Department of Health and Human Services: FY2021 Budget Request (CRS Report for Congress)
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| Release Date |
April 17, 2020 |
| Report Number |
R46321 |
| Report Type |
Report |
| Authors |
Karen E. Lynch, Jessica Tollestrup, Ada S. Cornell |
| Source Agency |
Congressional Research Service |
Summary:
This report provides information about the FY2021 budget request for the U.S. Department of Health and Human Services (HHS). Historically, HHS has been one of the larger federal departments in terms of budgetary resources. Estimates by the Office of Management and Budget (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 27% of all federal outlays in FY2019. (FY2019 funding levels are generally considered final, whereas some FY2020 funding levels remain estimates.)
The FY2021 President's budget request was submitted to Congress on February 10, 2020. Subsequently, on March 17, 2020, the President submitted a letter to Congress about FY2021 budget amendments (along with a supplemental appropriations request for FY2020) related to the response to the Coronavirus Disease 2019 (COVID-19) outbreak. According to the letter, these budget amendments would have budgetary effects for the FY2021 President's request for some HHS accounts at the Centers for Disease Control and Prevention (CDC) and the National Institutes of Health (NIH). The letter did not contain sufficient details to incorporate potential effects of these amendments into the FY2021 request numbers contained in this report. As a result, the report reflects the President's initial request as submitted on February 10.
Under the FY2021 President's budget request, as submitted in February 2020, HHS would spend an estimated $1.37 trillion in outlays in FY2021. This would be $48 billion (+4%) more than estimated HHS outlays in FY2020 and $156 billion (+13%) more than actual HHS outlays in FY2019. Mandatory spending typically comprises the majority of the HHS budget. Two mandatory spending programsâMedicare and Medicaidâare expected to account for 86% of all estimated HHS outlays in FY2021, according to the President's budget 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.
Figure 1.Proposed FY2021 HHS Outlays by Major Program and Spending Category
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Source: Prepared by the Congressional Research Service (CRS) using data on pp. 18-19 of the FY2021 HHS Budget in Brief.
Notes: Percentages may not sum due to rounding. For mandatory spending, outlays reflect proposed law spending levels, not the current services baseline.
While mandatory spending is controlled (but not always provided) by authorizing laws, all discretionary spending is controlled and provided through the annual appropriations process. Discretionary spending accounts for about 8% of HHS outlays in the FY2021 President's budget request. Although discretionary spending represents a relatively small share of the HHS budget, the department nevertheless receives more discretionary money than most federal departments. According to OMB data, HHS accounted for nearly 8% of all discretionary budget authority across the government in FY2019.
