the American Association of Colleges of Osteopathic Medicine

This analysis was prepared by McDermott+ Consulting, on behalf of AACOM.

Timing and Process for FY 2024 Requests

U.S. Senate

On February 22, the Senate Appropriations Committee released information on appropriations requests and CDS for FY 2024, including a guidance document for Senators. The Committee confirmed that, in addition to accepting programmatic and language requests, it will again accept requests for CDS projects on a bipartisan basis. The guidance notes that CDS items can promote economic development, education, health care initiatives, and other worthy investments in communities across the country.

Senate rules define CDS as: “included primarily at the request of a Senator providing, authorizing, or recommending a specific amount of discretionary budget authority, credit authority, or other spending authority for a contract, loan, loan guarantee, grant, loan authority, or other expenditure with or to an entity, or targeted to a specific State, locality or Congressional district, other than through a statutory or administrative formula-driven or competitive award process.”

Under Senate rules, Senators requesting CDS projects must comply with specific accountability and transparency procedures. Senators must make requests in writing, and must verify they (and their immediate family) have no financial interest in the project. Additional accountability and transparency rules include:

Total funding for CDS items shall not exceed one percent of discretionary spending.
For-profit entities are not eligible for CDS, and Senators must certify that none of the entities for which they have requested CDS are for-profit.
Senators submitting CDS requests must publish the requests on their websites.
The Government Accountability Office (GAO) will audit a sample of enacted CDS items and report its findings to Congress.

A full description of Senate CDS requirements can be found here.

Each Senate Appropriations Subcommittee has a specific deadline by which Senators must submit their requests. Of note for health-related projects, the Labor-HHS Subcommittee has a deadline of April 13, and the Agriculture, Rural Development, Food and Drug Administration (FDA) and Related Agencies Subcommittee has a deadline of March 31. A full list of Subcommittee deadlines can be found in the guidance document linked above.

U.S. House of Representatives

On February 28, the House Appropriations Committee, under the new Republican majority, released its guidance for FY 2024 appropriations requests. Notably, with respect to health-related projects, the Labor-HHS Subcommittee is not accepting CPF requests this year. The Labor-HHS Subcommittee is still accepting requests for report language (directing or encouraging specific actions by federal agencies) and programmatic requests (requests for specific funding levels for agencies and programs funded through the annual appropriations bills). Additional guidance from the Labor-HHS Subcommittee on those requests, along with a Dear Colleague, can be found here and here.

In addition, the House Appropriations Committee has cut in half the total dollar value that earmarks can total, to 0.5% of total discretionary spending.

The Labor-HHS Subcommittee deadline for Members to submit programmatic and report language requests in March 24, and the deadline for the Agriculture Subcommittee—which is accepting CPF requests, and which includes the FDA—is also March 24. Specific parameters and guidelines for all FY 2024 House appropriations requests can be found in the above-linked guidance.

Internal Member Deadlines

It is important to note that Member offices set their own, internal deadlines that can be several weeks ahead of Appropriations Subcommittee deadlines. This allows Member offices to vet the many requests that are submitted to them, and to fill out the submission forms required by each Subcommittee. There is no standardized deadline for internal office deadlines, though many Senate offices appear to be coalescing around March 6 as a deadline by which organizations must submit their requests. Most offices post this information on their websites or will provide information on deadline dates over the phone.

Additional Notes

Also of note, not all Members of Congress participate in the earmark process. Historically, some Republican Members of Congress have questioned the spending of earmarks and their transparency and, as a result, some Republican offices do not submit earmark requests.

The restrictions on CPF for health-related projects in the House will result in all health care projects falling entirely to the Senate. This means that it will be harder to gain funding for health-related earmarks this year, and makes it even harder, or impossible, in states where one or neither Senator participates in the earmark process.

Further, the two chambers’ differing approaches to earmark requests in the Labor-HHS bill place greater importance on Senate requests for health-related projects in FY 2024. The differing approaches on the Labor-HHS bill (along with the Financial Services and Defense bills) could also result in complications in completing the appropriations process later this year, should House Republicans object to Labor-HHS earmarks included by the Senate.

Background

In the 110th Congress (2007-2008), the House and Senate codified earmark disclosure requirements into their respective rules in order to bring more transparency to the often-maligned practice. An earmark was defined as “any congressionally directed spending, tax benefit, or tariff that would benefit a specific entity or state, locality, or congressional district other than through a statutory or administrative formula or competitive award process.”

In the 112th Congress (2011-2012), the House and Senate began observing an earmark moratorium. After debating the merits of the return to the practice of earmarking over the course of multiple years, the 117th Congress (2021-2022) reinstated the process in a more limited manner, under new rules and guidelines that include greater transparency. Such spending is now more formally referred to as congressionally directed spending (CDS) in the Senate and community project funding (CPF) in the House, though the term earmark is still used informally.

During the FY 2023 appropriations process, for example, House Members were permitted to submit up to 15 earmark requests (up from a cap of 10 the previous year), recipients could not be for-profit entities, and legislators had to publicly post all requests, among other stipulations. Organizations requesting funding also had to demonstrate community support for the project.

Historically speaking, when an earmark is included in a House or Senate appropriations report, it remains in the final version of the appropriations bill that is enacted. In other words, the earmark does not have to be included in both chambers’ reports in order to be successful. However, new House guidance for FY 2024 that reduces the funding allowed for earmarks, enforces additional rules on their use and bans earmark request in the Labor, Health and Human Services, Education and Related Agencies (Labor-HHS) Subcommittee bill (as well as Defense and Financial Services) could result in complications when the two chambers seek to finalize appropriations agreements later this year (see below for additional details).

It should also be noted that while legislators are permitted to submit a specified number of requests, not all such requests will be funded. In addition, individual Members may have their own more stringent requirements regarding submissions.