    [Appendix]
    [Detailed Budget Estimates by Agency]
    [Department of Health and Human Services]
    [From the U.S. Government Printing Office, www.gpo.gov]

                         THE BUDGET FOR FISCAL YEAR 2006

    [[Page 427]]

                     DEPARTMENT OF HEALTH AND HUMAN SERVICES

                          FOOD AND DRUG ADMINISTRATION

                                  Federal Funds

    General and special funds:

                              Salaries and Expenses

        For necessary expenses of the Food and Drug Administration,
    including hire and purchase of passenger motor vehicles; for payment of
    space rental and related costs pursuant to Public Law 92-313 for
    programs and activities of the Food and Drug Administration which are
    included in this Act; for rental of special purpose space in the
    District of Columbia or elsewhere; for miscellaneous and emergency
    expenses of enforcement activities, authorized and approved by the
    Secretary and to be accounted for solely on the Secretary's certificate,
    not to exceed $25,000; and notwithstanding section 521 of Public Law
    107-188; [$1,788,478,000] $1,856,676,000, of which $7,000,000 shall
    remain available until expended for plans, construction, extension,
    alteration, and purchase of fixed equipment or facilities: Provided,
    That of the amount provided under this heading, [$284,394,000]
    $305,332,000 shall be derived from prescription drug user fees
    authorized by 21 U.S.C. 379h, [and] shall be credited to this account
    and remain available until expended, and shall not include any fees
    pursuant to 21 U.S.C. 379h(a)(2) and (a)(3) assessed for fiscal year
    2007 but collected in fiscal year 2006; [$33,938,000] $40,300,000 shall
    be derived from medical device user fees authorized by 21 U.S.C. 379j,
    and shall be credited to this account and remain available until
    expended; and [$8,354,000] $11,318,000 shall be derived from animal drug
    user fees authorized by 21 U.S.C. 379j, and shall be credited to this
    account and remain available until expended: Provided further, That fees
    derived from prescription drug, medical device, and animal drug
    assessments received during fiscal year [2005] 2006, including any such
    fees assessed prior to the current fiscal year but credited during the
    current year, shall be subject to the fiscal year [2005] 2006
    limitation[: Provided further, That none of these funds shall be used to
    develop, establish, or operate any program of user fees authorized by 31
    U.S.C. 9701: Provided further, That of the total amount appropriated:
    (1) $439,038,000 shall be for the Center for Food Safety and Applied
    Nutrition and related field activities in the Office of Regulatory
    Affairs; (2) $498,647,000 shall be for the Center for Drug Evaluation
    and Research and related field activities in the Office of Regulatory
    Affairs; (3) $172,714,000 shall be for the Center for Biologics
    Evaluation and Research and for related field activities in the Office
    of Regulatory Affairs; (4) $98,964,000 shall be for the Center for
    Veterinary Medicine and for related field activities in the Office of
    Regulatory Affairs; (5) $235,078,000 shall be for the Center for Devices
    and Radiological Health and for related field activities in the Office
    of Regulatory Affairs; (6) $40,530,000 shall be for the National Center
    for Toxicological Research; (7) $57,722,000 shall be for Rent and
    Related activities, other than the amounts paid to the General Services
    Administration for rent; (8) $129,815,000 shall be for payments to the
    General Services Administration for rent; and (9) $115,970,000 shall be
    for other activities, including the Office of the Commissioner; the
    Office of Management; the Office of External Relations; the Office of
    Policy and Planning; and central services for these offices: Provided
    further, That funds may be transferred from one specified activity to
    another with the prior approval of the Committees on Appropriations of
    both Houses of Congress].
        In addition, mammography user fees authorized by 42 U.S.C. 263b may
    be credited to this account, to remain available until expended.
        In addition, export certification user fees authorized by 21 U.S.C.
    381 may be credited to this account, to remain available until expended.
    (Agriculture, Rural Development, Food and Drug Administration, and
    Related Agencies Appropriations Act, 2005.)

                    Unavailable Receipts (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-9911-0-1-554      2004 actual   2005 est.   2006 est.
    ----------------------------------------------------------------------------
        Receipts:
    02.20 Cooperative research and
            development agreements, FDA.....           2           2           2
        Appropriations:
    05.00 Salaries and expenses.............          -2          -2          -2
                                               ---------   ---------  ----------
    07.99 Balance, end of year..............
    ---------------------------------------------------------------------------

                   Program and Financing (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-9911-0-1-554      2004 actual   2005 est.   2006 est.
    ----------------------------------------------------------------------------

        Obligations by program activity:
    00.01 Foods.............................         412         435         461
    00.02 Drugs.............................         498         505         507
    00.03 Devices and radiological products.         191         215         221
    00.04 National Center for Toxicological
            Research........................          40          40          41
    00.05 Other activities..................          91          87          87
    00.06 Other rent and rent related
            activities......................          38          54          58
    00.07 Rental payments...................         114         114         117
    00.08 Buildings and facilities..........          23                       7
    00.09 CRADAs............................           2           2           2
    09.01 Reimbursable program..............         306         379         411
                                               ---------   ---------  ----------
    10.00   Total new obligations...........       1,715       1,831       1,912
    ----------------------------------------------------------------------------

        Budgetary resources available for obligation:
    21.40 Unobligated balance carried
            forward, start of year..........          65          78          61
    22.00 New budget authority (gross)......       1,719       1,814       1,900
    22.10 Resources available from
            recoveries of prior year
            obligations.....................           9
                                               ---------   ---------  ----------
    23.90   Total budgetary resources
              available for obligation......       1,793       1,892       1,961
    23.95 Total new obligations.............      -1,715      -1,831      -1,912
                                               ---------   ---------  ----------
    24.40   Unobligated balance carried
              forward, end of year..........          78          61          49
    ----------------------------------------------------------------------------

        New budget authority (gross), detail:
          Discretionary:

    40.00   Appropriation...................       1,394       1,462       1,500
    40.35   Appropriation permanently
              reduced.......................          -8         -12
                                               ---------   ---------  ----------
    43.00     Appropriation (total
                discretionary)..............       1,386       1,450       1,500
          Mandatory:

    60.20   Appropriation (special fund)....           2           2           2
          Spending authority from offsetting
              collections:

            Discretionary:
    68.00     Offsetting collections (cash).         354         379         411
    68.10     Change in uncollected customer
                payments from Federal
                sources (unexpired).........           1
    68.26     Offsetting collections
                (previously unavailable)....         139         163         180
    68.45     Portion precluded from
                obligation (limitation on
                obligations)................        -163        -180        -193
                                               ---------   ---------  ----------
    68.90       Spending authority from
                  offsetting collections
                  (total discretionary).....         331         362         398
                                               ---------   ---------  ----------
    70.00   Total new budget authority
              (gross).......................       1,719       1,814       1,900
    ----------------------------------------------------------------------------

        Change in obligated balances:
    72.40 Obligated balance, start of year..         460         408         542
    73.10 Total new obligations.............       1,715       1,831       1,912
    73.20 Total outlays (gross).............      -1,770      -1,697      -1,888
    73.40 Adjustments in expired accounts
            (net)...........................           3
    73.45 Recoveries of prior year
            obligations.....................          -9
    74.00 Change in uncollected customer
            payments from Federal sources
            (unexpired).....................          -1
    74.10 Change in uncollected customer
            payments from Federal sources
            (expired).......................          10
                                               ---------   ---------  ----------
    74.40   Obligated balance, end of year..         408         542         566
    ----------------------------------------------------------------------------

        Outlays (gross), detail:
    86.90 Outlays from new discretionary
            authority.......................       1,440       1,450       1,523
    86.93 Outlays from discretionary
            balances........................         329         245         363
    86.97 Outlays from new mandatory
            authority.......................           1           2           2
                                               ---------   ---------  ----------
    87.00   Total outlays (gross)...........       1,770       1,697       1,888
    ----------------------------------------------------------------------------

    [[Page 428]]

        Offsets:
          Against gross budget authority and outlays:

            Offsetting collections (cash)
                from:
    88.00     Federal sources...............         -57         -34         -34
    88.40     Non-Federal sources...........        -334        -345        -377
                                               ---------   ---------  ----------
    88.90       Total, offsetting
                  collections (cash)........        -391        -379        -411
          Against gross budget authority only:

    88.95   Change in uncollected customer
              payments from Federal sources
              (unexpired)...................          -1
    88.96   Portion of offsetting
              collections (cash) credited to
              expired accounts..............          37
    ----------------------------------------------------------------------------

        Net budget authority and outlays:
    89.00 Budget authority..................       1,364       1,435       1,489
    90.00 Outlays...........................       1,379       1,318       1,477
    94.01 Unavailable balance, start of
            year: Offsetting collections....                     163         180
    94.02 Unavailable balance, end of year:
            Offsetting collections..........         163         180         193
    ---------------------------------------------------------------------------

                            [In millions of dollars]

                                            2004         2005        2006
    Distribution of budget authority by
        account:
      Salaries and expenses.............       1,339       1,433       1,480
      Buildings and facilities..........          23           0           7
    Distribution of outlays by account:
      Salaries and expenses.............       1,356       1,313       1,472
      Buildings and facilities..........          23           5           5

                                 Performance Metrics

    ----------------------------------------------------------------------------
    Identification code 75-9911-0-1-554      2004 actual   2005 est.   2006 est.
    ----------------------------------------------------------------------------
        Food and Drug Administration:
    105701Reduce administrative staff.......       3,086       2,623
    105704Percentage of medical device
            submissions that will receive
            final decisions within 320
            review days.....................                     70%         80%
    ---------------------------------------------------------------------------

        The FDA is responsible for protecting the public health by assuring
    the safety, efficacy, and security of human and veterinary drugs,
    biological products, medical devices, our Nation's food supply,
    cosmetics, and products that emit radiation. The FDA is also responsible
    for advancing the public health by helping to speed innovations that
    make medicines more effective, safer, and more affordable; and helping
    the public get the accurate, science-based information they need to use
    medicines and foods to improve their health. The Budget includes funding
    for counterterrorism activities that specifically relate to the
    protection of products or therapies regulated by the FDA (such as drugs,
    vaccines, foods, and animal feed), and the availability of medical
    products for public health preparedness in the event of an attack.
    Specifically, the Budget requests increased funding for food defense,
    drug safety, medical device reviews, and moving expenses for a new Human
    Drugs facility in White Oak, Maryland.

                   Object Classification (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-9911-0-1-554      2004 actual   2005 est.   2006 est.
    ----------------------------------------------------------------------------

          Direct obligations:

            Personnel compensation:
    11.1      Full-time permanent...........         549         639         638
    11.3      Other than full-time permanent          64          40          39
    11.5      Other personnel compensation..          22          22          22
    11.7      Military personnel............          43          36          36
                                               ---------   ---------  ----------
    11.9        Total personnel compensation         678         737         735
    12.1    Civilian personnel benefits.....         161         156         156
    12.2    Military personnel benefits.....          23          17          17
    13.0    Benefits for former personnel...           7
    21.0    Travel and transportation of
              persons.......................          23          24          25
    22.0    Transportation of things........           4           5           5
    23.1    Rental payments to GSA..........         114         114         118
    23.2    Rental payments to others.......           4           5           5
    23.3    Communications, utilities, and
              miscellaneous charges.........          23          24          27
    24.0    Printing and reproduction.......           2           2           3
    25.1    Advisory and assistance services          39          48          43
    25.2    Other services..................          83          87          90
    25.3    Other purchases of goods and
              services from Government
              accounts......................          76          80          83
    25.4    Operation and maintenance of
              facilities....................          49          50          52
    25.5    Research and development
              contracts.....................          19          20          22
    25.7    Operation and maintenance of
              equipment.....................          22          22          25
    26.0    Supplies and materials..........          19          19          22
    31.0    Equipment.......................          25          25          30
    32.0    Land and structures.............          22           1           6
    41.0    Grants, subsidies, and
              contributions.................          22          23          45
    44.0    Refunds.........................          -6          -7          -8
                                               ---------   ---------  ----------
    99.0      Direct obligations............       1,409       1,452       1,501
    99.0  Reimbursable obligations..........         306         379         411
                                               ---------   ---------  ----------
    99.9    Total new obligations...........       1,715       1,831       1,912
    ---------------------------------------------------------------------------

                                  Personnel Summary

    ----------------------------------------------------------------------------
    Identification code 75-9911-0-1-554      2004 actual   2005 est.   2006 est.
    ----------------------------------------------------------------------------
        Direct:
          Total compensable workyears:

    1001    Civilian full-time equivalent
              employment....................       7,959       7,957       7,746
    1101    Military full-time equivalent
              employment....................         608         601         588
        Reimbursable:
          Total compensable workyears:

    2001    Civilian full-time equivalent
              employment....................       1,495       1,701       1,738
    2101    Military full-time equivalent
              employment....................         113         125         132
    ---------------------------------------------------------------------------

    Public enterprise funds:

               Revolving Fund for Certification and Other Services

                   Program and Financing (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-4309-0-3-554      2004 actual   2005 est.   2006 est.
    ----------------------------------------------------------------------------

        Obligations by program activity:
    09.01 Reimbursable program..............           6           6           6
                                               ---------   ---------  ----------
    10.00   Total new obligations...........           6           6           6
    ----------------------------------------------------------------------------

        Budgetary resources available for obligation:
    21.40 Unobligated balance carried
            forward, start of year..........           2           1
    22.00 New budget authority (gross)......           5           5           6
                                               ---------   ---------  ----------
    23.90   Total budgetary resources
              available for obligation......           7           6           6
    23.95 Total new obligations.............          -6          -6          -6
                                               ---------   ---------  ----------
    24.40   Unobligated balance carried
              forward, end of year..........           1
    ----------------------------------------------------------------------------

        New budget authority (gross), detail:
          Mandatory:

    69.00   Offsetting collections (cash)...           5           5           6
    ----------------------------------------------------------------------------

        Change in obligated balances:
    72.40 Obligated balance, start of year..           2           2           2
    73.10 Total new obligations.............           6           6           6
    73.20 Total outlays (gross).............          -6          -6          -6
                                               ---------   ---------  ----------
    74.40   Obligated balance, end of year..           2           2           2
    ----------------------------------------------------------------------------

        Outlays (gross), detail:
    86.97 Outlays from new mandatory
            authority.......................           5           5           5
    86.98 Outlays from mandatory balances...           1           1           1
                                               ---------   ---------  ----------
    87.00   Total outlays (gross)...........           6           6           6
    ----------------------------------------------------------------------------

        Offsets:
          Against gross budget authority and outlays:

    88.40   Offsetting collections (cash)
              from: Non-Federal sources.....          -5          -5          -6
    ----------------------------------------------------------------------------

        Net budget authority and outlays:
    89.00 Budget authority..................
    90.00 Outlays...........................           1           1
    ---------------------------------------------------------------------------

    [[Page 429]]

        FDA certifies color additives for use in foods, drugs, and
    cosmetics. It also lists color additives for use in foods, drugs,
    medical devices, and cosmetics (21 U.S.C. 346a, 356, 357, 376). These
    services are financed wholly by fees paid by the industries affected.

                   Object Classification (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-4309-0-3-554      2004 actual   2005 est.   2006 est.
    ----------------------------------------------------------------------------
    11.1  Personnel compensation: Full-time
            permanent.......................           2           2           2
    12.1  Civilian personnel benefits.......           1           1           1
    23.1  Rental payments to GSA............           1           1           1
    23.3  Communications, utilities, and
            miscellaneous charges...........           1
    25.2  Other services....................           1           1           1
    31.0  Equipment.........................                       1           1
                                               ---------   ---------  ----------
    99.9    Total new obligations...........           6           6           6
    ---------------------------------------------------------------------------

                                  Personnel Summary

    ----------------------------------------------------------------------------
    Identification code 75-4309-0-3-554      2004 actual   2005 est.   2006 est.
    ----------------------------------------------------------------------------
        Reimbursable:
    2001  Total compensable workyears:
            Civilian full-time equivalent
            employment......................          35          38          38
    ---------------------------------------------------------------------------

                  HEALTH RESOURCES AND SERVICES ADMINISTRATION

                                  Federal Funds

    General and special funds:

                          Health Resources and Services

        For carrying out titles II, III, IV, VII, VIII, X, XII, [XIX,] and
    XXVI of the Public Health Service Act, section 427(a) of the Federal
    Coal Mine Health and Safety Act, title V and sections 1128E[,] and 711[,
    and 1820] of the Social Security Act, the Health Care Quality
    Improvement Act of 1986, as amended, the Native Hawaiian Health Care Act
    of 1988, as amended, the Cardiac Arrest Survival Act of 2000, [section
    712 of the American Jobs Creation Act of 2004,] and the Poison Control
    Center Enhancement and Awareness Act, as amended, [$6,856,624,000, of
    which $484,629,000 shall be available for construction and renovation
    (including equipment) of health care and other facilities and other
    health-related activities as specified in the statement of the managers
    on the conference report accompanying this Act, and of which $39,499,000
    from general revenues, notwithstanding section 1820(j) of the Social
    Security Act, shall be available for carrying out the Medicare rural
    hospital flexibility grants program under section 1820 of such Act:
    Provided, That of the funds made available under this heading, $249,000]
    $5,966,144,000, of which $222,000 shall be available until expended for
    facilities renovations at the Gillis W. Long Hansen's Disease Center:
    Provided [further], That in addition to fees authorized by section
    427(b) of the Health Care Quality Improvement Act of 1986, fees shall be
    collected for the full disclosure of information under the Act
    sufficient to recover the full costs of operating the National
    Practitioner Data Bank, and shall remain available until expended to
    carry out that Act: Provided further, That fees collected for the full
    disclosure of information under the ``Health Care Fraud and Abuse Data
    Collection Program'', authorized by section 1128E(d)(2) of the Social
    Security Act, shall be sufficient to recover the full costs of operating
    the program, and shall remain available until expended to carry out that
    Act: [Provided further, That $31,000,000 of the funding provided for
    community health centers shall be used for base grant adjustments for
    existing centers: Provided further, That no more than $100,000 is
    available until expended for carrying out the provisions of 42 U.S.C.
    233(o) including associated administrative expenses:]  Provided further,
    That $26,000,000 of the funding provided for Health Centers shall be
    used for high-need counties, notwithstanding section 330(s)(2)(B) of the
    Public Health Service Act: Provided further, That no more than
    [$45,000,000] $45,000,000 is available until expended for carrying out
    the provisions of Public Law 104-73: [Provided further, That $9,941,000
    is available until expended for the National Cord Blood Stem Cell Bank
    Program as described in House Report 108-401:] Provided further, That of
    the funds made available under this heading, [$288,963,000] $285,963,000
    shall be for the program under title X of the Public Health Service Act
    to provide for voluntary family planning projects: Provided further,
    That amounts provided to said projects under such title shall not be
    expended for abortions, that all pregnancy counseling shall be
    nondirective, and that such amounts shall not be expended for any
    activity (including the publication or distribution of literature) that
    in any way tends to promote public support or opposition to any
    legislative proposal or candidate for public office: Provided further,
    That [$793,872,000] $797,521,000 shall be for State AIDS Drug Assistance
    Programs authorized by section 2616 of the Public Health Service Act:
    Provided further, That in addition to amounts provided herein,
    [$25,000,000] $25,000,000 shall be available from amounts available
    under section 241 of the Public Health Service Act to carry out Parts A,
    B, C, and D of title XXVI of the Public Health Service Act to fund
    section 2691 Special Projects of National Significance[: Provided
    further, That, notwithstanding section 502(a)(1) of the Social Security
    Act, not to exceed $119,158,000 is available for carrying out special
    projects of regional and national significance pursuant to section
    501(a)(2) of such Act: Provided further, That of the funds provided,
    $40,000,000 shall be provided to the Denali Commission as a direct lump
    payment pursuant to Public Law 106-113, of which $10,000,000 shall be
    for a psychiatric treatment facility in Bethel, Alaska, $10,000,000
    shall be for residential and supportive housing for elders, $2,500,000
    shall be for medical and dental equipment for rural clinics, and
    $5,000,000 shall be for upgrade and construction of shelters for victims
    of domestic violence and child abuse]. (Department of Health and Human
    Services Appropriations Act, 2005.)

                   Program and Financing (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-0350-0-1-550      2004 actual   2005 est.   2006 est.
    ----------------------------------------------------------------------------

        Obligations by program activity:
    00.02 Loan guarantee subsidy............           2           1           1
    00.07 Reestimates of loan guarantee
            subsidy.........................                       1
    00.10 Health centers....................       1,573       1,690       1,993
    00.11 National Health Service Corps.....          45          45          41
    00.12 National Health Service Corps
            recruitment.....................         124          86          86
    00.13 Hansen's disease center...........          17          17          16
    00.14 Payment to Hawaii for the
            treatment of Hansen's disease...           2           2           2
    00.15 Black lung clinics................           6           6           6
    00.16 Nursing education loan repayment
            and scholarships................          26          31          31
    00.17 Health professions................         410         416         129
    00.18 Maternal and child health block
            grant...........................         730         724         724
    00.19 Healthy start.....................          98         102          98
    00.20 Poison control centers............          24          23          23
    00.21 EMS for children..................          20          20
    00.22 Universal newborn hearing
            screening.......................          10          10
    00.23 HIV/AIDS..........................       2,040       2,048       2,058
    00.24 Organ transplantation.............          25          24          23
    00.25 Bone marrow donor registry........          23          25          23
    00.26 Rural health policy development...           9           9           9
    00.27 Rural health outreach grants......          40          39          11
    00.28 Rural health flexibility grants...          39          39
    00.29 Denali Commission.................          35          39
    00.30 Telehealth........................           4           4           4
    00.31 Program management................         149         147         146
    00.32 Family planning...................         278         286         286
    00.33 Abstinence education..............          31
    00.36 Health centers tort claim fund....          56          45          45
    00.37 Trauma EMS........................           3           3
    00.39 Childrens' GME....................         303         298         200
    00.41 Community based abstinence grants.          70
    00.42 State offices of rural health.....           8           8           8
    00.43 Healthy communities access program          83          82
    00.44 State planning grant program......          15          11
    00.45 Rural and community access to
            emergency devices...............          11           9           2
    00.46 Radiogenic diseases...............           2           2           2
    00.47 Traumatic brain injury............           9           9
    00.49 Health care facilities
            construction and miscellaneous
            projects........................         371         478
    00.50 Cord blood stem cell bank.........           1           2           8
    00.52 Free clinic medical malpractice...                                   1
                                               ---------   ---------  ----------
    03.00   Total direct programs...........       6,692       6,781       5,976
    09.01 Reimbursable program..............         161         130         130
                                               ---------   ---------  ----------
    10.00   Total new obligations...........       6,853       6,911       6,106
    ----------------------------------------------------------------------------

        Budgetary resources available for obligation:
    21.40 Unobligated balance carried
            forward, start of year..........          64          71          81
    22.00 New budget authority (gross)......       6,868       6,921       6,096
                                               ---------   ---------  ----------

    [[Page 430]]

    23.90   Total budgetary resources
              available for obligation......       6,932       6,992       6,177
    23.95 Total new obligations.............      -6,853      -6,911      -6,106
    23.98 Unobligated balance expiring or
            withdrawn.......................          -8
                                               ---------   ---------  ----------
    24.40   Unobligated balance carried
              forward, end of year..........          71          81          71
    ----------------------------------------------------------------------------

        New budget authority (gross), detail:
          Discretionary:

    40.00   Appropriation...................       6,705       6,859       5,966
    40.35   Appropriation permanently
              reduced.......................         -42         -56
    41.00   Transferred to other accounts...                     -13
                                               ---------   ---------  ----------
    43.00     Appropriation (total
                discretionary)..............       6,663       6,790       5,966
          Mandatory:

    60.00   Appropriation...................          38
    60.00   Appropriation...................                       1
                                               ---------   ---------  ----------
    62.50     Appropriation (total
                mandatory)..................          38           1
          Spending authority from offsetting
              collections:

            Discretionary:
    68.00     Offsetting collections (cash).          84         130         130
    68.10     Change in uncollected customer
                payments from Federal
                sources (unexpired).........          48
                                               ---------   ---------  ----------
    68.90       Spending authority from
                  offsetting collections
                  (total discretionary).....         132         130         130
          Mandatory:

    69.00   Offsetting collections
              (cash)(HPSL&NSL)..............          35
                                               ---------   ---------  ----------
    70.00   Total new budget authority
              (gross).......................       6,868       6,921       6,096
    ----------------------------------------------------------------------------

        Change in obligated balances:
    72.40 Obligated balance, start of year..       5,484       5,538       5,750
    73.10 Total new obligations.............       6,853       6,911       6,106
    73.20 Total outlays (gross).............      -6,702      -6,699      -6,583
    73.40 Adjustments in expired accounts
            (net)...........................         -53
    74.00 Change in uncollected customer
            payments from Federal sources
            (unexpired).....................         -48
    74.10 Change in uncollected customer
            payments from Federal...........       6,702       6,699       6,583
    ----------------------------------------------------------------------------

        Offsets:
          Against gross budget authority and outlays:

            Offsetting collections (cash)
                from:
    88.00     Federal sources...............         -69        -100        -100
    88.40     Non-Federal sources...........         -54         -30         -30
                                               ---------   ---------  ----------
    88.90       Total, offsetting
                  collections (cash)........        -123        -130        -130
          Against gross budget authority only:

    88.95   Change in uncollected customer
              payments from Federal sources
              (unexpired)...................         -48
    88.96   Portion of offsetting
              collections (cash) credited to
              expired accounts..............           4
    ----------------------------------------------------------------------------

        Net budget authority and outlays:
    89.00 Budget authority..................       6,701       6,791       5,966
    90.00 Outlays...........................       6,579       6,569       6,453
    ---------------------------------------------------------------------------

    Summary of Loan Levels, Subsidy Budget Authority and Outlays by Program (in
                                millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-0350-0-1-550      2004 actual   2005 est.   2006 est.
    ----------------------------------------------------------------------------
        Guaranteed loan levels supportable by subsidy
                    budget authority:
    215001Health centers: Facilities
            renovation loan guarantee levels           4          10          10
    215002Health centers: Managed care
            network development loan
            guarantee levels................                       2           2
    215003Health centers: Managed care plan
            loan guarantee levels...........           9           5           5
                                               ---------   ---------  ----------
    215901Total loan guarantee levels.......          13          17          17
        Guaranteed loan subsidy (in percent):
    232001Health centers: Facilities
            renovation loan guarantee levels        3.52        3.57        3.50
    232002Health centers: Managed care
            network development loan
            guarantee levels................        9.28        9.28        8.00
    232003Health centers: Managed care plan
            loan guarantee levels...........       16.61        7.33        8.17
                                               ---------   ---------  ----------
    232901Weighted average subsidy rate.....       12.58        5.35        5.40
        Guaranteed loan subsidy budget authority:
    233001Health centers: Facilities
            renovation loan guarantee levels                       1           1
    233002Health centers: Managed care
            network development loan
            guarantee levels................
    233003Health centers: Managed care plan
            loan guarantee levels...........           2
                                               ---------   ---------  ----------
    233901Total subsidy budget authority....           2           1           1
        Guaranteed loan subsidy outlays:
    234001Health centers: Facilities
            renovation loan guarantee levels           2           1           1
    234002Health centers: Managed care
            network development loan
            guarantee levels................
    234003Health centers: Managed care plan
            loan guarantee levels...........
                                               ---------   ---------  ----------
    234901Total subsidy outlays.............           2           1           1
        Guaranteed loan upward reestimate subsidy
                    budget authority:
    235007Upward reestimate subsidy budget
            authority--Facilities Loans.....
    235007Upward reestimate subsidy budget
            authority--HMO Plan Loans.......                       1
                                               ---------   ---------  ----------
    235901Total upward reestimate budget
            authority.......................                       1
    ----------------------------------------------------------------------------

        Administrative expense data:
    351001Administrative expenses...........           1           1           1
    359001Outlays for administrative
            expenses........................           1           1           1
    ---------------------------------------------------------------------------

        Activities displayed here support categorical health resources and
    services grants, treatment and care for those living with HIV/AIDS, and
    the medical malpractice claims funds, which pay malpractice claims filed
    against employees of federally-supported health centers and free
    clinics. Abstinence education activities formerly administered by HRSA
    have been transferred to the Administration for Children and Families.

                   Object Classification (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-0350-0-1-550      2004 actual   2005 est.   2006 est.
    ----------------------------------------------------------------------------

          Direct obligations:

            Personnel compensation:
    11.1      Full-time permanent...........         101         114         101
    11.3      Other than full-time permanent           3           3           3
    11.5      Other personnel compensation..           2           2           2
    11.7      Military personnel............          26          26          26
                                               ---------   ---------  ----------
    11.9        Total personnel compensation         132         145         132
    12.1    Civilian personnel benefits.....          23          25          23
    12.2    Military personnel benefits.....          13          14          14
    13.0    Benefits for former personnel...           3           1           1
    21.0    Travel and transportation of
              persons.......................           3           3           3
    23.1    Rental payments to GSA..........          13          13          13
    23.3    Communications, utilities, and
              miscellaneous charges.........           4           4           4
    24.0    Printing and reproduction.......           1           1           1
    25.1    Advisory and assistance services          64          64          64
    25.2    Other services..................          95          90          90
    25.3    Other purchases of goods and
              services from Government
              accounts......................         149         140         140
    25.4    Operation and maintenance of
              facilities....................           1           1           1
    25.6    Medical care....................           1           1           1
    25.7    Operation and maintenance of
              equipment.....................           4           3           3
    26.0    Supplies and materials..........           2           2           2
    31.0    Equipment.......................           1           1           1
    33.0    Investments and loans...........           5
    41.0    Grants, subsidies, and
              contributions.................       6,128       6,217       5,427
    42.0    Insurance claims and indemnities          50          55          56
                                               ---------   ---------  ----------
    99.0      Direct obligations............       6,692       6,780       5,976
    99.0  Reimbursable obligations..........         161         131         130
                                               ---------   ---------  ----------
    99.9    Total new obligations...........       6,853       6,911       6,106
    ---------------------------------------------------------------------------

    [[Page 431]]

                                  Personnel Summary

    ----------------------------------------------------------------------------
    Identification code 75-0350-0-1-550      2004 actual   2005 est.   2006 est.
    ----------------------------------------------------------------------------
        Direct:
          Total compensable workyears:

    1001    Civilian full-time equivalent
              employment....................       1,315       1,412       1,195
    1101    Military full-time equivalent
              employment....................         270         254         254
        Reimbursable:
          Total compensable workyears:

    2001    Civilian full-time equivalent
              employment....................          73         145         145
    2101    Military full-time equivalent
              employment....................         163         179         179
        Allocation account:
          Total compensable workyears:

    3001    Civilian full-time equivalent
              employment....................          16          16          16
    3101    Military full-time equivalent
              employment....................          20          20          20
    ---------------------------------------------------------------------------

                           Vaccine Injury Compensation

                   Program and Financing (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-0320-0-1-551      2004 actual   2005 est.   2006 est.
    ----------------------------------------------------------------------------

        Obligations by program activity:
    00.01 Direct program activity...........           3
                                               ---------   ---------  ----------
    10.00   Total new obligations (object
              class 42.0)...................           3
    ----------------------------------------------------------------------------

        Budgetary resources available for obligation:
    21.40 Unobligated balance carried
            forward, start of year..........           2
    22.00 New budget authority (gross)......           2
                                               ---------   ---------  ----------
    23.90   Total budgetary resources
              available for obligation......           4
    23.95 Total new obligations.............          -3
                                               ---------   ---------  ----------
    24.40   Unobligated balance carried
              forward, end of year..........
    ----------------------------------------------------------------------------

        New budget authority (gross), detail:
          Mandatory:

    69.00   Offsetting collections (cash)...           2
    ----------------------------------------------------------------------------

        Change in obligated balances:
    72.40 Obligated balance, start of year..                       2
    73.10 Total new obligations.............           3
    73.20 Total outlays (gross).............          -2          -2
                                               ---------   ---------  ----------
    74.40   Obligated balance, end of year..           2
    ----------------------------------------------------------------------------

        Outlays (gross), detail:
    86.98 Outlays from mandatory balances...           2           2
    ----------------------------------------------------------------------------

        Offsets:
          Against gross budget authority and outlays:

    88.40   Offsetting collections (cash)
              from: Non-Federal sources.....          -2
    ----------------------------------------------------------------------------

        Net budget authority and outlays:
    89.00 Budget authority..................
    90.00 Outlays...........................                       2
    ---------------------------------------------------------------------------

        The Vaccine Injury Compensation program was established pursuant to
    Public Law 99-660 and Public Law 100-203, and serves as a source of
    funds to pay claims for compensation for vaccine related injury or
    death. Payment of claims associated with vaccine related injury or death
    occurring before October 1, 1988 are financed from the General Fund and
    are reflected in this account. Given sufficient carry-over funds from
    prior years' appropriations to pay for the balance of the pre-1988
    backlog of claims yet to be adjudicated, no appropriation is requested
    in 2006 to cover payment of pre-1988 claims. By statute, no new claims
    are accepted for this account. Payment of claims associated with vaccine
    related injury or death occurring after October 1, 1988 are reflected in
    the Vaccine improvement trust fund account.

    Credit accounts:

                 Health Center Guaranteed Loan Financing Account

                   Program and Financing (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-4442-0-3-551      2004 actual   2005 est.   2006 est.
    ----------------------------------------------------------------------------

        Budgetary resources available for obligation:
    21.40 Unobligated balance carried
            forward, start of year..........           1           2           3
    22.00 New financing authority (gross)...           2           1           1
                                               ---------   ---------  ----------
    23.90   Total budgetary resources
              available for obligation......           3           3           4
    23.95 Total new obligations.............
                                               ---------   ---------  ----------
    24.40   Unobligated balance carried
              forward, end of year..........           2           3           4
    ----------------------------------------------------------------------------

        New financing authority (gross), detail:
          Discretionary:

    68.00   Spending authority from
              offsetting collections:
              (Federal sources: From program
              account)......................                       1           1
          Mandatory:

    69.00   Offsetting collections (cash)...           2
                                               ---------   ---------  ----------
    70.00   Total new financing authority
              (gross).......................           2           1           1
    ----------------------------------------------------------------------------

        Change in obligated balances:
    73.10 Total new obligations.............
    87.00 Total financing disbursements
            (gross).........................
    ----------------------------------------------------------------------------

        Offsets:
          Against gross financing authority and
              financing disbursements:

            Offsetting collections (cash)
                from:
    88.00     Federal sources...............          -2          -1          -1
    88.40     Non-Federal sources...........
                                               ---------   ---------  ----------
    88.90       Total, offsetting
                  collections (cash)........          -2          -1          -1
    ----------------------------------------------------------------------------

        Net financing authority and financing
            disbursements:
    89.00 Financing authority...............
    90.00 Financing disbursements...........          -2          -1          -1
    ---------------------------------------------------------------------------

                 Status of Guaranteed Loans (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-4442-0-3-551      2004 actual   2005 est.   2006 est.
    ----------------------------------------------------------------------------
        Position with respect to appropriations act
                    limitation on commitments:
    2111  Limitation on guaranteed loans
            made by private lenders.........
    2121  Limitation available from carry-
            forward.........................         134         117         100
    2143  Uncommitted limitation carried
            forward.........................        -121        -100         -83
                                               ---------   ---------  ----------
    2150    Total guaranteed loan
              commitments...................          13          17          17
    2199  Guaranteed amount of guaranteed
            loan commitments................          10          14          14
    ----------------------------------------------------------------------------

        Cumulative balance of guaranteed loans
                    outstanding:
    2210  Outstanding, start of year........          10          23          40
    2231  Disbursements of new guaranteed
            loans...........................          13          17          17
    2251  Repayments and prepayments........
    2264  Adjustments: Other adjustments,
            net.............................
                                               ---------   ---------  ----------
    2290    Outstanding, end of year........          23          40          57
    ----------------------------------------------------------------------------

        Memorandum:
    2299  Guaranteed amount of guaranteed
            loans outstanding, end of year..          21          38          55
    ---------------------------------------------------------------------------

        P.L. 104-299 and P.L. 104-208 authorize HRSA to guarantee up to $80
    million in private loans to health centers for the costs of developing
    and operating managed care networks or plans and for the construction,
    renovation and modernization of medical facilities. As required by the
    Federal Credit Reform Act of 1990, this financing account records all
    cash flows to and from the Government resulting from the Health center
    loan guarantee program. The program account for this activity is
    displayed in the Health resources and services account (75-0350) as a
    line in the program and financing schedule.

    [[Page 432]]

                                 Balance Sheet (in millions of dollars)

    -----------------------------------------------------------------------------------------------
    Identification code   75-4442-0-3-551

    2003 actual

    2004 actual

    -----------------------------------------------------------------------------------------------
        ASSETS:
    1101

    Federal assets: Fund balances with Treasury

    1

    1

    1999

    Total assets

    1

    1

        LIABILITIES:
    2204

    Non-Federal liabilities: Liabilities for loan guarantees

    1

    1

    2999

    Total liabilities

    1

    1

    4999

    Total liabilities and net position

    1

    1

    -----------------------------------------------------------------------------------------------

                Health Education Assistance Loans Program Account

        Such sums as may be necessary to carry out the purpose of the
    program, as authorized by title VII of the Public Health Service Act, as
    amended. For administrative expenses to carry out the guaranteed loan
    program, including section 709 of the Public Health Service Act,
    [$3,270,000] $2,916,000. (Department of Health and Human Services
    Appropriations Act, 2005.)

            General Fund Credit Receipt Accounts (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-0340-0-1-552      2004 actual   2005 est.   2006 est.
    ----------------------------------------------------------------------------
    0101  Negative subsidies/subsidy
            reestimates.....................          49          55
    ---------------------------------------------------------------------------

                   Program and Financing (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-0340-0-1-552      2004 actual   2005 est.   2006 est.
    ----------------------------------------------------------------------------

        Obligations by program activity:
    00.02 Guarantee loan subsidy............          25
    00.07 Reestimates of Subsidy............           1           7
    00.08 Interest on Reestimates...........           1           1
    00.09 Administrative expenses...........           3           3           3
                                               ---------   ---------  ----------
    10.00   Total new obligations...........          30          11           3
    ----------------------------------------------------------------------------

        Budgetary resources available for obligation:
    22.00 New budget authority (gross)......          28          11           3
    23.95 Total new obligations.............         -30         -11          -3
    ----------------------------------------------------------------------------

        New budget authority (gross), detail:
          Discretionary:

    40.00   Appropriation...................           3           3           3
          Mandatory:

    60.00   Appropriation...................          25           8
                                               ---------   ---------  ----------
    70.00   Total new budget authority
              (gross).......................          28          11           3
    ----------------------------------------------------------------------------

        Change in obligated balances:
    72.40 Obligated balance, start of year..           2           2           2
    73.10 Total new obligations.............          30          11           3
    73.20 Total outlays (gross).............         -30         -11          -3
                                               ---------   ---------  ----------
    74.40   Obligated balance, end of year..           2           2           2
    ----------------------------------------------------------------------------

        Outlays (gross), detail:
    86.90 Outlays from new discretionary
            authority.......................           3           3           3
    86.93 Outlays from discretionary
            balances........................           2
    86.97 Outlays from new mandatory
            authority.......................          25           8
                                               ---------   ---------  ----------
    87.00   Total outlays (gross)...........          30          11           3
    ----------------------------------------------------------------------------

        Net budget authority and outlays:
    89.00 Budget authority..................          28          11           3
    90.00 Outlays...........................          29          11           3
    ---------------------------------------------------------------------------

    Summary of Loan Levels, Subsidy Budget Authority and Outlays by Program (in
                                millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-0340-0-1-552      2004 actual   2005 est.   2006 est.
    ----------------------------------------------------------------------------
        Guaranteed loan levels supportable by subsidy
                    budget authority:
    215001HEAL Loan guarantee...............          46
                                               ---------   ---------  ----------
    215901Total loan guarantee levels.......          46
        Guaranteed loan subsidy (in percent):
    232001HEAL Loan guarantee...............       16.48        0.00        0.00
                                               ---------   ---------  ----------
    232901Weighted average subsidy rate.....       16.48        0.00        0.00
        Guaranteed loan subsidy budget authority:
    233001HEAL Loan guarantee...............          25
                                               ---------   ---------  ----------
    233901Total subsidy budget authority....          25
        Guaranteed loan subsidy outlays:
    234001HEAL Loan guarantee...............          25
                                               ---------   ---------  ----------
    234901Total subsidy outlays.............          25
        Guaranteed loan upward reestimate subsidy
                    budget authority:
    235001HEAL Loan guarantee...............           2           8
                                               ---------   ---------  ----------
    235901Total upward reestimate budget
            authority.......................           2           8
        Guaranteed loan downward reestimate subsidy
                    budget authority:
    237001HEAL Loan guarantee...............         -49         -55
                                               ---------   ---------  ----------
    237901Total downward reestimate subsidy
            budget authority................         -49         -55
    ----------------------------------------------------------------------------

        Administrative expense data:
    351001Budget authority..................           3           3           3
    359001Outlays from new authority........           3           3           3
    ---------------------------------------------------------------------------

        The Health Education Assistance Loan (HEAL) program guarantees loans
    from private lenders to health professions students to help pay for the
    costs of their training. As required by the Federal Credit Reform Act of
    1990, this account records, for the HEAL program, the subsidy costs
    associated with HEAL loan guarantees committed in 1992 and beyond
    (including modifications of HEAL loan guarantees that resulted from
    obligations or commitments in any year), as well as administrative
    expenses of the program. The administrative expenses are estimated on a
    cash basis.

                   Object Classification (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-0340-0-1-552      2004 actual   2005 est.   2006 est.
    ----------------------------------------------------------------------------
    11.1  Personnel compensation: Full-time
            permanent.......................           1           1           1
    25.3  Other purchases of goods and
            services from Government
            accounts........................           2           2           2
    41.0  Grants, subsidies, and
            contributions...................          27           8
                                               ---------   ---------  ----------
    99.9    Total new obligations...........          30          11           3
    ---------------------------------------------------------------------------

                                  Personnel Summary

    ----------------------------------------------------------------------------
    Identification code 75-0340-0-1-552      2004 actual   2005 est.   2006 est.
    ----------------------------------------------------------------------------
        Direct:
          Total compensable workyears:

    1001    Civilian full-time equivalent
              employment....................          15          15          15
    1101    Military full-time equivalent
              employment....................           2           2           2
    ---------------------------------------------------------------------------

               Health Education Assistance Loans Financing Account

                   Program and Financing (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-4304-0-3-552      2004 actual   2005 est.   2006 est.
    ----------------------------------------------------------------------------

        Obligations by program activity:
    00.01 Death and disability claims.......           3           2           2
    00.02 Default claims....................          25          25          25
                                               ---------   ---------  ----------
    00.91   Subtotal........................          28          27          27
    08.02 Payment of downward reestimate to
            receipt account.................          38          40
    08.04 Payment of interest on downward
            reestimate to receipt account...          11          15
                                               ---------   ---------  ----------

    [[Page 433]]

    08.91   Subtotal (reestimates)..........          49          55
                                               ---------   ---------  ----------
    10.00   Total new obligations...........          77          82          27
    ----------------------------------------------------------------------------

        Budgetary resources available for obligation:
    21.40 Unobligated balance carried
            forward, start of year..........         249         219         152
    22.00 New financing authority (gross)...          47          15           7
                                               ---------   ---------  ----------
    23.90   Total budgetary resources
              available for obligation......         296         234         159
    23.95 Total new obligations.............         -77         -82         -27
                                               ---------   ---------  ----------
    24.40   Unobligated balance carried
              forward, end of year..........         219         152         132
    ----------------------------------------------------------------------------

        New financing authority (gross), detail:
          Mandatory:

    69.00   Offsetting collections (cash)...          47          15           7
    ----------------------------------------------------------------------------

        Change in obligated balances:
    72.40 Obligated balance, start of year..                                  82
    73.10 Total new obligations.............          77          82          27
    73.20 Total financing disbursements
            (gross).........................         -77
                                               ---------   ---------  ----------
    74.40   Obligated balance, end of year..                      82         109
    87.00 Total financing disbursements
            (gross).........................          77
    ----------------------------------------------------------------------------

        Offsets:
          Against gross financing authority and
              financing disbursements:

            Offsetting collections (cash)
                from:
    88.00     Federal sources...............         -27          -8
    88.25     Interest on uninvested funds..         -15          -3          -3
    88.40     Recoveries of defaulted loans.          -5          -4          -4
                                               ---------   ---------  ----------
    88.90       Total, offsetting
                  collections (cash)........         -47         -15          -7
    ----------------------------------------------------------------------------

        Net financing authority and financing
            disbursements:
    89.00 Financing authority...............
    90.00 Financing disbursements...........          30         -15          -7
    ---------------------------------------------------------------------------

                 Status of Guaranteed Loans (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-4304-0-3-552      2004 actual   2005 est.   2006 est.
    ----------------------------------------------------------------------------
        Position with respect to appropriations act
                    limitation on commitments:
    2111  Limitation on guaranteed loans
            made by private lenders.........         150
    2142  Uncommitted loan guarantee
            limitation......................        -104
                                               ---------   ---------  ----------
    2150    Total guaranteed loan
              commitments...................          46
    2199  Guaranteed amount of guaranteed
            loan commitments................          46
    ----------------------------------------------------------------------------

        Cumulative balance of guaranteed loans
                    outstanding:
    2210  Outstanding, start of year........       1,760       1,860       1,827
    2231  Disbursements of new guaranteed
            loans...........................         150
    2251  Repayments and prepayments........          -6          -4          -4
          Adjustments:

    2261    Terminations for default that
              result in loans receivable....         -41         -25         -24
    2263    Terminations for default that
              result in claim payments......          -3          -4          -4
                                               ---------   ---------  ----------
    2290    Outstanding, end of year........       1,860       1,827       1,795
    ----------------------------------------------------------------------------

        Memorandum:
    2299  Guaranteed amount of guaranteed
            loans outstanding, end of year..       1,860       1,827       1,795
    ----------------------------------------------------------------------------

        Addendum:
          Cumulative balance of defaulted guaranteed
              loans that result in loans receivable:

    2310    Outstanding, start of year......         423         458         479
    2331    Disbursements for guaranteed
              loan claims...................          41          25          24
    2351    Repayments of loans receivable..          -6          -4          -4
                                               ---------   ---------  ----------
    2390      Outstanding, end of year......         458         479         499
    ---------------------------------------------------------------------------

        This account records all cash flows to and from the Government
    resulting from HEAL loan guarantees committed between 1992 and 2004. No
    new loan guarantees will be issued after 2004.

                                 Balance Sheet (in millions of dollars)

    -----------------------------------------------------------------------------------------------
    Identification code   75-4304-0-3-552

    2003 actual

    2004 actual

    -----------------------------------------------------------------------------------------------
        ASSETS:
    1101

    Federal assets: Fund balances with Treasury

    340

    340

    1206

    Non-Federal assets: Receivables, net

    67

    67

    1999

    Total assets

    407

    407

        LIABILITIES:
    2204

    Non-Federal liabilities: Liabilities for loan guarantees

    407

    407

    2999

    Total liabilities

    407

    407

    4999

    Total liabilities and net position

    407

    407

    -----------------------------------------------------------------------------------------------

              Health Education Assistance Loans Liquidating Account

                   Program and Financing (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-4305-0-3-552      2004 actual   2005 est.   2006 est.
    ----------------------------------------------------------------------------

        Obligations by program activity:
    00.01 Death and disability claims.......           3           3           3
    00.02 Defaulted loans...................           8          15          15
    00.03 Debt Collection...................           4
                                               ---------   ---------  ----------
    10.00   Total new obligations...........          15          18          18
    ----------------------------------------------------------------------------

        Budgetary resources available for obligation:
    22.00 New budget authority (gross)......          15          18          18
    23.95 Total new obligations.............         -15         -18         -18
    ----------------------------------------------------------------------------

        New budget authority (gross), detail:
          Mandatory:

    60.00   Appropriation...................           4           4           4
    69.00 Offsetting collections (cash).....          21          14          14
    69.27 Capital transfer to general fund..         -10
                                               ---------   ---------  ----------
    69.90   Spending authority from
              offsetting collections (total
              mandatory)....................          11          14          14
                                               ---------   ---------  ----------
    70.00   Total new budget authority
              (gross).......................          15          18          18
    ----------------------------------------------------------------------------

        Change in obligated balances:
    72.40 Obligated balance, start of year..           5           6           6
    73.10 Total new obligations.............          15          18          18
    73.20 Total outlays (gross).............         -14         -18         -18
                                               ---------   ---------  ----------
    74.40   Obligated balance, end of year..           6           6           6
    ----------------------------------------------------------------------------

        Outlays (gross), detail:
    86.97 Outlays from new mandatory
            authority.......................          14          18          18
    ----------------------------------------------------------------------------

        Offsets:
          Against gross budget authority and outlays:

    88.40   Offsetting collections (cash)
              from: Non-Federal sources.....         -21         -14         -14
    ----------------------------------------------------------------------------

        Net budget authority and outlays:
    89.00 Budget authority..................          -6           4           4
    90.00 Outlays...........................          -7           4           4
    ---------------------------------------------------------------------------

                 Status of Guaranteed Loans (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-4305-0-3-552      2004 actual   2005 est.   2006 est.
    ----------------------------------------------------------------------------
        Cumulative balance of guaranteed loans
                    outstanding:\1\
    2210  Outstanding, start of year........         585         556         529
    2251  Repayments and prepayments........         -15         -15         -15
          Adjustments:

    2261    Terminations for default that
              result in loans receivable....         -12         -10         -10
    2263    Terminations for default that
              result in claim payments......          -2          -2          -2
                                               ---------   ---------  ----------
    2290    Outstanding, end of year........         556         529         502
    ----------------------------------------------------------------------------

        Memorandum:
    2299  Guaranteed amount of guaranteed
            loans outstanding, end of year..         556         529         502
    ----------------------------------------------------------------------------

    [[Page 434]]

        Addendum:
          Cumulative balance of defaulted guaranteed
              loans that result in loans receivable:

    2310    Outstanding, start of year......         468         442         413
    2331    Disbursements for guaranteed
              loan claims...................          12          10          10
    2351    Repayments of loans receivable..         -14         -15         -15
    2361    Write-offs of loans receivable..         -24         -24         -24
                                               ---------   ---------  ----------
    2390      Outstanding, end of year......         442         413         384
    ---------------------------------------------------------------------------
        Note.--Includes carryover commitments from prior years.
        Note.--The adjustment to loans receivable represents interest, which
    had not previously been reflected in cumulative outstanding balances.

        This account records all cash flows to and from the Government
    resulting from HEAL loan guarantees committed prior to 1992. The debt
    collection contract financed from this account in 2004 will be financed
    from the HEAL program account in 2005 and subsequent fiscal years.

                                 Balance Sheet (in millions of dollars)

    -----------------------------------------------------------------------------------------------
    Identification code   75-4305-0-3-552

    2003 actual

    2004 actual

    -----------------------------------------------------------------------------------------------
        ASSETS:
    1101

    Federal assets: Fund balances with Treasury

    4

    4

    1206

    Non-Federal assets: Receivables, net

    376

    376

    1999

    Total assets

    380

    380

        LIABILITIES:
    2204

    Non-Federal liabilities: Liabilities for loan guarantees

    380

    380

    2999

    Total liabilities

    380

    380

    4999

    Total liabilities and net position

    380

    380

    -----------------------------------------------------------------------------------------------

                   Object Classification (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-4305-0-3-552      2004 actual   2005 est.   2006 est.
    ----------------------------------------------------------------------------
    25.2  Other services....................           4
    42.0  Insurance claims and indemnities..          11          18          18
                                               ---------   ---------  ----------
    99.9    Total new obligations...........          15          18          18
    ---------------------------------------------------------------------------

                   Medical Facilities Guarantee and Loan Fund

                   Program and Financing (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-9931-0-3-551      2004 actual   2005 est.   2006 est.
    ----------------------------------------------------------------------------

        Budgetary resources available for obligation:
    21.40 Unobligated balance carried
            forward, start of year..........          68          68
    22.40 Capital transfer to general fund..                     -68
                                               ---------   ---------  ----------
    23.90   Total budgetary resources
              available for obligation......          68
                                               ---------   ---------  ----------
    24.40   Unobligated balance carried
              forward, end of year..........          68
    ----------------------------------------------------------------------------

        Change in obligated balances:
    72.40 Obligated balance, start of year..           1           1           1
                                               ---------   ---------  ----------
    74.40   Obligated balance, end of year..           1           1           1
    ----------------------------------------------------------------------------

        Net budget authority and outlays:
    89.00 Budget authority..................
    90.00 Outlays...........................
    ---------------------------------------------------------------------------

                   Status of Direct Loans (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-9931-0-3-551      2004 actual   2005 est.   2006 est.
    ----------------------------------------------------------------------------
        Cumulative balance of direct loans
                    outstanding:
    1210  Outstanding, start of year........           7           7           7
    1251  Repayments: Repayments and
            prepayments.....................
                                               ---------   ---------  ----------
    1290    Outstanding, end of year........           7           7           7
    ---------------------------------------------------------------------------

                 Status of Guaranteed Loans (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-9931-0-3-551      2004 actual   2005 est.   2006 est.
    ----------------------------------------------------------------------------
        Cumulative balance of guaranteed loans
                    outstanding:
    2210  Outstanding, start of year........          13
    2251  Repayments and prepayments........         -13
                                               ---------   ---------  ----------
    2290    Outstanding, end of year........
    ----------------------------------------------------------------------------

        Memorandum:
    2299  Guaranteed amount of guaranteed
            loans outstanding, end of year..
    ---------------------------------------------------------------------------

        Title VI and subsequently title XVI of the Public Health Service Act
    established a loan and loan guarantee fund for medical facilities with a
    maximum amount allowable for the Government's liability. Direct loans
    were made available for public facilities and guaranteed loans for
    private, nonprofit facilities. Funds under this authority were
    established in the amount of $50 million for use in fulfilling
    guarantees in event of default, $30 million as a revolving fund for
    direct loans and an amount for interest subsidy payments on guaranteed
    loans.

                                 Balance Sheet (in millions of dollars)

    -----------------------------------------------------------------------------------------------
    Identification code   75-9931-0-3-551

    2003 actual

    2004 actual

    -----------------------------------------------------------------------------------------------
        ASSETS:
    1206

    Non-Federal assets: Receivables, net

    13

    1999

    Total assets

    13

        LIABILITIES:
    2204

    Non-Federal liabilities: Liabilities for loan guarantees

    13

    2999

    Total liabilities

    13

    4999

    Total liabilities and net position

    13

    -----------------------------------------------------------------------------------------------

                                   Trust Funds

                 Vaccine Injury Compensation Program Trust Fund

        For payments from the Vaccine Injury Compensation Program Trust
    Fund, such sums as may be necessary for claims associated with vaccine-
    related injury or death with respect to vaccines administered after
    September 30, 1988, pursuant to subtitle 2 of title XXI of the Public
    Health Service Act, to remain available until expended: Provided, That
    for necessary administrative expenses, not to exceed [$3,176,000]
    $2,832,000 shall be available from the Trust Fund to the Secretary of
    Health and Human Services. (Department of Health and Human Services
    Appropriations Act, 2005.)

                    Unavailable Receipts (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 20-8175-0-7-551      2004 actual   2005 est.   2006 est.
    ----------------------------------------------------------------------------
    01.99 Balance, start of year............       1,901       2,024       2,172
        Receipts:
    02.00 Deposits, Vaccine injury
            compensation trust fund.........         142         170         188
    02.40 Interest and profits on
            investments, Vaccine injury
            compensation....................          55          60          62
                                               ---------   ---------  ----------
    02.99   Total receipts and collections..         197         230         250
                                               ---------   ---------  ----------
    04.00 Total: Balances and collections...       2,098       2,254       2,422
        Appropriations:
    05.00 Vaccine injury compensation
            program trust fund..............         -11         -13         -13
    05.01 Vaccine injury compensation
            program trust fund..............         -63         -69         -71
                                               ---------   ---------  ----------
    05.99   Total appropriations............         -74         -82         -84
                                               ---------   ---------  ----------
    07.99 Balance, end of year..............       2,024       2,172       2,338
    ---------------------------------------------------------------------------

    [[Page 435]]

                   Program and Financing (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 20-8175-0-7-551      2004 actual   2005 est.   2006 est.
    ----------------------------------------------------------------------------

        Obligations by program activity:
    00.01 Compensation: Claims for post--FY
            1989 injuries...................          65          69          71
          Administrative expenses:

    01.03   Claims processing (Claims Court)           4           4           4
    01.04   Claims processing (Public Health
              Service)......................           3           3           3
    01.05   Claims processing (Dept. of
              Justice)......................           3           6           6
                                               ---------   ---------  ----------
    01.91     Total, administrative expenses          10          13          13
                                               ---------   ---------  ----------
    10.00   Total new obligations...........          75          82          84
    ----------------------------------------------------------------------------

        Budgetary resources available for obligation:
    21.40 Unobligated balance carried
            forward, start of year..........           1
    22.00 New budget authority (gross)......          75          82          84
                                               ---------   ---------  ----------
    23.90   Total budgetary resources
              available for obligation......          76          82          84
    23.95 Total new obligations.............         -75         -82         -84
                                               ---------   ---------  ----------
    24.40   Unobligated balance carried
              forward, end of year..........
    ----------------------------------------------------------------------------

        New budget authority (gross), detail:
          Discretionary:

    40.26   Appropriation (trust fund)......          11          13          13
          Mandatory:

    60.26   Appropriation (trust fund)......          63          69          71
    69.00 Offsetting collections (cash).....           1
                                               ---------   ---------  ----------
    70.00   Total new budget authority
              (gross).......................          75          82          84
    ----------------------------------------------------------------------------

        Change in obligated balances:
    72.40 Obligated balance, start of year..           1           3
    73.10 Total new obligations.............          75          82          84
    73.20 Total outlays (gross).............         -73         -85         -84
                                               ---------   ---------  ----------
    74.40   Obligated balance, end of year..           3
    ----------------------------------------------------------------------------

        Outlays (gross), detail:
    86.90 Outlays from new discretionary
            authority.......................           9          13          13
    86.97 Outlays from new mandatory
            authority.......................          64          69          71
    86.98 Outlays from mandatory balances...                       3
                                               ---------   ---------  ----------
    87.00   Total outlays (gross)...........          73          85          84
    ----------------------------------------------------------------------------

        Offsets:
          Against gross budget authority and outlays:

    88.00   Offsetting collections (cash)
              from: Federal sources.........          -1
    ----------------------------------------------------------------------------

        Net budget authority and outlays:
    89.00 Budget authority..................          74          82          84
    90.00 Outlays...........................          72          85          84
    ----------------------------------------------------------------------------

        Memorandum (non-add) entries:
    92.01 Total investments, start of year:
            Federal securities: Par value...       1,896       2,015       2,163
    92.02 Total investments, end of year:
            Federal securities: Par value...       2,015       2,163       2,329
    ---------------------------------------------------------------------------

        The Vaccine injury compensation program was established pursuant to
    Public Law 99-660 and Public Law 100-203, and serves as a source of
    funds to pay claims for compensation for vaccine related injury or
    death. This account reflects payments for claims for vaccine related
    injury or death occurring after October 1, 1988.

                   Object Classification (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 20-8175-0-7-551      2004 actual   2005 est.   2006 est.
    ----------------------------------------------------------------------------

          Direct obligations:

    25.2    Other services..................           3           3           3
    25.3    Other purchases of goods and
              services from Government
              accounts......................           6          10          10
    42.0    Insurance claims and indemnities          65          69          71
                                               ---------   ---------  ----------
    99.0      Direct obligations............          74          82          84
    99.0  Reimbursable obligations..........           1
                                               ---------   ---------  ----------
    99.9    Total new obligations...........          75          82          84
    ---------------------------------------------------------------------------

                        Ricky Ray Hemophilia Relief Fund

                   Program and Financing (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-8074-0-7-551      2004 actual   2005 est.   2006 est.
    ----------------------------------------------------------------------------

        Obligations by program activity:
    00.01 Claims............................           1
    00.02 Administrative Expenses...........           1
    00.03 Funds Returned to Treasury........          86
                                               ---------   ---------  ----------
    10.00   Total new obligations...........          88
    ----------------------------------------------------------------------------

        Budgetary resources available for obligation:
    21.40 Unobligated balance carried
            forward, start of year..........          91           3
    23.95 Total new obligations.............         -88
    23.98 Unobligated balance expiring or
            withdrawn.......................                      -3
                                               ---------   ---------  ----------
    24.40   Unobligated balance carried
              forward, end of year..........           3
    ----------------------------------------------------------------------------

        Change in obligated balances:
    72.40 Obligated balance, start of year..           1           3
    73.10 Total new obligations.............          88
    73.20 Total outlays (gross).............         -86          -3
                                               ---------   ---------  ----------
    74.40   Obligated balance, end of year..           3
    ----------------------------------------------------------------------------

        Outlays (gross), detail:
    86.98 Outlays from mandatory balances...          86           3
    ----------------------------------------------------------------------------

        Net budget authority and outlays:
    89.00 Budget authority..................
    90.00 Outlays...........................          86           3
    ----------------------------------------------------------------------------

        Memorandum (non-add) entries:
    92.01 Total investments, start of year:
            Federal securities: Par value...          89
    92.02 Total investments, end of year:
            Federal securities: Par value...
    ---------------------------------------------------------------------------

        The Ricky Ray Hemophilia Relief Fund was established pursuant to
    Public Law 105-369 and served as a source of funds to pay claims to
    eligible individuals on behalf of persons with HIV and a blood clotting
    disorder, who were treated with an anti-hemophiliac factor between July
    1982 and December 1987. By law the fund terminated November 12, 2003,
    five years after the date of enactment. All unobligated balances have
    been returned to the Treasury.

                   Object Classification (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-8074-0-7-551      2004 actual   2005 est.   2006 est.
    ----------------------------------------------------------------------------
    25.2  Other services....................           1
    42.0  Insurance claims and indemnities..           1
    94.0  Financial transfers...............          86
                                               ---------   ---------  ----------
    99.0      Direct obligations............          88
                                               ---------   ---------  ----------
    99.9    Total new obligations...........          88
    ---------------------------------------------------------------------------

                                  Personnel Summary

    ----------------------------------------------------------------------------
    Identification code 75-8074-0-7-551      2004 actual   2005 est.   2006 est.
    ----------------------------------------------------------------------------
        Direct:
    1001  Total compensable workyears:
            Civilian full-time equivalent
            employment......................           4           2
    ---------------------------------------------------------------------------

                              INDIAN HEALTH SERVICE

                                  Federal Funds

    General and special funds:

                             Indian Health Services

        For expenses necessary to carry out the Act of August 5, 1954 (68
    Stat. 674), the Indian Self-Determination Act, the Indian Health Care
    Improvement Act, and titles II and III of the Public Health Service Act
    with respect to the Indian Health Service, [$2,633,072,000]
    $2,732,298,000, together with payments received

    [[Page 436]]

    during the fiscal year pursuant to 42 U.S.C. 238(b) for services
    furnished by the Indian Health Service: Provided, That funds made
    available to tribes and tribal organizations through contracts, grant
    agreements, or any other agreements or compacts authorized by the Indian
    Self-Determination and Education Assistance Act of 1975 (25 U.S.C. 450),
    shall be deemed to be obligated at the time of the grant or contract
    award and thereafter shall remain available to the tribe or tribal
    organization without fiscal year limitation: Provided further, That up
    to $18,000,000 shall remain available until expended, for the Indian
    Catastrophic Health Emergency Fund: Provided further, That
    [$487,085,000] $507,021,000 for contract medical care shall remain
    available for obligation until September 30, [2006:] 2007: Provided
    further, That of the funds provided, up to $27,000,000 to remain
    available until expended, shall be used to carry out the loan repayment
    program under section 108 of the Indian Health Care Improvement Act:
    Provided further, That funds provided in this Act may be used for one-
    year contracts and grants which are to be performed in two fiscal years,
    so long as the total obligation is recorded in the year for which the
    funds are appropriated: Provided further, That the amounts collected by
    the Secretary of Health and Human Services under the authority of title
    IV of the Indian Health Care Improvement Act shall remain available
    until expended for the purpose of achieving compliance with the
    applicable conditions and requirements of titles XVIII and XIX of the
    Social Security Act (exclusive of planning, design, or construction of
    new facilities): Provided further, That funding contained herein, and in
    any earlier appropriations Acts for scholarship programs under the
    Indian Health Care Improvement Act (25 U.S.C. 1613) shall remain
    available until expended: Provided further, That amounts received by
    tribes and tribal organizations under title IV of the Indian Health Care
    Improvement Act shall be reported and accounted for and available to the
    receiving tribes and tribal organizations until expended: Provided
    further, That, notwithstanding any other provision of law, of the
    amounts provided herein, not to exceed [$267,398,000] $268,683,000 shall
    be for payments to tribes and tribal organizations for contract or grant
    support costs associated with contracts, grants, self-governance
    compacts or annual funding agreements between the Indian Health Service
    and a tribe or tribal organization pursuant to the Indian Self-
    Determination Act of 1975, as amended, prior to or during fiscal year
    [2005] 2006, of which not to exceed [$2,500,000] $5,000,000 may be used
    for contract support costs associated with new or expanded self-
    determination contracts, grants, self-governance compacts or annual
    funding agreements: Provided further, That funds available for the
    Indian Health Care Improvement Fund may be used, as needed, to carry out
    activities typically funded under the Indian Health Facilities account[:
    Provided further, That of the amounts provided to the Indian Health
    Service, $15,000,000 is provided for alcohol control, enforcement,
    prevention, treatment, sobriety and wellness, and education in Alaska:
    Provided further, That none of the funds may be used for tribal courts
    or tribal ordinance programs or any program that is not directly related
    to alcohol control, enforcement, prevention, treatment, or sobriety:
    Provided further, That no more than 15 percent may be used by any entity
    receiving funding for administrative overhead including indirect costs].
    (Department of the Interior and Related Agencies Appropriations Act,
    2005.)

                   Program and Financing (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-0390-0-1-551      2004 actual   2005 est.   2006 est.
    ----------------------------------------------------------------------------

        Obligations by program activity:
          Direct program:

    00.01   Clinical services...............       2,057       2,091       2,209
    00.02   Preventive health...............         107         110         119
    00.03   Urban health....................          32          32          33
    00.04   Indian health professions.......          29          30          32
    00.05   Tribal management...............           2           2           2
    00.06   Direct operations...............          61          62          63
    00.07   Self-governance.................           6           5           6
    00.08   Contract support costs..........         267         264         269
    00.09   Diabetes funds..................         153         150         150
    09.01 Reimbursable program..............         793         821         830
                                               ---------   ---------  ----------
    10.00   Total new obligations...........       3,507       3,567       3,713
    ----------------------------------------------------------------------------

        Budgetary resources available for obligation:
    21.40 Unobligated balance carried
            forward, start of year..........         300         233         233
    22.00 New budget authority (gross)......       3,445       3,567       3,712
                                               ---------   ---------  ----------
    23.90   Total budgetary resources
              available for obligation......       3,745       3,800       3,945
    23.95 Total new obligations.............      -3,507      -3,567      -3,713
    23.98 Unobligated balance expiring or
            withdrawn.......................          -5
                                               ---------   ---------  ----------
    24.40   Unobligated balance carried
              forward, end of year..........         233         233         232
    ----------------------------------------------------------------------------

        New budget authority (gross), detail:
          Discretionary:

    40.00   Appropriation...................       2,562       2,633       2,732
    40.35   Appropriation permanently
              reduced.......................         -32         -37
                                               ---------   ---------  ----------
    43.00     Appropriation (total
                discretionary)..............       2,530       2,596       2,732
          Mandatory:

    60.00   Appropriation...................         150         150         150
          Spending authority from offsetting
              collections:

            Discretionary:
    68.00     Offsetting collections (cash).         814         821         830
    68.10     Change in uncollected customer
                payments from Federal
                sources (unexpired).........         -49
                                               ---------   ---------  ----------
    68.90       Spending authority from
                  offsetting collections
                  (total discretionary).....         765         821         830
                                               ---------   ---------  ----------
    70.00   Total new budget authority
              (gross).......................       3,445       3,567       3,712
    ----------------------------------------------------------------------------

        Change in obligated balances:
    72.40 Obligated balance, start of year..         506         572         583
    73.10 Total new obligations.............       3,507       3,567       3,713
    73.20 Total outlays (gross).............      -3,517      -3,556      -3,767
    73.40 Adjustments in expired accounts
            (net)...........................          24
    74.00 Change in uncollected customer
            payments from Federal sources
            (unexpired).....................          49
    74.10 Change in uncollected customer
            payments from Federal sources
            (expired).......................           3
                                               ---------   ---------  ----------
    74.40   Obligated balance, end of year..         572         583         529
    ----------------------------------------------------------------------------

        Outlays (gross), detail:
    86.90 Outlays from new discretionary
            authority.......................       3,251       3,106       3,234
    86.93 Outlays from discretionary
            balances........................         266         304         383
    86.97 Outlays from new mandatory
            authority.......................                     132         132
    86.98 Outlays from mandatory balances...                      14          18
                                               ---------   ---------  ----------
    87.00   Total outlays (gross)...........       3,517       3,556       3,767
    ----------------------------------------------------------------------------

        Offsets:
          Against gross budget authority and outlays:

            Offsetting collections (cash)
                from:
    88.00     Federal sources...............        -404        -405        -407
    88.40     Non-Federal sources...........        -412        -416        -423
                                               ---------   ---------  ----------
    88.90       Total, offsetting
                  collections (cash)........        -816        -821        -830
          Against gross budget authority only:

    88.95   Change in uncollected customer
              payments from Federal sources
              (unexpired)...................          49
    88.96   Portion of offsetting
              collections (cash) credited to
              expired accounts..............           2
    ----------------------------------------------------------------------------

        Net budget authority and outlays:
    89.00 Budget authority..................       2,680       2,746       2,882
    90.00 Outlays...........................       2,700       2,735       2,937
    ---------------------------------------------------------------------------

        The Indian health services account provides medical care, public
    health services, and health professions training opportunities to
    American Indians and Alaska Natives. An estimated $1,606 million will be
    administered by tribal governments under self-determination contracts
    and self-governance compacts in 2006.

                   Object Classification (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-0390-0-1-551      2004 actual   2005 est.   2006 est.
    ----------------------------------------------------------------------------

          Direct obligations:

            Personnel compensation:
    11.1      Full-time permanent...........         320         378         389
    11.3      Other than full-time permanent          16          18          19
    11.5      Other personnel compensation..          31          35          36
    11.7      Military personnel............          72          85          88
                                               ---------   ---------  ----------
    11.9        Total personnel compensation         439         516         532
    12.1    Civilian personnel benefits.....          94         109         112
    12.2    Military personnel benefits.....          32          37          38

    [[Page 437]]

    13.0    Benefits for former personnel...          12          13          12
    21.0    Travel and transportation of
              persons.......................          13          13          12
    21.0    Patient Travel..................          16          16          16
    22.0    Transportation of things........           9           8           8
    23.1    Rental payments to GSA..........           5           4           4
    23.2    Rental payments to others.......           2           2           2
    23.3    Communications, utilities, and
              miscellaneous charges.........          17          15          15
    24.0    Printing and reproduction.......           1           1           1
    25.1    Advisory and assistance services           5           4           4
    25.2    Other services..................          86          61          59
    25.3    Other purchases of goods and
              services from Government
              accounts......................          44          47          47
    25.4    Operation and maintenance of
              facilities....................           6           5           5
    25.6    Medical care....................         216         215         206
    25.7    Operation and maintenance of
              equipment.....................           5           4           4
    25.8    Subsistence and support of
              persons.......................           2           2           2
    26.0    Supplies and materials..........         102          94          91
    31.0    Equipment.......................          11           9           9
    41.0    Grants, subsidies, and
              contributions.................       1,597       1,571       1,704
                                               ---------   ---------  ----------
    99.0      Direct obligations............       2,714       2,746       2,883
    99.0  Reimbursable obligations..........         793         821         830
                                               ---------   ---------  ----------
    99.9    Total new obligations...........       3,507       3,567       3,713
    ---------------------------------------------------------------------------

                                  Personnel Summary

    ----------------------------------------------------------------------------
    Identification code 75-0390-0-1-551      2004 actual   2005 est.   2006 est.
    ----------------------------------------------------------------------------
        Direct:
          Total compensable workyears:

    1001    Civilian full-time equivalent
              employment....................       6,825       7,733       7,733
    1101    Military full-time equivalent
              employment....................       1,458       1,603       1,603
        Reimbursable:
          Total compensable workyears:

    2001    Civilian full-time equivalent
              employment....................       5,041       5,041       5,041
    2101    Military full-time equivalent
              employment....................         423         423         423
    ---------------------------------------------------------------------------

                            Indian Health Facilities

        For construction, repair, maintenance, improvement, and equipment of
    health and related auxiliary facilities, including quarters for
    personnel; preparation of plans, specifications, and drawings;
    acquisition of sites, purchase and erection of modular buildings, and
    purchases of trailers; and for provision of domestic and community
    sanitation facilities for Indians, as authorized by section 7 of the Act
    of August 5, 1954 (42 U.S.C. 2004a), the Indian Self-Determination Act,
    and the Indian Health Care Improvement Act, and for expenses necessary
    to carry out such Acts and titles II and III of the Public Health
    Service Act with respect to environmental health and facilities support
    activities of the Indian Health Service, [$394,048,000] $315,668,000, to
    remain available until expended: Provided, That notwithstanding any
    other provision of law, funds appropriated for the planning, design,
    construction or renovation of health facilities for the benefit of an
    Indian tribe or tribes may be used to purchase land for sites to
    construct, improve, or enlarge health or related facilities: Provided
    further, That not to exceed $500,000 shall be used by the Indian Health
    Service to purchase TRANSAM equipment from the Department of Defense for
    distribution to the Indian Health Service and tribal facilities:
    Provided further, That none of the funds appropriated to the Indian
    Health Service may be used for sanitation facilities construction for
    new homes funded with grants by the housing programs of the United
    States Department of Housing and Urban Development: Provided further,
    That not to exceed $1,000,000 from this account and the ``Indian Health
    Services'' account shall be used by the Indian Health Service to obtain
    ambulances for the Indian Health Service and tribal facilities in
    conjunction with an existing interagency agreement between the Indian
    Health Service and the General Services Administration: [Provided
    further, That notwithstanding any other provision of law, funds
    appropriated for the planning, design, and construction of the
    replacement health care facility in Barrow, Alaska, may be used to
    purchase land up to approximately 8 hectares for a site upon which to
    construct the new health care facility:] Provided further, That not to
    exceed $500,000 shall be placed in a Demolition Fund, available until
    expended, to be used by the Indian Health Service for demolition of
    Federal buildings[: Provided further, That up to $2,700,000 from
    unobligated balances may be used for the purchase of land at two sites
    for the construction of the northern and southern California Youth
    Regional Treatment Centers subject to advance approval from the House
    and Senate Committees on Appropriations]. (Department of the Interior
    and Related Agencies Appropriations Act, 2005.)

                    Unavailable Receipts (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-0391-0-1-551      2004 actual   2005 est.   2006 est.
    ----------------------------------------------------------------------------
        Receipts:
    02.20 Rent and charges for quarters,
            Indian Health Service...........           6           6           6
        Appropriations:
    05.00 Indian health facilities..........          -6          -6          -6
                                               ---------   ---------  ----------
    07.99 Balance, end of year..............
    ---------------------------------------------------------------------------

                   Program and Financing (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-0391-0-1-551      2004 actual   2005 est.   2006 est.
    ----------------------------------------------------------------------------

        Obligations by program activity:
          Direct program:

    00.01   Sanitation and health facilities         138         180          97
    00.02   Maintenance.....................          45          55          56
    00.03   Facilities and environmental
              health........................         144         142         151
    00.04   Equipment.......................          15          17          18
                                               ---------   ---------  ----------
    01.00     Total direct program..........         342         394         322
    09.01 Reimbursable program..............           7           7           7
                                               ---------   ---------  ----------
    10.00   Total new obligations...........         349         401         329
    ----------------------------------------------------------------------------

        Budgetary resources available for obligation:
    21.40 Unobligated balance carried
            forward, start of year..........         227         279         279
    22.00 New budget authority (gross)......         401         401         329
                                               ---------   ---------  ----------
    23.90   Total budgetary resources
              available for obligation......         628         680         608
    23.95 Total new obligations.............        -349        -401        -329
                                               ---------   ---------  ----------
    24.40   Unobligated balance carried
              forward, end of year..........         279         279         279
    ----------------------------------------------------------------------------

        New budget authority (gross), detail:
          Discretionary:

    40.00   Appropriation...................         396         394         316
    40.35   Appropriation permanently
              reduced.......................          -5          -6
                                               ---------   ---------  ----------
    43.00     Appropriation (total
                discretionary)..............         391         388         316
          Mandatory:

    60.20   Appropriation (special fund)....           6           6           6
          Discretionary:

    68.00   Spending authority from
              offsetting collections:
              Offsetting collections (cash).           4           7           7
                                               ---------   ---------  ----------
    70.00   Total new budget authority
              (gross).......................         401         401         329
    ----------------------------------------------------------------------------

        Change in obligated balances:
    72.40 Obligated balance, start of year..         252         234         348
    73.10 Total new obligations.............         349         401         329
    73.20 Total outlays (gross).............        -366        -287        -400
                                               ---------   ---------  ----------
    74.40   Obligated balance, end of year..         234         348         277
    ----------------------------------------------------------------------------

        Outlays (gross), detail:
    86.90 Outlays from new discretionary
            authority.......................         360         123         102
    86.93 Outlays from discretionary
            balances........................                     158         292
    86.97 Outlays from new mandatory
            authority.......................           6           6           6
                                               ---------   ---------  ----------
    87.00   Total outlays (gross)...........         366         287         400
    ----------------------------------------------------------------------------

        Offsets:
          Against gross budget authority and outlays:

    88.00   Offsetting collections (cash)
              from: Federal sources.........          -4          -7          -7
    ----------------------------------------------------------------------------

        Net budget authority and outlays:
    89.00 Budget authority..................         397         394         322
    90.00 Outlays...........................         364         280         393
    ---------------------------------------------------------------------------

        The Indian health facilities account supports construction, repair
    and improvement, equipment, and environmental health and facilities
    support for the Indian health services.

    [[Page 438]]

                   Object Classification (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-0391-0-1-551      2004 actual   2005 est.   2006 est.
    ----------------------------------------------------------------------------

          Direct obligations:

            Personnel compensation:
    11.1      Full-time permanent...........          35          40          41
    11.3      Other than full-time permanent           6           7           7
    11.5      Other personnel compensation..           1           2           2
    11.7      Military personnel............          19          22          23
                                               ---------   ---------  ----------
    11.9        Total personnel compensation          61          71          73
    12.1    Civilian personnel benefits.....          10          12          12
    12.2    Military personnel benefits.....           7           9          10
    13.0    Benefits for former personnel...           1           1           1
    21.0    Travel and transportation of
              persons.......................           3           3           3
    22.0    Transportation of things........           2           2           2
    23.3    Communications, utilities, and
              miscellaneous charges.........          11          11          11
    25.1    Advisory and assistance services           2           1           1
    25.2    Other services..................         158          77          73
    25.3    Other purchases of goods and
              services from Government
              accounts......................           2           1           1
    25.4    Operation and maintenance of
              facilities....................          16          15           5
    25.7    Operation and maintenance of
              equipment.....................           1           1           1
    26.0    Supplies and materials..........           5           6           6
    31.0    Equipment.......................          12          11           7
    32.0    Land and structures.............         -48          74          17
    41.0    Grants, subsidies, and
              contributions.................          99          99          99
                                               ---------   ---------  ----------
    99.0      Direct obligations............         342         394         322
    99.0  Reimbursable obligations..........           7           7           7
                                               ---------   ---------  ----------
    99.9    Total new obligations...........         349         401         329
    ---------------------------------------------------------------------------

                                  Personnel Summary

    ----------------------------------------------------------------------------
    Identification code 75-0391-0-1-551      2004 actual   2005 est.   2006 est.
    ----------------------------------------------------------------------------
        Direct:
          Total compensable workyears:

    1001    Civilian full-time equivalent
              employment....................       1,035       1,176       1,176
    1101    Military full-time equivalent
              employment....................         226         249         249
    ---------------------------------------------------------------------------

                Administrative Provisions, Indian Health Service

        Appropriations in this Act to the Indian Health Service shall be
    available for services as authorized by 5 U.S.C. 3109 but at rates not
    to exceed the per diem rate equivalent to the maximum rate payable for
    senior-level positions under 5 U.S.C. 5376; hire of passenger motor
    vehicles and aircraft; purchase of medical equipment; purchase of
    reprints; purchase, renovation and erection of modular buildings and
    renovation of existing facilities; payments for telephone service in
    private residences in the field, when authorized under regulations
    approved by the Secretary; and for uniforms or allowances therefor as
    authorized by 5 U.S.C. 5901-5902; and for expenses of attendance at
    meetings which are concerned with the functions or activities for which
    the appropriation is made or which will contribute to improved conduct,
    supervision, or management of those functions or activities.
        In accordance with the provisions of the Indian Health Care
    Improvement Act, non-Indian patients may be extended health care at all
    tribally administered or Indian Health Service facilities, subject to
    charges, and the proceeds along with funds recovered under the Federal
    Medical Care Recovery Act (42 U.S.C. 2651-2653) shall be credited to the
    account of the facility providing the service and shall be available
    without fiscal year limitation. Notwithstanding any other law or
    regulation, funds transferred from the Department of Housing and Urban
    Development to the Indian Health Service shall be administered under
    Public Law 86-121 (the Indian Sanitation Facilities Act) and Public Law
    93-638, as amended.
        Funds appropriated to the Indian Health Service in this Act, except
    those used for administrative and program direction purposes, shall not
    be subject to limitations directed at curtailing Federal travel and
    transportation.
        [None of the funds made available to the Indian Health Service in
    this Act shall be used for any assessments or charges by the Department
    of Health and Human Services unless identified in the budget
    justification and provided in this Act, or approved by the House and
    Senate Committees on Appropriations through the reprogramming process.
    Personnel ceilings may not be imposed on the Indian Health Service nor
    may any action be taken to reduce the full time equivalent level of the
    Indian Health Service below the level in fiscal year 2002 adjusted
    upward for the staffing of new and expanded facilities, funding provided
    for staffing at the Lawton, Oklahoma hospital in fiscal years 2003 and
    2004, critical positions not filled in fiscal year 2002, and staffing
    necessary to carry out the intent of Congress with regard to program
    increases.]
        Notwithstanding any other provision of law, funds previously or
    herein made available to a tribe or tribal organization through a
    contract, grant, or agreement authorized by title I or title V of the
    Indian Self-Determination and Education Assistance Act of 1975 (25
    U.S.C. 450), may be deobligated and reobligated to a self-determination
    contract under title I, or a self-governance agreement under title V of
    such Act and thereafter shall remain available to the tribe or tribal
    organization without fiscal year limitation.
        None of the funds made available to the Indian Health Service in
    this Act shall be used to implement the final rule published in the
    Federal Register on September 16, 1987, by the Department of Health and
    Human Services, relating to the eligibility for the health care services
    of the Indian Health Service until the Indian Health Service has
    submitted a budget request reflecting the increased costs associated
    with the proposed final rule, and such request has been included in an
    appropriations Act and enacted into law.
        With respect to functions transferred by the Indian Health Service
    to tribes or tribal organizations, the Indian Health Service is
    authorized to provide goods and services to those entities, on a
    reimbursable basis, including payment in advance with subsequent
    adjustment. The reimbursements received therefrom, along with the funds
    received from those entities pursuant to the Indian Self-Determination
    Act, may be credited to the same or subsequent appropriation account
    which provided the funding. Such amounts shall remain available until
    expended.
        Reimbursements for training, technical assistance, or services
    provided by the Indian Health Service will contain total costs,
    including direct, administrative, and overhead associated with the
    provision of goods, services, or technical assistance.
        [The Indian Health Service may purchase 8.5 acres of land for
    expansion of parking facilities at the W.W. Hastings hospital in
    Tahlequah, Oklahoma using third party collections subject to advance
    approval from the House and Senate Committees on Appropriations.
        Notwithstanding any other provision of law, the Tulsa and Oklahoma
    City Clinic demonstration projects shall be permanent programs under the
    direct care program of the Indian Health Service; shall be treated as
    service units and operating units in the allocation of resources and
    coordination of care; shall continue to meet the requirements applicable
    to an Urban Indian organization under this title; and shall not be
    subject to the Indian Self-Determination and Education Assistance Act
    (25 U.S.C. 450 et seq.).]
        The appropriation structure for the Indian Health Service may not be
    altered without advance [approval of] notification to the House and
    Senate Committees on Appropriations. (Department of the Interior and
    Related Agencies Appropriations Act, 2005.)

                   CENTERS FOR DISEASE CONTROL AND PREVENTION

                                  Federal Funds

    General and special funds:

                     Disease Control, Research, and Training

        To carry out titles II, III, VII, XI, XV, XVII, [XIX,] XXI, and XXVI
    of the Public Health Service Act, sections 101, 102, 103, 201, 202, 203,
    301, and 501 of the Federal Mine Safety and Health Act of 1977, sections
    20, 21, and 22 of the Occupational Safety and Health Act of 1970, title
    IV of the Immigration and Nationality Act, and section 501 of the
    Refugee Education Assistance Act of 1980; including purchase and
    insurance of official motor vehicles in foreign countries; and purchase,
    hire, maintenance, and operation of aircraft, [$4,533,911,000]
    $4,040,963,000, of which [$272,000,000] $30,000,000 shall remain
    available until expended for equipment, and construction and renovation
    of facilities[,] ; of which $30,000,000 of the amounts available for
    immunization activities shall remain

    [[Page 439]]

    available until expended; and of which [$124,882,000] $123,883,000 for
    international HIV/AIDS shall remain available until September 30, [2006]
    2007. In addition, such sums as may be derived from authorized user
    fees, which shall be credited to this account: Provided, That in
    addition to amounts provided herein, the following amounts shall be
    available from amounts available under section 241 of the Public Health
    Service Act: (1) $12,794,000 to carry out the National Immunization
    Surveys; (2) $109,021,000 to carry out the National Center for Health
    Statistics surveys; (3) $24,751,000 to carry out information systems
    standards development and architecture and applications-based research
    used at local public health levels; (4) $463,000 for Health Marketing
    evaluations; (5) $31,000,000 to carry out Public Health Research; and
    (6) $87,071,000 to carry out [Research Tools and Approaches] research
    activities within the National Occupational Research Agenda: Provided
    further, That none of the funds made available for injury prevention and
    control at the Centers for Disease Control and Prevention may be used,
    in whole or in part, to advocate or promote gun control: Provided
    further, That up to $30,000,000 shall be made available until expended
    for Individual Learning Accounts for full-time equivalent employees of
    the Centers for Disease Control and Prevention: Provided further, That
    the Director may redirect the total amount made available under
    authority of Public Law 101-502, section 3, dated November 3, 1990, to
    activities the Director may so designate: Provided further, That the
    Congress is to be notified promptly of any such transfer: Provided
    further, That not to exceed $12,500,000 may be available for making
    grants under section 1509 of the Public Health Service Act to not more
    than 15 States, tribes, or tribal organizations: Provided further, That
    without regard to existing statute, funds appropriated may be used to
    proceed, at the discretion of the Centers for Disease Control and
    Prevention, with property acquisition, including a long-term ground
    lease for construction on non-Federal land, to support the construction
    of a replacement laboratory in the Fort Collins, Colorado area:
    [Provided further, That notwithstanding any other provision of law, a
    single contract or related contracts for development and construction of
    facilities may be employed which collectively include the full scope of
    the project: Provided further, That the solicitation and contract shall
    contain the clause ``availability of funds'' found at 48 CFR 52.232-18:]
    Provided further, That of the funds appropriated, $10,000 is for
    official reception and representation expenses when specifically
    approved by the Director of the Centers for Disease Control and
    Prevention. (Department of Health and Human Services Appropriations Act,
    2005.)

                    Unavailable Receipts (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-0943-0-1-550      2004 actual   2005 est.   2006 est.
    ----------------------------------------------------------------------------
        Receipts:
    02.20 Cooperative research and
            development agreements, Centers
            for Disease Control.............           1           1           1
        Appropriations:
    05.01 Disease control, research, and
            training........................          -1          -1          -1
                                               ---------   ---------  ----------
    07.99 Balance, end of year..............
    ---------------------------------------------------------------------------

                   Program and Financing (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-0943-0-1-550      2004 actual   2005 est.   2006 est.
    ----------------------------------------------------------------------------

        Obligations by program activity:
    00.01 Infectious Diseases...............                   1,692       1,697
    00.02 Health Promotion..................                   1,010         964
    00.03 Health Information and Service....                      94          90
    00.04 Environmental Hlth and Injury.....                     286         285
    00.05 Occupational Safety and Hlth......                     199         199
    00.06 Global Health.....................                     294         306
    00.08 Public Hlth Improvement and
            Leadership......................                     267         207
    00.09 Prev. Hlth and Hlth Svcs Block
            Grant...........................                     117
    00.10 Buildings and Facilities..........                     270          30
    00.11 Business Services Support.........                     279         263
    00.19 Birth defects/developmental
            disabilities/disability and
            health..........................         113
    00.20 Chronic disease prev & health
            promotion.......................         853
    00.21 Environmental health..............         183
    00.22 Epidemic services and response....          91
    00.24 HIV/AIDS, STD and TB prevention...       1,150
    00.25 Immunization......................         630
    00.26 Infectious disease control........         369
    00.27 Injury prevention and control.....         154
    00.28 Occupational safety and health....         235
    00.29 Preventive health and heath
            service block grant.............         133
    00.30 Public health improvement.........         142
    00.31 Building and facilities...........         212
    00.32 Office of the Director............          59
          Reimbursable program:

    09.01   Health statistics...............         128         109         109
    09.02   Other reimbursable program......         441         485         490
    09.03   Public Health Research..........                      31          31
                                               ---------   ---------  ----------
    09.09     Subtotal, reimbursable
                programs....................         569         625         630
                                               ---------   ---------  ----------
    10.00   Total new obligations...........       4,893       5,133       4,671
    ----------------------------------------------------------------------------

        Budgetary resources available for obligation:
    21.40 Unobligated balance carried
            forward, start of year..........         165         218         219
    22.00 New budget authority (gross)......       4,940       5,134       4,672
    22.10 Resources available from
            recoveries of prior year
            obligations.....................           7
                                               ---------   ---------  ----------
    23.90   Total budgetary resources
              available for obligation......       5,112       5,352       4,891
    23.95 Total new obligations.............      -4,893      -5,133      -4,671
    23.98 Unobligated balance expiring or
            withdrawn.......................          -1
                                               ---------   ---------  ----------
    24.40   Unobligated balance carried
              forward, end of year..........         218         219         220
    ----------------------------------------------------------------------------

        New budget authority (gross), detail:
          Discretionary:

    40.00   Appropriation...................       4,547       4,534       4,041
    40.35   Appropriation permanently
              reduced.......................         -31         -38
    42.00   Transferred from other accounts.                      12
                                               ---------   ---------  ----------
    43.00     Appropriation (total
                discretionary)..............       4,516       4,508       4,041
          Mandatory:

    60.20   Appropriation (special fund)....           1           1           1
          Spending authority from offsetting
              collections:

            Discretionary:
    68.00     Offsetting collections (cash).         239         625         630
    68.10     Change in uncollected customer
                payments from Federal
                sources (unexpired).........         184
                                               ---------   ---------  ----------
    68.90       Spending authority from
                  offsetting collections
                  (total discretionary).....         423         625         630
                                               ---------   ---------  ----------
    70.00   Total new budget authority
              (gross).......................       4,940       5,134       4,672
    ----------------------------------------------------------------------------

        Change in obligated balances:
    72.40 Obligated balance, start of year..       3,582       3,705       3,804
    73.10 Total new obligations.............       4,893       5,133       4,671
    73.20 Total outlays (gross).............      -4,880      -5,034      -5,023
    73.40 Adjustments in expired accounts
            (net)...........................         -33
    73.45 Recoveries of prior year
            obligations.....................          -7
    74.00 Change in uncollected customer
            payments from Federal sources
            (unexpired).....................        -184
    74.10 Change in uncollected customer
            payments from Federal sources
            (expired).......................         334
                                               ---------   ---------  ----------
    74.40   Obligated balance, end of year..       3,705       3,804       3,452
    ----------------------------------------------------------------------------

        Outlays (gross), detail:
    86.90 Outlays from new discretionary
            authority.......................       2,536       2,158       2,004
    86.93 Outlays from discretionary
            balances........................       2,344       2,875       3,018
    86.97 Outlays from new mandatory
            authority.......................                       1           1
                                               ---------   ---------  ----------
    87.00   Total outlays (gross)...........       4,880       5,034       5,023
    ----------------------------------------------------------------------------

        Offsets:
          Against gross budget authority and outlays:

            Offsetting collections (cash)
                from:
    88.00     Federal sources...............         -70        -575        -580
    88.40     Non-Federal sources...........        -499         -50         -50
                                               ---------   ---------  ----------
    88.90       Total, offsetting
                  collections (cash)........        -569        -625        -630
          Against gross budget authority only:

    88.95   Change in uncollected customer
              payments from Federal sources
              (unexpired)...................        -184
    88.96   Portion of offsetting
              collections (cash) credited to
              expired accounts..............         330
    ----------------------------------------------------------------------------

        Net budget authority and outlays:
    89.00 Budget authority..................       4,517       4,509       4,042
    90.00 Outlays...........................       4,311       4,409       4,393
    ---------------------------------------------------------------------------

                     Summary of Budget Authority and Outlays

                            (in millions of dollars)

                                         2004 actual  2005 est.   2006 est.
    Enacted/requested:
      Budget Authority..................       4,517       4,509       4,042
      Outlays...........................       4,311       4,409       4,393

    [[Page 440]]

    Legislative proposal, not subject to
        PAYGO:
      Budget Authority..................                                -100
      Outlays...........................                                 -34
                                        ------------------------------------
    Total:
      Budget Authority..................       4,517       4,509       3,942
      Outlays...........................       4,311       4,409       4,359
                                        ====================================

        The Centers for Disease Control and Prevention (CDC) supports a
    number of categorical programs designed to improve the health, safety,
    and protection of all Americans. These programs include immunization,
    HIV prevention, chronic disease prevention and health promotion,
    infectious disease control, occupational safety and health, injury
    prevention and control, environmental health, and programs that reduce
    the occurrence of birth defects and developmental disabilities. CDC also
    supports bioterrorism and emergency response activities. Funding for
    these activities is included in the Public Health and Social Services
    Emergency Fund provided to CDC from the Office of the Secretary of
    Health and Human Services. The Budget request for the 317 immunization
    program assumes enactment of a legislative proposal that reduces the
    discretionary request by $100 million.

                   Object Classification (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-0943-0-1-550      2004 actual   2005 est.   2006 est.
    ----------------------------------------------------------------------------

          Direct obligations:

            Personnel compensation:
    11.1      Full-time permanent...........         347         365         380
    11.3      Other than full-time permanent          39          42          43
    11.5      Other personnel compensation..          24          25          26
    11.7      Military personnel............          56          57          58
    11.8      Special personal services
                payments....................           1           1           1
                                               ---------   ---------  ----------
    11.9        Total personnel compensation         467         490         508
    12.1    Civilian personnel benefits.....         112         119         123
    12.2    Military personnel benefits.....          32          33          34
    21.0    Travel and transportation of
              persons.......................          41          43          40
    22.0    Transportation of things........           9           9           9
    23.1    Rental payments to GSA..........          30          32          32
    23.2    Rental payments to others.......           2           2           2
    23.3    Communications, utilities, and
              miscellaneous charges.........          24          25          23
    24.0    Printing and reproduction.......           6           6           6
    25.1    Advisory and assistance services         218         229         213
    25.2    Other services..................         109         114          62
    25.3    Other purchases of goods and
              services from Government
              accounts......................         297         311         290
    25.4    Operation and maintenance of
              facilities....................          45          47          24
    25.5    Research and development
              contracts.....................         161         137         137
    25.6    Medical care....................           1           1           1
    25.7    Operation and maintenance of
              equipment.....................          21          22          20
    26.0    Supplies and materials..........          29          31          29
    31.0    Equipment.......................          94          98          52
    32.0    Land and structures.............         147         156          20
    41.0    Grants, subsidies, and
              contributions.................       2,479       2,603       2,416
                                               ---------   ---------  ----------
    99.0      Direct obligations............       4,324       4,508       4,041
    99.0  Reimbursable obligations..........         569         625         630
                                               ---------   ---------  ----------
    99.9    Total new obligations...........       4,893       5,133       4,671
    ---------------------------------------------------------------------------

                                  Personnel Summary

    ----------------------------------------------------------------------------
    Identification code 75-0943-0-1-550      2004 actual   2005 est.   2006 est.
    ----------------------------------------------------------------------------
        Direct:
          Total compensable workyears:

    1001    Civilian full-time equivalent
              employment....................       5,819       5,604       5,593
    1101    Military full-time equivalent
              employment....................         558         558         558
        Reimbursable:
          Total compensable workyears:

    2001    Civilian full-time equivalent
              employment....................       1,176       1,176       1,176
    2101    Military full-time equivalent
              employment....................         296         296         296
        Allocation account:
    3001  Total compensable workyears:
            Civilian full-time equivalent
            employment......................         538         779       1,029
    ---------------------------------------------------------------------------

                     Disease Control, Research, and Training

                  (Legislative proposal, not subject to PAYGO)

                   Program and Financing (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-0943-2-1-550      2004 actual   2005 est.   2006 est.
    ----------------------------------------------------------------------------

        Obligations by program activity:
    00.01 Infectious Diseases...............                                -100
                                               ---------   ---------  ----------
    10.00   Total new obligations (object
              class 41.0)...................                                -100
    ----------------------------------------------------------------------------

        Budgetary resources available for obligation:
    22.00 New budget authority (gross)......                                -100
    23.95 Total new obligations.............                                 100
    ----------------------------------------------------------------------------

        New budget authority (gross), detail:
          Discretionary:

    40.00   Appropriation...................                                -100
    ----------------------------------------------------------------------------

        Change in obligated balances:
    72.40 Obligated balance, start of year..
    73.10 Total new obligations.............                                -100
    73.20 Total outlays (gross).............                                  34
                                               ---------   ---------  ----------
    74.40   Obligated balance, end of year..                                 -66
    ----------------------------------------------------------------------------

        Outlays (gross), detail:
    86.90 Outlays from new discretionary
            authority.......................                                 -34
    ----------------------------------------------------------------------------

        Net budget authority and outlays:
    89.00 Budget authority..................                                -100
    90.00 Outlays...........................                                 -34
    ---------------------------------------------------------------------------

        The Budget includes legislative proposals for the Vaccines for
    Children (VFC) program to expand access to immunizations for VFC-
    eligible children. Legislation amending the Vaccines for Children
    program will be proposed to allow underinsured children to receive
    immunizations at State and local public health clinics and to lift price
    caps. These proposals will result in approximately $100 million in
    savings from the CDC discretionary 317 immunization program. The Budget
    request for the 317 program assumes enactment of this proposal.

                Agency for Toxic Substances and Disease Registry

                toxic substances and environmental public health

        For necessary expenses for the Agency for Toxic Substances and
    Disease Registry (ATSDR) in carrying out activities set forth in
    sections 104(i), 111(c)(4), and 111(c)(14) of the Comprehensive
    Environmental Response, Compensation, and Liability Act of 1980
    (CERCLA), as amended; section 118(f) of the Superfund Amendments and
    Reauthorization Act of 1986 (SARA), as amended; and section 3019 of the
    Solid Waste Disposal Act, as amended, [$76,654,000] $76,024,000, of
    which up to $1,500,000, to remain available until expended, is for
    Individual Learning Accounts for full-time equivalent employees of the
    Agency for Toxic Substances and Disease Registry: Provided, That
    notwithstanding any other provision of law, in lieu of performing a
    health assessment under section 104(i)(6) of CERCLA, the Administrator
    of ATSDR may conduct other appropriate health studies, evaluations, or
    activities, including, without limitation, biomedical testing, clinical
    evaluations, medical monitoring, and referral to accredited health care
    providers: Provided further, That in performing any such health
    assessment or health study, evaluation, or activity, the Administrator
    of ATSDR shall not be bound by the deadlines in section 104(i)(6)(A) of
    CERCLA: Provided further, That none of the funds appropriated under this
    heading shall be available for ATSDR to issue in excess of 40
    toxicological profiles pursuant to section 104(i) of CERCLA during
    fiscal year [2005] 2006, and existing profiles may be updated as
    necessary. (Department of Health and Human Services Appropriations Act,
    2005.)

    [[Page 441]]

                   Program and Financing (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-0944-0-1-551      2004 actual   2005 est.   2006 est.
    ----------------------------------------------------------------------------

        Obligations by program activity:
    00.01 Direct program....................          73          76          76
    09.01 Reimbursable program..............          12          25          25
                                               ---------   ---------  ----------
    10.00   Total new obligations...........          85         101         101
    ----------------------------------------------------------------------------

        Budgetary resources available for obligation:
    22.00 New budget authority (gross)......          86         101         101
    23.95 Total new obligations.............         -85        -101        -101
    ----------------------------------------------------------------------------

        New budget authority (gross), detail:
          Discretionary:

    40.00   Appropriation...................          73          77          76
    40.35   Appropriation permanently
              reduced.......................                      -1
                                               ---------   ---------  ----------
    43.00     Appropriation (total
                discretionary)..............          73          76          76
          Spending authority from offsetting
              collections:

    68.00   Offsetting collections (cash)...           7          25          25
    68.10   Change in uncollected customer
              payments from Federal sources
              (unexpired)...................           6
                                               ---------   ---------  ----------
    68.90     Spending authority from
                offsetting collections
                (total discretionary).......          13          25          25
                                               ---------   ---------  ----------
    70.00   Total new budget authority
              (gross).......................          86         101         101
    ----------------------------------------------------------------------------

        Change in obligated balances:
    72.40 Obligated balance, start of year..                      10          11
    73.10 Total new obligations.............          85         101         101
    73.20 Total outlays (gross).............         -69        -100        -100
    74.00 Change in uncollected customer
            payments from Federal sources
            (unexpired).....................          -6
                                               ---------   ---------  ----------
    74.40   Obligated balance, end of year..          10          11          12
    ----------------------------------------------------------------------------

        Outlays (gross), detail:
    86.90 Outlays from new discretionary
            authority.......................          69          86          86
    86.93 Outlays from discretionary
            balances........................                      14          14
                                               ---------   ---------  ----------
    87.00   Total outlays (gross)...........          69         100         100
    ----------------------------------------------------------------------------

        Offsets:
          Against gross budget authority and outlays:

    88.00   Offsetting collections (cash)
              from: Federal sources.........          -7         -25         -25
          Against gross budget authority only:

    88.95   Change in uncollected customer
              payments from Federal sources
              (unexpired)...................          -6
    ----------------------------------------------------------------------------

        Net budget authority and outlays:
    89.00 Budget authority..................          73          76          76
    90.00 Outlays...........................          63          75          75
    ---------------------------------------------------------------------------

        The Agency for Toxic Substances and Disease Registry (ATSDR) is
    authorized under the Comprehensive Environmental Response, Compensation,
    and Liability Act of 1980 (CERCLA). ATSDR assesses health hazards at
    specific hazardous waste sites helping to prevent or reduce exposure and
    illnesses that result, and increasing knowledge and understanding of the
    health effects that may result from exposure to hazardous substances.

                   Object Classification (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-0944-0-1-551      2004 actual   2005 est.   2006 est.
    ----------------------------------------------------------------------------

          Direct obligations:

            Personnel compensation:
    11.1      Full-time permanent...........          22          23          24
    11.3      Other than full-time permanent           1           1           1
    11.5      Other personnel compensation..           1           1           1
    11.7      Military personnel............           4           4           4
                                               ---------   ---------  ----------
    11.9        Total personnel compensation          28          29          30
    12.1    Civilian personnel benefits.....           6           6           6
    12.2    Military personnel benefits.....           2           2           2
    21.0    Travel and transportation of
              persons.......................           1           1           1
    23.3    Communications, utilities, and
              miscellaneous charges.........                       1           1
    25.1    Advisory and assistance services           6           6           6
    25.2    Other services..................           3           3           3
    25.3    Other purchases of goods and
              services from Government
              accounts......................          14          14          13
    25.5    Research and development
              contracts.....................           4           4           4
    31.0    Equipment.......................           1           1           1
    41.0    Grants, subsidies, and
              contributions.................           8           9           9
                                               ---------   ---------  ----------
    99.0      Direct obligations............          73          76          76
    99.0  Reimbursable obligations..........          12          25          25
                                               ---------   ---------  ----------
    99.9    Total new obligations...........          85         101         101
    ---------------------------------------------------------------------------

                                  Personnel Summary

    ----------------------------------------------------------------------------
    Identification code 75-0944-0-1-551      2004 actual   2005 est.   2006 est.
    ----------------------------------------------------------------------------
        Direct:
          Total compensable workyears:

    1001    Civilian full-time equivalent
              employment....................         300         300         300
    1101    Military full-time equivalent
              employment....................          63          63          63
        Reimbursable:
          Total compensable workyears:

    2001    Civilian full-time equivalent
              employment....................          48          58          58
    2101    Military full-time equivalent
              employment....................           8           8           8
    ---------------------------------------------------------------------------

                                   Trust Funds

       Toxic Substances and Environmental Public Health, Agency for Toxic
                         Substances and Disease Registry

                   Program and Financing (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-8252-0-7-551      2004 actual   2005 est.   2006 est.
    ----------------------------------------------------------------------------

        Change in obligated balances:
    72.40 Obligated balance, start of year..          55          19          12
    73.20 Total outlays (gross).............         -45          -7          -3
    73.40 Adjustments in expired accounts
            (net)...........................          -1
    74.10 Change in uncollected customer
            payments from Federal sources
            (expired).......................          10
                                               ---------   ---------  ----------
    74.40   Obligated balance, end of year..          19          12           9
    ----------------------------------------------------------------------------

        Outlays (gross), detail:
    86.93 Outlays from discretionary
            balances........................          45           7           3
    ----------------------------------------------------------------------------

        Offsets:
          Against gross budget authority and outlays:

    88.00   Offsetting collections (cash)
              from: Federal sources.........         -10
          Against gross budget authority only:

    88.96   Portion of offsetting
              collections (cash) credited to
              expired accounts..............          10
    ----------------------------------------------------------------------------

        Net budget authority and outlays:
    89.00 Budget authority..................
    90.00 Outlays...........................          35           7           3
    ---------------------------------------------------------------------------

        The Agency for Toxic Substances and Disease Registry (ATSDR)
    received appropriations solely from the Hazardous Substance Superfund
    trust fund until 2004, when ATSDR received an appropriation from the
    general fund, depending on any available balances from the trust fund.
    The budget requests that ATSDR's appropriation come only from the
    general fund in 2006, without regard to any available balances in the
    trust fund.

                          NATIONAL INSTITUTES OF HEALTH

                                  Federal Funds

    General and special funds:

                            National Cancer Institute

        For carrying out section 301 and title IV of the Public Health
    Service Act with respect to cancer, [$4,865,525,000] $4,841,774,000, of
    which up to $8,000,000 may be used for facilities repairs and
    improvements at the NCI-Frederick Federally Funded Research and
    Development Center in Frederick, Maryland. (Department of Health and
    Human Services Appropriations Act, 2005.)

    [[Page 442]]

                    National Heart, Lung, and Blood Institute

        For carrying out section 301 and title IV of the Public Health
    Service Act with respect to cardiovascular, lung, and blood diseases,
    and blood and blood products, [$2,965,453,000] 2,951,270,000.
    (Department of Health and Human Services Appropriations Act, 2005.)

             National Institute of Dental and Craniofacial Research

        For carrying out section 301 and title IV of the Public Health
    Service Act with respect to dental disease, [$395,080,000] $393,269,000.
    (Department of Health and Human Services Appropriations Act, 2005.)

        National Institute of Diabetes and Digestive and Kidney Diseases

        For carrying out section 301 and title IV of the Public Health
    Service Act with respect to diabetes and digestive and kidney disease,
    [$1,727,696,000] $1,722,146,000. (Department of Health and Human
    Services Appropriations Act, 2005.)

             National Institute of Neurological Disorders and Stroke

        For carrying out section 301 and title IV of the Public Health
    Service Act with respect to neurological disorders and stroke,
    [$1,552,123,000] $1,550,260,000. (Department of Health and Human
    Services Appropriations Act, 2005.)

              National Institute of Allergy and Infectious Diseases

                          (including transfer of funds)

        For carrying out section 301 and title IV of the Public Health
    Service Act with respect to allergy and infectious diseases,
    [$4,440,007,000] $4,459,395,000: Provided, That $100,000,000 may be made
    available to International Assistance Programs ``Global Fund to Fight
    HIV/AIDS, Malaria, and Tuberculosis'', to remain available until
    expended: Provided further, That up to [$150,000,000] $30,000,000 shall
    be for extramural facilities construction grants to enhance the Nation's
    capability to do research on biological and other agents. (Department of
    Health and Human Services Appropriations Act, 2005.)

                 National Institute of General Medical Sciences

        For carrying out section 301 and title IV of the Public Health
    Service Act with respect to general medical sciences, [$1,959,810,000]
    $1,955,170,000. (Department of Health and Human Services Appropriations
    Act, 2005.)

            National Institute of Child Health and Human Development

        For carrying out section 301 and title IV of the Public Health
    Service Act with respect to child health and human development,
    [$1,280,915,000] $1,277,544,000. (Department of Health and Human
    Services Appropriations Act, 2005.)

                             National Eye Institute

        For carrying out section 301 and title IV of the Public Health
    Service Act with respect to eye diseases and visual disorders,
    [$674,578,000] $673,491,000. (Department of Health and Human Services
    Appropriations Act, 2005.)

               National Institute of Environmental Health Sciences

        For carrying out sections 301 and 311 and title IV of the Public
    Health Service Act with respect to environmental health sciences,
    [$650,027,000] $647,608,000. (Department of Health and Human Services
    Appropriations Act, 2005.)
        For necessary expenses for the National Institute of Environmental
    Health Sciences in carrying out activities set forth in section 311(a)
    of the Comprehensive Environmental Response, Compensation, and Liability
    Act of 1980, as amended, and section 126(g) of the Superfund Amendments
    and Reauthorization Act of 1986, [$80,486,000] $80,289,000. (Departments
    of Veterans Affairs and Housing and Urban Development, and Independent
    Agencies Appropriations Act, 2005).

                           National Institute on Aging

        For carrying out section 301 and title IV of the Public Health
    Service Act with respect to aging, [$1,060,666,000] $1,057,203,000.
    (Department of Health and Human Services Appropriations Act, 2005.)

      National Institute of Arthritis and Musculoskeletal and Skin Diseases

        For carrying out section 301 and title IV of the Public Health
    Service Act with respect to arthritis and musculoskeletal and skin
    diseases, [$515,378,000] $513,063,000. (Department of Health and Human
    Services Appropriations Act, 2005.)

        National Institute on Deafness and Other Communication Disorders

        For carrying out section 301 and title IV of the Public Health
    Service Act with respect to deafness and other communication disorders,
    [$397,507,000] $397,432,000. (Department of Health and Human Services
    Appropriations Act, 2005.)

                     National Institute of Nursing Research

        For carrying out section 301 and title IV of the Public Health
    Service Act with respect to nursing research, [$139,198,000]
    $138,729,000. (Department of Health and Human Services Appropriations
    Act, 2005.)

               National Institute on Alcohol Abuse and Alcoholism

        For carrying out section 301 and title IV of the Public Health
    Service Act with respect to alcohol abuse and alcoholism, [$441,911,000]
    $440,333,000. (Department of Health and Human Services Appropriations
    Act, 2005.)

                        National Institute on Drug Abuse

        For carrying out section 301 and title IV of the Public Health
    Service Act with respect to drug abuse, [$1,014,760,000] $1,010,130,000.
    (Department of Health and Human Services Appropriations Act, 2005.)

                       National Institute of Mental Health

        For carrying out section 301 and title IV of the Public Health
    Service Act with respect to mental health, [$1,423,609,000]
    $1,417,692,000. (Department of Health and Human Services Appropriations
    Act, 2005.)

                    National Human Genome Research Institute

        For carrying out section 301 and title IV of the Public Health
    Service Act with respect to human genome research, [$492,670,000]
    $490,959,000. (Department of Health and Human Services Appropriations
    Act, 2005.)

           National Institute of Biomedical Imaging and Bioengineering

        For carrying out section 301 and title IV of the Public Health
    Service Act with respect to biomedical imaging and bioengineering
    research, [$300,647,000] $299,808,000. (Department of Health and Human
    Services Appropriations Act, 2005.)

                     National Center for Research Resources

        For carrying out section 301 and title IV of the Public Health
    Service Act with respect to research resources and general research
    support grants, [$1,124,141,000] $1,100,203,000: Provided, That none of
    these funds shall be used to pay recipients of the general research
    support grants program any amount for indirect expenses in connection
    with such grants[: Provided further, That $30,000,000 shall be for
    extramural facilities construction grants]. (Department of Health and
    Human Services Appropriations Act, 2005.)

           National Center for Complementary and Alternative Medicine

        For carrying out section 301 and title IV of the Public Health
    Service Act with respect to complementary and alternative medicine,
    [$123,116,000] $122,692,000. (Department of Health and Human Services
    Appropriations Act, 2005.)

            National Center on Minority Health and Health Disparities

        For carrying out section 301 and title IV of the Public Health
    Service Act with respect to minority health and health disparities
    research, [$197,780,000] $197,379,000. (Department of Health and Human
    Services Appropriations Act, 2005.)

                      John E. Fogarty International Center

        For carrying out the activities at the John E. Fogarty International
    Center, [$67,182,000] $67,048,000. (Department of Health and Human
    Services Appropriations Act, 2005.)

    [[Page 443]]

                          National Library of Medicine

        For carrying out section 301 and title IV of the Public Health
    Service Act with respect to health information communications,
    [$317,947,000] $318,091,000, of which $4,000,000 shall be available
    until expended for improvement of information systems: Provided, That in
    fiscal year [2005] 2006, the Library may enter into personal services
    contracts for the provision of services in facilities owned, operated,
    or constructed under the jurisdiction of the National Institutes of
    Health[: Provided further, That in addition to amounts provided herein].
    In addition, $8,200,000 shall be available from amounts available under
    section 241 of the Public Health Service Act to carry out National
    Information Center on Health Services Research and Health Care
    Technology and related health services. (Department of Health and Human
    Services Appropriations Act, 2005.)

                             Office of the Director

                          (including transfer of funds)

        For carrying out the responsibilities of the Office of the Director,
    National Institutes of Health, [$361,145,000, of which up to $10,000,000
    shall be used to carry out section 217 of this Act] $385,195,000:
    Provided, That funding shall be available for the purchase of not to
    exceed 29 passenger motor vehicles for replacement only: Provided
    further, That the Director may direct up to 1 percent of the total
    amount made available in this or any other Act to all National
    Institutes of Health appropriations to activities the Director may so
    designate: Provided further, That no such appropriation shall be
    decreased by more than 1 percent by any such transfers and that the
    Congress is promptly notified of the transfer: Provided further, That
    the National Institutes of Health is authorized to collect third party
    payments for the cost of clinical services that are incurred in National
    Institutes of Health research facilities and that such payments shall be
    credited to the National Institutes of Health Management Fund: Provided
    further, That all funds credited to the National Institutes of Health
    Management Fund shall remain available for 1 fiscal year after the
    fiscal year in which they are deposited[: Provided further, That up to
    $500,000 shall be available to carry out section 499 of the Public
    Health Service Act]: Provided further, That of the funds provided
    $10,000 shall be for official reception and representation expenses when
    specifically approved by the Director of NIH[: Provided further, That a
    uniform percentage of the amounts appropriated in this Act to each
    Institute and Center may be utilized for the National Institutes of
    Health Roadmap Initiative: Provided further, That the amount utilized
    under the preceding proviso shall not exceed $176,800,000 without prior
    notification to the Committees on Appropriations of the House of
    Representatives and the Senate: Provided further, That amounts utilized
    under the preceding two provisos shall be in addition to amounts made
    available for the Roadmap Initiative from the Director's Discretionary
    Fund and to any amounts allocated to activities related to the Roadmap
    Initiative through the normal research priority-setting process of
    individual Institutes and Centers]. (Department of Health and Human
    Services Appropriations Act, 2005.)

                            buildings and facilities

        For the study of, construction of, renovation of, and acquisition of
    equipment for, facilities of or used by the National Institutes of
    Health, including the acquisition of real property, [$111,177,000]
    $81,900,000, to remain available until expended[: Provided, That
    notwithstanding any other provision of law, single contracts or related
    contracts, which collectively include the full scope of the project, may
    be employed for the development and construction of the first and second
    phases of the John Edward Porter Neuroscience Research Center: Provided
    further, That the solicitations and contracts shall contain the clause
    ``availability of funds'' found at 48 CFR 52.232-18]. (Department of
    Health and Human Services Appropriations Act, 2005.)

                    Unavailable Receipts (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-9915-0-1-552      2004 actual   2005 est.   2006 est.
    ----------------------------------------------------------------------------
        Receipts:
    02.20 Cooperative research and
            development agreements, NIH.....          12          16          16
        Appropriations:
    05.00 National Institutes of Health.....          -3         -16         -16
    05.01 National Institutes of Health.....          -9
                                               ---------   ---------  ----------
    05.99   Total appropriations............         -12         -16         -16
                                               ---------   ---------  ----------
    07.99 Balance, end of year..............
    ---------------------------------------------------------------------------

                   Program and Financing (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-9915-0-1-552      2004 actual   2005 est.   2006 est.
    ----------------------------------------------------------------------------

        Obligations by program activity:
          Direct program:

    00.01   National Cancer Institute.......       4,727       4,824       4,842
    00.02   National Heart, Lung, and Blood
              Institute.....................       2,883       2,940       2,951
    00.03   National Institute of Dental and
              Craniofacial Research.........         382         392         393
    00.04   National Institute of Diabetes
              and Digestive and Kidney
              Disease.......................       1,829       1,863       1,872
    00.05   National Institute of
              Neurological Disorders and
              Stroke........................       1,498       1,539       1,550
    00.06   National Institute of Allergy
              and Infectious Diseases.......       4,142       4,401       4,460
    00.07   National Institute of General
              Medical Sciences..............       1,915       1,943       1,955
    00.08   National Institute of Child
              Health and Human Development..       1,248       1,270       1,278
    00.09   National Eye Institute..........         651         669         674
    00.10   National Institute of
              Environmental Health Sciences.         709         724         728
    00.11   National Institute on Aging.....       1,021       1,052       1,057
    00.12   National Institute of Arthritis
              and Musculoskeletal and Skin
              Disease.......................         499         511         513
    00.13   National Institute on Deafness
              and Other Communication
              Disorder......................         381         394         398
    00.14   National Institute of Mental
              Health........................       1,379       1,411       1,418
    00.15   National Institute on Drug Abuse         991       1,006       1,010
    00.16   Natinal Institute on Alcohol
              Abuse and Alcoholism..........         427         438         440
    00.17   National Institute of Nursing
              Research......................         134         138         139
    00.18   National Human Genome Research
              Institute.....................         491         488         491
    00.19   National Institute of Biomedical
              Imaging and Bioengineering....         287         298         300
    00.20   National Center for Research
              Resources.....................       1,192       1,115       1,100
    00.21   National Center for
              Complementary and Alternative
              Medicine......................         117         122         122
    00.22   National Center on Minority
              Health and Health Disparities.         191         196         197
    00.23   John E. Fogarty International
              Center........................          65          67          67
    00.24   National Library of Medicine....         310         325         318
    00.25   Office of the Director..........         327         358         385
    00.26   Buildings and facilities........         303         110          82
    00.27   Cooperative Research and
              Development Agreements........          10          16          16
    00.28   Royalities......................          42
    09.00 Reimbursable program..............       2,250       2,514       2,555
                                               ---------   ---------  ----------
    10.00   Total new obligations...........      30,401      31,124      31,311
    ----------------------------------------------------------------------------

        Budgetary resources available for obligation:
    21.40 Unobligated balance carried
            forward, start of year..........         649         555         555
    22.00 New budget authority (gross)......      30,310      31,124      31,311
                                               ---------   ---------  ----------
    23.90   Total budgetary resources
              available for obligation......      30,959      31,679      31,866
    23.95 Total new obligations.............     -30,401     -31,124     -31,311
    23.98 Unobligated balance expiring or
            withdrawn.......................          -4
                                               ---------   ---------  ----------
    24.40   Unobligated balance carried
              forward, end of year..........         555         555         555
    ----------------------------------------------------------------------------

        New budget authority (gross), detail:
          Discretionary:

    40.00   Appropriation...................      28,061      28,680      28,590
    40.35   Appropriation permanently
              reduced.......................        -183        -236
    41.00   Transferred to other accounts...        -149
    42.00   Transferred from other accounts.           4
                                               ---------   ---------  ----------
    43.00     Appropriation (total
                discretionary)..............      27,733      28,444      28,590
          Mandatory:

    60.00   Appropriation...................         150         150         150
    60.20   Appropriation (special fund)....           3          16          16
    60.20   Appropriation (special fund)....           9
                                               ---------   ---------  ----------
    62.50     Appropriation (total
                mandatory)..................         162         166         166
          Spending authority from offsetting
              collections:

            Discretionary:
    68.00     Offsetting collections (cash).       1,790       2,514       2,555
    68.10     Change in uncollected customer
                payments from Federal
                sources (unexpired).........         625
                                               ---------   ---------  ----------
    68.90       Spending authority from
                  offsetting collections
                  (total discretionary).....       2,415       2,514       2,555
                                               ---------   ---------  ----------
    70.00   Total new budget authority
              (gross).......................      30,310      31,124      31,311
    ----------------------------------------------------------------------------

    [[Page 444]]

        Change in obligated balances:
    72.40 Obligated balance, start of year..      25,591      27,777      28,904
    73.10 Total new obligations.............      30,401      31,124      31,311
    73.20 Total outlays (gross).............     -27,742     -29,997     -31,134
    73.40 Adjustments in expired accounts
            (net)...........................        -182
    74.00 Change in uncollected customer
            payments from Federal sources
            (unexpired).....................        -625
    74.10 Change in uncollected customer
            payments from Federal sources
            (expired).......................         334
                                               ---------   ---------  ----------
    74.40   Obligated balance, end of year..      27,777      28,904      29,081
    ----------------------------------------------------------------------------

        Outlays (gross), detail:
    86.90 Outlays from new discretionary
            authority.......................       9,191       9,596      10,155
    86.93 Outlays from discretionary
            balances........................      18,431      20,258      20,817
    86.97 Outlays from new mandatory
            authority.......................          35          40          40
    86.98 Outlays from mandatory balances...          85         103         122
                                               ---------   ---------  ----------
    87.00   Total outlays (gross)...........      27,742      29,997      31,134
    ----------------------------------------------------------------------------

        Offsets:
          Against gross budget authority and outlays:

            Offsetting collections (cash)
                from:
    88.00     Federal sources...............      -2,059      -2,514      -2,555
    88.40     Non-Federal sources...........         -57
                                               ---------   ---------  ----------
    88.90       Total, offsetting
                  collections (cash)........      -2,116      -2,514      -2,555
          Against gross budget authority only:

    88.95   Change in uncollected customer
              payments from Federal sources
              (unexpired)...................        -625
    88.96   Portion of offsetting
              collections (cash) credited to
              expired accounts..............         326
    ----------------------------------------------------------------------------

        Net budget authority and outlays:
    89.00 Budget authority..................      27,895      28,610      28,756
    90.00 Outlays...........................      25,626      27,483      28,579
    ---------------------------------------------------------------------------

             DISTRIBUTION OF BUDGET AUTHORITY AND OUTLAYS BY ACCOUNT

                              [Dollars in millions]

                                            2004         2005        2006
    Distribution of budget authority by
        account:
      National Cancer Institute.........       4,724       4,824       4,842
      National Heart, Lung, and Blood
        Institute.......................       2,883       2,940       2,951
      National Institute of Dental and
        Craniofacial Research...........         382         392         393
      National Institute of Diabetes and
        Digestive and Kidney Diseases...       1,830       1,863       1,872
      National Institute of Neurological
        Disorder and Stroke.............       1,498       1,539       1,550
      National Institute of Allergy and
        Infectious Diseases.............       4,142       4,401       4,460
      National Institute of General
        Medical Sciences................       1,915       1,943       1,955
      National Institute of Child Health
        and Human Development...........       1,248       1,270       1,278
      National Eye Institute............         651         669         674
      National Institute of
        Environmental Health Sciences...         709         724         728
      National Institute on Aging.......       1,021       1,052       1,057
      National Institute of Arthritis
        and Musculoskeletal and Skin
        Diseases........................         499         511         513
      National Institute on Deafness and
        Other Communication Disorders...         381         394         397
      National Institute of Nursing
        Research........................         134         138         139
      National Institute on Alcohol
        Abuse and Alcoholism............         427         438         440
      National Institute on Drug Abuse..         991       1,006       1,010
      National Institute of Mental
        Health..........................       1,379       1,412       1,418
      National Center for Research
        Resources.......................       1,192       1,115       1,100
      National Human Genome Research
        Institute.......................         491         488         491
      National Institute of Biomedical
        Imaging and Bioengineering......         287         298         300
      National Center for Complementary
        and Alternative Medicine........         117         122         123
      National Center for Minority
        Health and Health Disparities...         191         196         197
      John E. Fogarty International
        Center..........................          65          67          67
      National Library of Medicine......         310         324         318
      Office of the Director............         327         358         385
      Buildings and facilities..........          89         110          82
                                        ------------------------------------
          Subtotal......................      27,883      28,594      28,740
      Cooperative Research and
        Development Agreements..........          12          16          16
                                        ------------------------------------
          Total Budget Authority, NIH...      27,895      28,610      28,756
                                        ====================================

                              [Dollars in millions]

                                            2004         2005        2006
    Distribution of outlays by account:
      National Cancer Institute.........       4,437       4,676       4,806
      National Heart, Lung, and Blood
        Institute.......................       2,725       2,824       2,925
      National Institute of Dental and
        Craniofacial Research...........         364         375         389
      National Institute of Diabetes and
        Digestive and Kidney Diseases...       1,663       1,773       1,845
      National Institute of Neurological
        Disorders and Stroke............       1,439       1,465       1,531
      National Institute of Allergy and
        Infectious Diseases.............       3,090       4,068       4,337
      National Institute of General
        Medical Sciences................       1,873       1,887       1,931
      National Institute of Child Health
        and Human Development...........       1,191       1,216       1,266
      National Eye Institute............         616         640         666
      National Institute of
        Environmental Health Sciences...         676         698         722
      National Institute on Aging.......         972       1,003       1,044
      National Institute of Arthritis
        and Musculoskeletal and Skin
        Diseases........................         481         495         508
      National Institute on Deafness and
        Other Communication Disorders...         368         373         392
      National Institute of Nursing
        Research........................         123         130         137
      National Institute on Alcohol
        Abuse and Alcoholism............         403         418         436
      National Institute on Drug Abuse..         957         973       1,000
      National Institute of Mental
        Health..........................       1,351       1,360       1,404
      National Center for Research
        Resources.......................       1,096       1,165       1,125
      National Human Genome Research
        Institute.......................         460         489         489
      National Institute of Biomedical
        Imaging and Bioengineering......         230         273         292
      National Center for Complementary
        and Alternative Medicine........         110         112         120
      National Center for Minority
        Health and Health Disparities...         168         179         189
      John E. Fogarty International
        Center..........................          63          62          66
      National Library of Medicine......         279         310         320
      Office of the Director............         272         300         353
      Buildings and Facilities..........         286         208         275
      Service and Supply Fund/Management
        Fund............................         -76           0           0
                                        ------------------------------------
          Subtotal Outlays..............      25,617      27,472      28,568
      Cooperative Research and
        Development Agreements..........           9          10          10
                                        ------------------------------------
          Total Outlays, NIH............      25,626      27,483      29,579
                                        ====================================

        This program funds biomedical research and research training. These
    accounts will continue to be appropriated separately, and are displayed
    in a consolidated format to improve the readability of the presentation.
    Detailed information is available through the Department of Health and
    Human Services.

        NIH will continue to implement strategies and policies in 2006 and
    beyond to maximize budgetary and management flexibility in the future.
    Such strategies include funding the total costs of grants in the grant's
    first year and managing grant average cost.

                   Object Classification (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-9915-0-1-552      2004 actual   2005 est.   2006 est.
    ----------------------------------------------------------------------------

          Direct obligations:

            Personnel compensation:
    11.1      Full-time permanent...........         658         664         690
    11.3      Other than full-time permanent         338         345         358
    11.5      Other personnel compensation..          37          28          29
    11.7      Military personnel............          23          24          24
    11.8      Special personal services
                payments....................         147         152         156
                                               ---------   ---------  ----------
    11.9        Total personnel compensation       1,203       1,213       1,257
    12.1    Civilian personnel benefits.....         267         271         281
    12.2    Military personnel benefits.....          16          16          17
    13.0    Benefits for former personnel...           1           1           1
    21.0    Travel and transportation of
              persons.......................          56          57          57
    22.0    Transportation of things........           5           6           6
    23.1    Rental payments to GSA..........           4           4           4
    23.2    Rental payments to others.......          15          15          16
    23.3    Communications, utilities, and
              miscellaneous charges.........          30          31          31
    24.0    Printing and reproduction.......          19          19          19
    25.1    Advisory and assistance services         116         104         104
    25.2    Other services..................         609         580         569
    25.3    Other purchases of goods and
              services from Government
              accounts......................       2,222       2,311       2,362
    25.4    Operation and maintenance of
              facilities....................         379         269         237
    25.5    Research and development
              contracts.....................       2,164       2,115       2,236

    [[Page 445]]

    25.6    Medical care....................          24          24          24
    25.7    Operation and maintenance of
              equipment.....................          72          74          74
    26.0    Supplies and materials..........         214         223         225
    31.0    Equipment.......................         190         197         199
    41.0    Grants, subsidies, and
              contributions.................      20,541      21,080      21,037
    42.0    Insurance claims and indemnities           4
                                               ---------   ---------  ----------
    99.0      Direct obligations............      28,151      28,610      28,756
    99.0  Reimbursable obligations..........       2,250       2,514       2,555
                                               ---------   ---------  ----------
    99.9    Total new obligations...........      30,401      31,124      31,311
    ---------------------------------------------------------------------------

                                  Personnel Summary

    ----------------------------------------------------------------------------
    Identification code 75-9915-0-1-552      2004 actual   2005 est.   2006 est.
    ----------------------------------------------------------------------------
        Direct:
          Total compensable workyears:

    1001    Civilian full-time equivalent
              employment....................      12,322      11,875      11,899
    1101    Military full-time equivalent
              employment....................         320         328         328
        Reimbursable:
          Total compensable workyears:

    2001    Civilian full-time equivalent
              employment....................       4,337       5,231       5,211
    2101    Military full-time equivalent
              employment....................         112         104         104
    ---------------------------------------------------------------------------

            SUBSTANCE ABUSE AND MENTAL HEALTH SERVICES ADMINISTRATION

                                  Federal Funds

    General and special funds:

                   Substance Abuse and Mental Health Services

        For carrying out titles V and XIX of the Public Health Service Act
    (``PHS Act'') with respect to substance abuse and mental health
    services, the Protection and Advocacy for Individuals with Mental
    Illness Act, and section 301 of the [Public Health Service] PHS Act with
    respect to program management, [$3,295,361,000, of which $23,107,000
    shall be available for projects and in the amounts specified in the
    statement of the managers on the conference report accompanying this
    Act] $3,214,720,000: Provided, That notwithstanding section 520A(f)(2)
    of the PHS Act, no funds appropriated for carrying out section 520A are
    available for carrying out section 1971 of the PHS Act: Provided
    further, That in addition to amounts provided herein, the following
    amounts shall be available from amounts available under section 241 of
    the [Public Health Service] PHS Act: (1) $79,200,000 to carry out
    subpart II of part B of title XIX of the [Public Health Service] PHS Act
    to fund section 1935(b) technical assistance, national data, data
    collection and evaluation activities, and further that the total
    available under this Act for section 1935(b) activities shall not exceed
    5 percent of the amounts appropriated for subpart II of part B of title
    XIX; (2) $21,803,000 to carry out subpart I of Part B of title XIX of
    the [Public Health Service Act] PHS Act, to fund section 1920(b)
    technical assistance, national data, data collection and evaluation
    activities, and further that the total available under this Act for
    section 1920(b) activities shall not exceed 5 percent of the amounts
    appropriated for subpart I of Part B of title XIX; (3) $16,000,000 to
    carry out national surveys on drug abuse; (4) [$2,000,000 for mental
    health data collection; and (5)] $4,300,000 [for] to evaluate substance
    abuse treatment programs. (Department of Health and Human Services
    Appropriations Act, 2005.)

                   Program and Financing (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-1362-0-1-551      2004 actual   2005 est.   2006 est.
    ----------------------------------------------------------------------------

        Obligations by program activity:
          Direct program:

    00.01   Mental health and substance
              abuse activities..............       1,035       1,085       1,032
    00.02   Mental health partnership.......         413         411         411
    00.03   Substance abuse partnership.....       1,700       1,696       1,696
    00.05   Program management..............          76          76          76
    09.01 Reimbursable program..............         185         203         202
                                               ---------   ---------  ----------
    10.00   Total new obligations...........       3,409       3,471       3,417
    ----------------------------------------------------------------------------

        Budgetary resources available for obligation:
    21.40 Unobligated balance carried
            forward, start of year..........           1           1           1
    22.00 New budget authority (gross)......       3,419       3,471       3,417
                                               ---------   ---------  ----------
    23.90   Total budgetary resources
              available for obligation......       3,420       3,472       3,418
    23.95 Total new obligations.............      -3,409      -3,471      -3,417
    23.98 Unobligated balance expiring or
            withdrawn.......................         -10
                                               ---------   ---------  ----------
    24.40   Unobligated balance carried
              forward, end of year..........           1           1           1
    ----------------------------------------------------------------------------

        New budget authority (gross), detail:
          Discretionary:

    40.00   Appropriation...................       3,254       3,295       3,215
    40.35   Appropriation permanently
              reduced.......................         -20         -27
                                               ---------   ---------  ----------
    43.00     Appropriation (total
                discretionary)..............       3,234       3,268       3,215
          Spending authority from offsetting
              collections:

    68.00   Offsetting collections (cash)...          84         203         202
    68.10   Change in uncollected customer
              payments from Federal sources
              (unexpired)...................         101
                                               ---------   ---------  ----------
    68.90     Spending authority from
                offsetting collections
                (total discretionary).......         185         203         202
                                               ---------   ---------  ----------
    70.00   Total new budget authority
              (gross).......................       3,419       3,471       3,417
    ----------------------------------------------------------------------------

        Change in obligated balances:
    72.40 Obligated balance, start of year..       2,465       2,555       2,632
    73.10 Total new obligations.............       3,409       3,471       3,417
    73.20 Total outlays (gross).............      -3,228      -3,394      -3,441
    73.40 Adjustments in expired accounts
            (net)...........................         -23
    74.00 Change in uncollected customer
            payments from Federal sources
            (unexpired).....................        -101
    74.10 Change in uncollected customer
            payments from Federal sources
            (expired).......................          33
                                               ---------   ---------  ----------
    74.40   Obligated balance, end of year..       2,555       2,632       2,608
    ----------------------------------------------------------------------------

        Outlays (gross), detail:
    86.90 Outlays from new discretionary
            authority.......................       1,331       1,445       1,424
    86.93 Outlays from discretionary
            balances........................       1,897       1,949       2,017
                                               ---------   ---------  ----------
    87.00   Total outlays (gross)...........       3,228       3,394       3,441
    ----------------------------------------------------------------------------

        Offsets:
          Against gross budget authority and outlays:

    88.00   Offsetting collections (cash)
              from: Federal sources.........        -116        -203        -202
          Against gross budget authority only:

    88.95   Change in uncollected customer
              payments from Federal sources
              (unexpired)...................        -101
    88.96   Portion of offsetting
              collections (cash) credited to
              expired accounts..............          32
    ----------------------------------------------------------------------------

        Net budget authority and outlays:
    89.00 Budget authority..................       3,234       3,268       3,215
    90.00 Outlays...........................       3,112       3,191       3,239
    ---------------------------------------------------------------------------

        This program provides Federal support to strengthen the capacity of
    the Nation's health care delivery system to provide substance abuse
    prevention, addiction treatment, and mental health services, for people
    at risk for or experiencing substance abuse or mental illness. SAMHSA
    builds partnerships with states, communities, and private organizations
    to address the needs of individuals with substance abuse disorders and/
    or mental illness and to identify and respond to the community risk
    factors that contribute to these illnesses.

                   Object Classification (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-1362-0-1-551      2004 actual   2005 est.   2006 est.
    ----------------------------------------------------------------------------

          Direct obligations:

            Personnel compensation:
    11.1      Full-time permanent...........          37          42          44
    11.3      Other than full-time permanent           2           2           2
    11.5      Other personnel compensation..           1           1           1
    11.7      Military personnel............           2           2           2
                                               ---------   ---------  ----------
    11.9        Total personnel compensation          42          47          49
    12.1    Civilian personnel benefits.....           9          10          10
    12.2    Military personnel benefits.....           1           1           1
    21.0    Travel and transportation of
              persons.......................           1           1           1
    23.1    Rental payments to GSA..........           6           6           6
    23.3    Communications, utilities, and
              miscellaneous charges.........           3           3           3
    24.0    Printing and reproduction.......           5           4           4
    25.1    Advisory and assistance services          22          23          23
    25.2    Other services..................         172         196         152
    25.3    Other purchases of goods and
              services from Government
              accounts......................         104         110          91

    [[Page 446]]

    31.0    Equipment.......................           3           2           2
    41.0    Grants, subsidies, and
              contributions.................       2,854       2,863       2,871
    42.0    Insurance claims and indemnities           2           2           2
                                               ---------   ---------  ----------
    99.0      Direct obligations............       3,224       3,268       3,215
    99.0  Reimbursable obligations..........         185         203         202
                                               ---------   ---------  ----------
    99.9    Total new obligations...........       3,409       3,471       3,417
    ---------------------------------------------------------------------------

                                  Personnel Summary

    ----------------------------------------------------------------------------
    Identification code 75-1362-0-1-551      2004 actual   2005 est.   2006 est.
    ----------------------------------------------------------------------------
        Direct:
          Total compensable workyears:

    1001    Civilian full-time equivalent
              employment....................         450         466         466
    1101    Military full-time equivalent
              employment....................          20          20          20
        Reimbursable:
          Total compensable workyears:

    2001    Civilian full-time equivalent
              employment....................          19          42          42
    2101    Military full-time equivalent
              employment....................          30          30          30
    ---------------------------------------------------------------------------

                   AGENCY FOR HEALTHCARE RESEARCH AND QUALITY

                                  Federal Funds

    General and special funds:

                         Healthcare Research and Quality

        For carrying out titles III and IX of the Public Health Service Act,
    and part A of title XI of the Social Security Act, amounts received from
    Freedom of Information Act fees, reimbursable and interagency
    agreements, and the sale of data shall be credited to this appropriation
    and shall remain available until expended: Provided, That the amount
    made available pursuant to section 927(c) of the Public Health Service
    Act shall not exceed $318,695,000. (Department of Health and Human
    Services Appropriations Act, 2005.)

                   Program and Financing (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-1700-0-1-552      2004 actual   2005 est.   2006 est.
    ----------------------------------------------------------------------------

        Obligations by program activity:
    00.01 Direct Program Activity...........                       3
    09.00 Reimbursable program..............         333         348         348
                                               ---------   ---------  ----------
    10.00   Total new obligations...........         333         351         348
    ----------------------------------------------------------------------------

        Budgetary resources available for obligation:
    21.40 Unobligated balance carried
            forward, start of year..........          19          16          19
    22.00 New budget authority (gross)......         331         354         348
                                               ---------   ---------  ----------
    23.90   Total budgetary resources
              available for obligation......         350         370         367
    23.95 Total new obligations.............        -333        -351        -348
                                               ---------   ---------  ----------
    24.40   Unobligated balance carried
              forward, end of year..........          16          19          19
    ----------------------------------------------------------------------------

        New budget authority (gross), detail:
          Discretionary:

    42.00   Transferred from other accounts.                       3
          Spending authority from offsetting
              collections:

    68.00   Offsetting collections (cash)...         106         351         348
    68.10   Change in uncollected customer
              payments from Federal sources
              (unexpired)...................         225
                                               ---------   ---------  ----------
    68.90     Spending authority from
                offsetting collections
                (total discretionary).......         331         351         348
                                               ---------   ---------  ----------
    70.00   Total new budget authority
              (gross).......................         331         354         348
    ----------------------------------------------------------------------------

        Change in obligated balances:
    72.40 Obligated balance, start of year..         131          63          60
    73.10 Total new obligations.............         333         351         348
    73.20 Total outlays (gross).............        -321        -354        -348
    73.40 Adjustments in expired accounts
            (net)...........................          -2
    74.00 Change in uncollected customer
            payments from Federal sources
            (unexpired).....................        -225
    74.10 Change in uncollected customer
            payments from Federal sources
            (expired).......................         147
                                               ---------   ---------  ----------
    74.40   Obligated balance, end of year..          63          60          60
    ----------------------------------------------------------------------------

        Outlays (gross), detail:
    86.90 Outlays from new discretionary
            authority.......................         331         354         348
    86.93 Outlays from discretionary
            balances........................         -10
                                               ---------   ---------  ----------
    87.00   Total outlays (gross)...........         321         354         348
    ----------------------------------------------------------------------------

        Offsets:
          Against gross budget authority and outlays:

    88.00   Offsetting collections (cash)
              from: Federal sources.........        -252        -351        -348
          Against gross budget authority only:

    88.95   Change in uncollected customer
              payments from Federal sources
              (unexpired)...................        -225
    88.96   Portion of offsetting
              collections (cash) credited to
              expired accounts..............         146
    ----------------------------------------------------------------------------

        Net budget authority and outlays:
    89.00 Budget authority..................                       3
    90.00 Outlays...........................          69           3
    ---------------------------------------------------------------------------

        This activity supports the development of scientific evidence and
    tools to improve the quality, safety, and effectiveness of all aspects
    of the health care system, and initiatives to disseminate and translate
    scientific findings into health care practice.

                   Object Classification (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-1700-0-1-552      2004 actual   2005 est.   2006 est.
    ----------------------------------------------------------------------------
    25.5  Direct obligations: Research and
            development contracts...........                       3
    99.0  Reimbursable obligations:
            Reimbursable obligations........         333         348         348
                                               ---------   ---------  ----------
    99.9    Total new obligations...........         333         351         348
    ---------------------------------------------------------------------------

                                  Personnel Summary

    ----------------------------------------------------------------------------
    Identification code 75-1700-0-1-552      2004 actual   2005 est.   2006 est.
    ----------------------------------------------------------------------------
        Reimbursable:
          Total compensable workyears:

    2001    Civilian full-time equivalent
              employment....................         277         286         286
    2101    Military full-time equivalent
              employment....................          13          13          13
    ---------------------------------------------------------------------------

                   CENTERS FOR MEDICARE AND MEDICAID SERVICES

                                  Federal Funds

    General and special funds:

                          Grants to States for Medicaid

        For carrying out, except as otherwise provided, titles XI and XIX of
    the Social Security Act, [$119,124,488,000] $156,954,419,000, to remain
    available until expended.
        For making, after May 31, [2005] 2006, payments to States under
    title XIX of the Social Security Act for the last quarter of fiscal year
    [2005] 2006 for unanticipated costs, incurred for the current fiscal
    year, such sums as may be necessary.
        For making payments to States or in the case of section 1928 on
    behalf of States under title XIX of the Social Security Act for the
    first quarter of fiscal year [2006, $58,517,290,000] 2007,
    $62,783,825,000, to remain available until expended.
        Payment under title XIX may be made for any quarter with respect to
    a State plan or plan amendment in effect during such quarter, if
    submitted in or prior to such quarter and approved in that or any
    subsequent quarter. (Department of Health and Human Services
    Appropriations Act, 2005.)

    [[Page 447]]

                   Program and Financing (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-0512-0-1-551      2004 actual   2005 est.   2006 est.
    ----------------------------------------------------------------------------

        Obligations by program activity:
    00.01 Medicaid vendor payments..........     174,003     177,525     181,256
    00.02 State and local administration....       9,327       9,112       9,803
    00.03 Vaccine purchases.................       1,052       1,635       1,502
    00.04 Incurred by providers but not yet
            reported........................                              22,910
    09.01 Medicare Part B premiums..........                     190
    09.02 Medicare Part D eligibility
            determinations..................                      73          99
                                               ---------   ---------  ----------
    10.00   Total new obligations...........     184,382     188,535     215,570
    ----------------------------------------------------------------------------

        Budgetary resources available for obligation:
    21.40 Unobligated balance carried
            forward, start of year..........          10       6,077
    22.00 New budget authority (gross)......     182,921     182,458     215,570
    22.10 Resources available from
            recoveries of prior year
            obligations.....................       7,527
                                               ---------   ---------  ----------
    23.90   Total budgetary resources
              available for obligation......     190,458     188,535     215,570
    23.95 Total new obligations.............    -184,382    -188,535    -215,570
                                               ---------   ---------  ----------
    24.40   Unobligated balance carried
              forward, end of year..........       6,077
    ----------------------------------------------------------------------------

        New budget authority (gross), detail:
          Mandatory:

    60.00   Appropriation...................     130,892     119,125     156,954
    60.00   Appropriation...................                   4,654
                                               ---------   ---------  ----------
    62.50     Appropriation (total
                mandatory)..................     130,892     123,779     156,954
    65.00   Advance appropriation...........      51,861      58,416      58,517
    69.00 Offsetting collections (cash).....         168         263          99
                                               ---------   ---------  ----------
    70.00   Total new budget authority
              (gross).......................     182,921     182,458     215,570
    ----------------------------------------------------------------------------

        Change in obligated balances:
    72.40 Obligated balance, start of year..       9,412       9,868       9,868
    73.10 Total new obligations.............     184,382     188,535     215,570
    73.20 Total outlays (gross).............    -176,399    -188,535    -192,661
    73.45 Recoveries of prior year
            obligations.....................      -7,527
                                               ---------   ---------  ----------
    74.40   Obligated balance, end of year..       9,868       9,868      32,777
    ----------------------------------------------------------------------------

        Outlays (gross), detail:
    86.97 Outlays from new mandatory
            authority.......................     176,389     182,458     191,661
    86.98 Outlays from mandatory balances...          10       6,077       1,000
                                               ---------   ---------  ----------
    87.00   Total outlays (gross)...........     176,399     188,535     192,661
    ----------------------------------------------------------------------------

        Offsets:
          Against gross budget authority and outlays:

    88.00   Offsetting collections (cash)
              from: Federal sources.........        -168        -263         -99
    ----------------------------------------------------------------------------

        Net budget authority and outlays:
    89.00 Budget authority..................     182,753     182,195     215,471
    90.00 Outlays...........................     176,231     188,272     192,562
    ---------------------------------------------------------------------------

                     Summary of Budget Authority and Outlays

                            (in millions of dollars)

                                         2004 actual  2005 est.   2006 est.
    Enacted/requested:
      Budget Authority..................     182,753     182,195     215,471
      Outlays...........................     176,231     188,272     192,562
    Legislative proposal, not subject to
        PAYGO:
      Budget Authority..................                                -230
      Outlays...........................                                -230
    Legislative proposal, subject to
        PAYGO:
      Budget Authority..................                     225         386
      Outlays...........................                     225         386
                                        ------------------------------------
    Total:
      Budget Authority..................     182,753     182,420     215,627
      Outlays...........................     176,231     188,497     192,718
                                        ====================================

        Medicaid assists States in providing medical care to their low-
    income populations by granting Federal matching payments under title XIX
    of the Social Security Act to States with approved plans.

        Medicaid estimates assume budget authority for expenses that are
    Incurred But Not Reported (IBNR).

                   Object Classification (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-0512-0-1-551      2004 actual   2005 est.   2006 est.
    ----------------------------------------------------------------------------
    41.0  Direct obligations: Grants,
            subsidies, and contributions....     184,382     188,272     215,471
    99.0  Reimbursable obligations:
            Reimbursable obligations........                     263          99
                                               ---------   ---------  ----------
    99.9    Total new obligations...........     184,382     188,535     215,570
    ---------------------------------------------------------------------------

                          Grants to States for Medicaid

                  (Legislative proposal, not subject to PAYGO)

                   Program and Financing (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-0512-2-1-551      2004 actual   2005 est.   2006 est.
    ----------------------------------------------------------------------------

        Offsets:
          Against gross budget authority and outlays:

    88.00   Offsetting collections (cash)
              from: Federal sources.........                                -230
    ----------------------------------------------------------------------------

        Net budget authority and outlays:
    89.00 Budget authority..................                                -230
    90.00 Outlays...........................                                -230
    ---------------------------------------------------------------------------

        This schedule reflects the Administration's Medicaid proposals.

                          Grants to States for Medicaid

                    (Legislative proposal, subject to PAYGO)

                   Program and Financing (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-0512-4-1-551      2004 actual   2005 est.   2006 est.
    ----------------------------------------------------------------------------

        Obligations by program activity:
    00.01 Asset transfer Reform.............                                 -99
    00.02 Provider Tax Reform...............                                -231
    00.03 Administrative claiming allotment.
    00.04 Payment reform....................
    00.05 Appropriate payment for Medicaid
            services........................                                -129
    00.06 Medicaid Pharmacy overpayment.....                                -542
    00.07 Medicaid Transitional Assistance..                     225         560
    00.08 New Freedom Initiatives...........                                  30
    00.09 Vaccines for Children.............                                 140
    00.10 Cover the Kids....................                                 389
    00.11 Other proposals with Medicaid
            Impact..........................                                  38
    09.00 Reimburseable Program: Medicare
            Part B premiums.................                                 230
                                               ---------   ---------  ----------
    10.00   Total new obligations...........                     225         386
    ----------------------------------------------------------------------------

        Budgetary resources available for obligation:
    22.00 New budget authority (gross)......                     225         386
    23.95 Total new obligations.............                    -225        -386
    ----------------------------------------------------------------------------

        New budget authority (gross), detail:
          Mandatory:

    60.00   Appropriation...................                     225         156
    69.00 Offsetting collections (cash).....                                 230
                                               ---------   ---------  ----------
    70.00   Total new budget authority
              (gross).......................                     225         386
    ----------------------------------------------------------------------------

        Change in obligated balances:
    73.10 Total new obligations.............                     225         386
    73.20 Total outlays (gross).............                    -225        -386
    ----------------------------------------------------------------------------

        Outlays (gross), detail:
    86.97 Outlays from new mandatory
            authority.......................                     225         386
    ----------------------------------------------------------------------------

        Net budget authority and outlays:
    89.00 Budget authority..................                     225         386
    90.00 Outlays...........................                     225         386
    ---------------------------------------------------------------------------

        This schedule reflects the Administration's Medicaid proposals.

    [[Page 448]]

                   Object Classification (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-0512-4-1-551      2004 actual   2005 est.   2006 est.
    ----------------------------------------------------------------------------
    41.0  Direct obligations: Grants,
            subsidies, and contributions....                     225         156
    99.0  Reimbursable obligations:
            Reimbursable obligations........                                 230
                                               ---------   ---------  ----------
    99.9    Total new obligations...........                     225         386
    ---------------------------------------------------------------------------

                         State Grants and Demonstrations

                   Program and Financing (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-0516-0-1-551      2004 actual   2005 est.   2006 est.
    ----------------------------------------------------------------------------

        Obligations by program activity:
    00.01 TWWIIA--grants....................          27          62          49
    00.02 High-risk pools--grants...........          43          40
    00.03 Federal reimbursement of emergency
            health services--undocumented
            aliens..........................                     250         250
    00.04 Background Checks.................           2          12          11
    00.05 SPAP..............................                      62          63
                                               ---------   ---------  ----------
    10.00   Total new obligations...........          72         426         373
    ----------------------------------------------------------------------------

        Budgetary resources available for obligation:
    21.40 Unobligated balance carried
            forward, start of year..........         194         248         215
    22.00 New budget authority (gross)......         142         393         394
                                               ---------   ---------  ----------
    23.90   Total budgetary resources
              available for obligation......         336         641         609
    23.95 Total new obligations.............         -72        -426        -373
    23.98 Unobligated balance expiring or
            withdrawn.......................         -16
                                               ---------   ---------  ----------
    24.40   Unobligated balance carried
              forward, end of year..........         248         215         236
    ----------------------------------------------------------------------------

        New budget authority (gross), detail:
          Mandatory:

    60.00   Appropriation--(P.L. 106-170,
              Sections 203 & 204)...........          77          81          81
    60.00   Appropriation--(P.L. 107-210)...          40
    60.00   Appropriation--(P. L. 108-173)--
              Undocumented Aliens...........                     250         250
    60.00   Appropriation- (P.L. 108-173)--
              Background Checks.............          25
    60.00   Appropriation-(P.L. 108-173)--
              SPAP..........................                      62          63
                                               ---------   ---------  ----------
    62.50     Appropriation (total
                mandatory)..................         142         393         394
    ----------------------------------------------------------------------------

        Change in obligated balances:
    72.40 Obligated balance, start of year..          39          63         289
    73.10 Total new obligations.............          72         426         373
    73.20 Total outlays (gross).............         -48        -200        -399
                                               ---------   ---------  ----------
    74.40   Obligated balance, end of year..          63         289         263
    ----------------------------------------------------------------------------

        Outlays (gross), detail:
    86.97 Outlays from new mandatory
            authority.......................           7         149         333
    86.98 Outlays from mandatory balances...          41          51          66
                                               ---------   ---------  ----------
    87.00   Total outlays (gross)...........          48         200         399
    ----------------------------------------------------------------------------

        Net budget authority and outlays:
    89.00 Budget authority..................         142         393         394
    90.00 Outlays...........................          48         200         399
    ---------------------------------------------------------------------------

                     Summary of Budget Authority and Outlays

                            (in millions of dollars)

                                         2004 actual  2005 est.   2006 est.
    Enacted/requested:
      Budget Authority..................         142         393         394
      Outlays...........................          48         200         399
    Legislative proposal, subject to
        PAYGO:
      Budget Authority..................                                 900
      Outlays...........................                                 400
                                        ------------------------------------
    Total:
      Budget Authority..................         142         393       1,294
      Outlays...........................          48         200         799
                                        ====================================

        State Grants and Demonstrations provides funding for grant programs
    established under several legislative authorities. Title II of the
    Ticket to Work and Work Incentives Improvement Act of 1999 (P.L. 106-
    170), established two grant programs. Section 203 provides funding for
    Medicaid grants to support the design, establishment and operation of
    State infrastructures to help working people with disabilities purchase
    health coverage through Medicaid. Section 204 provides funding for
    States to establish Demonstrations to Maintain Independence and
    Employment, which will provide Medicaid benefits and services to working
    individuals who have a condition that, without medical assistance, will
    result in disability.

        Part of Title II of the Trade Act of 2002 (P.L. 107-210) amends the
    Public Health Service Act by adding section 2745, which addresses
    promotion of qualified high-risk pools for assisting ``high-risk''
    individuals who may find private health insurance unavailable,
    unaffordable, or undesirable. This section establishes: (1) seed grants
    to States for the creation and initial operation of a qualified high-
    risk pool and (2) grants to States for operation of qualified high-risk
    pools.

        CMS now administers several programs enacted under the Medicare
    Prescription Drug, Improvement, and Modernization Act of 2003 (MNA)
    (Public Law 108-173). The Pilot program for National and State
    Background Checks is authorized to spend a total of $25 million during
    fiscal years 2004 through 2007 to identify efficient, effective, and
    economical procedures for long-term care facilities or providers to
    conduct background checks on prospective employees who would have direct
    access to patients.

        The Federal Reimbursement of Emergency Health Services Furnished to
    Undocumented Aliens has an annual appropriation of $250 million
    beginning in FY 2005 and continuing through FY 2008. The funding is
    available to reimburse eligible providers for furnishing emergency
    health services to undocumented aliens.

        Transitional grants totaling $62.5 million each year in FY 2005 and
    FY 2006 are available to States that operate State Pharmaceutical
    Assistance Programs. These funds will be used to educate Part D eligible
    individuals enrolled in the Program about the prescription drug coverage
    available through Part D of the MMA.

                   Object Classification (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-0516-0-1-551      2004 actual   2005 est.   2006 est.
    ----------------------------------------------------------------------------
    41.0  Grants, subsidies, and
            contributions--Ticket to Work...          27          62          49
    41.0  Grants, subsidies, and
            contributions--High-Risk Pools..          43          40
    41.0  Grants, subsidies, and
            contributions--Fed'l Reimb.--
            Emer Svcs, Undoc. Aliens........                     250         250
    41.0  Grants, subsidies, and
            contributions--Background Checks           2          12          11
    41.0  Grants, subsidies, and
            contributions--SPAP.............                      62          63
                                               ---------   ---------  ----------
    99.9    Total new obligations...........          72         426         373
    ---------------------------------------------------------------------------

                         State Grants and Demonstrations

                     Legislative proposal, subject to PAYGO

                   Program and Financing (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-0516-4-1-551      2004 actual   2005 est.   2006 est.
    ----------------------------------------------------------------------------

        Obligations by program activity:
    00.06 State Purchasing Pools............                                 400
    00.07 Cover the Kids Outreach...........                                 500
                                               ---------   ---------  ----------
    10.00   Total new obligations...........                                 900
    ----------------------------------------------------------------------------

        Budgetary resources available for obligation:
    22.00 New budget authority (gross)......                                 900
    23.95 Total new obligations.............                                -900
    ----------------------------------------------------------------------------

    [[Page 449]]

        New budget authority (gross), detail:
          Mandatory:

    60.00   Appropriation-State Purchasing
              Pools.........................                                 400
    60.00   Appropriation-Cover the Kids
              Outreach......................                                 500
                                               ---------   ---------  ----------
    62.50     Appropriation (total
                mandatory)..................                                 900
    ----------------------------------------------------------------------------

        Change in obligated balances:
    72.40 Obligated balance, start of year..
    73.10 Total new obligations.............                                 900
    73.20 Total outlays (gross).............                                -400
                                               ---------   ---------  ----------
    74.40   Obligated balance, end of year..                                 500
    ----------------------------------------------------------------------------

        Outlays (gross), detail:
    86.97 Outlays from new mandatory
            authority.......................                                 400
    ----------------------------------------------------------------------------

        Net budget authority and outlays:
    89.00 Budget authority..................                                 900
    90.00 Outlays...........................                                 400
    ---------------------------------------------------------------------------

        This schedule reflects the Administration's State Grants and
    Demonstrations proposals.

                   Object Classification (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-0516-4-1-551      2004 actual   2005 est.   2006 est.
    ----------------------------------------------------------------------------
    41.0  Grants, subsidies, and
            contributions-State Purchasing
            Pools...........................                                 400
    41.0  Grants, subsidies, and
            contributions-Cover the Kids
            Outreach........................                                 500
                                               ---------   ---------  ----------
    99.9    Total new obligations...........                                 900
    ---------------------------------------------------------------------------

     Payment to Health Care Trust Funds for Post-1956 Military Service Wage
                                     Credits

                   Program and Financing (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-0517-0-1-054      2004 actual   2005 est.   2006 est.
    ----------------------------------------------------------------------------

        Obligations by program activity:
    00.01 Military Wage Credits (HI)........         173
                                               ---------   ---------  ----------
    10.00   Total new obligations (object
              class 41.0)...................         173
    ----------------------------------------------------------------------------

        Budgetary resources available for obligation:
    22.00 New budget authority (gross)......         173
    23.95 Total new obligations.............        -173
    ----------------------------------------------------------------------------

        New budget authority (gross), detail:
          Mandatory:

    60.00   Appropriation...................         173
    ----------------------------------------------------------------------------

        Change in obligated balances:
    73.10 Total new obligations.............         173
    73.20 Total outlays (gross).............        -173
    ----------------------------------------------------------------------------

        Outlays (gross), detail:
    86.97 Outlays from new mandatory
            authority.......................         173
    ----------------------------------------------------------------------------

        Net budget authority and outlays:
    89.00 Budget authority..................         173
    90.00 Outlays...........................         173
    ---------------------------------------------------------------------------

        The Hospital Insurance Trust Fund was compensated for the equivalent
    of payroll taxes on deemed wages posted to the Social Security earnings
    of uniformed services personnel in 2000 and 2001.

                       Payments to Health Care Trust Funds

        For payment to the Federal Hospital Insurance and the Federal
    Supplementary Medical Insurance Trust Funds, as provided under section
    1844, 1860D-16, and 1860D-31 of the Social Security Act, sections 103(c)
    and 111(d) of the Social Security Amendments of 1965, section 278(d) of
    Public Law 97-248, and for administrative expenses incurred pursuant to
    section 201(g) of the Social Security Act, [$114,608,900,000]
    $183,039,100,000. [To ensure prompt payments of Medicare prescription
    drug benefits as provided under section 1860 D-16 of the Social Security
    Act, $5,216,900,000, to become available on October 1, 2005 for fiscal
    year 2006.]
        In addition, for making matching payments under section 1844, and
    benefit payments under 1860D-16 and 1860D-31, of the Social Security
    Act, not anticipated in budget estimates, such sums as may be necessary.
    (Department of Health and Human Services Appropriations Act, 2005.)

                   Program and Financing (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-0580-0-1-571      2004 actual   2005 est.   2006 est.
    ----------------------------------------------------------------------------

        Obligations by program activity:
    00.01 Supplementary medical insurance
            (SMI)...........................      94,518     114,002     128,015
    00.02 Hospital insurance for uninsured
            (HI)............................         197          87         202
    00.03 Federal uninsured payment (HI)....         168         199         206
    00.04 Program management (HI)...........         201         215         164
    00.05 FHI trust fund, Transfers from
            general fund (civil monetary
            penalties)......................          10          11          11
    00.06 Federal payments from taxation of
            OASDI benefits (HI).............       8,577       8,717       9,726
    00.07 Fraud and abuse control, FBI......         114         114         114
    00.08 Fraud and abuse control, criminal
            fines...........................         305           3           3
    00.09 Federal contributions, Drug
            account State low-income
            determinations..................                      73          99
    00.10 Federal contributions,
            Transitional assistance account.         216       1,155         361
    00.11 General Revenue for Part D
            Benefits........................                              53,596
    00.12 General Revenue for Part D Admin
            (CMS)...........................                                 357
    00.13 General Revenue for Part D Admin
            (SSA)...........................                                 320
    00.14 HCFAC reimbursement...............                                  80
                                               ---------   ---------  ----------
    10.00   Total new obligations...........     104,306     124,576     193,254
    ----------------------------------------------------------------------------

        Budgetary resources available for obligation:
    22.00 New budget authority (gross)......     106,411     124,609     193,254
    23.95 Total new obligations.............    -104,306    -124,576    -193,254
    23.98 Unobligated balance expiring or
            withdrawn.......................      -2,105         -33
    ----------------------------------------------------------------------------

        New budget authority (gross), detail:
          Mandatory:

    60.00   Appropriation...................       8,577       8,717       9,726
    60.00   Appropriation...................         315          14          14
    60.00   Appropriation...................      95,084     114,503     128,667
    60.00   Appropriation...................         114         114         114
    60.00   Appropriation...................       2,321       1,155         361
    60.00   Appropriation...................                     106          99
    60.00   Appropriation...................                              54,273
                                               ---------   ---------  ----------
    62.50     Appropriation (total
                mandatory)..................     106,411     124,609     193,254
    ----------------------------------------------------------------------------

        Change in obligated balances:
    73.10 Total new obligations.............     104,306     124,576     193,254
    73.20 Total outlays (gross).............    -104,306    -124,576    -193,254
    ----------------------------------------------------------------------------

        Outlays (gross), detail:
    86.97 Outlays from new mandatory
            authority.......................     104,306     124,576     193,254
    ----------------------------------------------------------------------------

        Net budget authority and outlays:
    89.00 Budget authority..................     106,411     124,609     193,254
    90.00 Outlays...........................     104,306     124,576     193,254
    ---------------------------------------------------------------------------

                     Summary of Budget Authority and Outlays

                            (in millions of dollars)

                                         2004 actual  2005 est.   2006 est.
    Enacted/requested:
      Budget Authority..................     106,411     124,609     193,254
      Outlays...........................     104,306     124,576     193,254
    Legislative proposal, not subject to
        PAYGO:
      Budget Authority..................                                 108
      Outlays...........................                                 108
                                        ------------------------------------
    Total:
      Budget Authority..................     106,411     124,609     193,362
      Outlays...........................     104,306     124,576     193,362
                                        ====================================

        Payments are made to the Federal Hospital Insurance and Federal
    Supplementary Medical Insurance trust funds from the general fund of the
    Treasury to finance Medicare's medical and drug benefits for
    beneficiaries and certain other qualified individuals.

    [[Page 450]]

                   Object Classification (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-0580-0-1-571      2004 actual   2005 est.   2006 est.
    ----------------------------------------------------------------------------
    41.0  Grants, subsidies, and
            contributions...................     103,740     124,002     191,826
    42.0  Insurance claims and indemnities..         365         286         408
    94.0  Financial transfers...............         201         288       1,020
                                               ---------   ---------  ----------
    99.0      Direct obligations............     104,306     124,576     193,254
                                               ---------   ---------  ----------
    99.9    Total new obligations...........     104,306     124,576     193,254
    ---------------------------------------------------------------------------

                       Payments to Health Care Trust Funds

                  (Legislative proposal, not subject to PAYGO)

                   Program and Financing (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-0580-2-1-571      2004 actual   2005 est.   2006 est.
    ----------------------------------------------------------------------------

        Obligations by program activity:
    00.01 Supplementary medical insurance
            (SMI)...........................                                 108
                                               ---------   ---------  ----------
    10.00   Total new obligations (object
              class 41.0)...................                                 108
    ----------------------------------------------------------------------------

        Budgetary resources available for obligation:
    22.00 New budget authority (gross)......                                 108
    23.95 Total new obligations.............                                -108
    ----------------------------------------------------------------------------

        New budget authority (gross), detail:
          Mandatory:

    60.00   Appropriation...................
    60.00   Appropriation...................
    60.00   Appropriation...................                                 108
                                               ---------   ---------  ----------
    62.50     Appropriation (total
                mandatory)..................                                 108
    ----------------------------------------------------------------------------

        Change in obligated balances:
    73.10 Total new obligations.............                                 108
    73.20 Total outlays (gross).............                                -108
    ----------------------------------------------------------------------------

        Outlays (gross), detail:
    86.97 Outlays from new mandatory
            authority.......................                                 108
    ----------------------------------------------------------------------------

        Net budget authority and outlays:
    89.00 Budget authority..................                                 108
    90.00 Outlays...........................                                 108
    ---------------------------------------------------------------------------

        The Budget includes a Medicaid proposal to extend the subsidy of
    Medicare cost sharing for certain qualified individuals that are
    reimbursed by Medicare.

                               Program Management

        For carrying out, except as otherwise provided, titles XI, XVIII,
    XIX, and XXI of the Social Security Act, titles XIII and XXVII of the
    Public Health Service Act, and the Clinical Laboratory Improvement
    Amendments of 1988, not to exceed [$2,696,402,000] $3,177,478,000, to be
    transferred from the Federal Hospital Insurance and the Federal
    Supplementary Medical Insurance Trust Funds, as authorized by section
    201(g) of the Social Security Act; together with all funds collected in
    accordance with section 353 of the Public Health Service Act and section
    1857(e)(2) of the Social Security Act, and such sums as may be collected
    from authorized user fees and the sale of data, which shall remain
    available until expended: Provided, That all funds derived in accordance
    with 31 U.S.C. 9701 from organizations established under title XIII of
    the Public Health Service Act shall be credited to and available for
    carrying out the purposes of this appropriation: Provided further, That
    [$24,400,000] $24,205,000, to remain available until September 30,
    [2006] 2007, is for contract costs for CMS's Systems Revitalization
    Plan: Provided further, That [$78,300,000] $79,934,000, to remain
    available until September 30, [2006] 2007, is for contract costs for the
    Healthcare Integrated General Ledger Accounting System: [Provided
    further, That of the amounts made available for research, demonstration
    and evaluation, $100,000 is available for Advocate Metro Outreach
    Initiative, Oak Brook, Illinois, to implement an initiative to provide
    comprehensive health education and services to the deaf and hard-of-
    hearing community, $150,000 is available for African American
    Interdenominational Ministries, Inc., Philadelphia, Pennsylvania, to
    implement an insurance outreach program, $1,900,000 is available for
    AIDS Healthcare Foundation, Los Angeles, California, for a demonstration
    of residential and outpatient treatment facilities, $450,000 is
    available for Bronx-Lebanon Hospital Center, Bronx, New York, for a
    comprehensive adolescent and young adult health program to demonstrate
    means of improving health care and preventive services for underserved
    inner city teenagers and young adults, $300,000 is available for
    Children's Institute for Palliative Care, Children's Hospitals and
    Clinics, Minneapolis, Minnesota, for a pediatric palliative care
    demonstration program, $600,000 is available for the City of Detroit,
    Michigan, for a project to improve access to primary care and preventive
    health services for low-income and uninsured persons, $100,000 is
    available for Community Catalyst, Inc., Boston, Massachusetts, for the
    expansion of a benefits management program, $150,000 is available for
    Cook County Bureau of Health Services in Chicago, Illinois, for the
    Antibiotic Resistance Program, $340,000 is available for Donald R.
    Watkins Memorial Foundation, Houston, Texas, for a comprehensive HIV/
    AIDS treatment and research demonstration program, $100,000 is available
    for Focus on Therapeutic Outcomes, Inc., Knoxville, Tennessee, $250,000
    is available for Hamot Medical Center, Erie, Pennsylvania and the Ohio
    Health System, Columbus, Ohio, to implement a demonstration project on
    the Medicare Advantage program, $25,000 is available for HealthRight,
    Inc., Philadelphia, Pennsylvania, for their Care Access Program, $75,000
    is available for the Inglis Foundation, Philadelphia, Pennsylvania, for
    healthcare and social services for low-income adults with severe
    physical disabilities in an effort to promote independent living,
    $50,000 is available for Medical Care for Children Partnership, Fairfax,
    Virginia, for access to specialty health care for children who have
    serious medical needs, $500,000 is available for Memphis Biotech
    Foundation in Memphis, Tennessee, to develop a biologistics network in
    Mississippi and Tennessee, $225,000 is available for Muskegon Community
    Health Project, Muskegon, Michigan, for the Access Health Program,
    $30,000 is available for Our House of Portland, Portland, Oregon, to
    develop a Care Program for people living with AIDS, $750,000 is
    available for Pace Vermont, Burlington, Vermont, for the Rural Program
    for All-inclusive Care for the Elderly, $150,000 is available for
    Patient Advocate Foundation, Newport News, Virginia, to assist the PAF
    in serving patients experiencing difficulty accessing quality health
    care services, $450,000 is available for Puerto Rico's Governor's Office
    of Elderly Affairs for the Medication Error Prevention Pilot Program,
    $1,500,000 is available for San Francisco Department of Public Health,
    San Francisco, California, for a demonstration project to improve HIV/
    AIDS treatment and prevention services, $300,000 is available for Santa
    Clara County, California, for outreach and enrollment assistance
    activities of the Children's Health Initiative, $500,000 is available
    for Susquehanna Health System, Williamsport, Pennsylvania, for
    stabilizing workforce for patient care, $500,000 is available for Swope
    Health Services, Kansas City, Missouri, to supplement recurring
    healthcare costs for underemployed, uninsured, and income-qualified
    patients in Wyandotte and Johnson Counties, Kansas, $100,000 is
    available for Temple University, Crime and Justice Research Center,
    Philadelphia, Pennsylvania, for DNA backlog and utilization, and
    $250,000 is available for University of Maine, Partnership for Early
    Childhood Health & Services:] Provided further, That funds appropriated
    under this heading are available for the Healthy Start, Grow Smart
    program under which the Centers for Medicare and Medicaid Services may,
    directly or through grants, contracts, or cooperative agreements,
    produce and distribute informational materials including, but not
    limited to, pamphlets and brochures on infant and toddler health care to
    expectant parents enrolled in the Medicaid program and to parents and
    guardians enrolled in such program with infants and children: [Provided
    further, That not less than $79,000,000 shall be for processing Medicare
    appeals:] Provided further, That the Secretary of Health and Human
    Services is directed to collect fees in fiscal year [2005 from
    Medicare+Choice] 2006 from Medicare Advantage organizations pursuant to
    section 1857(e)(2) of the Social Security Act and from eligible
    organizations with risk-sharing contracts under section 1876 of that Act
    pursuant to section 1876(k)(4)(D) of that Act[: Provided further, That
    to the extent Medicare claims processing unit costs are projected by the
    Centers for Medicare and Medicaid Services to exceed $0.87 for Part A
    claims and/or $0.63 for Part B claims, up to an additional

    [[Page 451]]

    $18,000,000 may be available for obligation for every $0.04 increase in
    Medicare claims processing unit costs from the Federal Hospital
    Insurance and the Federal Supplementary Medical Insurance Trust Funds.
    The calculation of projected unit costs shall be derived in the same
    manner in which the estimated unit costs were calculated for the Federal
    budget estimate for the fiscal year]. (Department of Health and Human
    Services Appropriations Act, 2005.)

                   Program and Financing (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-0511-0-1-550      2004 actual   2005 est.   2006 est.
    ----------------------------------------------------------------------------

        Obligations by program activity:
          Direct program:

    00.01   Medicare operations.............       2,036       2,255       2,190
    00.02   Federal administration..........         612         641         657
    00.03   State survey and certification..         250         259         261
    00.04   Research, demonstrations, and
              evaluation projects...........          87         110          45
    00.05   Revitalization plan.............          23          31          24
                                               ---------   ---------  ----------
    01.00   Total direct program............       3,008       3,296       3,177
    09.01 CLIA..............................          40          43          43
    09.03 Other reimbursements..............           7           2           2
    09.06 Medicare+Choice...................          11          13          56
                                               ---------   ---------  ----------
    09.09   Total reimbursable program......          58          58         101
                                               ---------   ---------  ----------
    10.00   Total new obligations...........       3,066       3,354       3,278
    ----------------------------------------------------------------------------

        Budgetary resources available for obligation:
    21.40 Unobligated balance carried
            forward, start of year..........         106         735         112
    22.00 New budget authority (gross)......       3,700       2,731       3,278
    22.10 Resources available from
            recoveries of prior year
            obligations.....................           5
                                               ---------   ---------  ----------
    23.90   Total budgetary resources
              available for obligation......       3,811       3,466       3,390
    23.95 Total new obligations.............      -3,066      -3,354      -3,278
    23.98 Unobligated balance expiring or
            withdrawn.......................         -10
                                               ---------   ---------  ----------
    24.40   Unobligated balance carried
              forward, end of year..........         735         112         112
    ----------------------------------------------------------------------------

        New budget authority (gross), detail:
          Spending authority from offsetting
              collections:

            Discretionary:
    68.00     Offsetting collections (cash).       2,473       2,731       3,278
    68.00     Offsetting collections (cash).                     623
    68.10     Change in uncollected customer
                payments from Federal
                sources (unexpired).........       1,227        -623
                                               ---------   ---------  ----------
    68.90       Spending authority from
                  offsetting collections
                  (total discretionary).....       3,700       2,731       3,278
    ----------------------------------------------------------------------------

        Change in obligated balances:
    72.40 Obligated balance, start of year..        -187        -448         175
    73.10 Total new obligations.............       3,066       3,354       3,278
    73.20 Total outlays (gross).............      -2,794      -3,354      -3,278
    73.40 Adjustments in expired accounts
            (net)...........................         -21
    73.45 Recoveries of prior year
            obligations.....................          -5
    74.00 Change in uncollected customer
            payments from Federal sources
            (unexpired).....................      -1,227         623
    74.10 Change in uncollected customer
            payments from Federal sources
            (expired).......................         720
                                               ---------   ---------  ----------
    74.40   Obligated balance, end of year..        -448         175         175
    ----------------------------------------------------------------------------

        Outlays (gross), detail:
    86.90 Outlays from new discretionary
            authority.......................       2,197       2,731       3,278
    86.93 Outlays from discretionary
            balances........................         597         623
                                               ---------   ---------  ----------
    87.00   Total outlays (gross)...........       2,794       3,354       3,278
    ----------------------------------------------------------------------------

        Offsets:
          Against gross budget authority and outlays:

            Offsetting collections (cash)
                from:
    88.00     Federal sources...............      -3,090      -2,673      -3,177
    88.00     Federal sources...............                    -623
    88.40     Non-Federal sources...........         -60         -58        -101
                                               ---------   ---------  ----------
    88.90       Total, offsetting
                  collections (cash)........      -3,150      -3,354      -3,278
          Against gross budget authority only:

    88.95   Change in uncollected customer
              payments from Federal sources
              (unexpired)...................      -1,227         623
    88.96   Portion of offsetting
              collections (cash) credited to
              expired accounts..............         677
    ----------------------------------------------------------------------------

        Net budget authority and outlays:
    89.00 Budget authority..................
    90.00 Outlays...........................        -356
    ---------------------------------------------------------------------------

        Program management activities include funding for research, Medicare
    operations, survey and certification, CLIA, Medicare Advantage, the CMS
    systems revitalization plan, and administrative costs. Program
    management activities also include funding for the implementation of the
    Medicare Prescription Drug, Improvement, and Modernization Act of 2003.

                   Object Classification (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-0511-0-1-550      2004 actual   2005 est.   2006 est.
    ----------------------------------------------------------------------------

          Direct obligations:

            Personnel compensation:
    11.1      Full-time permanent...........         338         377         397
    11.3      Other than full-time permanent           8          11          10
    11.5      Other personnel compensation..           6           5           5
    11.7      Military personnel............           7           8          10
                                               ---------   ---------  ----------
    11.9        Total personnel compensation         359         401         422
    12.1    Civilian personnel benefits.....          79          94          94
    12.2    Military personnel benefits.....           3           2           3
    21.0    Travel and transportation of
              persons.......................           9           9          11
    22.0    Transportation of things........           1
    23.1    Rental payments to GSA..........          20          30          26
    23.3    Communications, utilities, and
              miscellaneous charges.........          49           3           2
    24.0    Printing and reproduction.......          14           3           3
    25.1    Advisory and assistance services          22
    25.2    Other services..................         622         198         172
    25.3    Other purchases of goods and
              services from Government
              accounts......................         137           3           3
    25.5    Research and development
              contracts.....................          35
    25.6    Medical care....................       1,437       2,493       2,430
    25.7    Operation and maintenance of
              equipment.....................         120
    26.0    Supplies and materials..........           2           1           1
    31.0    Equipment.......................          10
    32.0    Land and structures.............          10          10          10
    41.0    Grants, subsidies, and
              contributions.................          79          49
                                               ---------   ---------  ----------
    99.0      Direct obligations............       3,008       3,296       3,177
    99.0  Reimbursable obligations..........          58          58         101
                                               ---------   ---------  ----------
    99.9    Total new obligations...........       3,066       3,354       3,278
    ---------------------------------------------------------------------------

                                  Personnel Summary

    ----------------------------------------------------------------------------
    Identification code 75-0511-0-1-550      2004 actual   2005 est.   2006 est.
    ----------------------------------------------------------------------------
        Direct:
          Total compensable workyears:

    1001    Civilian full-time equivalent
              employment....................       4,343       4,680       4,662
    1101    Military full-time equivalent
              employment....................          93          91         109
        Reimbursable:
    2001  Total compensable workyears:
            Civilian full-time equivalent
            employment......................          78          72          72
    ---------------------------------------------------------------------------

                     State Children's Health Insurance Fund

                   Program and Financing (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-0515-0-1-551      2004 actual   2005 est.   2006 est.
    ----------------------------------------------------------------------------

        Obligations by program activity:
    00.01 Grants, subsidies, and
            contributions...................       4,924       4,725       4,082
                                               ---------   ---------  ----------
    10.00   Total new obligations (object
              class 41.0)...................       4,924       4,725       4,082
    ----------------------------------------------------------------------------

        Budgetary resources available for obligation:
    22.00 New budget authority (gross)......       3,175       4,082       4,082
    22.30 Expired unobligated balance
            transfer to unexpired account...       1,749         643
                                               ---------   ---------  ----------
    23.90   Total budgetary resources
              available for obligation......       4,924       4,725       4,082
    23.95 Total new obligations.............      -4,924      -4,725      -4,082
    ----------------------------------------------------------------------------

        New budget authority (gross), detail:
          Mandatory:

    60.00   Appropriation, BBA..............       3,150       4,050       4,050
    60.00   Appropriation, BBRA for
              territories...................          25          32          32
                                               ---------   ---------  ----------
    62.50     Appropriation (total
                mandatory)..................       3,175       4,082       4,082
    ----------------------------------------------------------------------------

    [[Page 452]]

        Change in obligated balances:
    72.40 Obligated balance, start of year..       9,754       8,322       5,780
    73.10 Total new obligations.............       4,924       4,725       4,082
    73.20 Total outlays (gross).............      -4,607      -5,343      -5,434
    73.40 Adjustments in expired accounts
            (net)...........................      -1,749      -1,924         -37
                                               ---------   ---------  ----------
    74.40   Obligated balance, end of year..       8,322       5,780       4,391
    ----------------------------------------------------------------------------

        Outlays (gross), detail:
    86.97 Outlays from new mandatory
            authority.......................         126         331       1,149
    86.98 Outlays from mandatory balances...       4,481       5,012       4,285
                                               ---------   ---------  ----------
    87.00   Total outlays (gross)...........       4,607       5,343       5,434
    ----------------------------------------------------------------------------

        Net budget authority and outlays:
    89.00 Budget authority..................       3,175       4,082       4,082
    90.00 Outlays...........................       4,607       5,343       5,434
    ---------------------------------------------------------------------------

                     Summary of Budget Authority and Outlays

                            (in millions of dollars)

                                         2004 actual  2005 est.   2006 est.
    Enacted/requested:
      Budget Authority..................       3,175       4,082       4,082
      Outlays...........................       4,607       5,343       5,434
    Legislative proposal, subject to
        PAYGO:
      Budget Authority..................
      Outlays...........................                                 799
                                        ------------------------------------
    Total:
      Budget Authority..................       3,175       4,082       4,082
      Outlays...........................       4,607       5,343       6,233
                                        ====================================

        The Balanced Budget Act of 1997 established the State Children's
    Health Insurance Program (SCHIP) under Title XXI of the Social Security
    Act. Title XXI provides Federal matching funds to States to enable them
    to extend coverage to uninsured children from low-income families.
    States are able to use Title XXI funds for obtaining health benefit
    coverage for uninsured children through a SCHIP program, a SCHIP
    Medicaid expansion program, or a combination of both.

                     State Children's Health Insurance Fund

                    (Legislative proposal, subject to PAYGO)

                   Program and Financing (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-0515-4-1-551      2004 actual   2005 est.   2006 est.
    ----------------------------------------------------------------------------

        Obligations by program activity:
    00.01 SCHIP redistribution..............                                 670
    00.02 Cover the kids....................                                 129
                                               ---------   ---------  ----------
    10.00   Total new obligations (object
              class 41.0)...................                                 799
    ----------------------------------------------------------------------------

        Budgetary resources available for obligation:
    22.30 Expired unobligated balance
            transfer to unexpired account...                                 799
    23.95 Total new obligations.............                                -799
    ----------------------------------------------------------------------------

        Change in obligated balances:
    73.10 Total new obligations.............                                 799
    73.20 Total outlays (gross).............                                -799
    ----------------------------------------------------------------------------

        Outlays (gross), detail:
    86.98 Outlays from mandatory balances...                                 799
    ----------------------------------------------------------------------------

        Net budget authority and outlays:
    89.00 Budget authority..................
    90.00 Outlays...........................                                 799
    ---------------------------------------------------------------------------

        This schedule reflects the Administration's SCHIP proposals.

          Health Maintenance Organization Loan and Loan Guarantee Fund

        For carrying out subsections (d) and (e) of section 1308 of the
    Public Health Service Act, any amounts received by the Secretary in
    connection with loans and loan guarantees under title XIII of the Public
    Health Service Act, to be available without fiscal year limitation for
    the payment of outstanding obligations. During fiscal year [2005] 2006,
    no commitments for direct loans or loan guarantees shall be made.
    (Department of Health and Human Services Appropriations Act, 2005.)

                   Program and Financing (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-4420-0-3-551      2004 actual   2005 est.   2006 est.
    ----------------------------------------------------------------------------

        Budgetary resources available for obligation:
    21.40 Unobligated balance carried
            forward, start of year..........          10
    23.98 Unobligated balance expiring or
            withdrawn.......................         -10
                                               ---------   ---------  ----------
    24.40   Unobligated balance carried
              forward, end of year..........
    ----------------------------------------------------------------------------

        Net budget authority and outlays:
    89.00 Budget authority..................
    90.00 Outlays...........................
    ---------------------------------------------------------------------------

        The last loan commitments from the HMO loan fund were made in 1983.

                                   Trust Funds

                      Federal Hospital Insurance Trust Fund

                    Unavailable Receipts (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 20-8005-0-7-571      2004 actual   2005 est.   2006 est.
    ----------------------------------------------------------------------------
    01.99 Balance, start of year............     234,616     248,542     257,954
        Receipts:
    02.00 FHI trust fund, Transfers from
            general fund (FICA taxes).......     139,409     149,667     159,814
    02.01 FHI trust fund, Transfers from
            general fund (SECA taxes).......      10,789      11,282      11,904
    02.02 FHI trust fund, Receipts from
            Railroad Retirement Board.......         391         411         417
    02.03 FHI trust fund, Civil penalties
            and damages.....................         355         244         244
    02.20 FHI trust fund, Premiums collected
            for uninsured individuals not...       1,799       2,246       2,376
    02.22 Basic premium, Medicare Advantage,
            HI..............................                                  58
    02.40 FHI trust fund, Federal employer
            contributions (FICA)............       2,540       2,627       2,659
    02.41 FHI trust fund, Postal Service
            employer contributions (FICA)...         710         673         674
    02.42 FHI trust fund, Payments from the
            general fund (uninsured and pr..         568         501         652
    02.43 FHI trust fund, Taxation on OASDI
            benefits........................       8,577       8,717       9,726
    02.44 FHI trust fund, Interest payments
            by Railroad Retirement Board....          28          27          28
    02.45 FHI trust fund, Interest received
            by trust funds..................      15,046      14,941      14,994
    02.46 FHI trust fund, Payment from the
            general fund for health care fr.         114         114         114
    02.47 FHI trust fund, Transfers from
            general fund (criminal fines)...         305           3           3
    02.48 FHI trust fund, Transfers from
            general fund (civil monetary
            pena............................          11          11          11
    02.51 Federal hospital insurance trust
            fund............................         173
                                               ---------   ---------  ----------
    02.99   Total receipts and collections..     180,815     191,464     203,674
                                               ---------   ---------  ----------
    04.00 Total: Balances and collections...     415,431     440,006     461,628
        Appropriations:
    05.00 Federal hospital insurance trust
            fund............................      -1,889      -1,681      -1,768
    05.01 Federal hospital insurance trust
            fund............................    -177,865    -188,724    -200,752
    05.02 Federal hospital insurance trust
            fund............................      13,920       9,412      17,375
    05.03 Health care fraud and abuse
            control account.................      -1,075      -1,075      -1,075
    05.04 Appropriation temporarily reduced.          14          16
    05.09 Health care fraud and abuse
            control account.................                                 -80
                                               ---------   ---------  ----------
    05.99   Total appropriations............    -166,895    -182,052    -186,300
    06.10 Unobligated balance returned to
            receipts........................           6
                                               ---------   ---------  ----------
    07.99 Balance, end of year..............     248,542     257,954     275,328
    ---------------------------------------------------------------------------

    [[Page 453]]

                   Program and Financing (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 20-8005-0-7-571      2004 actual   2005 est.   2006 est.
    ----------------------------------------------------------------------------

        Obligations by program activity:
    00.01 Benefit payments, HI..............     163,801     178,889     182,566
    00.02 Administration, HI................       1,865       1,727       1,862
    00.03 Quality improvement organizations,
            HI..............................          86         293         619
    00.04 Research, HI......................          68          68          40
    00.05 MA Additional Premiums............                                  58
                                               ---------   ---------  ----------
    10.00   Total new obligations...........     165,820     180,977     185,145
    ----------------------------------------------------------------------------

        Budgetary resources available for obligation:
    22.00 New budget authority (gross)......     165,820     180,977     185,145
    23.95 Total new obligations.............    -165,820    -180,977    -185,145
    24.41 Unobligated balance returned to
            receipts........................           6
    ----------------------------------------------------------------------------

        New budget authority (gross), detail:
          Discretionary:

    40.26   Appropriation (trust fund)......       1,889       1,681       1,768
    40.37   Appropriation temporarily
              reduced.......................         -14         -16
                                               ---------   ---------  ----------
    43.00     Appropriation (total
                discretionary)..............       1,875       1,665       1,768
          Mandatory:

    60.26   Appropriation (trust fund)......     177,865     188,724     200,752
    60.45   Portion precluded from balances.     -13,920      -9,412     -17,375
                                               ---------   ---------  ----------
    62.50     Appropriation (total
                mandatory)..................     163,945     179,312     183,377
                                               ---------   ---------  ----------
    70.00   Total new budget authority
              (gross).......................     165,820     180,977     185,145
    ----------------------------------------------------------------------------

        Change in obligated balances:
    72.40 Obligated balance, start of year..      16,235      16,091      15,962
    73.10 Total new obligations.............     165,820     180,977     185,145
    73.20 Total outlays (gross).............    -165,964    -181,106    -184,962
                                               ---------   ---------  ----------
    74.40   Obligated balance, end of year..      16,091      15,962      16,145
    ----------------------------------------------------------------------------

        Outlays (gross), detail:
    86.90 Outlays from new discretionary
            authority.......................       1,411       1,364       1,455
    86.93 Outlays from discretionary
            balances........................         417         435         441
    86.97 Outlays from new mandatory
            authority.......................     148,344     162,934     166,382
    86.98 Outlays from mandatory balances...      15,792      16,373      16,684
                                               ---------   ---------  ----------
    87.00   Total outlays (gross)...........     165,964     181,106     184,962
    ----------------------------------------------------------------------------

        Net budget authority and outlays:
    89.00 Budget authority..................     165,820     180,977     185,145
    90.00 Outlays...........................     165,964     181,106     184,962
    ----------------------------------------------------------------------------

        Memorandum (non-add) entries:
    92.01 Total investments, start of year:
            Federal securities: Par value...     251,307     264,375     274,184
    92.02 Total investments, end of year:
            Federal securities: Par value...     264,375     274,184     291,767
    ---------------------------------------------------------------------------

        The Hospital Insurance (HI) program funds the costs of hospital and
    related care for individuals age 65 or older and for eligible disabled
    people.

        The status of the trust fund is as follows:

                      Status of Funds (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 20-8005-0-7-571      2004 actual   2005 est.   2006 est.
    ----------------------------------------------------------------------------
        Balance, start of year:
    0100  Treasury balance..................     251,091     264,901     274,184
          Adjustments:

                                               ---------   ---------  ----------
    0199    Total balance, start of year....     251,101     264,901     274,184
        Cash income during the year:
          Current law:

            Receipts:
    1200      FHI trust fund, transfers from
                general fund (FICA taxes)...     139,409     149,667     159,814
    1201      FHI trust fund, transfers from
                general fund (SECA taxes)...      10,789      11,282      11,904
    1202      FHI trust fund, receipts from
                Railroad Retirement Board...         391         411         417
    1203      HCFAC: Civil penalties and
                damages.....................         355         244         244
            Offsetting receipts
                (proprietary):
    1220      FHI trust fund, premiums
                collected for uninsured
                individuals not otherwise
                eligible....................       1,799       2,246       2,376
    1222      Offsetting receipts
                (proprietary)...............                                  58
            Offsetting receipts
                (intragovernmental):
    1240      FHI trust fund, Federal
                employer contributions
                (FICA)......................       2,540       2,627       2,659
    1241      FHI trust fund, Postal Service
                employer contributions
                (FICA)......................         710         673         674
    1242      FHI trust fund, Federal
                payment for transitional
                coverage for uninsured
                Federal employees...........         568         501         652
    1243      FHI trust fund, Federal
                payments for OASDI taxes....       8,577       8,717       9,726
    1244      FHI trust fund, interest
                payment from Railroad
                Retirement Board............          28          27          28
    1245      FHI trust fund, interest on
                investments.................      15,046      14,941      14,994
    1246      Offsetting receipts
                (intragovernmental).........         114         114         114
    1247      HCFAC: FBI....................         305           3           3
    1248      HCFAC: Criminal fines.........          11          11          11
    1251      Offsetting receipts
                (intragovernmental).........         173
            Offsetting collections:
    1280      Offsetting collections........           6           6           6
    1299    Income under present law........     180,821     191,470     203,680
                                               ---------   ---------  ----------
    3299    Total cash income...............     180,821     191,470     203,680
        Cash outgo during year:
          Current law:

    4500    Medicare Part A.................    -165,964    -181,106    -184,962
    4501    HCFAC...........................      -1,057      -1,081      -1,161
    4599    Outgo under current law (-).....    -167,021    -182,187    -186,123
                                               ---------   ---------  ----------
    6599    Total cash outgo (-)............    -167,021    -182,187    -186,123
        Unexpended balance, end of year:
                                               ---------   ---------  ----------
    8799    Total balance, end of year......     264,901     274,184     291,741
    ---------------------------------------------------------------------------

                   Object Classification (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 20-8005-0-7-571      2004 actual   2005 est.   2006 est.
    ----------------------------------------------------------------------------
    41.0  Payment for Quality Improvement
            Organization (QIO) activities...          86         293         619
    42.0  Insurance claims and indemnities
            (benefits)......................     163,801     178,889     182,624
    94.0  Financial transfers...............       1,933       1,795       1,902
                                               ---------   ---------  ----------
    99.0      Direct obligations............     165,820     180,977     185,145
                                               ---------   ---------  ----------
    99.9    Total new obligations...........     165,820     180,977     185,145
    ---------------------------------------------------------------------------

                   Health Care Fraud and Abuse Control Account

                    [(federal hospital insurance trust fund)]

        In addition to amounts otherwise available for program integrity and
    program management, $80,000,000, to be transferred from the Federal
    Hospital Insurance and the Federal Supplementary Medical Insurance Trust
    Funds, as authorized by section 201(g) of the Social Security Act, of
    which $75,000,000 is for the Medicare Integrity Program at the Centers
    for Medicare and Medicaid Services (``CMS'') to conduct oversight of
    activities authorized in Titles I and II of Public Law 108-173, with
    oversight activities including those activities listed in 18 U.S.C.
    1893(b), and of which $5,000,000 is for the Medicaid program integrity
    activities, together with not less than $20,000,000 made available to
    the Secretary by section 1817(k)(3) of the Social Security Act:
    Provided, That the report required by 18 U.S.C. 1817(k)(5) for FY 2006
    shall include measures of the operational efficiency and impact on
    fraud, waste and abuse in the Medicare and Medicaid programs for the
    funds provided by this appropriation.

                   Program and Financing (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-8393-0-7-571      2004 actual   2005 est.   2006 est.
    ----------------------------------------------------------------------------

        Obligations by program activity:
    00.01 Medicare integrity program........         720         720         720
    00.02 FBI fraud and abuse control.......         114         114         114
    00.03 Other fraud and abuse control.....         241         241         246
    00.04 Drug benefit integrity program....                                  75
    09.01 Reimbursable (OIG)................           2           6           6
                                               ---------   ---------  ----------
    10.00   Total new obligations...........       1,077       1,081       1,161
    ----------------------------------------------------------------------------

        Budgetary resources available for obligation:
    22.00 New budget authority (gross)......       1,081       1,081       1,161
    23.95 Total new obligations.............      -1,077      -1,081      -1,161
    23.98 Unobligated balance expiring or
            withdrawn.......................          -6
    ----------------------------------------------------------------------------

    [[Page 454]]

        New budget authority (gross), detail:
          Discretionary:

    40.26   Appropriation (trust fund)......                                  80
          Mandatory:

    60.28   Appropriation (unavailable
              balances).....................       1,075       1,075       1,075
    69.00 Offsetting collections (cash).....           6           6           6
                                               ---------   ---------  ----------
    70.00   Total new budget authority
              (gross).......................       1,081       1,081       1,161
    ----------------------------------------------------------------------------

        Change in obligated balances:
    72.40 Obligated balance, start of year..         250         268         268
    73.10 Total new obligations.............       1,077       1,081       1,161
    73.20 Total outlays (gross).............      -1,057      -1,081      -1,161
    73.40 Adjustments in expired accounts
            (net)...........................          -2
                                               ---------   ---------  ----------
    74.40   Obligated balance, end of year..         268         268         268
    ----------------------------------------------------------------------------

        Outlays (gross), detail:
    86.90 Outlays from new discretionary
            authority.......................                                  80
    86.97 Outlays from new mandatory
            authority.......................         904       1,081       1,081
    86.98 Outlays from mandatory balances...         153
                                               ---------   ---------  ----------
    87.00   Total outlays (gross)...........       1,057       1,081       1,161
    ----------------------------------------------------------------------------

        Offsets:
          Against gross budget authority and outlays:

    88.00   Offsetting collections (cash)
              from: Federal sources.........          -6          -6          -6
    ----------------------------------------------------------------------------

        Net budget authority and outlays:
    89.00 Budget authority..................       1,075       1,075       1,155
    90.00 Outlays...........................       1,051       1,075       1,155
    ---------------------------------------------------------------------------

        P.L. 104-191 established the Health Care Fraud and Abuse Control
    (HCFAC) account within the Federal hospital insurance trust fund and
    appropriated funds, to be available without further appropriation, from
    the trust fund to the HCFAC account for specified health care fraud and
    abuse control activities of the Department of Health and Human Services
    (HHS), the Department of Justice, and other agencies.

        This schedule reflects the estimated distribution of the account for
    2005 and 2006. As required by statute, actual 2005 and 2006 agency
    distributions will be determined by the Secretary of HHS and the
    Attorney General consistent with the Administration's priorities.

                                         2004 actual  2005 est.   2006 est.
    Department of Justice, DOJ..........          49          49          49
    Office of the Inspector General, HHS         160         160         160
    Centers for Medicare and Medicaid
    Services, Medicaid/SCHIP Program
    Integrity, HHS......................          14          17          20
    Centers for Medicare and Medicaid
    Services, Other HHS.................           8           5           5
    Office of the General Counsel, HHS..           5           5           5
    Other HHS...........................           4           4           1
                                        ------------------------------------
          Total.........................         240         240         240
                                        ====================================

        The 2006 Budget includes a discretionary request for efforts to
    safeguard Medicaid and the Medicare prescription drug benefit, and will
    supplement the mandatory funds made available by P.L. 104-191.

        It is important that these cost increases and new enforcement
    investments be fully funded. The Administration is proposing to fund
    them as contingent appropriations. To ensure full funding of the new
    enforcement investments, the Administration proposes to employ a budget
    enforcement mechanism that allows for an adjustment by the Budget
    Committees to the section 302(a) allocation to the Appropriations
    Committees found in the concurrent resolution on the budget. In
    addition, the Administration will also seek to establish statutory
    spending limits, as defined by section 251 of the Balanced Budget and
    Emergency Deficit Control Act of 1985, and to adjust them for this
    purpose. These adjustments would only be permissible if the use of these
    funds was clearly restricted to the specified purpose. The maximum
    allowable adjustment to the 302(a) allocation and/or the statutory
    spending limit would be $80 million for 2006 (see chapter 15 in
    Analytical Perspectives).

                   Object Classification (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-8393-0-7-571      2004 actual   2005 est.   2006 est.
    ----------------------------------------------------------------------------

          Direct obligations:

    11.1    Personnel compensation: Full-
              time permanent (CMS 100 FTEs).                       8           8
    12.1    Civilian personnel benefits
              (CMS).........................                       2           2
    23.2    Rental payments to others.......           2           1           1
    25.1    Advisory and assistance services
              (CMS).........................           9           5           5
    25.2    Other services (CMS)............          12           4          84
    25.3    Other purchases of goods and
              services from Government
              accounts (DoJ)................          49          49          49
    25.3    Other purchases of goods and
              services from Government
              accounts (HHS/OIG)............         160         160         160
    25.3    Other purchases of goods and
              services from Government
              accounts (HHS/AoA)............           4           2           2
    25.3    Other purchases of goods and
              services from Government
              accounts (HHS/OGC)............           5           5           5
    25.6    Medical care (CMS)..............         720         720         720
    41.0    Grants, subsidies, and
              contributions (CMS)...........                       5           5
    94.0    Financial transfers.............         114         114         114
                                               ---------   ---------  ----------
    99.0      Direct obligations............       1,075       1,075       1,155
    99.0  Reimbursable obligations..........           2           6           6
                                               ---------   ---------  ----------
    99.9    Total new obligations...........       1,077       1,081       1,161
    ---------------------------------------------------------------------------

                                  Personnel Summary

    ----------------------------------------------------------------------------
    Identification code 75-8393-0-7-571      2004 actual   2005 est.   2006 est.
    ----------------------------------------------------------------------------
        Direct:
    1001  Total compensable workyears:
            Civilian full-time equivalent
            employment......................           3         100         100
    ---------------------------------------------------------------------------

               Federal Supplementary Medical Insurance Trust Fund

                    Unavailable Receipts (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 20-8004-0-7-571      2004 actual   2005 est.   2006 est.
    ----------------------------------------------------------------------------
    01.99 Balance, start of year............       8,396         400       2,942
        Receipts:
    02.20 Premiums collected for the aged,
            FSMI Fund.......................      25,873      30,593      34,126
    02.21 Premiums collected for the
            disabled, FSMI Fund.............       4,468       5,171       5,890
    02.22 Basic premium, Medicare Advantage,
            SMI.............................                                  51
    02.23 Premiums collected for Medicare
            prescription drug account, FSMI.                               6,229
    02.24 Interest, Medicare prescription
            drug account, FSMI..............                                 335
    02.25 Payments from States, Medicare
            prescription drug account, FSMI.                               6,778
    02.27 Other proprietary receipts from
            the public, FSMI Fund...........           1
    02.28 Proposed legislation..............                                  30
    02.29 Proposed legislation..............                                   5
    02.40 Federal contributions, FSMI Fund..      94,518     114,002     128,015
    02.41 Interest received by trust fund,
            FSMI Fund.......................       1,727       1,755       2,117
    02.43 Legislative proposal: Federal
            contributions, FSMI.............                                 108
    02.44 Federal contributions, Medicare
            prescription drug account, FSMI.                              53,596
    02.45 Proposed legislation: Interest....                                  -4
    02.46 Federal contributions,
            Transitional assistance account,
            FSMI............................                   1,155         361
    02.48 Federal supplementary medical
            insurance trust fund............                                 357
    02.49 Federal supplementary medical
            insurance trust fund............         216
    02.50 Federal supplementary medical
            insurance trust fund............                                 320
    02.51 Federal supplementary medical
            insurance trust fund............                      73          99
    02.52 Miscellaneous Federal payments,
            Federal supplementary medical in           2
                                               ---------   ---------  ----------
    02.99   Total receipts and collections..     126,805     152,749     238,413
                                               ---------   ---------  ----------
    04.00 Total: Balances and collections...     135,201     153,149     241,355
        Appropriations:
    05.00 Federal supplementary medical
            insurance trust fund............      -2,333      -2,358      -2,536
    05.01 Federal supplementary medical
            insurance trust fund............    -123,049    -149,219    -167,496

    [[Page 455]]

    05.02 Federal supplementary medical
            insurance trust fund............      -7,996
    05.03 Federal supplementary medical
            insurance trust fund............          22          23
    05.04 Transitional drug assistance,
            Federal supplementary medical
            insu............................        -281      -1,155        -361
    05.05 Medicare prescription drug
            account, Federal supplementary
            insura..........................                     -73     -67,037
    05.06 Transitional drug assistance,
            Federal supplementary medical
            insu............................        -229
    05.07 Medicare prescription drug
            account, Federal supplementary
            insura..........................        -935                    -677
    05.08 Federal supplementary medical
            insurance trust fund............
    05.11 Federal supplementary medical
            insurance trust fund............                   2,575      14,787
    05.12 Federal supplementary medical
            insurance trust fund............                                -230
    05.20 Medicare prescription drug account                               8,446
                                               ---------   ---------  ----------
    05.99   Total appropriations............    -134,801    -150,207    -215,104
                                               ---------   ---------  ----------
    07.99 Balance, end of year..............         400       2,942      26,251
    ---------------------------------------------------------------------------

                   Program and Financing (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 20-8004-0-7-571      2004 actual   2005 est.   2006 est.
    ----------------------------------------------------------------------------

        Obligations by program activity:
    00.01 Benefit payments, SMI.............     130,855     146,375     152,548
    00.02 Administration, SMI...............       2,307       2,331       2,537
    00.03 Quality improvement organizations,
            SMI.............................          16          73         155
    00.04 Research, SMI.....................          10          10           5
    00.06 Transfer to Medicaid for payment
            of SMI premiums.................         168         190
                                               ---------   ---------  ----------
    10.00   Total new obligations...........     133,356     148,979     155,245
    ----------------------------------------------------------------------------

        Budgetary resources available for obligation:
    22.00 New budget authority (gross)......     133,356     148,979     155,245
    23.95 Total new obligations.............    -133,356    -148,979    -155,245
    ----------------------------------------------------------------------------

        New budget authority (gross), detail:
          Discretionary:

    40.26   Appropriation (trust fund)......       2,333       2,358       2,536
    40.37   Appropriation temporarily
              reduced.......................         -22         -23
                                               ---------   ---------  ----------
    43.00     Appropriation (total
                discretionary)..............       2,311       2,335       2,536
          Mandatory:

    60.26   Appropriation (trust fund)......     123,049     149,219     167,496
    60.28   Appropriation (unavailable
              balances).....................       7,996
    60.45   Portion precluded from
              obligation....................                  -2,575     -14,787
                                               ---------   ---------  ----------
    62.50     Appropriation (total
                mandatory)..................     131,045     146,644     152,709
                                               ---------   ---------  ----------
    70.00   Total new budget authority
              (gross).......................     133,356     148,979     155,245
    ----------------------------------------------------------------------------

        Change in obligated balances:
    72.40 Obligated balance, start of year..      16,404      15,639      15,470
    73.10 Total new obligations.............     133,356     148,979     155,245
    73.20 Total outlays (gross).............    -134,121    -149,148    -155,240
                                               ---------   ---------  ----------
    74.40   Obligated balance, end of year..      15,639      15,470      15,475
    ----------------------------------------------------------------------------

        Outlays (gross), detail:
    86.90 Outlays from new discretionary
            authority.......................       1,946       1,947       2,061
    86.93 Outlays from discretionary
            balances........................         543         556         547
    86.97 Outlays from new mandatory
            authority.......................     116,545     131,575     137,585
    86.98 Outlays from mandatory balances...      15,087      15,070      15,047
                                               ---------   ---------  ----------
    87.00   Total outlays (gross)...........     134,121     149,148     155,240
    ----------------------------------------------------------------------------

        Net budget authority and outlays:
    89.00 Budget authority..................     133,356     148,979     155,245
    90.00 Outlays...........................     134,121     149,148     155,240
    ----------------------------------------------------------------------------

        Memorandum (non-add) entries:
    92.01 Total investments, start of year:
            Federal securities: Par value...      24,849      17,439      18,603
    92.02 Total investments, end of year:
            Federal securities: Par value...      17,439      18,603      33,562
    ---------------------------------------------------------------------------

                     Summary of Budget Authority and Outlays

                            (in millions of dollars)

                                         2004 actual  2005 est.   2006 est.
    Enacted/requested:
      Budget Authority..................     133,356     148,979     155,245
      Outlays...........................     134,121     149,148     155,240
    Legislative proposal, not subject to
        PAYGO:
      Budget Authority..................                                 230
      Outlays...........................                                 230
                                        ------------------------------------
    Total:
      Budget Authority..................     133,356     148,979     155,475
      Outlays...........................     134,121     149,148     155,470
                                        ====================================

        The Supplementary Medical Insurance (SMI) program is a voluntary
    program that affords protection against the costs of physician and
    certain other medical services. The program also covers treatment of
    end-stage renal disease for eligible enrollees. SMI costs are financed
    by premium payments from enrollees and contributions from the general
    revenues.

        The status of the trust fund is as follows:

                      Status of Funds (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 20-8004-0-7-571      2004 actual   2005 est.   2006 est.
    ----------------------------------------------------------------------------
        Balance, start of year:
    0100  Treasury balance..................      24,801      17,115      18,603
          Adjustments:

                                               ---------   ---------  ----------
    0199    Total balance, start of year....      24,800      17,115      18,603
        Cash income during the year:
          Current law:

            Offsetting receipts
                (proprietary):
    1220      Premiums collected for the
                aged, FSMI fund.............      25,873      30,593      34,126
    1221      Premiums collected for the
                disabled, FSMI fund.........       4,468       5,171       5,890
    1222      Other proprietary receipts....                                  51
    1223      Premiums collected for
                Medicare prescription drug
                account, FSMI (proprietary).                               6,229
    1224      Interest, Medicare
                prescription drug account,
                FSMI (proprietary)..........                                 335
    1225      Payments from States, Medicare
                prescription drug account,
                FSMI (proprietary)..........                               6,778
    1227      Offsetting receipts
                (proprietary)...............           1
            Offsetting receipts
                (intragovernmental):
    1240      Federal contributions, FSMI
                fund........................      94,518     114,002     128,015
    1241      Interest received by trust
                fund, FSMI fund.............       1,727       1,755       2,117
    1244      Federal contributions,
                Medicare prescription drug
                account (intragovernmental).                              53,596
    1246      Federal contributions,
                Transitional assistance
                account (intragovernmental).                   1,155         361
    1248      Federal contributions,
                Medicare prescription drug
                account (intragovernmental).                                 357
    1249      Federal contributions,
                Transitional assistance
                account (intragovernmental).         216
    1250      Federal contributions,
                Medicare prescription drug
                account (intragovernmental).                                 320
    1251      Federal contributions,
                Medicare prescription drug
                account (intragovernmental).                      73          99
    1252      Offsetting receipts
                (intragovernmental).........           2
    1299    Income under present law........     126,805     152,749     238,274
          Proposed legislation:

            Offsetting receipts (proprietary
                receipts):
    2228      Offsetting receipts
                (proprietary receipts)......                                  30
    2229      Offsetting receipts
                (proprietary receipts)......                                   5
            Offsetting receipts
                (intragovernmental):
    2243      Offsetting receipts
                (intragovernmental).........                                 108
    2245      Offsetting receipts
                (intragovernmental).........                                  -4
    2299    Income under proposed
              legislation...................                                 139
                                               ---------   ---------  ----------
    3299    Total cash income...............     126,805     152,749     238,413
        Cash outgo during year:
          Current law:

    4500    Medicare Part B.................    -134,121    -149,148    -155,240
    4501    Transitional assistance account,
              FSMI (-)......................        -266      -1,399        -361
    4502    Medicare prescription drug
              account, FSMI.................        -103        -714     -59,341
    4599    Outgo under current law (-).....    -134,490    -151,261    -214,942
          Proposed legislation:

    5500    Administration, legislative
              proposal not subject to PAYGO.                                -230
    5599    Outgo under proposed legislation
              (-)...........................                                -230
                                               ---------   ---------  ----------
    6599    Total cash outgo (-)............    -134,490    -151,261    -215,172
        Unexpended balance, end of year:
                                               ---------   ---------  ----------
    8799    Total balance, end of year......      17,115      18,603      41,844
    ---------------------------------------------------------------------------

                   Object Classification (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 20-8004-0-7-571      2004 actual   2005 est.   2006 est.
    ----------------------------------------------------------------------------
    41.0  Payment for Quality Improvement
            Organization (QIO) activity.....          16          73         155
    42.0  Insurance claims and indemnities..     131,023     146,565     152,548
    94.0  Financial transfers...............       2,317       2,341       2,542
                                               ---------   ---------  ----------

    [[Page 456]]

    99.0      Direct obligations............     133,356     148,979     155,245
                                               ---------   ---------  ----------
    99.9    Total new obligations...........     133,356     148,979     155,245
    ---------------------------------------------------------------------------

               Federal Supplementary Medical Insurance Trust Fund

                  (Legislative proposal, not subject to PAYGO)

                   Program and Financing (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 20-8004-2-7-571      2004 actual   2005 est.   2006 est.
    ----------------------------------------------------------------------------

        Obligations by program activity:
    00.06 Transfer to Medicaid for payment
            of SMI premiums.................                                 230
                                               ---------   ---------  ----------
    10.00   Total new obligations (object
              class 42.0)...................                                 230
    ----------------------------------------------------------------------------

        Budgetary resources available for obligation:
    22.00 New budget authority (gross)......                                 230
    23.95 Total new obligations.............                                -230
    ----------------------------------------------------------------------------

        New budget authority (gross), detail:
          Discretionary:

    40.26   Appropriation (trust fund)......
          Mandatory:

    60.26   Appropriation (trust fund)......
    60.45   Portion precluded from
              obligation....................                                 230
                                               ---------   ---------  ----------
    62.50     Appropriation (total
                mandatory)..................                                 230
                                               ---------   ---------  ----------
    70.00   Total new budget authority
              (gross).......................                                 230
    ----------------------------------------------------------------------------

        Change in obligated balances:
    73.10 Total new obligations.............                                 230
    73.20 Total outlays (gross).............                                -230
    ----------------------------------------------------------------------------

        Outlays (gross), detail:
    86.97 Outlays from new mandatory
            authority.......................                                 230
    ----------------------------------------------------------------------------

        Net budget authority and outlays:
    89.00 Budget authority..................                                 230
    90.00 Outlays...........................                                 230
    ----------------------------------------------------------------------------

        Memorandum (non-add) entries:
    92.01 Total investments, start of year:
            Federal securities: Par value...
    92.02 Total investments, end of year:
            Federal securities: Par value...                                 -91
    ---------------------------------------------------------------------------

        The Budget includes a Medicaid proposal to extend the subsidy of
    Medicare cost sharing for certain qualified individuals that are
    reimbursed by Medicare.

     Transitional Drug Assistance, Federal Supplementary Medical Insurance
                                   Trust Fund

                   Program and Financing (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-8307-0-7-571      2004 actual   2005 est.   2006 est.
    ----------------------------------------------------------------------------

        Obligations by program activity:
    00.01 Benefit payments, transitional
            drug assistance.................         281       1,155         361
    00.02 Program management (CMS)..........         229
                                               ---------   ---------  ----------
    10.00   Total new obligations...........         510       1,155         361
    ----------------------------------------------------------------------------

        Budgetary resources available for obligation:
    22.00 New budget authority (gross)......         510       1,155         361
    23.95 Total new obligations.............        -510      -1,155        -361
    ----------------------------------------------------------------------------

        New budget authority (gross), detail:
          Discretionary:

    40.26   Appropriation (trust fund)......         229
          Mandatory:

    60.26   Appropriation (trust fund)......         281       1,155         361
                                               ---------   ---------  ----------
    70.00   Total new budget authority
              (gross).......................         510       1,155         361
    ----------------------------------------------------------------------------

        Change in obligated balances:
    72.40 Obligated balance, start of year..                     244
    73.10 Total new obligations.............         510       1,155         361
    73.20 Total outlays (gross).............        -266      -1,399        -361
                                               ---------   ---------  ----------
    74.40   Obligated balance, end of year..         244
    ----------------------------------------------------------------------------

        Outlays (gross), detail:
    86.90 Outlays from new discretionary
            authority.......................          50
    86.93 Outlays from discretionary
            balances........................                     179
    86.97 Outlays from new mandatory
            authority.......................         216       1,155         361
    86.98 Outlays from mandatory balances...                      65
                                               ---------   ---------  ----------
    87.00   Total outlays (gross)...........         266       1,399         361
    ----------------------------------------------------------------------------

        Net budget authority and outlays:
    89.00 Budget authority..................         510       1,155         361
    90.00 Outlays...........................         266       1,399         361
    ----------------------------------------------------------------------------

        Memorandum (non-add) entries:
    92.01 Total investments, start of year:
            Federal securities: Par value...
    92.02 Total investments, end of year:
            Federal securities: Par value...
    ---------------------------------------------------------------------------

        Authorized under the Medicare Modernization Act as section 1860 D-31
    of the Social Security Act, the Medicare Transitional Drug Assistance
    program provides low-income beneficiaries with $600 per year to help
    them pay for their prescription drugs and covers the cost of enrollment
    fees.

                   Object Classification (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-8307-0-7-571      2004 actual   2005 est.   2006 est.
    ----------------------------------------------------------------------------
    25.2  Other services....................         229
    42.0  Insurance claims and indemnities..         281       1,155         361
                                               ---------   ---------  ----------
    99.9    Total new obligations...........         510       1,155         361
    ---------------------------------------------------------------------------

       Medicare Prescription Drug Account, Federal Supplementary Medical
                              Insurance Trust Fund

                   Program and Financing (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-8308-0-7-571      2004 actual   2005 est.   2006 est.
    ----------------------------------------------------------------------------

        Obligations by program activity:
    00.01 Program management (CMS)..........         435                     357
    00.02 Limitation on administrative
            expenses (SSA)..................         500                     320
    00.03 Low-income determinations
            (Medicaid)......................                      73          99
    00.04 Prescription Drug Benefits........                              58,492
                                               ---------   ---------  ----------
    10.00   Total new obligations...........         935          73      59,268
    ----------------------------------------------------------------------------

        Budgetary resources available for obligation:
    22.00 New budget authority (gross)......         935          73      59,268
    23.95 Total new obligations.............        -935         -73     -59,268
    ----------------------------------------------------------------------------

        New budget authority (gross), detail:
          Discretionary:

    40.26   Appropriation (trust fund)......         935                     677
          Mandatory:

    60.26   Appropriation (trust fund)......                      73      67,037
    60.45   Portion precluded from
              obligation....................                              -8,446
                                               ---------   ---------  ----------
    62.50     Appropriation (total
                mandatory)..................                      73      58,591
                                               ---------   ---------  ----------
    70.00   Total new budget authority
              (gross).......................         935          73      59,268
    ----------------------------------------------------------------------------

        Change in obligated balances:
    72.40 Obligated balance, start of year..                     832         191
    73.10 Total new obligations.............         935          73      59,268
    73.20 Total outlays (gross).............        -103        -714     -59,341
                                               ---------   ---------  ----------

    [[Page 457]]

    74.40   Obligated balance, end of year..         832         191         118
    ----------------------------------------------------------------------------

        Outlays (gross), detail:
    86.90 Outlays from new discretionary
            authority.......................         103                     560
    86.93 Outlays from discretionary
            balances........................                     641         190
    86.97 Outlays from new mandatory
            authority.......................                      73      58,591
                                               ---------   ---------  ----------
    87.00   Total outlays (gross)...........         103         714      59,341
    ----------------------------------------------------------------------------

        Net budget authority and outlays:
    89.00 Budget authority..................         935          73      59,268
    90.00 Outlays...........................         103         714      59,341
    ----------------------------------------------------------------------------

        Memorandum (non-add) entries:
    92.01 Total investments, start of year:
            Federal securities: Par value...
    92.02 Total investments, end of year:
            Federal securities: Par value...                               8,373
    ---------------------------------------------------------------------------

        Beginning in 2006, Medicare beneficiaries will have the opportunity
    to enroll in a comprehensive prescription drug benefit. 2004 and 2005
    include start-up costs associated with implementing the benefit.

                   Object Classification (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-8308-0-7-571      2004 actual   2005 est.   2006 est.
    ----------------------------------------------------------------------------
    25.2  Other services....................         935          73         677
    41.0  Grants, subsidies, and
            contributions...................                              58,591
                                               ---------   ---------  ----------
    99.9    Total new obligations...........         935          73      59,268
    ---------------------------------------------------------------------------

                     Allocation Received From Other Accounts

        Note.--Obligations incurred under allocations from other accounts
    are included in the schedule of the parent appropriation as follows:
    Centers for Medicare and Medicaid Services ``Health Care Fraud and Abuse
    Control Account.''

                    ADMINISTRATION FOR CHILDREN AND FAMILIES

                                  Federal Funds

    General and special funds:

                     Temporary Assistance for Needy Families

                   Program and Financing (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-1552-0-1-609      2004 actual   2005 est.   2006 est.
    ----------------------------------------------------------------------------

        Obligations by program activity:
    00.01 State family assistance grant.....      16,480      16,489      16,489
    00.02 Territories--family assistance
            grants..........................          76          78          78
    00.03 Matching grants to territories....                       6           6
    00.04 Supplemental grants for population
            increases.......................         319         191
    00.05 Bonus to reward decrease in
            illegitimacy....................         100         100         100
    00.06 Tribal work programs..............           8           8           8
    00.07 Bonus to reward high performance
            States..........................         200         200         200
                                               ---------   ---------  ----------
    10.00   Total new obligations (object
              class 41.0)...................      17,183      17,072      16,881
    ----------------------------------------------------------------------------

        Budgetary resources available for obligation:
    21.40 Unobligated balance carried
            forward, start of year..........                                 800
    22.00 New budget authority (gross)......      17,209      17,881      16,689
                                               ---------   ---------  ----------
    23.90   Total budgetary resources
              available for obligation......      17,209      17,881      17,489
    23.95 Total new obligations.............     -17,183     -17,072     -16,881
    23.98 Unobligated balance expiring or
            withdrawn.......................         -25          -9          -8
                                               ---------   ---------  ----------
    24.40   Unobligated balance carried
              forward, end of year..........                     800         600
    ----------------------------------------------------------------------------

        New budget authority (gross), detail:
          Mandatory:

    60.00   Appropriation...................      17,209      17,881      16,689
    ----------------------------------------------------------------------------

        Change in obligated balances:
    72.40 Obligated balance, start of year..       7,016       6,474       5,476
    73.10 Total new obligations.............      17,183      17,072      16,881
    73.20 Total outlays (gross).............     -17,725     -18,070     -17,918
    73.40 Adjustments in expired accounts
            (net)...........................          -1
                                               ---------   ---------  ----------
    74.40   Obligated balance, end of year..       6,474       5,476       4,439
    ----------------------------------------------------------------------------

        Outlays (gross), detail:
    86.97 Outlays from new mandatory
            authority.......................      12,489      13,489      13,819
    86.98 Outlays from mandatory balances...       5,236       4,581       4,099
                                               ---------   ---------  ----------
    87.00   Total outlays (gross)...........      17,725      18,070      17,918
    ----------------------------------------------------------------------------

        Net budget authority and outlays:
    89.00 Budget authority..................      17,209      17,881      16,689
    90.00 Outlays...........................      17,725      18,070      17,918
    ---------------------------------------------------------------------------

                     Summary of Budget Authority and Outlays

                            (in millions of dollars)

                                         2004 actual  2005 est.   2006 est.
    Enacted/requested:
      Budget Authority..................      17,209      17,881      16,689
      Outlays...........................      17,725      18,070      17,918
    Legislative proposal, subject to
        PAYGO:
      Budget Authority..................                    -232         459
      Outlays...........................                      29         246
                                        ------------------------------------
    Total:
      Budget Authority..................      17,209      17,649      17,148
      Outlays...........................      17,725      18,099      18,164
                                        ====================================

        This account provides continued funding for activities established
    by the Personal Responsibility and Work Opportunity Reconciliation Act
    of 1996 (P.L. 104-193). The Temporary Assistance for Needy Families
    block grant provides funding to States for aid to low-income families
    with children.

                     Temporary Assistance for Needy Families

                    (Legislative proposal, subject to PAYGO)

                   Program and Financing (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-1552-4-1-609      2004 actual   2005 est.   2006 est.
    ----------------------------------------------------------------------------

        Obligations by program activity:
    00.04 Supplemental grants for population
            increases.......................                     128         319
    00.05 Bonus to reward decrease in
            illegitimacy....................                    -100        -100
    00.07 Bonus to reward high performance
            States..........................                    -100        -100
    00.08 Responsible Fatherhood Program....                      40          40
    00.09 Family Formation Grants...........                     100         100
    00.10 Healthy Marriage Research & Tech
            Asst............................                     100         100
                                               ---------   ---------  ----------
    10.00   Total new obligations (object
              class 41.0)...................                     168         359
    ----------------------------------------------------------------------------

        Budgetary resources available for obligation:
    21.40 Unobligated balance carried
            forward, start of year..........                                -400
    22.00 New budget authority (gross)......                    -232         459
                                               ---------   ---------  ----------
    23.90   Total budgetary resources
              available for obligation......                    -232          59
    23.95 Total new obligations.............                    -168        -359
                                               ---------   ---------  ----------
    24.40   Unobligated balance carried
              forward, end of year..........                    -400        -300
    ----------------------------------------------------------------------------

        New budget authority (gross), detail:
          Mandatory:

    60.00   Appropriation...................                    -232         459
    ----------------------------------------------------------------------------

        Change in obligated balances:
    72.40 Obligated balance, start of year..                                 139
    73.10 Total new obligations.............                     168         359
    73.20 Total outlays (gross).............                     -29        -246
                                               ---------   ---------  ----------
    74.40   Obligated balance, end of year..                     139         252
    ----------------------------------------------------------------------------

        Outlays (gross), detail:
    86.97 Outlays from new mandatory
            authority.......................                      29         135
    86.98 Outlays from mandatory balances...                                 111
                                               ---------   ---------  ----------
    87.00   Total outlays (gross)...........                      29         246
    ----------------------------------------------------------------------------

        Net budget authority and outlays:
    89.00 Budget authority..................                    -232         459
    90.00 Outlays...........................                      29         246
    ---------------------------------------------------------------------------

        This schedule reflects additional proposals to be included in the
    reauthorization of the Temporary Assistance for Needy

    [[Page 458]]

    Families program. These include funding for Supplemental Grants and
    initiatives to support healthy marriage, family formation, and
    responsible fatherhood activities.

                                Contingency Fund

                   Program and Financing (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-1522-0-1-609      2004 actual   2005 est.   2006 est.
    ----------------------------------------------------------------------------

        Obligations by program activity:
    00.01 Contingency Fund..................                      38          39
                                               ---------   ---------  ----------
    10.00   Total new obligations (object
              class 41.0)...................                      38          39
    ----------------------------------------------------------------------------

        Budgetary resources available for obligation:
    21.40 Unobligated balance carried
            forward, start of year..........                               1,920
    22.00 New budget authority (gross)......       1,958       1,958
                                               ---------   ---------  ----------
    23.90   Total budgetary resources
              available for obligation......       1,958       1,958       1,920
    23.95 Total new obligations.............                     -38         -39
    23.98 Unobligated balance expiring or
            withdrawn.......................      -1,958
                                               ---------   ---------  ----------
    24.40   Unobligated balance carried
              forward, end of year..........                   1,920       1,881
    ----------------------------------------------------------------------------

        New budget authority (gross), detail:
          Mandatory:

    60.00   Appropriation...................                   1,958
    63.00   Reappropriation.................       1,958
                                               ---------   ---------  ----------
    70.00   Total new budget authority
              (gross).......................       1,958       1,958
    ----------------------------------------------------------------------------

        Change in obligated balances:
    72.40 Obligated balance, start of year..                                   8
    73.10 Total new obligations.............                      38          39
    73.20 Total outlays (gross).............                     -30         -39
                                               ---------   ---------  ----------
    74.40   Obligated balance, end of year..                       8           8
    ----------------------------------------------------------------------------

        Outlays (gross), detail:
    86.97 Outlays from new mandatory
            authority.......................                      30
    86.98 Outlays from mandatory balances...                                  39
                                               ---------   ---------  ----------
    87.00   Total outlays (gross)...........                      30          39
    ----------------------------------------------------------------------------

        Net budget authority and outlays:
    89.00 Budget authority..................       1,958       1,958
    90.00 Outlays...........................                      30          39
    ---------------------------------------------------------------------------

                     Summary of Budget Authority and Outlays

                            (in millions of dollars)

                                         2004 actual  2005 est.   2006 est.
    Enacted/requested:
      Budget Authority..................       1,958       1,958
      Outlays...........................                      30          39
    Legislative proposal, subject to
        PAYGO:
      Budget Authority..................                      42
      Outlays...........................                                   6
                                        ------------------------------------
    Total:
      Budget Authority..................       1,958       2,000
      Outlays...........................                      30          45
                                        ====================================

                                Contingency Fund

                    (Legislative proposal, subject to PAYGO)

                   Program and Financing (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-1522-4-1-609      2004 actual   2005 est.   2006 est.
    ----------------------------------------------------------------------------

        Obligations by program activity:
    00.01 Direct Program Activity...........                                   7
                                               ---------   ---------  ----------
    10.00   Total new obligations (object
              class 41.0)...................                                   7
    ----------------------------------------------------------------------------

        Budgetary resources available for obligation:
    21.40 Unobligated balance carried
            forward, start of year..........                                  42
    22.00 New budget authority (gross)......                      42
                                               ---------   ---------  ----------
    23.90   Total budgetary resources
              available for obligation......                      42          42
    23.95 Total new obligations.............                                  -7
                                               ---------   ---------  ----------
    24.40   Unobligated balance carried
              forward, end of year..........                      42          35
    ----------------------------------------------------------------------------

        New budget authority (gross), detail:
          Mandatory:

    60.00   Appropriation...................                      42
    ----------------------------------------------------------------------------

        Change in obligated balances:
    73.10 Total new obligations.............                                   7
    73.20 Total outlays (gross).............                                  -6
    ----------------------------------------------------------------------------

        Outlays (gross), detail:
    86.98 Outlays from mandatory balances...                                   6
    ----------------------------------------------------------------------------

        Net budget authority and outlays:
    89.00 Budget authority..................                      42
    90.00 Outlays...........................                                   6
    ---------------------------------------------------------------------------

        This schedule reflects a proposal to authorize a more accessible
    Contingency Fund.

      Payments to States for Child Support Enforcement and Family Support
                                    Programs

        For making payments to States or other non-Federal entities under
    titles I, IV-D, X, XI, XIV, and XVI of the Social Security Act and the
    Act of July 5, 1960 (24 U.S.C. ch. 9), [$2,873,802,000] $2,121,643,000,
    to remain available until expended; and for such purposes for the first
    quarter of fiscal year [2006] 2007, $1,200,000,000, to remain available
    until expended.
        For making payments to each State for carrying out the program of
    Aid to Families with Dependent Children under title IV-A of the Social
    Security Act before the effective date of the program of Temporary
    Assistance for Needy Families (TANF) with respect to such State, such
    sums as may be necessary: Provided, That the sum of the amounts
    available to a State with respect to expenditures under such title IV-A
    in fiscal year 1997 under this appropriation and under such title IV-A
    as amended by the Personal Responsibility and Work Opportunity
    Reconciliation Act of 1996 shall not exceed the limitations under
    section 116(b) of such Act.
        For making, after May 31 of the current fiscal year, payments to
    States or other non-Federal entities under titles I, IV-D, X, XI, XIV,
    and XVI of the Social Security Act and the Act of July 5, 1960 (24
    U.S.C. ch. 9), for the last 3 months of the current fiscal year for
    unanticipated costs, incurred for the current fiscal year, such sums as
    may be necessary. (Department of Health and Human Services
    Appropriations Act, 2005.)

                   Program and Financing (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-1501-0-1-609      2004 actual   2005 est.   2006 est.
    ----------------------------------------------------------------------------

        Obligations by program activity:
    00.01 State child support administrative
            costs...........................       3,348       3,403       3,560
    00.02 Child support incentive payments..         454         446         458
    00.03 Access and visitation grants......          10          10          10
                                               ---------   ---------  ----------
    00.91   Subtotal, child support
              enforcement...................       3,812       3,859       4,028
    01.02 Payments to territories...........          23          33          33
    01.03 Repatriation......................           1           1           1
                                               ---------   ---------  ----------
    01.91   Subtotal, other payments........          24          34          34
    02.01 AFDC benefit payments.............          20
    09.01 Offset obligations (cse grants to
            states).........................         192         208         208
                                               ---------   ---------  ----------
    10.00   Total new obligations...........       4,048       4,101       4,270
    ----------------------------------------------------------------------------

        Budgetary resources available for obligation:
    21.40 Unobligated balance carried
            forward, start of year..........                     559         740
    22.00 New budget authority (gross)......       4,605       4,282       3,530
    22.10 Resources available from
            recoveries of prior year
            obligations.....................           2
                                               ---------   ---------  ----------
    23.90   Total budgetary resources
              available for obligation......       4,607       4,841       4,270
    23.95 Total new obligations.............      -4,048      -4,101      -4,270
                                               ---------   ---------  ----------
    24.40   Unobligated balance carried
              forward, end of year..........         559         740
    ----------------------------------------------------------------------------

        New budget authority (gross), detail:
          Mandatory:

    60.00   Appropriation...................       3,313       2,874       2,122

    [[Page 459]]

    65.00   Advance appropriation...........       1,100       1,200       1,200
    69.00 Offsetting collections (cash).....         192         208         208
                                               ---------   ---------  ----------
    70.00   Total new budget authority
              (gross).......................       4,605       4,282       3,530
    ----------------------------------------------------------------------------

        Change in obligated balances:
    72.40 Obligated balance, start of year..         797         836         795
    73.10 Total new obligations.............       4,048       4,101       4,270
    73.20 Total outlays (gross).............      -4,007      -4,142      -4,289
    73.45 Recoveries of prior year
            obligations.....................          -2
                                               ---------   ---------  ----------
    74.40   Obligated balance, end of year..         836         795         776
    ----------------------------------------------------------------------------

        Outlays (gross), detail:
    86.97 Outlays from new mandatory
            authority.......................       3,487       3,015       3,019
    86.98 Outlays from mandatory balances...         520       1,127       1,270
                                               ---------   ---------  ----------
    87.00   Total outlays (gross)...........       4,007       4,142       4,289
    ----------------------------------------------------------------------------

        Offsets:
          Against gross budget authority and outlays:

            Offsetting collections (cash)
                from:
    88.00     Federal sources...............        -192
    88.45     Offsetting governmental
                collections (from non-
                Federal sources)............                    -208        -208
                                               ---------   ---------  ----------
    88.90       Total, offsetting
                  collections (cash)........        -192        -208        -208
    ----------------------------------------------------------------------------

        Net budget authority and outlays:
    89.00 Budget authority..................       4,413       4,074       3,322
    90.00 Outlays...........................       3,815       3,934       4,081
    ---------------------------------------------------------------------------

                     Summary of Budget Authority and Outlays

                            (in millions of dollars)

                                         2004 actual  2005 est.   2006 est.
    Enacted/requested:
      Budget Authority..................       4,413       4,074       3,322
      Outlays...........................       3,815       3,934       4,081
    Legislative proposal, subject to
        PAYGO:
      Budget Authority..................                                 -50
      Outlays...........................                                 -50
                                        ------------------------------------
    Total:
      Budget Authority..................       4,413       4,074       3,272
      Outlays...........................       3,815       3,934       4,031
                                        ====================================

        This account provides for payments to States for child support
    enforcement and other family support programs, including access and
    visitation programs for families. The Federal share of child support
    collections is returned to the Treasury in a receipt account. The text
    table below shows the net Federal costs of child support enforcement and
    assumes enactment of legislative proposals effective in FY 2006.

                 Net Federal Costs of Child Support Enforcement

                            (In millions of dollars)

                                            2004         2005        2006
    Gross Federal share of collections..      -1,096      -1,087      -1,110
    Federal incentive payments to States         454         446         458
    State child support administrative
    costs...............................       3,540       3,610       3,716
    Access and visitation grants........          10          10          12
                                        ------------------------------------
        Total...........................       2,908       2,979       3,076
                                        ====================================

                   Object Classification (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-1501-0-1-609      2004 actual   2005 est.   2006 est.
    ----------------------------------------------------------------------------
    41.0  Direct obligations: Grants,
            subsidies, and contributions....       3,856       3,893       4,062
    99.0  Reimbursable obligations:
            Reimbursable obligations........         192         208         208
                                               ---------   ---------  ----------
    99.9    Total new obligations...........       4,048       4,101       4,270
    ---------------------------------------------------------------------------

      Payments to States for Child Support Enforcement and Family Support
                                    Programs

                    (Legislative proposal, subject to PAYGO)

                   Program and Financing (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-1501-4-1-609      2004 actual   2005 est.   2006 est.
    ----------------------------------------------------------------------------

        Obligations by program activity:
    00.01 State child support administrative
            costs...........................                                 -52
    00.03 Access and visitation grants......                                   2
                                               ---------   ---------  ----------
    10.00   Total new obligations (object
              class 41.0)...................                                 -50
    ----------------------------------------------------------------------------

        Budgetary resources available for obligation:
    22.00 New budget authority (gross)......                                 -50
    23.95 Total new obligations.............                                  50
    ----------------------------------------------------------------------------

        New budget authority (gross), detail:
          Mandatory:

    60.00   Appropriation...................                                 -50
    ----------------------------------------------------------------------------

        Change in obligated balances:
    73.10 Total new obligations.............                                 -50
    73.20 Total outlays (gross).............                                  50
    ----------------------------------------------------------------------------

        Outlays (gross), detail:
    86.97 Outlays from new mandatory
            authority.......................                                 -50
    ----------------------------------------------------------------------------

        Net budget authority and outlays:
    89.00 Budget authority..................                                 -50
    90.00 Outlays...........................                                 -50
    ---------------------------------------------------------------------------

        This legislative proposal increases child support collections and
    directs more of these payments to families. Also included are provisions
    to increase and improve medical child support collections on behalf of
    children.

                        Low Income Home Energy Assistance

        For making payments under title XXVI of the Omnibus Budget
    Reconciliation Act of 1981, [$1,900,000,000] $1,800,000,000.
        For making payments under title XXVI of the Omnibus Budget
    Reconciliation Act of 1981, [$300,000,000] $200,000,000, to remain
    available until expended: Provided, That these funds are for the
    unanticipated home energy assistance needs of one or more States, as
    authorized by section 2604(e) of the Act[: Provided further, That the
    entire amount is designated as an emergency requirement pursuant to
    section 402 of S. Con. Res. 95 (108th Congress) as made applicable to
    the House of Representatives by H. Res. 649 (108th Congress) and
    applicable to the Senate by section 14007 of Public Law 108-287] and
    notwithstanding the designation requirement by section 2602(e).
    (Department of Health and Human Services Appropriations Act, 2005.)

                   Program and Financing (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-1502-0-1-609      2004 actual   2005 est.   2006 est.
    ----------------------------------------------------------------------------

        Obligations by program activity:
    00.01 Direct program activity...........       1,889       2,182       2,000
                                               ---------   ---------  ----------
    10.00   Total new obligations...........       1,889       2,182       2,000
    ----------------------------------------------------------------------------

        Budgetary resources available for obligation:
    22.00 New budget authority (gross)......       1,889       2,182       2,000
    23.95 Total new obligations.............      -1,889      -2,182      -2,000
    ----------------------------------------------------------------------------

        New budget authority (gross), detail:
          Discretionary:

    40.00   Appropriation...................       1,900       1,900       1,800
    40.00   Appropriation...................                     300         200
    40.35   Appropriation permanently
              reduced.......................         -11         -18
                                               ---------   ---------  ----------
    43.00     Appropriation (total
                discretionary)..............       1,889       2,182       2,000
    ----------------------------------------------------------------------------

        Change in obligated balances:
    72.40 Obligated balance, start of year..         492         487         549
    73.10 Total new obligations.............       1,889       2,182       2,000
    73.20 Total outlays (gross).............      -1,891      -2,115      -2,026

    [[Page 460]]

    73.40 Adjustments in expired accounts
            (net)...........................          -3          -5
                                               ---------   ---------  ----------
    74.40   Obligated balance, end of year..         487         549         523
    ----------------------------------------------------------------------------

        Outlays (gross), detail:
    86.90 Outlays from new discretionary
            authority.......................       1,404       1,680       1,540
    86.93 Outlays from discretionary
            balances........................         487         435         486
                                               ---------   ---------  ----------
    87.00   Total outlays (gross)...........       1,891       2,115       2,026
    ----------------------------------------------------------------------------

        Net budget authority and outlays:
    89.00 Budget authority..................       1,889       2,182       2,000
    90.00 Outlays...........................       1,891       2,115       2,026
    ---------------------------------------------------------------------------

        This program makes grants to States and Indian Tribes to aid low-
    income households with high energy costs through payments to eligible
    households, energy suppliers, and weatherization providers. Obligation
    estimates for the contingency fund are based on average historical
    obligation rates.

                   Object Classification (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-1502-0-1-609      2004 actual   2005 est.   2006 est.
    ----------------------------------------------------------------------------
    25.1  Advisory and assistance services..                                   1
    41.0  Grants, subsidies, and
            contributions...................       1,889       2,182       1,999
                                               ---------   ---------  ----------
    99.9    Total new obligations...........       1,889       2,182       2,000
    ---------------------------------------------------------------------------

                         Refugee and Entrant Assistance

        For necessary expenses for refugee and entrant assistance activities
    and for costs associated with the care and placement of unaccompanied
    alien children authorized by title IV of the Immigration and Nationality
    Act and section 501 of the Refugee Education Assistance Act of 1980
    (Public Law 96-422), for carrying out section 462 of the Homeland
    Security Act of 2002 (Public Law 107-296), and for carrying out the
    Torture Victims Relief Act of 2003 (Public Law 108-179), [$488,336,000]
    $552,040,000, of which up to [$10,000,000] $9,915,000 shall be available
    to carry out the Trafficking Victims Protection Act of 2003 (Public Law
    108-193): Provided, That funds appropriated under this heading pursuant
    to section 414(a) of the Immigration and Nationality Act and section 462
    of the Homeland Security Act of 2002 for fiscal year [2005] 2006 shall
    be available for the costs of assistance provided and other activities
    to remain available through September 30, [2007] 2008. (Department of
    Health and Human Services Appropriations Act, 2005.)

                   Program and Financing (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-1503-0-1-609      2004 actual   2005 est.   2006 est.
    ----------------------------------------------------------------------------

        Obligations by program activity:
    00.01 Refugee and entrant assistance....         410         458         479
    00.02 Assistance for treatment of
            torture victims.................          10          10          10
    00.03 Unaccompanied alien children......          53          54          63
                                               ---------   ---------  ----------
    10.00   Total new obligations...........         473         522         552
    ----------------------------------------------------------------------------

        Budgetary resources available for obligation:
    21.40 Unobligated balance carried
            forward, start of year..........          28           8
    22.00 New budget authority (gross)......         448         484         552
    22.10 Resources available from
            recoveries of prior year
            obligations.....................           6          30
                                               ---------   ---------  ----------
    23.90   Total budgetary resources
              available for obligation......         482         522         552
    23.95 Total new obligations.............        -473        -522        -552
                                               ---------   ---------  ----------
    24.40   Unobligated balance carried
              forward, end of year..........           8
    ----------------------------------------------------------------------------

        New budget authority (gross), detail:
          Discretionary:

    40.00   Appropriation...................         450         488         552
    40.35   Appropriation permanently
              reduced.......................          -2          -4
                                               ---------   ---------  ----------
    43.00     Appropriation (total
                discretionary)..............         448         484         552
    ----------------------------------------------------------------------------

        Change in obligated balances:
    72.40 Obligated balance, start of year..         542         483         491
    73.10 Total new obligations.............         473         522         552
    73.20 Total outlays (gross).............        -517        -484        -504
    73.40 Adjustments in expired accounts
            (net)...........................          -9
    73.45 Recoveries of prior year
            obligations.....................          -6         -30
                                               ---------   ---------  ----------
    74.40   Obligated balance, end of year..         483         491         539
    ----------------------------------------------------------------------------

        Outlays (gross), detail:
    86.90 Outlays from new discretionary
            authority.......................         151         165         188
    86.93 Outlays from discretionary
            balances........................         366         319         316
                                               ---------   ---------  ----------
    87.00   Total outlays (gross)...........         517         484         504
    ----------------------------------------------------------------------------

        Offsets:
          Against gross budget authority and outlays:

    88.00   Offsetting collections (cash)
              from: Federal sources.........          -6
          Against gross budget authority only:

    88.96   Portion of offsetting
              collections (cash) credited to
              expired accounts..............           6
    ----------------------------------------------------------------------------

        Net budget authority and outlays:
    89.00 Budget authority..................         448         484         552
    90.00 Outlays...........................         511         484         504
    ---------------------------------------------------------------------------

        States are subsidized for administering the refugee assistance
    program. Funds are also provided to assist in the rehabilitation of
    victims of torture, trafficking victims, and the care and placement of
    unaccompanied alien children.

                   Object Classification (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-1503-0-1-609      2004 actual   2005 est.   2006 est.
    ----------------------------------------------------------------------------
    11.1  Personnel compensation: Full-time
            permanent.......................           1           2           3
    25.1  Advisory and assistance services..           5          11          12
    25.2  Other services....................          10                       1
    25.3  Other purchases of goods and
            services from Government
            accounts........................           6           5           5
    41.0  Grants, subsidies, and
            contributions...................         451         504         531
                                               ---------   ---------  ----------
    99.9    Total new obligations...........         473         522         552
    ---------------------------------------------------------------------------

                                  Personnel Summary

    ----------------------------------------------------------------------------
    Identification code 75-1503-0-1-609      2004 actual   2005 est.   2006 est.
    ----------------------------------------------------------------------------
        Direct:
    1001  Total compensable workyears:
            Civilian full-time equivalent
            employment......................          13          18          28
    ---------------------------------------------------------------------------

                       Promoting Safe and Stable Families

        For carrying out section 436 of the Social Security Act,
    $305,000,000 and for section 437, [$99,383,000] $105,000,000.
    (Department of Health and Human Services Appropriations Act, 2005.)

                   Program and Financing (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-1512-0-1-506      2004 actual   2005 est.   2006 est.
    ----------------------------------------------------------------------------

        Obligations by program activity:
    00.01 Grants to States and Tribes.......         382         381         387
    00.02 Research, training and technical
            assistance......................           9           9           9
    00.03 State court assessment activities.          13          13          14
                                               ---------   ---------  ----------
    10.00   Total new obligations...........         404         403         410
    ----------------------------------------------------------------------------

        Budgetary resources available for obligation:
    22.00 New budget authority (gross)......         404         403         410
    23.95 Total new obligations.............        -404        -403        -410
    ----------------------------------------------------------------------------

        New budget authority (gross), detail:
          Discretionary:

    40.00   Appropriation...................         100          99         105
    40.35   Appropriation permanently
              reduced.......................          -1          -1
                                               ---------   ---------  ----------

    [[Page 461]]

    43.00     Appropriation (total
                discretionary)..............          99          98         105
          Mandatory:

    60.00   Appropriation...................         305         305         305
                                               ---------   ---------  ----------
    70.00   Total new budget authority
              (gross).......................         404         403         410
    ----------------------------------------------------------------------------

        Change in obligated balances:
    72.40 Obligated balance, start of year..         463         436         444
    73.10 Total new obligations.............         404         403         410
    73.20 Total outlays (gross).............        -423        -395        -404
    73.40 Adjustments in expired accounts
            (net)...........................          -8
                                               ---------   ---------  ----------
    74.40   Obligated balance, end of year..         436         444         450
    ----------------------------------------------------------------------------

        Outlays (gross), detail:
    86.90 Outlays from new discretionary
            authority.......................          26          25          27
    86.93 Outlays from discretionary
            balances........................          61          69          72
    86.97 Outlays from new mandatory
            authority.......................          81          79          79
    86.98 Outlays from mandatory balances...         255         222         226
                                               ---------   ---------  ----------
    87.00   Total outlays (gross)...........         423         395         404
    ----------------------------------------------------------------------------

        Net budget authority and outlays:
    89.00 Budget authority..................         404         403         410
    90.00 Outlays...........................         424         395         404
    ---------------------------------------------------------------------------

        This program provides funds for a broad range of child welfare
    services, including family preservation and family support services.

                   Object Classification (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-1512-0-1-506      2004 actual   2005 est.   2006 est.
    ----------------------------------------------------------------------------
    25.1  Advisory and assistance services..           3           4           3
    25.3  Other purchases of goods and
            services from Government
            accounts........................           1
    41.0  Grants, subsidies, and
            contributions...................         400         399         407
                                               ---------   ---------  ----------
    99.9    Total new obligations...........         404         403         410
    ---------------------------------------------------------------------------

                        Child Care Entitlement to States

                   Program and Financing (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-1550-0-1-609      2004 actual   2005 est.   2006 est.
    ----------------------------------------------------------------------------

        Obligations by program activity:
    00.01 Mandatory child care..............       1,178       1,178       1,178
    00.02 Matching child care...............       1,493       1,478       1,478
    00.03 Training and technical assistance.           7           7           7
    00.04 Child care tribal grants..........          54          54          54
                                               ---------   ---------  ----------
    10.00   Total new obligations...........       2,732       2,717       2,717
    ----------------------------------------------------------------------------

        Budgetary resources available for obligation:
    22.00 New budget authority (gross)......       2,732       2,717       2,717
    23.95 Total new obligations.............      -2,732      -2,717      -2,717
    ----------------------------------------------------------------------------

        New budget authority (gross), detail:
          Mandatory:

    60.00   Appropriation...................       2,717       2,717       2,717
    63.00   Reappropriation.................          15
                                               ---------   ---------  ----------
    70.00   Total new budget authority
              (gross).......................       2,732       2,717       2,717
    ----------------------------------------------------------------------------

        Change in obligated balances:
    72.40 Obligated balance, start of year..         965         956         955
    73.10 Total new obligations.............       2,732       2,717       2,717
    73.20 Total outlays (gross).............      -2,695      -2,718      -2,718
    73.40 Adjustments in expired accounts
            (net)...........................         -46
                                               ---------   ---------  ----------
    74.40   Obligated balance, end of year..         956         955         954
    ----------------------------------------------------------------------------

        Outlays (gross), detail:
    86.97 Outlays from new mandatory
            authority.......................       1,920       1,929       1,929
    86.98 Outlays from mandatory balances...         775         789         789
                                               ---------   ---------  ----------
    87.00   Total outlays (gross)...........       2,695       2,718       2,718
    ----------------------------------------------------------------------------

        Net budget authority and outlays:
    89.00 Budget authority..................       2,732       2,717       2,717
    90.00 Outlays...........................       2,695       2,718       2,718
    ---------------------------------------------------------------------------

        This account provides child care funding for welfare recipients and
    low-income working families and was established by the Personal
    Responsibility and Work Opportunity Reconciliation Act of 1996 (P.L.
    104-193).

                   Object Classification (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-1550-0-1-609      2004 actual   2005 est.   2006 est.
    ----------------------------------------------------------------------------
    25.1  Advisory and assistance services..           7           7           7
    41.0  Grants, subsidies, and
            contributions...................       2,725       2,710       2,710
                                               ---------   ---------  ----------
    99.9    Total new obligations...........       2,732       2,717       2,717
    ---------------------------------------------------------------------------

        Payments to States for the Child Care and Development Block Grant

        For carrying out sections 658A through 658R of the Omnibus Budget
    Reconciliation Act of 1981 (The Child Care and Development Block Grant
    Act of 1990), [$2,099,729,000] $2,082,910,000 shall be used to
    supplement, not supplant State general revenue funds for child care
    assistance for low-income families: Provided, That [$19,120,000]
    $18,967,040 shall be available for child care resource and referral and
    school-aged child care activities, of which [$1,000,000] $992,000 shall
    be for the Child Care Aware toll free hotline: Provided further, That,
    in addition to the amounts required to be reserved by the States under
    section 658G, [$272,672,000] $270,490,624 shall be reserved by the
    States for activities authorized under section 658G, of which
    [$100,000,000] $99,200,000 shall be for activities that improve the
    quality of infant and toddler care: Provided further, That [$10,000,000]
    $9,920,000 shall be for use by the Secretary for child care research,
    demonstration, and evaluation activities. (Department of Health and
    Human Services Appropriations Act, 2005.)

                   Program and Financing (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-1515-0-1-609      2004 actual   2005 est.   2006 est.
    ----------------------------------------------------------------------------

        Obligations by program activity:
    00.01 Block grant payments to States....       2,077       2,073       2,073
    00.04 Research and evaluation fund......          10          10          10
    09.00 Reimbursable program..............                       1           1
                                               ---------   ---------  ----------
    10.00   Total new obligations...........       2,087       2,084       2,084
    ----------------------------------------------------------------------------

        Budgetary resources available for obligation:
    22.00 New budget authority (gross)......       2,088       2,083       2,083
    23.95 Total new obligations.............      -2,087      -2,084      -2,084
    ----------------------------------------------------------------------------

        New budget authority (gross), detail:
          Discretionary:

    40.00   Appropriation...................       2,100       2,100       2,083
    40.35   Appropriation permanently
              reduced.......................         -12         -17
                                               ---------   ---------  ----------
    43.00     Appropriation (total
                discretionary)..............       2,088       2,083       2,083
    ----------------------------------------------------------------------------

        Change in obligated balances:
    72.40 Obligated balance, start of year..         805         749         734
    73.10 Total new obligations.............       2,087       2,084       2,084
    73.20 Total outlays (gross).............      -2,138      -2,099      -2,083
    73.40 Adjustments in expired accounts
            (net)...........................          -5
                                               ---------   ---------  ----------
    74.40   Obligated balance, end of year..         749         734         735
    ----------------------------------------------------------------------------

        Outlays (gross), detail:
    86.90 Outlays from new discretionary
            authority.......................       1,476       1,479       1,479
    86.93 Outlays from discretionary
            balances........................         662         620         604
                                               ---------   ---------  ----------
    87.00   Total outlays (gross)...........       2,138       2,099       2,083
    ----------------------------------------------------------------------------

        Net budget authority and outlays:
    89.00 Budget authority..................       2,088       2,083       2,083
    90.00 Outlays...........................       2,137       2,099       2,083
    ---------------------------------------------------------------------------

        This appropriation helps low-income families pay for child care and
    related services and supports grants to States for child care quality
    activities.

    [[Page 462]]

                   Object Classification (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-1515-0-1-609      2004 actual   2005 est.   2006 est.
    ----------------------------------------------------------------------------

          Direct obligations:

    25.1    Advisory and assistance services           6           6           6
    25.3    Other purchases of goods and
              services from Government
              accounts......................           1           1           1
    41.0    Grants, subsidies, and
              contributions.................       2,080       2,076       2,076
                                               ---------   ---------  ----------
    99.0      Direct obligations............       2,087       2,083       2,083
    99.0  Reimbursable obligations..........                       1           1
                                               ---------   ---------  ----------
    99.9    Total new obligations...........       2,087       2,084       2,084
    ---------------------------------------------------------------------------

                           Social Services Block Grant

        For making grants to States pursuant to section 2002 of the Social
    Security Act, $1,700,000,000: Provided, That notwithstanding
    subparagraph (B) of section 404(d)(2) of such Act, the applicable
    percent specified under such subparagraph for a State to carry out State
    programs pursuant to title XX of such Act shall be 10 percent.
    (Department of Health and Human Services Appropriations Act, 2005.)

                   Program and Financing (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-1534-0-1-506      2004 actual   2005 est.   2006 est.
    ----------------------------------------------------------------------------

        Obligations by program activity:
    00.01 Direct program activity...........       1,700       1,700       1,700
                                               ---------   ---------  ----------
    10.00   Total new obligations (object
              class 41.0)...................       1,700       1,700       1,700
    ----------------------------------------------------------------------------

        Budgetary resources available for obligation:
    21.40 Unobligated balance carried
            forward, start of year..........           4           4           4
    22.00 New budget authority (gross)......       1,700       1,700       1,700
                                               ---------   ---------  ----------
    23.90   Total budgetary resources
              available for obligation......       1,704       1,704       1,704
    23.95 Total new obligations.............      -1,700      -1,700      -1,700
                                               ---------   ---------  ----------
    24.40   Unobligated balance carried
              forward, end of year..........           4           4           4
    ----------------------------------------------------------------------------

        New budget authority (gross), detail:
          Mandatory:

    60.00   Appropriation...................       1,700       1,700       1,700
    ----------------------------------------------------------------------------

        Change in obligated balances:
    72.40 Obligated balance, start of year..         618         563         499
    73.10 Total new obligations.............       1,700       1,700       1,700
    73.20 Total outlays (gross).............      -1,752      -1,764      -1,762
    73.40 Adjustments in expired accounts
            (net)...........................          -3
                                               ---------   ---------  ----------
    74.40   Obligated balance, end of year..         563         499         437
    ----------------------------------------------------------------------------

        Outlays (gross), detail:
    86.97 Outlays from new mandatory
            authority.......................       1,397       1,394       1,394
    86.98 Outlays from mandatory balances...         355         370         368
                                               ---------   ---------  ----------
    87.00   Total outlays (gross)...........       1,752       1,764       1,762
    ----------------------------------------------------------------------------

        Net budget authority and outlays:
    89.00 Budget authority..................       1,700       1,700       1,700
    90.00 Outlays...........................       1,752       1,764       1,762
    ---------------------------------------------------------------------------

                     Children and Families Services Programs

        For carrying out, except as otherwise provided, the Runaway and
    Homeless Youth Act, the Developmental Disabilities Assistance and Bill
    of Rights Act, the Head Start Act, the Child Abuse Prevention and
    Treatment Act, sections 310 and 316 of the Family Violence Prevention
    and Services Act, as amended, the Native American Programs Act of 1974,
    title II of Public Law 95-266 (adoption opportunities), the Adoption and
    Safe Families Act of 1997 (Public Law 105-89), sections 1201 and 1211 of
    the Children's Health Act of 2000, the Abandoned Infants Assistance Act
    of 1988, sections 261 and 291 of the Help America Vote Act of 2002, [the
    Early Learning Opportunities Act, part B(1) of title IV and] sections
    413, 429A, 1110, [and] 1115 [of the Social Security Act, and sections
    40155, 40211, and 40241 of Public Law 103-322; for making payments under
    the Community Services Block Grant Act, sections], 439(h), 473A, and
    477(i) of the Social Security Act, and title IV of Public Law 105-285,
    and for necessary administrative expenses to carry out said Acts and
    titles I, IV, V, X, XI, XIV, XVI, and XX of the Social Security Act, the
    Act of July 5, 1960 (24 U.S.C. ch. 9), the Omnibus Budget Reconciliation
    Act of 1981, title IV of the Immigration and Nationality Act, section
    501 of the Refugee Education Assistance Act of 1980, [sections 40155,
    40211, and 40241 of Public Law 103-322,] and section 126 and titles IV
    and V of Public Law 100-485, [$9,069,853,000] $8,386,293,000, of which
    [$32,103,000] $31,846,000, to remain available until September 30,
    [2006] 2007, shall be for grants to States for adoption incentive
    payments, as authorized by section 473A of title IV of the Social
    Security Act (42 U.S.C. 670-679) and may be made for adoptions completed
    before September 30, [2005] 2006: Provided further, That
    [$6,898,580,000] $6,888,136,000 shall be for making payments under the
    Head Start Act, of which $45,000,000 shall be for grants to States that
    directly administer the Head Start program, notwithstanding section 640
    of such Act; and of which [$1,400,000,000] $1,388,800,000 shall become
    available October 1, [2005] 2006 and remain available through September
    30, [2006] 2007: Provided further, [That $732,385,000 shall be for
    making payments under the Community Services Block Grant Act: Provided
    further, That not less than $7,300,000 shall be for section 680(3)(B) of
    the Community Services Block Grant Act, Provided further, That within
    amounts provided herein for abstinence education for adolescents, up to
    $10,000,000 may be available for a national abstinence education
    campaign: Provided further,] That in addition to amounts provided
    herein, $6,000,000 shall be available from amounts available under
    section 241 of the Public Health Service Act to carry out the provisions
    of section 1110 of the Social Security Act: [Provided further, That to
    the extent Community Services Block Grant funds are distributed as grant
    funds by a State to an eligible entity as provided under the Act, and
    have not been expended by such entity, they shall remain with such
    entity for carryover into the next fiscal year for expenditure by such
    entity consistent with program purposes: Provided further, That the
    Secretary shall establish procedures regarding the disposition of
    intangible property which permits grant funds, or intangible assets
    acquired with funds authorized under section 680 of the Community
    Services Block Grant Act, as amended, to become the sole property of
    such grantees after a period of not more than 12 years after the end of
    the grant for purposes and uses consistent with the original grant:
    Provided further, That funds appropriated for section 680(a)(2) of the
    Community Services Block Grant Act, as amended, shall be available for
    financing construction and rehabilitation and loans or investments in
    private business enterprises owned by community development
    corporations:] Provided further, That [$55,000,000] $100,000,000 is for
    a compassion capital fund to provide grants to charitable organizations
    to emulate model social service programs and to encourage research on
    the best practices of social service organizations: Provided further,
    That [$15,000,000] $14,879,000 shall be for activities authorized by the
    Help America Vote Act of 2002, of which [$10,000,000] $9,919,000 shall
    be for payments to States to promote access for voters with
    disabilities, and of which [$5,000,000] $4,960,000 shall be for payments
    to States for protection and advocacy systems for voters with
    disabilities: Provided further, That [$100,000,000] $138,045,000 shall
    be for making competitive grants to provide abstinence education (as
    defined by section 510(b)(2) of the Social Security Act) to adolescents,
    and for Federal costs of administering the grant: Provided further, That
    grants under the immediately preceding proviso shall be made only to
    public and private entities which agree that, with respect to an
    adolescent to whom the entities provide abstinence education under such
    grant, the entities will not provide to that adolescent any other
    education regarding sexual conduct, except that, in the case of an
    entity expressly required by law to provide health information or
    services the adolescent shall not be precluded from seeking health
    information or services from the entity in a different setting than the
    setting in which abstinence education was provided: Provided further,
    That within amounts provided herein for abstinence education for
    adolescents, up to $10,000,000 may be available for a national
    abstinence education campaign: Provided further, That in addition to
    amounts provided herein for abstinence education for adolescents,
    $4,500,000 shall be available from amounts available under section 241
    of the Public Health Services Act to carry out evaluations (includ

    [[Page 463]]

    ing longitudinal evaluations) of adolescent pregnancy prevention
    approaches: Provided further, That $2,000,000 shall be for improving the
    Public Assistance Reporting Information System, including grants to
    States to support data collection for a study of the system's
    effectiveness. (Department of Health and Human Services Appropriations
    Act, 2005.)

                   Program and Financing (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-1536-0-1-506      2004 actual   2005 est.   2006 est.
    ----------------------------------------------------------------------------

        Obligations by program activity:
    01.01 Head start........................       6,774       6,843       6,888
    01.02 Early Learning Opportunities......          34          35
    01.03 Runaway and homeless youth (Basic
            Centers)........................          49          49          49
    01.04 Transitional living...............          40          40          40
    01.05 Maternity group homes.............                                  10
    01.06 Education grants to reduce sexual
            abuse of runaway youth..........          15          15          15
    01.07 Abstinence education (Mandatory)..          10          25
    01.08 Mentoring children of prisoners...          50          50          50
    01.09 Child abuse State grants..........          22          27          27
    01.10 Child abuse discretionary
            activities......................          34          31          32
    01.11 Community based resource centers..          33          43          43
    01.12 Child welfare services............         289         290         290
    01.13 Child welfare training............           7           7           7
    01.14 Adoption opportunities............          27          27          27
    01.15 Abandoned infants.................          12          12          12
    01.16 Adoption incentives...............          18          32          32
    01.17 Independent training vouchers.....          45          47          60
    01.18 Children's health act programs....          13          13          13
    01.19 State grants......................          73          72          72
    01.20 Protection and advocacy...........          38          38          38
    01.21 Projects of national significance.          12          12          11
    01.22 Centers for excellence............          27          32          31
    01.23 Voting access for individuals with
            disabilities....................          15          15          15
    01.24 Native American programs..........          45          45          45
    01.25 Social services and income
            maintenance research............          13          26
    01.26 Compassion capital fund...........          48          54         100
    01.28 Federal administration............         177         185         186
    01.29 Faith-based center................           2           1           1
    01.30 Abstinence Education
            (Discretionary).................                      99         138
                                               ---------   ---------  ----------
    01.91   Subtotal........................       7,922       8,165       8,232
          Community services programs:

    03.01   Community services block grants.         642         631
    03.03   Rural communtiy facilities......           7           7
    03.04   Community services discretionary
              (JOLI & CED)..................          32          33
    03.05   Community food and nutrition....           7           7
    03.06 Individual development accounts...          25          25          25
    03.07 National youth sports.............          18          18
    03.08 Domestic violence hotline.........           3           3           3
    03.09 Grants for battered women's
            shelters........................         126         126         126
                                               ---------   ---------  ----------
    03.91   Subtotal........................         860         850         154
                                               ---------   ---------  ----------
    04.00   Total, direct program...........       8,782       9,015       8,386
    09.01 Reimbursable program..............          14          22          22
                                               ---------   ---------  ----------
    10.00   Total new obligations...........       8,796       9,037       8,408
    ----------------------------------------------------------------------------

        Budgetary resources available for obligation:
    21.40 Unobligated balance carried
            forward, start of year..........          29          10          10
    22.00 New budget authority (gross)......       8,791       9,037       8,409
                                               ---------   ---------  ----------
    23.90   Total budgetary resources
              available for obligation......       8,820       9,047       8,419
    23.95 Total new obligations.............      -8,796      -9,037      -8,408
    23.98 Unobligated balance expiring or
            withdrawn.......................         -14
                                               ---------   ---------  ----------
    24.40   Unobligated balance carried
              forward, end of year..........          10          10          11
    ----------------------------------------------------------------------------

        New budget authority (gross), detail:
          Discretionary:

    40.00   Appropriation...................       7,417       7,681       6,998
    40.35   Appropriation permanently
              reduced.......................         -53         -73
    41.00   Transferred to other accounts...                      -7
                                               ---------   ---------  ----------
    43.00     Appropriation (total
                discretionary)..............       7,364       7,601       6,998
    55.00   Advance appropriation...........       1,400       1,389       1,389
          Mandatory:

    60.00   Appropriation...................          13          25
          Spending authority from offsetting
              collections:

            Discretionary:
    68.00     Offsetting collections (cash).           5          22          22
    68.10     Change in uncollected customer
                payments from Federal
                sources (unexpired).........           9
                                               ---------   ---------  ----------
    68.90       Spending authority from
                  offsetting collections
                  (total discretionary).....          14          22          22
                                               ---------   ---------  ----------
    70.00   Total new budget authority
              (gross).......................       8,791       9,037       8,409
    ----------------------------------------------------------------------------

        Change in obligated balances:
    72.40 Obligated balance, start of year..       4,753       4,782       4,918
    73.10 Total new obligations.............       8,796       9,037       8,408
    73.20 Total outlays (gross).............      -8,689      -8,901      -8,658
    73.40 Adjustments in expired accounts
            (net)...........................         -71
    74.00 Change in uncollected customer
            payments from Federal sources
            (unexpired).....................          -9
    74.10 Change in uncollected customer
            payments from Federal sources
            (expired).......................           2
                                               ---------   ---------  ----------
    74.40   Obligated balance, end of year..       4,782       4,918       4,668
    ----------------------------------------------------------------------------

        Outlays (gross), detail:
    86.90 Outlays from new discretionary
            authority.......................       4,763       4,827       4,473
    86.93 Outlays from discretionary
            balances........................       3,916       4,065       4,173
    86.97 Outlays from new mandatory
            authority.......................          10           9
    86.98 Outlays from mandatory balances...                                  12
                                               ---------   ---------  ----------
    87.00   Total outlays (gross)...........       8,689       8,901       8,658
    ----------------------------------------------------------------------------

        Offsets:
          Against gross budget authority and outlays:

    88.00   Offsetting collections (cash)
              from: Federal sources.........         -12         -22         -22
          Against gross budget authority only:

    88.95   Change in uncollected customer
              payments from Federal sources
              (unexpired)...................          -9
    88.96   Portion of offsetting
              collections (cash) credited to
              expired accounts..............           7
    ----------------------------------------------------------------------------

        Net budget authority and outlays:
    89.00 Budget authority..................       8,777       9,015       8,387
    90.00 Outlays...........................       8,677       8,879       8,636
    ---------------------------------------------------------------------------

                     Summary of Budget Authority and Outlays

                            (in millions of dollars)

                                         2004 actual  2005 est.   2006 est.
    Enacted/requested:
      Budget Authority..................       8,777       9,015       8,387
      Outlays...........................       8,677       8,879       8,636
    Legislative proposal, subject to
        PAYGO:
      Budget Authority..................                      25          50
      Outlays...........................                       9          30
                                        ------------------------------------
    Total:
      Budget Authority..................       8,777       9,040       8,437
      Outlays...........................       8,677       8,888       8,666
                                        ====================================

        The FY 2006 Budget proposes to consolidate the Community Services
    Block Grant, Community Economic Development, and Rural Community
    Facilities programs into a new economic and community development
    program to be administered by the Department of Commerce. The new
    program would be designed to achieve greater results and focus on
    communities most in need of assistance.

                   Object Classification (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-1536-0-1-506      2004 actual   2005 est.   2006 est.
    ----------------------------------------------------------------------------

          Direct obligations:

            Personnel compensation:
    11.1      Full-time permanent...........         104         112         110
    11.3      Other than full-time permanent           1           2           1
    11.5      Other personnel compensation..           1           1           1
                                               ---------   ---------  ----------
    11.9        Total personnel compensation         106         115         112
    12.1    Civilian personnel benefits.....          21          23          22
    21.0    Travel and transportation of
              persons.......................           4           4           4
    23.1    Rental payments to GSA..........          16          18          19
    23.3    Communications, utilities, and
              miscellaneous charges.........           2           3           3
    24.0    Printing and reproduction.......           2           3           3
    25.1    Advisory and assistance services         125         131         132
    25.2    Other services..................           6          14          19
    25.3    Other purchases of goods and
              services from Government
              accounts......................          79          75          74
    25.4    Operation and maintenance of
              facilities....................           1           1           1
    25.5    Research and development
              contracts.....................                       5
    25.7    Operation and maintenance of
              equipment.....................           1
    26.0    Supplies and materials..........           1           1           1

    [[Page 464]]

    31.0    Equipment.......................           1
    41.0    Grants, subsidies, and
              contributions.................       8,417       8,622       7,996
                                               ---------   ---------  ----------
    99.0      Direct obligations............       8,782       9,015       8,386
    99.0  Reimbursable obligations..........          14          22          22
                                               ---------   ---------  ----------
    99.9    Total new obligations...........       8,796       9,037       8,408
    ---------------------------------------------------------------------------

                                  Personnel Summary

    ----------------------------------------------------------------------------
    Identification code 75-1536-0-1-506      2004 actual   2005 est.   2006 est.
    ----------------------------------------------------------------------------
        Direct:
    1001  Total compensable workyears:
            Civilian full-time equivalent
            employment......................       1,250       1,292       1,213
    ---------------------------------------------------------------------------

                     Children and Families Services Programs

                    (Legislative proposal, subject to PAYGO)

                   Program and Financing (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-1536-4-1-506      2004 actual   2005 est.   2006 est.
    ----------------------------------------------------------------------------

        Obligations by program activity:
    01.07 Abstinence education..............                      25          50
                                               ---------   ---------  ----------
    10.00   Total new obligations (object
              class 41.0)...................                      25          50
    ----------------------------------------------------------------------------

        Budgetary resources available for obligation:
    22.00 New budget authority (gross)......                      25          50
    23.95 Total new obligations.............                     -25         -50
    ----------------------------------------------------------------------------

        New budget authority (gross), detail:
          Mandatory:

    60.00   Appropriation...................                      25          50
    ----------------------------------------------------------------------------

        Change in obligated balances:
    72.40 Obligated balance, start of year..                                  16
    73.10 Total new obligations.............                      25          50
    73.20 Total outlays (gross).............                      -9         -30
                                               ---------   ---------  ----------
    74.40   Obligated balance, end of year..                      16          36
    ----------------------------------------------------------------------------

        Outlays (gross), detail:
    86.97 Outlays from new mandatory
            authority.......................                       9          18
    86.98 Outlays from mandatory balances...                                  12
                                               ---------   ---------  ----------
    87.00   Total outlays (gross)...........                       9          30
    ----------------------------------------------------------------------------

        Net budget authority and outlays:
    89.00 Budget authority..................                      25          50
    90.00 Outlays...........................                       9          30
    ---------------------------------------------------------------------------

        The budget extends funding for State-based abstinence education
    activities for five years. These activities formerly administered by the
    Health Resources and Services Administration have been transferred to
    the Administration for Children and Families.

                        Violent Crime Reduction Programs

                   Program and Financing (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-8605-0-1-754      2004 actual   2005 est.   2006 est.
    ----------------------------------------------------------------------------

        Change in obligated balances:
    72.40 Obligated balance, start of year..           6           2
    73.20 Total outlays (gross).............          -1          -2
    73.40 Adjustments in expired accounts
            (net)...........................          -3
                                               ---------   ---------  ----------
    74.40   Obligated balance, end of year..           2
    ----------------------------------------------------------------------------

        Outlays (gross), detail:
    86.93 Outlays from discretionary
            balances........................           1           2
    ----------------------------------------------------------------------------

        Net budget authority and outlays:
    89.00 Budget authority..................
    90.00 Outlays...........................           1           2
    ---------------------------------------------------------------------------

                  Children's Research and Technical Assistance

                   Program and Financing (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-1553-0-1-609      2004 actual   2005 est.   2006 est.
    ----------------------------------------------------------------------------

        Obligations by program activity:
    00.01 Training and technical assistance.          11          12          11
    00.02 Federal parent locator service....          24          25          23
    00.03 Child welfare study...............           6           3
    00.04 Welfare research..................          15           8
    09.01 Reimbursable program..............          11          15          19
                                               ---------   ---------  ----------
    10.00   Total new obligations...........          67          63          53
    ----------------------------------------------------------------------------

        Budgetary resources available for obligation:
    21.40 Unobligated balance carried
            forward, start of year..........           2           4           1
    22.00 New budget authority (gross)......          67          60          53
    22.10 Resources available from
            recoveries of prior year
            obligations.....................           2
                                               ---------   ---------  ----------
    23.90   Total budgetary resources
              available for obligation......          71          64          54
    23.95 Total new obligations.............         -67         -63         -53
                                               ---------   ---------  ----------
    24.40   Unobligated balance carried
              forward, end of year..........           4           1           1
    ----------------------------------------------------------------------------

        New budget authority (gross), detail:
          Mandatory:

    60.00   Appropriation...................          56          45          34
    69.00 Offsetting collections (cash).....          11          15          19
                                               ---------   ---------  ----------
    70.00   Total new budget authority
              (gross).......................          67          60          53
    ----------------------------------------------------------------------------

        Change in obligated balances:
    72.40 Obligated balance, start of year..          29          48          47
    73.10 Total new obligations.............          67          63          53
    73.20 Total outlays (gross).............         -45         -64         -66
    73.45 Recoveries of prior year
            obligations.....................          -2
    74.10 Change in uncollected customer
            payments from Federal sources
            (expired).......................          -1
                                               ---------   ---------  ----------
    74.40   Obligated balance, end of year..          48          47          34
    ----------------------------------------------------------------------------

        Outlays (gross), detail:
    86.97 Outlays from new mandatory
            authority.......................          19          28          30
    86.98 Outlays from mandatory balances...          26          36          36
                                               ---------   ---------  ----------
    87.00   Total outlays (gross)...........          45          64          66
    ----------------------------------------------------------------------------

        Offsets:
          Against gross budget authority and outlays:

            Offsetting collections (cash)
                from:
    88.00     Federal sources...............         -11          -6          -7
    88.40     Non-Federal sources...........                      -9         -12
                                               ---------   ---------  ----------
    88.90       Total, offsetting
                  collections (cash)........         -11         -15         -19
    ----------------------------------------------------------------------------

        Net budget authority and outlays:
    89.00 Budget authority..................          56          45          34
    90.00 Outlays...........................          35          49          47
    ---------------------------------------------------------------------------

                     Summary of Budget Authority and Outlays

                            (in millions of dollars)

                                         2004 actual  2005 est.   2006 est.
    Enacted/requested:
      Budget Authority..................          56          45          34
      Outlays...........................          34          49          47
    Legislative proposal, subject to
        PAYGO:
      Budget Authority..................                       7          15
      Outlays...........................                                   4
                                        ------------------------------------
    Total:
      Budget Authority..................          56          52          49
      Outlays...........................          34          49          51
                                        ====================================

    [[Page 465]]

        This account provides funding for research and technical assistance
    activities established in P.L. 104-193. Amounts for welfare research are
    in addition to research amounts in the Children and Families services
    program account and the Temporary Assistance for Needy Families account
    under Healthy Marriage and Family Formation activities.

                   Object Classification (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-1553-0-1-609      2004 actual   2005 est.   2006 est.
    ----------------------------------------------------------------------------

          Direct obligations:

    11.1    Personnel compensation: Full-
              time permanent................           7           7           7
    12.1    Civilian personnel benefits.....           1           1           1
    21.0    Travel and transportation of
              persons.......................           1           1           1
    23.1    Rental payments to GSA..........           3           3           3
    25.1    Advisory and assistance services          36          29          17
    25.2    Other services..................           1           1           1
    25.3    Other purchases of goods and
              services from Government
              accounts......................           4           4           2
    41.0    Grants, subsidies, and
              contributions.................           3           2           2
                                               ---------   ---------  ----------
    99.0      Direct obligations............          56          48          34
    99.0  Reimbursable obligations..........          11          15          19
                                               ---------   ---------  ----------
    99.9    Total new obligations...........          67          63          53
    ---------------------------------------------------------------------------

                                  Personnel Summary

    ----------------------------------------------------------------------------
    Identification code 75-1553-0-1-609      2004 actual   2005 est.   2006 est.
    ----------------------------------------------------------------------------
        Direct:
    1001  Total compensable workyears:
            Civilian full-time equivalent
            employment......................          73          70          70
    ---------------------------------------------------------------------------

                  Children's Research and Technical Assistance

                    (Legislative proposal, subject to PAYGO)

                   Program and Financing (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-1553-4-1-609      2004 actual   2005 est.   2006 est.
    ----------------------------------------------------------------------------

        Obligations by program activity:
    00.04 Welfare research..................                       7          15
                                               ---------   ---------  ----------
    10.00   Total new obligations...........                       7          15
    ----------------------------------------------------------------------------

        Budgetary resources available for obligation:
    22.00 New budget authority (gross)......                       7          15
    23.95 Total new obligations.............                      -7         -15
    ----------------------------------------------------------------------------

        New budget authority (gross), detail:
          Mandatory:

    60.00   Appropriation...................                       7          15
    ----------------------------------------------------------------------------

        Change in obligated balances:
    72.40 Obligated balance, start of year..                                   7
    73.10 Total new obligations.............                       7          15
    73.20 Total outlays (gross).............                                  -4
                                               ---------   ---------  ----------
    74.40   Obligated balance, end of year..                       7          18
    ----------------------------------------------------------------------------

        Outlays (gross), detail:
    86.97 Outlays from new mandatory
            authority.......................                                   2
    86.98 Outlays from mandatory balances...                                   2
                                               ---------   ---------  ----------
    87.00   Total outlays (gross)...........                                   4
    ----------------------------------------------------------------------------

        Net budget authority and outlays:
    89.00 Budget authority..................                       7          15
    90.00 Outlays...........................                                   4
    ---------------------------------------------------------------------------

        This schedule includes funds for welfare research activities to be
    included in the reauthorization of the Temporary Assistance for Needy
    Families program.

                   Object Classification (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-1553-4-1-609      2004 actual   2005 est.   2006 est.
    ----------------------------------------------------------------------------
    25.1  Advisory and assistance services..                       7          13
    25.2  Other services....................                                   1
    41.0  Grants, subsidies, and
            contributions...................                                   1
                                               ---------   ---------  ----------
    99.9    Total new obligations...........                       7          15
    ---------------------------------------------------------------------------

                             Disabled Voter Services

                   Program and Financing (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-1533-0-1-808      2004 actual   2005 est.   2006 est.
    ----------------------------------------------------------------------------

        Change in obligated balances:
    72.40 Obligated balance, start of year..          15          12           4
    73.20 Total outlays (gross).............          -3          -8          -4
                                               ---------   ---------  ----------
    74.40   Obligated balance, end of year..          12           4
    ----------------------------------------------------------------------------

        Outlays (gross), detail:
    86.93 Outlays from discretionary
            balances........................           3           8           4
    ----------------------------------------------------------------------------

        Net budget authority and outlays:
    89.00 Budget authority..................
    90.00 Outlays...........................           3           8           4
    ---------------------------------------------------------------------------

           Payments to States for Foster Care and Adoption Assistance

        For making payments to States or other non-Federal entities under
    title IV-E of the Social Security Act, [$5,037,900,000] $4,852,800,000.
        For making payments to States or other non-Federal entities under
    title IV-E of the Act, for the first quarter of fiscal year [2006] 2007,
    [$1,767,200,000] $1,730,000,000.
        For making, after May 31 of the current fiscal year, payments to
    States or other non-Federal entities under section 474 of title IV-E,
    for the last 3 months of the current fiscal year for unanticipated
    costs, incurred for the current fiscal year, such sums as may be
    necessary. (Department of Health and Human Services Appropriations Act,
    2005.)

                   Program and Financing (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-1545-0-1-609      2004 actual   2005 est.   2006 est.
    ----------------------------------------------------------------------------

        Obligations by program activity:
    00.01 Foster care.......................       4,742       4,627       4,685
    00.02 Independent living................         140         140         140
    00.04 Adoption assistance...............       1,544       1,703       1,795
                                               ---------   ---------  ----------
    10.00   Total new obligations...........       6,426       6,470       6,620
    ----------------------------------------------------------------------------

        Budgetary resources available for obligation:
    22.00 New budget authority (gross)......       6,814       6,806       6,620
    23.95 Total new obligations.............      -6,426      -6,470      -6,620
    23.98 Unobligated balance expiring or
            withdrawn.......................        -388        -336
    ----------------------------------------------------------------------------

        New budget authority (gross), detail:
          Mandatory:

    60.00   Appropriation...................       5,068       5,038       4,853
    65.00   Advance appropriation...........       1,746       1,768       1,767
                                               ---------   ---------  ----------
    70.00   Total new budget authority
              (gross).......................       6,814       6,806       6,620
    ----------------------------------------------------------------------------

        Change in obligated balances:
    72.40 Obligated balance, start of year..       1,167       1,245       1,241
    73.10 Total new obligations.............       6,426       6,470       6,620
    73.20 Total outlays (gross).............      -6,341      -6,474      -6,619
    73.40 Adjustments in expired accounts
            (net)...........................          -7
                                               ---------   ---------  ----------
    74.40   Obligated balance, end of year..       1,245       1,241       1,242
    ----------------------------------------------------------------------------

        Outlays (gross), detail:
    86.97 Outlays from new mandatory
            authority.......................       5,495       5,534       5,691
    86.98 Outlays from mandatory balances...         846         940         928
                                               ---------   ---------  ----------
    87.00   Total outlays (gross)...........       6,341       6,474       6,619
    ----------------------------------------------------------------------------

        Offsets:
          Against gross budget authority and outlays:

    88.00   Offsetting collections (cash)
              from: Federal sources.........          -1
          Against gross budget authority only:

    88.96   Portion of offsetting
              collections (cash) credited to
              expired accounts..............           1
    ----------------------------------------------------------------------------

    [[Page 466]]

        Net budget authority and outlays:
    89.00 Budget authority..................       6,814       6,806       6,620
    90.00 Outlays...........................       6,340       6,474       6,619
    ---------------------------------------------------------------------------

                     Summary of Budget Authority and Outlays

                            (in millions of dollars)

                                         2004 actual  2005 est.   2006 est.
    Enacted/requested:
      Budget Authority..................       6,814       6,806       6,620
      Outlays...........................       6,340       6,474       6,619
    Legislative proposal, subject to
        PAYGO:
      Budget Authority..................                                 -40
      Outlays...........................                                 -58
                                        ------------------------------------
    Total:
      Budget Authority..................       6,814       6,806       6,580
      Outlays...........................       6,340       6,474       6,561
                                        ====================================

        Foster care.--The proposed level will support eligible low-income
    children who must be placed outside the home. An average of 230,300
    children per month will be served in 2006.

        Adoption assistance.--The proposed funding level will support
    subsidies for families adopting eligible low-income children with
    special needs. An average of 369,500 children per month will be served
    in 2006.

                   Object Classification (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-1545-0-1-609      2004 actual   2005 est.   2006 est.
    ----------------------------------------------------------------------------
    25.1  Advisory and assistance services..           6          13          14
    41.0  Grants, subsidies, and
            contributions...................       6,420       6,457       6,606
                                               ---------   ---------  ----------
    99.9    Total new obligations...........       6,426       6,470       6,620
    ---------------------------------------------------------------------------

                                  Personnel Summary

    ----------------------------------------------------------------------------
    Identification code 75-1545-0-1-609      2004 actual   2005 est.   2006 est.
    ----------------------------------------------------------------------------
        Direct:
    1001  Total compensable workyears:
            Civilian full-time equivalent
            employment......................           2           2           2
    ---------------------------------------------------------------------------

           Payments to States for Foster Care and Adoption Assistance

                    (Legislative proposal, subject to PAYGO)

                   Program and Financing (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-1545-4-1-609      2004 actual   2005 est.   2006 est.
    ----------------------------------------------------------------------------

        Obligations by program activity:
    00.01 Foster care.......................                                 -40
                                               ---------   ---------  ----------
    10.00   Total new obligations...........                                 -40
    ----------------------------------------------------------------------------

        Budgetary resources available for obligation:
    22.00 New budget authority (gross)......                                 -40
    23.95 Total new obligations.............                                  40
    ----------------------------------------------------------------------------

        New budget authority (gross), detail:
          Mandatory:

    60.00   Appropriation...................                                 -40
    ----------------------------------------------------------------------------

        Change in obligated balances:
    72.40 Obligated balance, start of year..
    73.10 Total new obligations.............                                 -40
    73.20 Total outlays (gross).............                                  58
                                               ---------   ---------  ----------
    74.40   Obligated balance, end of year..                                  18
    ----------------------------------------------------------------------------

        Outlays (gross), detail:
    86.97 Outlays from new mandatory
            authority.......................                                 -58
    ----------------------------------------------------------------------------

        Net budget authority and outlays:
    89.00 Budget authority..................                                 -40
    90.00 Outlays...........................                                 -58
    ---------------------------------------------------------------------------

        This legislative proposal includes provisions to introduce an option
    available to all states to participate in an alternative financing
    system for child welfare that will better meet the needs of each state's
    foster care population. States choosing to participate face far fewer
    administrative burdens and will receive funds in the form of flexible
    grants. Also included is a legislative change to clarify the process for
    determining Title IV-E eligibility in the Foster Care Program.

                   Object Classification (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-1545-4-1-609      2004 actual   2005 est.   2006 est.
    ----------------------------------------------------------------------------
    25.5  Research and development contracts                                   1
    41.0  Grants, subsidies, and
            contributions...................                                 -41
                                               ---------   ---------  ----------
    99.9    Total new obligations...........                                 -40
    ---------------------------------------------------------------------------

                             ADMINISTRATION ON AGING

                                  Federal Funds

    General and special funds:

                             Aging Services Programs

        For carrying out, to the extent not otherwise provided, the Older
    Americans Act of 1965, as amended, and section 398 of the Public Health
    Service Act, [$1,404,634,000] $1,369,028,000, of which $5,500,000 shall
    be available for activities regarding medication management, screening,
    and education to prevent incorrect medication and adverse drug
    reactions[; and of which $4,558,000 shall remain available until
    September 30, 2007, for the White House Conference on Aging].
    (Department of Health and Human Services Appropriations Act, 2005.)

                   Program and Financing (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-0142-0-1-506      2004 actual   2005 est.   2006 est.
    ----------------------------------------------------------------------------

        Obligations by program activity:
    01.01 Home and community-based
            supportive services.............         354         354         354
    01.02 Preventive health services........          22          22          22
    01.03 National family caregiver support
            program.........................         153         156         156
    01.04 Native American caregiver support
            program.........................           6           6           6
    01.05 Congregate nutrition services.....         386         387         387
    01.06 Home-delivered nutrition services.         180         183         183
    01.07 Nutrition services incentive
            program.........................         148         149         149
    01.08 Native American nutrition and
            supportive services.............          27          26          26
    01.09 Program innovations...............          34          43          24
    01.10 Aging network support activities..          13          13          13
    01.11 Long-term care ombudsmen program..          14          14          14
    01.12 Prevention of elder abuse and
            neglect.........................           5           5           5
    01.13 Alzheimer's disease demonstration
            grants..........................          12          12          12
    01.14 Program administration............          17          18          18
    01.15 White House Conference on Aging...           1           3           4
                                               ---------   ---------  ----------
    02.00   Total, direct program...........       1,372       1,391       1,373
    09.01 Reimbursable program..............           4           4           4
                                               ---------   ---------  ----------
    10.00   Total new obligations...........       1,376       1,395       1,377
    ----------------------------------------------------------------------------

        Budgetary resources available for obligation:
    21.40 Unobligated balance carried
            forward, start of year..........                       2           4
    22.00 New budget authority (gross)......       1,378       1,397       1,373
                                               ---------   ---------  ----------
    23.90   Total budgetary resources
              available for obligation......       1,378       1,399       1,377
    23.95 Total new obligations.............      -1,376      -1,395      -1,377
                                               ---------   ---------  ----------
    24.40   Unobligated balance carried
              forward, end of year..........           2           4
    ----------------------------------------------------------------------------

        New budget authority (gross), detail:
          Discretionary:

    40.00   Appropriation...................       1,382       1,404       1,369
    40.35   Appropriation permanently
              reduced.......................          -8         -11
                                               ---------   ---------  ----------
    43.00     Appropriation (total
                discretionary)..............       1,374       1,393       1,369
    68.00 Spending authority from offsetting
            collections: Offsetting
            collections (cash)..............           4           4           4
                                               ---------   ---------  ----------

    [[Page 467]]

    70.00   Total new budget authority
              (gross).......................       1,378       1,397       1,373
    ----------------------------------------------------------------------------

        Change in obligated balances:
    72.40 Obligated balance, start of year..         542         572         596
    73.10 Total new obligations.............       1,376       1,395       1,377
    73.20 Total outlays (gross).............      -1,350      -1,371      -1,383
    73.40 Adjustments in expired accounts
            (net)...........................           1
    74.10 Change in uncollected customer
            payments from Federal sources
            (expired).......................           3
                                               ---------   ---------  ----------
    74.40   Obligated balance, end of year..         572         596         590
    ----------------------------------------------------------------------------

        Outlays (gross), detail:
    86.90 Outlays from new discretionary
            authority.......................         876         882         876
    86.93 Outlays from discretionary
            balances........................         474         489         507
                                               ---------   ---------  ----------
    87.00   Total outlays (gross)...........       1,350       1,371       1,383
    ----------------------------------------------------------------------------

        Offsets:
          Against gross budget authority and outlays:

    88.00   Offsetting collections (cash)
              from: Federal sources.........          -8          -4          -4
          Against gross budget authority only:

    88.96   Portion of offsetting
              collections (cash) credited to
              expired accounts..............           4
    ----------------------------------------------------------------------------

        Net budget authority and outlays:
    89.00 Budget authority..................       1,374       1,393       1,369
    90.00 Outlays...........................       1,342       1,367       1,379
    ---------------------------------------------------------------------------
        Note.--The reimbursable program (HCFAC) in the Administration on
    Aging (AoA) reflects the estimated distribution of the allocation
    account for 2006. Actual 2006 distributions will be determined by the
    Secretary of HHS and the Attorney General.

        Administration on Aging.--The proposed level will provide continued
    funding for core formula grant programs that provide nutrition,
    supportive services and caregiver support services through the aging
    network. These programs are part of a comprehensive system of support
    for older people and their families.

        The proposed budget will also provide continued support for the
    Department's efforts to create a more balanced system of long term care
    and build partnerships to enhance the delivery of an integrated,
    consumer-oriented, and cost effective system of health and social
    supports to seniors and their family caregivers. Re-balancing the long-
    term care system will provide older Americans more choices and
    opportunities for independence.

                   Object Classification (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-0142-0-1-506      2004 actual   2005 est.   2006 est.
    ----------------------------------------------------------------------------

          Direct obligations:

    11.1    Personnel compensation: Full-
              time permanent................          10          11          11
    12.1    Civilian personnel benefits.....           2           2           2
    21.0    Travel and transportation of
              persons.......................                       1           2
    23.1    Rental payments to GSA..........           2           2           2
    23.3    Communications, utilities, and
              miscellaneous charges.........                                   1
    24.0    Printing and reproduction.......                                   1
    25.1    Advisory and assistance services           7           7           6
    25.2    Other services..................           1           1           1
    25.3    Other purchases of goods and
              services from Government
              accounts......................           7           8           7
    41.0    Grants, subsidies, and
              contributions.................       1,343       1,359       1,340
                                               ---------   ---------  ----------
    99.0      Direct obligations............       1,372       1,391       1,373
    99.0  Reimbursable obligations..........           4           4           4
                                               ---------   ---------  ----------
    99.9    Total new obligations...........       1,376       1,395       1,377
    ---------------------------------------------------------------------------

                                  Personnel Summary

    ----------------------------------------------------------------------------
    Identification code 75-0142-0-1-506      2004 actual   2005 est.   2006 est.
    ----------------------------------------------------------------------------
        Direct:
    1001  Total compensable workyears:
            Civilian full-time equivalent
            employment......................         110         119         116
        Reimbursable:
    2001  Total compensable workyears:
            Civilian full-time equivalent
            employment......................           7           7           7
    ---------------------------------------------------------------------------

                             DEPARTMENTAL MANAGEMENT

                                  Federal Funds

    General and special funds:

                             Office of the Secretary

                         General Departmental Management

        For necessary expenses, not otherwise provided, for general
    departmental management, including hire of six sedans, and for carrying
    out titles III, XVII, XX, and XXI of the Public Health Service Act,
    [and] the United States-Mexico Border Health Commission Act, and
    research studies under section 1110 of the Social Security Act,
    [$371,975,000] $353,595,000, together with [$55,851,000] $5,581,000 to
    be transferred and expended as authorized by section 201(g)(1) of the
    Social Security Act from the Hospital Insurance Trust Fund and the
    Supplemental Medical Insurance Trust Fund, and $39,552,000 from the
    amounts available under section 241 of the Public Health Service Act to
    carry out national health or human services research and evaluation
    activities: Provided, That of the funds made available under this
    heading for carrying out title XX of the Public Health Service Act,
    $13,120,000 shall be for activities specified under section 2003(b)(2),
    all of which shall be for prevention service demonstration grants under
    section 510(b)(2) of title V of the Social Security Act, as amended,
    without application of the limitation of section 2010(c) of said title
    XX: Provided further, That of this amount, [$52,838,000] $52,415,000
    shall be for minority AIDS prevention and treatment activities;
    [$14,847,000] $14,630,000 shall be for an Information Technology
    Security and Innovation Fund for Department-wide activities involving
    cybersecurity, information technology security, and related innovation
    projects; and [$6,000,000] $5,952,000 shall be to assist Afghanistan in
    the development of maternal and child health clinics, consistent with
    section 103(a)(4)(H) of the Afghanistan Freedom Support Act of 2002:
    [Provided further, That no more than $2,754,000 shall be available for
    the Office of the Assistant Secretary for Legislation: Provided further,
    That $50,000,000 shall be transferred to the Social Security
    Administration for processing Medicare appeals: Provided further, That
    specific information requests from the chairmen and ranking members of
    the Subcommittees on Labor, Health and Human Services, and Education,
    and Related Agencies, on scientific research or any other matter, shall
    be transmitted to the Committees on Appropriations in a prompt
    professional manner and within the time frame specified in the request:
    Provided further, That scientific information requested by the
    Committees on Appropriations and prepared by government researchers and
    scientists shall be transmitted to the Committees on Appropriations,
    uncensored and without delay.]

                             Office for Civil Rights

        For expenses necessary for the Office for Civil Rights,
    [$32,043,000] $31,682,000, together with not to exceed $3,314,000 to be
    transferred and expended as authorized by section 201(g)(1) of the
    Social Security Act from the Hospital Insurance Trust Fund and the
    Supplemental Medical Insurance Trust Fund.

                                [Policy Research]

        [For carrying out, to the extent not otherwise provided, research
    studies under section 1110 of the Social Security Act and title III of
    the Public Health Service Act, $20,750,000, which shall be available
    from amounts available under section 241 of the Public Health Service
    Act to carry out national health or human services research and
    evaluation activities: Provided, That the expenditure of any funds
    available under section 241 of the Public Health Service Act are subject
    to the requirements of section 206 of this Act.]

                Public Health and Social Services Emergency Fund

        For expenses necessary to support activities related to countering
    potential biological, disease, nuclear, radiological and chemical
    threats to civilian populations, [$2,208,287,000] $2,427,833,000:
    Provided, That this amount is distributed as follows: Centers for
    Disease Control and Prevention, [$1,173,300,000] $1,016,723,000; Office
    of the Secretary, [$64,438,000] $83,589,000; Strategic National
    Stockpile, [$400,000,000] $600,000,000, to remain available until
    expended; National Institutes of Health, [$47,400,000] $97,021,000; and
    Health Resources and Services Administration, [$523,149,000: Provided
    further, That employees of the Centers for Disease Control and
    Prevention or the Public Health Service, both civilian and Commissioned
    Officers, detailed to States, municipalities, or other organizations
    under authority of section 214 of the Public Health Service

    [[Page 468]]

    Act for purposes related to homeland security, shall be treated as non-
    Federal employees for reporting purposes only and shall not be included
    within any personnel ceiling applicable to the Agency, Service, or the
    Department of Health and Human Services during the period of detail or
    assignment] $510,500,000: Provided further, That at the discretion of
    the Secretary, these amounts may be transferred between categories
    subject to normal reprogramming procedures: Provided further, That from
    amounts provided in this paragraph, up to $1,800,000, to remain
    available until expended, is for Individual Learning Accounts for full-
    time equivalent employees of the Centers for Disease Control and
    Prevention.
        In addition, for activities to ensure a year-round influenza vaccine
    production capacity; the development and implementation of rapidly
    expandable influenza vaccine production technologies; and if determined
    necessary by the Secretary, the purchase of influenza vaccine,
    [$100,000,000] $120,000,000, to remain available until expended.
    (Department of Health and Human Services Appropriations Act, 2005.)
        [For an additional amount for ``Public Health and Social Services
    Emergency Fund'' to support aging services, social services and health
    services associated with natural disaster recovery and response efforts,
    $50,000,000, to remain available until expended: Provided, That such
    amount is designated as an emergency requirement pursuant to section 402
    of S. Con. Res. 95 (108th Congress), as made applicable to the House of
    Representatives by H. Res. 649 (108th Congress) and applicable to the
    Senate by section 14007 of Public Law 108-287.] (Emergency Supplemental
    Appropriations for Hurricane Disasters Assistance Act, 2005.)

                   Program and Financing (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-9912-0-1-551      2004 actual   2005 est.   2006 est.
    ----------------------------------------------------------------------------

        Obligations by program activity:
    00.01 General departmental management...         361         375         353
    00.02 Office for Civil Rights...........          31          32          32
    00.04 Public health and social services
            emergency fund..................       2,433       2,604       2,428
    09.01 Reimbursable program..............         199         275         159
    09.02 Reimbursable program (HCFAC)......           5           5           5
                                               ---------   ---------  ----------
    10.00   Total new obligations...........       3,029       3,291       2,977
    ----------------------------------------------------------------------------

        Budgetary resources available for obligation:
    21.40 Unobligated balance carried
            forward, start of year..........         187         313          26
    22.00 New budget authority (gross)......       3,147       3,004       2,977
    22.10 Resources available from
            recoveries of prior year
            obligations.....................          10
                                               ---------   ---------  ----------
    23.90   Total budgetary resources
              available for obligation......       3,344       3,317       3,003
    23.95 Total new obligations.............      -3,029      -3,291      -2,977
    23.98 Unobligated balance expiring or
            withdrawn.......................          -2
                                               ---------   ---------  ----------
    24.40   Unobligated balance carried
              forward, end of year..........         313          26          26
    ----------------------------------------------------------------------------

        New budget authority (gross), detail:
          Discretionary:

    40.00   Appropriation...................       2,563       2,762       2,813
    40.35   Appropriation permanently
              reduced.......................         -14         -23
    40.36   Unobligated balance permanently
              reduced.......................                     -20
    42.00   Transferred from other accounts.           8           5
                                               ---------   ---------  ----------
    43.00     Appropriation (total
                discretionary)..............       2,557       2,724       2,813
          Mandatory:

    60.00   Appropriation...................         200
          Spending authority from offsetting
              collections:

            Discretionary:
    68.00     Offsetting collections (cash).         165         275         159
    68.00     Offsetting collections (cash)
                HCFAC.......................           5           5           5
    68.10     Change in uncollected customer
                payments from Federal
                sources (unexpired).........         220
                                               ---------   ---------  ----------
    68.90       Spending authority from
                  offsetting collections
                  (total discretionary).....         390         280         164
                                               ---------   ---------  ----------
    70.00   Total new budget authority
              (gross).......................       3,147       3,004       2,977
    ----------------------------------------------------------------------------

        Change in obligated balances:
    72.40 Obligated balance, start of year..       3,281       3,548       4,113
    73.10 Total new obligations.............       3,029       3,291       2,977
    73.20 Total outlays (gross).............      -2,616      -2,726      -3,202
    73.40 Adjustments in expired accounts
            (net)...........................          -9
    73.45 Recoveries of prior year
            obligations.....................         -10
    74.00 Change in uncollected customer
            payments from Federal sources
            (unexpired).....................        -220
    74.10 Change in uncollected customer
            payments from Federal sources
            (expired).......................          93
                                               ---------   ---------  ----------
    74.40   Obligated balance, end of year..       3,548       4,113       3,888
    ----------------------------------------------------------------------------

        Outlays (gross), detail:
    86.90 Outlays from new discretionary
            authority.......................         585         793         680
    86.93 Outlays from discretionary
            balances........................       2,031       1,933       2,522
                                               ---------   ---------  ----------
    87.00   Total outlays (gross)...........       2,616       2,726       3,202
    ----------------------------------------------------------------------------

        Offsets:
          Against gross budget authority and outlays:

    88.00   Offsetting collections (cash)
              from: Federal sources.........        -256        -280        -164
          Against gross budget authority only:

    88.95   Change in uncollected customer
              payments from Federal sources
              (unexpired)...................        -220
    88.96   Portion of offsetting
              collections (cash) credited to
              expired accounts..............          86
    ----------------------------------------------------------------------------

        Net budget authority and outlays:
    89.00 Budget authority..................       2,757       2,724       2,813
    90.00 Outlays...........................       2,360       2,446       3,038
    ---------------------------------------------------------------------------
        Note.--The reimbursable program (HCFAC) in Departmental Management
    reflects the estimated distribution from the allocation account for 2005
    and 2006. Actual 2005 and 2006 distributions will be determined by the
    Secretary of HHS and the Attorney General.

                              (Dollars in millions)

                                         2004 actual  2005 est.   2006 est.
    Distribution of budget authority by
        account:
      General Departmental Management
        \1\.............................         362         373         353
      Office for Civil Rights...........          31          32          32
      Public Health and Social Services
        Emergency Fund..................       2,364       2,319       2,428
    Distribution of outlays by account:
      General Departmental Management...         326         379         325
      Office for Civil Rights...........          30          33          32
      Public Health and Social Services
        Emergency Fund..................       2,004       2,034       2,681
        \1\ Includes $10 million for the Health Information Technology
    Initiative in 2005.

        Departmental management (DM) is a consolidated display of accounts
    that fund activities which provide leadership, policy, legal, and
    administrative guidance to HHS components; carry out the Department's
    civil rights nondiscrimination and health information privacy compliance
    programs; and support research to develop policy initiatives and improve
    existing HHS programs. DM also includes the activities of the Office of
    Public Health and Science, including adolescent family life, disease
    prevention and health promotion, physical fitness and sports, minority
    health, research integrity, women's health, as well as programs to
    counter bioterrorist threats. The 2006 Budget displays the transfer of
    the Strategic National Stockpile from DHS into HHS as enacted in P.L.
    108-276 on a three-year comparable basis. All budget authority, balances
    and outlays are shown in HHS in all years.

                   Object Classification (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-9912-0-1-551      2004 actual   2005 est.   2006 est.
    ----------------------------------------------------------------------------

          Direct obligations:

            Personnel compensation:
    11.1      Full-time permanent...........         107         122         127
    11.3      Other than full-time permanent           5           4           4
    11.5      Other personnel compensation..           2           2           2
    11.7      Military personnel............           5           5           5
                                               ---------   ---------  ----------
    11.9        Total personnel compensation         119         133         138
    12.1    Civilian personnel benefits.....          27          29          30
    12.2    Military personnel benefits.....           1           1           1
    13.0    Benefits for former personnel...           1
    21.0    Travel and transportation of
              persons.......................           5           4           4
    23.1    Rental payments to GSA..........          21          24          25
    23.3    Communications, utilities, and
              miscellaneous charges.........           5           5           5
    24.0    Printing and reproduction.......           3           2           2
    25.1    Advisory and assistance services          17           4           4
    25.2    Other services..................          48          85          75

    [[Page 469]]

    25.3    Other purchases of goods and
              services from Government
              accounts......................         236          32          32
    25.4    Operation and maintenance of
              facilities....................          10           3           3
    25.7    Operation and maintenance of
              equipment.....................           3          22          22
    26.0    Supplies and materials..........           3           2           2
    31.0    Equipment.......................           6           3           3
    41.0    Grants, subsidies, and
              contributions.................         109         137         122
                                               ---------   ---------  ----------
    99.0      Direct obligations............         614         486         468
    99.0  Reimbursable obligations..........         204         280         164
          Allocation Account:

            Personnel compensation:
    11.1      Full-time permanent...........          42          44          45
    11.3      Other than full-time permanent           3           3           3
    11.5      Other personnel compensation..           2           2           3
                                               ---------   ---------  ----------
    11.9        Total personnel compensation          47          49          51
    12.1    Civilian personnel benefits.....          16          16          17
    21.0    Travel and transportation of
              persons.......................           9           9           9
    22.0    Transportation of things........          11           9          11
    23.1    Rental payments to GSA..........          13          11          12
    23.3    Communications, utilities, and
              miscellaneous charges.........           9           9           9
    24.0    Printing and reproduction.......                       1           1
    25.1    Advisory and assistance services          67          64          64
    25.2    Other services..................         132         197         180
    25.3    Other purchases of goods and
              services from Government
              accounts......................          37          42          39
    25.4    Operation and maintenance of
              facilities....................           2           6           6
    25.5    Research and development
              contracts.....................          89         123         158
    25.7    Operation and maintenance of
              equipment.....................           4          27          23
    26.0    Supplies and materials..........          15         258         452
    31.0    Equipment.......................         332           3           3
    32.0    Land and structures.............           5
    41.0    Grants, subsidies, and
              contributions.................       1,423       1,701       1,310
                                               ---------   ---------  ----------
    99.0      Allocation account............       2,211       2,525       2,345
                                               ---------   ---------  ----------
    99.9    Total new obligations...........       3,029       3,291       2,977
    ---------------------------------------------------------------------------

                                  Personnel Summary

    ----------------------------------------------------------------------------
    Identification code 75-9912-0-1-551      2004 actual   2005 est.   2006 est.
    ----------------------------------------------------------------------------
        Direct:
          Total compensable workyears:

    1001    Civilian full-time equivalent
              employment....................       1,311       1,400       1,401
    1101    Military full-time equivalent
              employment....................          97          71          70
        Reimbursable:
    2001  Total compensable workyears:
            Civilian full-time equivalent
            employment......................         319         496         358
    ---------------------------------------------------------------------------

                    Health Information Technology Initiative

        For expenses necessary for the Office of the National Coordinator
    for Health Information Technology, including grants, contracts and
    cooperative agreements for the development and advancement of an
    interoperable national health information technology infrastructure,
    $75,000,000.

                   Program and Financing (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-0130-0-1-551      2004 actual   2005 est.   2006 est.
    ----------------------------------------------------------------------------

        Obligations by program activity:
    00.01 Health Information Technology.....                                  75
    09.01 Reimbursable program..............                                   6
                                               ---------   ---------  ----------
    10.00   Total new obligations...........                                  81
    ----------------------------------------------------------------------------

        Budgetary resources available for obligation:
    22.00 New budget authority (gross)......                                  81
    23.95 Total new obligations.............                                 -81
    ----------------------------------------------------------------------------

        New budget authority (gross), detail:
          Discretionary:

    40.00   Appropriation...................                                  75
    68.00 Spending authority from offsetting
            collections: Offsetting
            collections (cash)..............                                   6
                                               ---------   ---------  ----------
    70.00   Total new budget authority
              (gross).......................                                  81
    ----------------------------------------------------------------------------

        Change in obligated balances:
    72.40 Obligated balance, start of year..
    73.10 Total new obligations.............                                  81
    73.20 Total outlays (gross).............                                 -45
                                               ---------   ---------  ----------
    74.40   Obligated balance, end of year..                                  36
    ----------------------------------------------------------------------------

        Outlays (gross), detail:
    86.90 Outlays from new discretionary
            authority.......................                                  45
    ----------------------------------------------------------------------------

        Offsets:
          Against gross budget authority and outlays:

    88.00   Offsetting collections (cash)
              from: Federal sources.........                                  -6
    ----------------------------------------------------------------------------

        Net budget authority and outlays:
    89.00 Budget authority..................                                  75
    90.00 Outlays...........................                                  39
    ---------------------------------------------------------------------------

        This program supports coordination of Federal health information
    technology activities, and of Federal initiatives for the development
    and advancement of an interoperable national health information
    technology infrastructure, in cooperation with participants in the
    health sector. The Office of the National Coordinator for Health
    Information Technology was created by Executive Order 13335, for the
    purpose of addressing strategic planning, coordination, and the analysis
    of key technical, economic and other issues related to the public and
    private adoption of health information technology.

        Through this program, activities related to health information
    technology are coordinated across several HHS organizations, as shown in
    the following consolidated table.

                      Health Information Technology Funding

                      [Program level--Dollars in millions]

                                         2004 actual  2005 est.   2006 est.
    Distribution of funding by account:
        Health Information Technology
          Initiative....................           0           0          75
        General Departmental Management.           0          27           0
        Agency for Healthcare Research
          and Quality...................          50          64          50
        National Library of Medicine....           0           9           0
        HIT Initiative Total............          50         100         125
        Federal Health Architecture and
          Other Activities..............           2           8           8

        Note.--Includes budget authority, Public Health Service evaluation funds
    and other resources.

                   Object Classification (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-0130-0-1-551      2004 actual   2005 est.   2006 est.
    ----------------------------------------------------------------------------

          Direct obligations:

    11.1    Personnel compensation: Full-
              time permanent................                                   4
    12.1    Civilian personnel benefits.....                                   1
    25.2    Other services..................                                  70
                                               ---------   ---------  ----------
    99.0      Direct obligations............                                  75
    99.0  Reimbursable obligations..........                                   6
                                               ---------   ---------  ----------
    99.9    Total new obligations...........                                  81
    ---------------------------------------------------------------------------

                                  Personnel Summary

    ----------------------------------------------------------------------------
    Identification code 75-0130-0-1-551      2004 actual   2005 est.   2006 est.
    ----------------------------------------------------------------------------
        Direct:
    1001  Total compensable workyears:
            Civilian full-time equivalent
            employment......................                                  36
        Reimbursable:
    2001  Total compensable workyears:
            Civilian full-time equivalent
            employment......................                                  21
    ---------------------------------------------------------------------------

                                Medicare Appeals

        For expenses necessary for administrative law judges responsible for
    hearing cases under title XVIII of the Social Security Act (and related
    provisiosn of title XI of such Act), $80,000,000, to be transferred in
    appropriate part from the Federal Hospital Insurance and the Federal
    Supplementary Medical Insurance Trust Funds.

    [[Page 470]]

                   Program and Financing (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-0139-0-1-551      2004 actual   2005 est.   2006 est.
    ----------------------------------------------------------------------------

        Obligations by program activity:
    00.01 Direct Program Activity...........                                  80
                                               ---------   ---------  ----------
    10.00   Total new obligations...........                                  80
    ----------------------------------------------------------------------------

        Budgetary resources available for obligation:
    22.00 New budget authority (gross)......                                  80
    23.95 Total new obligations.............                                 -80
    ----------------------------------------------------------------------------

        New budget authority (gross), detail:
          Discretionary:

    68.00   Spending authority from
              offsetting collections
              (gross): Offsetting
              collections (cash)............                                  80
    ----------------------------------------------------------------------------

        Change in obligated balances:
    72.40 Obligated balance, start of year..
    73.10 Total new obligations.............                                  80
    73.20 Total outlays (gross).............                                 -68
                                               ---------   ---------  ----------
    74.40   Obligated balance, end of year..                                  12
    ----------------------------------------------------------------------------

        Outlays (gross), detail:
    86.90 Outlays from new discretionary
            authority.......................                                  68
    ----------------------------------------------------------------------------

        Offsets:
          Against gross budget authority and outlays:

    88.00   Offsetting collections (cash)
              from: Federal sources.........                                 -80
    ----------------------------------------------------------------------------

        Net budget authority and outlays:
    89.00 Budget authority..................
    90.00 Outlays...........................                                 -12
    ---------------------------------------------------------------------------

        This activity funds the Office of Medicare Appeals, as directed by
    Medicare Prescription Drug, Improvement, and Modernization Act of 2003.

                   Object Classification (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-0139-0-1-551      2004 actual   2005 est.   2006 est.
    ----------------------------------------------------------------------------
    11.1  Personnel compensation: Full-time
            permanent.......................                                  21
    12.1  Civilian personnel benefits.......                                   5
    21.0  Travel and transportation of
            persons.........................                                   3
    23.1  Rental payments to GSA............                                   6
    23.3  Communications, utilities, and
            miscellaneous charges...........                                  17
    25.1  Advisory and assistance services..                                   6
    25.2  Other services....................                                   2
    25.7  Operation and maintenance of
            equipment.......................                                  20
                                               ---------   ---------  ----------
    99.9    Total new obligations...........                                  80
    ---------------------------------------------------------------------------

                                  Personnel Summary

    ----------------------------------------------------------------------------
    Identification code 75-0139-0-1-551      2004 actual   2005 est.   2006 est.
    ----------------------------------------------------------------------------
        Direct:
    1001  Total compensable workyears:
            Civilian full-time equivalent
            employment......................                                 261
    ---------------------------------------------------------------------------

                    Allocations Received From Other Accounts

        Note.--Obligations incurred under allocations from other accounts
    are included in the schedules of the parent appropriation as follows:
    Centers for Medicare and Medicaid Services ``Health Care Fraud and Abuse
    Control Account.''

                             PROGRAM SUPPORT CENTER

    General and special funds:

          Retirement Pay and Medical Benefits for Commissioned Officers

        For retirement pay and medical benefits of Public Health Service
    Commissioned Officers as authorized by law, for payments under the
    Retired Serviceman's Family Protection Plan and Survivor Benefit Plan,
    for medical care of dependents and retired personnel under the
    Dependents' Medical Care Act (10 U.S.C. [chapters] chapter 55 [and 56]),
    such amounts as may be required during the current fiscal year. [The
    following are definitions for the medical benefits of the Public Health
    Service Commissioned Officers that apply to 10 U.S.C. chapter 56,
    section 1116(c). The source of funds for the monthly accrual payments
    into the Department of Defense Medicare-Eligible Retiree Health Care
    Fund shall be the Retirement Pay and Medical Benefits for Commissioned
    Officers account. For purposes of this Act, the term ``pay of members''
    shall be construed to be synonymous with retirement payments to United
    States Public Health Service officers who are retired for age,
    disability, or length of service; payments to survivors of deceased
    officers; medical care to active duty and retired members and dependents
    and beneficiaries; all of which payments are provided for by the
    Retirement Pay and Medical Benefits for Commissioned Officers account.]
    (Department of Health and Human Services Appropriations Act, 2005.)

                   Program and Financing (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-0379-0-1-551      2004 actual   2005 est.   2006 est.
    ----------------------------------------------------------------------------

        Obligations by program activity:
    00.01 Retirement payments...............         227         241         256
    00.02 Survivors' benefits...............          14          15          16
    00.03 Medical care......................          53          55          57
    00.04 Medicare Eligible Accruals........          27          33          34
                                               ---------   ---------  ----------
    10.00   Total new obligations...........         321         344         363
    ----------------------------------------------------------------------------

        Budgetary resources available for obligation:
    22.00 New budget authority (gross)......         322         344         363
    23.95 Total new obligations.............        -321        -344        -363
    23.98 Unobligated balance expiring or
            withdrawn.......................          -1
    ----------------------------------------------------------------------------

        New budget authority (gross), detail:
          Discretionary:

    40.00   Appropriation...................          27          33          34
          Mandatory:

    60.00   Appropriation...................         295         311         329
                                               ---------   ---------  ----------
    70.00   Total new budget authority
              (gross).......................         322         344         363
    ----------------------------------------------------------------------------

        Change in obligated balances:
    72.40 Obligated balance, start of year..          30          25          34
    73.10 Total new obligations.............         321         344         363
    73.20 Total outlays (gross).............        -320        -335        -361
    73.40 Adjustments in expired accounts
            (net)...........................          -5
                                               ---------   ---------  ----------
    74.40   Obligated balance, end of year..          25          34          36
    ----------------------------------------------------------------------------

        Outlays (gross), detail:
    86.90 Outlays from new discretionary
            authority.......................          24          30          31
    86.93 Outlays from discretionary
            balances........................           2           2           3
    86.97 Outlays from new mandatory
            authority.......................         266         280         296
    86.98 Outlays from mandatory balances...          28          23          31
                                               ---------   ---------  ----------
    87.00   Total outlays (gross)...........         320         335         361
    ----------------------------------------------------------------------------

        Net budget authority and outlays:
    89.00 Budget authority..................         322         344         363
    90.00 Outlays...........................         321         335         361
    ---------------------------------------------------------------------------

        The number of beneficiaries using the Commissioned Corps system is
    estimated as follows:

                          Eligible Beneficiary Category

                                           FY2004       FY2005      FY2006
    Active Duty:
        Health and Human Services.......       4,989       5,138       5,150
        Department of Justice, Bureau of
          Prisons.......................         667         667         667
        Department of Homeland Security.         181         181         181
        Environmental Protection Agency.          88          88          88
        All Other.......................          69          69          69
    Total Active Duty...................       5,994       6,143       6,155
    Retirees............................       4,364       4,472       4,582
    Retiree Family Members and Survivors         636         648         660
    Total Beneficiaries.................      10,994      11,263      11,397

        This activity funds annuities of retired Public Health Service (PHS)
    commissioned officers and survivors of retirees, and medical benefits
    for active duty PHS commissioned officers,

    [[Page 471]]

    retirees, and dependents of member and retirees of the PHS Commissioned
    Corps.

        The cost of medical benefits for Medicare-eligible beneficiaries is
    paid from the Department of Defense Medicare-Eligible Retiree Health
    Care Fund (10 U.S.C., ch. 56). Beginning in 2006, permanent indefinite
    authority is provided for a discretionary appropriation of the annual
    accrual payment into this fund (P.L. No. 108-375, section 725).

                   Object Classification (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-0379-0-1-551      2004 actual   2005 est.   2006 est.
    ----------------------------------------------------------------------------
    13.0  Benefits for former personnel.....         243         256         272
    25.6  Medical care......................          78          88          91
                                               ---------   ---------  ----------
    99.9    Total new obligations...........         321         344         363
    ---------------------------------------------------------------------------

                             Health Activities Funds

                   Program and Financing (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-9913-0-1-552      2004 actual   2005 est.   2006 est.
    ----------------------------------------------------------------------------

        Budgetary resources available for obligation:
    21.40 Unobligated balance carried
            forward, start of year..........           7           7           7
                                               ---------   ---------  ----------
    24.40   Unobligated balance carried
              forward, end of year..........           7           7           7
    ----------------------------------------------------------------------------

        Change in obligated balances:
    72.40 Obligated balance, start of year..           2           2           2
                                               ---------   ---------  ----------
    74.40   Obligated balance, end of year..           2           2           2
    ----------------------------------------------------------------------------

        Net budget authority and outlays:
    89.00 Budget authority..................
    90.00 Outlays...........................
    ---------------------------------------------------------------------------

        This display shows activities in support of St. Elizabeths Hospital
    and scientific activities overseas that were supported by foreign
    currencies by the United States abroad.

    Intragovernmental funds:

                           HHS Service and Supply Fund

                   Program and Financing (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-9941-0-4-551      2004 actual   2005 est.   2006 est.
    ----------------------------------------------------------------------------

        Obligations by program activity:
    09.01 Program support center............         506         536         542
    09.02 OS activities.....................          42          70          71
                                               ---------   ---------  ----------
    10.00   Total new obligations...........         548         606         613
    ----------------------------------------------------------------------------

        Budgetary resources available for obligation:
    21.40 Unobligated balance carried
            forward, start of year..........          67          64          64
    22.00 New budget authority (gross)......         545         606         613
                                               ---------   ---------  ----------
    23.90   Total budgetary resources
              available for obligation......         612         670         677
    23.95 Total new obligations.............        -548        -606        -613
                                               ---------   ---------  ----------
    24.40   Unobligated balance carried
              forward, end of year..........          64          64          64
    ----------------------------------------------------------------------------

        New budget authority (gross), detail:
          Mandatory:

    69.00   Offsetting collections (cash)...         499         606         613
    69.10   Change in uncollected customer
              payments from Federal sources
              (unexpired)...................          46
                                               ---------   ---------  ----------
    69.90     Spending authority from
                offsetting collections
                (total mandatory)...........         545         606         613
    ----------------------------------------------------------------------------

        Change in obligated balances:
    72.40 Obligated balance, start of year..         -34         -35         -35
    73.10 Total new obligations.............         548         606         613
    73.20 Total outlays (gross).............        -503        -606        -613
    74.00 Change in uncollected customer
            payments from Federal sources
            (unexpired).....................         -46
                                               ---------   ---------  ----------
    74.40   Obligated balance, end of year..         -35         -35         -35
    ----------------------------------------------------------------------------

        Outlays (gross), detail:
    86.97 Outlays from new mandatory
            authority.......................          90         606         613
    86.98 Outlays from mandatory balances...         413
                                               ---------   ---------  ----------
    87.00   Total outlays (gross)...........         503         606         613
    ----------------------------------------------------------------------------

        Offsets:
          Against gross budget authority and outlays:

    88.00   Offsetting collections (cash)
              from: Federal sources.........        -499        -606        -613
          Against gross budget authority only:

    88.95   Change in uncollected customer
              payments from Federal sources
              (unexpired)...................         -46
    ----------------------------------------------------------------------------

        Net budget authority and outlays:
    89.00 Budget authority..................
    90.00 Outlays...........................           4
    ---------------------------------------------------------------------------

        HHS Service and Supply Fund (SSF) provides a wide range of
    logistical and support services to components of the Department and
    other Federal agencies. The Program Support Center line includes
    activities such as personnel and payroll administration, financial
    management operations, and administrative services, including
    acquisitions management, building and property management,
    telecommunication services, medical supplies repackaging and
    distribution services, and the Federal Occupational Health Service. The
    Office of Secretary activities line includes the fund manager,
    departmental contracts, audit resolutions, Commissioned Corps force
    management, information technology, web management, claims, and
    acquisition integration and modernization.

        Most Commissioned Corps officers work for agencies in the Department
    of Health and Human Services and are reflected in the agencies'
    personnel summaries. However, some officers are assigned to other
    Federal agencies. The allocation account section in the following
    personnel summary shows officers assigned to other agencies which are
    paid directly by that agency, either through an allocation account or by
    directly citing that agency's appropriation.

                   Object Classification (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-9941-0-4-551      2004 actual   2005 est.   2006 est.
    ----------------------------------------------------------------------------

          Personnel compensation:

    11.1    Full-time permanent.............          77         101         103
    11.3    Other than full-time permanent..           4           5           5
    11.5    Other personnel compensation....           2           2           2
    11.7    Military personnel..............           8          11          11
                                               ---------   ---------  ----------
    11.9      Total personnel compensation..          91         119         121
    12.1  Civilian personnel benefits.......          23          29          30
    12.2  Military personnel benefits.......           4           5           5
    13.0  Benefits for former personnel.....           1           1           1
    21.0  Travel and transportation of
            persons.........................           6           6           6
    22.0  Transportation of things..........           3           3           3
    23.1  Rental payments to GSA............          12          15          16
    23.3  Communications, utilities, and
            miscellaneous charges...........          45          49          50
    24.0  Printing and reproduction.........           1           1           1
    25.1  Advisory and assistance services..          24          25          25
    25.2  Other services....................         127         130         132
    25.3  Other purchases of goods and
            services from Government
            accounts........................          37          39          39
    25.4  Operation and maintenance of
            facilities......................          19          19          19
    25.6  Medical care......................          37          38          38
    25.7  Operation and maintenance of
            equipment.......................          22          22          22
    26.0  Supplies and materials............          88          95          95
    31.0  Equipment.........................           8          10          10
                                               ---------   ---------  ----------
    99.9    Total new obligations...........         548         606         613
    ---------------------------------------------------------------------------

                                  Personnel Summary

    ----------------------------------------------------------------------------
    Identification code 75-9941-0-4-551      2004 actual   2005 est.   2006 est.
    ----------------------------------------------------------------------------
        Reimbursable:
          Total compensable workyears:

    2001    Civilian full-time equivalent
              employment....................       1,111       1,454       1,453
    2101    Military full-time equivalent
              employment....................          95          99         100

    [[Page 472]]

        Allocation account:
          Total compensable workyears:

    3101    Military full-time equivalent
              employment....................         667         667         667
    3101    Military full-time equivalent
              employment....................         250         250         250
    ---------------------------------------------------------------------------

                                   Trust Funds

                            Miscellaneous Trust Funds

                    Unavailable Receipts (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-9971-0-7-551      2004 actual   2005 est.   2006 est.
    ----------------------------------------------------------------------------
        Receipts:
    02.00 Gifts and contributions,
            Miscellaneous trust funds.......          11          43          43
    02.20 Contributions, Indian health
            facilities......................          38          38          38
                                               ---------   ---------  ----------
    02.99   Total receipts and collections..          49          81          81
        Appropriations:
    05.00 Miscellaneous trust funds.........         -49         -81         -81
                                               ---------   ---------  ----------
    07.99 Balance, end of year..............
    ---------------------------------------------------------------------------

                   Program and Financing (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-9971-0-7-551      2004 actual   2005 est.   2006 est.
    ----------------------------------------------------------------------------

        Obligations by program activity:
    00.02 Gifts.............................          33          43          43
    00.03 Contributions, Indian health
            facilities......................          34          38          38
                                               ---------   ---------  ----------
    10.00   Total new obligations...........          67          81          81
    ----------------------------------------------------------------------------

        Budgetary resources available for obligation:
    21.40 Unobligated balance carried
            forward, start of year..........         114         128         128
    22.00 New budget authority (gross)......          81          81          81
                                               ---------   ---------  ----------
    23.90   Total budgetary resources
              available for obligation......         195         209         209
    23.95 Total new obligations.............         -67         -81         -81
                                               ---------   ---------  ----------
    24.40   Unobligated balance carried
              forward, end of year..........         128         128         128
    ----------------------------------------------------------------------------

        New budget authority (gross), detail:
          Mandatory:

    60.26   Appropriation (trust fund)......          49          81          81
    60.26   Appropriation (trust fund)......          32
                                               ---------   ---------  ----------
    62.50     Appropriation (total
                mandatory)..................          81          81          81
    ----------------------------------------------------------------------------

        Change in obligated balances:
    72.40 Obligated balance, start of year..          58          64          63
    73.10 Total new obligations.............          67          81          81
    73.20 Total outlays (gross).............         -61         -82         -93
                                               ---------   ---------  ----------
    74.40   Obligated balance, end of year..          64          63          51
    ----------------------------------------------------------------------------

        Outlays (gross), detail:
    86.97 Outlays from new mandatory
            authority.......................          12          17          17
    86.98 Outlays from mandatory balances...          49          65          76
                                               ---------   ---------  ----------
    87.00   Total outlays (gross)...........          61          82          93
    ----------------------------------------------------------------------------

        Net budget authority and outlays:
    89.00 Budget authority..................          81          81          81
    90.00 Outlays...........................          61          82          93
    ----------------------------------------------------------------------------

        Memorandum (non-add) entries:
    92.01 Total investments, start of year:
            Federal securities: Par value...          25          22          25
    92.02 Total investments, end of year:
            Federal securities: Par value...          22          25          25
    ---------------------------------------------------------------------------

                              [Dollars in millions]

                                            2004         2005        2006
    Distribution of budget authority by
        account:
      Gifts.............................          43          43          43
      Contributions, Indian health
        facilities......................          38          38          38
    Distribution of outlays by account:
      Gifts.............................          32          45          50
      Contributions, Indian health
        facilities......................          29          37          43

        Gifts to the Public Health Service are for the benefit of patients
    and for research. Contributions are made for the construction,
    improvement, extension, and provision of sanitation facilities.

                   Object Classification (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-9971-0-7-551      2004 actual   2005 est.   2006 est.
    ----------------------------------------------------------------------------

          Personnel compensation:

    11.1    Full-time permanent.............           2           2           2
    11.3    Other than full-time permanent..           1           1           1
                                               ---------   ---------  ----------
    11.9      Total personnel compensation..           3           3           3
    21.0  Travel and transportation of
            persons.........................           1           2           2
    25.1  Advisory and assistance services..           2           3           3
    25.2  Other services....................          23          27          27
    25.3  Other purchases of goods and
            services from Government
            accounts........................                       1           1
    25.4  Operation and maintenance of
            facilities......................           4           5           5
    25.5  Research and development contracts           5           6           6
    25.7  Operation and maintenance of
            equipment.......................           1           1           1
    26.0  Supplies and materials............           1           3           3
    31.0  Equipment.........................           1           1           1
    41.0  Grants, subsidies, and
            contributions...................          26          29          29
                                               ---------   ---------  ----------
    99.9    Total new obligations...........          67          81          81
    ---------------------------------------------------------------------------

                                  Personnel Summary

    ----------------------------------------------------------------------------
    Identification code 75-9971-0-7-551      2004 actual   2005 est.   2006 est.
    ----------------------------------------------------------------------------
        Direct:
    1001  Total compensable workyears:
            Civilian full-time equivalent
            employment......................          37          37          37
    ---------------------------------------------------------------------------

                         OFFICE OF THE INSPECTOR GENERAL

    General and special funds:

                           Office of Inspector General

        For expenses necessary for the Office of Inspector General,
    including the hire of passenger motor vehicles for investigations, in
    carrying out the provisions of the Inspector General Act of 1978, as
    amended, [$40,323,000] $39,813,000: Provided, That of such amount,
    necessary sums are available for providing protective services to the
    Secretary and investigating non-payment of child support cases for which
    non-payment is a Federal offense under 18 U.S.C. 228: Provided further,
    That funds transferred to this heading pursuant to section 220 of the
    Department of Health and Human Services Appropriations Act, 2005, shall
    remain available until September 30, 2006. (Department of Health and
    Human Services Appropriations Act, 2005.)

                   Program and Financing (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-0128-0-1-551      2004 actual   2005 est.   2006 est.
    ----------------------------------------------------------------------------

        Obligations by program activity:
    00.01 Direct program....................          39          40          40
    09.01 HCFAC reimbursable program........         164         167         165
    09.02 Reimbursable program..............          20          44          19
                                               ---------   ---------  ----------
    10.00   Total new obligations...........         223         251         224
    ----------------------------------------------------------------------------

        Budgetary resources available for obligation:
    21.40 Unobligated balance carried
            forward, start of year..........           1           1           1
    22.00 New budget authority (gross)......         223         251         224
                                               ---------   ---------  ----------
    23.90   Total budgetary resources
              available for obligation......         224         252         225
    23.95 Total new obligations.............        -223        -251        -224
                                               ---------   ---------  ----------
    24.40   Unobligated balance carried
              forward, end of year..........           1           1           1
    ----------------------------------------------------------------------------

    [[Page 473]]

        New budget authority (gross), detail:
          Discretionary:

    40.00   Appropriation...................          39          40          40
          Spending authority from offsetting
              collections:

    68.00   Offsetting collections (cash)...          15          44          19
    68.10   Change in uncollected customer
              payments from Federal sources
              (unexpired)...................           5
                                               ---------   ---------  ----------
    68.90     Spending authority from
                offsetting collections
                (total discretionary).......          20          44          19
          Mandatory:

    69.00   Offsetting collections (cash)...         164         167         165
                                               ---------   ---------  ----------
    70.00   Total new budget authority
              (gross).......................         223         251         224
    ----------------------------------------------------------------------------

        Change in obligated balances:
    72.40 Obligated balance, start of year..          14          32          32
    73.10 Total new obligations.............         223         251         224
    73.20 Total outlays (gross).............        -221        -251        -224
    73.40 Adjustments in expired accounts
            (net)...........................          -1
    74.00 Change in uncollected customer
            payments from Federal sources
            (unexpired).....................          -5
    74.10 Change in uncollected customer
            payments from Federal sources
            (expired).......................          21
                                               ---------   ---------  ----------
    74.40   Obligated balance, end of year..          32          32          32
    ----------------------------------------------------------------------------

        Outlays (gross), detail:
    86.90 Outlays from new discretionary
            authority.......................          39          78          53
    86.93 Outlays from discretionary
            balances........................           2           6           6
    86.97 Outlays from new mandatory
            authority.......................         164         167         165
    86.98 Outlays from mandatory balances...          16
                                               ---------   ---------  ----------
    87.00   Total outlays (gross)...........         221         251         224
    ----------------------------------------------------------------------------

        Offsets:
          Against gross budget authority and outlays:

    88.00   Offsetting collections (cash)
              from: Federal sources.........        -200        -211        -184
          Against gross budget authority only:

    88.95   Change in uncollected customer
              payments from Federal sources
              (unexpired)...................          -5
    88.96   Portion of offsetting
              collections (cash) credited to
              expired accounts..............          21
    ----------------------------------------------------------------------------

        Net budget authority and outlays:
    89.00 Budget authority..................          39          40          40
    90.00 Outlays...........................          21          40          40
    ---------------------------------------------------------------------------

        The Office of Inspector General (OIG) identifies and recommends
    actions to correct fraud, waste, and abuse in HHS administered and
    assisted programs and operations through audits, evaluations, and
    investigations.

        In addition to the discretionary resources appropriated to the OIG,
    the Health Insurance Portability and Accountability Act of 1996 makes
    available mandatory funding for use by the OIG. These funds are used to
    combat Medicare, Medicaid, and State Children's Health Insurance Program
    (SCHIP) fraud, waste, and abuse through a coordinated Health care fraud
    and abuse control (HCFAC) program with the Department of Justice. The
    following table shows total funding resources for the OIG:

                              (In millions of dollars)

                                             2004 actual   2005 est.   2006 est.
    Budget Authority:
      Discretionary appropriations..........          39          40          40
      Mandatory (HCFAC Account).............         160         160         160
                                               ---------   ---------  ----------
          Total.............................         199         200         200
        Note.--The reimbursable program (HCFAC) in Office of the Inspector
    General reflects the estimated distribution of the allocation account
    for 2006. Actual 2006 distributions will be determined by the Secretary
    of HHS and the Attorney General.

                   Object Classification (in millions of dollars)

    ----------------------------------------------------------------------------
    Identification code 75-0128-0-1-551      2004 actual   2005 est.   2006 est.
    ----------------------------------------------------------------------------

          Direct obligations:

            Personnel compensation:
    11.1      Full-time permanent...........          21          22          22
    11.5      Other personnel compensation..           1           1           1
                                               ---------   ---------  ----------
    11.9        Total personnel compensation          22          23          23
    12.1    Civilian personnel benefits.....           7           7           7
    21.0    Travel and transportation of
              persons.......................           1           1           1
    23.1    Rental payments to GSA..........           3           3           3
    23.3    Communications, utilities, and
              miscellaneous charges.........           1           1           1
    25.3    Other purchases of goods and
              services from Government
              accounts......................           4           4           4
    31.0    Equipment.......................           1           1           1
                                               ---------   ---------  ----------
    99.0      Direct obligations............          39          40          40
    99.0  Reimbursable obligations..........         184         211         184
                                               ---------   ---------  ----------
    99.9    Total new obligations...........         223         251         224
    ---------------------------------------------------------------------------

                                  Personnel Summary

    ----------------------------------------------------------------------------
    Identification code 75-0128-0-1-551      2004 actual   2005 est.   2006 est.
    ----------------------------------------------------------------------------
        Direct:
          Total compensable workyears:

    1001    Civilian full-time equivalent
              employment....................         284         278         268
    1101    Military full-time equivalent
              employment....................           1           1           1
        Reimbursable:
    2001  Total compensable workyears:
            Civilian full-time equivalent
            employment......................       1,215       1,228       1,126
    ---------------------------------------------------------------------------

                    Allocations Received From Other Accounts

        Note.--Obligations incurred under allocations from other accounts
    are included in the schedules of the parent appropriations as follows:
    Centers for Medicare and Medicaid Services ``Health Care Fraud and Abuse
    Control Account.''

                          GENERAL FUND RECEIPT ACCOUNTS

                               (in millions of dollars)

    ----------------------------------------------------------------------------
                                             2004 actual   2005 est.   2006 est.
    ----------------------------------------------------------------------------
    Offsetting receipts from the public:
      75-274530  Health education assistance
        loans, Downward reestimates of
        subsidies...........................          49          55
      75-310700  Federal share of child
        support collections.................       1,096       1,087       1,097
        Legislative proposal, subject to
          PAYGO.............................                                  13
                                               ---------   ---------  ----------
    General Fund Offsetting receipts from
     the public.............................       1,145       1,142       1,110
    ---------------------------------------------------------------------------

                               GENERAL PROVISIONS

        Sec. 201. Funds appropriated in this title shall be available for
    not to exceed $50,000 for official reception and representation expenses
    when specifically approved by the Secretary.
        Sec. 202. The Secretary shall make available through assignment not
    more than 60 employees of the Public Health Service to assist in child
    survival activities and to work in AIDS programs through and with funds
    provided by the Agency for International Development, the United Nations
    International Children's Emergency Fund or the World Health
    Organization.
        Sec. 203. None of the funds appropriated under this Act may be used
    to implement section 399F(b) of the Public Health Service Act or section
    1503 of the National Institutes of Health Revitalization Act of 1993,
    Public Law 103-43.
        Sec. 204. None of the funds appropriated in this Act for the
    National Institutes of Health, the Agency for Healthcare Research and
    Quality, and the Substance Abuse and Mental Health Services
    Administration shall be used to pay the salary of an individual, through
    a grant or other extramural mechanism, at a rate in excess of Executive
    Level [I] II.
        Sec. 205. None of the funds appropriated in this title for Head
    Start shall be used to pay the compensation of an individual, either as
    direct costs or any proration as an indirect cost, at a rate in excess
    of Executive Level II.
        [Sec. 206. None of the funds appropriated in this Act may be
    expended pursuant to section 241 of the Public Health Service Act,
    except for funds specifically provided for in this Act, or for other
    taps and assessments made by any office located in the Department of
    Health and Human Services, prior to the Secretary's preparation and
    submission of a report to the Committee on Appropriations of the Senate
    and of the House detailing the planned uses of such funds.]

    [[Page 474]]

        Sec. [207] 206. Notwithstanding section 241(a) of the Public Health
    Service Act, such portion as the Secretary shall determine, but not more
    than 2.4 percent, of any amounts appropriated for programs authorized
    under said Act shall be made available for the evaluation (directly, or
    by grants or contracts) of the implementation and effectiveness of such
    programs.

                               (transfer of funds)

        Sec. [208] 207. Not to exceed [1] 3 percent of any discretionary
    funds (pursuant to the Balanced Budget and Emergency Deficit Control Act
    of 1985, as amended) which are appropriated for the current fiscal year
    for the Department of Health and Human Services in this Act may be
    transferred between [a program, project, or activity] appropriations,
    but no such [program, project, or activity] appropriation shall be
    increased by more than 3 percent by any such transfer: Provided, That [a
    program, project, or activity] an appropriation may be increased by up
    to an additional 2 percent [subject to approval by] after notification
    of the House and Senate Committees on Appropriations: Provided further,
    That the Appropriations Committees of both Houses of Congress are
    notified at least 15 days in advance of any transfer.
        Sec. 208. The Director of the National Institutes of Health, jointly
    with the Director of the Office of AIDS Research, may transfer up to 3
    percent among institutes, centers, and divisions from the total amounts
    identified by these two Directors as funding for research pertaining to
    the human immunodeficiency virus: Provided, That the Congress is
    promptly notified of the transfer.
        Sec. 209. Of the amounts made available in this Act for the National
    Institutes of Health, the amount for research related to the human
    immunodeficiency virus, as jointly determined by the Director of the
    National Institutes of Health and the Director of the Office of AIDS
    Research, shall be made available to the ``Office of AIDS Research''
    account. The Director of the Office of AIDS Research shall transfer from
    such account amounts necessary to carry out section 2353(d)(3) of the
    Public Health Service Act.
        Sec. 210. None of the funds appropriated in this Act may be made
    available to any entity under title X of the Public Health Service Act
    unless the applicant for the award certifies to the Secretary that it
    encourages family participation in the decision of minors to seek family
    planning services and that it provides counseling to minors on how to
    resist attempts to coerce minors into engaging in sexual activities.
        Sec. 211. None of the funds appropriated by this Act (including
    funds appropriated to any trust fund) may be used to carry out the
    [Medicare+Choice] Medicare Advantage program if the Secretary denies
    participation in such program to an otherwise eligible entity (including
    a Provider Sponsored Organization) because the entity informs the
    Secretary that it will not provide, pay for, provide coverage of, or
    provide referrals for abortions: Provided, That the Secretary shall make
    appropriate prospective adjustments to the capitation payment to such an
    entity (based on an actuarially sound estimate of the expected costs of
    providing the service to such entity's enrollees): Provided further,
    That nothing in this section shall be construed to change the Medicare
    program's coverage for such services and a [Medicare+Choice] Medicare
    Advantage organization described in this section shall be responsible
    for informing enrollees where to obtain information about all Medicare
    covered services.
        Sec. 212. Notwithstanding any other provision of law, no provider of
    services under title X of the Public Health Service Act shall be exempt
    from any State law requiring notification or the reporting of child
    abuse, child molestation, sexual abuse, rape, or incest.
        [Sec. 213. The Foreign Operations, Export Financing, and Related
    Programs Appropriations Act, 1990 (Public Law 101-167) is amended--
            (1) in section 599D (8 U.S.C. 1157 note)--
                    (A) in subsection (b)(3), by striking ``1997, 1998,
                1999, 2000, 2001, 2002, 2003, 2004, and 2005'' and inserting
                ``1997, 1998, 1999, 2000, 2001, 2002, 2003, 2004, 2005, and
                2006'';
                    (B) in subsection (e), by striking ``October 1, 2004''
                each place it appears and inserting ``October 1, 2005''; and
                    (C) in subsection (b)(1)--
                (i) in subparagraph (A), by striking ``and'' at the end;
                (ii) in subparagraph (B), by striking the period and
            inserting ``; and''; and
                (iii) by adding at the end the following:
            ``(C) one or more categories of aliens who are or were nationals
        and residents of the Islamic Republic or Iran who, as members of a
        religious minority in Iran, share common characteristics that
        identify them as targets of persecution in that state on account of
        race, religion, nationality, membership in a particular social
        group, or political opinion.''; and
            (2) in section 599E (8 U.S.C. 1255 note) in subsection (b)(2),
        by striking ``September 30, 2004'' and inserting ``September 30,
        2005''.]
        Sec. [214] 213. (a) Except as provided by subsection (e) none of the
    funds appropriated by this Act may be used to withhold substance abuse
    funding from a State pursuant to section 1926 of the Public Health
    Service Act (42 U.S.C. 300x-26) if such State certifies to the Secretary
    of Health and Human Services by May 1, [2005] 2006 that the State will
    commit additional State funds, in accordance with subsection (b), to
    ensure compliance with State laws prohibiting the sale of tobacco
    products to individuals under 18 years of age.
        (b) The amount of funds to be committed by a State under subsection
    (a) shall be equal to 1 percent of such State's substance abuse block
    grant allocation for each percentage point by which the State misses the
    retailer compliance rate goal established by the Secretary of Health and
    Human Services under section 1926 of such Act.
        (c) The State is to maintain State expenditures in fiscal year
    [2005] 2006 for tobacco prevention programs and for compliance
    activities at a level that is not less than the level of such
    expenditures maintained by the State for fiscal year [2004] 2005, and
    adding to that level the additional funds for tobacco compliance
    activities required under subsection (a). The State is to submit a
    report to the Secretary on all fiscal year [2004] 2005 State
    expenditures and all fiscal year [2005] 2006 obligations for tobacco
    prevention and compliance activities by program activity by July 31,
    [2005] 2006.
        (d) The Secretary shall exercise discretion in enforcing the timing
    of the State obligation of the additional funds required by the
    certification described in subsection (a) as late as July 31, [2005]
    2006.
        (e) None of the funds appropriated by this Act may be used to
    withhold substance abuse funding pursuant to section 1926 from a
    territory that receives less than $1,000,000.
        Sec. [215] 214. In order for the Centers for Disease Control and
    Prevention to carry out international health activities, including HIV/
    AIDS and other infectious disease, chronic and environmental disease,
    and other health activities abroad during fiscal year [2005] 2006, the
    Secretary of Health and Human Services--
            (1) may exercise authority equivalent to that available to the
        Secretary of State in section 2(c) of the State Department Basic
        Authorities Act of 1956 (22 U.S.C. 2669(c)). The Secretary of Health
        and Human Services shall consult with the Secretary of State and
        relevant Chief of Mission to ensure that the authority provided in
        this section is exercised in a manner consistent with section 207 of
        the Foreign Service Act of 1980 (22 U.S.C. 3927) and other
        applicable statutes administered by the Department of State, and
            (2) is authorized to provide such funds by advance or
        reimbursement to the Secretary of State as may be necessary to pay
        the costs of acquisition, lease, alteration, renovation, and
        management of facilities outside of the United States for the use of
        the Department of Health and Human Services. The Department of State
        shall cooperate fully with the Secretary of Health and Human
        Services to ensure that the Department of Health and Human Services
        has secure, safe, functional facilities that comply with applicable
        regulation governing location, setback, and other facilities
        requirements and serve the purposes established by this Act. The
        Secretary of Health and Human Services is authorized, in
        consultation with the Secretary of State, through grant or
        cooperative agreement, to make available to public or nonprofit
        private institutions or agencies in participating foreign countries,
        funds to acquire, lease, alter, or renovate facilities in those
        countries as necessary to conduct programs of assistance for
        international health activities, including activities relating to
        HIV/AIDS and other infectious diseases, chronic and environmental
        diseases, and other health activities abroad.
        Sec. [216] 215. The Division of Federal Occupational Health
    hereafter may utilize personal services contracting to employ
    professional management/administrative and occupational health
    professionals.
        Sec. [217] 216. (a) Authority.--Notwithstanding any other provision
    of law, the Director of the National Institutes of Health may use funds
    available under section 402(i) of the Public Health Service Act (42
    U.S.C. 282(i)) to enter into transactions (other than contracts,
    cooperative agreements, or grants) to carry out research in support of
    the NIH Roadmap [Initiative of the Director] for Medical Research.

    [[Page 475]]

        (b) Peer Review.--In entering into transactions under subsection
    (a), the Director of the National Institutes of Health may utilize such
    peer review procedures (including consultation with appropriate
    scientific experts) as the Director determines to be appropriate to
    obtain assessments of scientific and technical merit. Such procedures
    shall apply to such transactions in lieu of the peer review and advisory
    council review procedures that would otherwise be required under
    sections 301(a)(3), 405(b)(1)(B), 405(b)(2), 406(a)(3)(A), 492, and 494
    of the Public Health Service Act (42 U.S.C. 241, 284(b)(1)(B),
    284(b)(2), 284a(a)(3)(A), 289a, and 289c).
        Sec. 217. Funds which are available for Individual Learning Accounts
    for employees of the Centers for Disease Control and Prevention and the
    Agency for Toxic Substances and Disease Registry may be transferred to
    ``Disease Control, Research, and Training,'' to be available only for
    Individual Learning Accounts: Provided, That such funds may be used for
    any individual full-time equivalent employee while such employee is
    employed either by CDC or ATSDR.
        [Sec. 218. Notwithstanding any other provisions of law, funds made
    available under this heading may be used to continue operating the
    Council on Graduate Medical Education established by section 301 of
    Public Law 102-408.]
        [Sec. 219. (a) Notwithstanding section 412.23(b)(2) of title 42 of
    the Code of Federal Regulations, none of the funds appropriated by this
    Act may be expended by the Secretary of Health and Human Services to
    treat a hospital or unit of a hospital that was certified by the
    Secretary as an inpatient rehabilitation facility on or before June 30,
    2004, as a subsection (d) hospital (as defined in section 1886(d)(1)(B)
    of the Social Security Act (42 U.S.C. 1395ww(d)(1)(B))) until, not later
    than 60 days after the date on which the report under subsection (b) is
    issued, the Secretary, taking into account the recommendations in such
    report--
            (1) determines that the classification criteria of hospitals and
        units of hospitals as inpatient rehabilitation facilities under such
        section 412.23(b)(2) are not inconsistent with such recommendations;
        or
            (2) promulgates a regulation providing for revised criteria
        under such section 412.23(b)(2), which regulation shall be effective
        and final immediately on an interim basis as of the date of
        publication of the regulation.
        (b) The study referred to in subsection (a) is a study by the
    Comptroller General of the United States directed in the statement of
    managers accompanying the conference report on the bill H.R. 1 of the
    108th Congress regarding clinically appropriate standards for defining
    inpatient rehabilitation services under such section 412.23(b)(2).]
        [Sec. 220. In addition to funds appropriated to the Office of
    Inspector General of the Department of Health and Human Services under
    Public Law 104-191 and this Act, $25,000,000 shall be transferred from
    amounts appropriated under section 1015(a)(1) of Public Law 108-173 for
    activities by the Office of Inspector General of the Department of
    Health and Human Services relating to oversight of programs established
    or revised by Public Law 108-173.]
        [Sec. 221. The unobligated balance of the Health Professions Student
    Loan program authorized in Subpart II, Federally-Supported Student Loan
    Funds, of title VII of the Public Health Services Act is rescinded.]
        [Sec. 222. The unobligated balance of the Nursing Student Loan
    program authorized by section 835 of the Public Health Services Act is
    rescinded.]
        [Sec. 223. The unobligated balance, excluding amounts necessary for
    the costs of potential defaults, in the Medical Facilities Guarantee and
    Loan Fund is rescinded.]
        [Sec. 224. The unobligated balance in the amount of $20,000,000
    appropriated by Public Law 108-11 under the heading ``Public Health and
    Social Services Emergency Fund'' is rescinded.]
        [Sec. 225. The Center for Biodefense and Emerging Infectious
    Diseases (Building 33) at the National Institutes of Health is hereby
    named the C.W. Bill Young Center for Biodefense and Emerging Infectious
    Diseases.] (Department of Health and Human Services Appropriations Act,
    2005.)
        [Sec. 119. Notwithstanding any other provision of law, in addition
    to amounts otherwise provided in this or any other Act for fiscal year
    2005, the following amounts are appropriated: $2,000,000 for the Helen
    Keller National Center for Deaf-Blind Youths and Adults for activities
    authorized under the Helen Keller National Center Act; and for the
    Department of Health and Human Services, Health Resources and Services
    Administration, $1,000,000 for the Hospital for Special Surgery to
    establish a National Center for Musculoskeletal Research, New York, New
    York, for facilities and equipment; and for the Department of Health and
    Human Services, Health Resources and Services Administration, $1,000,000
    for the Jesse Helms Nursing Center at Union Regional Medical Center,
    Union County, North Carolina for facilities and equipment.]
    (Miscellaneous Appropriations and Offsets Act, 2005.)