Status of FY2024 Labor, Health and Human Services, and Education Appropriations: In Brief

Status of FY2024 Labor, Health and Human Services, and Education Appropriations: In Brief

Status of FY2024 Labor, Health and Human
April 25, 2024
Services, and Education Appropriations:
Karen E. Lynch
In Brief
Specialist in Social Policy

This report provides a brief summary of the status of FY2024 Labor, Health and Human
Jessica Tollestrup
Services, and Education (LHHS) appropriations as of the cover date of this report. It also
Specialist in Social Policy
provides background on the scope of the LHHS bill generally and the context for congressional

appropriations decisions, including the submission of the FY2024 President’s budget request and
budget enforcement in the absence of a budget resolution.

Full-year FY2024 appropriations for LHHS were enacted on March 23, 2024, when the Further Consolidated Appropriations
Act, 2024 (FY2024 LHHS omnibus; H.R. 2882; P.L. 118-47) was signed into law by the President. The FY2024 LHHS
omnibus reduced regular discretionary appropriations for LHHS by 6% (-$12.9 billion) relative to FY2023 and by 1% (-$2.6
billion) relative to FY2022. Prior to its enactment, the final version of the measure was approved by the House on March 22,
and the Senate on March 23 (74-24).
Prior to enactment of full-year appropriations, FY2024 funding was provided temporarily through four continuing resolutions
(CRs). The first CR was signed into law on September 30, 2023 (Division A of H.R. 5860; P.L. 118-15), providing
continuing appropriations for all 12 annual appropriations acts (including LHHS) through November 17, 2023. Subsequently,
three additional CRs were enacted, which extended the provisions of the first CR with some additional provisions (see
Division A of P.L. 118-22, enacted on November 16, 2023; Division A of P.L. 118-35, enacted on January 19, 2024;
Division A of P.L. 118-40, enacted on March 1, 2024). In general, the CRs funded discretionary programs at the same rate,
and under the same conditions, as in FY2023 and funded annually appropriated entitlements at their current law levels. The
CRs included a few provisions that were specific to LHHS accounts or related activities.
On July 27, 2023, the Senate Appropriations Committee voted to report the FY2024 LHHS bill, 26-2; the measure was
subsequently reported to the Senate that same day (S. 2624; S.Rept. 118-84). The Senate committee bill would have reduced
discretionary appropriations for LHHS by 6% (-$12.1 billion) relative to FY2023 and by 1% (-$1.8 billion) relative to
FY2022. The measure was not formally marked up in subcommittee prior to full committee consideration. The Senate
Appropriations Committee reported its initial suballocations for all 12 subcommittees, including LHHS, on June 22, 2023
(15-13).
While the House Appropriations Committee did not report its version of the LHHS bill, a draft bill was approved in
subcommittee on July 14, 2023, by a voice vote. Previously, on June 15, 2023, the House Appropriations Committee
approved draft suballocations (33-27), which would have reduced regular discretionary appropriations for LHHS by 29%
(-$60.3 billion) relative to FY2023 and by 25% (-$49.9 billion) relative to FY2022.
The LHHS bill also received some House floor consideration, but the House did not vote on passage of the bill. On October
6, 2023, Representative Aderholt, Chair of the House Appropriations LHHS Subcommittee, introduced an LHHS bill (H.R.
5894); the text of H.R. 5894 was substantially the same as the subcommittee draft bill. The bill was brought to the House
floor for consideration on November 14, under the terms of a special rule (H.Res. 864). The special rule specified the
amendments that were to be in order, and provided that the text of the bill would be Rules Committee Print 118-13, which in
effect made numerous alterations to the provisions in H.R. 5894 as introduced. Floor amendments were considered on
November 14 and 15, with a total of 109 being adopted.
One proposal has been signed into law providing LHHS emergency-designated appropriations for FY2024. In P.L. 118-50
(H.R. 815, April 24, 2024), Division B, the Ukraine Security Supplemental Appropriations Act, 2024, provided $481 million
in emergency-designated appropriations for the Refugee and Entrant account at the Administration for Children and Families
(HHS).

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Contents
Scope of the LHHS Bill ................................................................................................................... 1
Context for FY2024 ......................................................................................................................... 2
FY2024 President’s Budget Submission ................................................................................... 2
FY2024 Discretionary Spending Levels and Appropriations Allocations ................................ 3
Statutory Spending Limits .................................................................................................. 4
Appropriations Allocations Under the Budget Resolution.................................................. 4
FY2024 LHHS Legislative Action .................................................................................................. 5
FY2024 Further Consolidated Appropriations Act ................................................................... 5
FY2024 Continuing Appropriations .......................................................................................... 5
FY2024 Emergency-Designated Appropriations ...................................................................... 6
Earlier Congressional Action on an LHHS Bill ........................................................................ 6
LHHS Funding Levels .............................................................................................................. 7

Tables
Table 1. LHHS Discretionary Appropriations: Comparison of FY2022 Enacted, FY2023
Enacted, FY2024 House and Senate Appropriations Committee Initial 302(b)
Suballocations, and FY2024 Enacted ........................................................................................... 8

Contacts
Author Information ........................................................................................................................ 10

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Status of FY2024 LHHS Appropriations: In Brief

ull-year FY2024 funding for the Departments of Labor, Health and Human Services, and
Education, and Related Agencies (LHHS) appropriations act were enacted on March 23,
F 2024, when the Further Consolidated Appropriations Act, 2024 (FY2024 LHHS omnibus;
H.R. 2882; P.L. 118-47) was signed into law by the President. Previously, FY2024 funding had
been provided temporarily through four continuing resolutions (P.L. 118-15, P.L. 118-22, P.L.
118-35, P.L. 118-40). This report provides a brief summary of the status of Labor, Health and
Human Services, and Education (LHHS) appropriations during the FY2024 appropriations cycle,
including relevant congressional actions and a top-line comparison of discretionary funding
enacted in FY2023 versus relevant FY2024 legislative proposals as of the cover date of this
report. It also provides background on the scope of the bill and the context for congressional
appropriations decisions.
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 of the 12 annual appropriations bills when accounting for both
mandatory and discretionary funding ($1.4 trillion in FY2023).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), Corporation for National and Community Service,
Corporation for Public Broadcasting, Institute of Museum and Library Services,
National Labor Relations Board, and Railroad Retirement Board.
In general, mandatory funding represents more than 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
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

1 Calculated based on the explanatory statement accompanying the FY2023 LHHS omnibus (P.L. 117-328) available in
the Congressional Record, vol. 168, no. 198, book II, December 20, 2022, pp. S8874-S9198. 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 FY2024 Senate committee-approved LHHS appropriations
on pages 7-11 of CRS Report R47936, Labor, Health and Human Services, and Education: FY2024 Appropriations.
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Status of FY2024 LHHS Appropriations: In Brief

focus of this report generally is on the discretionary spending 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 FY2024 LHHS appropriations act generally contains advance appropriations that
become available in FY2025 and FY2026 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, including
budget authority for emergency requirements, health care fraud and abuse control, and 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 bil ) 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 FY2024
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 FY2024 cycle has been affected by a number
of issues, including the circumstances affecting the timing of the President’s budget and the
recent imposition of statutory discretionary spending limits on defense and nondefense spending.
Background related to these issues is provided below.
FY2024 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 typically 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. 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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Status of FY2024 LHHS Appropriations: In Brief

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 FY2024 was submitted on March 9, 2023, about five weeks
after it was due. It was preceded by the enactment of FY2023 full-year annual appropriations
(P.L. 117-328) on December 29, 2022, about three months into the fiscal year. The delay of the
budget submission allowed the FY2023 funding amounts displayed in the budget materials
generally to reflect the annual appropriations in December.
On May 9, the President submitted amendments to the FY2024 budget request that included
changes to the amounts requested for specified Department of Education accounts.8 In addition,
two supplemental appropriations proposals made since that time have included requests for
LHHS-related discretionary funding. The request for “critical national security funding needs”
made on October 20 included funding for HHS and DOL accounts.9 The request for “critical
domestic needs” made on October 25 included funding for HHS and ED accounts.10
FY2024 Discretionary Spending Levels and Appropriations
Allocations
For FY2024, the discretionary spending levels in appropriations measures are enforceable by both
statutory and procedural means. Statutory budget enforcement is through the discretionary
spending limits in the Balanced Budget and Emergency Deficit Control Act of 1985 (BBEDCA;
P.L. 99-177), as amended. These statutory limits are enforced through sequestration: largely
across-the-board reductions made to the category of spending that is in excess of the limit
(defense or nondefense), to eliminate the excess spending.11 Procedural budget enforcement is
primarily associated with the budget resolution, which provides a process for the House and
Senate to agree on budgetary targets ahead of consideration of spending and revenue legislation.
These targets are enforced through points of order.
Certain spending is effectively exempt from these limits (commonly referred to as adjustments to
those 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), the SSA (continuing disability reviews

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.
8 See the budget amendments package at https://www.whitehouse.gov/wp-content/uploads/2023/05/
FY_2024_Budget_Amendment_Corrections_5-9-23.pdf.
9 See Executive Office of the President (EOP), Office of Management and Budget (OMB), “Letter Regarding Critical
National Security Funding Needs for FY 2024,” October 20, 2023, https://www.whitehouse.gov/omb/briefing-room/
2023/10/20/letter-regarding-critical-national-security-funding-needs-for-fy-2024/.
10 See EOP, OMB, “FACT SHEET: White House Calls on Congress to Support Critical Domestic Needs,” October 25,
2023, https://www.whitehouse.gov/briefing-room/statements-releases/2023/10/25/fact-sheet-white-house-calls-on-
congress-to-support-critical-domestic-needs/; and EOP, OMB, “Funding Request to meet Critical Needs,” undated,
https://www.whitehouse.gov/wp-content/uploads/2023/10/Funding-Request-to-Meet-Critical-Needs.pdf.
11 The Fiscal Responsibility Act of 2023 (FRA; P.L. 118-5) also contains procedures by which these limits might be
temporarily or permanently adjusted in the case of a continuing resolution. For a summary of these adjustments, see
CRS Insight IN12168, Discretionary Spending Caps in the Fiscal Responsibility Act of 2023.
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Status of FY2024 LHHS Appropriations: In Brief

and redeterminations), and for DOL to fund reemployment services and eligibility assessments
conducted by the states related to unemployment compensation.12
Statutory Spending Limits
The statutory limits on discretionary spending that are currently in effect were enacted as part of
the Fiscal Responsibility Act of 2023 (FRA; P.L. 118-5) on June 3, 2023.13 Prior to the FRA,
statutory limits on discretionary spending had been in effect from FY2012 through FY2021
(having expired at the end of FY2021).14 The FRA amended the BBEDCA to provide limits on
defense discretionary (all spending under budget function 050) and nondefense discretionary (all
other spending) for FY2024 and FY2025. All funding in the LHHS bill is subject to the
nondefense limit. The statutory limit on nondefense discretionary spending for FY2024 is
$703.65 billion. This would be a $40.2 billion (-5%) reduction relative to FY2023 enacted
nondefense discretionary spending when accounting for Congressional Budget Office (CBO)
scorekeeping, and prior to any adjustments to the limits pursuant to BBEDCA authorities.15 For
LHHS programs and activities, the FRA also provided for adjustments to the nondefense
spending limit for health care fraud and abuse control, continuing disability reviews and
redeterminations, and reemployment services and eligibility assessments, up to a specified
amount of funding for each of FY2024 and FY2025.16 The maximum amount of funding allowed
for these LHHS adjustments is $2.447 billion total in FY2024 and $2.531 billion in FY2025.
Appropriations Allocations Under the Budget Resolution
The budget resolution process dates back to the Congressional Budget Act of 1974, and is used
each year to impose 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 (referred to as 302(b)
suballocations).17

12 For further information on how these generally function, see Appendix A in CRS Report R47345, Labor, Health and
Human Services, and Education: FY2023 Appropriations.
13 For more information, see CRS Insight IN12168, Discretionary Spending Caps in the Fiscal Responsibility Act of
2023.
14 These limits were initially established in 2011 by the amendments made by the Budget Control Act of 2011 (BCA;
P.L. 112-25) to the BBEDCA, but they were subsequently revised several times over the course of their effective
period. For a summary of these changes, see CRS Insight IN11148, The Bipartisan Budget Act of 2019: Changes to the
BCA and Debt Limit.
15 These calculations are based on CBO, Report on the Status of Discretionary Appropriations, Fiscal Year 2023, U.S.
Senate, February 10, 2023, https://www.cbo.gov/system/files?file=2023-02/FY2023-Senate-2022-12-23.pdf. Note that
CBO tabulates a slightly different amount of funding using House conventions in CBO, Report on the Status of
Discretionary Appropriations, Fiscal Year 2023, U.S. House of Representatives, February 10, 2023,
https://www.cbo.gov/system/files?file=2023-02/FY2023-House-2022-12-23.pdf. The FRA includes a provision
described as incentivizing Members to enact regular full-year appropriations legislation. The FRA states that in the
event that a continuing resolution (CR) is in effect on January 1 of 2024 or 2025 for any budget account, the
discretionary spending limits for that fiscal year are automatically revised. The revision would result in an increase in
nondefense discretionary budget authority and a decrease for defense discretionary spending levels when compared
with the original levels. Under such a scenario, a sequester order would be issued on April 30 of either 2024 or 2025.
The FRA states that the revised limits would revert to the original FRA limits if full-year appropriations were enacted
before April 30. For more information, see CRS Insight IN12183, The FRA’s Discretionary Spending Caps Under a
CR: FAQs.
16 The FRA also provided for a designation for emergency requirements, which would generally be available for
funding under the purview of any appropriations act (not just LHHS).
17 For further information, see CRS Report 98-815, Budget Resolution Enforcement.
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As of the cover date of this report, there has been no House or Senate action on a FY2024 budget
resolution.18 For the purposes of providing 302(a) allocations and budgetary aggregates for the
consideration of FY2024 appropriations, as well as other matters that would have been
traditionally associated with the budget resolution, the FRA directed the Chairs of the House
Budget Committee and the Senate Budget Committee to enter those amounts into the
Congressional Record as soon as practicable. These were published in the Senate on June 21,
2023, but have not been published in the House.19
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., FY2024) appropriations within each subcommittee’s
jurisdiction and incorporate any applicable scorekeeping adjustments made by CBO.20 On June
15, 2023, the House Appropriations Committee voted to approve draft suballocations for all 12
subcommittees, including LHHS (33-27).21 Subsequently, the Senate Appropriations Committee
reported its suballocations on June 22, 2023 (15-13).22 These suballocations are displayed in
Table 1.
FY2024 LHHS Legislative Action
FY2024 Further Consolidated Appropriations Act
Full-year FY2024 appropriations for LHHS were enacted on March 23, 2024, when the Further
Consolidated Appropriations Act, 2024 (FY2024 LHHS omnibus; H.R. 2882; P.L. 118-47) was
signed into law by the President. The FY2024 LHHS omnibus provided full-year appropriations
for six of the annual appropriations acts in Divisions A-F, with LHHS appropriations being
provided in Division D. Prior to its enactment, the final version of the measure was approved by
the House on March 22,23 and the Senate on March 23 (74-24). The FY2024 LHHS
appropriations provided in the omnibus are summarized in the “LHHS Funding Levels” section.
FY2024 Continuing Appropriations
Between the start of FY2024 and the enactment of full-year appropriations, FY2024 LHHS
regular appropriations were provided by a series of CRs. The first CR was signed into law on
September 30, 2023 (Division A of H.R. 5860; P.L. 118-15). It provided continuing
appropriations for all 12 of the annual appropriations acts (including LHHS) through November

18 The House Budget Committee voted to report a FY2024 budget resolution on September 20, 2023, but the measure
has not yet been reported.
19 “Budget Enforcement Levels,” Congressional Record, daily edition, vol. 169, no. 108 (June 21, 2023), pp. S2180-
S2181.
20 Such suballocations are commonly revised throughout the appropriations process to reflect changing budgetary
priorities.
21 The House Appropriations Committee suballocations have not been formally reported, but they have been published
by the committee at https://appropriations.house.gov/sites/republicans.appropriations.house.gov/files/documents/
FY24%20House%20Subcommittee%20Allocations%206.13.23_0.pdf.
22 S.Rept. 118-45. These suballocations were subsequently revised in S.Rept. 118-57, S.Rept. 118-69, S.Rept. 118-78,
S.Rept. 118-98, S.Rept. 118-108, and S.Rept. 118-162.
23 The House vote on the LHHS omnibus was with regard to the special rule H.Res. 1102, which was brought up under
suspension of the rules and passed by a vote of 286-134. H.Res. 1102, as agreed to by the House, deemed that the
House concurred in the Senate amendment to H.R. 2282 passed on March 12, 2024, with a further amendment that
includes six appropriations bill divisions.
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17, 2023. H.R. 5860 was introduced by Representative Granger, the House Appropriations
Committee Chair, on September 30, 2023. That same day, the measure was passed by both the
House (335-91) and the Senate (88-9), and signed into law. Subsequently, three additional CRs
were enacted, (see Division A of P.L. 118-22, enacted on November 16, 2023; Division A of P.L.
118-35, enacted on January 19, 2024; Division A of P.L. 118-40, enacted on March 1, 2024).
In general, the FY2024 CRs funded discretionary programs at the same rate and under the same
conditions as in FY2023 annual appropriations acts (§101), with specified exceptions, and funded
annually appropriated entitlements at their current law levels (§111).24 The CRs included a few
provisions that were specific to LHHS accounts or related activities. Most of these LHHS-specific
provisions were included in the first CR and continued in the subsequent CRs (§§101(8), 133);
one new LHHS-specific provision was added in the second CR (§145).25
FY2024 Emergency-Designated Appropriations
Emergency designated appropriations are effectively exempt from otherwise applicable budget
enforcement requirements, such as committee allocations, as described above. One proposal has
been signed into law providing LHHS emergency-designated appropriations for FY2024. In P.L.
118-50 (H.R. 815, April 24, 2024), Division B, the Ukraine Security Supplemental
Appropriations Act, 2024, provided $481 million in emergency-designated appropriations for the
Refugee and Entrant account at the Administration for Children and Families (HHS).26
Earlier Congressional Action on an LHHS Bill
In the Senate, the FY2024 LHHS bill was reported out of the Senate Appropriations Committee,
but did not receive floor consideration. On July 27, 2023, the Senate Appropriations Committee
voted to report the FY2024 LHHS bill, 26-2; the measure was subsequently reported to the Senate
that same day (S. 2624; S.Rept. 118-84). The measure was not formally marked up in
subcommittee prior to full committee action.
In the House, the FY2024 LHHS bill received some House Appropriations Committee
consideration, but was not marked up by the full committee. The draft bill was approved in
subcommittee on July 14, 2023, by a voice vote.27

24 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.
25 The LHHS-specific provisions in the first CR (§§101(8) and 133) are discussed in CRS Report R47749, Overview of
Continuing Appropriations for FY2024 (Division A of P.L. 118-15).
26 The budgetary effects of Section 301 of Division B, related to eligibility for certain benefits, also were emergency-
designated. These budgetary effects are not included in this report because no definite dollar amount was specified. For
further information, see CBO, CBO Estimate for H.R. 8035, Ukraine Security Supplemental Appropriations Act, 2024,
As Posted on the website of the House Committee on Rules on April 17, 2024, April 19, 2024, https://www.cbo.gov/
system/files/2024-04/hr8035_Ukraine_Security_Supplemental_Appropriations_Act_2024.pdf.
27 See draft text linked to House Appropriations Committee, “Committee Releases FY24 Labor, Health and Human
Services, Education, and Related Agencies Appropriations Bill,” July 13, 2023, https://appropriations.house.gov/news/
press-releases/committee-releases-fy24-labor-health-and-human-services-education-and-related.
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The LHHS bill also received some House floor consideration, but the House did not vote on
passage of the bill. On October 6, 2023, Representative Aderholt, Chair of the House
Appropriations LHHS Subcommittee, introduced an LHHS bill (H.R. 5894); the text of H.R.
5894 as introduced was substantially the same as the subcommittee draft. The bill was brought to
the House floor for consideration on November 14, under the terms of a special rule (H.Res. 864),
that specified the amendments that would be in order and provided that the text of the bill would
be Rules Committee Print 118-13, which in effect made numerous alterations to the provisions in
H.R. 5894 as introduced.28 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)29; a total of 49 amendments were
considered in this manner. When counting amendments considered en bloc as separate
amendments, 109 amendments were adopted, 23 were rejected, and 2 were offered and
withdrawn.
LHHS Funding Levels
Table 1 displays the CBO estimate of enacted LHHS discretionary appropriations for FY2022
FY2023, and the FY2024 LHHS omnibus (FY2024 enacted), alongside the FY2024 draft House
suballocation for LHHS30 and the FY2024 Senate committee-reported bill (S. 2624). The amounts
shown for “regular discretionary appropriations” do not include any funding that is subject to
program integrity adjustments or emergency designations. The amounts shown represent current-
year budget authority subject to the spending limits and take into account any applicable CBO
scorekeeping adjustments. Under this method of estimating the bill, the FY2024 LHHS omnibus
reduced regular discretionary appropriations for LHHS by 6% (-$12.9 billion) relative to FY2023
and by 1% (-$2.6 billion) relative to FY2022. The enacted amount is similar to the Senate
proposal, which would have reduced discretionary appropriations for LHHS by 6% (-$12.1
billion) relative to FY2023 and by 1% (-$1.8 billion) relative to FY2022.31 In comparison, the

28 See the Rules Committee report accompanying H.Res. 864 for the text of the amendments made in order (H.Rept.
118-272). The text of Rules Committee Print 118-13 is posted at https://rules.house.gov/sites/
republicans.rules118.house.gov/files/LHHS%20RCP%20FINAL_xml.pdf. A comparative print of H.R. 5894 and the
Rules Committee Print 118-13 is posted at https://rules.house.gov/sites/republicans.rules118.house.gov/files/
118hr5894ih_to_LHHS%20RCP%20FINAL_xml.pdf. Draft explanatory materials accompanying H.R. 5894 and Rules
Committee Print 118-13 have also been released by the House Appropriations Committee and posted at
https://appropriations.house.gov/sites/republicans.appropriations.house.gov/files/FY24-LHHS-Explanatory-
Materials.pdf.
29 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.
30 The House Appropriations Committee majority summary of the subcommittee draft LHHS bill indicated that total
discretionary funding in the draft aligns with the draft subcommittee allocation. (See bill summary linked at House
Appropriations Committee majority, “Committee Releases FY24 Labor, Health and Human Services, Education, and
Related Agencies Appropriations Bill,” July 13 2023, https://appropriations.house.gov/news/press-releases/committee-
releases-fy24-labor-health-and-human-services-education-and-related.) According to page 2 of the draft explanatory
materials released by the House Appropriations Committee, the LHHS appropriations in H.R. 5894 (and presumably as
proposed in Rules Committee Print 118-13) align with the draft subcommittee suballocation.
31 An alternative way of calculating the amount of the Senate-proposed reductions was provided in the committee
report accompanying S. 2624. The subcommittee’s effective base discretionary funding allocation, which includes
discretionary funding offset by savings in changes in mandatory programs and other similar adjustments, is
$1,218,000,000 below the comparable FY2023 level (S.Rept. 118-84, p. 1). With regard to the House-proposed
reductions, it could not be determined based on the suballocations alone the extent to which these reductions would
have been achieved via rescissions to previously enacted funding and other related budgetary mechanisms, versus
reducing the amount of LHHS funding that would be newly enacted for FY2024.
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House proposal would have reduced regular discretionary appropriations for LHHS by 29%
(-$60.3 billion) relative to FY2023 and by 25% (-$49.9 billion) relative to FY2022.32
As mentioned previously, certain LHHS appropriations, such as those allowed for program
integrity funding or designated as for emergency requirements, are effectively exempt from the
discretionary spending limits (see discussion in the “FY2024 Discretionary Spending Levels and
Appropriations Allocations” section). The “adjusted appropriations” total in the table includes
funding under these adjustments, plus “regular discretionary appropriations.” Both the proposed
and enacted FY2024 LHHS appropriations provided the maximum amount allowed ($2.4 billion)
for the program integrity adjustments. (Note that the draft House Appropriations Committee
report on FY2024 suballocations for LHHS only presented an aggregate total for the three LHHS
“program integrity” adjustments.) FY2024 enacted emergency-designated appropriations for a
LHHS total of $481 million. The House suballocations for LHHS did not include any FY2024
funding for emergency requirements, whereas the FY2024 Senate committee-reported LHHS bill
would have provided $4.5 billion in emergency-designated discretionary funding.33
Table 1. LHHS Discretionary Appropriations: Comparison of FY2022 Enacted,
FY2023 Enacted, FY2024 House and Senate Appropriations Committee Initial
302(b) Suballocations, and FY2024 Enacted
(budget authority in billions of dollars)

FY2024
FY2024 Draft
Senate
House
Committee-
FY2022
FY2023
Committee
Reported
FY2024
Enacted
Enacted
Suballocationa
Bill (S. 2624)
Enacted
Regular discretionary
196.994
207.367
147.096
195.231
194.434
appropriations
Adjustments:b

Program Integrity
2.124
2.345
2.447
2.447
2.447
Health Care
0.556
0.576
—
0.604
0.604
Fraud and Abuse
Control (non-add)
Continuing
1.435
1.511
—
1.578
1.578
Disability Reviews
and
Redeterminations
(non-add)
Reemployment
0.133
0.258
—
0.265
0.265
Services and
Eligibility
Assessments
(non-add)
Emergency
7.831
9.920
—
4.500
0.481c
requirements

32 This CRS estimate 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 discretionary spending budget authority
allocation.
33 Emergency-designed funding in S. 2624 was proposed for a total of 11 accounts under the Health and Human
Services (Title II) and Related Agencies (Title IV) titles in the bill.
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link to page 12 Status of FY2024 LHHS Appropriations: In Brief

FY2024
FY2024 Draft
Senate
House
Committee-
FY2022
FY2023
Committee
Reported
FY2024
Enacted
Enacted
Suballocationa
Bill (S. 2624)
Enacted
Adjusted appropriations
206.949
219.632
149.543
202.178
197.362
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 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. The 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.
The FY2024 House Appropriations Committee initial suballocations are as published at
https://appropriations.house.gov/sites/republicans.appropriations.house.gov/files/documents/
FY24%20House%20Subcommittee%20Allocations%206.13.23_0.pdf. The FY2024 Senate Committee-reported bill
(S. 2624) amounts are from S.Rept. 118-84, p. 1, and CRS analysis of the text of S. 2624. FY2024 Enacted
amounts are from CBO, Report on the Status of Discretionary Appropriations, Fiscal Year 2024, House of
Representatives, as of March 23, 2024, https://www.cbo.gov/system/files/2024-04/FY2024-House-2024-03-23.pdf;
and CRS analysis of P.L. 118-50. “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.
Notes: Amounts reflect current-year discretionary budget authority subject to spending limits.
a. According to page 2 of the draft explanatory materials released by the House Appropriations Committee,
the LHHS appropriations in H.R. 5894 (and presumably as proposed in Rules Committee Print 118-13) align
with the draft subcommittee suballocation (House Appropriations Committee, draft explanatory materials
timestamped 03:26 on November 2, 2023, p. 2, https://appropriations.house.gov/sites/
republicans.appropriations.house.gov/files/FY24-LHHS-Explanatory-Materials.pdf).
b. The FY2022 enacted amounts for these activities are identified via CRS analysis of Division H of P.L. 117-
103. The FY2023 enacted amounts for these activities are identified via CRS analysis of 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.
c. The budgetary effects of Section 301 of Division B, related to eligibility for certain benefits, also were
emergency-designated. These budgetary effects are not included in this report because no definite dol ar
amount was specified. For further information, see CBO, CBO Estimate for H.R. 8035, Ukraine Security
Supplemental Appropriations Act, 2024, As Posted on the website of the House Committee on Rules on April 17,
2024, April 19, 2024, https://www.cbo.gov/system/files/2024-04/
hr8035_Ukraine_Security_Supplemental_Appropriations_Act_2024.pdf.

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Status of FY2024 LHHS Appropriations: In Brief

Author Information

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

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Congressional Research Service
R47622 · VERSION 13 · UPDATED
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