Department of Health and Human Services: FY2019 Budget Request (CRS Report for Congress)
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| Release Date |
Revised March 22, 2018 |
| Report Number |
R45138 |
| Report Type |
Report |
| Authors |
Lynch, Karen E.;Tollestrup, Jessica |
| Source Agency |
Congressional Research Service |
| Older Revisions |
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Summary:
This report provides information about the FY2019 budget request for the Department of Health
and Human Services (HHS). The report begins by reviewing the department’s mission and
structure. Next, the report offers a brief explanation of the conventions used for the FY2018
estimates and FY2019 request levels in the budget documents released by the HHS and the Office
of Management and Budget (OMB). The report also discusses the concept of the HHS budget as a
whole, in comparison to how funding is provided to HHS through the annual appropriations
process. The report concludes with a breakdown of the HHS request by agency, along with
additional HHS resources that provide further information on the request. A table of CRS key
policy staff is included at the end of the report.
Historically, HHS has been one of the larger federal departments in terms of budgetary resources.
Estimates by OMB indicate that HHS has accounted for at least 20% of all federal outlays in each
year since FY1995. Most recently, HHS is estimated to have accounted for 28% of all federal
outlays in FY2017.
Under the FY2019 President’s budget proposal, HHS would spend an estimated $1.2 trillion in
FY2019. This is $48 billion more than FY2018 estimated spending levels and about $113 billion
(+10%) more than FY2017 actual spending levels. Final FY2018 appropriations were not enacted
prior to the release of the FY2019 President’s budget request. As a result, the FY2018 estimates in
FY2019 President’s budget materials (and this report) are based on annualized amounts provided
in an FY2018 continuing resolution, plus current services estimates for mandatory spending.
Mandatory spending typically accounts for the majority of the HHS budget. Two programs—
Medicare and Medicaid—are expected to account for 86% of all estimated HHS spending in
FY2019, according to the President’s request. Medicare and Medicaid are “entitlement”
programs, meaning the federal government is required to make mandatory payments to
individuals, states, or other entities based on criteria established in authorizing law.
Discretionary spending accounts for about 8% of HHS outlays in the FY2019 President’s request.
Although discretionary spending represents a relatively small share of total HHS spending, the
department nevertheless receives more discretionary money than most federal departments.
According to OMB data, HHS accounted for 7% of all discretionary budget authority in FY2017.
