Contents

• Most Recent Developments
• Continuing Appropriations Resolution (CR) Further Extended in the 112^th Congress (P.L. 112-4 and P.L. 112-6); Full-Year Continuing Appropriations Measures Considered (H.R. 1 and S.Amdt. 149)
• FY2011 Interim CRs Enacted (P.L. 111-242) and Extended (P.L. 111-290, P.L. 111-317, and P.L. 111-322) in the 111^th Congress
• Senate Bill S. 3686 Reported
• House Subcommittee Markup Held
• President's Budget Submitted
• Note on Most Recent Data
• Overview
• Discretionary and Mandatory Funding: Program Level Appropriations and Current Year Appropriations
• Discretionary Funding Trends, FY2002-FY2010
• Discretionary Appropriations by Bill Title, FY2010-FY2011
• 302(a) and 302(b) Allocation Ceilings
• Advance Appropriations
• Department of Labor
• Highlights
• Detailed Appropriations Table
• Department of Health and Human Services
• Highlights
• Abortion: Funding Restrictions
• Research on Human Embryos and Human Embryonic Stem Cells: Funding Restrictions
• Detailed Appropriations Table
• Department of Education
• Highlights
• Detailed Appropriations Table
• Related Agencies
• Highlights
• Detailed Appropriations Table

Summary

This report tracks FY2011 appropriations for the Departments of Labor, Health and Human Services, and Education, and Related Agencies (L-HHS-ED). This legislation provides discretionary funds for three major federal departments and 14 related agencies. The report summarizes L-HHS-ED discretionary funding issues but not authorization or entitlement issues.

President Obama requested $172 billion in discretionary L-HHS-ED funds for FY2011, compared to $165 billion provided in the FY2010 Consolidated Appropriations Act (P.L. 111-117, Division D). The House L-HHS-ED Appropriations Subcommittee held a markup session in July 2010, but the full committee did not report a bill. In August 2010, the Senate Committee on Appropriations reported S. 3686 (S.Rept. 111-243), its FY2011 L-HHS-ED proposal, recommending $171 billion in discretionary funds. A continuing appropriations resolution, P.L. 111-242 as amended, provides temporary funding for the government until April 8, 2011, at the FY2010 rate of operations for most programs. However, P.L. 112-4 and P.L. 112-6 reduced funding for some L-HHS-ED programs by a total of about $2.5 billion. The House passed a full-year government funding bill, H.R. 1, on February 19, 2011, which would have reduced L-HHS-ED funding by about $25 billion and included several controversial policy riders. On March 9, the Senate rejected both H.R. 1 and a substitute amendment that would have cut L-HHS-ED funds by about $0.5 billion.

Department of Labor (DOL). The Administration requested $14.0 billion in discretionary funding for DOL for FY2011, compared to $13.5 billion provided for FY2010. The request included increases for Unemployment Compensation, youth training, and adult training. The Senate Appropriations Committee approved $13.9 billion. H.R. 1 and the Senate amendment would have provided $8.6 billion and $13.2 billion, respectively.

Department of Health and Human Services (HHS). The Administration requested $74.7 billion in discretionary funding for HHS for FY2011, compared to $73.0 billion provided for FY2010. The request included increases for Health Centers, National Institutes of Health, Health Care Fraud and Abuse Control, Child Care and Development Block Grant, and Head Start. The Senate Appropriations Committee approved $75.0 billion. H.R. 1 and the Senate amendment would have provided $64.7 billion and $72.9 billion, respectively.

Department of Education (ED). The Administration requested $67.8 billion in discretionary funding for ED for FY2011, compared to $64.3 billion provided for FY2010. The request included two programs previously funded by the American Recovery and Reinvestment Act (P.L. 111-5), and would increase funding for several additional programs in FY2011. The Senate Appropriations Committee approved $67.0 billion. H.R. 1 and the Senate amendment would have provided $59.4 billion and $70.1 billion, respectively.

Related Agencies. The Administration requested $15.2 billion in discretionary funding for Related Agencies for FY2011, compared to $14.1 billion provided for FY2010. The Senate Appropriations Committee approved $15.2 billion. H.R. 1 and the Senate amendment would have provided $12.3 billion and $14.4 billion, respectively.

Note that at present, only the Summary and the Most Recent Developments sections of this report have been updated to reflect the 112^th Congress's activities on continuing resolutions and full-year appropriations proposals. Links to other recent CRS reports are provided. The balance of this report discusses the President's request and the Senate Appropriations Committee bill.

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Labor, Health and Human Services, and Education: FY2011 Appropriations

Most Recent Developments

Continuing Appropriations Resolution (CR) Further Extended in the 112^th Congress (P.L. 112-4 and P.L. 112-6); Full-Year Continuing Appropriations Measures Considered (H.R. 1 and S.Amdt. 149)

P.L. 111-242, the initial Continuing Appropriations Act, 2011, was amended twice more in March 2011 to provide more time for Congress to resolve differences on final federal funding for FY2011.¹ Interim funding was provided by P.L. 112-4 (H.J.Res. 44) through March 18, 2011 (two weeks), and by P.L. 112-6 (H.J.Res. 48) through April 8, 2011 (three weeks). In contrast to the four CRs enacted in 2010, which largely continued funding at FY2010 rates of operations, the two CRs enacted in March 2011 cut overall discretionary budget authority for FY2011 by selectively terminating or reducing funding for some programs and some earmarks. The two-week CR, P.L. 112-4, reduced FY2011 annualized funding by $4 billion overall compared to FY2010 levels,² and the three-week CR, P.L. 112-6, cut another $6 billion from the annualized total.³ Within those totals, discretionary programs funded in the Labor, Health and Human Services, and Education, and Related Agencies (L-HHS-ED) appropriations act were reduced by approximately $1.5 billion and $1.0 billion, respectively, according to the Congressional Budget Office (CBO).⁴ All of the program reductions enacted in the two CRs (a total of $10 billion) were originally proposed in H.R. 1, discussed below.

Full-year appropriations proposals for FY2011 have also been considered by the 112^th Congress. Prior to enactment of P.L. 112-4, the House passed H.R. 1 on February 19, 2011. The bill would have provided regular FY2011 appropriations for the Department of Defense and continuing appropriations for the rest of the government, with specified reductions below FY2010 levels for many domestic discretionary programs.⁵ CBO estimated at the time that the bill would have reduced overall non-emergency discretionary budget authority by $61.5 billion from FY2010 levels; the L-HHS-ED share of the reduction was estimated at $25.5 billion.⁶ On March 9, 2011, the Senate rejected both H.R. 1 and a substitute amendment (S.Amdt. 149) offered by Senator Inouye.⁷ According to CBO, the funding reductions proposed in the Senate amendment were $8.7 billion below FY2010 levels overall and $0.5 billion below FY2010 levels for L-HHS-ED agencies.⁸ On April 1, 2011, the House passed H.R. 1255, which would enact H.R. 1 if the Senate fails to pass FY2011 appropriations.

In addition to appropriations, H.R. 1 as passed by the House also included a number of potentially controversial policy riders, many of which are matters of debate in ongoing budget negotiations. They are often in the form of "limitation amendments" that prohibit the use of funding in the bill for certain activities. Examples of such provisions affecting L-HHS-ED funding include several that prohibit spending to implement, in whole or in part, the March 2010 health care reform laws (P.L. 111-148, P.L. 111-152); a prohibition on funding the Planned Parenthood Federation of America, Inc., or any of its affiliates; and a ban on funding Department of Education forthcoming rules on federal student aid to for-profit colleges.

For further analysis from CRS on funding under the various proposals for FY2011 appropriations, see the following: CRS Report R41703, FY2011 Appropriations: A Side-by-Side Comparison of Key Proposals; CRS Report R41657, Proposed FY2011 Appropriations for the Departments of Education and Labor Under H.R. 1 and Related Bills; and CRS Report R41737, Public Health Service (PHS) Agencies: Overview and Funding, FY2010-FY2012. Additional reports related to Labor-HHS-ED appropriations are listed on the CRS Issues in Focus page at http://crs.gov/pages/subissue.aspx?cliid=2347&parentid=73&preview=False.

FY2011 Interim CRs Enacted (P.L. 111-242) and Extended (P.L. 111-290, P.L. 111-317, and P.L. 111-322) in the 111^th Congress

On September 30, 2010, the President signed into law H.R. 3081, the Continuing Appropriations Act, 2011 (P.L. 111-242), which provided temporary funding at the FY2010 rate of operations for most government agencies for the period October 1 through December 3, 2010, unless regular FY2011 appropriations measures were enacted sooner. The law was amended on December 4 (P.L. 111-290), December 18 (P.L. 111-317), and December 22, 2010 (P.L. 111-322), to extend the expiration date of the CR and provide for some special funding situations (known as "anomalies") for certain programs. P.L. 111-322 extended funding through March 4, 2011.⁹

Under the FY2011 continuing resolution, the funding level for most activities is provided at a rate of operations like that provided in FY2010 appropriations acts and under the same conditions and authority. Only the most limited funding actions are authorized in order to provide for the continuation of projects and activities. New initiatives are prohibited. For programs with high spend-out rates that normally would occur early in the fiscal year, special restrictions prohibit spending levels that would impinge on final FY2011 funding decisions. For entitlements and other mandatory activities, spending is allowed that would maintain existing program levels under current law, including additional funding, if needed, to continue benefits for eligible beneficiaries.

Senate Bill S. 3686 Reported

On August 2, 2010, the Senate Committee on Appropriations reported S. 3686 (S.Rept. 111-243), its proposal for FY2011 L-HHS-ED appropriations. The committee recommended $171.1 billion in discretionary L-HHS-ED funds.

House Subcommittee Markup Held

The House L-HHS-ED Appropriations Subcommittee held a markup session on July 15, 2010, and approved a draft bill, but the full committee did not take further action. The subcommittee published only a summary table showing some of the discretionary program levels approved at the markup.

President's Budget Submitted

On February 1, 2010, President Obama submitted his FY2011 budget to Congress. Modified by some later adjustments, the request included $171.7 billion in discretionary funds for programs covered in the L-HHS-ED appropriations bill.

Table 1 summarizes the legislative status of FY2011 L-HHS-ED appropriations.

Note on Most Recent Data

At present, only the Summary and the Most Recent Developments sections of this report have been updated to reflect the 112^th Congress's activities on continuing resolutions and full-year appropriations proposals. The balance of the report discusses the President's request and the Senate Appropriations Committee bill from the 111^th Congress.

In this report, unless stated otherwise, data on FY2010 appropriations and FY2011 proposals are based on the August 24, 2010, table from the Senate Committee on Appropriations (see the table at the back of S.Rept. 111-243). Funding amounts are rounded to the nearest million. The dollar changes and percent changes discussed in the text are based on unrounded amounts.

The data for FY2010 appropriations primarily reflect enactment of P.L. 111-117, the Consolidated Appropriations Act, 2010, on December 16, 2009. Some FY2010 amounts were subsequently affected by transfers or adjustments for comparability. The data for FY2010 do not reflect enactment of several laws providing supplemental appropriations, or in a few cases, rescissions of previously appropriated funds. These include the American Recovery and Reinvestment Act of 2009 (ARRA, P.L. 111-5, enacted February 17, 2009), which provided supplemental FY2009 appropriations that carried over to FY2010; the Patient Protection and Affordable Care Act (PPACA, P.L. 111-148, as amended by P.L. 111-152, both enacted in March 2010); the Supplemental Appropriations Act, 2010 (P.L. 111-212, July 29, 2010); and an unnamed law funding education jobs and Medicaid (P.L. 111-226, August 10, 2010).

The data for FY2011 reflect the President's budget request as of July 2010 and the Senate committee recommendations on S. 3686. Amounts for the Department of Education request, however, were revised after the Senate committee table was published, and reflect information available on the ED website at http://www2.ed.gov/about/overview/budget/tables.html?src=ct. The revision was not presented as an official budget amendment.

In most cases, data represent net funding for specific programs and activities, and take into account current and forward funding and advance appropriations; however, all data are subject to additional budgetary scorekeeping. Except where noted, data refer only to those programs within the purview of L-HHS-ED appropriations, and not to all programs within the jurisdiction of the relevant departments and agencies. Funding from other appropriations bills, and entitlements funded outside of the annual appropriations process, are excluded.

Overview

This report describes the highlights of President Obama's proposals for FY2011 appropriations for L-HHS-ED programs, as submitted to Congress on February 1, 2010, and the congressional response to those proposals. Discussions focus primarily on discretionary programs. The report does not follow specific funding issues related to mandatory L-HHS-ED programs—such as Medicare or Social Security—nor does it follow any authorizing legislation related to the President's budget initiatives. For a glossary of budget terms and relevant websites, see the Appendix, "Terminology and Web Resources."

The L-HHS-ED bill typically is one of the more controversial of the regular appropriations bills because of the size of its funding total and the scope of its programs, as well as various related issues, such as restrictions on the use of federal funds for abortion and for research on human embryos and stem cells. This bill provides discretionary and mandatory funds to three federal departments and 14 related agencies, including the Social Security Administration (SSA). Discretionary funding represents less than one-quarter of the total in the bill. Among the various appropriations bills, L-HHS-ED is the largest single source of discretionary funds for domestic (non-defense) federal programs (the Department of Defense bill is the largest source of discretionary funds among all federal programs).

This section presents several overview tables on funding in the bill, particularly discretionary funding, and discusses related issues such as 302(b) allocations and advance appropriations. Later sections provide details on individual L-HHS-ED departments and agencies.

Discretionary and Mandatory Funding: Program Level Appropriations and Current Year Appropriations

Table 2 summarizes the L-HHS-ED appropriations enacted for FY2010 and proposed for FY2011, including both discretionary and mandatory appropriations. The table shows various aggregate measures of L-HHS-ED appropriations, including the discretionary program level, current year level, and advance appropriations, as well as scorekeeping adjustments.

• Program level discretionary appropriations reflect the total discretionary appropriations in a given bill, regardless of the year in which they will be spent, and therefore include advance funding for future years. Unless otherwise specified, appropriations levels in this report refer to program level amounts.
• Current year discretionary appropriations represent discretionary appropriations in a given bill for the current year, plus discretionary appropriations for the current year that were enacted in prior years—for example, FY2011 appropriations that were enacted in the FY2010 act. As the annual congressional appropriations process unfolds, current year discretionary appropriations, including scorekeeping adjustments (see below), are measured against the 302(b) allocation ceilings (discussed later in this report). Note that media reports and comments from the Administration about appropriations activities typically cite figures representing the current year discretionary totals rather than the program levels in the bill.
• Advance appropriations are funds that will not become available until after the fiscal year for which the appropriations are enacted (for example, funds for certain education programs like Special Education State Grants that were included in the FY2010 act that could not be spent before FY2011 at the earliest).
• Scorekeeping adjustments are made to account for special funding situations, as monitored by the Congressional Budget Office (CBO).

Because appropriations may consist of mixtures of budget authority enacted in various years, both of the summary measures mentioned above are frequently used: program level appropriations and current year appropriations. How are these measures related? For an "operational definition," program level funding equals (a) current year, plus (b) advances for future years, minus (c) advances from prior years, and minus (d) scorekeeping adjustments. Table 2 shows each of these amounts for discretionary funding, along with funding levels for mandatory programs, and the grand total for L-HHS-ED.

Discretionary Funding Trends, FY2002-FY2010

The L-HHS-ED appropriations bills include both mandatory and discretionary funds; however, the appropriations committees fully control only the discretionary funds. Mandatory funding levels for programs included in the annual appropriations bills are modified through changes in the authorizing legislation. Typically, these changes are accomplished through authorizing committees by means of reconciliation legislation, and not through appropriations committees in annual appropriations bills.

Table 3 shows the trend in discretionary budget authority enacted in the regular (not including supplementals) L-HHS-ED appropriations for FY2002 through FY2010. During these years, L-HHS-ED discretionary funds have grown by 30% from $127.2 billion in FY2002 to $164.9 billion in FY2010, an increase of $37.7 billion.

Discretionary Appropriations by Bill Title, FY2010-FY2011

The annual L-HHS-ED appropriations act typically includes five titles. The first three provide appropriations and program direction for the Department of Labor (Title I), the Department of Health and Human Services (Title II), and the Department of Education (Title III). Each of the three titles includes some sections of "General Provisions" for the department; they provide specific program directions, modifications, or restrictions that the appropriators wish to convey in bill language, not just in report language. Title IV covers funding for 14 related agencies, the largest of which is the Social Security Administration. Title V contains general provisions with broader policy application than those in the department titles. Occasionally, the act has one or more additional titles, which may be legislative (authorizing) language rather than appropriations provisions.¹⁰

Table 4 summarizes by title the program level discretionary spending that was provided for FY2010 and proposed for FY2011 L-HHS-ED appropriations and compares the program level totals with the current year discretionary totals.

302(a) and 302(b) Allocation Ceilings

The House and Senate Appropriations Committees and their 12 parallel subcommittees are not free to fund their bills at whatever levels they might wish. Instead, the maximum budget authority for annual appropriations acts is determined under procedures laid out by the Congressional Budget Act of 1974, as amended. First, through the annual concurrent resolution on the budget, Congress establishes the 302(a) allocations—the maximum spending totals for a given fiscal year that are allowed for the two appropriations committees and various authorizing committees.¹¹ For further information, see CRS Report RS20144, Allocations and Subdivisions in the Congressional Budget Process, by [author name scrubbed]; and CRS Report R40472, The Budget Resolution and Spending Legislation, by Megan Suzanne Lynch.

Second, the House and Senate Committees on Appropriations separately subdivide their 302(a) allocations and establish the 302(b) allocations—the maximum discretionary budget authority available to each of the 12 subcommittees for each annual appropriations bill. The total of these allocations must not exceed the 302(a) discretionary total. This process creates the basis for enforcing discretionary budget discipline, since any appropriations bill reported with a total above the ceiling is subject to a point of order. The 302(b) allocations can and often do get adjusted during the year as the various appropriations bills progress toward final enactment. Table 5 shows the 302(b) discretionary allocations for the FY2011 L-HHS-ED appropriations determined by the House and Senate Committees on Appropriations, together with the comparable amount for the FY2010 appropriations. Both the 302(a) and 302(b) allocations regularly become contested issues in their own right.

Advance Appropriations

Advance appropriations occur when funds enacted in one fiscal year are not available for obligation until a subsequent fiscal year. For example, P.L. 111-117, which enacted FY2010 L-HHS-ED appropriations, provided $445 million for the Corporation for Public Broadcasting (CPB) for use in FY2012. Advance appropriations may be used to meet several objectives. These might include the provision of long-term budget information to recipients, such as state and local educational systems, to enable better planning of future program activities and personnel levels. The more contentious aspect of advance appropriations, however, involves how they are counted in budget ceilings.

Advance appropriations avoid the 302(a) and 302(b) allocation ceilings for the current year, but must be counted in the year in which they first become available for obligation. This procedure uses up ahead of time part of what will be counted against the allocation ceiling in future years. For FY2002, President George W. Bush's budget proposed eliminating advance appropriations for federal discretionary programs, including those for L-HHS-ED programs. Congress rejected that idea, and the proposal has not been repeated. For more information, see CRS Report RS20441, Advance Appropriations, Forward Funding, and Advance Funding, by [author name scrubbed].

Department of Labor

Discretionary appropriations for the Department of Labor (DOL) for FY2010 were $13,534 million. For FY2011, the Obama Administration requested $13,972 million, $438 million (3.2%) more than the amount provided for FY2010. The Senate Appropriations Committee would provide DOL with $13,907 million in discretionary funding for FY2011, a 2.8% increase over the amount provided for FY2010. See Table 6.

Mandatory DOL programs were funded at $3.1 billion for FY2010 and consist of Federal Unemployment Benefits and Allowances ($1,818 million), the Black Lung Disability Trust Fund ($663 million), Special Benefits for Disabled Coal Miners ($214 million), benefits under the Federal Employees' Compensation Program and the Longshore and Harbor Workers' Compensation Program ($187 million), Advances to the Unemployment Insurance and Other Trust Funds ($120 million), and administrative expenses for the Energy Employees Occupational Illness Compensation Fund ($52 million).

Highlights

The following are some highlights for DOL of President Obama's FY2011 budget request and the amounts recommended by the Senate Appropriations Committee. See Table 7 for details. All comparisons of funding levels with FY2010 appropriations are based on FY2010 regular appropriations only. Funding amounts in Table 7 are rounded to the nearest million. The dollar changes and percent changes discussed in the text are based on unrounded amounts.

• The President requested $3,581 million to administer the Unemployment Compensation program, an increase of $324 million (10.0%) above the $3,257 million provided for FY2010. The Senate Appropriations Committee agreed to the President's request.
• The President requested a $101 million (10.9%) increase for youth training activities and a $45 million (5.3%) increase for adult training activities. The President's request would increase funding for youth training from $924 million for FY2010 to $1,025 million for FY2011. The request would increase funding for adult training from $862 million for FY2010 to $907 million for FY2011. The Senate Appropriations Committee would provide $30 million less than the President's request for youth training and $10 million less than the request for adult training.
• The Administration requested $600 million for the Community Service Employment for Older Americans Program, $225 million (27.3%) less than the $825 million provided for FY2010. The Senate Appropriations Committee agreed to the President's request for a reduction in funding.
• The Administration requested a $120 million (6.6%) increase in benefits and training under the Trade Adjustment Assistance (TAA) program. The request would increase funding from the $1,818 million provided for FY2010 to $1,938 million for FY2011. (See Federal Unemployment Benefits and Allowances in Table 7.) The Senate Appropriations Committee agreed to the President's request for an increase in funding.
• The Administration requested an additional $17 million (7.3%) for the Wage and Hour Division (WHD). The request would increase funding for WHD to $244 million in FY2011. The Senate Appropriations Committee agreed to the President's request.
• The request includes $14 million (2.6%) more for the Occupational Safety and Health Administration (OSHA). For FY2011, the Administration would provide OSHA with $573 million. The Senate Appropriations Committee would increase funding for OSHA by $1 million more than the President's request.
• The Administration requested a $22 million (24.1%) increase for the Bureau of International Labor Affairs (ILAB). The request would increase funding for ILAB to $115 million for FY2011. The Senate Appropriations Committee would increase funding for ILAB to $117 million, $2 million more than the President's request.
• The budget request includes $50 million for a new State Paid Leave Fund. The fund would provide grants to states to establish paid leave programs. These programs would offer benefits to workers after the birth or adoption of a child and to workers who must take time off from work to care for a child, spouse, or parent who is ill. The Senate Appropriations Committee would provide $10 million for the fund.
• In FY2010, the Career Pathways Innovation Fund (part of Training and Employment Services) replaced the Community-Based Job Training Grants program. The fund received $125 million for FY2010. The Administration did not request any money for this fund for FY2011. Instead, the Administration supported legislation to create the American Graduation Initiative, which would provide support for community colleges. The Senate Appropriations Committee agreed to eliminate appropriations for the Career Pathways Innovation Fund, and noted that significant funding for similar purposes was provided in the Health Care and Education Reconciliation Act of 2010 (HCERA, P.L. 111-152).¹²

In FY2009, ARRA provided an additional $4.8 billion for DOL programs. Some of these funds could be obligated in FY2011. DOL program-specific plans for spending the money and other DOL reports are available at http://www.dol.gov/recovery.

DOL budget materials may be found at http://www.dol.gov/dol/aboutdol/main.htm#budget.

Detailed Appropriations Table

Table 7 shows the appropriations details for offices and major programs of DOL.

Department of Health and Human Services

FY2010 discretionary appropriations for the Department of Health and Human Services (HHS) were $72,998 million. For FY2011, the Obama Administration requested $74,699 million, $1,701 million (2.3%) more than the FY2010 amount, as shown in Table 8. As reported by the Senate Appropriations Committee, S. 3686 included $75,005 million in discretionary funding, $306 million above the request and an increase of $2,007 million (2.7%) over FY2010.

Mandatory HHS programs included in the L-HHS-ED act were funded at $537.3 billion in FY2010, and consist primarily of Medicaid Grants to States ($307.8 billion), Payments to Health Care Trust Funds ($214.6 billion, including Medicare Part B and Part D), Foster Care and Adoption Assistance State Payments ($7.4 billion), Family Support Payments to States ($4.9 billion), and the Social Services Block Grant ($1.7 billion). Note that some other large mandatory HHS programs are not funded through the L-HHS-ED act. The Children's Health Insurance Program (CHIP) and the Temporary Assistance for Needy Families (TANF) program receive their funding directly in authorizing statutes, while Medicare Part A is funded primarily through payroll taxes.

Highlights

The following are some highlights for HHS of President Obama's FY2011 budget request and the amounts recommended by the Senate Appropriations Committee. See Table 9 for details. All comparisons of funding levels with FY2010 appropriations are based on regular appropriations only; they do not include ARRA funding obligated in FY2010. In addition, supplemental funds provided to a number of HHS programs by the Patient Protection and Affordable Care Act are not reflected in this report.¹³ The Senate committee, however, in explaining some of its funding decisions, made reference to PPACA appropriations available to certain programs. Funding amounts in Table 9 are rounded to the nearest million. The dollar changes and percent changes discussed in the text are based on unrounded amounts.

A unique budget feature for some of the agencies and programs in HHS is funding received through the Public Health Service (PHS) Evaluation Set-Aside program, also known as the Evaluation Tap. The tap provides more than a dozen HHS programs with funding beyond their regular appropriations (or in a few cases, the tap provides their entire funding). The tap is authorized in section 241 of the PHS Act (42 U.S.C. § 238j), which allows the Secretary of HHS to redistribute a portion of eligible PHS agency appropriations for program evaluation purposes across HHS. In the annual L-HHS-ED act, Congress specifies the maximum percentage for the set-aside (currently 2.5% of eligible appropriations), and also allocates a portion of the available money for transfer to specific programs, as shown in Table 9.¹⁴

The funding amounts from the tap are labeled "non-add" in the table since they are not counted in the totals of appropriated funds. They do figure, however, in the calculation of a program's or agency's "program level" funding amount, which reflects funding available from a number of possible sources, not just the annual appropriated amount. In some cases, an apparent change in the level of proposed appropriations for a program simply reflects a shifting of the share of funding supplied by appropriated funds versus funds made available through the tap; the "program level" of funding may not change greatly in such cases.

• Health Resources and Services Administration (HRSA) Health Centers programs. The President requested an additional $295 million (13.5%) for community health centers and other health centers programs, which would increase funding to $2,480 million. The Senate committee recommended $2,185 million, the same as the FY2010 level, and noted that an additional $1 billion had been appropriated for FY2011 for health centers in PPACA.
• HRSA Workforce Training programs. The President requested an increase of $27 million (19%) for the National Health Service Corps (NHSC), no increase for nursing workforce programs, and a $7 million (2.7%) increase for Title VII health professions programs. The Senate committee recommended level funding for NHSC at $141 million, noting that PPACA had provided $290 million for FY2011. The committee increased funding for nursing programs by $48 million (20%) from $244 million in FY2010 to $292 million for FY2011, and increased Title VII programs by $104 million (41%) from $253 million to $357 million.
• HRSA Health Care-Related Facilities and Activities. In FY2010, this account supported $337 million in non-competitive grants for construction and renovation (including equipment) at a variety of facilities, as well as related activities. The President requested $100 million for grants to help develop medical schools in health professional shortage areas. The Senate committee recommended $156 million for a list of specific projects.
• Centers for Disease Control and Prevention (CDC). For the FY2011 CDC appropriation, the President requested a $131 million (2.0%) decrease, while the Senate committee recommended a $130 million (2.0%) increase, from $6,453 million to $6,583 million. The committee's increase, however, was more than offset in program-level terms by its recommended $214 million decrease in the funding CDC would receive for certain programs through the PHS Evaluation Tap, discussed above. The request and the committee also differed in the amount they planned to use in funding available from a June 2009 supplemental appropriation for pandemic influenza (P.L. 111-32). At the program level, the request and the committee would provide CDC with increases of 1.3% and 2.1%, respectively, over the FY2010 level. In describing total funding available for CDC programs, the committee also recommended that $663 million be transferred to CDC from the FY2011 appropriation of $750 million that was provided to the Prevention and Public Health Fund created by PPACA.
• Program-level funding for CDC's National Institute for Occupational Safety and Health (NIOSH) would increase by about 22% in both the request and the Senate committee recommendation, largely to provide a $79 million increase for the World Trade Center program. The committee shifted $70 million of the funds to come from the appropriation instead of from the evaluation tap.
• National Institutes of Health (NIH). The President requested a $1.0 billion increase (3.2%) for NIH, which was funded at $31.0 billion in FY2010. The Senate committee recommended the same level as the request, $32.0 billion. The committee noted that NIH faces a "funding cliff" in FY2011 (a steep drop in funding compared to FY2010) following the large amount of stimulus funding received through ARRA. About $5.7 billion of ARRA money was obligated in FY2010 in addition to regular appropriations. The committee indicated that the $1 billion, 3.2% proposed increase for FY2011 would match the estimated inflation rate for biomedical research. Within the $1 billion increase, the committee included $50 million to create the Cures Acceleration Network (CAN) authorized in PPACA. Its statutory language requires that NIH use only specifically appropriated funds to support the CAN.
• Substance Abuse and Mental Health Services Administration (SAMHSA). The President and the Senate committee substantially agreed on giving SAMHSA an increase of just over 3%, boosting the appropriation from $3.4 billion to $3.5 billion. A 10% increase of about $20 million was included for Substance Abuse Prevention activities.
• Agency for Healthcare Research and Quality (AHRQ). AHRQ is funded entirely through the PHS evaluation tap, receiving $397 million in FY2010. The President requested an overall increase of $214 million (54%) to $611 million, which included an increase of $252 million (67%) for patient-centered health research, also called comparative effectiveness research (CER). The Senate committee kept total AHRQ funding at $397 million, with $35 million designated for CER. The committee noted that PPACA created the Patient Centered Outcomes Research Institute to manage CER, and stated that it did not want to duplicate that effort.
• Centers for Medicare and Medicaid Services (CMS). The CMS Health Care Fraud and Abuse Control Initiative, first funded in FY2009, was proposed for a $250 million increase (80%), from $311 million to $561 million. The Senate committee agreed to that amount. The President also requested a $131 million increase (3.8%) for CMS Program Management, from $3.5 billion in FY2010 to $3.6 billion. The Senate committee recommended an increase of $104 million, $27 million less than the request.
• Administration for Children and Families (ACF). The President requested a decrease of $1.8 billion (35%) in discretionary funding for the Low-Income Home Energy Assistance Program (LIHEAP), which was funded at $5.1 billion in FY2010. A legislative proposal was offered with the budget request that would provide additional mandatory funding if energy prices increased significantly. The Senate committee agreed with the $3.3 billion discretionary funding request, noting that it assumed enactment of the trigger that would provide an estimated $2.0 billion in additional mandatory funding in FY2011, for a total program level of $5.3 billion.
• ACF Refugee and Entrant Assistance programs. The President requested $878 million for refugee programs, an additional $147 million (20%) above the FY2010 level of $731 million. The Senate committee recommended an increase of $104 million (14%) to $835 million.
• ACF Child Care and Development Block Grant (CCDBG). The President requested $2,927 million for CCDBG, an additional $800 million (38%) above the FY2010 level of $2,127 million. The Senate committee recommended an increase of $1.0 billion (47%) to $3,127 million to maintain the level of funding provided in ARRA.
• ACF Head Start program. The Senate committee agreed with the President's request to increase funding for Head Start by $990 million (14%), from $7,234 million in FY2010 to $8,224 million.
• Administration on Aging (AoA). The President requested $1,625 million for AoA aging services programs, an additional $109 million (7.2%) above the FY2010 level of $1,516 million. The Senate committee recommended an increase of $143 million (9.5%) to $1,659 million. Increases were recommended for various caregiver programs, senior nutrition services, and Lifespan Respite Care, among others. Funding for Aging and Disability Resource Centers was reduced by $10 million, the amount of a mandatory appropriation to AoA provided by PPACA.
• Within the Office of the HHS Secretary, the Public Health and Social Services Emergency Fund (PHSSEF) supports a number of preparedness, response, and related public health security functions. Total appropriations for the PHSSEF account, which were $1,346 million in FY2010, were decreased in the President's request by $136 million (10%) to $1,211 million. The Senate committee substantially agreed, recommending a total of $1,197 million in discretionary funding, $14 million less than the request. In addition, both the President and the committee planned to use $330 million in available balances from FY2009 funding for pandemic influenza.
• Within the PHSSEF, Biomedical Advanced Research and Development was proposed for a $136 million (40%) increase from $340 million in FY2010 to $476 million. The Senate committee agreed with the request. Funding for this activity is transferred from the Project BioShield Special Reserve Fund. The funds were originally appropriated as multi-year money to the Department of Homeland Security in FY2004, to remain available until FY2013; in FY2010, the remaining balances were transferred to HHS.
• Also within the PHSSEF, discretionary funding for pandemic influenza preparedness was $341 million in FY2010. For FY2011, the President requested and the Senate committee concurred in decreasing the amount by $275 million, to $66 million. HHS also plans to use $330 million from supplemental FY2009 funds for pandemic influenza contingencies, available until expended, that were provided in P.L. 111-32 in June 2009.
• L-HHS-ED acts from FY1998 through FY2009 barred federal funding for needle and syringe exchange programs set up to prevent blood-borne infections in intravenous drug users. The FY2010 appropriations act replaced the ban with a prohibition on funding such programs in any location that local public health or law enforcement agencies determine to be inappropriate (§505 of P.L. 111-117, Division D). That language is retained in S. 3686.

ARRA provided HHS with an additional $21.9 billion in discretionary funding for FY2009, most of which was obligated by the end of FY2010. Some ARRA funds could be obligated in FY2011, and many programs will continue to outlay ARRA funds for the next several years. HHS program-specific plans for spending the money and other HHS Recovery Act reports are available at http://www.hhs.gov/recovery/reports/index.html.

HHS budget materials may be found at http://www.hhs.gov/asrt/ob/docbudget/.

Abortion: Funding Restrictions

Annual L-HHS-ED appropriations regularly contain restrictions that limit—for one year at a time—the circumstances under which federal funds can be used to pay for abortions. Restrictions on appropriated funds, popularly referred to as the "Hyde Amendments," generally apply to all L-HHS-ED funds. Medicaid is the largest program affected. As evidence of the perennial volatility of this issue, these provisions have been subject to periodic revision during the annual consideration of L-HHS-ED appropriations. From FY1977 to FY1993, abortions could be funded only when the life of the mother was endangered. The 103^rd Congress modified the provisions to permit federal funding of abortions in cases of rape or incest. The FY1998 L-HHS-ED appropriations, P.L. 105-78, extended the Hyde provisions to prohibit the use of federal funds to buy managed care packages that include abortion coverage, except in the cases of rape, incest, or life endangerment. The FY1999 L-HHS-ED appropriations, P.L. 105-277, continued the FY1998 Hyde Amendments with two added provisions: (1) a clarification to ensure that the restrictions apply to all trust fund programs (namely, Medicare), and (2) an assurance that Medicare + Choice plans (now Medicare Advantage) cannot require the provision of abortion services. No changes were made from FY2000 through FY2004.

The FY2005 L-HHS-ED appropriations, P.L. 108-447, added a restriction, popularly referred to as the "Weldon Amendment," that prevents federal programs or state or local governments that receive L-HHS-ED funds from discriminating against health care entities that do not provide or pay for abortions or abortion services. The FY2006 through FY2010 L-HHS-ED appropriations retained the Weldon amendment language and the Hyde restrictions. The current provisions can be found in §507 and §508 of P.L. 111-117, Division D. For additional information, please see CRS Report RL33467, Abortion: Judicial History and Legislative Response, by [author name scrubbed].

Research on Human Embryos and Human Embryonic Stem Cells: Funding Restrictions

In 1996, Congress prohibited NIH from using appropriated funds to create human embryos for research purposes or for research in which human embryos are destroyed (P.L. 104-99, §128). Since FY1997, annual appropriations acts have extended the prohibition to all L-HHS-ED funds, with NIH as the agency primarily affected. The restriction, popularly referred to as the "Dickey Amendment," has not changed significantly since it was first enacted. The current provision is found in §509 of P.L. 111-117, Division D. It is retained in S. 3686.

In 2001, specific restrictions on federal funding for human embryonic stem cell research were put in place by executive order by President George W. Bush; they were subsequently removed by President Obama in 2009. Currently, guidelines developed by NIH in 2009 govern the conduct of human embryonic stem cell research and the approval of human embryonic stem cell lines that are eligible for use in research supported by federal funds. A pending court case challenges this use of federal funds, citing the Dickey Amendment language. For additional information, please see CRS Report RL33554, Stem Cell Research: Ethical and Legal Issues, by [author name scrubbed], [author name scrubbed], and [author name scrubbed], and CRS Report RL33540, Stem Cell Research: Science, Federal Research Funding, and Regulatory Oversight, by [author name scrubbed] and [author name scrubbed].

Detailed Appropriations Table

Table 9 shows the appropriations details for offices and major programs of HHS.

Department of Education

For FY2011, the Obama Administration requested $67,840 million in discretionary funding, $3,563 million (5.5%) more than the FY2010 amount, as shown in Table 10. The Senate Appropriations Committee recommended $67,032 million in discretionary funding, $2,755 million (4.3%) more than the FY2010 amount.

A single mandatory ED program is included in the L-HHS-ED bill, the Vocational Rehabilitation State Grants program. It was provided funding of $3,085 million in FY2010. Both the President's budget and the Senate Committee on Appropriations recommended level funding for the program for FY2011.

Highlights

The President's original budget request, issued in February 2010, was based on the assumption that the Elementary and Secondary Education Act (ESEA) would be authorized prior to, or in concert with, enactment of FY2011 appropriations legislation. The original budget proposed significant restructuring of the ESEA and would have consolidated many separate authorities into larger programs as part of a reauthorization.¹⁵ However, as ESEA reauthorization has not occurred, a revised budget request based on the current ESEA, reflecting current account and program structures, was subsequently made available by ED.¹⁶ This report reflects the revised budget based on existing law (the current ESEA). ¹⁷ However, in order to facilitate comparison of the President's budget with the Senate Appropriations Committee's FY2011 recommendations and with the FY2010 funding level, the Pell grant program is treated as discretionary, although the President's budget proposes converting it to a mandatory program in FY2011.¹⁸

Both the President's FY2011 budget request and the Senate Appropriations Committee's recommendations for FY2011 would increase funding for several programs, and would eliminate several existing programs.¹⁹ Funding amounts in Table 11 are rounded to the nearest million. The dollar changes and percent changes discussed in the text are based on unrounded amounts.

• The Senate Committee on Appropriations recommended $14,942 million in discretionary funding for ESEA Title I-A Education Grants for the Disadvantaged, an increase of $450 million (3.1%) over FY2010 funding. The President's budget would level fund the program in FY2011.
• The Senate Committee on Appropriations recommended $300 million in discretionary funding for a new Early Learning Challenge Fund program. No discretionary funding was requested for this program in the President's FY2011 budget.
• The President's budget proposed funding of $900 million for School Improvement Grants in FY2011, $354 million (64.9%) above FY2010 funding. The Senate Committee on Appropriations recommended funding of $625 million for School Improvement Grants for FY2011, an increase of $79 million (14.5%) above FY2010 funding.
• The Senate Committee on Appropriations recommended expanding the mission of the 21^st Century Community Learning Centers program, and would provide funding of $1,266 million, an increase of $100 million (8.6%) over FY2010 funding. The President's budget would maintain funding for the program at FY2010 levels.
• The President's budget recommended FY2011 funding for two programs initiated by American Recovery and Reinvestment Act funding (P.L. 111-5) in FY2009; it would fund Race to the Top at $1,350 million, and Investing in Innovation at $500 million. Neither program received any regular FY2010 appropriations. The Senate Committee on Appropriations would fund Race to the Top at $675 million in FY2011, and it would fund Investing in Innovation at $250 million.
• The President's budget proposed funding of $800 million for the Teacher Incentive Fund in FY2011, $400 million (100%) above FY2010 funding. The Senate Committee on Appropriations recommended level funding for the program in FY2011.
• The President's budget proposed increasing funding for the Promise Neighborhoods Initiative to $210 million in FY2011, an increase of $200 million (2,000%) above FY2010 funding. The Senate Committee on Appropriations proposed funding Promise Neighborhoods at $20 million in FY2011, a $10 million increase (100%) above FY2010 funding.
• The President's budget proposed funding of $11,755 million for the Individuals with Disabilities Education Act (IDEA), Part B Grants to States, an increase of $250 million (2.2%) over FY2010 funding. The Senate Committee on Appropriations recommended funding of $11,925 million for IDEA Part B Grants to States, an increase of $420 million (3.7%) over FY2010 funding.

Detailed Appropriations Table

Table 11 shows the appropriations details for major programs of ED.

Related Agencies

Discretionary appropriations for Related Agencies for FY2010 were $14,077 million. For FY2011, the Obama Administration requested $15,232 million, which is $1,156 million (8.2%) more than the FY2010 amount. The Senate Appropriations Committee would provide $15,195 million for Related Agencies for FY2011, which is a 7.9% increase above the amount provided for FY2010. See Table 12.

Mandatory programs for Related Agencies included in the L-HHS-ED bill were funded at $47.3 billion for FY2010, virtually all of it for the Supplemental Security Income (SSI) program.

Highlights

The following are some highlights for Related Agencies of President Obama's FY2011 budget request and the amounts recommended by the Senate Appropriations Committee. See Table 13 for details. All comparisons of funding levels with FY2010 appropriations are based on FY2010 regular appropriations only. Funding amounts in Table 13 are rounded to the nearest million. The dollar changes and percent changes discussed in the text are based on unrounded amounts.

• The Administration requested $12,378 million for administrative expenses for the Social Security Administration (SSA). The request is $932 million (8.1%) more than the amount Congress provided for FY2010. The Senate Appropriations Committee agreed to the Administration's request.
• The President requested $1,416 million for the Corporation for National Community Service (CNCS). The request is $266 million (23.1%) more than the amount provided for FY2010. The request includes an additional $148 million (from $537 million to $685 million) for National Community Service Programs and $97 million more (from $197 million to $294 million) for the National Service Trust. The Senate Appropriations Committee provided $1,366 million more for the CNCS, or $50 million less than the amount requested by the President.
• The President's budget includes a request for $50,138 million for Supplemental Security Income (SSI) benefits. The request is $2,838 million (6.0%) more than the amount provided for FY2010. The Senate Appropriations Committee agreed to the President's request.
• The Senate Appropriations Committee would provide $3 million for the National Health Care Workforce Commission, which was created by the Patient Protection Affordable Care Act (PPACA, P.L. 111-148).

In FY2009, the ARRA provided an additional $1.2 billion in discretionary funding for Related Agencies. Some of this money could be obligated in FY2011. Both SSA and CCNS have developed implementation plans for spending the money. The plans and other reports are available at http://www.ssa.gov/recovery and http://www.nationalservice.gov/about/recovery/index.asp.

Detailed Appropriations Table

Table 13 shows the appropriations details for offices and major programs of the L-HHS-ED Related Agencies.

Appendix. Terminology and Web Resources

The following items include some of the key budget terms used in this report; they are based on CRS Report 98-720, Manual on the Federal Budget Process, by [author name scrubbed] and Allen Schick (pdf). The websites provide general information on the federal budget and appropriations.

Advance appropriation is budget authority that will become available in a fiscal year beyond the fiscal year for which the appropriations act is enacted; scorekeeping counts the entire amount in the fiscal year it first becomes available for obligation.

Appropriation is budget authority that permits federal agencies to incur obligations and to make payments out of the Treasury for specified purposes. Appropriations represent the amounts that agencies may obligate during the period of time specified in the law. Annual appropriations are provided in appropriations acts; most permanent appropriations are provided in substantive law. Major types of appropriations are regular, supplemental, and continuing.

Budget authority is legal authority to incur financial obligations that normally result in the outlay of federal government funds. Major types of budget authority are appropriations, borrowing authority, and contract authority. Budget authority also includes the subsidy cost to the federal government of direct loans and loan guarantees, estimated on a net present value basis.

Budget resolution is a concurrent resolution passed by both chambers of Congress, but not requiring the signature of the President, setting forth the congressional budget for at least five fiscal years. It includes various budget totals and functional allocations.

Discretionary spending is budget authority provided in annual appropriations acts, other than appropriated entitlements.

Entitlement authority is the authority to make payments to persons, businesses, or governments that meet the eligibility criteria established by law; as such, it represents a legally binding obligation on the part of the federal government. Entitlement authority may be funded by either annual or permanent appropriations acts.

Forward funding is budget authority that becomes available after the beginning of the fiscal year for which the appropriation is enacted and remains available into the next fiscal year; the entire amount is counted or scored in the fiscal year in which it first becomes available.

Mandatory (direct) spending is budget authority provided in laws other than annual appropriations acts, including appropriated entitlements.

Rescission is the cancellation of budget authority previously enacted.

Scorekeeping is a set of procedures for tracking and reporting on the status of congressional budgetary actions.

Supplemental appropriation is budget authority provided in an appropriations act that provides funds that are in addition to regular appropriations.

Websites

General information on budget and appropriations may be found at these websites. Specific
L-HHS-ED agency sites are listed in relevant sections of this report.

House Committees
http://appropriations.house.gov/
http://democrats.appropriations.house.gov
http://budget.house.gov/
http://democrats.budget.house.gov/

Senate Committees
http://appropriations.senate.gov/
http://budget.senate.gov/democratic/
http://budget.senate.gov/republican/

Congressional Budget Office (CBO)
http://www.cbo.gov/

Congressional Research Service (CRS)
http://www.crs.gov/Pages/clis.aspx?cliid=73

Government Accountability Office (GAO)
http://www.gao.gov/

Government Printing Office (GPO)
http://www.gpoaccess.gov/usbudget/

Office of Management and Budget (OMB)
http://www.whitehouse.gov/omb/budget/Overview/

Statements of Administration Policy (SAPs):
http://www.whitehouse.gov/omb/111/legislative_sap_date/