Labor, Health and Human Services, and Education: FY2022 Appropriations

Labor, Health and Human Services, and Education: FY2022 Appropriations

Labor, Health and Human Services, and
September 13, 2022
Education: FY2022 Appropriations
Jessica Tollestrup,
This report offers an overview of actions taken by Congress and the President to provide
Coordinator
FY2022 appropriations for accounts funded by the Departments of Labor, Health and
Specialist in Social Policy
Human Services, and Education, and Related Agencies (LHHS) appropriations bill. This

bill includes all accounts funded through the annual appropriations process at the
Karen E. Lynch,
Department of Labor (DOL) and Department of Education (ED). It also provides annual
Coordinator
appropriations for most agencies within the Department of Health and Human Services
Specialist in Social Policy
(HHS), with certain exceptions (e.g., the Food 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 FY2022 LHHS discretionary funding enacted during the annual
appropriations process. Totals in the report tables do not include emergency-designated funds.
Regular Appropriations
FY2022 LHHS Omnibus: 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 LHHS omnibus provided
full-year appropriations for all 12 annual appropriations acts in Divisions A-L. Annual discretionary LHHS
appropriations 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. The distribution of discretionary funding was as follows:
 DOL: $13.2 billion, 5.2% more than FY2021.
 HHS: $108.6 billion, 12.0% more than FY2021.
 ED: $76.4 billion, 3.9% more than FY2021.
 Related Agencies: $16.0 billion, 3.3% more than FY2021.
FY2022 LHHS Senate Action: The FY2022 LHHS bill did not receive 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 October 18, 2021. These draft numbers are not
presented in this report. In addition, on October 25, Senator Murray, Chair of the Senate Appropriations LHHS
Subcommittee, introduced an FY2022 LHHS bill (S. 3062). This bill was referred to the Senate Appropriations
Committee. Because S. 3062 did not receive any congressional action, this report does not discuss this measure.
FY2022 LHHS House Action: On July 15, 2021, the House Appropriations Committee voted to report the
FY2022 LHHS appropriations bill, 33-25; the measure was subsequently reported to the House on July 19 (H.R.
4502; H.Rept. 117-96). The measure was approved in subcommittee, via voice vote, on July 12, 2021. As reported
by the full committee, the bill would have provided $254.4 billion in discretionary LHHS funds, a 28.1% increase
from FY2021 enacted levels. This amount was 0.2% more than the FY2022 President’s request. In addition, the
House committee bill would have provided an estimated $1.102 trillion in mandatory funding, for a combined
total of $1.356 trillion for LHHS as a whole. The distribution of discretionary funding was as follows:
 DOL: $14.7 billion, 17.4% more than FY2021.
 HHS: $119.8 billion, 23.6% more than FY2021.
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 ED: $102.8 billion, 39.8% more than FY2021.
 Related Agencies: $17.0 billion, 9.8% more than FY2021.
The House version of LHHS appropriations was initially considered on the floor as part of a consolidated
appropriations package and passed the House (219-208), as amended, on July 31, 2021 (Division A of H.R. 4502).
Of the amendments offered, 47 were adopted and 9 were rejected. Because there is no publicly available source
that estimates the account- or subaccount-level budgetary effects of the amendments adopted to Division A, this
report provides analysis of the House Committee-reported version of the LHHS bill. For information on the LHHS
amendments offered during floor consideration, see Appendix B.
FY2022 President’s Budget Request: The full FY2022 President’s budget request was submitted to Congress on
May 28, 2021. (The President had previously submitted to Congress an outline of his discretionary funding
priorities for FY2022 on April 9, 2021.) The President requested $254.0 billion in discretionary funding for
accounts funded by the LHHS bill, which is an increase of 27.9% from FY2021 levels. In addition, the President
requested $1.102 trillion in annually appropriated mandatory funding, for a total of $1.355 trillion for LHHS as a
whole. The distribution of discretionary funding was as follows:
 DOL: $14.3 billion, 14.2% more than FY2021.
 HHS: $120.0 billion, 23.7% more than FY2021.
 ED: $102.8 billion, 39.8% more than FY2021.
 Related Agencies: $16.9 billion, 9.0% more than FY2021.
Emergency-Designated Appropriations
Over the course of FY2022, five laws were enacted providing FY2022 emergency-designated appropriations for
accounts typically funded in the LHHS bill.
 Division B of the Bipartisan Safer Communities Act (S. 2938; P.L. 117-159, June 25, 2022)
provided a total of $1.6 billion in FY2022 for several programs within HHS and ED related to
community mental and behavioral health services, pediatric health care, school attendance and
engagement, and school-based mental health service;
 Title IV of the Additional Ukraine Supplemental Appropriations Act, 2022 (H.R. 7691; P.L. 117-
128, May 21, 2022) provided a total of $1.0 billion to HHS agencies, mostly for resettlement
assistance for eligible Ukrainians in the United States;
 Division B of the Further Extending Government Funding Act (H.R. 6119; P.L. 117-70,
December 3, 2021) provided a total of $1.3 billion for public health and support services for
Afghan arrivals and refugees;
 Division J of the Infrastructure Investment and Jobs Act (H.R. 3684; P.L. 117-58, November 15,
2021) provided $100 million in FY2022 for the HHS Low Income Home Energy Assistance
Program, and rescinded $353 million in previously enacted emergency funding from the
Education Stabilization Fund; and
 Divisions A and C of the Extending Government Funding and Delivering Emergency Assistance
Act (H.R. 5305; P.L. 117-43, September 30, 2021) provided a total of $4.2 billion for HHS
spending related to shelter and support services for unaccompanied minors (Division A), and
public health and support services for Afghan arrivals and refugees (Division C).

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Contents
Introduction ..................................................................................................................................... 1
Report Roadmap and Useful Terminology ...................................................................................... 1
Scope of the Report ................................................................................................................... 2
Important Budget Concepts ....................................................................................................... 2
Mandatory vs. Discretionary Budget Authority .................................................................. 2
Total Budget Authority Provided in the Bill vs. Total Budget Authority Available
in the Fiscal Year .............................................................................................................. 3
Status of FY2022 LHHS Appropriations ........................................................................................ 4
FY2022 Emergency-Designated Appropriations ...................................................................... 4
FY2022 Annual LHHS Appropriations ..................................................................................... 5
FY2022 Consolidated Appropriations Act .......................................................................... 5
FY2022 Continuing Appropriations ................................................................................... 7
Prior Congressional Action on an LHHS Bill ..................................................................... 7
FY2022 President’s Budget Request......................................................................................... 9
FY2021 LHHS Omnibus (Division H, Consolidated Appropriations Act, 2021, H.R.
133; P.L. 116-260) .................................................................................................................. 9
Summary of FY2022 LHHS Appropriations .................................................................................. 11
Department of Labor (DOL) ......................................................................................................... 14
About DOL ............................................................................................................................. 15
FY2022 DOL Appropriations Overview ................................................................................. 15
Selected DOL Highlights ........................................................................................................ 16
Employment and Training Administration (ETA) ............................................................. 16
Employment Service ......................................................................................................... 17
Wage and Hour Division (WHD) ...................................................................................... 17
Bureau of Labor Statistics (BLS) ...................................................................................... 18
Bureau of International Labor Affairs (ILAB) .................................................................. 18
Labor-Related General Provisions .................................................................................... 18
Department of Health and Human Services (HHS) ....................................................................... 22
About HHS .............................................................................................................................. 22
FY2022 HHS Appropriations Overview ................................................................................. 23
Special Public Health Funding Mechanisms ........................................................................... 25
Public Health Service Evaluation Tap............................................................................... 25
Prevention and Public Health Fund .................................................................................. 27
Selected HHS Highlights by Agency ...................................................................................... 28
HRSA ................................................................................................................................ 28
CDC .................................................................................................................................. 28
NIH ................................................................................................................................... 30
SAMHSA .......................................................................................................................... 31
AHRQ ............................................................................................................................... 31
CMS .................................................................................................................................. 32
ACF ................................................................................................................................... 32
ACL .................................................................................................................................. 33
Restrictions Related to Certain Controversial Issues .............................................................. 34
Department of Education (ED) ...................................................................................................... 41
About ED ................................................................................................................................ 41
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FY2022 ED Appropriations Overview .................................................................................... 42
Selected ED Highlights ........................................................................................................... 43
Education for the Disadvantaged ...................................................................................... 43
Safe Schools and Citizenship Education ........................................................................... 44
Higher Education .............................................................................................................. 44
Related Agencies ........................................................................................................................... 47
FY2022 Related Agencies Appropriations Overview ............................................................. 47
Selected Related Agencies Highlights ..................................................................................... 48
SSA Limitation on Administrative Expenses (LAE) ........................................................ 49
Corporation for National and Community Service ........................................................... 49
National Labor Relations Board (NLRB) ......................................................................... 49

Figures
Figure 1. FY2022 Enacted LHHS Appropriations .......................................................................... 6
Figure 2. FY2022 Enacted LHHS Appropriations by Title ........................................................... 14
Figure 3. FY2022 Enacted HHS Appropriations by Agency ......................................................... 25

Tables
Table 1. Status of Full-Year LHHS Appropriations Legislation, FY2022 ....................................... 5
Table 2. LHHS Appropriations Overview by Bill Title, FY2021-FY2022 ................................... 12
Table 3. DOL Appropriations Overview ....................................................................................... 16
Table 4. Detailed DOL Appropriations .......................................................................................... 19
Table 5. HHS Appropriations Overview........................................................................................ 23
Table 6. HHS Appropriations Totals by Agency ........................................................................... 35
Table 7. HHS Discretionary Appropriations for Selected Programs or Activities,
by Agency .................................................................................................................................. 38
Table 8. ED Appropriations Overview .......................................................................................... 42
Table 9. Detailed ED Appropriations ............................................................................................ 45
Table 10. Related Agencies Appropriations Overview .................................................................. 48
Table 11. Detailed Related Agencies Appropriations .................................................................... 50

Table A-1. LHHS Discretionary FY2021 and FY2022 Enacted Levels, and FY2022
House 302(b) Suballocations ..................................................................................................... 56
Table A-2. LHHS Appropriations Overview, by Bill Title: FY2021-FY2022 ............................... 57
Table B-1. LHHS House Floor Amendments Offered to H.R. 4502 ............................................. 60

Appendixes
Appendix A. Budget Enforcement Activities ................................................................................ 52
Appendix B. House Floor Amendments Offered to Division A of H.R. 4502 .............................. 60

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Contacts
Author Information ........................................................................................................................ 65

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Introduction
This report provides an overview of FY2022
Scope of the Report:
appropriations actions for accounts traditionally funded
Emergency Funding and
in the appropriations bill for the Departments of Labor,
Mandatory Funding Related
Health and Human Services, and Education, and Related
to COVID-19
Agencies (LHHS). This bill provides discretionary and
This report primarily focuses on regular
mandatory appropriations to three federal departments:
FY2022 LHHS discretionary funding
the Department of Labor (DOL), the Department of
enacted during the annual appropriations
Health and Human Services (HHS), and the Department
process. The emergency discretionary
funding that was enacted for FY2021 or
of Education (ED). In addition, the bill provides annual
FY2022 is generally not included in the
appropriations for more than a dozen related agencies,
budgetary figures discussed or table totals
including the Social Security Administration (SSA).
presented in the main body of the report.
(Such spending is presented below the
Discretionary funds represent less than one-fifth of the
table totals and is in addition to regular
total funds appropriated in the annual LHHS bill.
appropriations.) In addition, during
Nevertheless, the LHHS bill is typically the largest single
FY2021, mandatory appropriations were
source of discretionary funds for domestic nondefense
enacted for certain LHHS-related
accounts for COVID-19 pandemic
federal programs among the various appropriations bills.
response, including in the American
(The Department of Defense bill is the largest source of
Rescue Plan Act of 2021 (P.L. 117-2).
discretionary funds among all federal programs.)
These mandatory funds are also not
Because the appropriations process both provides and
included in this report.
controls discretionary funding (concepts discussed
further in the “Mandatory vs. Discretionary Budget Authority” section), the bulk of this report is
focused on these funds.
The LHHS bill typically is one of the more controversial of the regular appropriations bills
because of the size of its funding and the scope of its programs, as well as various related social
policy issues addressed in the bill, such as restrictions on the use of federal funds for abortion and
for research on human embryos, stem cells, and gun violence.
Congressional clients may consult the LHHS experts list in CRS Report R42638, Appropriations:
CRS Experts, for information on which analysts to contact at the Congressional Research Service
(CRS) with questions on specific agencies and programs funded in the LHHS bill.
Report Roadmap and Useful Terminology
This report is divided into several sections. The opening section provides an explanation of the
scope of the LHHS bill (and hence, the scope of this report) and an introduction to important
terminology and concepts that carry throughout the report. Next is a series of sections describing
major congressional actions on FY2022 appropriations and (for context) a review of the
conclusion of the FY2021 appropriations process. This is followed by a high-level summary and
analysis of appropriations for FY2022, compared to FY2021 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 FY2022 proposed
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funding levels compared to FY2021. (Note that the distribution of funds is sometimes illustrated
by figures, which in all cases are based on the FY2022 enacted levels.1)
Appendix A provides a summary of budget enforcement activities for FY2022. This includes
information on mandatory spending sequestration pursuant to the Budget Control Act of 2011
(BCA; P.L. 112-25), discretionary spending budget enforcement pursuant to the FY2022 budget
resolution, the House LHHS subcommittee spending allocation, and current-year spending levels.
This is followed by Appendix B, which provides an overview of the LHHS floor amendments
that were offered in the House during its consideration of H.R. 4502.
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 FY2021 and proposed by the FY2022 President’s budget and in the FY2022 House committee bill.
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-
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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 FY2022 President’s budget submission
reflect current-law (or current services) estimates; they generally do not include the President’s
proposed changes to a mandatory spending program’s authorizing statute that might affect total
spending. (In general, such proposals are excluded from this report, as they typically would be
enacted in authorizing legislation.)
The report focuses most closely on discretionary funding because discretionary funding receives
the bulk of attention during the appropriations process. (While the LHHS bill includes more
mandatory funding than discretionary funding, the appropriators generally have less flexibility in
adjusting mandatory funding levels than discretionary funding levels.)
Mandatory and discretionary spending is subject to budget enforcement processes that include
sequestration. In general, sequestration involves largely across-the-board reductions that are made
to certain categories of discretionary or mandatory spending. However, the conditions that trigger
sequestration, and how it is carried out, differ for each type of spending. This is discussed further
in Appendix A.
Total Budget Authority Provided in the Bill vs. Total Budget Authority
Available in the Fiscal Year
Budget authority is the amount of money a federal agency is legally authorized to commit or
spend. Appropriations bills may include budget authority that becomes available in the current
fiscal year, in future fiscal years, or some combination. Amounts that become available in future
fiscal years are typically referred to as advance appropriations.
Unless otherwise specified, appropriations levels displayed in this report refer to the total amount
of budget authority provided in an appropriations bill (i.e., “total in the bill”), regardless of the
year in which the funding becomes available.4 In some cases, the report breaks out current-year

05-734SP. (Terms of interest may include appropriated entitlement, direct spending, discretionary, entitlement
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.
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appropriations (i.e., the amount of budget authority available for obligation in a given fiscal year,
regardless of the year in which it was first appropriated).5
As the annual appropriations process unfolds, the amount of current-year budget authority is
measured against 302(b) allocation ceilings (budget enforcement caps for appropriations
subcommittees that traditionally emerge following the budget resolution process, see Appendix
A). The process of measuring appropriations against these spending ceilings takes into account
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 FY2022 LHHS Appropriations
FY2022 Emergency-Designated Appropriations
Over the course of FY2022, five bills were signed into law providing FY2022 emergency-
designated appropriations for accounts typically funded in the LHHS bill.
 Division B of the Bipartisan Safer Communities Act (S. 2938, P.L. 117-159, June
25, 2022) provided a total of $1.6 billion in FY2022 for several purposes or
programs within HHS and ED related to community mental and behavioral
health services, pediatric health care, school attendance and engagement, and
school-based mental health services.7
 Title IV of the Additional Ukraine Supplemental Appropriations Act, 2022 (H.R.
7691, P.L. 117-128, May 21, 2022) provided $54 million to the CDC for medical
support, screening, and related public health activities related to the situation in
Ukraine, including for populations displaced from Ukraine, and $900 million to
ACF for resettlement assistance for Ukrainian refugees, Ukrainian parolees, and
other eligible Ukrainians in the United States.
 Division B of the Further Extending Government Funding Act (H.R. 6119; P.L.
117-70, December 3, 2021) contained the Additional Afghanistan Supplemental
Appropriations Act, 2022, which provided $8 million to the CDC for medical
support, screening, and related public health activities for Afghan arrivals and
refugees, and $1.3 billion to ACF for resettlement assistance for Afghan arrivals
and refugees.8

5 Such figures exclude advance appropriations for future years, but include advance appropriations from prior years that
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 See Table 3 in CBO, cost estimate, “The Bipartisan Safer Communities Act would provide funding to encourage
enactment of state laws aimed at controlling access to guns and to support a variety of other initiatives to enhance
school safety, mental health programs, and violence prevention,” June 22, 2022, https://www.cbo.gov/system/files?
file=2022-06/S2938.pdf.
8 See the summary of these provisions from the House Appropriations Committee majority staff, H.R. 6119, Further
Extending Government Funding Act Section-by-Section Summary, https://appropriations.house.gov/sites/
democrats.appropriations.house.gov/files/
Further%20Extending%20Government%20Funding%20Act%20Summary.pdf.
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 Division J of the Infrastructure Investment and Jobs Act (H.R. 3684; P.L. 117-58,
November 15, 2021) provided $100 million in FY2022 for the HHS Low Income
Home Energy Assistance Program,9 and rescinded $353 million in previously
enacted emergency funding from the Education Stabilization Fund.
 Divisions A and C of the Extending Government Funding and Delivering
Emergency Assistance Act (H.R. 5305; P.L. 117-43, September 30, 2021)
provided $4.2 billion in emergency-designated funding, as follows:10
 Division A, which contained the first CR for FY2022, provided $2.5 billion
(§141) to the HHS Administration for Children and Families (ACF) for
shelter and support services for unaccompanied minors referred to HHS,
including funding to expand the capacity of state-licensed shelters.
 Division C, which contained the Afghanistan Supplemental Appropriations
Act, 2022, provided $1.7 billion to ACF for resettlement assistance for
Afghan arrivals and refugees, and $21.5 million to the HHS Centers for
Disease Control and Prevention (CDC) for medical support, screening, and
related public health activities for Afghan arrivals and refugees.
FY2022 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, FY2022

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
7/12/21 -
H.R. 4502
-
H.R. 4502, -
-
H.R. 2471, H.R. 2471,
P.L. 117-
voice
H.Rept.
Division A
Division H Division H 103
vote
117-96
7/29/21
3/9/22
3/10/22
3/15/22
7/15/21
219-208
361-69
68-31

33-25
Source: CRS Appropriations Status Table.
FY2022 Consolidated Appropriations Act
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-

9 Division J of P.L. 117-58 further provided to the Low Income Home Energy Assistance Program advance
appropriations of $100 million for each of FY2023 through FY2026, for a total of $500 million for the program with all
fiscal years taken into account.
10 See the summary of these provisions from House Appropriations Committee majority staff, H.R. 5305, Extending
Government Funding and Delivering Emergency Assistance Act: Section-by-Section Summary,
https://appropriations.house.gov/sites/democrats.appropriations.house.gov/files/documents/Summary_0.pdf.
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Labor, Health and Human Services, and Education: FY2022 Appropriations

year appropriations for all 12 annual appropriations acts in Divisions A-L.11 (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.)12 The bill was approved by the Senate (68-31) on March 10.
See Figure 1 for a breakdown of FY2022 discretionary and mandatory LHHS appropriations
enacted in the FY2022 LHHS omnibus.13 Annual discretionary LHHS appropriations 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.
Figure 1. FY2022 Enacted LHHS Appropriations

Source: Amounts in this figure are generally drawn from or calculated based on data contained in the
explanatory statement accompanying the FY2022 LHHS omnibus (P.L. 117-103), available in the Congressional
Record, vol. 168, no. 42, book IV, March 9, 2022, pp. H2668-H2915. Enacted totals 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. 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

11 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.
12 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, 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, 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.
13 While the percentages in this figure were calculated based on amounts in the FY2022 LHHS omnibus, they are
generally also illustrative—within a few percentage points—of the share of mandatory and discretionary funds in
FY2021 and under the FY2022 President’s budget and the FY2022 House committee bill.
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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.
FY2022 Continuing Appropriations
Between the start of FY2022 and the enactment of full-year annual appropriations, FY2022
LHHS appropriations were provided by a series of CRs. The first CR was signed into law on
September 30, 2021 (Division A of H.R. 5305; P.L. 117-43). The measure had previously been
introduced by the House Appropriations Committee chair, Representative DeLauro, on September
21, and was passed by the House that same day, 220-211. On September 30, the Senate took up
and passed the measure with an amendment, 65-35,14 which was subsequently agreed to by the
House, 254-175.
The first CR provided continuing appropriations for all 12 annual appropriations acts (including
LHHS) through December 3, 2021. In general, the CR funded discretionary programs at the same
rate and under the same conditions as in FY2021 (§101) and annually appropriated entitlements at
their current law levels (§111).15 It also included several anomalies that are specific to LHHS
accounts or related activities (§§138-149).
A second CR was enacted extending the provisions of the first CR with some additional
anomalies (for LHHS, see Section 162) through February 18, 2022 (Division A of H.R. 6119; P.L.
117-70, December 3, 2021). The measure had previously been introduced by Representative
DeLauro on December 2, and passed the House (221-212) and the Senate (69-28) that same day.
A third CR was enacted extending the provisions on the second CR with some additional
anomalies (none of which were LHHS-related) through March 11, 2022 (Division A of H.R.
6617; P.L. 117-86, February 18, 2022). The measure had been previously introduced by
Representative DeLauro on February 7. It passed the House (272-182) on February 8 and the
Senate (65-27) on February 17.
A fourth CR was enacted extending the provisions of the third CR with some additional
anomalies (not LHHS-related) through March 15, 2022 (H.J.Res 75; P.L. 117-95, March 11,
2022). The measure had been previously introduced by Representative DeLauro on March 8. It
passed the House (voice vote) on March 8 and the Senate (voice vote) on March 10.
Prior Congressional Action on an LHHS Bill
FY2022 LHHS Action in the Senate
The FY2022 LHHS bill did not receive 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 October 18, 2021. According to the
chair, the purpose of this release was to further negotiations toward enacting all 12 annual
appropriations bills prior to when the CR was to expire on December 3.16 These draft numbers
are not presented in this report.

14 No substantive changes were made by the Senate amendment to the CR provisions in Division A of H.R. 5305.
15 For an estimate of the discretionary appropriations contained in Division A of H.R. 5305, see Table 1-H and 1-S in
Congressional Budget Office (CBO) Estimate for H.R. 5305, the Extending Government Funding and Delivering
Emergency Assistance Act as Passed by the House of Representatives on September 21, 2021, https://www.cbo.gov/
system/files/2021-09/57491-CBO-Estimate-for-HR5305.pdf.
16 The text of the Senate majority draft LHHS bill and accompanying committee report is linked to the press release,
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In addition, on October 25, Senator Murray, Chair of the Senate Appropriations LHHS
Subcommittee, introduced an FY2022 LHHS bill (S. 3062). This bill was referred to the Senate
Appropriations Committee.17 Because S. 3062 did not receive any congressional action, this
report does not discuss this measure.
FY2022 LHHS Action in the House (Division A, H.R. 2740)
The House LHHS subcommittee approved the draft LHHS bill on July 12, 2021, by a voice vote.
On July 15, 2021, the House Appropriations Committee voted (33-25) to report the LHHS bill;
the measure was subsequently reported to the House on July 19 (H.R. 4502; H.Rept. 117-96).
As reported by the full committee, the bill would provide $254.4 billion in discretionary LHHS
funds, a 28.1% increase from FY2021 enacted levels. This amount would be 0.2% more than the
FY2022 President’s request. In addition, the House committee bill would provide an estimated
$1.102 trillion in mandatory funding, for a combined total of $1.356 trillion for LHHS as a whole.
(Note that these totals are based only on amounts of non-emergency appropriations that would
have been provided by the House committee bill and do not include emergency-designated funds,
which are in addition to the regular annual appropriations.)
Later in July, LHHS appropriations were initially considered on the House floor as part of a
consolidated appropriations package and passed the House (219-208), as amended, on July 29,
2021 (Division A of H.R. 4502). This package would provide appropriations for six other
appropriations acts in addition to LHHS.18 Floor action was regulated by the terms of a special
rule (H.Res. 555). A total of 56 amendments to the LHHS title of the bill were made in order for
consideration on the floor.19 This rule also provided the authority for the chair of the
Appropriations Committee or her designee to offer any of the amendments made in order en bloc
(i.e., in groups of amendments to be disposed of together).20 All but two LHHS amendments were
considered in this manner.21 When counted as 56 separate amendments, 47 were adopted and 9
were rejected.
Because there is no publicly available source that estimates the account- or subaccount-level
budgetary effects of the amendments adopted to Division A, this report provides analysis of the
House Committee-reported version of the LHHS bill. For information on the LHHS amendments
offered during floor consideration, see Appendix B.

“Chairman Leahy Releases Remaining Nine Senate Appropriations Bills,” October 18, 2021,
https://www.appropriations.senate.gov/news/majority/chairman-leahy-releases-remaining-nine-senate-appropriations-
bills. See also “Shelby: Democrats’ Partisan Bills Threaten FY22 Appropriations Process,” October 18, 2021,
https://www.appropriations.senate.gov/news/shelby-democrats-partisan-bills-threaten-fy22-appropriations-process.
17 The text of S. 3062 as introduced was generally the same as the draft LHHS bill released by the chair of the Senate
Appropriations Committee on October 18, discussed above.
18 Those appropriations acts were Agriculture and Rural Development, Energy and Water Development, Financial
Services and General Government, Interior and Environment, Military Construction and Veterans Affairs, and
Transportation and Housing and Urban Development.
19 For a list of these LHHS amendments (numbered 1-56) and the text of each that was made in order, see pages 8-13
and 30-38 of H.Rept. 117-109.
20 For further information about en bloc authority in the context of House floor consideration of appropriations
measures, see CRS Report R46841, Changes in the House of Representatives’ Initial Consideration of Regular
Appropriations Measures, 113th-116th Congresses.
21 For the en bloc amendments proposing changes to the LHHS division of the bill, see consideration of amendments en
bloc nos. 1, 2, 3, and 4 in Congressional Record, daily edition, Vol. 167, No. 131 (July 27, 2021), pp. H4055-H4073.
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FY2022 President’s Budget Request
The President’s budget request for the upcoming fiscal year is due to be submitted to Congress by
the first Monday in February. However, the FY2022 budget was submitted during a year in which
a presidential transition occurred (on January 20, 2021). Recent Presidents have not submitted
detailed budget proposals until April or May of their first year in office, although each has
advised Congress regarding the general contours of their economic and budgetary policies in
special messages submitted to Congress prior to that submission.22 This delay allows time to
prepare a proposal that reflects the priorities of the new Administration.
On April 9, President Biden submitted to Congress an outline of his discretionary funding
priorities for FY2022.23 This preliminary document provided early highlights for numerous policy
areas, including several funded in the LHHS bill. The full budget request was submitted on May
28, almost four months after its due date.24
The President requested $254.0 billion in discretionary funding for accounts funded by the LHHS
bill, which is an increase of 27.9% from FY2021 levels. In addition, the President requested
$1.102 trillion in annually appropriated mandatory funding, for a total of $1.355 trillion for
LHHS as a whole.
FY2021 LHHS Omnibus (Division H, Consolidated Appropriations
Act, 2021, H.R. 133; P.L. 116-260)
On December 27, 2020, the Consolidated Appropriations Act, 2021 was signed into law by the
President (H.R. 133, P.L. 116-260). P.L. 116-260 provided full-year appropriations for all 12
annual appropriations acts in Divisions A-L, and supplemental appropriations for COVID-19
pandemic relief in Division M.25 (Full-year LHHS appropriations were enacted in Division H,
referred to as “the FY2021 LHHS omnibus.”) Prior to its enactment, the final version of the
measure was approved by the House on December 21. (The vote to approve the portion that
contained LHHS appropriations was 359-53.26) It was approved by the Senate (92-6) later that
same day.
LHHS discretionary appropriations in the FY2021 LHHS omnibus totaled $198.5 billion. This
amount was 1.6% more than FY2020 enacted and 11.0% more than the FY2021 President’s
budget request. The omnibus also provided $980.0 billion in mandatory funding, for a combined
LHHS total of $1.178 trillion. (Note that these totals are based only on amounts of non-

22 See CRS Insight IN11655, Budget Submission After a Presidential Transition: Contextualizing the Biden
Administration’s FY2022 Request.
23 Office of Management and Budget (OMB), The President’s FY2022 Discretionary Request, April 9, 2021,
https://www.whitehouse.gov/omb/fy-2022-discretionary-request/.
24 See https://www.whitehouse.gov/omb/budget/.
25 P.L. 116-260 also contained additional COVID-19 pandemic response provisions in Division N, but this division is
considered authorizing legislation, rather than appropriations legislation, and is thus beyond the scope of this report.
For further discussion, see the Congressional Budget Office cost estimate for Division N, released on January 14, 2021,
at https://www.cbo.gov/system/files/2021-01/PL_116-260_div_N.pdf. In addition, Divisions O-FF of P.L. 116-260
contained miscellaneous authorizing provisions that are also beyond the scope of this report.
26 The special rule, H.Res. 1271, provided for the consideration of an amendment consisting of the final text for
enactment (as contained in House Rules Committee Print 116-68) to the Senate amendment to H.R. 133. H.Res. 1271
also provided for the House to adopt the amendment in two votes: the first on Divisions B, C, E, and F, and the second
on the remaining divisions. The House adopted Divisions B, C, E, and F by a vote of 327-85, and adopted the
remaining divisions by a vote of 359-53. The subsequent motion that the House agree to the Senate amendment with an
amendment was agreed to without objection.
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emergency appropriations provided by the FY2021 LHHS omnibus and do not include
emergency-designated or supplemental funds, which were provided in addition to the annual
appropriations. Division H also enacted $1.6 billion in emergency-designated budget authority, of
which $925 million was for DOL in Title I, and $638 million was for HHS in Title II, which is not
reflected in the above figures, consistent with the conventions for displaying emergency-
designated budget authority in this report.)
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Summary of FY2022 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. For FY2022 enacted, amounts for HHS include $1.6 billion in regular discretionary
appropriations enacted as part of the second continuing resolution for FY2022, P.L. 117-70, for the
Unaccompanied Alien Children program.
Throughout this report, the FY2022 House Appropriations Committee-reported LHHS bil is commonly referred
to as the House “committee bil .” (This report does not contain estimates of the House-passed version of Division
A of H.R. 4502, as there is no publicly available source that estimates the account- and subaccount-level budgetary
effects of the adopted amendments. However, information on the LHHS amendments offered during floor
consideration can be found in Appendix B.)
Amounts for the FY2021 Enacted, FY2022 Request, and FY2022 Enacted columns are generally drawn from or
calculated based on data contained in the explanatory statement accompanying the FY2022 LHHS omnibus (P.L.
117-103), available in the Congressional Record, vol. 168, no. 42, book IV, March 9, 2022, pp. H2668-H2915.
Amounts in the FY2021 House Committee column are generally drawn from or calculated based on data
contained in the committee report (H.Rept. 117-96) accompanying H.R. 4502. The amounts shown for
emergency-designated appropriations provided in Title II of P.L. 117-31, Divisions A and C of P.L. 117-43, Division
J of P.L. 117-58, Division B of P.L. 117-70, Title IV of P.L. 117-128, and Division B of P.L. 117-159, are based on
CRS analysis of the texts of those laws.
In general, the enacted totals (“Total BA in the Bil ”) in this report do not include emergency-designated
appropriations. An exception to this rule is made in Table A-1, which includes FY2021 and FY2022 enacted
emergency-designated funds in the “Adjusted Appropriations” totals, as scored by the Congressional Budget
Office. In addition, as applicable, other tables in this report include, at the bottom, a separate line or lines for
emergency-designated appropriations; these lines are shown for informational purposes and the amounts displayed
are not included in the table totals.
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.27 CRS calculations do, however, include LHHS funding provided to HHS
pursuant to the 21st Century Cures Act (P.L. 114-255), as amended.
The descriptions of the LHHS appropriations in this report frequently reference “report language,” which
Congress may use to further specify funding or to communicate a range of directives to the agency. Each regular
appropriations bil reported from committee is usually accompanied by a written committee report, and the final
explanatory text may be used to reconcile any differences between those reports. For example, earlier report
language may address certain issues in ways that are difficult to reconcile harmoniously with the final enacted text.
In these instances, the explanatory text normally seeks to clarify how the affected agency is to proceed. On the
other hand, if the original committee language is ultimately acceptable to congressional negotiators, the
explanatory statement might be silent due to an expectation that the agency wil fol ow the original directive. For
further information, see CRS Report R44124, Appropriations Report Language: Overview of Components and
Development.
Table 2 displays FY2022 discretionary and mandatory LHHS budget authority proposed and
enacted, by bill title, along with FY2021 enacted levels. The amounts shown in this table reflect

27 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
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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, FY2021-FY2022
(total budget authority provided in the bill, in billions of dollars)
FY2022
House
FY2021
FY2022
Cmte.
FY2022
Bill Title
Enacted
Request
(H.R. 4502)
Enacted
Title I: Labor
13.9
15.5
16.0
14.4
Discretionary
12.5
14.3
14.7
13.2
Mandatory
1.4
1.2
1.2
1.2
Title II: HHS
1,016.6
1,159.6
1,159.4
1,148.2
Discretionary
97.0
120.0
119.8
108.6
Mandatory
919.6
1,039.6
1,039.6
1,039.6
Title III: Education
77.2
106.5
106.5
80.1
Discretionary
73.5
102.8
102.8
76.4
Mandatory
3.7
3.7
3.7
3.7
Title IV: Related Agencies
70.8
73.8
74.0
73.0
Discretionary
15.5
16.9
17.0
16.0
Mandatory
55.3
57.0
57.0
57.0
Total BA in the Bill
1,178.5
1,355.5
1,355.9
1,315.7
Discretionary
198.5
254.0
254.4
214.2
Mandatory
980.0
1,101.5
1,101.5
1,101.5
Emergency Funding (not in above totals)

P.L. 116-260, Division H
1.6
—
—
—
P.L. 116-260, Division M
154.9
—
—
—
P.L. 117-31, Title II
0.0a
—
—
—
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. 117-159, Division B
—
—
—
3.0

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-FY2021 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 FY2022, the source materials used for this report continue this most recent approach.
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FY2022
House
FY2021
FY2022
Cmte.
FY2022
Bill Title
Enacted
Request
(H.R. 4502)
Enacted
Memoranda (non-emergency funds only):

Advances for Future Years
197.6
210.7
210.8
210.7
(provided in current bil )b
Advances from Prior Years
189.0
197.6
197.6
197.6
(for use in current year)b
Additional Scorekeeping Adjustmentsc
-22.8
-25.4
-14.7
-15.0
Source: Amounts in this table for the FY2021 Enacted, FY2022 Request, and FY2022 Enacted columns are
generally drawn from or calculated based on data contained in the explanatory statement accompanying the
FY2022 LHHS omnibus (P.L. 117-103), available in the Congressional Record, vol. 168, no. 42, book IV, March 9,
2022, pp. H2668-H2915. Amounts in the FY2021 House Committee column are generally drawn from or
calculated based on data contained in the committee report (H.Rept. 117-96) accompanying H.R. 4502. Enacted
totals (“Total BA in the Bil ”) for FY2021 or 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. No
amounts are shown for Title V, because this title consists solely of general provisions.
a. P.L. 117-31 provided $25 mil ion in supplemental appropriations for the Refugee and Entrant Assistance
account at HHS for specified purposes related to Afghan special immigrants, which rounds to $0.0 in bil ions
(the unit of measure used in this table).
b. Totals in this table are based on budget authority provided in the bil (i.e., they exclude advance
appropriations from prior bil s and include advance appropriations from this bil made available in future
years). The calculation for total budget authority available in a given fiscal year is as fol ows: Total BA in the
Bil , minus Advances for Future Years, plus Advances from Prior Years. FY2022 advance appropriations
enacted in prior fiscal years are listed in the FY2022 Request and FY2022 House Cmte. columns.
c. Totals in this table have generally not been adjusted for scorekeeping. (To adjust for scorekeeping, add this
line to the total budget authority.)
Figure 2 displays discretionary and mandatory LHHS funding levels enacted for FY2022, by bill
title. (While the dollars and percentages discussed in this section were calculated based on the
FY2022 enacted amounts, they are generally also illustrative—within several percentage points—
of the share of funds directed to each bill title in FY2021, and under the FY2022 President’s
budget and House committee bill.)
As this figure demonstrates, HHS accounts for the largest share of total FY2022 LHHS
appropriations: $1.148 trillion, or 87.3%. 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 6.1% and 5.5%, respectively. (The majority
of the ED appropriations each year are discretionary, while the bulk of funding for the Related
Agencies goes toward mandatory payments and administrative costs of the Supplemental Security
Income program at the Social Security Administration.) DOL accounts for the smallest share of
total LHHS funds, 1.1%.
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The overall composition of LHHS funding is noticeably different when comparing only
discretionary appropriations. HHS accounts for a comparatively smaller share of total
discretionary appropriations (50.7%), while ED accounts for a relatively larger share (35.7%).
Together, these two departments represent the majority (86.4%) of discretionary LHHS
appropriations. DOL and the Related Agencies account for the remaining discretionary funds, at
6.2% and 7.5% of the total, respectively.
Figure 2. FY2022 Enacted 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
explanatory statement accompanying the FY2022 LHHS omnibus (P.L. 117-103), available in the Congressional
Record, vol. 168, no. 42, book IV, March 9, 2022, pp. H2668-H2915. Enacted totals 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. 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)
Note that 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.
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About DOL
DOL is a federal department comprised of 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).29 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)28
Safety and Health Administration (OSHA),
the Mine Safety and Health Administration (MSHA), and the Wage and Hour Division (WHD)
provide different types of regulation and oversight of working conditions. DOL entities focused
on worker protection provide services to ensure worker safety, adherence to wage and overtime
laws, and contract compliance, among other duties. In addition to these two main functional
areas, DOL’s Bureau of Labor Statistics (BLS) collects data and provides analysis on the labor
market and related labor issues.
FY2022 DOL Appropriations Overview
Table 3 displays FY2022 enacted and proposed funding levels for DOL, along with FY2021
levels. The totals in this table do not include emergency supplemental 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. (Although not technically supplemental
appropriations, the bottom of the table also includes emergency-designated discretionary funding
proposed or enacted in annual LHHS measures.)
Discretionary funds represent the majority of DOL appropriations, accounting for 90% or more of
FY2021 and FY2022 enacted levels. The FY2022 LHHS omnibus increased discretionary
appropriations for DOL by $653 million (+5.2%) compared to the FY2021 LHHS omnibus.
Relative to the FY2021 LHHS omnibus, discretionary DOL appropriations would have increased

28 Departmental Management includes the DOL salaries and expenses, Veterans Employment and Training Service
(VETS), IT Modernization, and the Office of the Inspector General.
29 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).
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by $2.2 billion (+17.4%) under the FY2022 House committee bill and $1.8 billion (14.3%) under
the FY2022 President’s budget request.
Table 3. DOL Appropriations Overview
(in billions of dollars)
FY2022
House
Cmte.
FY2021
FY2022
(H.R.
FY2022
Funding
Enacted
Request
4502)
Enacted
Discretionary
12.5
14.3
14.7
13.2
Mandatory
1.4
1.2
1.2
1.2
Total BA in the Bill
13.9
15.5
16.0
14.4
Emergency Funding (not in above totals)

P.L. 116-260, Division H
0.9
—
—
—
Source: Amounts in this table for the FY2021 Enacted, FY2022 Request, and FY2022 Enacted columns are
generally drawn from or calculated based on data contained in the explanatory statement accompanying the
FY2022 LHHS omnibus (P.L. 117-103), available in the Congressional Record, vol. 168, no. 42, book IV, March 9,
2022, pp. H2668-H2915. Amounts in the FY2021 House Committee column are generally drawn from or
calculated based on data contained in the committee report (H.Rept. 117-96) accompanying H.R. 4502. Enacted
totals (“Total BA in the Bil ”) for FY2021 or 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.
Selected DOL Highlights
The following sections present highlights from FY2022 enacted and proposed appropriations
compared to FY2021 enacted appropriations for selected DOL accounts and programs.30 Table 4
displays funding for DOL programs and activities discussed in this section.
Employment and Training Administration (ETA)
ETA administers the primary federal workforce development statute, the Workforce Innovation
and Opportunity Act (WIOA, P.L. 113-128). The WIOA, which replaced the Workforce
Investment Act, was enacted in July 2014 and authorized appropriations for its programs and
activities from FY2015 through FY2020. Authorization of appropriations for WIOA programs
and activities expired at the end of FY2020 but was extended through FY2021 by the FY2021
LHHS omnibus (P.L. 116-260, Division H, Title I) and through FY2022 by the FY2022 LHHS
omnibus (P.L. 117-103, Division H, Title I).
Title I of WIOA, which authorizes more than half of all funding for the programs authorized by
the four titles of WIOA, includes three state formula grant programs serving Adults, Youth, and

30 DOL budget materials can be found at https://www.dol.gov/general/aboutdol#budget.
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Dislocated Workers. While the FY2022 LHHS omnibus provided a $34 million increase (+1.2%)
for the three WIOA state formula grant programs compared to FY2021, the FY2022 President’s
budget would have provided $174 million more (+6.1%) and the House committee bill would
have increased funding by $250 million (+8.8%), compared to FY2021 enacted levels.
The FY2022 LHHS omnibus provided $301 million for the Dislocated Workers Activities
National Reserve (DWA National Reserve), an increase of $20 million (+7.1%) compared to the
FY2021 enacted level. The House committee bill would have increased funding for the DWA
National Reserve by $155 million (+55.2%), whereas the FY2022 President’s budget would have
increased funding for the DWA National Reserve by $100 million (+35.6%), compared to the
FY2021 LHHS omnibus. In addition, the FY2022 LHHS omnibus maintained a provision in that
account (which originated in the FY2018 omnibus) directing $45 million from the DWA National
Reserve toward training and employment assistance for workers dislocated in both the
Appalachian, lower Mississippi, and Northern Border Regional Commission regions. Finally, the
FY2022 LHHS omnibus maintained a provision that originated in the FY2020 omnibus directing
$50 million from the DWA National Reserve to be used in developing, offering, or improving
career training programs at community colleges.
The FY2022 LHHS omnibus provided $235 million for the Apprenticeship Grant program, which
was $50 million (+27.0%) more than the level enacted in FY2021. The House committee bill and
the FY2022 President’s budget would have increased the level of funding for the Apprenticeship
Grant program by $100 million (+54.1%) compared to the FY2021 enacted level.
Finally, under the pilot and demonstration authority in WIOA (Section 169), the FY2022 House
committee bill and the FY2022 President’s budget would have provided new funding for a
National Youth Employment Program ($50 million) and a Veterans Clean Energy Training
program ($20 million). These did not ultimately receive funding in the FY2022 LHHS omnibus.
Employment Service
The FY2022 LHHS omnibus provided $700 million for the Employment Service (ES), which was
an increase of $8 million (+1.1%) compared to the FY2021 LHHS omnibus. The FY2022 House
committee bill would have provided $771 million for the ES, which would have been an increase
of $79 million (+11.4%) compared to the FY2021 LHHS omnibus and $50 million (+6.9%) more
than requested in the FY2022 President’s budget. The ES is a joint federal-state partnership that
funds staff to provide career counseling, job search services, and administration of the work test
for the UI system. The FY2022 House committee bill included a provision to prohibit DOL from
using any funds provided in the FY2022 LHHS appropriations bill to implement or enforce a
2020 final rule allowing the use of non-merit-staff employees to deliver Employment Service
services.31 This provision was not included in the FY2022 LHHS omnibus.
Wage and Hour Division (WHD)
The FY2022 LHHS omnibus provided $251 million for the WHD, an increase of $5 million
(+2.0%) compared to the FY2021 LHHS omnibus. The FY2022 House committee bill would
have provided $300 million for WHD, an increase of $54 million (+22.0%) compared to the
FY2021 enacted level and $24 million (+8.5%) more than the FY2022 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), and other labor standards statutes. The
FY2022 explanatory statement accompanying the FY2022 LHHS omnibus included a

31 See Section 114 and H.Rept. 117-96, p. 24, for further information.
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requirement for the WHD to collect and report annually data on employer participation in the
14(c) program, which allows employers to pay workers with disabilities less than the prevailing
federal minimum wage.32
Bureau of Labor Statistics (BLS)
The FY2022 LHHS omnibus provided $688 million for BLS, an increase of $33 million (+5.0%)
compared to the FY2021 LHHS omnibus, whereas the FY2022 House committee bill and the
FY2022 President’s budget each proposed a $46 million increase (+7.0%) relative to FY2021. As
noted in the explanatory statement accompanying the FY2022 LHHS omnibus, $28.5 million of
the FY2022 appropriation is for costs associated with completing the physical relocation of BLS
headquarters to the Suitland Federal Complex, which was initiated in FY2020.33 Similarly, the
FY2022 House committee report indicated continued support for BLS to continue
implementation of several data projects started in FY2020, including a BLS plan to increase
spending on the new National Longitudinal Survey of Youth (NLSY) cohort to $14.5 million and
for BLS to develop plans to increase the Job Openings and Labor Turnover Survey (JOLTS)
sample and to release JOLTS on a monthly basis, rather than its current quarterly release.34
Bureau of International Labor Affairs (ILAB)
The ILAB provides research, advocacy, technical assistance, and grants to promote workers’
rights in different parts of the world. The FY2022 LHHS omnibus provided $106 million for
ILAB, which was an increase of $10 million (+10.4%) above the FY2021 enacted level. The
FY2022 House committee bill would have increased funding for ILAB by $40 million (+41.5%)
compared to the FY2021 LHHS omnibus, while the FY2022 President’s budget would have
increased funding by $28 million (+28.7%) for ILAB.
Language in the FY2022 explanatory statement accompanying the FY2022 LHHS omnibus
requests ILAB to include the amounts spent on technical assistance grants to combat exploitative
child labor and worker rights issues in future Congressional Budget Justifications.35
In addition, language in the FY2022 House committee report directs ILAB to place additional
labor attachés in strategic countries to assist with promoting worker rights, such as freedom of
association and collective bargaining.36
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 FY2022 LHHS omnibus.
The FY2022 LHHS omnibus continued several provisions that have been included in at least one
previous LHHS appropriations act, including provisions that

32 Congressional Record, March 9, 2022, Vol. 168, No. 42, Book IV, p. H2668.
33 Congressional Record, March 9, 2022, Vol. 168, No. 42, Book IV, p. H2668.
34 See H.Rept. 117-96, p. 36, for further information.
35 Congressional Record, March 9, 2022, Vol. 168, No. 42, Book IV, p. H2668.
36 H.Rept. 117-96, p. 38.
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 exempted certain insurance claims adjusters from overtime protection for two
years following a “major disaster” (included since FY2016);37
 directed the Secretary of Labor to accept private wage surveys as part of the
process of determining prevailing wages in the H-2B program, even in instances
in which relevant wage data are available from the Bureau of Labor Statistics
(included since FY2016);38
 authorized the Secretary of Labor to provide up to $2 million in “excess personal
property” to apprenticeship programs to assist training apprentices (included
since FY2018);39
 authorized the Secretary of Labor to employ law enforcement officers or special
agents to provide protection to the Secretary of Labor and certain other
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);40
 authorized 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 is located (included since FY2018);41 and
 prohibited annual appropriations from being used to alter the Interagency
Agreement between DOL and USDA or to close any Civilian Conservation
Centers unless certain conditions are met (included since FY2020).42
Table 4. Detailed DOL Appropriations
(in millions of dollars)
FY2022
House
FY2021
FY2022
Cmte.
FY2022
Agency or Selected Program
Enacted
Request
(H.R. 4502)
Enacted
ETA—Mandatorya
634
540
551
540
ETA—Discretionary
9,392
10,708
11,075
9,942
Discretionary ETA Programs:

Training and Employment Services:
3,663
4,211
4,407
3,912
State Formula Grants:
2,845
3,019
3,095
2,879
Adult Activities Grants to States
863
900
923
871
Youth Activities Grants to States
921
964
989
933
Dislocated Worker Activities
1,062
1,155
1,184
1,076
(DWA) Grants to States

37 See Division H, Title I, §108 of P.L. 117-103.
38 See Division H, Title I, §110 of P.L. 117-103. The H-2B program allows for the temporary employment of foreign
workers in nonagricultural sectors and requires these workers to be paid the “prevailing wage” (i.e., the average wage
paid to similar workers in the local area). Under DOL regulations, private employer surveys may be considered only if
the employer meets certain conditions.
39 See Division H, Title I, §112 of P.L. 117-103.
40 See Division H, Title I, §113 of P.L. 117-103.
41 See Division H, Title I, §114 of P.L. 117-103.
42 See Division H, Title I, §115 of P.L. 117-103.
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FY2022
House
FY2021
FY2022
Cmte.
FY2022
Agency or Selected Program
Enacted
Request
(H.R. 4502)
Enacted
National Activities:
818
1,192
1,312
1,033
DWA National Reserve
281
381
436
301
Native Americans
56
58
58
57
Migrant and Seasonal Farmworkers
94
97
97
95
YouthBuild
97
145
145
99
Reintegration of Ex-Offenders
100
150
150
102
Workforce Data Quality Initiative
6
6
7
6
Apprenticeship Grants
185
285
285
235
Community Projects
0
0
64
138
National Youth Employment
Program
0
50
50
0
Veterans Clean Energy Training
0
20
20
0
Job Corps
1,749
1,755
1,830
1,749
Community Service Employment for Older
405
405
450
405
Americans
State Unemployment Insurance and
3,417
4,126
4,176
3,711
Employment Service Operations (SUI/ESO):
Unemployment Compensation
2,584
3,243
3,243
2,869
Employment Service
692
721
771
700
Foreign Labor Certification
78
94
94
80
One-Stop Career Centers
63
68
68
63
ETA Program Administration
159
212
212
164
Employee Benefits Security
181
218
218
186
Administration
Pension Benefit Guaranty Corp, (PBGC) program
(465)
(473)
(473)
(473)
level (non-add)b
Wage and Hour Division
246
277
300
251
Office of Labor-Management Standards
44
52
44
46
Office of Federal Contract Compliance
106
141
141
108
Programs
Office of Workers’ Compensation
739
683
683
683
Programs—Mandatoryc
Office of Workers’ Compensation
118
141
141
120
Programs—Discretionary
Occupational Safety & Health
592
665
692
612
Administration
Mine Safety & Health Administration
380
447
405
384
Bureau of Labor Statistics
655
701
701
688
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FY2022
House
FY2021
FY2022
Cmte.
FY2022
Agency or Selected Program
Enacted
Request
(H.R. 4502)
Enacted
Office of Disability Employment Policy
39
43
43
41
Departmental Management
784
933
961
812
Salaries and Expenses
349
440
457
368
International Labor Affairs (non-addd)
96
124
136
106
Veterans Employment and Training
316
325
335
325
IT Modernization
27
37
37
28
Working Capital Fund
0
36
36
0
Office of the Inspector General
91
95
95
91
Total, DOL BA in the Bill
13,909
15,548
15,954
14,412
Subtotal, Mandatory
1,373
1,223
1,234
1,223
Subtotal, Discretionary
12,536
14,325
14,720
13,189
Emergency Funding (not in above totals)

P.L. 116-260, Division H
925
—
—
—
Memoranda (non-emergency funds only)

Total, BA Available in Fiscal Year (current year
13,909
15,551
15,957
14,415
from any bil )
Total, BA Advances for Future Years (provided
1,786
1,783
1,783
1,783
in current bil )
Total, BA Advances from Prior Years (for use
1,786
1,786
1,786
1,786
in current year)
Source: Amounts in this table for the FY2021 Enacted, FY2022 Request, and FY2022 Enacted columns are
generally drawn from or calculated based on data contained in the explanatory statement accompanying the
FY2022 LHHS omnibus (P.L. 117-103), available in the Congressional Record, vol. 168, no. 42, book IV, March 9,
2022, pp. H2668-H2915. Amounts in the FY2022 House Committee column are generally drawn from or
calculated based on data contained in the committee report (H.Rept. 117-96) accompanying H.R. 4502. Enacted
totals (“Total BA in the Bil ”) for FY2021 or 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.
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Department of Health and Human Services (HHS)
Note that 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.
About HHS
HHS Agencies Funded via the
HHS is a large federal department composed
LHHS Appropriations Process
of multiple agencies working to enhance the
Health Resources and Services Administration (HRSA)
health and well-being of Americans. Annual
Centers for Disease Control and Prevention (CDC)
LHHS appropriations laws direct funding to
National Institutes of Health (NIH)
most (but not all) HHS agencies (see text box
Substance Abuse and Mental Health Services
for HHS agencies supported by the LHHS
Administration (SAMHSA)
bill).43 For instance, the LHHS bill directs
Agency for Healthcare Research and Quality (AHRQ)
funding to five Public Health Service (PHS)
Centers for Medicare & Medicaid Services (CMS)
agencies: the Health Resources and Services
Administration for Children and Families (ACF)
Administration (HRSA), Centers for Disease
Administration for Community Living (ACL)
Control and Prevention (CDC), National
Institutes of Health (NIH), Substance Abuse
Office of the Secretary (OS)
and Mental Health Services Administration
(SAMHSA), and Agency for Healthcare Research and Quality (AHRQ).44 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).
In addition, the LHHS bill provides funding for annually appropriated components of CMS,45
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

43 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.
44 For more information on HHS PHS agencies, see CRS Report R44916, Public Health Service Agencies: Overview
and Funding (FY2016-FY2018).
45 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.
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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.
FY2022 HHS Appropriations Overview
Table 5 displays enacted and proposed FY2022 funding levels for HHS, along with FY2021
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.46
In general, discretionary funds account for about 10% of HHS appropriations in the LHHS bill.
Compared to the FY2021 funding levels, the FY2022 LHHS omnibus increased HHS
discretionary appropriations by 12.0%. Both the House committee bill and the President’s request
would have increased HHS discretionary appropriations to a greater degree, by 23.6% and 23.7%,
respectively.
Table 5. HHS Appropriations Overview
(in billions of dollars)
FY2022
House
Cmte.
FY2021
FY2022
(H.R.
FY2022
Funding
Enacted Request
4502)
Enacted
Discretionary
97.0
120.0
119.8
108.6
Mandatory
919.6
1,039.6
1,039.6
1,039.6
Total BA in the Bill
1,016.6
1,159.6
1,159.4
1,148.2
Emergency Funding (not in above totals)

P.L. 116-260, Division H
0.6
—
—
—
P.L. 116-260, Division M
72.9
—
—
—
P.L. 117-31, Title IIa
0.0
—
—
—
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
Sources: Amounts in this table for the FY2021 Enacted, FY2022 Request, and FY2022 Enacted columns are
generally drawn from or calculated based on data contained in the explanatory statement accompanying the
FY2022 LHHS omnibus (P.L. 117-103), available in the Congressional Record, vol. 168, no. 42, book IV, March 9,
2022, pp. H2668-H2915. Amounts in the FY2022 House Committee column are generally drawn from or
calculated based on data contained in the committee report (H.Rept. 117-96) accompanying H.R. 4502. Enacted
totals (“Total BA in the Bil ”) for FY2021 and FY2022 do not include emergency-designated appropriations. For

46 For a discussion of the COVID-19-related FY2021 supplemental appropriations in Division M of P.L. 116-260, see
CRS Report R46775, Overview of COVID-19 LHHS Supplemental Appropriations: FY2020 and FY2021.
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consistency with source materials, amounts in this figure generally do not reflect mandatory spending
sequestration, where applicable, nor do they reflect any transfers or reprogramming of funds pursuant to
executive authorities. CRS calculations do, however, include LHHS funding provided to HHS pursuant to the 21st
Century Cures Act (P.L. 114-255), as amended.
Notes: 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. P.L. 117-31 provided $25 mil ion in supplemental appropriations for the Refugee and Entrant Assistance
account at HHS for specified purposes related to Afghan special immigrants, which rounds to $0.0 in bil ions
(the unit of measure used in this table).
Figure 3 provides an HHS agency-level breakdown of FY2022 enacted appropriations. As this
figure demonstrates, annual HHS appropriations are dominated by mandatory funding, the
majority of which goes to CMS to provide Medicaid benefits and payments to health care trust
funds. When taking into account both mandatory and discretionary funding, CMS accounts for
$1,027.1 billion, which is 89.5% of all enacted appropriations for HHS. ACF and NIH account for
the next-largest shares of total HHS appropriations, receiving 4.0% and 3.8% apiece, respectively.
By contrast, when looking exclusively at discretionary appropriations, funding for CMS
constitutes about 4.5% of FY2022 enacted HHS appropriations. Instead, the bulk of discretionary
appropriations went to the PHS agencies, which combined to account for 61.2% of discretionary
appropriations provided for HHS. NIH typically receives the largest share of all discretionary
funding among HHS agencies (40.2% in FY2022), with ACF accounting for the second-largest
share (27.5% in FY2022).
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Figure 3. FY2022 Enacted HHS Appropriations by Agency
(budget authority in billions of dollars)

Source: Amounts in this figure are generally drawn from or calculated based on data contained in the
explanatory statement accompanying the FY2022 LHHS omnibus (P.L. 117-103), available in the Congressional
Record, vol. 168, no. 42, book IV, March 9, 2022, pp. H2668-H2915. 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. CRS calculations do, however, include
LHHS funding provided to HHS pursuant to the 21st Century Cures Act (P.L. 114-255), as amended.
Notes: Details may not add to totals due to rounding. The bar representing the combined mandatory and
discretionary total for CMS has been abbreviated due to space constraints. When taking into account both
mandatory and discretionary funding, CMS receives over 20 times the funding appropriated to either ACF or
NIH in the FY2022 LHHS omnibus. Amounts in this table (1) reflect all BA appropriated in the bil , regardless of
the year in which funds become available (i.e., totals do not include advances from prior-year appropriations, but
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 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),
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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 1.0% 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. Since FY2010, and including in FY2022, this higher maximum set-aside
level has been 2.5% of eligible appropriations.47 (Both the House committee bill and the
President’s budget would have continued 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
evaluation tap from donor agencies’ appropriations).
That is to say, tap amounts shown in the fol owing
activity. However, since FY2015 and
tables are in addition to amounts shown for budget
including in FY2022, LHHS appropriations
authority, but the amounts shown for budget authority
laws have directed tap funds to a smaller
have not been adjusted to reflect potential “transfer-
number of programs or activities within three
out” of funds to 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
FY2014, but has received discretionary appropriations since then.48 Since FY2015, LHHS
appropriations laws have directed the largest share of tap transfers to NIH.
The FY2022 LHHS omnibus directed $1.3 billion in tap funds to NIH, which was a small
increase relative to FY2021 (+$38 million, 3.0%). The President’s budget and House committee
bill would have kept the NIH transfers the same as FY2022. With regard to the OS, the FY2022
LHHS omnibus almost doubled the tap transfers to OS (+$64 million, 99.1%) to transition the
Office of the National Coordinator for Health Information Technology to being solely funded by
the PHS tap.49 Both the President’s budget and the House committee bill also proposed that
funding transition, but would have increased the transfers to OS to a greater degree than what was
ultimately enacted for FY2022—$106 million (+163.7%) and $97 million (+149.0%),
respectively. The FY2022 LHHS omnibus, President’s budget, and House committee bill kept the
tap transfers to SAMHSA the same amount as FY2021 ($134 million).
In addition to the transfers to NIH, SAMHSA, and OS, the FY2022 House committee bill
proposed that AHRQ receive $129 million in tap funding, slightly over half the amount that it
proposed for AHRQ’s discretionary funding for FY2022 ($251 million), for a total of $380

47 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 FY2022 omnibus 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.
48 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.
49 Congressional Record, vol. 168, no. 42, book IV, March 9, 2022, pp. H2684.
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million. The FY2022 President’s budget had
Display of PPHF Transfers
requested that AHRQ receive a comparatively
lesser amount of tap funding ($27 million),
PPHF transfer amounts displayed in the HHS tables in
this report are in addition to amounts shown for
with a greater proportion of AHRQ’s funding
budget authority provided in the bil . For consistency
in the LHHS bill being derived from
with source materials, the amounts shown for PPHF
discretionary appropriations ($353 million),
transfers in these tables reflect the estimated effects of
for a total of $380 million. This proposed use
mandatory spending sequestration; this is not the case
of tap funds was rejected by the FY2022
for other mandatory spending shown in this report
(also for consistency with source materials).
LHHS omnibus.
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 ($139
million), and Paralysis Resource Center, Limb Loss, and Traumatic Brain Injury at ACL ($17
million). The House committee bill and the FY2022 LHHS omnibus rejected 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.50 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.51
The ACA had appropriated $2 billion in mandatory funds to the PPHF for FY2022, but this
amount was reduced by subsequent laws that decreased PPHF funding for FY2022 and other
fiscal years. Under current law, the FY2022 appropriation is $1 billion.52 This appropriation was
subject to a 5.7% reduction due to sequestration of nonexempt mandatory spending.53 (For more
information on sequestration, see the budget enforcement discussion in Appendix A.) After
sequestration, the total PPHF appropriation available for FY2022 was $943 million, an increase
of $47 million relative to FY2021. Of this amount, the FY2022 LHHS omnibus allocated $903
million to CDC, $12 million to SAMHSA, and $28 million to ACL, the same amounts as
proposed by the House committee bill and the President’s budget.
CDC commonly receives the largest share of annual PPHF funds. The amount that was provided
to CDC by the FY2022 LHHS omnibus, $903 million, was a $47 million (+5.5%) increase
relative to FY2021. The amounts for SAMHSA and ACL were the same as FY2021.

50 For more information, see CRS Report R41301, Appropriations and Fund Transfers in the Affordable Care Act
(ACA).
51 For the FY2022 LHHS omnibus, see Division H, §222, P.L. 117-103.
52 42 U.S.C. §300u-11.
53 OMB Report to the Congress on the BBEDCA 251A Sequestration for Fiscal Year 2022, May 28, 2021, p. 7 of 17,
https://www.whitehouse.gov/wp-content/uploads/2021/05/BBEDCA_251A_Sequestration_Report_FY2022.pdf.
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Selected HHS Highlights by Agency
This section begins with a limited selection of FY2022 discretionary funding highlights by HHS
agency. The discussion is largely based on the enacted and proposed appropriations levels for
FY2022 compared to FY2021 enacted levels.54 These summaries are followed by a brief
overview of significant provisions from annual HHS appropriations laws that restrict spending in
certain controversial areas, such as abortion and stem cell research. The section concludes with
two tables (Table 6 and Table 7) presenting more detailed information on FY2021 enacted and
FY2022 proposed and enacted funding levels for HHS.
HRSA
The FY2022 LHHS omnibus provided $8.6 billion in discretionary budget authority for HRSA.
This was $1.4 billion (+18.8%) more than HRSA’s FY2021 discretionary funding level and $741
million (+9.5%) more than the FY2022 President’s budget request.
Under the Primary Health Care account, the Community Health Centers program received $1.7
billion, an increase of $65 million (+3.9%) relative to FY2021.55 The explanatory statement also
recommended $122.3 million under that same account for the Ending the HIV Epidemic
Initiative.56 Under the Ryan White HIV/AIDS Program appropriation, there is an additional $125
million set aside for this HIV initiative.57
The Maternal and Child Health Block Grant received $748 million, an increase of $35 million
(+4.9%) relative to FY2021. Related to maternal health, the explanatory statement also set aside
$12 million for the Alliance for Maternal Health Safety Bundles, which are “a set of targeted and
evidence-based best practices that, when implemented, improve patient outcomes and reduce
maternal mortality and severe maternal morbidity,”58 and $29 million for State Maternal Health
Innovation Grants.59 The Rural Communities Opioid Response program received $135 million in
the law, an increase of $25 million (+22.7%) relative to FY2021.60
CDC
The FY2022 LHHS omnibus provided $7.5 billion in discretionary budget authority for CDC,
which was $535 million (+7.7%) more than CDC’s FY2021 funding level. The FY2022 LHHS
omnibus did not direct any PHS tap funds to the CDC, continuing the practice started in FY2015.
The FY2022 LHHS omnibus supplemented discretionary CDC appropriations by directing $903
million in PPHF transfers to the CDC, which was $47 million (+5.5%) more than FY2021.
Altogether, this combination of funding represented an increase of $582 million (+7.4%) from
FY2021 in budget authority that is inclusive of directed transfers.

54 HHS budget materials can be found at http://www.hhs.gov/budget/.
55 The Health Centers program also received significant additional FY2020 and FY2021 funding related to the COVID-
19 pandemic, totaling roughly $2 billion in discretionary funding, and $4 billion in mandatory funding. For a discussion
of this funding, see CRS Report R46711, U.S. Public Health Service: COVID-19 Supplemental Appropriations in the
116th Congress.
56 Congressional Record, March 9, 2022, Vol. 168, No. 42, Book IV, p. H2669.
57 Ibid, p. H2670. This initiative also was supported by funds from other parts of HHS. For more information, see
https://www.hiv.gov/federal-response/ending-the-hiv-epidemic/funding.
58 Ibid, p. H2669. See H.Rept. 117-96 p. 57, for a description of this activity.
59 Ibid, p. H2670.
60 See Ibid, p. H2670, for a description of this activity.
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The President’s FY2022 budget request would have increased discretionary budget authority by
$1.5 billion (+21.4%) relative to FY2021, while also requesting that $139 million in tap funds be
directed to the CDC. The President’s budget also requested $903 million in PPHF transfers, the
same as enacted. All told, this combination of funding would have represented an increase of $1.7
billion (+21.5%) from FY2021. The FY2022 omnibus provided $1.1 billion (-11.5%) less than
the FY2022 requested amount, inclusive of directed transfers.
All but one programmatic account received an increase in discretionary budget authority relative
to FY2021. The Immunization and Respiratory Diseases account was flat-funded in terms of
discretionary budget authority only, but was increased by $47 million (+5.7%) when also
accounting for PPHF transfers. Some notable increases included the HIV/AIDS, Viral Hepatitis,
STI and TB Prevention account, which was funded at an increased level of $1.3 billion (+2.4%
above FY2021), and included $195 million for CDC’s contribution the Ending HIV/AIDS
Initiative;61 the Public Health Scientific Services account, which was funded at $652 million
(+10.1%) above FY2021, and included $100 million for public health data modernization
(+100% above FY2021 funding of $50 million).62 Discretionary funding for the CDC-Wide
Activities and Program Support account was increased by $210 million (+169.9%). When also
accounting for PPHF transfers, which were kept at the same level as FY2021 ($160 million), the
program level for that account was increased by 74.1% relative to FY2021. Of the discretionary
funding, $200 million was designated for public health infrastructure and capacity.63
With regard to the Injury Prevention and Control account, which received $715 million (+4.7%
over FY2021), the explanatory statement included funding for several line items that were first
included in FY2020, including child sexual abuse prevention ($2 million), suicide prevention
($20 million), and adverse childhood experiences (ACEs, $7 million).64 The explanatory
statement also included specific funding for Firearm Injury and Mortality Prevention Research
program ($12.5 million) and Opioid Overdose Prevention and Surveillance ($491 million).65

61 Congressional Record, vol. 168, no. 42, March 9, 2022, p. H2670. See also Centers for Disease Control and
Prevention, “Ending the HIV Epidemic,” https://www.cdc.gov/endhiv/index.html.
62 Ibid, p. H2672. For FY2021, see Congressional Record, vol. 166, no. 218 (December 21, 2020), p. H8623.
63 P.L. 117-103, 136 STAT. 448. See also Congressional Record, vol. 168, no. 42, March 9, 2022, p. H2674.
64 Ibid., pp. H2672-H2673. For FY2021 enacted, see Congressional Record, vol. 166, no. 218 (December 21, 2020), p.
H8623.
65 Ibid. When taking account of the $12.5 million in NIH funding that was reserved for the same purpose, the total
provided for Firearm Injury and Mortality Prevention Research was $25 million.
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NIH
The FY2022 LHHS omnibus provided $43.7 billion in discretionary budget authority for NIH.
This was $2.2 billion (+5.3%) more than FY2021, but $6.8 billion (-13.5%) less than the FY2022
President’s budget request. When adding the $1.0 billion appropriation for the new Advanced
Research Projects Agency for Health (ARPA-H)—which the HHS Secretary has placed within
NIH after enactment of FY2022 LHHS funding—the NIH’s FY2022 discretionary budget
authority was $44.7 billion.66 ARPA-H was originally proposed as a part of President Biden’s
FY2022 NIH budget request with proposed funding of $6.5 billion. The FY2022 enacted NIH
discretionary budget authority, plus the ARPA-H transfer, was $5.8 billion (-11.5%) less than the
President’s FY2022 budget request.
All NIH Institute and Center (IC) accounts received increases in FY2022 relative to FY2021.
Among the ICs, the National Institute of Minority Health and Health Disparities saw the largest
percentage increase compared to FY2021 (+17.4%). In addition, the FY2022 LHHS omnibus
directed $1.3 billion in PHS tap transfers to NIH, $38 million more than FY2021. The entirety of
the PHS tap transfer was provided to the National Institute of General Medical Sciences
(NIGMS), and was paired with a discretionary appropriation of $1.8 billion. The NIGMS
discretionary appropriation was $63 million (+3.7%) more than FY2021. When combined with
the tap transfer, total funding for NIGMS increased by $101 million (+3.4%) from FY2021. The
Buildings and Facilities account saw a $50 million increase (+25.0%) in discretionary budget
authority relative to FY2021, but a decrease of $175 million (-41.2%) relative to FY2021 when
accounting for the $225 million NEF transfer to that account in FY2021.67
In line with recent practice, the explanatory statement on the FY2022 LHHS omnibus directed
NIH to reserve a specific dollar amount for a number of purposes, for example, an increase of
$289 million for Alzheimer’s disease and related dementia research.68 It also included a
reservation of funds for Firearm Injury and Mortality Prevention Research of $12.5 million, the
same amount as in FY2020 and FY2021.69 Reserving a specific dollar amount for a particular

66 Although the FY2022 President’s budget and FY2022 House committee bill proposed that ARPA-H funding be
appropriated to the NIH, the $1 billion in enacted funding for ARPA-H was ultimately appropriated to the HHS Office
of the Secretary (OS). Those funds were subsequently transferred to the NIH when ARPA-H was placed within that
operating division by the HHS Secretary. The enacted ARPA-H funding is displayed under the OS in Table 7 in
keeping with how it was appropriated in the LHHS omnibus. 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.
67 The NEF was established by the Consolidated Appropriations Act of 2008 to enable the HHS Secretary to repurpose
certain unobligated balances of expired discretionary funds appropriated to HHS from the General Fund (P.L. 110-161,
Division G, Title II, §223). Most accounts in annual appropriations measures receive appropriations from the General
Fund at the U.S. Treasury. This term refers to all federal money not allocated by law to any other fund account, such as
federal trust funds for Medicare. Funds transferred into the NEF are generally available to the Secretary for capital
acquisitions across HHS, including facilities infrastructure and information technology. Until recently, it has not been
common for LHHS appropriations acts to specify that particular projects are to be funded by the NEF, but there have
been a few such cases since FY2017, including in FY2021 where the LHHS omnibus directed $225 million from the
NEF transfers to the NIH Buildings and Facilities account.
68 Congressional Record, vol. 168, no. 42 (March 9, 2022), p. H2676. For a list of specified funding levels in the
explanatory statement accompanying the LHHS omnibus, see Table A-2 in CRS Report R43341, National Institutes of
Health (NIH) Funding: FY1996-FY2023.
69 Ibid., p. H2678. When taking account of the $12.5 million in CDC funding that was reserved for the same purpose,
the total provided for Firearm Injury and Mortality Prevention Research was $25 million in FY2020, FY2021 and
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disease or area of research at NIH is a relatively new practice that has expanded since 2015; still,
most NIH funding is not designated for particular diseases or areas of research.70
SAMHSA
The FY2022 LHHS omnibus provided $6.4 billion in discretionary budget authority for
SAMHSA. This amount was $530 million (+9.0%) more than SAMHSA’s FY2021 funding level
and $3.2 billion (-33.2%) less than the President’s FY2022 budget request. The FY2022 LHHS
omnibus also directed $134 million in PHS evaluation tap funding and $12 million in PPHF
funding to SAMHSA, which were the same amounts as FY2021.
The additional funding provided to SAMHSA was spread across several programs in the
explanatory statement. All accounts received discretionary budget authority increases relative to
FY2021. The programs within the Mental Health Programs of Regional and National
Significance (PRNS) received an increase of $112 million (+23.6%), including the increase of
$78 million (+323.4%) to the Suicide Lifeline program to prepare for the launch of a new 988
number for suicide prevention.71 The programs within the Substance Abuse Treatment PRNS
received an increase of $25 million (+5.0%) and the programs within the Substance Abuse
Prevention PRNS received an increase of $10 million (+4.8%). There was also an increase in
funding to the Certified Community Behavioral Health Clinics (CCBHCs)—$65 million
(+26.0%) more than FY2021. The Community Mental Health Services Block Grant (MHBG)
received an increase of $100 million (+13.6%) while the Substance Abuse Prevention and
Treatment Block Grant (SABG) received an increase of $50 million (+2.8%) more than FY2021.
The State Opioid Response (SOR) grant program received an increase of $25 million (+1.7%)
compared to FY2021.
AHRQ
The FY2022 LHHS omnibus provided $350 million in discretionary budget authority to AHRQ.
This amount was $12 million (+3.7%) more than AHRQ’s FY2021 funding level and $3 million
(-0.7%) less than the President’s FY2022 budget request. The FY2022 LHHS omnibus did not
direct any PHS tap transfers to AHRQ, which is in keeping with practices since FY2015 but
contrasts with earlier years (FY2003-FY2014) in which AHRQ had been funded primarily with
tap transfers.72 (The President’s budget proposed $27 million, and the House bill proposed $129

FY2022.
70 Historically, Congress generally did not specify funding for certain research areas within NIH accounts through the
appropriations process. For example, the explanatory statement on the FY2015 omnibus stipulated, “In keeping with
longstanding practice, the agreement does not recommend a specific amount of NIH funding for this purpose
[Alzheimer’s disease] or for any other individual disease. Doing so would establish a dangerous precedent that could
politicize the NIH peer review system. Nevertheless, in recognition that Alzheimer’s disease poses a serious threat to
the Nation’s long-term health and economic stability, the agreement expects that a significant portion of the
recommended increase for NIA should be directed to research on Alzheimer’s. The exact amount should be determined
by scientific opportunity of additional research on this disease and the quality of grant applications that are submitted
for Alzheimer’s relative to those submitted for other diseases.” See Congressional Record, vol. 160, no. 151
(December 11, 2014), p. H9832.
71 As described in the explanatory statement accompanying the FY2022 LHHS omnibus (Congressional Record, vol.
168, no. 42, March 9, 2022, p. H2680). For the FY2021 amount, see Congressional Record, vol. 166, no. 218
(December 21, 2020), p. H8629.
72 In addition to funds provided through the annual appropriations process, AHRQ is also scheduled in FY2022 to
receive a transfer of certain mandatory funds that were authorized and appropriated to the Patient-Centered Outcomes
Research Trust Fund (PCORTF) by ACA Section 6301(e), as amended (26 U.S.C. §9511). Transfers to AHRQ from
the PCORTF are to be used to disseminate the results of patient-centered outcomes research. (PCORTF funds are
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million, in tap transfers for AHRQ, but these proposals were not enacted.) Among other
initiatives, the explanatory statement noted increases in funding to establish the Center for
Primary Care Research and to research diagnostic errors and risks to patient safety.73
CMS
The FY2022 LHHS omnibus provided $4.9 billion in discretionary budget authority for CMS,
$421 million (+9.4%) more than FY2021 enacted. (Both the President’s budget and House
committee bill would have provided $712 million (+15.9%) more than FY2021.) The FY2022
LHHS omnibus provided $873 million for the CMS Health Care Fraud and Abuse Control
(HCFAC) account, 8.2% more than FY2021 and the same amount that was proposed by the
President’s budget and House committee bill. Of this total amount for HCFAC, $556 million
would be effectively exempt from the discretionary budget caps. (See Appendix A for an
explanation of the LHHS budget cap exemptions.)
The FY2022 LHHS omnibus provided a $355 million (+9.7%) increase to the CMS Program
Management Account, which was less than the increased proposed by the House committee bill
and the President’s request (+17.6%). 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 FY2022 LHHS
omnibus continued a provision (§227) that has been 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 ACA implementation. Both the
President’s budget and House committee bill would have eliminated this provision.
ACF
The FY2022 LHHS omnibus provided $29.9 billion in discretionary budget authority for ACF.
This is $5.2 billion (+21.1%) more than FY2021, and $729 less (-$2.4%) than the President’s
budget.
The FY2022 LHHS omnibus provided $6.4 billion for the Refugee and Entrant Assistance
programs account, an increase of $4.5 billion (+236.4%) relative to FY2021.74 The President’s
budget would have increased this account to a lesser degree relative to FY2021, by $2.4 billion
(+130.6%). The FY2022 LHHS omnibus retained 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 15% limit on those
transfers was the same as FY2021.

generally not displayed in this report, as they are not provided by or modified through annual LHHS appropriations
bills.) For more information on the PCORTF, see CRS Insight IN11010, Funding for ACA-Established Patient-
Centered Outcomes Research Trust Fund (PCORTF) Extended Through FY2029.
73 See the explanatory statement accompanying the FY2022 LHHS omnibus (Congressional Record, vol. 168, no. 42,
March 9, 2022, p. H2681).
74 Of the total amount for FY2022, $1.6 billion was enacted as part of the second continuing resolution for FY2022,
P.L. 117-70, for the Unaccompanied Alien Children program.
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The explanatory statement accompanying the FY2022 LHHS omnibus directed $5.5 billion of the
appropriation for Refugee and Entrant Assistance programs toward the Unaccompanied Alien
Children (UAC) program, a $4.2 billion (+322.5%) increase over the FY2021 level.75 The UAC
program provides for the shelter, care, and placement of unaccompanied alien children who have
been apprehended in the United States. The President’s budget had proposed $3.3 billion for this
program to “allow [the Office of Refugee Resettlement] ORR to increase the number of state-
licensed beds and foster family placements, including both long-term and transitional foster care
placements.”76
The FY2022 LHHS omnibus also included several general provisions that were enacted in
FY2021 related to the UAC program. For instance, the LHHS omnibus
 authorized HHS to accept donations for the care of UAC arrivals (§230),
 limited the use of funds for unlicensed facilities for unaccompanied alien
children (§231),
 imposed additional congressional notification requirements prior to the use of
unlicensed facilities (§232),
 prohibited HHS appropriations from being used to prevent a Member of
Congress from visiting a UAC facility for oversight purposes (§233), and
 imposed additional public monthly reporting requirements on the number of
unaccompanied alien children who were separated from their parents or legal
guardians and transferred to the care of the ORR (§234).
The House committee report contained additional “directives ... for ORR to reduce its reliance on
large, unlicensed emergency intake sites when capacity is strained; raise standards of care;
expand legal, post-release, and child advocacy services for children; rebuild, support and train
staff on trauma-informed care; establish an independent office to better serve children in ORR’s
care; and increase planning for future humanitarian responses at the border.”77 The explanatory
statement accompanying the LHHS omnibus reiterated that language included in that House
report “should be complied with unless specifically addressed to the contrary in this explanatory
statement.”78 It also contained additional directives, such as that ORR “place siblings in the same
facility, or with the same sponsor, to the extent practicable, and so long as it is appropriate and in
the best interest of the child.”79
ACL
The FY2022 LHHS omnibus provided $2.3 billion in discretionary budget authority for ACL.
This was $60 million (+2.7%) more than FY2021. In addition, the FY2022 LHHS omnibus
directed $28 million in PPHF transfers to ACL, the same as FY2021. The explanatory statement
accompanying the FY2022 LHHS omnibus specified that the PPHF transfers were for the
Alzheimer’s Disease Program, Chronic Disease Self-Management, and Falls Prevention. These
distributions were consistent FY2021 levels, as well as the FY2022 President’s request and House

75 Ibid.
76 HHS, ACF, FY 2022 Congressional Justification, p. 59, https://www.acf.hhs.gov/sites/default/files/documents/olab/
fy_2022_congressional_justification.pdf.
77 H.Rept. 117-96, pp. 208-215.
78 Congressional Record, vol. 168, no. 42, book IV, March 9, 2022, pp. H2682.
79 Ibid.
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committee bill.80 The FY2022 LHHS omnibus did not adopt the proposal made in the President’s
budget for $17 million in evaluation tap funding.81 The FY2022 LHHS omnibus provided $691
million (-23.0%) less in ACL’s discretionary budget authority than the President’s budget, which
had proposed larger increases than what was enacted for several ACL programs including home-
delivered meals (part of the Nutrition Services Program) and home and community-based
supportive services.
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 FY2022 President’s budget and House
committee bill would have omitted this provision entirely, but the FY2022 LHHS omnibus
retained these existing restrictions (§§506 and 507).82
Human Embryo Research: Since FY1996, annual LHHS appropriations have included a
provision prohibiting any LHHS funds (including NIH funds) from being used to create human
embryos for research purposes or for research in which human embryos are destroyed. The
FY2022 LHHS omnibus retained these existing restrictions (§508).83
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).84 Starting in FY2016, the provision was modified to allow funds to be

80 The same PPHF amounts were directed to these ACL programs by the FY2021 LHHS omnibus and accompanying
explanatory statement.
81 Administration for Community Living, Fiscal Year 2022 Justification of Estimates for Appropriations Committees,
https://acl.gov/sites/default/files/about-acl/2021-06/
FY%202022%20ACL%20Justification%20of%20Estimates%20for%20Appropriations%20Committees_Final.pdf.
82 The current provisions are commonly referred to as the Hyde and Weldon Amendments. For additional information,
see CRS Report RL33467, Abortion: Judicial History and Legislative Response and CRS In Focus IF12167, The Hyde
Amendment: An Overview.
83 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.
84 The one exception is the FY1992 LHHS appropriations act (P.L. 102-170), which appears to have included no such
provision. Since the provision’s inception in FY1990, there has been variation in its scope and application during
certain fiscal years. For example, the LHHS appropriations act for FY1998 (P.L. 105-78) made the ban subject to
action by the HHS Secretary. The LHHS appropriations acts for FY2010 (P.L. 111-117, Division D) and FY2011 (P.L.
112-10, Division B) applied the ban only in locations that local authorities determined to be inappropriate.
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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 FY2022
President’s budget and House committee bill would have omitted this provision entirely, but the
FY2022 LHHS omnibus retained these existing restrictions and conditions (§526).
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). FY2022 omnibus retained these existing restrictions
(§210 [HHS] and §503(c) [all LHHS, plus PPHF transfers]).85
Table 6. HHS Appropriations Totals by Agency
(in millions of dollars)
FY2022
House
Cmte.
FY2021
FY2022
(H.R.
FY2022
HHS Agency
Enacted
Request
4502)
Enacted
HRSA
7,484
8,151
9,062
8,892
Mandatory BA
266
317
317
317
Discretionary BA
7,218
7,834
8,745
8,575
CDCa
7,019
8,510
9,668
7,554
Mandatory BA
55
55
55
55
Discretionary BA
6,963
8,455
9,613
7,499
Evaluation Tap Fundingb
0
139
0
0
PPHFc
856
903
903
903
NIHa
41,437
50,461
48,162
43,650
Mandatory BA
0
0
0
0
Discretionary BAd
41,437
50,461
48,162
43,650
Evaluation Tap Fundingb
1,272
1,272
1,272
1,309
Nonrecurring Expenses Fund Transfere
225
0
0
0
SAMHSA
5,870
9,587
9,015
6,400
Mandatory BA
0
0
0
0
Discretionary BA
5,870
9,587
9,015
6,400
Evaluation Tap Fundingb
134
134
134
134

85 The FY2022 LHHS explanatory statement directs that $12.5 million apiece ($25 million total) be allocated by the
CDC and NIH for Firearm Injury and Mortality Prevention Research (Congressional Record, vol. 168, no. 42, book IV,
March 9, 2022, pp. H2673 and H2678). CDC and NIH funding reservations for Firearm Injury and Mortality
Prevention were first included in LHHS explanatory statements in FY2020. The report accompanying the FY2022
House committee bill had proposed that these amounts be doubled to $25 million apiece ($50 million total) (H.Rept.
117-96).
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FY2022
House
Cmte.
FY2021
FY2022
(H.R.
FY2022
HHS Agency
Enacted
Request
4502)
Enacted
PPHFc
12
12
12
12
AHRQ
338
353
251
350
Mandatory BA
0
0
0
0
Discretionary BA
338
353
251
350
Evaluation Tap Fundingb
0
27
129
0
CMS
906,627 1,027,439
1,027,439
1,027,148
Mandatory BA
902,150
1,022,250
1,022,250
1,022,250
Discretionary BA
4,477
5,189
5,189
4,898
ACF
41,190
46,944
47,624
46,215
Mandatory BA
16,496
16,303
16,302
16,303
Discretionary BAf
24,695
30,641
31,321
29,912
ACL
2,258
3,009
3,105
2,318
Mandatory BA
0
0
0
0
Discretionary BA
2,258
3,009
3,105
2,318
Evaluation Tap Fundingb
0
17
0
0
PPHFc
28
28
28
28
Office of the Secretary (OS)
4,359
5,101
5,101
5,697
Mandatory BA
653
657
657
673
Discretionary BA
3,706
4,444
4,445
5,024
Evaluation Tap Fundingb
65
171
161
129
Total, HHS BA in the Bill
1,016,583 1,159,555
1,159,426
1,148,224
Mandatory
919,620 1,039,582
1,039,581
1,039,599
Discretionary
96,963
119,973
119,845
108,625
Emergency Funding (not in above totals)

P.L. 116-260, Division H
0.6
-
-
-
P.L. 116-260, Division M
72.9
-
-
-
P.L. 117-31g
0.0
-
-
-
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
Memoranda (non-emergency funds only)

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FY2022
House
Cmte.
FY2021
FY2022
(H.R.
FY2022
HHS Agency
Enacted
Request
4502)
Enacted
Total, BA Available in Fiscal Year (current year
1,007,753
1,142,465
1,142,337
1,131,134
from any bil )
Total, BA Advances for Future Years (provided in
153,132
170,222
170,222
170,222
current bil )
Total, BA Advances from Prior Years (for use in
144,303
153,132
153,132
153,132
current year)
Total, Additional Scorekeeping Adjustments
-21,748
-25,262
-14,676
-13,790
Sources: Amounts in this table for the FY2021 Enacted, FY2022 Request, and FY2022 Enacted columns are
generally drawn from or calculated based on data contained in the explanatory statement accompanying the
FY2022 LHHS omnibus (P.L. 117-103), available in the Congressional Record, vol. 168, no. 42, book IV, March 9,
2022, pp. H2668-H2915. Amounts in the FY2022 House Committee column are generally drawn from or
calculated based on data contained in the committee report (H.Rept. 117-96) accompanying H.R. 4502. Enacted
totals (“Total BA in the Bil ”) for FY2021 or 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. CRS calculations do, however, include LHHS funding provided to HHS pursuant to the 21st
Century Cures Act (P.L. 114-255), as amended.
Notes: BA = Budget Authority. Details may not add to totals due to rounding. Amounts in this table (1) reflect
all BA appropriated in the bil , regardless of the year in which funds become available (i.e., totals do not include
advances from prior-year appropriations, but do include advances for subsequent years provided in this bil ); (2)
have generally not been adjusted to reflect scorekeeping; (3) comprise only those funds provided (or requested)
for agencies and accounts subject to the jurisdiction of the LHHS subcommittees of the House and Senate
appropriations committees (e.g., department totals do not include funding for the Food and Drug Administration,
the Indian Health Service, or the Agency for Toxic Substances and Disease Registry, all of which are funded by
other bil s); and (4) do not include appropriations that occur outside of appropriations bil s.
a. Each year, CDC and NIH also receive funding in the Interior-Environment appropriations bil as part of their
overall budget authority.
b. By convention, this table shows only the amount of PHS Evaluation Tap funds received by an agency, not the
amount of tap funds donated by an agency. That is to say, tap amounts shown in this table are in addition to
amounts shown for budget authority, but the amounts shown for budget authority have not been adjusted
to reflect potential “transfer-out” of funds to the tap.
c. PPHF funds are not appropriated in the LHHS bil , but are shown here for il ustrative purposes as they may
be used to supplement the funding selected agencies and programs receive through the appropriations
process. Amounts shown for PPHF in this table are in addition to amounts shown for budget authority.
d. When adding the $1.0 bil ion appropriation for the new Advanced Research Projects Agency for Health
(ARPA-H)—which the HHS Secretary placed within NIH after enactment of FY2022 LHHS funding—the
NIH’s FY2022 discretionary budget authority was $44.7 bil ion.
e. The Nonrecurring Expenses Fund (NEF) was established by the Consolidated Appropriations Act of 2008,
to enable the HHS Secretary to repurpose certain unobligated balances of expired discretionary funds
appropriated to HHS from the General Fund. The FY2021 omnibus specified that HHS transfer $225 mil ion
to the building and facilities account at NIH. Amounts shown for the NEF transfer are in addition to amounts
shown for budget authority.
f.
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.
g. P.L. 117-31 provided $25 mil ion in supplemental appropriations for the Refugee and Entrant Assistance
account at HHS for specified purposes related to Afghan special immigrants, which rounds to $0.0 in bil ions
(the unit of measure used in this table).

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Table 7. HHS Discretionary Appropriations for Selected
Programs or Activities, by Agency
(in millions of dollars)
FY2022
House
Cmte.
FY2021
FY2022
(H.R.
FY2022
Agency or Selected Program
Enacted
Request
4502)
Enacted
HRSA

Community Health Centers
1,684
1,734
1,832
1,749
National Health Service Corps
120
185
185
122
Children’s Hospitals Graduate Medical Education
350
350
400
375
Maternal & Child Health Block Grant
713
823
869
748
Autism and Other Developmental Disorders
53
57
57
54
Healthy Start
128
128
145
132
Ryan White AIDS Programs
2,424
2,555
2,655
2,495
Organ Transplantation
29
29
34
30
Telehealth
34
37
39
35
Rural Communities Opioid Response
110
165
140
135
Family Planning (Title X)
286
340
400
286
CDC

Immunization and Respiratory Diseases
449
527
532
449
PPHFa
372
419
419
419
HIV/AIDS, Viral Hepatitis, STDs, TB Prevention
1,314
1,421
1,502
1,345
Emerging and Zoonotic Infectious Diseases
596
626
674
641
PPHFa
52
52
52
52
Chronic Disease Prevention and Health Promotion
1,022
1,198
1,302
1,084
PPHFa
255
255
255
255
Birth Defects and Developmental Disabilities
168
173
187
177
Public Health Scientific Services
592
610
757
652
Evaluation Tap Fundingb
0
132
0
0
Environmental Health
206
309
326
210
PPHFa
17
17
17
17
Evaluation Tap Fundingb
0
7
0
0
Injury Prevention and Control
683
1,103
1,064
715
National Institute for Occupational Safety and
345
345
360
352
Health
Global Health
593
698
843
647
Buildings and Facilities
30
55
55
30
CDC-Wide Activities and Program Support
124
549
1,149
334
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FY2022
House
Cmte.
FY2021
FY2022
(H.R.
FY2022
Agency or Selected Program
Enacted
Request
4502)
Enacted
NIH

National Institute of Allergy and Infectious Diseases
6,070
6,246
6,558
6,323
National Institute of General Medical Sciences
1,720
1,825
1,868
1,783
Evaluation Tap Funding
1,272
1,272
1,272
1,309
National Institute on Aging
3,899
4,036
4,258
4,220
National Institute on Drug Abuse
1,480
1,853
1,860
1,595
National Institute of Minority Health and Health
391
652
662
459
Disparities
NIH Innovation Account
109
150
150
150
Advanced Research Projects Agency for Health
0
6,500
3,000
0
(ARPA-H)c

SAMHSA

Mental Health Programs of Regional & National
475
659
727
587
Significance (PRNS)
PPHFa
12
12
12
12
Mental Health Block Grant
737
1,562
1,562
837
Evaluation Tap Fundingb
21
21
21
21
Certified Community Behavioral Health Clinics
250
375
375
315
Children’s Mental Health
125
125
150
125
Substance Abuse Treatment PRNS
495
649
652
520
Evaluation Tap Fundingb
2
2
2
2
Substance Abuse Block Grant
1,779
3,429
2,779
1,829
Evaluation Tap Fundingb
79
79
79
79
State Opioid Response Grants
1,500
2,250
2,000
1,525
Substance Abuse Prevention PRNS
208
217
244
218
Health Surveillance and Support
129
139
212
260
Evaluation Tap Fundingb
31
31
31
31

AHRQ

Research on Health Costs, Quality, and Outcomes
195
210
106
206
Evaluation Tap Fundingb
0
25
129
0
Medical Expenditure Surveys
72
72
72
72
Program Support
71
71
73
73

CMS

CMS Program Management
3,670
4,316
4,316
4,025
Health Care Fraud and Abuse Control
807
873
873
873

ACF

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FY2022
House
Cmte.
FY2021
FY2022
(H.R.
FY2022
Agency or Selected Program
Enacted
Request
4502)
Enacted
Low Income Home Energy Assistance Program
3,750
3,850
3,900
3,800
Formula Grants
Refugee and Entrant Assistance Programsd
1,910
4,405
4,505
6,425
Child Care and Development Block Grant
5,911
7,377
7,377
6,165
Head Start
10,748
11,932
12,182
11,037
Preschool Development Grants
275
450
450
290
Child Welfare Services
269
275
275
269
Adoption Opportunities
44
46
46
48
Community Services Block Grant
745
754
800
755

ACL

Home & Community-Based Supportive Services
393
551
551
399
Family Caregiver Support Services
189
250
250
194
Nutrition Services Programs
952
1,341
1,388
967
Alzheimer’s Disease Demonstrations
13
15
20
15
PPHFa
15
15
15
15
State Health Insurance Program (SHIP)
52
55
57
53
Paralysis Resource Center
10
4
10
10
Evaluation Tap Fundingb
0
7
0
0
Limb Loss Resource Center
4
1
4
4
Evaluation Tap Fundingb
0
3
0
0
Developmental Disabilities Programs
183
206
209
186
WIOA Activities (transferred from ED)
267
311
317
273

Office of the Secretary

Office of Nat'l Coord. for Health Information
62
0
0
0
Technology
Evaluation Tap Fundingb
0
87
87
64
Office of the Inspector General
80
100
100
82
Public Health and Social Services Emergency Fund
2,847
3,523
3,518
3,200
Advanced Research Projects Agency for Health
0
0
0
1,000
(ARPA-H)c
Sources: Amounts in this table for the FY2021 Enacted, FY2022 Request, and FY2022 Enacted columns are
generally drawn from or calculated based on data contained in the explanatory statement accompanying the
FY2022 LHHS omnibus (P.L. 117-103), available in the Congressional Record, vol. 168, no. 42, book IV, March 9,
2022, pp. H2668-H2915. Amounts in the FY2022 House Committee column are generally drawn from or
calculated based on data contained in the committee report (H.Rept. 117-96) accompanying H.R. 4502. Enacted
totals (“Total BA in the Bil ”) for FY2021 or 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
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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: 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. Although the FY2022 President’s budget and FY2022 House committee bil proposed that ARPA-H funding
be appropriated to the NIH, the $1 bil ion in enacted funding for ARPA-H was ultimately appropriated to
the HHS Office of the Secretary (OS). Those funds were subsequently transferred to the NIH when ARPA-
H was placed within that operating division by the HHS Secretary. The enacted ARPA-H funding is displayed
under the OS in keeping with how it was appropriated in the LHHS omnibus. 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)
Note that amounts in this section are based on regular LHHS appropriations only. They do not
include mandatory funds provided outside of the annual appropriations process (e.g., direct
appropriations for the Federal Direct Student Loan program and the mandatory portion of the
Federal Pell Grant program). Amounts are rounded (e.g., to the nearest million), as labeled. The
dollar and percentage changes discussed are based on unrounded amounts. For consistency with
source materials, amounts do not reflect sequestration or reestimates of mandatory spending
programs, where applicable.
About ED
Federal policymakers established the U.S. Department of Education in 1980.86 Its mission is to
“promote student achievement and preparation for global competitiveness by fostering
educational excellence and ensuring equal access.”87 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

86 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.
87 U.S. Department of Education, “About ED,” http://www2.ed.gov/about/landing.jhtml, accessed on June 24, 2022.
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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.88 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
57% of undergraduate and graduate student aid in academic year (AY) 2020-2021.89
FY2022 ED Appropriations Overview
Table 8 displays FY2022 enacted and proposed funding levels for ED, along with FY2021 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.90
Discretionary funds represent the majority of ED’s annual appropriations, accounting for roughly
95% of the FY2021 and FY2022 enacted levels.91 The FY2022 enacted discretionary ED
appropriations were 3.9% higher than FY2021 levels. Proposed discretionary ED appropriations
for FY2022 compared to FY2021 would have increased 39.8% under both the President’s budget
and House committee bill.
Table 8. ED Appropriations Overview
(in billions of dollars)
FY2022
House
Cmte.
FY2021
FY2022
(H.R.
FY2022
Funding
Enacted
Request
4502)
Enacted
Discretionary
73.5
102.8
102.8
76.4
Mandatory
3.7
3.7
3.7
3.7
Total BA in the Bill
77.2
106.5
106.5
80.1
Emergency Funding (not in above totals)

P.L. 116-260, Division Ma
82.0
—
—
—
P.L. 117-58, Division Jb
—
—
—
-0.4
P.L. 117-159, Division Bc
—
—
—
2.1

88 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.
89 For the purposes of this calculation, the federal contribution included $134 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 2021, p. 31,
https://research.collegeboard.org/pdf/trends-college-pricing-student-aid-2021.pdf.
90 For a discussion of the COVID-19-related FY2021 supplemental appropriations in Division M of P.L. 116-260, see
CRS Report R46775, Overview of COVID-19 LHHS Supplemental Appropriations: FY2020 and FY2021.
91 The only mandatory ED funding provided in the LHHS Appropriations Act in each of these years is for Vocational
Rehabilitation State Grants. This excludes any rescissions of mandatory appropriations that are used in the
appropriations process.
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Sources: Amounts in this table for the FY2021 Enacted, FY2022 Request, and FY2022 Enacted columns are
generally drawn from or calculated based on data contained in the explanatory statement accompanying the
FY2022 LHHS omnibus (P.L. 117-103), available in the Congressional Record, vol. 168, no. 42, book IV, March 9,
2022, pp. H2668-H2915. Amounts in the FY2022 House Committee column are generally drawn from or
calculated based on data contained in the committee report (H.Rept. 117-96) accompanying H.R. 4502 Enacted
totals (“Total BA in the Bil ”) for FY2021 or 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. The Coronavirus Response and Relief Supplemental Appropriations Act (CRRSAA), included in P.L. 116-
260, provided approximately $82 bil ion for the Education Stabilization Fund.
b. 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.
c. 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 FY2022 appropriations for selected ED accounts and
programs.92 Table 9 tracks funding levels for major ED budget and appropriations accounts, and
selected items within those accounts.
Education for the Disadvantaged
The Education for the Disadvantaged account is the largest account related to elementary and
secondary education and has been the second largest overall within ED based on funding
provided through the annual appropriations process in recent years. Within the account, a
majority of funds are for Grants to Local Educational Agencies, authorized under Title I-A of the
Elementary and Secondary Education Act (ESEA), as amended by the Every Student Succeeds
Act (ESSA; P.L. 114-95). Title I-A grants provide supplementary educational and related services
to low-achieving and other students attending elementary and secondary schools with relatively
high concentrations of students from low-income families, as well as eligible students who live in
the areas served by these public schools but attend private schools.93
The enacted FY2022 appropriation for the Education for the Disadvantaged account was $18.2
billion, a 5.8% increase over the enacted FY2021 level of $17.2 billion. Of the $18.2 billion
appropriated for the account, $17.5 billion was provided for Title I-A grants.94 The House
committee bill and accompanying report had recommended a funding level of $36.8 billion for
the account, with $36.0 billion designated for the Title I-A program.95 President Biden’s FY2022
budget requested $37.2 billion for the Education for the Disadvantaged Account, of which $16.5

92 ED budget materials can be found at https://www2.ed.gov/about/overview/focus/performance.html.
93 Although Title I-A funds are used to serve eligible private school students, funds remain under the control of public
school authorities (i.e., they are not transferred to private schools).
94 See the explanatory statement accompanying the LHHS omnibus (Congressional Record, vol. 168, no. 42, March 9,
2022, p. H2887).
95 See p. 499 of H.Rept. 117-96.
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billion would have been provided for Title I-A grants. Of the remaining funds, $20.0 billion
would have been provided for a new Title I Equity Grants program proposed in the President’s
budget. According to the President’s budget, the new program would have been intended to “help
address long-standing funding disparities between under-resourced school districts and their
wealthier counterparts and provide critical new support to advance the President’s commitments
to ensure teachers at Title I schools are paid competitively, ensure equitable access to rigorous
curriculum, expand access to pre-kindergarten and provide meaningful incentives to examine and
address inequalities in school funding systems.”96
Safe Schools and Citizenship Education
The Safe Schools and Citizenship Education account provides funding for activities intended to
improve students’ safety and well-being, enhance the educational and developmental outcomes of
children in distressed communities, and provide comprehensive services for students, their
families, and community members in school settings.97 The account includes several programs
authorized under Title IV-F of the ESEA, as amended: Promise Neighborhoods; Full-Service
Community Schools; and School Safety National Activities, including Project Prevent and Project
SERV. Among ED appropriations accounts, the Safe Schools and Citizenship Education account
received the largest percentage increase of funding enacted in the FY2022 LHHS omnibus
compared to the FY2021 LHHS omnibus at 66.4%.
The enacted FY2022 appropriation for the Safe Schools and Citizenship Education account was
$361 million, up from the enacted level of $217 million in FY2021. The House committee bill
recommended $1.7 billion for the account, and the President’s budget requested $1.7 billion for
the account. Both the House committee bill and the President’s budget would have designated the
majority of funds ($1.0 billion) for school-based mental health services.98
Higher Education
The Higher Education account includes numerous grant programs to support postsecondary
education authorized under the Higher Education Act of 1965, as amended, and other authorizing
statutes. Activities funded under the Higher Education account include aid for institutional
development (e.g., grants for minority-serving institutions), other aid for institutions, and
assistance for students, among others.
The FY2022 LHHS omnibus provided $3.0 billion for the Higher Education account, a 17.8%
increase over the enacted FY2021 level of $2.5 billion. The House committee bill recommended
$3.4 billion in discretionary funding for the Higher Education account, which would have been an
increase of 35.0% compared to the FY2021 appropriation level, and the President’s budget
requested $3.3 billion in discretionary funding, which would have been a 30.2% increase over
FY2021 funding.

96 Budget of the Unites States Government, Fiscal Year 2022, Appendix, p. 336, https://www.govinfo.gov/content/pkg/
BUDGET-2022-APP/pdf/BUDGET-2022-APP.pdf#page=340.
97 U.S. Department of Education, “Safe Schools and Citizenship Education,” Justification of Appropriation Estimates
to the Congress: Fiscal Year 2022, https://www2.ed.gov/about/overview/budget/budget22/justifications/d-ssce.pdf.
98 The FY2022 President’s budget proposed to establish a new School-Based Health Professionals program, within the
School Improvement Programs account, that would provide formula grants to support increasing the number of health
professionals—including school counselors, nurses, school psychologists, and social workers—at public schools. To
aid comparability between the President’s budget and the House committee bill, this proposal is reflected in the Safe
Schools and Citizenship Education account in this report. For more information, see pp. 280-281 of H.Rept. 117-96.
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The largest activity funded under the account is the set of discretionary grant programs—
collectively known as the TRIO programs—designed to assist qualified individuals from
disadvantaged backgrounds with preparing for and completing postsecondary education.99 The
FY2022 LHHS omnibus provided $1.1 billion for the TRIO program, a 3.6% increase over the
enacted FY2021 level. The House committee bill and the President’s budget both proposed $1.3
billion for the Federal TRIO programs, compared to $1.1 billion provided for FY2021, which
would have been an increase of 18.3%.
For Aid for Institutional Development, the FY2022 LHHS omnibus provided $885 million, a
12.2% increase over the FY2021 enacted level of $789 million. The House committee bill and the
President’s budget both proposed $1.1 billion, an increase of 43.7% over the enacted FY2021
level.
Table 9. Detailed ED Appropriations
(in millions of dollars)
FY2022
House
FY2021
FY2022
Cmte.
FY2022
Account and Selected Program
Enacted
Request
(H.R. 4502)
Enacted
Education for the Disadvantageda
17,227
37,247
36,757
18,230
Grants to Local Educational Agencies
16,537
16,537
36,037
17,537
Impact Aid
1,501
1,541
1,552
1,557
School Improvement Programs
5,444
5,533
5,804
5,596
Supporting Effective Instruction State Grants
2,143
2,149
2,293
2,170
21st Century Community Learning Centers
1,260
1,310
1,360
1,290
Student Support and Academic Enrichment Grants
1,220
1,220
1,305
1,280
Indian Education
181
186
188
189
Innovation and Improvement
1,114
1,284
1,385
1,301
Safe Schools and Citizenship Educationb
217
1,650
1,666
361
English Language Acquisition
797
917
1,000
831
Special Education
14,071
17,193
17,200
14,519
Part B—Assistance for Education of all Children with
13,335
16,040
16,040
13,753
Disabilitiesc
Part C—Infants and Toddlers with Disabilities
482
732
732
496
Rehabilitation Services
3,814
3,895
3,897
3,863
Vocational Rehabilitation State Grants (mandatory)
3,675
3,719
3,719
3,719
Special Institutions for Persons with Disabilities
256
265
265
275
Career, Technical, and Adult Education
2,031
2,184
2,239
2,091
Career and Technical Education
1,342
1,470
1,500
1,387
Student Financial Assistance
24,545
27,545
27,187
24,580

99 Originally, in 1965, there were three such programs—Upward Bound, Student Support Services, and Talent
Search—that provided a range of student support services, thus the name TRIO. Subsequent legislation authorized
additional programs with a similar purpose, but the TRIO name remains.
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FY2022
House
FY2021
FY2022
Cmte.
FY2022
Account and Selected Program
Enacted
Request
(H.R. 4502)
Enacted
Pell maximum grant (non-add)
5,435
5,835
5,835
5,835
Federal Pell Grant Program
22,475
25,475
24,725
22,475
Federal Direct Student Loan Program Account
50
25
25
25
Student Aid Administration
1,854
2,054
2,054
2,034
Higher Education
2,542
3,309
3,431
2,994
Aid for Institutional Development
789
1,134
1,134
885
Federal TRIO Programs
1,097
1,298
1,298
1,137
Howard University
251
261
411
344
College Housing & Academic Facilities Loansd
0
0
0
0
HBCU Capital Financing Program Account
48
20
24
20
Institute of Education Sciences
642
737
762
737
Departmental Management
624
694
694
594
Total, ED BA in the Bill
77,212
106,542
106,542
80,143
Subtotal, Mandatory
3,675
3,719
3,719
3,719
Subtotal, Discretionary
73,537
102,823
102,823
76,424
Emergency Funding (not in above totals)

P.L. 116-260, Division Me
82,000
—
—
—
P.L. 117-58, Division Jf
—
—
—
-353
P.L. 117-159, Division Bg
—
—
—
2,050
Memoranda (non-emergency funds only)

Total, BA Available in Fiscal Year (current year from
77,212
106,542
106,542
80,143
any bil )
Total, BA Advances for Future Years (provided in
22,597
22,597
22,597
22,597
current bil )
Total, BA Advances from Prior Years (for use in
22,597
22,597
22,597
22,597
current year)
Sources: Amounts in this table for the FY2021 Enacted, FY2022 Request, and FY2022 Enacted columns are
generally drawn from or calculated based on data contained in the explanatory statement accompanying the
FY2022 LHHS omnibus (P.L. 117-103), available in the Congressional Record, vol. 168, no. 42, book IV, March 9,
2022, pp. H2668-H2915. Amounts in the FY2022 House Committee column are generally drawn from or
calculated based on data contained in the committee report (H.Rept. 117-96) accompanying H.R. 4502 Enacted
totals (“Total BA in the Bil ”) for FY2021 or 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.
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Non-add amounts are displayed in italics and parentheses; these amounts are not part of the appropriations
totals.
a. The FY2022 Request amount for the Education for the Disadvantaged account includes $20 bil ion for a
new Title I Equity Grants program proposed in the President’s budget. The House committee bil did not
include a new Title I Equity Grants program, but it did recommend $19.5 bil ion more than the FY2022
Request amount for existing Grants to Local Educational Agencies. A new Title I Equity Grants program
was not enacted in the FY2022 LHHS omnibus.
b. The FY2022 President’s budget proposed to establish a new School-Based Health Professionals program,
within the School Improvement Programs account, that would provide formula grants to support increasing
the number of health professionals—including school counselors, nurses, school psychologists, and social
workers—at public schools. To aid comparability between the President’s budget and the House committee
bil , which recommended funding for a similar purpose within the Safe Schools and Citizenship Education
account, this proposal is reflected in the Safe Schools and Citizenship Education account in this report.
c. Includes Grants to States Part B and Preschool Grants.
d. Actual amount for Col ege Housing & Academic Facilities Loans is $435,000 in each column, which rounds
to $0 in mil ions (the unit of measure used in this table).
e. The Coronavirus Response and Relief Supplemental Appropriations Act (CRRSAA), included in P.L. 116-
260, provided approximately $82 bil ion for the Education Stabilization Fund.
f.
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.
g. 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
Note that 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.
FY2022 Related Agencies Appropriations Overview
Table 10 displays FY2022 proposed and enacted funding levels for LHHS related agencies, along
with FY2021 enacted levels. Note that the totals in this table do not include emergency-
designated appropriations and that no such appropriations were enacted for the related agencies in
FY2021 or FY2022.
In general, discretionary funding constitutes about 20% of total appropriations for LHHS related
agencies each year. The FY2022 LHHS omnibus increased discretionary appropriations for
related agencies by about 3.3% compared to FY2021. The President’s budget would have
increased discretionary appropriations for related agencies by about 9.0%, while the House
committee bill would have increased such appropriations by 9.8%.
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Table 10. Related Agencies Appropriations Overview
(in billions of dollars)
FY2022
House
Cmte.
FY2021
FY2022
(H.R.
FY2022
Funding
Enacted
Request
4502)
Enacted
Discretionary
15.5
16.9
17.0
16.0
Mandatory
55.3
57.0
57.0
57.0
Total BA in the Bill
70.8
73.8
74.0
73.0
Emergency Funding (not in above totals)
—
—
—
—
Sources: Amounts in this table for the FY2021 Enacted, FY2022 Request, and FY2022 Enacted columns are
generally drawn from or calculated based on data contained in the explanatory statement accompanying the
FY2022 LHHS omnibus (P.L. 117-103), available in the Congressional Record, vol. 168, no. 42, book IV, March 9,
2022, pp. H2668-H2915. Amounts in the FY2021 House Committee column are generally drawn from or
calculated based on data contained in the committee report (H.Rept. 117-96) accompanying H.R. 4502. Enacted
totals (“Total BA in the Bil ”) for FY2021 or 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.
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 received 84.2% of discretionary
appropriations for LHHS related agencies in the FY2022 LHHS omnibus. After SSA, the next-
largest related agency in terms of appropriations is usually the Corporation for National and
Community Service (CNCS), which accounted for about 1.6% of total appropriations and 7.2% of
discretionary appropriations to LHHS related agencies in FY2022. Typically, each of the
remaining related agencies receives less than $1 billion from the annual LHHS appropriations
bill. For more information, see Table 11.
Selected Related Agencies Highlights
The following sections highlight FY2022 appropriations issues for selected related agencies.
Table 11 tracks funding levels for these related agencies.
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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.100 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 FY2022
LHHS omnibus provided $13.3 billion to the LAE account, which was an increase of $411
million (+3.2%) relative to the FY2021 enacted level. The President’s request would have
provided $1.3 billion (+9.7%) more for the LAE account relative to FY2021, while the House
committee bill would have increased LAE funding by $1.1 billion (+8.8%).
Of the $13.3 billion provided to the LAE account for FY2022, $1.7 billion (12.8% of this total)
was dedicated to program integrity activities. The program integrity portion of the LAE account
included $273 million in base funding subject to the committee allocations pursuant to the
FY2022 budget resolution, S.Con.Res. 14, as well as additional funding that is effectively exempt
from those allocations and subject to an annual limit (adjustment funding; see Table A-1 for
further information). The FY2022 LHHS omnibus provided $1.4 billion in adjustment funding,
which was the maximum amount permitted for FY2022 under the budget resolution. The
combined amount of program integrity funding enacted for FY2022 was $133 million (+8.4%)
more than the combined amount enacted for FY2021. Both the FY2021 President’s budget and
the House committee bill would have also provided the maximum amount of adjustment funding
permitted for FY2022.
Corporation for National and Community Service
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.101 The FY2022
LHHS omnibus provided $1.2 billion in total CNCS funding, a $30 million (+2.6%) increase
from the FY2021 enacted level. The FY2022 President’s budget would have provided $89 million
(+8.0%) more in total CNCS funding relative to FY2021, while the House committee bill would
have increased total CNCS funding by $194 million (+17.3%).
National Labor Relations Board (NLRB)
The NLRB is an independent board that enforces provisions in the National Labor Relations Act
(NLRA). The FY2022 LHHS omnibus maintained the FY2021 funding level for the NLRB of
$274 million. The FY2022 President’s budget would have increased funding for the NLRB by
$28 million (+10.1%) compared to the FY2021 enacted level, while the House committee bill
would have increased funding for the NLRB by $43 million (+15.6%).
The FY2022 LHHS omnibus retained a provision that has been included in the LHHS bill since
FY2012 that prohibits any funds appropriated to the NLRB in the bill, or any prior appropriations
act, from being used to issue a directive or regulation to provide employees a means of voting
through any electronic method in an election determining representation for collective bargaining
(§408).

100 See CRS Report R47103, Social Security Administration (SSA) FY2022 Annual Limitation on Administrative
Expenses (LAE) Appropriation: In Brief.
101 See CRS Report RL33931, The Corporation for National and Community Service: Overview of Programs and
Funding.
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Table 11. Detailed Related Agencies Appropriations
(in millions of dollars)
FY2022
House
Cmte.
FY2021
FY2022
(H.R.
FY2022
Agency, Program, Project, or Activity
Enacted
Request
4502)
Enacted
Committee for Purchase from People Who Are Blind or
11
12
12
11
Severely Disabled (U.S. AbilityOne Commission)
Corporation for National and Community Service
1,121
1,210
1,315
1,151
(CNCS)
Selected CNCS Programs/Initiatives:

Volunteers in Service to America (VISTA)
97
104
104
100
National Senior Volunteer Corps
225
245
245
231
AmeriCorps State and National Grants
455
501
601
467
National Civilian Community Corps
34
38
38
35
National Service Trust
185
191
196
191
Corporation for Public Broadcasting (CPB)
495
495
585
545
Federal Mediation and Conciliation Service
49
50
50
50
Federal Mine Safety and Health Review Commission
17
18
18
18
Institute of Museum and Library Services (IMLS)
257
265
282
268
Medicare Payment Advisory Commission (MedPAC)
13
13
13
13
Medicaid and CHIP Payment and Access Commission
9
9
9
9
(MACPAC)
National Council on Disability
3
4
4
4
National Labor Relations Board (NLRB)
274
302
317
274
National Mediation Board
14
15
16
15
Occupational Safety and Health Review Commission
13
15
15
14
Railroad Retirement Board (RRB)
147
148
153
147
Dual Benefits (minus tax receipts)
12
10
10
10
Federal Payment to RR Retirement Account (mandatory)a
0
0
0
0
Limitation on Administration
124
125
130
124
Inspector General
12
13
13
13
Social Security Administration (SSA)
68,329
71,293
71,172
70,443
Payments to Social Security Trust Funds (mandatory)
11
11
11
11
Supplemental Security Income (SSI) (mandatory)
55,282
56,982
56,982
56,982
Limitation on Administrative Expenses (LAE)
12,930
14,188
14,067
13,341
Regular LAE (incl. user fees, non-add)
11,355
12,480
12,359
11,633
Program Integrity (non-add)
1,575
1,708
1,708
1,708
Office of Inspector General
106
112
112
109
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FY2022
House
Cmte.
FY2021
FY2022
(H.R.
FY2022
Agency, Program, Project, or Activity
Enacted
Request
4502)
Enacted
Total, Related Agencies BA in the Bill
70,752
73,849
73,961
72,960
Subtotal, Mandatory
55,294
56,993
56,993
56,993
Subtotal, Discretionary
15,459
16,855
16,967
15,967
Emergency Funding (not in above totals)
—
—
—
—
Memoranda (non-emergency funds only)

Total, BA Available in Fiscal Year (current year from any bil )
71,022
77,839
77,861
76,900
Total, BA Advances for Future Years (provided in current bil )
20,075
16,075
16,165
16,125
Total, BA Advances from Prior Years (for use in current year)
20,345
20,065
20,065
20,065
Sources: Amounts in this table for the FY2021 Enacted, FY2022 Request, and FY2022 Enacted columns are
generally drawn from or calculated based on data contained in the explanatory statement accompanying the
FY2022 LHHS omnibus (P.L. 117-103), available in the Congressional Record, vol. 168, no. 42, book IV, March 9,
2022, pp. H2668-H2915. Amounts in the FY2021 House Committee column are generally drawn from or
calculated based on data contained in the committee report (H.Rept. 117-96) accompanying H.R. 4502. Enacted
totals (“Total BA in the Bil ”) for FY2021 or 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. 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).

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Appendix A. 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).102 (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 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 FY2031.103
On May 28, 2021, concurrent with the release of the President’s budget submission, President
Biden issued the required FY2022 sequestration order, calling for nonexempt mandatory
spending to be reduced on October 1, 2021.104 At that time, the Office of Management and
Budget (OMB) estimated that the FY2022 sequestration percentages would equal 2% of
nonexempt Medicare spending and 5.7% of other nonexempt nondefense mandatory spending,
for a total reduction of $23 billion in FY2022.105 (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

102 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.
103 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, P.L. 117-58.
104 Sequestration Order for Fiscal Year 2022 Pursuant to Section 251A of the Balanced Budget and Emergency Deficit
Control Act, As Amended, Federal Register Volume 86, No. 105, June 3, 2021, p. 29927, https://www.govinfo.gov/
content/pkg/FR-2021-06-03/pdf/2021-11819.pdf.
105 OMB Report to the Congress on the BBEDCA 251A Sequestration for Fiscal Year 2022, May 28, 2021,
https://www.whitehouse.gov/wp-content/uploads/2021/05/BBEDCA_251A_Sequestration_Report_FY2022.pdf. See
the report’s appendix for an itemized list of budget accounts that include mandatory spending subject to sequestration
in FY2022, 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.
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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.106
Since FY2020, the Medicare sequestration has been temporarily suspended through a series of
laws, starting with the enactment of the CARES Act on May 1, 2020 (P.L. 116-136). The act
suspended the Medicare sequestration from May 1, 2020, through December 31, 2020.
Subsequent laws (P.L. 116-260, P.L. 117-7, and P.L. 117-71) extended this suspension through
March 31, 2022.
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.107 However, since those statutory limits expired, any exemptions from budget control
for LHHS programs and activities generally were pursuant to provisions in the budget resolution,
with certain exceptions. The adjustments that apply to LHHS discretionary funding that are
currently in effect (pursuant to S.Con.Res. 14, discussed below108) 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

106 For more information, see CRS Report R42050, Budget “Sequestration” and Selected Program Exemptions and
Special Rules.
107 For further information, see CRS Report R45778, Exceptions to the Budget Control Act’s Discretionary Spending
Limits.
108 Section 4011 of S.Con.Res. 14 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
FY2022 adjustment for reemployment services and eligibility assessments pursuant to Section 314(g) of the
Congressional Budget Act (CBA) continues to be in effect, the limit on that adjustment in the CBA is the same as that
provided by S.Con.Res. 14 ($133 million in additional new budget authority).
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to the amount of appropriations each fiscal year that can be designated in this
manner. FY2022 emergency-designated LHHS spending enacted as of the date of
this report has totaled $7.8 billion. (For FY2021, $156.5 billion in LHHS
emergency-designated discretionary spending was enacted, almost all of which
related to COVID-19 pandemic response.109)
 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 FY2022, the
amount of this adjustment is limited to $1.4 billion in additional new budget
authority. However, at least $273 million must first be appropriated for these
purposes, subject to the budget resolution limits, in order for the additional $1.4
billion adjustment to be available. (For FY2021, the amount of the adjustment
was $1.3 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 FY2022, the
amount of this adjustment is limited to $556 million in additional new budget
authority. However, at least $317 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 FY2021, the amount of the adjustment
was $496 million, and the amount subject to the limits was $311 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 FY2022, the amount of this adjustment is limited to $133 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 $133 million adjustment to be available.110 (For FY2021, the
amount of the adjustment was $83 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.111 For the purposes of FY2022 LHHS appropriations, these
procedures apply only to the NIH Innovation Account that was created by the act.112 The Cures

109 For further information, see CRS Report R46775, Overview of COVID-19 LHHS Supplemental Appropriations:
FY2020 and FY2021.
110 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 FY2022 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).
111 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.
112 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).
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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 FY2022, these Cures Act funds
allowed in the LHHS bill total $496 million.
FY2022 Budget Resolution
A FY2022 budget resolution was agreed to by the House and the Senate. S.Con.Res. 14 was
adopted by the Senate on August 11, 2021, and by the House (without amendment) on August 24.
To provide for 302(a) allocations associated with S.Con.Res. 14, Section 4006 of the budget
resolution provided the Chair of the Senate Budget Committee the authority to enter into the
Congressional Record allocations consistent with the levels in the budget resolution. Those levels
were filed in the Senate on September 23, 2021.113 Section 4006 provided similar authority to the
Chair of the House Budget Committee and those allocations were filed on October 27, 2021.114 In
addition, S.Con.Res. 14 allowed adjustments to those allocations for emergency requirements,
health care fraud and abuse control, continuing disability reviews and redeterminations, and
reemployment services and eligibility assessments (as well as other purposes that do not apply to
LHHS). With the exception of emergency requirements, all of these adjustments are subject to
limits specified in S.Con.Res. 14.115 Neither the House nor the Senate filed 302(b) suballocations
pursuant to the FY2022 budget resolution.
Earlier in 2021, the House provided for budget enforcement in the absence of a budget resolution
prior to initial floor consideration of the FY2022 appropriations measures by adopting a deeming
resolution, H.Res. 467, on June 14, 2021.116 This resolution provided for 302(a) allocations to the
House Appropriations Committee at a specified level, provided limits on advance
appropriations,117 and allowed 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).118 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 24.119 The House Appropriations

113 “Publication of Budgetary Material,” Congressional Record, daily edition, Vol. 167, No. 165 (September 23, 2021),
pp. S6667-S6668.
114 Publication of Budgetary Material,” Congressional Record, daily edition, Vol. 167, No. 189 (October 27, 2021), pp.
H5956-H5957.
115 Section 4011 of S.Con.Res. 14 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
FY2022 adjustment for reemployment services and eligibility assessments pursuant to Section 314(g) of the
Congressional Budget Act (CBA) continues to be in effect, the limit on that adjustment in the CBA is the same as that
provided by S.Con.Res. 14 ($133 million in additional new budget authority).
116 For a discussion of budget enforcement through methods such as H.Res. 467, see CRS Report R44296, Deeming
Resolutions: Budget Enforcement in the Absence of a Budget Resolution.
117 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.
118 H.Res. 467 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 for FY2022 through FY2027 pursuant
to Section 314(g) of the Congressional Budget Act, subject to specified limits.
119 “Publication of Budgetary Material,” Congressional Record, daily edition, Vol. 167, No. 110 (June 24, 2021), p.
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Committee reported their initial 302(b) suballocations for all 12 subcommittees on July 1
(H.Rept. 117-78).120
For current-year LHHS discretionary funding, Table A-1 displays FY2021 enacted levels, the
House FY2022 initial suballocations (pursuant to H.Res. 467), and FY2022 enacted levels. 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, FY2022 enacted appropriations increased regular discretionary appropriations for LHHS
relative to FY2021 by 13% ($22.9 billion). The House committee suballocation would have
increased regular discretionary appropriations for LHHS relative to FY2021 by 36% (+$63.4
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
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 FY2021 and FY2022 Enacted Levels, and FY2022
House 302(b) Suballocations
(budget authority in billions of dollars)
FY2022 Initial
House 302(b)
FY2021
(and
FY2022

Enacted
Adjustments)
Enacted
Regular Discretionary Appropriations
174.073
237.466
196.994

Adjustmentsa:

Health care fraud and abuse control
0.496
0.556
0.556
Continuing disability reviews and
1.302
1.435
1.435
redeterminations
Reemployment services and eligibility
0.083
0.133
0.133
assessments
Emergency Requirements
156.588
—
7.831
Adjusted Appropriations
332.542
239.590
206.949

H3130.
120 Suballocations are commonly adjusted through the appropriations cycle to account for changing priorities. For
FY2022, the House Appropriations Committee reported revised suballocations on July 16 (H.Rept. 117-91) to
incorporate the cap adjustments where applicable, but otherwise the suballocation for the LHHS subcommittee was the
same as originally reported.
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Sources: Table prepared by CRS. The FY2021 Enacted amounts are from CBO, Report on the Status of
Discretionary Appropriations, Fiscal Year 2021, House of Representatives, as of July 30, 2021, https://www.cbo.gov/
system/files?file=2021-09/FY2021-House.pdf and CRS analysis of Division H of P.L. 116-260. The FY2022 House
amount for regular discretionary appropriations is from H.Rept. 117-78. The FY2022 House amount for the
adjustments is from a CRS analysis of H.R. 4502, as reported. 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, CRS analysis of Division H of P.L.
117-103, and Table 3 in CBO, cost estimate, “The Bipartisan Safer Communities Act would provide funding to
encourage enactment of state laws aimed at control ing access to guns and to support a variety of other
initiatives to enhance school safety, mental health programs, and violence prevention,” June 22, 2022,
https://www.cbo.gov/system/files?file=2022-06/S2938.pdf.
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 FY2021, these funds totaled $404 mil ion; for FY2022, these funds total $496 mil ion.)
a. The House initial 302(b) for LHHS (H.Rept. 117-78) did not include any adjustments to the LHHS
suballocations. These amounts are based on a CRS analysis of H.R. 4502, 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 FY2021 enacted column include FY2021
advance appropriations budget authority provided by the FY2019 LHHS omnibus (P.L. 116-94)
and FY2020 LHHS omnibus (P.L. 116-260). Similarly, the FY2022 President’s budget, FY2022
House Cmte., and FY2022 Enacted columns include FY2022 advance appropriations budget
authority provided by the FY2020 and FY2021 LHHS omnibuses. (For a comparable table
showing total budget authority in the bill, rather than current-year budget authority, see Table 2 in
this report.) As mentioned above, it is current-year budget authority (adjusted for scorekeeping by
CBO) that is used to determine compliance with discretionary spending allocations.
Table A-2. LHHS Appropriations Overview, by Bill Title: FY2021-FY2022
(current-year budget authority in billions of dollars)
FY2022
FY2021
FY2022
House Cmte.
FY2022
Bill Title
Enacted
Request
(H.R. 4502)
Enacted
Title I: Labor
13.9
15.6
16.0
14.4
Discretionary
12.5
14.3
14.7
13.2
Mandatory
1.4
1.2
1.2
1.2
Title II: HHS
1,007.8
1,142.5
1,142.3
1,131.1
Discretionary
97.0
120.0
119.8
108.6
Mandatory
910.8
1,022.5
1,022.5
1,022.5
Title III: Education
77.2
106.5
106.5
80.1
Discretionary
73.5
102.8
102.8
76.4
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FY2022
FY2021
FY2022
House Cmte.
FY2022
Bill Title
Enacted
Request
(H.R. 4502)
Enacted
Mandatory
3.7
3.7
3.7
3.7
Title IV: Related Agencies
71.0
77.8
77.9
76.9
Discretionary
15.4
16.8
16.9
15.9
Mandatory
55.6
61.0
61.0
61.0
Total Current Year BAa
1,169.9
1,342.4
1,342.7
1,302.6
Discretionary
198.5
254.0
254.3
214.1
Mandatory
971.4
1,088.4
1,088.4
1,088.4
Emergency Funding (not in above totals)

P.L. 116-260, Division H
1.6
—
—
—
P.L. 116-260, Division M
154.9
—
—
—
P.L. 117-31
0.0b
—
—
—
P.L. 117-43, Divisions A and C
—
—
—
4.2
P.L. 117-58, Division J
—
—
—
-0.3
P.L. 117-70, Division B
—
—
—
1.3
P.L. 117-128, Title IV
—
—
—
1.0
P.L. 117-159, Division B
—
—
—
1.6
Memoranda:

Advances for Future Years (provided in current
197.6
210.7
210.8
210.7
bil )c
Advances from Prior Years (for use in current
189.0
197.6
197.6
197.6
year)c
Additional Scorekeeping Adjustmentsd
-22.8
-25.4
-14.7
-15.0
Sources: Amounts in this table for the FY2021 Enacted, FY2022 Request, and FY2022 Enacted columns are
generally drawn from or calculated based on data contained in the explanatory statement accompanying the
FY2022 LHHS omnibus (P.L. 117-103), available in the Congressional Record, vol. 168, no. 42, book IV, March 9,
2022, pp. H2668-H2915. Amounts in the FY2021 House Committee column are generally drawn from or
calculated based on data contained in the committee report (H.Rept. 117-96) accompanying H.R. 4502. 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 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).
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b. P.L. 117-31 provided $25 mil ion in supplemental appropriations for the Refugee and Entrant Assistance
account at HHS for specified purposes related to Afghan special immigrants, which rounds to $0.0 in bil ions
(the unit of measure used in this table).
c. The calculation for total budget authority in the bil (rather than total budget authority available for
obligation in the current fiscal year) is as fol ows: Total Current Year BA minus Advances from Prior Years
plus Advances for Future Years. The amount for both Advances from Prior Years and Advances for Future
Years is the combined total of mandatory and discretionary spending.
d. Totals in this table have generally not been adjusted for further scorekeeping. (To adjust for scorekeeping,
add this line to the total budget authority.)
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link to page 66 Labor, Health and Human Services, and Education: FY2022 Appropriations

Appendix B. House Floor Amendments Offered to
Division A of H.R. 4502
The House began its initial floor consideration of FY2022 LHHS appropriations on July 27, 2021.
Those appropriations were initially considered on the floor as part of a consolidated
appropriations package and passed the House (219-208), as amended, on July 29, 2021 (Division
A of H.R. 4502). This package would have provided appropriations for six other appropriations
acts in addition to LHHS: Agriculture and Rural Development, Energy and Water Development,
Financial Services and General Government, Interior and Environment, Military Construction and
Veterans Affairs, and Transportation and Housing and Urban Development. LHHS amendments
were to Division A of what was to be the base text for amendment (Rules Committee Print 117-
12, as amended by H.Res. 555).
Floor action on H.R. 4502 was regulated by the terms of a special rule (H.Res. 555) that made in
order 56 amendments to the LHHS title of the bill.121 This rule also provided the authority for the
chair of the Appropriations Committee or her designee to offer any of the amendments made in
order en bloc (i.e., in groups of amendments to be disposed of together).122 All but two LHHS
amendments were considered in this manner.123 When counted as 56 separate amendments, 47
were adopted and 9 were rejected.124
All of the amendments that were offered and their dispositions are listed in Table B-1 below. The
summary of each amendment is as published in H.Rept. 117-109, the Rules Committee report
accompanying H.Res. 555.
Table B-1. LHHS House Floor Amendments Offered to H.R. 4502
En
Bloc
Amdt. No. and Summary from the Rules Committee
No.
Disposition
1. Scott, David (GA): Increases and decreases funds in the Workforce Innovation and
2
Adopted,
Opportunity Act (WIOA) program by $1,000,000 with the intent of supporting the
220-203
Secretary in carrying out activities that expand the national apprenticeship system for
recruitment, employment, and on-the-job earn-as-you-learn training of young African
Americans. (10 minutes)
2. Spanberger (VA), McKinley (WV): Increases and decreases HRSA’s Office of
3
Adopted,
Pharmacy Affairs by $1,000,000 to highlight the need to protect the integrity of the
voice vote
340B program by halting pharmaceutical manufacturers' unlawful actions that have
resulted in overcharges to 340B covered entities. (10 minutes)

121 For a list of these LHHS amendments (numbered 1-56) and the text of each that was made in order, see pages 8-13
and 30-38 of H.Rept. 117-109.
122 For further information about en bloc authority in the context of House floor consideration of appropriations
measures, see CRS Report R46841, Changes in the House of Representatives’ Initial Consideration of Regular
Appropriations Measures, 113th-116th Congresses.
123 For the en bloc amendments proposing changes to the LHHS division of the bill, see consideration of amendments
en bloc nos. 1, 2, 3, and 4 in Congressional Record, daily edition, vol. 167, no. 131 (July 27, 2021), pp. H4055-H4073.
124 Note that several of these amendments were plus-minus amendments, which provide an amount of funding that is to
be both added and subtracted from a specified account or activity. These amendments may be used to allow Members
to obtain floor time to speak during floor consideration, and may also help indicate congressional support for funds
being allotted for a particular purpose. For further information, see CRS In Focus IF11973, “Plus-Minus” Amendments
to Regular Appropriations Measures.
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En
Bloc
Amdt. No. and Summary from the Rules Committee
No.
Disposition
3. Speier (CA), Kuster (NH), Pressley (MA), Moore (WI), Garcia, Sylvia (TX), Maloney,
2
Adopted,
Carolyn (NY), Escobar (TX), Slotkin (MI): Prohibits the use of funds to implement or
220-203
enforce sections of former Secretary DeVos's Title IX rule. (10 minutes)
4. Welch (VT), McKinley (WV), Moore (WI), Garbarino (NY), Dean (PA): Increases
2
Adopted,
funding for the Low Income Housing Energy Assistance Program (LIHEAP) by
220-203
$10,000,000 offset by a reduction to Office of the Secretary - General Departmental
Management. (10 minutes)
5. Axne (IA), Schrier (WA), Malinowski (NJ): Provides $5 mil ion for community
2
Adopted,
col eges who provide training programs to dislocated workers, including those who lost
220-203
work due to COVID-19. (10 minutes)
6. Buchanan (FL): Transfers $2,000,000 from Office of the Secretary - General
3
Adopted,
Departmental Management to the Substance Abuse and Mental Health Administration
voice vote
to increase available grants to prevent prescription drug/opioid overdoses. (10 minutes)
7. Burgess (TX): Increases and decreases by $10,000,000 for the Director of the
3
Adopted,
National Institutes of Health Office for Acute Flaccid Myelitis Research. (10 minutes)
voice vote
8. Burgess (TX), Spanberger (VA): Transfers $5 mil ion from the Health Resources and
3
Adopted,
Services Administration, Program Support to fund the Rural Health, Project ECHO
voice vote
telehealth mentoring model, to improve health workforce capacity in underserved
areas. (10 minutes)
9. Bush, Cori (MO), Pressley (MA), Schakowsky (IL), Jayapal (WA): Increases and
2
Adopted,
decreases funding by $1 mil ion in the SAMHSA account to highlight the need for a
220-203
GAO study on alternative and non-punitive behavioral health crisis response programs
to determine the effectiveness of such programs in improving public health and public
safety. (10 minutes)
10. Bush, Cori (MO): Increases funding by $5 mil ion for Health Centers account to
2
Adopted,
provide health care services, including COVID-19 testing and vaccine outreach, to the
220-203
unhoused community. Reduces funding for the Office of the Secretary, General
Departmental Management by the same amount. (10 minutes)
11. Castor (FL): Increase and decrease funding in the Innovation and Improvement
2
Adopted,
account by $1 mil ion to encourage the Department of Education to conduct proper
220-203
oversight of for-profit charter schools to ensure they are supporting students adhering
to federal civil rights laws. (10 minutes)
12. DeSaulnier (CA): Increases funding for Statewide Family Engagement Centers at the
2
Adopted,
Department of Education by $1 mil ion offset by a reduction to Departmental
220-203
Management - Program Administration. (10 minutes)
13. Escobar (TX): Increases and decreases funding for the U.S. Mexico Border Health
2
Adopted,
Commission to emphasize the need for a binational COVID-19 vaccination plan for
220-203
border communities. (10 minutes)
14. Escobar (TX): Increases funding for the Department of Civil Rights at the
2
Adopted,
Department of Education to support economically disadvantaged communities.
220-203
Decreases funding for Departmental Management - Program Administration. (10
minutes)
15. Escobar (TX): Increases and decreases the Department of Education's Education for
2
Adopted,
the Disadvantaged account by $1 mil ion to make clear that States must disburse all
220-203
funds under this division in accordance with Congressional intent and not for purposes
not otherwise outlined in the corresponding report and bil text. (10 minutes)
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En
Bloc
Amdt. No. and Summary from the Rules Committee
No.
Disposition
16. Foxx (NC), Fulcher (ID): Prohibits funds from being used to rescind the
4
Rejected,
Department of Labor's December 9, 2020, final rule titled “Implementing Legal
192-232
Requirements Regarding the Equal Opportunity Clause's Religious Exemption" relating
to federal contractors. (10 minutes)
17. Gomez (CA): Increases and decreases by $5 mil ion in order to highlight the need
2
Adopted,
to improve access to life-saving cancer screenings in primary health centers to address
220-203
disproportionate cancer outcomes in underserved communities, particularly
communities of color. (10 minutes)
18. Gomez (CA): Increases and decreases by $1 mil ion to improve awareness and
2
Adopted,
implementation of language access services consistent with standards set by the Office
220-203
of Minority Health’s Culturally and Linguistically Appropriate Services in Health Care
program so that patients with limited English-language proficiency have access to
equitable healthcare services. (10 minutes)
19. Gomez (CA), Takano (CA), Lowenthal (CA): Increases and decreases funding in the
2
Adopted,
Strengthening Asian American Native American Pacific Islander Serving-Institutions
220-203
(AANAPISI) program by $10,000,000 to highlight this Minority-Serving Institution
program that provides competitive grants to eligible col eges and universities that serve
a considerable number of Asian American and Pacific Islander students. The AANAPISI
program provides equitable access to education, promotes opportunities for success,
and aids institutions in being able to understand and respond to the unique challenges
faced by Asian American and Pacific Islander students today. (10 minutes)
20. Gottheimer (NJ): Increases and decreases funds by $1,000,000 in the Centers For
3
Adopted,
Disease Control And Prevention Environmental Health account to emphasize the
voice vote
importance of every child having access to drinking water at school that’s free of lead
and dangerous materials. (10 minutes)
21. Gottheimer (NJ): Increases and decreases funds by $1,000,000 in the National
3
Adopted,
Institutes of Health's Substance Abuse and Mental Health Services Administration
voice vote
account to emphasize the importance of SAMHSA focusing efforts to address COVID-
linked substance abuse and mental health issues among children and young adults. (10
minutes)
22. Grothman (WI): Reduces the Higher Education funding by $122,000,000 to meet
4
Rejected,
the President's budget request. (10 minutes)
192-232
23. Hern (OK): Reduces spending in this division by 20 percent. Exempts security
1
Rejected,
funding. (10 minutes)
154-264
24. Issa (CA), Harshbarger (TN), Guthrie (KY), Womack (AR), Kim, Young (CA), Steel,
4
Rejected,
Michelle (CA): Strikes the language prohibiting the implementation of the Industry
192-232
Recognized Apprenticeship Program (IRAP) final rule. (10 minutes)
25. Jackson Lee (TX): Increases and decreases funds by $10,000,000 to support greater
2
Adopted,
diversity in the pool of diabetes research professionals and patients participating in
220-203
clinical trials. (10 minutes)
26. Jackson Lee (TX): Increases and decreases funds by $10,000,000 with the intent of
2
Adopted,
supporting programs that provide outreach and support services targeting program
220-203
participants at greatest risk of not completing a col ege degree due to COVID-19
education disruption. (10 minutes)
27. Langevin (RI), Bass (CA): Increases the Children and Families Services Programs
3
Adopted,
account by $3,900,000 and decrease the HHS General Departmental Management
voice vote
account by $3,900,000. (10 minutes)
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En
Bloc
Amdt. No. and Summary from the Rules Committee
No.
Disposition
28. Lesko (AZ): Strikes section 241 which prohibits funding to any organization,
4
Rejected,
including under the Child Welfare or Federal Foster Care programs under parts B or E
192-232
of title IV of the Social Security Act, that does not comply with paragraphs (c) and (d) of
section 75.300 of title 45, Code of Federal Regulations prohibiting discrimination on the
basis of age, disability, sex, race, color, national origin, religion, gender identity, or
sexual orientation. (10 minutes)
29. Lesko (AZ): Strikes language that allows federal funding to go to institutions of
N/A
Rejected,
higher education that are conducting research on marijuana. (10 minutes)
147-276
30. Levin, Andy (MI): Increases and decreases by $1 mil ion for BLS funding with the
2
Adopted,
intent that the funds go towards the agency reevaluating its unemployment survey
220-203
methods, particularly in how it measures unemployment in historically marginalized and
discriminated populations. (10 minutes)
31. Levin, Andy (MI): Increases and decreases by $1 mil ion for ILAB funding with the
2
Adopted,
intent that the funds support workers’ rights and capacity to organize independent
220-203
unions in Mexico. (10 minutes)
32. Lynch (MA): Provides an increase of $2 Mil ion to Community Health Centers and
3
Adopted,
decreases funding for Office of the Secretary - General Departmental Management by
voice vote
the same amount. (10 minutes)
33. McKinley (WV), Tonko (NY), Blunt Rochester (DE), Spanberger (VA), Van Drew
3
Adopted,
(NJ): Increases funds in the Substance Abuse Prevention program by $2,500,000 with
voice vote
the intent of supporting prescription drug monitoring programs pilot program to test
the feasibility and outcomes of integrating a substance use disorder and behavioral
health treatment locator tool into the prescription drug monitoring programs of 5
eligible States. Offset by spending from the Office of the Secretary. (10 minutes)
34. Mil er (WV), Pappas (NH), McKinley (WV): Increases funding for Neonatal
3
Adopted,
Abstinence Syndrome research by $1,000,000 offset by spending from the Office of the
voice vote
Secretary. (10 minutes)
35. Neguse (CO): Increases funding for the School-Based Mental Health Services Grant
2
Adopted,
Program by $2 mil ion. Decreases Departmental Management - Program Administration
220-203
by $2 mil ion. (10 minutes)
36. Ocasio-Cortez (NY): Allows United States researchers to study and examine the
N/A
Rejected,
potential impacts of several schedule I drugs, such as MDMA, psilocybin, and or
140-285
ibogaine, that have been shown to be effective in treating critical diseases. (10 minutes)
37. Perry (PA): Strikes funding for electric vehicles and a provision on electric vehicle
4
Rejected,
chargers. (10 minutes)
192-232
38. Pressley (MA), Bush, Cori (MO), Watson Coleman (NJ), Bowman (NY), Omar
2
Adopted,
(MN): Increases and decreases $500,000 from the Safe Schools and Citizenship
220-203
Education account to direct the GAO to study the impacts of exclusionary discipline
practices in K-12 remote education settings over the course of the COVID-19
pandemic including the ways in which these practices contributed to learning loss,
negative mental health outcomes, and student involvement in criminal and child welfare
systems, among other impacts. (10 minutes)
39. Rice, Kathleen (NY), Fitzpatrick (PA), Schrader (OR), Salazar (FL), Norton (DC),
3
Adopted,
Cooper (TN), Posey (FL), Titus (NV), Upton (MI), Malliotakis (NY), Cohen (TN), Estes
voice vote
(KS), Gooden (TX): Increases and decreases funding for CDC's Emerging Zoonotic and
Infectious Disease account with the intent of preventing the reintroduction of canine
rabies virus variant into the United States and supporting CDC modernizing and ful y
operating its dog import program. (10 minutes)
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En
Bloc
Amdt. No. and Summary from the Rules Committee
No.
Disposition
40. Ross (NC): Increases and decreases funding for the Institute of Education Sciences
2
Adopted,
(IES) by $1 mil ion to instruct IES to conduct a study on obstacles pregnant and
220-203
parenting students face in the pursuit of education and recommendations for improving
educational outcomes, including graduation rates, for these students. (10 minutes)
41. Schweikert (AZ): Increases funding for the National Institute of Diabetes and
3
Adopted,
Digestive and Kidney Diseases by $1 mil ion with the intent these funds be used to fund
voice vote
a multicenter research consortium on Type II diabetes cures. Offsets the increase with
a decrease in funding of $1 mil ion from the General Departmental Management
account under the Office of the Secretary of Health and Human Services. (10 minutes)
42. Schweikert (AZ): Increases funding by $2 mil ion for the CDC’s Emerging Zoonotic
3
Adopted,
and Infectious Disease account with the intention that these funds be used for
voice vote
Coccidioidomycosis and other fungal diseases. Offsets the increase with a decrease in
funding of $2 mil ion from the General Departmental Management account under the
Office of the Secretary of Health and Human Services. (10 minutes)
43. Schweikert (AZ): Increases and decreases funding in Health Surveillance and
3
Adopted,
Program Support by $1,000,000 to express the intent that additional funding for the
voice vote
Mental Health Administration be used for research on medication adherence
technology. (10 minutes)
44. Schweikert (AZ): Increases and decreases funding for the Department of Health and
3
Adopted,
Human Services Office of Inspector General under the Center for Medicare and
voice vote
Medicaid Services program by $1,000,000 to express the intent that Medicare focus on
using artificial intelligence and other technology to promote cleans claims creation and
processing to combat improper payments, fraud, waste, and abuse. (10 minutes)
45. Sherril (NJ): Increases and decreases funds by $20,000,000 to highlight the need for
2
Adopted,
the Mental and Substance Use Disorder Workforce Training Demonstration Program
220-203
under HRSA Health Workforce. (10 minutes)
46. Sherril (NJ): Increases and decreases the National Institute of Mental health budget
3
Adopted,
by $5,000,000 with the intent to address youth mental health disparities. (10 minutes)
voice vote
47. Slotkin (MI): Increase the DOL Registered Apprenticeship budget by $1 mil ion for
3
Adopted,
the purpose of improving coordination between DOL and VA to ensure that registered
voice vote
apprenticeships are approved by VA for GI Bil benefits. Offsets the amendment with a
$1 mil ion decrease in funds from the Program Administration account. (10 minutes)
48. Slotkin (MI): Increases and decreases the funding for Strategic National Stockpile by
3
Adopted,
$10 mil ion to emphasize the importance of working with the commercial sector to
voice vote
enhance medical supply chain flexibility and maintain domestic reserves of critical
medical supplies. (10 minutes)
49. Slotkin (MI): Increases and decreases by $10,000,000 the Child Care and
2
Adopted,
Development Block Grant (CCDBG) account to ensure that we stil have accessible,
220-203
quality child care for working families. (10 minutes)
50. Smith, Christopher (NJ), Delgado (NY), Fitzpatrick (PA), Posey (FL), Gottheimer
3
Adopted,
(NJ), Malinowski (NJ): Redirects $3 mil ion from CDC-Wide Activities and Program
voice vote
Support to CDC’s Emerging Zoonotic and Infectious Diseases account for Lyme disease
research and surveillance. (10 minutes)
51. Smith, Christopher (NJ), Delgado (NY), Fitzpatrick (PA), Posey (FL), Gottheimer
3
Adopted,
(NJ), Malinowski (NJ): Decreases and then increases funding for the HHS Office of the
voice vote
Secretary by $5 mil ion to express the intent that HHS use the $5 mil ion for their
recently announced LymeX Innovation Accelerator. (10 minutes)
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Labor, Health and Human Services, and Education: FY2022 Appropriations

En
Bloc
Amdt. No. and Summary from the Rules Committee
No.
Disposition
52. Smith, Christopher (NJ), Doyle (PA): Redirects $10 mil ion from HHS Office of the
3
Adopted,
Secretary to CDC’s Birth Defects, Developmental Disabilities, Disabilities and Health
voice vote
account. This $10 mil ion increase would allow CDC to expand their Autism
Developmental Disability Monitoring (ADDM) Network to nine additional sites, as well
as enhance six of the existing sites by fol owing-up with 16 year-olds who were
identified as autistic by 8 years-old. (10 minutes)
53. Spanberger (VA), Johnson, Dusty (SD), Meuser (PA): Increases and decreases funds
3
Adopted,
by $5 mil ion to highlight the need for additional funding for the Telehealth Resource
voice vote
Center program. (10 minutes)
54. Stevens (MI): Increases and decreases funding for injury prevention and control at
2
Adopted,
the Department of Health and Human Services by $25 mil ion to emphasize the intent
220-203
that additional funding be used for research on federal firearm injury and mortality
prevention research. (10 minutes)
55. Walberg (MI): Brings the Office of Labor-Management Standards funding in line with
4
Rejected,
the President’s request. Currently the House Appropriations bil provides level funding
192-232
for OLMS. The Amendment would increase the funding by $7,117,000 and decrease
funding for Wage and Hour Division by the same amount. (10 minutes)
56. Wild (PA): Invests $2 mil ion in additional funding for the National Cancer Institute,
3
Adopted,
for the purposes of enhancing pediatric cancer research. Specifically, funds would enable
voice vote
NCI's Childhood Cancer Data Initiative to incorporate molecular tumor board data
into its work. Offset by a reduction to Office of the Secretary - General Departmental
Management. (10 minutes)
Sources: The amendment numbers and summaries are from pages 8-13 and 30-38 of H.Rept. 117-109. En bloc
amendment numbers and the disposition of all amendments is from Congressional Record, daily edition, Vol. 167,
No. 131 (July 27, 2021).

Author Information

Jessica Tollestrup, Coordinator
William R. Morton
Specialist in Social Policy
Analyst in Income Security

Karen E. Lynch, Coordinator
Angela Napili
Specialist in Social Policy
Senior Research Librarian

David H. Bradley
Kavya Sekar
Specialist in Labor Economics
Analyst in Health Policy

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

Disclaimer
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Labor, Health and Human Services, and Education: FY2022 Appropriations

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