This analysis was prepared by Venable, LLP, on behalf of AACOM.

The House Appropriations Committee is in the midst of marking up its fiscal year (FY) 2023 appropriation bills. Below is a summary and analysis of the various programs in the Labor, Health, and Human Services, Education, and Related Agencies (LHHSE) funding bill. 

Labor, Health and Human Services, Education, and Related Agencies

On June 30, 2022, the House Appropriations Committee approved the FY 2023 LHHS funding bill on a 32 to 24 vote. The legislation funds agencies and programs in the Departments of Health and Human Services, Labor, and Education. For 2023, the bill provides $242.1 billion overall, an increase of $28.5 billion—13 percent—above 2022.

Department of Health and Human Services (HHS)

Report Language

• Osteopathic Medical Schools.—The Committee recognizes that increased access to research funding for the osteopathic profession will bolster NIH's capacity to support recovery from the COVID-19 pandemic, address health disparities in rural and medically-underserved populations, and advance research in primary care, prevention, and treatment. The Committee requests an update on the current status of NIH funding to colleges of osteopathic medicine and representation of doctors of osteopathic medicine on NIH National Advisory Councils and standing study sections in the fiscal year 2024 Congressional Justification.

Discretionary Funding

The bill provides a total of $124.2 billion for HHS, an increase of $15.6 billion above the FY 2022 enacted level and $298 million below the President’s budget request. Of this amount, the bill includes:

• Health Resources and Services Administration (HRSA)—$9.6 billion for HRSA, an increase of $683 million above the FY 2022 enacted level and $792 million above the President’s budget request. This amount includes:
  • $1.9 billion, an increase of $198 million over FY 2022 enacted levels, for the Health Centers program, which delivers affordable, accessible, quality, and cost-effective primary health care to millions of people across the country regardless of their ability to pay. Programs supported by this funding include community health centers, migrant health centers, health care for the homeless, and public housing health service grants.
  • $25 million to establish the Public Health Loan Repayment program, which will support loan repayment for public health professionals who agree to serve three years in a local, state, or tribal health department.
  • $25 million to develop and disseminate best practices for Preventing Burnout in the Health Workforce, including support to prevent suicide, burnout, and mental and behavior health conditions among health care workers.
• Title VII—$652 million for the Title VII Health Professions Programs, an increase of $133 million above FY 2022 enacted levels and $63 million below the President’s budget request. This includes:
  • $30 million for Centers of Excellence (COEs), $6 million above the FY 2022 enacted level, to provide grants to health professions schools and other institutions to serve as resource and education centers for the recruitment, training, and retention of underrepresented minority students and faculty.
  • $18.5 million for Health Careers Opportunity Program (HCOP), $3 million above the FY2022 enacted level and the same as the President’s budget request, to assist students from minority and poor backgrounds to navigate careers in the health professions.
  • $1.5 million for Faculty Loan Repayment, an increase of $274,000 above the FY 2022 enacted level, to provide loan repayment to health profession graduates from disadvantaged backgrounds who serve as faculty at eligible health professions academic institutions.
  • $56 million for Scholarships for Disadvantaged Students (SDS), $3 million above the FY 2022 enacted level and $4 million above the President’s budget request, to provide grants to health professions and nursing schools to provide scholarships to students from disadvantaged backgrounds who have financial need.
  • $55 million for Primary Care Training and Enhancement (PCTE) programs, an increase of $6 million of the FY 2022 enacted level and $1 million above the President’s budget request, to support training and direct financial assistance for future primary care clinicians, teachers, and researchers.
  • $48 million for the Area Health Education Centers (AHEC) program, an increase of $3 million over the FY 2022 enacted level and $4.75 million above the President’s budget request, to link university health science centers with community health service delivery systems to provide education and training networks.
  • $48 million for the Geriatric Workforce Enhancement Program (GWEP), $3 million above the FY 2022 enacted level and $1.7 million above the President’s budget request, to support training to integrate geriatrics into primary care delivery and develop academic-primary care-community based partnerships to address gaps in health care for older adults.
  • $44 million for the Mental and Behavioral Health Programs, an increase of $5 million above the FY 2022 enacted levels.
  • $25 million for Graduate Psychology Education (GPE), an increase of $5 million above the FY 2022 enacted level, for the interprofessional GPE program to increase the number of health service psychologists trained to provide integrated services to high-need, underserved populations in rural and urban communities.
  • $185 million for Behavioral Health Workforce Education and Training (BHWET), a $62 million increase above the FY 2022 enacted level, to establish and expand internships or field placement programs in behavioral health, serving populations in rural and medically underserved areas.
  • $18 million for Public Health and Preventive Medicine Training Programs, $1 million above the FY 2022 enacted level and the same as the President’s budget request, including an increase of $500,000 for the Preventive Medicine Residency Training program and a $500,000 increase for Public Health Training Centers.
  • $60 million for Medical Student Education, a $5 million increase above the FY 2022 enacted level, to support colleges of medicine at public universities located in the top quartile of states projected to have a primary care provider shortage.
  • $15 million for the Pediatric Subspeciality Loan Repayment Program (LRP), an increase of $10 million over the FY 2022 enacted level, to address significant shortages of pediatric subspecialists, child psychiatrists, and other child mental health providers in underserved areas.
• Rural Health Residency Program—$12.7 million for the Rural Health Residency program, an increase of $2.2 million above the FY 2022 enacted level and the same as the President’s budget request, to fund physician residency training programs that support physician workforce expansion in rural areas.
• National Health Service Corps (NHSC)—$156 million for NHSC, an increase of $34 million above the FY 2022 enacted level, to support competitive awards to health care providers dedicated to working in underserved communities in urban, rural, and tribal areas. This amount includes:
  • $10 million to conduct a Rural Demonstration program to evaluate the benefit to patient access and practitioner recruitment and retention of extending loan repayment for 5 years and $200,000 for providers serving in a rural Health Professional Shortage Area (HPSA).
• Children’s Hospital Graduate Medical Education (CHGME)—$385 million for the CHGME payment program, $10 million above the FY 2022 enacted level and $35 million above the President’s budget request, to help eligible hospitals maintain graduate medical education program, which support the training of residents to care for the pediatric population and enhance the supply of primary care and pediatric medical and surgical subspecialities.
• National Institutes of Health (NIH)—$47.5 billion for NIH, an increase of $2.5 billion above the FY 2022 enacted level. This amount includes:
  • $2.75 billion for the Advanced Research Projects Agency for Health (ARPA-H), $1.75 billion above the FY 2022 enacted level and $2.25 billion below the President’s budget Request.
  • Funding for initiatives established in the 21st Century Cures Act, including a total of $216 million for the Cancer Moonshot Initiative, $541 million for the All of Us precision medicine initiative (including $419 million from the Cures Act); and $620 million for the Brain Research through Application of Innovative Neurotechnologies (BRAIN) Initiative (including $450 million from the Cures Act).
  • $7.4 billion for the National Cancer Institute ($7.4 billion); $3.7 billion for Alzheimer’s disease and related dementias research; $75 million for the ACT for ALS Act; $3.4 billion for HIV/AIDS research; $100 million for research related to opioids, stimulants, and pain/pain management; $100 million for health disparities research; and a 3.2 percent across-the-board increase for the NIH Institutes and Centers to support the biomedical research workforce.
• Agency for Healthcare Research and Quality (AHRQ)—$385 million for AHRQ, an increase of $35 million above the FY 2022 enacted level.
• Centers for Disease Control and Prevention (CDC)—$10.5 billion for the CDC, an increase of $2 billion above the FY 2022 enacted level and $231 million below the President’s budget request. This amount includes:
  • $750 million, an increase of $550 million above the FY 2022 enacted level, for public health infrastructure and capacity nationwide.
  • $106 million, an increase of $45 million above the FY 2022 enacted level, in public health workforce initiatives.

Department of Education (ED)

Discretionary Funding

The bill provides a total of $86.7 billion in discretionary appropriation for ED, an increase of $10.3 billion above the FY 2022 enacted level. Of this amount, the bill includes:

• Student Financial Assistance—$26.4 billion for federal student aid programs, an increase of $59 million above the FY 2022 enacted level. This includes:
  • $7,395 for the maximum Pell Grant, an increase of $500 above the FY 2022 enacted level.

90/10 Rule—Additionally, the bill includes language to revert the 90/10 Rule—which prohibits for-profit postsecondary institutions from deriving more than 90 percent of revenues from Title IV of the Higher Education Act—back to the original 85/15 ratio.

Department of Labor (DOL)

Discretionary Funding 

The bill provides a total of $15 billion in discretionary appropriations for DOL, an increase of $1.9 billion above the FY 2022 enacted level and $125 million above the President’s budget request. Of this amount, the bill includes:

• $3.1 billion for Workforce Innovation and Opportunity Act (WIOA) State Grants, an increase of $256 million above the FY 2022 enacted level and $116 million above the President’s budget request. WIOA, enacted in 2014, is designed to help job seekers access employment, education, training, and support services to success in the labor market and to match employers with skilled workers. 
• $100 million to continue and expand Strengthening Community College Training Grants, an increase of $50 million over the FT 2022 enacted level and the same as the President’s budget request. This program is designed to help meet local and regional labor market demand for a skilled workforce by providing training to workers in in-demand industries at community colleges and four-year partners.

Please contact AACOM Government Relations at aacomgr@aacom.org with questions or for further information.

Click here to return to the AACOM Action Center.