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

             <h1>DEPARTMENT OF HEALTH AND HUMAN SERVICES

             </h1>

          DEPARTMENT OF HEALTH AND HUMAN SERVICES

             Food and Drug Administration

             Federal Funds
             Salaries and ExpensesFor 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; [$3,083,408,000:]$3,957,738,000: Provided, That, of the amount provided under this heading,  [$30,530,000]$760,000,000 shall be derived from [animal]prescription drug user fees authorized by [section 740 of the Federal Food, Drug, and Cosmetic Act (21 U.S.C. 379j–12)]21 U.S.C. 379h, and shall be credited to this account and remain available until expended; [$7,595,000] $114,833,000 shall be derived from [animal generic drug] medical device user fees authorized by [section 741 of the Federal Food, Drug, and Cosmetic Act (21 U.S.C. 379j-21)]21 U.S.C. 379j, and shall be credited to this account and shall remain available until expended; [$505,000,000] $534,000,000 shall be derived from tobacco product user fees authorized by 21 U.S.C. 387s, and shall be credited to this account and remain available until expended[; $12,925,000 shall be derived from food and feed recall fees authorized by section 743 of the Federal Food, Drug, and Cosmetic
             Act (Public Law 75–717), as amended by the Food Safety Modernization Act (Public Law 111–353), and shall be credited to this
             account and remain available until expended; $15,367,000 shall be derived from food reinspection fees authorized by section
             743 of the Federal Food, Drug, and Cosmetic Act (Public Law 75–717), as amended by the Food Safety Modernization Act (Public
             Law 111–353), and shall be credited to this account and remain available until expended; and amounts derived from voluntary
             qualified importer program fees authorized by section 743 of the Federal Food, Drug, and Cosmetic Act (Public Law 75–717),
             as amended by the Food Safety Modernization Act (Public Law 111–353), and shall be credited to this account and remain available
             until expended]: Provided further, That, in addition to and notwithstanding any other provision under this heading, amounts collected for [animal] prescription drug user fees and [animal generic drug]medical device user fees that exceed the respective fiscal year [2013]2014 limitations are appropriated and shall be credited to this account and remain available until expended: Provided further, That fees derived from [animal drug and animal generic drug] prescription drug, medical device, human generic drug, and biosimilar biological product assessments for fiscal year [2013 received during fiscal year 2013]2014, including any such fees [assessed] collected prior to fiscal year [2013] 2014 but credited for fiscal year [2013]2014, shall be subject to the fiscal year [2013]2014 limitations: Provided further, That the Secretary may, prior to the due date for such fees, accept payment [of animal drug user fees and animal generic drug user fees authorized for fiscal year 2014, and that amounts of such fees
             assessed for fiscal year 2014 for which the Secretary accepts payment in]during fiscal year [2013 shall not be included in amounts provided] 2014 of user fees specified under this heading and authorized for fiscal year 2015, and that amounts of such fiscal year 2015 fees for which the Secretary accepts payment
                during fiscal year 2014 shall not be included in amounts provided under this heading: Provided further, That not to exceed $25,000 of this amount shall be for official reception and representation expenses, not otherwise provided for, as determined by
             the Commissioner.

          In addition, human generic drug user fees authorized by 21 U.S.C. 379j-42, biosimilar biological product fees authorized by 21 U.S.C. 379j-52,
                mammography user fees authorized by 42 U.S.C. 263b, export certification user fees authorized by 21 U.S.C. 381, [and] priority review user fees authorized by 21 U.S.C. 360n, [may]and food and feed recall and reinspection fees authorized by 21 U.S.C. 379j-31 shall be credited to this account, to remain available until expended.
             Buildings and FacilitiesFor plans, construction, repair, improvement, extension, alteration, and purchase of fixed equipment or facilities of or used
             by the Food and Drug Administration, where not otherwise provided, [$5,320,000]$8,788,000, to remain available until expended.  Note.—A full-year 2013 appropriation for this account was not enacted at the time the budget was prepared; therefore, the
                budget assumes this account is operating under the Continuing Appropriations Resolution, 2013 (P.L. 112–175). The amounts
                included for 2013 reflect the annualized level provided by the continuing resolution.
          Special and Trust Fund Receipts (in millions of dollars)

                      Identification code 75–9911–0–1–554
                      2012 actual
                      2013 CR
                      2014 est.

                      0100
                      Balance, start of year

                      Receipts:

                      0220
                      Cooperative Research and Development Agreements, FDA
                      2
                      2
                      2

                      0400
                      Total: Balances and collections
                      2
                      2
                      2

                      Appropriations:

                      0500
                      Salaries and Expenses
                      –2
                      –2
                      –2

                      0799
                      Balance, end of year

          Program and Financing (in millions of dollars)

                      Identification code 75–9911–0–1–554
                      2012 actual
                      2013 CR
                      2014 est.

                      Obligations by program activity:

                      0001
                      Foods
                      866
                      864
                      883

                      0002
                      Drugs
                      828
                      481
                      466

                      0003
                      Devices and radiological products
                      323
                      325
                      321

                      0004
                      National Center for Toxicological Research
                      60
                      60
                      59

                      0005
                      Other activities
                      154
                      163
                      173

                      0006
                      Other rent and rent related activities
                      106
                      107
                      133

                      0007
                      Rental payments
                      160
                      161
                      162

                      0008
                      Buildings and facilities
                      9
                      9
                      9

                      0009
                      CRADAs
                      2
                      2
                      2

                      0010
                      Animal Drugs and Feed

                      138
                      141

                      0011
                      Biologics

                      213
                      211

                      0799
                      Total direct obligations
                      2,508
                      2,523
                      2,560

                      0801
                      Reimbursable program (User fees)
                      1,086
                      1,686
                      1,788

                      0802
                      Reimbursable program (Federal sources)

                      49
                      49

                      0899
                      Total reimbursable obligations
                      1,086
                      1,735
                      1,837

                      0900
                      Total new obligations
                      3,594
                      4,258
                      4,397

                      Budgetary Resources:

                      Unobligated balance:

                      1000
                      Unobligated balance brought forward, Oct 1
                      581
                      854
                      854

                      1001
                      Discretionary unobligated balance brought fwd, Oct 1
                      581
                      854

                      1021
                      Recoveries of prior year unpaid obligations
                      1

                      1050
                      Unobligated balance (total)
                      582
                      854
                      854

                      Budget authority:

                      Appropriations, discretionary:

                      1100
                      Appropriation
                      2,506
                      2,521
                      2,558

                      1160
                      Appropriation, discretionary (total)
                      2,506
                      2,521
                      2,558

                      Appropriations, mandatory:

                      1201
                      Appropriation (special or trust fund)
                      2
                      2
                      2

                      1260
                      Appropriations, mandatory (total)
                      2
                      2
                      2

                      Spending authority from offsetting collections, discretionary:

                      1700
                      Collected
                      1,275
                      1,416
                      1,837

                      1701
                      Change in uncollected payments, Federal sources
                      19

                      1702
                      Offsetting collections (previously unavailable)
                      388
                      324
                      333

                      1725
                      Spending authority from offsetting collections precluded from obligation (limitation on obligations)
                      –324
                      –324
                      –333

                      1750
                      Spending auth from offsetting collections, disc (total)
                      1,358
                      1,416
                      1,837

                      Spending authority from offsetting collections, mandatory:

                      1800
                      Collected

                      319

                      1850
                      Spending auth from offsetting collections, mand (total)

                      319

                      1900
                      Budget authority (total)
                      3,866
                      4,258
                      4,397

                      1930
                      Total budgetary resources available
                      4,448
                      5,112
                      5,251

                      Memorandum (non-add) entries:

                      1941
                      Unexpired unobligated balance, end of year
                      854
                      854
                      854

                      Change in obligated balance:

                      Unpaid obligations:

                      3000
                      Unpaid obligations, brought forward, Oct 1
                      1,459
                      1,663
                      1,641

                      3010
                      Obligations incurred, unexpired accounts
                      3,594
                      4,258
                      4,397

                      3011
                      Obligations incurred, expired accounts
                      5

                      3020
                      Outlays (gross)
                      –3,330
                      –4,280
                      –4,354

                      3040
                      Recoveries of prior year unpaid obligations, unexpired
                      –1

                      3041
                      Recoveries of prior year unpaid obligations, expired
                      –64

                      3050
                      Unpaid obligations, end of year
                      1,663
                      1,641
                      1,684

                      Uncollected payments:

                      3060
                      Uncollected pymts, Fed sources, brought forward, Oct 1
                      –46
                      –44
                      –44

                      3070
                      Change in uncollected pymts, Fed sources, unexpired
                      –19

                      3071
                      Change in uncollected pymts, Fed sources, expired
                      21

                      3090
                      Uncollected pymts, Fed sources, end of year
                      –44
                      –44
                      –44

                      Memorandum (non-add) entries:

                      3100
                      Obligated balance, start of year
                      1,413
                      1,619
                      1,597

                      3200
                      Obligated balance, end of year
                      1,619
                      1,597
                      1,640

                      Budget authority and outlays, net:

                      Discretionary:

                      4000
                      Budget authority, gross
                      3,864
                      3,937
                      4,395

                      Outlays, gross:

                      4010
                      Outlays from new discretionary authority
                      2,420
                      2,888
                      3,331

                      4011
                      Outlays from discretionary balances
                      908
                      1,071
                      1,021

                      4020
                      Outlays, gross (total)
                      3,328
                      3,959
                      4,352

                      Offsets against gross budget authority and outlays:

                      Offsetting collections (collected) from:

                      4030
                      Federal sources
                      –49
                      –49
                      –49

                      4033
                      Non-Federal sources
                      –1,252
                      –1,367
                      –1,788

                      4040
                      Offsets against gross budget authority  and outlays (total)
                      –1,301
                      –1,416
                      –1,837

                      Additional offsets against gross budget authority only:

                      4050
                      Change in uncollected pymts, Fed sources, unexpired
                      –19

                      4052
                      Offsetting collections credited to expired accounts
                      26

                      4060
                      Additional offsets against budget authority only (total)
                      7

                      4070
                      Budget authority, net (discretionary)
                      2,570
                      2,521
                      2,558

                      4080
                      Outlays, net (discretionary)
                      2,027
                      2,543
                      2,515

                      Mandatory:

                      4090
                      Budget authority, gross
                      2
                      321
                      2

                      Outlays, gross:

                      4100
                      Outlays from new mandatory authority
                      2
                      321
                      2

                      Offsets against gross budget authority and outlays:

                      Offsetting collections (collected) from:

                      4123
                      Non-Federal sources

                      –319

                      4180
                      Budget authority, net (total)
                      2,572
                      2,523
                      2,560

                      4190
                      Outlays, net (total)
                      2,029
                      2,545
                      2,517

                      Memorandum (non-add) entries:

                      5090
                      Unavailable balance, SOY: Offsetting collections
                      413
                      349
                      349

                      5091
                      Unavailable balance, EOY: Offsetting collections
                      349
                      349
                      349

             [In millions of dollars]

                         2012
                         2013
                         2014

                         Distribution of discretionary budget authority by account:

                         Salaries and expenses
                         2497
                         2512
                         2549

                         Buildings and facilities
                         9
                         9
                         9

                         Distribution of discretionary outlays by account:

                         Salaries and expenses
                         2018
                         2534
                         2506

                         Buildings and facilities
                         9
                         9
                         9

             The Food and Drug Administration (FDA) is responsible for protecting the public health by ensuring the safety, effectiveness,
                and security of human and veterinary drugs, biological products and medical devices; ensuring the safety of foods, cosmetics,
                and radiation-emitting products; and regulating tobacco products.  FDA also advances public health by helping to speed innovations
                that make medicines and devices safer and more effective.  The agency strives to provide the public with accurate, science-based
                information necessary to use medical products and foods to maintain and improve their health.  FDA also has responsibility
                for regulating the manufacturing, marketing and distribution of tobacco products to protect the public health and to reduce
                tobacco use by minors. Finally, FDA plays a significant role in the Nations counterterrorism efforts.  FDA fulfills this responsibility
                by ensuring the security of the food supply and by fostering the development of medical products to respond to intentional
                and natural public health threats. 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 funding for
                food protection, drug safety, medical device review and safety, developing medical countermeasures, and headquarters consolidation
                in White Oak, Maryland.

          Object Classification (in millions of dollars)

                      Identification code 75–9911–0–1–554
                      2012 actual
                      2013 CR
                      2014 est.

                      Direct obligations:

                      Personnel compensation:

                      11.1
                      Full-time permanent
                      757
                      719
                      787

                      11.3
                      Other than full-time permanent
                      101
                      97
                      106

                      11.5
                      Other personnel compensation
                      54
                      51
                      56

                      11.7
                      Military personnel
                      60
                      57
                      61

                      11.8
                      Special personal services payments
                      1
                      1
                      1

                      11.9
                      Total personnel compensation
                      973
                      925
                      1,011

                      12.1
                      Civilian personnel benefits
                      267
                      254
                      278

                      12.2
                      Military personnel benefits
                      32
                      30
                      32

                      21.0
                      Travel and transportation of persons
                      47
                      51
                      49

                      22.0
                      Transportation of things
                      4
                      5
                      5

                      23.1
                      Rental payments to GSA
                      161
                      161
                      162

                      23.2
                      Rental payments to others
                      3
                      3
                      3

                      23.3
                      Communications, utilities, and miscellaneous charges
                      37
                      40
                      38

                      24.0
                      Printing and reproduction
                      3
                      3
                      3

                      25.1
                      Advisory and assistance services
                      47
                      50
                      48

                      25.2
                      Other services from non-Federal sources
                      359
                      384
                      340

                      25.3
                      Other goods and services from Federal sources
                      226
                      242
                      233

                      25.4
                      Operation and maintenance of facilities
                      57
                      61
                      59

                      25.5
                      Research and development contracts
                      33
                      35
                      34

                      25.7
                      Operation and maintenance of equipment
                      48
                      52
                      50

                      26.0
                      Supplies and materials
                      42
                      46
                      44

                      31.0
                      Equipment
                      54
                      58
                      56

                      32.0
                      Land and structures
                      4
                      5
                      5

                      41.0
                      Grants, subsidies, and contributions
                      110
                      117
                      109

                      42.0
                      Insurance claims and indemnities
                      1
                      1
                      1

                      99.0
                      Direct obligations
                      2,508
                      2,523
                      2,560

                      99.0
                      Reimbursable obligations
                      1,086
                      1,735
                      1,837

                      99.9
                      Total new obligations
                      3,594
                      4,258
                      4,397

          Employment Summary

                      Identification code 75–9911–0–1–554
                      2012 actual
                      2013 CR
                      2014 est.

                      1001
                      Direct civilian full-time equivalent employment
                      8,974
                      10,025
                      10,316

                      1101
                      Direct military average strength employment
                      690
                      690
                      690

                      2001
                      Reimbursable civilian full-time equivalent employment
                      3,514
                      3,477
                      3,580

                      2101
                      Reimbursable military average strength employment
                      270
                      270
                      270

                      3001
                      Allocation account civilian full-time equivalent employment
                      53
                      72
                      74

                      3101
                      Allocation account military average strength employment
                      1
                      1
                      1

             Salaries and Expenses
             (Legislative proposal, not subject to PAYGO)In addition, contingent upon the enactment of authorizing legislation, the Secretary shall assess a fee with respect to animal
                drugs and animal generic drugs: Provided, That fees of $23,600,000 with respect to animal drugs shall be credited to this
                account and remain available until expended; and $7,328,000 with respect to animal generic drugs shall be credited to this
                account and remain available until expended: Provided further, That in addition to and notwithstanding any other provision
                under this heading, amounts collected for such animal drug user fees and animal generic drug user fees that exceed the respective
                fiscal year 2014 limitations are appropriated and shall be credited to this account and remain available until expended: Provided
                further, That fees derived from such animal drugs and animal generic drugs assessments for fiscal year 2014, including any
                such fees collected prior to fiscal year 2014 but credited for fiscal 2014, shall be subject to the fiscal year 2014 limitations:
                Provided further, That the Secretary may, prior to the due date for such animal drug and animal generic drug user fees, accept
                payment during fiscal year 2014 of such fees authorized for fiscal year 2015, and that amounts of such fiscal year 2015 fees
                for which the Secretary accepts payment during fiscal year 2014 shall not be included in amounts provided under this heading.

          In addition, contingent upon the enactment of authorizing legislation, the Secretary shall assess user fees with respect to
                food facility registrations and inspections, food imports, food contact notification activities, reinspection of medical product
                facilities, cosmetic activities, and international express courier import activities, and such fees shall be credited to this
                account and remain available until expended.
          Program and Financing (in millions of dollars)

                      Identification code 75–9911–2–1–554
                      2012 actual
                      2013 CR
                      2014 est.

                      Obligations by program activity:

                      0801
                      ADUFA

                      23

                      0802
                      AGDUFA

                      7

                      0803
                      Med.Prod.Reinspect

                      15

                      0804
                      Intl.Courier

                      6

                      0805
                      Food Reg.and Inspect

                      59

                      0806
                      Food Import

                      166

                      0807
                      Cosmetics

                      19

                      0808
                      Food Contact

                      5

                      0900
                      Total new obligations

                      300

                      Budgetary Resources:

                      Budget authority:

                      Spending authority from offsetting collections, discretionary:

                      1700
                      Collected

                      300

                      1750
                      Spending auth from offsetting collections, disc (total)

                      300

                      1900
                      Budget authority (total)

                      300

                      1930
                      Total budgetary resources available

                      300

                      Change in obligated balance:

                      Unpaid obligations:

                      3010
                      Obligations incurred, unexpired accounts

                      300

                      3020
                      Outlays (gross)

                      –300

                      Budget authority and outlays, net:

                      Discretionary:

                      4000
                      Budget authority, gross

                      300

                      Outlays, gross:

                      4010
                      Outlays from new discretionary authority

                      300

                      Offsets against gross budget authority and outlays:

                      Offsetting collections (collected) from:

                      4033
                      Non-Federal sources

                      –300

             The 2014 Budget includes a number of new user fees. Legislation will be proposed to allow FDA to collect fees for food facility
                registration and inspection as well as for food import to implement the requirements of the FDA Food Safety Modernization
                Act (FSMA). The additional resources, estimated at $59 million for the food facility registration and inspection program,
                would enable FDA to target new and improved activities required by FSMA to modernize the food safety system and support improvements
                in food safety science and risk analysis to prevent food safety outbreaks. The fees collected for the food import program,
                estimated at $166 million, would support FDA's food safety efforts to modernize the import system.  The Budget also reproposes
                user fees to support activities related to cosmetics and food contact notification activities and user fees to support inspection-related
                activities at domestic courier facilities and reinspections at medical product facilities.

             The FDA transmitted proposed legislation to reauthorize the Animal Drug User Fee Act and the Animal Generic Drug User Fee
                Act to Congress on February 25, 2012. The proposed legislation authorizes the collection and spending of these fees subject
                to appropriations.

          Object Classification (in millions of dollars)

                      Identification code 75–9911–2–1–554
                      2012 actual
                      2013 CR
                      2014 est.

                      99.9
                      Total new obligations

                      300

          Employment Summary

                      Identification code 75–9911–2–1–554
                      2012 actual
                      2013 CR
                      2014 est.

                      1001
                      Direct civilian full-time equivalent employment

                      1101
                      Direct military average strength employment

                      2001
                      Reimbursable civilian full-time equivalent employment

                      612

                      2101
                      Reimbursable military average strength employment

                      3001
                      Allocation account civilian full-time equivalent employment

                      3101
                      Allocation account military average strength employment

             Revolving Fund for Certification and Other Services

             Program and Financing (in millions of dollars)

                      Identification code 75–4309–0–3–554
                      2012 actual
                      2013 CR
                      2014 est.

                      Obligations by program activity:

                      0801
                      Reimbursable program
                      7
                      8
                      8

                      Budgetary Resources:

                      Unobligated balance:

                      1000
                      Unobligated balance brought forward, Oct 1
                      2
                      3
                      3

                      Budget authority:

                      Spending authority from offsetting collections, mandatory:

                      1800
                      Collected
                      8
                      8
                      8

                      1850
                      Spending auth from offsetting collections, mand (total)
                      8
                      8
                      8

                      1930
                      Total budgetary resources available
                      10
                      11
                      11

                      Memorandum (non-add) entries:

                      1941
                      Unexpired unobligated balance, end of year
                      3
                      3
                      3

                      Change in obligated balance:

                      Unpaid obligations:

                      3000
                      Unpaid obligations, brought forward, Oct 1
                      3
                      3
                      2

                      3010
                      Obligations incurred, unexpired accounts
                      7
                      8
                      8

                      3020
                      Outlays (gross)
                      –7
                      –9
                      –9

                      3050
                      Unpaid obligations, end of year
                      3
                      2
                      1

                      Memorandum (non-add) entries:

                      3100
                      Obligated balance, start of year
                      3
                      3
                      2

                      3200
                      Obligated balance, end of year
                      3
                      2
                      1

                      Budget authority and outlays, net:

                      Mandatory:

                      4090
                      Budget authority, gross
                      8
                      8
                      8

                      Outlays, gross:

                      4100
                      Outlays from new mandatory authority
                      2
                      8
                      8

                      4101
                      Outlays from mandatory balances
                      5
                      1
                      1

                      4110
                      Outlays, gross (total)
                      7
                      9
                      9

                      Offsets against gross budget authority and outlays:

                      Offsetting collections (collected) from:

                      4123
                      Non-Federal sources
                      –8
                      –8
                      –8

                      4190
                      Outlays, net (total)
                      –1
                      1
                      1

             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
                      2012 actual
                      2013 CR
                      2014 est.

                      Reimbursable obligations:

                      11.1
                      Personnel compensation: Full-time permanent
                      4
                      4
                      4

                      12.1
                      Civilian personnel benefits
                      1
                      1
                      1

                      23.1
                      Rental payments to GSA
                      1
                      1
                      1

                      25.2
                      Other services from non-Federal sources
                      1
                      1
                      1

                      26.0
                      Supplies and materials

                      1
                      1

                      99.9
                      Total new obligations
                      7
                      8
                      8

          Employment Summary

                      Identification code 75–4309–0–3–554
                      2012 actual
                      2013 CR
                      2014 est.

                      2001
                      Reimbursable civilian full-time equivalent employment
                      36
                      37
                      37

             Health Resources and Services Administration

             Federal Funds
             Health Resources and Services
             Primary Health CareFor carrying out titles II and III of the Public Health Service Act (referred to in this Act as the "PHS Act'') with respect
             to primary health care and the Native Hawaiian Health Care Act of 1988, [$1,579,975,000, of which $127,000 shall be available until expended for facilities renovations at the Gillis W. Long Hansen's
             Disease Center]$1,566,932,000: Provided, That no more than $40,000 shall be available until expended for carrying out the provisions of section 224(o) of the PHS
             Act, including associated administrative expenses and relevant evaluations: Provided further, That no more than $94,893,000 shall be available until expended for carrying out the provisions of Public Law 104–73 and
             for expenses incurred by the Department of Health and Human Services (referred to in this Act as "HHS'') pertaining to administrative
             claims made under such law.  Note.—A full-year 2013 appropriation for this account was not enacted at the time the budget was prepared; therefore, the
                budget assumes this account is operating under the Continuing Appropriations Resolution, 2013 (P.L. 112–175). The amounts
                included for 2013 reflect the annualized level provided by the continuing resolution.
             Health WorkforceFor carrying out titles III, VII, and VIII of the PHS Act with respect to the health workforce, section 1128E and 1921(b)
             of the Social Security Act, and the Health Care Quality Improvement Act of 1986, [$522,187,000]$540,804,000: Provided, That sections 747(c)(2)[, 340G-1(b) and (d),] and the proportional funding amounts in paragraphs (1) through (4) of section 756(e) of the PHS Act shall not apply to funds
             made available under this heading: 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 such 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 fees collected for the disclosure of information under the information reporting requirement program authorized by
             section 1921 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 funds transferred to this account to carry out section 846 and subpart 3 of part D of title III of the PHS Act may
             be used to make prior year adjustments to awards made under such sections: [Provided further, That, in addition to amounts appropriated under this heading, $35,000,000 shall be available under section 241 of the PHS
             Act to carry out titles VII and VIII of the PHS Act:] Provided further, That, of the amount appropriated under this heading, $88,000,000 shall be for payments to children's hospitals pursuant
             to section 340E of the PHS Act, all of which shall be for payments for direct graduate medical education as described in section
             340E(c).
             Maternal and Child HealthFor carrying out titles III, XI, XII, and XIX of the PHS Act with respect to maternal and child health, title V of the Social
             Security Act, and section 712 of the American Jobs Creation Act of 2004, [$854,807,000]$824,861,000: Provided, That notwithstanding sections 502(a)(1) and 502(b)(1) of the Social Security Act, not more than $78,641,000 shall be available
             for carrying out special projects of regional and national significance pursuant to section 501(a)(2) of such Act and $10,276,000
             shall be available for projects described in paragraphs (A) through (F) of section 501(a)(3) of such Act.
             Ryan White HIV/AIDS ProgramFor carrying out title XXVI of the PHS Act with respect to the Ryan White HIV/AIDS program, [$2,446,772,000]$2,387,178,000, of which [$2,093,599,000] $2,036,898,000 shall remain available to the Secretary through September 30, [2014]2016, for parts A and B of title XXVI of the PHS Act: Provided, That of the funds available for parts A and B of title XXVI of the PHS Act, not less than [$1,000,000,000] $943,299,000 shall be for State AIDS Drug Assistance Programs pursuant to section 2616 or 311(c) of such Act: Provided further, That in addition to amounts provided herein, $25,000,000 shall be available from amounts available under section 241 of
             the PHS Act to carry out parts A, B, C, and D of title XXVI of the PHS Act to fund Special Projects of National Significance
             under section 2691.
             Health Care SystemsFor carrying out titles III and XII of the PHS Act with respect to health care systems, and the Stem Cell Therapeutic and
             Research Act of 2005, [$82,534,000]$83,836,000, of which $127,000 shall be available until expended for facilities renovations at the Gillis W. Long Hansen's
                Disease Center: Provided, That the Secretary may collect a fee of 0.1 percent of each purchase of 340B drugs from entities participating in the Drug
             Pricing Program pursuant to section 340B of the PHS Act to pay for the operating costs of such program: Provided further, That fees pursuant to the 340B Drug Pricing Program shall be collected by [manufacturers at the time of sale,] the Secretary based on sales data that shall be submitted by drug manufacturers and shall be credited to this account,  to remain available until expended.
             Rural HealthFor carrying out titles III and IV of the PHS Act with respect to rural health, section 427(a) of the Federal Coal Mine Health
             and Safety Act, the Cardiac Arrest Survival Act of 2000, and sections 711 and 1820 of the Social Security Act, $122,232,000,
             of which $26,200,000 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: Provided, That, of the funds made available under this heading for Medicare rural hospital flexibility grants, $1,000,000 shall be
             to carry out section 1820(g)(6) of the Social Security Act, with funds provided for grants under section 1820(g)(6) available
             for the purchase and implementation of telehealth services, including pilots and demonstrations on the use of electronic health
             records to coordinate rural veterans care between rural providers and the Department of Veterans Affairs electronic health
             record system: Provided further, That notwithstanding section 338J(k) of the PHS Act, $10,036,000 shall be available for State Offices of Rural Health.
             Family PlanningFor carrying out the program under title X of the PHS Act to provide for voluntary family planning projects, [$296,838,000]$327,402,000: Provided, 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.
             Program ManagementFor program support in the Health Resources and Services Administration, [$162,517,000]$161,794,000: Provided, That funds made available under this heading may be used to supplement program support funding provided under the headings
             "Primary Health Care'', "Health Workforce'', "Maternal and Child Health'', "Ryan White HIV/AIDS Program'', "Health Care Systems'',
             and "Rural Health'': Provided further, That the Administrator may transfer funds between any of the accounts of HRSA with notification to the Committees on Appropriations
             of both Houses of Congress at least 15 days in advance of any transfer, but no such account shall be decreased by more than
             3 percent by any such transfer.   Note.—A full-year 2013 appropriation for this account was not enacted at the time the budget was prepared; therefore, the
                budget assumes this account is operating under the Continuing Appropriations Resolution, 2013 (P.L. 112–175). The amounts
                included for 2013 reflect the annualized level provided by the continuing resolution.
          Program and Financing (in millions of dollars)

                      Identification code 75–0350–0–1–550
                      2012 actual
                      2013 CR
                      2014 est.

                      Obligations by program activity:

                      0010
                      Health Centers
                      1,472
                      1,492
                      1,472

                      0013
                      Hansen's Disease Center
                      16
                      16
                      16

                      0014
                      Payment to Hawaii for the Treatment of Hansen's Disease
                      2
                      2
                      2

                      0015
                      Black Lung Clinics
                      7
                      7
                      7

                      0016
                      Nursing Education Loan Repayment and Scholarships
                      83
                      84
                      83

                      0017
                      Health Professions
                      376
                      383
                      363

                      0018
                      Maternal and Child Health Block Grant
                      639
                      649
                      639

                      0019
                      Healthy Start
                      104
                      105
                      104

                      0020
                      Poison Control Centers
                      19
                      19

                      0021
                      EMS for Children
                      21
                      21
                      21

                      0022
                      Universal Newborn Hearing Screening
                      19
                      19

                      0023
                      HIV/AIDS
                      2,367
                      2,337
                      2,387

                      0024
                      Organ Transplantation
                      24
                      25
                      26

                      0025
                      Bone Marrow Donor Registry
                      23
                      23
                      23

                      0026
                      Rural Health Policy Development
                      10
                      10
                      10

                      0027
                      Rural Health Outreach Grants
                      55
                      56
                      56

                      0028
                      Rural Health Flexibility Grants
                      41
                      41
                      26

                      0030
                      Telehealth
                      11
                      12
                      12

                      0031
                      Program Management
                      160
                      162
                      162

                      0032
                      Family Planning
                      294
                      299
                      327

                      0033
                      Loan Repayment/Faculty Fellowship
                      1
                      1
                      1

                      0035
                      Health Centers Tort Claim Fund
                      75
                      133
                      95

                      0036
                      Heritable Disorders
                      10
                      10

                      0038
                      Childrens' GME
                      265
                      270
                      88

                      0041
                      State Offices of Rural Health
                      10
                      10
                      10

                      0043
                      Radiogenic Diseases
                      2
                      2
                      2

                      0044
                      Traumatic Brain Injury
                      10
                      10
                      10

                      0045
                      Autism and Other Developmental Disorders
                      47
                      48
                      47

                      0046
                      Cord Blood Stem Cell Bank
                      12
                      12
                      12

                      0048
                      Sickle Cell
                      5
                      5
                      5

                      0049
                      Drug Pricing Program
                      4
                      4
                      4

                      0050
                      Family to Family Health Information Centers ACA
                      5
                      5

                      0067
                      Prevention Fund
                      37

                      57

                      0073
                      Health Centers ACA
                      1,171
                      1,220
                      1,246

                      0074
                      Health Centers Construction ACA
                      741
                      10
                      7

                      0075
                      National Health Service Corps ACA
                      297
                      300
                      305

                      0076
                      School Based Health Centers ACA
                      19
                      83

                      0077
                      GME Payments THC ACA
                      17
                      50
                      73

                      0079
                      Rural Health AED
                      1
                      3

                      0080
                      Pediatric Loan Repayment

                      5

                      0300
                      Total direct programs
                      8,472
                      7,938
                      7,703

                      0799
                      Total direct obligations
                      8,472
                      7,938
                      7,703

                      0801
                      Reimbursable program
                      75
                      71
                      77

                      0802
                      Reimbursable program: PHS evaluation
                      22
                      25
                      25

                      0899
                      Total reimbursable obligations
                      97
                      96
                      102

                      0900
                      Total new obligations
                      8,569
                      8,034
                      7,805

                      Budgetary Resources:

                      Unobligated balance:

                      1000
                      Unobligated balance brought forward, Oct 1
                      1,061
                      381
                      531

                      1001
                      Discretionary unobligated balance brought fwd, Oct 1
                      58
                      83

                      1021
                      Recoveries of prior year unpaid obligations
                      8

                      1050
                      Unobligated balance (total)
                      1,069
                      381
                      531

                      Budget authority:

                      Appropriations, discretionary:

                      1100
                      Appropriation
                      6,206
                      6,232
                      6,015

                      1121
                      Appropriations transferred from other accts [75–9915]
                      9

                      1121
                      Appropriations transferred from other accts [75–0943]
                      1

                      1121
                      Appropriations transferred from other accts [75–1362]
                      1

                      1130
                      Appropriations permanently reduced
                      –12

                      1160
                      Appropriation, discretionary (total)
                      6,205
                      6,232
                      6,015

                      Appropriations, mandatory:

                      1200
                      Appropriation
                      1,550
                      1,855
                      2,505

                      1221
                      Appropriations transferred from other accts [75–0116]
                      37

                      57

                      1260
                      Appropriations, mandatory (total)
                      1,587
                      1,855
                      2,562

                      Spending authority from offsetting collections, discretionary:

                      1700
                      Collected
                      33
                      81
                      87

                      1701
                      Change in uncollected payments, Federal sources
                      45

                      1750
                      Spending auth from offsetting collections, disc (total)
                      78
                      81
                      87

                      Spending authority from offsetting collections, mandatory:

                      1800
                      Offsetting collections (cash)(HPSL&NSL)
                      14
                      16
                      16

                      1850
                      Spending auth from offsetting collections, mand (total)
                      14
                      16
                      16

                      1900
                      Budget authority (total)
                      7,884
                      8,184
                      8,680

                      1930
                      Total budgetary resources available
                      8,953
                      8,565
                      9,211

                      Memorandum (non-add) entries:

                      1940
                      Unobligated balance expiring
                      –3

                      1941
                      Unexpired unobligated balance, end of year
                      381
                      531
                      1,406

                      Change in obligated balance:

                      Unpaid obligations:

                      3000
                      Unpaid obligations, brought forward, Oct 1
                      6,836
                      6,681
                      6,186

                      3010
                      Obligations incurred, unexpired accounts
                      8,569
                      8,034
                      7,805

                      3011
                      Obligations incurred, expired accounts
                      15

                      3020
                      Outlays (gross)
                      –8,638
                      –8,529
                      –8,272

                      3040
                      Recoveries of prior year unpaid obligations, unexpired
                      –8

                      3041
                      Recoveries of prior year unpaid obligations, expired
                      –93

                      3050
                      Unpaid obligations, end of year
                      6,681
                      6,186
                      5,719

                      Uncollected payments:

                      3060
                      Uncollected pymts, Fed sources, brought forward, Oct 1
                      –42
                      –80
                      –80

                      3070
                      Change in uncollected pymts, Fed sources, unexpired
                      –45

                      3071
                      Change in uncollected pymts, Fed sources, expired
                      7

                      3090
                      Uncollected pymts, Fed sources, end of year
                      –80
                      –80
                      –80

                      Memorandum (non-add) entries:

                      3100
                      Obligated balance, start of year
                      6,794
                      6,601
                      6,106

                      3200
                      Obligated balance, end of year
                      6,601
                      6,106
                      5,639

                      Budget authority and outlays, net:

                      Discretionary:

                      4000
                      Budget authority, gross
                      6,283
                      6,313
                      6,102

                      Outlays, gross:

                      4010
                      Outlays from new discretionary authority
                      2,515
                      2,549
                      2,460

                      4011
                      Outlays from discretionary balances
                      4,277
                      3,764
                      3,721

                      4020
                      Outlays, gross (total)
                      6,792
                      6,313
                      6,181

                      Offsets against gross budget authority and outlays:

                      Offsetting collections (collected) from:

                      4030
                      Federal sources
                      –16
                      –52
                      –53

                      4033
                      Non-Federal sources
                      –29
                      –29
                      –28

                      4033
                      Non-Federal sources

                      –6

                      4040
                      Offsets against gross budget authority  and outlays (total)
                      –45
                      –81
                      –87

                      Additional offsets against gross budget authority only:

                      4050
                      Change in uncollected pymts, Fed sources, unexpired
                      –45

                      4052
                      Offsetting collections credited to expired accounts
                      12

                      4060
                      Additional offsets against budget authority only (total)
                      –33

                      4070
                      Budget authority, net (discretionary)
                      6,205
                      6,232
                      6,015

                      4080
                      Outlays, net (discretionary)
                      6,747
                      6,232
                      6,094

                      Mandatory:

                      4090
                      Budget authority, gross
                      1,601
                      1,871
                      2,578

                      Outlays, gross:

                      4100
                      Outlays from new mandatory authority
                      801
                      850
                      855

                      4101
                      Outlays from mandatory balances
                      1,045
                      1,366
                      1,236

                      4110
                      Outlays, gross (total)
                      1,846
                      2,216
                      2,091

                      Offsets against gross budget authority and outlays:

                      Offsetting collections (collected) from:

                      4123
                      Non-Federal sources
                      –14
                      –16
                      –16

                      4180
                      Budget authority, net (total)
                      7,792
                      8,087
                      8,577

                      4190
                      Outlays, net (total)
                      8,579
                      8,432
                      8,169

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

                      Identification code 75–0350–0–1–550
                      2012 actual
                      2013 CR
                      2014 est.

                      Guaranteed loan levels supportable by subsidy budget authority:

                      215001
                      Health centers: Facilities renovation loan guarantee levels
                      10
                      8
                      4

                      215002
                      Health centers: Managed care network development loan guarantee

                      1
                      1

                      215003
                      Health centers: Managed care plan loan guarantee levels

                      3
                      1

                      215999
                      Total loan guarantee levels
                      10
                      12
                      6

                      Guaranteed loan subsidy (in percent):

                      232001
                      Health centers: Facilities renovation loan guarantee levels
                      2.67
                      2.69
                      2.81

                      232002
                      Health centers: Managed care network development loan guarantee
                      9.62
                      9.73
                      10.10

                      232003
                      Health centers: Managed care plan loan guarantee levels
                      5.76
                      5.79
                      5.86

                      232999
                      Weighted average subsidy rate
                      2.67
                      4.05
                      4.53

              Resources displayed here support categorical grants and contracts managed by Health Resources and Services Administration
                (HRSA).  These activities include support for Federally Qualified Health Centers, treatment and care for those living with
                HIV/AIDS, health professions training, maternal and child health care services, promotion of organ and bone marrow donation,
                and the medical malpractice claims funds, which pay malpractice claims filed against employees of federally-supported health
                centers and free clinics.  HRSA is also responsible for oversight of the 340B Drug Discount Program.  The 2014 Budget proposes
                a new user fee for this program to improve administration and oversight of this activity.

             HRSA administers the following revolving loan programs: Health Professions Student Loans (HPSL), Nursing Student Loans (NSL),
                Primary Care Loans (PCL) and Loans for Disadvantaged Students (LDS).  These programs are financed through revolving accounts
                (Federal Capital Contribution) and do not receive annual appropriations. Through these revolving fund accounts, funds are
                awarded to institutions that in turn provide loans to individual students. As borrowers pay back loans the programs revolving
                account gets replenished, and the collected funds are then used to give out new loans in the following academic years. If
                the programs revolving account has excess funds that will not be used to provide new loans, these excess funds are returned
                to HRSA. Funds returned to HRSA are then awarded to programs that are in need of additional funds.  The information below
                reflects Academic Year 2011–2012 data reported in the Annual Operating Report.

             Health Professions Revolving Loan Programs Federal Capital Contribution

                         Program
                         Account Balance

                         HPSL
                         $378,701,815

                         NSL
                         $171,324,184

                         PCL
                         $246,664,915

                         LDS
                         $130,836,447

                         Total
                         $927,527,361

          Object Classification (in millions of dollars)

                      Identification code 75–0350–0–1–550
                      2012 actual
                      2013 CR
                      2014 est.

                      Direct obligations:

                      Personnel compensation:

                      11.1
                      Full-time permanent
                      150
                      150
                      151

                      11.3
                      Other than full-time permanent
                      6
                      6
                      6

                      11.5
                      Other personnel compensation
                      3
                      3
                      4

                      11.7
                      Military personnel
                      20
                      20
                      20

                      11.8
                      Special personal services payments
                      1
                      1

                      11.9
                      Total personnel compensation
                      180
                      180
                      181

                      12.1
                      Civilian personnel benefits
                      45
                      45
                      44

                      12.2
                      Military personnel benefits
                      11
                      11
                      11

                      21.0
                      Travel and transportation of persons
                      3
                      3
                      4

                      23.1
                      Rental payments to GSA
                      23
                      23
                      23

                      23.2
                      Rental payments to others
                      1
                      1
                      1

                      23.3
                      Communications, utilities, and miscellaneous charges
                      2
                      2
                      1

                      24.0
                      Printing and reproduction

                      1

                      25.1
                      Advisory and assistance services
                      13
                      13
                      38

                      25.2
                      Other services from non-Federal sources
                      181
                      176
                      156

                      25.3
                      Other goods and services from Federal sources
                      202
                      201
                      197

                      25.4
                      Operation and maintenance of facilities
                      1
                      1
                      1

                      25.6
                      Medical care
                      3
                      3
                      3

                      25.7
                      Operation and maintenance of equipment
                      13
                      13
                      14

                      26.0
                      Supplies and materials
                      2
                      2
                      1

                      31.0
                      Equipment
                      6
                      6
                      4

                      41.0
                      Grants, subsidies, and contributions
                      7,718
                      7,131
                      6,934

                      42.0
                      Insurance claims and indemnities
                      68
                      127
                      89

                      99.0
                      Direct obligations
                      8,472
                      7,938
                      7,703

                      99.0
                      Reimbursable obligations
                      97
                      96
                      102

                      99.9
                      Total new obligations
                      8,569
                      8,034
                      7,805

          Employment Summary

                      Identification code 75–0350–0–1–550
                      2012 actual
                      2013 CR
                      2014 est.

                      1001
                      Direct civilian full-time equivalent employment
                      1,564
                      1,556
                      1,547

                      1101
                      Direct military average strength employment
                      200
                      200
                      200

                      2001
                      Reimbursable civilian full-time equivalent employment
                      79
                      85
                      85

                      2101
                      Reimbursable military average strength employment
                      8
                      8
                      8

             Vaccine Injury Compensation

             Program and Financing (in millions of dollars)

                      Identification code 75–0320–0–1–551
                      2012 actual
                      2013 CR
                      2014 est.

                      Budgetary Resources:

                      Unobligated balance:

                      1000
                      Unobligated balance brought forward, Oct 1
                      12
                      16
                      16

                      Budget authority:

                      Spending authority from offsetting collections, mandatory:

                      1800
                      Collected
                      4

                      1850
                      Spending auth from offsetting collections, mand (total)
                      4

                      1900
                      Budget authority (total)
                      4

                      1930
                      Total budgetary resources available
                      16
                      16
                      16

                      Memorandum (non-add) entries:

                      1941
                      Unexpired unobligated balance, end of year
                      16
                      16
                      16

                      Budget authority and outlays, net:

                      Mandatory:

                      4090
                      Budget authority, gross
                      4

                      Offsets against gross budget authority and outlays:

                      Offsetting collections (collected) from:

                      4120
                      Federal sources
                      –4

                      4190
                      Outlays, net (total)
                      –4

             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 claims yet to be
                adjudicated, no appropriation is requested 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 Injury Compensation Program trust fund account.

             Covered Countermeasure Process Fund

             Program and Financing (in millions of dollars)

                      Identification code 75–0343–0–1–551
                      2012 actual
                      2013 CR
                      2014 est.

                      Obligations by program activity:

                      0001
                      Claims

                      2
                      1

                      0103
                      Admin Expense
                      2
                      3
                      3

                      0900
                      Total new obligations
                      2
                      5
                      4

                      Budgetary Resources:

                      Unobligated balance:

                      1000
                      Unobligated balance brought forward, Oct 1
                      2
                      3
                      1

                      1011
                      Unobligated balance transfer from other accts [75–0140]
                      3
                      3
                      3

                      1050
                      Unobligated balance (total)
                      5
                      6
                      4

                      1930
                      Total budgetary resources available
                      5
                      6
                      4

                      Memorandum (non-add) entries:

                      1941
                      Unexpired unobligated balance, end of year
                      3
                      1

                      Change in obligated balance:

                      Unpaid obligations:

                      3000
                      Unpaid obligations, brought forward, Oct 1
                      2
                      1
                      6

                      3010
                      Obligations incurred, unexpired accounts
                      2
                      5
                      4

                      3020
                      Outlays (gross)
                      –3

                      3050
                      Unpaid obligations, end of year
                      1
                      6
                      10

                      Memorandum (non-add) entries:

                      3100
                      Obligated balance, start of year
                      2
                      1
                      6

                      3200
                      Obligated balance, end of year
                      1
                      6
                      10

                      Budget authority and outlays, net:

                      Discretionary:

                      Outlays, gross:

                      4011
                      Outlays from discretionary balances
                      3

                      4190
                      Outlays, net (total)
                      3

             The Covered Countermeasure Process Fund is established pursuant to the PHS Act, as amended by Division C of Public Law 109–148,
                to serve as a source of funds to pay for compensation for injuries, illnesses or death, or losses resulting from the administration
                to or use by an individual of a covered countermeasure for which a Secretarial Declaration has been issued, pursuant to section
                319F–3(b) of the Public Health Service Act.  Additionally, authority is provided to address any unexpected claims that may
                arise under the Smallpox Emergency Personal Protection Act of 2003.

          Object Classification (in millions of dollars)

                      Identification code 75–0343–0–1–551
                      2012 actual
                      2013 CR
                      2014 est.

                      Direct obligations:

                      11.1
                      Personnel compensation: Full-time permanent
                      2
                      3
                      3

                      42.0
                      Insurance claims and indemnities

                      2
                      1

                      99.9
                      Total new obligations
                      2
                      5
                      4

          Employment Summary

                      Identification code 75–0343–0–1–551
                      2012 actual
                      2013 CR
                      2014 est.

                      1001
                      Direct civilian full-time equivalent employment
                      4
                      4
                      4

                      1101
                      Direct military average strength employment
                      3
                      3
                      3

             Maternal, Infant, and Early Childhood Home Visiting Programs

             Program and Financing (in millions of dollars)

                      Identification code 75–0321–0–1–551
                      2012 actual
                      2013 CR
                      2014 est.

                      Obligations by program activity:

                      0010
                      Maternal, Infant, and Early Childhood Home Visiting Programs
                      344
                      400
                      406

                      Budgetary Resources:

                      Unobligated balance:

                      1000
                      Unobligated balance brought forward, Oct 1

                      13
                      13

                      1012
                      Unobligated balance transfers between expired and unexpired accounts
                      7

                      1050
                      Unobligated balance (total)
                      7
                      13
                      13

                      Budget authority:

                      Appropriations, mandatory:

                      1200
                      Appropriation
                      350
                      400
                      400

                      1260
                      Appropriations, mandatory (total)
                      350
                      400
                      400

                      1930
                      Total budgetary resources available
                      357
                      413
                      413

                      Memorandum (non-add) entries:

                      1941
                      Unexpired unobligated balance, end of year
                      13
                      13
                      7

                      Change in obligated balance:

                      Unpaid obligations:

                      3000
                      Unpaid obligations, brought forward, Oct 1
                      313
                      528
                      527

                      3010
                      Obligations incurred, unexpired accounts
                      344
                      400
                      406

                      3020
                      Outlays (gross)
                      –122
                      –401
                      –318

                      3041
                      Recoveries of prior year unpaid obligations, expired
                      –7

                      3050
                      Unpaid obligations, end of year
                      528
                      527
                      615

                      Memorandum (non-add) entries:

                      3100
                      Obligated balance, start of year
                      313
                      528
                      527

                      3200
                      Obligated balance, end of year
                      528
                      527
                      615

                      Budget authority and outlays, net:

                      Mandatory:

                      4090
                      Budget authority, gross
                      350
                      400
                      400

                      Outlays, gross:

                      4100
                      Outlays from new mandatory authority
                      19
                      120
                      120

                      4101
                      Outlays from mandatory balances
                      103
                      281
                      198

                      4110
                      Outlays, gross (total)
                      122
                      401
                      318

                      4180
                      Budget authority, net (total)
                      350
                      400
                      400

                      4190
                      Outlays, net (total)
                      122
                      401
                      318

             P.L. 111–148 provides resources to Maternal, Infant and Early Childhood Home Visiting Program through 2014 to provide comprehensive
                services for at risk communities.  These activities are administered by HRSA.

          Object Classification (in millions of dollars)

                      Identification code 75–0321–0–1–551
                      2012 actual
                      2013 CR
                      2014 est.

                      Direct obligations:

                      11.1
                      Personnel compensation: Full-time permanent
                      3
                      2
                      2

                      12.1
                      Civilian personnel benefits
                      1
                      1
                      1

                      25.1
                      Advisory and assistance services
                      18
                      15
                      15

                      41.0
                      Grants, subsidies, and contributions
                      322
                      382
                      388

                      99.9
                      Total new obligations
                      344
                      400
                      406

          Employment Summary

                      Identification code 75–0321–0–1–551
                      2012 actual
                      2013 CR
                      2014 est.

                      1001
                      Direct civilian full-time equivalent employment
                      19
                      21
                      21

                      1101
                      Direct military average strength employment
                      4
                      4
                      4

             Health Center Guaranteed Loan Financing Account

             Program and Financing (in millions of dollars)

                      Identification code 75–4442–0–3–551
                      2012 actual
                      2013 CR
                      2014 est.

                      Obligations by program activity:

                      Credit program obligations:

                      0711
                      Default claim payments on principal

                      1
                      1

                      0900
                      Total new obligations

                      1
                      1

                      Budgetary Resources:

                      Unobligated balance:

                      1000
                      Unobligated balance brought forward, Oct 1
                      3
                      3
                      2

                      1930
                      Total budgetary resources available
                      3
                      3
                      2

                      Memorandum (non-add) entries:

                      1941
                      Unexpired unobligated balance, end of year
                      3
                      2
                      1

                      Change in obligated balance:

                      Unpaid obligations:

                      3000
                      Unpaid obligations, brought forward, Oct 1

                      1

                      3010
                      Obligations incurred, unexpired accounts

                      1
                      1

                      3050
                      Unpaid obligations, end of year

                      1
                      2

                      Memorandum (non-add) entries:

                      3100
                      Obligated balance, start of year

                      1

                      3200
                      Obligated balance, end of year

                      1
                      2

          Status of Guaranteed Loans (in millions of dollars)

                      Identification code 75–4442–0–3–551
                      2012 actual
                      2013 CR
                      2014 est.

                      Position with respect to appropriations act limitation on commitments:

                      2121
                      Limitation available from carry-forward
                      28
                      18
                      6

                      2143
                      Uncommitted limitation carried forward
                      –18
                      –6

                      2150
                      Total guaranteed loan commitments
                      10
                      12
                      6

                      2199
                      Guaranteed amount of guaranteed loan commitments
                      8
                      10
                      5

                      Cumulative balance of guaranteed loans outstanding:

                      2210
                      Outstanding, start of year
                      80
                      77
                      77

                      2231
                      Disbursements of new guaranteed loans
                      8
                      11
                      5

                      2251
                      Repayments and prepayments
                      –10
                      –10
                      –10

                      2263
                      Adjustments: Terminations for default that result in claim payments
                      –1
                      –1
                      –1

                      2290
                      Outstanding, end of year
                      77
                      77
                      71

                      Memorandum:

                      2299
                      Guaranteed amount of guaranteed loans outstanding, end of year
                      70
                      65
                      60

             P.L. 104–299 and P.L. 104–208 authorize Health Resources and Services Administration (HRSA) to guarantee up to $160 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.

          Balance Sheet (in millions of dollars)

                      Identification code 75–4442–0–3–551
                      2011 actual
                      2012 actual

                      ASSETS:

                      1101
                      Federal assets: Fund balances with Treasury
                      3
                      3

                      1999
                      Total assets
                      3
                      3

                      LIABILITIES:

                      2204
                      Non-Federal liabilities: Liabilities for loan guarantees
                      3
                      3

                      4999
                      Total liabilities and net position
                      3
                      3

             Health Education Assistance Loans Program AccountSuch sums as may be necessary to carry out the purpose of the program, as authorized by title VII of the PHS Act.
          In addition, for administrative expenses to carry out the guaranteed loan program, including section 709 of the PHS Act, [$2,807,000]$2,807,000.  Note.—A full-year 2013 appropriation for this account was not enacted at the time the budget was prepared; therefore, the
                budget assumes this account is operating under the Continuing Appropriations Resolution, 2013 (P.L. 112–175). The amounts
                included for 2013 reflect the annualized level provided by the continuing resolution.
          Program and Financing (in millions of dollars)

                      Identification code 75–0340–0–1–552
                      2012 actual
                      2013 CR
                      2014 est.

                      Obligations by program activity:

                      Credit program obligations:

                      0707
                      Reestimates of loan guarantee subsidy

                      25

                      0708
                      Interest on reestimates of loan guarantee subsidy

                      31

                      0709
                      Administrative expenses
                      3
                      3

                      0900
                      Total new obligations
                      3
                      59

                      Budgetary Resources:

                      Budget authority:

                      Appropriations, discretionary:

                      1100
                      Appropriation
                      3
                      3
                      3

                      1120
                      Appropriations transferred to other accts [91–0202]

                      –3

                      1160
                      Appropriation, discretionary (total)
                      3
                      3

                      Appropriations, mandatory:

                      1200
                      Appropriation

                      56

                      1260
                      Appropriations, mandatory (total)

                      56

                      1900
                      Budget authority (total)
                      3
                      59

                      1930
                      Total budgetary resources available
                      3
                      59

                      Change in obligated balance:

                      Unpaid obligations:

                      3000
                      Unpaid obligations, brought forward, Oct 1
                      2
                      1
                      1

                      3010
                      Obligations incurred, unexpired accounts
                      3
                      59

                      3020
                      Outlays (gross)
                      –3
                      –59

                      3041
                      Recoveries of prior year unpaid obligations, expired
                      –1

                      3050
                      Unpaid obligations, end of year
                      1
                      1
                      1

                      Memorandum (non-add) entries:

                      3100
                      Obligated balance, start of year
                      2
                      1
                      1

                      3200
                      Obligated balance, end of year
                      1
                      1
                      1

                      Budget authority and outlays, net:

                      Discretionary:

                      4000
                      Budget authority, gross
                      3
                      3

                      Outlays, gross:

                      4010
                      Outlays from new discretionary authority
                      2
                      3

                      4011
                      Outlays from discretionary balances
                      1

                      4020
                      Outlays, gross (total)
                      3
                      3

                      Mandatory:

                      4090
                      Budget authority, gross

                      56

                      Outlays, gross:

                      4100
                      Outlays from new mandatory authority

                      56

                      4180
                      Budget authority, net (total)
                      3
                      59

                      4190
                      Outlays, net (total)
                      3
                      59

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

                      Identification code 75–0340–0–1–552
                      2012 actual
                      2013 CR
                      2014 est.

                      Guaranteed loan upward reestimates:

                      235001
                      HEAL Loan guarantee

                      56

                      235999
                      Total upward reestimate budget authority

                      56

                      Guaranteed loan downward reestimates:

                      237001
                      HEAL Loan guarantee
                      –12

                      237999
                      Total downward reestimate subsidy budget authority
                      –12

                      Administrative expense data:

                      3510
                      Budget authority
                      3
                      3

                      3590
                      Outlays from new authority

                      3

              In 2014 the Department of Education will assume responsibility for the program.  Legislative language that would effect this
                transfer is included under General Provisions. The authority to administer, service, collect, and enforce the program as well
                as the functions, assets, and liabilities of the Secretary of Health and Human Services will be permanently transferred to
                the Secretary of Education.

          Object Classification (in millions of dollars)

                      Identification code 75–0340–0–1–552
                      2012 actual
                      2013 CR
                      2014 est.

                      Direct obligations:

                      11.1
                      Personnel compensation: Full-time permanent
                      2
                      2

                      25.3
                      Other goods and services from Federal sources
                      1
                      1

                      41.0
                      Grants, subsidies, and contributions

                      56

                      99.9
                      Total new obligations
                      3
                      59

          Employment Summary

                      Identification code 75–0340–0–1–552
                      2012 actual
                      2013 CR
                      2014 est.

                      1001
                      Direct civilian full-time equivalent employment
                      13
                      13

             Health Education Assistance Loans Financing Account

             Program and Financing (in millions of dollars)

                      Identification code 75–4304–0–3–552
                      2012 actual
                      2013 CR
                      2014 est.

                      Obligations by program activity:

                      Credit program obligations:

                      0711
                      Default claim payments on principal
                      19
                      13

                      0742
                      Downward reestimate paid to receipt account
                      5

                      0743
                      Interest on downward reestimates
                      7

                      0900
                      Total new obligations
                      31
                      13

                      Budgetary Resources:

                      Unobligated balance:

                      1000
                      Unobligated balance brought forward, Oct 1
                      69
                      49
                      99

                      1010
                      Unobligated balance transfer to other accts [91–4300]

                      –99

                      1050
                      Unobligated balance (total)
                      69
                      49

                      Financing authority:

                      Spending authority from offsetting collections, mandatory:

                      1800
                      Collected
                      11
                      63

                      1850
                      Spending auth from offsetting collections, mand (total)
                      11
                      63

                      1930
                      Total budgetary resources available
                      80
                      112

                      Memorandum (non-add) entries:

                      1941
                      Unexpired unobligated balance, end of year
                      49
                      99

                      Change in obligated balance:

                      Unpaid obligations:

                      3010
                      Obligations incurred, unexpired accounts
                      31
                      13

                      3020
                      Financing disbursements (gross)
                      –31
                      –13

                      Financing authority and disbursements, net:

                      Mandatory:

                      4090
                      Financing authority, gross
                      11
                      63

                      Financing disbursements:

                      4110
                      Financing disbursements, gross
                      31
                      13

                      Offsets against gross financing authority and disbursements:

                      Offsetting collections (collected) from:

                      4120
                      Federal sources-upward estimate and interest

                      –56

                      4122
                      Interest on uninvested funds
                      –4
                      –3

                      4123
                      Recoveries of defaulted loans
                      –7
                      –4

                      4130
                      Offsets against gross financing auth and disbursements (total)
                      –11
                      –63

                      4170
                      Financing disbursements, net (mandatory)
                      20
                      –50

                      4190
                      Financing disbursements, net (total)
                      20
                      –50

          Status of Guaranteed Loans (in millions of dollars)

                      Identification code 75–4304–0–3–552
                      2012 actual
                      2013 CR
                      2014 est.

                      Cumulative balance of guaranteed loans outstanding:

                      2210
                      Outstanding, start of year
                      526
                      430
                      402

                      2251
                      Repayments and prepayments
                      –77
                      –15

                      Adjustments:

                      2261
                      Terminations for default that result in loans receivable
                      –18
                      –9

                      2263
                      Terminations for default that result in claim payments
                      –1
                      –4

                      2264
                      Other adjustments, net

                      –402

                      2290
                      Outstanding, end of year
                      430
                      402

                      Memorandum:

                      2299
                      Guaranteed amount of guaranteed loans outstanding, end of year
                      430

                      Addendum:

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

                      2310
                      Outstanding, start of year
                      175
                      184
                      190

                      2331
                      Disbursements for guaranteed loan claims
                      16
                      10

                      2361
                      Write-offs of loans receivable
                      –7
                      –4

                      2364
                      Other adjustments, net

                      –190

                      2390
                      Outstanding, end of year
                      184
                      190

          Balance Sheet (in millions of dollars)

                      Identification code 75–4304–0–3–552
                      2011 actual
                      2012 actual

                      ASSETS:

                      1101
                      Federal assets: Fund balances with Treasury
                      70
                      50

                      Net value of assets related to post-1991 acquired defaulted guaranteed loans receivable:

                      1501
                      Defaulted guaranteed loans receivable, gross
                      175
                      184

                      1505
                      Allowance for subsidy cost (-)
                      –126
                      –126

                      1599
                      Net present value of assets related to defaulted guaranteed loans
                      49
                      58

                      1999
                      Total assets
                      119
                      108

                      LIABILITIES:

                      2204
                      Non-Federal liabilities: Liabilities for loan guarantees
                      119
                      108

                      4999
                      Total liabilities and net position
                      119
                      108

             Health Education Assistance Loans Liquidating Account

             Program and Financing (in millions of dollars)

                      Identification code 75–4305–0–3–552
                      2012 actual
                      2013 CR
                      2014 est.

                      Obligations by program activity:

                      Credit program obligations:

                      0711
                      Default claim payments on principal
                      4
                      3

                      0900
                      Total new obligations (object class 33.0)
                      4
                      3

                      Budgetary Resources:

                      Budget authority:

                      Appropriations, mandatory:

                      1200
                      Appropriation
                      1
                      1

                      1260
                      Appropriations, mandatory (total)
                      1
                      1

                      Spending authority from offsetting collections, mandatory:

                      1800
                      Collected
                      8
                      7

                      1820
                      Capital transfer of spending authority from offsetting collections to general fund
                      –5
                      –5

                      1850
                      Spending auth from offsetting collections, mand (total)
                      3
                      2

                      1900
                      Budget authority (total)
                      4
                      3

                      1930
                      Total budgetary resources available
                      4
                      3

                      Change in obligated balance:

                      Unpaid obligations:

                      3010
                      Obligations incurred, unexpired accounts
                      4
                      3

                      3020
                      Outlays (gross)
                      –4
                      –3

                      Budget authority and outlays, net:

                      Mandatory:

                      4090
                      Budget authority, gross
                      4
                      3

                      Outlays, gross:

                      4100
                      Outlays from new mandatory authority
                      4
                      3

                      Offsets against gross budget authority and outlays:

                      Offsetting collections (collected) from:

                      4123
                      Non-Federal sources
                      –8
                      –7

                      4180
                      Budget authority, net (total)
                      –4
                      –4

                      4190
                      Outlays, net (total)
                      –4
                      –4

          Status of Guaranteed Loans (in millions of dollars)

                      Identification code 75–4305–0–3–552
                      2012 actual
                      2013 CR
                      2014 est.

                      Cumulative balance of guaranteed loans outstanding:

                      2210
                      Outstanding, start of year
                      83
                      64
                      53

                      2251
                      Repayments and prepayments
                      –15
                      –8

                      Adjustments:

                      2261
                      Terminations for default that result in loans receivable
                      –4
                      –3

                      2264
                      Other adjustments, net

                      –53

                      2290
                      Outstanding, end of year
                      64
                      53

                      Memorandum:

                      2299
                      Guaranteed amount of guaranteed loans outstanding, end of year
                      64
                      53

                      Addendum:

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

                      2310
                      Outstanding, start of year
                      362
                      346
                      324

                      2331
                      Disbursements for guaranteed loan claims
                      3
                      3

                      2351
                      Repayments of loans receivable
                      –8
                      –7

                      2361
                      Write-offs of loans receivable
                      –21
                      –18

                      2364
                      Other adjustments, net
                      10

                      –324

                      2390
                      Outstanding, end of year
                      346
                      324

          Balance Sheet (in millions of dollars)

                      Identification code 75–4305–0–3–552
                      2011 actual
                      2012 actual

                      ASSETS:

                      1101
                      Federal assets: Fund balances with Treasury
                      1
                      1

                      1701
                      Defaulted guaranteed loans, gross
                      362
                      346

                      1703
                      Allowance for estimated uncollectible loans and interest (-)
                      –238
                      –238

                      1799
                      Value of assets related to loan guarantees
                      124
                      108

                      1999
                      Total assets
                      125
                      109

                      LIABILITIES:

                      2104
                      Federal liabilities: Resources payable to Treasury
                      119
                      109

                      2204
                      Non-Federal liabilities: Liabilities for loan guarantees
                      6

                      2999
                      Total liabilities
                      125
                      109

                      4999
                      Total liabilities and net position
                      125
                      109

             Medical Facilities Guarantee and Loan Fund

             Program and Financing (in millions of dollars)

                      Identification code 75–9931–0–3–551
                      2012 actual
                      2013 CR
                      2014 est.

                      Budgetary Resources:

                      Unobligated balance:

                      1021
                      Recoveries of prior year unpaid obligations
                      1

                      1022
                      Capital transfer of unobligated balances to general fund
                      –1

                      Change in obligated balance:

                      Unpaid obligations:

                      3000
                      Unpaid obligations, brought forward, Oct 1
                      1

                      3040
                      Recoveries of prior year unpaid obligations, unexpired
                      –1

                      Memorandum (non-add) entries:

                      3100
                      Obligated balance, start of year
                      1

          Status of Direct Loans (in millions of dollars)

                      Identification code 75–9931–0–3–551
                      2012 actual
                      2013 CR
                      2014 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

             Titles VI and 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
                      2011 actual
                      2012 actual

                      ASSETS:

                      1601
                      Direct loans, gross
                      7
                      7

                      1999
                      Total assets
                      7
                      7

                      LIABILITIES:

                      2201
                      Non-Federal liabilities: Accounts payable
                      7
                      7

                      4999
                      Total liabilities and net position
                      7
                      7

          Trust Funds
             Vaccine Injury Compensation Program Trust FundFor payments from the Vaccine Injury Compensation Program Trust Fund ("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 PHS Act, to remain available until expended: Provided, That for necessary administrative expenses, not to exceed [$6,477,000] $6,477,000 shall be available from the Trust Fund to the Secretary.  Note.—A full-year 2013 appropriation for this account was not enacted at the time the budget was prepared; therefore, the
                budget assumes this account is operating under the Continuing Appropriations Resolution, 2013 (P.L. 112–175). The amounts
                included for 2013 reflect the annualized level provided by the continuing resolution.
          Special and Trust Fund Receipts (in millions of dollars)

                      Identification code 75–8175–0–7–551
                      2012 actual
                      2013 CR
                      2014 est.

                      0100
                      Balance, start of year
                      3,115
                      3,214
                      3,289

                      Receipts:

                      0200
                      Deposits, Vaccine Injury Compensation Trust Fund
                      254
                      262
                      271

                      0240
                      Interest and Profits on Investments, Vaccine Injury Compensation Trust Fund
                      49
                      74
                      121

                      0299
                      Total receipts and collections
                      303
                      336
                      392

                      0400
                      Total: Balances and collections
                      3,418
                      3,550
                      3,681

                      Appropriations:

                      0500
                      Vaccine Injury Compensation Program Trust Fund
                      –19
                      –19
                      –19

                      0501
                      Vaccine Injury Compensation Program Trust Fund
                      –185
                      –242
                      –242

                      0599
                      Total appropriations
                      –204
                      –261
                      –261

                      0799
                      Balance, end of year
                      3,214
                      3,289
                      3,420

          Program and Financing (in millions of dollars)

                      Identification code 75–8175–0–7–551
                      2012 actual
                      2013 CR
                      2014 est.

                      Obligations by program activity:

                      0001
                      Compensation: Claims for post - FY 1989 injuries
                      185
                      242
                      242

                      0103
                      Claims processing (Claims Court)
                      5
                      5
                      5

                      0104
                      Claims processing (HRSA)
                      6
                      6
                      6

                      0105
                      Claims processing (Dept. of Justice)
                      8
                      8
                      8

                      0191
                      Total, administrative expenses
                      19
                      19
                      19

                      0799
                      Total direct obligations
                      204
                      261
                      261

                      0801
                      Reimbursable program activity (claims)
                      1

                      0900
                      Total new obligations
                      205
                      261
                      261

                      Budgetary Resources:

                      Budget authority:

                      Appropriations, discretionary:

                      1101
                      Appropriation (special or trust fund)
                      19
                      19
                      19

                      1160
                      Appropriation, discretionary (total)
                      19
                      19
                      19

                      Appropriations, mandatory:

                      1201
                      Appropriation (special or trust fund)
                      185
                      242
                      242

                      1260
                      Appropriations, mandatory (total)
                      185
                      242
                      242

                      Spending authority from offsetting collections, mandatory:

                      1800
                      Collected
                      1

                      1850
                      Spending auth from offsetting collections, mand (total)
                      1

                      1900
                      Budget authority (total)
                      205
                      261
                      261

                      1930
                      Total budgetary resources available
                      205
                      261
                      261

                      Change in obligated balance:

                      Unpaid obligations:

                      3000
                      Unpaid obligations, brought forward, Oct 1
                      19
                      19

                      3001
                      Adjustments to unpaid obligations, brought forward, Oct 1
                      2

                      3010
                      Obligations incurred, unexpired accounts
                      205
                      261
                      261

                      3020
                      Outlays (gross)
                      –207
                      –280
                      –261

                      3050
                      Unpaid obligations, end of year
                      19

                      Memorandum (non-add) entries:

                      3100
                      Obligated balance, start of year
                      21
                      19

                      3200
                      Obligated balance, end of year
                      19

                      Budget authority and outlays, net:

                      Discretionary:

                      4000
                      Budget authority, gross
                      19
                      19
                      19

                      Outlays, gross:

                      4010
                      Outlays from new discretionary authority
                      10
                      19
                      19

                      4011
                      Outlays from discretionary balances
                      10
                      19

                      4020
                      Outlays, gross (total)
                      20
                      38
                      19

                      Mandatory:

                      4090
                      Budget authority, gross
                      186
                      242
                      242

                      Outlays, gross:

                      4100
                      Outlays from new mandatory authority
                      2
                      242
                      242

                      4101
                      Outlays from mandatory balances
                      185

                      4110
                      Outlays, gross (total)
                      187
                      242
                      242

                      Offsets against gross budget authority and outlays:

                      Offsetting collections (collected) from:

                      4120
                      Federal sources
                      –1

                      4180
                      Budget authority, net (total)
                      204
                      261
                      261

                      4190
                      Outlays, net (total)
                      206
                      280
                      261

                      Memorandum (non-add) entries:

                      5000
                      Total investments, SOY: Federal securities: Par value
                      3,108
                      3,194
                      3,287

                      5001
                      Total investments, EOY: Federal securities: Par value
                      3,194
                      3,287
                      3,433

             The Vaccine Injury Compensation Program was established pursuant to P.L. 99–660 and P.L. 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 75–8175–0–7–551
                      2012 actual
                      2013 CR
                      2014 est.

                      Direct obligations:

                      25.3
                      Other goods and services from Federal sources
                      19
                      19
                      19

                      42.0
                      Insurance claims and indemnities
                      185
                      242
                      242

                      99.0
                      Direct obligations
                      204
                      261
                      261

                      99.0
                      Reimbursable obligations
                      1

                      99.9
                      Total new obligations
                      205
                      261
                      261

             Indian Health Service

             Federal Funds
             Indian Health ServiceFor 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,
             [$3,978,974,000]$3,505,293,000, together with payments received during the fiscal year pursuant to 42 U.S.C. 238(b) and 238b 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, [$897,562,000]$878,575,000 for [contract medical care] Purchased/Referred Care, including $51,500,000 for the Indian Catastrophic Health Emergency Fund, shall remain available until expended: [Provided further, That of the funding provided for information technology activities and, notwithstanding any other provision of law, $4,000,000
             shall be allocated at the discretion of the Director of the Indian Health Service:] Provided further, That, of the funds provided, up to $36,000,000 shall remain available until expended for implementation of the loan repayment program
             under section 108 of the Indian Health Care Improvement Act: Provided further, That the amounts collected by the Federal Government as authorized by sections 104 and 108 of the Indian Health Care Improvement
             Act (25 U.S.C. 1613a and 1616a) during the preceding fiscal year for breach of contracts shall be deposited to the Fund authorized
             by section 108A of the Act (25 U.S.C. 1616a-1) and shall remain available until expended and, notwithstanding section 108A(c)
             of the Act (25 U.S.C. 1616a-1(c)), funds shall be available to make new awards under the loan repayment and scholarship programs
             under sections 104 and 108 of the Act (25 U.S.C. 1613a and 1616a): Provided further, That notwithstanding any other provision of law, the amounts made available within this account for the methamphetamine
             and suicide prevention and treatment initiative and for the domestic violence prevention initiative shall be allocated at
             the discretion of the Director of the Indian Health Service and shall remain available until expended: Provided further, That funds provided in this Act may be used for annual contracts and grants that fall within 2 fiscal years, provided the
             total obligation is recorded in the year 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, except for those related to the planning, design, or
             construction of new facilities: Provided further, That funding contained herein 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 $476,446,000 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 2012, of which not to exceed $10,000,000
             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 the Bureau of Indian Affairs may collect from the Indian Health Service, tribes and tribal organizations operating
             health facilities pursuant to Public Law 93–638, such individually identifiable health information relating to disabled children
             as may be necessary for the purpose of carrying out its functions under the Individuals with Disabilities Education Act (20
             U.S.C. 1400, et seq.): Provided further, That the Indian Health Care Improvement Fund may be used, as needed, to carry out activities typically funded under the
             Indian Health Facilities account.   Note.—A full-year 2013 appropriation for this account was not enacted at the time the budget was prepared; therefore, the
                budget assumes this account is operating under the Continuing Appropriations Resolution, 2013 (P.L. 112–175). The amounts
                included for 2013 reflect the annualized level provided by the continuing resolution.
          Program and Financing (in millions of dollars)

                      Identification code 75–0390–0–1–551
                      2012 actual
                      2013 CR
                      2014 est.

                      Obligations by program activity:

                      0001
                      Clinical services
                      3,153
                      3,177
                      3,189

                      0002
                      Preventive health
                      147
                      148
                      152

                      0003
                      Urban health
                      43
                      43
                      43

                      0004
                      Indian health professions
                      41
                      41
                      41

                      0005
                      Tribal management
                      3
                      3
                      3

                      0006
                      Direct operations
                      72
                      72
                      72

                      0007
                      Self-governance
                      6
                      6
                      6

                      0008
                      Contract support costs
                      471
                      476

                      0009
                      Diabetes funds
                      187
                      187
                      150

                      0799
                      Total direct obligations
                      4,123
                      4,153
                      3,656

                      0801
                      Reimbursable program
                      1,100
                      1,102
                      1,100

                      0900
                      Total new obligations
                      5,223
                      5,255
                      4,756

                      Budgetary Resources:

                      Unobligated balance:

                      1000
                      Unobligated balance brought forward, Oct 1
                      745
                      560
                      510

                      1001
                      Discretionary unobligated balance brought fwd, Oct 1
                      700
                      514

                      1021
                      Recoveries of prior year unpaid obligations
                      118

                      1050
                      Unobligated balance (total)
                      863
                      560
                      510

                      Budget authority:

                      Appropriations, discretionary:

                      1100
                      Appropriation
                      3,872
                      3,890
                      3,505

                      1120
                      Appropriations transferred to other accts [75–0390]
                      –69

                      1121
                      Appropriations transferred from other accts [75–0390]
                      69

                      1130
                      Appropriations permanently reduced
                      –6

                      1160
                      Appropriation, discretionary (total)
                      3,866
                      3,890
                      3,505

                      Appropriations, mandatory:

                      1200
                      Appropriation
                      150
                      150
                      150

                      1260
                      Appropriations, mandatory (total)
                      150
                      150
                      150

                      Spending authority from offsetting collections, discretionary:

                      1700
                      Collected
                      1,147
                      1,165
                      1,165

                      1701
                      Change in uncollected payments, Federal sources
                      –242

                      1750
                      Spending auth from offsetting collections, disc (total)
                      905
                      1,165
                      1,165

                      1900
                      Budget authority (total)
                      4,921
                      5,205
                      4,820

                      1930
                      Total budgetary resources available
                      5,784
                      5,765
                      5,330

                      Memorandum (non-add) entries:

                      1940
                      Unobligated balance expiring
                      –1

                      1941
                      Unexpired unobligated balance, end of year
                      560
                      510
                      574

                      Change in obligated balance:

                      Unpaid obligations:

                      3000
                      Unpaid obligations, brought forward, Oct 1
                      866
                      844
                      768

                      3010
                      Obligations incurred, unexpired accounts
                      5,223
                      5,255
                      4,756

                      3011
                      Obligations incurred, expired accounts
                      30

                      3020
                      Outlays (gross)
                      –5,138
                      –5,331
                      –5,010

                      3040
                      Recoveries of prior year unpaid obligations, unexpired
                      –118

                      3041
                      Recoveries of prior year unpaid obligations, expired
                      –19

                      3050
                      Unpaid obligations, end of year
                      844
                      768
                      514

                      Uncollected payments:

                      3060
                      Uncollected pymts, Fed sources, brought forward, Oct 1
                      –332
                      –82
                      –82

                      3070
                      Change in uncollected pymts, Fed sources, unexpired
                      242

                      3071
                      Change in uncollected pymts, Fed sources, expired
                      8

                      3090
                      Uncollected pymts, Fed sources, end of year
                      –82
                      –82
                      –82

                      Memorandum (non-add) entries:

                      3100
                      Obligated balance, start of year
                      534
                      762
                      686

                      3200
                      Obligated balance, end of year
                      762
                      686
                      432

                      Budget authority and outlays, net:

                      Discretionary:

                      4000
                      Budget authority, gross
                      4,771
                      5,055
                      4,670

                      Outlays, gross:

                      4010
                      Outlays from new discretionary authority
                      4,307
                      4,355
                      4,039

                      4011
                      Outlays from discretionary balances
                      721
                      820
                      815

                      4020
                      Outlays, gross (total)
                      5,028
                      5,175
                      4,854

                      Offsets against gross budget authority and outlays:

                      Offsetting collections (collected) from:

                      4030
                      Federal sources
                      –324
                      –368
                      –368

                      4033
                      Non-Federal sources
                      –823
                      –797
                      –797

                      4040
                      Offsets against gross budget authority  and outlays (total)
                      –1,147
                      –1,165
                      –1,165

                      Additional offsets against gross budget authority only:

                      4050
                      Change in uncollected pymts, Fed sources, unexpired
                      242

                      4070
                      Budget authority, net (discretionary)
                      3,866
                      3,890
                      3,505

                      4080
                      Outlays, net (discretionary)
                      3,881
                      4,010
                      3,689

                      Mandatory:

                      4090
                      Budget authority, gross
                      150
                      150
                      150

                      Outlays, gross:

                      4100
                      Outlays from new mandatory authority
                      49
                      144
                      144

                      4101
                      Outlays from mandatory balances
                      61
                      12
                      12

                      4110
                      Outlays, gross (total)
                      110
                      156
                      156

                      4180
                      Budget authority, net (total)
                      4,016
                      4,040
                      3,655

                      4190
                      Outlays, net (total)
                      3,991
                      4,166
                      3,845

             The Indian Health Services account provides medical care, public health services, and health professions training opportunities
                to American Indians and Alaska Natives. An estimated $2.403 billion primarily through self determination contracts and compacts,
                will be administered by tribal governments in 2014.

          Object Classification (in millions of dollars)

                      Identification code 75–0390–0–1–551
                      2012 actual
                      2013 CR
                      2014 est.

                      Direct obligations:

                      Personnel compensation:

                      11.1
                      Full-time permanent
                      413
                      413
                      409

                      11.3
                      Other than full-time permanent
                      21
                      21
                      20

                      11.5
                      Other personnel compensation
                      58
                      58
                      58

                      11.7
                      Military personnel
                      76
                      76
                      75

                      11.9
                      Total personnel compensation
                      568
                      568
                      562

                      12.1
                      Civilian personnel benefits
                      148
                      148
                      147

                      12.2
                      Military personnel benefits
                      35
                      35
                      34

                      13.0
                      Benefits for former personnel
                      9
                      9
                      9

                      21.0
                      Travel and transportation of persons
                      8
                      8
                      8

                      21.0
                      Patient travel
                      35
                      35
                      37

                      22.0
                      Transportation of things
                      7
                      7
                      7

                      23.1
                      Rental payments to GSA
                      9
                      9
                      9

                      23.2
                      Rental payments to others
                      1
                      1
                      1

                      23.3
                      Communications, utilities, and miscellaneous charges
                      12
                      12
                      12

                      25.1
                      Advisory and assistance services
                      9
                      9
                      4

                      25.2
                      Other services from non-Federal sources
                      123
                      125
                      121

                      25.3
                      Other goods and services from Federal sources
                      48
                      48
                      48

                      25.4
                      Operation and maintenance of facilities
                      8
                      8
                      8

                      25.6
                      Medical care
                      328
                      333
                      343

                      25.7
                      Operation and maintenance of equipment
                      18
                      18
                      19

                      25.8
                      Subsistence and support of persons
                      3
                      3
                      4

                      26.0
                      Supplies and materials
                      109
                      111
                      114

                      31.0
                      Equipment
                      12
                      12
                      12

                      41.0
                      Grants, subsidies, and contributions
                      2,633
                      2,654
                      2,157

                      99.0
                      Direct obligations
                      4,123
                      4,153
                      3,656

                      99.0
                      Reimbursable obligations
                      1,100
                      1,102
                      1,100

                      99.9
                      Total new obligations
                      5,223
                      5,255
                      4,756

          Employment Summary

                      Identification code 75–0390–0–1–551
                      2012 actual
                      2013 CR
                      2014 est.

                      1001
                      Direct civilian full-time equivalent employment
                      7,013
                      7,128
                      7,128

                      1101
                      Direct military average strength employment
                      1,085
                      1,103
                      1,103

                      2001
                      Reimbursable civilian full-time equivalent employment
                      5,272
                      5,291
                      5,291

                      2101
                      Reimbursable military average strength employment
                      816
                      819
                      819

              Indian Health Contract Support Costs
             For payments of contract support costs associated with ongoing Indian Self-Determination Act agreements with the Indian Health
                Service for fiscal or calendar year 2014, not to exceed $477,205,000: Provided, That, notwithstanding any other provision
                of law, the amount available for contract support costs associated with each ongoing Indian Self-Determination Act agreement
                with the Indian Health Service for fiscal or calendar year 2014 shall not exceed the amount identified in the Indian Health
                Service Contract Support Costs table submitted by the Secretary of Health and Human Services to the House and Senate Committees
                on Appropriations.
          In addition, not to exceed $500,000 shall be available for payments for contract support costs associated with new or expanded
                Indian Self-Determination Act agreements with the Indian Health Service for fiscal or calendar year 2014.
          Program and Financing (in millions of dollars)

                      Identification code 75–3920–0–1–551
                      2012 actual
                      2013 CR
                      2014 est.

                      Obligations by program activity:

                      0001
                      Contract Support Costs

                      477

                      0900
                      Total new obligations (object class 41.0)

                      477

                      Budgetary Resources:

                      Budget authority:

                      Appropriations, discretionary:

                      1100
                      Appropriation

                      477

                      1160
                      Appropriation, discretionary (total)

                      477

                      1930
                      Total budgetary resources available

                      477

                      Change in obligated balance:

                      Unpaid obligations:

                      3010
                      Obligations incurred, unexpired accounts

                      477

                      3020
                      Outlays (gross)

                      –391

                      3050
                      Unpaid obligations, end of year

                      86

                      Memorandum (non-add) entries:

                      3200
                      Obligated balance, end of year

                      86

                      Budget authority and outlays, net:

                      Discretionary:

                      4000
                      Budget authority, gross

                      477

                      Outlays, gross:

                      4010
                      Outlays from new discretionary authority

                      391

                      4180
                      Budget authority, net (total)

                      477

                      4190
                      Outlays, net (total)

                      391

             The Indian Health Service Contract Support Costs (CSC) account supports federal government payments to tribes for certain
                administrative costs associated with executing tribal self-governance contracts and compacts under the Indian Self Determination
                and Education Assistance Act (ISDEAA), P.L. 93–638, that are not otherwise funded under the contract or compact. The Bureau
                of Indian Affairs is also required to pay CSC under   ISDEAA.  Payments are available for direct and indirect contract support
                costs.  Indirect contract support costs are those incurred for a Tribe's or tribal organization's common services, including,
                but not limited to, insurance and audits.  Direct contract costs include program-specific costs such as unemployment taxes
                and workers compensation insurance. The account also supports the costs associated with executing or administering new and/or
                expanded self-determination contracts.

             Indian Health FacilitiesFor 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, [$443,502,000]$448,139,000 to remain available until expended: Provided, That notwithstanding any other provision of law, funds appropriated for the planning, design, construction, renovation or
             expansion of health facilities for the benefit of an Indian tribe or tribes may be used to purchase land on which such facilities
             will be located: 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 $2,700,000 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 not to exceed $500,000 shall be placed in a Demolition Fund, to remain available until expended, and be used by the
             Indian Health Service for the demolition of Federal buildings.   Note.—A full-year 2013 appropriation for this account was not enacted at the time the budget was prepared; therefore, the
                budget assumes this account is operating under the Continuing Appropriations Resolution, 2013 (P.L. 112–175). The amounts
                included for 2013 reflect the annualized level provided by the continuing resolution.
          Special and Trust Fund Receipts (in millions of dollars)

                      Identification code 75–0391–0–1–551
                      2012 actual
                      2013 CR
                      2014 est.

                      0100
                      Balance, start of year

                      Receipts:

                      0220
                      Rent and Charges for Quarters, Indian Health Service
                      8
                      8
                      8

                      0400
                      Total: Balances and collections
                      8
                      8
                      8

                      Appropriations:

                      0500
                      Indian Health Facilities
                      –8
                      –8
                      –8

                      0799
                      Balance, end of year

          Program and Financing (in millions of dollars)

                      Identification code 75–0391–0–1–551
                      2012 actual
                      2013 CR
                      2014 est.

                      Obligations by program activity:

                      0001
                      Sanitation and health facilities
                      175
                      176
                      164

                      0002
                      Maintenance
                      63
                      63
                      54

                      0003
                      Facilities and environmental health
                      203
                      205
                      207

                      0004
                      Equipment
                      26
                      26
                      23

                      0100
                      Total direct program
                      467
                      470
                      448

                      0799
                      Total direct obligations
                      467
                      470
                      448

                      0801
                      Reimbursable program
                      39
                      39
                      39

                      0900
                      Total new obligations
                      506
                      509
                      487

                      Budgetary Resources:

                      Unobligated balance:

                      1000
                      Unobligated balance brought forward, Oct 1
                      216
                      167
                      115

                      1001
                      Discretionary unobligated balance brought fwd, Oct 1
                      216
                      167

                      1021
                      Recoveries of prior year unpaid obligations
                      7

                      1050
                      Unobligated balance (total)
                      223
                      167
                      115

                      Budget authority:

                      Appropriations, discretionary:

                      1100
                      Appropriation
                      441
                      443
                      448

                      1130
                      Appropriations permanently reduced
                      –1

                      1160
                      Appropriation, discretionary (total)
                      440
                      443
                      448

                      Appropriations, mandatory:

                      1201
                      Appropriation (special or trust fund)
                      8
                      8
                      8

                      1260
                      Appropriations, mandatory (total)
                      8
                      8
                      8

                      Spending authority from offsetting collections, discretionary:

                      1700
                      Collected
                      18
                      6
                      6

                      1701
                      Change in uncollected payments, Federal sources
                      –16

                      1750
                      Spending auth from offsetting collections, disc (total)
                      2
                      6
                      6

                      1900
                      Budget authority (total)
                      450
                      457
                      462

                      1930
                      Total budgetary resources available
                      673
                      624
                      577

                      Memorandum (non-add) entries:

                      1941
                      Unexpired unobligated balance, end of year
                      167
                      115
                      90

                      Change in obligated balance:

                      Unpaid obligations:

                      3000
                      Unpaid obligations, brought forward, Oct 1
                      578
                      526
                      540

                      3010
                      Obligations incurred, unexpired accounts
                      506
                      509
                      487

                      3011
                      Obligations incurred, expired accounts
                      1

                      3020
                      Outlays (gross)
                      –551
                      –495
                      –491

                      3040
                      Recoveries of prior year unpaid obligations, unexpired
                      –7

                      3041
                      Recoveries of prior year unpaid obligations, expired
                      –1

                      3050
                      Unpaid obligations, end of year
                      526
                      540
                      536

                      Uncollected payments:

                      3060
                      Uncollected pymts, Fed sources, brought forward, Oct 1
                      –21
                      –6
                      –6

                      3070
                      Change in uncollected pymts, Fed sources, unexpired
                      16

                      3071
                      Change in uncollected pymts, Fed sources, expired
                      –1

                      3090
                      Uncollected pymts, Fed sources, end of year
                      –6
                      –6
                      –6

                      Memorandum (non-add) entries:

                      3100
                      Obligated balance, start of year
                      557
                      520
                      534

                      3200
                      Obligated balance, end of year
                      520
                      534
                      530

                      Budget authority and outlays, net:

                      Discretionary:

                      4000
                      Budget authority, gross
                      442
                      449
                      454

                      Outlays, gross:

                      4010
                      Outlays from new discretionary authority
                      283
                      139
                      141

                      4011
                      Outlays from discretionary balances
                      263
                      348
                      342

                      4020
                      Outlays, gross (total)
                      546
                      487
                      483

                      Offsets against gross budget authority and outlays:

                      Offsetting collections (collected) from:

                      4030
                      Federal sources
                      –18
                      –6
                      –6

                      Additional offsets against gross budget authority only:

                      4050
                      Change in uncollected pymts, Fed sources, unexpired
                      16

                      4070
                      Budget authority, net (discretionary)
                      440
                      443
                      448

                      4080
                      Outlays, net (discretionary)
                      528
                      481
                      477

                      Mandatory:

                      4090
                      Budget authority, gross
                      8
                      8
                      8

                      Outlays, gross:

                      4100
                      Outlays from new mandatory authority
                      2
                      8
                      8

                      4101
                      Outlays from mandatory balances
                      3

                      4110
                      Outlays, gross (total)
                      5
                      8
                      8

                      4180
                      Budget authority, net (total)
                      448
                      451
                      456

                      4190
                      Outlays, net (total)
                      533
                      489
                      485

             The Indian Health Facilities account supports construction, repair and improvement, equipment, and environmental health and
                facilities support for the Indian Health Service. An estimated $208.8 million primarily through self determination contracts
                and compacts, will be administered by tribal governments in 2014.

          Object Classification (in millions of dollars)

                      Identification code 75–0391–0–1–551
                      2012 actual
                      2013 CR
                      2014 est.

                      Direct obligations:

                      Personnel compensation:

                      11.1
                      Full-time permanent
                      47
                      47
                      47

                      11.3
                      Other than full-time permanent
                      2
                      2
                      2

                      11.5
                      Other personnel compensation
                      2
                      2
                      2

                      11.7
                      Military personnel
                      23
                      23
                      24

                      11.9
                      Total personnel compensation
                      74
                      74
                      75

                      12.1
                      Civilian personnel benefits
                      15
                      15
                      14

                      12.2
                      Military personnel benefits
                      8
                      8
                      8

                      21.0
                      Travel and transportation of persons
                      2
                      2
                      2

                      22.0
                      Transportation of things
                      4
                      4
                      4

                      23.1
                      Rental payments to GSA
                      1
                      1
                      1

                      23.3
                      Communications, utilities, and miscellaneous charges
                      16
                      16
                      16

                      25.1
                      Advisory and assistance services
                      2
                      2
                      2

                      25.2
                      Other services from non-Federal sources
                      81
                      82
                      71

                      25.3
                      Other goods and services from Federal sources
                      4
                      4
                      4

                      25.4
                      Operation and maintenance of facilities
                      8
                      8
                      6

                      25.7
                      Operation and maintenance of equipment
                      4
                      4
                      4

                      25.8
                      Subsistence and support of persons
                      1
                      1
                      1

                      26.0
                      Supplies and materials
                      8
                      8
                      7

                      31.0
                      Equipment
                      14
                      14
                      13

                      32.0
                      Land and structures
                      42
                      43
                      41

                      41.0
                      Grants, subsidies, and contributions
                      183
                      184
                      179

                      99.0
                      Direct obligations
                      467
                      470
                      448

                      99.0
                      Reimbursable obligations
                      39
                      39
                      39

                      99.9
                      Total new obligations
                      506
                      509
                      487

          Employment Summary

                      Identification code 75–0391–0–1–551
                      2012 actual
                      2013 CR
                      2014 est.

                      1001
                      Direct civilian full-time equivalent employment
                      1,021
                      1,021
                      1,021

                      1101
                      Direct military average strength employment
                      170
                      170
                      170

                      2001
                      Reimbursable civilian full-time equivalent employment
                      32
                      32
                      32

             ADMINISTRATIVE PROVISIONS

             Administrative Provisions—Indian Health ServiceAppropriations provided in this Act to the Indian Health Service shall be available for services as authorized by 5 U.S.C.
             3109 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; uniforms or allowances therefor as authorized by
             5 U.S.C. 5901–5902; and for expenses of attendance at meetings that relate to the functions or activities of the Indian Health
             Service: Provided, That 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: Provided further, That 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: Provided further, That 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: Provided further, That 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: Provided further, That 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: Provided further, That 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: Provided further, That 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 payments in advance
             with subsequent adjustment, and 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 from which the funds
             were originally derived, with such amounts to remain available until expended: Provided further, That 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:
             Provided further, That the appropriation structure for the Indian Health Service may not be altered without advance notification to the House
             and Senate Committees on Appropriations.
             Centers for Disease Control and Prevention

             Federal Funds
             CDC-Wide Activities and Program Support
             Immunization and Respiratory DiseasesFor carrying out titles II, III, [VII,] XVII, and XXI, and section 2821 of the PHS Act, titles II and IV of the Immigration and Nationality Act, and section 501
             of the Refugee Education Assistance Act, with respect to immunization and respiratory diseases, [$583,855,000]$668,696,000: Provided, That in addition to amounts provided herein, [$13,765,000]$12,864,000 shall be available from amounts available under section 241 of the PHS Act to carry out the National Immunization Surveys. Note.—A full-year 2013 appropriation for this account was not enacted at the time the budget was prepared; therefore, the
                budget assumes this account is operating under the Continuing Appropriations Resolution, 2013 (P.L. 112–175). The amounts
                included for 2013 reflect the annualized level provided by the continuing resolution.
             HIV/AIDS, Viral Hepatitis, Sexually Transmitted Diseases, and Tuberculosis PreventionFor carrying out titles II, III, [VII,] XVII, and XXIII[, and XXVI] of the PHS Act with respect to HIV/AIDS, viral hepatitis, sexually transmitted diseases, and tuberculosis prevention, [$1,145,678,000: Provided, That Centers for Disease Control and Prevention and State grant recipients may transfer up to ten percent of funds appropriated
             for Centers for Disease Control and Prevention HIV/AIDS, sexually transmitted disease, hepatitis, and tuberculosis activities
             to address the overlapping epidemics of these diseases by improving program collaboration and providing integrated services
             in accordance with priorities identified by the Centers for Disease Control and Prevention: Provided further, That with respect to the previous proviso, grantees shall submit a plan in writing to the Centers for Disease Control and
             Prevention and obtain the approval of the Centers for Disease Control and Prevention to transfer such funds]$1,173,942,000: Provided, That in addition to the amounts provided herein, $3,000,000 shall be available from amounts available
                under section 241 of the PHS Act to carry out the evaluation of HIV school health activities.
             Emerging and Zoonotic Infectious DiseasesFor carrying out titles II, III, [VII,] and XVII, and section 2821 of the PHS Act, titles II and IV of the Immigration and Nationality Act, and section 501 of the
             Refugee Education Assistance Act, with respect to emerging and zoonotic infectious diseases, [$279,477,000]$380,664,000, of which $1,000,000 shall remain available until expended to pay for the transportation, medical care, treatment, and other
             related costs of persons quarantined or isolated under federal or state quarantine laws.
             Chronic Disease Prevention and Health PromotionFor carrying out titles II, III, [VII,] XI, XV, and XVII [, and XIX]  of the PHS Act and [section 4201 of the Patient Protection and Affordable Care Act,] Public Law 111–148 with respect to chronic disease prevention and health promotion, [$608,019,000]$620,189,000: Provided, That [, in addition to amounts provided herein, $25,000,000 shall be available from amounts available under section 241 of the PHS
             Act to carry out the Prevention Research Centers:] Centers for Disease Control and Prevention and State grant recipients may reallocate up to five percent of grant funds received
                for diabetes, heart disease and stroke, obesity, and school health activities to address cross-cutting chronic disease issues:
                Provided further, That with respect to the previous proviso, grantees shall submit a plan in writing to the Centers for Disease
                Control and Prevention and obtain the approval of the Centers for Disease Control and Prevention to reallocate such funds:
                Provided further, That funds appropriated under this account may be available for making grants under section 1509 of the PHS Act for up to
             21 States, tribes, or tribal organizations: Provided further, That the Secretary may grant up to ten waivers under section 1503(d) of the PHS Act.
             Birth Defects, Developmental Disabilities, Disabilities and HealthFor carrying out titles II, III, [VII,] XI, and XVII of the PHS Act with respect to birth defects, developmental disabilities, disabilities and health, [$18,476,000]$67,148,000.
             Public Health Scientific ServicesFor carrying out titles II, [and] III, and XVII of the PHS Act and Public Law 111–148 with respect to health statistics, surveillance, health informatics, and workforce development, [$35,695,000]$144,416,000: Provided, That in addition to amounts provided herein, [$379,374,000]$324,889,000 shall be available from amounts available under section 241 of the PHS Act to carry out Public Health Scientific Services.
             Environmental HealthFor carrying out titles II, III, [VII,] and XVII of the PHS Act with respect to environmental health, [$103,672,000]$126,126,000.
             Injury Prevention and ControlFor carrying out titles II, III, [VII,] and XVII of the PHS Act with respect to injury prevention and control, [$137,754,000: Provided, That funds appropriated under this heading may be used to fund evaluation, research, and pilot programs for sexual violence
             prevention programs]$176,585,000: Provided, that in addition to the amounts provided herein, $5,000,000 shall be available from amounts under
                section 241 of the PHS Act to carry out the evaluation of Rape Prevention and Education programs authorized by the Violence
                Against Women Act.
             National Institute for Occupational Safety and HealthFor carrying out titles II, III, [VII,] and XVII of the PHS Act, sections 101, 102, 103, 201, 202, 203, 301, 501, and 514 of the Federal Mine Safety and Health Act,
             section 13 of the Mine Improvement and New Emergency Response Act, and sections 20, 21, and 22 of the Occupational Safety
             and Health Act, with respect to occupational safety and health, [$249,364,000]$271,911,000 shall be available from amounts available under section 241 of the PHS Act.
             Energy Employees Occupational Illness Compensation ProgramFor necessary expenses to administer the Energy Employees Occupational Illness Compensation Program Act, [$55,358,000]$55,358,000 to remain available until expended: Provided, That this amount shall be available consistent with the provision regarding administrative expenses in section 151(b) of
             division B, title I of Public Law 106–554.
             Global HealthFor carrying out titles II, III, [VII] and XVII of the PHS Act with respect to global health, [$362,889,000]$393,024,000 of which [$117,156,000]$131,942,000 for international HIV/AIDS shall remain available through September 30, [2014]2015: Provided, That funds may be used for purchase and insurance of official motor vehicles in foreign countries.
             Public Health Preparedness and ResponseFor carrying out titles II, III, [VII,] and XVII of the PHS Act with respect to public health preparedness and response, and for expenses necessary to support activities
             related to countering potential biological, nuclear, radiological, and chemical threats to civilian populations, [$1,228,360,000]$1,334,316,000, of which [$439,444,000] $510,278,000 shall remain available until expended for the Strategic National Stockpile[pursuant to section 319F-2 of the PHS Act].
             CDC-Wide Activities and Program SupportFor carrying out titles II, III, [VII,] and XVII [and XIX,] and section 2821 of the PHS Act and for cross-cutting activities and program support that supplement activities funded under
             the headings "Immunization and Respiratory Diseases'', "HIV/AIDS, Viral Hepatitis, Sexually Transmitted Diseases, and Tuberculosis
             Prevention'', "Emerging and Zoonotic Infectious Diseases'', "Chronic Disease Prevention and Health Promotion'', "Birth Defects,
             Developmental Disabilities, Disabilities and Health'', "Environmental Health'', "Injury Prevention and Control'', "National
             Institute for Occupational Safety and Health'', "Employees Occupational Illness Compensation Program Act'', "Global Health'',
             "Public Health Preparedness and Response'', and "Public Health Scientific Services'', and for carrying out section 4001 of
             the Patient Protection and Affordable Care Act, [$487,648,000] $131,403,000, of which [$368,529,000]$14,591,000 shall be available until [September 30, 2014, for business services: Provided, That paragraphs (1) through (3) of subsection (b) of section 2821 of the PHS Act shall not apply to funds appropriated under
             this heading and in all other accounts of the Centers for Disease Control and Prevention (referred to in this title as "CDC'')]expended for equipment, construction, and renovation of facilities: Provided[further], That funds appropriated under this heading and in all other accounts of the Centers for Disease Control and Prevention (referred to in this title as "CDC") may be used to support the purchase, hire, maintenance, and operation of aircraft for use and support of the activities of
             CDC: Provided further, That employees of CDC or the Public Health Service, both civilian and commissioned officers, detailed to States, municipalities,
             or other organizations under authority of section 214 of the PHS Act, or in overseas assignments, 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 HHS during the period of detail or assignment: Provided further, That CDC may use up to $10,000 from amounts appropriated to CDC in this Act for official reception and representation expenses
             when specifically approved by the Director of CDC: Provided further, That in addition, such sums as may be derived from authorized user fees, which shall be credited to the appropriation charged
             with the cost thereof: Provided further, That with respect to the previous proviso, authorized user fees from the Vessel Sanitation Program shall be available through
             September 30, [2014]2015: Provided further, That of the funds made available under this heading and in all other accounts of CDC, up to $1,000 per eligible employee of CDC shall be made available until expended for Individual Learning Accounts: Provided further, That the Director may transfer funds between any of the accounts of CDC with notification to the Committees on Appropriations
             of both Houses of Congress at least 15 days in advance of any transfer, but no such account shall be decreased by more than
             3 percent by any such transfer.   Note.—A full-year 2013 appropriation for this account was not enacted at the time the budget was prepared; therefore, the
                budget assumes this account is operating under the Continuing Appropriations Resolution, 2013 (P.L. 112–175). The amounts
                included for 2013 reflect the annualized level provided by the continuing resolution.
          Special and Trust Fund Receipts (in millions of dollars)

                      Identification code 75–0943–0–1–999
                      2012 actual
                      2013 CR
                      2014 est.

                      0100
                      Balance, start of year

                      Receipts:

                      0220
                      Cooperative Research and Development Agreements, Centers for Disease Control
                      3
                      2
                      2

                      0400
                      Total: Balances and collections
                      3
                      2
                      2

                      Appropriations:

                      0500
                      CDC-Wide Activities and Program Support
                      –3
                      –2
                      –2

                      0799
                      Balance, end of year

          Program and Financing (in millions of dollars)

                      Identification code 75–0943–0–1–999
                      2012 actual
                      2013 CR
                      2014 est.

                      Obligations by program activity:

                      0001
                      Birth Defects, Developmental Disabilities, Disability and Health (BA & Prevention Fund) (0958)
                      137
                      138
                      142

                      0002
                      CDC Wide Activities and Program Support (0943)
                      659
                      622
                      173

                      0004
                      Chronic Disease Prevention and Health Promotion (0948)
                      1,167
                      761
                      1,036

                      0005
                      Emerging and Zoonotic Infectious Diseases (0949)
                      304
                      254
                      432

                      0006
                      Energy Employee Illness Occupational Compensation Program Act (EEOICPA) (0954)
                      54

                      55

                      0007
                      Environmental Health (0947)
                      140
                      106
                      155

                      0008
                      Global Health (0955)
                      348
                      350
                      393

                      0012
                      HIV/AIDS, Viral Hepatitis, STD and TB Prevention (0950)
                      1,110
                      1,107
                      1,177

                      0013
                      Immunization and Respiratory Diseases (0951)
                      779
                      593
                      754

                      0015
                      Injury Prevention and Control (0952)
                      138
                      139
                      182

                      0016
                      Occupational Safety and Health (0953)
                      293
                      294
                      272

                      0019
                      Public Health Preparedness & Response (0956)
                      1,299
                      1,308
                      1,334

                      0020
                      Public Health Scientific Services (0959)
                      462
                      394
                      539

                      0021
                      Cooperative Research and Development Agreements (CRADA) (5146)
                      2
                      2
                      2

                      0799
                      Total direct obligations
                      6,892
                      6,068
                      6,646

                      0802
                      Other Reimbursable Programs
                      273
                      273
                      273

                      0809
                      Reimbursable program activities, subtotal
                      273
                      273
                      273

                      0900
                      Total new obligations
                      7,165
                      6,341
                      6,919

                      Budgetary Resources:

                      Unobligated balance:

                      1000
                      Unobligated balance brought forward, Oct 1
                      193
                      182

                      1001
                      Discretionary unobligated balance brought fwd, Oct 1
                      96
                      96

                      1021
                      Recoveries of prior year unpaid obligations
                      7

                      1050
                      Unobligated balance (total)
                      200
                      182

                      Budget authority:

                      Appropriations, discretionary:

                      1100
                      Appropriation
                      5,688
                      5,692
                      5,217

                      1120
                      Appropriations transferred to other accts [75–0350]
                      –1

                      1130
                      Appropriations permanently reduced
                      –31

                      1160
                      Appropriation, discretionary (total)
                      5,656
                      5,692
                      5,217

                      Appropriations, mandatory:

                      1200
                      Appropriation
                      55

                      55

                      1201
                      Appropriation (special or trust fund)
                      3
                      2
                      2

                      1221
                      Appropriations transferred from other accts [75–0116]
                      809

                      755

                      1260
                      Appropriations, mandatory (total)
                      867
                      2
                      812

                      Spending authority from offsetting collections, discretionary:

                      1700
                      Collected
                      326
                      465
                      890

                      1701
                      Change in uncollected payments, Federal sources
                      307

                      1750
                      Spending auth from offsetting collections, disc (total)
                      633
                      465
                      890

                      1900
                      Budget authority (total)
                      7,156
                      6,159
                      6,919

                      1930
                      Total budgetary resources available
                      7,356
                      6,341
                      6,919

                      Memorandum (non-add) entries:

                      1940
                      Unobligated balance expiring
                      –9

                      1941
                      Unexpired unobligated balance, end of year
                      182

                      Change in obligated balance:

                      Unpaid obligations:

                      3000
                      Unpaid obligations, brought forward, Oct 1
                      6,452
                      6,314
                      5,830

                      3010
                      Obligations incurred, unexpired accounts
                      7,165
                      6,341
                      6,919

                      3011
                      Obligations incurred, expired accounts
                      28

                      3020
                      Outlays (gross)
                      –7,243
                      –6,825
                      –6,809

                      3040
                      Recoveries of prior year unpaid obligations, unexpired
                      –7

                      3041
                      Recoveries of prior year unpaid obligations, expired
                      –81

                      3050
                      Unpaid obligations, end of year
                      6,314
                      5,830
                      5,940

                      Uncollected payments:

                      3060
                      Uncollected pymts, Fed sources, brought forward, Oct 1
                      –468
                      –460
                      –460

                      3070
                      Change in uncollected pymts, Fed sources, unexpired
                      –307

                      3071
                      Change in uncollected pymts, Fed sources, expired
                      315

                      3090
                      Uncollected pymts, Fed sources, end of year
                      –460
                      –460
                      –460

                      Memorandum (non-add) entries:

                      3100
                      Obligated balance, start of year
                      5,984
                      5,854
                      5,370

                      3200
                      Obligated balance, end of year
                      5,854
                      5,370
                      5,480

                      Budget authority and outlays, net:

                      Discretionary:

                      4000
                      Budget authority, gross
                      6,289
                      6,157
                      6,107

                      Outlays, gross:

                      4010
                      Outlays from new discretionary authority
                      2,497
                      2,415
                      2,702

                      4011
                      Outlays from discretionary balances
                      4,183
                      3,994
                      3,723

                      4020
                      Outlays, gross (total)
                      6,680
                      6,409
                      6,425

                      Offsets against gross budget authority and outlays:

                      Offsetting collections (collected) from:

                      4030
                      Federal sources
                      –629
                      –458
                      –881

                      4033
                      Non-Federal sources
                      –7
                      –7
                      –9

                      4040
                      Offsets against gross budget authority  and outlays (total)
                      –636
                      –465
                      –890

                      Additional offsets against gross budget authority only:

                      4050
                      Change in uncollected pymts, Fed sources, unexpired
                      –307

                      4052
                      Offsetting collections credited to expired accounts
                      310

                      4060
                      Additional offsets against budget authority only (total)
                      3

                      4070
                      Budget authority, net (discretionary)
                      5,656
                      5,692
                      5,217

                      4080
                      Outlays, net (discretionary)
                      6,044
                      5,944
                      5,535

                      Mandatory:

                      4090
                      Budget authority, gross
                      867
                      2
                      812

                      Outlays, gross:

                      4100
                      Outlays from new mandatory authority
                      207
                      2
                      303

                      4101
                      Outlays from mandatory balances
                      356
                      414
                      81

                      4110
                      Outlays, gross (total)
                      563
                      416
                      384

                      4180
                      Budget authority, net (total)
                      6,523
                      5,694
                      6,029

                      4190
                      Outlays, net (total)
                      6,607
                      6,360
                      5,919

             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 activities include immunization and respiratory diseases, HIV/AIDS, Hepatitis,
                STDs, and Tuberculosis prevention, emerging and zoonotic infectious diseases, chronic disease prevention and health promotion,
                occupational safety and health, public health and scientific services, injury prevention and control, environmental health,
                global health, programs that reduce the occurrence of birth defects and developmental disabilities, and CDC-Wide Activities
                and Program Support. CDC also supports bioterrorism, and emergency response.  The 2012 and 2013 levels in MAX are not comparable
                with the 2014 Budget levels. The 2014 Budget realigns business support services from the prior fiscal to the program budget
                lines based on previous consumption data.

          Object Classification (in millions of dollars)

                      Identification code 75–0943–0–1–999
                      2012 actual
                      2013 CR
                      2014 est.

                      Direct obligations:

                      Personnel compensation:

                      11.1
                      Full-time permanent
                      696
                      737
                      742

                      11.3
                      Other than full-time permanent
                      95
                      92
                      92

                      11.5
                      Other personnel compensation
                      31
                      39
                      39

                      11.7
                      Military personnel
                      68
                      67
                      69

                      11.8
                      Special personal services payments
                      1
                      1
                      1

                      11.9
                      Total personnel compensation
                      891
                      936
                      943

                      12.1
                      Civilian personnel benefits
                      247
                      252
                      254

                      12.2
                      Military personnel benefits
                      46
                      48
                      48

                      21.0
                      Travel and transportation of persons
                      46
                      41
                      41

                      22.0
                      Transportation of things
                      20
                      15
                      15

                      23.1
                      Rental payments to GSA
                      25
                      52
                      52

                      23.2
                      Rental payments to others
                      2
                      1
                      1

                      23.3
                      Communications, utilities, and miscellaneous charges
                      51
                      34
                      34

                      24.0
                      Printing and reproduction
                      3
                      5
                      5

                      25.1
                      Advisory and assistance services
                      634
                      448
                      448

                      25.2
                      Other services from non-Federal sources
                      226
                      193
                      193

                      25.3
                      Other goods and services from Federal sources
                      386
                      371
                      371

                      25.4
                      Operation and maintenance of facilities
                      74
                      47
                      47

                      25.5
                      Research and development contracts
                      84
                      63
                      63

                      25.6
                      Medical care
                      36
                      28
                      28

                      25.7
                      Operation and maintenance of equipment
                      40
                      33
                      33

                      25.8
                      Subsistence and support of persons (Includes 1259)
                      41
                      30
                      30

                      26.0
                      Supplies and materials
                      646
                      528
                      528

                      31.0
                      Equipment
                      94
                      56
                      56

                      32.0
                      Land and structures
                      15
                      8
                      8

                      41.0
                      Grants, subsidies, and contributions
                      3,285
                      2,879
                      3,448

                      99.0
                      Direct obligations
                      6,892
                      6,068
                      6,646

                      99.0
                      Reimbursable obligations
                      273
                      273
                      273

                      99.9
                      Total new obligations
                      7,165
                      6,341
                      6,919

          Employment Summary

                      Identification code 75–0943–0–1–999
                      2012 actual
                      2013 CR
                      2014 est.

                      1001
                      Direct civilian full-time equivalent employment
                      8,676
                      8,623
                      8,623

                      1101
                      Direct military average strength employment
                      805
                      805
                      805

                      2001
                      Reimbursable civilian full-time equivalent employment
                      1,018
                      1,018
                      1,018

                      2101
                      Reimbursable military average strength employment
                      72
                      72
                      72

             CDC Working Capital Fund

             The Consolidated Appropriations Bill, 2012 (P.L. 112–74, Division F) provided authorities equivalent to those provided in
                42 U.S.C. 231 for CDC to begin creating a Working Capital Fund. The Working Capital Fund will be used by CDC to achieve greater
                cost efficiencies across the administrative operations of the agency.

             Agency for Toxic Substances and Disease Registry
             toxic substances and environmental public healthFor necessary expenses for the Agency for Toxic Substances and Disease Registry (ATSDR) in carrying out activities set forth
             in sections 104(i) and 111(c)(4) 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, [$76,300,000]$76,215,000 of which up to $1,000 per eligible employee of the Agency for Toxic Substances and Disease Registry shall remain available
             until expended for Individual Learning Accounts: 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 healthcare 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]i) of CERCLA during fiscal year [2013]2014, and existing profiles may be updated as necessary.   Note.—A full-year 2013 appropriation for this account was not enacted at the time the budget was prepared; therefore, the
                budget assumes this account is operating under the Continuing Appropriations Resolution, 2013 (P.L. 112–175). The amounts
                included for 2013 reflect the annualized level provided by the continuing resolution.
          Program and Financing (in millions of dollars)

                      Identification code 75–0944–0–1–551
                      2012 actual
                      2013 CR
                      2014 est.

                      Obligations by program activity:

                      0001
                      Direct program
                      79
                      77
                      76

                      0801
                      Reimbursable program
                      11
                      10
                      10

                      0900
                      Total new obligations
                      90
                      87
                      86

                      Budgetary Resources:

                      Unobligated balance:

                      1000
                      Unobligated balance brought forward, Oct 1
                      20
                      17
                      17

                      Budget authority:

                      Appropriations, discretionary:

                      1100
                      Appropriation
                      76
                      77
                      76

                      1160
                      Appropriation, discretionary (total)
                      76
                      77
                      76

                      Spending authority from offsetting collections, discretionary:

                      1700
                      Collected
                      4
                      10
                      10

                      1701
                      Change in uncollected payments, Federal sources
                      7

                      1750
                      Spending auth from offsetting collections, disc (total)
                      11
                      10
                      10

                      1900
                      Budget authority (total)
                      87
                      87
                      86

                      1930
                      Total budgetary resources available
                      107
                      104
                      103

                      Memorandum (non-add) entries:

                      1941
                      Unexpired unobligated balance, end of year
                      17
                      17
                      17

                      Change in obligated balance:

                      Unpaid obligations:

                      3000
                      Unpaid obligations, brought forward, Oct 1
                      48
                      52
                      26

                      3010
                      Obligations incurred, unexpired accounts
                      90
                      87
                      86

                      3020
                      Outlays (gross)
                      –85
                      –113
                      –81

                      3041
                      Recoveries of prior year unpaid obligations, expired
                      –1

                      3050
                      Unpaid obligations, end of year
                      52
                      26
                      31

                      Uncollected payments:

                      3060
                      Uncollected pymts, Fed sources, brought forward, Oct 1
                      –13
                      –14
                      –14

                      3070
                      Change in uncollected pymts, Fed sources, unexpired
                      –7

                      3071
                      Change in uncollected pymts, Fed sources, expired
                      6

                      3090
                      Uncollected pymts, Fed sources, end of year
                      –14
                      –14
                      –14

                      Memorandum (non-add) entries:

                      3100
                      Obligated balance, start of year
                      35
                      38
                      12

                      3200
                      Obligated balance, end of year
                      38
                      12
                      17

                      Budget authority and outlays, net:

                      Discretionary:

                      4000
                      Budget authority, gross
                      87
                      87
                      86

                      Outlays, gross:

                      4010
                      Outlays from new discretionary authority
                      53
                      64
                      63

                      4011
                      Outlays from discretionary balances
                      29
                      38
                      15

                      4020
                      Outlays, gross (total)
                      82
                      102
                      78

                      Offsets against gross budget authority and outlays:

                      Offsetting collections (collected) from:

                      4030
                      Federal sources
                      –9
                      –10
                      –10

                      Additional offsets against gross budget authority only:

                      4050
                      Change in uncollected pymts, Fed sources, unexpired
                      –7

                      4052
                      Offsetting collections credited to expired accounts
                      5

                      4060
                      Additional offsets against budget authority only (total)
                      –2

                      4070
                      Budget authority, net (discretionary)
                      76
                      77
                      76

                      4080
                      Outlays, net (discretionary)
                      73
                      92
                      68

                      Mandatory:

                      Outlays, gross:

                      4101
                      Outlays from mandatory balances
                      3
                      11
                      3

                      4180
                      Budget authority, net (total)
                      76
                      77
                      76

                      4190
                      Outlays, net (total)
                      76
                      103
                      71

             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
                      2012 actual
                      2013 CR
                      2014 est.

                      Direct obligations:

                      Personnel compensation:

                      11.1
                      Full-time permanent
                      22
                      22
                      22

                      11.3
                      Other than full-time permanent
                      1
                      1
                      1

                      11.5
                      Other personnel compensation
                      1
                      1
                      1

                      11.7
                      Military personnel
                      3
                      4
                      4

                      11.9
                      Total personnel compensation
                      27
                      28
                      28

                      12.1
                      Civilian personnel benefits
                      7
                      7
                      7

                      12.2
                      Military personnel benefits
                      1
                      2
                      2

                      21.0
                      Travel and transportation of persons
                      1

                      25.1
                      Advisory and assistance services
                      4
                      4
                      4

                      25.2
                      Other services from non-Federal sources
                      7
                      7
                      7

                      25.3
                      Other goods and services from Federal sources
                      14
                      11
                      11

                      31.0
                      Equipment
                      1
                      1
                      1

                      41.0
                      Grants, subsidies, and contributions
                      17
                      17
                      15

                      99.0
                      Direct obligations
                      79
                      77
                      75

                      99.0
                      Reimbursable obligations
                      11
                      10
                      11

                      99.9
                      Total new obligations
                      90
                      87
                      86

          Employment Summary

                      Identification code 75–0944–0–1–551
                      2012 actual
                      2013 CR
                      2014 est.

                      1001
                      Direct civilian full-time equivalent employment
                      249
                      250
                      250

                      1101
                      Direct military average strength employment
                      37
                      35
                      35

                      2001
                      Reimbursable civilian full-time equivalent employment
                      10
                      10
                      10

             World Trade Center Health Program Fund

             Program and Financing (in millions of dollars)

                      Identification code 75–0946–0–1–551
                      2012 actual
                      2013 CR
                      2014 est.

                      Obligations by program activity:

                      0001
                      Federal Share
                      187
                      231
                      241

                      0002
                      NYC
                      21
                      26
                      26

                      0900
                      Total new obligations
                      208
                      257
                      267

                      Budgetary Resources:

                      Budget authority:

                      Appropriations, mandatory:

                      1200
                      Appropriation (WTC (CDC Direct))
                      187
                      231
                      241

                      1200
                      Appropriation (WTC—NYC DHSS—CDC)
                      18
                      26
                      26

                      1260
                      Appropriations, mandatory (total)
                      205
                      257
                      267

                      Spending authority from offsetting collections, mandatory:

                      1800
                      Collected
                      3

                      1850
                      Spending auth from offsetting collections, mand (total)
                      3

                      1900
                      Budget authority (total)
                      208
                      257
                      267

                      1930
                      Total budgetary resources available
                      208
                      257
                      267

                      Change in obligated balance:

                      Unpaid obligations:

                      3000
                      Unpaid obligations, brought forward, Oct 1
                      68
                      113
                      137

                      3010
                      Obligations incurred, unexpired accounts
                      208
                      257
                      267

                      3020
                      Outlays (gross)
                      –146
                      –233
                      –226

                      3041
                      Recoveries of prior year unpaid obligations, expired
                      –17

                      3050
                      Unpaid obligations, end of year
                      113
                      137
                      178

                      Memorandum (non-add) entries:

                      3100
                      Obligated balance, start of year
                      68
                      113
                      137

                      3200
                      Obligated balance, end of year
                      113
                      137
                      178

                      Budget authority and outlays, net:

                      Mandatory:

                      4090
                      Budget authority, gross
                      208
                      257
                      267

                      Outlays, gross:

                      4100
                      Outlays from new mandatory authority
                      106
                      129
                      134

                      4101
                      Outlays from mandatory balances
                      40
                      104
                      92

                      4110
                      Outlays, gross (total)
                      146
                      233
                      226

                      Offsets against gross budget authority and outlays:

                      Offsetting collections (collected) from:

                      4123
                      Non-Federal sources
                      –6

                      Additional offsets against gross budget authority only:

                      4142
                      Offsetting collections credited to expired accounts
                      3

                      4160
                      Budget authority, net (mandatory)
                      205
                      257
                      267

                      4170
                      Outlays, net (mandatory)
                      140
                      233
                      226

                      4180
                      Budget authority, net (total)
                      205
                      257
                      267

                      4190
                      Outlays, net (total)
                      140
                      233
                      226

             HHS along with CDC began implementing provisions of The James Zadroga 9/11 Health and Compensation Act of 2010 (P.L. 111–347)
                on July 1, 2011, to provide monitoring and treatment benefits to eligible responders and survivors. CDC/NIOSH serves as the
                Program Administrator for the WTC Health Program.  The WTC Health Program provides quality care for WTC-related health conditions,
                conducts WTC research, and maintains a health registry to collect data on victims of the September 11, 2001, terrorist attacks.
                The amounts included for 2013 and 2014 Budget reflect estimated Federal obligations for the WTC Health Program.

          Object Classification (in millions of dollars)

                      Identification code 75–0946–0–1–551
                      2012 actual
                      2013 CR
                      2014 est.

                      Direct obligations:

                      Personnel compensation:

                      11.1
                      Full-time permanent
                      2
                      2
                      2

                      11.7
                      Military personnel
                      1
                      1
                      1

                      11.9
                      Total personnel compensation
                      3
                      3
                      3

                      25.1
                      Advisory and assistance services
                      3
                      20
                      20

                      25.2
                      Other services from non-Federal sources

                      33
                      33

                      25.3
                      Other goods and services from Federal sources
                      77
                      4
                      4

                      25.6
                      Medical care
                      106
                      177
                      187

                      41.0
                      Grants, subsidies, and contributions
                      19
                      20
                      20

                      99.9
                      Total new obligations
                      208
                      257
                      267

          Employment Summary

                      Identification code 75–0946–0–1–551
                      2012 actual
                      2013 CR
                      2014 est.

                      1001
                      Direct civilian full-time equivalent employment
                      8
                      8
                      8

                      1101
                      Direct military average strength employment
                      2
                      2
                      2

             National Institutes of Health

             Federal Funds
             National Cancer InstituteFor carrying out section 301 and title IV of the PHS Act with respect to cancer, [$5,068,864,000,]$5,125,951,000, of which up to $8,000,000 may be used for facilities repairs and improvements at the National Cancer Institute[—]–Frederick  Federally Funded Research and Development Center in Frederick, Maryland.
             National Heart, Lung, and Blood InstituteFor carrying out section 301 and title IV of the PHS Act with respect to cardiovascular, lung, and blood diseases, and blood
             and blood products, [$3,076,067,000] $3,098,508,000.
             National Institute of Dental and Craniofacial ResearchFor carrying out section 301 and title IV of the PHS Act with respect to dental and craniofacial diseases, [$408,212,000]$411,515,000.
             National Institute of Diabetes and Digestive and Kidney DiseasesFor carrying out section 301 and title IV of the PHS Act with respect to diabetes and digestive and kidney disease, [$1,792,107,000]$1,811,786,000.
             National Institute of Neurological Disorders and StrokeFor carrying out section 301 and title IV of the PHS Act with respect to neurological disorders and stroke, [$1,624,707,000]$1,642,619,000.
             National Institute of Allergy and Infectious DiseasesFor carrying out section 301 and title IV of the PHS Act with respect to allergy and infectious diseases, [$4,495,307,000]$4,578,813,000.
             National Institute of General Medical SciencesFor carrying out section 301 and title IV of the PHS Act with respect to general medical sciences, [$2,378,835,000]$2,401,011,000.
             Eunice Kennedy Shriver National Institute of Child Health and Human DevelopmentFor carrying out section 301 and title IV of the PHS Act with respect to child health and human development, [$1,320,600,000]$1,339,360,000.
             National Eye InstituteFor carrying out section 301 and title IV of the PHS Act with respect to eye diseases and visual disorders, [$693,015,000]$699,216,000.
             National Institute of Environment Health SciencesFor carrying out section 301 and title IV of the PHS Act with respect to environmental health sciences, $691,348,000.

          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, [$78,928,000]$79,411,000.
             National Institute on AgingFor carrying out section 301 and title IV of the PHS Act with respect to aging, [$1,102,650,000]$1,193,370,000.
             National Institute of Arthritis and Musculoskeletal and Skin DiseasesFor carrying out section 301 and title IV of the PHS Act with respect to arthritis and musculoskeletal and skin diseases,
             [$535,610,000]$540,993,000.
             National Institute on Deafness and Other Communication DisordersFor carrying out section 301 and title IV of the PHS Act with respect to deafness and other communication disorders, [$417,297,000]$422,936,000.
             National Institute of Nursing ResearchFor carrying out section 301 and title IV of the PHS Act with respect to nursing research, [$144,153,000]$146,244,000.
             National Institute on Alcohol Abuse and AlcoholismFor carrying out section 301 and title IV of the PHS Act with respect to alcohol abuse and alcoholism, [$457,104,000]$463,848,000.
             National Institute on Drug AbuseFor carrying out section 301 and title IV of the PHS Act with respect to drug abuse, [$1,054,001,000]$1,071,612,000.
             National Institute of Mental HealthFor carrying out section 301 and title IV of the PHS Act with respect to mental health, [$1,479,204,000]$1,465,782,000.
             National Human Genome Research InstituteFor carrying out section 301 and title IV of the PHS Act with respect to human genome research, [$511,370,000]$517,319,000.
             National Institute of Biomedical Imaging and BioengineeringFor carrying out section 301 and title IV of the PHS Act with respect to biomedical imaging and bioengineering research, [$336,896,000]$338,892,000.
             National Center for Complementary and Alternative MedicineFor carrying out section 301 and title IV of the PHS Act with respect to complementary and alternative medicine, [$127,930,000]$129,041,000.
             National Institute on Minority Health and Health DisparitiesFor carrying out section 301 and title IV of the PHS Act with respect to minority health and health disparities research,
             [$279,389,000]$283,299,000.
             John E. Fogarty International CenterFor carrying out the activities of the John E. Fogarty International Center (described in subpart 2 of part E of title IV
             of the PHS Act), [$69,758,000]$72,864,000.
             National Library of MedicineFor carrying out section 301 and title IV of the PHS Act with respect to health information communications, [$372,651,000]$382,252,000, of which $4,000,000 shall be available until September 30, [2014]2015, for improvement of information systems: Provided, That in fiscal year [2013]2014, the National Library of Medicine 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 (referred to in this title as
             "NIH''): Provided further, That in addition to amounts provided herein, $8,200,000 shall be available from amounts available under section 241 of the
             PHS Act to carry out the purposes of the National Information Center on Health Services Research and Health Care Technology
             established under section 478A of the PHS Act and related health information services.
             National Center for Advancing Translational SciencesFor carrying out section 301 and title IV of the PHS Act with respect to translational sciences, [$639,033,000]$665,688,000: Provided, That up to $50,000,000 shall be available to implement section [402C]480 of the PHS Act, relating to the Cures Acceleration Network.
             Office of the DirectorFor carrying out the responsibilities of the Office of the Director, NIH, [$1,429,161,000]$1,473,398,000, of which up to $25,000,000 shall be used to carry out section [212]211 of this Act: Provided, That funding shall be available for the purchase of not to exceed 29 passenger motor vehicles for replacement only: Provided further, That NIH is authorized to collect third-party payments for the cost of clinical services that are incurred in NIH research
             facilities and that such payments shall be credited to the NIH Management Fund: Provided further, That all funds credited to the NIH Management Fund shall remain available for one fiscal year after the fiscal year in which
             they are deposited:  Provided further, That [$544,930,000]$572,948,000 shall be available for the Common Fund established under section 402A(c)(1) of the PHS 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 the NIH: Provided further, That the Office of AIDS Research within the Office of the Director of the NIH may spend up to $8,000,000 to make grants
             for construction or renovation of facilities as provided for in section 2354(a)(5)(B) of the PHS Act: Provided further, That the Director may direct up to 1 percent of the total made available in this or any other Act to all National Institutes
             of Health appropriations to activities that 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.
             Buildings and FacilitiesFor the study of, construction of, renovation of, and acquisition of equipment for, facilities of or used by NIH, including
             the acquisition of real property, [$125,308,000]$126,111,000, to remain available until expended.  Note.—A full-year 2013 appropriation for this account was not enacted at the time the budget was prepared; therefore, the
                budget assumes this account is operating under the Continuing Appropriations Resolution, 2013 (P.L. 112–175). The amounts
                included for 2013 reflect the annualized level provided by the continuing resolution.
          Special and Trust Fund Receipts (in millions of dollars)

                      Identification code 75–9915–0–1–552
                      2012 actual
                      2013 CR
                      2014 est.

                      0100
                      Balance, start of year

                      Receipts:

                      0220
                      Cooperative Research and Development Agreements, NIH
                      16
                      17
                      17

                      0400
                      Total: Balances and collections
                      16
                      17
                      17

                      Appropriations:

                      0500
                      National Institutes of Health
                      –16
                      –17
                      –17

                      0799
                      Balance, end of year

          Program and Financing (in millions of dollars)

                      Identification code 75–9915–0–1–552
                      2012 actual
                      2013 CR
                      2014 est.

                      Obligations by program activity:

                      0001
                      National Cancer Institute (0849)
                      5,068
                      5,103
                      5,126

                      0002
                      National Heart, Lung, and Blood Institute (0872)
                      3,052
                      3,098
                      3,099

                      0003
                      National Institute of Dental and Craniofacial Research (0873)
                      410
                      413
                      412

                      0004
                      National Institute of Diabetes and Digestive and Kidney Disease (0884)
                      1,795
                      1,808
                      1,812

                      0005
                      National Institute of Neurological Disorders and Stroke (0886)
                      1,625
                      1,636
                      1,643

                      0006
                      National Institute of Allergy and Infectious Diseases (0885)
                      4,487
                      4,518
                      4,579

                      0007
                      National Institute of General Medical Sciences (0851)
                      2,428
                      2,445
                      2,401

                      0008
                      National Institute of Child Health and Human Development (0844)
                      1,320
                      1,329
                      1,339

                      0009
                      National Eye Institute (0887)
                      702
                      707
                      699

                      0010
                      National Institute of Environmental Health Sciences (0862)
                      764
                      769
                      771

                      0011
                      National Institute on Aging (0843)
                      1,121
                      1,110
                      1,193

                      0012
                      National Institute of Arthritis and Musculoskeletal and Skin Disease (0888)
                      535
                      539
                      541

                      0013
                      National Institute on Deafness and Other Communication Disorder (0890)
                      416
                      419
                      423

                      0014
                      National Institute of Mental Health (0892)
                      1,479
                      1,489
                      1,466

                      0015
                      National Institute on Drug Abuse (0893)
                      1,052
                      1,060
                      1,072

                      0016
                      National Institute on Alcohol Abuse and Alcoholism (0894)
                      459
                      462
                      464

                      0017
                      National Institute of Nursing Research (0889)
                      145
                      146
                      146

                      0018
                      National Human Genome Research Institute (0891)
                      513
                      516
                      517

                      0019
                      National Institute of Biomedical Imaging and Bioengineering (0898)
                      338
                      340
                      339

                      0021
                      National Center for Complementary and Alternative Medicine (0896)
                      128
                      129
                      129

                      0022
                      National Institute on Minority Health and Health Disparities (0897)
                      276
                      278
                      283

                      0023
                      John E. Fogarty International Center (0819)
                      70
                      70
                      73

                      0024
                      National Library of Medicine (0807)
                      337
                      340
                      382

                      0025
                      Office of the Director (0846)
                      1,458
                      1,468
                      1,473

                      0026
                      Buildings and facilities (0838)
                      99
                      126
                      126

                      0027
                      Cooperative Research and Development Agreements
                      18
                      17
                      17

                      0028
                      National Center for Advancing Translational Sciences (0875)
                      575
                      579
                      666

                      0031
                      Type 1 Diabetes
                      150
                      150
                      150

                      0799
                      Total direct obligations
                      30,820
                      31,064
                      31,341

                      0801
                      Reimbursable program activity
                      3,166
                      3,168
                      3,377

                      0802
                      Royalties
                      87
                      88
                      88

                      0809
                      Reimbursable program activities, subtotal
                      3,253
                      3,256
                      3,465

                      0899
                      Total reimbursable obligations
                      3,253
                      3,256
                      3,465

                      0900
                      Total new obligations
                      34,073
                      34,320
                      34,806

                      Budgetary Resources:

                      Unobligated balance:

                      1000
                      Unobligated balance brought forward, Oct 1
                      374
                      457
                      371

                      1001
                      Discretionary unobligated balance brought fwd, Oct 1
                      342
                      420

                      1021
                      Recoveries of prior year unpaid obligations
                      52

                      1050
                      Unobligated balance (total)
                      426
                      457
                      371

                      Budget authority:

                      Appropriations, discretionary:

                      1100
                      Appropriation
                      30,769
                      30,899
                      31,173

                      1120
                      Appropriations transferred to other accts [75–0350]
                      –9

                      1130
                      Appropriations permanently reduced
                      –58

                      1160
                      Appropriation, discretionary (total)
                      30,702
                      30,899
                      31,173

                      Appropriations, mandatory:

                      1200
                      Appropriation
                      150
                      150
                      150

                      1201
                      Appropriation (special or trust fund)
                      16
                      17
                      17

                      1260
                      Appropriations, mandatory (total)
                      166
                      167
                      167

                      Spending authority from offsetting collections, discretionary:

                      1700
                      Collected
                      2,733
                      3,168
                      3,377

                      1701
                      Change in uncollected payments, Federal sources
                      530

                      1750
                      Spending auth from offsetting collections, disc (total)
                      3,263
                      3,168
                      3,377

                      1900
                      Budget authority (total)
                      34,131
                      34,234
                      34,717

                      1930
                      Total budgetary resources available
                      34,557
                      34,691
                      35,088

                      Memorandum (non-add) entries:

                      1940
                      Unobligated balance expiring
                      –27

                      1941
                      Unexpired unobligated balance, end of year
                      457
                      371
                      282

                      Change in obligated balance:

                      Unpaid obligations:

                      3000
                      Unpaid obligations, brought forward, Oct 1
                      35,624
                      33,051
                      32,411

                      3010
                      Obligations incurred, unexpired accounts
                      34,073
                      34,320
                      34,806

                      3011
                      Obligations incurred, expired accounts
                      926

                      3020
                      Outlays (gross)
                      –36,568
                      –34,960
                      –34,713

                      3040
                      Recoveries of prior year unpaid obligations, unexpired
                      –52

                      3041
                      Recoveries of prior year unpaid obligations, expired
                      –952

                      3050
                      Unpaid obligations, end of year
                      33,051
                      32,411
                      32,504

                      Uncollected payments:

                      3060
                      Uncollected pymts, Fed sources, brought forward, Oct 1
                      –1,151
                      –938
                      –938

                      3070
                      Change in uncollected pymts, Fed sources, unexpired
                      –530

                      3071
                      Change in uncollected pymts, Fed sources, expired
                      743

                      3090
                      Uncollected pymts, Fed sources, end of year
                      –938
                      –938
                      –938

                      Memorandum (non-add) entries:

                      3100
                      Obligated balance, start of year
                      34,473
                      32,113
                      31,473

                      3200
                      Obligated balance, end of year
                      32,113
                      31,473
                      31,566

                      Budget authority and outlays, net:

                      Discretionary:

                      4000
                      Budget authority, gross
                      33,965
                      34,067
                      34,550

                      Outlays, gross:

                      4010
                      Outlays from new discretionary authority
                      10,769
                      11,512
                      11,794

                      4011
                      Outlays from discretionary balances
                      25,653
                      23,140
                      22,750

                      4020
                      Outlays, gross (total)
                      36,422
                      34,652
                      34,544

                      Offsets against gross budget authority and outlays:

                      Offsetting collections (collected) from:

                      4030
                      Federal sources
                      –3,675
                      –3,168
                      –3,377

                      4033
                      Non-Federal sources
                      –112

                      4040
                      Offsets against gross budget authority  and outlays (total)
                      –3,787
                      –3,168
                      –3,377

                      Additional offsets against gross budget authority only:

                      4050
                      Change in uncollected pymts, Fed sources, unexpired
                      –530

                      4052
                      Offsetting collections credited to expired accounts
                      1,054

                      4060
                      Additional offsets against budget authority only (total)
                      524

                      4070
                      Budget authority, net (discretionary)
                      30,702
                      30,899
                      31,173

                      4080
                      Outlays, net (discretionary)
                      32,635
                      31,484
                      31,167

                      Mandatory:

                      4090
                      Budget authority, gross
                      166
                      167
                      167

                      Outlays, gross:

                      4100
                      Outlays from new mandatory authority
                      10
                      52
                      53

                      4101
                      Outlays from mandatory balances
                      136
                      256
                      116

                      4110
                      Outlays, gross (total)
                      146
                      308
                      169

                      4180
                      Budget authority, net (total)
                      30,868
                      31,066
                      31,340

                      4190
                      Outlays, net (total)
                      32,781
                      31,792
                      31,336

             DISTRIBUTION OF BUDGET AUTHORITY AND OUTLAYS BY ACCOUNT (in millions of dollars)

                         2012
                         20131
                         2014

                         Distribution of budget authority by account:

                         National Cancer Institute
                         5,072
                         5,103
                         5,126

                         National Heart, Lung, and Blood Institute
                         3,079
                         3,098
                         3,099

                         National Institute of Dental and Craniofacial Research
                         411
                         413
                         412

                         National Institute of Diabetes and Digestive and Kidney Diseases
                         1,947
                         1,958
                         1,962

                         National Institute of Neurological Disorder and Stroke
                         1,626
                         1,636
                         1,643

                         National Institute of Allergy and Infectious Diseases
                         4,491
                         4,518
                         4,579

                         National Institute of General Medical Sciences
                         2,430
                         2,445
                         2,401

                         Eunice Kennedy Shriver National Institute of Child Health and Human Development
                         1,321
                         1,329
                         1,339

                         National Eye Institute
                         703
                         707
                         699

                         National Institute of Environmental Health Sciences
                         764
                         769
                         771

                         National Institute on Aging
                         1,103
                         1,110
                         1,193

                         National Institute of Arthritis and Musculoskeletal and Skin Diseases
                         536
                         539
                         541

                         National Institute on Deafness and Other Communication Disorders
                         416
                         419
                         423

                         National Institute of Mental Health
                         1,480
                         1,489
                         1,466

                         National Institute on Drug Abuse
                         1,053
                         1,060
                         1,072

                         National Institute on Alcohol Abuse and Alcoholism
                         460
                         462
                         464

                         National Institute of Nursing Research
                         145
                         146
                         146

                         National Center for Research Resources
                         0
                         0
                         0

                         National Human Genome Research Institute
                         513
                         516
                         517

                         National Institute of Biomedical Imaging and Bioengineering
                         338
                         340
                         339

                         National Institute on Minority Health and Health Disparities
                         276
                         278
                         283

                         National Center for Complementary and Alternative Medicine
                         128
                         129
                         129

                         National Center for Advancing Translational Sciences
                         575
                         579
                         666

                         John E. Fogarty International Center
                         70
                         70
                         73

                         National Library of Medicine
                         338
                         340
                         382

                         Office of the Director
                         1,459
                         1,468
                         1,473

                         Buildings and Facilities
                         125
                         126
                         126

                         ARRA Funds
                         0
                         0
                         0

                         Subtotal
                         30,861
                         31,049
                         31,323

                         Cooperative Research and Development Agreements
                         17
                         17
                         17

                         Total Budget Authority, NIH
                         30,878
                         31,066
                         31,340

             1Assumes annualized continuing resolution
             (in millions of dollars)

                         2012
                         2013
                         2014

                         Distribution of outlays by account:

                         National Cancer Institute
                         5,154
                         4,909
                         5,102

                         National Heart, Lung, and Blood Institute
                         3,151
                         2,925
                         3,089

                         National Institute of Dental and Craniofacial Research
                         403
                         423
                         412

                         National Institute of Diabetes and Digestive and Kidney Diseases
                         1,927
                         2,342
                         1,956

                         National Institute of Neurological Disorders and Stroke
                         1,593
                         1,715
                         1,636

                         National Institute of Allergy and Infectious Diseases
                         4,569
                         4,340
                         4,527

                         National Institute of General Medical Sciences
                         1,824
                         2,668
                         2,427

                         Eunice Kennedy Shriver National Institute of Child Health and Human Development
                         1,289
                         1,359
                         1,331

                         National Eye Institute
                         699
                         707
                         704

                         National Institute of Environmental Health Sciences
                         1,049
                         490
                         769

                         National Institute on Aging
                         1,101
                         1,081
                         1,131

                         National Institute of Arthritis and Musculoskeletal and Skin Diseases
                         531
                         527
                         539

                         National Institute on Deafness and Other Communication Disorders
                         417
                         420
                         419

                         National Institute of Mental Health
                         1,490
                         1,435
                         1,481

                         National Institute on Drug Abuse
                         1,090
                         962
                         1,061

                         National Institute on Alcohol Abuse and Alcoholism
                         467
                         460
                         462

                         National Institute of Nursing Research
                         145
                         137
                         146

                         National Center for Research Resources
                         910
                         406
                         77

                         National Human Genome Research Institute
                         498
                         537
                         516

                         National Institute of Biomedical Imaging and Bioengineering
                         318
                         331
                         339

                         National Institute on Minority Health and Health Disparities
                         227
                         243
                         274

                         National Center for Complementary and Alternative Medicine
                         123
                         126
                         129

                         National Center for Advancing Translational Sciences
                         98
                         326
                         554

                         John E. Fogarty International Center
                         65
                         72
                         71

                         National Library of Medicine
                         341
                         328
                         362

                         Office of the Director
                         1,341
                         1,359
                         1,439

                         Buildings and Facilities
                         112
                         130
                         90

                         ARRA Funds
                         1,880
                         1,020
                         277

                         Management Fund/Service and Supply Fund
                         –46
                         0
                         0

                         Subtotal Outlays
                         32,769
                         31,777
                         31,318

                         Cooperative Research and Development Agreements
                         13
                         16
                         16

                         Total Outlays, NIH
                         32,782
                         31,792
                         31,336

             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.

          Object Classification (in millions of dollars)

                      Identification code 75–9915–0–1–552
                      2012 actual
                      2013 CR
                      2014 est.

                      Direct obligations:

                      Personnel compensation:

                      11.1
                      Full-time permanent
                      879
                      933
                      944

                      11.3
                      Other than full-time permanent
                      475
                      487
                      496

                      11.5
                      Other personnel compensation
                      30
                      32
                      33

                      11.7
                      Military personnel
                      21
                      22
                      22

                      11.8
                      Special personal services payments
                      162
                      163
                      166

                      11.9
                      Total personnel compensation
                      1,567
                      1,637
                      1,661

                      12.1
                      Civilian personnel benefits
                      411
                      430
                      435

                      12.2
                      Military personnel benefits
                      15
                      16
                      16

                      21.0
                      Travel and transportation of persons
                      50
                      49
                      49

                      22.0
                      Transportation of things
                      5
                      5
                      5

                      23.1
                      Rental payments to GSA
                      1
                      2
                      2

                      23.2
                      Rental payments to others
                      1
                      1
                      1

                      23.3
                      Communications, utilities, and miscellaneous charges
                      27
                      27
                      27

                      24.0
                      Printing and reproduction
                      3
                      3
                      3

                      25.1
                      Advisory and assistance services
                      125
                      115
                      115

                      25.2
                      Other services from non-Federal sources
                      819
                      702
                      725

                      25.3
                      Other goods and services from Federal sources
                      3,171
                      3,126
                      3,273

                      25.4
                      Operation and maintenance of facilities
                      45
                      45
                      45

                      25.5
                      Research and development contracts
                      1,996
                      1,984
                      1,905

                      25.6
                      Medical care
                      20
                      20
                      20

                      25.7
                      Operation and maintenance of equipment
                      88
                      86
                      86

                      26.0
                      Supplies and materials
                      193
                      190
                      189

                      31.0
                      Equipment
                      154
                      142
                      144

                      32.0
                      Land and structures

                      126
                      126

                      41.0
                      Grants, subsidies, and contributions
                      22,130
                      22,358
                      22,514

                      99.0
                      Direct obligations
                      30,821
                      31,064
                      31,341

                      99.0
                      Reimbursable obligations
                      3,252
                      3,256
                      3,465

                      99.9
                      Total new obligations
                      34,073
                      34,320
                      34,806

          Employment Summary

                      Identification code 75–9915–0–1–552
                      2012 actual
                      2013 CR
                      2014 est.

                      1001
                      Direct civilian full-time equivalent employment
                      13,048
                      13,604
                      13,607

                      1101
                      Direct military average strength employment
                      201
                      201
                      198

                      2001
                      Reimbursable civilian full-time equivalent employment
                      5,137
                      4,581
                      4,581

                      2101
                      Reimbursable military average strength employment
                      107
                      107
                      107

             Substance Abuse and Mental Health Services Administration

             Federal Funds
             Mental HealthFor carrying out titles III, V, and XIX of the PHS Act with respect to mental health, and the Protection and Advocacy for
             Individuals with Mental Illness Act, [$902,856,000]$990,341,000 of which $438,717,000 shall be for carrying out Section 1911 of the PHS Act: Provided, That notwithstanding section 520A(f)(2) of the PHS Act, no funds appropriated for carrying out section 520A shall be available
             for carrying out section 1971 of the PHS Act: Provided further, That in addition to amounts provided herein, [$21,039,000]$21,039,000 shall be available under section 241 of the PHS Act to carry out subpart I of part B of title XIX of the 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: Provided further, That section 520E(b)(2) of the PHS Act shall not apply to funds appropriated under this Act for fiscal year [2013]2014: Provided further, That notwithstanding section 565(b)(1) of the PHS Act, technical assistance may be provided to communities
                that wish to establish such programs irrespective of whether the communities have a grant under section 561(a): Provided further,
                That States shall expend at least 3 percent of the amount for carrying out section 1911 of the PHS Act to award competitive
                subawards that assist providers in building capacity to bill third party insurance or assist individuals to enroll in insurance
                for which they are eligible: Provided further, That States shall expend at least 5 percent of the amount for carrying out
                section 1911 of the PHS Act to award competitive subawards that support effective evidence-based mental health prevention
                and treatment practices: Provided further, That any State receiving 2 percent or more of the total amount distributed for
                carrying out section 1911 of the PHS Act shall expend the amounts described in the two immediately preceding provisos through
                competitive subawards.
              Substance Abuse TreatmentFor carrying out titles III, V, and XIX of the PHS Act with respect to substance abuse treatment [, $1,711,045,000]and section 1922(a) of the PHS Act with respect to substance abuse prevention, $2,052,926,000 of which $1,748,132,000 shall
                be for carrying out Section 1921 of the PHS Act: Provided, That in addition to amounts provided herein, [$71,724,000]$71,724,000 shall be available under section 241 of the PHS Act to carry out subpart II of part B of title XIX of the 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: Provided further, That [section 1922(a)(1) of the PHS Act shall not apply to amounts provided herein]States shall expend at least 3 percent of the amount for carrying out section 1921 of the PHS Act to award competitive subawards
                that assist providers in building capacity to bill third party insurance or assist individuals to enroll in insurance for
                which they are eligible: Provided further, That any State receiving 1 percent or more of the total amount distributed for
                carrying out section 1921 of the PHS Act shall expend the amounts described in the immediately preceding proviso through competitive
                subawards.
              Substance Abuse PreventionFor carrying out titles III and V of the PHS Act with respect to substance abuse prevention, [$463,378,000]$175,560,000.
             Health Surveillance and Program SupportFor program support and cross-cutting activities that supplement activities funded under the headings "Mental Health'', "Substance
             Abuse Treatment'', and "Substance Abuse Prevention'' in carrying out titles III, V, and XIX of the PHS Act and the Protection
             and Advocacy for Individuals with Mental Illness Act in the Substance Abuse and Mental Health Services Administration, [$74,229,000]$129,124,000: Provided, That in addition to amounts provided herein, [$71,995,000]$71,995,000 shall be available under section 241 of the PHS Act to supplement funds available to carry out national surveys on drug abuse
             and mental health, to collect and analyze program data, and to conduct public awareness and technical assistance activities:
             Provided further, That, in addition, fees may be collected for the costs [associated with additional] of publications, data, data tabulations, and data analysis completed under title V of the PHS Act and provided to a public or
             private entity upon request, which shall be credited to this appropriation and shall remain available until expended for such
             purposes: Provided further, That funds made available under this heading may be used to supplement program support funding provided under the headings
             "Mental Health'', "Substance Abuse Treatment'', and "Substance Abuse Prevention'': Provided further, That the Administrator may transfer funds between any of the accounts of SAMHSA with notification to the Committees on Appropriations
             of both Houses of Congress at least 15 days in advance of any transfer, but no such account shall be decreased by more than
             3 percent by any such transfer.  Note.—A full-year 2013 appropriation for this account was not enacted at the time the budget was prepared; therefore, the
                budget assumes this account is operating under the Continuing Appropriations Resolution, 2013 (P.L. 112–175). The amounts
                included for 2013 reflect the annualized level provided by the continuing resolution.
          Program and Financing (in millions of dollars)

                      Identification code 75–1362–0–1–551
                      2012 actual
                      2013 CR
                      2014 est.

                      Obligations by program activity:

                      0006
                      Mental Health
                      978
                      934
                      990

                      0007
                      Substance Abuse Treatment
                      2,148
                      2,132
                      2,053

                      0008
                      Substance Abuse Prevention
                      186
                      187
                      176

                      0009
                      Health Surveillance and Program Support
                      126
                      115
                      129

                      0100
                      Total, direct program
                      3,438
                      3,368
                      3,348

                      0799
                      Total direct obligations
                      3,438
                      3,368
                      3,348

                      0802
                      Reimbursable program: PHS Evaluation
                      248
                      253
                      257

                      0900
                      Total new obligations
                      3,686
                      3,621
                      3,605

                      Budgetary Resources:

                      Budget authority:

                      Appropriations, discretionary:

                      1100
                      Appropriation
                      3,354
                      3,368
                      3,348

                      1120
                      Appropriations transferred to other accts [75–0350]
                      –1

                      1130
                      Appropriations permanently reduced
                      –6

                      1160
                      Appropriation, discretionary (total)
                      3,347
                      3,368
                      3,348

                      Appropriations, mandatory:

                      1221
                      Appropriations transferred from the Prevention and Public Health Fund [75–0116]
                      92

                      58

                      1260
                      Appropriations, mandatory (total)
                      92

                      58

                      Spending authority from offsetting collections, discretionary:

                      1700
                      Collected
                      238
                      253
                      259

                      1701
                      Change in uncollected payments, Federal sources
                      10

                      1750
                      Spending auth from offsetting collections, disc (total)
                      248
                      253
                      259

                      1900
                      Budget authority (total)
                      3,687
                      3,621
                      3,665

                      1930
                      Total budgetary resources available
                      3,687
                      3,621
                      3,665

                      Memorandum (non-add) entries:

                      1940
                      Unobligated balance expiring
                      –1

                      1941
                      Unexpired unobligated balance, end of year

                      60

                      Change in obligated balance:

                      Unpaid obligations:

                      3000
                      Unpaid obligations, brought forward, Oct 1
                      2,965
                      3,125
                      2,899

                      3010
                      Obligations incurred, unexpired accounts
                      3,686
                      3,621
                      3,605

                      3011
                      Obligations incurred, expired accounts
                      5

                      3020
                      Outlays (gross)
                      –3,487
                      –3,847
                      –3,669

                      3041
                      Recoveries of prior year unpaid obligations, expired
                      –44

                      3050
                      Unpaid obligations, end of year
                      3,125
                      2,899
                      2,835

                      Uncollected payments:

                      3060
                      Uncollected pymts, Fed sources, brought forward, Oct 1
                      –241
                      –22
                      –22

                      3070
                      Change in uncollected pymts, Fed sources, unexpired
                      –10

                      3071
                      Change in uncollected pymts, Fed sources, expired
                      229

                      3090
                      Uncollected pymts, Fed sources, end of year
                      –22
                      –22
                      –22

                      Memorandum (non-add) entries:

                      3100
                      Obligated balance, start of year
                      2,724
                      3,103
                      2,877

                      3200
                      Obligated balance, end of year
                      3,103
                      2,877
                      2,813

                      Budget authority and outlays, net:

                      Discretionary:

                      4000
                      Budget authority, gross
                      3,595
                      3,621
                      3,607

                      Outlays, gross:

                      4010
                      Outlays from new discretionary authority
                      1,359
                      1,469
                      1,468

                      4011
                      Outlays from discretionary balances
                      2,118
                      2,295
                      2,150

                      4020
                      Outlays, gross (total)
                      3,477
                      3,764
                      3,618

                      Offsets against gross budget authority and outlays:

                      Offsetting collections (collected) from:

                      4030
                      Federal sources
                      –471
                      –253
                      –257

                      4033
                      Non-Federal sources

                      –2

                      4040
                      Offsets against gross budget authority  and outlays (total)
                      –471
                      –253
                      –259

                      Additional offsets against gross budget authority only:

                      4050
                      Change in uncollected pymts, Fed sources, unexpired
                      –10

                      4052
                      Offsetting collections credited to expired accounts
                      233

                      4060
                      Additional offsets against budget authority only (total)
                      223

                      4070
                      Budget authority, net (discretionary)
                      3,347
                      3,368
                      3,348

                      4080
                      Outlays, net (discretionary)
                      3,006
                      3,511
                      3,359

                      Mandatory:

                      4090
                      Budget authority, gross
                      92

                      58

                      Outlays, gross:

                      4100
                      Outlays from new mandatory authority
                      10

                      4101
                      Outlays from mandatory balances

                      83
                      51

                      4110
                      Outlays, gross (total)
                      10
                      83
                      51

                      4180
                      Budget authority, net (total)
                      3,439
                      3,368
                      3,406

                      4190
                      Outlays, net (total)
                      3,016
                      3,594
                      3,410

             This program provides Federal support to strengthen the capacity of the Nation's health care delivery system to provide effective
                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, tribal and private not-for-profit organizations
                to enhance health and reduce the adverse impact of substance abuse and mental illness on America's communities.

          Object Classification (in millions of dollars)

                      Identification code 75–1362–0–1–551
                      2012 actual
                      2013 CR
                      2014 est.

                      Direct obligations:

                      Personnel compensation:

                      11.1
                      Full-time permanent
                      46
                      54
                      57

                      11.3
                      Other than full-time permanent
                      2
                      3
                      4

                      11.5
                      Other personnel compensation
                      1
                      4
                      4

                      11.7
                      Military personnel
                      4
                      4
                      4

                      11.9
                      Total personnel compensation
                      53
                      65
                      69

                      12.1
                      Civilian personnel benefits
                      12
                      15
                      16

                      12.2
                      Military personnel benefits
                      2
                      2
                      2

                      21.0
                      Travel and transportation of persons
                      2
                      1
                      1

                      23.1
                      Rental payments to GSA
                      7
                      7
                      7

                      23.3
                      Communications, utilities, and miscellaneous charges
                      1
                      1
                      1

                      24.0
                      Printing and reproduction
                      3
                      2
                      2

                      25.1
                      Advisory and assistance services
                      26
                      55
                      49

                      25.2
                      Other services from non-Federal sources
                      201
                      173
                      166

                      25.3
                      Other goods and services from Federal sources
                      90
                      41
                      32

                      25.7
                      Operation and maintenance of equipment
                      1
                      1
                      1

                      41.0
                      Grants, subsidies, and contributions
                      3,039
                      3,005
                      3,002

                      42.0
                      Insurance claims and indemnities
                      1

                      99.0
                      Direct obligations
                      3,438
                      3,368
                      3,348

                      99.0
                      Reimbursable obligations
                      248
                      253
                      257

                      99.9
                      Total new obligations
                      3,686
                      3,621
                      3,605

          Employment Summary

                      Identification code 75–1362–0–1–551
                      2012 actual
                      2013 CR
                      2014 est.

                      1001
                      Direct civilian full-time equivalent employment
                      498
                      533
                      552

                      1101
                      Direct military average strength employment
                      44
                      48
                      48

                      2001
                      Reimbursable civilian full-time equivalent employment
                      40
                      43
                      48

                      2101
                      Reimbursable military average strength employment
                      8
                      7
                      7

             Agency for Healthcare Research and Quality

             Federal Funds
             Healthcare Research and QualityFor carrying out titles III and IX of the PHS Act, part A of title XI of the Social Security Act, and section 1013 of the
             Medicare Prescription Drug, Improvement, and Modernization Act of 2003, [$334,357,000]$333,697,000 shall be available from amounts available under section 241 of the PHS Act, notwithstanding subsection 947(c) of such Act:
             Provided, That in addition, 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.  Note.—A full-year 2013 appropriation for this account was not enacted at the time the budget was prepared; therefore, the
                budget assumes this account is operating under the Continuing Appropriations Resolution, 2013 (P.L. 112–175). The amounts
                included for 2013 reflect the annualized level provided by the continuing resolution.
          Program and Financing (in millions of dollars)

                      Identification code 75–1700–0–1–552
                      2012 actual
                      2013 CR
                      2014 est.

                      Obligations by program activity:

                      0003
                      Prevention and Public Health Fund
                      12

                      0801
                      Reimbursable program
                      15
                      15
                      15

                      0802
                      Reimbursable program: PHS evaluation
                      366
                      371
                      334

                      0899
                      Total reimbursable obligations
                      381
                      386
                      349

                      0900
                      Total new obligations
                      393
                      386
                      349

                      Budgetary Resources:

                      Unobligated balance:

                      1000
                      Unobligated balance brought forward, Oct 1
                      4
                      5
                      5

                      1001
                      Discretionary unobligated balance brought fwd, Oct 1
                      4
                      5

                      Budget authority:

                      Appropriations, mandatory:

                      1221
                      Appropriations transferred from other accts [75–0116]
                      12

                      1260
                      Appropriations, mandatory (total)
                      12

                      Spending authority from offsetting collections, discretionary:

                      1700
                      Collected
                      187
                      386
                      349

                      1701
                      Change in uncollected payments, Federal sources
                      195

                      1750
                      Spending auth from offsetting collections, disc (total)
                      382
                      386
                      349

                      1900
                      Budget authority (total)
                      394
                      386
                      349

                      1930
                      Total budgetary resources available
                      398
                      391
                      354

                      Memorandum (non-add) entries:

                      1941
                      Unexpired unobligated balance, end of year
                      5
                      5
                      5

                      Change in obligated balance:

                      Unpaid obligations:

                      3000
                      Unpaid obligations, brought forward, Oct 1
                      989
                      726
                      68

                      3010
                      Obligations incurred, unexpired accounts
                      393
                      386
                      349

                      3020
                      Outlays (gross)
                      –647
                      –1,044
                      –375

                      3041
                      Recoveries of prior year unpaid obligations, expired
                      –9

                      3050
                      Unpaid obligations, end of year
                      726
                      68
                      42

                      Uncollected payments:

                      3060
                      Uncollected pymts, Fed sources, brought forward, Oct 1
                      –382
                      –293
                      –293

                      3070
                      Change in uncollected pymts, Fed sources, unexpired
                      –195

                      3071
                      Change in uncollected pymts, Fed sources, expired
                      284

                      3090
                      Uncollected pymts, Fed sources, end of year
                      –293
                      –293
                      –293

                      Memorandum (non-add) entries:

                      3100
                      Obligated balance, start of year
                      607
                      433
                      –225

                      3200
                      Obligated balance, end of year
                      433
                      –225
                      –251

                      Budget authority and outlays, net:

                      Discretionary:

                      4000
                      Budget authority, gross
                      382
                      386
                      349

                      Outlays, gross:

                      4010
                      Outlays from new discretionary authority
                      124
                      386
                      349

                      4011
                      Outlays from discretionary balances
                      517
                      651
                      21

                      4020
                      Outlays, gross (total)
                      641
                      1,037
                      370

                      Offsets against gross budget authority and outlays:

                      Offsetting collections (collected) from:

                      4030
                      Federal sources
                      –463
                      –839
                      –349

                      Additional offsets against gross budget authority only:

                      4050
                      Change in uncollected pymts, Fed sources, unexpired
                      –195

                      4052
                      Offsetting collections credited to expired accounts
                      276
                      453

                      4060
                      Additional offsets against budget authority only (total)
                      81
                      453

                      4080
                      Outlays, net (discretionary)
                      178
                      198
                      21

                      Mandatory:

                      4090
                      Budget authority, gross
                      12

                      Outlays, gross:

                      4101
                      Outlays from mandatory balances
                      6
                      7
                      5

                      4180
                      Budget authority, net (total)
                      12

                      4190
                      Outlays, net (total)
                      184
                      205
                      26

             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
                      2012 actual
                      2013 CR
                      2014 est.

                      Direct obligations:

                      25.5
                      Research and development contracts
                      8

                      41.0
                      Grants, subsidies, and contributions
                      4

                      99.0
                      Direct obligations
                      12

                      99.0
                      Reimbursable obligations
                      381
                      386
                      349

                      99.9
                      Total new obligations
                      393
                      386
                      349

          Employment Summary

                      Identification code 75–1700–0–1–552
                      2012 actual
                      2013 CR
                      2014 est.

                      1001
                      Direct civilian full-time equivalent employment

                      2001
                      Reimbursable civilian full-time equivalent employment
                      295
                      299
                      294

                      2101
                      Reimbursable military average strength employment
                      9
                      9
                      9

                      3001
                      Allocation account civilian full-time equivalent employment
                      4
                      12
                      20

             Centers for Medicare and Medicaid Services

             Federal Funds
             Grants to States for MedicaidFor carrying out, except as otherwise provided, titles XI and XIX of the Social Security Act, [$178,791,197,000]$177,872,985,000, to remain available until expended.

          For making, after May 31, [2013]2014, payments to States under title XIX or in the case of section 1928 on behalf of States under title XIX of the Social Security
             Act for the last quarter of fiscal year [2013]2014 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 [2014, $106,335,631,000]2015, $103,472,323,000, to remain available until expended.

          Payment under such 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.  Note.—A full-year 2013 appropriation for this account was not enacted at the time the budget was prepared; therefore, the
                budget assumes this account is operating under the Continuing Appropriations Resolution, 2013 (P.L. 112–175). The amounts
                included for 2013 reflect the annualized level provided by the continuing resolution.
          Program and Financing (in millions of dollars)

                      Identification code 75–0512–0–1–551
                      2012 actual
                      2013 CR
                      2014 est.

                      Obligations by program activity:

                      0001
                      Medicaid vendor payments
                      248,004
                      246,797
                      283,045

                      0002
                      State and local administration
                      17,216
                      16,182
                      16,453

                      0003
                      Vaccines for Children
                      4,000
                      3,607
                      4,293

                      0004
                      Incurred by providers but not yet reported
                      1,092
                      1,959
                      2,369

                      0799
                      Total direct obligations
                      270,312
                      268,545
                      306,160

                      0801
                      Medicare Part B premiums
                      602
                      645
                      300

                      0900
                      Total new obligations
                      270,914
                      269,190
                      306,460

                      Budgetary Resources:

                      Unobligated balance:

                      1000
                      Unobligated balance brought forward, Oct 1
                      408
                      21,091
                      21,951

                      1021
                      Recoveries of prior year unpaid obligations
                      20,186

                      1050
                      Unobligated balance (total)
                      20,594
                      21,091
                      21,951

                      Budget authority:

                      Appropriations, mandatory:

                      1200
                      Appropriation Medicaid
                      184,279
                      178,791
                      177,873

                      1260
                      Appropriations, mandatory (total)
                      184,279
                      178,791
                      177,873

                      Advance appropriations, mandatory:

                      1270
                      Advance appropriation
                      86,445
                      90,614
                      106,336

                      1280
                      Advanced appropriation, mandatory (total)
                      86,445
                      90,614
                      106,336

                      Spending authority from offsetting collections, mandatory:

                      1800
                      Collected
                      687
                      645
                      300

                      1850
                      Spending auth from offsetting collections, mand (total)
                      687
                      645
                      300

                      1900
                      Budget authority (total)
                      271,411
                      270,050
                      284,509

                      1930
                      Total budgetary resources available
                      292,005
                      291,141
                      306,460

                      Memorandum (non-add) entries:

                      1941
                      Unexpired unobligated balance, end of year
                      21,091
                      21,951

                      Change in obligated balance:

                      Unpaid obligations:

                      3000
                      Unpaid obligations, brought forward, Oct 1
                      28,392
                      27,899
                      29,858

                      3010
                      Obligations incurred, unexpired accounts
                      270,914
                      269,190
                      306,460

                      3020
                      Outlays (gross)
                      –251,221
                      –267,231
                      –304,091

                      3040
                      Recoveries of prior year unpaid obligations, unexpired
                      –20,186

                      3050
                      Unpaid obligations, end of year
                      27,899
                      29,858
                      32,227

                      Memorandum (non-add) entries:

                      3100
                      Obligated balance, start of year
                      28,392
                      27,899
                      29,858

                      3200
                      Obligated balance, end of year
                      27,899
                      29,858
                      32,227

                      Budget authority and outlays, net:

                      Mandatory:

                      4090
                      Budget authority, gross
                      271,411
                      270,050
                      284,509

                      Outlays, gross:

                      4100
                      Outlays from new mandatory authority
                      226,477
                      232,191
                      267,211

                      4101
                      Outlays from mandatory balances
                      24,744
                      35,040
                      36,880

                      4110
                      Outlays, gross (total)
                      251,221
                      267,231
                      304,091

                      Offsets against gross budget authority and outlays:

                      Offsetting collections (collected) from:

                      4120
                      Federal sources
                      –602
                      –645
                      –300

                      4123
                      Non-Federal sources
                      –85

                      4130
                      Offsets against gross budget authority and outlays (total)
                      –687
                      –645
                      –300

                      4160
                      Budget authority, net (mandatory)
                      270,724
                      269,405
                      284,209

                      4170
                      Outlays, net (mandatory)
                      250,534
                      266,586
                      303,791

                      4180
                      Budget authority, net (total)
                      270,724
                      269,405
                      284,209

                      4190
                      Outlays, net (total)
                      250,534
                      266,586
                      303,791

          Summary of Budget Authority and Outlays (in millions of dollars)

                      2012 actual
                      2013 CR
                      2014 est.

                      Enacted/requested:

                      Budget Authority
                      270,724
                      269,405
                      284,209

                      Outlays
                      250,534
                      266,586
                      303,791

                      Legislative proposal, not subject to PAYGO:

                      Budget Authority

                      –21
                      –436

                      Outlays

                      –21
                      –436

                      Legislative proposal, subject to PAYGO:

                      Budget Authority

                      279

                      Outlays

                      279

                      Total:

                      Budget Authority
                      270,724
                      269,384
                      284,052

                      Outlays
                      250,534
                      266,565
                      303,634

             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).
             Authorized as part of Title XIX, Vaccines for Children (VFC) finances the purchase of vaccines for low-income, eligible children.
                VFC is administered by the Centers for Disease Control and Prevention and is funded entirely by the Federal Government.

             Vaccines for Children (in millions of dollars)

                         Obligations
                         2012
                         2013
                         2014

                         Vaccine Purchase
                         3,703
                         3,335
                         3,996

                         Vaccine Stockpile
                         137
                         137
                         137

                         Ordering, Distribution, and Operations
                         117
                         92
                         117

                         Vaccine Management Contract Support
                         2
                         1
                         0

                         Evaluation Activities
                         41
                         42
                         43

                         Total Obligations
                         4,000
                         3,607
                         4,293

          Object Classification (in millions of dollars)

                      Identification code 75–0512–0–1–551
                      2012 actual
                      2013 CR
                      2014 est.

                      41.0
                      Direct obligations: Grants, subsidies, and contributions
                      270,312
                      268,545
                      306,160

                      99.0
                      Reimbursable obligations
                      602
                      645
                      300

                      99.9
                      Total new obligations
                      270,914
                      269,190
                      306,460

             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
                      2012 actual
                      2013 CR
                      2014 est.

                      Obligations by program activity:

                      0001
                      Medicaid vendor payments

                      –21
                      –31

                      0900
                      Total new obligations (object class 41.0)

                      –21
                      –31

                      Budgetary Resources:

                      Budget authority:

                      Appropriations, mandatory:

                      1200
                      Appropriation

                      –21
                      –31

                      1260
                      Appropriations, mandatory (total)

                      –21
                      –31

                      1930
                      Total budgetary resources available

                      –21
                      –31

                      Change in obligated balance:

                      Unpaid obligations:

                      3010
                      Obligations incurred, unexpired accounts

                      –21
                      –31

                      3020
                      Outlays (gross)

                      21
                      31

                      Budget authority and outlays, net:

                      Mandatory:

                      4090
                      Budget authority, gross

                      –21
                      –31

                      Outlays, gross:

                      4100
                      Outlays from new mandatory authority

                      –21
                      –31

                      Offsets against gross budget authority and outlays:

                      Offsetting collections (collected) from:

                      4120
                      Federal sources

                      –405

                      4180
                      Budget authority, net (total)

                      –21
                      –436

                      4190
                      Outlays, net (total)

                      –21
                      –436

             Please see the narratives in the Program Integrity Administrative Expenses (Social Security Administration) and Health Care Fraud and Abuse Control accounts for a description of the program integrity estimates reflected here.  This schedule also reflects the offsetting
                collections from Medicare Part B for the extension of the Qualified Individuals (QI) program.

             Grants to States for Medicaid

             (Legislative proposal, subject to PAYGO)Program and Financing (in millions of dollars)

                      Identification code 75–0512–4–1–551
                      2012 actual
                      2013 CR
                      2014 est.

                      Obligations by program activity:

                      0001
                      Medicaid Proposals

                      –126

                      0801
                      Medicare Part B premiums

                      405

                      0900
                      Total new obligations

                      279

                      Budgetary Resources:

                      Budget authority:

                      Appropriations, mandatory:

                      1200
                      Appropriation Medicaid

                      –126

                      1260
                      Appropriations, mandatory (total)

                      –126

                      Spending authority from offsetting collections, mandatory:

                      1800
                      Collected

                      405

                      1850
                      Spending auth from offsetting collections, mand (total)

                      405

                      1900
                      Budget authority (total)

                      279

                      1930
                      Total budgetary resources available

                      279

                      Change in obligated balance:

                      Unpaid obligations:

                      3010
                      Obligations incurred, unexpired accounts

                      279

                      3020
                      Outlays (gross)

                      –279

                      Budget authority and outlays, net:

                      Mandatory:

                      4090
                      Budget authority, gross

                      279

                      Outlays, gross:

                      4100
                      Outlays from new mandatory authority

                      279

                      4180
                      Budget authority, net (total)

                      279

                      4190
                      Outlays, net (total)

                      279

             This schedule reflects the Administration's Medicaid proposals.

          Object Classification (in millions of dollars)

                      Identification code 75–0512–4–1–551
                      2012 actual
                      2013 CR
                      2014 est.

                      41.0
                      Direct obligations: Grants, subsidies, and contributions

                      –126

                      99.0
                      Reimbursable obligations

                      405

                      99.9
                      Total new obligations

                      279

             State Grants and Demonstrations

             Program and Financing (in millions of dollars)

                      Identification code 75–0516–0–1–551
                      2012 actual
                      2013 CR
                      2014 est.

                      Obligations by program activity:

                      0010
                      Ticket to Work grants
                      1

                      0011
                      Emergency health services for undocumented aliens
                      22
                      16
                      5

                      0012
                      Medicaid integrity program
                      63
                      96
                      86

                      0018
                      Money follows the person (MFP) demonstration
                      296
                      434
                      434

                      0019
                      MFP evaluations and technical support
                      1
                      1
                      1

                      0023
                      Grants to improve outreach and enrollment
                      3
                      39
                      2

                      0024
                      Application of Prospective Payment System
                      1

                      0025
                      Medicaid emergency psychiatric demonstration
                      1
                      28
                      26

                      0026
                      Incentives for prevention of chronic diseases in Medicaid
                      28
                      22
                      22

                      0900
                      Total new obligations
                      416
                      636
                      576

                      Budgetary Resources:

                      Unobligated balance:

                      1000
                      Unobligated balance brought forward, Oct 1
                      1,303
                      1,459
                      1,353

                      1021
                      Recoveries of prior year unpaid obligations
                      44

                      1050
                      Unobligated balance (total)
                      1,347
                      1,459
                      1,353

                      Budget authority:

                      Appropriations, mandatory:

                      1200
                      Appropriation (Money follows the person (MFP) demonstration)
                      449
                      449
                      449

                      1200
                      Appropriation (MFP research & evaluation)
                      1
                      1
                      1

                      1200
                      Appropriation (Medicaid integrity program)
                      78
                      80
                      82

                      1260
                      Appropriations, mandatory (total)
                      528
                      530
                      532

                      1930
                      Total budgetary resources available
                      1,875
                      1,989
                      1,885

                      Memorandum (non-add) entries:

                      1941
                      Unexpired unobligated balance, end of year
                      1,459
                      1,353
                      1,309

                      Change in obligated balance:

                      Unpaid obligations:

                      3000
                      Unpaid obligations, brought forward, Oct 1
                      881
                      764
                      612

                      3010
                      Obligations incurred, unexpired accounts
                      416
                      636
                      576

                      3011
                      Obligations incurred, expired accounts
                      12

                      3020
                      Outlays (gross)
                      –480
                      –788
                      –749

                      3040
                      Recoveries of prior year unpaid obligations, unexpired
                      –44

                      3041
                      Recoveries of prior year unpaid obligations, expired
                      –21

                      3050
                      Unpaid obligations, end of year
                      764
                      612
                      439

                      Memorandum (non-add) entries:

                      3100
                      Obligated balance, start of year
                      881
                      764
                      612

                      3200
                      Obligated balance, end of year
                      764
                      612
                      439

                      Budget authority and outlays, net:

                      Mandatory:

                      4090
                      Budget authority, gross
                      528
                      530
                      532

                      Outlays, gross:

                      4100
                      Outlays from new mandatory authority

                      81
                      133

                      4101
                      Outlays from mandatory balances
                      480
                      707
                      616

                      4110
                      Outlays, gross (total)
                      480
                      788
                      749

                      Offsets against gross budget authority and outlays:

                      Offsetting collections (collected) from:

                      4123
                      Non-Federal sources
                      –3

                      Additional offsets against gross budget authority only:

                      4142
                      Offsetting collections credited to expired accounts
                      3

                      4160
                      Budget authority, net (mandatory)
                      528
                      530
                      532

                      4170
                      Outlays, net (mandatory)
                      477
                      788
                      749

                      4180
                      Budget authority, net (total)
                      528
                      530
                      532

                      4190
                      Outlays, net (total)
                      477
                      788
                      749

             State Grants and Demonstrations includes funding for grant programs enacted in several legislative authorities, including
                the Ticket to Work and Work Incentives Improvement Act of 1999 (P.L. 106–170), the Medicare Prescription Drug, Improvement,
                and Modernization Act of 2003 (P.L. 108–173), the Deficit Reduction Act of 2005 (P.L. 109–171), the Children's Health Insurance
                Program Reauthorization Act of 2009 (P.L. 111–3), the Patient Protection and Affordable Care Act (P.L. 111–148), and the Health
                Care and Education Reconciliation Act of 2010 (P.L. 111–152).

             The Budget includes an unobligated balance of $129 million for activities authorized by Section 204 of the Ticket to Work
                and Work Incentives Improvement Act.  Thus, pursuant to 31 U.S.C. 1555, any remaining balance (whether obligated or unobligated)
                will be withdrawn and returned to the Treasury two years after there has been no disbursement made against the appropriation.

          Object Classification (in millions of dollars)

                      Identification code 75–0516–0–1–551
                      2012 actual
                      2013 CR
                      2014 est.

                      Direct obligations:

                      11.1
                      Personnel compensation: Full-time permanent - Medicaid Integrity Program
                      9
                      9
                      9

                      12.1
                      Civilian personnel benefits - Medicaid Integrity Program
                      6
                      6
                      6

                      41.0
                      Grants, subsidies, and contributions - Ticket to Work
                      1

                      41.0
                      Grants, subsidies, and contributions - Emergency services for undocumented aliens
                      22
                      16
                      5

                      41.0
                      Grants, subsidies, and contributions - Medicaid Integrity Program
                      48
                      81
                      71

                      41.0
                      Grants, subsidies, and contributions - Money follows the person (MFP) demonstration
                      296
                      434
                      434

                      41.0
                      Grants, subsidies, and contributions - MFP evaluations and technical support
                      1
                      1
                      1

                      41.0
                      Grants, subsidies, and contributions - Grants to improve outreach and enrollment
                      3
                      39
                      2

                      41.0
                      Grants, subsidies, and contributions - Application of Prospective Payment System
                      1

                      41.0
                      Grants, subsidies, and contributions - Medicaid emergency psychiatric demonstration
                      1
                      28
                      26

                      41.0
                      Grants, subsidies, and contributions - Incentives for prevention of chronic diseases in Medicaid
                      28
                      22
                      22

                      99.9
                      Total new obligations
                      416
                      636
                      576

          Employment Summary

                      Identification code 75–0516–0–1–551
                      2012 actual
                      2013 CR
                      2014 est.

                      1001
                      Direct civilian full-time equivalent employment
                      80
                      97
                      102

             Payments to Health Care Trust FundsFor payment to the Federal Hospital Insurance Trust Fund and the Federal Supplementary Medical Insurance Trust Fund, as provided
             under sections 217(g), 1844, and 1860D-16 of the Social Security Act, sections 103(c) and 111(d) of the Social Security Amendments
             of 1965, section 278(d)(3) of Public Law 97–248, and for administrative expenses incurred pursuant to section 201(g) of the
             Social Security Act, [$251,359,000,000] $255,185,000,000.

          In addition, for making matching payments under section 1844 and benefit payments under section 1860D-16 of the Social Security
             Act that were not anticipated in budget estimates, such sums as may be necessary.  Note.—A full-year 2013 appropriation for this account was not enacted at the time the budget was prepared; therefore, the
                budget assumes this account is operating under the Continuing Appropriations Resolution, 2013 (P.L. 112–175). The amounts
                included for 2013 reflect the annualized level provided by the continuing resolution.
          Program and Financing (in millions of dollars)

                      Identification code 75–0580–0–1–571
                      2012 actual
                      2013 CR
                      2014 est.

                      Obligations by program activity:

                      0001
                      Federal contribution to match premiums (SMI)
                      165,254
                      181,351
                      194,565

                      0002
                      Part D benefits (Rx Drug)
                      44,875
                      51,245
                      58,596

                      0003
                      Part D Federal administration (Rx Drug)
                      394
                      382
                      373

                      0004
                      General Fund Transfers to HI
                      485
                      1,104
                      1,651

                      0006
                      Federal Bureau of Investigation (HCFAC)
                      132
                      135
                      138

                      0007
                      Federal payments from taxation of OASDI benefits (HI)
                      18,643
                      14,387
                      18,877

                      0008
                      Criminal fines (HCFAC)
                      1,389
                      1,126
                      1,141

                      0009
                      Civil monetary penalties and damages (HCFAC - DOJ and CMS administration)
                      18
                      20
                      21

                      0010
                      Asset Forfeiture
                      20
                      23
                      23

                      0900
                      Total new obligations
                      231,210
                      249,773
                      275,385

                      Budgetary Resources:

                      Unobligated balance:

                      1000
                      Unobligated balance brought forward, Oct 1

                      184

                      Budget authority:

                      Appropriations, mandatory:

                      1200
                      Appropriation (definite, annual)
                      230,741
                      234,266
                      255,321

                      1200
                      Appropriation (indefinite, permanent)
                      18,643
                      14,387
                      18,877

                      1200
                      Appropriation (HCFAC for FBI)
                      132
                      135
                      138

                      1200
                      Appropriation (indefinite for HCFAC)
                      1,428
                      1,169
                      1,049

                      1260
                      Appropriations, mandatory (total)
                      250,944
                      249,957
                      275,385

                      1930
                      Total budgetary resources available
                      250,944
                      249,957
                      275,569

                      Memorandum (non-add) entries:

                      1940
                      Unobligated balance expiring
                      –19,734

                      1941
                      Unexpired unobligated balance, end of year

                      184
                      184

                      Change in obligated balance:

                      Unpaid obligations:

                      3010
                      Obligations incurred, unexpired accounts
                      231,210
                      249,773
                      275,385

                      3011
                      Obligations incurred, expired accounts
                      171

                      3020
                      Outlays (gross)
                      –231,381
                      –249,773
                      –275,385

                      Budget authority and outlays, net:

                      Mandatory:

                      4090
                      Budget authority, gross
                      250,944
                      249,957
                      275,385

                      Outlays, gross:

                      4100
                      Outlays from new mandatory authority
                      231,210
                      249,773
                      275,385

                      4101
                      Outlays from mandatory balances
                      171

                      4110
                      Outlays, gross (total)
                      231,381
                      249,773
                      275,385

                      Offsets against gross budget authority and outlays:

                      Offsetting collections (collected) from:

                      4120
                      Federal sources
                      –14

                      Additional offsets against gross budget authority only:

                      4142
                      Offsetting collections credited to expired accounts
                      14

                      4160
                      Budget authority, net (mandatory)
                      250,944
                      249,957
                      275,385

                      4170
                      Outlays, net (mandatory)
                      231,367
                      249,773
                      275,385

                      4180
                      Budget authority, net (total)
                      250,944
                      249,957
                      275,385

                      4190
                      Outlays, net (total)
                      231,367
                      249,773
                      275,385

          Summary of Budget Authority and Outlays (in millions of dollars)

                      2012 actual
                      2013 CR
                      2014 est.

                      Enacted/requested:

                      Budget Authority
                      250,944
                      249,957
                      275,385

                      Outlays
                      231,367
                      249,773
                      275,385

                      Amounts included in the adjusted baseline:

                      Budget Authority

                      2,007

                      Outlays

                      2,007

                      Legislative proposal, not subject to PAYGO:

                      Budget Authority

                      136

                      Outlays

                      127
                      136

                      Total:

                      Budget Authority
                      250,944
                      249,957
                      277,528

                      Outlays
                      231,367
                      249,900
                      277,528

             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.

          Object Classification (in millions of dollars)

                      Identification code 75–0580–0–1–571
                      2012 actual
                      2013 CR
                      2014 est.

                      Direct obligations:

                      41.0
                      Grants, subsidies, and contributions
                      230,181
                      248,413
                      273,625

                      42.0
                      Insurance claims and indemnities
                      262
                      228
                      204

                      94.0
                      Financial transfers (Federal admin)
                      767
                      1,132
                      1,556

                      99.9
                      Total new obligations
                      231,210
                      249,773
                      275,385

             Payments to Health Care Trust Funds

             (Amounts included in the adjusted baseline)Program and Financing (in millions of dollars)

                      Identification code 75–0580–7–1–571
                      2012 actual
                      2013 CR
                      2014 est.

                      Obligations by program activity:

                      0001
                      Federal contribution to match premiums (SMI)

                      2,007

                      0900
                      Total new obligations (object class 41.0)

                      2,007

                      Budgetary Resources:

                      Budget authority:

                      Appropriations, mandatory:

                      1200
                      Appropriation (definite annual)

                      2,007

                      1260
                      Appropriations, mandatory (total)

                      2,007

                      1930
                      Total budgetary resources available

                      2,007

                      Change in obligated balance:

                      Unpaid obligations:

                      3010
                      Obligations incurred, unexpired accounts

                      2,007

                      3020
                      Outlays (gross)

                      –2,007

                      Budget authority and outlays, net:

                      Mandatory:

                      4090
                      Budget authority, gross

                      2,007

                      Outlays, gross:

                      4100
                      Outlays from new mandatory authority

                      2,007

                      4180
                      Budget authority, net (total)

                      2,007

                      4190
                      Outlays, net (total)

                      2,007

             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
                      2012 actual
                      2013 CR
                      2014 est.

                      Obligations by program activity:

                      0004
                      General Fund Transfers to HI

                      127
                      136

                      0900
                      Total new obligations (object class 41.0)

                      127
                      136

                      Budgetary Resources:

                      Budget authority:

                      Appropriations, mandatory:

                      1200
                      Appropriation (definite annual)

                      136

                      1260
                      Appropriations, mandatory (total)

                      136

                      1930
                      Total budgetary resources available

                      136

                      Memorandum (non-add) entries:

                      1940
                      Unobligated balance expiring

                      127

                      Change in obligated balance:

                      Unpaid obligations:

                      3010
                      Obligations incurred, unexpired accounts

                      127
                      136

                      3020
                      Outlays (gross)

                      –127
                      –136

                      Budget authority and outlays, net:

                      Mandatory:

                      4090
                      Budget authority, gross

                      136

                      Outlays, gross:

                      4100
                      Outlays from new mandatory authority

                      127
                      136

                      4180
                      Budget authority, net (total)

                      136

                      4190
                      Outlays, net (total)

                      127
                      136

             Quality Improvement Organizations

             Program and Financing (in millions of dollars)

                      Identification code 75–0519–0–1–571
                      2012 actual
                      2013 CR
                      2014 est.

                      Obligations by program activity:

                      0001
                      QIO contracts
                      147
                      173
                      270

                      0002
                      QIO support contracts
                      226
                      286
                      108

                      0900
                      Total new obligations
                      373
                      459
                      378

                      Budgetary Resources:

                      Unobligated balance:

                      1000
                      Unobligated balance brought forward, Oct 1

                      69

                      Budget authority:

                      Spending authority from offsetting collections, mandatory:

                      1800
                      Collected
                      40
                      528
                      628

                      1801
                      Change in uncollected payments, Federal sources
                      472

                      1850
                      Spending auth from offsetting collections, mand (total)
                      512
                      528
                      628

                      1930
                      Total budgetary resources available
                      512
                      528
                      697

                      Memorandum (non-add) entries:

                      1940
                      Unobligated balance expiring
                      –139

                      1941
                      Unexpired unobligated balance, end of year

                      69
                      319

                      Change in obligated balance:

                      Unpaid obligations:

                      3000
                      Unpaid obligations, brought forward, Oct 1
                      825
                      766
                      697

                      3010
                      Obligations incurred, unexpired accounts
                      373
                      459
                      378

                      3011
                      Obligations incurred, expired accounts
                      3

                      3020
                      Outlays (gross)
                      –429
                      –528
                      –628

                      3041
                      Recoveries of prior year unpaid obligations, expired
                      –6

                      3050
                      Unpaid obligations, end of year
                      766
                      697
                      447

                      Uncollected payments:

                      3060
                      Uncollected pymts, Fed sources, brought forward, Oct 1
                      –999
                      –1,100
                      –1,100

                      3070
                      Change in uncollected pymts, Fed sources, unexpired
                      –472

                      3071
                      Change in uncollected pymts, Fed sources, expired
                      371

                      3090
                      Uncollected pymts, Fed sources, end of year
                      –1,100
                      –1,100
                      –1,100

                      Memorandum (non-add) entries:

                      3100
                      Obligated balance, start of year
                      –174
                      –334
                      –403

                      3200
                      Obligated balance, end of year
                      –334
                      –403
                      –653

                      Budget authority and outlays, net:

                      Mandatory:

                      4090
                      Budget authority, gross
                      512
                      528
                      628

                      Outlays, gross:

                      4100
                      Outlays from new mandatory authority
                      50
                      56
                      207

                      4101
                      Outlays from mandatory balances
                      379
                      472
                      421

                      4110
                      Outlays, gross (total)
                      429
                      528
                      628

                      Offsets against gross budget authority and outlays:

                      Offsetting collections (collected) from:

                      4120
                      Baseline Program [Text]
                      –411
                      –528
                      –628

                      Additional offsets against gross budget authority only:

                      4140
                      Change in uncollected pymts, Fed sources, unexpired
                      –472

                      4142
                      Offsetting collections credited to expired accounts
                      371

                      4150
                      Additional offsets against budget authority only (total)
                      –101

                      4170
                      Outlays, net (mandatory)
                      18

                      4190
                      Outlays, net (total)
                      18

             Part B of Title XI of the Social Security Act, as amended by the Peer Review Improvement Act of 1982, provides the statutory
                authority for the Medicare Quality Improvement Organization (QIO) Program.  The mission of the program is to promote the effectiveness,
                efficiency, economy, and quality of services delivered to Medicare beneficiaries and to ensure that those services are reasonable
                and necessary.  The program is funded through transfers from the Medicare Hospital Insurance Trust Fund and the Medicare Supplementary
                Medical Insurance Trust Fund.  In FY 2012, a Treasury account specific to the QIO program was established to improve budgetary
                operations.

          Object Classification (in millions of dollars)

                      Identification code 75–0519–0–1–571
                      2012 actual
                      2013 CR
                      2014 est.

                      Direct obligations:

                      11.1
                      Personnel compensation: Full-time permanent
                      20
                      28
                      28

                      25.2
                      Other services from non-Federal sources
                      353
                      342
                      342

                      25.3
                      Other goods and services from Federal sources

                      89
                      8

                      99.9
                      Total new obligations
                      373
                      459
                      378

          Employment Summary

                      Identification code 75–0519–0–1–571
                      2012 actual
                      2013 CR
                      2014 est.

                      1001
                      Direct civilian full-time equivalent employment
                      138
                      174
                      182

             Program ManagementFor carrying out, except as otherwise provided, titles XI, XVIII, XIX, and XXI of the Social Security Act, titles XIII and
             XXVII of the PHS Act, the Clinical Laboratory Improvement Amendments of 1988, and other responsibilities of the Centers for
             Medicare [and] & Medicaid Services, not to exceed [$4,820,808,000] $5,217,357,000, to be transferred from the Federal Hospital Insurance Trust Fund and the Federal Supplementary Medical Insurance Trust Fund,
             as authorized by section 201(g) of the Social Security Act; together with all funds collected in accordance with section 353
             of the PHS Act and section 1857(e)(2) of the Social Security Act, funds retained by the Secretary pursuant to section 302
             of the Tax Relief and Health Care Act of 2006; and such sums as may be collected from authorized user fees and the sale of
             data, which shall be credited to this account and 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 PHS Act
             shall be credited to and available for carrying out the purposes of this appropriation: [Provided further, That $11,150,000, to remain available through September 30, 2014, shall be for contract costs for the Healthcare Integrated
             General Ledger Accounting System:]  Provided further, That the Secretary is directed to collect fees in fiscal year [2013] 2014 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.  Note.—A full-year 2013 appropriation for this account was not enacted at the time the budget was prepared; therefore, the
                budget assumes this account is operating under the Continuing Appropriations Resolution, 2013 (P.L. 112–175). The amounts
                included for 2013 reflect the annualized level provided by the continuing resolution.
          Program and Financing (in millions of dollars)

                      Identification code 75–0511–0–1–550
                      2012 actual
                      2013 CR
                      2014 est.

                      Obligations by program activity:

                      0001
                      Program operations
                      2,856
                      2,773
                      4,034

                      0002
                      Federal administration
                      780
                      942
                      866

                      0003
                      State survey and certification
                      386
                      415
                      450

                      0004
                      Research, demonstrations, and evaluation projects
                      33
                      623
                      56

                      0006
                      High-risk pool grants
                      44
                      44
                      22

                      0007
                      ARRA Medicare/Medicaid HIT
                      142
                      166
                      140

                      0008
                      Consumer Assistance Grants
                      2
                      2

                      0100
                      Total direct program
                      4,243
                      4,965
                      5,568

                      0799
                      Total direct obligations
                      4,243
                      4,965
                      5,568

                      0801
                      Clinical laboratory improvement amendments
                      55
                      50
                      50

                      0802
                      Sale of data
                      11
                      7
                      7

                      0803
                      Coordination of benefits
                      33
                      35
                      35

                      0804
                      Medicare advantage/Prescription drug plan
                      107
                      70
                      71

                      0805
                      Provider enrollment
                      2
                      28
                      28

                      0806
                      Recovery audit contractors
                      228
                      310
                      310

                      0807
                      Other reimbursable program activity
                      35

                      0808
                      Marketplace User Fee

                      450

                      0809
                      Reimbursable program activities, subtotal
                      471
                      500
                      951

                      0899
                      Total reimbursable obligations
                      471
                      500
                      951

                      0900
                      Total new obligations
                      4,714
                      5,465
                      6,519

                      Budgetary Resources:

                      Unobligated balance:

                      1000
                      Unobligated balance brought forward, Oct 1
                      1,349
                      1,296
                      525

                      1001
                      Discretionary unobligated balance brought fwd, Oct 1
                      217
                      195

                      1021
                      Recoveries of prior year unpaid obligations
                      20

                      1050
                      Unobligated balance (total)
                      1,369
                      1,296
                      525

                      Budget authority:

                      Appropriations, mandatory:

                      1200
                      Appropriation
                      253
                      253
                      253

                      1260
                      Appropriations, mandatory (total)
                      253
                      253
                      253

                      Spending authority from offsetting collections, discretionary:

                      1700
                      Collected
                      2,024
                      4,369
                      5,224

                      1701
                      Change in uncollected payments, Federal sources
                      2,303

                      1750
                      Spending auth from offsetting collections, disc (total)
                      4,327
                      4,369
                      5,224

                      Spending authority from offsetting collections, mandatory:

                      1800
                      Collected
                      103
                      72
                      970

                      1801
                      Change in uncollected payments, Federal sources
                      31

                      1850
                      Spending auth from offsetting collections, mand (total)
                      134
                      72
                      970

                      1900
                      Budget authority (total)
                      4,714
                      4,694
                      6,447

                      1930
                      Total budgetary resources available
                      6,083
                      5,990
                      6,972

                      Memorandum (non-add) entries:

                      1940
                      Unobligated balance expiring
                      –73

                      1941
                      Unexpired unobligated balance, end of year
                      1,296
                      525
                      453

                      Change in obligated balance:

                      Unpaid obligations:

                      3000
                      Unpaid obligations, brought forward, Oct 1
                      2,824
                      3,436
                      3,157

                      3010
                      Obligations incurred, unexpired accounts
                      4,714
                      5,465
                      6,519

                      3011
                      Obligations incurred, expired accounts
                      133

                      3020
                      Outlays (gross)
                      –4,035
                      –5,744
                      –6,519

                      3040
                      Recoveries of prior year unpaid obligations, unexpired
                      –20

                      3041
                      Recoveries of prior year unpaid obligations, expired
                      –180

                      3050
                      Unpaid obligations, end of year
                      3,436
                      3,157
                      3,157

                      Uncollected payments:

                      3060
                      Uncollected pymts, Fed sources, brought forward, Oct 1
                      –3,623
                      –4,251
                      –4,251

                      3070
                      Change in uncollected pymts, Fed sources, unexpired
                      –2,334

                      3071
                      Change in uncollected pymts, Fed sources, expired
                      1,706

                      3090
                      Uncollected pymts, Fed sources, end of year
                      –4,251
                      –4,251
                      –4,251

                      Memorandum (non-add) entries:

                      3100
                      Obligated balance, start of year
                      –799
                      –815
                      –1,094

                      3200
                      Obligated balance, end of year
                      –815
                      –1,094
                      –1,094

                      Budget authority and outlays, net:

                      Discretionary:

                      4000
                      Budget authority, gross
                      4,327
                      4,369
                      5,224

                      Outlays, gross:

                      4010
                      Outlays from new discretionary authority
                      1,935
                      4,369
                      5,224

                      4011
                      Outlays from discretionary balances
                      1,726

                      4020
                      Outlays, gross (total)
                      3,661
                      4,369
                      5,224

                      Offsets against gross budget authority and outlays:

                      Offsetting collections (collected) from:

                      4030
                      Federal sources
                      –3,240
                      –3,896
                      –5,217

                      4033
                      Non-Federal sources
                      –356
                      –473
                      –7

                      4040
                      Offsets against gross budget authority  and outlays (total)
                      –3,596
                      –4,369
                      –5,224

                      Additional offsets against gross budget authority only:

                      4050
                      Change in uncollected pymts, Fed sources, unexpired
                      –2,303

                      4052
                      Offsetting collections credited to expired accounts
                      1,572

                      4060
                      Additional offsets against budget authority only (total)
                      –731

                      4080
                      Outlays, net (discretionary)
                      65

                      Mandatory:

                      4090
                      Budget authority, gross
                      387
                      325
                      1,223

                      Outlays, gross:

                      4100
                      Outlays from new mandatory authority
                      9
                      75
                      989

                      4101
                      Outlays from mandatory balances
                      365
                      1,300
                      306

                      4110
                      Outlays, gross (total)
                      374
                      1,375
                      1,295

                      Offsets against gross budget authority and outlays:

                      Offsetting collections (collected) from:

                      4120
                      Federal sources
                      –119
                      –44
                      –26

                      4123
                      Non-Federal sources
                      –30
                      –28
                      –944

                      4130
                      Offsets against gross budget authority and outlays (total)
                      –149
                      –72
                      –970

                      Additional offsets against gross budget authority only:

                      4140
                      Change in uncollected pymts, Fed sources, unexpired
                      –31

                      4142
                      Offsetting collections credited to expired accounts
                      46

                      4150
                      Additional offsets against budget authority only (total)
                      15

                      4160
                      Budget authority, net (mandatory)
                      253
                      253
                      253

                      4170
                      Outlays, net (mandatory)
                      225
                      1,303
                      325

                      4180
                      Budget authority, net (total)
                      253
                      253
                      253

                      4190
                      Outlays, net (total)
                      290
                      1,303
                      325

             Program management activities include funding for program operations, survey and certification, State high-risk pools, the
                Clinical Laboratory Improvement Amendments (CLIA), Medicare Advantage, Medicare Part D coordination of benefits, recovery
                audit contracts and other administrative costs.

          Object Classification (in millions of dollars)

                      Identification code 75–0511–0–1–550
                      2012 actual
                      2013 CR
                      2014 est.

                      Direct obligations:

                      Personnel compensation:

                      11.1
                      Full-time permanent
                      433
                      489
                      487

                      11.3
                      Other than full-time permanent
                      14
                      12
                      12

                      11.5
                      Other personnel compensation
                      6
                      8
                      8

                      11.7
                      Military personnel
                      9
                      12
                      13

                      11.9
                      Total personnel compensation
                      462
                      521
                      520

                      12.1
                      Civilian personnel benefits
                      133
                      133
                      136

                      12.2
                      Military personnel benefits
                      4
                      7
                      6

                      21.0
                      Travel and transportation of persons
                      6
                      7
                      7

                      22.0
                      Transportation of things
                      1

                      23.1
                      Rental payments to GSA
                      17
                      34
                      35

                      23.3
                      Communications, utilities, and miscellaneous charges
                      62

                      24.0
                      Printing and reproduction
                      30
                      3
                      3

                      25.1
                      Advisory and assistance services
                      79
                      8
                      8

                      25.2
                      Other services from non-Federal sources
                      2,180
                      2,586
                      3,172

                      25.3
                      Other goods and services from Federal sources
                      137
                      19
                      11

                      25.5
                      Research and development contracts
                      21
                      21

                      25.6
                      Medical care
                      808
                      1,338
                      1,412

                      25.7
                      Operation and maintenance of equipment
                      151
                      16
                      16

                      26.0
                      Supplies and materials
                      2
                      1
                      1

                      31.0
                      Equipment
                      28

                      32.0
                      Land and structures

                      11
                      11

                      41.0
                      Grants, subsidies, and contributions
                      120
                      260
                      230

                      42.0
                      Insurance claims and indemnities
                      2

                      99.0
                      Direct obligations
                      4,243
                      4,965
                      5,568

                      99.0
                      Reimbursable obligations
                      471
                      500
                      951

                      99.9
                      Total new obligations
                      4,714
                      5,465
                      6,519

          Employment Summary

                      Identification code 75–0511–0–1–550
                      2012 actual
                      2013 CR
                      2014 est.

                      1001
                      Direct civilian full-time equivalent employment
                      4,241
                      4,622
                      4,511

                      1001
                      Direct civilian full-time equivalent employment
                      156
                      190
                      204

                      1101
                      Direct military average strength employment
                      114
                      124
                      124

                      2001
                      Reimbursable civilian full-time equivalent employment
                      103
                      124
                      124

             Children's Health Insurance Fund

             Program and Financing (in millions of dollars)

                      Identification code 75–0515–0–1–551
                      2012 actual
                      2013 CR
                      2014 est.

                      Obligations by program activity:

                      0001
                      Grants to States and U.S. territories
                      8,971
                      8,939
                      9,306

                      0002
                      Performance bonus payments
                      352
                      330
                      340

                      0003
                      Child health quality improvement
                      39
                      47
                      52

                      0900
                      Total new obligations (object class 41.0)
                      9,362
                      9,316
                      9,698

                      Budgetary Resources:

                      Unobligated balance:

                      1000
                      Unobligated balance brought forward, Oct 1
                      7,527
                      860
                      2,627

                      1012
                      Unobligated balance transfers between expired and unexpired accounts
                      80

                      1020
                      Adjustment of unobligated bal brought forward, Oct 1
                      –34

                      1021
                      Recoveries of prior year unpaid obligations
                      1

                      1050
                      Unobligated balance (total)
                      7,574
                      860
                      2,627

                      Budget authority:

                      Appropriations, discretionary:

                      1130
                      Appropriations permanently reduced

                      –6,368
                      –3,779

                      1160
                      Appropriation, discretionary (total)

                      –6,368
                      –3,779

                      Appropriations, mandatory:

                      1200
                      Appropriation
                      14,982
                      17,406
                      19,147

                      1200
                      Appropriation
                      45
                      45

                      1230
                      Appropriations and/or unobligated balance of appropriations permanently reduced
                      –6,368

                      1260
                      Appropriations, mandatory (total)
                      8,659
                      17,451
                      19,147

                      1900
                      Budget authority (total)
                      8,659
                      11,083
                      15,368

                      1930
                      Total budgetary resources available
                      16,233
                      11,943
                      17,995

                      Memorandum (non-add) entries:

                      1940
                      Unobligated balance expiring
                      –6,011

                      1941
                      Unexpired unobligated balance, end of year
                      860
                      2,627
                      8,297

                      Change in obligated balance:

                      Unpaid obligations:

                      3000
                      Unpaid obligations, brought forward, Oct 1
                      7,106
                      6,474
                      5,893

                      3010
                      Obligations incurred, unexpired accounts
                      9,362
                      9,316
                      9,698

                      3011
                      Obligations incurred, expired accounts
                      215

                      3020
                      Outlays (gross)
                      –9,065
                      –9,897
                      –9,992

                      3040
                      Recoveries of prior year unpaid obligations, unexpired
                      –1

                      3041
                      Recoveries of prior year unpaid obligations, expired
                      –1,143

                      3050
                      Unpaid obligations, end of year
                      6,474
                      5,893
                      5,599

                      Memorandum (non-add) entries:

                      3100
                      Obligated balance, start of year
                      7,106
                      6,474
                      5,893

                      3200
                      Obligated balance, end of year
                      6,474
                      5,893
                      5,599

                      Budget authority and outlays, net:

                      Discretionary:

                      4000
                      Budget authority, gross

                      –6,368
                      –3,779

                      Mandatory:

                      4090
                      Budget authority, gross
                      8,659
                      17,451
                      19,147

                      Outlays, gross:

                      4100
                      Outlays from new mandatory authority
                      3,073
                      2,045
                      1,500

                      4101
                      Outlays from mandatory balances
                      5,992
                      7,852
                      8,492

                      4110
                      Outlays, gross (total)
                      9,065
                      9,897
                      9,992

                      4180
                      Budget authority, net (total)
                      8,659
                      11,083
                      15,368

                      4190
                      Outlays, net (total)
                      9,065
                      9,897
                      9,992

             The Balanced Budget Act of 1997 established the Children's Health Insurance Program (CHIP) 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 separate
                CHIP program, a CHIP Medicaid expansion program, or a combination of both.  The Children's Health Insurance Program Reauthorization
                Act of 2009 (P.L. 111–3, CHIPRA) reauthorized the CHIP program and appropriated funding for CHIP through 2013. CHIPRA made
                some modifications to the program including increased funding for States and territories, bonus payments for States that exceed
                Medicaid child enrollment targets, and support for child health quality and outreach activities. A contingency fund to assist
                States who project spending above their available allocated CHIP funds was also created by CHIPRA and funding is included
                in a separate account. The Patient Protection and Affordable Care Act of 2010 (P.L. 111–148) extended funding for CHIP, providing
                appropriations through 2015.

             Center for Medicare and Medicaid Innovation

             Program and Financing (in millions of dollars)

                      Identification code 75–0522–0–1–551
                      2012 actual
                      2013 CR
                      2014 est.

                      Obligations by program activity:

                      0001
                      Administration
                      71
                      151
                      155

                      0002
                      Innovation Activities
                      713
                      1,162
                      1,257

                      0900
                      Total new obligations
                      784
                      1,313
                      1,412

                      Budgetary Resources:

                      Unobligated balance:

                      1000
                      Unobligated balance brought forward, Oct 1
                      9,910
                      9,129
                      7,816

                      1021
                      Recoveries of prior year unpaid obligations
                      3

                      1050
                      Unobligated balance (total)
                      9,913
                      9,129
                      7,816

                      1930
                      Total budgetary resources available
                      9,913
                      9,129
                      7,816

                      Memorandum (non-add) entries:

                      1941
                      Unexpired unobligated balance, end of year
                      9,129
                      7,816
                      6,404

                      Change in obligated balance:

                      Unpaid obligations:

                      3000
                      Unpaid obligations, brought forward, Oct 1
                      84
                      647
                      967

                      3010
                      Obligations incurred, unexpired accounts
                      784
                      1,313
                      1,412

                      3020
                      Outlays (gross)
                      –218
                      –993
                      –1,339

                      3040
                      Recoveries of prior year unpaid obligations, unexpired
                      –3

                      3050
                      Unpaid obligations, end of year
                      647
                      967
                      1,040

                      Memorandum (non-add) entries:

                      3100
                      Obligated balance, start of year
                      84
                      647
                      967

                      3200
                      Obligated balance, end of year
                      647
                      967
                      1,040

                      Budget authority and outlays, net:

                      Mandatory:

                      Outlays, gross:

                      4101
                      Outlays from mandatory balances
                      218
                      993
                      1,339

                      4190
                      Outlays, net (total)
                      218
                      993
                      1,339

             The Center for Medicare and Medicaid Innovation ("Innovation Center") was established by section 1115A of the Social Security
                Act (as added by section 3021 of the Affordable Care Act).  The Innovation Center is tasked with testing innovative payment
                and service delivery models to reduce program expenditures while preserving or enhancing the quality of care provided to individuals
                under Medicare, Medicaid, or Children's Health Insurance Program (CHIP).  The statute provides $10 billion in mandatory funding
                for these purposes in fiscal year 2011 through 2019.

          Object Classification (in millions of dollars)

                      Identification code 75–0522–0–1–551
                      2012 actual
                      2013 CR
                      2014 est.

                      Direct obligations:

                      11.1
                      Personnel compensation: Full-time permanent
                      17
                      47
                      51

                      12.1
                      Civilian personnel benefits
                      5
                      13
                      14

                      25.2
                      Other services from non-Federal sources
                      713
                      1,162
                      1,257

                      25.3
                      Other goods and services from Federal sources
                      49
                      91
                      90

                      99.9
                      Total new obligations
                      784
                      1,313
                      1,412

          Employment Summary

                      Identification code 75–0522–0–1–551
                      2012 actual
                      2013 CR
                      2014 est.

                      1001
                      Direct civilian full-time equivalent employment
                      163
                      309
                      347

             Child Enrollment Contingency Fund

             Special and Trust Fund Receipts (in millions of dollars)

                      Identification code 75–5551–0–2–551
                      2012 actual
                      2013 CR
                      2014 est.

                      0100
                      Balance, start of year

                      Receipts:

                      0240
                      Interest, Child Enrollment Contingency Fund

                      3
                      4

                      0400
                      Total: Balances and collections

                      3
                      4

                      Appropriations:

                      0500
                      Child Enrollment Contingency Fund

                      –3
                      –4

                      0799
                      Balance, end of year

          Program and Financing (in millions of dollars)

                      Identification code 75–5551–0–2–551
                      2012 actual
                      2013 CR
                      2014 est.

                      Obligations by program activity:

                      0001
                      Grants to States and US Territories
                      1
                      100
                      100

                      0900
                      Total new obligations (object class 41.0)
                      1
                      100
                      100

                      Budgetary Resources:

                      Unobligated balance:

                      1000
                      Unobligated balance brought forward, Oct 1
                      2,093
                      2,092
                      1,995

                      Budget authority:

                      Appropriations, mandatory:

                      1201
                      Appropriation (special or trust fund)

                      3
                      4

                      1260
                      Appropriations, mandatory (total)

                      3
                      4

                      1930
                      Total budgetary resources available
                      2,093
                      2,095
                      1,999

                      Memorandum (non-add) entries:

                      1941
                      Unexpired unobligated balance, end of year
                      2,092
                      1,995
                      1,899

                      Change in obligated balance:

                      Unpaid obligations:

                      3000
                      Unpaid obligations, brought forward, Oct 1
                      25
                      26
                      1

                      3010
                      Obligations incurred, unexpired accounts
                      1
                      100
                      100

                      3020
                      Outlays (gross)

                      –125
                      –100

                      3050
                      Unpaid obligations, end of year
                      26
                      1
                      1

                      Memorandum (non-add) entries:

                      3100
                      Obligated balance, start of year
                      25
                      26
                      1

                      3200
                      Obligated balance, end of year
                      26
                      1
                      1

                      Budget authority and outlays, net:

                      Mandatory:

                      4090
                      Budget authority, gross

                      3
                      4

                      Outlays, gross:

                      4101
                      Outlays from mandatory balances

                      125
                      100

                      4180
                      Budget authority, net (total)

                      3
                      4

                      4190
                      Outlays, net (total)

                      125
                      100

                      Memorandum (non-add) entries:

                      5000
                      Total investments, SOY: Federal securities: Par value
                      2,093
                      2,096
                      1,996

                      5001
                      Total investments, EOY: Federal securities: Par value
                      2,096
                      1,996
                      1,899

             The Children's Health Insurance Program Reauthorization Act of 2009 (P.L. 111–3, CHIPRA) established the Child Enrollment Contingency Fund under Title XXI of the Social Security Act.  Beginning in 2009, a State may qualify for a contingency fund payment if it projects a funding shortfall for the fiscal
                year and if its average monthly child enrollment exceeds its target average number of enrollees for the fiscal year. The Patient
                Protection and Affordable Care Act of 2010 (P.L. 111–148) extended the contingency fund through 2015.

             The fund received an initial appropriation equal to 20 percent of the FY 2009 national allotment ($2.1 billion). In fiscal
                years 2010 through 2015, the statute appropriates the amount necessary to make payments to eligible States, but not to exceed
                20 percent of the total annual appropriation for CHIP allotments to States.  Any amounts in excess of this aggregate cap will
                be made available for CHIP performance bonus payments.  The contingency fund is invested in interest bearing securities of
                the United States, and the income derived from these investments constitutes a part of the fund.

             Medicare Health Information Technology Incentive Payments, Recovery Act

             Program and Financing (in millions of dollars)

                      Identification code 75–0508–0–1–551
                      2012 actual
                      2013 CR
                      2014 est.

                      Obligations by program activity:

                      0801
                      Incentive payments to hospitals
                      2,560
                      2,920
                      2,670

                      0802
                      Incentive payments to eligible professionals
                      1,620
                      1,640
                      2,790

                      0900
                      Total new obligations (object class 42.0)
                      4,180
                      4,560
                      5,460

                      Budgetary Resources:

                      Unobligated balance:

                      1000
                      Unobligated balance brought forward, Oct 1
                      1,659
                      1,070
                      1,070

                      Budget authority:

                      Spending authority from offsetting collections, mandatory:

                      1800
                      Collected from the HI Trust Fund
                      2,111
                      2,920
                      2,670

                      1800
                      Collected from the SMI Trust Fund
                      1,421
                      1,640
                      2,790

                      1801
                      Change in uncollected payments, Federal sources
                      59

                      1850
                      Spending auth from offsetting collections, mand (total)
                      3,591
                      4,560
                      5,460

                      1930
                      Total budgetary resources available
                      5,250
                      5,630
                      6,530

                      Memorandum (non-add) entries:

                      1941
                      Unexpired unobligated balance, end of year
                      1,070
                      1,070
                      1,070

                      Change in obligated balance:

                      Unpaid obligations:

                      3000
                      Unpaid obligations, brought forward, Oct 1
                      90
                      448
                      448

                      3010
                      Obligations incurred, unexpired accounts
                      4,180
                      4,560
                      5,460

                      3020
                      Outlays (gross)
                      –3,822
                      –4,560
                      –5,460

                      3050
                      Unpaid obligations, end of year
                      448
                      448
                      448

                      Uncollected payments:

                      3060
                      Uncollected pymts, Fed sources, brought forward, Oct 1
                      –1,839
                      –1,898
                      –1,898

                      3070
                      Change in uncollected pymts, Fed sources, unexpired
                      –59

                      3090
                      Uncollected pymts, Fed sources, end of year
                      –1,898
                      –1,898
                      –1,898

                      Memorandum (non-add) entries:

                      3100
                      Obligated balance, start of year
                      –1,749
                      –1,450
                      –1,450

                      3200
                      Obligated balance, end of year
                      –1,450
                      –1,450
                      –1,450

                      Budget authority and outlays, net:

                      Mandatory:

                      4090
                      Budget authority, gross
                      3,591
                      4,560
                      5,460

                      Outlays, gross:

                      4100
                      Outlays from new mandatory authority
                      2,164
                      4,114
                      5,460

                      4101
                      Outlays from mandatory balances
                      1,658
                      446

                      4110
                      Outlays, gross (total)
                      3,822
                      4,560
                      5,460

                      Offsets against gross budget authority and outlays:

                      Offsetting collections (collected) from:

                      4120
                      Federal sources
                      –3,532
                      –4,560
                      –5,460

                      Additional offsets against gross budget authority only:

                      4140
                      Change in uncollected pymts, Fed sources, unexpired
                      –59

                      4170
                      Outlays, net (mandatory)
                      290

                      4190
                      Outlays, net (total)
                      290

             Rate Review Grants

             Program and Financing (in millions of dollars)

                      Identification code 75–0112–0–1–551
                      2012 actual
                      2013 CR
                      2014 est.

                      Obligations by program activity:

                      0001
                      Premium rate review grants
                      8
                      90

                      0900
                      Total new obligations (object class 41.0)
                      8
                      90

                      Budgetary Resources:

                      Unobligated balance:

                      1000
                      Unobligated balance brought forward, Oct 1
                      91
                      90

                      1021
                      Recoveries of prior year unpaid obligations
                      7

                      1050
                      Unobligated balance (total)
                      98
                      90

                      1930
                      Total budgetary resources available
                      98
                      90

                      Memorandum (non-add) entries:

                      1941
                      Unexpired unobligated balance, end of year
                      90

                      Change in obligated balance:

                      Unpaid obligations:

                      3000
                      Unpaid obligations, brought forward, Oct 1
                      147
                      126
                      116

                      3010
                      Obligations incurred, unexpired accounts
                      8
                      90

                      3020
                      Outlays (gross)
                      –22
                      –100
                      –80

                      3040
                      Recoveries of prior year unpaid obligations, unexpired
                      –7

                      3050
                      Unpaid obligations, end of year
                      126
                      116
                      36

                      Memorandum (non-add) entries:

                      3100
                      Obligated balance, start of year
                      147
                      126
                      116

                      3200
                      Obligated balance, end of year
                      126
                      116
                      36

                      Budget authority and outlays, net:

                      Mandatory:

                      Outlays, gross:

                      4101
                      Outlays from mandatory balances
                      22
                      100
                      80

                      4190
                      Outlays, net (total)
                      22
                      100
                      80

             The Affordable Care Act (P.L. 111–148) amends Section 2794 of the Public Health Service Act and provides that the Secretary
                shall carry out a program to award grants to States for a five-year period beginning in fiscal year 2010.  The Grants to States
                for Health Insurance Premium Review program provides funding to help States develop or enhance their current rate review activities.
                The program provides $250,000,000 over the five-year period beginning with fiscal year 2010.  States may receive no less than
                $1,000,000 and no more than $5,000,000 in any one grant year. Grant recipients are required to submit data to the Secretary
                on health insurance rate trends.

             Pre-Existing Condition Insurance Plan Program

             Program and Financing (in millions of dollars)

                      Identification code 75–0113–0–1–551
                      2012 actual
                      2013 CR
                      2014 est.

                      Obligations by program activity:

                      0001
                      Direct program activity
                      2,131
                      1,520
                      312

                      0801
                      Premiums from Fallback States
                      98
                      199
                      46

                      0900
                      Total new obligations
                      2,229
                      1,719
                      358

                      Budgetary Resources:

                      Unobligated balance:

                      1000
                      Unobligated balance brought forward, Oct 1
                      3,961
                      1,832
                      312

                      1021
                      Recoveries of prior year unpaid obligations
                      2

                      1050
                      Unobligated balance (total)
                      3,963
                      1,832
                      312

                      Budget authority:

                      Spending authority from offsetting collections, mandatory:

                      1800
                      Collected
                      98
                      199
                      46

                      1850
                      Spending auth from offsetting collections, mand (total)
                      98
                      199
                      46

                      1900
                      Budget authority (total)
                      98
                      199
                      46

                      1930
                      Total budgetary resources available
                      4,061
                      2,031
                      358

                      Memorandum (non-add) entries:

                      1941
                      Unexpired unobligated balance, end of year
                      1,832
                      312

                      Change in obligated balance:

                      Unpaid obligations:

                      3000
                      Unpaid obligations, brought forward, Oct 1
                      633
                      1,261
                      625

                      3010
                      Obligations incurred, unexpired accounts
                      2,229
                      1,719
                      358

                      3020
                      Outlays (gross)
                      –1,599
                      –2,355
                      –983

                      3040
                      Recoveries of prior year unpaid obligations, unexpired
                      –2

                      3050
                      Unpaid obligations, end of year
                      1,261
                      625

                      Memorandum (non-add) entries:

                      3100
                      Obligated balance, start of year
                      633
                      1,261
                      625

                      3200
                      Obligated balance, end of year
                      1,261
                      625

                      Budget authority and outlays, net:

                      Mandatory:

                      4090
                      Budget authority, gross
                      98
                      199
                      46

                      Outlays, gross:

                      4100
                      Outlays from new mandatory authority
                      63
                      199
                      46

                      4101
                      Outlays from mandatory balances
                      1,536
                      2,156
                      937

                      4110
                      Outlays, gross (total)
                      1,599
                      2,355
                      983

                      Offsets against gross budget authority and outlays:

                      Offsetting collections (collected) from:

                      4123
                      Non-Federal sources
                      –98
                      –199
                      –46

                      4190
                      Outlays, net (total)
                      1,501
                      2,156
                      937

             This account funds the Pre-Existing Condition Insurance Plan Program (PCIP), which makes health insurance available to people
                who have been unable to get insurance due to a pre-existing condition.  Enrollees pay monthly premiums similar to those charged
                in the commercial individual market, and the Federal government pays for remaining costs that exceed enrollee contributions.
                The funding for this program, including operating costs, was provided in the FY 2010 appropriation by the Affordable Care
                Act (P.L. 111–148). The FY 2014 President's Budget obligation and outlays projections are based on policy assumptions to manage
                costs in the program to the $5 billion appropriation and continue coverage for current enrollees.

          Object Classification (in millions of dollars)

                      Identification code 75–0113–0–1–551
                      2012 actual
                      2013 CR
                      2014 est.

                      Direct obligations:

                      11.1
                      Personnel compensation: Full-time permanent
                      4
                      5
                      5

                      25.2
                      Other services from non-Federal sources
                      28
                      21
                      21

                      41.0
                      Grants, subsidies, and contributions
                      2,099
                      1,494
                      286

                      99.0
                      Direct obligations
                      2,131
                      1,520
                      312

                      99.0
                      Reimbursable obligations
                      98
                      199
                      46

                      99.9
                      Total new obligations
                      2,229
                      1,719
                      358

          Employment Summary

                      Identification code 75–0113–0–1–551
                      2012 actual
                      2013 CR
                      2014 est.

                      1001
                      Direct civilian full-time equivalent employment
                      18
                      16
                      16

             Early Retiree Reinsurance Program

             Program and Financing (in millions of dollars)

                      Identification code 75–0114–0–1–551
                      2012 actual
                      2013 CR
                      2014 est.

                      Obligations by program activity:

                      0001
                      Subsidies for early retirees
                      1,907
                      41

                      0002
                      Administration
                      27
                      24
                      8

                      0799
                      Total direct obligations
                      1,934
                      65
                      8

                      0801
                      Reimbursable program activity
                      24
                      75

                      0900
                      Total new obligations
                      1,958
                      140
                      8

                      Budgetary Resources:

                      Unobligated balance:

                      1000
                      Unobligated balance brought forward, Oct 1
                      1,998
                      74
                      9

                      1021
                      Recoveries of prior year unpaid obligations
                      10

                      1050
                      Unobligated balance (total)
                      2,008
                      74
                      9

                      Budget authority:

                      Spending authority from offsetting collections, mandatory:

                      1800
                      Collected
                      24
                      75

                      1850
                      Spending auth from offsetting collections, mand (total)
                      24
                      75

                      1900
                      Budget authority (total)
                      24
                      75

                      1930
                      Total budgetary resources available
                      2,032
                      149
                      9

                      Memorandum (non-add) entries:

                      1941
                      Unexpired unobligated balance, end of year
                      74
                      9
                      1

                      Change in obligated balance:

                      Unpaid obligations:

                      3000
                      Unpaid obligations, brought forward, Oct 1
                      26
                      24
                      17

                      3010
                      Obligations incurred, unexpired accounts
                      1,958
                      140
                      8

                      3020
                      Outlays (gross)
                      –1,950
                      –147
                      –23

                      3040
                      Recoveries of prior year unpaid obligations, unexpired
                      –10

                      3050
                      Unpaid obligations, end of year
                      24
                      17
                      2

                      Memorandum (non-add) entries:

                      3100
                      Obligated balance, start of year
                      26
                      24
                      17

                      3200
                      Obligated balance, end of year
                      24
                      17
                      2

                      Budget authority and outlays, net:

                      Mandatory:

                      4090
                      Budget authority, gross
                      24
                      75

                      Outlays, gross:

                      4100
                      Outlays from new mandatory authority

                      75

                      4101
                      Outlays from mandatory balances
                      1,950
                      72
                      23

                      4110
                      Outlays, gross (total)
                      1,950
                      147
                      23

                      Offsets against gross budget authority and outlays:

                      Offsetting collections (collected) from:

                      4120
                      Federal sources
                      –24
                      –75

                      4190
                      Outlays, net (total)
                      1,926
                      72
                      23

             The Affordable Care Act (P.L. 111–148) authorized and appropriated $5 billion for the Early Retiree Reinsurance Program (ERRP).
                ERRP provides reimbursement to participating sponsors of certified plans that provide health benefits to early retirees (age
                55 and older and not eligible for Medicare), their spouses, and surviving spouses and dependents.  Reimbursement is equal
                to 80 percent of the actual cost of health expenses paid for an individual (net of price concessions) between a cost threshold
                of $15,000 and cost limit of $90,000 beginning in 2010.  The cost threshold and cost limit are adjusted for inflation each
                year based on the Medical Care Component of the consumer price index for all urban consumers.  Reimbursements to sponsors
                shall be used to reduce the sponsor's health benefit or premium costs, provide premium and cost sharing relief to plan participants,
                or both.

          Object Classification (in millions of dollars)

                      Identification code 75–0114–0–1–551
                      2012 actual
                      2013 CR
                      2014 est.

                      Direct obligations:

                      11.1
                      Personnel compensation: Full-time permanent
                      1
                      1
                      1

                      25.2
                      Other services from non-Federal sources
                      26
                      23
                      7

                      42.0
                      Insurance claims and indemnities
                      1,907
                      41

                      99.0
                      Direct obligations
                      1,934
                      65
                      8

                      99.0
                      Reimbursable obligations
                      24
                      75

                      99.9
                      Total new obligations
                      1,958
                      140
                      8

          Employment Summary

                      Identification code 75–0114–0–1–551
                      2012 actual
                      2013 CR
                      2014 est.

                      1001
                      Direct civilian full-time equivalent employment
                      4
                      12
                      12

             Affordable Insurance Exchange Grants

             Program and Financing (in millions of dollars)

                      Identification code 75–0115–0–1–551
                      2012 actual
                      2013 CR
                      2014 est.

                      Obligations by program activity:

                      0001
                      Planning and establishment grants
                      1,626
                      2,700
                      1,292

                      0002
                      Administration
                      29
                      51
                      51

                      0900
                      Total new obligations
                      1,655
                      2,751
                      1,343

                      Budgetary Resources:

                      Budget authority:

                      Appropriations, mandatory:

                      1200
                      Appropriation
                      1,655
                      2,751
                      1,343

                      1260
                      Appropriations, mandatory (total)
                      1,655
                      2,751
                      1,343

                      1930
                      Total budgetary resources available
                      1,655
                      2,751
                      1,343

                      Change in obligated balance:

                      Unpaid obligations:

                      3000
                      Unpaid obligations, brought forward, Oct 1
                      503
                      1,900
                      3,194

                      3010
                      Obligations incurred, unexpired accounts
                      1,655
                      2,751
                      1,343

                      3020
                      Outlays (gross)
                      –167
                      –1,457
                      –2,061

                      3041
                      Recoveries of prior year unpaid obligations, expired
                      –91

                      3050
                      Unpaid obligations, end of year
                      1,900
                      3,194
                      2,476

                      Memorandum (non-add) entries:

                      3100
                      Obligated balance, start of year
                      503
                      1,900
                      3,194

                      3200
                      Obligated balance, end of year
                      1,900
                      3,194
                      2,476

                      Budget authority and outlays, net:

                      Mandatory:

                      4090
                      Budget authority, gross
                      1,655
                      2,751
                      1,343

                      Outlays, gross:

                      4100
                      Outlays from new mandatory authority
                      37
                      275
                      134

                      4101
                      Outlays from mandatory balances
                      130
                      1,182
                      1,927

                      4110
                      Outlays, gross (total)
                      167
                      1,457
                      2,061

                      4180
                      Budget authority, net (total)
                      1,655
                      2,751
                      1,343

                      4190
                      Outlays, net (total)
                      167
                      1,457
                      2,061

              This program provides funding for Planning and Establishment Grants to States for their activities to implement Affordable
                Insurance Exchanges, which are also referred to as Marketplaces.  The Exchanges will facilitate the purchase of qualified
                health plans in the individual market and provide for the establishment of a Small Business Health Options Program to allow
                small businesses to offer qualified health plans to their employees. Section 1311 of the Patient Protection and Affordable
                Care Act (P.L. 111–148) provides amounts necessary to enable the Secretary to award grants to States beginning no later than
                March 23, 2011, and allows for renewal grants through January 1, 2015.

          Object Classification (in millions of dollars)

                      Identification code 75–0115–0–1–551
                      2012 actual
                      2013 CR
                      2014 est.

                      Direct obligations:

                      11.1
                      Personnel compensation: Full-time permanent
                      8
                      8
                      8

                      25.2
                      Other services from non-Federal sources
                      21
                      43
                      43

                      41.0
                      Grants, subsidies, and contributions
                      1,626
                      2,700
                      1,292

                      99.9
                      Total new obligations
                      1,655
                      2,751
                      1,343

          Employment Summary

                      Identification code 75–0115–0–1–551
                      2012 actual
                      2013 CR
                      2014 est.

                      1001
                      Direct civilian full-time equivalent employment
                      44
                      62
                      63

             Reduced Cost Sharing for Individuals Enrolling in Qualified Health PlansFor carrying out, except as otherwise provided, sections 1402 and 1412 of the Patient Protection and Affordable Care Act (Public
                Law 111–148), such sums as necessary.
          For carrying out, except as otherwise provided, such sections in the first quarter of fiscal year 2015 (including upward adjustments
                to prior year payments), $1,420,000,000.
          Program and Financing (in millions of dollars)

                      Identification code 75–0126–0–1–551
                      2012 actual
                      2013 CR
                      2014 est.

                      Obligations by program activity:

                      0001
                      Benefit payments

                      3,978

                      0900
                      Total new obligations (object class 42.0)

                      3,978

                      Budgetary Resources:

                      Budget authority:

                      Appropriations, mandatory:

                      1200
                      Appropriation

                      3,978

                      1260
                      Appropriations, mandatory (total)

                      3,978

                      1930
                      Total budgetary resources available

                      3,978

                      Change in obligated balance:

                      Unpaid obligations:

                      3010
                      Obligations incurred, unexpired accounts

                      3,978

                      3020
                      Outlays (gross)

                      –3,978

                      Budget authority and outlays, net:

                      Mandatory:

                      4090
                      Budget authority, gross

                      3,978

                      Outlays, gross:

                      4100
                      Outlays from new mandatory authority

                      3,978

                      4180
                      Budget authority, net (total)

                      3,978

                      4190
                      Outlays, net (total)

                      3,978

             Section 1402 of the Patient Protection and Affordable Care Act (P.L. 111–148) provides for reductions in cost sharing for
                certain individuals enrolled in qualified health plans purchased on the Exchanges, and section 1412 of the Patient Protection
                and Affordable Care Act (P.L. 111–148) provides for the advance payment of these reductions to issuers.  This assistance helps
                eligible low- and moderate-income qualified individuals and families afford the out-of-pocket spending associated with health
                care services provided through Exchange-based qualified health plan coverage.

             Risk Corridors Program Payments

             Risk Adjustment Program Payments

             Transitional Reinsurance Program

             Consumer Operated and Oriented Plan Program Contingency Fund

             Program and Financing (in millions of dollars)

                      Identification code 75–0524–0–1–551
                      2012 actual
                      2013 CR
                      2014 est.

                      Obligations by program activity:

                      Credit program obligations:

                      0701
                      Direct loan subsidy

                      68

                      0709
                      Administrative expenses

                      17
                      17

                      0900
                      Total new obligations

                      85
                      17

                      Budgetary Resources:

                      Unobligated balance:

                      1000
                      Unobligated balance brought forward, Oct 1

                      168

                      1011
                      Unobligated balance transfer from other accts [75–0118]

                      253

                      1050
                      Unobligated balance (total)

                      253
                      168

                      1930
                      Total budgetary resources available

                      253
                      168

                      Memorandum (non-add) entries:

                      1941
                      Unexpired unobligated balance, end of year

                      168
                      151

                      Change in obligated balance:

                      Unpaid obligations:

                      3000
                      Unpaid obligations, brought forward, Oct 1

                      55

                      3010
                      Obligations incurred, unexpired accounts

                      85
                      17

                      3020
                      Outlays (gross)

                      –30
                      –55

                      3050
                      Unpaid obligations, end of year

                      55
                      17

                      Memorandum (non-add) entries:

                      3100
                      Obligated balance, start of year

                      55

                      3200
                      Obligated balance, end of year

                      55
                      17

                      Budget authority and outlays, net:

                      Mandatory:

                      Outlays, gross:

                      4101
                      Outlays from mandatory balances

                      30
                      55

                      4190
                      Outlays, net (total)

                      30
                      55

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

                      Identification code 75–0524–0–1–551
                      2012 actual
                      2013 CR
                      2014 est.

                      Direct loan levels supportable by subsidy budget authority:

                      115001
                      Contingency Fund Loans

                      180

                      115999
                      Total direct loan levels

                      180

                      Direct loan subsidy (in percent):

                      132001
                      Contingency Fund Loans

                      37.66
                      0.00

                      132999
                      Weighted average subsidy rate

                      37.66
                      0.00

                      Direct loan subsidy budget authority:

                      133001
                      Contingency Fund Loans

                      68

                      133999
                      Total subsidy budget authority

                      68

                      Direct loan subsidy outlays:

                      134001
                      Contingency Fund Loans

                      25
                      39

                      134999
                      Total subsidy outlays

                      25
                      39

                      Direct loan downward reestimates:

                      Administrative expense data:

                      3580
                      Outlays from balances

                      5
                      16

             The Consumer Operated and Oriented Plan Contingency Fund was established by the American Taxpayer Relief Act of 2012 (P.L.
                112–240).  This fund provides assistance and oversight to qualified nonprofit health insurance issuers that have been awarded
                loans or grants under section 1322 of the Affordable Care Act (P.L. 111–148).

          Object Classification (in millions of dollars)

                      Identification code 75–0524–0–1–551
                      2012 actual
                      2013 CR
                      2014 est.

                      Direct obligations:

                      11.1
                      Personnel compensation: Full-time permanent

                      5
                      5

                      25.2
                      Other services from non-Federal sources

                      12
                      12

                      41.0
                      Grants, subsidies, and contributions

                      68

                      99.9
                      Total new obligations

                      85
                      17

          Employment Summary

                      Identification code 75–0524–0–1–551
                      2012 actual
                      2013 CR
                      2014 est.

                      1001
                      Direct civilian full-time equivalent employment

                      25
                      22

             Consumer Operated and Oriented Plan Program Account

             Program and Financing (in millions of dollars)

                      Identification code 75–0118–0–1–551
                      2012 actual
                      2013 CR
                      2014 est.

                      Obligations by program activity:

                      Credit program obligations:

                      0701
                      Direct loan subsidy
                      726
                      122

                      0703
                      Subsidy for modifications of direct loans

                      5

                      0705
                      Reestimates of direct loan subsidy

                      3

                      0709
                      Administrative expenses
                      12
                      1

                      0900
                      Total new obligations
                      738
                      131

                      Budgetary Resources:

                      Unobligated balance:

                      1000
                      Unobligated balance brought forward, Oct 1
                      3,797
                      2,659

                      1010
                      Unobligated balance transfer to other accts [75–0524]

                      –253

                      1050
                      Unobligated balance (total)
                      3,797
                      2,406

                      Budget authority:

                      Appropriations, mandatory:

                      1200
                      Appropriation

                      3

                      1230
                      Appropriations and/or unobligated balance of appropriations permanently reduced
                      –400
                      –2,278

                      1260
                      Appropriations, mandatory (total)
                      –400
                      –2,275

                      1930
                      Total budgetary resources available
                      3,397
                      131

                      Memorandum (non-add) entries:

                      1941
                      Unexpired unobligated balance, end of year
                      2,659

                      Change in obligated balance:

                      Unpaid obligations:

                      3000
                      Unpaid obligations, brought forward, Oct 1
                      3
                      703
                      580

                      3010
                      Obligations incurred, unexpired accounts
                      738
                      131

                      3020
                      Outlays (gross)
                      –38
                      –254
                      –175

                      3050
                      Unpaid obligations, end of year
                      703
                      580
                      405

                      Memorandum (non-add) entries:

                      3100
                      Obligated balance, start of year
                      3
                      703
                      580

                      3200
                      Obligated balance, end of year
                      703
                      580
                      405

                      Budget authority and outlays, net:

                      Mandatory:

                      4090
                      Budget authority, gross
                      –400
                      –2,275

                      Outlays, gross:

                      4101
                      Outlays from mandatory balances
                      38
                      254
                      175

                      4180
                      Budget authority, net (total)
                      –400
                      –2,275

                      4190
                      Outlays, net (total)
                      38
                      254
                      175

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

                      Identification code 75–0118–0–1–551
                      2012 actual
                      2013 CR
                      2014 est.

                      Direct loan levels supportable by subsidy budget authority:

                      115002
                      Startup Loans
                      281
                      38

                      115003
                      Solvency
                      1,410
                      257

                      115999
                      Total direct loan levels
                      1,691
                      295

                      Direct loan subsidy (in percent):

                      132002
                      Startup Loans
                      37.51
                      37.66
                      0.00

                      132003
                      Solvency
                      43.99
                      41.90
                      0.00

                      132999
                      Weighted average subsidy rate
                      42.91
                      41.35
                      0.00

                      Direct loan subsidy budget authority:

                      133002
                      Startup Loans
                      105
                      14

                      133003
                      Solvency
                      620
                      108

                      133999
                      Total subsidy budget authority
                      725
                      122

                      Direct loan subsidy outlays:

                      134002
                      Startup Loans
                      34
                      65
                      19

                      134003
                      Solvency

                      176
                      155

                      134999
                      Total subsidy outlays
                      34
                      241
                      174

                      Direct loan upward reestimates:

                      135002
                      Startup Loans

                      3

                      135999
                      Total upward reestimate budget authority

                      3

                      Direct loan downward reestimates:

                      Administrative expense data:

                      3510
                      Budget authority
                      12
                      1

                      3580
                      Outlays from balances
                      4
                      10
                      1

              Section 1322 of the Affordable Care Act (P.L. 111–148) authorized and appropriated funding for the Consumer Operated and
                Oriented Plan (CO-OP) Program.  The CO-OP Program fosters the creation of qualified nonprofit health insurance issuers that
                operate with a strong consumer focus to offer qualified health plans in the individual and small group markets in the States.
                The Secretary shall award loans to qualified nonprofit issuers to fund start-up costs and reserves which enable qualified
                issuers to meet state solvency requirements. The Secretary may also award loans for the purposes of encouraging the establishment
                of CO-OPs in states where no issuer applies to be a qualified nonprofit issuer under Section 1322.

             As required by the Federal Credit Reform Act of 1990, this account records, for this program, the subsidy costs associated
                with CO-OP Program grants and loans, as well as administrative expenses of this program. The subsidy amounts are estimated
                on a present value basis; the administrative expenses are estimated on a cash basis.

          Object Classification (in millions of dollars)

                      Identification code 75–0118–0–1–551
                      2012 actual
                      2013 CR
                      2014 est.

                      Direct obligations:

                      11.1
                      Personnel compensation: Full-time permanent
                      1

                      25.2
                      Other services from non-Federal sources
                      11
                      1

                      41.0
                      Grants, subsidies, and contributions
                      726
                      130

                      99.9
                      Total new obligations
                      738
                      131

          Employment Summary

                      Identification code 75–0118–0–1–551
                      2012 actual
                      2013 CR
                      2014 est.

                      1001
                      Direct civilian full-time equivalent employment
                      6

             Consumer Operated and Oriented Plan Financing Account

             Program and Financing (in millions of dollars)

                      Identification code 75–4418–0–3–551
                      2012 actual
                      2013 CR
                      2014 est.

                      Obligations by program activity:

                      Credit program obligations:

                      0710
                      Direct loan obligations
                      1,691
                      295

                      0713
                      Payment of interest to Treasury
                      4
                      14
                      18

                      0900
                      Total new obligations
                      1,695
                      309
                      18

                      Budgetary Resources:

                      Unobligated balance:

                      1000
                      Unobligated balance brought forward, Oct 1

                      2,228

                      1020
                      Adjustment of unobligated bal brought forward, Oct 1

                      –2,228

                      Financing authority:

                      Borrowing authority, mandatory:

                      1400
                      Borrowing authority
                      3,194
                      182
                      18

                      1440
                      Borrowing authority, mandatory (total)
                      3,194
                      182
                      18

                      Spending authority from offsetting collections, mandatory:

                      1800
                      Collected
                      37
                      244
                      174

                      1801
                      Change in uncollected payments, Federal sources
                      692
                      –114
                      –174

                      1825
                      Spending authority from offsetting collections applied to repay debt

                      –3

                      1850
                      Spending auth from offsetting collections, mand (total)
                      729
                      127

                      1900
                      Financing authority (total)
                      3,923
                      309
                      18

                      1930
                      Total budgetary resources available
                      3,923
                      309
                      18

                      Memorandum (non-add) entries:

                      1941
                      Unexpired unobligated balance, end of year
                      2,228

                      Change in obligated balance:

                      Unpaid obligations:

                      3000
                      Unpaid obligations, brought forward, Oct 1

                      1,601
                      1,326

                      3010
                      Obligations incurred, unexpired accounts
                      1,695
                      309
                      18

                      3020
                      Financing disbursements (gross)
                      –94
                      –584
                      –422

                      3050
                      Unpaid obligations, end of year
                      1,601
                      1,326
                      922

                      Uncollected payments:

                      3060
                      Uncollected pymts, Fed sources, brought forward, Oct 1

                      –692
                      –578

                      3070
                      Change in uncollected pymts, Fed sources, unexpired
                      –692
                      114
                      174

                      3090
                      Uncollected pymts, Fed sources, end of year
                      –692
                      –578
                      –404

                      Memorandum (non-add) entries:

                      3100
                      Obligated balance, start of year

                      909
                      748

                      3200
                      Obligated balance, end of year
                      909
                      748
                      518

                      Financing authority and disbursements, net:

                      Mandatory:

                      4090
                      Financing authority, gross
                      3,923
                      309
                      18

                      Financing disbursements:

                      4110
                      Financing disbursements, gross
                      94
                      584
                      422

                      Offsets against gross financing authority and disbursements:

                      Offsetting collections (collected) from:

                      4120
                      Federal sources
                      –34
                      –244
                      –174

                      4122
                      Interest on uninvested funds
                      –3

                      4130
                      Offsets against gross financing auth and disbursements (total)
                      –37
                      –244
                      –174

                      Additional offsets against financing authority only (total):

                      4140
                      Change in uncollected pymts, Fed sources, unexpired
                      –692
                      114
                      174

                      4160
                      Financing authority, net (mandatory)
                      3,194
                      179
                      18

                      4170
                      Financing disbursements, net (mandatory)
                      57
                      340
                      248

                      4180
                      Financing authority, net (total)
                      3,194
                      179
                      18

                      4190
                      Financing disbursements, net (total)
                      57
                      340
                      248

          Status of Direct Loans (in millions of dollars)

                      Identification code 75–4418–0–3–551
                      2012 actual
                      2013 CR
                      2014 est.

                      Position with respect to appropriations act limitation on obligations:

                      1131
                      Direct loan obligations exempt from limitation
                      1,691
                      295

                      1150
                      Total direct loan obligations
                      1,691
                      295

                      Cumulative balance of direct loans outstanding:

                      1210
                      Outstanding, start of year

                      90
                      660

                      1231
                      Disbursements: Direct loan disbursements
                      90
                      570
                      404

                      1251
                      Repayments: Repayments and prepayments

                      1263
                      Write-offs for default: Direct loans

                      1290
                      Outstanding, end of year
                      90
                      660
                      1,064

             As required by the Federal Credit Reform Act of 1990, this non-budgetary account records all cash flows to and from the Government
                resulting from direct loans obligated in 1992 and beyond (including modifications of direct loans that resulted from obligations
                in any year). The amounts in this account are a means of financing and are not included in the budget totals.

          Balance Sheet (in millions of dollars)

                      Identification code 75–4418–0–3–551
                      2011 actual
                      2012 actual

                      Group heading

                      ASSETS:

                      Net value of assets related to post-1991 direct loans receivable:

                      1401
                      Direct loans receivable, gross

                      90

                      1405
                      Allowance for subsidy cost (-)

                      –34

                      1499
                      Net present value of assets related to direct loans

                      56

                      1999
                      Total assets

                      56

                      LIABILITIES:

                      2103
                      Federal liabilities: Debt

                      56

                      4999
                      Total liabilities and net position

                      56

             Consumer Operated and Oriented Plan Program Contingency Fund Financing Account

             Program and Financing (in millions of dollars)

                      Identification code 75–4482–0–3–551
                      2012 actual
                      2013 CR
                      2014 est.

                      Obligations by program activity:

                      Credit program obligations:

                      0710
                      Direct loan obligations

                      180

                      0713
                      Payment of interest to Treasury

                      1
                      2

                      0900
                      Total new obligations

                      181
                      2

                      Budgetary Resources:

                      Financing authority:

                      Borrowing authority, mandatory:

                      1400
                      Borrowing authority

                      113
                      2

                      1440
                      Borrowing authority, mandatory (total)

                      113
                      2

                      Spending authority from offsetting collections, mandatory:

                      1800
                      Collected

                      25
                      39

                      1801
                      Change in uncollected payments, Federal sources

                      43
                      –39

                      1850
                      Spending auth from offsetting collections, mand (total)

                      68

                      1900
                      Financing authority (total)

                      181
                      2

                      1930
                      Total budgetary resources available

                      181
                      2

                      Change in obligated balance:

                      Unpaid obligations:

                      3000
                      Unpaid obligations, brought forward, Oct 1

                      114

                      3010
                      Obligations incurred, unexpired accounts

                      181
                      2

                      3020
                      Financing disbursements (gross)

                      –67
                      –106

                      3050
                      Unpaid obligations, end of year

                      114
                      10

                      Uncollected payments:

                      3060
                      Uncollected pymts, Fed sources, brought forward, Oct 1

                      –43

                      3070
                      Change in uncollected pymts, Fed sources, unexpired

                      –43
                      39

                      3090
                      Uncollected pymts, Fed sources, end of year

                      –43
                      –4

                      Memorandum (non-add) entries:

                      3100
                      Obligated balance, start of year

                      71

                      3200
                      Obligated balance, end of year

                      71
                      6

                      Financing authority and disbursements, net:

                      Mandatory:

                      4090
                      Financing authority, gross

                      181
                      2

                      Financing disbursements:

                      4110
                      Financing disbursements, gross

                      67
                      106

                      Offsets against gross financing authority and disbursements:

                      Offsetting collections (collected) from:

                      4120
                      Federal sources

                      –25
                      –39

                      Additional offsets against financing authority only (total):

                      4140
                      Change in uncollected pymts, Fed sources, unexpired

                      –43
                      39

                      4160
                      Financing authority, net (mandatory)

                      113
                      2

                      4170
                      Financing disbursements, net (mandatory)

                      42
                      67

                      4180
                      Financing authority, net (total)

                      113
                      2

                      4190
                      Financing disbursements, net (total)

                      42
                      67

          Status of Direct Loans (in millions of dollars)

                      Identification code 75–4482–0–3–551
                      2012 actual
                      2013 CR
                      2014 est.

                      Position with respect to appropriations act limitation on obligations:

                      1131
                      Direct loan obligations exempt from limitation

                      180

                      1150
                      Total direct loan obligations

                      180

                      Cumulative balance of direct loans outstanding:

                      1210
                      Outstanding, start of year

                      66

                      1231
                      Disbursements: Direct loan disbursements

                      66
                      104

                      1251
                      Repayments: Repayments and prepayments

                      1263
                      Write-offs for default: Direct loans

                      1290
                      Outstanding, end of year

                      66
                      170

             As required by the Federal Credit Reform Act of 1990, this non-budgetary account records all cash flows to and from the federal
                treasury resulting from direct loans obligated in 1992 and beyond (including modifications of direct loans that resulted from
                obligations in any year).  The amounts in this account are a means of financing only and are not included in the budget totals.

          Trust Funds
             Federal Hospital Insurance Trust Fund

             Special and Trust Fund Receipts (in millions of dollars)

                      Identification code 75–8005–0–7–571
                      2012 actual
                      2013 CR
                      2014 est.

                      0100
                      Balance, start of year
                      212,203
                      203,744
                      175,265

                      Adjustments:

                      0190
                      Adjustment - rounding issues over several years.
                      2

                      0191
                      Adjustment - HCFAC - Small Jobs Act
                      100

                      0199
                      Balance, start of year
                      212,305
                      203,744
                      175,265

                      Receipts:

                      0200
                      FHI Trust Fund, Transfers from General Fund (FICA Taxes)
                      186,773
                      191,684
                      205,563

                      0201
                      FHI Trust Fund, Transfers from General Fund (FICA Taxes)

                      7
                      224

                      0202
                      FHI Trust Fund, Receipts from Railroad Retirement Board
                      484
                      508
                      546

                      0203
                      FHI Trust Fund, Transfers from General Fund (SECA Taxes)
                      13,886
                      16,220
                      17,465

                      0204
                      FHI Trust Fund, Civil Penalties and Damages
                      602
                      675
                      663

                      0220
                      FHI Trust Fund, Other Proprietary Interest from the Public
                      3
                      2
                      2

                      0221
                      FHI Trust Fund, Basic Premium, Medicare Advantage
                      234
                      258
                      248

                      0222
                      FHI Trust Fund, Basic Premium, Medicare Advantage

                      5

                      0223
                      FHI Trust Fund, Medicare Refunds
                      7,115
                      5,800
                      6,000

                      0224
                      FHI Trust Fund, Premiums Collected for Uninsured Individuals not Otherwise Eligible
                      3,400
                      3,529
                      3,507

                      0240
                      FHI Trust Fund, Federal Employer Contributions (FICA)
                      3,510
                      3,586
                      3,690

                      0241
                      FHI Trust Fund, Postal Service Employer Contributions (FICA)
                      583
                      595
                      623

                      0242
                      FHI Trust Fund, Interest Received by Trust Funds
                      11,270
                      9,972
                      8,787

                      0243
                      FHI Trust Fund, Taxation on OASDI Benefits
                      18,643
                      14,387
                      18,877

                      0244
                      FHI Trust Fund, Payment from the General Fund for Health Care Fraud and Abuse Control Account
                      132
                      135
                      138

                      0245
                      FHI Trust Fund, Transfers from General Fund (criminal Fines)
                      1,389
                      1,126
                      1,141

                      0246
                      FHI Trust Fund, Transfers from General Fund (civil Monetary Penalties)
                      16
                      22
                      23

                      0247
                      FHI Trust Fund, Transfers from General Fund (asset Forfeitures)
                      20
                      23
                      23

                      0248
                      FHI Trust Fund, Interest Payments by Railroad Retirement Board
                      27
                      25
                      27

                      0249
                      FHI Trust Fund, Payments from the General Fund (uninsured and Program Management)
                      657
                      1,105
                      1,652

                      0250
                      FHI Trust Fund, Payments from the General Fund (uninsured and Program Management)

                      127
                      136

                      0299
                      Total receipts and collections
                      248,744
                      249,786
                      269,340

                      0400
                      Total: Balances and collections
                      461,049
                      453,530
                      444,605

                      Appropriations:

                      0500
                      Federal Hospital Insurance Trust Fund
                      –2,441
                      –2,573
                      –3,954

                      0501
                      Federal Hospital Insurance Trust Fund
                      5

                      0502
                      Federal Hospital Insurance Trust Fund
                      –244,733
                      –245,479
                      –263,389

                      0503
                      Federal Hospital Insurance Trust Fund
                      –8,646
                      –28,828
                      –15,596

                      0504
                      Federal Hospital Insurance Trust Fund

                      –600
                      –821

                      0505
                      Federal Hospital Insurance Trust Fund

                      600
                      821

                      0506
                      Federal Hospital Insurance Trust Fund

                      303
                      329

                      0507
                      Federal Hospital Insurance Trust Fund

                      –303
                      –329

                      0508
                      Federal Hospital Insurance Trust Fund

                      324

                      0509
                      Federal Hospital Insurance Trust Fund

                      –806

                      0510
                      Health Care Fraud and Abuse Control Account
                      –310
                      –312
                      –311

                      0511
                      Health Care Fraud and Abuse Control Account
                      –1,290
                      –1,243
                      –1,219

                      0512
                      Health Care Fraud and Abuse Control Account

                      473
                      685

                      0513
                      Health Care Fraud and Abuse Control Account

                      –303
                      –329

                      0599
                      Total appropriations
                      –257,415
                      –278,265
                      –284,595

                      0610
                      Federal Hospital Insurance Trust Fund
                      1

                      0611
                      Health Care Fraud and Abuse Control Account
                      26

                      0620
                      Federal Hospital Insurance Trust Fund
                      83

                      0799
                      Balance, end of year
                      203,744
                      175,265
                      160,010

          Program and Financing (in millions of dollars)

                      Identification code 75–8005–0–7–571
                      2012 actual
                      2013 CR
                      2014 est.

                      Obligations by program activity:

                      0001
                      Benefit payments, HI
                      251,139
                      270,814
                      275,461

                      0002
                      HIT Incentive Payments
                      2,135
                      2,920
                      2,670

                      0003
                      Administration, HI
                      2,612
                      2,773
                      4,180

                      0004
                      Quality improvement organizations, HI
                      419
                      367
                      628

                      0900
                      Total new obligations
                      256,305
                      276,874
                      282,939

                      Budgetary Resources:

                      Unobligated balance:

                      1021
                      Recoveries of prior year unpaid obligations
                      436

                      1026
                      Adjustment for change in allocation of trust fund limitation or foreign exchange valuation
                      –83

                      1029
                      Other balances withdrawn
                      –1

                      1050
                      Unobligated balance (total)
                      352

                      Budget authority:

                      Appropriations, discretionary:

                      1101
                      Appropriation (special or trust fund)
                      2,441
                      2,573
                      3,954

                      1130
                      Appropriations permanently reduced

                      –6

                      1132
                      Appropriations temporarily reduced
                      –5

                      1160
                      Appropriation, discretionary (total)
                      2,436
                      2,567
                      3,954

                      Appropriations, mandatory:

                      1201
                      Appropriation (special or trust fund)
                      244,733
                      245,479
                      263,389

                      1203
                      Appropriation (previously unavailable)
                      8,646
                      28,828
                      15,596

                      1260
                      Appropriations, mandatory (total)
                      253,379
                      274,307
                      278,985

                      Spending authority from offsetting collections, mandatory:

                      1800
                      Collected
                      138

                      1850
                      Spending auth from offsetting collections, mand (total)
                      138

                      1900
                      Budget authority (total)
                      255,953
                      276,874
                      282,939

                      1930
                      Total budgetary resources available
                      256,305
                      276,874
                      282,939

                      Memorandum (non-add) entries:

                      Special and non-revolving trust funds:

                      1950
                      Other balances withdrawn
                      1

                      Change in obligated balance:

                      Unpaid obligations:

                      3000
                      Unpaid obligations, brought forward, Oct 1
                      32,195
                      24,209
                      24,178

                      3010
                      Obligations incurred, unexpired accounts
                      256,305
                      276,874
                      282,939

                      3020
                      Outlays (gross)
                      –263,855
                      –276,905
                      –282,186

                      3040
                      Recoveries of prior year unpaid obligations, unexpired
                      –436

                      3050
                      Unpaid obligations, end of year
                      24,209
                      24,178
                      24,931

                      Uncollected payments:

                      3060
                      Uncollected pymts, Fed sources, brought forward, Oct 1
                      –1
                      –1
                      –1

                      3090
                      Uncollected pymts, Fed sources, end of year
                      –1
                      –1
                      –1

                      Memorandum (non-add) entries:

                      3100
                      Obligated balance, start of year
                      32,194
                      24,208
                      24,177

                      3200
                      Obligated balance, end of year
                      24,208
                      24,177
                      24,930

                      Budget authority and outlays, net:

                      Discretionary:

                      4000
                      Budget authority, gross
                      2,436
                      2,567
                      3,954

                      Outlays, gross:

                      4010
                      Outlays from new discretionary authority
                      1,619
                      1,936
                      2,694

                      4011
                      Outlays from discretionary balances
                      365
                      540
                      585

                      4020
                      Outlays, gross (total)
                      1,984
                      2,476
                      3,279

                      Mandatory:

                      4090
                      Budget authority, gross
                      253,517
                      274,307
                      278,985

                      Outlays, gross:

                      4100
                      Outlays from new mandatory authority
                      232,676
                      251,666
                      252,523

                      4101
                      Outlays from mandatory balances
                      29,195
                      22,763
                      26,384

                      4110
                      Outlays, gross (total)
                      261,871
                      274,429
                      278,907

                      Offsets against gross budget authority and outlays:

                      Offsetting collections (collected) from:

                      4123
                      Non-Federal sources
                      –138

                      4180
                      Budget authority, net (total)
                      255,815
                      276,874
                      282,939

                      4190
                      Outlays, net (total)
                      263,717
                      276,905
                      282,186

                      Memorandum (non-add) entries:

                      5000
                      Total investments, SOY: Federal securities: Par value
                      245,939
                      228,292
                      199,923

                      5001
                      Total investments, EOY: Federal securities: Par value
                      228,292
                      199,923
                      185,039

          Summary of Budget Authority and Outlays (in millions of dollars)

                      2012 actual
                      2013 CR
                      2014 est.

                      Enacted/requested:

                      Budget Authority
                      255,815
                      276,874
                      282,939

                      Outlays
                      263,717
                      276,905
                      282,186

                      Amounts included in the adjusted baseline:

                      Budget Authority

                      482

                      Outlays

                      482

                      Total:

                      Budget Authority
                      255,815
                      276,874
                      283,421

                      Outlays
                      263,717
                      276,905
                      282,668

             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.  In addition, the Budget includes a package of proposals that improve Medicare's
                sustainability by promoting high-quality, efficient care; aligning payments with the costs of providing care; encouraging
                beneficiaries to seek high-value services; and reducing the Federal subsidy of Medicare costs for those beneficiaries who
                can most afford them.

          Status of Funds (in millions of dollars)

                      Identification code 75–8005–0–7–571
                      2012 actual
                      2013 CR
                      2014 est.

                      Unexpended balance, start of year:

                      0100
                      Balance, start of year
                      245,698
                      229,337
                      200,668

                      Adjustments:

                      0190
                      Adjustment - HCFAC - Small Jobs Act
                      100

                      0199
                      Total balance, start of year
                      245,798
                      229,337
                      200,668

                      Cash income during the year:

                      Current law:

                      Receipts:

                      1200
                      FHI Trust Fund, Transfers from General Fund (FICA Taxes)
                      186,773
                      191,684
                      205,563

                      1202
                      FHI Trust Fund, Receipts from Railroad Retirement Board
                      484
                      508
                      546

                      1203
                      FHI Trust Fund, Transfers from General Fund (SECA Taxes)
                      13,886
                      16,220
                      17,465

                      1204
                      FHI Trust Fund, Civil Penalties and Damages
                      602
                      675
                      663

                      Offsetting receipts (proprietary):

                      1220
                      FHI Trust Fund, Other Proprietary Interest from the Public
                      3
                      2
                      2

                      1221
                      FHI Trust Fund, Basic Premium, Medicare Advantage
                      234
                      258
                      248

                      1222
                      FHI Trust Fund, Basic Premium, Medicare Advantage

                      5

                      1223
                      FHI Trust Fund, Medicare Refunds
                      7,115
                      5,800
                      6,000

                      1224
                      FHI Trust Fund, Premiums Collected for Uninsured Individuals not Otherwise Eligible
                      3,400
                      3,529
                      3,507

                      Offsetting receipts (intragovernmental):

                      1240
                      FHI Trust Fund, Federal Employer Contributions (FICA)
                      3,510
                      3,586
                      3,690

                      1241
                      FHI Trust Fund, Postal Service Employer Contributions (FICA)
                      583
                      595
                      623

                      1242
                      FHI Trust Fund, Interest Received by Trust Funds
                      11,270
                      9,972
                      8,787

                      1243
                      FHI Trust Fund, Taxation on OASDI Benefits
                      18,643
                      14,387
                      18,877

                      1244
                      FHI Trust Fund, Payment from the General Fund for Health Care Fraud and Abuse Control Account
                      132
                      135
                      138

                      1245
                      FHI Trust Fund, Transfers from General Fund (criminal Fines)
                      1,389
                      1,126
                      1,141

                      1246
                      FHI Trust Fund, Transfers from General Fund (civil Monetary Penalties)
                      16
                      22
                      23

                      1247
                      FHI Trust Fund, Transfers from General Fund (asset Forfeitures)
                      20
                      23
                      23

                      1248
                      FHI Trust Fund, Interest Payments by Railroad Retirement Board
                      27
                      25
                      27

                      1249
                      FHI Trust Fund, Payments from the General Fund (uninsured and Program Management)
                      657
                      1,105
                      1,652

                      Offsetting collections:

                      1280
                      Federal Hospital Insurance Trust Fund
                      138

                      1299
                      Income under present law
                      248,882
                      249,652
                      268,980

                      Proposed legislation:

                      Receipts:

                      2201
                      FHI Trust Fund, Transfers from General Fund (FICA Taxes)

                      7
                      224

                      Offsetting receipts (intragovernmental):

                      2250
                      FHI Trust Fund, Payments from the General Fund (uninsured and Program Management)

                      127
                      136

                      2299
                      Income under proposed legislation

                      134
                      360

                      3299
                      Total cash income
                      248,882
                      249,786
                      269,340

                      Cash outgo during year:

                      Current law:

                      4500
                      Federal Hospital Insurance Trust Fund
                      –263,855
                      –276,905
                      –282,186

                      4500
                      Health Care Fraud and Abuse Control Account
                      –1,488
                      –1,714
                      –1,614

                      4500
                      Federal Hospital Insurance Trust Fund

                      –482

                      4599
                      Outgo under current law (-)
                      –265,343
                      –278,619
                      –284,282

                      Proposed legislation:

                      5500
                      Health Care Fraud and Abuse Control Account

                      –303
                      –329

                      5500
                      Health Care Fraud and Abuse Control Account

                      473
                      685

                      5599
                      Outgo under proposed legislation (-)

                      170
                      356

                      6599
                      Total cash outgo (-)
                      –265,343
                      –278,449
                      –283,926

                      7625
                      Federal Hospital Insurance Trust Fund

                      –6

                      7699
                      Total adjustments

                      –6

                      Unexpended balance, end of year:

                      8700
                      Uninvested balance (net), end of year
                      1,045
                      745
                      1,043

                      8701
                      Federal Hospital Insurance Trust Fund
                      228,292
                      199,923
                      185,039

                      8799
                      Total balance, end of year
                      229,337
                      200,668
                      186,082

          Object Classification (in millions of dollars)

                      Identification code 75–8005–0–7–571
                      2012 actual
                      2013 CR
                      2014 est.

                      Direct obligations:

                      41.0
                      Payment for Quality Improvement Organization (QIO) activities
                      419
                      367
                      628

                      42.0
                      Insurance claims and indemnities (benefits)
                      253,274
                      273,734
                      278,131

                      94.0
                      Financial transfers
                      2,612
                      2,773
                      4,180

                      99.9
                      Total new obligations
                      256,305
                      276,874
                      282,939

             Federal Hospital Insurance Trust Fund

             (Amounts included in the adjusted baseline)Program and Financing (in millions of dollars)

                      Identification code 75–8005–7–7–571
                      2012 actual
                      2013 CR
                      2014 est.

                      Obligations by program activity:

                      0001
                      Benefit payments, HI

                      482

                      0900
                      Total new obligations (object class 42.0)

                      482

                      Budgetary Resources:

                      Budget authority:

                      Appropriations, mandatory:

                      1201
                      Appropriation (special or trust fund)

                      –324

                      1203
                      Appropriation (previously unavailable)

                      806

                      1260
                      Appropriations, mandatory (total)

                      482

                      1900
                      Budget authority (total)

                      482

                      1930
                      Total budgetary resources available

                      482

                      Change in obligated balance:

                      Unpaid obligations:

                      3010
                      Obligations incurred, unexpired accounts

                      482

                      3020
                      Outlays (gross)

                      –482

                      Budget authority and outlays, net:

                      Mandatory:

                      4090
                      Budget authority, gross

                      482

                      Outlays, gross:

                      4100
                      Outlays from new mandatory authority

                      482

                      4180
                      Budget authority, net (total)

                      482

                      4190
                      Outlays, net (total)

                      482

             Federal Hospital Insurance Trust Fund

             (Legislative proposal, not subject to PAYGO)Program and Financing (in millions of dollars)

                      Identification code 75–8005–2–7–571
                      2012 actual
                      2013 CR
                      2014 est.

                      Budgetary Resources:

                      Budget authority:

                      Appropriations, mandatory:

                      1201
                      Appropriation (special or trust fund)

                      600
                      821

                      1203
                      Appropriation (previously unavailable)

                      –600
                      –821

             Federal Hospital Insurance Trust Fund

             (Legislative proposal, subject to PAYGO)Program and Financing (in millions of dollars)

                      Identification code 75–8005–4–7–571
                      2012 actual
                      2013 CR
                      2014 est.

                      Budgetary Resources:

                      Budget authority:

                      Appropriations, mandatory:

                      1201
                      Appropriation (special or trust fund)

                      –303
                      –329

                      1203
                      Appropriation (previously unavailable)

                      303
                      329

             Health Care Fraud and Abuse Control AccountIn addition to amounts otherwise available for program integrity and program management, [$610,000,000]$311,000,000, to remain available through September 30, [2014]2015, to be transferred from the Federal Hospital Insurance Trust Fund and the Federal Supplementary Medical Insurance Trust Fund,
             as authorized by section 201(g) of the Social Security Act, of which [$409,697,693]$251,420,650 shall be for the Centers for Medicare and Medicaid Services Program Integrity Activities, including administrative costs,
             to conduct oversight activities for the Medicare program including, but not limited to, Medicare Advantage and the Medicare
             Prescription Drug Program authorized in title XVIII of the Social Security Act and for activities described in section 1893
             of such Act and for Medicaid and Children's Health Insurance Program ("CHIP") program integrity activities, of which [$102,499,971]$29,789,675 shall be for the Department of Health and Human Services Office of Inspector General to carry out fraud and abuse activities
             authorized by section 1817(k)(3) of such Act, and of which [$97,802,336]$29,789,675 shall be for the Department of Justice to carry out fraud and abuse activities authorized by section 1817(k)(3) of such Act:
             Provided, [That of the amount provided under this heading, $311,000,000 is provided to meet the terms of section 251(b)(2)(C)(ii) of
             the Balanced Budget and Emergency Deficit Control Act of 1985, as amended, and $299,000,000 is additional new budget authority
             specified for purposes of section 251(b)(2)(C) of such Act: Provided further,] That the report required by section 1817(k)(5) of the Social Security Act for fiscal year [2013]2014 shall include measures of the operational efficiency and impact on fraud, waste, and abuse in the Medicare, Medicaid, and
             CHIP programs for the funds provided by this appropriation.  Note.—A full-year 2013 appropriation for this account was not enacted at the time the budget was prepared; therefore, the
                budget assumes this account is operating under the Continuing Appropriations Resolution, 2013 (P.L. 112–175). The amounts
                included for 2013 reflect the annualized level provided by the continuing resolution.
          Program and Financing (in millions of dollars)

                      Identification code 75–8393–0–7–571
                      2012 actual
                      2013 CR
                      2014 est.

                      Obligations by program activity:

                      0001
                      Medicare integrity program
                      854
                      864
                      882

                      0002
                      FBI fraud and abuse control
                      131
                      135
                      138

                      0003
                      Other fraud and abuse control
                      323
                      295
                      300

                      0004
                      Predictive Modeling
                      39
                      30
                      3

                      0091
                      Total Mandatory
                      1,347
                      1,324
                      1,323

                      0101
                      CMS discretionary
                      269
                      252
                      251

                      0102
                      Other discretionary
                      78
                      60
                      60

                      0191
                      Total Discretionary
                      347
                      312
                      311

                      0900
                      Total new obligations
                      1,694
                      1,636
                      1,634

                      Budgetary Resources:

                      Unobligated balance:

                      1000
                      Unobligated balance brought forward, Oct 1
                      241
                      185
                      104

                      1001
                      Discretionary unobligated balance brought fwd, Oct 1
                      74
                      55

                      1021
                      Recoveries of prior year unpaid obligations
                      41

                      1050
                      Unobligated balance (total)
                      282
                      185
                      104

                      Budget authority:

                      Appropriations, discretionary:

                      1101
                      Appropriation (special or trust fund)
                      310
                      312
                      311

                      1160
                      Appropriation, discretionary (total)
                      310
                      312
                      311

                      Appropriations, mandatory:

                      1201
                      Appropriation (special or trust fund)
                      1,290
                      1,243
                      1,219

                      1260
                      Appropriations, mandatory (total)
                      1,290
                      1,243
                      1,219

                      1900
                      Budget authority (total)
                      1,600
                      1,555
                      1,530

                      1930
                      Total budgetary resources available
                      1,882
                      1,740
                      1,634

                      Memorandum (non-add) entries:

                      1940
                      Unobligated balance expiring
                      –3

                      1941
                      Unexpired unobligated balance, end of year
                      185
                      104

                      Special and non-revolving trust funds:

                      1951
                      Unobligated balance expiring
                      3

                      1952
                      Expired unobligated balance, start of year
                      41
                      44
                      44

                      1953
                      Expired unobligated balance, end of year
                      41
                      44
                      44

                      1954
                      Unobligated balance canceling
                      26

                      Change in obligated balance:

                      Unpaid obligations:

                      3000
                      Unpaid obligations, brought forward, Oct 1
                      1,018
                      1,157
                      1,079

                      3010
                      Obligations incurred, unexpired accounts
                      1,694
                      1,636
                      1,634

                      3011
                      Obligations incurred, expired accounts
                      1

                      3020
                      Outlays (gross)
                      –1,488
                      –1,714
                      –1,614

                      3040
                      Recoveries of prior year unpaid obligations, unexpired
                      –41

                      3041
                      Recoveries of prior year unpaid obligations, expired
                      –27

                      3050
                      Unpaid obligations, end of year
                      1,157
                      1,079
                      1,099

                      Memorandum (non-add) entries:

                      3100
                      Obligated balance, start of year
                      1,018
                      1,157
                      1,079

                      3200
                      Obligated balance, end of year
                      1,157
                      1,079
                      1,099

                      Budget authority and outlays, net:

                      Discretionary:

                      4000
                      Budget authority, gross
                      310
                      312
                      311

                      Outlays, gross:

                      4010
                      Outlays from new discretionary authority
                      58
                      312
                      311

                      4011
                      Outlays from discretionary balances
                      233

                      4020
                      Outlays, gross (total)
                      291
                      312
                      311

                      Mandatory:

                      4090
                      Budget authority, gross
                      1,290
                      1,243
                      1,219

                      Outlays, gross:

                      4100
                      Outlays from new mandatory authority
                      436
                      841
                      808

                      4101
                      Outlays from mandatory balances
                      761
                      561
                      495

                      4110
                      Outlays, gross (total)
                      1,197
                      1,402
                      1,303

                      4180
                      Budget authority, net (total)
                      1,600
                      1,555
                      1,530

                      4190
                      Outlays, net (total)
                      1,488
                      1,714
                      1,614

          Summary of Budget Authority and Outlays (in millions of dollars)

                      2012 actual
                      2013 CR
                      2014 est.

                      Enacted/requested:

                      Budget Authority
                      1,600
                      1,555
                      1,530

                      Outlays
                      1,488
                      1,714
                      1,614

                      Legislative proposal, not subject to PAYGO:

                      Budget Authority

                      –473
                      –685

                      Outlays

                      –473
                      –685

                      Legislative proposal, subject to PAYGO:

                      Budget Authority

                      303
                      329

                      Outlays

                      303
                      329

                      Total:

                      Budget Authority
                      1,600
                      1,385
                      1,174

                      Outlays
                      1,488
                      1,544
                      1,258

             The Health Insurance Portability and Accountability Act of 1996 (P.L. 104–191) established the Health Care Fraud and Abuse
                Control (HCFAC) account within the Federal Hospital Insurance Trust Fund and appropriated funds 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.

             The Budget includes a discretionary request for efforts to safeguard Medicare, Medicaid, and CHIP that will supplement the
                mandatory funds made available by P.L. 104–191 and subsequent Acts.  See additional discussion in the Budget Process chapter
                in the Analytical Perspectives volume.

          Object Classification (in millions of dollars)

                      Identification code 75–8393–0–7–571
                      2012 actual
                      2013 CR
                      2014 est.

                      Direct obligations:

                      11.1
                      Personnel compensation: Full-time permanent (CMS)
                      45
                      42
                      42

                      12.1
                      Civilian personnel benefits (CMS)
                      13
                      13
                      12

                      23.3
                      Communications, utilities, and miscellaneous charges
                      12
                      11
                      11

                      25.1
                      Advisory and assistance services (predictive modeling)
                      39
                      30
                      3

                      25.2
                      Other services (CMS/Medicaid)
                      46
                      29
                      29

                      25.3
                      Other purchases of goods and services from Government accounts (HHS/DOJ)
                      110
                      91
                      92

                      25.3
                      Other purchases of goods and services from Government accounts (HHS/OIG)
                      233
                      226
                      230

                      25.3
                      Other purchases of goods and services from Government accounts (HHS/AoA)
                      11
                      11
                      11

                      25.3
                      Other purchases of goods and services from Government accounts (HHS/OGC)
                      9
                      9
                      9

                      25.3
                      Other goods and services from Federal sources (HHS/CMS)
                      26
                      15
                      15

                      25.3
                      Other goods and services from Government accounts (HHS/FDA)
                      6
                      3
                      3

                      25.6
                      Medical care  (CMS)
                      1,005
                      1,021
                      1,039

                      94.0
                      Financial transfers (FBI)
                      139
                      135
                      138

                      99.9
                      Total new obligations
                      1,694
                      1,636
                      1,634

          Employment Summary

                      Identification code 75–8393–0–7–571
                      2012 actual
                      2013 CR
                      2014 est.

                      1001
                      Direct civilian full-time equivalent employment
                      333
                      405
                      405

             Health Care Fraud and Abuse Control Account

             (Legislative proposal, not subject to PAYGO)Program and Financing (in millions of dollars)

                      Identification code 75–8393–2–7–571
                      2012 actual
                      2013 CR
                      2014 est.

                      Obligations by program activity:

                      0001
                      Medicare Program Integrity savings

                      –430
                      –476

                      0002
                      SSA Program integrity savings

                      –43
                      –209

                      0900
                      Total new obligations (object class 25.6)

                      –473
                      –685

                      Budgetary Resources:

                      Budget authority:

                      Appropriations, mandatory:

                      1201
                      Appropriation (special or trust fund)

                      –473
                      –685

                      1260
                      Appropriations, mandatory (total)

                      –473
                      –685

                      1930
                      Total budgetary resources available

                      –473
                      –685

                      Change in obligated balance:

                      Unpaid obligations:

                      3010
                      Obligations incurred, unexpired accounts

                      –473
                      –685

                      3020
                      Outlays (gross)

                      473
                      685

                      Budget authority and outlays, net:

                      Mandatory:

                      4090
                      Budget authority, gross

                      –473
                      –685

                      Outlays, gross:

                      4100
                      Outlays from new mandatory authority

                      –473
                      –685

                      4180
                      Budget authority, net (total)

                      –473
                      –685

                      4190
                      Outlays, net (total)

                      –473
                      –685

             The mandatory proposal included in the Budget is estimated to achieve additional savings.

             Health Care Fraud and Abuse Control Account

             (Legislative proposal, subject to PAYGO)Program and Financing (in millions of dollars)

                      Identification code 75–8393–4–7–571
                      2012 actual
                      2013 CR
                      2014 est.

                      Obligations by program activity:

                      0001
                      CMS program integrity

                      162
                      221

                      0002
                      Other program integrity

                      141
                      108

                      0900
                      Total new obligations

                      303
                      329

                      Budgetary Resources:

                      Budget authority:

                      Appropriations, mandatory:

                      1201
                      Appropriation (special or trust fund)

                      303
                      329

                      1260
                      Appropriations, mandatory (total)

                      303
                      329

                      1930
                      Total budgetary resources available

                      303
                      329

                      Change in obligated balance:

                      Unpaid obligations:

                      3010
                      Obligations incurred, unexpired accounts

                      303
                      329

                      3020
                      Outlays (gross)

                      –303
                      –329

                      Budget authority and outlays, net:

                      Mandatory:

                      4090
                      Budget authority, gross

                      303
                      329

                      Outlays, gross:

                      4100
                      Outlays from new mandatory authority

                      303
                      329

                      4180
                      Budget authority, net (total)

                      303
                      329

                      4190
                      Outlays, net (total)

                      303
                      329

             Despite enactment of multi-year discretionary cap adjustments in the Budget Control Act (BCA) of 2011, annual appropriations
                bills have not provided the full amount of program integrity funding authorized in law.  Billions of dollars in deficit savings
                over the next ten years from curtailing improper payments will not be realized if the administrative expenses for program
                integrity envisioned by the Balanced Budget and Emergency Deficit Control Act (BBEDCA), as amended by the BCA, are not provided
                in each year.  As a result, the Budget is proposing to repeal the discretionary cap adjustments beginning in 2013 for HCFAC
                and instead provide a dedicated, dependable source of mandatory funding that will ensure the Department of Health and Human
                Services (HHS) and the Department of Justice (DOJ) have the resources they need to conduct necessary program integrity activities
                and make certain that only the right people receive the right payment for the right reason at the right time.  Providing additional
                mandatory funding for HCFAC will also eliminate delays in annual appropriations that make it difficult for the agencies to
                execute their budget plans and achieve targeted results in each year.  For 2014, the Budget proposes to continue to provide
                the base funding ($311 million for HHS and DOJ) through discretionary appropriations.  After 2014, no discretionary funding
                is being proposed for this purpose. In addition, an annual reduction to the discretionary spending limits in section 251(c)
                of the BBEDCA, as amended, is proposed beginning in 2015 to offset the cost of shifting the base funding from discretionary
                to mandatory.  The more stable mandatory program integrity funding will produce new net deficit savings of over $2 billion
                over 11 years.

             Proposed Additional Mandatory Funding for HCFAC

                         ($Mil)
                         FY 2013
                         FY 2014

                         HHS-CMS
                         161
                         178

                         HHS-OIG
                         73
                         78

                         DOJ
                         69
                         73

                         Total Additional Mandatory Funding
                         303
                         329

          Object Classification (in millions of dollars)

                      Identification code 75–8393–4–7–571
                      2012 actual
                      2013 CR
                      2014 est.

                      Direct obligations:

                      25.2
                      Other services (CMS/Medicaid)

                      16
                      25

                      25.3
                      Other purchases of goods and services from Government accounts (HHS/DOJ)

                      68
                      53

                      25.3
                      Other purchases of goods and services from Government accounts (HHS/OIG)

                      73
                      55

                      25.3
                      Other goods and services from Federal sources (HHS/CMS)

                      146
                      196

                      99.9
                      Total new obligations

                      303
                      329

             Federal Supplementary Medical Insurance Trust Fund

             Special and Trust Fund Receipts (in millions of dollars)

                      Identification code 75–8004–0–7–571
                      2012 actual
                      2013 CR
                      2014 est.

                      0100
                      Balance, start of year
                      42,930
                      41,270
                      39,454

                      Receipts:

                      0200
                      Fee on Branded Prescription Pharmaceutical Manufacturers and Importers, SMI
                      2,808
                      4,207
                      2,960

                      0220
                      Other Proprietary Interest from the Public, FSMI Fund
                      1
                      3
                      3

                      0221
                      Premiums Collected for Medicare Prescription Drug Account, FSMI
                      2,955
                      3,432
                      3,843

                      0222
                      Payments from States, Medicare Prescription Drug Account, FSMI
                      8,324
                      8,766
                      9,036

                      0223
                      Basic Premium, Medicare Advantage, FSMI Trust Fund
                      208
                      233
                      242

                      0224
                      Basic Premium, Medicare Advantage, FSMI Trust Fund

                      19

                      0225
                      Medicare Refunds, SMI
                      4,989
                      4,400
                      4,500

                      0226
                      Premiums Collected for the Aged, FSMI Fund
                      48,297
                      52,481
                      53,997

                      0227
                      Premiums Collected for the Aged, FSMI Fund

                      545

                      0228
                      Premiums Collected for the Disabled, FSMI Fund
                      9,592
                      9,707
                      10,031

                      0229
                      Premiums Collected for the Disabled, FSMI Fund

                      101

                      0240
                      Federal Contributions, FSMI Fund
                      165,254
                      181,351
                      194,565

                      0241
                      Federal Contributions, FSMI Fund

                      2,007

                      0242
                      Interest Received by Trust Fund, FSMI Fund
                      2,941
                      2,074
                      3,077

                      0243
                      Interest Received by Trust Fund, FSMI Fund

                      –123

                      0244
                      Interest, Medicare Prescription Drug Account, FSMI
                      6
                      6
                      8

                      0245
                      Federal Contribution for Admin. Contribution for Admin. Costs, Prescription Drug Account, FSMI
                      380
                      382
                      373

                      0246
                      Federal Contributions for Benefits, Prescription Drug Account, SMI
                      44,874
                      51,245
                      58,596

                      0247
                      Miscellaneous Federal Payments, Federal Supplementary Medical Insurance Trust Fund
                      1
                      1
                      1

                      0299
                      Total receipts and collections
                      290,630
                      318,288
                      343,781

                      0400
                      Total: Balances and collections
                      333,560
                      359,558
                      383,235

                      Appropriations:

                      0500
                      Federal Supplementary Medical Insurance Trust Fund
                      –3,270
                      –3,148
                      –3,042

                      0501
                      Federal Supplementary Medical Insurance Trust Fund
                      6

                      0502
                      Federal Supplementary Medical Insurance Trust Fund
                      –231,232
                      –251,238
                      –266,390

                      0503
                      Federal Supplementary Medical Insurance Trust Fund
                      –1,860
                      –1,812

                      0504
                      Federal Supplementary Medical Insurance Trust Fund

                      11,898

                      0505
                      Federal Supplementary Medical Insurance Trust Fund

                      –2,550

                      0506
                      Federal Supplementary Medical Insurance Trust Fund

                      –13,037

                      0507
                      Medicare Prescription Drug Account, Federal Supplementary Insurance Trust Fund
                      –302
                      –361
                      –328

                      0508
                      Medicare Prescription Drug Account, Federal Supplementary Insurance Trust Fund
                      –55,745
                      –63,545
                      –71,471

                      0599
                      Total appropriations
                      –292,403
                      –320,104
                      –344,920

                      0610
                      Federal Supplementary Medical Insurance Trust Fund
                      1

                      0620
                      Federal Supplementary Medical Insurance Trust Fund
                      76

                      0795
                      Adjustment- expired accounts, receipts withdrawn.
                      36

                      0799
                      Balance, end of year
                      41,270
                      39,454
                      38,315

          Program and Financing (in millions of dollars)

                      Identification code 75–8004–0–7–571
                      2012 actual
                      2013 CR
                      2014 est.

                      Obligations by program activity:

                      0001
                      Benefit payments, SMI
                      230,916
                      250,593
                      251,160

                      0002
                      Transfer to Medicaid for payment of SMI premiums
                      602
                      645
                      300

                      0003
                      HIT Incentive Payments
                      1,456
                      1,640
                      2,790

                      0004
                      Administration, SMI
                      3,328
                      3,224
                      3,127

                      0005
                      Quality Improvement Organizations, SMI
                      93
                      92
                      157

                      0799
                      Total direct obligations
                      236,395
                      256,194
                      257,534

                      0801
                      Reimbursable program activity
                      17

                      0900
                      Total new obligations
                      236,412
                      256,194
                      257,534

                      Budgetary Resources:

                      Unobligated balance:

                      1000
                      Unobligated balance brought forward, Oct 1

                      1
                      1

                      1021
                      Recoveries of prior year unpaid obligations
                      117

                      1026
                      Adjustment for change in allocation of trust fund limitation or foreign exchange valuation
                      –76

                      1029
                      Other balances withdrawn
                      –1

                      1050
                      Unobligated balance (total)
                      40
                      1
                      1

                      Budget authority:

                      Appropriations, discretionary:

                      1101
                      Appropriation (special or trust fund)
                      3,270
                      3,148
                      3,042

                      1130
                      Appropriations permanently reduced

                      –4

                      1132
                      Appropriations temporarily reduced
                      –6

                      1160
                      Appropriation, discretionary (total)
                      3,264
                      3,144
                      3,042

                      Appropriations, mandatory:

                      1201
                      Appropriation (special or trust fund)
                      231,232
                      251,238
                      266,390

                      1203
                      Appropriation (previously unavailable)
                      1,860
                      1,812

                      1235
                      Appropriations precluded from obligation

                      –11,898

                      1260
                      Appropriations, mandatory (total)
                      233,092
                      253,050
                      254,492

                      Spending authority from offsetting collections, mandatory:

                      1800
                      Collected
                      17

                      1850
                      Spending auth from offsetting collections, mand (total)
                      17

                      1900
                      Budget authority (total)
                      236,373
                      256,194
                      257,534

                      1930
                      Total budgetary resources available
                      236,413
                      256,195
                      257,535

                      Memorandum (non-add) entries:

                      1941
                      Unexpired unobligated balance, end of year
                      1
                      1
                      1

                      Special and non-revolving trust funds:

                      1950
                      Other balances withdrawn
                      1

                      Change in obligated balance:

                      Unpaid obligations:

                      3000
                      Unpaid obligations, brought forward, Oct 1
                      24,063
                      24,403
                      24,369

                      3010
                      Obligations incurred, unexpired accounts
                      236,412
                      256,194
                      257,534

                      3020
                      Outlays (gross)
                      –235,955
                      –256,228
                      –257,570

                      3040
                      Recoveries of prior year unpaid obligations, unexpired
                      –117

                      3050
                      Unpaid obligations, end of year
                      24,403
                      24,369
                      24,333

                      Memorandum (non-add) entries:

                      3100
                      Obligated balance, start of year
                      24,063
                      24,403
                      24,369

                      3200
                      Obligated balance, end of year
                      24,403
                      24,369
                      24,333

                      Budget authority and outlays, net:

                      Discretionary:

                      4000
                      Budget authority, gross
                      3,264
                      3,144
                      3,042

                      Outlays, gross:

                      4010
                      Outlays from new discretionary authority
                      1,830
                      2,162
                      2,086

                      4011
                      Outlays from discretionary balances
                      1,294
                      935
                      959

                      4020
                      Outlays, gross (total)
                      3,124
                      3,097
                      3,045

                      Mandatory:

                      4090
                      Budget authority, gross
                      233,109
                      253,050
                      254,492

                      Outlays, gross:

                      4100
                      Outlays from new mandatory authority
                      211,941
                      231,342
                      230,373

                      4101
                      Outlays from mandatory balances
                      20,890
                      21,789
                      24,152

                      4110
                      Outlays, gross (total)
                      232,831
                      253,131
                      254,525

                      Offsets against gross budget authority and outlays:

                      Offsetting collections (collected) from:

                      4123
                      Non-Federal sources
                      –17

                      4180
                      Budget authority, net (total)
                      236,356
                      256,194
                      257,534

                      4190
                      Outlays, net (total)
                      235,938
                      256,228
                      257,570

                      Memorandum (non-add) entries:

                      5000
                      Total investments, SOY: Federal securities: Par value
                      70,446
                      69,324
                      67,876

                      5001
                      Total investments, EOY: Federal securities: Par value
                      69,324
                      67,876
                      66,660

          Summary of Budget Authority and Outlays (in millions of dollars)

                      2012 actual
                      2013 CR
                      2014 est.

                      Enacted/requested:

                      Budget Authority
                      236,356
                      256,194
                      257,534

                      Outlays
                      235,938
                      256,228
                      257,570

                      Amounts included in the adjusted baseline:

                      Budget Authority

                      15,587

                      Outlays

                      15,587

                      Total:

                      Budget Authority
                      236,356
                      256,194
                      273,121

                      Outlays
                      235,938
                      256,228
                      273,157

             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 generally financed by premium payments from enrollees and contributions from the general revenues.

             The status of the trust fund is as follows.  In addition, the Budget includes a package of proposals that improve Medicare's
                sustainability by promoting high-quality, efficient care; aligning payments with the costs of providing care; encouraging
                beneficiaries to seek high-value services; and reducing the Federal subsidy of Medicare costs for those beneficiaries who
                can most afford them.

          Status of Funds (in millions of dollars)

                      Identification code 75–8004–0–7–571
                      2012 actual
                      2013 CR
                      2014 est.

                      Unexpended balance, start of year:

                      0100
                      Balance, start of year
                      72,780
                      71,728
                      69,862

                      0199
                      Total balance, start of year
                      72,780
                      71,728
                      69,862

                      Cash income during the year:

                      Current law:

                      Receipts:

                      1200
                      Fee on Branded Prescription Pharmaceutical Manufacturers and Importers, SMI
                      2,808
                      4,207
                      2,960

                      Offsetting receipts (proprietary):

                      1220
                      Other Proprietary Interest from the Public, FSMI Fund
                      1
                      3
                      3

                      1221
                      Premiums Collected for Medicare Prescription Drug Account, FSMI
                      2,955
                      3,432
                      3,843

                      1222
                      Payments from States, Medicare Prescription Drug Account, FSMI
                      8,324
                      8,766
                      9,036

                      1223
                      Basic Premium, Medicare Advantage, FSMI Trust Fund
                      208
                      233
                      242

                      1224
                      Basic Premium, Medicare Advantage, FSMI Trust Fund

                      19

                      1225
                      Medicare Refunds, SMI
                      4,989
                      4,400
                      4,500

                      1226
                      Premiums Collected for the Aged, FSMI Fund
                      48,297
                      52,481
                      53,997

                      1227
                      Premiums Collected for the Aged, FSMI Fund

                      545

                      1228
                      Premiums Collected for the Disabled, FSMI Fund
                      9,592
                      9,707
                      10,031

                      1229
                      Premiums Collected for the Disabled, FSMI Fund

                      101

                      Offsetting receipts (intragovernmental):

                      1240
                      Federal Contributions, FSMI Fund
                      165,254
                      181,351
                      194,565

                      1241
                      Federal Contributions, FSMI Fund

                      2,007

                      1242
                      Interest Received by Trust Fund, FSMI Fund
                      2,941
                      2,074
                      3,077

                      1243
                      Interest Received by Trust Fund, FSMI Fund

                      –123

                      1244
                      Interest, Medicare Prescription Drug Account, FSMI
                      6
                      6
                      8

                      1245
                      Federal Contribution for Admin. Contribution for Admin. Costs, Prescription Drug Account, FSMI
                      380
                      382
                      373

                      1246
                      Federal Contributions for Benefits, Prescription Drug Account, SMI
                      44,874
                      51,245
                      58,596

                      1247
                      Miscellaneous Federal Payments, Federal Supplementary Medical Insurance Trust Fund
                      1
                      1
                      1

                      Offsetting collections:

                      1280
                      Federal Supplementary Medical Insurance Trust Fund
                      17

                      1281
                      Medicare Prescription Drug Account, Federal Supplementary Insurance Trust Fund
                      2,216

                      1299
                      Income under present law
                      292,863
                      318,288
                      343,781

                      3299
                      Total cash income
                      292,863
                      318,288
                      343,781

                      Cash outgo during year:

                      Current law:

                      4500
                      Federal Supplementary Medical Insurance Trust Fund
                      –235,955
                      –256,228
                      –257,570

                      4500
                      Medicare Prescription Drug Account, Federal Supplementary Insurance Trust Fund
                      –57,960
                      –63,922
                      –71,839

                      4500
                      Federal Supplementary Medical Insurance Trust Fund

                      –15,587

                      4599
                      Outgo under current law (-)
                      –293,915
                      –320,150
                      –344,996

                      6599
                      Total cash outgo (-)
                      –293,915
                      –320,150
                      –344,996

                      7625
                      Federal Supplementary Medical Insurance Trust Fund

                      –4

                      7699
                      Total adjustments

                      –4

                      Unexpended balance, end of year:

                      8700
                      Uninvested balance (net), end of year
                      2,404
                      1,986
                      1,987

                      8701
                      Federal Supplementary Medical Insurance Trust Fund
                      69,324
                      67,876
                      66,660

                      8799
                      Total balance, end of year
                      71,728
                      69,862
                      68,647

          Object Classification (in millions of dollars)

                      Identification code 75–8004–0–7–571
                      2012 actual
                      2013 CR
                      2014 est.

                      Direct obligations:

                      41.0
                      Payment for Quality Improvement Organization (QIO) activity
                      93
                      92
                      157

                      42.0
                      Insurance claims and indemnities
                      232,974
                      252,878
                      254,250

                      94.0
                      Financial transfers
                      3,328
                      3,224
                      3,127

                      99.0
                      Direct obligations
                      236,395
                      256,194
                      257,534

                      42.0
                      Allocation Account - reimbursable: Insurance claims and indemnities
                      17

                      99.9
                      Total new obligations
                      236,412
                      256,194
                      257,534

             Federal Supplementary Medical Insurance Trust Fund

             (Amounts included in the adjusted baseline)Program and Financing (in millions of dollars)

                      Identification code 75–8004–7–7–571
                      2012 actual
                      2013 CR
                      2014 est.

                      Obligations by program activity:

                      0001
                      Benefits

                      15,587

                      0900
                      Total new obligations (object class 42.0)

                      15,587

                      Budgetary Resources:

                      Budget authority:

                      Appropriations, mandatory:

                      1201
                      Appropriation (special or trust fund)

                      2,550

                      1235
                      Appropriations precluded from obligation

                      13,037

                      1260
                      Appropriations, mandatory (total)

                      15,587

                      1900
                      Budget authority (total)

                      15,587

                      1930
                      Total budgetary resources available

                      15,587

                      Change in obligated balance:

                      Unpaid obligations:

                      3010
                      Obligations incurred, unexpired accounts

                      15,587

                      3020
                      Outlays (gross)

                      –15,587

                      Budget authority and outlays, net:

                      Mandatory:

                      4090
                      Budget authority, gross

                      15,587

                      Outlays, gross:

                      4100
                      Outlays from new mandatory authority

                      15,587

                      Offsets against gross budget authority and outlays:

                      Offsetting collections (collected) from:

                      4180
                      Budget authority, net (total)

                      15,587

                      4190
                      Outlays, net (total)

                      15,587

             Medicare Prescription Drug Account, Federal Supplementary Insurance Trust Fund

             Program and Financing (in millions of dollars)

                      Identification code 75–8308–0–7–571
                      2012 actual
                      2013 CR
                      2014 est.

                      Obligations by program activity:

                      0001
                      Prescription Drug Benefits
                      58,365
                      63,540
                      71,467

                      0002
                      Administrative Costs
                      306
                      366
                      332

                      0900
                      Total new obligations
                      58,671
                      63,906
                      71,799

                      Budgetary Resources:

                      Unobligated balance:

                      1000
                      Unobligated balance brought forward, Oct 1

                      1
                      1

                      1021
                      Recoveries of prior year unpaid obligations
                      409

                      1050
                      Unobligated balance (total)
                      409
                      1
                      1

                      Budget authority:

                      Appropriations, discretionary:

                      1101
                      Appropriation (special or trust fund)
                      302
                      361
                      328

                      1160
                      Appropriation, discretionary (total)
                      302
                      361
                      328

                      Appropriations, mandatory:

                      1201
                      Appropriation (special or trust fund)
                      55,745
                      63,545
                      71,471

                      1260
                      Appropriations, mandatory (total)
                      55,745
                      63,545
                      71,471

                      Spending authority from offsetting collections, mandatory:

                      1800
                      Collected
                      2,216

                      1850
                      Spending auth from offsetting collections, mand (total)
                      2,216

                      1900
                      Budget authority (total)
                      58,263
                      63,906
                      71,799

                      1930
                      Total budgetary resources available
                      58,672
                      63,907
                      71,800

                      Memorandum (non-add) entries:

                      1941
                      Unexpired unobligated balance, end of year
                      1
                      1
                      1

                      Special and non-revolving trust funds:

                      1952
                      Expired unobligated balance, start of year
                      572
                      449
                      449

                      1953
                      Expired unobligated balance, end of year
                      449
                      449
                      449

                      Change in obligated balance:

                      Unpaid obligations:

                      3000
                      Unpaid obligations, brought forward, Oct 1
                      5,216
                      5,606
                      5,590

                      3010
                      Obligations incurred, unexpired accounts
                      58,671
                      63,906
                      71,799

                      3011
                      Obligations incurred, expired accounts
                      120

                      3020
                      Outlays (gross)
                      –57,960
                      –63,922
                      –71,839

                      3040
                      Recoveries of prior year unpaid obligations, unexpired
                      –409

                      3041
                      Recoveries of prior year unpaid obligations, expired
                      –32

                      3050
                      Unpaid obligations, end of year
                      5,606
                      5,590
                      5,550

                      Memorandum (non-add) entries:

                      3100
                      Obligated balance, start of year
                      5,216
                      5,606
                      5,590

                      3200
                      Obligated balance, end of year
                      5,606
                      5,590
                      5,550

                      Budget authority and outlays, net:

                      Discretionary:

                      4000
                      Budget authority, gross
                      302
                      361
                      328

                      Outlays, gross:

                      4010
                      Outlays from new discretionary authority
                      276
                      286
                      259

                      4011
                      Outlays from discretionary balances
                      100
                      73
                      72

                      4020
                      Outlays, gross (total)
                      376
                      359
                      331

                      Mandatory:

                      4090
                      Budget authority, gross
                      57,961
                      63,545
                      71,471

                      Outlays, gross:

                      4100
                      Outlays from new mandatory authority
                      55,335
                      59,916
                      67,771

                      4101
                      Outlays from mandatory balances
                      2,249
                      3,647
                      3,737

                      4110
                      Outlays, gross (total)
                      57,584
                      63,563
                      71,508

                      Offsets against gross budget authority and outlays:

                      Offsetting collections (collected) from:

                      4120
                      Federal sources
                      –2,216

                      4180
                      Budget authority, net (total)
                      56,047
                      63,906
                      71,799

                      4190
                      Outlays, net (total)
                      55,744
                      63,922
                      71,839

             Since January 2006, Medicare beneficiaries have had the opportunity to enroll in a comprehensive voluntary prescription drug
                benefit. The Budget includes a package of proposals that slow the growth of Part D net expenditures.

          Object Classification (in millions of dollars)

                      Identification code 75–8308–0–7–571
                      2012 actual
                      2013 CR
                      2014 est.

                      Direct obligations:

                      25.2
                      Other services from non-Federal sources
                      306
                      366
                      332

                      42.0
                      Insurance claims and indemnities
                      58,365
                      63,540
                      71,467

                      99.9
                      Total new obligations
                      58,671
                      63,906
                      71,799

             Allocations 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
             Temporary Assistance for Needy Families

             Program and Financing (in millions of dollars)

                      Identification code 75–1552–0–1–609
                      2012 actual
                      2013 CR
                      2014 est.

                      Obligations by program activity:

                      0001
                      State family assistance grant
                      16,488
                      16,486
                      16,486

                      0002
                      Territories - family assistance grants
                      75
                      78
                      78

                      0006
                      Tribal work programs
                      8
                      8
                      8

                      0009
                      Healthy marriage and responsible fatherhood grants
                      150
                      150
                      150

                      0900
                      Total new obligations
                      16,721
                      16,722
                      16,722

                      Budgetary Resources:

                      Unobligated balance:

                      1000
                      Unobligated balance brought forward, Oct 1

                      2

                      Budget authority:

                      Appropriations, mandatory:

                      1200
                      Appropriation
                      16,739
                      16,739
                      16,739

                      1260
                      Appropriations, mandatory (total)
                      16,739
                      16,739
                      16,739

                      1930
                      Total budgetary resources available
                      16,739
                      16,739
                      16,741

                      Memorandum (non-add) entries:

                      1940
                      Unobligated balance expiring
                      –18
                      –15
                      –15

                      1941
                      Unexpired unobligated balance, end of year

                      2
                      4

                      Change in obligated balance:

                      Unpaid obligations:

                      3000
                      Unpaid obligations, brought forward, Oct 1
                      4,595
                      5,180
                      5,054

                      3010
                      Obligations incurred, unexpired accounts
                      16,721
                      16,722
                      16,722

                      3020
                      Outlays (gross)
                      –16,136
                      –16,848
                      –16,982

                      3050
                      Unpaid obligations, end of year
                      5,180
                      5,054
                      4,794

                      Memorandum (non-add) entries:

                      3100
                      Obligated balance, start of year
                      4,595
                      5,180
                      5,054

                      3200
                      Obligated balance, end of year
                      5,180
                      5,054
                      4,794

                      Budget authority and outlays, net:

                      Mandatory:

                      4090
                      Budget authority, gross
                      16,739
                      16,739
                      16,739

                      Outlays, gross:

                      4100
                      Outlays from new mandatory authority
                      13,210
                      13,379
                      13,379

                      4101
                      Outlays from mandatory balances
                      2,926
                      3,469
                      3,603

                      4110
                      Outlays, gross (total)
                      16,136
                      16,848
                      16,982

                      4180
                      Budget authority, net (total)
                      16,739
                      16,739
                      16,739

                      4190
                      Outlays, net (total)
                      16,136
                      16,848
                      16,982

          Summary of Budget Authority and Outlays (in millions of dollars)

                      2012 actual
                      2013 CR
                      2014 est.

                      Enacted/requested:

                      Budget Authority
                      16,739
                      16,739
                      16,739

                      Outlays
                      16,136
                      16,848
                      16,982

                      Legislative proposal, subject to PAYGO:

                      Budget Authority

                      319

                      Outlays

                      289

                      Total:

                      Budget Authority
                      16,739
                      16,739
                      17,058

                      Outlays
                      16,136
                      16,848
                      17,271

             This account provides funding for the Temporary Assistance for Needy Families block grant and related activities authorized
                by the Personal Responsibility and Work Opportunity Reconciliation Act of 1996 (P.L. 104–193), as amended by the Deficit Reduction
                Act of 2005 (P.L. 109–171). Since 2010, this account has been temporarily reauthorized by a series of Acts and at the time
                the Budget was prepared was operating under the Continuing Appropriations Resolution, 2013 (P.L. 112–175).

          Object Classification (in millions of dollars)

                      Identification code 75–1552–0–1–609
                      2012 actual
                      2013 CR
                      2014 est.

                      Direct obligations:

                      11.1
                      Personnel compensation: Full-time permanent
                      2
                      1
                      1

                      12.1
                      Civilian personnel benefits
                      1
                      1
                      1

                      21.0
                      Travel and transportation of persons
                      1
                      1
                      1

                      23.1
                      Rental payments to GSA
                      1
                      1
                      1

                      25.1
                      Advisory and assistance services
                      23
                      23
                      23

                      25.2
                      Other services from non-Federal sources
                      15
                      15
                      15

                      25.3
                      Other goods and services from Federal sources
                      1
                      1
                      1

                      41.0
                      Grants, subsidies, and contributions
                      16,677
                      16,679
                      16,679

                      99.9
                      Total new obligations
                      16,721
                      16,722
                      16,722

          Employment Summary

                      Identification code 75–1552–0–1–609
                      2012 actual
                      2013 CR
                      2014 est.

                      1001
                      Direct civilian full-time equivalent employment
                      15
                      15
                      15

             Temporary Assistance for Needy Families

             (Legislative proposal, subject to PAYGO)Program and Financing (in millions of dollars)

                      Identification code 75–1552–4–1–609
                      2012 actual
                      2013 CR
                      2014 est.

                      Obligations by program activity:

                      0007
                      Supplemental Grants

                      319

                      0900
                      Total new obligations (object class 41.0)

                      319

                      Budgetary Resources:

                      Budget authority:

                      Appropriations, mandatory:

                      1200
                      Appropriation

                      319

                      1260
                      Appropriations, mandatory (total)

                      319

                      1930
                      Total budgetary resources available

                      319

                      Change in obligated balance:

                      Unpaid obligations:

                      3010
                      Obligations incurred, unexpired accounts

                      319

                      3020
                      Outlays (gross)

                      –289

                      3050
                      Unpaid obligations, end of year

                      30

                      Memorandum (non-add) entries:

                      3200
                      Obligated balance, end of year

                      30

                      Budget authority and outlays, net:

                      Mandatory:

                      4090
                      Budget authority, gross

                      319

                      Outlays, gross:

                      4100
                      Outlays from new mandatory authority

                      289

                      4180
                      Budget authority, net (total)

                      319

                      4190
                      Outlays, net (total)

                      289

             Contingency Fund

             Program and Financing (in millions of dollars)

                      Identification code 75–1522–0–1–609
                      2012 actual
                      2013 CR
                      2014 est.

                      Obligations by program activity:

                      0001
                      Contingency fund
                      612
                      612
                      612

                      0900
                      Total new obligations (object class 41.0)
                      612
                      612
                      612

                      Budgetary Resources:

                      Budget authority:

                      Appropriations, mandatory:

                      1200
                      Appropriation
                      612
                      612
                      612

                      1260
                      Appropriations, mandatory (total)
                      612
                      612
                      612

                      1930
                      Total budgetary resources available
                      612
                      612
                      612

                      Change in obligated balance:

                      Unpaid obligations:

                      3000
                      Unpaid obligations, brought forward, Oct 1
                      832
                      595
                      331

                      3010
                      Obligations incurred, unexpired accounts
                      612
                      612
                      612

                      3020
                      Outlays (gross)
                      –678
                      –876
                      –776

                      3041
                      Recoveries of prior year unpaid obligations, expired
                      –171

                      3050
                      Unpaid obligations, end of year
                      595
                      331
                      167

                      Memorandum (non-add) entries:

                      3100
                      Obligated balance, start of year
                      832
                      595
                      331

                      3200
                      Obligated balance, end of year
                      595
                      331
                      167

                      Budget authority and outlays, net:

                      Mandatory:

                      4090
                      Budget authority, gross
                      612
                      612
                      612

                      Outlays, gross:

                      4100
                      Outlays from new mandatory authority
                      473
                      555
                      555

                      4101
                      Outlays from mandatory balances
                      205
                      321
                      221

                      4110
                      Outlays, gross (total)
                      678
                      876
                      776

                      4180
                      Budget authority, net (total)
                      612
                      612
                      612

                      4190
                      Outlays, net (total)
                      678
                      876
                      776

          Summary of Budget Authority and Outlays (in millions of dollars)

                      2012 actual
                      2013 CR
                      2014 est.

                      Enacted/requested:

                      Budget Authority
                      612
                      612
                      612

                      Outlays
                      678
                      876
                      776

                      Legislative proposal, subject to PAYGO:

                      Budget Authority

                      –319

                      Outlays

                      –289

                      Total:

                      Budget Authority
                      612
                      612
                      293

                      Outlays
                      678
                      876
                      487

             This account provides funding for the TANF Contingency Fund authorized by section 403(b) of the Social Security Act that currently
                provides money to qualifying States (but not Territories or Tribes) during an economic downturn.

             Contingency Fund

             (Legislative proposal, subject to PAYGO)Program and Financing (in millions of dollars)

                      Identification code 75–1522–4–1–609
                      2012 actual
                      2013 CR
                      2014 est.

                      Obligations by program activity:

                      0001
                      Contingency fund

                      –319

                      0900
                      Total new obligations (object class 41.0)

                      –319

                      Budgetary Resources:

                      Budget authority:

                      Appropriations, mandatory:

                      1200
                      Appropriation

                      –319

                      1260
                      Appropriations, mandatory (total)

                      –319

                      1930
                      Total budgetary resources available

                      –319

                      Change in obligated balance:

                      Unpaid obligations:

                      3010
                      Obligations incurred, unexpired accounts

                      –319

                      3020
                      Outlays (gross)

                      289

                      3050
                      Unpaid obligations, end of year

                      –30

                      Memorandum (non-add) entries:

                      3200
                      Obligated balance, end of year

                      –30

                      Budget authority and outlays, net:

                      Mandatory:

                      4090
                      Budget authority, gross

                      –319

                      Outlays, gross:

                      4100
                      Outlays from new mandatory authority

                      –289

                      4180
                      Budget authority, net (total)

                      –319

                      4190
                      Outlays, net (total)

                      –289

             Payments to States for Child Support Enforcement and Family Support ProgramsFor [making payments to States or other non-Federal entities under] carrying out, except as otherwise provided, titles I, IV-D, X, XI, XIV, and XVI of the Social Security Act and the Act of July 5, 1960, [$2,756,485,000] $2,965,245,000, to remain available until expended; and for such purposes for the first quarter of fiscal year [2014] 2015, [$1,100,000,000] $1,250,000,000, 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 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, 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.  Note.—A full-year 2013 appropriation for this account was not enacted at the time the budget was prepared; therefore, the
                budget assumes this account is operating under the Continuing Appropriations Resolution, 2013 (P.L. 112–175). The amounts
                included for 2013 reflect the annualized level provided by the continuing resolution.
          Program and Financing (in millions of dollars)

                      Identification code 75–1501–0–1–609
                      2012 actual
                      2013 CR
                      2014 est.

                      Obligations by program activity:

                      0001
                      State child support administrative costs
                      3,626
                      3,730
                      3,780

                      0002
                      Child support incentive payments
                      508
                      530
                      541

                      0003
                      Access and visitation grants
                      10
                      10
                      10

                      0091
                      Subtotal, child support enforcement
                      4,144
                      4,270
                      4,331

                      0102
                      Payments to territories
                      32
                      33
                      33

                      0103
                      Repatriation
                      1
                      1
                      1

                      0191
                      Subtotal, other payments
                      33
                      34
                      34

                      0799
                      Total direct obligations
                      4,177
                      4,304
                      4,365

                      0801
                      Offset obligations (CSE grants to States)
                      2
                      8
                      8

                      0900
                      Total new obligations
                      4,179
                      4,312
                      4,373

                      Budgetary Resources:

                      Unobligated balance:

                      1000
                      Unobligated balance brought forward, Oct 1

                      1

                      1021
                      Recoveries of prior year unpaid obligations
                      341
                      300
                      300

                      1050
                      Unobligated balance (total)
                      341
                      301
                      300

                      Budget authority:

                      Appropriations, mandatory:

                      1200
                      Appropriation
                      2,636
                      2,904
                      2,965

                      1260
                      Appropriations, mandatory (total)
                      2,636
                      2,904
                      2,965

                      Advance appropriations, mandatory:

                      1270
                      Advance appropriation
                      1,200
                      1,100
                      1,100

                      1280
                      Advanced appropriation, mandatory (total)
                      1,200
                      1,100
                      1,100

                      Spending authority from offsetting collections, mandatory:

                      1800
                      Collected
                      3
                      7
                      8

                      1850
                      Spending auth from offsetting collections, mand (total)
                      3
                      7
                      8

                      1900
                      Budget authority (total)
                      3,839
                      4,011
                      4,073

                      1930
                      Total budgetary resources available
                      4,180
                      4,312
                      4,373

                      Memorandum (non-add) entries:

                      1941
                      Unexpired unobligated balance, end of year
                      1

                      Change in obligated balance:

                      Unpaid obligations:

                      3000
                      Unpaid obligations, brought forward, Oct 1
                      1,108
                      986
                      997

                      3010
                      Obligations incurred, unexpired accounts
                      4,179
                      4,312
                      4,373

                      3020
                      Outlays (gross)
                      –3,960
                      –4,001
                      –4,043

                      3040
                      Recoveries of prior year unpaid obligations, unexpired
                      –341
                      –300
                      –300

                      3050
                      Unpaid obligations, end of year
                      986
                      997
                      1,027

                      Memorandum (non-add) entries:

                      3100
                      Obligated balance, start of year
                      1,108
                      986
                      997

                      3200
                      Obligated balance, end of year
                      986
                      997
                      1,027

                      Budget authority and outlays, net:

                      Mandatory:

                      4090
                      Budget authority, gross
                      3,839
                      4,011
                      4,073

                      Outlays, gross:

                      4100
                      Outlays from new mandatory authority
                      3,627
                      3,702
                      3,751

                      4101
                      Outlays from mandatory balances
                      333
                      299
                      292

                      4110
                      Outlays, gross (total)
                      3,960
                      4,001
                      4,043

                      Offsets against gross budget authority and outlays:

                      Offsetting collections (collected) from:

                      4123
                      Non-Federal sources
                      –3
                      –7
                      –8

                      4180
                      Budget authority, net (total)
                      3,836
                      4,004
                      4,065

                      4190
                      Outlays, net (total)
                      3,957
                      3,994
                      4,035

          Summary of Budget Authority and Outlays (in millions of dollars)

                      2012 actual
                      2013 CR
                      2014 est.

                      Enacted/requested:

                      Budget Authority
                      3,836
                      4,004
                      4,065

                      Outlays
                      3,957
                      3,994
                      4,035

                      Legislative proposal, subject to PAYGO:

                      Budget Authority

                      10

                      Outlays

                      10

                      Total:

                      Budget Authority
                      3,836
                      4,004
                      4,075

                      Outlays
                      3,957
                      3,994
                      4,045

             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. This request proposes a Child Support and Fatherhood Initiative, a comprehensive set of proposals which promotes
                using child support payments in the best interest of the child; supports noncustodial parents becoming and staying involved
                in their children's lives; and improves establishment and enforcement procedures by closing loopholes and improving federal
                processes.

          Object Classification (in millions of dollars)

                      Identification code 75–1501–0–1–609
                      2012 actual
                      2013 CR
                      2014 est.

                      41.0
                      Direct obligations: Grants, subsidies, and contributions
                      4,177
                      4,304
                      4,365

                      99.0
                      Reimbursable obligations
                      2
                      8
                      8

                      99.9
                      Total new obligations
                      4,179
                      4,312
                      4,373

             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
                      2012 actual
                      2013 CR
                      2014 est.

                      Obligations by program activity:

                      0001
                      State child support administrative costs

                      10

                      0900
                      Total new obligations (object class 41.0)

                      10

                      Budgetary Resources:

                      Budget authority:

                      Appropriations, mandatory:

                      1200
                      Appropriation

                      10

                      1260
                      Appropriations, mandatory (total)

                      10

                      1930
                      Total budgetary resources available

                      10

                      Change in obligated balance:

                      Unpaid obligations:

                      3010
                      Obligations incurred, unexpired accounts

                      10

                      3020
                      Outlays (gross)

                      –10

                      Budget authority and outlays, net:

                      Mandatory:

                      4090
                      Budget authority, gross

                      10

                      Outlays, gross:

                      4100
                      Outlays from new mandatory authority

                      10

                      4180
                      Budget authority, net (total)

                      10

                      4190
                      Outlays, net (total)

                      10

             Low Income Home Energy AssistanceFor making payments under subsections (b), (d), and (e) of section 2602 of the Low Income Home Energy Assistance Act of 1981,
             [$3,020,000,000] $2,970,000,000, of which $2,820,000,000 shall be for making payments under subsections (b) and (d) of such section; and of which [$200,000,000] $150,000,000 shall be for making payments under subsection (e) of such section, to be made notwithstanding the designation requirements
             of such subsection: Provided, That all but $403,000,000 of the amount provided in this section for subsections (b) and (d) shall be allocated as though
             the total appropriation for such payments for fiscal year [2013] 2014 was less than $1,975,000,000: Provided further, That notwithstanding section 2609A(a), the Secretary may reserve up to $3,000,000 of the amounts appropriated under section 2602(b) [, not more than $3,000,000 of such amounts may be reserved by the Secretary] for technical assistance, training, and monitoring of program activities for compliance with internal controls, policies
             and procedures and may, in addition to the authorities provided in section 2609A(a)(1), use such funds through contracts with private entities
                that do not qualify as nonprofit organizations.
          For making competitive grants to assist low-income households in reducing household energy burdens and for conducting a national
                evaluation of such grants, $50,000,000.  Note.—A full-year 2013 appropriation for this account was not enacted at the time the budget was prepared; therefore, the
                budget assumes this account is operating under the Continuing Appropriations Resolution, 2013 (P.L. 112–175). The amounts
                included for 2013 reflect the annualized level provided by the continuing resolution.
          Program and Financing (in millions of dollars)

                      Identification code 75–1502–0–1–609
                      2012 actual
                      2013 CR
                      2014 est.

                      Obligations by program activity:

                      0001
                      LIHEAP Block Grant
                      3,472
                      3,493
                      2,820

                      0002
                      Contingency Fund

                      150

                      0003
                      Energy Burden Reduction Grants

                      50

                      0900
                      Total new obligations
                      3,472
                      3,493
                      3,020

                      Budgetary Resources:

                      Budget authority:

                      Appropriations, discretionary:

                      1100
                      Appropriation
                      3,478
                      3,493
                      3,020

                      1130
                      Appropriations permanently reduced
                      –6

                      1160
                      Appropriation, discretionary (total)
                      3,472
                      3,493
                      3,020

                      1930
                      Total budgetary resources available
                      3,472
                      3,493
                      3,020

                      Change in obligated balance:

                      Unpaid obligations:

                      3000
                      Unpaid obligations, brought forward, Oct 1
                      1,991
                      1,642
                      1,431

                      3010
                      Obligations incurred, unexpired accounts
                      3,472
                      3,493
                      3,020

                      3020
                      Outlays (gross)
                      –3,817
                      –3,704
                      –2,936

                      3041
                      Recoveries of prior year unpaid obligations, expired
                      –4

                      3050
                      Unpaid obligations, end of year
                      1,642
                      1,431
                      1,515

                      Memorandum (non-add) entries:

                      3100
                      Obligated balance, start of year
                      1,991
                      1,642
                      1,431

                      3200
                      Obligated balance, end of year
                      1,642
                      1,431
                      1,515

                      Budget authority and outlays, net:

                      Discretionary:

                      4000
                      Budget authority, gross
                      3,472
                      3,493
                      3,020

                      Outlays, gross:

                      4010
                      Outlays from new discretionary authority
                      2,191
                      2,201
                      1,905

                      4011
                      Outlays from discretionary balances
                      1,626
                      1,503
                      1,031

                      4020
                      Outlays, gross (total)
                      3,817
                      3,704
                      2,936

                      4180
                      Budget authority, net (total)
                      3,472
                      3,493
                      3,020

                      4190
                      Outlays, net (total)
                      3,817
                      3,704
                      2,936

             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 assume
                that all funds will be released in response to emergencies such as extreme weather related events and high fuel prices.  The
                Budget proposes new competitive grants to reduce household energy burdens for low-income households.

          Object Classification (in millions of dollars)

                      Identification code 75–1502–0–1–609
                      2012 actual
                      2013 CR
                      2014 est.

                      Direct obligations:

                      25.1
                      Advisory and assistance services
                      2
                      2
                      2

                      25.3
                      Other goods and services from Federal sources
                      1
                      1
                      1

                      41.0
                      Grants, subsidies, and contributions
                      3,469
                      3,490
                      3,017

                      99.9
                      Total new obligations
                      3,472
                      3,493
                      3,020

             Refugee and Entrant AssistanceFor necessary expenses for refugee and entrant assistance activities authorized by section 414 of the Immigration and Nationality
             Act and section 501 of the Refugee Education Assistance Act of 1980, and for carrying out section 462 of the Homeland Security Act of 2002, the Torture Victims Relief Act of 1998, the Trafficking Victims Protection Act of 2000 (TVPA), section 203 of the Trafficking
                Victims Protection Reauthorization Act of 2005, and section 235 of the William Wilberforce Trafficking Victims Protection Reauthorization Act of 2008, [and the Trafficking Victims Protection Act of 2000, for costs associated with the care and placement of unaccompanied alien
             children, and for carrying out the Torture Victims Relief Act of 1998, $805,358,000] $1,123,432,000, to remain available through September 30, 2016: Provided, That [of which] up to [$9,775,000] $19,775,000 shall be available to carry out the [Trafficking Victims Protection Act of 2000: Provided, That funds appropriated under this heading pursuant to section 414(a) of the Immigration and Nationality Act, section 462
             of the Homeland Security Act of 2002, section 235 of the William Wilberforce Trafficking Victims Protection Reauthorization
             Act of 2008, and the Trafficking Victims Protection Act of 2000 for fiscal year 2013 shall be available for the costs of assistance
             provided and other activities to remain available through September 30, 2015] last three Acts cited above, of which $300,000 of such amount shall be available for research and evaluation under sections
                107(f) and 112A of the TVPA, as amended, notwithstanding any limitations or earmarks in such sections.  Note.—A full-year 2013 appropriation for this account was not enacted at the time the budget was prepared; therefore, the
                budget assumes this account is operating under the Continuing Appropriations Resolution, 2013 (P.L. 112–175). The amounts
                included for 2013 reflect the annualized level provided by the continuing resolution.
          Program and Financing (in millions of dollars)

                      Identification code 75–1503–0–1–609
                      2012 actual
                      2013 CR
                      2014 est.

                      Obligations by program activity:

                      0001
                      Refugee and entrant assistance
                      507
                      587
                      607

                      0002
                      Assistance for treatment of torture victims
                      11
                      11
                      11

                      0003
                      Unaccompanied alien children
                      274
                      302
                      495

                      0005
                      Domestic Trafficking Victims program

                      10

                      0900
                      Total new obligations
                      792
                      900
                      1,123

                      Budgetary Resources:

                      Unobligated balance:

                      1000
                      Unobligated balance brought forward, Oct 1
                      24
                      1
                      1

                      1021
                      Recoveries of prior year unpaid obligations
                      1

                      1050
                      Unobligated balance (total)
                      25
                      1
                      1

                      Budget authority:

                      Appropriations, discretionary:

                      1100
                      Appropriation
                      769
                      900
                      1,123

                      1130
                      Appropriations permanently reduced
                      –1

                      1160
                      Appropriation, discretionary (total)
                      768
                      900
                      1,123

                      1930
                      Total budgetary resources available
                      793
                      901
                      1,124

                      Memorandum (non-add) entries:

                      1941
                      Unexpired unobligated balance, end of year
                      1
                      1
                      1

                      Change in obligated balance:

                      Unpaid obligations:

                      3000
                      Unpaid obligations, brought forward, Oct 1
                      567
                      544
                      552

                      3010
                      Obligations incurred, unexpired accounts
                      792
                      900
                      1,123

                      3011
                      Obligations incurred, expired accounts
                      1

                      3020
                      Outlays (gross)
                      –802
                      –892
                      –952

                      3040
                      Recoveries of prior year unpaid obligations, unexpired
                      –1

                      3041
                      Recoveries of prior year unpaid obligations, expired
                      –13

                      3050
                      Unpaid obligations, end of year
                      544
                      552
                      723

                      Memorandum (non-add) entries:

                      3100
                      Obligated balance, start of year
                      567
                      544
                      552

                      3200
                      Obligated balance, end of year
                      544
                      552
                      723

                      Budget authority and outlays, net:

                      Discretionary:

                      4000
                      Budget authority, gross
                      768
                      900
                      1,123

                      Outlays, gross:

                      4010
                      Outlays from new discretionary authority
                      435
                      450
                      562

                      4011
                      Outlays from discretionary balances
                      367
                      442
                      390

                      4020
                      Outlays, gross (total)
                      802
                      892
                      952

                      4180
                      Budget authority, net (total)
                      768
                      900
                      1,123

                      4190
                      Outlays, net (total)
                      802
                      892
                      952

             This program provides funds to States and non-governmental organizations for administering the refugee and entrant assistance
                program.  Funds also are provided to assist in the rehabilitation of victims of torture, trafficking victims, and the care
                and placement of unaccompanied alien children. Additional funding is included to address the increase in unaccompanied alien
                children and for a new initiative aimed at preventing human trafficking and providing direct services to domestic victims.

          Object Classification (in millions of dollars)

                      Identification code 75–1503–0–1–609
                      2012 actual
                      2013 CR
                      2014 est.

                      Direct obligations:

                      11.1
                      Personnel compensation: Full-time permanent
                      4
                      5
                      6

                      12.1
                      Civilian personnel benefits
                      1
                      1
                      2

                      23.1
                      Rental payments to GSA
                      2
                      2
                      2

                      25.1
                      Advisory and assistance services
                      35
                      20
                      31

                      25.2
                      Other services from non-Federal sources
                      5
                      6
                      7

                      25.3
                      Other goods and services from Federal sources
                      4
                      24
                      30

                      41.0
                      Grants, subsidies, and contributions
                      741
                      842
                      1,045

                      99.9
                      Total new obligations
                      792
                      900
                      1,123

          Employment Summary

                      Identification code 75–1503–0–1–609
                      2012 actual
                      2013 CR
                      2014 est.

                      1001
                      Direct civilian full-time equivalent employment
                      45
                      54
                      64

             Supporting Health Families and Adolescent DevelopmentFor carrying out, except as otherwise provided, section 436 of the Social Security Act, $345,000,000 and, in addition, for carrying out, except as otherwise provided, section 437 of such Act, $63,065,000.  Note.—A full-year 2013 appropriation for this account was not enacted at the time the budget was prepared; therefore, the
                budget assumes this account is operating under the Continuing Appropriations Resolution, 2013 (P.L. 112–175). The amounts
                included for 2013 reflect the annualized level provided by the continuing resolution.
          Program and Financing (in millions of dollars)

                      Identification code 75–1512–0–1–506
                      2012 actual
                      2013 CR
                      2014 est.

                      Obligations by program activity:

                      0001
                      Grants to States and Tribes
                      368
                      368
                      368

                      0002
                      Research, training and technical assistance
                      8
                      8
                      8

                      0003
                      State court improvement activities
                      32
                      32
                      32

                      0004
                      Family Connection Grants
                      15
                      15

                      0005
                      PREP
                      84
                      84
                      82

                      0006
                      Abstinence Education
                      39
                      37
                      37

                      0900
                      Total new obligations
                      546
                      544
                      527

                      Budgetary Resources:

                      Unobligated balance:

                      1000
                      Unobligated balance brought forward, Oct 1
                      25
                      16
                      20

                      Budget authority:

                      Appropriations, discretionary:

                      1100
                      Appropriation
                      63
                      63
                      75

                      1130
                      Appropriations permanently reduced

                      –12

                      1160
                      Appropriation, discretionary (total)
                      63
                      63
                      63

                      Appropriations, mandatory:

                      1200
                      Appropriation
                      485
                      485
                      470

                      1260
                      Appropriations, mandatory (total)
                      485
                      485
                      470

                      1900
                      Budget authority (total)
                      548
                      548
                      533

                      1930
                      Total budgetary resources available
                      573
                      564
                      553

                      Memorandum (non-add) entries:

                      1940
                      Unobligated balance expiring
                      –11

                      1941
                      Unexpired unobligated balance, end of year
                      16
                      20
                      26

                      Change in obligated balance:

                      Unpaid obligations:

                      3000
                      Unpaid obligations, brought forward, Oct 1
                      614
                      678
                      708

                      3010
                      Obligations incurred, unexpired accounts
                      546
                      544
                      527

                      3020
                      Outlays (gross)
                      –476
                      –511
                      –525

                      3041
                      Recoveries of prior year unpaid obligations, expired
                      –6
                      –3

                      3050
                      Unpaid obligations, end of year
                      678
                      708
                      710

                      Memorandum (non-add) entries:

                      3100
                      Obligated balance, start of year
                      614
                      678
                      708

                      3200
                      Obligated balance, end of year
                      678
                      708
                      710

                      Budget authority and outlays, net:

                      Discretionary:

                      4000
                      Budget authority, gross
                      63
                      63
                      63

                      Outlays, gross:

                      4010
                      Outlays from new discretionary authority
                      19
                      20
                      24

                      4011
                      Outlays from discretionary balances
                      38
                      43
                      44

                      4020
                      Outlays, gross (total)
                      57
                      63
                      68

                      Mandatory:

                      4090
                      Budget authority, gross
                      485
                      485
                      470

                      Outlays, gross:

                      4100
                      Outlays from new mandatory authority
                      91
                      98
                      98

                      4101
                      Outlays from mandatory balances
                      328
                      350
                      359

                      4110
                      Outlays, gross (total)
                      419
                      448
                      457

                      4180
                      Budget authority, net (total)
                      548
                      548
                      533

                      4190
                      Outlays, net (total)
                      476
                      511
                      525

          Summary of Budget Authority and Outlays (in millions of dollars)

                      2012 actual
                      2013 CR
                      2014 est.

                      Enacted/requested:

                      Budget Authority
                      548
                      548
                      533

                      Outlays
                      476
                      511
                      525

                      Legislative proposal, subject to PAYGO:

                      Budget Authority

                      15

                      Total:

                      Budget Authority
                      548
                      548
                      548

                      Outlays
                      476
                      511
                      525

             This account provides funds for a broad range of child welfare services, including family preservation and family support
                services. Additionally, this account includes funding for the Personal Responsibility Education Program (PREP) and Abstinence
                Education which were made available by the Patient Protection and Affordable Care Act (P.L. 111–148). This account also includes
                a new initiative to prevent pregnancy among youth in foster care.

          Object Classification (in millions of dollars)

                      Identification code 75–1512–0–1–506
                      2012 actual
                      2013 CR
                      2014 est.

                      Direct obligations:

                      11.1
                      Personnel compensation: Full-time permanent
                      1
                      1
                      1

                      25.1
                      Advisory and assistance services
                      12
                      11
                      11

                      25.3
                      Other goods and services from Federal sources
                      2
                      3
                      2

                      41.0
                      Grants, subsidies, and contributions
                      531
                      529
                      513

                      99.9
                      Total new obligations
                      546
                      544
                      527

          Employment Summary

                      Identification code 75–1512–0–1–506
                      2012 actual
                      2013 CR
                      2014 est.

                      1001
                      Direct civilian full-time equivalent employment
                      10
                      10
                      10

             Supporting Healthy Families and Adolescent Development

             (Legislative proposal, subject to PAYGO)Program and Financing (in millions of dollars)

                      Identification code 75–1512–4–1–506
                      2012 actual
                      2013 CR
                      2014 est.

                      Obligations by program activity:

                      0004
                      Family Connection Grants

                      15

                      Budgetary Resources:

                      Budget authority:

                      Appropriations, mandatory:

                      1200
                      Appropriation

                      15

                      1260
                      Appropriations, mandatory (total)

                      15

                      1900
                      Budget authority (total)

                      15

                      1930
                      Total budgetary resources available

                      15

                      Change in obligated balance:

                      Unpaid obligations:

                      3010
                      Obligations incurred, unexpired accounts

                      15

                      3050
                      Unpaid obligations, end of year

                      15

                      Memorandum (non-add) entries:

                      3200
                      Obligated balance, end of year

                      15

                      Budget authority and outlays, net:

                      Mandatory:

                      4090
                      Budget authority, gross

                      15

                      4180
                      Budget authority, net (total)

                      15

          Object Classification (in millions of dollars)

                      Identification code 75–1512–4–1–506
                      2012 actual
                      2013 CR
                      2014 est.

                      Direct obligations:

                      25.1
                      Advisory and assistance services

                      1

                      41.0
                      Grants, subsidies, and contributions

                      14

                      99.9
                      Total new obligations

                      15

             Child Care Entitlement to States

             Program and Financing (in millions of dollars)

                      Identification code 75–1550–0–1–609
                      2012 actual
                      2013 CR
                      2014 est.

                      Obligations by program activity:

                      0001
                      Mandatory child care
                      1,178
                      1,178
                      1,178

                      0002
                      Matching child care
                      1,697
                      1,674
                      1,674

                      0003
                      Training and technical assistance
                      7
                      7
                      7

                      0004
                      Child care tribal grants
                      58
                      58
                      58

                      0900
                      Total new obligations
                      2,940
                      2,917
                      2,917

                      Budgetary Resources:

                      Unobligated balance:

                      1012
                      Unobligated balance transfers between expired and unexpired accounts
                      23

                      1050
                      Unobligated balance (total)
                      23

                      Budget authority:

                      Appropriations, mandatory:

                      1200
                      Appropriation
                      2,917
                      2,917
                      2,917

                      1260
                      Appropriations, mandatory (total)
                      2,917
                      2,917
                      2,917

                      1900
                      Budget authority (total)
                      2,917
                      2,917
                      2,917

                      1930
                      Total budgetary resources available
                      2,940
                      2,917
                      2,917

                      Change in obligated balance:

                      Unpaid obligations:

                      3000
                      Unpaid obligations, brought forward, Oct 1
                      609
                      710
                      719

                      3010
                      Obligations incurred, unexpired accounts
                      2,940
                      2,917
                      2,917

                      3020
                      Outlays (gross)
                      –2,828
                      –2,908
                      –2,916

                      3041
                      Recoveries of prior year unpaid obligations, expired
                      –11

                      3050
                      Unpaid obligations, end of year
                      710
                      719
                      720

                      Memorandum (non-add) entries:

                      3100
                      Obligated balance, start of year
                      609
                      710
                      719

                      3200
                      Obligated balance, end of year
                      710
                      719
                      720

                      Budget authority and outlays, net:

                      Mandatory:

                      4090
                      Budget authority, gross
                      2,917
                      2,917
                      2,917

                      Outlays, gross:

                      4100
                      Outlays from new mandatory authority
                      2,291
                      2,363
                      2,363

                      4101
                      Outlays from mandatory balances
                      537
                      545
                      553

                      4110
                      Outlays, gross (total)
                      2,828
                      2,908
                      2,916

                      4180
                      Budget authority, net (total)
                      2,917
                      2,917
                      2,917

                      4190
                      Outlays, net (total)
                      2,828
                      2,908
                      2,916

          Summary of Budget Authority and Outlays (in millions of dollars)

                      2012 actual
                      2013 CR
                      2014 est.

                      Enacted/requested:

                      Budget Authority
                      2,917
                      2,917
                      2,917

                      Outlays
                      2,828
                      2,908
                      2,916

                      Legislative proposal, subject to PAYGO:

                      Budget Authority

                      500

                      Outlays

                      406

                      Total:

                      Budget Authority
                      2,917
                      2,917
                      3,417

                      Outlays
                      2,828
                      2,908
                      3,322

             This account provides child care subsidies for low-income working families and was established by the Personal Responsibility
                and Work Opportunity Reconciliation Act of 1996 (P.L. 104–193), as amended by the Deficit Reduction Act of 2005 (P.L. 109–171).
                Since 2010, this account has been temporarily reauthorized by a series of Acts and at the time the Budget was prepared was
                operating under the Continuing Appropriations Resolution, 2013 (P.L. 112–175).

          Object Classification (in millions of dollars)

                      Identification code 75–1550–0–1–609
                      2012 actual
                      2013 CR
                      2014 est.

                      Direct obligations:

                      25.1
                      Advisory and assistance services
                      7
                      1
                      1

                      25.2
                      Other services from non-Federal sources
                      11
                      6
                      6

                      41.0
                      Grants, subsidies, and contributions
                      2,922
                      2,910
                      2,910

                      99.9
                      Total new obligations
                      2,940
                      2,917
                      2,917

             Child Care Entitlement to States

             (Legislative proposal, subject to PAYGO)Program and Financing (in millions of dollars)

                      Identification code 75–1550–4–1–609
                      2012 actual
                      2013 CR
                      2014 est.

                      Obligations by program activity:

                      0002
                      Matching child care

                      480

                      0003
                      Training and technical assistance

                      10

                      0004
                      Child care tribal grants

                      10

                      0900
                      Total new obligations

                      500

                      Budgetary Resources:

                      Budget authority:

                      Appropriations, mandatory:

                      1200
                      Appropriation

                      500

                      1260
                      Appropriations, mandatory (total)

                      500

                      1900
                      Budget authority (total)

                      500

                      1930
                      Total budgetary resources available

                      500

                      Change in obligated balance:

                      Unpaid obligations:

                      3010
                      Obligations incurred, unexpired accounts

                      500

                      3020
                      Outlays (gross)

                      –406

                      3050
                      Unpaid obligations, end of year

                      94

                      Memorandum (non-add) entries:

                      3200
                      Obligated balance, end of year

                      94

                      Budget authority and outlays, net:

                      Mandatory:

                      4090
                      Budget authority, gross

                      500

                      Outlays, gross:

                      4100
                      Outlays from new mandatory authority

                      406

                      4180
                      Budget authority, net (total)

                      500

                      4190
                      Outlays, net (total)

                      406

          Object Classification (in millions of dollars)

                      Identification code 75–1550–4–1–609
                      2012 actual
                      2013 CR
                      2014 est.

                      Direct obligations:

                      25.2
                      Other services from non-Federal sources

                      10

                      41.0
                      Grants, subsidies, and contributions

                      490

                      99.9
                      Total new obligations

                      500

             Payments to States for the Child Care and Development Block GrantFor carrying out the Child Care and Development Block Grant Act of 1990, [$2,303,313,000] $2,278,313,000 shall be used to supplement, not supplant State general revenue funds for child care assistance for low-income families: Provided, That [$19,609,000] $19,396,000 shall be available for child care resource and referral and school-aged child care activities, of which $1,000,000 shall be
             available to the Secretary for a competitive grant for the operation of a national toll free hotline and Web site to develop
             and disseminate child care consumer education information for parents and help parents access child care in their local community:
             Provided further, That, in addition to the amounts required to be reserved by the States under section 658G, [$293,887,000] $290,698,000 shall be reserved by the States for activities authorized under section 658G, of which [$107,781,000] $106,611,000 shall be for activities that improve the quality of infant and toddler care: Provided further, That $9,871,000 shall be for use by the Secretary for child care research, demonstration, and evaluation activities.

          In addition, [$300,000,000, for grants to States to improve the quality of child care and for the Federal costs of carrying out evaluations] $200,000,000, to be allocated by the Secretary for discretionary grants to States to improve the quality of child care, including
                health and safety measures, under section 658I(a)(1) of such Act. Note.—A full-year 2013 appropriation for this account was not enacted at the time the budget was prepared; therefore, the
                budget assumes this account is operating under the Continuing Appropriations Resolution, 2013 (P.L. 112–175). The amounts
                included for 2013 reflect the annualized level provided by the continuing resolution.
          Program and Financing (in millions of dollars)

                      Identification code 75–1515–0–1–609
                      2012 actual
                      2013 CR
                      2014 est.

                      Obligations by program activity:

                      0001
                      Block grant payments to States
                      2,268
                      2,282
                      2,468

                      0004
                      Research and evaluation fund
                      10
                      10
                      10

                      0900
                      Total new obligations
                      2,278
                      2,292
                      2,478

                      Budgetary Resources:

                      Budget authority:

                      Appropriations, discretionary:

                      1100
                      Appropriation
                      2,282
                      2,292
                      2,478

                      1130
                      Appropriations permanently reduced
                      –4

                      1160
                      Appropriation, discretionary (total)
                      2,278
                      2,292
                      2,478

                      1930
                      Total budgetary resources available
                      2,278
                      2,292
                      2,478

                      Change in obligated balance:

                      Unpaid obligations:

                      3000
                      Unpaid obligations, brought forward, Oct 1
                      478
                      555
                      561

                      3010
                      Obligations incurred, unexpired accounts
                      2,278
                      2,292
                      2,478

                      3020
                      Outlays (gross)
                      –2,200
                      –2,286
                      –2,442

                      3041
                      Recoveries of prior year unpaid obligations, expired
                      –1

                      3050
                      Unpaid obligations, end of year
                      555
                      561
                      597

                      Memorandum (non-add) entries:

                      3100
                      Obligated balance, start of year
                      478
                      555
                      561

                      3200
                      Obligated balance, end of year
                      555
                      561
                      597

                      Budget authority and outlays, net:

                      Discretionary:

                      4000
                      Budget authority, gross
                      2,278
                      2,292
                      2,478

                      Outlays, gross:

                      4010
                      Outlays from new discretionary authority
                      1,788
                      1,857
                      2,007

                      4011
                      Outlays from discretionary balances
                      412
                      429
                      435

                      4020
                      Outlays, gross (total)
                      2,200
                      2,286
                      2,442

                      4180
                      Budget authority, net (total)
                      2,278
                      2,292
                      2,478

                      4190
                      Outlays, net (total)
                      2,200
                      2,286
                      2,442

             This program provides grants to States for child care subsidies for low-income working families and activities to improve
                child care quality. In FY 2014, it includes a new initiative to improve the quality of child care, including healthy and safety
                measures.

          Object Classification (in millions of dollars)

                      Identification code 75–1515–0–1–609
                      2012 actual
                      2013 CR
                      2014 est.

                      Direct obligations:

                      25.1
                      Advisory and assistance services
                      14
                      13
                      13

                      25.2
                      Other services from non-Federal sources
                      10

                      25.3
                      Other goods and services from Federal sources
                      1
                      1
                      1

                      41.0
                      Grants, subsidies, and contributions
                      2,253
                      2,278
                      2,464

                      99.9
                      Total new obligations
                      2,278
                      2,292
                      2,478

             Social Services Block GrantFor 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-A of such Act shall be 10 percent.  Note.—A full-year 2013 appropriation for this account was not enacted at the time the budget was prepared; therefore, the
                budget assumes this account is operating under the Continuing Appropriations Resolution, 2013 (P.L. 112–175). The amounts
                included for 2013 reflect the annualized level provided by the continuing resolution.
          Program and Financing (in millions of dollars)

                      Identification code 75–1534–0–1–506
                      2012 actual
                      2013 CR
                      2014 est.

                      Obligations by program activity:

                      0001
                      Social Services Block Grant
                      1,700
                      1,700
                      1,700

                      0002
                      Health Profession Opportunity Grants
                      85
                      85
                      85

                      0003
                      Emergency Funding

                      500

                      0900
                      Total new obligations
                      1,785
                      2,285
                      1,785

                      Budgetary Resources:

                      Unobligated balance:

                      1000
                      Unobligated balance brought forward, Oct 1
                      30
                      30
                      30

                      Budget authority:

                      Appropriations, mandatory:

                      1200
                      Appropriation
                      1,785
                      1,785
                      1,785

                      1221
                      Appropriations transferred from other accts [75–0140]

                      500

                      1260
                      Appropriations, mandatory (total)
                      1,785
                      2,285
                      1,785

                      1930
                      Total budgetary resources available
                      1,815
                      2,315
                      1,815

                      Memorandum (non-add) entries:

                      1941
                      Unexpired unobligated balance, end of year
                      30
                      30
                      30

                      Change in obligated balance:

                      Unpaid obligations:

                      3000
                      Unpaid obligations, brought forward, Oct 1
                      580
                      572
                      893

                      3010
                      Obligations incurred, unexpired accounts
                      1,785
                      2,285
                      1,785

                      3020
                      Outlays (gross)
                      –1,715
                      –1,964
                      –2,062

                      3041
                      Recoveries of prior year unpaid obligations, expired
                      –78

                      3050
                      Unpaid obligations, end of year
                      572
                      893
                      616

                      Memorandum (non-add) entries:

                      3100
                      Obligated balance, start of year
                      580
                      572
                      893

                      3200
                      Obligated balance, end of year
                      572
                      893
                      616

                      Budget authority and outlays, net:

                      Mandatory:

                      4090
                      Budget authority, gross
                      1,785
                      2,285
                      1,785

                      Outlays, gross:

                      4100
                      Outlays from new mandatory authority
                      1,359
                      1,498
                      1,398

                      4101
                      Outlays from mandatory balances
                      356
                      466
                      664

                      4110
                      Outlays, gross (total)
                      1,715
                      1,964
                      2,062

                      4180
                      Budget authority, net (total)
                      1,785
                      2,285
                      1,785

                      4190
                      Outlays, net (total)
                      1,715
                      1,964
                      2,062

          Object Classification (in millions of dollars)

                      Identification code 75–1534–0–1–506
                      2012 actual
                      2013 CR
                      2014 est.

                      Direct obligations:

                      11.1
                      Personnel compensation: Full-time permanent
                      1
                      1
                      1

                      25.1
                      Advisory and assistance services
                      16
                      16
                      16

                      41.0
                      Grants, subsidies, and contributions
                      1,768
                      2,268
                      1,768

                      99.9
                      Total new obligations
                      1,785
                      2,285
                      1,785

          Employment Summary

                      Identification code 75–1534–0–1–506
                      2012 actual
                      2013 CR
                      2014 est.

                      1001
                      Direct civilian full-time equivalent employment
                      7
                      7
                      7

             Children and Families Services ProgramsFor 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 303 and 313 of the Family Violence Prevention
             and Services Act, the Native American Programs Act of 1974, title II of the Child Abuse Prevention and Treatment and Adoption
             Reform Act of 1978 (adoption opportunities), the Abandoned Infants Assistance Act of 1988, [section 291 of the Help America Vote Act of 2002,] part B-1 of title IV and sections 413, 1110, and 1115 of the Social Security Act; for making payments under the Community
             Services Block Grant Act ("CSBG Act''), sections 473B and 477(i) of the Social Security Act, and the Assets for Independence
             Act; and for necessary administrative expenses to carry out such Acts and titles I, IV, V, X, XI, XIV, XVI, and XX of the
             Social Security Act, the Act of July 5, 1960, the Low Income Home Energy Assistance Act of 1981, title IV of the Immigration
             and Nationality Act, [and] section 501 of the Refugee Education Assistance Act of 1980, and for the administration of prior year obligations made by the Administration for Children and Families under the Developmental
                Disabilities Assistance and Bill of Rights Act and the Help America Vote Act of 2002, [$9,688,767,000]$11,083,182,000, of which $39,346,000, to remain available through September 30, [2014]2015, shall be for grants to States for adoption incentive payments, as authorized by section 473A of the Social Security Act
             and may be made for adoptions completed before September 30, [2013]2014: Provided, That [$8,054,000,000]$9,621,070,000 shall be for making payments under the Head Start Act: Provided further, That of the amount in the previous proviso, [$7,968,543,933]$8,190,694,000 shall be available for payments under section 640 of the Head Start Act [at the same level of such payments for FY 2012;] of which [$40,000,000]$25,000,000 shall be available [through fiscal year 2014] for allocation by the Secretary to supplement activities described in paragraphs (7)(B) and (9) of section 641(c) of such
             Act under the Designation Renewal System, established under the authority of sections 641(c)(7), 645A(b)(12) and 645A(d) of
             such Act[; and of which $45,456,067 shall be available for carrying out the cost of living adjustment described in section 640(a)(3)(A)(ii)(II)(aa)
             of such Act]: Provided further, That amounts allocated to Head Start grantees at the discretion of the Secretary to supplement activities pursuant to the
             previous proviso shall not be included in the calculation of the "base grant" in subsequent fiscal years, as such term is
             used in section 640(a)(7)(A) of the Head Start Act: Provided further, That notwithstanding section 640 of the Head Start Act, of the amount described in the first proviso, $1,430,376,000
                shall be available to entities defined as eligible under section 645A(d) of such Act for expansion of Early Head Start programs
                as described in section 645(A) of such Act, for conversion of Head Start services to Early Head Start services as described
                in section 645(a)(5)(A) of such Act, and for new discretionary grants for high quality infant and toddler care through Early
                Head Start-Child Care Partnerships, and, notwithstanding section 645A(c)(2) of such Act, these funds are available to serve
                children under age 4: Provided further, That of the amount made available in the immediately preceding proviso, up to $15,000,000
                shall be available for the Federal costs of administration and evaluation activities of the program described in such proviso:
                Provided further, That an Early Head Start agency awarded funds for an Early Head Start-Child Care Partnership after October
                1, 2014, shall not be subject to the requirements of the system for designation renewal as defined by section 641 of the Head
                Start Act, for this award only, prior to 18 months after the date of such award: Provided further, That [$379,943,000]$350,000,000 shall be for making payments under the CSBG Act: Provided further, That [$30,293,000 shall be for sections 680 and 678E(b)(2) of the CSBG Act, of which not less than $29,943,000 shall be for section
             680(a)(2) of such Act]no more than $350,000 shall be reserved under section 674(b)(3) of the CSBG Act, all of which shall be available solely for
                carrying out section 678E(b)(2) of such Act: Provided further, That, to the extent funds for the Assets for Independence Act are distributed as grant funds to a qualified entity and have
             not been expended by such entity within three years after the date of award, such funds may be recaptured and reallocated
             among other qualified entities, to remain available for five years: Provided further, That, notwithstanding section 414(e) of the Assets for Independence Act, the Secretary may award up to $1,000,000 to support
             evidence-based research to evaluate the demonstration project: [Provided further, That amounts provided herein to carry out section 1110 of the Social Security Act shall remain available until expended:] Provided further, That, in addition to amounts provided herein, $5,762,000 shall be available from amounts available under section 241 of
             the PHS Act to carry out the provisions of section 1110 of the Social Security Act: Provided further, That amounts provided under this heading to carry out section 1110 of the Social Security Act, other than
                amounts made available for that purpose under the immediately preceeding proviso, shall remain available until expended; 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 CSBG 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 assets and program income that permit
             such assets acquired with, and program income derived from, grant funds authorized under section 680 of the CSBG Act to become
             the sole property of such grantees after a period of not more than 12 years after the end of the grant period for any activity
             consistent with section 680(a)(2)(A) of the CSBG Act: Provided further, That intangible assets in the form of loans, equity investments and other debt instruments, and program income may be used
             by grantees for any eligible purpose consistent with section 680(a)(2)(A) of the CSBG Act: Provided further, That these procedures shall apply to such grant funds made available after November 29, 1999: Provided further, That funds appropriated for section 680(a)(2) of the CSBG Act shall be available for financing construction and rehabilitation
             and loans or investments in private business enterprises owned by community development corporations: [Provided further, That $5,235,000 shall be for activities authorized by section 291 of the Help America Vote Act of 2002:] Provided further, That [$1,996,000]$1,992,000 shall be for a human services case management system for federally declared disasters, to include a comprehensive national
             case management contract and Federal costs of administering the system: Provided further, That section 303 (a)(2)(A)(i) of the Family Violence Prevention and Services Act shall not apply to amounts provided herein:
             Provided further, That up to $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.  Note.—A full-year 2013 appropriation for this account was not enacted at the time the budget was prepared; therefore, the
                budget assumes this account is operating under the Continuing Appropriations Resolution, 2013 (P.L. 112–175). The amounts
                included for 2013 reflect the annualized level provided by the continuing resolution as well as amounts from P.L. 113–2, the
                Disaster Relief Appropriations Act, 2013 (no language shown).
          Program and Financing (in millions of dollars)

                      Identification code 75–1536–0–1–506
                      2012 actual
                      2013 CR
                      2014 est.

                      Obligations by program activity:

                      0101
                      Head start
                      7,968
                      8,017
                      9,621

                      0102
                      Head Start Emergency Hurricane Sandy funding

                      15
                      50

                      0103
                      Runaway and homeless youth (basic centers)
                      53
                      54
                      53

                      0104
                      Transitional living
                      44
                      44
                      44

                      0105
                      Prevalence, Needs and Characteristics of Homeless Youth

                      3

                      0106
                      Education grants to reduce sexual abuse of runaway youth
                      18
                      18
                      18

                      0109
                      Child abuse State grants
                      26
                      26
                      26

                      0110
                      Child abuse discretionary activities
                      26
                      26
                      26

                      0111
                      Community-based child abuse prevention
                      42
                      42
                      42

                      0112
                      Child welfare services
                      281
                      282
                      281

                      0113
                      Child welfare training, research, or demonstration projects
                      26
                      26
                      26

                      0114
                      Adoption opportunities
                      39
                      40
                      39

                      0115
                      Abandoned infants assistance
                      12
                      12
                      11

                      0116
                      Adoption incentives
                      42
                      40
                      39

                      0117
                      Independent living training vouchers
                      45
                      45
                      45

                      0119
                      State councils on developmental disabilities
                      75
                      75

                      0120
                      Protection and advocacy
                      41
                      41

                      0121
                      Projects of national significance
                      8
                      9

                      0122
                      University centers for excellence
                      39
                      39

                      0123
                      Voting access for individuals with disabilities
                      5
                      5

                      0124
                      Native American programs
                      49
                      49
                      49

                      0125
                      Social services and income maintenance research

                      44

                      0128
                      Federal administration
                      199
                      205
                      204

                      0129
                      Center for faith-based and community initiatives
                      1
                      1
                      1

                      0131
                      Disaster human services case management
                      2
                      2
                      2

                      0191
                      Direct program activities, subtotal
                      9,041
                      9,113
                      10,624

                      0301
                      Community services block grant
                      677
                      682
                      350

                      0303
                      Rural community facilities
                      5
                      5

                      0304
                      Community services discretionary (JOLI & CED)
                      30
                      30

                      0306
                      Assets for independence
                      20
                      20
                      19

                      0308
                      Domestic violence hotline
                      3
                      3
                      5

                      0309
                      Family violence prevention and services
                      129
                      131
                      135

                      0391
                      Direct program activities, subtotal
                      864
                      871
                      509

                      0400
                      Total, direct program
                      9,905
                      9,984
                      11,133

                      0799
                      Total direct obligations
                      9,905
                      9,984
                      11,133

                      0801
                      Reimbursable program
                      53
                      25
                      25

                      0809
                      Reimbursable program activities, subtotal
                      53
                      25
                      25

                      0900
                      Total new obligations
                      9,958
                      10,009
                      11,158

                      Budgetary Resources:

                      Unobligated balance:

                      1000
                      Unobligated balance brought forward, Oct 1
                      2
                      3
                      88

                      1001
                      Discretionary unobligated balance brought fwd, Oct 1
                      2
                      3

                      1021
                      Recoveries of prior year unpaid obligations
                      3

                      1050
                      Unobligated balance (total)
                      5
                      3
                      88

                      Budget authority:

                      Appropriations, discretionary:

                      1100
                      Appropriation
                      9,927
                      9,969
                      11,083

                      1121
                      Discretionary Emergency pursuant to 2011 Budget Control Act [75–0140]

                      100

                      1130
                      Appropriations permanently reduced
                      –19

                      1160
                      Appropriation, discretionary (total)
                      9,908
                      10,069
                      11,083

                      Spending authority from offsetting collections, discretionary:

                      1700
                      Collected
                      46
                      24
                      24

                      1701
                      Change in uncollected payments, Federal sources
                      5

                      1750
                      Spending auth from offsetting collections, disc (total)
                      51
                      24
                      24

                      Spending authority from offsetting collections, mandatory:

                      1800
                      Collected
                      1
                      1
                      1

                      1801
                      Change in uncollected payments, Federal sources
                      1

                      1850
                      Spending auth from offsetting collections, mand (total)
                      2
                      1
                      1

                      1900
                      Budget authority (total)
                      9,961
                      10,094
                      11,108

                      1930
                      Total budgetary resources available
                      9,966
                      10,097
                      11,196

                      Memorandum (non-add) entries:

                      1940
                      Unobligated balance expiring
                      –5

                      1941
                      Unexpired unobligated balance, end of year
                      3
                      88
                      38

                      Change in obligated balance:

                      Unpaid obligations:

                      3000
                      Unpaid obligations, brought forward, Oct 1
                      6,703
                      6,626
                      6,793

                      3010
                      Obligations incurred, unexpired accounts
                      9,958
                      10,009
                      11,158

                      3020
                      Outlays (gross)
                      –9,909
                      –9,842
                      –10,461

                      3040
                      Recoveries of prior year unpaid obligations, unexpired
                      –3

                      3041
                      Recoveries of prior year unpaid obligations, expired
                      –123

                      3050
                      Unpaid obligations, end of year
                      6,626
                      6,793
                      7,490

                      Uncollected payments:

                      3060
                      Uncollected pymts, Fed sources, brought forward, Oct 1
                      –7
                      –10
                      –10

                      3070
                      Change in uncollected pymts, Fed sources, unexpired
                      –6

                      3071
                      Change in uncollected pymts, Fed sources, expired
                      3

                      3090
                      Uncollected pymts, Fed sources, end of year
                      –10
                      –10
                      –10

                      Memorandum (non-add) entries:

                      3100
                      Obligated balance, start of year
                      6,696
                      6,616
                      6,783

                      3200
                      Obligated balance, end of year
                      6,616
                      6,783
                      7,480

                      Budget authority and outlays, net:

                      Discretionary:

                      4000
                      Budget authority, gross
                      9,959
                      10,093
                      11,107

                      Outlays, gross:

                      4010
                      Outlays from new discretionary authority
                      4,180
                      4,217
                      4,681

                      4011
                      Outlays from discretionary balances
                      5,726
                      5,623
                      5,778

                      4020
                      Outlays, gross (total)
                      9,906
                      9,840
                      10,459

                      Offsets against gross budget authority and outlays:

                      Offsetting collections (collected) from:

                      4030
                      Federal sources
                      –49
                      –18
                      –18

                      4033
                      Non-Federal sources

                      –6
                      –6

                      4040
                      Offsets against gross budget authority  and outlays (total)
                      –49
                      –24
                      –24

                      Additional offsets against gross budget authority only:

                      4050
                      Change in uncollected pymts, Fed sources, unexpired
                      –5

                      4052
                      Offsetting collections credited to expired accounts
                      3

                      4060
                      Additional offsets against budget authority only (total)
                      –2

                      4070
                      Budget authority, net (discretionary)
                      9,908
                      10,069
                      11,083

                      4080
                      Outlays, net (discretionary)
                      9,857
                      9,816
                      10,435

                      Mandatory:

                      4090
                      Budget authority, gross
                      2
                      1
                      1

                      Outlays, gross:

                      4100
                      Outlays from new mandatory authority
                      2
                      1
                      1

                      4101
                      Outlays from mandatory balances
                      1
                      1
                      1

                      4110
                      Outlays, gross (total)
                      3
                      2
                      2

                      Offsets against gross budget authority and outlays:

                      Offsetting collections (collected) from:

                      4120
                      Federal sources
                      –1
                      –1
                      –1

                      Additional offsets against gross budget authority only:

                      4140
                      Change in uncollected pymts, Fed sources, unexpired
                      –1

                      4170
                      Outlays, net (mandatory)
                      2
                      1
                      1

                      4180
                      Budget authority, net (total)
                      9,908
                      10,069
                      11,083

                      4190
                      Outlays, net (total)
                      9,859
                      9,817
                      10,436

              The request prioritizes investments in early learning to improve outcomes for children.  A total of $9.6 billion is requested
                to support an early learning initiative to expand access to high quality infant and toddler care, maintain the number of children
                served in Head Start, and support the transition between new and incumbent Head Start grantees in the Designation Renewal
                System. This Budget also requests an additional $7 million for family violence prevention, $35 million for an initiative to
                address marriage disincentives, and $3 million to study the prevalence, needs and characteristics of homeless youth. This
                request discontinues funding for the Rural Communities Facilities and the Community Economic Development programs.

          Object Classification (in millions of dollars)

                      Identification code 75–1536–0–1–506
                      2012 actual
                      2013 CR
                      2014 est.

                      Direct obligations:

                      Personnel compensation:

                      11.1
                      Full-time permanent
                      110
                      116
                      121

                      11.3
                      Other than full-time permanent
                      4
                      5
                      5

                      11.5
                      Other personnel compensation
                      2
                      2
                      2

                      11.9
                      Total personnel compensation
                      116
                      123
                      128

                      12.1
                      Civilian personnel benefits
                      30
                      32
                      33

                      21.0
                      Travel and transportation of persons
                      4
                      4
                      4

                      23.1
                      Rental payments to GSA
                      13
                      14
                      14

                      23.2
                      Rental payments to others
                      1
                      1
                      1

                      23.3
                      Communications, utilities, and miscellaneous charges
                      4
                      4
                      4

                      24.0
                      Printing and reproduction
                      1
                      1
                      1

                      25.1
                      Advisory and assistance services
                      234
                      241
                      246

                      25.2
                      Other services from non-Federal sources
                      5
                      4
                      4

                      25.3
                      Other goods and services from Federal sources
                      47
                      49
                      49

                      25.4
                      Operation and maintenance of facilities
                      2
                      2
                      2

                      25.5
                      Research and development contracts
                      1
                      1
                      1

                      26.0
                      Supplies and materials
                      1
                      1
                      1

                      41.0
                      Grants, subsidies, and contributions
                      9,446
                      9,507
                      10,645

                      99.0
                      Direct obligations
                      9,905
                      9,984
                      11,133

                      99.0
                      Reimbursable obligations
                      53
                      25
                      25

                      99.9
                      Total new obligations
                      9,958
                      10,009
                      11,158

          Employment Summary

                      Identification code 75–1536–0–1–506
                      2012 actual
                      2013 CR
                      2014 est.

                      1001
                      Direct civilian full-time equivalent employment
                      1,145
                      1,203
                      1,243

                      1101
                      Direct military average strength employment
                      4
                      6
                      6

                      2001
                      Reimbursable civilian full-time equivalent employment
                      10
                      10
                      10

             Children's Research and Technical Assistance

             Program and Financing (in millions of dollars)

                      Identification code 75–1553–0–1–609
                      2012 actual
                      2013 CR
                      2014 est.

                      Obligations by program activity:

                      0001
                      Training and technical assistance
                      14
                      12
                      12

                      0002
                      Federal parent locator service
                      25
                      25
                      25

                      0004
                      Welfare research
                      15
                      15
                      15

                      0799
                      Total direct obligations
                      54
                      52
                      52

                      0801
                      Reimbursable program FPLS REIMB
                      21
                      26
                      26

                      0900
                      Total new obligations
                      75
                      78
                      78

                      Budgetary Resources:

                      Unobligated balance:

                      1000
                      Unobligated balance brought forward, Oct 1
                      7
                      7
                      7

                      1021
                      Recoveries of prior year unpaid obligations
                      3

                      1050
                      Unobligated balance (total)
                      10
                      7
                      7

                      Budget authority:

                      Appropriations, mandatory:

                      1200
                      Appropriation
                      52
                      52
                      52

                      1260
                      Appropriations, mandatory (total)
                      52
                      52
                      52

                      Spending authority from offsetting collections, mandatory:

                      1800
                      Collected
                      20
                      26
                      26

                      1850
                      Spending auth from offsetting collections, mand (total)
                      20
                      26
                      26

                      1900
                      Budget authority (total)
                      72
                      78
                      78

                      1930
                      Total budgetary resources available
                      82
                      85
                      85

                      Memorandum (non-add) entries:

                      1941
                      Unexpired unobligated balance, end of year
                      7
                      7
                      7

                      Change in obligated balance:

                      Unpaid obligations:

                      3000
                      Unpaid obligations, brought forward, Oct 1
                      61
                      60
                      52

                      3010
                      Obligations incurred, unexpired accounts
                      75
                      78
                      78

                      3020
                      Outlays (gross)
                      –73
                      –86
                      –84

                      3040
                      Recoveries of prior year unpaid obligations, unexpired
                      –3

                      3050
                      Unpaid obligations, end of year
                      60
                      52
                      46

                      Uncollected payments:

                      3060
                      Uncollected pymts, Fed sources, brought forward, Oct 1
                      –5
                      –5
                      –5

                      3090
                      Uncollected pymts, Fed sources, end of year
                      –5
                      –5
                      –5

                      Memorandum (non-add) entries:

                      3100
                      Obligated balance, start of year
                      56
                      55
                      47

                      3200
                      Obligated balance, end of year
                      55
                      47
                      41

                      Budget authority and outlays, net:

                      Mandatory:

                      4090
                      Budget authority, gross
                      72
                      78
                      78

                      Outlays, gross:

                      4100
                      Outlays from new mandatory authority
                      29
                      15
                      15

                      4101
                      Outlays from mandatory balances
                      44
                      71
                      69

                      4110
                      Outlays, gross (total)
                      73
                      86
                      84

                      Offsets against gross budget authority and outlays:

                      Offsetting collections (collected) from:

                      4120
                      Federal sources
                      –19
                      –25
                      –25

                      4123
                      Non-Federal sources
                      –1
                      –1
                      –1

                      4130
                      Offsets against gross budget authority and outlays (total)
                      –20
                      –26
                      –26

                      4160
                      Budget authority, net (mandatory)
                      52
                      52
                      52

                      4170
                      Outlays, net (mandatory)
                      53
                      60
                      58

                      4180
                      Budget authority, net (total)
                      52
                      52
                      52

                      4190
                      Outlays, net (total)
                      53
                      60
                      58

             This account provides funding for research and technical assistance activities established by the Personal Responsibility
                and Work Opportunity Reconciliation Act of 1996 (P.L. 104–193), as amended by the Deficit Reduction Act of 2005 (P.L. 109–171).
                Since 2010, Welfare Research has been temporarily reauthorized by a series of Acts and is currently authorized through March
                27, 2013, in the Continuing Appropriations Resolution, 2013 (P.L. 112–175).

          Object Classification (in millions of dollars)

                      Identification code 75–1553–0–1–609
                      2012 actual
                      2013 CR
                      2014 est.

                      Direct obligations:

                      11.1
                      Personnel compensation: Full-time permanent
                      7
                      7
                      7

                      12.1
                      Civilian personnel benefits
                      2
                      2
                      2

                      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
                      13
                      11
                      11

                      25.2
                      Other services from non-Federal sources
                      15
                      13
                      13

                      25.3
                      Other goods and services from Federal sources
                      7
                      6
                      6

                      25.7
                      Operation and maintenance of equipment
                      4
                      7
                      7

                      41.0
                      Grants, subsidies, and contributions
                      2
                      2
                      2

                      99.0
                      Direct obligations
                      54
                      52
                      52

                      99.0
                      Reimbursable obligations
                      21
                      26
                      26

                      99.9
                      Total new obligations
                      75
                      78
                      78

          Employment Summary

                      Identification code 75–1553–0–1–609
                      2012 actual
                      2013 CR
                      2014 est.

                      1001
                      Direct civilian full-time equivalent employment
                      62
                      70
                      70

             Payments for Foster Care and PermanencyFor [making payments to States or other non-Federal entities under] carrying out, except as otherwise provided, title IV-E of the Social Security Act, [$4,810,000,000] $4,806,000,0000.

          For [making payments to States or other non-Federal entities under] carrying out, except as otherwise provided, title IV-E of the Social Security Act, for the first quarter of fiscal year [2014] 2015, $2,200,000,000.

          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 of the Social Security Act, 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.  Note.—A full-year 2013 appropriation for this account was not enacted at the time the budget was prepared; therefore, the
                budget assumes this account is operating under the Continuing Appropriations Resolution, 2013 (P.L. 112–175). The amounts
                included for 2013 reflect the annualized level provided by the continuing resolution.
          Program and Financing (in millions of dollars)

                      Identification code 75–1545–0–1–609
                      2012 actual
                      2013 CR
                      2014 est.

                      Obligations by program activity:

                      0001
                      Foster care
                      4,180
                      4,286
                      4,279

                      0002
                      Independent living
                      140
                      140
                      140

                      0004
                      Adoption assistance
                      2,296
                      2,369
                      2,463

                      0005
                      Guardianship
                      74
                      123
                      124

                      0006
                      Tribal T&TA
                      3
                      3
                      3

                      0900
                      Total new obligations
                      6,693
                      6,921
                      7,009

                      Budgetary Resources:

                      Budget authority:

                      Appropriations, mandatory:

                      1200
                      Appropriation
                      5,156
                      4,821
                      4,809

                      1260
                      Appropriations, mandatory (total)
                      5,156
                      4,821
                      4,809

                      Advance appropriations, mandatory:

                      1270
                      Advance appropriation
                      1,850
                      2,100
                      2,200

                      1280
                      Advanced appropriation, mandatory (total)
                      1,850
                      2,100
                      2,200

                      1900
                      Budget authority (total)
                      7,006
                      6,921
                      7,009

                      1930
                      Total budgetary resources available
                      7,006
                      6,921
                      7,009

                      Memorandum (non-add) entries:

                      1940
                      Unobligated balance expiring
                      –313

                      Change in obligated balance:

                      Unpaid obligations:

                      3000
                      Unpaid obligations, brought forward, Oct 1
                      1,218
                      979
                      1,153

                      3010
                      Obligations incurred, unexpired accounts
                      6,693
                      6,921
                      7,009

                      3011
                      Obligations incurred, expired accounts
                      2

                      3020
                      Outlays (gross)
                      –6,847
                      –6,744
                      –6,899

                      3041
                      Recoveries of prior year unpaid obligations, expired
                      –87
                      –3
                      –4

                      3050
                      Unpaid obligations, end of year
                      979
                      1,153
                      1,259

                      Memorandum (non-add) entries:

                      3100
                      Obligated balance, start of year
                      1,218
                      979
                      1,153

                      3200
                      Obligated balance, end of year
                      979
                      1,153
                      1,259

                      Budget authority and outlays, net:

                      Mandatory:

                      4090
                      Budget authority, gross
                      7,006
                      6,921
                      7,009

                      Outlays, gross:

                      4100
                      Outlays from new mandatory authority
                      5,878
                      6,027
                      6,113

                      4101
                      Outlays from mandatory balances
                      969
                      717
                      786

                      4110
                      Outlays, gross (total)
                      6,847
                      6,744
                      6,899

                      4180
                      Budget authority, net (total)
                      7,006
                      6,921
                      7,009

                      4190
                      Outlays, net (total)
                      6,847
                      6,744
                      6,899

          Summary of Budget Authority and Outlays (in millions of dollars)

                      2012 actual
                      2013 CR
                      2014 est.

                      Enacted/requested:

                      Budget Authority
                      7,006
                      6,921
                      7,009

                      Outlays
                      6,847
                      6,744
                      6,899

                      Legislative proposal, subject to PAYGO:

                      Budget Authority

                      2

                      Outlays

                      2

                      Total:

                      Budget Authority
                      7,006
                      6,921
                      7,011

                      Outlays
                      6,847
                      6,744
                      6,901

             This account provides formula grants for Foster Care, Adoption Assistance, Guardianship Assistance, and the Chafee Foster
                Care Independence Program as well as technical assistance and implementation services for Tribal programs.

             Foster Care.—The proposed level will support eligible low-income children who must be placed outside the home. An average of 147,300
                children per month are estimated to be served in FY 2014.

             Adoption Assistance.—The proposed funding level will support subsidies for families adopting eligible low-income children with special needs.
                An average of 450,700 children per month are estimated to be served in FY 2014.

             Guardianship Assistance.—The proposed funding level will provide payments for relatives taking legal guardianship of eligible children who have been
                in foster care.  An average of 24,200 children per month are estimated to be served in FY 2014.

          Object Classification (in millions of dollars)

                      Identification code 75–1545–0–1–609
                      2012 actual
                      2013 CR
                      2014 est.

                      Direct obligations:

                      23.1
                      Rental payments to GSA
                      1
                      1
                      1

                      25.1
                      Advisory and assistance services
                      15
                      17
                      22

                      25.3
                      Other goods and services from Federal sources
                      1

                      41.0
                      Grants, subsidies, and contributions
                      6,676
                      6,903
                      6,986

                      99.9
                      Total new obligations
                      6,693
                      6,921
                      7,009

          Employment Summary

                      Identification code 75–1545–0–1–609
                      2012 actual
                      2013 CR
                      2014 est.

                      1001
                      Direct civilian full-time equivalent employment
                      4
                      4
                      4

             Payments for Foster Care and Permanency

             (Legislative proposal, subject to PAYGO)Program and Financing (in millions of dollars)

                      Identification code 75–1545–4–1–609
                      2012 actual
                      2013 CR
                      2014 est.

                      Obligations by program activity:

                      0001
                      Foster care

                      2

                      0900
                      Total new obligations (object class 41.0)

                      2

                      Budgetary Resources:

                      Budget authority:

                      Appropriations, mandatory:

                      1200
                      Appropriation

                      2

                      1260
                      Appropriations, mandatory (total)

                      2

                      1900
                      Budget authority (total)

                      2

                      1930
                      Total budgetary resources available

                      2

                      Change in obligated balance:

                      Unpaid obligations:

                      3010
                      Obligations incurred, unexpired accounts

                      2

                      3020
                      Outlays (gross)

                      –2

                      Budget authority and outlays, net:

                      Mandatory:

                      4090
                      Budget authority, gross

                      2

                      Outlays, gross:

                      4100
                      Outlays from new mandatory authority

                      2

                      4180
                      Budget authority, net (total)

                      2

                      4190
                      Outlays, net (total)

                      2

             This request continues support for the proposal to require that child support payments made on behalf of youth in foster care
                are used in the best interest of the child, rather than as an offset to state and federal child welfare costs.

             Administration for Community Living

             Federal Funds
             Aging and Disability Services Programs
             (including transfer of funds)For carrying out, to the extent not otherwise provided, the Older Americans Act of 1965 ("OAA''), [section 398 and title] titles III and XXIX of the PHS Act, section 119 of the Medicare Improvements for Patients and Providers Act of 2008, section 6021(d) of the Deficit Reduction Act of 2005, [and] title XX-B of the Social Security Act, the Developmental Disabilities Assistance and Bill of Rights Act, parts 2 and 5 of subtitle D of title II of the Help America
                Vote Act of 2002, and for department-wide coordination of policy and program activities that assist individuals with disabilities,
                [$1,926,434,000] $2,042,640,000, together with [$51,902,000] $52,115,000 to be transferred from the Federal Hospital Insurance Trust Fund and the Federal Supplementary Medical Insurance Trust Fund
             to carry out section 4360 of the Omnibus Budget [Reconcilliation]Reconciliation Act of 1990: Provided, That amounts appropriated under this heading may be used for grants to States under section 361 of the OAA only for disease
             prevention and health promotion programs and activities which have been demonstrated through rigorous evaluation to be evidence-based
             and effective: Provided further, That, notwithstanding section 206(g) of the OAA, up to one percent of amounts appropriated to carry out programs authorized
             under title III of such Act shall be available for conducting evaluations, training and technical assistance: Provided further, That none of the funds provided shall be used to carry out sections 1701 and 1703 of the PHS Act (with respect to chronic
             disease self-management activity grants), except that such funds may be used for necessary expenses associated with administering
             any such grants awarded prior to the date of the enactment of this Act: Provided further, That notwithstanding any other provision of this Act, funds made available under this heading to carry out section 311 of
             the OAA may be transferred to the Secretary of Agriculture in accordance with such section: Provided further, That, of the amounts provided under this heading, [$448,251,000] $380,000,000 shall be available for carrying out title V of the OAA: Provided further, That, with respect to the previous proviso, such funds shall be available through June 30, [2014] 2015, and may be recaptured and reobligated in accordance with section 517(c) of the OAA.  Note.—A full-year 2013 appropriation for this account was not enacted at the time the budget was prepared; therefore, the
                budget assumes this account is operating under the Continuing Appropriations Resolution, 2013 (P.L. 112–175). The amounts
                included for 2013 reflect the annualized level provided by the continuing resolution.
          Program and Financing (in millions of dollars)

                      Identification code 75–0142–0–1–506
                      2012 actual
                      2013 CR
                      2014 est.

                      Obligations by program activity:

                      0101
                      Home and community-based supportive services
                      367
                      369
                      367

                      0102
                      Preventive health services
                      21
                      21
                      21

                      0103
                      National family caregiver support program
                      154
                      155
                      154

                      0104
                      Native American caregiver support program
                      6
                      6
                      6

                      0105
                      Congregate nutrition services
                      439
                      442
                      439

                      0106
                      Home-delivered nutrition services
                      217
                      218
                      217

                      0107
                      Nutrition services incentive program
                      158
                      159
                      160

                      0108
                      Native American nutrition and supportive services
                      28
                      28
                      28

                      0110
                      Aging network support activities
                      8
                      8
                      8

                      0111
                      Long-term care ombudsmen program
                      17
                      17
                      17

                      0112
                      Prevention of elder abuse and neglect
                      5
                      5
                      5

                      0113
                      Alzheimer's disease demonstration grants
                      4
                      4
                      9

                      0114
                      Program administration
                      23
                      23
                      30

                      0115
                      Lifespan respite care program
                      2
                      2
                      2

                      0117
                      Aging and Disability Resource Centers (ADRC)
                      16
                      16
                      10

                      0118
                      Chronic Disease Self-Management Education Program
                      10

                      10

                      0121
                      Senior Medicare Patrol program
                      9
                      9
                      9

                      0122
                      Elder Rights Support Activities
                      4
                      4
                      4

                      0126
                      National Clearinghouse Long-Term Care Information
                      3

                      3

                      0127
                      Alzheimer's Disease Awareness and Education
                      4

                      4

                      0128
                      Adult Protective Services
                      6

                      8

                      0129
                      Senior Community Service Employment Program

                      380

                      0131
                      State Health Insurance Assistance Program

                      26

                      0133
                      Alzheimer's Disease Initiative - Services

                      11

                      0135
                      Paralysis Resource Center

                      7

                      0136
                      Voting Access for People With Disabilities

                      5

                      0138
                      State Councils on Developmental Disabilities

                      75

                      0139
                      Protection and Advocacy

                      41

                      0141
                      University Centers for Excellence in Developmental Disabilities

                      39

                      0142
                      Projects of National Significance

                      8

                      0300
                      Total, direct program
                      1,501
                      1,486
                      2,103

                      0799
                      Total direct obligations
                      1,501
                      1,486
                      2,103

                      0801
                      Reimbursable program - HCFAC and Other
                      11
                      11
                      11

                      0802
                      ADRC's - MIPPA (TRA)

                      5

                      0803
                      Area Agencies on Aging - MIPPA (TRA)

                      8

                      0804
                      MIPPA - Natl Center Benefits Outreach Enrollment

                      5

                      0805
                      SHIPs

                      26

                      0899
                      Total reimbursable obligations
                      11
                      29
                      37

                      0900
                      Total new obligations
                      1,512
                      1,515
                      2,140

                      Budgetary Resources:

                      Unobligated balance:

                      1000
                      Unobligated balance brought forward, Oct 1

                      1
                      5

                      1021
                      Recoveries of prior year unpaid obligations
                      2

                      1050
                      Unobligated balance (total)
                      2
                      1
                      5

                      Budget authority:

                      Appropriations, discretionary:

                      1100
                      Appropriation
                      1,474
                      1,480
                      2,043

                      1120
                      Appropriations transferred to other accts [12–3507]
                      –2

                      1130
                      Appropriations permanently reduced
                      –3

                      1160
                      Appropriation, discretionary (total)
                      1,469
                      1,480
                      2,043

                      Appropriations, mandatory:

                      1200
                      Appropriation
                      13
                      10
                      10

                      1221
                      PPHF Appropriations transferred from other accounts [75–0116]
                      20

                      25

                      1260
                      Appropriations, mandatory (total)
                      33
                      10
                      35

                      Spending authority from offsetting collections, discretionary:

                      1700
                      Collected

                      52

                      1750
                      Spending auth from offsetting collections, disc (total)

                      52

                      Spending authority from offsetting collections, mandatory:

                      1800
                      Collected
                      22
                      29
                      11

                      1801
                      Change in uncollected payments, Federal sources
                      –12

                      1850
                      Spending auth from offsetting collections, mand (total)
                      10
                      29
                      11

                      1900
                      Budget authority (total)
                      1,512
                      1,519
                      2,141

                      1930
                      Total budgetary resources available
                      1,514
                      1,520
                      2,146

                      Memorandum (non-add) entries:

                      1940
                      Unobligated balance expiring
                      –1

                      1941
                      Unexpired unobligated balance, end of year
                      1
                      5
                      6

                      Change in obligated balance:

                      Unpaid obligations:

                      3000
                      Unpaid obligations, brought forward, Oct 1
                      679
                      691
                      707

                      3010
                      Obligations incurred, unexpired accounts
                      1,512
                      1,515
                      2,140

                      3020
                      Outlays (gross)
                      –1,493
                      –1,499
                      –1,889

                      3040
                      Recoveries of prior year unpaid obligations, unexpired
                      –2

                      3041
                      Recoveries of prior year unpaid obligations, expired
                      –5

                      3050
                      Unpaid obligations, end of year
                      691
                      707
                      958

                      Uncollected payments:

                      3060
                      Uncollected pymts, Fed sources, brought forward, Oct 1
                      –37
                      –18
                      –18

                      3070
                      Change in uncollected pymts, Fed sources, unexpired
                      12

                      3071
                      Change in uncollected pymts, Fed sources, expired
                      7

                      3090
                      Uncollected pymts, Fed sources, end of year
                      –18
                      –18
                      –18

                      Memorandum (non-add) entries:

                      3100
                      Obligated balance, start of year
                      642
                      673
                      689

                      3200
                      Obligated balance, end of year
                      673
                      689
                      940

                      Budget authority and outlays, net:

                      Discretionary:

                      4000
                      Budget authority, gross
                      1,469
                      1,480
                      2,095

                      Outlays, gross:

                      4010
                      Outlays from new discretionary authority
                      936
                      903
                      1,298

                      4011
                      Outlays from discretionary balances
                      522
                      554
                      567

                      4020
                      Outlays, gross (total)
                      1,458
                      1,457
                      1,865

                      Offsets against gross budget authority and outlays:

                      Offsetting collections (collected) from:

                      4030
                      Federal sources

                      –52

                      Mandatory:

                      4090
                      Budget authority, gross
                      43
                      39
                      46

                      Outlays, gross:

                      4100
                      Outlays from new mandatory authority
                      3
                      30
                      15

                      4101
                      Outlays from mandatory balances
                      32
                      12
                      9

                      4110
                      Outlays, gross (total)
                      35
                      42
                      24

                      Offsets against gross budget authority and outlays:

                      Offsetting collections (collected) from:

                      4120
                      Federal sources
                      –28
                      –29
                      –11

                      Additional offsets against gross budget authority only:

                      4140
                      Change in uncollected pymts, Fed sources, unexpired
                      12

                      4142
                      Offsetting collections credited to expired accounts
                      6

                      4150
                      Additional offsets against budget authority only (total)
                      18

                      4160
                      Budget authority, net (mandatory)
                      33
                      10
                      35

                      4170
                      Outlays, net (mandatory)
                      7
                      13
                      13

                      4180
                      Budget authority, net (total)
                      1,502
                      1,490
                      2,078

                      4190
                      Outlays, net (total)
                      1,465
                      1,470
                      1,826

             Note.—The reimbursable program (HCFAC) in the Administration on Aging (AoA) reflects the actual distribution of the allocation
                account for 2012.  Future allocations will be determined annually, and are not estimated in the current budget.

             This account provides funding for formula grant programs that provide nutrition, supportive services and caregiver support
                services through a network of aging-related organizations to help predominantly older Americans, with the assistance of their
                caregivers, maintain their dignity and independence in their homes and communities.  The Budget proposes to transfer the Senior
                Community Services Employment Program (SCSEP), authorized under title V of the Older Americans Act, from the Department of
                Labor to the Department of Health and Human Services (HHS), which administers the remainder of the Older Americans Act. SCSEP
                offers participants work-based community service training so that they can gain on-the-job experience and prepare to enter
                or to re-enter the workforce.  As a part of the proposed transfer to HHS, the Department will make improving program performance,
                including targeting the SCSEP program to people with the greatest need, a priority.  This process is expected to include better
                aligning the program's eligibility, income, and other requirements with those of other HHS income maintenance programs

          Object Classification (in millions of dollars)

                      Identification code 75–0142–0–1–506
                      2012 actual
                      2013 CR
                      2014 est.

                      Direct obligations:

                      11.1
                      Personnel compensation: Full-time permanent
                      12
                      12
                      19

                      12.1
                      Civilian personnel benefits
                      3
                      3
                      5

                      23.1
                      Rental payments to GSA
                      2
                      2
                      4

                      25.1
                      Advisory and assistance services
                      18
                      13
                      28

                      25.3
                      Other goods and services from Federal sources
                      8
                      7
                      9

                      41.0
                      Grants, subsidies, and contributions
                      1,458
                      1,449
                      2,038

                      99.0
                      Direct obligations
                      1,501
                      1,486
                      2,103

                      99.0
                      Reimbursable obligations
                      11
                      29
                      37

                      99.9
                      Total new obligations
                      1,512
                      1,515
                      2,140

          Employment Summary

                      Identification code 75–0142–0–1–506
                      2012 actual
                      2013 CR
                      2014 est.

                      1001
                      Direct civilian full-time equivalent employment
                      111
                      111
                      188

                      2001
                      Reimbursable civilian full-time equivalent employment
                      8
                      8
                      8

             Departmental Management

             Federal Funds
             Office of the Secretary
             general departmental managementFor necessary expenses, not otherwise provided, for general departmental management, including hire of passenger motor vehicles,
             and for carrying out titles II, III, XVII, and XXI of the PHS Act, the United States-Mexico Border Health Commission Act, and research studies under section
             1110 of the Social Security Act, [$306,320,000] $301,435,000, together with [$116,841,000] $119,841,000 from the amounts available under section 241 of the PHS Act to carry out national health or human services research and evaluation
             activities: Provided, That of the funds made available under this heading, [$3,500,000] $1,750,000 is for strengthening the Department's acquisition workforce capacity and capabilities: Provided further, That with respect to the previous proviso, such funds shall be available for training, recruitment, retention and hiring
             members of the acquisition workforce as defined by [the Office of Federal Procurement Policy Act, as amended (41 U.S.C. 401 et seq.)] 41 U.S.C. 1703: Provided further, That, with respect to the second proviso, such funds shall be available for information technology in support of acquisition
             workforce effectiveness or for management solutions to improve acquisition management: Provided further, That of the amounts provided under this heading from amounts available under section 241 of the PHS Act, no less than [$4,232,000] $4,232,000 shall be available to carry out evaluations (including longitudinal evaluations) of teenage pregnancy prevention approaches,
             and $53,891,000 shall be for minority AIDS prevention and treatment activities.   Note.—A full-year 2013 appropriation for this account was not enacted at the time the budget was prepared; therefore, the
                budget assumes this account is operating under the Continuing Appropriations Resolution, 2013 (P.L. 112–175). The amounts
                included for 2013 reflect the annualized level provided by the continuing resolution.
          Program and Financing (in millions of dollars)

                      Identification code 75–9912–0–1–551
                      2012 actual
                      2013 CR
                      2014 est.

                      Obligations by program activity:

                      0001
                      General Departmental Management
                      475
                      477
                      301

                      0004
                      Prevention & Public Health Fund (PPHF) (MAND)
                      30

                      105

                      0799
                      Total direct obligations
                      505
                      477
                      406

                      0801
                      GDM (PHS Evaluation & Collected)
                      166
                      166
                      166

                      0802
                      HCFAC (Mandatory)
                      9
                      9
                      9

                      0803
                      PHS Evaluation (Collected)
                      69
                      70
                      120

                      0899
                      Total reimbursable obligations
                      244
                      245
                      295

                      0900
                      Total new obligations
                      749
                      722
                      701

                      Budgetary Resources:

                      Unobligated balance:

                      1000
                      Unobligated balance brought forward, Oct 1
                      2
                      3
                      2

                      1021
                      Recoveries of prior year unpaid obligations
                      1

                      1050
                      Unobligated balance (total)
                      3
                      3
                      2

                      Budget authority:

                      Appropriations, discretionary:

                      1100
                      Appropriation
                      475
                      477
                      301

                      1130
                      Appropriations permanently reduced (Rescission)
                      –1

                      1160
                      Appropriation, discretionary (total)
                      474
                      477
                      301

                      Appropriations, mandatory:

                      1221
                      Appropriations transferred from other accts [75–0116]
                      30

                      105

                      1260
                      Appropriations, mandatory (total)
                      30

                      105

                      Spending authority from offsetting collections, discretionary:

                      1700
                      Collected (PHS Evaluation & Collected)
                      113
                      235
                      286

                      1701
                      Change in uncollected payments, Federal sources (PHS Evaluation & Collected)
                      125

                      1750
                      Spending auth from offsetting collections, disc (total)
                      238
                      235
                      286

                      Spending authority from offsetting collections, mandatory:

                      1800
                      Collected HCFAC (Mandatory)

                      9
                      9

                      1801
                      Change in uncollected payments, Federal sources
                      9

                      1850
                      Spending auth from offsetting collections, mand (total)
                      9
                      9
                      9

                      1900
                      Budget authority (total)
                      751
                      721
                      701

                      1930
                      Total budgetary resources available
                      754
                      724
                      703

                      Memorandum (non-add) entries:

                      1940
                      Unobligated balance expiring
                      –2

                      1941
                      Unexpired unobligated balance, end of year
                      3
                      2
                      2

                      Change in obligated balance:

                      Unpaid obligations:

                      3000
                      Unpaid obligations, brought forward, Oct 1
                      717
                      623
                      710

                      3010
                      Obligations incurred, unexpired accounts
                      749
                      722
                      701

                      3011
                      Obligations incurred, expired accounts
                      49

                      3020
                      Outlays (gross)
                      –860
                      –635
                      –815

                      3040
                      Recoveries of prior year unpaid obligations, unexpired
                      –1

                      3041
                      Recoveries of prior year unpaid obligations, expired
                      –31

                      3050
                      Unpaid obligations, end of year
                      623
                      710
                      596

                      Uncollected payments:

                      3060
                      Uncollected pymts, Fed sources, brought forward, Oct 1
                      –226
                      –233
                      –233

                      3070
                      Change in uncollected pymts, Fed sources, unexpired
                      –134

                      3071
                      Change in uncollected pymts, Fed sources, expired
                      127

                      3090
                      Uncollected pymts, Fed sources, end of year
                      –233
                      –233
                      –233

                      Memorandum (non-add) entries:

                      3100
                      Obligated balance, start of year
                      491
                      390
                      477

                      3200
                      Obligated balance, end of year
                      390
                      477
                      363

                      Budget authority and outlays, net:

                      Discretionary:

                      4000
                      Budget authority, gross
                      712
                      712
                      587

                      Outlays, gross:

                      4010
                      Outlays from new discretionary authority
                      340
                      339
                      289

                      4011
                      Outlays from discretionary balances
                      485
                      271
                      490

                      4020
                      Outlays, gross (total)
                      825
                      610
                      779

                      Offsets against gross budget authority and outlays:

                      Offsetting collections (collected) from:

                      4030
                      Federal sources (PHS Evaluation & Collected)
                      –219
                      –235
                      –286

                      Additional offsets against gross budget authority only:

                      4050
                      Change in uncollected pymts, Fed sources, unexpired
                      –125

                      4052
                      Offsetting collections credited to expired accounts
                      106

                      4060
                      Additional offsets against budget authority only (total)
                      –19

                      4070
                      Budget authority, net (discretionary)
                      474
                      477
                      301

                      4080
                      Outlays, net (discretionary)
                      606
                      375
                      493

                      Mandatory:

                      4090
                      Budget authority, gross
                      39
                      9
                      114

                      Outlays, gross:

                      4100
                      Outlays from new mandatory authority
                      16
                      9
                      23

                      4101
                      Outlays from mandatory balances
                      19
                      16
                      13

                      4110
                      Outlays, gross (total)
                      35
                      25
                      36

                      Offsets against gross budget authority and outlays:

                      Offsetting collections (collected) from:

                      4120
                      Federal sources (HCFAC Mandatory)
                      –34
                      –9
                      –9

                      Additional offsets against gross budget authority only:

                      4140
                      Change in uncollected pymts, Fed sources, unexpired
                      –9

                      4142
                      Offsetting collections credited to expired accounts
                      34

                      4150
                      Additional offsets against budget authority only (total)
                      25

                      4160
                      Budget authority, net (mandatory)
                      30

                      105

                      4170
                      Outlays, net (mandatory)
                      1
                      16
                      27

                      4180
                      Budget authority, net (total)
                      504
                      477
                      406

                      4190
                      Outlays, net (total)
                      607
                      391
                      520

             Note.—The reimbursable program (HCFAC) in the General Department Management (GDM) account reflects the actual distribution
                of the allocation account for 2012.  Future allocation will be determined annually, and are not estimated in the current budget.

             General Departmental Management (GDM) funds activities that provide leadership, policy, legal, and administrative guidance
                to HHS components, and support research to develop policy initiatives and improve existing HHS programs. GDM also funds the
                activities of the Office of the Assistant Secretary for Health, including adolescent health, disease prevention and health
                promotion, physical fitness and sports, minority health, research integrity, women's health, and programs funded through the
                Prevention and Public Health Fund.  This includes funding the continuation of grants for medically accurate and age appropriate
                programs to reduce teen pregnancy, including funds for research, demonstration grants, and replication of programs that have
                been proven effective through rigorous evaluation to reduce teen pregnancy.

          Object Classification (in millions of dollars)

                      Identification code 75–9912–0–1–551
                      2012 actual
                      2013 CR
                      2014 est.

                      Direct obligations:

                      Personnel compensation:

                      11.1
                      Full-time permanent
                      92
                      92
                      94

                      11.3
                      Other than full-time permanent
                      12
                      12
                      12

                      11.5
                      Other personnel compensation
                      3
                      3
                      3

                      11.7
                      Military personnel
                      4
                      4
                      4

                      11.9
                      Total personnel compensation
                      111
                      111
                      113

                      12.1
                      Civilian personnel benefits
                      28
                      29
                      28

                      12.2
                      Military personnel benefits
                      2
                      2
                      2

                      21.0
                      Travel and transportation of persons
                      5
                      5
                      4

                      23.1
                      Rental payments to GSA
                      18
                      18
                      19

                      23.3
                      Communications, utilities, and miscellaneous charges
                      4
                      4
                      3

                      24.0
                      Printing and reproduction
                      1
                      1
                      1

                      25.1
                      Advisory and assistance services
                      59
                      30
                      23

                      25.2
                      Other services from non-Federal sources
                      39
                      40
                      31

                      25.3
                      Other goods and services from Federal sources
                      75
                      75
                      48

                      25.4
                      Operation and maintenance of facilities
                      7
                      7
                      5

                      25.7
                      Operation and maintenance of equipment
                      4
                      4
                      4

                      26.0
                      Supplies and materials
                      1
                      1
                      1

                      31.0
                      Equipment
                      1

                      1

                      41.0
                      Grants, subsidies, and contributions
                      150
                      150
                      123

                      99.0
                      Direct obligations
                      505
                      477
                      406

                      99.0
                      Reimbursable obligations
                      244
                      245
                      295

                      99.9
                      Total new obligations
                      749
                      722
                      701

          Employment Summary

                      Identification code 75–9912–0–1–551
                      2012 actual
                      2013 CR
                      2014 est.

                      1001
                      Direct civilian full-time equivalent employment
                      1,043
                      1,054
                      1,035

                      1101
                      Direct military average strength employment
                      40
                      37
                      37

                      2001
                      Reimbursable civilian full-time equivalent employment
                      485
                      418
                      434

                      2101
                      Reimbursable military average strength employment
                      27
                      17
                      17

             Office for Civil RightsFor expenses necessary for the Office for Civil Rights, [$38,966,000] $42,205,000.  Note.—A full-year 2013 appropriation for this account was not enacted at the time the budget was prepared; therefore, the
                budget assumes this account is operating under the Continuing Appropriations Resolution, 2013 (P.L. 112–175). The amounts
                included for 2013 reflect the annualized level provided by the continuing resolution.
          Program and Financing (in millions of dollars)

                      Identification code 75–0135–0–1–751
                      2012 actual
                      2013 CR
                      2014 est.

                      Obligations by program activity:

                      0001
                      Direct program activity
                      41
                      41
                      42

                      0801
                      Reimbursable program activity
                      4
                      6
                      7

                      0900
                      Total new obligations
                      45
                      47
                      49

                      Budgetary Resources:

                      Budget authority:

                      Appropriations, discretionary:

                      1100
                      Appropriation
                      41
                      41
                      42

                      1160
                      Appropriation, discretionary (total)
                      41
                      41
                      42

                      Spending authority from offsetting collections, discretionary:

                      1700
                      Collected
                      4
                      6
                      7

                      1750
                      Spending auth from offsetting collections, disc (total)
                      4
                      6
                      7

                      1900
                      Budget authority (total)
                      45
                      47
                      49

                      1930
                      Total budgetary resources available
                      45
                      47
                      49

                      Change in obligated balance:

                      Unpaid obligations:

                      3000
                      Unpaid obligations, brought forward, Oct 1
                      12
                      12
                      11

                      3010
                      Obligations incurred, unexpired accounts
                      45
                      47
                      49

                      3020
                      Outlays (gross)
                      –44
                      –48
                      –49

                      3041
                      Recoveries of prior year unpaid obligations, expired
                      –1

                      3050
                      Unpaid obligations, end of year
                      12
                      11
                      11

                      Uncollected payments:

                      3060
                      Uncollected pymts, Fed sources, brought forward, Oct 1
                      –1

                      3071
                      Change in uncollected pymts, Fed sources, expired
                      1

                      Memorandum (non-add) entries:

                      3100
                      Obligated balance, start of year
                      11
                      12
                      11

                      3200
                      Obligated balance, end of year
                      12
                      11
                      11

                      Budget authority and outlays, net:

                      Discretionary:

                      4000
                      Budget authority, gross
                      45
                      47
                      49

                      Outlays, gross:

                      4010
                      Outlays from new discretionary authority
                      37
                      39
                      41

                      4011
                      Outlays from discretionary balances
                      7
                      9
                      8

                      4020
                      Outlays, gross (total)
                      44
                      48
                      49

                      Offsets against gross budget authority and outlays:

                      Offsetting collections (collected) from:

                      4030
                      Federal sources
                      –1

                      4033
                      Non-Federal sources
                      –4
                      –6
                      –7

                      4040
                      Offsets against gross budget authority  and outlays (total)
                      –5
                      –6
                      –7

                      Additional offsets against gross budget authority only:

                      4052
                      Offsetting collections credited to expired accounts
                      1

                      4070
                      Budget authority, net (discretionary)
                      41
                      41
                      42

                      4080
                      Outlays, net (discretionary)
                      39
                      42
                      42

                      4180
                      Budget authority, net (total)
                      41
                      41
                      42

                      4190
                      Outlays, net (total)
                      39
                      42
                      42

             The Office for Civil Rights funds activities that carry out the Department's civil rights nondiscrimination and health information
                privacy and security compliance programs.

          Object Classification (in millions of dollars)

                      Identification code 75–0135–0–1–751
                      2012 actual
                      2013 CR
                      2014 est.

                      Direct obligations:

                      Personnel compensation:

                      11.1
                      Full-time permanent
                      21
                      22
                      23

                      11.3
                      Other than full-time permanent
                      1
                      1
                      1

                      11.9
                      Total personnel compensation
                      22
                      23
                      24

                      12.1
                      Civilian personnel benefits
                      6
                      5
                      6

                      23.1
                      Rental payments to GSA
                      3
                      3
                      3

                      25.2
                      Other services from non-Federal sources
                      3
                      2
                      2

                      25.3
                      Other goods and services from Federal sources
                      5
                      6
                      5

                      25.4
                      Operation and maintenance of facilities
                      1
                      1
                      1

                      25.7
                      Operation and maintenance of equipment
                      1
                      1
                      1

                      99.0
                      Direct obligations
                      41
                      41
                      42

                      99.0
                      Reimbursable obligations
                      4
                      6
                      7

                      99.9
                      Total new obligations
                      45
                      47
                      49

          Employment Summary

                      Identification code 75–0135–0–1–751
                      2012 actual
                      2013 CR
                      2014 est.

                      1001
                      Direct civilian full-time equivalent employment
                      223
                      220
                      228

                      1101
                      Direct military average strength employment
                      1
                      2
                      2

                      2001
                      Reimbursable civilian full-time equivalent employment
                      2
                      3
                      3

             Office of the National Coordinator for Health Information TechnologyFor 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 interoperable health information technology, [$26,246,000] $20,576,000: Provided, That in addition to amounts provided herein, [$40,011,000] $56,307,000 shall be available from amounts available under section 241 of the PHS Act: Provided further, That health information technology user fees collected in FY 2014, as provided in this Act, shall be credited
                to this account as offsetting collections, to remain available until expended.  Note.—A full-year 2013 appropriation for this account was not enacted at the time the budget was prepared; therefore, the
                budget assumes this account is operating under the Continuing Appropriations Resolution, 2013 (P.L. 112–175). The amounts
                included for 2013 reflect the annualized level provided by the continuing resolution.
          Program and Financing (in millions of dollars)

                      Identification code 75–0130–0–1–551
                      2012 actual
                      2013 CR
                      2014 est.

                      Obligations by program activity:

                      0001
                      Health information technology
                      16
                      17
                      21

                      0002
                      Recovery Act activities
                      33

                      0799
                      Total direct obligations
                      49
                      17
                      21

                      0801
                      Reimbursable program
                      12
                      7
                      7

                      0802
                      Reimbursable program: PHS evaluation
                      44
                      45
                      57

                      0803
                      Reimbursable program activity: User Fee

                      1

                      0899
                      Total reimbursable obligations
                      56
                      52
                      65

                      0900
                      Total new obligations
                      105
                      69
                      86

                      Budgetary Resources:

                      Unobligated balance:

                      1000
                      Unobligated balance brought forward, Oct 1
                      5
                      1
                      1

                      1021
                      Recoveries of prior year unpaid obligations
                      30

                      1050
                      Unobligated balance (total)
                      35
                      1
                      1

                      Budget authority:

                      Appropriations, discretionary:

                      1100
                      Appropriation
                      16
                      17
                      21

                      1160
                      Appropriation, discretionary (total)
                      16
                      17
                      21

                      Spending authority from offsetting collections, discretionary:

                      1700
                      PHS and Other
                      47
                      52
                      64

                      1700
                      User Fee

                      1

                      1701
                      Change in uncollected payments, Federal sources
                      9

                      1750
                      Spending auth from offsetting collections, disc (total)
                      56
                      52
                      65

                      1900
                      Budget authority (total)
                      72
                      69
                      86

                      1930
                      Total budgetary resources available
                      107
                      70
                      87

                      Memorandum (non-add) entries:

                      1940
                      Unobligated balance expiring
                      –1

                      1941
                      Unexpired unobligated balance, end of year
                      1
                      1
                      1

                      Change in obligated balance:

                      Unpaid obligations:

                      3000
                      Unpaid obligations, brought forward, Oct 1
                      1,553
                      977
                      414

                      3010
                      Obligations incurred, unexpired accounts
                      105
                      69
                      86

                      3011
                      Obligations incurred, expired accounts
                      1

                      3020
                      Outlays (gross)
                      –648
                      –632
                      –441

                      3040
                      Recoveries of prior year unpaid obligations, unexpired
                      –30

                      3041
                      Recoveries of prior year unpaid obligations, expired
                      –4

                      3050
                      Unpaid obligations, end of year
                      977
                      414
                      59

                      Uncollected payments:

                      3060
                      Uncollected pymts, Fed sources, brought forward, Oct 1
                      –44
                      –23
                      –3

                      3070
                      Change in uncollected pymts, Fed sources, unexpired
                      –9

                      3071
                      Change in uncollected pymts, Fed sources, expired
                      30
                      20

                      3090
                      Uncollected pymts, Fed sources, end of year
                      –23
                      –3
                      –3

                      Memorandum (non-add) entries:

                      3100
                      Obligated balance, start of year
                      1,509
                      954
                      411

                      3200
                      Obligated balance, end of year
                      954
                      411
                      56

                      Budget authority and outlays, net:

                      Discretionary:

                      4000
                      Budget authority, gross
                      72
                      69
                      86

                      Outlays, gross:

                      4010
                      Outlays from new discretionary authority
                      46
                      66
                      83

                      4011
                      Outlays from discretionary balances
                      599
                      563
                      358

                      4020
                      Outlays, gross (total)
                      645
                      629
                      441

                      Offsets against gross budget authority and outlays:

                      Offsetting collections (collected) from:

                      4030
                      Federal sources
                      –78
                      –52
                      –64

                      4033
                      Non-Federal sources

                      –1

                      4040
                      Offsets against gross budget authority  and outlays (total)
                      –78
                      –52
                      –65

                      Additional offsets against gross budget authority only:

                      4050
                      Change in uncollected pymts, Fed sources, unexpired
                      –9

                      4052
                      Offsetting collections credited to expired accounts
                      31

                      4060
                      Additional offsets against budget authority only (total)
                      22

                      4070
                      Budget authority, net (discretionary)
                      16
                      17
                      21

                      4080
                      Outlays, net (discretionary)
                      567
                      577
                      376

                      Mandatory:

                      Outlays, gross:

                      4101
                      Outlays from mandatory balances
                      3
                      3

                      4180
                      Budget authority, net (total)
                      16
                      17
                      21

                      4190
                      Outlays, net (total)
                      570
                      580
                      376

             This program supports coordination, leadership, and development of Federal health information technology activities and Federal
                initiatives for the nationwide advancement of private and secure interoperable health information technology, in cooperation
                with participants in the health sector. The Office of the National Coordinator for Health Information Technology was established
                in the Health Information Technology for Economic and Clinical Health Act (P.L. 111–5, Title XIII), 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.

          Object Classification (in millions of dollars)

                      Identification code 75–0130–0–1–551
                      2012 actual
                      2013 CR
                      2014 est.

                      Direct obligations:

                      11.1
                      Personnel compensation: Full-time permanent
                      3

                      12.1
                      Civilian personnel benefits
                      1

                      23.1
                      Rental payments to GSA
                      3
                      2
                      3

                      25.1
                      Advisory and assistance services

                      1
                      1

                      25.2
                      Other services from non-Federal sources
                      5
                      6
                      8

                      25.3
                      Other goods and services from Federal sources
                      6
                      7
                      8

                      25.4
                      Operation and maintenance of facilities
                      2
                      1
                      1

                      41.0
                      Grants, subsidies, and contributions
                      29

                      99.0
                      Direct obligations
                      49
                      17
                      21

                      99.0
                      Reimbursable obligations
                      56
                      52
                      65

                      99.9
                      Total new obligations
                      105
                      69
                      86

          Employment Summary

                      Identification code 75–0130–0–1–551
                      2012 actual
                      2013 CR
                      2014 est.

                      1001
                      Direct civilian full-time equivalent employment
                      158
                      190
                      190

                      1101
                      Direct military average strength employment
                      1
                      1
                      1

             Office of Medicare Hearings and AppealsFor expenses necessary for [administrative law judges responsible for hearing cases under title XVIII of the Social Security Act (and related provisions
             of title XI of such Act), $84,234,000] the Office of Medicare Hearings and Appeals, $82,381,000, to be transferred in appropriate part from the Federal Hospital Insurance Trust Fund and the Federal Supplementary Medical
             Insurance Trust Fund.  Note.—A full-year 2013 appropriation for this account was not enacted at the time the budget was prepared; therefore, the
                budget assumes this account is operating under the Continuing Appropriations Resolution, 2013 (P.L. 112–175). The amounts
                included for 2013 reflect the annualized level provided by the continuing resolution.
          Program and Financing (in millions of dollars)

                      Identification code 75–0139–0–1–551
                      2012 actual
                      2013 CR
                      2014 est.

                      Obligations by program activity:

                      0001
                      Direct program activity
                      71
                      72
                      82

                      Budgetary Resources:

                      Budget authority:

                      Spending authority from offsetting collections, discretionary:

                      1700
                      Collected
                      72
                      72
                      82

                      1750
                      Spending auth from offsetting collections, disc (total)
                      72
                      72
                      82

                      1930
                      Total budgetary resources available
                      72
                      72
                      82

                      Memorandum (non-add) entries:

                      1940
                      Unobligated balance expiring
                      –1

                      Change in obligated balance:

                      Unpaid obligations:

                      3000
                      Unpaid obligations, brought forward, Oct 1
                      15
                      14

                      3010
                      Obligations incurred, unexpired accounts
                      71
                      72
                      82

                      3011
                      Obligations incurred, expired accounts
                      1

                      3020
                      Outlays (gross)
                      –70
                      –86
                      –82

                      3041
                      Recoveries of prior year unpaid obligations, expired
                      –3

                      3050
                      Unpaid obligations, end of year
                      14

                      Memorandum (non-add) entries:

                      3100
                      Obligated balance, start of year
                      15
                      14

                      3200
                      Obligated balance, end of year
                      14

                      Budget authority and outlays, net:

                      Discretionary:

                      4000
                      Budget authority, gross
                      72
                      72
                      82

                      Outlays, gross:

                      4010
                      Outlays from new discretionary authority
                      62
                      72
                      82

                      4011
                      Outlays from discretionary balances
                      8
                      14

                      4020
                      Outlays, gross (total)
                      70
                      86
                      82

                      Offsets against gross budget authority and outlays:

                      Offsetting collections (collected) from:

                      4030
                      Federal sources
                      –72
                      –72
                      –82

                      4190
                      Outlays, net (total)
                      –2
                      14

             This appropriation funds the operations of the Office of Medicare Hearings and Appeals (OMHA), as authorized by the Medicare
                Prescription Drug, Improvement, and Modernization Act of 2003. OMHA provides an independent and impartial forum for the adjudication
                of claims brought by or on behalf of Medicare beneficiaries related to their benefits and care.

          Object Classification (in millions of dollars)

                      Identification code 75–0139–0–1–551
                      2012 actual
                      2013 CR
                      2014 est.

                      Direct obligations:

                      11.1
                      Personnel compensation: Full-time permanent
                      39
                      42
                      45

                      12.1
                      Civilian personnel benefits
                      12
                      13
                      14

                      22.0
                      Transportation of things

                      1

                      23.1
                      Rental payments to GSA
                      7
                      6
                      7

                      23.3
                      Communications, utilities, and miscellaneous charges
                      1
                      3
                      4

                      25.1
                      Advisory and assistance services
                      1

                      25.2
                      Other services from non-Federal sources
                      1
                      1
                      1

                      25.3
                      Other goods and services from Federal sources
                      9
                      5
                      5

                      25.4
                      Operation and maintenance of facilities

                      1
                      1

                      25.7
                      Operation and maintenance of equipment

                      1

                      26.0
                      Supplies and materials
                      1

                      1

                      31.0
                      Equipment

                      1
                      2

                      99.9
                      Total new obligations
                      71
                      72
                      82

          Employment Summary

                      Identification code 75–0139–0–1–551
                      2012 actual
                      2013 CR
                      2014 est.

                      1001
                      Direct civilian full-time equivalent employment
                      466
                      490
                      514

             Public Health and Social Services Emergency Fund
             (including transfer of funds)For expenses necessary to support activities related to countering potential biological, nuclear, radiological, chemical,
             and cybersecurity threats to civilian populations, and for other public health emergencies, [$625,262,000; of which $5,000,000 shall remain available until expended to support emergency operations and] $858,521,000, of which [$50,000,000] $415,130,000 shall remain available [until expended] through September 30, 2015, for expenses necessary to support advanced research and development pursuant to section 319L of the PHS Act, and other administrative
                expenses of the Biomedical Advanced Research and Development Authority, and of which up to $5,000,000 shall remain available
                through September 30, 2016, to support the delivery of medical countermeasures and shall be in addition to any other amounts
                available for such purpose: Provided, That funds provided under this heading for the purpose of acquisition of security countermeasures
                shall be in addition to any other funds available for such purpose: Provided further, That products purchased with funds provided
                under this heading may, at the discretion of the Secretary, be deposited in the Strategic National Stockpile pursuant to section
                319F-2 of the PHS Act: Provided further, That $5,000,000 of the amounts made available to support emergency operations shall
                remain available through September 30, 2016: Provided further, That of the amounts made available to support advanced research
                and development, $20,000,000 shall remain available through September 30, 2015, for the purposes of establishing and funding, using for either such purpose contracts, grants, cooperative agreements, or other transactions as described in section 319L
                of the PHS Act (42 U.S.C. 247d-7e), a strategic investment corporation [established] , which shall not be deemed to be a Federal agency for any purpose, to further the purposes of such section 319L [of the PHS Act (42 U.S.C. 247d-7e)] to foster innovation in the development of medical countermeasures[; and of which up to $5,000,000 shall remain available through September 30, 2015 to support the delivery of medical countermeasures].

          For necessary expenses for procuring security countermeasures (as defined in section 319F-2(c)(1)(B) of the PHS Act), $250,000,000,
                to remain available until expended.
          For expenses necessary to prepare for and respond to an influenza pandemic, $140,009,000; of which $108,000,000 shall be available
                until expended, for activities including the development and purchase of vaccine, antivirals, necessary medical supplies,
                diagnostics, and other surveillance tools: Provided further, That notwithstanding section 496(b) of the PHS Act, funds may
                be used for the construction or renovation of privately owned facilities for the production of pandemic influenza vaccines
                and other biologics, if the Secretary finds such construction or renovation necessary to secure sufficient supplies of such
                vaccines or biologics: Provided further, That funds appropriated in this paragraph may be transferred to other appropriation
                accounts of the Department of Health and Human Services, as determined by the Secretary to be appropriate, to be used for
                the purposes specified in this paragraph.
          [From funds transferred to this account pursuant to the fourth paragraph under this heading in Public Law 111–117, up to $415,000,000
             shall be available for expenses necessary to support advanced research and development pursuant to section 319L of the PHS
             Act, and other administrative expenses of the Biomedical Advanced Research and Development Authority to support additional
             advanced research and development: Provided, That funds provided under this heading for the purpose of acquisition of security countermeasures may be used and shall
             be in addition to any other funds available for such purpose: Provided further, That products purchased with funds provided under this heading may, at the discretion of the Secretary, be deposited in
             the Strategic National Stockpile pursuant to section 319F-2 of the PHS Act.]
          In addition, for expenses necessary for replacement of building leases and associated renovation costs for Public Health Service
             agencies and other components of the Department of Health and Human Services, including relocation and fit-out costs, [$17,000,000] $41,000,000, to remain available until expended.  Note.—A full-year 2013 appropriation for this account was not enacted at the time the budget was prepared; therefore, the
                budget assumes this account is operating under the Continuing Appropriations Resolution, 2013 (P.L. 112–175). The amounts
                included for 2013 reflect the annualized level provided by the continuing resolution as well as amounts from P.L. 113–2, the
                Disaster Relief Appropriations Act, 2013 (no language shown).
          Program and Financing (in millions of dollars)

                      Identification code 75–0140–0–1–551
                      2012 actual
                      2013 CR
                      2014 est.

                      Obligations by program activity:

                      0001
                      Public Health and Social Services Emergency Fund
                      1,749
                      2,305
                      881

                      0801
                      Reimbursable program
                      36
                      60
                      60

                      0900
                      Total new obligations
                      1,785
                      2,365
                      941

                      Budgetary Resources:

                      Unobligated balance:

                      1000
                      Unobligated balance brought forward, Oct 1
                      3,414
                      2,349
                      808

                      1010
                      Unobligated balance transfer to other accts [75–0343]
                      –3
                      –3
                      –3

                      1021
                      Recoveries of prior year unpaid obligations
                      120

                      1050
                      Unobligated balance (total)
                      3,531
                      2,346
                      805

                      Budget authority:

                      Appropriations, discretionary:

                      1100
                      Appropriation
                      569
                      1,372
                      1,290

                      1120
                      Appropriations transferred to other accts [75–1534]

                      –500

                      1120
                      Appropriations transferred to other accts [75–1536]

                      –100

                      1120
                      Appropriations transferred to other accts [75–0128]

                      –5

                      1130
                      Appropriations permanently reduced
                      –1

                      1160
                      Appropriation, discretionary (total)
                      568
                      767
                      1,290

                      Spending authority from offsetting collections, discretionary:

                      1700
                      Collected
                      1
                      60
                      60

                      1701
                      Change in uncollected payments, Federal sources
                      35

                      1750
                      Spending auth from offsetting collections, disc (total)
                      36
                      60
                      60

                      1900
                      Budget authority (total)
                      604
                      827
                      1,350

                      1930
                      Total budgetary resources available
                      4,135
                      3,173
                      2,155

                      Memorandum (non-add) entries:

                      1940
                      Unobligated balance expiring
                      –1

                      1941
                      Unexpired unobligated balance, end of year
                      2,349
                      808
                      1,214

                      Change in obligated balance:

                      Unpaid obligations:

                      3000
                      Unpaid obligations, brought forward, Oct 1
                      4,611
                      4,455
                      4,931

                      3010
                      Obligations incurred, unexpired accounts
                      1,785
                      2,365
                      941

                      3011
                      Obligations incurred, expired accounts
                      2

                      3020
                      Outlays (gross)
                      –1,795
                      –1,889
                      –1,999

                      3040
                      Recoveries of prior year unpaid obligations, unexpired
                      –120

                      3041
                      Recoveries of prior year unpaid obligations, expired
                      –28

                      3050
                      Unpaid obligations, end of year
                      4,455
                      4,931
                      3,873

                      Uncollected payments:

                      3060
                      Uncollected pymts, Fed sources, brought forward, Oct 1
                      –290
                      –241
                      –241

                      3070
                      Change in uncollected pymts, Fed sources, unexpired
                      –35

                      3071
                      Change in uncollected pymts, Fed sources, expired
                      84

                      3090
                      Uncollected pymts, Fed sources, end of year
                      –241
                      –241
                      –241

                      Memorandum (non-add) entries:

                      3100
                      Obligated balance, start of year
                      4,321
                      4,214
                      4,690

                      3200
                      Obligated balance, end of year
                      4,214
                      4,690
                      3,632

                      Budget authority and outlays, net:

                      Discretionary:

                      4000
                      Budget authority, gross
                      604
                      827
                      1,350

                      Outlays, gross:

                      4010
                      Outlays from new discretionary authority
                      147
                      248
                      431

                      4011
                      Outlays from discretionary balances
                      1,648
                      1,641
                      1,568

                      4020
                      Outlays, gross (total)
                      1,795
                      1,889
                      1,999

                      Offsets against gross budget authority and outlays:

                      Offsetting collections (collected) from:

                      4030
                      Federal sources
                      –81
                      –60
                      –60

                      Additional offsets against gross budget authority only:

                      4050
                      Change in uncollected pymts, Fed sources, unexpired
                      –35

                      4052
                      Offsetting collections credited to expired accounts
                      80

                      4060
                      Additional offsets against budget authority only (total)
                      45

                      4070
                      Budget authority, net (discretionary)
                      568
                      767
                      1,290

                      4080
                      Outlays, net (discretionary)
                      1,714
                      1,829
                      1,939

                      4180
                      Budget authority, net (total)
                      568
                      767
                      1,290

                      4190
                      Outlays, net (total)
                      1,714
                      1,829
                      1,939

             The Public Health and Social Services Emergency Fund (PHSSEF) provides resources to support a comprehensive program to prepare
                for the health and medical consequences of bioterrorism or other public health emergencies. This account includes funding
                for the Office of the Assistant Secretary for Preparedness and Response (ASPR), as authorized by the Pandemic and All-Hazards
                Preparedness Act. Funds will be used for hospital preparedness and other emergency preparedness activities including the National
                Disaster Medical System.  The PHSSEF also supports the HHS Cyber Security and Security and Strategic Information programs,
                and the Medical Reserve Corps.

             The PHSSEF also continues to support the advanced development and procurement of biodefense and pandemic influenza countermeasures.

              A Strategic Investor corporation will be created to make investments in the private sector with specific focus on disruptive
                technologies including novel antimicrobials and multi-use platform technologies for diagnostics and medical countermeasures.

             Resources are also being provided for the Department's consolidation of lease replacements and renovation costs for the National
                Capital Region.

          Object Classification (in millions of dollars)

                      Identification code 75–0140–0–1–551
                      2012 actual
                      2013 CR
                      2014 est.

                      Direct obligations:

                      Personnel compensation:

                      11.1
                      Full-time permanent
                      57
                      57
                      58

                      11.3
                      Other than full-time permanent
                      14
                      14
                      15

                      11.7
                      Military personnel
                      9
                      9
                      9

                      11.9
                      Total personnel compensation
                      80
                      80
                      82

                      12.1
                      Civilian personnel benefits
                      21
                      21
                      21

                      12.2
                      Military personnel benefits
                      4
                      4
                      4

                      21.0
                      Travel and transportation of persons
                      8
                      6
                      3

                      22.0
                      Transportation of things
                      10
                      9
                      7

                      23.1
                      Rental payments to GSA
                      11
                      10
                      10

                      23.3
                      Communications, utilities, and miscellaneous charges
                      5
                      5
                      4

                      25.1
                      Advisory and assistance services
                      281
                      279
                      62

                      25.2
                      Other services from non-Federal sources
                      37
                      36
                      26

                      25.3
                      Other goods and services from Federal sources
                      525
                      498
                      103

                      25.4
                      Operation and maintenance of facilities
                      3
                      3
                      3

                      25.5
                      Research and development contracts
                      176
                      786
                      226

                      25.7
                      Operation and maintenance of equipment
                      43
                      43
                      31

                      26.0
                      Supplies and materials
                      48
                      40
                      17

                      31.0
                      Equipment
                      32
                      30
                      24

                      32.0
                      Land and structures
                      25
                      15
                      15

                      41.0
                      Grants, subsidies, and contributions
                      440
                      440
                      243

                      99.0
                      Direct obligations
                      1,749
                      2,305
                      881

                      99.0
                      Reimbursable obligations
                      36
                      60
                      60

                      99.9
                      Total new obligations
                      1,785
                      2,365
                      941

          Employment Summary

                      Identification code 75–0140–0–1–551
                      2012 actual
                      2013 CR
                      2014 est.

                      1001
                      Direct civilian full-time equivalent employment
                      551
                      567
                      608

                      1101
                      Direct military average strength employment
                      75
                      83
                      83

             Transfers from the Patient-Centered Outcomes Research Trust Fund

             Program and Financing (in millions of dollars)

                      Identification code 75–0145–0–1–552
                      2012 actual
                      2013 CR
                      2014 est.

                      Obligations by program activity:

                      0801
                      AHRQ
                      8
                      43
                      75

                      0802
                      Office of the Secretary
                      3
                      19
                      25

                      0900
                      Total new obligations
                      11
                      62
                      100

                      Budgetary Resources:

                      Unobligated balance:

                      1000
                      Unobligated balance brought forward, Oct 1
                      9
                      28
                      42

                      Budget authority:

                      Spending authority from offsetting collections, mandatory:

                      1800
                      Collected
                      30
                      76
                      125

                      1850
                      Spending auth from offsetting collections, mand (total)
                      30
                      76
                      125

                      1930
                      Total budgetary resources available
                      39
                      104
                      167

                      Memorandum (non-add) entries:

                      1941
                      Unexpired unobligated balance, end of year
                      28
                      42
                      67

                      Change in obligated balance:

                      Unpaid obligations:

                      3000
                      Unpaid obligations, brought forward, Oct 1
                      1
                      9
                      61

                      3010
                      Obligations incurred, unexpired accounts
                      11
                      62
                      100

                      3020
                      Outlays (gross)
                      –3
                      –10
                      –35

                      3050
                      Unpaid obligations, end of year
                      9
                      61
                      126

                      Memorandum (non-add) entries:

                      3100
                      Obligated balance, start of year
                      1
                      9
                      61

                      3200
                      Obligated balance, end of year
                      9
                      61
                      126

                      Budget authority and outlays, net:

                      Mandatory:

                      4090
                      Budget authority, gross
                      30
                      76
                      125

                      Outlays, gross:

                      4100
                      Outlays from new mandatory authority
                      1
                      2
                      4

                      4101
                      Outlays from mandatory balances
                      2
                      8
                      31

                      4110
                      Outlays, gross (total)
                      3
                      10
                      35

                      Offsets against gross budget authority and outlays:

                      Offsetting collections (collected) from:

                      4120
                      Federal sources
                      –30
                      –76
                      –125

                      4190
                      Outlays, net (total)
                      –27
                      –66
                      –90

             Public Law 111–148 established the Patient-Centered Outcomes Research Trust Fund (PCORTF).  Beginning in FY 2011, a total
                of 20 percent of the funds appropriated or credited to the PCORTF will be transferred each year to the Department of Health
                and Human Services (HHS).  As authorized in section 937 of the Public Health Service Act, HHS will disseminate research findings
                from the Patient-Centered Outcomes Research Institute and other government-funded comparative clinical effectiveness research
                and build research and data capacity for comparative clinical effectiveness research.  Transferred funds will be distributed
                to the Secretary of HHS and the Agency for Healthcare Research and Quality to carry out these activities.

          Object Classification (in millions of dollars)

                      Identification code 75–0145–0–1–552
                      2012 actual
                      2013 CR
                      2014 est.

                      99.0
                      Reimbursable obligations
                      3
                      19
                      25

                      Allocation Account - reimbursable:

                      11.1
                      Personnel compensation: Full-time permanent

                      2
                      3

                      25.5
                      Research and development contracts
                      8
                      41
                      72

                      99.0
                      Allocation account - reimbursable
                      8
                      43
                      75

                      99.9
                      Total new obligations
                      11
                      62
                      100

          Employment Summary

                      Identification code 75–0145–0–1–552
                      2012 actual
                      2013 CR
                      2014 est.

                      2001
                      Reimbursable civilian full-time equivalent employment
                      1
                      2
                      2

             Prevention and Wellness Fund, Recovery Act

             Program and Financing (in millions of dollars)

                      Identification code 75–0144–0–1–551
                      2012 actual
                      2013 CR
                      2014 est.

                      Change in obligated balance:

                      Unpaid obligations:

                      3000
                      Unpaid obligations, brought forward, Oct 1
                      18
                      2
                      2

                      3020
                      Outlays (gross)
                      –14

                      3041
                      Recoveries of prior year unpaid obligations, expired
                      –2

                      3050
                      Unpaid obligations, end of year
                      2
                      2
                      2

                      Memorandum (non-add) entries:

                      3100
                      Obligated balance, start of year
                      18
                      2
                      2

                      3200
                      Obligated balance, end of year
                      2
                      2
                      2

                      Budget authority and outlays, net:

                      Discretionary:

                      Outlays, gross:

                      4011
                      Outlays from discretionary balances
                      14

                      4190
                      Outlays, net (total)
                      14

             The Prevention and Wellness Fund is authorized under the American Recovery and Reinvestment Act (ARRA), (P.L. 111–5).  The
                Prevention and Wellness Fund administers evidence-based clinical and community-based prevention and wellness strategies.

             Nonrecurring Expenses Fund

             The Nonrecurring Expenses Fund is a no-year account that captures expired unobligated balances from discretionary accounts
                prior to cancellation. The Fund will be used for capital acquisition, including facilities infrastructure and information
                technology infrastructure.

             Health Insurance Reform Implementation Fund

             Program and Financing (in millions of dollars)

                      Identification code 75–0119–0–1–551
                      2012 actual
                      2013 CR
                      2014 est.

                      Obligations by program activity:

                      0001
                      Direct program activity
                      333
                      241

                      Budgetary Resources:

                      Unobligated balance:

                      1000
                      Unobligated balance brought forward, Oct 1
                      565
                      241

                      1021
                      Recoveries of prior year unpaid obligations
                      9

                      1050
                      Unobligated balance (total)
                      574
                      241

                      1930
                      Total budgetary resources available
                      574
                      241

                      Memorandum (non-add) entries:

                      1941
                      Unexpired unobligated balance, end of year
                      241

                      Change in obligated balance:

                      Unpaid obligations:

                      3000
                      Unpaid obligations, brought forward, Oct 1
                      205
                      265
                      188

                      3010
                      Obligations incurred, unexpired accounts
                      333
                      241

                      3020
                      Outlays (gross)
                      –264
                      –318
                      –163

                      3040
                      Recoveries of prior year unpaid obligations, unexpired
                      –9

                      3050
                      Unpaid obligations, end of year
                      265
                      188
                      25

                      Memorandum (non-add) entries:

                      3100
                      Obligated balance, start of year
                      205
                      265
                      188

                      3200
                      Obligated balance, end of year
                      265
                      188
                      25

                      Budget authority and outlays, net:

                      Mandatory:

                      Outlays, gross:

                      4101
                      Outlays from mandatory balances
                      264
                      318
                      163

                      4190
                      Outlays, net (total)
                      264
                      318
                      163

             Section 1005 of the Health Care and Education Reconciliation Act of 2010 (P.L. 111–152) appropriated $1,000,000,000 to the
                Health Insurance Reform Implementation Fund within the Department of Health and Human Services.  The Fund shall be used for
                Federal administrative expenses necessary to carry out the requirements of the Patient Protection and Affordable Care Act
                of 2010 (P.L. 111–148) and the Health Care and Education Reconciliation Act of 2010.

          Object Classification (in millions of dollars)

                      Identification code 75–0119–0–1–551
                      2012 actual
                      2013 CR
                      2014 est.

                      Direct obligations:

                      11.1
                      Personnel compensation: Full-time permanent
                      1

                      12.1
                      Civilian personnel benefits
                      1

                      25.2
                      Other services from non-Federal sources
                      25
                      237

                      25.3
                      Other goods and services from Federal sources

                      4

                      99.0
                      Direct obligations
                      27
                      241

                      Allocation Account - direct:

                      Personnel compensation:

                      11.1
                      Full-time permanent
                      71

                      11.3
                      Other than full-time permanent
                      1

                      11.5
                      Other personnel compensation
                      1

                      11.9
                      Total personnel compensation
                      73

                      12.1
                      Civilian personnel benefits
                      20

                      21.0
                      Travel and transportation of persons
                      2

                      25.1
                      Advisory and assistance services
                      181

                      25.2
                      Other services from non-Federal sources
                      9

                      31.0
                      Equipment
                      20

                      99.0
                      Allocation account - direct
                      305

                      99.5
                      Below reporting threshold
                      1

                      99.9
                      Total new obligations
                      333
                      241

          Employment Summary

                      Identification code 75–0119–0–1–551
                      2012 actual
                      2013 CR
                      2014 est.

                      1001
                      Direct civilian full-time equivalent employment
                      16

             Prevention and Public Health Fund

             Program and Financing (in millions of dollars)

                      Identification code 75–0116–0–1–551
                      2012 actual
                      2013 CR
                      2014 est.

                      Obligations by program activity:

                      0001
                      Direct program activity

                      1,000

                      Budgetary Resources:

                      Budget authority:

                      Appropriations, mandatory:

                      1200
                      Appropriation
                      1,000
                      1,250
                      1,250

                      1220
                      Appropriations transferred to other accts [75–0142]
                      –20

                      –25

                      1220
                      Appropriations transferred to other accts [75–1700]
                      –12

                      1220
                      Appropriations transferred to other accts [75–0943]
                      –809

                      –755

                      1220
                      Appropriations transferred to other accts [75–9912]
                      –30

                      –105

                      1220
                      Appropriations transferred to other accts [75–0350]
                      –37

                      –57

                      1220
                      Appropriations transferred to other accts [75–1362]
                      –92

                      –58

                      1230
                      Appropriations and/or unobligated balance of appropriations permanently reduced

                      –250
                      –250

                      1260
                      Appropriations, mandatory (total)

                      1,000

                      1930
                      Total budgetary resources available

                      1,000

                      Change in obligated balance:

                      Unpaid obligations:

                      3000
                      Unpaid obligations, brought forward, Oct 1

                      890

                      3010
                      Obligations incurred, unexpired accounts

                      1,000

                      3020
                      Outlays (gross)

                      –110
                      –800

                      3050
                      Unpaid obligations, end of year

                      890
                      90

                      Memorandum (non-add) entries:

                      3100
                      Obligated balance, start of year

                      890

                      3200
                      Obligated balance, end of year

                      890
                      90

                      Budget authority and outlays, net:

                      Mandatory:

                      4090
                      Budget authority, gross

                      1,000

                      Outlays, gross:

                      4100
                      Outlays from new mandatory authority

                      110

                      4101
                      Outlays from mandatory balances

                      800

                      4110
                      Outlays, gross (total)

                      110
                      800

                      4180
                      Budget authority, net (total)

                      1,000

                      4190
                      Outlays, net (total)

                      110
                      800

             The Affordable Care Act, (P.L. 111–148) establishes the Prevention and Public Health Fund as a mandatory appropriation for
                prevention and public health activities.  For FY 2014, $1.00 billion is available within the Fund to support a range of public
                health efforts intended to prevent disease and reduce health care costs.  The Secretary has authority to transfer to accounts
                within HHS.

          Object Classification (in millions of dollars)

                      Identification code 75–0116–0–1–551
                      2012 actual
                      2013 CR
                      2014 est.

                      Direct obligations:

                      25.2
                      Other services from non-Federal sources

                      250

                      41.0
                      Grants, subsidies, and contributions

                      750

                      99.9
                      Total new obligations

                      1,000

             Pregnancy Assistance Fund

             Program and Financing (in millions of dollars)

                      Identification code 75–0117–0–1–551
                      2012 actual
                      2013 CR
                      2014 est.

                      Obligations by program activity:

                      0001
                      Direct program activity
                      25
                      25
                      25

                      Budgetary Resources:

                      Budget authority:

                      Appropriations, mandatory:

                      1200
                      Appropriation
                      25
                      25
                      25

                      1260
                      Appropriations, mandatory (total)
                      25
                      25
                      25

                      1930
                      Total budgetary resources available
                      25
                      25
                      25

                      Change in obligated balance:

                      Unpaid obligations:

                      3000
                      Unpaid obligations, brought forward, Oct 1
                      40
                      39
                      39

                      3010
                      Obligations incurred, unexpired accounts
                      25
                      25
                      25

                      3020
                      Outlays (gross)
                      –26
                      –25
                      –21

                      3050
                      Unpaid obligations, end of year
                      39
                      39
                      43

                      Memorandum (non-add) entries:

                      3100
                      Obligated balance, start of year
                      40
                      39
                      39

                      3200
                      Obligated balance, end of year
                      39
                      39
                      43

                      Budget authority and outlays, net:

                      Mandatory:

                      4090
                      Budget authority, gross
                      25
                      25
                      25

                      Outlays, gross:

                      4100
                      Outlays from new mandatory authority
                      1
                      2
                      2

                      4101
                      Outlays from mandatory balances
                      25
                      23
                      19

                      4110
                      Outlays, gross (total)
                      26
                      25
                      21

                      4180
                      Budget authority, net (total)
                      25
                      25
                      25

                      4190
                      Outlays, net (total)
                      26
                      25
                      21

             For awarding competitive grants to States to assist pregnant and parenting teens and women.

          Object Classification (in millions of dollars)

                      Identification code 75–0117–0–1–551
                      2012 actual
                      2013 CR
                      2014 est.

                      Direct obligations:

                      25.3
                      Other goods and services from Federal sources
                      1
                      1
                      1

                      41.0
                      Grants, subsidies, and contributions
                      24
                      24
                      24

                      99.9
                      Total new obligations
                      25
                      25
                      25

             Section 241 Evaluation Transactions Account

             Program and Financing (in millions of dollars)

                      Identification code 75–3902–0–1–552
                      2012 actual
                      2013 CR
                      2014 est.

                      Obligations by program activity:

                      0801
                      Reimbursable program activity

                      530
                      1,331

                      0809
                      Reimbursable program activities, subtotal

                      530
                      1,331

                      0900
                      Total new obligations (object class 25.3)

                      530
                      1,331

                      Budgetary Resources:

                      Budget authority:

                      Spending authority from offsetting collections, discretionary:

                      1700
                      Collected

                      530
                      1,331

                      1750
                      Spending auth from offsetting collections, disc (total)

                      530
                      1,331

                      1930
                      Total budgetary resources available

                      530
                      1,331

                      Change in obligated balance:

                      Unpaid obligations:

                      3010
                      Obligations incurred, unexpired accounts

                      530
                      1,331

                      3020
                      Outlays (gross)

                      –530
                      –1,331

                      Budget authority and outlays, net:

                      Discretionary:

                      4000
                      Budget authority, gross

                      530
                      1,331

                      Outlays, gross:

                      4010
                      Outlays from new discretionary authority

                      530
                      1,331

                      Offsets against gross budget authority and outlays:

                      Offsetting collections (collected) from:

                      4030
                      Federal sources

                      –530
                      –1,331

             The Public Health Service Act (PHS) Evaluation Transactions account supports the execution of section 241 of the PHS Act.

          Object Classification (in millions of dollars)

                      Identification code 75–3902–0–1–552
                      2012 actual
                      2013 CR
                      2014 est.

                      99.0
                      Reimbursable obligations

                      530
                      1,331

             Program Support Center

             Federal Funds
             Retirement Pay and Medical Benefits for Commissioned OfficersFor 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, and for medical care of dependents and retired
             personnel under the Dependents' Medical Care Act, such amounts as may be required during the current fiscal year.  Note.—A full-year 2013 appropriation for this account was not enacted at the time the budget was prepared; therefore, the
                budget assumes this account is operating under the Continuing Appropriations Resolution, 2013 (P.L. 112–175). The amounts
                included for 2013 reflect the annualized level provided by the continuing resolution.
          Program and Financing (in millions of dollars)

                      Identification code 75–0379–0–1–551
                      2012 actual
                      2013 CR
                      2014 est.

                      Obligations by program activity:

                      0001
                      Retirement payments
                      405
                      394
                      415

                      0002
                      Survivors' benefits
                      25
                      27
                      28

                      0003
                      Medical care
                      94
                      101
                      108

                      0900
                      Total new obligations
                      524
                      522
                      551

                      Budgetary Resources:

                      Budget authority:

                      Appropriations, mandatory:

                      1200
                      Appropriation
                      524
                      522
                      551

                      1260
                      Appropriations, mandatory (total)
                      524
                      522
                      551

                      1930
                      Total budgetary resources available
                      524
                      522
                      551

                      Change in obligated balance:

                      Unpaid obligations:

                      3000
                      Unpaid obligations, brought forward, Oct 1
                      29
                      101
                      31

                      3001
                      Adjustments to unpaid obligations, brought forward, Oct 1

                      –31

                      3010
                      Obligations incurred, unexpired accounts
                      524
                      522
                      551

                      3011
                      Obligations incurred, expired accounts
                      10

                      3020
                      Outlays (gross)
                      –453
                      –561
                      –549

                      3041
                      Recoveries of prior year unpaid obligations, expired
                      –9

                      3050
                      Unpaid obligations, end of year
                      101
                      31
                      33

                      Memorandum (non-add) entries:

                      3100
                      Obligated balance, start of year
                      29
                      70
                      31

                      3200
                      Obligated balance, end of year
                      101
                      31
                      33

                      Budget authority and outlays, net:

                      Mandatory:

                      4090
                      Budget authority, gross
                      524
                      522
                      551

                      Outlays, gross:

                      4100
                      Outlays from new mandatory authority
                      440
                      496
                      523

                      4101
                      Outlays from mandatory balances
                      13
                      65
                      26

                      4110
                      Outlays, gross (total)
                      453
                      561
                      549

                      4180
                      Budget authority, net (total)
                      524
                      522
                      551

                      4190
                      Outlays, net (total)
                      453
                      561
                      549

          Summary of Budget Authority and Outlays (in millions of dollars)

                      2012 actual
                      2013 CR
                      2014 est.

                      Enacted/requested:

                      Budget Authority
                      524
                      522
                      551

                      Outlays
                      453
                      561
                      549

                      Legislative proposal, subject to PAYGO:

                      Budget Authority

                      –1

                      Outlays

                      –1

                      Total:

                      Budget Authority
                      524
                      522
                      550

                      Outlays
                      453
                      561
                      548

             The number of beneficiaries using the Commissioned Corps system is estimated as follows:
             Retirement Pay, Survivor Benefits, and Medical Benefits

                         2012
                         2013
                         2014

                         Active Duty:

                         HHS
                         4888
                         4935
                         4938

                         DOJ, BOP
                         812
                         845
                         845

                         Homeland Security
                         474
                         509
                         509

                         EPA
                         74
                         70
                         70

                         All Other
                         380
                         407
                         407

                         Total Active Duty
                         6628
                         6766
                         6769

                         Retirees & Survivors:

                         Retirees
                         5430
                         5565
                         5700

                         Retiree family members and survivors
                         979
                         1000
                         1021

                         Total Retirement Pay
                         6409
                         6565
                         6721

                         Total Beneficiaries (active duty, retirees, survivors)
                         13037
                         13331
                         13490

             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, retirees, and dependents of members and retirees of the PHS Commissioned
                Corps.

          Object Classification (in millions of dollars)

                      Identification code 75–0379–0–1–551
                      2012 actual
                      2013 CR
                      2014 est.

                      Direct obligations:

                      13.0
                      Benefits for former personnel
                      430
                      421
                      443

                      25.6
                      Medical care
                      94
                      101
                      108

                      99.9
                      Total new obligations
                      524
                      522
                      551

             Retirement Pay and Medical Benefits for Commissioned Officers

             (Legislative proposal, subject to PAYGO)Program and Financing (in millions of dollars)

                      Identification code 75–0379–4–1–551
                      2012 actual
                      2013 CR
                      2014 est.

                      Obligations by program activity:

                      0001
                      Direct program activity

                      –1

                      0900
                      Total new obligations (object class 25.6)

                      –1

                      Budgetary Resources:

                      Budget authority:

                      Appropriations, mandatory:

                      1200
                      Appropriation

                      –1

                      1260
                      Appropriations, mandatory (total)

                      –1

                      1930
                      Total budgetary resources available

                      –1

                      Change in obligated balance:

                      Unpaid obligations:

                      3010
                      Obligations incurred, unexpired accounts

                      –1

                      3020
                      Outlays (gross)

                      1

                      Budget authority and outlays, net:

                      Mandatory:

                      4090
                      Budget authority, gross

                      –1

                      Outlays, gross:

                      4100
                      Outlays from new mandatory authority

                      –1

                      4180
                      Budget authority, net (total)

                      –1

                      4190
                      Outlays, net (total)

                      –1

             HHS Accrual Contribution to the Uniformed Services Retiree Health Care Fund

             Program and Financing (in millions of dollars)

                      Identification code 75–0170–0–1–551
                      2012 actual
                      2013 CR
                      2014 est.

                      Obligations by program activity:

                      0001
                      Medicare eligible accruals
                      36
                      29
                      28

                      0900
                      Total new obligations (object class 12.2)
                      36
                      29
                      28

                      Budgetary Resources:

                      Budget authority:

                      Appropriations, discretionary:

                      1100
                      Appropriation
                      36
                      29
                      28

                      1160
                      Appropriation, discretionary (total)
                      36
                      29
                      28

                      1930
                      Total budgetary resources available
                      36
                      29
                      28

                      Change in obligated balance:

                      Unpaid obligations:

                      3010
                      Obligations incurred, unexpired accounts
                      36
                      29
                      28

                      3020
                      Outlays (gross)
                      –36
                      –29
                      –28

                      Budget authority and outlays, net:

                      Discretionary:

                      4000
                      Budget authority, gross
                      36
                      29
                      28

                      Outlays, gross:

                      4010
                      Outlays from new discretionary authority
                      36
                      29
                      28

                      4180
                      Budget authority, net (total)
                      36
                      29
                      28

                      4190
                      Outlays, net (total)
                      36
                      29
                      28

          Summary of Budget Authority and Outlays (in millions of dollars)

                      2012 actual
                      2013 CR
                      2014 est.

                      Enacted/requested:

                      Budget Authority
                      36
                      29
                      28

                      Outlays
                      36
                      29
                      28

                      Legislative proposal, not subject to PAYGO:

                      Budget Authority

                      –2

                      Outlays

                      –2

                      Total:

                      Budget Authority
                      36
                      29
                      26

                      Outlays
                      36
                      29
                      26

             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).

             HHS Accrual Contribution to the Uniformed Services Retiree Health Care Fund

             (Legislative proposal, not subject to PAYGO)Program and Financing (in millions of dollars)

                      Identification code 75–0170–2–1–551
                      2012 actual
                      2013 CR
                      2014 est.

                      Obligations by program activity:

                      0001
                      Direct Program Activity

                      –2

                      0900
                      Total new obligations (object class 12.2)

                      –2

                      Budgetary Resources:

                      Budget authority:

                      Appropriations, discretionary:

                      1100
                      Appropriation

                      –2

                      1160
                      Appropriation, discretionary (total)

                      –2

                      1930
                      Total budgetary resources available

                      –2

                      Change in obligated balance:

                      Unpaid obligations:

                      3010
                      Obligations incurred, unexpired accounts

                      –2

                      3020
                      Outlays (gross)

                      2

                      Budget authority and outlays, net:

                      Discretionary:

                      4000
                      Budget authority, gross

                      –2

                      Outlays, gross:

                      4010
                      Outlays from new discretionary authority

                      –2

                      4180
                      Budget authority, net (total)

                      –2

                      4190
                      Outlays, net (total)

                      –2

             Health Activities Funds

             Program and Financing (in millions of dollars)

                      Identification code 75–9913–0–1–552
                      2012 actual
                      2013 CR
                      2014 est.

                      Change in obligated balance:

                      Unpaid obligations:

                      3000
                      Unpaid obligations, brought forward, Oct 1
                      1
                      1
                      1

                      3050
                      Unpaid obligations, end of year
                      1
                      1
                      1

                      Memorandum (non-add) entries:

                      3100
                      Obligated balance, start of year
                      1
                      1
                      1

                      3200
                      Obligated balance, end of year
                      1
                      1
                      1

             This display shows activities in support of scientific activities overseas that were supported by foreign currencies by the
                United States abroad.

             HHS Service and Supply Fund

             Program and Financing (in millions of dollars)

                      Identification code 75–9941–0–4–551
                      2012 actual
                      2013 CR
                      2014 est.

                      Obligations by program activity:

                      0801
                      Program Support Center
                      887
                      775
                      785

                      0802
                      OS activities
                      116
                      309
                      318

                      0900
                      Total new obligations
                      1,003
                      1,084
                      1,103

                      Budgetary Resources:

                      Unobligated balance:

                      1000
                      Unobligated balance brought forward, Oct 1
                      216
                      103
                      103

                      1021
                      Recoveries of prior year unpaid obligations
                      67

                      1050
                      Unobligated balance (total)
                      283
                      103
                      103

                      Budget authority:

                      Spending authority from offsetting collections, discretionary:

                      1700
                      Collected
                      1,019
                      1,084
                      1,103

                      1701
                      Change in uncollected payments, Federal sources
                      –196

                      1750
                      Spending auth from offsetting collections, disc (total)
                      823
                      1,084
                      1,103

                      1930
                      Total budgetary resources available
                      1,106
                      1,187
                      1,206

                      Memorandum (non-add) entries:

                      1941
                      Unexpired unobligated balance, end of year
                      103
                      103
                      103

                      Change in obligated balance:

                      Unpaid obligations:

                      3000
                      Unpaid obligations, brought forward, Oct 1
                      415
                      509
                      25

                      3010
                      Obligations incurred, unexpired accounts
                      1,003
                      1,084
                      1,103

                      3020
                      Outlays (gross)
                      –842
                      –1,568
                      –1,103

                      3040
                      Recoveries of prior year unpaid obligations, unexpired
                      –67

                      3050
                      Unpaid obligations, end of year
                      509
                      25
                      25

                      Uncollected payments:

                      3060
                      Uncollected pymts, Fed sources, brought forward, Oct 1
                      –481
                      –285
                      –285

                      3070
                      Change in uncollected pymts, Fed sources, unexpired
                      196

                      3090
                      Uncollected pymts, Fed sources, end of year
                      –285
                      –285
                      –285

                      Memorandum (non-add) entries:

                      3100
                      Obligated balance, start of year
                      –66
                      224
                      –260

                      3200
                      Obligated balance, end of year
                      224
                      –260
                      –260

                      Budget authority and outlays, net:

                      Discretionary:

                      4000
                      Budget authority, gross
                      823
                      1,084
                      1,103

                      Outlays, gross:

                      4010
                      Outlays from new discretionary authority
                      600
                      1,084
                      1,103

                      4011
                      Outlays from discretionary balances
                      242
                      484

                      4020
                      Outlays, gross (total)
                      842
                      1,568
                      1,103

                      Offsets against gross budget authority and outlays:

                      Offsetting collections (collected) from:

                      4030
                      Federal sources
                      –1,012
                      –1,084
                      –1,103

                      4033
                      Non-Federal sources
                      –7

                      4040
                      Offsets against gross budget authority  and outlays (total)
                      –1,019
                      –1,084
                      –1,103

                      Additional offsets against gross budget authority only:

                      4050
                      Change in uncollected pymts, Fed sources, unexpired
                      196

                      4080
                      Outlays, net (discretionary)
                      –177
                      484

                      4190
                      Outlays, net (total)
                      –177
                      484

             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 includes activities such as personnel and payroll support, information
                technology, 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 include the fund manager, departmental contracts, audit resolutions, Commissioned
                Corps force management, web management, claims, acquisition integration and modernization, small business, grants tracking,
                the physical access aspects of the Department's implementation of Homeland Security Presidential Directive 12, and commercial
                services management.

             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
                      2012 actual
                      2013 CR
                      2014 est.

                      Reimbursable obligations:

                      Personnel compensation:

                      11.1
                      Full-time permanent
                      110
                      103
                      103

                      11.3
                      Other than full-time permanent
                      4
                      2
                      2

                      11.5
                      Other personnel compensation
                      2
                      3
                      3

                      11.7
                      Military personnel
                      8
                      10
                      10

                      11.8
                      Special personal services payments
                      10

                      11.9
                      Total personnel compensation
                      134
                      118
                      118

                      12.1
                      Civilian personnel benefits
                      32
                      29
                      29

                      12.2
                      Military personnel benefits
                      4
                      2
                      2

                      21.0
                      Travel and transportation of persons
                      2
                      2
                      2

                      22.0
                      Transportation of things
                      3
                      4
                      4

                      23.1
                      Rental payments to GSA
                      25
                      22
                      22

                      23.3
                      Communications, utilities, and miscellaneous charges
                      32
                      6
                      6

                      24.0
                      Printing and reproduction
                      2
                      3
                      3

                      25.1
                      Advisory and assistance services
                      36
                      56
                      57

                      25.2
                      Other services from non-Federal sources
                      480
                      612
                      625

                      25.3
                      Other goods and services from Federal sources
                      127
                      69
                      71

                      25.4
                      Operation and maintenance of facilities
                      18
                      7
                      7

                      25.6
                      Medical care
                      14
                      29
                      29

                      25.7
                      Operation and maintenance of equipment
                      51
                      92
                      94

                      26.0
                      Supplies and materials
                      41
                      31
                      32

                      31.0
                      Equipment
                      2
                      2
                      2

                      99.9
                      Total new obligations
                      1,003
                      1,084
                      1,103

          Employment Summary

                      Identification code 75–9941–0–4–551
                      2012 actual
                      2013 CR
                      2014 est.

                      2001
                      Reimbursable civilian full-time equivalent employment
                      1,280
                      1,166
                      1,168

                      2101
                      Reimbursable military average strength employment
                      94
                      94
                      94

                      3101
                      Allocation account military average strength employment
                      1,665
                      1,761
                      1,761

          Trust Funds
             Miscellaneous Trust Funds

             Special and Trust Fund Receipts (in millions of dollars)

                      Identification code 75–9971–0–7–551
                      2012 actual
                      2013 CR
                      2014 est.

                      0100
                      Balance, start of year

                      3

                      Receipts:

                      0220
                      Contributions, Indian Health Facilities
                      48
                      48
                      48

                      0221
                      Contributions, N.I.H., Unconditional Gift Fund
                      3
                      3
                      3

                      0222
                      Centers for Disease Control, Gifts and Donations
                      15
                      15
                      15

                      0223
                      Contributions, N.I.H., Conditional Gift Fund
                      27
                      27
                      27

                      0224
                      Contributions to the Indian Health Service Gift Fund
                      1
                      1
                      1

                      0299
                      Total receipts and collections
                      94
                      94
                      94

                      0400
                      Total: Balances and collections
                      94
                      94
                      97

                      Appropriations:

                      0500
                      Miscellaneous Trust Funds
                      –94
                      –91
                      –91

                      0799
                      Balance, end of year

                      3
                      6

          Program and Financing (in millions of dollars)

                      Identification code 75–9971–0–7–551
                      2012 actual
                      2013 CR
                      2014 est.

                      Obligations by program activity:

                      0002
                      Gifts
                      55
                      57
                      57

                      0003
                      Contributions, Indian Health Facilities
                      33
                      35
                      35

                      0900
                      Total new obligations
                      88
                      92
                      92

                      Budgetary Resources:

                      Unobligated balance:

                      1000
                      Unobligated balance brought forward, Oct 1
                      114
                      133
                      132

                      1021
                      Recoveries of prior year unpaid obligations
                      13

                      1050
                      Unobligated balance (total)
                      127
                      133
                      132

                      Budget authority:

                      Appropriations, mandatory:

                      1201
                      Appropriation (special or trust fund)
                      94
                      91
                      91

                      1260
                      Appropriations, mandatory (total)
                      94
                      91
                      91

                      1930
                      Total budgetary resources available
                      221
                      224
                      223

                      Memorandum (non-add) entries:

                      1941
                      Unexpired unobligated balance, end of year
                      133
                      132
                      131

                      Change in obligated balance:

                      Unpaid obligations:

                      3000
                      Unpaid obligations, brought forward, Oct 1
                      61
                      76
                      127

                      3010
                      Obligations incurred, unexpired accounts
                      88
                      92
                      92

                      3020
                      Outlays (gross)
                      –60
                      –41
                      –56

                      3040
                      Recoveries of prior year unpaid obligations, unexpired
                      –13

                      3050
                      Unpaid obligations, end of year
                      76
                      127
                      163

                      Memorandum (non-add) entries:

                      3100
                      Obligated balance, start of year
                      61
                      76
                      127

                      3200
                      Obligated balance, end of year
                      76
                      127
                      163

                      Budget authority and outlays, net:

                      Mandatory:

                      4090
                      Budget authority, gross
                      94
                      91
                      91

                      Outlays, gross:

                      4100
                      Outlays from new mandatory authority
                      22
                      9
                      9

                      4101
                      Outlays from mandatory balances
                      38
                      32
                      47

                      4110
                      Outlays, gross (total)
                      60
                      41
                      56

                      4180
                      Budget authority, net (total)
                      94
                      91
                      91

                      4190
                      Outlays, net (total)
                      60
                      41
                      56

                      Memorandum (non-add) entries:

                      5000
                      Total investments, SOY: Federal securities: Par value
                      28
                      25
                      25

                      5001
                      Total investments, EOY: Federal securities: Par value
                      25
                      25
                      25

             (in millions of dollars)

                         2012
                         2013
                         2014

                         Distribution of budget authority by account:

                         Gifts
                         55
                         57
                         57

                         Contributions, Indian Health Facilities
                         33
                         35
                         35

                         Distribution of outlays by account:

                         Gifts
                         30
                         21
                         28

                         Contributions, Indian Health Facilities
                         30
                         20
                         28

             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
                      2012 actual
                      2013 CR
                      2014 est.

                      Direct obligations:

                      Personnel compensation:

                      11.1
                      Full-time permanent
                      2
                      2
                      2

                      11.3
                      Other than full-time permanent
                      1
                      1
                      1

                      11.8
                      Special personal services payments
                      1

                      11.9
                      Total personnel compensation
                      4
                      3
                      3

                      12.1
                      Civilian personnel benefits
                      1
                      1
                      1

                      21.0
                      Travel and transportation of persons
                      1
                      1
                      1

                      25.1
                      Advisory and assistance services
                      3
                      3
                      3

                      25.2
                      Other services from non-Federal sources
                      13
                      13
                      13

                      25.3
                      Other goods and services from Federal sources
                      14
                      14
                      14

                      25.5
                      Research and development contracts
                      8
                      8
                      8

                      25.6
                      Medical care
                      1
                      1
                      1

                      26.0
                      Supplies and materials
                      6
                      6
                      6

                      31.0
                      Equipment
                      5
                      6
                      6

                      41.0
                      Grants, subsidies, and contributions
                      32
                      36
                      36

                      99.9
                      Total new obligations
                      88
                      92
                      92

          Employment Summary

                      Identification code 75–9971–0–7–551
                      2012 actual
                      2013 CR
                      2014 est.

                      1001
                      Direct civilian full-time equivalent employment
                      27
                      27
                      27

             Office of the Inspector General

             Federal Funds
             Office of Inspector GeneralFor 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, [$58,579,000]$68,879,000: Provided, That of such amount, necessary sums shall be available for providing protective services to the Secretary of Health and
             Human Services and investigating non-payment of child support cases for which non-payment is a Federal offense under 18 U.S.C.
             228.   Note.—A full-year 2013 appropriation for this account was not enacted at the time the budget was prepared; therefore, the
                budget assumes this account is operating under the Continuing Appropriations Resolution, 2013 (P.L. 112–175). The amounts
                included for 2013 reflect the annualized level provided by the continuing resolution as well as amounts from P.L. 113–2, the
                Disaster Relief Appropriations Act, 2013 (no language shown).
          Program and Financing (in millions of dollars)

                      Identification code 75–0128–0–1–551
                      2012 actual
                      2013 CR
                      2014 est.

                      Obligations by program activity:

                      0001
                      Direct program
                      74
                      53
                      70

                      0801
                      HCFAC Reimbursable program
                      216
                      222
                      214

                      0802
                      Direct Reimbursable program
                      19
                      24
                      24

                      0803
                      HCFAC Discretionary allocation adjustment
                      24
                      103
                      114

                      0899
                      Total reimbursable obligations
                      259
                      349
                      352

                      0900
                      Total new obligations
                      333
                      402
                      422

                      Budgetary Resources:

                      Unobligated balance:

                      1000
                      Unobligated balance brought forward, Oct 1
                      44
                      9
                      25

                      1001
                      Discretionary unobligated balance brought fwd, Oct 1
                      5

                      1012
                      Unobligated balance transfers between expired and unexpired accounts
                      7
                      10

                      1021
                      Recoveries of prior year unpaid obligations
                      1

                      1050
                      Unobligated balance (total)
                      52
                      19
                      25

                      Budget authority:

                      Appropriations, discretionary:

                      1100
                      Appropriation
                      50
                      50
                      69

                      1121
                      Appropriations transferred from other accts [75–0140]

                      5

                      1160
                      Appropriation, discretionary (total)
                      50
                      55
                      69

                      Spending authority from offsetting collections, discretionary:

                      1700
                      Collected
                      29
                      140
                      132

                      1701
                      Change in uncollected payments, Federal sources
                      14

                      1750
                      Spending auth from offsetting collections, disc (total)
                      43
                      140
                      132

                      Spending authority from offsetting collections, mandatory:

                      1800
                      Collected
                      195
                      213
                      212

                      1801
                      Change in uncollected payments, Federal sources
                      13

                      1850
                      Spending auth from offsetting collections, mand (total)
                      208
                      213
                      212

                      1900
                      Budget authority (total)
                      301
                      408
                      413

                      1930
                      Total budgetary resources available
                      353
                      427
                      438

                      Memorandum (non-add) entries:

                      1940
                      Unobligated balance expiring
                      –11

                      1941
                      Unexpired unobligated balance, end of year
                      9
                      25
                      16

                      Change in obligated balance:

                      Unpaid obligations:

                      3000
                      Unpaid obligations, brought forward, Oct 1
                      61
                      56
                      51

                      3010
                      Obligations incurred, unexpired accounts
                      333
                      402
                      422

                      3011
                      Obligations incurred, expired accounts
                      4

                      3020
                      Outlays (gross)
                      –336
                      –407
                      –412

                      3040
                      Recoveries of prior year unpaid obligations, unexpired
                      –1

                      3041
                      Recoveries of prior year unpaid obligations, expired
                      –5

                      3050
                      Unpaid obligations, end of year
                      56
                      51
                      61

                      Uncollected payments:

                      3060
                      Uncollected pymts, Fed sources, brought forward, Oct 1
                      –73
                      –61
                      –61

                      3070
                      Change in uncollected pymts, Fed sources, unexpired
                      –27

                      3071
                      Change in uncollected pymts, Fed sources, expired
                      39

                      3090
                      Uncollected pymts, Fed sources, end of year
                      –61
                      –61
                      –61

                      Memorandum (non-add) entries:

                      3100
                      Obligated balance, start of year
                      –12
                      –5
                      –10

                      3200
                      Obligated balance, end of year
                      –5
                      –10

                      Budget authority and outlays, net:

                      Discretionary:

                      4000
                      Budget authority, gross
                      93
                      195
                      201

                      Outlays, gross:

                      4010
                      Outlays from new discretionary authority
                      82
                      184
                      191

                      4011
                      Outlays from discretionary balances
                      19
                      7
                      9

                      4020
                      Outlays, gross (total)
                      101
                      191
                      200

                      Offsets against gross budget authority and outlays:

                      Offsetting collections (collected) from:

                      4030
                      Federal sources
                      –66
                      –140
                      –132

                      Additional offsets against gross budget authority only:

                      4050
                      Change in uncollected pymts, Fed sources, unexpired
                      –14

                      4052
                      Offsetting collections credited to expired accounts
                      37

                      4060
                      Additional offsets against budget authority only (total)
                      23

                      4070
                      Budget authority, net (discretionary)
                      50
                      55
                      69

                      4080
                      Outlays, net (discretionary)
                      35
                      51
                      68

                      Mandatory:

                      4090
                      Budget authority, gross
                      208
                      213
                      212

                      Outlays, gross:

                      4100
                      Outlays from new mandatory authority
                      177
                      213
                      212

                      4101
                      Outlays from mandatory balances
                      58
                      3

                      4110
                      Outlays, gross (total)
                      235
                      216
                      212

                      Offsets against gross budget authority and outlays:

                      Offsetting collections (collected) from:

                      4120
                      Federal sources
                      –157
                      –201
                      –200

                      4123
                      Non-Federal sources
                      –20
                      –12
                      –12

                      4130
                      Offsets against gross budget authority and outlays (total)
                      –177
                      –213
                      –212

                      Additional offsets against gross budget authority only:

                      4140
                      Change in uncollected pymts, Fed sources, unexpired
                      –13

                      4142
                      Offsetting collections credited to expired accounts
                      –18

                      4150
                      Additional offsets against budget authority only (total)
                      –31

                      4170
                      Outlays, net (mandatory)
                      58
                      3

                      4180
                      Budget authority, net (total)
                      50
                      55
                      69

                      4190
                      Outlays, net (total)
                      93
                      54
                      68

              The Office of Inspector General (OIG) is an independent and objective oversight unit of the U.S. Department of Health and
                Human Services (HHS) that promotes economy, efficiency, and effectiveness through preventing and detecting fraud, waste, and
                abuse in the Department's programs and operations.  OIG fulfills its mission through a broad range of audits, evaluations,
                investigations, and enforcement and compliance activities.  In addition to discretionary appropriations, OIG receives funds
                through the Health Care Fraud and Abuse Control (HCFAC) account created by the Health Insurance Portability and Accountability
                Act of 1996.

          Object Classification (in millions of dollars)

                      Identification code 75–0128–0–1–551
                      2012 actual
                      2013 CR
                      2014 est.

                      Direct obligations:

                      Personnel compensation:

                      11.1
                      Full-time permanent
                      40
                      28
                      36

                      11.3
                      Other than full-time permanent
                      1
                      1
                      1

                      11.9
                      Total personnel compensation
                      41
                      29
                      37

                      12.1
                      Civilian personnel benefits
                      14
                      10
                      13

                      21.0
                      Travel and transportation of persons
                      2
                      1
                      2

                      22.0
                      Transportation of things
                      1

                      1

                      23.1
                      Rental payments to GSA
                      3
                      5
                      3

                      23.3
                      Communications, utilities, and miscellaneous charges
                      1
                      1
                      1

                      25.2
                      Other services from non-Federal sources
                      2
                      1
                      3

                      25.3
                      Other goods and services from Federal sources
                      5
                      4
                      7

                      25.4
                      Operation and maintenance of facilities
                      2
                      1
                      1

                      25.7
                      Operation and maintenance of equipment
                      1

                      26.0
                      Supplies and materials
                      1

                      31.0
                      Equipment
                      1
                      1
                      2

                      99.0
                      Direct obligations
                      74
                      53
                      70

                      99.0
                      Reimbursable obligations
                      259
                      349
                      352

                      99.9
                      Total new obligations
                      333
                      402
                      422

          Employment Summary

                      Identification code 75–0128–0–1–551
                      2012 actual
                      2013 CR
                      2014 est.

                      1001
                      Direct civilian full-time equivalent employment
                      404
                      273
                      346

                      2001
                      Reimbursable civilian full-time equivalent employment
                      1,369
                      1,610
                      1,684

             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)

                      2012 actual
                      2013 CR
                      2014 est.

                      Offsetting receipts from the public:

                      75–143500
                      General Fund Proprietary Interest Receipts, not Otherwise Classified
                      93
                      90
                      90

                      75–274530
                      Health Education Assistance Loans, Downward Reestimates of Subsidies
                      12

                      75–310700
                      Federal Share of Child Support Collections
                      789
                      852
                      831

                      Legislative proposal, subject to PAYGO

                      4

                      75–322000
                      All Other General Fund Proprietary Receipts Including Budget Clearing Accounts
                      34
                      34
                      34

                      General Fund Offsetting receipts from the public
                      928
                      976
                      959

                      Intragovernmental payments:

                      75–388500
                      Undistributed Intragovernmental Payments and Receivables from Cancelled Accounts
                      –27

                      General Fund Intragovernmental payments
                      –27

             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]202.  None of the discretionary funds appropriated in this title [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 II.SEC. [204]203.  Notwithstanding section 241(a) of the PHS Act, such portion as the Secretary shall determine, but not more than [3.2]3.0 percent, of any amounts appropriated for programs authorized under such 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. [205]204.  Not to exceed 1 percent of any discretionary funds (pursuant to the Balanced Budget and Emergency Deficit Control Act of
          1985) which are appropriated for the current fiscal year for HHS in this Act may be transferred between appropriations, but
          no such appropriation shall be increased by more than 3 percent by any such transfer: Provided, That the transfer authority granted by this section shall not be used to create any new program or to fund any project or
          activity for which no funds are provided in this Act: Provided further, That the Committees on Appropriations of the House of Representatives and the Senate are notified at least 15 days in advance
          of any transfer.'

          (transfer of funds)SEC. [206]205.  The Director of the NIH, jointly with the Director of the Office of AIDS Research, may transfer up to 3 percent among institutes
          and centers from the total amounts identified by these two Directors as funding for research pertaining to the human immunodeficiency
          virus: Provided, That the Committees on Appropriations of the House of Representatives and the Senate are notified at least 15 days in advance
          of any transfer.'

          (transfer of funds)SEC. [207]206.  Of the amounts made available in this Act for NIH, the amount for research related to the human immunodeficiency virus, as
          jointly determined by the Director of NIH 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 PHS Act.SEC. [208]207.  None of the funds appropriated in this Act may be made available to any entity under title X of the PHS 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. [209]208.  Notwithstanding any other provision of law, no provider of services under title X of the PHS Act shall be exempt from any
          State law requiring notification or the reporting of child abuse, child molestation, sexual abuse, rape, or incest.SEC. [210]209.  None of the funds appropriated by this Act (including funds appropriated to any trust fund) may be used to carry out the
          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
          Advantage organization described in this section shall be responsible for informing enrollees where to obtain information
          about all Medicare covered services.SEC. [211]210.  In order for HHS 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 [2013] 2014:
          (1)  The Secretary 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. The Secretary 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 and other applicable statutes administered by the Department of State.

          (2)  The Secretary 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 HHS. The Department of State shall cooperate fully with the Secretary to ensure that HHS 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 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.

          (3)  The Secretary is authorized to provide to personnel appointed or assigned by the Secretary to serve abroad, allowances and
             benefits similar to those provided under chapter 9 of title I of the Foreign Service Act of 1980, and 22 U.S.C. 4081 through
             4086 and subject to such regulations prescribed by the Secretary. The Secretary is further authorized to provide locality-based
             comparability payments (stated as a percentage) up to the amount of the locality-based comparability payment (stated as a
             percentage) that would be payable to such personnel under section 5304 of title 5, United States Code if such personnel's
             official duty station were in the District of Columbia. Leaves of absence for personnel under this subsection shall be on
             the same basis as that provided under subchapter I of chapter 63 of title 5, United States Code, or section 903 of the Foreign
             Service Act of 1980, to individuals serving in the Foreign Service.
          SEC. [212]211. (a) Authority.—Notwithstanding any other provision of law, the Director of NIH ("Director'') may use funds available under section 402(b)(7)
          or 402(b)(12) of the PHS Act to enter into transactions (other than contracts, cooperative agreements, or grants) to carry
          out research identified pursuant to such section 402(b)(7) (pertaining to the Common Fund) or research and activities described
          in such section 402(b)(12).
          (b) Peer Review.—In entering into transactions under subsection (a), the Director 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 PHS
             Act.
          SEC. [213]212.  Funds which are available for Individual Learning Accounts for employees of CDC and the Agency for Toxic Substances and Disease
          Registry ("ATSDR'') may be transferred to appropriate accounts of CDC, 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. [214]213.  Notwithstanding any other provisions of law, discretionary funds made available in this Act may be used to continue operating
          the Council on Graduate Medical Education established by section 301 of Public Law 102–408.SEC. [215]214.  Not to exceed $45,000,000 of funds appropriated by this Act to the institutes and centers of the National Institutes of Health
          may be used for alteration, repair, or improvement of facilities, as necessary for the proper and efficient conduct of the
          activities authorized herein, at not to exceed $3,500,000 per project.'

          (transfer of funds)SEC. [216]215.  Of the amounts made available for NIH, 1 percent of the amount made available for National Research Service Awards ("NRSA'')
          shall be made available to the Administrator of the Health Resources and Services Administration to make NRSA awards for research
          in primary medical care to individuals affiliated with entities who have received grants or contracts under section 747 of
          the PHS Act, and 1 percent of the amount made available for NRSA shall be made available to the Director of the Agency for
          Healthcare Research and Quality to make NRSA awards for health service research.[SEC. 217. Such portion as the Secretary shall determine, but not more than 1 percent, of any discretionary funds which are appropriated
          in this Act for the current fiscal year for domestic HIV/AIDS activities in any program, project, or activity carried out
          by the Department of Health and Human Services shall be made available to the Office of the Assistant Secretary for Health
          to support the National HIV/AIDS Strategy: Provided, That such support may be provided directly, or by grants or contracts, on a reimbursable basis.]SEC. [218]216.
          (a) A state shall be entitled to receive a grant under section 510 of the Social Security Act (42 U.S.C. 710) for fiscal year
             [2013] 2014 only if the Department of Health and Human Services receives an application under section 505(a) of such Act (42 U.S.C. 705(a))
             for such fiscal year by no later than September 20, [2013] 2014.

             (b) CANCELLATION.—The remaining unobligated balances of the amount appropriated for fiscal year [2013] 2014 by section 510(d) of such Act (42 U.S.C. 710(d)) for which no application has been received by September 20, [2013] 2014, shall be permanently cancelled as of September 27, [2013] 2014.

             (c) APPROPRIATION.—There is appropriated to the Department of Health and Human Services, to become available on September
                27, [2013] 2014, and to remain available through September 30, [2014] 2015, an amount equal to the unobligated balances cancelled pursuant to subsection (b), for carrying out (in addition to any other
                funds that may be available for such purpose) a program of competitive contracts and grants to State and local governments
                to develop approaches to reduce pregnancy among youth in foster care and to fund age appropriate evidence-based programs that
                reduce teenage pregnancy, behavioral risk factors underlying teen pregnancy, or other associated risk factors among youth
                in foster care and for the Federal costs associated with administering and evaluating such contracts and grants.

          SEC. 217.  The Director of the CDC, or the Administrator of the Agency for Toxic Substances and Disease Registry, may detail staff without
                reimbursement for up to 180 days, to support the CDC response to a public health emergency or urgent public health event that
                involves activation of the Emergency Operations Center at the CDC. SEC. 218.  Funds provided to the National Institutes of Health in this and subsequent acts may be used to support the Sanctuary System
                for Surplus Chimpanzees authorized by section 404K of the Public Health Service Act, including for the construction, renovation,
                and funding of current or additional facilities of the sanctuary system as authorized by section 404K, notwithstanding the
                limitations in subsection (g) of such section. SEC. 219.  In the event of a public health emergency declared under section 319 of the PHS Act, the Secretary of HHS may, during the
                duration of the emergency, transfer discretionary funds (pursuant to the Balanced Budget and Emergency Deficit Control Act
                of 1985) which are appropriated in this Act for the current fiscal year for HHS between appropriations for costs of responding
                to and aiding in recovery from such public health emergency: Provided, That no appropriation may be reduced by more than 10
                percent under this section: Provided further, That the Committees on Appropriations of the House of Representatives and the
                Senate shall be promptly notified of such transfers: Provided further, That this transfer authority is in addition to any
                other transfer authority. SEC. 220.  Notwithstanding section 338E(c)(2) of the PHS Act, unless funds have been paid to or on behalf of an individual under section
                338B(g) of such Act, the Secretary or the individual with whom the Secretary entered into a contract under section 338B of
                such Act in this or any subsequent fiscal year may terminate the contract within 60 days of its execution.  The party electing
                to terminate the contract under such section must provide written notice to the other party prior to expiration of the 60-day
                period, and termination of the contract shall be effective upon verified receipt of the termination notice. SEC. 221.  Health Information Technology User Fees.— (a) The Secretary of HHS shall prescribe by regulation, for application in the current fiscal year and in subsequent fiscal
                   years, a schedule of fees for certification of health information technology as established by Section 300jj-11(c)(5) of Title
                   42. The fees shall be paid by health information technology vendors based on the fee structure established by the Secretary
                   and published in the Federal Register. The Secretary shall periodically update this schedule of fees through a notice in the
                   Federal Register. This fee structure shall be designed to be sufficient to recover costs associated with the administration
                   of certification programs authorized by Section 300jj-11(c)(5) of Title 42, including the costs for health information technology
                   standards, testing and certification, and other related costs for improving the efficiency of certification programs.
          (b) Collection Procedures.—The Secretary shall prescribe procedures to collect the fees. The Secretary may, for the purpose
                   of collecting fees, use the services of a department, agency, or instrumentality authorized by the National Coordinator to
                   perform the certification of health information technology in accordance with Section 300jj-11(c)(5) of Title 42, and may
                   reimburse such department, agency, or instrumentality a reasonable amount for its services.
          (c) Collection, Deposit, and Use.—(1) Fees collected under this section shall be deposited in the HHS Office of the National
                   Coordinator for Health Information Technology account as offsetting collections.
          (2) Such fees shall be collected and available only to the extent and in such amounts as provided in advance in appropriations
                   acts.SEC. 222.  (a) The Biomedical Advanced Research and Development Authority (BARDA) may enter into a contract, for more than one but no
                more than ten program years, for purchase of research services or of security countermeasures, as that term is defined in
                section 319F-2(c)(1)(B) of the Public Health Service Act (42 U.S.C. 247d-6b(c)(1)(B)), if—
             (1) funds are available and obligated—

                (A) for the full period of the contract or for the first fiscal year in which the contract is in effect; and

           (B) for the estimated costs associated with a necessary termination of the contract; and

             (2) the Secretary determines that a multi-year contract will serve the best interests of the Federal Government by encouraging
                      full and open competition or promoting economy in administration, performance, and operation of BARDA's programs.

           (b) A contract entered into under this section:
           (1) shall include a termination clause as described by subsection (c) of section 3903 of title 41, United States Code; and

           (2) shall be subject to the congressional notice requirement stated in subsection (d) of such section.