of the second continuing resolution for FY2022, P.L. 117-70, for the Unaccompanied Alien Children
program.
Congressional Research Service

35

link to page 45 link to page 45 link to page 45 link to page 45 link to page 45 Labor, Health and Human Services, and Education: FY2023 Appropriations

Table 8. HHS Discretionary Appropriations for Selected
Programs or Activities, by Agency
(in millions of dollars)
FY2023
House
Cmte.
FY2022
FY2023
(H.R.
FY2023
Agency or Selected Program
Enacted
Request
8295)
Enacted
HRSA

Community Health Centers
1,748
1,838
1,946
—
National Health Service Corps
122
210
156
—
Children’s Hospitals Graduate Medical Education
375
350
385
—
Maternal & Child Health Block Grant
748
954
873
—
Autism and Other Developmental Disorders
54
57
57
—
Healthy Start
132
145
145
—
Ryan White AIDS Programs
2,495
2,655
2,695
—
Organ Transplantation
30
29
31
—
Telehealth
35
0
0
—
Rural Communities Opioid Response
135
165
160
—
Family Planning (Title X)
286
400
500
—
CDC

Immunization and Respiratory Diseases
449
832
664
—
PPHFa
419
419
419
—
Subtotal (Discretionary BA + Transfers)
868
1,251
1,083
—
HIV/AIDS, Viral Hepatitis, STDs, TB Prevention
1,345
1,471
1,464
—
Emerging and Zoonotic Infectious Diseases
641
651
747
—
PPHFa
52
0
0
—
Subtotal (Discretionary BA + Transfers)
693
651
747
—
Chronic Disease Prevention and Health Promotion
1,084
1,357
1,347
—
PPHFa
255
255
255
—
Subtotal (Discretionary BA + Transfers)
1,339
1,612
1,602
—
Birth Defects and Developmental Disabilities
177
195
225
—
Public Health Scientific Services
652
655
867
—
Environmental Health
210
378
312
—
PPHFa
17
17
17
—
Evaluation Tap Fundingb
0
7
0
—
Subtotal (Discretionary BA + Transfers)
227
402
329
—
Injury Prevention and Control
715
1,283
898
—
National Institute for Occupational Safety and
352
345
363
—
Health
Congressional Research Service

36

link to page 45 link to page 45 link to page 45 link to page 45 link to page 45 link to page 45 link to page 45 Labor, Health and Human Services, and Education: FY2023 Appropriations

FY2023
House
Cmte.
FY2022
FY2023
(H.R.
FY2023
Agency or Selected Program
Enacted
Request
8295)
Enacted
Global Health
647
748
758
—
Buildings and Facilities
30
55
55
—
CDC-Wide Activities and Program Support
334
809
959
—
PPHFa
160
160
160

Subtotal (Discretionary BA + Transfers)
494
969
1,119

NIH

National Institute of Allergy and Infectious Diseases
6,323
6,268
6,643
—
National Institute of General Medical Sciences
1,783
1,826
1,779
—
Evaluation Tap Funding
1,309
1,272
1,421
—
Subtotal (Discretionary BA + Transfers)
3,092
3,098
3,200
—
National Institute on Aging
4,220
4,011
4,443
—
National Institute on Drug Abuse
1,595
1,843
1,713
—
NIH Innovation Account
150
419
419
—
Advanced Research Projects Agency for Health
0
5,000
0
—
(ARPA-H)c

SAMHSA

Mental Health Programs of Regional & National
587
1,518
1,543
—
Significance (PRNS)
PPHFa
12
12
12
—
Subtotal (Discretionary BA + Transfers)
599
1,530
1,555
—
Mental Health Block Grant
837
1,632
1,337
—
Evaluation Tap Fundingb
21
21
21
—
Subtotal (Discretionary BA + Transfers)
858
1,653
1,358
—
Certified Community Behavioral Health Clinics
315
553
400
—
Children’s Mental Health
125
225
225
—
Substance Abuse Treatment PRNS
520
564
641
—
Evaluation Tap Fundingb
2
2
2
—
Subtotal (Discretionary BA + Transfers)
522
566
643
—
Substance Abuse Block Grant
1,829
2,929
2,329
—
Evaluation Tap Fundingb
79
79
79
—
Subtotal (Discretionary BA + Transfers)
1,908
3,008
2,408
—
State Opioid Response Grants
1,525
2,000
1,775
—
Substance Abuse Prevention PRNS
218
312
248
—
Health Surveillance and Support
260
150
257
—
Evaluation Tap Fundingb
31
31
31
—
Congressional Research Service

37

link to page 45 link to page 45 link to page 45 Labor, Health and Human Services, and Education: FY2023 Appropriations

FY2023
House
Cmte.
FY2022
FY2023
(H.R.
FY2023
Agency or Selected Program
Enacted
Request
8295)
Enacted
Subtotal (Discretionary BA + Transfers)
292
181
289
—

AHRQ

Research on Health Costs, Quality, and Outcomes
206
229
238
—
Evaluation Tap Fundingb
0
40
0
—
Subtotal (Discretionary BA + Transfers)
206
269
238
—
Medical Expenditure Surveys
72
72
72
—
Program Support
73
75
75
—

CMS
—
CMS Program Management
4,025
4,347
4,347
—
Health Care Fraud and Abuse Control
873
899
899
—

ACF

Low Income Home Energy Assistance Program
3,800
3,975
4,000
—
Formula Grants
Refugee and Entrant Assistance Programsd
6,425
6,328
7,979
—
Child Care and Development Block Grant
6,165
7,562
7,165
—
Head Start
11,037
12,203
12,397
—
Preschool Development Grants
290
450
350
—
Child Welfare Services
269
279
274
—
Adoption Opportunities
48
46
50
—
Community Services Block Grant
755
754
800
—

ACL

Home & Community-Based Supportive Services
399
500
450
—
Family Caregiver Support Services
194
250
230
—
Nutrition Services Programs
967
1,272
1,260
—
Aging Network Support Activities
18
23
37

Elder Rights Support Activities
19
77
100

State Health Insurance Program (SHIP)
53
55
58
—
Developmental Disabilities Programs
186
232
203
—
WIOA Activities (transferred from ED)
273
323
301
—

Office of the Secretary

Office of Nat'l Coord. for Health Information
0
0
0
—
Technology
Evaluation Tap Fundingb
64
104
87
—
Subtotal (Discretionary BA + Transfers)
64
104
87
—
Office of the Inspector General
82
106
94
—
Congressional Research Service

38

link to page 45 Labor, Health and Human Services, and Education: FY2023 Appropriations

FY2023
House
Cmte.
FY2022
FY2023
(H.R.
FY2023
Agency or Selected Program
Enacted
Request
8295)
Enacted
Public Health and Social Services Emergency Fund
3,200
3,815
3,699
—
Advanced Research Projects Agency for Health
1,000
0
2,750
—
(ARPA-H)c
Sources: Amounts in this table for the FY2022 Enacted, FY2023 Request, and FY2023 House Cmte. columns
are generally drawn from the committee report (H.Rept. 117-403) accompanying the FY2023 House committee
bil (H.R. 8295, as reported). Enacted totals (“Total BA in the Bil ”) for FY2022 do not include emergency-
designated appropriations. For consistency with source materials, amounts in this table generally do not reflect
mandatory spending sequestration, where applicable, nor do they reflect any transfers or reprogramming of
funds pursuant to executive authorities.
Notes: BA = budget authority. Details may not add to totals due to rounding. Amounts in this table (1) reflect
all BA appropriated in the bil , regardless of the year in which funds become available (i.e., totals do not include
advances from prior-year appropriations, but do include advances for subsequent years provided in this bil ); (2)
have generally not been adjusted to reflect scorekeeping; (3) comprise only those funds provided (or requested)
for agencies and accounts subject to the jurisdiction of the LHHS subcommittees of the House and Senate
appropriations committees (e.g., department totals do not include funding for the Food and Drug Administration,
the Indian Health Service, or the Agency for Toxic Substances and Disease Registry, all of which are funded by
other bil s); and (4) do not include appropriations that occur outside of appropriations bil s.
a. PPHF funds are not appropriated in the LHHS bil , but are shown here for il ustrative purposes as they may
be used to supplement the funding selected agencies and programs receive through the appropriations
process. Amounts shown for PPHF in this table are in addition to amounts shown for budget authority.
b. By convention, this table shows the amount of PHS Evaluation Tap funds received by an agency for a
particular program or activity separately from the budget authority appropriated for that program or
activity. Tap amounts are in addition to amounts shown for budget authority, though the amounts shown for
budget authority have not been adjusted to reflect potential “transfer-out” of funds to the tap.
c. The FY2022 LHHS omnibus funded ARPA-H with $1.0 bil ion under the HHS Office of the Secretary, but
gave the Secretary the ability to place ARPA-H anywhere in the department. The HHS Secretary placed
ARPA-H within NIH. The President’s FY2023 request for NIH therefore includes proposed funding for
ARPA-H ($5.0 bil ion) within the NIH total. However, the House Appropriations Committee has taken the
view that ARPA-H should be established as a separate entity within HHS (apart from NIH), and has
therefore proposed FY2023 ARPA-H funding ($2.75 bil ion) in a separate account under the HHS Secretary.
The numbers in this report generally fol ow the committee convention, which is to include ARPA-H funding
within the HHS Office of the Secretary totals for FY2022 enacted and the FY2023 House committee bil ,
but within NIH for the FY2023 President’s request. For background on ARPA-H and its placement, see CRS
Report R47074, Advanced Research Projects Agency for Health (ARPA-H): Congressional Action and Selected Policy
Issues.
d. Of the total FY2022 enacted for Refugee and Entrant Assistance Programs, $1.6 bil ion was enacted as part
of the second continuing resolution for FY2022, P.L. 117-70, for the Unaccompanied Alien Children
program.
Department of Education (ED)
All amounts in this section are based on regular LHHS appropriations only. They do not include
mandatory funds provided outside of the annual appropriations process (e.g., direct appropriations
for the Federal Direct Student Loan program and the mandatory portion of the Federal Pell Grant
program). Amounts are rounded (e.g., to the nearest million), as labeled. The dollar and
percentage changes discussed are based on unrounded amounts. For consistency with source
materials, amounts do not reflect sequestration or reestimates of mandatory spending programs,
where applicable.
Congressional Research Service

39

link to page 46 Labor, Health and Human Services, and Education: FY2023 Appropriations

About ED
Federal policymakers established the U.S. Department of Education in 1980.94 Its mission is to
“promote student achievement and preparation for global competitiveness by fostering
educational excellence and ensuring equal access.”95 Typically, about three-quarters of ED’s
discretionary appropriations go either to local educational agencies—which primarily use the
funds to provide educational and related services for economically disadvantaged students and
students with disabilities—or to low-income postsecondary students in the form of Pell Grants,
which help pay for college. The remainder of ED’s discretionary budget provides for a wide
range of activities, including (but not limited to) support for minority-serving institutions;
educational research; and career, technical, and adult education.
The federal government provides roughly 8% of overall funding for elementary and secondary
education in the United States.96 The majority of school funding—about 92%—comes from states
and local districts, which have primary responsibility for the provision of elementary and
secondary education. With regard to higher education, the federal government provided roughly
56% of undergraduate and graduate student aid in academic year (AY) 2021-2022.97
FY2023 ED Appropriations Overview
Table 9 displays proposed FY2023 discretionary and mandatory ED budget authority, along with
FY2022 enacted levels. Note that the totals in this table do not include emergency-designated
appropriations. Those amounts are displayed separately, along with the law in which they were
enacted, at the bottom of the table and are in addition to regular appropriations.
Discretionary funds represent the majority of ED’s annual appropriations, accounting for roughly
95% of ED funding. Proposed discretionary ED appropriations for FY2023 would increase under
the House committee bill (+13.5%) and the President’s budget (+15.6%) compared to FY2022.
Table 9. ED Appropriations Overview
(in billions of dollars)
FY2023
FY2022
FY2023
House Cmte.
FY2023
Funding
Enacted
Request
(H.R. 8295)
Enacted
Discretionary
76.4
88.3
86.7
—
Mandatory
3.7
3.9
3.9
—
Total BA in the Bill
80.1
92.3
90.7
—

94 ED in its current incarnation became a department in 1980 pursuant to the Department of Education Organization
Act (enacted on October 17, 1979). However, the department dates its origins to 1867. See U.S. Department of
Education, “About ED: The Federal Role in Education,” http://www2.ed.gov/about/overview/fed/role.html.
95 U.S. Department of Education, “About ED,” http://www2.ed.gov/about/landing.jhtml, accessed on October 28, 2022.
96 U.S. Department of Education, National Center for Education Statistics, Revenues and Expenditures for Public
Elementary and Secondary Education: FY20 (NCES 2022-301), May 2022, https://nces.ed.gov/pubs2022/2022301.pdf.
97 For the purposes of this calculation, the federal contribution included $131 billion (grants, loans, work-study, and tax
benefits) out of a total of $235 billion (federal aid, state aid, institutional grants, and private and employer-provided
grants). See the College Board’s Trends in College Pricing and Student Aid 2022, p. 31,
https://research.collegeboard.org/media/pdf/trends-in-college-pricing-student-aid-2022.pdf.
Congressional Research Service

40

link to page 47 link to page 47 link to page 49 Labor, Health and Human Services, and Education: FY2023 Appropriations

FY2023
FY2022
FY2023
House Cmte.
FY2023
Funding
Enacted
Request
(H.R. 8295)
Enacted
Emergency Funding (not in

above totals)
P.L. 117-58, Division Ja
-0.4
—
—
—
P.L. 117-159, Division Bb
2.1
—
—
—
Sources: Amounts in this table for the FY2022 Enacted, FY2023 Request, and FY2023 House Cmte. columns
are generally drawn from the committee report (H.Rept. 117-403) accompanying the FY2023 House committee
bil (H.R. 8295, as reported). Enacted totals (“Total BA in the Bil ”) for FY2022 do not include emergency-
designated appropriations. Amounts shown for emergency-designated appropriations are based on CRS analysis
of the specified laws. For consistency with source materials, amounts in this table generally do not reflect
mandatory spending sequestration, where applicable, nor do they reflect any transfers or reprogramming of
funds pursuant to executive authorities.
Notes: BA = budget authority. Details may not add to totals due to rounding. Amounts in this table (1) reflect
all BA appropriated in the bil , regardless of the year in which funds become available (i.e., totals do not include
advances from prior-year appropriations, but do include advances for subsequent years provided in this bil ); (2)
have generally not been adjusted to reflect scorekeeping; (3) comprise only those funds provided (or requested)
for agencies and accounts subject to the jurisdiction of the LHHS subcommittees of the House and Senate
appropriations committees; and (4) do not include appropriations that occur outside of appropriations bil s.
a. Section 90007(f)(1) of the Infrastructure Investment and Jobs Act (P.L. 117-58) rescinded $353.4 mil ion of
unobligated balances previously made available for the Education Stabilization Fund.
b. Division B of the Bipartisan Safer Communities Act (P.L. 117-59) provided $1.05 bil ion for School
Improvement Programs for FY2022 and $200 mil ion for Safe Schools and Citizenship Education for each
fiscal year from FY2022 through FY2026 ($1.0 bil ion total).
Selected ED Highlights
The following sections highlight FY2023 appropriations proposals for selected ED accounts and
programs.98 Table 10 tracks funding levels for major ED budget and appropriations accounts, and
selected items within those accounts.
Elementary and Secondary Education
The primary sources of federal aid to elementary and secondary education are through the
Elementary and Secondary Education Act (ESEA) and the Individuals with Disabilities Education
Act (IDEA). The House committee report and President’s budget indicate an intention to increase
appropriations in an effort to help reduce funding inequities between wealthier and lower income
local educational agencies (LEAs) and raise the federal share of contributions toward the excess
cost of educating children with disabilities.99
The largest ESEA program, Grants to Local Educational Agencies as authorized under Title I-A,
provides compensatory grants to LEAs to fund educational and related services for low-achieving

98 ED budget materials can be found at https://www2.ed.gov/about/overview/focus/performance.html.
99 When the predecessor legislation to IDEA was enacted in 1975 (P.L. 94-142), the assumption was that education for
children with disabilities was, on average, twice as costly to provide as education for other children. At that time, the
law authorized the federal government to provide grants to states to pay a percentage of each state’s “excess cost” of
educating children with disabilities. For more information about the IDEA Part B Grants to States program, see CRS
Report R41833, The Individuals with Disabilities Education Act (IDEA), Part B: Key Statutory and Regulatory
Provisions.
Congressional Research Service

41

Labor, Health and Human Services, and Education: FY2023 Appropriations

and other students who attend elementary and secondary schools with relatively high
concentrations of students from low-income families.
The largest part of the IDEA is Part B, Assistance for Education of all Children with Disabilities,
which includes the Grants to States program that provides federal support for special education
and related services for children and youth with disabilities between the ages of 3 and 21. IDEA
Part B also funds a Preschool grants program that provides supplemental grants to states that
provide preschool services to children with disabilities ages 3 through 5 years old. The IDEA Part
B, Grants to States program is the largest and most often discussed part of the IDEA, generally
accounting for more than 90% of total IDEA funding.
The House committee bill and President’s budget would provide $20.5 billion for ESEA Title I-A
Grants to Local Educational Agencies, which would represent a 17.1% increase compared to the
enacted FY2022 level of $17.5 billion. Under the program, funds are allocated to LEAs via state
educational agencies (SEAs) using four different allocation formulas specified in statute: Basic
Grants, Concentration Grants, Targeted Grants, and Education Finance Incentive Grants
(EFIG).100 Both the Targeted Grant and EFIG formulas include weighting schemes to increase aid
to LEAs with the highest concentrations of formula children—primarily children in poor families.
The House committee bill would apply a majority of the increase to allocations under the
Targeted Grant and EFIG formulas. The President’s budget did not recommend a different
distribution between the four allocation formulas.
The House committee bill would provide $16.7 billion for IDEA Part B, which would represent a
21.4% increase compared to the enacted FY2022 level of $13.8 billion. The President’s budget
would also provide $16.8 billion for the program. The Part B Grants to States program is intended
to supplement state and local funding to pay for some of the additional or excess costs of
educating children with disabilities compared to children who have not been identified as children
with disabilities. Both the House committee bill report and President’s budget estimate that the
federal share of the excess cost has decreased in recent years.
Student Aid Administration
The House committee bill would provide $2.6 billion in discretionary funding for the Student Aid
Administration account, which would be an increase of 26.8% compared to the FY2022
appropriation level of $2.0 billion. The President’s budget would provide about $2.7 billion in
discretionary funding, which would be a 30.5% increase over FY2022 funding. The Student Aid
Administration account provides funds to administer the federal student aid programs authorized
under Title IV of the Higher Education Act (HEA) and Title VII-A-I of the Public Health Service
Act. Activities funded under the Student Aid Administration account include personnel
compensation, loan servicing costs, student aid application processing, and the disbursement of
aid dollars.
Loan servicing costs account for the largest portion of the spending under the account. ED uses
third party vendors (i.e., loan servicers) to service the portfolio of ED-held non-defaulted federal
student loans. Loan servicers are responsible for collecting payments on federal student loans,
advising borrowers on resources and benefits to better manage their federal student loan
obligations, responding to customer service inquiries, administering loan forgiveness and
discharge benefits, and performing other associated administrative tasks. The current loan

100 SEAs make a number of adjustments before determining the final amounts that LEAs actually receive, such as
reservations for school improvement and administration. For more information about the ESEA Title I-A formula, see
CRS Report R44164, ESEA Title I-A Formulas: In Brief.
Congressional Research Service

42

link to page 51 Labor, Health and Human Services, and Education: FY2023 Appropriations

servicing contracts were originally awarded between 2009 and 2013, and some have been
successively extended through December 2023.
Since 2014, ED has been attempting to shift to a new student loan servicing environment.101 The
House committee report proposes $1.4 billion for loan servicing activities, compared to the $1.0
billion provided for FY2022 (+42.7%). The President’s budget proposes $1.5 billion for loan
servicing activities, or an increase of 50.4% compared to the FY2022 level. The House committee
bill provides similar language to that which has been included in appropriations bills since
FY2020 requiring that ED hold servicers accountable for contract requirements, service
performance, and compliance with applicable consumer protection laws. The House committee
report contains language similar language to that which has been included in appropriations bills
since FY2020 requiring ED to provide quarterly briefings to the committee on its progress related
to solicitations for Federal student loan servicing contracts.102 The President’s budget states that
the Administration intends to use the requested increase to award loan servicing contracts to
provide a single servicing interface for all Direct Loan borrowers and hold servicers more
accountable.103
Table 10. Detailed ED Appropriations
(in millions of dollars)
FY2023
FY2022
FY2023
House Cmte.
FY2023
Account and Selected Program
Enacted
Request
(H.R. 8295)
Enacted
Education for the Disadvantaged
18,230
21,281
21,261
—
Grants to Local Educational Agencies
17,537
20,537
20,537
—
Impact Aid
1,557
1,541
1,614
—
School Improvement Programs
5,596
5,526
5,906
—
Indian Education
189
186
195
—
Innovation and Improvement
1,301
1,572
1,485
—
Safe Schools and Citizenship Education
361
1,693
1,708
—
English Language Acquisition
831
1,075
1,000
—
Special Education
14,519
18,130
17,761
—
Part B—Assistance for Education of all
13,753
16,762
16,699
—
Children with Disabilitiesa
Part C—Infants and Toddlers with Disabilities
496
932
621
—
Rehabilitation Services
3,863
4,126
4,105
—
Vocational Rehabilitation State Grants
3,719
3,950
3,950
—
(mandatory)
Special Institutions for Persons with
275
265
291
—
Disabilities

101 For more information on the modernization efforts, see U.S. Government Accountability Office, Information
Technology: Education Needs to Address Student Aid Modernization Weaknesses, GAO-23-105333, October 20, 2022,
https://www.gao.gov/products/gao-23-105333.
102 H.Rept. 117-403, pp. 280-283.
103 U.S. Department of Education, Student Aid Administration, Fiscal Year 2023 Budget Request, pp. 13-48,
https://www2.ed.gov/about/overview/budget/budget23/justifications/y-saa.pdf.
Congressional Research Service

43

link to page 51 link to page 51 link to page 51 Labor, Health and Human Services, and Education: FY2023 Appropriations

FY2023
FY2022
FY2023
House Cmte.
FY2023
Account and Selected Program
Enacted
Request
(H.R. 8295)
Enacted
Career, Technical, and Adult Education
2,091
2,309
2,215
—
Career and Technical Education
1,387
1,570
1,482
—
Student Financial Assistance
24,580
26,345
24,639
—
Pell maximum grant (non-add)
5,835
6,335
6,335
—
Federal Pell Grant Program
22,475
24,275
22,475
—
Federal Direct Student Loan Program
25
0
0
—
Account
Student Aid Administration
2,034
2,654
2,579
—
Loan Servicing Activities
975
1,466
1,391
—
Higher Education
2,994
3,793
3,959
—
Howard University
344
311
394
—
College Housing & Academic Facilities
0
0
0
—
Loansb
HBCU Capital Financing Program
20
21
21
—
Account
Institute of Education Sciences
737
663
844
—
Departmental Management
594
786
690
—
Total, ED BA in the Bill
80,143
92,277
90,667
—
Subtotal, Mandatory
3,719
3,950
3,950
—
Subtotal, Discretionary
76,424
88,327
86,717
—
Emergency Funding (not in above totals)

—
—
—
P.L. 117-58, Division Jc
-353
—
—
—
P.L. 117-159, Division Bd
2,050
—
—
—
Memoranda (non-emergency funds

only)

Total, BA Available in Fiscal Year (current
80,143
92,277
90,667
—
year from any bil )
Total, BA Advances for Future Years
22,597
22,597
22,597
—
(provided in current bil )
Total, BA Advances from Prior Years (for use
22,597
22,597
22,597
—
in current year)
Source: Amounts in this table for the FY2022 Enacted, FY2023 Request, and FY2023 House Cmte. columns are
generally drawn from the committee report (H.Rept. 117-403) accompanying the FY2023 House committee bil
(H.R. 8295, as reported). Enacted totals (“Total BA in the Bil ”) for FY2022 do not include emergency-designated
appropriations. Amounts shown for emergency-designated appropriations are based on CRS analysis of the
specified laws. For consistency with source materials, amounts in this table generally do not reflect mandatory
spending sequestration, where applicable, nor do they reflect any transfers or reprogramming of funds pursuant
to executive authorities.
Notes: BA = budget authority. Details may not add to totals due to rounding. Amounts in this table (1) reflect
all BA appropriated in the bil , regardless of the year in which funds become available (i.e., totals do not include
advances from prior year appropriations, but do include advances for subsequent years provided in this bil ); (2)
have generally not been adjusted to reflect scorekeeping; (3) comprise only those funds provided (or requested)
Congressional Research Service

44

link to page 51 Labor, Health and Human Services, and Education: FY2023 Appropriations

for agencies and accounts subject to the jurisdiction of the LHHS subcommittees of the House and Senate
appropriations committees; and (4) do not include appropriations that occur outside of appropriations bil s.
Non-add amounts are displayed in italics; these amounts are not part of the appropriations totals.
a. Includes Part B Grants to States and Preschool Grants.
b. The actual amount for Col ege Housing & Academic Facilities Loans is $435,000 for the FY2022 Enacted and
$298,000 for the FY2023 Request and the FY2023 House Cmte. (H.R. 8295) columns, each of which rounds
to $0 in mil ions (the unit of measure used in this table).
c. Section 90007(f)(1) of the Infrastructure Investment and Jobs Act (P.L. 117-58) rescinded $353.4 mil ion of
unobligated balances previously made available for the Education Stabilization Fund.
d. Division B of the Bipartisan Safer Communities Act (P.L. 117-59) provided $1.05 bil ion for School
Improvement Programs for FY2022 and $200 mil ion for Safe Schools and Citizenship Education for each
fiscal year from FY2022 through FY2026 ($1.0 bil ion total).
Related Agencies
All amounts in this section are based on regular LHHS appropriations only; they do not include
funds provided outside of the annual appropriations process (e.g., mandatory appropriations for
Social Security benefit payments). All amounts in this section are rounded (e.g., to the nearest
million), as labeled. The dollar changes and percentage changes in the text are based on
unrounded amounts. For consistency with source materials, amounts do not reflect sequestration
or re-estimates of mandatory spending programs, where applicable.
FY2023 Related Agencies Appropriations Overview
Table 11 displays FY2023 proposed funding levels for LHHS Related Agencies, along with
FY2022 enacted levels. Note that the totals in this table do not include emergency-designated
appropriations. Those amounts are generally displayed separately, along with the law in which
they were enacted, at the bottom of the table and are in addition to regular appropriations.
However, no such appropriations were enacted for the Related Agencies in FY2022, or thus far in
FY2023.
In general, discretionary funding constitutes about 20% of total appropriations for LHHS Related
Agencies each year. Compared to FY2022, discretionary appropriations for Related Agencies
would be increased in both proposals. The House committee bill would increase them by 8.8%
and the President’s budget by 11.1%.
Table 11. Related Agencies Appropriations Overview
(in billions of dollars)
FY2023
FY2022
FY2023
House Cmte.
FY2023
Funding
Enacted
Request
(H.R. 8295)
Enacted
Discretionary
16.0
17.7
17.4
—
Mandatory
57.0
59.6
59.6
—
Total BA in the Bill
73.0
77.4
77.0
—
Emergency Funding (not in above totals)
—
—
—
—
Sources: Amounts in this table for the FY2022 Enacted, FY2023 Request, and FY2023 House Cmte. columns
are generally drawn from the committee report (H.Rept. 117-403) accompanying the FY2023 House committee
bil (H.R. 8295, as reported). Enacted totals (“Total BA in the Bil ”) for FY2022 do not include emergency-
designated appropriations. For consistency with source materials, amounts in this table generally do not reflect
Congressional Research Service

45

link to page 53 link to page 53 link to page 55 Labor, Health and Human Services, and Education: FY2023 Appropriations

mandatory spending sequestration, where applicable, nor do they reflect any transfers or reprogramming of
funds pursuant to executive authorities.
Notes: BA = budget authority. Details may not add to totals due to rounding. Amounts in this table (1) reflect
all BA appropriated in the bil , regardless of the year in which funds become available (i.e., totals do not include
advances from prior-year appropriations, but do include advances for subsequent years provided in this bil ); (2)
have generally not been adjusted to reflect scorekeeping; (3) comprise only those funds provided (or requested)
for agencies and accounts subject to the jurisdiction of the LHHS subcommittees of the House and Senate
appropriations committees; and (4) do not include appropriations that occur outside of appropriations bil s.
The largest share of funding appropriated to Related Agencies in the LHHS bill consistently goes
to the SSA. When taking into account both mandatory and discretionary funding, SSA usually
represents roughly 97% of total appropriations to Related Agencies in the LHHS bill. The bulk of
mandatory funding provided to SSA from the LHHS bill supports the Supplemental Security
Income (SSI) program, which provides means-tested cash assistance to disabled adults and
children and to seniors aged 65 or older.
When looking exclusively at discretionary funding, SSA usually receives about 84% of
discretionary appropriations for LHHS Related Agencies. After SSA, the next-largest related
agency in terms of appropriations is usually the Corporation for National and Community Service
(CNCS), which usually accounts for about 2% of total appropriations and 7% of discretionary
appropriations to LHHS Related Agencies. Typically, each of the remaining agencies receives less
than $1 billion from the annual LHHS appropriations bill. For more information, see Table 12.
Selected Related Agencies Highlights
The following sections highlight FY2023 appropriations issues for selected agencies, programs,
or accounts within Related Agencies. Table 12 tracks funding levels for the Related Agencies.
SSA Limitation on Administrative Expenses (LAE)
The SSA LAE account consists mainly of funds that are used by SSA to administer the Social
Security and SSI programs and to support CMS in administering portions of Medicare. The
account also contains funds that are specifically set aside for certain program integrity activities,
such as continuing disability reviews (CDRs) and SSI nonmedical redeterminations. The House
committee bill proposes $14.4 billion in discretionary funding for the LAE account for FY2023,
an increase of $1.1 billion (+8.2%) compared to the FY2022 enacted level. The President’s
request of $14.8 billion in discretionary funding for FY2023 would provide $1.4 billion (+10.7%)
more for the LAE account than the FY2022 enacted level.
Similar to FY2022, the House committee bill and the President’s request would dedicate about
12% of total funding for the LAE account to program integrity activities in FY2023. The program
integrity portion of the LAE account for FY2023 includes $288 million in base funding subject to
the committee allocations pursuant to the FY2023 deeming resolution, H.Res. 1151, as well as
additional funding that is effectively exempt from those allocations and subject to an annual limit
(adjustment funding; see the Appendix for further information). Both the House committee bill
and the President’s request would provide almost $1.8 billion in combined program integrity
funding for the LAE account for FY2023: $288 million in base funding plus $1.5 billion in
adjustment funding, which is the maximum amount of adjustment funding permitted for FY2023
under H.Res. 1151. Compared to the FY2022 enacted level of nearly $1.7 billion, the House
committee bill and the President’s request would both provide $91 million (+5.3%) more in
combined program integrity funding for the LAE account for FY2023.
Congressional Research Service

46

Labor, Health and Human Services, and Education: FY2023 Appropriations

Corporation for National and Community Service (CNCS)
The CNCS is an independent federal agency that administers a variety of national and community
service programs, such as AmeriCorps and the National Senior Volunteer Corps.104 Compared to
the FY2022 enacted level of $1.2 billion, the House committee bill would increase total
discretionary funding for CNCS by $150 million (+13.0%), while the President’s request would
increase it by $189 million (+16.5%).
National Labor Relations Board (NLRB)
The NLRB is an independent board that enforces provisions in the National Labor Relations Act
(NLRA). Compared to the FY2022 enacted level of $274 million, the House committee bill and
the President’s request would both increase total discretionary funding for NLRB by $45 million
(+16.5%).
Table 12. Detailed Related Agencies Appropriations
(in millions of dollars)
FY2023
House
Cmte.
FY2022
FY2023
(H.R.
FY2023
Agency, Program, Project, or Activity
Enacted
Request
8295)
Enacted
Committee for Purchase from People Who Are Blind or
11
13
13
—
Severely Disabled (U.S. AbilityOne Commission)
Corporation for National and Community Service
1,151
1,340
1,301
—
(CNCS)
Selected CNCS Programs/Initiatives:

Volunteers in Service to America (VISTA)
100
106
106
—
National Senior Volunteer Corps
231
245
245
—
AmeriCorps State and National Grants
467
557
523
—
National Civilian Community Corps
35
38
38
—
National Service Trust
191
235
235
—
Corporation for Public Broadcasting (CPB)
545
625
625
—
Federal Mediation and Conciliation Service
50
54
54
—
Federal Mine Safety and Health Review Commission
18
18
18
—
Institute of Museum and Library Services (IMLS)
268
277
280
—
Medicare Payment Advisory Commission (MedPAC)
13
13
14
—
Medicaid and CHIP Payment and Access Commission
—
(MACPAC)
9
10
9
National Council on Disability
4
4
4
—
National Labor Relations Board (NLRB)
274
319
319
—
National Mediation Board
15
15
15
—

104 See CRS Report RL33931, The Corporation for National and Community Service: Overview of Programs and
Funding.
Congressional Research Service

47

link to page 54 Labor, Health and Human Services, and Education: FY2023 Appropriations

FY2023
House
Cmte.
FY2022
FY2023
(H.R.
FY2023
Agency, Program, Project, or Activity
Enacted
Request
8295)
Enacted
Occupational Safety and Health Review Commission
14
15
15
—
Railroad Retirement Board (RRB)
147
153
153
—
Dual Benefits (minus tax receipts)
10
8
8
—
Federal Payment to RR Retirement Account (mandatory)a
0
0
0
—
Limitation on Administration
124
132
132
—
Inspector General
13
13
13
—
Social Security Administration (SSA)
70,443
74,536
74,204
—
Payments to Social Security Trust Funds (mandatory)
11
11
11
—
Supplemental Security Income (SSI) (mandatory)
56,982
59,635
59,635
—
Limitation on Administrative Expenses (LAE)
13,341
14,772
14,441
—
Regular LAE (incl. user fees, non-add)
11,633
12,973
12,642
—
Program Integrity (non-add)
1,708
1,799
1,799
—
Office of Inspector General
109
118
118
—
Total, Related Agencies BA in the Bill
72,960
77,392
77,025
—
Subtotal, Mandatory
56,993
59,646
59,646
—
Subtotal, Discretionary
15,967
17,746
17,379
—
Emergency Funding (not in above totals)
—
—
—
—
Memoranda (non-emergency funds only)

Total, BA Available in Fiscal Year (current year from any bil )
76,900
77,102
76,735
—
Total, BA Advances for Future Years (provided in current bil )
16,125
16,365
16,365
—
Total, BA Advances from Prior Years (for use in current year)
20,065
16,075
16,075
—
Source: Amounts in this table for the FY2022 Enacted, FY2023 Request, and FY2023 House Cmte. columns are
generally drawn from the committee report (H.Rept. 117-403) accompanying the FY2023 House committee bil
(H.R. 8295, as reported). Enacted totals (“Total BA in the Bil ”) for FY2022 do not include emergency-designated
appropriations. For consistency with source materials, amounts in this table generally do not reflect mandatory
spending sequestration, where applicable, nor do they reflect any transfers or reprogramming of funds pursuant
to executive authorities.
Notes: BA = budget authority. Details may not add to totals due to rounding. Amounts in this table (1) reflect
all BA appropriated in the bil , regardless of the year in which funds become available (i.e., totals do not include
advances from prior-year appropriations, but do include advances for subsequent years provided in this bil ); (2)
have generally not been adjusted to reflect scorekeeping; (3) comprise only those funds provided (or requested)
for agencies and accounts subject to the jurisdiction of the LHHS subcommittees of the House and Senate
appropriations committees; and (4) do not include appropriations that occur outside of appropriations bil s.
a. The actual amount of mandatory federal payments to the Railroad Retirement account is roughly $150,000
in each column, which rounds to $0 in mil ions (the unit of measure used in this table).
Congressional Research Service

48

Labor, Health and Human Services, and Education: FY2023 Appropriations

Appendix. Budget Enforcement Activities
The framework for budget enforcement under the congressional budget process has both
procedural and statutory elements. The procedural elements are primarily associated with the
budget resolution and limit both total discretionary spending and spending under the jurisdiction
of each appropriations subcommittee. The statutory elements relevant to the LHHS bill include
the mandatory spending sequester derived from the Budget Control Act of 2011 (BCA; P.L. 112-
25) and the Balanced Budget and Emergency Deficit Control Act of 1985 (BBEDCA; P.L. 99-
177), as amended (most recently by the Infrastructure Investment and Jobs Act [P.L. 117-58],
enacted on November 15, 2021).
For the decade prior to FY2022, the framework for discretionary spending budget enforcement
included statutory limits on defense and nondefense discretionary spending established by the
Budget Control Act of 2011 (BCA; P.L. 112-25).105 (LHHS appropriations are classified as
nondefense spending, and the bill has the largest share of such spending compared to the other
annual appropriations bills.) The BCA statutory limits on discretionary spending expired at the
end of FY2021, which meant that discretionary budget enforcement for FY2022 and thus far in
FY2023 occurred via procedural means only.
BCA and Mandatory Sequestration
For deficit-reduction purposes, the BCA (as amended) requires mandatory spending reductions to
occur through sequestration in each of FY2013 through FY2031.106
On March 28, 2022, concurrent with the release of the President’s budget submission, President
Biden issued the required FY2023 sequestration order, calling for nonexempt mandatory
spending to be reduced on October 1, 2022.107 At that time, the Office of Management and
Budget (OMB) estimated that the FY2023 sequestration percentages would equal 2% of
nonexempt Medicare spending and 5.7% of other nonexempt nondefense mandatory spending,
for a total reduction of $24 billion in FY2023.108 (OMB also estimated an 8.3% reduction,
totaling $1.1 billion, in nonexempt defense mandatory spending, which does not affect LHHS
funds.)
The BCA includes a number of statutory exemptions to sequestration and other special rules that
are relevant for the appropriated mandatory spending in the LHHS bill. For instance, the LHHS
bill contains several programs that are exempt from sequestration, including Medicaid, payments

105 The BCA initially imposed limits on discretionary spending for each of FY2012-FY2021. Further reductions to
discretionary spending for FY2013-FY2021 were triggered when the Joint Committee on Deficit Reduction did not
report legislation to achieve a specified amount of budgetary savings.
106 As originally enacted, mandatory sequestration was scheduled to run through FY2021, but this period has
subsequently been incrementally extended to FY2031 by P.L. 113-67, P.L. 113-82, P.L. 114-74, P.L. 115-123, P.L.
116-37, P.L. 116-136, and P.L. 117-58.
107 Sequestration Order for Fiscal Year 2023 Pursuant to Section 251A of the Balanced Budget and Emergency Deficit
Control Act, As Amended, Federal Register Volume 87, No. 62, March 31, 2022, p. 18603, https://www.govinfo.gov/
content/pkg/FR-2022-03-31/pdf/2022-06939.pdf.
108 OMB Report to the Congress on the BBEDCA 251A Sequestration for Fiscal Year 2023, March 28, 2022,
https://www.whitehouse.gov/wp-content/uploads/2022/03/BBEDCA_251A_Sequestration_Report_FY2023.pdf. See
the report’s appendix for an itemized list of budget accounts that include mandatory spending subject to sequestration
in FY2023, the dollar amounts subject to sequestration (based on OMB’s current law baseline), the percentage by
which they would be reduced, and the dollar amount of the reduction. While the report displays reductions at the
account level, the sequester itself is implemented at the program, project, or activity level.
Congressional Research Service

49

Labor, Health and Human Services, and Education: FY2023 Appropriations

to health care trust funds, Supplemental Security Income, Special Benefits for Disabled Coal
Miners, retirement pay and medical benefits for commissioned Public Health Service officers,
foster care and adoption assistance, and certain family support payments. The LHHS bill also
contains several programs that are subject to special rules under sequestration, such as health
centers and portions of Medicare.109
Budget Resolution, 302(b) Suballocations, and Exceptions to
Budget Enforcement
The procedural elements of budget enforcement generally stem from requirements under the
Congressional Budget Act of 1974 (P.L. 93-44) that are associated with the adoption of an annual
budget resolution. Through this process, the Appropriations Committee in each chamber receives
a procedural limit on the total amount of discretionary budget authority for the upcoming fiscal
year, referred to as a 302(a) allocation. The Appropriations Committee subsequently divides this
allocation among its 12 subcommittees. These subcommittee-level spending limits are referred to
as 302(b) suballocations. The 302(b) suballocations restrict the amount of budget authority
available to each subcommittee for the agencies, projects, and activities under its jurisdiction,
effectively acting as a cap on each of the 12 regular appropriations bills. Enforcement of the
302(a) allocation and 302(b) suballocations occurs through points of order.
For the past several years, certain spending has been made effectively exempt from discretionary
budget enforcement (both the previously mentioned statutory spending caps and 302(a) and
302(b) limits) by a mechanism that is commonly referred to as an adjustment. An adjustment
increases the applicable spending limit to accommodate additional specified funding.
Adjustments to the 302(a) and 302(b) limits are typically specified in the budget resolution. For
FY2011-FY2021, when statutory discretionary spending limits were also in effect pursuant to the
BCA, adjustments to those statutory limits also could be made under Section 251(b) of the
BBEDCA.110 However, since those statutory limits expired, any exemptions from budget control
for LHHS programs and activities generally were pursuant to provisions in or associated with a
budget resolution, with certain exceptions for the reemployment services and eligibility
assessments. The adjustments that apply to LHHS discretionary funding in the House111 that are
currently in effect (pursuant to H.Res. 1151, discussed below) are as follows:
 Emergency requirement. Funding for this adjustment is designated as being
provided for an emergency requirement. There are no criteria that would restrict
the use of this adjustment to particular accounts or activities, and no dollar limit
to the amount of appropriations each fiscal year that can be designated in this
manner. FY2023 emergency-designated LHHS spending enacted as of the date of
this report has totaled $3.3 billion. (For FY2022, $7.8 billion in LHHS
emergency-designated discretionary spending was enacted.)

109 For more information, see CRS Report R42050, Budget “Sequestration” and Selected Program Exemptions and
Special Rules.
110 For further information, see CRS Report R45778, Exceptions to the Budget Control Act’s Discretionary Spending
Limits.
111 Section (d) of H.Res. 1151, provided that the BCA cap adjustments (Section 251(b) of the Balanced Budget and
Emergency Deficit Control Act) would not apply to allocations established pursuant to that resolution. Although the
FY2023 adjustment for reemployment services and eligibility assessments pursuant to Section 314(g) of the
Congressional Budget Act (CBA) continues to be in effect for both the House and the Senate, the limit on that
adjustment in the CBA is the same as that provided by H.Res. 1151 ($258 million in additional new budget authority).
Congressional Research Service

50

Labor, Health and Human Services, and Education: FY2023 Appropriations

 Continuing disability reviews and redeterminations. Funding for this
adjustment is for the costs associated with conducting continuing disability
reviews, SSI nonmedical redeterminations of eligibility, co-operative disability
investigation units, and the prosecution of fraud in the programs and operations
of the SSA by Special Assistant United States Attorneys. For FY2023, the
amount of this adjustment is limited to $1.5 billion in additional new budget
authority. However, at least $288 million must first be appropriated for these
purposes, subject to the budget resolution limits, in order for the additional $1.5
billion adjustment to be available. (For FY2022, the amount of the adjustment
was $1.4 billion, and the amount subject to the limits was $273 million.)
 Health care fraud and abuse control. Funding for this adjustment is for the
health care fraud abuse control program at CMS (in HHS). For FY2023, the
amount of this adjustment is limited to $576 million in additional new budget
authority. However, at least $323 million must first be appropriated for these
purposes, subject to the budget resolution limits, in order for the additional $556
million adjustment to be available. (For FY2022, the amount of the adjustment
was $556 million, and the amount subject to the limits was $317 million.)
 Reemployment services and eligibility assessments. Funding for this
adjustment is for a DOL program providing grants to states under section 306 of
the Social Security Act for claimants of regular compensation, as defined in such
section, including those who are profiled as most likely to exhaust their benefits.
For FY2023, the amount of this adjustment is limited to $258 million in
additional new budget authority. However, at least $117 million must first be
appropriated for these purposes, subject to the budget resolution limits, in order
for the additional $258 million adjustment to be available.112 (For FY2022, the
amount of the adjustment was $133 million, and the amount subject to the limits
was $117 million.)
Separate from these cap adjustments, the 21st Century Cures Act (Cures Act, P.L. 114-255), which
was enacted on December 13, 2016, includes additional budget enforcement procedures related to
the discretionary spending limits.113 For the purposes of FY2023 LHHS appropriations, these
procedures apply only to the NIH Innovation Account that was created by the act.114 The Cures
Act provides that discretionary appropriations from this account (up to the amount authorized) are
to be subtracted from any cost estimates provided for purposes of budget controls. Thus, the
Cures Act ensures that appropriations from this account will not count against any spending
limits, such as those associated with the budget resolution. For FY2023, these Cures Act funds
allowed in the LHHS bill total $1.085 billion.

112 Unlike the other adjustments, the reemployment services and eligibility assessments adjustment has separately been
established in Section 314(g) of the CBA, which continues to be in effect. However, the FY2023 limit on that
adjustment in the CBA is the same as that provided by the adjustment in S.Con.Res. 14 ($133 million in additional new
budget authority).
113 These procedures originally applied to two accounts within the scope of the LHHS bill that were created by the
Cures Act: the NIH Innovation Account (FY2017-FY2026) and the Account for the State Response to the Opioid
Abuse Crisis (FY2017-FY2018). These procedures have lapsed for the State Response to the Opioid Abuse Crisis
account as of the end of FY2018, but are still in effect for the NIH Innovation Account through FY2026.
114 The 21st Century Cures Act also created a non-LHHS account—the FDA Innovation Account—and made it subject
to similar budget enforcement-related provisions. For more information, see CRS Report R44720, The 21st Century
Cures Act (Division A of P.L. 114-255).
Congressional Research Service

51

link to page 59 Labor, Health and Human Services, and Education: FY2023 Appropriations

FY2023 Budget Resolution
As of the date of this report there has been no House or Senate action on a FY2023 budget
resolution. In its absence, on June 8, 2022, the House adopted a resolution (H.Res. 1151) to
provide for 302(a) allocations to the House Appropriations Committee at a specified level, to
provide limits on advance appropriations115, and to allow adjustments to those allocations for
emergency requirements, health care fraud and abuse control, and continuing disability reviews
and redeterminations (as well as other purposes that do not apply to LHHS).116 Pursuant to this
resolution, the Chair of the House Budget Committee, Representative Yarmuth, published in the
Congressional Record the House Appropriations Committee allocations on June 21.117 The Senate
has not taken similar action to establish Senate Appropriations Committee allocations.118
Generally, the next step in the appropriations process is for each of the appropriations committees
to adopt suballocations from the total amount allocated to them. These 302(b) suballocations
provide a limit on current-year (i.e., FY2023) appropriations within each subcommittee’s
jurisdiction and incorporate any applicable scorekeeping adjustments made by CBO. The House
Appropriations Committee reported their initial 302(b) suballocations for all 12 subcommittees
on June 24 (H.Rept. 117-390).119
For current-year LHHS discretionary funding, Table A-1 displays FY2022 enacted levels and the
House FY2023 initial suballocations (H.Res. 1151). The amount shown represents current-year
budget authority subject to the spending limits and takes into account any applicable CBO
scorekeeping adjustments. Under this method of estimating the bill, FY2023 House committee
suballocation would increase regular discretionary appropriations for LHHS relative to FY2022
by 14% (+$27.4 billion).
The table also displays funding for which adjustments may be made to the discretionary spending
limits under the BCA, including funding for certain LHHS program integrity activities and
emergency requirements, where applicable. The “Adjusted Appropriations” total includes this
funding.
Compliance with discretionary spending allocations is evaluated based on budget authority
available in the current fiscal year, adjusted for scorekeeping by CBO. As such, totals shown in
this table may not be comparable to other totals shown in this report. Current-year budget
authority totals exclude advance appropriations for future years, but include advance
appropriations from prior years that become available in the current year. (Advance

115 Advance appropriations become available for obligation one or more fiscal years after the budget year covered by
the appropriations act. The FY2022 LHHS appropriations bill generally would contain advance appropriations for
FY2023 and FY2024 for certain programs and activities. For further information, see CRS Report R43482, Advance
Appropriations, Forward Funding, and Advance Funding: Concepts, Practice, and Budget Process Considerations.
116 H.Res. 1151 further provided that the BCA cap adjustments (Section 251(b) of the Balanced Budget and Emergency
Deficit Control Act) would not apply to allocations established pursuant to that resolution. However, the adjustment for
reemployment services and eligibility assessments would continue to be in effect FY2022-FY2027 pursuant to Section
314(g) of the Congressional Budget Act, subject to specified limits.
117 “Publication of Budgetary Material,” Congressional Record, daily edition, Vol. 168, No. 105 (June 21, 2022), p.
H5731-H5732.
118 For a discussion of budget enforcement through methods such as H.Res. 1151, see CRS Report R47175, Setting
Budgetary Levels: The House’s FY2023 Deeming Resolution.
119 Suballocations are commonly adjusted through the appropriations cycle to account for changing priorities. For
FY2023, the House Appropriations Committee reported revised suballocations on July 1 (H.Rept. 117-398) to
incorporate the cap adjustments where applicable and make an adjustment to outlay levels, but otherwise the
suballocation for the LHHS subcommittee was the same as originally reported.
Congressional Research Service

52

link to page 59 link to page 60 link to page 14 Labor, Health and Human Services, and Education: FY2023 Appropriations

appropriations are provided to selected LHHS accounts, generally in order to manage specific
planning concerns and ensure continuity of operations at the start of a new fiscal year.)
Table A-1. LHHS Discretionary FY2022 and FY2023 Enacted Levels and FY2023
House 302(b) Suballocations
(budget authority in billions of dollars)
FY2023 Initial
House 302(b)
FY2022
(and
FY2023

Enacted
Adjustments)
Enacted
Regular Discretionary Appropriations
196.994
224.399
—
Adjustmentsa:

Health care fraud and abuse control
0.556
0.576
—
Continuing disability reviews and
1.435
1.511
—
redeterminations
Reemployment services and eligibility
0.133
0.258
—
assessments
Emergency Requirements
7.831
—
3.270
Adjusted Appropriations
206.949
226.744
—
Source: The FY2022 Enacted amounts are from CBO, Report on the Status of Discretionary Appropriations, Fiscal
Year 2022, House of Representatives, as of May 26, 2022, https://www.cbo.gov/system/files?file=2022-05/FY2022-
House-2022-05-26.pdf, and CRS analysis of the texts of relevant laws. The FY2023 House amount for regular
discretionary appropriations is from page 3 of H.Rept. 117-403. The FY2023 House amount for the adjustments
is from a CRS analysis of H.R. 8295, as reported. The FY2023 enacted emergency-designated appropriations are
from CRS analysis of the texts of relevant laws.
Notes: It is common for suballocations to be revised over the course of the year to reflect actual action on
appropriations bil s and changes in congressional priorities. Regular appropriations reflect current-year
discretionary budget authority subject to the spending limits. Adjusted appropriations include, where applicable,
discretionary funds for which special rules apply with regard to the spending limits, including certain funds for
program integrity activities. Amounts include advance appropriations enacted in prior fiscal years that first
become available in those fiscal years. Amounts do not include, where applicable, funds provided under certain
authorities in the 21st Century Cures Act (P.L. 114-255) that are effectively exempt from discretionary spending
limits. (For FY2022, these funds totaled $496 mil ion; for FY2023, these funds total $1.085 bil ion.)
a. The House initial 302(b) for FY2023 LHHS (H.Rept. 117-390) did not include any adjustments to the LHHS
suballocations. These amounts are based on a CRS analysis of H.R. 8295, as reported.
Current-Year Budget Authority
Table A-2 displays the total LHHS current-year budget authority, by title. The amounts shown in
this table reflect total budget authority available for obligation in the fiscal year, regardless of the
year in which it was first appropriated. (In other words, these amounts exclude advance
appropriations for future years, but include advance appropriations from prior years that became
available in the applicable current year.) Amounts in the FY2022 Enacted column include
FY2022 advance appropriations budget authority provided by the FY2020 LHHS omnibus (P.L.
116-260) and the FY2021 LHHS omnibus (P.L. 116-260). Similarly, the FY2023 President’s
budget request and FY2023 House Cmte. columns include FY2023 advance appropriations
budget authority provided by the FY2021 and FY2022 LHHS omnibuses. (For a comparable table
showing total budget authority in the bill, rather than current-year budget authority, see Table 2 in
this report.) As mentioned above, it is current-year budget authority (adjusted for scorekeeping by
CBO) that is used to determine compliance with discretionary spending allocations. The amounts
Congressional Research Service

53

link to page 61 link to page 61 link to page 61 link to page 61 link to page 61 link to page 61 Labor, Health and Human Services, and Education: FY2023 Appropriations

in this table have not be adjusted for scorekeeping; those estimated scorekeeping adjustments are
shown at the bottom of the table.
Table A-2. LHHS Appropriations Overview, by Bill Title: FY2022-FY2023
(current-year budget authority in billions of dollars)
FY2023
FY2022
FY2023
House Cmte.
FY2023
Bill Title
Enacted
Request
(H.R. 8295)
Enacted
Title I: Labor
14.4
16.2
16.3
—
Discretionary
13.2
14.9
15.0
—
Mandatory
1.2
1.3
1.3
—
Title II: HHS
1,131.1
1,223.2
1,223.5
—
Discretionary
108.6
123.9
124.2
—
Mandatory
1,022.5
1,099.3
1,099.3
—
Title III: Education
80.1
92.3
90.7
—
Discretionary
76.4
88.3
86.7
—
Mandatory
3.7
3.9
3.9
—
Title IV: Related Agencies
76.9
77.1
76.7
—
Discretionary
15.9
17.7
17.3
—
Mandatory
61.0
59.4
59.4
—
Total Current Year BAa
1,302.6
1,408.7
1,407.2
—
Discretionary
214.1
244.8
243.3
—
Mandatory
1,088.4
1,163.9
1,163.9
—
Emergency Funding (not in above totals)

P.L. 117-43, Divisions A and C
4.2
—
—
—
P.L. 117-58, Division Jb
-0.3
—
—
0.1
P.L. 117-70, Division B
1.3
—
—
—
P.L. 117-128, Title IV
1.0
—
—
—
P.L. 117-159, Division Bc
1.6
—
—
0.4
P.L. 117-180, Division A
0.0
—
—
2.8
Memoranda:

Advances for Future Years (provided in current
210.7
242.8
242.8
—
bil )d
Advances from Prior Years (for use in current
197.6
210.7
210.7
—
year)d
Additional Scorekeeping Adjustmentse
-15.0
-33.9
-16.5
—
Source: Amounts in this table for the FY2022 Enacted, FY2023 Request, and FY2023 House Cmte. columns are
generally drawn from the committee report (H.Rept. 117-403) accompanying the FY2023 House committee bil
(H.R. 8295, as reported). The amounts shown for emergency funding at the bottom of the table are based on
CRS analysis of the texts of those laws. For consistency with source materials, regular annual appropriations
totals generally do not include emergency funds; instead, emergency funds are shown separately and are in
addition to the regular annual amounts. For consistency with source materials, amounts in this table generally do
Congressional Research Service

54

Labor, Health and Human Services, and Education: FY2023 Appropriations

not reflect mandatory spending sequestration, where applicable, nor do they reflect any transfers or
reprogramming of funds pursuant to executive authorities.
Notes: BA = budget authority. Details may not add to totals due to rounding. Amounts in this table (1) reflect
current-year budget authority; (2) have generally not been adjusted to reflect scorekeeping; (3) comprise only
those funds provided (or requested) for agencies and accounts subject to the jurisdiction of the LHHS
Subcommittees of the House and the Senate Committees on Appropriations; and (4) do not include
appropriations that occur outside of appropriations bil s. No amounts are shown for Title V, because this title
consists solely of general provisions.
a. Totals in this table are based on current-year budget authority, meaning budget authority that is available
for obligation in a given fiscal year, regardless of the year in which it was first appropriated (i.e., totals
exclude advance appropriations for future years, but include advance appropriations from prior years that
became available in the applicable current year).
b. P.L. 117-58, Division J, enacted both FY2022 and advance appropriations for the Low Income Energy
Assistance Program at HHS, of $100 mil ion each of FY2022-FY2026. It also rescinded $343 mil ion in
previously enacted FY2022 emergency-designated LHHS appropriations.
c. P.L. 117-159, Division B, enacted both FY2022 and advance appropriations for several programs at HHS and
ED, totaling $1.6 bil ion for FY2022, $395 mil ion for FY2023, $395 mil ion for FY2024, $395 mil ion for
FY2025, and $12 mil ion for FY2026.
d. The calculation for total budget authority in the bil (rather than total budget authority available for
obligation in the current fiscal year) is as fol ows: Total Current Year BA minus Advances from Prior Years
plus Advances for Future Years. The amount for both Advances from Prior Years and Advances for Future
Years is the combined total of mandatory and discretionary spending.
e. Totals in this table have generally not been adjusted for further scorekeeping. (To adjust for scorekeeping,
add this line to the total budget authority.)

Author Information

Karen E. Lynch, Coordinator
Jessica Tollestrup, Coordinator
Specialist in Social Policy
Specialist in Social Policy

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.

Congressional Research Service
R47345 · VERSION 1 · NEW
55