Status of FY2023 Labor, Health and Human Services, and Education Appropriations: In Brief

Status of FY2023 Labor, Health and Human Services, and Education Appropriations: In Brief

Status of FY2023 Labor, Health and Human
April 27, 2023
Services, and Education Appropriations:
Jessica Tollestrup
In Brief
Specialist in Social Policy

This report provides a brief summary of the status of FY2023 Departments of Labor, Health and
Karen E. Lynch
Human Services, and Education, and Related Agencies (LHHS) appropriations as of the cover
Specialist in Social Policy
date of this report. It also provides background on the scope of the LHHS bill generally and the

budgetary context for congressional decisionmaking, including the submission of the FY2023
President’s budget request and budget enforcement in the absence of a budget resolution.

Full-year FY2023 appropriations for LHHS were enacted on December 29, 2022, when the Consolidated Appropriations Act,
2023 (FY2023 omnibus; H.R. 2617; P.L. 117-328) was signed into law by the President. Prior to its enactment, the final
version of the measure was approved by the Senate on December 22 (68-29). It was approved by the House on December 23
(225-201).
In the interim, FY2023 LHHS funding had been provided temporarily through three continuing resolutions. The first CR was
signed into law on September 30, 2022 (Division A of H.R. 6833; P.L. 117-180), providing continuing appropriations for all
12 annual appropriations acts (including LHHS) through December 16, 2022. The second CR was signed into law on
December 16, 2022 (Division A of H.R. 1437; P.L. 117-229), extending appropriations through December 23, 2022. The
third CR was signed into law on December 23, 2022 (Division A of H.R. 4373; P.L. 117-264), extending appropriations
through December 30, 2022.
Previously, on June 30 2022, the House Appropriations Committee voted to report its FY2023 LHHS bill, 32-24; the measure
was subsequently reported to the House on July 5 (H.R. 8295; H.Rept. 117-403). The committee-reported bill would have
increased regular discretionary LHHS appropriations by an estimated $12.4 billion (+14%) relative to FY2022. Prior to full
committee action, the measure was approved in subcommittee, via a voice vote, on June 23, 2022. The committee reported its
initial suballocations for all 12 bills, including LHHS, on June 24, 2022 (H.Rept. 117-390).
While the Senate Appropriations Committee did not vote to report the legislation, the committee chair, Senator Leahy,
released a majority draft of the LHHS bill and accompanying draft report language on July 28, 2022. The Senate majority
draft proposal would have increased regular discretionary LHHS appropriations by about $19.1 billion (+10%) relative to
FY2022. (Also on July 28, 2022, Senator Patty Murray, Chair of the Senate Appropriations LHHS Subcommittee, introduced
an FY2023 LHHS bill [S. 4659] that appeared to be substantially the same as the majority draft.)
A handful of proposals have been signed into law providing LHHS emergency-designated appropriations for FY2023:
• Division A of the Continuing Appropriations and Ukraine Supplemental Appropriations Act, 2023 (H.R.
6833; P.L. 117-180, September 30, 2022) provided emergency-designated appropriations for two accounts
at the HHS Administration for Children and Families (ACF): $1.0 billion for the Low Income Home
Energy Assistance Program (§146) and $1.8 billion for expenses to carry out the Unaccompanied Children
Program and for certain refugee and entrant assistance activities (§147).
• Division M of H.R. 2617 (P.L. 117-328), the Additional Ukraine Supplemental Appropriations Act, 2023,
provided $2.4 billion in emergency-designated appropriations for the Refugee and Entrant Assistance
Account at ACF.
• Division N of H.R. 2617 (P.L. 117-328), the Disaster Relief Supplemental Appropriations Act, 2023,
provided a total of $4.3 billion in emergency-designated appropriations to several HHS accounts and
programs.

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Contents
Scope of the LHHS Bill ................................................................................................................... 1
Context for FY2023 ......................................................................................................................... 2
FY2023 President’s Budget Submission ................................................................................... 2
FY2023 Discretionary Spending Levels and Appropriations Allocations ................................ 3
FY2023 LHHS Legislative Action .................................................................................................. 4
FY2023 Consolidated Appropriations Act ................................................................................ 4
FY2023 Continuing Appropriations .......................................................................................... 5
FY2023 Emergency-Designated Appropriations ...................................................................... 5
Prior Congressional Action on an FY2023 Full-Year LHHS Bill ............................................. 6
FY2022 and FY2023 Discretionary Funding Levels ................................................................ 7

Tables
Table 1. LHHS Discretionary Appropriations: Comparison of FY2022 and FY2023
Enacted with FY2023 House Appropriations Committee Proposal and FY2023 Senate
Majority Draft .............................................................................................................................. 8

Contacts
Author Information .......................................................................................................................... 9

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Status of FY2023 Labor, Health and Human Services, and Education Appropriations

ull-year FY2023 appropriations for the Departments of Labor, Health and Human Services,
and Education, and Related Agencies (LHHS) appropriations act were enacted on
F December 29, 2022, when the Consolidated Appropriations Act, 2023 (FY2023 omnibus;
H.R. 2617; P.L. 117-328) was signed into law by the President. Previously, FY2023 funding had
been provided temporarily through three continuing resolutions (P.L. 117-180, P.L. 117-229, and
P.L. 117-264). This report provides a brief summary of the status of LHHS appropriations during
the FY2023 cycle, including relevant congressional actions and a topline comparison of
discretionary funding enacted in FY2022 and FY2023, versus relevant FY2023 legislative
proposals as of the cover date of this report. It also provides background on the scope of the bill
and the budgetary context for congressional decisionmaking. In addition, it summarizes the
FY2023 LHHS emergency-designated appropriations enacted in P.L. 117-180 and P.L. 117-328.
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.
Scope of the LHHS Bill
The LHHS bill is the largest ($1.4 trillion in FY2023) of the 12 annual appropriations bills when
accounting for both mandatory and discretionary funding.1 It provides annually appropriated
budget authority for the following federal departments and agencies:
• the Department of Labor (DOL);
• most agencies at the Department of Health and Human Services (HHS), 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 (funded through the Interior-Environment appropriations bill);
• the Department of Education (ED); and
• more than a dozen related agencies (RA), including the Social Security
Administration (SSA), 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.
In general, mandatory funding represents just over 80% of the total LHHS bill, supporting
annually appropriated entitlements such as Medicaid and Supplemental Security Income (SSI).
Discretionary funds, which account for less than 20% of total funds in the bill, tend to be the
focus of congressional debate during the appropriations process.2 This is because the
appropriations process generally has little control over the amount of mandatory funding provided

1 See the FY2023 Joint Explanatory Statement for LHHS in Congressional Record, daily edition, vol. 168, no. 198,
book II (December 20, 2022), p. S9197. The discretionary funding provided in the LHHS appropriations act is both
provided and controlled by that act. The mandatory funding provided in the LHHS act is controlled by provisions in
authorizing law. For definitions of these and other budget terms, see U.S. Government Accountability Office (GAO), A
Glossary of Terms Used in the Federal Budget Process, GAO-05-734SP, September 1, 2005, http://www.gao.gov/
products/GAO-05-734SP. (Terms of interest may include budget authority, appropriated entitlement, direct spending,
discretionary, entitlement authority, and mandatory.)
2 For an illustrative discussion of the distribution of funds among the different titles of the bill, and between
discretionary and mandatory spending, see the summary of FY2023 LHHS appropriations inCRS Report R47345,
Labor, Health and Human Services, and Education: FY2023 Appropriations, coordinated by Karen E. Lynch and
Jessica Tollestrup.
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for appropriated entitlements; rather, the authorizing statute controls the program parameters
(e.g., eligibility rules, benefit levels) that entitle certain recipients to payments. Consequently, the
focus of this report generally is on the discretionary spending that has been or would be provided
for LHHS programs and activities under various laws and proposals.
Even though discretionary appropriations represent a relatively small share of the entire LHHS
bill, the bill is typically the largest single source of nondefense discretionary funding for the
federal government. (The Department of Defense bill is the largest single source of discretionary
funding overall.)
Calculating Total LHHS Budget Authority
Budget authority is the amount of money a federal agency is legally authorized to commit or spend. Appropriations
bil s 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 (e.g., the FY2023 LHHS appropriations act contains advance appropriations that become available in
FY2024 and FY2025 for certain programs and activities). In addition, while new budget authority is generally
subject to a variety of statutory and congressional rules that are intended to control the budget (i.e., budget
controls), some budget authority may be effectively exempted from those controls (e.g., budget authority for
emergency requirements, health care fraud and abuse control, continuing disability reviews and redeterminations).
The amount of LHHS budget authority can be tabulated in various ways. The total amount of budget authority
provided in an appropriations bil (i.e., total in the bill) would be calculated regardless of the year in which the
funding becomes available.3 In some cases, such as the 302(b) suballocations (discussed later), the total is based on
current-year appropriations (i.e., the amount of budget authority available for obligation in a given fiscal year), which is
calculated regardless of the year in which it was first appropriated.4 Additionally, budgetary totals may or may not
include Congressional Budget Office (CBO) scorekeeping and other adjustments to reflect budget enforcement
conventions and special instructions of Congress.5 Finally, calculations of LHHS budget authority might include or
exclude budget authority that is exempted from budget controls.
Context for FY2023
Under the congressional budget process, congressional consideration of annual appropriations
traditionally is preceded by the submission of the President’s budget request and the adoption of
the congressional budget resolution. However, the FY2023 cycle has been affected by a number
of timing and budgetary issues related to the late submission of the President’s budget and the
lack of congressional agreement on topline discretionary spending amounts for the appropriations
committees. Background related to these issues is provided below.
FY2023 President’s Budget Submission
The Budget and Accounting Act of 1921 (P.L. 67-13), as amended, requires the President to
submit an annual consolidated federal budget to Congress at the beginning of each regular
congressional session, not later than the first Monday in February. Many of the proposals in the
President’s budget would require changes to laws that govern mandatory spending levels or
policies, which are typically established on a multiyear or permanent basis. Discretionary

3 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.
4 Such figures exclude advance appropriations for future years, but include advance appropriations from prior years that
become available in the given fiscal year.
5 For more information on scorekeeping, see CRS Report 98-560, Baselines and Scorekeeping in the Federal Budget
Process, by Bill Heniff Jr. 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).
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spending, however, which is roughly one-third of the federal budget,6 is decided and controlled
each fiscal year through the annual appropriations process. While Congress is ultimately not
required to adopt the President’s proposals or recommendations, the submission of the President’s
budget typically initiates the congressional budget process and informs Congress of the
President’s recommended spending levels for agencies and programs.7
The President’s budget request for FY2023 was submitted on March 28, 2022, about seven weeks
after it was due. It was preceded by the enactment of FY2022 full-year annual appropriations
(P.L. 107-103) on March 15, 2022, more than six months into the fiscal year. In some cases, the
President’s budget request reflected those full-year appropriations amounts that had been enacted
two weeks prior. However, in many other cases, the funding requested for LHHS programs and
activities was based on annualized estimates of the continuing appropriations that were in effect
at the time the budget was being prepared. As a consequence, many of the underlying
assumptions about funding increases and decreases relative to the prior year that went into the
formulation of the budget were outdated by the time the budget was submitted.
On June 7, the President submitted amendments to the FY2023 budget that included changes to
appropriations language requested for DOL and HHS.8 The Administration characterized the two
LHHS budget amendments as technical in nature; neither were estimated to affect budget
authority totals on net in the bill.
FY2023 Discretionary Spending Levels and Appropriations
Allocations
The congressional budget process generally enforces discretionary spending levels in
appropriations measures via procedural means.9 This procedural budget enforcement is primarily
associated with the budget resolution, which provides a process for the House and the Senate to
agree on budgetary targets ahead of consideration of spending and revenue legislation.
The budget resolution imposes a limit on total discretionary spending available to the
appropriations committees (commonly referred to as a 302(a) allocation) and, subsequently,
limits on spending under the jurisdiction of each appropriations subcommittee are created
(referred to as 302(b) suballocations). Certain spending is effectively exempt from these limits
(commonly referred to as adjustments to the limits). In recent years, adjustments that have been
applied to LHHS appropriations are for emergency requirements, to accommodate new budget
authority for specified program integrity initiatives at HHS (health care fraud and abuse control)
and the SSA (continuing disability reviews and redeterminations), and for DOL to fund
reemployment services and eligibility assessments conducted by the states related to
unemployment compensation.10

6 Congressional Budget Office (CBO), The 2022 Long-Term Budget Outlook, July 2022, p. 18, https://www.cbo.gov/
system/files/2022-07/57971-LTBO.pdf.
7 For more information, see CRS Report R47019, The Executive Budget Process: An Overview, by Dominick A.
Fiorentino and Taylor N. Riccard.
8 See the budget amendments package at https://www.whitehouse.gov/wp-content/uploads/2022/06/
FY_2023_Budget_Amendments_Package_6-7-22.pdf.
9 Between FY2012 and FY2021, the framework for discretionary spending budget enforcement under the congressional
budget process involved both statutory and procedural elements. Those statutory elements included limits on defense
and nondefense discretionary spending established by the Budget Control Act of 2011 (BCA; P.L. 112-25). These
limits expired at the end of FY2021 and were not renewed.
10 For further information, see Appendix A in CRS Report R47345, Labor, Health and Human Services, and Education:
FY2023 Appropriations, coordinated by Karen E. Lynch and Jessica Tollestrup.
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As of the cover date of this report, there has been no House or Senate action on an FY2023
budget resolution. In its absence, on June 8, 2022, the House adopted a resolution (H.Res. 1151)
to provide for 302(a) allocations to the House Appropriations Committee at a specified level,
provide limits on advance appropriations,11 and allow adjustments to those allocations for
emergency requirements, health care fraud and abuse control, and continuing disability reviews
and redeterminations (as well as other purposes that do not apply to LHHS).12 Pursuant to this
resolution, the chair of the House Budget Committee, Representative Yarmuth, published in the
Congressional Record the House Appropriations Committee allocations on June 21.13 The Senate
has not taken similar action to establish Senate Appropriations Committee allocations.14
Generally, the next step in the appropriations process is for each of the appropriations committees
to adopt suballocations from the total amount allocated to them. These 302(b) suballocations
provide a limit on current-year (i.e., FY2023) appropriations within each subcommittee’s
jurisdiction and incorporate any applicable scorekeeping adjustments made by CBO. The House
Appropriations Committee reported their initial 302(b) suballocations for all 12 subcommittees
on June 24 (H.Rept. 117-390).15 The discretionary budget authority suballocation for LHHS of
$224.399 billion represented a 14% (+$27.405 billion) increase relative to FY2022. That amount
did not include funding subject to adjustments, such as for emergency requirements.
FY2023 LHHS Legislative Action
FY2023 Consolidated Appropriations Act
Full-year FY2023 appropriations for LHHS were enacted on December 29, 2022, when the
Consolidated Appropriations Act, 2023 (FY2023 omnibus; H.R. 2617; P.L. 117-328) was signed
into law by the President. The FY2023 omnibus provided full-year appropriations for all 12
annual appropriations acts in Divisions A-L. (Full-year LHHS appropriations were enacted in
Division H.) Prior to its enactment, the final version of the measure was approved by the Senate
on December 22 (68-29). It was approved by the House on December 23 (225-201). The FY2023
LHHS appropriations provided in the FY2023 omnibus are summarized in “FY2022 and FY2023
Discretionary Funding Levels.”

11 Advance appropriations become available for obligation one or more fiscal years after the budget year covered by
the appropriations act. The FY2023 LHHS appropriations bill generally would contain advance appropriations for
FY2024 and FY2025 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, by
Jessica Tollestrup and Megan S. Lynch.
12 H.Res. 1151 also provided a technical clarification: the BCA cap adjustments (§251(b) of the Balanced Budget and
Emergency Deficit Control Act) that applied to discretionary appropriations between FY2012 and FY2021 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-FY2027 pursuant to §314(g) of the Congressional
Budget Act, subject to specified limits.
13 “Publication of Budgetary Material,” Congressional Record, daily edition, Vol. 168, No. 105 (June 21, 2022), pp.
H5731-H5732. For a discussion of budget enforcement through methods such as H.Res. 1151, see CRS Report
R47175, Setting Budgetary Levels: The House’s FY2023 Deeming Resolution, by Megan S. Lynch.
14 In the absence of such actions, the adjustment for emergency requirements that was established in the FY2022
budget resolution (S.Con.Res. 14, §4001) continued to apply in the Senate to the consideration of FY2023
appropriations.
15 Suballocations are commonly adjusted through the appropriations cycle to account for changing priorities. For
FY2023, the House Appropriations Committee reported revised suballocations on July 1 (H.Rept. 117-398) to
incorporate the cap adjustments where applicable and make an adjustment to outlay levels, but otherwise the
suballocation for the LHHS subcommittee was the same as originally reported.
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FY2023 Continuing Appropriations
Between the start of FY2023 and the enactment of full-year appropriations, FY2023 LHHS
regular appropriations were provided by a series of CRs. The first CR was signed into law on
September 30, 2022 (Division A of H.R. 6833; P.L. 117-180), providing continuing
appropriations for all 12 of the annual appropriations acts (including LHHS) through December
16, 2022. The measure, which was originally an unrelated vehicle that had been passed
previously by the House, was taken up by the Senate the week prior to the start of the fiscal year.
The Senate amended the measure to contain the CR, and passed it as amended (72-25) on
September 29, 2022. The House subsequently took up the measure and agreed to the Senate
amendment (230-201) on September 30, 2022.
A second CR was signed into law on December 16, 2022 (Division A of H.R. 1437; P.L. 117-
229), extending appropriations through December 23, 2022. The measure, which was originally
an unrelated vehicle that had been passed previously by the House and the Senate, was amended
in the House to contain the CR. The House passed (224-201) the amended bill on December 14.
The Senate passed (71-19) the bill on December 15.
A third CR was signed into law on December 23, 2022 (Division A of H.R. 4373; P.L. 117-264),
extending appropriations through December 30, 2022. The measure, which was originally an
unrelated appropriations measure that had been passed previously by the House, was amended by
the Senate to contain the CR. The Senate passed (voice vote) the amended bill on December 22.
The House agreed to the measure pursuant to provisions of H.Res. 1531 on December 23.
In general, the FY2023 CRs funded discretionary programs at the same rate and under the same
conditions as in FY2022 (§101) and annually appropriated entitlements at their current law levels
(§111).16 The CRs also included several anomalies that were specific to LHHS accounts or related
activities (§§101(8), 145-150).17
FY2023 Emergency-Designated Appropriations
Emergency designated appropriations are effectively exempt from otherwise applicable budget
enforcement requirements, such as committee allocations, as described above. A handful of
proposals have been signed into law providing LHHS emergency-designated appropriations for
FY2023:
• Division A of the Continuing Appropriations and Ukraine Supplemental
Appropriations Act, 2023 (H.R. 6833; P.L. 117-180, September 30, 2022)
provided emergency-designated appropriations for two accounts at the HHS
Administration for Children and Families (ACF): $1.0 billion for the Low
Income Home Energy Assistance Program (§146) and $1.8 billion for expenses

16 For an estimate of the discretionary appropriations contained in Division A of H.R. 6833, see Estimated
Discretionary Appropriations Under Division A of Senate Amendment Number 5745 to H.R. 6833, the Continuing
Appropriations and Ukraine Supplemental Appropriations Act, 2023, with Adjustments Made in the Senate, September
28, 2022, https://www.cbo.gov/system/files/2021-09/57491-CBO-Estimate-for-HR5305.pdf. For an estimate of the
discretionary appropriations contained in Division A of H.R. 1437, see Estimated Discretionary Appropriations Under
Division A of the Further Continuing Appropriations and Extensions Act, 2023 (Rules Committee Print 117-72, the
House Amendment to the Senate Amendment to H.R. 1437) as posted on the Rules Committee Website
(https://rules.house.gov/bill/117/hr1437-sa), with Adjustments Made in the House, December 14, 2022,
https://www.cbo.gov/system/files/2022-12/hr1437%28as_modified%29.pdf.
17 The LHHS anomalies are discussed in CRS Report R47283, Overview of Continuing Appropriations for FY2023
(Division A of P.L. 117-180), by Drew C. Aherne and Sarah B. Solomon.
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to carry out the Unaccompanied Children Program and for certain refugee and
entrant assistance activities (§147).18
• Division M of H.R. 2617 (P.L. 117-328), the Additional Ukraine Supplemental
Appropriations Act, 2023, provided $2.40 billion in emergency-designated
appropriations for the Refugee and Entrant Assistance Account at ACF.19
• Division N of H.R. 2617 (P.L. 117-328), the Disaster Relief Supplemental
Appropriations Act, 2023, provided a total of $4.25 billion in emergency-
designated appropriations to several HHS accounts and programs:
• $86 million for CDC-wide Activities and Program Support Account (Centers
for Disease Control and Prevention);
• $2.5 million to the National Institute of Environmental Health Sciences
(National Institutes of Health; NIH);
• $25 million to the Office of the Director (NIH);
• $3.5 billion to the Low Income Home Energy Assistance Program (ACF);
• $100 million to the Child Care and Development Block Grant (ACF);
• $408 million to the Children and Families Services Programs Account (ACF)
for several programs, including $345 million to the Head Start Program; and
• $128.8 million to the Public Health and Social Services Emergency Fund.

Prior Congressional Action on an FY2023 Full-Year LHHS Bill
On June 30 2022, the House Appropriations Committee voted to report the FY2023 LHHS bill,
32-24; the measure was subsequently reported to the House on July 5 (H.R. 8295; H.Rept. 117-
403). Previously, the measure was approved in subcommittee, via a voice vote, on June 23, 2022.
While the Senate Appropriations Committee did not vote to report its version of the legislation,
the committee chair, Senator Leahy, released a majority draft of the LHHS bill and accompanying
draft report language on July 28, 2022.20

18 The budgetary effects of §149 related to Afghan parolee eligibility for certain benefits also were emergency-
designated. These budgetary effects are not included in this report because the amount of funding was not specified in
the provision. For further information, see CBO, Estimated Discretionary Appropriations Under Division A of Senate
Amendment Number 5745 to H.R. 6833, the Continuing Appropriations and Ukraine Supplemental Appropriations Act,
2023, September 28, 2022, https://www.cbo.gov/system/files/2022-09/hr6833-CA.pdf.
19 The budgetary effects of §1501 related to Afghan parolee eligibility for certain benefits also were emergency-
designated. These budgetary effects are not included in this report because the amount of funding was not specified in
the provision. For further information, see CBO, Discretionary Spending in Fiscal Year 2023 Under Divisions A
Through L of H.R. 2617 (as modified by Senate Amendment 6552), the Consolidated Appropriations Act, 2023,
December 21, 2022, https://www.cbo.gov/system/files/2022-12/HR-2617_div-A%E2%80%93N.pdf.
20 See the draft text and explanatory statement linked to Senate Appropriations Committee, “Chairman Leahy Releases
Fiscal Year 2023 Senate Appropriations Bills,” July 28, 2022, https://www.appropriations.senate.gov/news/majority/
breaking-chairman-leahy-releases-fiscal-year-2023-senate-appropriations-bills. See also Senate Appropriations
Committee, “Shelby: Democrats’ Partisan Bills Threaten FY23 Appropriations Process,” July 28, 2022,
https://www.appropriations.senate.gov/news/minority/shelby-democrats-partisan-bills-threaten-fy23-appropriations-
process. Also on July 28, 2022, Senator Patty Murray, Chair of the Senate Appropriations LHHS Subcommittee,
introduced an FY2023 LHHS bill (S. 4659). This bill was referred to the Senate Appropriations Committee. Because S.
4659 did not received any congressional action, this report does not discuss this measure.
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FY2022 and FY2023 Discretionary Funding Levels
Table 1 displays the CBO estimate of enacted LHHS discretionary appropriations for FY2022
and FY2023, the House committee-reported FY2023 discretionary appropriations for LHHS, and
those in the Senate majority draft proposal. The amount shown for “regular discretionary
appropriations” does not include any funding that is subject to program integrity adjustments or
emergency designations. 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, the House proposal would increase regular discretionary
appropriations for LHHS relative to FY2022 by 14% (+$27.4 billion), while the Senate majority
draft proposal would increase those appropriations by 10% (+19.1 billion).21 Ultimately, the
FY2023 enacted amount was an increase in such funding of 5.3% (+10.4 billion).
As previously mentioned, certain LHHS appropriations, such as those allowed for program
integrity funding or designated for emergency requirements, are effectively exempt from the
discretionary spending limits. FY2023 enacted and the FY2023 House and Senate proposals
would provide the same amount for program integrity spending (see discussion in the “FY2023
Discretionary Spending Levels and Appropriations Allocations” section). With regard to new
FY2023 funding for emergency requirements, no such emergency-designated funding was
proposed in the House committee bill, but the Senate majority draft would enact such funding in
Titles II and VI. The “adjusted appropriations” total in the table includes these additional funds
along with “regular discretionary appropriations.”

21 This CRS estimate of the increase proposed by the Senate majority draft is based on a comparison of the CBO
estimate for FY2022 enacted (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)
to the total amount of spending listed on page 1 of the Senate majority draft LHHS committee report
(https://www.appropriations.senate.gov/imo/media/doc/LHHSFY23REPT.pdf).

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Table 1. LHHS Discretionary Appropriations: Comparison of FY2022 and FY2023
Enacted with FY2023 House Appropriations Committee Proposal and FY2023
Senate Majority Draft
(current-year budget authority in billions of dollars)
FY2023 House
FY2023 Senate
FY2022
Committee Bill
Majority Draft
FY2023

Enacted
(H.R. 8295)
(July 28, 2022)
Enacted
Regular discretionary appropriations
196.994
224.399
216.079
207.4
Adjustments:a

Health Care Fraud and Abuse
0.556
0.576
0.576
0.576
Control
Continuing Disability Reviews and
1.435
1.511
1.511
1.511
Redeterminations
Reemployment Services and
0.133
0.258
0.258
0.258
Eligibility Assessments
Emergency requirementsb
7.831
—
18.500
9.920
Adjusted appropriations
206.949
226.744
236.924
219.632
Source: The FY2022 Enacted amounts are from CBO, Report on the Status of Discretionary Appropriations, Fiscal
Year 2022, House of Representatives, as of May 26, 2022, https://www.cbo.gov/system/files?file=2022-05/FY2022-
House-2022-05-26.pdf, and 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. The FY2023 House Committee Bil amounts are
from page 3 of H.Rept. 117-403 and CRS analysis of H.R. 8295, as reported. FY2023 Senate Majority Draft
amounts are from page 1 of the Senate majority draft LHHS committee report
(https://www.appropriations.senate.gov/imo/media/doc/LHHSFY23REPT.pdf) and CRS analysis of the Senate
majority draft LHHS bil (https://www.appropriations.senate.gov/download/lhhsfy2023). FY2023 Enacted amounts
are from CBO, CBO Estimate for Divisions A through N of H.R. 2617 (as modified by S.A. 6552), the Consolidated
Appropriations Act, 2023, December 21, 2022, https://www.cbo.gov/publication/58872, and CRS analysis of P.L.
117-180 and P.L. 117-328.
Notes: Amounts reflect current-year discretionary budget authority subject to spending limits. “Regular
discretionary appropriations” exclude funds for which special rules apply under the spending limits (e.g., funds for
certain program integrity activities and emergency requirements), as well as funds provided under authorities in
the 21st Century Cures Act (P.L. 114-255) that are effectively exempt from the spending limits.
a. The FY2022 enacted amounts for these activities are identified via CRS analysis of Division H of P.L. 117-
103. The FY2023 proposed and enacted amounts for these activities are identified via CRS analysis of H.R.
8295, the FY2023 Senate Majority Draft, and Division H of P.L. 117-328. Note that CBO tabulates these
adjustments differently based on relevant procedures in CBO, Discretionary Spending in Fiscal Year 2023
Under Divisions A Through L of H.R. 2617 (as modified by Senate Amendment 6552), the Consolidated
Appropriations Act, 2023, December 21, 2022, https://www.cbo.gov/system/files/2022-12/HR-2617_div-
A%E2%80%93N.pdf. See also CBO, Report on the Status of Discretionary Appropriations, Fiscal Year 2023, House
of Representatives, February 10, 2023, https://www.cbo.gov/system/files?file=2023-02/FY2023-House-2022-
12-23.pdf; and CBO, Report on the Status of Discretionary Appropriations, Fiscal Year 2023, Senate, February 10,
2023, https://www.cbo.gov/system/files?file=2023-02/FY2023-Senate-2022-12-23.pdf.
b. The budgetary effects of §149 of P.L. 117-180 and §1501 of P.L. 117-328, both of which relate to Afghan
parolee eligibility for certain benefits, also were emergency-designated. These budgetary effects are not
included in this report because they did not specify a funding amount. For further information, see CBO,
Estimated Discretionary Appropriations Under Division A of Senate Amendment Number 5745 to H.R.
6833, the Continuing Appropriations and Ukraine Supplemental Appropriations Act, 2023, September 28,
2022, https://www.cbo.gov/system/files/2022-09/hr6833-CA.pdf; and CBO, Discretionary Spending in Fiscal
Year 2023 Under Divisions A Through L of H.R. 2617 (as modified by Senate Amendment 6552), the Consolidated
Appropriations Act, 2023, December 21, 2022, https://www.cbo.gov/system/files/2022-12/HR-2617_div-
A%E2%80%93N.pdf.
Congressional Research Service

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Status of FY2023 Labor, Health and Human Services, and Education Appropriations

Author Information

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

Disclaimer
This document was prepared by the Congressional Research Service (CRS). CRS serves as nonpartisan
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under the direction of Congress. Information in a CRS Report should not be relied upon for purposes other
than public understanding of information that has been provided by CRS to Members of Congress in
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Congressional Research Service
R47233 · VERSION 7 · UPDATED
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