[House Report 119-696]
[From the U.S. Government Publishing Office]
119th Congress } { Report
HOUSE OF REPRESENTATIVES
2d Session } { 119-696
_______________________________________________________________________
DEPARTMENTS OF LABOR, HEALTH, AND
HUMAN SERVICES, AND EDUCATION, AND
RELATED AGENCIES APPROPRIATIONS
BILL, 2027
----------
R E P O R T
OF THE
COMMITTEE ON APPROPRIATIONS
HOUSE OF REPRESENTATIVES
together with
MINORITY VIEWS
[TO ACCOMPANY H.R. 9260]
[GRAPHIC(S) NOT AVAILABLE IN TIFF FORMAT]
June 11, 2026.--Committed to the Committee of the Whole House on the
State of the Union and ordered to be printed
119th Congress } { Report
HOUSE OF REPRESENTATIVES
2d Session } { 119-696
_______________________________________________________________________
DEPARTMENTS OF LABOR, HEALTH, AND
HUMAN SERVICES, AND EDUCATION, AND
RELATED AGENCIES APPROPRIATIONS
BILL, 2027
__________
R E P O R T
OF THE
COMMITTEE ON APPROPRIATIONS
HOUSE OF REPRESENTATIVES
together with
MINORITY VIEWS
[TO ACCOMPANY H.R. 9260]
[GRAPHIC(S) NOT AVAILABLE IN TIFF FORMAT]
June 11, 2026.--Committed to the Committee of the Whole House on the
State of the Union and ordered to be printed
_______
U.S. GOVERNMENT PUBLISHING OFFICE
54-742 PDF WASHINGTON : 2024
119th Congress } { Report
HOUSE OF REPRESENTATIVES
2d Session } { 119-696
======================================================================
DEPARTMENTS OF LABOR, HEALTH AND HUMAN SERVICES, AND EDUCATION, AND
RELATED AGENCIES APPROPRIATIONS BILL, 2027
_______
June 11, 2026.--Committed to the Committee of the Whole House on the
State of the Union and ordered to be printed
_______
Mr. Aderholt, from the Committee on Appropriations,
submitted the following
R E P O R T
together with
MINORITY VIEWS
[To accompany H.R. 9260]
The Committee on Appropriations submits the following
report in explanation of the accompanying bill making
appropriations for the departments of Labor, Health and Human
Services (except the Food and Drug Administration, the Agency
for Toxic Substances and Disease Registry, and the Indian
Health Service), and Education, and the Committee for Purchase
from People Who Are Blind or Severely Disabled, Corporation for
National and Community Service, Corporation for Public
Broadcasting, Federal Mediation and Conciliation Service,
Federal Mine Safety and Health Review Commission, Institute of
Museum and Library Services, Medicaid and CHIP Payment and
Access Commission, Medicare Payment Advisory Commission,
National Council on Disability, National Labor Relations Board,
National Mediation Board, Occupational Safety and Health Review
Commission, Railroad Retirement Board, and Social Security
Administration for the fiscal year ending September 30, 2027,
and for other purposes.
INDEX TO BILL AND REPORT
Page number
Bill Report
List of Abbreviations......................................
6
Summary of Estimates and Appropriation.....................
9
General Summary of the Bill................................
9
Bill Wide Requirements.....................................
9
Title I--Department of Labor: 2
13
Employment and Training Administration............. 2
13
Training and Employment Services........... 2
15
Job Corps.................................. 8
20
Community Service Employment for Older
Americans..............................
21
Federal Unemployment Benefits and
Allowances............................. 9
21
State Unemployment Insurance and Employment
Service
Operations............................. 10
22
Advances to the Unemployment Trust Fund and
Other Funds............................ 17
24
Program Administration..................... 17
24
Veterans' Employment and Training.................. 17
24
Employee Benefits Security Administration.......... 21
26
Pension Benefit Guaranty Corporation............... 21
26
Office of Workers' Compensation Programs........... 23
28
Salaries and Expenses...................... 23
28
Special Benefits........................... 23
28
Energy Employees Occupational Illness
Compensation Fund...................... 26
29
Special Benefits for Disabled Coal Miners.. 26
29
Black Lung Disability Trust Fund........... 27
29
Wage and Hour Division............................. 23
27
Office of Federal Contract Compliance Programs.....
28
Office of Labor-Management Standards............... 23
28
Occupational Safety and Health Administration...... 27
30
Mine Safety and Health Administration.............. 30
31
Bureau of Labor Statistics......................... 32
32
Office of Disability Employment Policy............. 32
33
Departmental Management............................ 33
34
General Provisions................................. 35
36
Title II--Department of Health and Human Services: 49
38
Health Resources and Services Administration....... 49
38
Primary Health Care........................ 49
38
Health Workforce........................... 49
41
Maternal and Child Health.................. 54
48
Ryan White HIV/AIDS Program................ 55
55
Health Systems............................. 55
56
Rural Health............................... 56
57
HRSA-Wide Activities and Program Support... 58
62
Vaccine Injury Compensation Program........ 59
64
Centers for Disease Control and Prevention......... 59
65
Immunization and Respiratory Diseases...... 59
66
Viral Hepatitis, Sexually Transmitted
Disease, and
Tuberculosis Prevention................ 60
67
Emerging and Zoonotic Infectious Diseases.. 60
68
Chronic Disease Prevention and Health
Promotion.............................. 60
74
Birth Defects, Developmental Disabilities,
Disabilities and Health................ 61
80
Public Health Scientific Services.......... 61
83
Environmental Health....................... 61
85
Injury Prevention and Control.............. 61
87
National Institute for Occupational Safety
and Health............................. 62
88
Energy Employees Occupational Illness
Compensation
Program................................ 62
91
Global Health.............................. 62
92
Public Health Preparedness and Response.... 63
93
CDC-Wide Activities and Program Support.... 65
94
Buildings and Facilities................... 64
98
National Institutes of Health...................... 67
98
National Cancer Institute.................. 67
99
National Heart, Lung, and Blood Institute.. 67
106
National Institute of Dental and
Craniofacial Research.................. 67
109
National Institute of Diabetes and
Digestive and Kidney
Diseases............................... 67
110
National Institute of Neurological
Disorders and Stroke................... 68
111
National Institute of Allergy and
Infectious Diseases.................... 68
118
National Institute of General Medical
Sciences............................... 68
121
Eunice Kennedy Shriver National Institute
of Child Health and Human Development.. 68
123
National Eye Institute..................... 69
126
National Institute of Environmental Health
Sciences............................... 69
127
National Institute on Aging................ 69
127
National Institute of Arthritis and
Musculoskeletal and Skin Diseases...... 69
128
National Institute on Deafness and Other
Communication Disorders................ 69
129
National Institute of Nursing Research..... 70
129
National Institute on Alcohol Abuse and
Alcoholism............................. 70
130
National Institute on Drug Abuse........... 70
130
National Institute of Mental Health........ 70
132
National Human Genome Research Institute... 70
133
National Institute of Biomedical Imaging
and Bioengineering..................... 70
133
National Center for Complementary and
Integrative Health..................... 71
134
National Institute on Minority Health and
Health Disparities..................... 71
134
John E. Fogarty International Center....... 71
135
National Library of Medicine............... 71
135
National Center for Advancing Translational
Sciences............................... 72
136
Office of the Director..................... 72
137
Buildings and Facilities................... 74
153
Advanced Research Projects Agency for
Health................................. 74
153
Substance Abuse and Mental Health Services
Administration................................. 74
155
Mental Health.............................. 74
157
Substance Abuse Treatment.................. 77
166
Substance Abuse Prevention................. 78
171
Health Surveillance and Program Support.... 78
174
Agency for Healthcare Research and Quality.........
174
Centers for Medicare & Medicaid Services........... 79
174
Grants to States for Medicaid.............. 79
174
Payments to the Health Care Trust Funds.... 80
175
Program Management......................... 80
175
Health Care Fraud and Abuse Control Account 82
198
Administration for Children and Families........... 83
199
Payments to States for Child Support
Enforcement and
Family Support Programs................ 83
199
Low Income Home Energy Assistance.......... 84
199
Refugee and Entrant Assistance............. 85
199
Promoting Safe and Stable Families......... 92
203
Child Care and Development Block Grant..... 86
203
Social Services Block Grant................ 87
204
Children and Families Services Programs.... 87
205
Payments for Foster Care and Permanency.... 92
213
Administration for Community Living................ 93
214
Administration for Strategic Preparedness and
Response....................................... 96
221
Research, Development, and Procurement..... 96
226
Operations, Preparedness, and Emergency
Response............................... 98
233
Office of the Secretary............................ 99
237
General Departmental Management............ 99
237
Medicare Hearings and Appeals.............. 102
257
Office of the National Coordinator for
Health Information Technology.......... 102
257
Office of Inspector General................ 102
258
Office for Civil Rights.................... 103
259
General Provisions......................... 103
260
Title III--Department of Education: 133
264
Office of Elementary and Secondary
Education.............................. 133
264
Education for the Disadvantaged............ 133
264
Impact Aid................................. 134
267
School Improvement Programs................ 135
268
Safe Schools and Citizenship Education..... 139
270
Indian Education........................... 137
272
Innovation and Improvement................. 137
273
Office of English Language Acquisition.............
276
Office of Special Education and Rehabilitative
Services....................................... 140
276
Special Education.......................... 140
276
Rehabilitation Services.................... 145
279
Special Institutions for Persons with
Disabilities........................... 147
281
American Printing House for the Blind.... 147
281
National Technical Institute for the Deaf 147
281
Gallaudet University..................... 147
282
Office of Career, Technical, and Adult Education... 148
282
Office of Postsecondary Education.................. 149
290
Higher Education........................... 149
290
Howard University.......................... 152
298
College Housing and Academic Facilities
Loans.................................. 152
299
Historically Black College and University
Capital Financing Program Account...... 152
299
Office of Federal Student Aid...................... 148
284
Student Financial Assistance............... 148
287
Student Aid Administration................. 149
289
Institute of Education Sciences.................... 153
299
Departmental Management............................ 153
301
General Provisions................................. 154
306
Title IV--Related Agencies: 167
309
Committee for Purchase From People Who Are Blind or
Severely Disabled.............................. 167
309
Corporation for National and Community Service
(AmeriCorps)................................... 168
309
Federal Mediation and Conciliation Service......... 174
311
Federal Mine Safety and Health Review Commission... 175
312
Institute of Museum and Library Services........... 175
312
Medicaid and CHIP Payment and Access Commission.... 176
313
Medicare Payment Advisory Commission............... 176
313
National Council on Disability..................... 176
314
National Labor Relations Board..................... 176
314
National Mediation Board........................... 177
314
Occupational Safety and Health Review Commission... 178
315
Railroad Retirement Board.......................... 178
315
Social Security Administration..................... 180
315
Title V--General Provisions: 186
320
House of Representatives Report Requirements...............
323
Minority Views.....................................
323
Full Committee Votes...............................
327
Comparative Statement of Budget Authority..........
345
Budgetary Impact Tables............................
417
Committee Hearings.................................
419
Ramseyer...........................................
421
Changes in the Application of Existing Law.........
461
Appropriations Not Authorized by Law...............
470
Transfers of Funds.................................
474
Rescissions of Funds...............................
478
Disclosure of Earmarks and Congressionally Directed
Spending.......................................
479
List of Abbreviations
The following is a list of commonly used abbreviations and
acronyms that appear in this report.
AI--Artificial Intelligence
ACL--Administration for Community Living
AHRQ--Agency for Healthcare Research and Quality
ASPR--Administration for Strategic Preparedness and Response
BARDA--Biomedical Advanced Research and Development Authority
CBRN--Chemical, Biological, Radiological, and Nuclear
CDC--Centers for Disease Control and Prevention
CHIP--Children's Health Insurance Program
CMS--Centers for Medicare and Medicaid Services
CNCS--Corporation for National and Community Service
CTSA--Clinical and Translational Science Awards
CTE--Career and Technical Education
DOD--Department of Defense
DOE--Department of Energy
DOL--Department of Labor
EBSA--Employee Benefits Security Administration
ESEA--Elementary and Secondary Education Act
ETA--Employment and Training Administration
FDA--Food and Drug Administration
FIC--Fogarty International Center
FMSHRC--Federal Mine Safety and Health Review Commission
FTE--Full-time Equivalent
GAO--Government Accountability Office
GLS--Garrett Lee Smith Memorial Act
HBCUs--Historically Black Colleges and Universities
HCFAC--Health Care Fraud and Abuse Control
HELP--Health, Education, Labor, and Pensions
HHS--Health and Human Services
HRSA--Health Resources and Services Administration
HIPSA--Health Professional Shortage Area
IC--Institute and Center
IDEA--Individuals with Disabilities Education Act
IHE--Institutions of Higher Education
IMLS--Institute of Museum and Library Services
LEA--Local Educational Agency
MACPAC--Medicaid and CHIP Payment and Access Commission
MCM--Medical Countermeasures
MedPAC--Medicare Payment Advisory Commission
MHBG--Community Mental Health Services Block Grant
MSHA--Mine Safety and Health Administration
NCATS--National Center for Advancing Translational Sciences
NCES--National Center for Education Statistics
NCI--National Cancer Institute
NEI--National Eye Institute
NHGRI--National Human Genome Research Institute
NHLBI--National Heart, Lung, and Blood Institute
NIA--National Institute on Aging
NIAAA--National Institute on Alcohol Abuse and Alcoholism
NIAID--National Institute of Allergy and Infectious Diseases
NIAMS--National Institute of Arthritis and Musculoskeletal
and Skin Diseases
NIBIB--National Institute of Biomedical Imaging and Bio-
engineering
NICHD--Eunice Kennedy Shriver National Institute of Child
Health and Human Development
NIDA--National Institute on Drug Abuse
NIDCD--National Institute on Deafness and Other Communication
Disorders
NIDCR--National Institute of Dental and Craniofacial Research
NIDDK--National Institute of Diabetes and Digestive and
Kidney Disease
NIDRR--National Institute on Disability and Rehabilitation
Research
NIEHS--National Institute of Environmental Health Sciences
NIGMS--National Institute of General Medical Sciences
NIH--National Institutes of Health
NIMH--National Institute of Mental Health
NIMHD--National Institute on Minority Health and Health
Disparities
NINDS--National Institute of Neurological Disorders and
Stroke
NINR--National Institute of Nursing Research
NLM--National Library of Medicine
NLRB--National Labor Relations Board
NSF--National Science Foundation
NTID--National Technical Institute for the Deaf
OAA--Older Americans Act
OAR--Office of AIDS Research
OCR--Office for Civil Rights
ODEP--Office of Disability Employment Policy
OFCCP--Office of Federal Contract Compliance Programs
OIG--Office of the Inspector General
OLMS--Office of Labor-Management Standards
OMB--Office of Management and Budget
OMH--Office of Minority Health
OMHA--Office of Medicare Hearings and Appeals
ONC--Office of the National Coordinator for Health
Information Technology
ORR--Office of Refugee Resettlement
ORWH--Office of Research on Women's Health
OSHA--Occupational Safety and Health Administration
OWCP--Office of Workers' Compensation Programs
OWH--Office of Women's Health
PBGC--Pension Benefit Guaranty Corporation
PHS--Public Health Service
PPA--Program, Project, or Activity
PPHF--Prevention and Public Health Fund
PRNS--Programs of Regional and National Significance
RSA--Rehabilitation Services Administration
SAMHSA--Substance Abuse and Mental Health Services
Administration
SEA--State Educational Agency
SPRANS--Special Projects of Regional and National
Significance
SSA--Social Security Administration
SSI--Supplemental Security Income
STEM--Science, Technology, Engineering, and Mathematics
SUPTRS--Substance Use Prevention, Treatment, and Recovery
Services Block Grant
UAC--Unaccompanied Alien Children
UI--Unemployment Insurance
USAID--U.S. Agency for International Development
VETS--Veterans' Employment and Training Services
VISTA--Volunteers in Service to America
WANTO--Women in Apprenticeship and Non-Traditional
Occupations
WHD--Wage and Hour Division
WIA--Workforce Investment Act
WIOA--Workforce Innovation and Opportunity Act
Summary of Estimates and Appropriations
The following table compares on a summary basis the
appropriations, including trust funds for fiscal year 2027, the
budget request for fiscal year 2027, and the Committee
recommendation for fiscal year 2027 in the accompanying bill.
2027 LABOR, HHS, EDUCATION BILL
[Discretionary funding in thousands of dollars]
----------------------------------------------------------------------------------------------------------------
Fiscal Year-- 2027 Committee compared to--
Budget Activity -------------------------------------------------------------------------------
2026 Enacted 2027 Budget- 2027 Committee 2026 Enacted 2027 Budget
----------------------------------------------------------------------------------------------------------------
Department of Labor............. $13,459,430 $10,206,762 $9,776,305 -3,683,125 -430,457
Department of Health and Human 114,797,239 98,602,461 110,767,281 -4,029,958 +12,164,820
Services.......................
Department of Education......... 78,793,603 77,192,582 70,655,376 -8,138,227 -6,537,206
Related Agencies................ 17,079,804 15,516,381 16,966,419 -113,385 +1,450,038
----------------------------------------------------------------------------------------------------------------
General Summary of the Bill
For fiscal year 2027, the Committee recommends a total of
$189,279,000,000 in current year discretionary funding--the
302(b) allocation--and $208,165,381,000 in overall programmatic
funding, including offsets and adjustments. The fiscal year
2027 recommendation is a decrease of $15,964,695,000 below the
fiscal year 2026 enacted level.
The Committee notes that the President's budget request
includes several important proposals to reform and reorganize
the Federal government. The Committee applauds these efforts to
improve efficiency while reducing waste, fraud, and abuse. The
Committee notes that the authorizing committees of jurisdiction
have not yet had the opportunity to consider every
reorganizational proposal. Accordingly, the Committee's bill
and report reflect do not make significant changes to the
organizational structure of the agencies funded herein. The
Committee looks forward to working with the authorizing
committees of jurisdiction as they act on the proposed
organizational reforms submitted as part of the budget request.
Bill Wide Requirements
In cases where this report directs the submission of a
report, that report is to be submitted to the Committee on
Appropriations of the House of Representatives. Where this
report refers to the Committee or the Committee on
Appropriations, unless otherwise noted, this reference is to
the House of Representatives Subcommittee on Labor, Health and
Human Services, Education, and Related Agencies.
Each department and agency funded by this Act shall follow
the directives set forth by this Act and the accompanying
report and shall not reallocate resources or reorganize
activities except as provided herein. Funds for individual
programs and activities are displayed in the detailed table at
the end of the report accompanying this Act. Funding levels
that are not displayed in the detailed table are identified
within this report. Any action to eliminate or consolidate
programs, projects, and activities should be pursued through a
proposal in the President's Budget so it can be considered by
the Committee.
This report provides additional direction and specificity
on the uses of funds provided by the accompanying bill. For all
purposes, including the Balanced Budget and Emergency Deficit
Control Act of 1985, with respect to appropriations contained
in the accompanying bill, the terms ``program, project, and
activity'' shall mean any item for which a dollar amount is
contained in appropriations acts (including joint resolutions
providing continuing appropriations) or accompanying reports of
the House of Representatives and the Senate Committees on
Appropriations, or accompanying conference reports and joint
explanatory statements of the committee of conference.
The Committee directs agencies to submit any reprogramming
or transfer requests in compliance with requirements of the
accompanying act, as applicable, and to provide a thorough
explanation of the proposed reallocations, including a detailed
justification of increases and reductions. The Committee
directs each agency to manage the expenditures of its programs
and activities to remain within the amounts appropriated by
Congress.
Budget Submission.--As part of the President's Budget
Request, each department is directed to provide the Committee
in electronic format, a table that corresponds with every
program line found in the detailed table at the end of this
report. Such a table shall include a column for the most
recently enacted appropriation, the current year, and the
budget year, assuming current law.
In addition, the Committee continues to expect delivery of
all congressional justifications and budget summary documents
no later than the day of the President's Budget Appendix
publication online. The department shall notify the Committee
24 hours in advance of any anticipated delay.
As part of the congressional justifications submitted to
the Committee, each agency is directed to include a table, for
each program funded in the most recently enacted full year
appropriation or proposed for funding or elimination in the
budget request, that includes the following: last year of
authorization; authorization level; appropriations in the last
year of authorization (if applicable); appropriations in the
most recently enacted full year appropriation (if applicable);
amount proposed in the budget request (if applicable).
Congressional Reports.--Each department or agency is
directed to provide the Committee, within 30 days from the date
of enactment of this Act, and quarterly thereafter, a summary
describing each requested report to the Committee along with
related actions completed in the current and prior quarters and
planned actions to be completed in future quarters. Such a
summary shall be cumulative for all fiscal years for which any
report remains outstanding.
Customer Experience.--The Committee continues to support
efforts to improve agency customer experience. The Committee
urges all agencies funded by this Act to develop standards to
improve customer experience and incorporate the standards into
the performance plans required under 31 U.S.C. 1115. The
Committee requests an update from all agencies funded by this
Act to report on their implementation plans regarding this
subject in the fiscal year 2028 congressional justification.
Grant Continuation Cost Estimates.--As part of the fiscal
year 2028 congressional justification, each department or
agency funded by this Act with discretionary budget authority
for competitively awarded grants shall include the expected
cost of continuation awards for each competitively awarded
grant and any amount the department or agency would seek to
issue a new competitive funding opportunity announcement for
such grant in the fiscal year 2028 congressional justification.
In addition, the department shall include the anticipated
number of awards and average anticipated award for such year.
Grant Oversight.--The new Administration has identified
numerous discrepancies within existing grant programs
throughout the bill. In response to these issues the Committee
directs, within 30 days of enactment of this Act, and every 30
days thereafter until November 30, 2027, to brief the Committee
on the status of all formula and competitive grants. Each
briefing is to include a summary of competitive and formula
awards made in the prior 30 days, Notices of Funding
Opportunities (NOFOs) the respective department anticipates
issuing within the next 30 days, and a summary of Notices of
Funding Opportunities issued in the preceding 30 days. As
applicable per grant program, award and NOFO summaries are to
indicate whether such awards are continuation awards,
supplemental grant awards, and/or new competitions and if such
amounts are forward funded. NOFO summaries are to include new
competitive criteria, changes from the prior year, expected
number of awards, expected amount per award, and status of
review panels.
National Academy of Sciences, Engineering, and Medicine.--
The Committee notes prior concern with recommendations
developed by the National Academy of Sciences, Engineering, and
Medicine (NASEM). The Committee urges agencies to consider all
means for obtaining objective scientific review. The Committee
expects agencies to execute contracts with the highest
standards of scientific rigor in an objective, nonpartisan
manner. The full spectrum of scientific views should be
represented on a research committee, council, or panel
membership without conflict of interest or ideology.
Outcome-Based Reviews.--The Committee supports: (1) the
conduct of outcome-based program and operational reviews
consistent with the Government Performance and Results
Modernization Act of 2010; (2) the review of existing
regulations, internal policies, and administrative requirements
to identify outdated, duplicative, or unnecessarily burdensome
provisions; and (3) the identification of opportunities for
cost savings, administrative streamlining, and improved program
delivery. As part of the fiscal year 2028 congressional
justification the Secretaries of Health and Human Services,
Education, and Labor, shall include information on agency
efforts to strengthen performance management, regulatory
review, and oversight practices to better align spending with
measurable outcomes.
Performance Reporting.--As part of the congressional
justification for fiscal year 2028, each department or agency
funded by this Act is directed to include the percentage of the
Senior Executive Service for each performance level (5--
outstanding, 4--exceeds fully successful, 3--fully successful,
2--minimally satisfactory, or 1--unsatisfactory). In addition,
the department or agency shall include in such justification
the total dollar amount spent on performance awards for the
Senior Executive Service for the most recent fiscal year for
which data is available and the number of full time
equivalents.
Questions for the Record.--The Committee notes the
inclusion of section 526 of this Act, which requires each
department and agency to provide answers to questions submitted
for the record within 45 business days of receipt. The
Committee expects each department and agency to notify the
Committees at least 7 days in advance if they do not anticipate
meeting this statutory requirement.
TITLE I--DEPARTMENT OF LABOR
Appropriation, fiscal year 2026....................... $15,384,043,000
Budget request, fiscal year 2027...................... 11,773,555,000
Committee Recommendation.............................. 11,903,040,000
Change from enacted level......................... -3,481,003,000
Change from budget request........................ +169,485,000
Employment and Training Administration
Appropriation, fiscal year 2026....................... $10,420,366,000
Budget request, fiscal year 2027...................... 7,256,865,000
Committee Recommendation.............................. 7,072,113,000
Change from enacted level......................... -3,348,253,000
Change from budget request........................ -184,752,000
The Employment and Training Administration (ETA)
administers Federal job training grant programs and Trade
Adjustment Assistance and provides funding for the
administration and oversight of the State Unemployment
Insurance and Employment Service system.
Agriculture Labor Definition.--The Committee notes there is
a longstanding labor shortage impacting the agriculture
industry, especially the livestock industry. Many agricultural
businesses have turned to the H-2A program to remain
operational, but some industries, such as livestock auction
markets, are constrained or ineligible to participate due to
the Department of Labor definition of agricultural labor, work,
or services. Therefore, the Committee urges the Department to
assess ways to improve these definitions that accurately take
into account off-farm handling of livestock in sale barns or
auction houses.
Collaborations Between Manufacturers and Educational
Institutions.--The Committee encourages the Department to
develop pilot programs that facilitate education and training
programs in the field of advanced manufacturing.
Critical Minerals Battery Workforce Development.--The
Committee is aware of growing workforce needs associated with
domestic battery manufacturing and critical minerals processing
industries. The Committee urges the Department to support
workforce development activities aligned with battery
manufacturing and critical minerals processing, and to
collaborate with the Department of Energy (DoE) to align
workforce efforts with evolving industry needs.
Electric Vehicle Training.--The Committee recognizes the
growing need for highly-skilled mechanics and technicians in
the motorized vehicle, automotive, train, and aviation fields
to prepare for advances in the technology of electric vehicle
and related new propulsion industries, including biofuels and
internal combustion, and hydrogen engines. Therefore, the
Committee encourages the Department to work with industry
partners, workforce groups, labor unions, public transportation
leaders, and nonprofit experts to better support pathways for
mechanics and mechanical technicians in innovative automotive
and aviation fields, and to develop curriculum and training
programs to further career opportunities.
Identity Theft and SSN Truncation on Forms W-2.--The
Committee is concerned that federal law enacted in 2015, Sec.
409 of the Protecting Americans from Tax Hikes (PATH) Act of
2015 (P.L. 114-113) and related Internal Revenue Service (IRS)
regulations, are being ignored or disregarded in contravention
of the statute as state workforce entities conduct audits of
Unemployment Insurance (UI) claims and paid leave. Critically,
the PATH Act and resulting agency practice allow that ``all or
part'' of an individual's Social Security Number (SSN) be
reported to protect employees from identity theft. An excerpt
from the Department of Labor's ET Handbook No. 407. notes
clearly that a partial SSN is acceptable. The IRS has issued
final regulations (TD 9861, Use of Truncated Taxpayer
Identification Numbers on Forms W-2, Wage and Tax Statement,
Furnished to Employees), which allow employers to truncate
employees' SSNs on copies of Forms W-2. The Committee is
concerned that ``states have experienced a surge in fraudulent
unemployment claims filed by organized crime rings using stolen
identities,'' and efforts made by state agencies to prevent
such fraud could be a driving cause of continued identity
theft. The Committee urges the Secretary of Labor to issue
guidance to state agencies regarding full SSNs on Forms W-2,
Forms 1099, and similar forms that are provided for audit
purposes, including state audits for UI and paid leave.
Maritime Workforce Development.--The Committee urges the
Secretary of Labor to establish a maritime workforce
development exchange focused on training programs with
innovative technologies, including augmented-reality and
virtual-reality based welding and painting technologies, with
the objective of training and modernizing the U.S. shipbuilding
workforce.
O*NET Taxonomy Review.--The Committee directs the
Department to assess how the O*NET technology should be updated
to reflect artificial intelligence (AI)-related changes. No
longer than 180 days after the enactment of this Act, the
Department shall submit a report to the Committee on its
recommendations for updates, including timeline and resource
needs.
Prioritizing High Wage Industries.--The Committee notes the
efforts of the current Administration to target high-wage,
high-growth occupations. When consistent with authorizing
statute, the Committee continues to direct the Department to
prioritize grant applications in industries and occupations
that exceed the average earnings of a high school graduate
based on the Bureau of Labor Statistics Occupational Employment
and Wage Statistics when making competitive grant awards.
Property Management and Hospitality.--The Committee
recognizes the importance of career and technical education for
adults and youth who have not received traditional or adequate
education. The Committee encourages the Department to fund non-
profit organizations that deliver wraparound services to train
adults in technical skills to have careers such as property
management, property maintenance, digital marketing, and
hospitality.
Upskilling Workers in Industrial Sectors.--The Committee
acknowledges that in today's technology-driven industrial
environment, workers are expected to continuously upskill,
particularly in industries where generations of technology
outpace generations of workers. Immersive technology can equip
the workforce with the skills and knowledge necessary for the
future of work. The Committee encourages the Department to
assess the ways in which use of immersive technology can be
leveraged to train and upskill workers in industrial sectors
including but not limited to energy, manufacturing,
construction, mining, and automotive assembly.
Workforce Sustainability and Upskilling.--The Committee
encourages the Department to support national workforce
training organizations that partner with employers to provide
skills-based, industry-recognized credentialed training aligned
with high-demand, emerging industries. The Committee further
encourages the Department to prioritize reskilling and
upskilling of the existing workforce to meet needs in critical
industries and support long-term economic and national security
objectives.
TRAINING AND EMPLOYMENT SERVICES
Appropriation, fiscal year 2026....................... $3,981,588,000
Budget request, fiscal year 2027...................... 3,425,067,000
Committee Recommendation.............................. 1,889,912,000
Change from enacted level......................... -2,091,676,000
Change from budget request........................ -1,535,155,000
Training and Employment Services provides funding for
Federal job training programs authorized primarily by the
Workforce Innovation and Opportunity Act of 2014 (WIOA). The
Committee appreciates the potential value of the
Administration's proposed streamlining of ETA program.
Adult Employment and Training Activities
The Committee provides $712,000,000 in advance funding for
adult training, which is the same as the fiscal year 2026
enacted level. The Committee provides no funding for fiscal
year 2027 for this program.
The Committee has included a provision reducing the funding
available for fiscal year 2026 by $712,000,000.
The Committee provides no funding for Adult Employment and
Training Activities.
Youth Employment and Training Activities
The Committee provides no funding for Youth Employment and
Training Activities. The Committee notes the absence of
evidence that the program improves employment and educational
outcomes for program participants and that the Department has
failed to implement the program in a manner consistent with the
changes enacted in the now expired WIOA. This program is
largely duplicative of the Perkins Career and Technical
Education, 21st Century Community Learning Centers, and Student
Support and Academic Enrichment programs.
Dislocated Worker Employment and Training Activities
For this activity, the Committee provides $1,421,412,000.
Of the total provided for Dislocated Worker Employment and
Training Activities, $1,095,553,000 is designated for State
grants that provide core and intensive services, training, and
supportive services for dislocated workers. In addition, States
use these funds for rapid response assistance to help workers
affected by mass layoffs and plant closures. The remaining
amount is available for the Dislocated Workers National Reserve
(DWNR). DWNR supports national emergency grants, technical
assistance, and demonstration projects as authorized by WIOA.
Within this total. The Committee provides $860,000,000 in
advanced appropriations for fiscal year 2028.
Within the total for Dislocated Worker Employment and
Training Activities, the Committee provides the following
amounts:
------------------------------------------------------------------------
Budget Activity FY 2026 Enacted FY 2027 Committee
------------------------------------------------------------------------
Dislocated Worker Assistance $300,859,000 $325,859,000
National Reserve.................
Workforce Opportunity for 55,000,000 60,000,000
Rural Communities (non-add)..
Community Colleges Training 65,000,000 75,000,000
Grants (non-add).............
Cybersecurity Grants (non-add) 15,000,000 25,000,000
------------------------------------------------------------------------
Workforce Opportunity for Rural Communities.--Within the
funds provided for DWNR, the Committee provides $60,000,000 for
the Workforce Opportunity for Rural Communities (WORC) program,
an increase of $5,000,000, to provide enhanced worker training
in the Appalachian, Delta, and Northern Border regions. The
Committee directs DOL to ensure that this funding increase is
used to support multigenerational workforce training pipelines
developed in collaboration with institutions of higher
education and workforce development system partner agencies in
regions with a WORC program.
Strengthening Community Colleges Training Grants.--From
within the amounts provided for DWNR, the Committee provides
$75,000,000, an increase of $10,000,000 from fiscal year 2026
enacted, for the Strengthening Community Colleges Training
Grants.
The Committee recommends that future funding opportunities
for the Community College Training Grants include opportunities
for individual institutions rather than consortiums. The
Committee also encourages the Department to consider funding
alternative workforce development strategies that address
critical skill gaps and support direct, innovative pathways to
employment for community members.
Cybersecurity and Software Development Employment
Opportunities.--The Committee remains concerned about the high,
unmet demand for cybersecurity and software development skills
in both the DOD and the private sector. Of the total provided
for the DWNR, the Committee directs $25,000,000 for competitive
grants to institutions of higher education as defined in 20
U.S.C. 1001, State Workforce Agencies, local workforce
development boards, and employer associations for the purpose
of a targeted highly skilled job training grant to help
increase training capacity to meet this demand. For purposes of
making awards under this program, DOL is directed to prioritize
applicants located in States with the greatest number of
Federally recognized Tribes and with preexisting DOD
partnerships. DOL is directed to provide the Committee with a
briefing on this initiative within 120 days.
EMS Preparedness and Response Workforce Development.--The
Committee recognizes the significant workforce shortage in
emergency medical services (EMS) sector, particularly in
underserved, rural, and Tribal communities, which limits access
to critical prehospital ground ambulance medical services,
including critical care transport. The Committee encourages the
Department to utilize existing funds through the Workforce
Opportunities for Rural Communities Initiative to prioritize
sector-based workforce development strategies to address the
ongoing EMS workforce shortage in high-need areas. These
workforce development strategies should focus on the
recruitment, training, and retention of emergency medical
technicians and paramedics with an emphasis on creating career
pathways and expanding employment opportunities in underserved,
rural, and Tribal communities.
Native American Programs
For Native American programs, the Committee provides
$65,000,000, an increase of $2,500,000, for these programs.
Migrant and Seasonal Farmworkers
The Committee provides no fiscal year 2027 funding for this
program.
YouthBuild
For the YouthBuild program, the Committee provides
$107,500,000. WIOA reformed the YouthBuild program to
prioritize the employment and educational outcomes of program
participants.
Reintegration of Ex-Offenders
The Committee provides no fiscal year 2027 funding for this
program.
Workforce Data Quality Initiative
The Committee provides $6,000,000 for the Workforce Data
Quality Initiative.
Apprenticeship Programs
The Committee provides $290,000,000 for apprenticeship
grants including $100,000,000 for apprenticeship State grants.
The Committee notes the modest increase in the number of
apprentices generated by considerable and sustained
congressional investment.
AI Infrastructure Trades.--The Committee recognizes that
the buildout of data centers and associated electric
generation, transmission, and distribution infrastructure is
increasing demand for skilled trades. The Committee encourages
ETA, within existing authorities and available funds, to
prioritize industry-vetted training partnerships and registered
apprenticeship expansion for AI infrastructure trades, such as
electricians, HVAC/thermal technicians, and automation
technicians. To promote accountability and respond to rapidly
shifting demand, the Committee further encourages ETA to
support employer-led partnerships. The Committee requests
information in the fiscal year 2028 congressional justification
on the actions taken to improve training programs for AI
infrastructure trades.
Apprenticeships and Cooperative Agreements.--The Committee
recognizes the strong national demand for expanding registered
apprenticeships across priority industries such as defense, AI,
semiconductors, healthcare, transportation, telecommunications,
and advanced manufacturing. The Committee encourages the
Department, through ETA, to assess the feasibility and value of
cooperative agreements with experienced apprenticeship
intermediaries capable of providing sponsor functions,
supporting employers, coordinating with State agencies, and
strengthening system-wide quality and responsiveness.
Apprenticeship Degree.--The Committee encourages DOL to
support apprenticeship degree programs where institutions of
higher education integrate the awarding of affordable college
degrees with the hallmarks of registered apprenticeships. The
Committee further encourages DOL to prioritize funding for
apprenticeship degrees in future Funding Opportunity
Announcements.
Apprenticeship Networks.--The Committee urges the
Department to support the development of apprenticeship
networks with community colleges, in partnership with regional
workforce development boards and K-12 schools, working with
businesses and industry stakeholders to develop
apprenticeships, pre-apprenticeships, and apprenticeship
pathway programs for students, young adults, and other
individuals looking to work in industries, including, but not
limited to, automotive, early childhood education, healthcare,
information technologies, industrial technology, community and
public services, advanced manufacturing, and logistics and
distribution.
Apprenticeship Programs in Workforce Shortage Areas.--The
Committee recognizes the critical role that the Department's
Apprenticeship program plays in addressing workforce shortages
in priority industries and providing valuable educational and
on-the-job training opportunities for participants. The
Committee urges the Department to continue efforts to encourage
apprenticeships in health, education, and childcare industries
in communities with designated shortages, including health
provider shortage areas, teacher shortage areas, and childcare
deserts.
Automotive Technician Apprenticeships.--The Committee
recognizes the nation's economy depends on a reliable
transportation workforce. However, the nation faces a severe
and accelerating shortage of skilled automotive, diesel, and
collision technicians. The Committee is concerned that between
now and 2028, the United States will need to fill over 800,000
technician positions in automotive, collision, and diesel. The
Committee recognizes that without targeted, work-based training
solutions, the U.S. risks losing productivity, competitiveness,
and long-term workforce stability. The Committee encourages the
ETA to prioritize grants for technician apprenticeship programs
to sustain workforce needs.
Defense Industrial Base-focused Apprenticeship Programs.--
The Committee encourages DOL to prioritize increased funding
for existing training programs in advanced manufacturing,
defense technology, and other high-demand industries supporting
the defense industrial base. The Committee further encourages
DOL to continue facilitating partnerships between industry,
academia, and government agencies to establish and promote
pathway programs that would grow the defense industrial base
workforce.
Non-Traditional Apprenticeships.--The Committee supports
efforts by the Department aimed at developing non-traditional
apprenticeships, including supporting and scaling registered
apprenticeship programs beyond the building and fire trades.
Nuclear Workforce Development.--The Committee is concerned
with the continued shortage of skilled workers for civilian
nuclear power systems, including certified electrical workers.
Registered apprenticeship programs can offer the resources and
expertise needed to meet workforce capacity needs. However,
these programs and associated training centers face resource
and technical barriers when training employees to work safely
on these systems. The Committee encourages the Department to
prioritize nuclear workforce development programs, specifically
in coordination with registered apprenticeship programs.
Parents of Dependent Children.--The Committee encourages
DOL to provide grantees guidance related to coordinating with
community-based providers of wraparound services to support
parents of dependent children enrolled in registered
apprenticeship and pre-apprenticeship programs.
Partnerships.--The committee encourages the Department to
support collaborations between manufacturers and educational
institutions that facilitate education and training programs in
the field of advanced manufacturing.
Technology-Related Fields.--The Committee recognizes the
growing need to invest in registered apprenticeship programs
that prepare workers to meet the demands of an evolving labor
market. The Committee encourages DOL to continue to prioritize
grants centered on new, emerging, and in-demand industry
sectors and occupations, including those within the cyber
industry and other technology-related fields.
Recognition Process for Registered Apprenticeship
Intermediaries.--The Committee recognizes that qualified
registered apprenticeship intermediaries can play a critical
role in supporting employer engagement, sponsor development,
compliance, and multi-State coordination within the National
Apprenticeship System. However, the Committee believes greater
clarity and transparency regarding intermediary roles and
performance is necessary. The Committee therefore urges the
Department to review the feasibility and value of a formal
recognition process for Registered Apprenticeship
Intermediaries. Review should include roles and
responsibilities, standards for recognition, and geographic
recognition. The Department shall submit an update in the
fiscal year 2028 congressional justification.
Wastewater Apprenticeships.--The Committee commends the
Department for awarding funding to address challenges of
Registered Apprenticeship programs in rural areas and to
address inadequacies in the water sector across rural America
and U.S. territories. The Committee recommends $20,000,000 in
grant funding to establish, implement, expand, and administer
registered apprenticeship programs consistent with the National
Guideline Standards of Apprenticeship for Water and Wastewater
System Operations Specialists to address nationwide shortages
of qualified drinking water and wastewater operators,
especially in rural America and the areas of the U.S. with the
highest Safe Water Drinking Act violations.
JOB CORPS
Appropriation, fiscal year 2026....................... $1,760,155,000
Budget request, fiscal year 2027...................... 176,370,000
Committee Recommendation.............................. 880,078,000
Change from enacted level......................... -880,077,000
Change from budget request........................ +703,708,000
Job Corps is a residential education and vocational
training program that helps young people ages 16 through 24
improve the quality of their lives through vocational and
academic training.
The Committee has concerns about the historical oversight
of job placement contracts. The DOL Office of Inspector General
(OIG) found evidence that contractors helped only six percent
of the sampled participants find work. The others found jobs on
their own, or there was not enough evidence to show the
contractors helped them. The OIG estimated that nearly
$71,000,000 went to contractors for services they could not
show they provided.
Alignment with Defense Industrial Base and Veterans' Health
Workforce Needs.--The Committee directs the Department to work
with the Department of Defense and Department of Veterans
Affairs to improve Job Corps hiring, internships, and
apprenticeship pipelines to meet workforce shortages in the
defense industrial base and the veterans' health system.
Civilian Conservation Centers.--The Committee respectfully
urges the Department to ensure full funding of Civilian
Conservation Centers (CCCs) and that no funds provided under
the CCC program are used to alter or terminate the Interagency
Agreement between the DOL and the Department of Agriculture
(USDA), or to close any CCCs, thereby ensuring CCCs remain
fully operational in the coming fiscal year.
Cybersecurity Workforce Pathways for Job Corps Students.--
The Committee recognizes the urgent national need to address
the cybersecurity workforce shortage and supports efforts to
modernize Job Corps career training offerings in alignment with
current labor market demands. The Committee provides
$25,000,000 to expand existing pilot programs which improve the
current Information Technology pathway by creating an
opportunity for Job Corps students to earn industry-recognized
cybersecurity credentials and connect with employers in the
cybersecurity sector. The Committee is aware that this
initiative leverages national partnerships with technology
leaders and aligns with the Department's ongoing efforts to
improve job placement, instructional content, and program
efficiency within Job Corps. The Committee directs the
Department to provide a report within 180 days of enactment of
this Act on the implementation and expansion of such
cybersecurity training programs regionally and nationally, and
how such efforts align with existing Job Corps modernization
priorities.
Job Corps Competitiveness.--The Committee recognizes the
benefits of well-run, successful Job Corps programs in
providing vocational education to the youth of the United
States. On the other hand, underperforming Job Corps programs
have been weighing the appropriation down and undermining the
potential value of the program. According to the 2025 Job Corps
Transparency Report, the average graduation rate is 32 percent,
while the average cost per graduate is over $187,000.
Therefore, within the funds appropriated, the Committee urges
DOL to award contracts to the highest performing programs.
Job Corps Centers Utilization.--The Committee is concerned
with the persistent underutilization of Job Corps centers and
directs the DOL to conduct an analysis of application and
enrollment data to evaluate the relative effectiveness of
recruitment investments, including social media advertising
targeted at eligible youth and their influencers, national
media campaigns, and local outreach efforts.
Job Corps Programing.--The Committee is concerned that the
relative lack of success is due to instructional content that
does not reflect job-site best practices or the jobs of today's
economy. To better ensure a variety of high-quality programs
are available to Job Corps students, the Committee directs DOL
to limit grants, contracts, or cooperative agreements for
purposes of instructional content to no more than $10,000,000.
Leveraging External Resources.--The Committee encourages
the Department to transition new Job Corps campus operations
awards to contracts that are in the best interest to the
federal government to ensure such financial accountability.
Maximizing Employer Partnerships.--The Committee encourages
DOL to fully leverage section 29 U.S.C. 3208 to maximize the
resources available to campuses to develop these partnerships
and meet employers' needs.
COMMUNITY SERVICE EMPLOYMENT FOR OLDER AMERICANS
Appropriation, fiscal year 2026....................... $395,000,000
Budget request, fiscal year 2027...................... - - -
Committee Recommendation.............................. - - -
Change from enacted level......................... -395,000,000
Change from budget request........................ - - -
The Committee provides no funding for the Community Service
Employment for Older Americans program, also known as the
Senior Community Service Employment Program (SCSEP). The
Committee notes that the last comprehensive evaluation of SCSEP
found that the program led to unsubsidized employment for less
than half of program participants available for employment with
worse outcomes for participants with a disability, older
adults, and participants with lower levels of education.
Moreover, the largest recipients of SCSEP grants are
organizations based in the Washington, D.C. area rather than
direct service providers.
FEDERAL UNEMPLOYMENT BENEFITS AND ALLOWANCES
Appropriation, fiscal year 2026....................... $50,300,000
Budget request, fiscal year 2027...................... 28,800,000
Committee Recommendation.............................. 28,800,000
Change from enacted level......................... -21,500,000
Change from budget request........................ - - -
The Committee provides $28,800,000 for the Trade Adjustment
Assistance program, consistent with the fiscal year 2027 budget
request.
STATE UNEMPLOYMENT INSURANCE AND EMPLOYMENT SERVICE OPERATIONS
Appropriation, fiscal year 2026....................... $4,074,890,000
Budget request, fiscal year 2027...................... 3,459,338,000
Committee Recommendation.............................. 4,119,890,000
Change from enacted level......................... +45,000,000
Change from budget request........................ +660,552,000
The total includes $4,055,584 from the Employment Security
Administration Account in the Unemployment Trust Fund and
$64,306,000 from the General Fund of the Treasury. These funds
are used to support the administration of Federal and State
unemployment compensation laws.
Unemployment Insurance Compensation
In addition, the Committee provides contingency funding for
increased workloads that States may face in the administration
of unemployment insurance (UI). The Committee includes bill
language so that, during fiscal year 2026, for every 100,000
increase in the total average weekly insured unemployment
(AWIU) above 3,075,000, an additional $28,600,000 is made
available to States from the Unemployment Trust Fund.
If additional funds are provided to States under the AWIU
contingency authority, the Department is directed to provide
notification to the Committee of the current projected AWIU
level for the fiscal year, when funds were provided to States,
and how much additional funding was provided in total and to
each State within 15 days of funding being provided. If
additional funds are provided on a quarterly basis, the
Department is directed to provide this information to the
Committee on a quarterly basis.
The Committee provides $117,000,000 funding for the
Reemployment Services and Eligibility Assessments (RESEA)
program. The Committee supports the intent of the program to
provide more intensive services to individuals most likely to
use all their unemployment insurance benefits; however, the
Committee is concerned that the program has not achieved the
cost savings projected by the Congressional Budget Office (CBO)
and does not provide additional funding pursuant to the
Balanced Budget and Emergency Deficit Control Act.
Unemployment Insurance Integrity Center of Excellence
The Committee provides $9,000,000 for the continued support
of Unemployment Insurance Integrity Center of Excellence.
Unemployment Insurance National Activities
The Committee provides $22,000,000 for UI national
activities. This funding is intended to help modernize
information technology systems and support States in
administering the UI program.
Employment Service
The Committee provides $690,552,000 for the Employment
Service allotment to States. The Committee also provides
$15,500,000 for Employment Service National Activities.
Foreign Labor Certification
The Committee provides $64,528,000, an increase of
$3,000,000 from fiscal year 2026 enacted, for the Federal
administration of the Foreign Labor Certification program and
$23,282,000 for grants to States.
Adverse Effect on Wage Rate.--The Committee notes the
pending request with the Government Accountability Office (GAO)
to engage in a study on the Adverse Effect Wage Rates. The
Committee looks forward to reviewing the results of the study
and the report once published.
Agricultural Program Efficiency.--The Committee is
concerned with recurring delays and disruptions in the H-2A
temporary agricultural worker program, particularly
administrative holds, processing delays, and interruptions in
labor certification. The Committee directs the Department, in
coordination with the Department of Homeland Security and the
Department of State, to submit a report to the Committees not
later than 90 days after enactment of this Act detailing: (1)
current processing timelines across each stage of the H-2A
program; (2) identified points of delay or disruption; and (3)
contingency plans to address such delays and ensure continuity
of labor certification processing during periods of lapse in
appropriations or other operational disruptions.
Enhanced Wage Records.--A growing number of States are
beginning to collect or expand use of enhanced wage records
(EWRs), which include additional categories of data such as job
title, hours worked, and job location to complement employers'
Federally mandated quarterly unemployment insurance wage record
submissions. By significantly strengthening the quality of
labor market data, enhanced wage records are helping states to
improve program integrity and enhance workforce, industry-
level, and regional economic development strategies. To support
modernization efforts and reduce compliance burdens for
multistate employers, the Committee directs the Department to
develop, within 365 days of the enactment of this Act, optional
model language and guidance, including an Unemployment
Insurance Program Letter, for State governments interested in
expanding reporting wage record data collection. Additionally,
the Committee recommends that the Department develop a set of
common data standards for use by states to structure their EWR
collections and reporting approach.
Schedule A Occupational Classification.--The Committee is
aware that the Permanent Labor Certification Process, which
must be completed before an international worker is permitted
to move into the queue for an employment-based green card,
continues to take nearly 500 days at the Department. This delay
means that the total processing time at the Department to hire
or transition a foreign-born employee to a green card can take
up to two years, not including processing time at U.S.
Citizenship and Immigration Services or the Department of
State. Such a long wait makes it highly difficult for employers
to plan their business activities or take on new opportunities.
The Committee recommends that the Department continue efforts
to modernize the Schedule A classifications.
Seafood Processors.--The Committee encourages the
Department, in consultation with the Departments of
Agriculture, Homeland Security, State, and Commerce, to study
the workforce needs of seafood processors handling seasonal
harvests of domestically produced seafood and evaluate whether
existing temporary worker programs, including the H-2B program,
adequately meet these needs, and to report to the Committee on
potential long-term regulatory or statutory solutions. The
Committee requests an update in the fiscal year 2028
congressional justification.
Timely Processing of Labor Certification Applications.--The
Committee understands that the Secretary has taken steps to
improve the processing efficiency of the Office of Foreign
Labor Certification (OFLC). Despite these efforts, OFLC
processing efficiency remains a concern. The Committee
encourages the Department to utilize existing authority and
resources to improve the processing timelines to provide
certainty to employers that rely on these visa programs. Within
180 days of enactment, the Department shall provide an update
to the Committee detailing efforts being taken to improve
processing timeframes, including the expansion of concurrent
processing between DOL's labor certification functions and
Department of Homeland Security (DHS) visa application
processing to improve interagency coordination between DOL to
DHS to bolster national security.
One-Stop Career Centers/Labor Market Information
The Committee provides $42,893,000 for One-Stop Career
Centers and Labor Market Information.
ADVANCES TO THE UNEMPLOYMENT TRUST FUND AND OTHER FUNDS
The Committee recommends such sums as necessary for
Advances to the Unemployment Trust Fund and Other Funds. The
funds are made available to accounts authorized under Federal
and State unemployment insurance laws and the Black Lung
Disability Trust Fund when the balances in such accounts are
insufficient.
PROGRAM ADMINISTRATION
Appropriation, fiscal year 2026....................... $158,433,000
Budget request, fiscal year 2027...................... 167,290,000
Committee Recommendation.............................. 153,433,000
Change from enacted level......................... -5,000,000
Change from budget request........................ -13,857,000
The Committee provides $109,527,000 from the General Fund
of the Treasury and $43,906,000 from the Employment Security
Administration Account in the Unemployment Trust Fund. This
funding reflects the consolidation of Employment Security,
Apprenticeship Services, and Executive Direction into one
budget activity.
VETERANS' EMPLOYMENT AND TRAINING SERVICE
Appropriation, fiscal year 2026....................... $335,341,000
Budget request, fiscal year 2027...................... 335,341,000
Committee Recommendation.............................. 335,341,000
Change from enacted level......................... - - -
Change from budget request........................ - - -
The Committee provides $65,500,000 from the General Fund of
the Treasury and $269,841,000 from the Employment Security
Administration Account in the Unemployment Trust Fund.
The Veterans Employment and Training (VETS) program serves
America's veterans and separating service members by preparing
them for meaningful careers, providing employment resources and
expertise, and protecting their employment rights.
Within the total for VETS, the Committee provides the
following amounts:
------------------------------------------------------------------------
Budget Activity FY 2026 Enacted FY 2027 Committee
------------------------------------------------------------------------
Jobs for Veterans State Grants.... $185,000,000 $185,000,000
Transition Assistance Program..... 34,379,000 34,379,000
Federal Administration............ 47,048,000 47,048,000
Veterans Employment and Training 3,414,000 3,414,000
Institute........................
Homeless Veterans Reintegration 65,500,000 65,500,000
Program..........................
------------------------------------------------------------------------
The Transition Assistance Program (TAP) for separating
service members and their spouses provides a mandatory one-day
employment workshop, as well as two 2-day career track
workshops on employment preparation and vocational training, as
part of TAP to assist service members' transition to civilian
employment. TAP Employment Workshops are provided on military
installations, both domestically and abroad.
The Committee continues to provide $500,000 to support the
Honoring Investments in Recruiting and Employing American
Military Veterans Act of 2017 (HIRE Vets) Medallion program.
Career-Driven Employment Outcomes.--The Committee
recognizes the importance of enabling veterans to thrive in
careers after service. Studies indicate there is lack of
evidence demonstrating if existing veteran transition programs
have an effective impact on career outcomes. The Committee
urges the Department to work with employer-focused
organizations to develop an outcome-focused, data-driven tool
to measure the effectiveness of Federal veteran employment
transition programs on career outcomes to better inform program
impacts and design best practices to equip veterans with a more
seamless transition geared toward gainful civilian employment.
Off-Base Transition Training.--The Committee continues to
support the implementation of the Off-Base Transition Training
pilot program and encourages the Department to collaborate with
the Department of Veterans Affairs to offer resources on
benefit eligibility.
Transition Assistance Program.--The Department plays an
important role in educating veterans about many of their
benefits through the Transition Assistance Program, including
providing job assistance training, business ownership courses,
financial planning resources, and basic understandings of many
other benefits. Despite these efforts, the Committee is
concerned with the growing number of veterans and separating
service members who are unaware of many of the service-
connected benefits that are available to them once they
transition back to civilian life. The Committee directs the
Department to include in the fiscal year 2028 congressional
justification the estimated cost of modifying the Transition
Assistance Program to include a once-a-year workshop for all
service members, regardless of their enlistment status.
Employee Benefits Security Administration
SALARIES AND EXPENSES
Appropriation, fiscal year 2026....................... $191,100,000
Budget request, fiscal year 2027...................... 181,100,000
Committee Recommendation.............................. 181,100,000
Change from enacted level......................... -10,000,000
Change from budget request........................ - - -
The Employee Benefits Security Administration (EBSA)
assures the security of retirement, health, and other
workplace-related benefits of working Americans.
Case Status Report.--The Committee directs EBSA to provide
the report required in section 513(b)(2) of the Employee
Retirement Income Security Act of 1974 on the status of all
cases in enforcement status in the most recent fiscal year,
within 90 days of enactment of this Act.
Information Sharing.--The Committee understands that the
DOL Office of Inspector General's fiscal year 2026 workplan
includes an investigation into allegations of EBSA sharing
confidential information regarding employee benefit plans and
their fiduciaries and will follow this ongoing work. The
Committee also notes congressional oversight activities related
to this matter.
Reporting Simplification.--The Committee recognizes the
importance of retirement plan reporting requirements that are
transparent and effective. The Committee is aware of concerns
about the administrative burden of the current two-step filing
system reporting system. The Committee notes the opportunity
for the Department, within existing authorities, to evaluate
potential improvements that address existing complexities while
maintaining strong oversight.
Pension Benefit Guaranty Corporation
PENSION BENEFIT GUARANTY CORPORATION FUND
Appropriation, fiscal year 2026....................... $494,264,000
Budget request, fiscal year 2027...................... 484,264,000
Committee Recommendation.............................. 484,264,000
Change from enacted level......................... -10,000,000
Change from budget request........................ - - -
Congress established the Pension Benefit Guaranty
Corporation (PBGC) to insure Americans' defined-benefit pension
plans. It operates a single-employer program and a
multiemployer insurance program, financed through premiums,
investment income, and assets from terminated plans.
Delphi Salaried Plan Employees.--In 2009, the PBGC
terminated certain Delphi pension plans, including the Delphi
Retirement Program for Salaried Employees. The Committee notes
that some participants of the Delphi salaried pension plan
received less than their full benefit. PBGC paid benefits are
subject to statutory limitations. The Committee also notes
ongoing legislative efforts to restore full benefits to the
affected participants.
Wage And Hour Division
SALARIES AND EXPENSES
Appropriation, fiscal year 2026....................... $260,000,000
Budget request, fiscal year 2027...................... 235,000,000
Committee Recommendation.............................. 235,000,000
Change from enacted level......................... -25,000,000
Change from budget request........................ - - -
The Wage and Hour Division (WHD) enforces Federal minimum
wage, overtime pay, recordkeeping, and child labor requirements
of the Fair Labor Standards Act. WHD also has enforcement and
other administrative responsibilities related to the Migrant
and Seasonal Agricultural Worker Protection Act, the Employee
Polygraph Protection Act, the Family and Medical Leave Act, the
Davis Bacon Act, and the Service Contract Act.
Employment Opportunities.--The Committee recognizes the
importance and benefits of employment opportunities, including
for individuals with intellectual and developmental
disabilities. The Committee notes the Department's decision to
withdraw the 2024 proposed rule to phase out 14(c)
certification under the Fair Labor Standards Act (89 FR 96466).
The Department is encouraged to take appropriate steps to
support continued access to employment choice for individuals
with disabilities who rely on these opportunities.
Independent Contractors.--The Committee understands strong
concerns with the Department's final rule issued in January
2024 titled, ``Employee or Independent Contractor
Classification Under the Fair Labor Standards Act,''
particularly that it would severely restrict economic
opportunities and employment choice for the millions of
Americans who work as independent contractors. These
individuals value the freedom that independent contractor work
affords, and the Committee understands this flexibility is
especially important for independent workers who care for
children or other family members. The Committee understands
that in February 2026, the Wage and Hour Division issued a
proposed rule (91 FR 9932) to rescind this 2024 rule and
reinstate the regulatory framework the Department previously
adopted in a final rule in January 2021, with some
modifications. This proposal seeks to simplify and clarify how
workers are classified while preserving opportunities for
independent contractors. Due to this ongoing rulemaking
process, the Committee did not include a general provision
blocking funding for implementing the 2024 rule that the
Committee included in prior years.
Individuals with Disabilities.--The Committee is aware of
interest in ways to expand employment choice for individuals
with disabilities and address potential barriers to employment.
The Committee further understands the interest in ensuring
adults with disabilities have the freedom to choose their
preferred employment setting. The Committee notes ongoing
legislative efforts related to these goals.
Office of Labor Management Standards
SALARIES AND EXPENSES
Appropriation, fiscal year 2026....................... $48,515,000
Budget request, fiscal year 2027...................... 50,115,000
Committee Recommendation.............................. 48,515,000
Change from enacted level......................... - - -
Change from budget request........................ -1,600,000
The Office of Labor Management Standards administers the
Labor-Management Reporting and Disclosure Act, which
establishes safeguards for union democracy and union financial
integrity, and requires public disclosure reporting by unions,
union officers, employees of unions, labor relations
consultants, employers, and surety companies.
Office of Federal Contract Compliance Programs
SALARIES AND EXPENSES
Appropriation, fiscal year 2026....................... $100,976,000
Budget request, fiscal year 2027...................... - - -
Committee Recommendation.............................. - - -
Change from enacted level......................... -100,976,000
Change from budget request........................ - - -
The Committee recommendation does not provide funding for
OFCCP, consistent with the fiscal year 2027 budget request. As
the budget request notes, Executive Order 14173, issued on
January 21, 2025, rescinded Executive Order 11246, removing
much of the basis for the OFCCP's investigative and enforcement
activity.
Office of Workers' Compensation Programs
SALARIES AND EXPENSES
Appropriation, fiscal year 2026....................... $122,705,000
Budget request, fiscal year 2027...................... 110,000,000
Committee Recommendation.............................. 110,000,000
Change from enacted level......................... -12,705,000
Change from budget request........................ - - -
The Office of Workers' Compensation Programs (OWCP)
administers the Federal Employees' Compensation Act, the
Longshore and Harbor Workers' Compensation Act, the Energy
Employees Occupational Illness Compensation Program Act, and
the Black Lung Benefits Act. These programs provide eligible
injured and disabled workers and their survivors with
compensation, medical benefits, and services including
rehabilitation, supervision of medical care, and technical and
advisory counseling.
The Committee provides $107,823,000 in General Funds from
the Treasury and $2,177,000 from the Special Fund established
by the Longshore and Harbor Workers' Compensation Act.
SPECIAL BENEFITS
Appropriation, fiscal year 2026....................... $1,298,385,000
Budget request, fiscal year 2027...................... 1,508,251,000
Committee Recommendation.............................. 1,508,251,000
Change from enacted level......................... +209,866,000
Change from budget request........................ - - -
These funds provide mandatory benefits under the Federal
Employees' Compensation Act and the Longshore and Harbor
Workers' Compensation Act.
SPECIAL BENEFITS FOR DISABLED COAL MINERS
Appropriation, fiscal year 2026....................... $30,485,000
Budget request, fiscal year 2027...................... 27,535,000
Committee Recommendation.............................. 27,535,000
Change from enacted level......................... -2,950,000
Change from budget request........................ - - -
These funds provide mandatory benefits to coal miners
disabled by black lung disease, to their survivors and eligible
dependents, and for necessary administrative costs.
The Committee provides $5,450,000 as an advance
appropriation for the first quarter of fiscal year 2028. These
funds ensure uninterrupted payments to beneficiaries.
ADMINISTRATIVE EXPENSES, ENERGY EMPLOYEES OCCUPATIONAL ILLNESS
COMPENSATION FUND
Appropriation, fiscal year 2026....................... $68,148,000
Budget request, fiscal year 2027...................... 66,138,000
Committee Recommendation.............................. 66,138,000
Change from enacted level......................... -2,010,000
Change from budget request........................ - - -
These funds provide mandatory benefits to eligible
employees or survivors of employees of the Department of Energy
(DOE); its contractors and subcontractors; companies that
provided beryllium to DOE; atomic weapons employees who suffer
from a radiation-related cancer, beryllium-related disease, or
chronic silicosis because of their work in producing or testing
nuclear weapons; and uranium workers covered under the
Radiation Exposure Compensation Act.
BLACK LUNG DISABILITY TRUST FUND
Appropriation, fiscal year 2026....................... $477,295,000
Budget request, fiscal year 2027...................... 496,011,000
Committee Recommendation.............................. 496,011,000
Change from enacted level......................... +18,716,000
Change from budget request........................ - - -
The Black Lung Disability Trust Fund pays black lung
compensation, medical and survivor benefits, and administrative
expenses when no mine operator can be assigned liability for
such benefits, or when mine employment ceased prior to 1970.
The Black Lung Disability Trust Fund is financed by an excise
tax on coal, reimbursements from responsible mine operators,
and short-term advances from the U.S. Treasury. The Emergency
Economic Stabilization Act of 2008 authorized a restructuring
of the Black Lung Disability Trust Fund debt and required that
annual operating surpluses be used to pay down the debt until
all remaining obligations are retired.
Black Lung Benefits Claims Processing.--The Committee is
concerned with lengthy delays in the processing of Black Lung
Benefits Act claims, particularly where the mine operator's
ability to pay the claim is in question. Delays impede access
to necessary medical care while claims are pending. The
Committee supports efforts by the Secretary to resolve these
claims expediently, including through utilizing cloud
technology, to ensure miners can receive the benefits and
medical care they need. The Committee requests that the
Department provide an update on specific actions it has taken
to improve the speed and quality of black lung claims
processing as part of the fiscal year 2028 congressional
justification.
Occupational Safety and Health Administration
SALARIES AND EXPENSES
Appropriation, fiscal year 2026....................... $629,309,000
Budget request, fiscal year 2027...................... 582,381,000
Committee Recommendation.............................. 576,900,000
Change from enacted level......................... -52,409,000
Change from budget request........................ -5,481,000
The Occupational Safety and Health Administration (OSHA)
administers the Occupational Safety and Health Act of 1970, by
setting and enforcing health and safety standards for
workplaces and conducting training, outreach, education, and
compliance assistance.
Within the total for OSHA, the Committee provides the
following amounts:
------------------------------------------------------------------------
Budget Activity FY 2026 Enacted FY 2027 Committee
------------------------------------------------------------------------
Safety and Health Standards....... $18,500,000 $15,700,000
Federal Enforcement............... 243,000,000 210,078,000
Whistleblower Programs............ 22,500,000 22,500,000
State Programs.................... 120,000,000 120,000,000
Technical Support................. 26,000,000 22,500,000
Federal Compliance Assistance..... 78,262,000 78,262,000
State Consultation Grants......... 63,160,000 63,160,000
Training Grants................... 12,787,000 - - -
Safety and Health Statistics...... 35,500,000 35,500,000
Executive Direction and 9,600,000 9,200,000
Administration...................
------------------------------------------------------------------------
Opioid Use in the Workplace.--The Committee remains
concerned about the prevalence of opioid use in the workplace
and acknowledges that many employers may not be prepared to
address it. The Committee encourages the Department to issue
voluntary guidance to employers on acquiring and maintaining
opioid overdose reversal medication, as well as on how
employers could provide annual training for employees on the
usage of such medication. The Committee requests an update in
the fiscal year 2028 congressional justification on such
activities.
State Plans.--The Committee is aware the Occupational
Safety and Health Act allows the Federal cost-share of State
OSHA programs authorized under section 23(g) of the Act to be
up to 50 percent, and States cover the other portion. The
Committee is aware of interest in understanding State support
for these programs and requests the Department provide
information summarizing State support for OSHA State programs
as part of the fiscal year 2028 congressional justification.
Mine Safety and Health Administration
SALARIES AND EXPENSES
Appropriation, fiscal year 2026....................... $387,816,000
Budget request, fiscal year 2027...................... 348,207,000
Committee Recommendation.............................. 348,207,000
Change from enacted level......................... -39,609,000
Change from budget request........................ - - -
The Mine Safety and Health Administration (MSHA) enforces
the Federal Mine Safety and Health Act of 1977 and the Mine
Improvement and New Emergency Response Act of 2006 in
underground and surface coalmines and metal/non-metal mines.
Within the total for MSHA, the Committee provides the
following amounts:
------------------------------------------------------------------------
Budget Activity FY 2026 Enacted FY 2027 Committee
------------------------------------------------------------------------
Mine Safety and Health Enforcement $265,774,000 $252,307,000
Standards and Regulations 5,000,000 3,700,000
Development......................
Assessments....................... 7,191,000 7,000,000
Educational Policy and Development 39,820,000 25,000,000
Technical Support................. 36,041,000 31,200,000
Program Evaluation and Information 17,990,000 15,500,000
Resources........................
Program Administration............ 16,000,000 13,500,000
------------------------------------------------------------------------
Allocation of Resources.--The Committee notes significant
worker dislocations and mine closures because of economic
conditions throughout the mining industry, and in coal mining
in particular. The Committee reiterates its support for the
ongoing effort to bring MSHA enforcement into proportion by
redistributing resources and activities to the areas where mine
production is currently occurring and where MSHA identifies the
most significant safety hazards.
Respirable Crystalline Silica.--The Committee shares MSHA's
commitment to ensuring the safety and health of our nation's
miners. The Committee is aware of concerns regarding the final
rule, ``Lowering Miners' Exposure to Respirable Crystalline
Silica and Improving Respiratory Protection,'' published in the
Federal Register on April 18, 2024 (89 FR 28218). These
concerns relate to the rule's feasibility, proportionality, and
practicality; the rule's effects given operational and
environmental differences between the coal and metal and
nonmetal mining sectors; and the inclusion of certain
provisions such as an immediate notification requirement. The
Committee understands that on April 11, 2025, the Eighth
Circuit Court of Appeals issued an order indefinitely staying
the final rule's compliance deadlines for mine operators
pending judicial review. Additionally, the Committee
understands that MSHA told the Court that it will conduct
limited rulemaking to reconsider and seek comment on portions
of the Silica Rule affected by the litigation. The Committee
encourages MSHA to incorporate the principles of feasibility,
proportionality, and practicality as part of its evaluation of
this rule. Additionally, the Committee urges MSHA to provide
clear, timely communication to stakeholders regarding this rule
and respirable crystalline silica protections.
Bureau of Labor Statistics
SALARIES AND EXPENSES
Appropriation, fiscal year 2026....................... $708,500,000
Budget request, fiscal year 2027...................... 68,000,000
Committee Recommendation.............................. 716,500,000
Change from enacted level......................... +8,000,000
Change from budget request........................ +648,500,000
The Bureau of Labor Statistics (BLS) is an independent
national statistical agency that collects, processes, analyzes,
and disseminates essential economic data to the Congress,
Federal agencies, State and local governments, businesses, and
the public. Its principal surveys include the Consumer Price
Index and the monthly unemployment series. The Committee
appreciates the potential value of the Administration's
proposed consolidation of Federal statistical agencies. While
the Committee regrets that the pace of the budget cycle
precludes their consideration by the respective authorizing
committees of jurisdiction, the Committee looks forward to
continuing to partner with the Administration to identify
potential efficiencies in the data collection process while
preserving the high-quality of BLS's statistical analysis.
The Committee recommendation includes $648,500,000 from the
General Fund of the Treasury and $68,000,000 from the
Employment Security Administration Account in the Unemployment
Trust Fund.
Within the total for BLS, the Committee provides the
following amounts:
------------------------------------------------------------------------
Budget Activity FY 2026 Enacted FY 2027 Committee
------------------------------------------------------------------------
Employment and Unemployment $252,000,000 $255,000,000
Statistics.......................
Labor Market Information.......... 68,000,000 68,000,000
Prices and Cost of Living......... 248,000,000 253,000,000
Compensation and Working 91,500,000 91,500,000
Conditions.......................
Productivity and Technology....... 12,000,000 12,000,000
Executive Direction and Staff 37,000,000 37,000,000
Services.........................
------------------------------------------------------------------------
Declining Statistical Survey Response Rates.--The Committee
notes a report (Report No. 17-24-001-11-001) issued on October
26, 2023, by the OIG that describes how the BLS addresses
challenges posed by declining statistical survey response
rates, and the impact of the declining response rates on the
reliability and costs of economic information developed by BLS.
The OIG recommended, among other things, that BLS, based on the
nonresponse bias study or imputation assessment, establish, as
applicable, a threshold at which the Consumer Price Index and
Import and Export Price Index must publicly disclose the number
of imputations used. The OIG also recommended that BLS update
program policies and procedures to include the established
threshold, and document how to publicly disclose when the
threshold is met. The Committee remains concerned that BLS may
not have guidelines that require a sufficient degree of
transparency and urges that all DOL-OIG recommendations be
sufficiently addressed.
Farmworker Labor Shortages.--The Committee is concerned
about persistent labor shortages affecting agricultural
producers across the United States and the implications for
domestic food production, farm viability, and rural economies.
The Committee requests the Department, in consultation with the
USDA, to submit a report to the Committees not later than one
year after enactment of this Act assessing the extent and
causes of farmworker labor shortages over the past five years,
disaggregated by calendar year. The report shall include: (1)
data on agricultural job vacancies, recruitment efforts, and
unfilled positions across major agricultural sectors and
regions; (2) trends in the use of the H-2A temporary
agricultural worker program, including application volumes,
approvals, denials, processing times, and employer
participation; (3) analysis of barriers faced by agricultural
employers in recruiting and retaining domestic and foreign
farmworkers; (4) impacts of labor shortages on agricultural
production, crop losses, and supply chain stability; and (5)
recommendations for administrative or policy changes that could
help address workforce needs in the agricultural sector while
ensuring compliance with applicable labor protections.
Military Spouse Unemployment and Underemployment Data.--The
Committee recognizes the need for comprehensive data measuring
employment and underemployment among military spouses over
time. The Committee encourages BLS, in collaboration with
Department of Defense, the U.S. Census Bureau, the Internal
Revenue Service, and any other agency with relevant data to
assess labor market outcomes and characteristics of military
spouses with existing survey data, including survey data from
research entities and nonprofits, and explore options for
modifying such surveys to capture this population.
International Labor Comparisons Program.--The Committee
recognizes the importance that the Bureau of Labor Statistics'
International Labor Comparisons Program played in analyzing the
impact of trade and economic policies on U.S. workers,
especially in the manufacturing sector. The Committee urges the
BLS, to the extent possible, to collect and analyze
international data on wages in order to assess the impact of
trade and other economic policies on U.S. workers.
Office of Disability Employment Policy
SALARIES AND EXPENSES
Appropriation, fiscal year 2026....................... $43,000,000
Budget request, fiscal year 2027...................... 33,810,000
Committee Recommendation.............................. 43,000,000
Change from enacted level......................... - - -
Change from budget request........................ +9,190,000
The Office of Disability Employment Policy provides policy
guidance and leadership to eliminate employment barriers to
people with disabilities.
Departmental Management
SALARIES AND EXPENSES
Appropriation, fiscal year 2026....................... $363,185,000
Budget request, fiscal year 2027...................... 329,316,000
Committee Recommendation.............................. 242,241,000
Change from enacted level......................... -120,944,000
Change from budget request........................ -87,075,000
The Departmental Management appropriation provides funds
for the staff responsible for Departmental operations,
management, and policy development.
The Committee recommendation includes $241,933,000 from the
General Fund of the Treasury and $308,000 from the Employment
Security Administration Account in the Unemployment Trust Fund.
Within the total for Departmental Management, the Committee
provides the following amounts:
------------------------------------------------------------------------
Budget Activity FY 2026 Enacted FY 2027 Committee
------------------------------------------------------------------------
Program Direction and Support..... $22,000,000 $22,000,000
Departmental Evaluation........... 4,281,000 4,281,000
Legal Services.................... 120,754,000 115,935,000
International Labor Affairs....... 116,125,000 - - -
Administration and Management..... 28,450,000 28,450,000
Adjudication...................... 35,000,000 35,000,000
Women's Bureau.................... 23,000,000 23,000,000
Civil Rights Activities........... 7,586,000 7,586,000
Chief Financial Officer........... 5,681,000 5,681,000
------------------------------------------------------------------------
Bill Wide Requirements.--The Committee notes the inclusion
of a bill wide requirements section of this report. This
section contains requirements which apply to all agencies
funded by this Act.
Benefit Cliffs.--The Committee supports efforts by the
Department, where appropriate, to provide education,
information, and support services for individuals and families
navigating workforce issues to avoid potential financial shocks
associated with the loss of Federal and state benefits in order
to allow participants to make informed decisions around
earnings advancement.
Bureau of International Labor Affairs.--The Committee
provides no funding for the Bureau of International Labor
Affairs.
Health Care Professions.--The Committee encourages DOL to
support efforts that connect unemployed workers with
credentials in health care with employers that have acute
workforce needs.
Independent Contractor Status.--The Committee commends the
Department for rescinding the Biden-era final rule addressing
the classification of independent contractors. The new proposed
rule, released February 2026, replaces the old methodology with
a streamlined analysis, making it easier to properly
differentiate between employees with the protections under the
Fair Labor Standards Act and those workers who work as
independent contractors.
Investments in Impoverished Areas.--The Committee directs
DOL to update the report provided to the Committee in response
to a House Report 117-403 directive to include persistent
poverty percentages for competitions in fiscal year 2023 once
those data are available.
Paid Family and Medical Leave Glossary of Key Terms.--The
Committee directs the Department to work with mandatory State
paid family and medical leave programs, multi state employers,
insurers, and other stakeholders to produce and publicly
release a glossary of commonly used paid leave terms across
States to help support clarity, allow for flexibility in
employer benefit design, and foster potential interstate
harmonization. The Committee further directs the Department to
provide this report within 120 days of enactment of this Act.
Skilled Workforce Education Opportunities for K-12
Students.--The Committee requests that the Department of Labor
give special consideration to entities that promote Skilled
Workforce Education opportunities for K-12 students.
State Paid Leave Program Workshops.--The Committee directs
that, of the funds provided under this heading, not to exceed
$1,000,000 shall be used for the Department to convene one or
more meetings of the designated focal point for each mandatory
State paid family and medical leave program, starting within
120 days of enactment of this Act, to discuss opportunities for
interstate coordination and interoperability, including
technological systems for the transmission of information and
data between these State programs and employers, and to solicit
input, as appropriate, from multi-state employers, insurers,
and other stakeholders to inform the Department's understanding
of needs. Such funds may be used only for necessary expenses
associated with convening the State programs. The Committee
further directs the Department to produce and publicly release
a report within 45 days after each workshop summarizing areas
of potential collaboration and promising opportunities for
enhanced interstate coordination and interoperability.
Support Revitalization of Domestic Shipbuilding Industry.--
The Committee urges the Department to prioritize funding to
support a technical assistance project with the objective to
contribute to sustaining the future of the shipbuilding
industry in the U.S by establishing mechanisms for
international collaboration to draw on expertise in support of
expanding the number of skilled U.S. workers and training
institutions with shipbuilding skills and knowledge.
Office of Inspector General
SALARIES AND EXPENSES
Appropriation, fiscal year 2026....................... $97,028,000
Budget request, fiscal year 2027...................... 87,325,000
Committee Recommendation.............................. 97,028,000
Change from enacted level......................... - - -
Change from budget request........................ +9,703,000
The Office of Inspector General conducts audits of
Department programs and operations to determine that they
comply with the applicable laws and regulations, that they use
resources effectively, and that they are achieving their
intended results.
The recommendation includes $91,187,000 from the General
Fund of the Treasury and $5,841,000 from the Employment
Security Administration Account in the Unemployment Trust Fund.
IT MODERNIZATION
Appropriation, fiscal year 2026....................... $6,889,000
Budget request, fiscal year 2027...................... 18,160,000
Committee Recommendation.............................. 11,160,000
Change from enacted level......................... +4,271,000
Change from budget request........................ -7,000,000
Information Technology (IT) Modernization provides a
dedicated source of funding for Department-wide IT
modernization projects together with funding through the
Department's Working Capital Fund.
general provisions
Sec. 101. The Committee continues a provision to prohibit
the use of Job Corps funds for the salary of an individual at a
rate more than Executive Level II.
(TRANSFER OF FUNDS)
Sec. 102. The Committee continues a provision regarding
transfer authority.
Sec. 103. The Committee continues a prohibition on use of
funds to purchase goods that are in any part produced by
indentured children.
Sec. 104. The Committee continues a provision related to
grants made from funds available to the Department under the
American Competitiveness and Workforce Improvement Act.
Sec. 105. The Committee continues a provision to prohibit
recipients of funds provided to the Employment and Training
Administration from using such funds for the compensation of
any individual at a rate more than Executive Level II.
(TRANSFER OF FUNDS)
Sec. 106. The Committee continues a provision providing the
Secretary with the authority to transfer funds made available
to the Employment and Training Administration to Program
Administration for technical assistance and program integrity
activities.
(TRANSFER OF FUNDS)
Sec. 107. The Committee modifies a provision allowing up to
0.75 percent of discretionary appropriations provided in this
Act for specific Department of Labor agencies to be used by the
Office of the Chief Evaluation Officer for evaluation purposes
consistent with the terms and conditions in this Act applicable
to such office.
Sec. 108. The Committee continues a provision relating to
the Fair Labor Standards Act and certain insurance personnel
conducting post-disaster activity.
Sec. 109. The Committee continues a provision relating to
flexibility of H-2B nonimmigrant crossings.
Sec. 110. The Committee continues a provision related to
the prevailing wage in the H-2B program.
Sec. 111. The Committee continues a provision related to
workers in the H-2B program.
Sec. 112. The Committee modifies a provision relating to
surplus property and apprenticeship programs.
Sec. 113. The Committee continues a provision relating to
the Treasure Island and Gary Job Corps Centers.
Sec. 114. The Committee continues a provision relating to
Job Corps.
(RESCISSION)
Sec. 115. The Committee includes a provision related to the
Immigration and Nationality Act.
Sec. 116. The Committee includes new a provision related to
Adverse Effect Wage Rate determination.
Sec. 117. The Committee includes a new provision to
prohibit the use of funds to implement, administer, or enforce
a final rule issued by the Department of Labor regarding heat
injury and illness prevention in outdoor and indoor work
settings.
TITLE II--DEPARTMENT OF HEALTH AND HUMAN SERVICES
Appropriation, fiscal year 2026................... $114,797,239,000
Budget request, fiscal year 2027.................. 98,602,461,000
Committee Recommendation.......................... 110,767,281,000
Change from enacted level..................... -4,029,958,000
Change from budget request.................... +12,164,820,000
The Committee supports the efforts of the Secretary of
Health and Human Services to reform and reorganize the
Department. The Secretary has made a number of important
proposals to reorganize the Department to eliminate silos
within and among subagencies and make the Department more
efficient and responsive to the needs of the American people.
The Committee notes that the authorizing committees of
jurisdiction have not yet acted on the Department's proposals.
Accordingly, the Committee's bill and report reflect the
current organizational structure of the Department. The
Committee looks forward to working with the authorizing
committees of jurisdiction as they review the Department's
request to reorganize. The Committee strongly supports and
shares the Secretary's goal to end the chronic disease epidemic
and Make America Healthy Again.
Health Resources and Services Administration
Appropriation, fiscal year 2026....................... $9,220,107,000
Budget request, fiscal year 2027...................... 6,880,001,000
Committee Recommendation.............................. 8,346,949,000
Change from enacted level......................... -873,158,000
Change from budget request........................ +1,466,948,000
The Health Resources and Services Administration (HRSA)
administers programs that support primary health care in rural,
tribal, and underserved communities, improve maternal and child
health, train health professionals to serve in high need areas,
and provide technical assistance regarding the utilization of
health resources and facilities.
The Committee's recommendation for HRSA includes
$8,070,271,000 in discretionary budget authority and
$276,678,000 in mandatory funding.
PRIMARY HEALTH CARE
Appropriation, fiscal year 2026....................... $1,858,772,000
Budget request, fiscal year 2027...................... 1,877,772,000
Committee Recommendation.............................. 1,858,772,000
Change from enacted level......................... - - -
Change from budget request........................ -19,000,000
Health Centers
Health centers deliver affordable, accessible, quality, and
cost-effective primary health care to millions of people across
the country regardless of their ability to pay. The Health
Center program supports community health centers, health
centers for the homeless, health centers for residents of
public housing, and migrant health centers. HRSA reports that
in 2024, more than 32.4 million people relied on HRSA-funded
health centers for care, including one in five rural residents,
one in eight children, one in 15 seniors, and over 400,000
veterans.
Within the amount provided, the Committee includes bill
language providing up to $120,000,000 for the Federal Tort
Claims Act program.
Further, within the total provided for the Health Centers
program, the Committee includes not less than the following
amounts:
------------------------------------------------------------------------
Budget Activity FY 2026 Enacted FY 2027 Committee
------------------------------------------------------------------------
Addressing Intimate Partner $2,000,000 $2,000,000
Violence and Project Catalyst....
Alcee L. Hastings Program for 10,000,000 10,000,000
Advanced Cancer Screening........
Early Childhood Development....... 30,000,000 30,000,000
Native Hawaiian Health Care....... 27,000,000 27,000,000
Papa Ola Lokahi (non-add)..... 10,000,000 10,000,000
School Based Health Centers....... 55,000,000 55,000,000
------------------------------------------------------------------------
Alcee L. Hastings Program for Advanced Cancer Screening in
Underserved Communities.--The Committee commends HRSA for
effectively implementing the Alcee L. Hastings Program for
Advanced Cancer Screening in Underserved Communities. Initial
funding in fiscal year 2022 supported 11 innovative
Accelerating Cancer Screening (AxCS) awards for health centers
to work in collaboration with Comprehensive Cancer Centers to
improve screening in underserved populations. These grants have
encouraged collaborative efforts to address screening
shortfalls in underserved populations, identifying effective
interventions and facilitating follow-up care. The program's
initial focus on breast, cervical, and colorectal cancer
screening was expanded in fiscal year 2023 to include lung
cancer screening. The Committee encourages HRSA to continue
supporting screening initiatives in these four areas, to
support grantees that can expand existing projects focused on a
single particular cancer to include additional cancers, and to
support grantees that work to secure appropriate follow up
screening and access to care for individuals with abnormal
screening results.
Autonomous Artificial Intelligence and Diabetic
Retinopathy.--The Committee encourages HRSA to consider the
establishment, expansion, or maintenance of efforts at
Federally Qualified Health Centers (FQHC) to bring specialty
eyecare services to patients using FDA-cleared autonomous
artificial intelligence technology that diagnoses diabetic
retinopathy. HRSA is further encouraged to focus on supporting
efforts at FQHCs, where a majority of patients with diabetes
face challenges adhering to medical recommendations to receive
annual comprehensive diabetic eye exams. HRSA is also
encouraged to evaluate the utilization of FDA-cleared
autonomous AI within FQHCs and, in consultation with physician
specialty professional organizations, promote patient and
provider education on successful patient referral pathways from
FQHCs to specialty care.
Base Grant Adjustments.--The Committee recognizes that
community health center costs have increased significantly and
that it has been nearly a decade since the last base grant
adjustment. The Committee encourages HRSA to consider the needs
of existing health centers in relation to their current base
grants when allocating increased health center funding.
Cancer Mobile Screening.--Early detection of cancer has
been shown to significantly reduce cancer mortality, especially
with lung cancer, making treatments more timely, effective, and
cost efficient. Mobile screening units can increase access to
preventive care, significantly reducing disparities in
healthcare access. Mobile units play a crucial role in reaching
populations that are traditionally underserved, thereby
enhancing outcomes in communities often neglected in health
care. The Committee encourages HRSA to support cancer
screenings, including lung cancer detection, in communities
with a demonstrated need, including rural, tribal, and
underserved populations, with an emphasis on projects most
likely to impact patient mortality and address screening gaps
for high-risk individuals. The Committee requests an update on
this topic in the fiscal year 2028 congressional justification.
Early Childhood Development.--The Committee includes
funding for HRSA to support the availability of early childhood
development specialists in community health centers. The
Committee recognizes the critical role these specialists play
in improving child health through statewide systems of
developmental screening, early identification, and timely
intervention. The Committee urges HRSA to build upon this work
in States with high levels of childhood poverty and significant
health disparities, and to provide robust training and
technical assistance to support effective implementation in
these centers.
Food Access in Community Health Centers.--The Committee
commends the work of health centers that have partnered with
emergency feeding operations to provide access to food and
encourages the expansion of these partnerships to provide food
to underserved populations.
Native Hawaiian Health Care.--The Committee continues
$27,000,000 for the Native Hawaiian Health Care Program. Of the
total amount appropriated for the Native Hawaiian Health Care
Program, not less than $10,000,000 shall be provided to Papa
Ola Lokahi for administrative purposes authorized under 42
U.S.C. 11706, including expanded research and surveillance
related to the health status of Native Hawaiians and
strengthening the capacity of the Native Hawaiian Health Care
Systems.
Partnerships With Community Health Centers.--The Committee
recognizes the importance of community health centers entering
partnerships that close care gaps in medically underserved
areas. The Committee urges HRSA to examine how to support
existing health center partnerships and incentivize more
collaboration in underserved communities and requests an update
on this topic in the fiscal year 2028 congressional
justification.
School-Based Health Centers.--The Committee continues
funding for school-based health centers authorized under
section 330 of the PHS Act (42 U.S.C. 254b).
Technical Assistance.--The Committee believes funding for
the training and technical assistance available for health
centers through national and State cooperative agreements and
grants is critical to the successful operation and expansion of
the health centers program. Funds are available within the
amount provided to enhance technical assistance and training
activities and further quality improvement initiatives that
improve health outcomes and continue the development of and
support for health center-controlled networks so that new and
existing centers can improve patient access to quality health
services.
Testing and Treatment.--The Committee is concerned about
the continued rise in syphilis infections in the U.S.,
including congenital syphilis, and the impact on underserved
communities served by FQHCs. The Committee recognizes that
FQHCs play a critical role in providing services to individuals
at increased risk for sexually transmitted infections.
Therefore, the Committee urges HRSA to encourage increased
testing and treatment for syphilis, including prenatal syphilis
screening, to prevent congenital syphilis. The Committee
further urges HRSA to provide technical assistance and
training, utilizing expertise from outside organizations for
assistance, to FQHCs on implementation of screening protocols
and coordination with State and local public health
departments.
Testing for Hepatitis C.--The Committee recognizes the
value of point of care diagnostics for the hepatitis C virus
and supports efforts by HRSA to adopt practices and policies
that promote hepatitis C testing. The Committee encourages HRSA
to ensure that health centers have access to and utilize
available point of care diagnostic tests to adequately test the
populations they serve.
Free Clinics Medical Malpractice
Within the amount provided, the Committee continues bill
language providing up to $1,000,000 for payment of claims under
the FTCA to be made available for free clinic health
professionals as authorized by section 224(o) of the PHS Act.
This appropriation extends FTCA coverage to medical volunteers
in free clinics to expand access to healthcare services for
low-income individuals in medically underserved areas.
HEALTH WORKFORCE
Appropriation, fiscal year 2026....................... $1,413,776,000
Budget request, fiscal year 2027...................... 788,020,000
Committee Recommendation.............................. 1,438,876,000
Change from enacted level......................... +25,100,000
Change from budget request........................ +650,856,000
The Bureau of Health Workforce (BHW) strengthens the health
care workforce by connecting skilled health care providers to
communities in need through grant, scholarship, and loan
repayment programs. These programs are designed to help rural,
tribal, and underserved communities recruit and retain health
care providers.
Education and Training Related to the Care of Menopause.--
The Committee encourages HRSA to support efforts by medical
schools participating in HRSA health workforce programs to
provide education and training related to the care of women in
any of the stages of menopause as part of their curriculum.
GI Shortages in Rural Communities.--The Committee notes
that colorectal cancer (CRC) rates are rising, especially in
younger Americans, with CRC being the leading cancer killer for
people under the age of 50. Rural communities have severe
shortages of specialty physicians, including
gastroenterologists, who serve as the primary source for
diagnosing CRC. Access to preventative screenings and the
necessary follow up colonoscopy are critical to detecting and
preventing colorectal cancer. Therefore, the Committee
encourages HRSA to study the impact of such workforce shortages
and make recommendations to address the rising rates of CRC,
including the need for patients to have access to effective
screening measures.
Training Equipment for Health Workforce Education.--
Colleges play a vital role in preparing the next generation of
the health workforce by equipping students with the knowledge,
skills, and practical training necessary to meet the evolving
demands of our nation's healthcare system. This role is
especially important for those located in or near rural
communities, Medically Underserved Communities (MUCs), and
Health Professional Shortage Areas (HPSAs), where developing a
strong pipeline of well-trained health professionals is
critical to improving access to care. Investments in training
equipment such as simulation technology, clinical skills
laboratories, and other hands-on instructional tools can
significantly expand a college's ability to prepare students
for employment in high-need health occupations. Within the
funds provided for HRSA's Health Workforce programs, the
Committee encourages HRSA to support colleges seeking to expand
access to training equipment and instructional technologies
needed to educate the next generation of health workforce
professionals. In so doing, the Committee encourages HRSA to
prioritize institutions offering certificate programs and those
partnering with medical schools and allied health programs
located in rural communities, MUCs, and HPSAs. The Committee
requests an update on this topic and recommendations for any
legislative changes that may be needed for HRSA to provide such
support as part of the fiscal year 2028 congressional
justification.
National Health Service Corps
The Committee includes $133,100,000 for the National Health
Service Corps (NHSC) to support competitive awards to health
care providers dedicated to working in rural, tribal, and
underserved areas.
Tribal Set Aside.--Within the total provided for the NHSC,
the Committee includes a set aside of not less than 15 percent
to support awards to participating individuals that provide
health services in Indian Health Service facilities, tribally
operated health programs, and Urban Indian Health programs.
Maternity Care Target Areas (MCTAs).--The Committee
recognizes HRSA's progress in determining MCTAs in order to
begin making loan repayment awards to maternal health
practitioners, such as OB/GYNs and Certified Nurse Midwives,
who agree to serve in MCTAs. Within the total provided for the
NHSC, the Committee includes $8,000,000 to support loan
repayment for maternity care health services in health
professional shortage areas. The Committee requests an update
on this topic in the fiscal year 2028 congressional
justification.
Health Professions Education and Training (Title VII)
The Committee recommends $518,304,000 for the health
professions education and training programs authorized under
title VII of the PHS Act, which is equal to the fiscal year
2026 enacted level.
Centers of Excellence
The Committee includes $25,422,000 for the Centers of
Excellence Program. The Centers of Excellence program provides
innovative resources and education centers to recruit, train,
and retain students and faculty at health professions schools.
Health Careers Opportunity Program
The Committee includes $15,000,000 for the Health Careers
Opportunity Program (HCOP). The purpose of this grant program
is to assist students from disadvantaged backgrounds to enter
and successfully complete health professions schools. National
HCOP Academies prepare students to meet the admissions
requirements for the next level of their education and receive
a health professions degree or certificate.
Faculty Loan Repayment
The Committee includes $2,310,000 for the Faculty Loan
Repayment program. This program provides loan repayment to
health professions graduates from disadvantaged backgrounds who
serve as faculty at eligible health professions academic
institutions.
Scholarships for Disadvantaged Students
The Committee includes $55,014,000 for Scholarships for
Disadvantaged Students (SDS). The SDS program provides grants
to health professions and nursing schools to provide
scholarships to students from disadvantaged backgrounds who
have financial need.
Midwifery Training.--Within the total provided for SDS, the
Committee includes $5,000,000 to support grants awarded for the
purpose of educating midwives to address the national shortage
of maternity care providers.
Primary Care Training and Enhancement
The Committee includes $54,924,000 for Primary Care
Training and Enhancement (PCTE) programs. These programs
support the primary care workforce by providing enhanced
training for future primary care clinicians and faculty and
promoting primary care practice, particularly in rural and
underserved areas. The Committee recognizes that patient care
is frequently provided in a range of community-based settings
and that providing outpatient training opportunities in
underserved areas encourages long-term, sustainable physician
practice in high-need areas. The Committee includes an increase
of $5,000,000 to support medical school partnerships with
FQHCs, Rural Health Clinics, or other healthcare facilities
located in medically underserved communities to increase
medical school clinical rotations in rural and underserved
areas.
Oral Health Training
The Committee provides $46,673,000 for Training in Oral
Health Care programs, which includes not less than $14,000,000
for General Dentistry Programs, not less than $14,000,000 for
Pediatric Dentistry Programs, and not less than $15,000,000 for
State Oral Health Workforce grants. The Committee directs HRSA
to provide funding for section 748 post-doctoral training
grants, predoctoral dental grants, and dental faculty loan
repayment program (DFLRP) grants. The Committee continues to
support awards with a preference for pediatric dentistry
faculty supervising dental students or residents and providing
clinical services in dental schools, hospitals, and community-
based affiliated sites.
Pediatric Specialty Loan Repayment Program
The Committee includes $10,000,000 for the Pediatric
Specialty Loan Repayment program. This program supports loan
repayment for medical providers in exchange for a three-year
commitment to be employed or participate in a fellowship or
residency program in an underserved community.
Area Health Education Centers
The Committee includes $47,000,000 for the Area Health
Education Centers (AHEC) program. This program links university
health science centers with community health service delivery
systems to provide education and training networks that
recruit, train, and help retain health professionals committed
to underserved populations.
Simulation-Based Clinical Education.--Within the total
provided for AHEC, the Committee includes $3,000,000 for AHEC
recipients to provide experiential learning opportunities
through simulation labs designed to educate and train health
care professionals serving rural, medically underserved
communities. HRSA shall include as an allowable use the
purchase of simulation training equipment.
Geriatrics Programs
The Committee includes $48,245,000 for the Geriatrics
Workforce Enhancement Program and the Geriatrics Academic
Career Awards Program. These programs support training to
integrate geriatrics into primary care delivery and develop
academic-primary care-community based partnerships to address
gaps in health care for older adults.
Mental and Behavioral Health Programs
The Committee consolidates activities previously funded
under Mental and Behavioral Health programs into Behavioral
Health Workforce Education and Training (BHWET).
Behavioral Health Workforce Education and Training
The Committee includes $159,053,000 for the BHWET program.
This program establishes and expands internships or field
placement programs in behavioral health, serving populations in
rural and medically underserved areas.
Within the total provided for BHWET, the Committee includes
not less than the following amounts:
------------------------------------------------------------------------
Budget Activity FY 2026 Enacted FY 2027 Committee
------------------------------------------------------------------------
Graduate Psychology Education..... $25,000,000 $25,000,000
Mental and Substance Use Disorder 34,700,000 34,700,000
Workforce Training Demonstration.
Addiction Medicine Fellowship 25,000,000 25,000,000
(non-add)....................
Peer Support...................... 15,000,000 16,000,000
------------------------------------------------------------------------
Graduate Psychology Education.--The interprofessional
Graduate Psychology Education program increases the number of
health service psychologists trained to provide integrated
services to high-need, underserved populations in rural and
urban communities. The Committee notes data from CDC
demonstrating a rise in mental health issues for youth and
adolescents and urges HRSA to strengthen investments in the
training of health service psychologists to help address this
population.
Mental and Substance Use Disorder Workforce Training
Demonstration.--This program makes grants to institutions,
including but not limited to medical schools and FQHCs, to
support training for medical residents and fellows in
psychiatry and addiction medicine, as well as nurse
practitioners, physician assistants, health service
psychologists, counselors, nurses, and social workers trained
to provide mental health and substance use disorder services in
underserved and rural community-based settings, including such
settings that serve pediatric populations, as authorized under
section 760 of the PHS Act.
The Addiction Medicine Fellowship program provides
fellowships to train addiction medicine physicians and
addiction psychiatrists who work in underserved, community-
based settings that integrate primary care with mental health
disorder and SUD prevention and treatment services. One major
cause of the existing treatment gap is that physicians in
traditional medical settings lack the necessary training and
overall confidence to provide comprehensive assessments of
adolescents with SUD and subsequent evidence-based treatment.
The fellowship opportunities funded by this program provide
advanced training opportunities to a wide range of specialists,
including those in family medicine, internal medicine,
psychiatry, and emergency medicine.
Peer Support.--The Committee recognizes the value of peer
support programming in improving mental health outcomes and
addressing existing provider shortages. As the Committee aims
to ensure funds are allocated to the areas of highest need, the
Committee directs HRSA to collect data on the portion of peer
support program funds allocated to designated health
professional shortage areas in fiscal year 2026, including the
number of applicants and amount of awarded funds by State, and
submit this data to the Committees no later than 60 days after
the conclusion of fiscal year 2026.
Substance Use Disorder Treatment and Recovery (STAR) Loan
Repayment Program
The Committee includes $40,000,000 for this program. This
program addresses shortages in the SUD workforce by providing
for the repayment of education loans for individuals working in
a full-time SUD treatment job that involves direct patient care
in either a mental health HPSA or a county where the overdose
death rate exceeds the national average.
National Center for Health Workforce Analysis
The Committee includes $5,663,000 for the National Center
for Health Workforce Analysis (NCHWA). NCHWA is the primary
Federal entity that collects, analyzes, and reports on data and
information regarding the U.S. health workforce. NCHWA also
evaluates the effectiveness of HRSA's workforce investment
programs. The Committee commends NCHWA for the technical
assistance it provides to Congress to assist in the formulation
of health workforce policy.
Public Health and Preventive Medicine Training Programs
The Committee includes $9,000,000 for the Preventive
Medicine Residency program. This program provides awards for
residents to obtain enhanced experiential activities with a
focus on residents having longitudinal clinical rotations in
FQHCs in rural or medically underserved communities.
Consistent with the fiscal year 2027 budget request, the
Committee does not prioritize available funding for the Public
Health Training Centers program.
Nursing Workforce Development (Title VIII)
The Committee recommends $307,472,000 for the Nursing
Workforce Development programs authorized under title VIII of
the PHS Act, which is $2,000,000 above the fiscal year 2026
enacted level.
Expanding Access to Nursing Education.--The Committee
remains deeply concerned about persistent workforce shortages
across the healthcare sector, particularly within the nursing
profession. Between 2021 and 2022, the total supply of nurses
declined by more than 100,000. In 2022, over 25 percent of
registered nurses reported plans to leave the profession or
retire within five years, and by 2038, approximately one-third
of the nursing workforce is expected to reach retirement age.
These trends are expected to intensify, with recent projections
estimating that more than 275,000 additional nurses will be
needed between 2020 and 2030 to meet national demand. At the
same time, nursing schools nationwide face significant
challenges in expanding capacity to address this growing need.
Persistent shortages of qualified faculty, limited classroom
space, and insufficient clinical training sites continue to
restrict program capacity, preventing many schools from
admitting otherwise qualified applicants. The Committee
strongly supports efforts to expand access to high-quality
educational opportunities at accredited nursing schools to
ensure that qualified applicants can enter the profession and
help meet the nation's growing demand for nursing
professionals.
Nursing Faculty Shortage Reduction.--The Committee
recognizes the critical role nurse faculty play in the
development of a highly qualified nursing workforce. The
Committee is concerned about the persistent and worsening nurse
faculty shortage impacting nursing schools' ability to meet
current and projected nursing workforce demand. According to
the American Association of Colleges of Nursing's ``Survey on
Vacant Faculty Positions for Academic Year 2025--2026'', the
national nurse faculty vacancy rate is 7.2 percent. The
Committee urges HRSA to prioritize support for the recruitment
and retention of nurse faculty within the Title VIII Nursing
Workforce Development programs as a key means of supporting our
nation's nursing workforce.
Advanced Nursing Education and Nurse Practitioner Optional
Fellowship Program
The Committee includes $89,581,000 for the Advanced Nursing
Education Workforce (ANEW) program and an additional $8,000,000
for the Nurse Practitioner Optional Fellowship program within
ANEW. The ANEW program supports traineeships and faculty and
curriculum development to increase the number of qualified
nurses in the primary care workforce.
Certified Nurse Midwives.--The Committee continues
$8,000,000 for Certified Nurse Midwives within the total
provided for Advanced Nursing Education.
Sexual Assault Nurse Examiners (SANE).--The Committee
continues $15,000,000 within the total provided for Advanced
Nursing Education for this activity. The Committee urges HRSA
to prioritize rural, tribal, and underserved communities, and
urban areas without full-time coverage for this program. The
Committee recognizes the disproportionately high rates of
sexual violence, domestic violence, and intimate partner
violence within AI/AN communities.
Nurse Practitioner Optional Fellowship Program.--The
funding provided for this activity supports grants within the
Advanced Nursing Education Nurse Practitioner Residency and
Fellowship program to establish, expand, or maintain optional
community-based nurse practitioner fellowship programs with a
preference for those in FQHCs, for practicing postgraduate
nurse practitioners in primary care or behavioral health.
Nurse Education, Practice, Quality, and Retention
The Committee includes $68,756,000 for the Nurse Education,
Practice, Quality, and Retention (NEPQR) programs. These
programs support academic, service, and continuing education
projects to enhance nursing education, improve the quality of
care, increase nurse retention, and strengthen the nursing
workforce.
Experiential Learning.--Within the total provided for
NEPQR, the Committee continues not less than $10,750,000 for
grants to enhance nurse education through the expansion of
experiential learning opportunities. The Committee directs HRSA
to ensure that these grants include as an allowable use the
purchase of simulation training equipment.
Nursing Workforce Diversity
Consistent with the fiscal year 2027 budget request, the
Committee does not recommend funding for this program.
Nurse Corps Scholarship and Loan Repayment
The Committee includes $112,635,000 for Nurse Corps. This
program supports scholarships and loan repayment assistance for
nurses and nursing students committed to working in communities
with inadequate access to care.
Long-Term Care Workforce.--The Committee notes a critical
need in workforce development for Registered Nurses,
particularly those RNs who serve in the long-term care
workforce. The Committee directs HRSA to allocate not less than
5 percent of the funds provided for this program to establish
and support a Nurse Corps pathway for RNs who commit to
practice in skilled nursing facilities, assisted living
communities, and other long-term care settings.
Nurse Faculty Loan Program
The Committee includes $28,500,000 for Nurse Faculty Loan
Repayment to expand the number of qualified nursing faculty
nationwide by providing low interest loans for individuals
studying to be nurse faculty and loan cancellation for those
who then go on to work as faculty.
Children's Hospitals Graduate Medical Education
The Committee includes $400,000,000 for the Children's
Hospitals Graduate Medical Education (GME) program. This
program helps eligible hospitals maintain GME programs, which
support the training of residents to care for the pediatric
population and enhance the supply of primary care and pediatric
medical and surgical subspecialties. The program trains over
half of all general pediatric residents and pediatric
subspecialty residents and fellows.
Medical Student Education
The Committee includes $80,000,000 for the Medical Student
Education (MSE) program to support colleges of medicine at
public universities located in the top quartile of States
projected to have a primary care provider shortage. The
Committee directs HRSA to give priority to applications from
academic institutions located in States with the greatest
number of Federally recognized Tribes. The Committee also
directs HRSA to give priority to applications from public
universities with a demonstrated public-private partnership.
National Practitioner Data Bank
The Committee includes $43,000,000 for the National
Practitioner Data Bank (NPDB). As mandated by the Health Care
Quality Improvement Act (Public Law 99-660), the NPDB is
financed by the collection of user fees. The NPDB collects
certain adverse information, medical malpractice payment
history, and information related to healthcare fraud and abuse.
The data bank is available to healthcare agencies and
organizations that make licensing and employment decisions.
MATERNAL AND CHILD HEALTH
Appropriation, fiscal year 2026....................... $1,181,680,000
Budget request, fiscal year 2027...................... 922,729,000
Committee Recommendation.............................. 1,060,184,000
Change from enacted level......................... -121,496,000
Change from budget request........................ +137,455,000
The Maternal and Child Health Bureau (MCHB) strengthens
public health systems to meet the needs of America's mothers,
children, and their families. MCHB reaches approximately 59
million pregnant mothers, infants, and children, including
children with special health care needs.
Maternal and Child Health Services Block Grant
The Committee includes $604,584,000 for the Maternal and
Child Health (MCH) Services Block Grant. States use these funds
to improve access to care for mothers, children, and their
families; reduce infant mortality; provide pre- and post-natal
care; support screening and health assessments for children;
and provide systems of care for children with special health
care needs.
Community Integrated Service Systems.--Within the total
provided, the Committee includes $10,276,000 for community
integrated service systems. These grants help States and
communities build a comprehensive, integrated system of care to
improve access and outcomes for all children, including
children with special health care needs.
Crisis Nurseries.--Maternal mortality and severe maternal
morbidity are more likely to occur in the postpartum period
with close to 70 percent of women experiencing a moderate to
major complication. The Committee notes that crisis nurseries
can be a lifeline for the nation's most vulnerable families to
support maternal and infant health. Crisis nurseries provide a
vital family preservation service to keep families together
during a crisis. The Committee encourages HRSA to look for
opportunities within its maternal and child health programs to
support children and mothers in need of emergency childcare and
direct care services for infants and children when a parent
experiences a crisis. The Committee further notes that the
Maternal and Child Health Services Block Grant is a source of
flexible funding that States can use to support crisis
nurseries when that aligns with State-identified priority
needs.
Self-Measured Blood Pressure Monitoring.--The Committee is
pleased by the successes from the blood pressure monitoring
pilot at HRSA, including the early identification of
preeclampsia in a number of participants. The Committee would
like more States to benefit from this pilot project and asks
HRSA to coordinate and to expand the self-measured blood
pressure monitoring pilot, which works to identify preeclampsia
at an earlier stage in high-risk communities by distributing
blood pressure cuffs and patient information.
MCH Block Grant--Special Projects of Regional and National
Significance
The Committee includes $224,116,000 for Special Projects of
Regional and National Significance (SPRANS). Within the total
provided for SPRANS, the Committee includes not less than the
following amounts:
------------------------------------------------------------------------
Committee
Budget Activity Recommendation
------------------------------------------------------------------------
Early Childhood Development Grants................... $10,000,000
Epilepsy............................................. 3,642,000
Fetal Alcohol Syndrome............................... 1,000,000
Fetal Infant and Child Death Review.................. 5,000,000
Hereditary Hemorrhagic Telangiectasia................ 3,000,000
Infant-Toddler Court Teams........................... 21,000,000
Maternal Produce Prescriptions....................... 15,000,000
Minority Serving Institutions........................ 10,000,000
Newborn Essentials Support Toolkits.................. 5,000,000
Oral Health.......................................... 5,250,000
Pediatric Pulmonary Centers.......................... 2,100,000
Prenatally and Postnatally Diagnosed Conditions...... 5,000,000
Regional Pediatric Prevention Network................ 25,000,000
Sickle Cell Disease.................................. 7,000,000
State Maternal Health Innovation Grants.............. 55,000,000
Stillbirth Prevention................................ 1,000,000
------------------------------------------------------------------------
Early Childhood Development Grants.--The Committee includes
funding for the placement of early childhood development
specialists in pediatric settings serving a high percentage of
Medicaid and Children's Health Insurance Program (CHIP)
patients. The Committee urges HRSA to provide robust training
and technical assistance to support the effective integration
and placement of early childhood development specialists in
pediatric settings serving high Medicaid and CHIP populations.
Hemophilia Programs.--HRSA's hemophilia program provides
comprehensive care for blood disorder patients, including
services such as social work and physical therapy that are not
covered by insurance. Within the funding provided for SPRANS,
the Committee supports funding for a coordinating center to
disseminate best practices and advance high-quality care.
Infant Toddler Court Teams.--The Committee includes funding
to support research-based Infant-Toddler Court Teams that
improve outcomes for infants, toddlers, and their families.
This funding will sustain training and technical assistance for
States, Tribes, and communities to implement, expand, or build
capacity to adopt the Infant Toddler Court Teams approach,
along with appropriate evaluation activities.
Maternal Produce Prescriptions.--The Committee includes
funding for the maternal produce prescription program, which
supports grants to community-based organizations to develop
produce prescription interventions for maternal populations at
risk of poor health outcomes.
Newborn Essentials Support Toolkits.--The Committee
provides funding to continue the work of the Newborn Supply Kit
program at HRSA. The Committee directs HRSA to make contracts,
grants, or enter into cooperative agreements with entities to
procure supply kits for new mothers through partnerships with
local entities such as hospitals, health centers, community-
based organizations, or other organizations serving mothers and
infants. Such supply kits shall be composed of essential goods
to help mothers recover from childbirth and care for newborn
infants such as diapers, wipes, infant thermometers, postpartum
supplies, breastfeeding supplies, information on the Maternal
Mental Health Hotline, information on the National
Breastfeeding Helpline, educational material on breastfeeding
and nutrition, information about local, State, and national
community-based programs providing support to postpartum women
and children, evidence-based education material on the use of
low-dose aspirin (to address hypertension, preeclampsia, and
preterm birth), and a blood pressure monitor. For any new
awards, HRSA shall prioritize implementation of the program
through targeting medically underserved geographic areas,
including rural communities, maternal care deserts, tribal
communities, and communities with the highest maternal
mortality rates. The Committee further encourages HRSA to
compile information on local community-based mental health
supports for new mothers, and to include this information in
distributed newborn supply kits.
Oral Health and Primary Care Integration.--Within the total
provided for oral health within SPRANS, the Committee includes
$250,000 to continue demonstration projects to increase the
implementation of oral health and primary care practice
integration. The projects should model the core clinical oral
health competencies for non-dental providers that HRSA
published and initially tested in its 2014 report,
``Integration of Oral Health and Primary Care Practice.'' The
Committee encourages the Chief Dental Officer to continue to
direct the design, monitoring, oversight, and implementation of
these demonstration projects.
Pediatric Pulmonary Centers.--The Committee includes
funding to continue grants for the Pediatric Pulmonary Centers
program.
Prenatally and Postnatally Diagnosed Conditions.--The
Committee includes funding within SPRANS to support activities
that are generally consistent with activities described in
section 399T of the PHS Act.
Regional Pediatric Prevention Network.--The Committee
includes funding for the regional pediatric prevention network
consistent with the directives included in House Report 119-
271.
Stillbirth Prevention Technical Assistance.--Over 20,000
babies are stillborn in the U.S. every year, and nearly one in
four stillbirths are preventable. Despite medical advances, the
Committee is concerned that the rate of stillbirth has remained
relatively the same over the past 30 years. The Committee is
encouraged by HRSA's efforts to update its materials and
guidance to clarify that stillbirth prevention activities are
an allowable use of funds under the Maternal and Child Health
Services Block Grant program. The Committee provides $1,000,000
for HRSA to provide ongoing technical assistance and other
activities to support States' stillbirth prevention activities,
including facilitating the dissemination of stillbirth
screening resources and educational prevention tools to
integrate into existing care models. The Committee directs HRSA
to provide a report to the Committee within 180 days of
enactment of this Act on (1) HRSA's activities to provide
technical assistance to States on stillbirth prevention, and
(2) the needs of the agency to carry out this technical
assistance and other activities to support States' stillbirth
prevention activities.
Sickle Cell Disease Treatment Demonstration Program
The Committee includes $8,205,000 for this program. The
Sickle Cell Disease Treatment Demonstration program helps
individuals with sickle cell disease (SCD) access quality,
coordinated, comprehensive care by building comprehensive
sickle cell disease care teams that extend specialty care from
centrally based SCD experts in hospitals, clinics, or
university health centers to the communities where people live.
Autism and Other Developmental Disabilities
The Committee includes $57,344,000 for Autism and Other
Developmental Disabilities programs. These programs seek to
improve the health and well-being of children and adolescents
with autism spectrum disorder and other developmental
disabilities and to advance best practices for the early
identification and treatment of autism and related
developmental disabilities.
Leadership Education in Neurodevelopmental and Related
Disabilities.--Within the total provided for Autism and Other
Developmental Disabilities, the Committee includes not less
than $38,245,000 for the Leadership Education in
Neurodevelopmental and Related Disabilities (LEND) program to
allow LEND sites to maintain their capacity to train
interdisciplinary professionals to screen, diagnose, and
provide evidence-based interventions to individuals with autism
spectrum disorder and other developmental disabilities. The
LEND program is essential to increasing the number of
professionals with advanced interdisciplinary training in a
broad array of professional disciplines to train professionals
to improve the evaluation, diagnosis, and treatment of people
with autism and other developmental disabilities. The funding
provides the LENDs with support needed to address the critical
shortage of professionals, increase the number of trainees,
serve underrepresented communities, and fulfill the expanded
statutory mandate to serve persons with autism and
developmental disabilities across the lifespan.
Heritable Disorders in Newborns and Children
The Committee provides $24,883,000 for the Heritable
Disorders program. This program assists States to improve and
expand their newborn screening programs and to promote parental
and provider education.
Newborn Screening.--The Committee notes that even with
nationwide newborn screening, critical gaps remain in our
ability to systematically and longitudinally track laboratory
generated, child-level, and system-level health outcomes.
Efforts to date have not resulted in meaningful, coordinated
evidence generation at the national level and resource gaps
remain at the State level. The Committee directs HRSA, in
coordination with CDC, to conduct an evaluation of newborn
screening longitudinal data collection and evidence generation.
Further, the Committee directs HRSA to engage critical
stakeholders, including public health laboratories, patient
advocacy organizations, clinical organizations, public health
organizations, and research organizations to generate national,
State, and local priorities to build from strengths and
ameliorate deficiencies identified in the evaluation. Finally,
HRSA and HHS should designate a mechanism with appropriate
authority, accountability, and resources to enact the resulting
recommendations on the Federal and State levels, as recommended
in the National Academies report on ``Newborn Screening in the
United States: A Vision for Sustaining and Advancing
Excellence'' (2025).
Support Newborn Screening (NBS) for Metachromatic
Leukodystrophy (MLD).--On March 18, 2024, the FDA approved a
gene therapy for treatment of children with early-onset
metachromatic leukodystrophy (MLD), and on December 16, 2025,
HHS added this treatment to the Recommended Uniform Screening
Panel (RUSP). These children previously had no treatment
options beyond supportive and end-of-life care, and early
diagnosis and treatment are critical to survival rates for
children with MLD. The Committee notes that several States have
RUSP-alignment policies in place but are lacking the resources
to support the implementation of screening for this condition.
Therefore, within the total provided for Heritable Disorders in
Newborns and Children, the Committee includes $4,000,000 for
grants to State laboratories to support newborn screening for
MLD. This funding should be made available to States as
expeditiously as possible, with a focus on reducing
administrative burden on States. These grants should be
provided to States with established processes for adding newly
listed RUSP conditions to their screening protocols, as well as
to States intending to be early adopters of newborn screening
for MLD to ensure quick and effective adoption of this critical
screening protocol.
Healthy Start
The Committee notes that mandatory funding available for
the Maternal, Infant, and Early Childhood Home Visiting
(MIECHV) program continues to increase substantially and will
reach $800,000,000 in fiscal year 2027. The MIECHV program
supports pregnant women and parents with young children who
live in communities that face greater risk and barriers to
achieving positive maternal and child health outcomes.
Therefore, consistent with the fiscal year 2027 budget request,
the Committee does not recommend separate discretionary funding
for this program.
Early Hearing Detection and Intervention
The Committee includes $18,818,000 for the Early Hearing
Detection and Intervention program. This program awards grants
to States and territories to support statewide systems of
newborn hearing screening and early intervention programs.
Emergency Medical Services for Children
The Committee includes $24,334,000 for the Emergency
Medical Services for Children program. Funding is available to
every State's emergency medical services office to improve the
quality of emergency care for children and to support research
on and dissemination of best practices.
Screening and Treatment for Maternal Mental Health and
Substance Use Disorders
The Committee includes $14,500,000 for the Screening and
Treatment for Maternal Mental Health and Substance Use
Disorders (MMHSUD) program. Maternal mental health conditions
impact one in five pregnant and postpartum women and one in
three high-risk populations including service members, military
spouses, Native American and rural women. Maternal mental
health issues are the leading cause of maternal mortality in
the U.S. and cost the nation $14 billion each year. MMHSUD
provides grants to States and Tribes to increase access to care
and to expand the workforce by training health care providers
to screen, assess, and treat maternal mental health conditions
and substance use disorders and provide specialized psychiatric
consultation to providers. The Committee directs HRSA to set
aside not less than 15 percent of available funding for Tribes
or tribal organizations. HRSA currently provides no more than
one grant per State. The Committee directs HRSA to exempt
Tribes and tribal organizations from the one award per State
guideline so that Tribes are not required to directly compete
with their State. The Committee directs HRSA within 180 days of
the enactment of this Act to release an annual public report
detailing the most current data on the number of providers
trained and the number of individuals served by the program,
and geographical areas in which the services were provided. The
report shall include information on steps taken to provide
grants for Tribes and tribal organizations to support maternal
mental health and substance use disorders in these communities.
Pediatric Mental Health Care Access
The Committee includes $13,000,000 for the Pediatric Mental
Health Care Access program. This program supports expanded
access to behavioral health services in pediatric primary care
by supporting the development of pediatric mental health care
telehealth access programs.
Innovation for Maternal Health
The Committee includes $20,300,000 for the Innovation for
Maternal Health program. The Innovation for Maternal Health
program supports the establishment or continuation of a program
to identify, develop, or disseminate best practices to improve
maternal health care quality and outcomes, improve maternal and
infant health, and eliminate preventable maternal mortality and
severe maternal morbidity, among other activities. This funding
supports capacity building, technical assistance, and continued
implementation of the Alliance for Innovation on Maternal
Health Program's patient safety bundles to all States,
territories, and tribal organizations. Patient safety bundles
are a set of targeted and evidence-informed best practices
that, when implemented, improve patient outcomes and reduce
maternal mortality and severe maternal morbidity. The Committee
directs HRSA to reserve at least 10 percent of available
funding for Tribes and tribal organizations.
Maternal Mental Health Hotline
The Committee includes $10,000,000 for the Maternal Mental
Health Hotline. Maternal mental health conditions impact one in
five pregnant and postpartum women and one in three high-risk
populations including service members, military spouses, and
Native American and rural women. The Hotline provides 24-hour
voice, text, and chat support services for pregnant and
postpartum mothers. Since its launch on Mother's Day in 2022,
the Hotline has served over 100,000 women and families across
the U.S. with average response times of less than 30 seconds.
The most common reasons for calling include feeling
overwhelmed, depressed, or anxious. The Committee commends
HRSA's efforts to increase public awareness of the Hotline,
which has led to a 35 percent increase in calls from 2024 and a
record 3,800 calls and texts in August 2025. The Committee
directs HRSA to continue public awareness activities and to
meet the corresponding increased demand for Hotline services.
The activities shall focus on increasing public awareness of
the Hotline across the U.S. and its territories by proactively
reaching out to at-risk communities through both digital and
physical advertising targeted to areas regularly utilized by
new parents, such as baby changing stations, lactation pods,
pediatric offices, and childcare centers. Public awareness
activities shall include public and private partnerships with
companies and organizations serving individuals who would
benefit from information about the Hotline. The Committee
directs HRSA, within 180 days of the enactment of this Act, to
release an annual public report detailing: (1) how many
contacts the Hotline has received; (2) the reason for
contacting the Hotline; (3) the geographical area of the
caller; (4) whether the caller was a service member, veteran,
or military spouse; (5) the method of contact used by the
individual such as call, text, or chat; and (6) public
awareness campaign activities undertaken by HHS and HRSA to
promote the Hotline.
Poison Control Centers
The Committee includes $30,100,000 for Poison Control
Centers. The Poison Control Centers program supports a national
network of centers that prevent and treat poison exposures by
providing cost effective, quality health care advice to the
public and health care providers.
Integrated Services for Pregnant and Postpartum Women
The Committee includes $10,000,000 for integrated services
for pregnant and postpartum women. The Integrated Services for
Pregnant and Postpartum Women program helps States, Tribes, and
tribal organizations establish or operate innovative programs
to effectively deliver care for pregnant and postpartum women
while considering their social, behavioral, and health care
needs. The Committee encourages HRSA to work to expand grants
to Tribes and tribal organizations to provide integrated health
service models for maternal support and care within tribal
health systems.
RYAN WHITE HIV/AIDS PROGRAM
Appropriation, fiscal year 2026....................... $2,571,041,000
Budget request, fiscal year 2027...................... 2,497,535,000
Committee Recommendation.............................. 2,346,155,000
Change from enacted level......................... -224,886,000
Change from budget request........................ -151,380,000
The Ryan White HIV/AIDS program funds activities to address
the care and treatment of persons living with HIV/AIDS who need
assistance to obtain treatment. The program provides grants to
States and eligible metropolitan areas to improve the quality,
availability, and coordination of health care and support
services, including access to HIV-related medications; grants
to service providers for early intervention outpatient
services; grants to organizations to provide care to HIV
infected women, infants, children, and youth; and grants to
organizations to support the education and training of health
care providers.
Within the total provided for the Ryan White HIV/AIDS
program, the Committee includes the following amounts:
------------------------------------------------------------------------
Budget Activity FY 2026 Enacted FY 2027 Committee
------------------------------------------------------------------------
Emergency Relief Grants (Part A).. $680,752,000 $680,752,000
Grants to States (Part B)......... 1,364,878,000 1,364,878,000
AIDS Drug Assistance Program 900,313,000 900,313,000
(non-add)....................
Early Intervention Services (Part 208,970,000 208,970,000
C)...............................
Women, Infants, Children and Youth 77,935,000 77,935,000
(Part D).........................
Dental Programs (Part F).......... 13,620,000 13,620,000
------------------------------------------------------------------------
HEALTH SYSTEMS
Appropriation, fiscal year 2026....................... $127,009,000
Budget request, fiscal year 2027...................... 115,887,000
Committee Recommendation.............................. 126,887,000
Change from enacted level......................... -122,000
Change from budget request........................ +11,000,000
The Health Systems Bureau supports national activities that
enhance health care delivery in the U.S., including maintaining
a national system to allocate and distribute donor organs to
individuals awaiting transplant; building an inventory of cord
blood units; and maintaining a national system for the
recruitment of bone marrow donors.
Organ Transplantation
The Committee includes $59,049,000 for the Organ
Transplantation program.
Living Organ Donation Reimbursement Program.--Within the
funding provided for Organ Transplantation, the Committee
continues the fiscal year 2026 funding level for the living
organ donation reimbursement program. This program reduces
financial disincentives to living organ donation by providing
reimbursement to living organ donors for many expenses related
to donating an organ (e.g., travel, lost wages, and child
care). Research suggests that many of these donors could not
have donated without this program.
OPTN Next Generation Technology.--The Committee supports
HRSA's OPTN Modernization Initiative, with particular interest
in the efforts to develop and implement a technology solution
to fully modernize the OPTN so more individuals can be matched
with life-saving organs. The Committee understands that because
of outdated technology and a lack of dynamic algorithms, the
current matching system is inefficient, and therefore critical
time is lost in the effort to identify and match an available
organ to the most appropriate candidate, causing some organs to
go unused. The Committee urges HRSA to prioritize the
development of a modern, dynamic organ candidate matching
technology system that better serves donor families and
recipients, performs efficiently, allows for timely, systematic
updates in allocation policy, and supports clinical innovation.
The Committee requests an update on these efforts in the fiscal
year 2028 congressional justification.
Organ Procurement and Transplantation Network Modernization
Initiative.--The Committee continues the directive included
under this heading in House Report 119-271.
National Cord Blood Inventory
The Committee includes $19,266,000 for the National Cord
Blood Inventory (NCBI) program. The NCBI program supports cord
blood banks to build a genetically and ethnically diverse
inventory of the highest quality cord blood units for
transplantation.
C.W. Bill Young Cell Transplantation
The Committee includes $33,009,000 for the C.W. Bill Young
Cell Transplantation program. This program supports
coordinating the procurement of bone marrow and umbilical cord
blood units for transplantation.
Hansen's Disease Program
The Committee includes $13,706,000 for the National
Hansen's Disease Program (NHDP) and $1,857,000 for payments to
Hawaii for treatment of Hansen's disease. The NHDP supports
outpatient clinical care, as well as outreach, education, and
research activities through its facilities in Baton Rouge,
Louisiana and network of 14 outpatient clinics across the
continental United States and Puerto Rico.
RURAL HEALTH
Appropriation, fiscal year 2026....................... $417,907,000
Budget request, fiscal year 2027...................... 316,130,000
Committee Recommendation.............................. 575,765,000
Change from enacted level......................... +157,858,000
Change from budget request........................ +259,635,000
The Federal Office of Rural Health Policy's (FORHP)
programs provide funding to improve access, quality, and
coordination of care in rural communities; for research on
rural health issues; for technical assistance and recruitment
of health care providers; for screening activities for
individuals affected by the mining, transport, and processing
of uranium; and for the outreach and treatment of coal miners
and others with occupation-related respiratory and pulmonary
impairments.
Community Paramedicine.--The Committee supports community
paramedicine as an innovative healthcare delivery model that
enables paramedics to provide non-emergency, coordinated,
mobile, and preventive care within their communities. These
programs are particularly valuable in rural areas, where
millions of Americans face significant barriers to accessing
timely health care due to distance and provider shortages. The
Committee directs HRSA to submit a report to the Committee
within one year of enactment of this Act assessing the
effectiveness of community paramedicine programs and evaluating
how a Congressionally authorized grant program could support
the expansion of these programs and improve health outcomes in
underserved communities.
Financial Stability of Rural Hospitals.--The Committee is
concerned that rural hospitals face greater challenges
maintaining financial stability than non-rural hospitals. The
Committee directs GAO, to the extent data are available and
reliable, to examine operating margins or rural and non-rural
hospitals and the relative contribution of Medicare, Medicaid,
and other payers to those margins. The study should also assess
barriers to financial stability, particularly for rural
hospitals. The Committee directs GAO to provide a preliminary
briefing to the Committees on Appropriations of the House of
Representatives and the Senate no later than 12 months after
enactment of this Act, with a report to follow.
Increasing Autism Providers in Rural Areas.--The Committee
encourages HHS to identify opportunities to increase the number
of Board-Certified Behavior Analysts available to serve autism
centers in rural areas, providing Applied Behavioral Analysis
Therapy. Board-Certified Behavioral Analysts are important to
improving communication, social, and daily living skills in
individuals with autism. The Committee directs HHS to provide a
report to the Committees within 180 days of enactment of this
Act on any opportunities HHS has identified and steps HHS has
taken to ensure Board-Certified Behavior Analysts are included
in existing programs to the greatest extent permitted by law.
Rural Healthcare.--While current spending for all rural
health discretionary programs is relatively small, it plays a
critical role in solidifying the fragile healthcare
infrastructure in rural communities. The Committee supports
programs seeking to address the severe health care crisis
escalating in rural America and prevent additional rural
hospital closures. Health care workforce shortages continue to
plague rural communities, and while health care innovations,
such as telehealth technologies, show promise in rural areas,
the Committee believes that action must be taken to address the
workforce shortages in rural communities. Therefore, the
Committee urges the Secretary to implement programs and
policies to improve rural health outcomes, strengthen care
delivery, and address the immediate issues facing rural
communities.
Rural Health Outreach Programs
The Committee includes $120,000,000 for rural health
outreach programs. These programs support projects that
demonstrate new and innovative modes of outreach in rural
areas, such as integration and coordination of health services.
Within the total provided for Rural Health Outreach
Programs, the Committee includes not less than the following
amounts:
------------------------------------------------------------------------
Budget Activity FY 2026 Enacted FY 2027 Committee
------------------------------------------------------------------------
Appalachian Region Healthcare $2,500,000 $2,500,000
Support Program..................
Delta States...................... 31,000,000 34,000,000
Delta States Rural Development 12,000,000 15,000,000
Network Grants (non-add).....
Delta Region Maternal Care 2,250,000 2,250,000
Coordination Program (non-
add).........................
Delta Region Community Health 15,000,000 15,000,000
Systems Development Program
(non-add)....................
Rural Maternity and Obstetrics 15,000,000 15,000,000
Management Strategies............
Rural Northern Border Region 5,000,000 5,000,000
Healthcare Support Program.......
------------------------------------------------------------------------
Delta States.--These programs seek to strengthen healthcare
delivery in rural areas of the Delta region. The Delta States
region consists of Alabama, Arkansas, Illinois, Kentucky,
Louisiana, Mississippi, Missouri, and Tennessee. Within the
total for the Delta Region Community Health Systems Development
Program, the Committee includes funding for the Delta Health
Systems Implementation Program.
Delta Rural Health Innovation Demonstration Program.--The
Committee recognizes the persistent health disparities
affecting communities across the Mississippi River Delta
region, including high rates of chronic disease, food
insecurity, and shortages of healthcare professionals. The
Committee provides a $3,000,000 increase within the Delta
States Rural Development Network Grants program for HRSA to
support a Delta Rural Health Innovation Demonstration Program
to test innovative approaches to improving health outcomes in
rural communities. The Committee encourages HRSA to partner
with an institution of higher education located within the
Mississippi River Delta region that maintains comprehensive
health sciences programs, including pharmacy, nursing, and
allied health education, and preexisting partnerships with
osteopathic medical training programs. The Committee also
encourages HRSA to support demonstration projects that
integrate Food is Medicine interventions, including produce
prescriptions, medically tailored meals, and culinary medicine
education, as strategies to address diet-related chronic
disease and improve health outcomes in rural communities.
Mobile Integrated Health Pilot Project.--The Committee
encourages HRSA to make funding available to allow skilled
nursing facilities or post-acute care facilities with high re-
admittance rates to conduct a pilot program using
professionally administered diagnostic mobile device units
(MDUs). Such MDUs often include equipment used in emergency
rooms and triage units capable of connecting from the point of
care to a physician, providing electronic medical records, and
sharing real time diagnostics used to determine the severity of
an incident, illness, or injury. The Committee requests an
analysis of the potential for such a pilot program in the
fiscal year 2028 congressional justification.
Rural Maternity and Obstetrics Management Strategies.--The
Committee includes funding for rural maternity and obstetrics
management strategies (RMOMS). RMOMS supports grants to improve
access to and continuity of maternal and obstetrics care in
rural communities by increasing the delivery of and access to
preconception, pregnancy, labor and delivery, and postpartum
services, as well as developing sustainable financing models
for the provision of maternal and obstetrics care.
Rural Health Policy Development
The Committee includes $14,076,000 for Rural Health Policy
Development. Funding supports FORHP's activities to analyze,
advise the Secretary, and provide information to the public
regarding issues that affect the availability, access to, and
quality of health care in rural areas.
Rural Health Research Center Program.--The Rural Health
Research Center Program funds publicly available and policy
relevant research on rural health to assist providers and
Federal, State, and local governments in addressing challenges
faced by rural communities. Access to health services in rural
areas is under extreme stress with patients forced to travel
extended distances for even basic health care, while more than
30 percent of rural hospitals are at risk of closing.
Additional research is needed to inform solutions on the
significant and pervasive challenges faced by rural Americans
in accessing health care related to mental health, drug and
alcohol use, nutrition and healthy eating, and chronic health
management, among other critical needs. The Committee
encourages FORHP to continue funding studies on rural health
and support policy solutions that improve access to health
care, health outcomes, and population health.
Rural Hospital Flexibility Grants
The Committee includes $75,000,000 for Rural Hospital
Flexibility Grants. These programs help States assist small and
critical access rural hospitals to remain economically viable
and provide high-quality care.
Within the total provided for Rural Hospital Flexibility
Grants, the Committee includes not less than $5,000,000 for the
Rural Emergency Hospitals Technical Assistance Program and up
to $23,442,000 for the Small Rural Hospital Improvement
Program.
State Offices of Rural Health
The Committee includes $15,000,000 for State Offices of
Rural Health. HRSA supports the establishment and operation of
State offices of rural health to strengthen the rural health
care delivery system.
Black Lung Clinics
The Committee includes $12,800,000 for Black Lung Clinics.
This program funds clinics that treat respiratory and pulmonary
diseases of active and retired coal miners, steel mill workers,
agricultural workers, and others with occupationally related
respiratory and pulmonary impairments.
Radiation Exposure Screening and Education Program
The Committee includes $3,889,000 for the radiation
exposure screening and education program. This program provides
grants for education, prevention, and early detection of
radiogenic cancers and diseases resulting from exposure to
uranium during mining and milling at nuclear test sites.
Rural Communities Overdose Response Program
The Committee includes $147,000,000 for the Rural
Communities Overdose Response Program (RCORP).
Rural Centers of Excellence.--Within the funding provided
for RCORP, the Committee includes $12,000,000 to continue at
least three Rural Centers of Excellence (Centers), as
established by Public Law 115-245 and continued through Public
Laws 116-260 and 117-103. The Committee recognizes the success
of the Centers in addressing substance use disorders within
rural communities through various evidence-based treatment and
recovery models. The Committee supports HRSA's continued
investment in the current Centers and encourages HRSA to
consider how the Centers can expand their outreach into other
underserved communities.
Rural Residency Planning and Development
The Committee includes $19,000,000 for the rural residency
planning and development program. This program funds physician
residency training programs that support physician workforce
expansion in rural areas. The Committee commends FORHP for its
efforts to improve and expand the physician workforce in rural
areas by developing new, sustainable rural residency programs
and supports the continuation and expansion of the program to
develop new rural residency programs, or Rural Track Programs.
Tribal Track.--Within the total provided for Rural
Residency Planning and Development, the Committee includes up
to $5,000,000 to support residency programs administered by
Tribes or tribal organizations.
Financial and Community Sustainability for At Risk Hospitals
The Committee includes $20,000,000 for this activity. First
proposed in fiscal year 2024, this program will target
technical assistance to rural hospitals severely at risk for
imminent closure and struggling to maintain health care
services.
Rural Hospital Stabilization Program
The Committee includes $30,000,000 for the Rural Hospital
Stabilization Program. This program provides support to at-risk
rural hospitals to enhance or expand service lines to retain
health care services locally and increase service volume and
revenue that will enhance hospitals' financial viability.
Sustaining Access to Rural Healthcare.--The Committee notes
rural hospitals that do not meet all designation criteria for
critical access often still face the same financial challenges
as critical access hospitals and receive significantly lower
reimbursement from CMS. The Committee urges HRSA to focus the
next grant competition on hospitals in rural areas that share
similar criteria as critical access hospitals but often fail to
meet all criteria for designation.
Rural Hospital Provider Assistance Program
The Committee includes $100,000,000 for the Rural Hospital
Provider Assistance program. The Committee is concerned that
low reimbursements for low-wage hospitals prevent them from
paying higher wages, which in turn keeps them at the low end of
the wage index, resulting in a downward spiral. The Committee
supports efforts by the Secretary and the CMS Administrator to
address this issue through regulatory relief. To supplement
such efforts, the Committee provides funding for HRSA to
administer a formula grant program to support rural hospitals
at the low end of the wage index. By focusing limited resources
on areas with the greatest demonstrated need, the Committee
seeks to ensure sustained access to quality health care
providers for these rural communities.
Rural Tribal Prevention Innovation Program
The Committee includes $19,000,000 for the Rural Tribal
Prevention Innovation program proposed in the fiscal year 2027
budget request. As noted in the budget request for this
program, tribal communities experience some of the nation's
most significant gaps in healthcare access and outcomes,
including the highest rates of severe maternal morbidity and
mortality, disproportionate burdens of chronic disease,
geographic isolation, and longstanding shortages in health care
infrastructure and workforce. Funding for this program will
support innovative tribal-led and tribal-serving initiatives
targeting the root causes of chronic disease and maternal
health challenges.
FAMILY PLANNING
Appropriation, fiscal year 2026....................... $286,479,000
Budget request, fiscal year 2027...................... - - -
Committee Recommendation.............................. - - -
Change from enacted level......................... -286,479,000
Change from budget request........................ - - -
Consistent with the fiscal year 2027 budget request, the
Committee does not recommend funding for the Family Planning
program. The Family Planning program administers Title X of the
PHS Act.
HRSA-WIDE ACTIVITIES AND PROGRAM SUPPORT
Appropriation, fiscal year 2026....................... $1,076,181,000
Budget request, fiscal year 2027...................... 70,050,000
Committee Recommendation.............................. 648,432,000
Change from enacted level......................... -427,749,000
Change from budget request........................ +578,382,000
This account supports telehealth programs, operation of the
340B drug pricing program, and the cost of Federal staff and
related activities to coordinate, direct, and manage the
programs of HRSA. The budget request level does not reflect
program management funding requested for the proposed
Administration for a Healthy America or funding requested under
CMS for the Office of Pharmacy Affairs.
Community Project Funding.--The Committee includes
community project funding as specified in the table at the end
of this Committee Report. Within 60 days of enactment of this
Act and quarterly thereafter, the Committee directs HRSA to
provide a report to the Committee with the information
described under the heading for Congressionally Directed
Spending in Senate Report 119-55.
Oral Health Literacy.--The Committee includes $300,000 to
continue the development of an oral health awareness and
education campaign across relevant HRSA bureaus, including
Primary Health Care, Health Workforce, Maternal and Child
Health, Ryan White HIV/AIDS Program, and Rural Health. The
Committee directs HRSA to identify oral health literacy
strategies that are evidence-based and focused on oral health
care prevention and education, including prevention of oral
disease such as early childhood and other caries, periodontal
disease, and oral cancer. The Committee encourages HRSA to
ensure that the Chief Dental Officer plays a key role in the
design, monitoring, oversight, and implementation of this
project.
Promoting Health with Faith and Community-Based
Organizations.--The Committee notes the impact of ongoing
efforts and local partnerships focused on promoting health
access and addressing chronic health challenges in underserved
communities. The Committee encourages HRSA to maintain and
advance these promising partnerships with additional available
resources to preserve critical healthcare infrastructure
providing innovative access through houses of worship and
community organizations to ensure continued efforts to address
chronic and preventable illness and related drivers of poor
health outcomes.
Tribal Engagement.--HRSA's core mission is to improve
health outcomes and build the health workforce. Historically,
HRSA has had low participation by Indian Tribes in several core
program areas, despite the great tribal need in all of HRSA's
mission areas. The Committee commends HRSA's recent efforts to
expand tribal engagement efforts. The Committee looks forward
to receiving the report required under this heading in House
Report 119-271 and directs HRSA to provide an annual update to
the Committees on Appropriations of the House of
Representatives and the Senate. Such annual update shall be
made available on the agency's website.
Vision and Eye Health for Children.--The Committee notes
the lack of awareness, early detection practices, and
intervention initiatives regarding children's vision and eye
health. The Committee encourages HRSA to engage with
stakeholders to support care for children's vision care and eye
health, including public education, early detection, referral
to eye care, diagnosis and intervention, follow-up for
children, and connection to services for children with
identified vision problems and support for families. The
Committee notes that nearly 90 percent of children's vision
problems are preventable if caught and treated early and that
healthy vision contributes to learning readiness, mental
wellness, and lifelong potential.
Office of Pharmacy Affairs
The Committee includes $12,238,000 for the Office of
Pharmacy Affairs. The Committee notes that HHS proposes
transferring the Office of Pharmacy Affairs from HRSA to CMS.
The Committee looks forward to working with the authorizing
committees of jurisdiction as they consider the Department's
proposal.
Office for the Advancement of Telehealth
The Committee includes $45,550,000 for the Office for the
Advancement of Telehealth (OAT). Funds for OAT promote the
effective use of technologies to improve access to health
services for people who are isolated from health care and to
provide distance education for health professionals.
Within the total provided for OAT, the Committee includes
not less than the following amounts:
------------------------------------------------------------------------
Budget Activity FY 2026 Enacted FY 2027 Committee
------------------------------------------------------------------------
Technology-Enabled Collaborative $8,500,000 $8,500,000
Learning.........................
Telehealth Centers of Excellence.. 8,500,000 8,500,000
Telehealth Resource Centers....... 5,050,000 5,050,000
Telehealth Network Grants......... 5,400,000 5,400,000
------------------------------------------------------------------------
Technology-Enabled Collaborative Learning.--The Committee
provides not less than $8,500,000 to continue the use of
technology-enabled collaborative learning and capacity building
models. These innovative education models, often referred to as
Project ECHO, use a hub-and-spoke approach by linking expert
specialist teams at a ``hub'' with the ``spokes'' of health
providers in local communities to increase on-the-ground
expertise. Using case-based learning, Project ECHO models can
improve the capacity of providers, helping clinicians provide
expert-level care to patients wherever they live. It also
increases patient access to specialty treatment, especially in
rural and underserved areas, and educates providers on how to
best meet the needs of people living with many chronic
conditions, including Alzheimer's and other dementias. The
Committee directs GAO to provide a follow up report on the
Assistant Secretary for Planning and Evaluation's 2019 report
to Congress on the ``Current State of Technology-Enabled
Collaborative Learning and Capacity Building Models''. To the
extent feasible, this GAO report should focus on the impact of
Project ECHO across the United States and provide details on
the efficacy of the program since its inception, including
numbers and locations of patients reached and providers
trained. The Committee directs GAO to brief the Committees on
Appropriations of the House of Representatives and the Senate
within 180 days of enactment of this Act with a report to
follow.
Telehealth Centers of Excellence.--The Committee provides
not less than $8,500,000 for Telehealth Centers of Excellence.
These Centers identify best practices, serve as national
training resources, and test the efficacy of different
telehealth clinical applications. These Centers serve to
promote the adoption of telehealth programs across the country
by validating technology, establishing training protocols, and
by providing a comprehensive template for States to integrate
telehealth into their State health provider network. Funding
should serve to promote the adoption of telehealth services
nationwide and help address the access to care issue faced by
rural America.
VACCINE INJURY COMPENSATION PROGRAM
Appropriation, fiscal year 2026....................... $287,262,000
Budget request, fiscal year 2027...................... 291,878,000
Committee Recommendation.............................. 291,878,000
Change from enacted level......................... +4,616,000
Change from budget request........................ - - -
The Vaccine Injury Compensation Program (VICP) provides
compensation for individuals with vaccine-associated injuries
or deaths. The Committee provides $15,200,000 for expenses
associated with administering the program. The Committee also
includes $276,678,000 in mandatory funding from the Vaccine
Injury Compensation Program Trust Fund for claims.
The Committee continues to support the VICP as a critical,
no-fault alternative to traditional tort litigation that has
successfully processed over 28,000 claims and distributed
approximately $5 billion to petitioners. Over the same period,
over 5 billion doses of covered vaccines have been
administered. The Committee notes the number of VICP claims
increased dramatically between fiscal years 2015 and 2024. The
Committee urges HRSA to improve transparency, timeliness, and
accessibility of the VICP and continue efforts to reduce
backlogs and modernize claims processing. The Committee
requests an update in the fiscal year 2028 congressional
justification on the number of vaccine claims that have been
received each year over the past 5 years.
Centers for Disease Control and Prevention
Appropriation, fiscal year 2026....................... $9,202,991,000
Budget request, fiscal year 2027...................... 6,345,461,000
Committee Recommendation.............................. 8,164,411,000
Change from enacted level......................... -1,038,580,000
Change from budget request........................ +1,818,950,000
The Committee recommendation for the Centers for Disease
Control and Prevention (CDC) program level includes
$6,667,734,000 in discretionary budget authority, $55,358,000
in mandatory funds under the terms of the Energy Employees
Occupational Illness Compensation Program Act, and
$1,398,375,000 in transfers from the Health Fund (PPHF).
The CDC is the nation's primary public health protection
agency and a critical pillar of America's health security.
Charged with protecting the homeland against emerging health
threats that arise domestically and abroad, CDC conducts
rigorous science, provides timely, evidence-based guidance, and
deploys advanced surveillance, epidemiology, and laboratory
capabilities to detect threats early and mount rapid, effective
responses that safeguard American lives and economic stability.
CDC Core Capacities.--The Committee prioritizes
strengthening CDC data systems, building laboratory capacity,
modernizing communications, and developing a highly skilled
public health workforce to ensure robust Federal, State, and
local capabilities. With clear accountability and a focus on
domestic resilience, CDC funding should reinforce critical
health capabilities, accelerate disease threat detection and
medical countermeasure development, and sustain a resilient
public health system that protects vulnerable populations and
secures the nation against emerging threats and public health
challenges.
The Committee prioritizes funding for CDC Core Capacities
across 14 accounts, including Quarantine; Emerging Infectious
Diseases; Advanced Molecular Detection; Epi and Lab Capacity;
Health Statistics; Public Health Data Modernization; Public
Health Workforce; Advancing Laboratory Science; Surveillance,
Epi, and Informatics; Global Health Protection; Public Health
Emergency Preparedness Cooperative Agreements; Buildings and
Facilities; and the Infectious Diseases Rapid Response Reserve
Fund; Public Health Infrastructure. As part of the fiscal year
2028 congressional justification, CDC is directed to provide a
breakout table detailing the funding requested for these core
capacity program lines.
Public Awareness of CDC Activities.--The Committee
recognizes that many public health interventions are preventive
in nature and often occur without public notice. These
prevention activities are essential to protecting Americans
from threats both at home and abroad. Therefore, the Committee
urges CDC to expand public-facing communications that highlight
successful domestic and global prevention efforts, with the
goal of improving public understanding of how CDC programs save
lives, protect U.S. health security interests, and preserve
economic stability.
IMMUNIZATION AND RESPIRATORY DISEASES
Appropriation, fiscal year 2026....................... $913,291,000
Budget request, fiscal year 2027...................... 963,291,000
Committee Recommendation.............................. 928,291,000
Change from enacted level......................... +15,000,000
Change from budget request........................ -35,000,000
The Committee recommendation includes $231,358,000 in
discretionary budget authority and $696,933,000 in transfers
from PPHF.
Immunization cooperative agreements are awarded to State
and local public health departments for planning, developing,
and conducting childhood, adolescent, and adult immunization
programs, including enhancement of the vaccine delivery
infrastructure. CDC directly maintains a stockpile of vaccines,
supports consolidated purchase of vaccines for State and local
health agencies, conducts surveillance, supports jurisdictions
in investigating and responding to outbreaks of vaccine-
preventable diseases, and provides training and quality
improvement activities to improve healthcare providers' vaccine
storage, handling, and administration capabilities.
Within the total for Immunization and Respiratory Diseases,
the Committee recommends the following amounts:
------------------------------------------------------------------------
Budget Activity FY 2026 Enacted FY 2027 Committee
------------------------------------------------------------------------
Section 317 Immunization Program.. $681,933,000 $696,933,000
Section 317 Immunization 596,390,000 696,933,000
Program Transfer from the
Prevention and Public Health
Fund.........................
Section 317 Immunization 85,543,000 - - -
Program appropriations.......
Influenza Planning and Response 231,358,000 231,358,000
appropriations...................
------------------------------------------------------------------------
Avian Influenza.--The Committee recognizes the potential
risk of avian influenza spillover, particularly the H5N1
strain, from egg laying hens and cattle to workers with high-
risk exposure. The Committee urges CDC to continue
collaborating with USDA, State, and local partners through a
One Health approach to support outreach and education among at-
risk agricultural communities through existing funding
mechanisms.
Immunization During Pregnancy.--To increase access to
recommended immunizations, the Committee encourages CDC to
increase its efforts to educate health care providers about the
importance of immunization during pregnancy, which can provide
protection for children from 0-6 months from diseases such as
flu, pertussis (whooping cough), and respiratory syncytial
virus (RSV), when the children are at their most vulnerable.
The Committee also encourages CDC to work with Federal partners
to improve awareness and coordination among Federal partners to
increase immunization during pregnancy.
Vaccine Education & Awareness.--The Committee recognizes
that CDC's Section 317 Immunization Program plays a critical
role in achieving national immunization goals. This program
protects communities against vaccine-preventable diseases by
supporting State, tribal, local, and territorial immunization
infrastructure, including vaccine surveillance, outbreak
investigation, vaccine safety monitoring, immunization
registries, vaccine purchasing, technical assistance, and
education and awareness for families and providers. The
Committee continues to provide funding for vaccine outreach and
awareness campaigns, including support for community-based
approaches to addressing vaccine hesitancy. The Committee urges
CDC to expand existing immunization infrastructure, including
implementing strategies for underserved populations. The
Committee requests an update in the fiscal year 2028
congressional justification on these efforts and the rate of
routine immunization across all age groups.
Vaccines for Children.--The Vaccines for Children (VFC)
Program provides safe, effective, and life-saving immunizations
for millions of children each year, including the hepatitis B
immunization and Nirsevimab, a monoclonal antibody that helps
prevent RSV in infants and young children. The Committee
continues to support the CDC's administration of the VFC in an
effort to prevent disease, disability, and death in the U.S.
HIV/AIDS, VIRAL HEPATITIS, SEXUALLY TRANSMITTED DISEASES, AND
TUBERCULOSIS PREVENTION
Appropriation, fiscal year 2026....................... $1,384,056,000
Budget request, fiscal year 2027...................... 520,000,000
Committee Recommendation.............................. 566,000,000
Change from enacted level......................... -818,056,000
Change from budget request........................ +46,000,000
CDC provides national leadership and support for HIV/AIDS,
viral hepatitis, sexually transmitted infections (STIs), and
tuberculosis (TB) prevention research and the development,
implementation, and evaluation of evidence-based prevention
programs serving persons affected by, or at risk of, infection.
Activities include surveillance, epidemiologic and laboratory
studies, and prevention activities. CDC provides funds to
State, local, and tribal health departments and community-based
organizations to develop and implement integrated community
prevention plans.
Within the total for the National Center for HIV/AIDS,
Viral Hepatitis, Sexually Transmitted Diseases, and
Tuberculosis Prevention, the Committee provides the following
amounts:
------------------------------------------------------------------------
Budget Activity FY 2026 Enacted FY 2027 Committee
------------------------------------------------------------------------
Domestic HIV/AIDS Prevention and $1,013,712,000 $220,000,000
Research.........................
Ending HIV/HIV Initiative..... 220,000,000 220,000,000
Other HIV/AIDS Activities..... 793,712,000 - - -
Viral Hepatitis................... 46,000,000 - - -
Sexually Transmitted Infections... 164,310,000 - - -
Tuberculosis...................... 137,034,000 137,034,000
Infectious Diseases and Opioids... 23,000,000 - - -
Sexually Transmitted Disease and - - - 208,966,000
Viral Hepatitis Prevention Block
Grants...........................
------------------------------------------------------------------------
Block Grants.--The Committee provides $208,966,000 for
consolidated STIs, Viral Hepatitis, and Infectious Diseases and
Opioids grants to States. This funding will give States
flexibility to address local needs by consolidating funding for
these programs into a single, newly established grant program.
The Committee directs CDC to maintain national capabilities to
continue providing recipients of this consolidated grant
program with strategic direction, technical support,
programmatic expertise, including but not limited to disease
surveillance, laboratory services, evidence-based prevention
programming, and outbreak response. Within the amount provided,
the Committee directs CDC to allocate not less than $46,000,000
to maintain national capabilities to support health departments
in conducting viral hepatitis surveillance, prevention, and
outbreak response, including addressing coinfections, to
support viral hepatitis elimination planning and
implementation, and to work with health clinics and community-
based organizations to promote awareness of and uptake of
updated national viral hepatitis testing, treatment, and
vaccination recommendations.
Ending HIV Epidemic (EHE) Initiative.--The Committee
provides funding for the EHE Initiative to continue
implementation of EHE strategies, including nationwide HIV
surveillance, testing, prevention, outbreak response, and
laboratory services. Surveillance data is used to inform
resource allocation, including for the Ryan White HIV/AIDS
program.
Tuberculosis Screening for Cadaver Tissue Donors.--The
Committee is concerned about the continued risk of donor-
derived tuberculosis transmission through human cells, tissues,
and cellular- and tissue-based products (HCT/Ps) and the lack
of a standardized testing approach suitable for cadaveric donor
matrices. The Committee encourages CDC to continue funding
scientific research into the development of new TB diagnostic,
treatment, and prevention tools.
EMERGING AND ZOONOTIC INFECTIOUS DISEASES
Appropriation, fiscal year 2026....................... $781,272,000
Budget request, fiscal year 2027...................... 927,764,000
Committee Recommendation.............................. 882,872,000
Change from enacted level......................... +101,600,000
Change from budget request........................ -44,892,000
The Committee recommendation includes $815,872,000 in
discretionary appropriations and $67,000,000 in transfers from
PPHF.
Programs funded under Emerging and Zoonotic Infectious
Diseases (EZID) support the prevention and control of
infectious diseases through surveillance, outbreak
investigation and response, research, and prevention.
Within the total for EZID, the Committee recommends the
following amounts:
------------------------------------------------------------------------
Budget Activity FY 2026 Enacted FY 2027 Committee
------------------------------------------------------------------------
Antimicrobial Resistance $197,000,000 $207,000,000
Initiative appropriations........
Vector-Borne Diseases 64,603,000 65,603,000
appropriations...................
Lyme Disease appropriations....... 27,000,000 28,000,000
Prion Disease appropriations...... 9,000,000 10,000,000
Chronic Fatigue Syndrome 5,400,000 - - -
appropriations...................
Emerging Infectious Diseases 223,997,000 267,997,000
appropriations...................
Mycotic Diseases 24,000,000 29,000,000
appropriations (non-add).....
Parasitic Diseases and Malaria 29,000,000 29,000,000
appropriations (non-add).....
Harmful Algal Blooms 3,500,000 3,500,000
appropriations...................
Food Safety appropriations........ 74,000,000 79,000,000
National Healthcare Safety Network 24,000,000 24,000,000
appropriations...................
Travel and Port Health Protection 57,772,000 72,772,000
appropriations...................
Advanced Molecular Detection 43,000,000 58,000,000
appropriations...................
Epidemiology and Lab Capacity 40,000,000 55,000,000
Transfer from the Prevention and
Public Health Fund...............
Healthcare-Associated Infections 12,000,000 12,000,000
Transfer from the Prevention and
Public Health Fund...............
------------------------------------------------------------------------
Advanced Molecular Detection.--The Committee provides
increased funding to support CDC's Advanced Molecular Detection
(AMD) program, including as part of the Biothreat Radar
initiative. The AMD program is a key component of the nation's
biosecurity infrastructure. It provides multi-pathogen
sequencing and bioinformatics tools to enable rapid detection
and response to emerging infectious disease threats. The
Committee encourages CDC to build capacity to conduct
metagenomic surveillance and inform clinical and public health
action in collaboration with States, Tribes, localities, and
private sector partners.
Alpha-gal Syndrome.--The Committee appreciates the work of
the Division of Vector-Borne Diseases to prevent the
transmission of and promote health provider awareness of Alpha-
gal Syndrome (AGS). AGS is an emerging tick-borne condition and
allergy characterized by a potentially life-threatening
hypersensitivity to galactose-alpha-1,3- galactose (alpha-gal).
Its prevalence is closely associated with the range of the lone
star tick. AGS is a growing clinical and public health concern
for persons in the United States. Exploding lone star tick
populations may be driving an alarming increase in cases.
Health care provider knowledge is limited and can lead to
delayed diagnosis and inappropriate treatment.
The Committee encourages CDC to continue accelerating
measures to improve AGS surveillance, patient care, and public
awareness with an emphasis on healthcare provider education, in
keeping with the three public health priorities identified in
the CDC 2023 report. CDC is encouraged to focus on high or
growing prevalence States. CDC may also benefit from a focused
increase in its collaboration and partnership with local
governments, health, education, community, non-profit, and
faith-based sectors in those same high-incidence communities.
Antimicrobial Resistance (AMR) Solutions Initiative.--The
Committee remains concerned about the growing threat of AMR,
including emerging and drug-resistant fungal pathogens that are
resistant to, or inadequately treated by, currently available
antifungal therapies. The Committee strongly encourages CDC to
ensure that antifungal resistance and fungal pathogens such as
Candida auris are fully incorporated into AMR activities,
specifically efforts to improve response, detection, and
prevention strategies. The Committee further encourages CDC,
through the One Health Federal Interagency Coordination
Committee, to collaborate with Federal partners to address AMR
challenges across human, animal, and environmental health. The
Committee requests an update in the fiscal year 2028
congressional justification on current and planned activities
to address antifungal resistance and emerging fungal pathogens.
Biothreat Radar.--The Committee recognizes the importance
of strengthening the nation's early detection and response
capacities to novel and high-consequence pathogens. Therefore,
the Committee provides funding to support the Biothreat Radar
initiative through CDC's AMD, Wastewater Monitoring, and
Traveler-Based Genomic Surveillance (TGS) programs.
Drug-Resistant Infections.--The Committee strongly
encourages CDC to continue raising awareness of the elevated
risk of drug-resistant infections that impact patients,
especially those with cancer. The Committee urges CDC to
educate physicians and patients on infection prevention and
antibiotic stewardship in the cancer patient population.
Epidemiology and Laboratory Capacity.--The Committee
recognizes the importance of the Epidemiology and Laboratory
Capacity (ELC) program, which provides flexibility to State,
territorial, and local health departments to address gaps not
funded by the disease specific sections of the ELC cooperative
agreement. The ELC program provides critical foundational
support for these health departments to fund epidemiology,
surveillance, laboratory, and data science staff positions that
provide the backbone for public health programs. This funding
will allow public health departments to build their
foundational public health workforce and infrastructure and
will better prepare them to respond to emerging infectious
disease threats more quickly including vector-borne and tick-
related diseases such as alpha-gal, dengue, Lyme, malaria, West
Nile, Zika, healthcare associated infections, foodborne
illnesses and outbreaks, and high consequence emerging threats,
including viral hemorrhagic fevers like Marburg, rabies, and
emerging poxviruses (e.g. monkeypox).
Food Safety.--The Committee provides increased funding to
strengthen prevention and surveillance of foodborne and
waterborne diseases, including modernizing laboratory and
informatics infrastructure, incorporating next-generation
metagenomics, and bolstering partnerships with States, Tribes,
and localities.
Fungal Infection Disease Surveillance.--The Committee is
concerned by the spread of deadly fungal infections in the
United States in recent years and finds that the economic
burden of fungal infections in the United States is already
staggering, particularly in western States. The Committee finds
that a Federal plan with resources to address the threat of
fungal infections, including emerging and antimicrobial
resistant mycotic threats, holds the best potential to
safeguard the health of Americans in the event of a domestic
pandemic or in foreign theaters of war, and that the Federal
governments recognition of fungal infections as a microbial
threat to human health can allow for existing planning
mechanisms such as the U.S. National Action Plan for Combating
Antibiotic-Resistant Bacteria, the President's Advisory Council
on Combating Antibiotic-Resistant Bacteria, and CDC reports on
priority antimicrobial resistant threats to better account for
steps taken to respond to fungal threats in the United States.
Harmful Algal Blooms.--The Committee notes that harmful
algal blooms (HABs) are on the rise globally, particularly
across the Great Lakes region, Florida, and other coastal
communities. The Committee encourages CDC to increase national
surveillance efforts for HAB events and develop studies to
assess the health effects of exposure to cyanotoxins in the air
and water. CDC has a unique role in better understanding the
intersection of public health and environmental impacts of
HABs. The Committee encourages CDC to continue building
interagency cooperation surrounding HABs, especially the
Harmful Algal Bloom and Hypoxia Research and Control Act Task
Force and the Great Lakes Restoration Initiative. The scope of
future research may expand to include improving laboratory
methods for identifying and quantifying HAB-related toxins in
biological specimens, supporting clinical diagnostic methods to
identify HAB-related symptoms and illnesses, optimizing
emergency response capacities, increasing awareness among
affected communities, and identifying and addressing the
impacts of harmful algal toxins on humans.
Healthcare-Associated Infections.--The Committee supports
CDC's work to reduce infections acquired in health care
settings, including health care system monitoring through CDC's
National Healthcare Safety Network (NHSN) to inform prevention
efforts. A significant challenge in combating healthcare-
associated infections (HAIs) is addressing transmission of
pathogens via ``high-touch'' surfaces in patient care areas,
including best practices for managing hospital privacy and
cubicle curtains. Therefore, the Committee encourages CDC to
continue to promote infection prevention in health care
settings through research into the spread of infections in
healthcare settings, outbreak assistance, HAI burden
surveillance in NHSN, and through review and updates to its
guidelines to enhance infection control and prevention
practices in hospitals and other health care settings.
Lyme Disease.--Lyme disease can be found in at least 80
countries around the globe and is endemic in many regions. In
the U.S., Lyme disease is the most common disease transmitted
from animals to humans. After years of uncertainty, CDC
continues to note the number of reported Lyme disease cases in
the U.S. is likely far below the estimated number of actual
cases that are diagnosed and treated annually. According to
CDC, in 2023, approximately 89,000 cases of the disease were
reported, compared to estimates showing that more than 476,000
may be diagnosed and treated with Lyme disease annually in the
U.S. To address the risk of underreporting, the Committee
continues to support CDC's efforts to improve testing and
treatment related to Lyme and other tick-borne diseases and
encourages CDC to consider expanding activities related to the
development of more accurate diagnostic tools and tests for
Lyme disease and steps to educate high-risk workers and their
employers regarding the occupational risks of tick-borne
diseases.
Lyme Disease Surveillance.--The Committee encourages CDC to
continue working with States to improve surveillance, data
collection, and reporting on Lyme disease and other tick-borne
diseases. The Committee further encourages CDC, as appropriate
and consistent with available resources, to support State and
local public health entities in high-incidence areas engaged in
surveillance, prevention, education, and other public health
response activities related to tick-borne diseases.
Maternal Fetal Transmission of Lyme Disease.--The Committee
instructs CDC to complete the directives included under this
heading in the House Report 119-271.
Mycotic Diseases.--The Committee provides funding for
mycotic diseases, including, surveillance and prevention,
building capacity in State and local health departments,
cooperative agreements, education of the public and healthcare
providers, and laboratory support. The Committee continues to
support the CDC's collaboration with the Valley Fever Institute
and the Cocci Study Group. The Committee continues the
directive included under this heading in the House Report 119-
271.
National Strategy for Vector-borne Disease.--The Committee
encourages the CDC to execute the Lyme and tick-borne disease
portion of the National Strategy for Vector-borne Disease. It
is also important that the CDC accelerate measures to improve
Alpha-gal Syndrome surveillance, patient care, and public
awareness with an emphasis on healthcare provider education, in
keeping with the three public health priorities identified in
the 2023 CDC report.
The Committee further encourages CDC to expand nationwide
surveillance of vector-borne diseases through the VectorSurv
program. The Committee is aware that this modernized, data
management and analysis system is used by vector control and
state public health agencies to manage and analyze surveillance
and control data on mosquitos, ticks, arboviruses, and other
vector-borne diseases. The Committee notes that the expansion
of VectorSurv is a component of the goals for improved vector-
borne disease surveillance capabilities referenced in the CDC's
December, 2025 National Public Health Strategy to Prevent and
Control Vector-Borne Diseases in People.
New World Screwworm.--The Committee recognizes that the New
World Screwworm poses a serious threat to human and animal
health due to its dependence on living tissues for larval
development. While existing Federal and State efforts--focused
on surveillance, control, eradication, and sterile insect
techniques--have prevented infestation in the U.S., critical
gaps remain in public health and veterinary awareness,
training, and preparedness. These gaps disproportionately
affect health care providers serving high-risk populations, as
well as small ruminant and companion animal owners,
veterinarians and veterinary hospital staff, personnel in
animal shelters and rescues, and wildlife rehabilitation
organizations.
The Committee urges CDC to collaborate with USDA, DOI,
States, and institutions of higher education to expand efforts
under the One Health approach. Priorities should include
developing targeted educational materials, hosting continuing
education for physicians, veterinarians, and other relevant
stakeholders, enhancing detection technologies, and closing
awareness gaps to bolster community preparedness against this
emerging threat.
Parasitic Diseases and Malaria.--The Committee continues
funding for parasitic diseases and malaria prevention through
the National Center for Emerging and Zoonotic Infectious
Diseases. This funding was previously provided through the CDC
Global Health Center.
Prion Disease.--The Committee is concerned that Chronic
Wasting disease (CWD), a fatal condition in cervids (deer, elk,
and moose) caused by misfolded prions, has been detected in
over 37 States and all four regions of the country. Monitoring
the prevalence of prion diseases, including determining a
disease's incidence and whether it was acquired from animals or
other humans, is critical. In light of scientific observations
regarding the nationwide spread of CWD and concerns about the
potential for cross-species transmissions to humans and food
production animals, the Committee includes $10,000,000 for
surveillance efforts of human prion diseases, including
Creutzfeldt-Jakob Disease, through CDC's implementation of the
prion surveillance program in partnership with the National
Prion Disease Pathology Surveillance Center and state health
departments.
Travel and Port Health Protection.--The Committee provides
increased funding to support the integration of the TGS program
into the Biothreat Radar initiative. The Committee is aware of
the expansion of TGS to include multiple pathogens of public
health interest collected through aircraft wastewater, and
voluntary nasal swabs from travelers arriving at several U.S.-
based international airports and recommends the expansion of
these activities through resources made available in this bill
and from previous appropriations balances. This capability has
been effective in advancing the nation's pathogen surveillance
capabilities to provide early warning for detection,
characterization, and migratory disease origin.
Soil Transmitted Helminth and Related Diseases.--Within the
total amount provided for Parasitic Diseases and Malaria, the
Committee includes $1,500,000 to extend the currently funded
CDC projects aimed at surveillance, clinical care, and the
implementation of control measures to reduce soil transmitted
helminth infection and other parasitic infections of public
health concern.
Southern Tick Associated Rash Illness.--The Committee
instructs CDC to complete the directives included under this
heading in the House Report 119-271.
Tick-Borne Diseases (TBD) External Engagement.--The
Committee strongly encourages CDC to establish a panel of
expert outside stakeholders to evaluate and review the Lyme
disease information on its website for its inclusion of a
balance of scientifically valid perspectives, primarily
regarding the state of the science for diagnostics and
treatments. The stated goals and purposes of the review and the
identity of review participants, including the balanced panel
of experts, including experienced TBD clinicians, researchers,
and educators, should be fully transparent.
Tick-Borne Diseases Public Information.--The Committee
directs CDC, within 120 days of enactment of this Act, to
develop a two-year plan (to include fiscal years 2028 and 2029)
for conducting evaluation reviews of the information on its
website for TBDs, including any TBD overviews and information
on individual TBDs, including alpha-gal syndrome, the non-
infectious allergic disease related to a tick bite that is less
understood than other allergic conditions, and for developing
educational materials for clinicians, high-risk workers, and
the public for each TBD and tickborne condition, with priority
based on disease burden, determined by prevalence and level of
disability. The CDC is further directed, within 120 days of the
enactment of this Act, to publicly release a report on alpha-
gal syndrome, including prevalence, etiology, treatment,
outcomes, and prognosis.
Vector-Borne Diseases.--The Committee recognizes the
increased threat posed by vector-borne diseases such as Zika,
West Nile, STARI, Oropouche, alpha-gal syndrome, and dengue and
provides increased funding to support CDC's ability to assist
States affected by the increased prevalence in vector-borne
diseases.
Wastewater Monitoring.--The Committee provides funding
under Emerging Infectious Diseases to sustain and strengthen
CDC's infectious disease surveillance through wastewater
monitoring as part of the Biothreat Radar initiative.
Wastewater monitoring helps communities track multiple existing
infectious disease threats simultaneously and pivot quickly to
detect new threats. The Committee underscores the importance of
a wastewater monitoring system that can serve as a national
early-warning network with broad geographic representation,
strategically incorporating sites across the country to
strengthen early detection and biosecurity, and sharing results
publicly to inform communities and protect Americans.
The Committee encourages CDC to work with States and
localities to start or improve wastewater programs; provide
ongoing guidance and recommendations, particularly on methods
to rapidly detect emerging pathogens; partner with public,
private, and nonprofit entities at the forefront of this work;
and prioritize resources for sites that can sample and test for
multiple infectious diseases, pivot quickly to detect emerging
threats, and apply scientifically rigorous standards to ensure
reliable, comparable data. The Committee also encourages CDC to
further strengthen its metrics and methods to promote more
efficient and effective wastewater monitoring, expand testing
to a broader range of settings and threats, and ensure that the
wastewater sampling data reported to CDC are published on the
agency's website.
CHRONIC DISEASE PREVENTION AND HEALTH PROMOTION
Appropriation, fiscal year 2026....................... $1,432,815,000
Budget request, fiscal year 2027...................... 448,049,000
Committee Recommendation.............................. 1,311,641,000
Change from enacted level......................... -121,174,000
Change from budget request........................ +863,592,000
The Committee recommendation includes $873,199,000 in
discretionary appropriations and $438,442,000 in transfers from
PPHF.
Programs supported within Chronic Disease Prevention and
Health Promotion provide national leadership and support for
State, tribal, and community efforts to promote health and
well-being through the prevention and control of chronic
diseases.
Within the total provided, the Committee provides the
following amounts:
------------------------------------------------------------------------
Budget Activity FY 2026 Enacted FY 2027 Committee
------------------------------------------------------------------------
Tobacco........................... $246,500,000 $246,500,000
Tobacco appropriations........ 46,500,000 46,500,000
Tobacco Transfer from the 200,000,000 200,000,000
Prevention and Public Health
Fund.........................
Nutrition, Physical Activity, and 54,320,000 16,500,000
Obesity appropriations...........
High Obesity Rate Countries 16,500,000 16,500,000
appropriations...............
School Health appropriations...... 19,400,000 - - -
Health Promotion.................. 63,100,000 61,600,000
Vision and Eye Health 4,500,000 4,500,000
appropriations...............
Alzheimer's Disease 41,500,000 41,500,000
appropriations...............
Inflammatory Bowel Disease 3,000,000 3,500,000
appropriations...............
Interstitial Cystitis 2,100,000 2,100,000
appropriations...............
Chronic Kidney Disease 4,500,000 5,500,000
appropriations...............
Chronic Disease Education and 4,500,000 4,500,000
Awareness appropriations.....
Other Health Promotion 3,000,000 - - -
Activities...................
Prevention Research Centers 28,961,000 - - -
appropriations...................
Heart Disease and Stroke.......... 156,105,000 160,312,000
Heart Disease and Stroke 45,000,000 45,000,000
appropriations...............
Heart Disease and Stroke 111,105,000 115,312,000
Transfer from the Prevention
and Public Health Fund.......
Diabetes.......................... 163,130,000 165,130,000
Diabetes appropriations....... 45,000,000 47,000,000
Diabetes Transfer from the 118,130,000 118,130,000
Prevention and Public Health
Fund.........................
National Diabetes Prevention 37,300,000 39,300,000
Program appropriations...........
Cancer Prevention and Control..... 413,049,000 420,049,000
Breast and Cervical Cancer 236,500,000 238,500,000
appropriations...............
WISEWOMAN appropriations 34,620,000 34,620,000
(non-add)................
Breast Cancer Awareness for 6,960,000 6,960,000
Young Women appropriations...
Cancer Registries 53,440,000 53,440,000
appropriations...............
Colorectal Cancer 44,294,000 46,294,000
appropriations...............
Comprehensive Cancer Control 22,425,000 22,425,000
appropriations...............
Johanna's Law appropriations.. 12,000,000 13,000,000
Ovarian Cancer appropriations. 15,500,000 16,500,000
Prostate Cancer appropriations 16,205,000 17,205,000
Skin Cancer appropriations.... 5,000,000 5,000,000
Cancer Survivorship Resource 725,000 725,000
Center appropriations........
Oral Health appropriations........ 21,250,000 22,250,000
Safe Motherhood/Infant Health 113,500,000 115,500,000
appropriations...................
Arthritis appropriations.......... 2,000,000 2,000,000
Epilepsy appropriations........... 11,500,000 11,500,000
National Lupus Registry 14,000,000 16,000,000
appropriations...................
Good Health and Wellness in Indian 27,000,000 30,000,000
Country appropriations...........
Healthy Weight Task Force Obesity 5,000,000 5,000,000
Activities/National Early Child
Care Collaboration Transfer from
the Prevention and Public Health
Fund.............................
------------------------------------------------------------------------
Alzheimer's Disease and Related Dementias.--The Committee
recognizes that conformational disorders, such as Alzheimer's
disease, Creutzfeldt-Jakob Disease, and prion diseases, may
share disease characteristics which are overlooked or mistaken
in diagnosis. The Committee encourages CDC to support broader
conformational disease prevention and awareness activities with
Alzheimer's Disease awareness and prevention funding.
Assisted Reproductive Reporting Requirements.--The
Committee recognizes that Congress passed the Fertility Clinic
Success Rate and Certification Act in 1992, which ``mandates
that clinics performing assisted reproductive technology
annually provide data for all procedures performed to CDC and
sets forth definitions and reporting requirements.'' The
Committee acknowledges the importance of oversight to ensure
ethical assisted reproductive technology practices and to
address the long-term health outcomes and complications for
women and children. The Committee continues the directives
included under this heading in the House Report 119-271.
Breast and Cervical Cancer Screening.--The Committee
continues to support provisions of critical, lifesaving breast
and cervical cancer screenings and diagnostic services. The
Committee is aware that there are still substantial barriers to
screening like geographic isolation, limited health literacy,
lack of provider recommendation and trust, inconvenient times
to access services, and physical discomfort. The Committee is
encouraged by recent progress in screening methods and programs
that aim to eliminate patient access barriers. The Committee
encourages CDC to continue efforts to reduce breast and
cervical cancer and to work to reach women who may have delayed
screening services. The Committee is concerned with the decline
in screening rates, and the increase in diagnosis of advanced
cervical cancers, especially in rural and underserved
communities. Provided within the increase, the Committee
encourages the National Breast and Cervical Cancer Early
Detection Program to build on existing programs by finding new
and innovative outreach and education strategies to engage
women to increase screening rates. The use of navigators has
proven especially successful in reaching women with low rates
of screening. The Committee directs CDC provide an update on
these activities in the fiscal year 2028 congressional
justification.
Breast Cancer Risk Assessments.--The Committee recognizes
the need to increase education and awareness of existing breast
cancer risk assessment tools to improve screening rates,
promote a comprehensive understanding of risk factors, and
better inform clinical practice for early diagnosis and
treatment. The Committee is aware of several Federal online
breast cancer risk assessment tools, including those at CDC and
NCI. The Committee looks forward to reviewing CDC's report on
creating a comprehensive, publicly accessible risk assessment
tool and strategies to increase public awareness of said tool.
Cervical Cancer Outreach and Education.--The Committee is
concerned with the decline in screening rates, and the increase
in diagnosis of advanced cervical cancers, especially in rural
and underserved communities. Provided within the increase, the
Committee encourages NBCCEDP to build on existing programs by
finding new and innovative outreach and education strategies to
engage women to increase screening rates. The use of navigators
has proven especially successful in reaching women with low
rates of screening. The Committee looks forward to receiving a
briefing on these activities.
Chronic Kidney Disease.--Chronic kidney disease (CKD)
affects more than 37 million adults in the United States, with
an additional 1 in 3 U.S. adults at risk of developing CKD due
to diabetes and hypertension. The vast majority of adults
(about 90 percent) are unaware they have CKD until there is a
need for dialysis or kidney transplantation. Approximately 36
percent of total 2023 Medicare fee-for-service cost was spent
on care for CKD patients, however, CKD is underdiagnosed and
not detected early enough to initiate effective treatment
regimens to reduce cardiovascular complications, death, and
disability. A public health approach contributes toward better
and earlier detection to allow more time for interventions
targeted to improve outcomes. The Committee encourages
continued investment to educate the public about their risk for
CKD, educate clinical professionals, and spur innovation by
entities serving the CKD community. By improving surveillance,
patient and provider awareness, early detection, and treatment,
the progression of kidney disease can be slowed, and
complications can be reduced which will dramatically improve
the quality of life of patients and reduce healthcare costs.
Dental Caries and Nutrition.--The Committee is aware that
some States have implemented policies limiting or prohibiting
the use of public food assistance benefits to purchase ultra-
processed foods, including soda and candy. The Committee notes
the role these foods play in dental disease, including dental
caries. The Committee encourages CDC to evaluate the prevalence
of dental caries among children by State before and after the
implementation of such policies.
Diabetes.--According to CDC's 2023 data from the National
Diabetes Statistics Report, approximately 2.1 million Americans
have type 1 diabetes (T1D), with 314,000 of these individuals
under the age of 20. The incidence of T1D has increased
significantly over the past 20 years. Millions of individuals
are at an increased risk of developing T1D because they have a
first-degree relative with the condition, and a subset of these
individuals are in the early stages of T1D. The Committee
recognizes CDC's efforts to educate the public on T1D and
monitor scientific recommendations for testing, screening, and
treatment for people with T1D. The Committee encourages CDC to
continue providing timely updates on the agency website.
Diabetes in AI/AN.--The Committee notes that according to
the CDC, American Indian and Alaska Native (AI/AN) adults are
more likely to have diabetes than any other racial or ethnic
group, with one-in-seven AI/AN adults having diabetes. Within
the amount provided, the Committee reserves no less than 5
percent for Indian Tribes and Tribal Organizations.
Epilepsy.--The Committee commends CDC for its ongoing
leadership of this successful program and effective community
collaborations, and encourages further efforts to eliminate
stigma, improve awareness and education, and better connect
people with epilepsy to health and community services. The
Committee recognizes the importance of data to accurately
understand the incidence, prevalence, and mortality rate of
epilepsies, along with individual and social risk factors that
influence health outcomes. The Committee appreciates CDC's
ongoing epilepsy-related surveillance and funding of
epidemiologic studies on epilepsy. The Committee encourages CDC
to enhance surveillance and epidemiologic studies of epilepsies
to generate data that can guide interventions to improve
outcomes for people with epilepsy.
Endometriosis.--The Committee urges CDC to increase
awareness of endometriosis, including its prevalence, current
treatment options, and long-term health impacts. The Committee
encourages CDC to strengthen national surveillance, improve
data standardization, and assess the broader health and
economic burdens associated with delayed diagnosis and
untreated endometriosis. The Committee further encourages the
agency to identify disparities in access to diagnosis and
treatment of endometriosis across different populations.
Guidance on Core AYA Services.--The Committee recognizes
that adolescent and young adult (AYA) cancer patients, defined
as patients diagnosed between the ages of 15 and 39, have
unique psychological, reproductive and financial challenges
that are often not addressed in the current cancer care system.
The Committee encourages CDC, in collaboration with NCI and
other relevant stakeholder groups, to develop consensus
guidance for defining standards and improving quality of care
for AYA patients. This includes fertility preservation
counseling, psychosocial distress screening and survivorship
support, among others, which health care providers can utilize
to inform quality of care. The Committee requests an update in
the fiscal year 2028 congressional justification on these
efforts.
Healthy Brain Initiative.--The Committee supports the
Healthy Brain Initiative, including implementation of the
Healthy Brain Initiative Public Health Road Maps. The Committee
provides continued funding to implement community-based public
health interventions for Alzheimer's disease and related
dementias; promote brain health; translate clinical science
into public health action; and increase the analysis and timely
reporting of data related to cognitive decline, Alzheimer's
disease and related dementias, and dementia caregiving.
Heart Disease and Stroke.--The Committee continues funding
to support the implementation of the Cardiovascular Advances in
Research and Opportunities Legacy Act (P.L. 117-244). The
Committee encourages CDC to increase the programmatic emphasis
on heart valve disease education and awareness.
High Obesity Rate Counties.--The Committee continues to
support land grant universities in partnership with their
cooperative extensions in counties with obesity rates over 40
percent. The Committee directs CDC to encourage grantees to
work with State and local public health departments and other
partners to support measurable outcomes through community and
population-level evidence-based obesity intervention and
prevention programs. The Committee further directs that funded
projects integrate evidence-based policy, systems, and
environmental approaches to better understand and address the
environmental and societal implications of obesity. To ensure a
more seamless integration between grantees and public health
partners, the Committee directs that preference be given to
proposals that are led by or conducted in coordination with an
academic medical center to ensure that education and outreach
efforts are aligned with best medical practices. The Committee
further encourages CDC to consider including high childhood
obesity rates in its eligibility criteria for the High Obesity
Program as well as the preponderance of obesity by State based
on the CDC Behavioral Risk Factor Surveillance System.
Integrated Chronic Disease Prevention.--The Committee notes
the importance of an integrated approach to chronic disease
prevention and management among adults, including efforts that
address shared risk factors and common underlying drivers
across conditions. The Committee further notes potential
benefits of coordinated program design, improved data use, and
community-informed approaches, and streamlined support for
state and local public health partners. The Committee
encourages CDC to consider ways to advance these goals while
maintaining appropriate attention to disease-specific expertise
and minimizing unnecessary duplication of effort.
Inflammatory Bowel Diseases.--The committee applauds the
ongoing work to improve health outcomes for people impacted by
Crohn's disease and ulcerative colitis, known collectively as
IBD. The Committee provides funding to support CDC's work to
improve the public health response to IBD. This includes work
to increase awareness of IBD, improve understanding of
effective treatments, and improved early disease diagnosis. The
committee directs CDC to continue supporting this work.
Lung Cancer.--The Committee is concerned that only 16
percent of all those eligible are screened for lung cancer. To
improve screening rates, the Committee encourages the National
Comprehensive Cancer Control Program (NCCCP) to work with
States on targeted, cost-effective strategies that increase
lung cancer screening rates. Tactics might include improving
patient and provider education, increasing awareness of the
screening criteria, and leveraging patient navigators/community
health workers to reduce barriers to accessing lung cancer
screening.
National Lupus Registry.--The Committee continues to
support the National Lupus Patient Registry and the Developing
and Disseminating Strategies to Build Sustainable Lupus
Awareness, Knowledge, Skills, and Partnerships program. These
efforts improve the ability of patients and healthcare
providers to recognize the signs and symptoms of lupus, reduce
time to diagnosis, and ensure timely referrals to appropriate
specialty care, as well as access to self-management tools and
services and educational support programs. The Committee
encourages CDC to expand this work by strengthening community-
clinical linkages that enhance chronic care management and
patient-centered care. This includes fostering partnerships
with national lupus voluntary health organizations to better
address the needs of individuals living with lupus. Guided by
the National Public Health Agenda for Lupus, CDC funds
population registries and cohort studies to increase public
health knowledge about lupus as well as supporting activities
to improve awareness of the signs and symptoms of Lupus.
Oral Health.--The Committee understands the importance of
CDC's Division of Oral Health and its role in reducing oral
disease rates among vulnerable populations. The Committee
provides funding for the Division of Oral Health to evaluate
and enhance the nation's surveillance systems to better
identify oral health burden at the national, State, and local
levels. Such enhancements will make data available more
quickly, enable exploration and evaluation of methods to track
adherence to infection prevention, provide information for
dental settings to support educational efforts, and increase
awareness of the importance of oral health to overall health.
Prostate Cancer.--The Committee remains concerned about the
rise in prostate cancer deaths and supports the CDC's work to
address this trend by increasing public awareness of prostate
cancer risks, screening, and treatment in high-risk men. The
Committee urges CDC to develop a national education and
awareness campaign targeting high-risk men and their families.
The Committee requests an update in the fiscal year 2028
congressional justification on this effort.
Safe Motherhood and Infant Health.--The Committee includes
funding for this portfolio of programs to improve the health of
pregnant and postpartum women and their infants. The Committee
encourages CDC to prioritize funding to help Maternal Mortality
Review Committees (MMRCs) strengthen data systems and improve
data collection including through the Maternal Mortality Review
Information Application, to promote consistency and ensure
accuracy and completeness in data collection through the
Pregnancy Risk Assessment Monitoring System, analysis, and
reporting across State MMRCs. The Committee further encourages
CDC to prioritize funding to expand Perinatal Quality
Collaboratives (PQCs) in more jurisdictions, including building
capacity of existing PQCs. The Committee continues the
directive included under this heading in the House Report 119-
271.
Schizophrenia Awareness.--An estimated 2,800,000 people in
the U.S. are affected by schizophrenia and data show
approximately 75 percent of patients discontinue treatment
within the first 18 months. The Committee encourages CDC to
work with national partners on education, outreach, and public
awareness activities around schizophrenia and new treatment
approaches.
Triple-Negative Breast Cancers.--The committee recognizes
findings that African American women have twice the odds of
being diagnosed with Triple-Negative Breast Cancers (TNBCs).
TNBC is more common in younger women as those under the age of
40 diagnosed with breast cancer are nearly twice as likely to
have TNBC than women aged 50-64. Therefore, the Committee looks
forward to reviewing the report included under this heading in
the House Report 119-271.
U.S. Associated Islands.--The Committee continues to
support funding for the prevention and control of chronic
disease and associated risk factors in the U.S. affiliated
Pacific Islands, U.S. Virgin Islands, and Puerto Rico.
Vision and Eye Health.--The Committee provides funding to
continue national-level surveillance activities, including for
pediatric populations, on the risk and prevalence of vision
loss and eye disease through the Vision and Eye Health
Surveillance System. The Committee also encourages continued
community-level interventions for detecting serious,
progressive vision conditions such as glaucoma. The Committee
notes that vision impairments and eye disease contribute to or
complicate many other serious and costly chronic health
conditions, including diabetes, depression and anxiety,
cardiovascular disease, and cognitive decline and expresses
concern that conditions that carry a risk of vision loss,
including diabetes, are increasingly more prevalent in younger
populations.
BIRTH DEFECTS, DEVELOPMENTAL DISABILITIES, DISABILITIES AND HEALTH
Appropriation, fiscal year 2026....................... $205,060,000
Budget request, fiscal year 2027...................... 153,810,000
Committee Recommendation.............................. 199,460,000
Change from enacted level......................... -5,600,000
Change from budget request........................ +45,650,000
The National Center on Birth Defects and Developmental
Disabilities (NCBDDD) account supports efforts to conduct
research on and address the causes of birth defects and
developmental disabilities, as well as reduce the complications
of blood disorders and improve the health of people with
disabilities.
Within the total, the Committee recommends the following
amounts:
------------------------------------------------------------------------
FY 2027
Budget Activity FY 2026 Enacted Committee
------------------------------------------------------------------------
Child Health and Development...... $71,300,000 $61,600,000
Birth Defects ................ 19,000,000 19,000,000
Fetal Death .................. 900,000 2,000,000
Fetal Alcohol Syndrome ....... 11,500,000 11,500,000
Autism ....................... 28,100,000 29,100,000
Other CHD Activities ......... 11,800,000 - - -
Health and Development for People 85,410,000 87,510,000
with Disabilities................
Disabilities and Health ...... 46,500,000 47,500,000
Special Olympics (non-add) 20,500,000 21,500,000
Tourette Syndrome ............ 2,500,000 2,500,000
Early Hearing Detection and 6,760,000 6,760,000
Intervention ................
Muscular Dystrophy ........... 9,000,000 11,000,000
Fragile X .................... 2,000,000 2,000,000
Spina Bifida ................. 7,500,000 8,500,000
Congenital Heart Defects ..... 9,250,000 9,250,000
Public Health Approach to Blood 21,100,000 21,100,000
Disorders........................
Public Health Approach to 10,400,000 10,400,000
Blood Disorders .............
Hemophilia Activities ........ 3,500,000 3,500,000
Hemophilia Treatment Centers . 5,100,000 5,100,000
Thalassemia................... 2,100,000 2,100,000
Neonatal Abstinence Syndrome...... 4,250,000 4,250,000
Surveillance for Emerging Threats 23,000,000 25,000,000
to Mothers and Babies............
------------------------------------------------------------------------
Autism.--The Committee provides increased funding to
include biennial reporting on the prevalence and
characteristics of individuals with profound autism within the
Autism and Developmental Disabilities Monitoring (ADDM)
Network.
Blood Clots.--The Committee remains concerned about the
significant economic and health impacts of blood clots on
patients and the health care system, particularly among
pregnant women, veterans, Black Americans, people over 50,
cancer patients, and those with comorbidities. The Committee
notes that most blood clots are highly preventable, yet public
awareness remains low. Therefore, the Committee urges CDC to
partner with patient advocacy organizations to increase public
awareness of blood clots. The Committee further directs CDC to
include in its fiscal year 2028 congressional justification a
cost estimate of a nationwide public awareness campaign to
prevent and recognize blood clot symptoms, and for education
and training of health care professionals on the signs and
symptoms of blood clots and how to prevent them.
Cerebral Palsy.--Cerebral palsy (CP) is the most common,
lifelong motor disability caused by an early developmental
brain injury. The mechanism and type of injury underlying CP is
still not well understood, which can include perinatal stroke,
maternal infection, genetics and/or hypoxic ischemic
encephalopathy. The Committee encourages CDC to consider
supporting efforts to expand scientific knowledge on the
prevalence, risk factors, early detection, and co-morbidities
of CP in order to determine if the CP population is rising,
dropping, or staying the same.
Disability and Health.--The Committee supports the National
Center on Health, Physical Activity, and Disability (NCHPAD) in
promoting the health and wellness of people with physical
disabilities and mobility limitations. The Committee encourages
CDC to support NCHPAD in expanding its partnerships with more
jurisdictions.
Fetal Death.--The Committee includes increased funding to
support CDC's surveillance and stillbirth activities.
Stillbirths are one of the most common and devastating adverse
pregnancy outcomes. The Committee directs CDC to expand its
stillbirth surveillance program to two additional sites for the
purposes of informing prevention strategies.
Fetal Alcohol Syndrome.--The Committee encourages CDC to
build jurisdictional capacities to address fetal alcohol
spectrum disorders (FASD) through the development of education
and outreach activities, the dissemination of evidence-based
prevention and support services information, and the
availability of technical assistance to grantees.
Fragile X and Fragile X Associated Disorders.--The
Committee commends CDC's efforts to identify and define the
population impacted by Fragile X (FX) and all conditions
associated with the gene mutations with the goal of
understanding the public health impact of these conditions. The
Committee encourages the NCBDDD to support additional
strategies to promote earlier identification of children with
FX, such as voluntary newborn screening. The Committee further
encourages the NCBDDD work to ensure populations with FX
conditions are being properly diagnosed and made aware of
available medical services. Finally, the Committee recommends
the NCBDDD continue to support research across the lifespan of
individuals living with FX and the associated conditions and
disorders.
Muscular Dystrophy.--The Committee provides increased
funding to support muscular dystrophy research and monitoring
initiatives. The Committee encourages CDC to focus on
activities that leverage existing resources and provide the
greatest benefit to the Duchenne community, including active
engagement with external consortia to address the range of
issues that affect adolescents and adults with Duchenne, such
as bone, adrenal, cardiac, and pulmonary health, puberty,
weight management, and fertility. The Committee notes that
Duchenne has been added to the Recommended Uniform Screening
Panel (RUSP) and encourages CDC to expand surveillance efforts
to better track health outcomes of newborns with Duchenne. In
States where Duchenne newborn screening implementation efforts
have begun, CDC is directed to conduct an annual assessment of
State implementation efforts, including identification of
implementation barriers and laboratory standards. The Committee
also prioritizes incorporating existing data from prior
collection efforts into the next-generation data system. The
Committee continues the directive included under this heading
in the explanatory statement that accompanied Division B of
P.L. 119-75.
Spina Bifida.--The Committee recognizes that Spina Bifida
is the most common permanently disabling congenital condition
compatible with life in the United States, affecting
approximately 1,500 babies each year. An estimated 166,000
individuals are living with Spina Bifida nationwide, more than
65 percent of whom are adults, reflecting significant advances
in survival and the growing need for lifespan care. The
Committee provides funding for the National Spina Bifida
Program to support the continuation of the National Spina
Bifida Patient Registry, including the Spina Bifida Clinical
Care Monitoring and Tracking program, otherwise known as the
Spina Bifida Collaborative Care Network, to guide the health
care community in identifying and implementing best practices
for the care of individuals living with Spina Bifida. Funding
is also provided to support the expansion of the National Spina
Bifida Patient Registry, for the inclusion of additional
clinical sites and the examination of mental and behavioral
health outcomes among individuals with Spina Bifida.
The Committee understands that CDC intends to transition
operation of the Spina Bifida Collaborative Care Network to the
CDC Foundation and requests a briefing within 180 days of
enactment of this Act on its plans for this transition,
including governance, sustainability, and continued Federal
oversight.
The Committee further recognizes the substantial and
growing need for CDC support to address the transitional and
adult care needs of the aging Spina Bifida population,
including the increasing incidence of serious secondary
conditions such as bladder cancer. The Committee requests that
the CDC provide an update in its fiscal year 2028 congressional
justification detailing its efforts to address these adult and
aging-related health needs.
Surveillance for Emerging Threats to Mothers and Babies.--
The Committee includes funding to support CDC's Surveillance
for Emerging Threats to Mothers and Babies program. This
program supports CDC's collaboration with State, tribal,
territorial, and local health departments to monitor the impact
of emerging health threats on pregnant women and their babies
and to inform public health and clinical decision-making to
improve maternal and infant health.
Thalassemia.--The Committee continues to support CDC's work
on Thalassemia, a rare genetic blood disorder that requires
lifelong blood transfusions and associated chelation therapy to
remove excess iron, particularly from the heart and liver.
Thalassemia patients often experience serious comorbidities
that can impact almost every aspect of their lives. The
Committee urges CDC to continue examining the latest research,
best practices, and programs related to Thalassemia with the
goal of developing a strategic plan and blueprint for
Thalassemia action.
PUBLIC HEALTH SCIENTIFIC SERVICES
Appropriation, fiscal year 2026....................... $767,497,000
Budget request, fiscal year 2027...................... 879,897,000
Committee Recommendation.............................. 827,497,000
Change from enacted level......................... +60,000,000
Change from budget request........................ -52,400,000
The Committee recommendation includes $739,553,000 in
discretionary appropriations and $45,000,000 in transfers from
PPHF.
This account supports programs that provide leadership and
training for the public health workforce, support
infrastructure to modernize public health surveillance, promote
and facilitate science standards and policies, and improve
access to information on disease outbreaks and other threats.
Within the total, the Committee provides the following
amounts:
------------------------------------------------------------------------
Budget Activity FY 2026 Enacted FY 2027 Committee
------------------------------------------------------------------------
Health Statistics................. $187,397,000 $187,397,000
Health Statistics 144,453,000 144,453,000
appropriations...............
Health Statistics section 241 42,944,000 42,944,000
of the PHS Act...............
Surveillance, Epidemiology, and 298,100,000 313,100,000
Informatics appropriations.......
Advancing Laboratory Science 26,000,000 26,000,000
appropriations...................
Public Health Data Initiative 185,000,000 230,000,000
Modernization....................
Public Health Data 185,000,000 185,000,000
Modernization Initiative
appropriations...............
Public Health Data - - - 45,000,000
Modernization Initiative
Transfer from the Prevention
and Public Health Fund.......
Public Health Workforce 71,000,000 71,000,000
appropriations...................
------------------------------------------------------------------------
Advancing Laboratory Science.--The Committee appreciates
the work of the Advancing Laboratory Science program to deepen
organizational ties with commercial laboratories. The Committee
continues to provide funding to better position the CDC and the
nation to respond to future pathogenic threats.
Data Modernization.--The Committee recognizes CDC's
continued progress towards the implementation of CDC's data
modernization efforts to bolster the nation's health security
infrastructure and readiness response, including through the
One CDC Data Platform (1CDP). The Committee provides increased
funding to strengthen the core of public health data;
accelerate access to analytic and automated solutions to
support health investigations; visualize and share insights to
inform public health action; and advance more open and
interoperable public health data. Increased funding is provided
to bolster and expand data surveillance systems across
jurisdictional public health authorities, the health care
sector, and other key Federal partners.
The Committee also recognizes CDC's efforts to engage with
States, Tribes, localities, and territories through data use
agreements for core data sources as well as key recommendations
from the Advisory Committee to the Director Data and
Surveillance Workgroup. The Committee urges CDC to prioritize
support for jurisdictions with existing data modernization
barriers, including those facing significant workforce
constraints, interoperability challenges, and aging data
infrastructure. The Committee directs CDC to provide a briefing
within 90 days of enactment of this Act on the latest
developments related to the implementation of enterprise-level
public health data systems.
Eating Disorders.--The Committee remains concerned that
mental health problems among youth are at an all-time high,
with eating disorders-related emergency room admissions for
youth doubling during the pandemic. For 23 years, CDC conducted
surveillance of the signs and symptoms of eating disorders
within the Youth Risk Behavioral Surveillance System (YRBSS),
but the YRBSS coordinators voted to remove the question from
the 2015 survey. The resulting gap in data collection left
public health experts and researchers with limited data to
address eating disorders among youth. The Committee recognizes
CDC's recent classification of eating disorders as an emerging
and important youth health issue and its collaboration with
partners to include a question assessing student eating
disorders in the 2025 national questionnaire. The Committee
encourages CDC to use these findings to help inform prevention
strategies for eating disorders.
Surveillance, Epidemiology, and Informatics.--The
surveillance, epidemiology, and informatics programs are the
CDC's critical public health surveillance platforms programs,
including syndromic data and case reporting at the Federal,
State, and local level that provide vital information about the
nation's health. The increase provides continued support of
broad, State-based surveys used across health conditions and
risk factors, for both ongoing programs and CDC emergency
responses. These systems continuously monitor a wide range of
risk factors, providing health authorities with real-time data
to identify emerging threats and track trends over time. Early
detection of these risk factors enables timely interventions,
which can prevent diseases from spreading or becoming more
severe. Advancing capabilities for health information exchange
will improve CDC's and jurisdictions' ability to better use
longitudinal health data for essential public and population
health uses, which benefits all of the Department.
National Health and Nutrition Examination Survey
(NHANES).--The Committee recognizes the key role NHANES plays
in assessing the health and nutritional status of Americans,
including by tracking disease prevalence, dietary patterns,
environmental exposures, and health outcomes for different
populations. The Committee is concerned with declining response
rates, and requests a briefing within 90 days on CDC's work to
improve respondent participation,
National Neurological Conditions Surveillance System.--The
Committee provides $5,000,000, which is the same as the fiscal
year 2026 enacted level, to continue efforts on the two initial
conditions regarding multiple sclerosis and Parkinson's
disease.
Primary Immunodeficiencies.--The Committee provides
$3,500,000, which is the same as the fiscal year 2026 enacted
level, for education, awareness, and genetic sequencing
surveillance related to primary immunodeficiencies. This
program has proven effective in identifying undiagnosed
patients and linking them to centers of care.
ENVIRONMENTAL HEALTH
Appropriation, fiscal year 2026....................... $242,850,000
Budget request, fiscal year 2027...................... 162,350,000
Committee Recommendation.............................. 241,850,000
Change from enacted level......................... -1,000,000
Change from budget request........................ +79,500,000
The Committee recommendation includes $190,850,000 in
discretionary appropriations and $51,000,000 in transfers from
PPHF.
Programs supported within Environmental Health conduct
surveillance and data collection to detect and address emerging
pathogens and environmental toxins that pose significant
challenges to public health, as well as determine whether and
at what level of exposure these substances are harmful to
humans.
Within the total, the Committee provides the following
amounts:
------------------------------------------------------------------------
Budget Activity FY 2026 Enacted FY 2027 Committee
------------------------------------------------------------------------
Environmental Health Laboratory... $70,750,000 $75,750,000
Environmental Health 48,500,000 53,500,000
Laboratory appropriations....
Newborn Screening Quality 21,000,000 21,000,000
Assurance Program
appropriations...............
Newborn Screening/Severe 1,250,000 1,250,000
Combined Immunodeficiency
Diseases appropriations......
Environmental Health Activities... 48,600,000 41,600,000
Environmental Health 17,000,000 17,000,000
appropriations...............
Safe Water appropriations..... 8,600,000 8,600,000
Amyotrophic Lateral Sclerosis 10,000,000 13,000,000
(ALS) Registry appropriations
Climate and Health 10,000,000 - - -
appropriations...............
Trevor's Law appropriations... 3,000,000 3,000,000
Environmental and Health Outcome 34,000,000 34,000,000
Tracking Network appropriations..
Asthma appropriations............. 33,500,000 34,500,000
Lead Exposure Registry 5,000,000 5,000,000
appropriations...................
Childhood Lead Poisoning Transfer 51,000,000 51,000,000
from the Prevention and Public
Health Fund......................
------------------------------------------------------------------------
Amyotrophic Lateral Sclerosis (ALS).-- The Committee
continues to support the National ALS Registry and
Biorepository. The Committee notes that ALS prevalence is
projected to rise from 9.68 per 100,000 Americans in 2024 to
11.21 per 100,000, resulting in an estimated additional 9,000
individuals affected by this disease. The Committee directs CDC
to continue investing in ALS research to identify risk factors;
develop strategies to mitigate its future impact on patients,
families, and the nation's health care system; and reduce ALS
incidence through prevention and risk mitigation strategies for
civilians, active military personnel and veterans in the United
States. The Committee further directs CDC to continue
collaborating with the DOD and Veterans Affairs to provide a
publicly available report within 180 days of enactment of this
Act. The report should include incidence and prevalence data on
ALS among military veterans and a strategy to develop and test
risk reduction approaches that will lower ALS incidence among
active-duty personnel and veterans.
Asthma.--The Committee recognizes the significance of
asthma as a chronic disease with implications for public
health, productivity at work and at school, and healthcare
utilization. The Committee notes that the FDA has recognized a
shortage of albuterol sulfate inhalation solutions since 2022.
Access to inhalers is critical for preventing hospitalization
of patients with asthma and other chronic respiratory diseases.
The Committee urges the Department to prioritize interagency
coordination to ensure inhalers remain accessible to patients.
The Committee also continues the directives included under this
heading in the House Report 119-271.
Climate and Health.--The Committee provides no funding for
climate and health related activities.
Pediatric Reference Intervals (PRIs).--The Committee
provides $5,000,000 under Environmental Health Laboratory
appropriations to develop and implement universal PRIs for use
by all laboratories and health care providers. The Committee
acknowledges CDC's efforts to prevent, detect, and treat
chronic diseases in children. However, the Committee is
concerned that the current patchwork of PRI practices does not
adequately account for biological development in children,
which can lead to misdiagnosis, preventable deaths,
disabilities, and other irreversible health problems. PRIs are
a critical tools for assessing health, making correct
diagnoses, and evaluating treatment efficacy in pediatric
patients. The Committee requests an update in the fiscal year
2028 congressional justification on these efforts.
Polyendocrine Metabolic Ovarian Syndrome.--The Committee
encourages CDC to dedicate funding toward establishing
standardized reference intervals for polyendocrine metabolic
ovarian syndrome (PMOS) hormone tests in women, adolescents,
and girls, particularly testosterone, antimullerian hormone,
and others. This effort aims to enhance diagnostic precision,
improve the reliability of clinical and research data, and
support earlier diagnosis and more effective management,
ultimately driving better health outcomes for those affected by
PMOS and saving healthcare costs.
INJURY PREVENTION AND CONTROL
Appropriation, fiscal year 2026....................... $761,379,000
Budget request, fiscal year 2027...................... 588,329,000
Committee Recommendation.............................. 705,829,000
Change from enacted level......................... -55,550,000
Change from budget request........................ +117,500,000
Within the total, the Committee recommends the following
amounts:
------------------------------------------------------------------------
FY 2027
Budget Activity FY 2026 Enacted Committee
------------------------------------------------------------------------
Intentional Injury................ $164,550,000 $149,450,000
Domestic Violence and Sexual 38,200,000 39,200,000
Violence.....................
Child Maltreatment (non- 7,250,000 7,250,000
add).....................
Child Sexual Abuse 3,000,000 4,000,000
Prevention (non-add).....
Youth Violence Prevention..... 18,100,000 - - -
Domestic Violence Community 7,500,000 7,500,000
Projects.....................
Rape Prevention .............. 61,750,000 61,750,000
Suicide Prevention ........... 30,000,000 32,000,000
Adverse Childhood Experiences 9,000,000 9,000,000
National Violent Death Reporting 24,500,000 24,500,000
System ..........................
Unintentional Injury.............. 13,300,000 15,300,000
Traumatic Brain Injury ....... 8,250,000 9,250,000
Elderly Falls ................ 3,050,000 4,050,000
Drowning ..................... 2,000,000 2,000,000
Injury Prevention Activities...... 29,950,000 - - -
Opioid Overdose Prevention and 505,579,000 505,579,000
Surveillance.....................
Injury Control Research Centers... 11,000,000 11,000,000
Firearm Injury and Mortality 12,500,000 - - -
Prevention Research..............
------------------------------------------------------------------------
Cannabinoid Hyperemesis Syndrome in Youth.--The Committee
is increasingly concerned by the rise in reported cases of
cannabinoid hyperemesis syndrome (CHS)--a condition associated
with prolonged, high-potency cannabis use that leads to severe
nausea and vomiting. With the growth of high-THC vaping
products and their increasing use among adolescents, the
Committee believes further study is warranted. The Committee
instructs CDC to complete the directive under this heading in
the explanatory statement that accompanied Division B of P.L.
119-75.
Drowning Prevention.--The Committee includes funding to
prevent fatal drownings and drowning-related injuries. Drowning
is the leading cause of death among children ages 1-4 and the
second leading cause of unintentional death among children ages
5-14. The Committee recognizes that nonfatal drownings can
cause serious long-term injuries, including hypoxic-ischemic
brain injury, aspiration pneumonia, and acute respiratory
distress syndrome. This funding will enable CDC to scale proven
drowning prevention programs--such as those outlined in the
U.S. National Water Safety Action Plan--with national
organizations serving youth at greater risk of drowning or
drowning-related injury, including those in rural and
underserved communities and children with autism spectrum
disorder.
Firearm Research.--The Committee notes the CDC's historic
avoidance of research into the crimes and fatalities prevented
through self-defense with a firearm and therefore provides no
funding for firearm research.
National Poison Data System.--The committee urges CDC to
continue to partnership with the National Poison Data System to
support real-time monitoring of chemical exposures and public
health hazards.
Opioid Overdose Prevention and Surveillance.--The Committee
supports CDC's activities that promote effective strategies to
reduce addiction and overdose deaths and maintains limits on
administrative costs to ensure funding primarily supports
prevention activities. These activities include supporting
case-level syndromic surveillance data, improving interventions
that monitor prescribing and dispensing practices, enhancing
the timeliness and quality of epidemiologic data, and
strengthening coordination with medical examiners and coroners.
The Committee directs CDC to fund awards to State, local, and
tribal health departments at not less than the percentage of
base funding provided for this program in fiscal year 2026.
Prescription Drug Monitoring Programs.--The Committee
understands that nearly all 50 States and U.S. territories'
prescription drug monitoring programs are connected and
securely sharing critical controlled substance information for
the purposes of identifying and preventing abuse, misuse, or
diversion of prescription drugs. The Committee continues to
support all data-sharing solutions that address States'
priorities and CDC's commitment to preserve State choice in
selecting technology solutions that best address a State's
needs. The Committee directs CDC to continue to work with
states to maintain access to multiple platform options to
support interstate and intrastate integration.
Suicide.--The Committee recognizes that suicide is a
serious public health problem requiring strategic suicide
prevention solutions, especially among disproportionately
impacted populations. The Committee further recognizes that
suicide prevention requires a strategic public health approach
that addresses multiple risk factors at the individual,
community, and societal levels. States, Tribes, and territories
are most suited to lead a comprehensive public health approach
to suicide prevention, which demands effectively coordinating
with multisector partners to take a data-driven, evidence-based
process that addresses the broad range of risk and protective
factors associated with suicide. The Committee provides
increased funding to State public health departments to support
the Comprehensive Suicide Prevention program, and to increase
funding to Tribes and territories to build capacity and
implement strategies to prevent suicide.
NATIONAL INSTITUTE FOR OCCUPATIONAL SAFETY AND HEALTH
Appropriation, fiscal year 2026....................... $366,800,000
Budget request, fiscal year 2027...................... 92,200,000
Committee Recommendation.............................. 311,200,000
Change from enacted level......................... -55,600,000
Change from budget request........................ +219,000,000
The National Institute for Occupational Safety and Health
(NIOSH) conducts applied research, develops criteria for
occupational safety and health standards, and provides
technical services to government, labor, and industry,
including training for the prevention of work-related diseases
and injuries. This appropriation supports surveillance, health
hazard evaluations, intramural and extramural research,
instrument and methods development, dissemination, and training
grants.
Within the total, the Committee recommends the following
amounts:
------------------------------------------------------------------------
Budget Activity FY 2026 Enacted FY 2027 Committee
------------------------------------------------------------------------
National Occupational Research $120,500,000 $120,500,000
Agenda...........................
Agricultural, Forestry, and 30,000,000 30,000,000
Fishing (non-add)............
Education and Research Centers.... 32,000,000 33,000,000
Personal Protective Technology.... 23,000,000 23,000,000
Mining Research................... 68,500,000 68,500,000
Other Occupational Safety and 115,100,000 57,500,000
Health Research..................
Total Worker Health (non-add). 11,800,000 11,800,000
National Mesothelioma Registry and 1,200,000 1,200,000
Tissue Bank......................
Firefighter Cancer Registry....... 6,500,000 7,500,000
------------------------------------------------------------------------
Agriculture, Forestry, and Fishing (AgFF).--The AgFF
program funds evidence-based research, training, and outreach
that improves the health, safety, and productivity of workers
in the agriculture, forestry, and commercial fishing sectors.
These research collaboratives are especially important because
AgFF workers experience the highest fatal injury rates of any
industry in the United States. Additional research is needed to
better understand emerging infectious disease threats; the
safety and health benefits and emerging hazards related to new
technologies and trends in agricultural production; AgFF sector
issues related to rural public health, disaster preparedness,
and response; barriers to mental health care for farmers,
loggers, and fisherman; and other new and developing issues of
concern. The Committee encourages CDC to increase research
capacity for the AgFF program, prioritizing cooperative
agreements that demonstrate industry collaboration and
expertise in responding to emerging food and workforce health
security threats, as well as research to help ensure workforce
resilience, stability, and growth.
Chronic Obstructive Pulmonary Disease (COPD).--COPD is a
highly prevalent chronic disease and is a leading cause of
death in the U.S. Although combustible tobacco use is the most
important risk factor in the U.S., there are also other causes
and about 14 percent is attributable to occupation. The
Committee notes the opportunity for CDC's implementation of the
COPD National Action Plan developed by CDC and the NHLBI. The
Committee encourages CDC, including NCCDPHP and NIOSH to
support surveillance and awareness activities on COPD through
existing funding mechanisms.
Deep Mining.--Within the funding provided for occupational
mine safety and health, the Committee encourages CDC to partner
with institutions with the relevant mining expertise to
establish new safety protocols for deep mining that continue to
foster U.S. innovation and reduce foreign reliance on critical
minerals and metals.
Environmental Exposures and Cancer in First Responders
including Firefighters.--The Committee is aware that first
responders have increased rates of cancer diagnoses and death
relative to the general population they serve. First
responders, such as firefighters, are exposed to a complex mix
of known and possible cancer-causing chemicals through
breathing hazardous substances and absorbing them through their
skin. Despite an understanding of the risks associated with
firefighter and first responders' environmental exposures,
there has been no large-scale, systematic examination of the
mechanisms by which the environmental exposures experienced by
these frontline responders can cause cancer. The Committee
encourages NIOSH/CDC to establish a Total Worker Health Center
of Excellence to examine the health and safety of first
responders, including addressing the cancer disparity among
those in the fire service to build upon existing scientific
evidence-based research to further develop new solutions and
best practices for complex occupational safety and health
problems such as the toxic exposures and higher cancer
incidence rates in this population.
Firefighter Cancer Registry.--The Committee recognizes the
inherent dangers of firefighting and the importance of
understanding and reducing the risk of cancer among U.S.
firefighters. The Committee includes funding for CDC's National
Firefighter Registry for Cancer as the registry continues to
recruit and enroll participants.
Lung Cancer Screening.--The Committee is concerned that
only 24.5 percent of all those eligible are screened for lung
cancer using low dose chest computed tomography scans. To
improve screening rates, the Committee encourages the National
Comprehensive Cancer Control Program (NCCCP) to work with
States on targeted, cost-effective strategies that increase
lung cancer screening rates. Tactics might include improving
patient and provider education, increasing awareness of the
screening criteria, and leveraging patient navigators/community
health workers to reduce barriers to accessing lung cancer
screening. The Committee also encourages NIOSH to support
efforts to bring lung cancer screening to high-risk workers and
to explore using low-dose chest computed tomography scans to
screen for coal workers' pneumoconiosis in its Coal Workers'
Health Surveillance Program.
Education and Research Centers.--The Committee provides
increased funding for Education and Research Centers (ERCs) in
recognition of their important work to improve workplace safety
and health by translating scientific discoveries into practice
through effective education, training, and outreach. The
Committee applauds the work of NIOSH to implement innovative
approaches, and its translational research. The Committee
supports the education and training of graduate and post-
graduate students, particularly in Industrial Hygiene,
Occupational Health Nursing, Occupational Medicine Residency,
and Occupational Safety. The Committee encourages the CDC to
use such funding to expand Occupational Medicine Residency
programs at new or existing ERCs.
Total Worker Health.--The Committee is concerned about the
adverse safety and health effects experienced by many vehicle
mechanics and technicians across mechanical industries. The
Committee encourages CDC to use a Total Worker Health approach
to examine the exposures these workers face on the job,
including physical and chemical hazards affecting their safety,
health, and well-being. Research, workplace studies, and
strategies for prevention and intervention should prioritize
integrating protection from occupational hazards with workplace
efforts to promote and improve health and well-being. Creating
workplaces that focus on workers' physical and mental health,
longevity, and safety is crucial for those in hazardous roles--
like mechanics and shop workers--and for the overall health of
the nation.
World Trade Center Health Program.--The Committee
recognizes the World Trade Center Health Program's (WTCHP)
critical role in providing medical monitoring, treatment, and
research-informed care to responders and survivors affected by
the September 11, 2001 terrorist attacks. The Committee is
concerned by reports of staffing shortages, delays in
certifications and enrollment appeals, disruptions in
continuity of care, and ongoing challenges within the
Nationwide Provider Network that may limit timely access to
medically necessary services.
The Committee urges CDC to prioritize adequate staffing and
administrative capacity necessary to ensure timely enrollment
determinations, certifications, appeals processing, and
uninterrupted access to care for certified members. The
Committee strongly encourages WTCHP to strengthen oversight of
contractor performance and provider network operations,
including reimbursement timeliness, claims resolution, provider
retention, and enrollee complaints, in order to improve
transparency, maintain provider participation, and protect
access to high-quality care. The Committee requests a briefing
no later than 90 days after enactment of this Act on staffing
levels, vacancies, average processing times for certifications
and appeals, provider network participation trends, and the
steps being taken to reduce delays and improve continuity of
care.
World Trade Center Health Program Eligibility.--The
Committee recognizes that thousands of potentially eligible
members of the World Trade Center Health Program (WTCHP) reside
outside the New York metropolitan area. In consideration of
migration trends, and with a greater need to provide clinical
services, in particular monitoring and treatment of WTCHP-
certified conditions and improve access to research within
regions where eligible members live, the Committee urges CDC to
implement a competition to award an additional Clinical Center
of Excellence outside the New York metropolitan area. The
Committee encourages CDC to prioritize geographic regions with
a large concentration of WTCHP-eligible members.
ENERGY EMPLOYEES OCCUPATIONAL ILLNESS
COMPENSATION PROGRAM
Appropriation, fiscal year 2026....................... $55,358,000
Budget request, fiscal year 2027...................... 55,358,000
Committee Recommendation.............................. 55,358,000
Change from enacted level......................... - - -
Change from budget request........................ - - -
The Energy Employees Occupational Illness Compensation
Program provides compensation to employees and survivors of
employees of Department of Energy facilities and private
contractors who have been diagnosed with a radiation-related
cancer, beryllium-related disease, or chronic silicosis as a
result of their work. NIOSH estimates occupational radiation
exposure for cancer cases, considers and issues determinations
for adding classes of workers to the Special Exposure Cohort,
and provides administrative support to the Advisory Board on
Radiation and Worker Health.
Dose Reconstruction Program.--Within the funds made
available by the Energy Employees Occupational Illness
Compensation Program Act, CDC is encouraged to prioritize
additional funding to the NIOSH Radiation Dose Reconstruction
Program for scientific dose reconstruction activities for
additional health physicists and continue to meet compensation
timelines and expected applications.
GLOBAL HEALTH
Appropriation, fiscal year 2026....................... $692,843,000
Budget request, fiscal year 2027...................... 663,843,000
Committee Recommendation.............................. 663,843,000
Change from enacted level......................... -29,000,000
Change from budget request........................ - - -
Through its Global Health activities, CDC coordinates,
cooperates, participates with, and provides consultation to
other nations, Federal agencies, and international
organizations to prevent and contain diseases and environmental
health problems. In cooperation with ministries of health and
other appropriate organizations, CDC tracks and assesses
evolving global health threats and identifies and develops
activities to apply CDC's technical expertise.
Within the total, the Committee recommends the following
amounts:
------------------------------------------------------------------------
Budget Activity FY 2026 Enacted FY 2027 Committee
------------------------------------------------------------------------
Global HIV/AIDS Program........... $128,921,000 - - -
Global Tuberculosis............... 11,722,000 - - -
Polio Eradication................. 180,000,000 $180,000,000
Measles and Other Vaccine 50,000,000 - - -
Preventable Diseases.............
Global Emerging Infectious - - - 190,643,000
Diseases.........................
Global Public Health Protection... 293,200,000 293,200,000
------------------------------------------------------------------------
Global Emerging Infectious Diseases.--The Committee
recognizes that, since the inception of the President's
Emergency Plan for AIDS Relief (PEPFAR), CDC has served as an
implementing partner, providing technical expertise and program
oversight. The Committee directs continued coordination with
the State Department's Bureau of Global Health Security and
Diplomacy. The Committee provides funding to be programmed by
the CDC Director to sustain in-country health security
capacities with international partners, including global
capacity for HIV/AIDS, TB, and measles surveillance, laboratory
services, and related public health infrastructure and
activities for the prevention, detection, and response to
global emerging infectious diseases. The Committee further
directs CDC to prioritize existing CDC international staffing,
and to provide a briefing to the Committee not later than 90
days after enactment of this Act on the status of its
engagement with the Department of State, the agency's current
global health workforce capacity, overseas staffing footprint,
and plans to bolster core global health security and infectious
disease response capabilities.
Global Public Health Protection.--The Committee supports
CDC's global health security priorities, including responding
to public health emergencies, training and deploying
epidemiologists, and strengthening country capacity to detect
and respond to health threats. CDC's global health programs
provide a critical frontline defense by identifying and
containing public health threats before they destabilize
partner countries or reach the U.S. The Committee directs the
Department to sustain a skilled global workforce in partner
countries with the technical expertise, field presence, and
surge capacity necessary to rapidly respond to emerging health
threats and preserve U.S. leadership in global health security.
Parasitic Diseases and Malaria.--The Committee provides
funding for parasitic diseases and malaria prevention related
activities through the Emerging Infectious Diseases program
line within the CDC Center for Emerging Zoonotic and Infectious
Diseases.
Protecting Life in Global Health Assistance.--The Committee
notes that the Helms amendment prohibits Federal funds for
abortions in foreign aid programs. CDC has responsibility for
ensuring that recipients of awards made or administered by the
agency, including those funded through interagency transfers,
adhere to the terms and conditions of such awards. The
Committee directs CDC to continue taking steps to ensure
relevant grant management officers, grant management
specialists, and programmatic staff are effective in adhering
to the Helms Amendment.
PUBLIC HEALTH PREPAREDNESS AND RESPONSE
Appropriation, fiscal year 2026....................... $913,200,000
Budget request, fiscal year 2027...................... 489,000,000
Committee Recommendation.............................. 924,000,000
Change from enacted level......................... +10,800,000
Change from budget request........................ +435,000,000
The Public Health Preparedness and Response (PHPR) account
supports programs that build and strengthen national
preparedness for public health emergencies, both naturally
occurring and intentional. PHPR supports needs assessments,
response planning, training, epidemiology and surveillance, and
upgrades for laboratory capacity and communications systems.
Within the total, the Committee recommends the following
amounts:
------------------------------------------------------------------------
Budget Activity FY 2026 Enacted FY 2027 Committee
------------------------------------------------------------------------
Public Health Emergency $735,000,000 $750,000,000
Preparedness Cooperative
Agreement........................
Academic Centers for Public Health 9,200,000 - - -
Preparedness.....................
Ready Response Enterprise Data 30,000,000 35,000,000
Integration Platform & Center for
Forecasting Analytics............
CDC Preparedness and Response 139,000,000 139,000,000
Capability.......................
------------------------------------------------------------------------
Emergency Preparedness and Response.--The Committee
supports the CDC's efforts to provide guidance, technical
assistance, and resources, including emergency preparedness
epidemiologist and experts, to communities as they prepare for,
withstand, and recover from emergencies. Increasingly complex
and multi-state outbreaks, such as Measles, alongside major
events and mass gatherings across the country, including the
2026 World Cup, demonstrate the need for a nationwide public
health preparedness infrastructure which provides local health
departments the capability to rapidly detect, monitor, and
respond to health threats.
Response Ready Enterprise Data Integration (RREDI)
Platform/Center for Forecasting Analytics and Outbreak
Analytics (CFA).--The Committee provides increased funding for
the RREDI platform to enable rapid information sharing across
the U.S. government and with State and local health departments
during a public health response. The Committee encourages the
CDC to continue expanding enterprise response capabilities
within 1CDP, including improved data sharing with Federal,
State, tribal, local, and territorial partners. The Committee
further supports CFA in its goals to deliver actionable
analysis and response-ready modeling tools; generate practical
decision support products; and drive technological and analytic
innovation to guide public health action.
CDC-WIDE ACTIVITIES AND PROGRAM SUPPORT
Appropriation, fiscal year 2026....................... $646,570,000
Budget request, fiscal year 2027...................... 361,570,000
Committee Recommendation.............................. 506,570,000
Change from enacted level......................... -140,000,000
Change from budget request........................ +145,000,000
This account supports the Office of the Director as well as
public health leadership and support activities at CDC.
Within the total, the Committee recommends the following
amounts:
------------------------------------------------------------------------
Budget Activity FY 2026 Enacted FY 2027 Committee
------------------------------------------------------------------------
Public Health Leadership and $101,570,000 $101,570,000
Support & Office of the Director
appropriations...................
Office of Rural Health 6,000,000 7,000,000
appropriations (non-add).....
Infectious Diseases Rapid Response 25,000,000 35,000,000
Reserve Fund appropriations......
Public Health Infrastructure and 360,000,000 370,000,000
Capacity.........................
Public Health Infrastructure 270,000,000 270,000,000
and Capacity appropriations..
Public Health Infrastructure 90,000,000 100,000,000
and Capacity Transfer from
the Prevention and Public
Health Fund..................
------------------------------------------------------------------------
Automated External Defibrillators.--The Committee strongly
encourages CDC to support implementation of the Cardiomyopathy
Health Education, Awareness, Research and Training in Schools
Act, which provides funding for public schools to purchase
automated external defibrillators (AEDs). The Committee further
encourages CDC to assist States in expanding awareness and
educational resources for schools and families to better
identify and understand conditions that can lead to cardiac
arrest in youth.
Birthing experience and Maternity Care During Public Health
Emergencies and Natural Disasters.--In the face of public
health emergencies and natural disasters, pregnant and
postpartum patients need to take special measures to ensure the
health and safety of themselves and their children. To ensure
patients and providers have accurate, evidence-based
information on maternal and infant health risks during public
health emergencies and natural disasters, with a particular
focus on reaching pregnant and postpartum individuals in
underserved communities, the Committee encourages CDC to
convene a meeting of Federal; State, local, and/or territorial
public health officials; tribal public health officials; and
public stakeholders representing maternity care providers,
maternal and infant health focused community based
organizations, and patient voices to discuss measures to detect
maternal and infant health need and measures to facilitate
access and delivery of maternal and infant data during public
health emergencies and natural disasters.
Disease Modeling.--The Committee encourages CDC to work
with schools of public health and other academic institutions
to engage the nation's expertise in disease modeling, public
health data analysis, research, and training to build workforce
capacity in this emerging field.
Food Allergies.--The Committee recognizes food allergies as
a serious public health concern that affects children and
families across the U.S. and can result in severe, potentially
fatal anaphylactic reactions. The Committee encourages CDC to
support school-based efforts to address food allergies and
reduce the risk of allergic emergencies in schools.
Human Health Risks Posed by Wildlife.--The Committee is
concerned by the risk that imported wildlife pose to the
introduction of zoonotic diseases to the U.S. Therefore, the
Committee directs CDC and interagency partners to collaborate
toward work on implementing Objective 3.5 from the ``National
One Health Framework to Address Zoonotic Diseases and Advance
Public Health Preparedness in the United States,'' which
support the development, validation, and use of models and
tools for assessing zoonotic disease risks related to imported
wildlife. The Committee further directs CDC and implementing
partners to provide a briefing on its implementation of this
directive within 180 days of the enactment of this Act.
Indoor Air Quality.--The Committee encourages CDC to
conduct a study on how indoor air quality impacts pathogen
transmission including how increased use of outdoor air
ventilation, high-efficiency particulate air (HEPA) filtration,
and germicidal ultraviolet (GUV) light affect such
transmission.
Infectious Disease Rapid Response Reserve Fund (IDRRRF).--
The Committee provides increased funding for IDRRRF to ensure
that CDC remains positioned to respond quickly to an imminent
public health emergency. Congress first funded IDRRRF in 2019
to avoid the funding delays CDC experienced during prior large-
scale public health emergencies, including the 2014-2016 West
Africa Ebola outbreak. Since its inception, CDC has utilized
these flexible funds to respond to multiple domestic and global
outbreaks, including the Ebola outbreaks in 2019, 2021, 2022,
and most recently in 2025, when CDC worked with the Democratic
Republic of the Congo to provide laboratory, diagnostic, and
workforce capacity, and conducted case investigation, case
management, infection prevention and control, border health,
and risk communication and community engagement activities.
The IDRRRF is critical to helping prevent future outbreaks
from becoming public health emergencies. Therefore, the
Committee directs CDC to provide a detailed spend plan of the
planned uses of funds, including a narrative description of
planned and ongoing activities, within 30 days of enactment of
this Act, and to provide quarterly updates on such plan for any
active public health response. The Committee further directs
CDC to provide a table to the Committee each month, which shall
include all amounts available in the IDRRRF for the current
fiscal year and the preceding two fiscal years, including: (1)
each individual obligation above $5,000,000; (2) with respect
to each such obligation, the notification to which it relates;
and (3) the total amount unobligated in the IDRRRF.
Local Health Departments.--Federal funding intended for
both State and local health departments does not consistently
reach local health departments beyond those directly funded by
CDC. The Committee encourages CDC to require States to fund
local health departments when programmatically appropriate. The
Committee urges CDC to publicly track and report to the
Committee how funds provided to State health departments are
passed through to local health departments, including the
amount and date funds are made available, per grant award, by
local jurisdiction.
Myalgic encephalomyelitis/Chronic Fatigue Syndrome.--The
Committee supports CDC's work related to provider education and
public awareness for postural orthostatic tachycardia syndrome
(POTS) and other infection associated chronic conditions and
illnesses of dysautonomia, common chronic conditions that
impact millions of Americans and cause severe disability. The
Committee is concerned that 28 States do not have a board-
certified autonomic specialist resulting in POTS patients
facing on average a 5-year diagnostic delay and encourages the
CDC to work with patient advocates, clinicians, and researchers
to develop an education program for health care providers to
increase access to care for POTS and similar dysautonomia
patients.
Obesity.--The Committee recognizes obesity as a serious
chronic disease and public health and economic issue that must
be addressed. CDC formally recognizes obesity as a disease and
recommends that it be treated as such. Evidence-based
therapies, including innovative and highly effective obesity
medications (OMs) are available with others in development.
Expanded access to intensive behavioral therapy, such as CDC
recognized Family Healthy Weight Programs, and OMs, in addition
to existent surgical procedures, not only provide significant
weight loss reductions but lead to improved outcomes in over
200 obesity-related health conditions including diabetes,
coronary heart disease, and hypertension. The Committee
encourages CDC to take a comprehensive approach in treating
obesity as a chronic disease and find ways to improve access to
treatment options. The Committee also encourages CDC to
continue to collaborate with other Federal agencies who are
already treating obesity as a chronic disease as it considers
best practices to improve care for people with obesity.
Office of Rural Health.--The Committee is encouraged by
efforts from the agency to establish the CDC Office of Rural
Health (ORH) and ORH's early initiatives. The Committee directs
the agency to ensure that the established ORH will continue to
guide CDC's rural health leadership across the entire agency.
This includes by developing purposeful public health guidance
for rural health departments, analyzing and developing
initiatives to expand the rural public health workforce,
coordinating with the Federal Office of Rural Health Policy
under HRSA, and otherwise serving as a resource and technical
assistance hub for public health in rural communities. The
Committee includes funding for the continued efforts of this
office.
Peripheral Arterial Disease Prevalence (PAD).--Between 1995
and 2020, PAD prevalence in the U.S. increased from 11,300,000
to 21,000,000. Based on the aging population, by 2030 the
number of individuals with PAD is expected to increase to
23,800,000. The Committee encourages CDC, in collaboration with
HRSA, CMS, and leading clinical and patient advocacy
organizations, to establish a PAD education program.
Public Health Infrastructure.--The Committee notes that the
Public Health Infrastructure (PHI) program is intended, as
described in the explanatory statement that created it, to
support public health departments. Due to the historic failure
of CDC to support Tribes and tribal organizations with this
funding, the fiscal year 2026 agreement included a new
directive that 3 percent of this funding be designated
specifically for Tribes and tribal organizations. The provision
of a stable, disease agnostic funding line will better ensure
Tribes and tribal organizations are better equipped to
coordinate together to save lives. The Committee directs that
the CDC provide not less than 6 percent of such funding
provided for fiscal year 2027 to Tribes and tribal
organizations.
The Committee is concerned that the provision of funds to
national organizations and high programmatic assessment by the
CDC has undermined the ability of the program to effectively
support State, local, and territorial public health
organizations and directs that not less than 70 percent of this
funding be awarded to health departments.
Reporting.--The Committee is concerned that CDC abortion
surveillance reports, published annually in the CDC Morbidity
and Mortality Weekly Report, lack adequate participation by
States including incomplete submissions and even total
nonparticipation. The Committee requests a report on the extent
of data inconstancies; steps taken by CDC to improve data
completeness; and recommendations for legislative or regulatory
changes to achieve complete data.
Sleep Health and Sleep Disorders.--The Committee recognizes
that healthy sleep, like a healthy diet, contributes to
positive health outcomes. The Committee notes opportunities to
improve health and wellness through public health approaches to
sleep health and sleep disorders. Therefore, the Committee
encourages CDC to support sleep health and sleep disorder
initiatives, including awareness and educational activities at
the State and local levels. The Committee requests an update in
the fiscal year 2028 congressional justification on these
efforts.
Survey and Other Data Products.--The Committee notes the
proliferation of surveys and other data products related to
mental health within CDC and across HHS. As part of the Fiscal
Year 2028 Congressional Justification, the Committee directs
CDC, in collaboration with SAMHSA, NIH, and HRSA to include a
summary of all annual, biannual, quadrennial surveys or other
data products related to mental health.
Youth Electronic Cigarette Use.--The Committee recognizes
the growing challenge that schools undergo by increased use of
electronic cigarettes and other vaporizing equipment in their
facilities. These concerns often cause schools to lock bathroom
doors to prevent their use, but this can also pose a safety
risk. The Committee understands that there are commercially
available technologies that can detect vape smoke, THC, and
sound abnormalities in areas where cameras cannot be placed.
The Committee encourages CDC to clarify that funds may be used
for innovative detection technologies, and the Committee
encourages CDC to work with States and school districts to
increase awareness of this technology.
Youth Sports Injury Prevention Education.--Across the
country, communities continue to recognize the importance of
physical activity to maintain health, resulting in rapidly
growing youth sports activities. The Committee recognizes CDC's
Traumatic Brain Injury program for maintaining and updating
free educational resources and concussion prevention trainings
for coaches and parents of youth athletes through its HEADS UP
campaign. Additional research and education are needed to
examine sport and recreation injury across various activities
and demographic groups, in addition to age-related education
for prevention and management. Therefore, the Committee
provides increased funding to coordinate with respective State
health departments to develop public service announcements to
educate volunteer coaches and parents of children and youth
(ages 5-17) on the risks and means to prevent and manage
sports-related injuries.
BUILDINGS AND FACILITIES
Appropriation, fiscal year 2026....................... $40,000,000
Budget request, fiscal year 2027...................... 40,000,000
Committee Recommendation.............................. 40,000,000
Change from enacted level......................... - - -
Change from budget request........................ - - -
This account supports capital projects as well as repairs
and improvements to restore, maintain, and improve CDC's assets
and facilities. The Committee provides funding to continue
making progress on CDC's backlog of maintenance and repairs,
including at its Atlanta campuses.
The Committee continues language to allow CDC to retain
unobligated funds in the Individual Learning Accounts from
departed employees to support the replacement of the
underground and surface coal mine safety and health research
facility.
National Institutes of Health (NIH)
Appropriation, fiscal year 2026....................... $48,716,000,000
Budget request, fiscal year 2027...................... 42,967,953,000
Committee Recommendation.............................. 48,816,000
Change from enacted level......................... +100,000,000
Change from budget request........................ +5,848,047,000
The mission of NIH is to seek fundamental knowledge about
the nature and behavior of living systems and the application
of that knowledge to enhance health, lengthen life, and reduce
illness and disability. NIH conducts and supports research to
understand the basic biology of human health and disease; apply
this understanding towards designing new approaches for
preventing, diagnosing, and treating disease and disability;
and ensure that these approaches are widely available.
The Committee recommendation for the NIH program level is
$48,816,000,000 which includes $1,500,000,000 in funding for
the Advanced Research Projects Agency for Health (ARPA-H).
Excluding ARPA-H, the Committee provides $45,888,518,000 in
discretionary appropriations for the Institutes and Centers of
NIH and $1,427,482,000 in PHS Act section 241 evaluation set
aside transfers.
The Committee recommendation supports increased investments
in NIH-funded research, to drive more scientific discoveries
that translate into improved health for all Americans and to
maintain U.S. leadership in biomedical research. The
recommendation provides both broad-based funding increases, for
NCI, NHLBI, NIDCR, NIDDK, NINDS, and NIAID, as well as targeted
increases to make more resources available for NIH-funded
research in specific areas or initiatives.
The Committee commends the NIH for its commitment and
ongoing actions aimed at restoring public trust in the
institution and in the scientific research it supports both
intramurally and extramurally. Such efforts include
prioritizing rigor and replication for Federally funded
research, ensuring increased oversight of NIH grants, and a
renewed standard that Federal research investments must drive
measurable improvements in the health of all Americans. NIH
maintains a critical role in advancing our scientific
understanding of human health and disease to improve overall
health outcomes. The Committee appreciates NIH's efforts to
remain nimble in response to rapidly evolving science and open
to incorporating new tools and technologies, adhere to its
fundamental mission, and steward Federal taxpayer dollars
responsibly. It is equally vital for U.S. competitiveness that
the NIH remains the world pioneer in basic scientific and
biomedical research. The Committee looks forward to continuing
to work with the Administration and NIH to advance these goals.
NATIONAL CANCER INSTITUTE
Appropriation, fiscal year 2026....................... $7,352,159,000
Budget request, fiscal year 2027...................... 7,353,000,000
Committee Recommendation.............................. 7,462,159,000
Change from enacted level......................... +110,000,000
Change from budget request........................ +109,159,000
Mission.--NCI leads, conducts, and supports cancer research
across the nation to advance scientific knowledge and help all
people live longer, healthier lives.
Breast Cancer Screening Evidence Gaps.--The United States
Preventive Services Task Force (Task Force) breast cancer
screening recommendation statement, published in April 2024,
identifies several critical research gaps that restrict the
Task Force from making evidence-based recommendations that
address multiple important areas. For example, the Task Force
notes that research is needed: to better understand whether and
how the benefits quantitatively differ for annual vs. biennial
breast cancer screening; to help clinicians and patients
understand the best strategy for breast cancer screening in
women found to have dense breasts on a screening mammogram,
such as supplemental screening; and to understand and address
the higher breast cancer mortality among Black women. Breast
cancer is the second most common cancer among women in the
U.S., and over 40,000 women are expected to die from breast
cancer in 2026. For the Task Force to fulfill its mission to
improve health through actionable preventive services
recommendations, the Committee urges the NIH to continue to
support research in the areas outlined in the Evidence Gaps
Research Taxonomy Table from the USPSTF's 2024 Breast Cancer
Screening Recommendation Statement to ensure the Task Force has
the necessary evidence to create the strongest evidence-based
recommendations for all women and further reduce breast cancer
morbidity and mortality, especially among those with the
greatest burden of disease. The Committee encourages that these
efforts should continue to prioritize the inclusion of women of
all racial and ethnic groups to investigate whether the
effectiveness of screening, diagnosis, and treatment vary by
group. The Committee requests an update on this effort in the
fiscal year 2028 congressional justification.
Cancer Centers.--The Committee recognizes the role of NIH
designated cancer centers in supporting high-quality,
interdisciplinary cancer research with the goal of reducing
cancer incidence, mortality, and morbidity. This support
facilitates coordination across a broad spectrum of research--
from basic laboratory science to clinical investigation and
population health--by strengthening the organizational capacity
of cancer centers nationwide. The Committee encourages
continued support of these efforts.
Cancer Clinical Trials.--Clinical Cancer trials are pivotal
to translating scientific discoveries into new medications and
treatment options for patients. Clinical trials rely on
successful recruitment and enrollment of patients, yet the
Committee is concerned that clinical trials remain out of reach
for many Americans, with only 7 percent of patients with cancer
participating in clinical trials. Lengthy time to trial
activation can prevent trials from meeting accrual goals and
slow innovation, and navigating complex regulatory systems can
contribute to delays in activating clinical trials. The
Committee urges NCI to include an update in the fiscal year
2028 congressional justification on how it is addressing
barriers to aid NCI-designated cancer centers in improving time
to trial activation and accrual. The Committee also notes that
the lack of genomic variance in cancer clinical trials is
compromising our ability to understand how certain cancers
affect populations differently and hindering the development of
treatment and therapies. Therefore, the Committee encourages
this update to also include information on efforts to ensure
participation of underrepresented populations in clinical
trials.
Cancer Immunotherapy.--The Committee is aware of emerging
personalized dendritic and other promising cell--based
therapeutic platforms with the potential to improve immune-
mediated treatment responses across multiple cancer types. The
Committee encourages NCI to consider expanded support for
translational, manufacturing, and clinical evaluation efforts
that advance these broadly applicable patient-derived
immunotherapy strategies toward scalable, multi-center
implementation.
Cancer Survivorship Research.--Significant advancements in
early detection and treatments of many cancers have resulted in
a rapidly growing community of individuals living with and
beyond a diagnosis. There are currently more than 18.6 million
cancer survivors in the U.S., and for many, cancer can become a
chronic condition. The Committee encourages continued support
by NIH in cancer survivorship research, including essential
elements of survivorship care.
Cancer Vaccines.--While much progress has been made in the
study of mRNA cancer vaccines, and the mRNA vaccine platform
continues to hold tremendous potential in oncology, additional
advances from ongoing research are needed to hasten the
development of personalized cancer therapies using this
technology. Findings from NCI-supported research will inform
progress in this promising field. The Committee urges NIH to
ensure robust support for research that moves the field forward
for cutting-edge research for mRNA-based cancer immunotherapy,
leveraging collaborations with interested parties. Areas of
opportunity include enhancing immune recognition of solid
tumors, overcoming immune suppression in the tumor
microenvironment, personalization of mRNA vaccines, and
minimizing adverse effects. These strategies have high
potential for increasing the effectiveness for cancer
immunotherapy treatment and prevention. Additionally, the
Committee commends NCI's efforts to launch a public-private
partnerships that intends to invest $200,000,000 in combined
Federal agency and private sector funding to support clinical
evaluation of cancer vaccines. The Committee requests an update
on NCI's progress in these areas in the fiscal year 2028
congressional justification.
Childhood Cancer Data Initiative (CCDI).--The Committee
includes no less than $60,000,000 for the CCDI, which is a
$10,000,000 increase from the fiscal year 2026 enacted level.
CCDI focuses on the critical need to collect, analyze, and
share data to address the burden of cancer in children,
adolescents, and young adults. The Committee supports NIH's
efforts to advance AI integration in pediatric cancer
diagnosis, treatments, and studies, consistent with Executive
Order 14355, ``Unlocking Cures for Pediatric Cancer with
Artificial Intelligence.'' The Committee notes the ongoing
efforts of the CCDI Molecular Characterization Initiative,
which collects data that is used to identify risk factors, aid
in prognostication and treatment recommendations, inform
potential clinical trial participation, and assist with the
development of novel therapeutics for these diseases.
Childhood Cancer STAR Act.--The Committee includes no less
than $30,000,000 from amounts made available under this
heading, the same as the fiscal year 2026 enacted level, for
continued implementation of sections of the Childhood Cancer
Survivorship, Treatment, Access, and Research (STAR) Act (P.L.
115-180). This funding expands opportunities for childhood
cancer research, improves efforts to identify and track
childhood cancer incidences, and enhances the quality of life
for childhood cancer survivors. While some progress has been
made in pediatric cancer research--leading to a decline in
childhood cancer deaths by almost 70 percent over the last four
decades--cancer is still the leading cause of death by disease
past infancy among children in the U.S. While survival rates
for some forms of childhood cancer, such as leukemia, have
increased to greater than 85 percent, the median survival rate
for other childhood cancers, such as diffuse intrinsic pontine
glioma, is less than one year. STAR Act funding supports
critical research infrastructure, surveillance, and
survivorship programs that fundamentally change the lives of
pediatric blood cancer patients and survivors. NCI has been
able to expand its efforts to collect cancer tissue specimens
from children with cancer for which current treatments are
least effective, making samples more available to researchers
to develop the next breakthrough. The STAR Act funds important
research to further our understanding of the complications
survivors face later in life and of models to improve care as
survivors transition to primary care.
Colorectal Cancer and Early Onset Colorectal Cancer
Research.--The Committee recognizes that colorectal cancer
remains one of the leading causes of cancer-related deaths in
the U.S. in individuals under the age of 50. The Committee
urges NCI to continue supporting colorectal cancer research,
including basic, translational, and clinical research and
trials; improved screening and prevention strategies; and
efforts to address disparities in access to care and outcomes.
Additionally, the Committee is concerned about the steep
increase in incidence of colorectal cancer among younger
Americans and strongly encourages NIH to provide robust funding
for research on early onset colorectal cancer. The Committee
requests NIH include an update in the fiscal year 2028
congressional justification on NIH research activities and
funding into colorectal cancer, including early onset
colorectal cancer, and research into effective therapies and
treatments to reduce mortality.
Deadliest Cancers.--The Recalcitrant Cancer Research Act of
2012 focuses on cancers with a 5-year survival rate below 50
percent, which account for over 40 percent of all U.S. cancer
deaths. While advances in treatments of some cancers have made
it possible to reduce the overall rate of cancer deaths, there
has been limited progress in reducing mortality for these
diseases. The Committee encourages NCI to continue its focus on
these cancers, which include cancers of the brain, esophagus,
liver, lung, ovaries, pancreas, stomach, and mesothelioma and
requests an update on research focused on each of these areas
in the fiscal year 2028 congressional justification. Further,
given the high mortality rates for these cancers, the Committee
remains concerned about reports of increased incidence of
esophageal, liver, pancreas, and stomach cancer among young
adults and adolescents. The Committee urges the NCI to continue
to support research to understand the causes and risk factors
leading to these increased incidences, as well as potential
interventions, and requests an update in the fiscal year 2028
congressional justification.
Functional Precision Medicine.--The Committee has a long
history of working to address refractory cancers and the lack
of treatment options currently available when standard of care
has been exhausted. The Committee is encouraged by the promise
of functional precision medicine approaches to identify
individualized treatment options more rapidly for hard-to-treat
cancers, especially with minority populations. Recent data
showing the clinical utility of combining patient-specific drug
sensitivity testing and genomic profiling to treat refractory
cancers has proven to be potentially lifesaving. The Committee
supports efforts to further validate the clinical utility and
accessibility of functional precision drug testing approaches,
to guide therapeutic interventions and accelerate collaboration
across research and clinical institutions in the nation. The
Committee requests an update on this topic in the fiscal year
2028 congressional justification.
Improving Native American Cancer Outcomes.--The Committee
directs NCI to continue its coordination with NIMHD on the
Initiative for Improving Native American Cancer Outcomes, to
ensure alignment of research priorities, dissemination of
findings, and enhancement of cancer prevention and treatment
strategies in Native American populations.
Liver Cancer.--Primary liver cancer has a dismal 5-year
survival rate of only 22 percent, is the 3rd most common cause
of cancer death in the U.S., and, unlike most cancers, the rate
of liver cancer mortality continues to increase. The Committee
urges NCI to continue the use of program projects, cooperative
research and broad agency announcements, and other contract
mechanisms to develop, study, and validate promising and
innovative approaches to liver cancer risk stratification and
early detection, including new biomarkers, advanced imaging
incorporating AI, radiomics, deep learning tools, and risk
stratifying algorithms.
Medical Imaging Technologies in Cancer Screening Trials.--
The Committee supports clinical trials conducted by the NCI to
assess the potential role of blood tests to detect cancer in
the body. Medical imaging, as a means of conducting a
diagnostic workup following a positive assay and as a method
for disease characterization, is essential to this clinical
trial and assessment process, and is the current standard of
care for validation of positive cancer blood test results.
Imaging is a known necessity for a cancer diagnosis and
treatment and should continue to hold a core function in the
clinical trial process. The Committee encourages NCI to include
imaging technologies and tools in these clinical trials, as
they are the essential component of each precise cancer
diagnosis and help ensure patients receive effective care.
Metastatic Breast Cancer.--The Committee is aware that
clinical research is of utmost importance to those living with
metastatic breast cancer (MBC), which is breast cancer that has
spread to other organs and become incurable. An estimated
168,000 Americans live with MBC, and nearly all the more than
43,000 deaths from breast cancer are attributed to this late
stage of disease. Given the mortality associated with MBC and
the lack of treatment options, research offers the best
possibility of therapeutic advances and extended life for these
patients. MBC is also associated with startling health
disparities, since breast cancer mortality is about 40 percent
higher for Black women in the U.S. than Caucasian women and
breast cancer is the second most common cause of death by
cancer for Black women. The Committee encourages a continued
emphasis by NCI on research for MBC, to discover better
treatments and a cure for MBC and to address health disparities
in this population. The Committee requests an update on NCI's
activities regarding MBC in the fiscal year 2028 congressional
justification.
Metastatic Uveal Melanoma.--The Committee recognizes that
metastatic uveal melanoma is a rare but challenging eye cancer.
Up to half of patients who are successfully treated for primary
uveal melanoma subsequently develop systemic metastasis,
especially in the liver. Compared to metastatic cutaneous, or
skin, melanoma, immune checkpoint inhibitors rarely work for
metastatic uveal melanoma, and there is an unmet need for
improving the management of otherwise treatment-resistant
disease. The Committee urges NCI to support research into
better understanding the mechanisms of disease progression and
to expand access to early-phase clinical trials for metastatic
uveal melanoma. Such efforts could lead to improved survival
rates for these patients. The Committee also emphasizes
approaches that preserve vision and prevent systemic recurrence
after treatment of primary uveal melanoma.
Natural Products Research.--Research shows that derivatives
from natural products have been an important source of
clinically useful anti-cancer agents, yet not enough evidence-
based research has been done to strategically identify those
compounds that could provide potential benefits in cancer
treatment. The Committee believes that it is important to fully
explore whether and how natural products could be beneficial to
patients in reducing the toxicity of therapy or by enhancing
therapeutic efficacy as a primary or adjunctive therapy.
Therefore, the Committee encourages NCI to expand its support
of research to evaluate the potential value of natural products
in reducing adverse effects of cancer therapy and in enhancing
therapeutic efficacy through basic, translational, and clinical
trials research. NCI is encouraged to seek applicants that have
a demonstrated expertise in natural products research, can
conduct a holistic review of drugs and disease states, have
access to an annotated inventory of natural products, and can
test the safety and efficacy of natural products in communities
experiencing high rates of health care disparities in access to
cancer care.
Oligodendroglioma.--The Committee encourages NCI to
continue its research into brain tumors, including rare tumor
types such as isocitrate dehydrogenase (IDH) mutant
oligodendroglioma for which no cure currently exists. The
Committee is aware of recent advancements in the treatment of
this cancer and that future research findings could be applied
across other IDH-mutant cancers. Continued research into
oligodendroglioma and other rare brain cancers can further
advance treatments and ultimately produce a cure for the nearly
15,000 individuals living with the disease.
Pediatric Brain Cancer Research.--Pediatric brain cancer
remains the leading cause of cancer-related death in children.
The Committee is aware that in 2025, NCI ended funding for the
Pediatric Brain Tumor Consortium (PBTC) and began transitioning
early phase trials previously conducted by PBTC to the
Pediatric Early Phase Clinical Trials Network (PEP-CTN), which
is a larger network of early trials for all childhood cancers
with the capability of expanding these PBTC trials to 42 sites,
as appropriate. The Committee urges support of this transition
to ensure PEP-CTN can utilize its expertise and shepherd this
research portfolio. Because of the importance of advancing
critical pediatric brain tumor research and building on prior
investments and years of work, the Committee encourages NCI to
consider ways to continue current trials in PBTC's pipeline,
conduct analysis of highly valuable imaging, and continue
support for immunotherapy trials for pediatric brain tumors.
Additionally, the Committee encourages NCI to continue to
support research and initiatives specifically focused on
pediatric brain cancer and requests an update in the fiscal
year 2028 congressional justification on the transition to the
PEP-CTN as well as ongoing efforts to combat pediatric brain
tumors, including any stand-alone initiatives.
Pediatric Rare Cancer Therapeutic Development.--Childhood
cancers are rare and need specialized treatments, rather than
just lower-doses of treatments that adults receive. Each type
of cancer requires appropriate therapeutic approaches to save a
child's life or significantly improve quality of life and
extend a child's lifespan, yet many types of childhood cancer
do not yet have effective curative treatments available. The
Committee encourages NIH to continue to examine novel systems
for identifying how rare cancers develop and progress, and to
continue to support and accelerate development and evaluation
of life-saving therapeutics for pediatric cancer patients.
Prostate Cancer.--The Committee remains concerned that
prostate cancer, the most diagnosed cancer among American men
and the second leading cause of cancer-related death, receives
a disproportionately low share of Federal cancer research
funding. It accounts for approximately 15 percent of all new
cancer diagnoses and 11 percent of cancer deaths in men but
receives approximately 8 percent of the Federal government's
total cancer research budget. The Committee notes that when
detected early, it has a 99.9 percent survival rate. The
Committee encourages robust funding for prostate cancer
research at NCI, including to support improved diagnostics,
imaging technologies, and treatments for men with advanced
disease.
Surveillance, Epidemiology, and End Results Program.--The
Committee recognizes the importance of the NCI Surveillance,
Epidemiology, and End Results (SEER) program for building and
maintaining a comprehensive, population-based database on
cancer incidence, prevalence, and patient survival. The program
provides valuable information used by researchers, clinicians,
and others on trends in cancer rates, including for different
population groups such as children, as well as information on
the stage of disease individuals have at diagnosis and how that
has changed over time. The Committee urges continued funding
for SEER at levels necessary to continue nationwide cancer
surveillance activities. The Committee particularly encourages
continued assessment of the need for ongoing research in this
area, especially in areas with high prevalence of cancer,
including pediatric cancers.
Theranostics.--Theranostics is a nuclear medicine technique
that combines diagnostic imaging and targeted
radiopharmaceutical therapies to precisely identify and treat
diseases like cancer. This cutting-edge technology uses
diagnostic imaging to identify and target cancer cells and is
an innovative, precision medicine technique that allows for
personalized treatment of cancers--such as thyroid cancer,
prostate cancer, and neuroendocrine tumors--while sparing
healthy tissue around the tumor. The Committee encourages NCI
to support research that utilizes theranostics, and where
appropriate, to provide early, accurate, and effective cancer
diagnosis and treatment.
NATIONAL HEART, LUNG, AND BLOOD INSTITUTE (NHLBI)
Appropriation, fiscal year 2026....................... $3,990,345,000
Budget request, fiscal year 2027...................... 3,699,975,000
Committee Recommendation.............................. 4,013,345,000
Change from enacted level......................... +23,000,000
Change from budget request........................ +313,370,000
Mission.--NHLBI provides global leadership for research,
training, and education program to promote the prevention and
treatment of heart, lung, blood, and sleep disorders and
enhance the health of all individuals so that they can live
longer and more fulfilling lives.
Alpha-1 Antitrypsin Deficiency.--Alpha-1 Antitrypsin
Deficiency (AATD) is a genetic condition and leading hereditary
cause of chronic obstructive pulmonary disease and liver
disease. Current FDA-approved treatments are limited to plasma-
derived augmentation therapies requiring weekly infusion. No
treatments exist for Alpha-1-associated liver disease, and it
has been more than 35 years since the last FDA approval of a
next-generation therapy. The Committee supports NHLBI's
research into disease mechanisms and emerging therapeutic
approaches including gene therapy, gene editing, and RNA-based
therapies.
Bronchiectasis.--The Committee is aware that bronchiectasis
is a heterogeneous disease with multiple causes and that there
is a need for research to identify various endotypes to
determine specific interventions through precision medicine.
The Committee encourages NHLBI to support the development of
tests that would enable clinicians to predict this disease
activity and appropriate treatment approaches.
Cardiomyopathy Research.--The Committee encourages NHLBI to
expand and coordinate cardiomyopathy research, as authorized in
the Cardiomyopathy Health Education, Awareness, and Research,
and AED Training in the Schools Act of 2024 (P.L. 118-176).
Consistent with this Act, the Committee encourages NHLBI to
research the causation of cardiomyopathy, including genetic
causes and molecular biomarkers and long-term health outcomes
in individuals with cardiomyopathy, as well as facilitate
studies using longitudinal data and retrospective analysis to
identify effective treatments.
Chronic Lung Disease.--Chronic lung diseases, including
chronic obstructive pulmonary disease (COPD), are among the
leading causes of death and chronic illness in the U.S. COPD is
also a leading cause of disability and a large contributor to
healthcare spending. Most chronic lung disease research to date
has focused on later stages of disease when substantial loss of
lung function and damage to lung tissue have occurred. There is
a need for treatments that, when applied early in the course of
disease, can more effectively slow the progression and mitigate
lung tissue damage. NHLBI supports a wide array of basic and
translational research into these conditions, and additional
support could improve our understanding of early disease and
identify targets to modulate disease progression before
irreversible damage has occurred. NHLBI-funded cohort studies
such as the COPDGene and SPIROMICS projects have provided
significant insights into the biology of early disease in COPD.
The Committee notes the opportunity to test promising
treatments in proof-of-concept clinical trials, including both
new drugs and the repurposing of drugs approved for other
indications, to identify appropriate therapeutic targets and
generate the evidence to support later stage efficacy and
effectiveness in clinical trials. The Committee encourages
NHLBI to increase support for these and other early chronic
lung disease research activities.
Coronary Artery Risk Development in Young Adults.--The
Committee encourages continued support of the Coronary Artery
Risk Development in Young Adults (CARDIA) study. The CARDIA
study examines the factors that contribute to the development
of cardiovascular disease and enables researchers to perform
analyses of predictors of clinical events, study the
progression of risk factors subclinical to clinical
cardiovascular disease, and identify new risk factors or
interactions among risk factors that inform disease
pathophysiology.
Longitudinal Studies.--The Committee encourages continued
support of instrumental longitudinal studies that have created
a tremendous knowledge base and data around human health,
including the Framingham Heart Study, Strong Heart study,
Jackson Heart study, and RURAL study. These studies have
supported researchers' understanding of risk factors for heart
attacks and strokes across generations.
Mitochondria in Cardiovascular Disease.--The Committee
recognizes that heart failure and arrhythmias affect millions
of Americans, and despite advances in therapies, their
prognosis remains poor. The pathogenic mechanism involves
mitochondria, which are central to cardiac health, but due to
their sub-micrometer size and structural and functional
complexity, mitochondrial pathogenesis remains difficult to
address. The Committee urges NHLBI to increase its investment
in both preclinical and translational research aimed at the
development of technology that makes mitochondria accessible,
which could include functional and structural imaging combined
with AI, and identifying mitochondrial disease mechanisms and
mitochondrial targets for therapy.
Mitral Valve Prolapse Workshop.--The Committee commends
NHLBI for convening a 2024 workshop, to review the state of the
science and identify research needs and opportunities for the
treatment of individuals with mitral valve prolapse, including
individuals who are at risk of sudden cardiac arrest or sudden
cardiac death. The Committee urges NHLBI to continue engaging
with subject matter experts and stakeholders regarding research
needs and opportunities related to developing guidelines for
treatment of individuals with mitral valve prolapse.
Polyendocrine Metabolic Ovarian Syndrome.--The Committee
urges NHLBI to support research on the cardiovascular and
cardiometabolic consequences of polyendocrine metabolic ovarian
syndrome (PMOS), a condition affecting up to 15 percent of
women. The Committee recognizes that individuals with PMOS face
a significant cardiovascular disease burden that is not well
understood or adequately addressed through current treatment.
Research indicates that individuals with PMOS face an increased
risk of cardiovascular disease compared to those without the
condition. Additionally, the mechanisms driving cardiovascular
risk in PMOS remain unclear. There is no single effective
treatment for PMOS, and management is directed at specific
symptoms and cardiometabolic risk factors in this population.
Pharmacological interventions, however, have not been
rigorously evaluated in clinical trials for cardiovascular
outcomes. The Committee urges NHLBI to support research on the
mechanisms underlying cardiovascular risk in PMOS, including
longitudinal studies of cardiometabolic risk trajectories
across the lifespan, and clinical research evaluating the
safety and efficacy of pharmacological interventions to reduce
cardiovascular risk in this population.
Sarcoidosis.--Sarcoidosis is a rare disorder affecting
multiple organs in the body, most frequently in the lungs and
lymph nodes, and for some it can result in rapid deterioration
of the affected organ and be fatal. Some individuals with this
disease can manage it with medications such as corticosteroids,
but some types of this disease do not respond to existing
treatments. The Committee encourages NHLBI research into
sarcoidosis to drive novel prevention and treatment options.
Sickle Cell Disease and Sickle Cell Trait.--The Committee
encourages NIH to further its clinical research in Sickle Cell
Disease (SCD) and Sickle Cell Trait, which includes promising
approaches to eradicate the disease, save lives, and
dramatically reduce the substantial health care complications
and costs associated with SCD for both children and adults. The
NIH is encouraged to consider research into the effectiveness
of screening technologies for infants and children with sickle
cell trait and disease and research that could help spur
innovative technology and medicines to treat and cure SCD.
Sleep Research and Chronic Disease.--The Committee notes
the recent progress made in sleep research, leading to
innovative therapies, improvements in care, and better
outcomes. The Committee further notes the efforts of NHLBI's
National Center on Sleep Disorders Research and encourages
enhanced collaboration with other Institutes and Centers, the
U.S. Public Health Service Commissioned Corps, and other
Federal research entities to seek new research opportunities,
including as relates to neurodegeneration and pediatric chronic
disease.
Valvular Heart Disease Research.--Heart-valve disease
occurs if one or more of an individual's valves malfunctions,
and many people in the U.S. can have heart valve defects or
disease but no symptoms. While the condition remains stable for
some individuals and does not cause significant or life-
threatening problems, unfortunately more than 25,000 people die
each year in the U.S. from this disease, primarily due to
underdiagnosis and undertreatment. The Committee commends the
NHLBI for its work in advancing treatments for those with
valvular heart disease. The Committee encourages the agency to
expand these initiatives to include research that advances
technological imaging and precision medicine to generate data
on valvular disease, identifies individuals who are at high
risk of sudden cardiac death because of valvular disease,
develops prediction models for high-risk patients, and enables
interventions and treatment plans to keep these patients
healthy throughout life. For these efforts the Committee
includes $26,000,000, an increase of $3,000,000 from the fiscal
year 2026 enacted level, in funding to the NHLBI for this
activity.
Wildland Fire Smoke.--The Committee is concerned that
public health experts do not yet fully understand the risk
posed by exposure to wildland fire smoke, particularly acute
and chronic smoke exposure to patients with existing pulmonary
and cardiac disease. The Committee encourages NHLBI to support
research to understand the risk smoke exposure has for patients
with underlying health conditions and interventions that could
mitigate adverse health effects.
NATIONAL INSTITUTE OF DENTAL AND CRANIOFACIAL
RESEARCH (NIDCR)
Appropriation, fiscal year 2026....................... $525,163,000
Budget request, fiscal year 2027...................... 490,163,000
Committee Recommendation.............................. 535,163,000
Change from enacted level......................... +10,000,000
Change from budget request........................ +45,000,000
Mission.--The mission of NIDCR is to advance fundamental
knowledge about dental, oral, and craniofacial health and
disease and translate these findings into prevention, early
detection, and treatment strategies that improve overall health
for all individuals and communities across the lifespan.
Community Water Fluoridation.--The Committee notes the role
of community water fluoridation in public health as an
effective, economical, and evidence-based intervention for the
prevention of dental caries. The Committee is aware of concerns
regarding fluoride exposure and its potential impact on human
neurodevelopment and cognition. The Committee encourages NIDCR
and other institutes at NIH already conducting research in this
area such as NIEHS and NICHD, to support additional research to
investigate any possible links between total fluoride exposure
from fluoridated water systems and human neurodevelopment,
cognition, and other health outcomes.
Dental, Oral and Craniofacial Tissue Regeneration
Consortium.--The Committee commends NIDCR for establishing a
multidisciplinary Dental, Oral, and Craniofacial Tissue
Regeneration Consortium that is accelerating the development of
promising treatments to regenerate tissues of the head and
face. The program supports the advancement of potential
treatments from early laboratory research through clinical
trials and commercialization, aiming to develop combination
cell-, biologic-, and device-based products ready for FDA
submission and clinical use.
National Dental Practice-Based Research Network.--The
Committee recognizes the critical role of the NIDCR's National
Dental Practice-Based Research Network, which unites practicing
dentists and academic researchers to conduct real-world
clinical studies that directly inform and improve oral health
care. The Committee urges NIDCR to continue to support research
to advance oral health.
Oral Health Research.--The Committee reaffirms that oral
health care and its maintenance are integral to the medical
management of numerous diseases and medical conditions and that
the lack of medically necessary oral health care heightens the
risk of costly medical complications. The Committee appreciates
NIH's support for research that has demonstrated that dental
care is closely linked to the clinical success of other covered
medical services and urges NIH to fund additional research in
this area. Continued research on the causal mechanisms that
link untreated oral microbial infections and chronic systemic
conditions will provide clinical evidence that can be used to
support coverage of medically necessary dental treatment in
various benefit programs.
Practice-Based Research in Dental School Clinics.--The
Committee commends NIDCR for extending practice-based research
into dental school clinics, through the Practice-Based Research
Integrating Multidisciplinary Experiences in Dental Schools
(PRIMED) initiative, which serves safety net providers and
where oral health studies take place at the point of care. The
program supports the creation of an academic multidisciplinary
research culture as an integral part of dental education that
will support life-long clinical research skills development and
research experiences.
NATIONAL INSTITUTE OF DIABETES AND DIGESTIVE AND KIDNEY DISEASES
(NIDDK)
Appropriation, fiscal year 2026....................... $2,326,721,000
Budget request, fiscal year 2027...................... 2,159,629,000
Committee Recommendation.............................. 2,348,721,000
Change from enacted level......................... +22,000,000
Change from budget request........................ +189,092,000
Mission.--The NIDDK mission is to conduct and support
medical research and research training and disseminate science-
based information on diabetes and other endocrine and metabolic
diseases; digestive diseases, nutritional disorders, and
obesity; and kidney, urologic, and hematologic diseases, to
improve people's health and quality of life.
Alpha-1 Liver Disease.--The Committee recognizes Alpha-1 as
a leading genetic cause of pediatric liver transplantation and
a contributor to adult liver failure. Therefore, the Committee
encourages NIDDK to expand research into the natural history
and progression of Alpha-1 liver disease, support development
of non-invasive biomarkers for liver involvement, to coordinate
with NHLBI and NHGRI to advance integrated lung-liver research
strategies, and consider opportunities to support early
detection strategies, including newborn screening research
pilots.
Chronic Kidney Disease.--The Committee notes the
significant health burden caused by chronic kidney disease
(CKD). According to the CDC, an estimated 37 million people, or
more than 1 in 7 U.S. adults, have CKD. The Committee is aware
that poor kidney function can lead to other burdensome or
debilitating conditions. The Committee notes the opportunities
for NIH-funded kidney research to advance early detection,
prevention, novel therapeutics, and transformative approaches
to kidney diseases. The Committee encourages robust support for
kidney research at NIDDK and requests an update on such
research in the fiscal year 2028 congressional justification.
The Committee also encourages NIDDK to coordinate with other
Federal agencies, such as ARPA-H, CMS, and the Department of
Veterans Affairs, as appropriate, to accelerate high-risk,
high-reward research and innovation, strengthen evidence
development, and support models that facilitate the translation
of kidney innovations into clinical practice.
Diabetes.--The Committee encourages NIDDK to continue
robust investments in diabetes research. The Committee
encourages NIH to focus efforts on Type 1 Diabetes.
Diabetic Eye Disease.--The Committee notes the connection
between diabetes and eye health. The Committee encourages the
Institute to engage with relevant ICs and stakeholders to
identify collaborative opportunities to improve research and
community-level intervention activities in diabetic eye
disease.
Prevention Research and Inflammatory Bowel Disease.--The
Committee is encouraged by emerging research indicating that
Inflammatory Bowel Disease--also known as Crohn's Disease and
ulcerative colitis--may be detectable at stages early enough to
enable timely interventions. The Committee encourages NIDDK to
build upon this knowledge by supporting research into measures
to prevent and manage the onset of disease symptoms and disease
progression. The Committee also recognizes the need to
establish nutrition research priorities, identify knowledge
gaps, and better understand precision nutrition and dietary
responses to address diet-related chronic diseases. The
Committee urges NIDDK to support research focused on developing
evidence-based dietary intervention recommendations to prevent
and manage Crohn's disease and ulcerative colitis.
Special Diabetes Program.--The Committee notes the role of
the Special Diabetes Program, which is supported by mandatory
funding under 42 U.S.C. 254c-2, in advancing research on the
prevention and cure of Type 1 Diabetes.
NATIONAL INSTITUTE OF NEUROLOGICAL DISORDERS AND
STROKE (NINDS)
Appropriation, fiscal year 2026....................... $2,804,925,000
Budget request, fiscal year 2027...................... 2,601,557,000
Committee Recommendation.............................. 2,866,925,000
Change from enacted level......................... +62,000,000
Change from budget request........................ +265,368,000
Mission.--The NINDS mission is to seek fundamental
knowledge about the brain and nervous system and use that
knowledge to reduce the burden of neurological disease.
Accelerating Access to Critical Therapies for ALS Expanded
Access Grants.--The Committee notes that Amyotrophic Lateral
Sclerosis (ALS) remains fatal, with most individuals surviving
only two to five years after symptom onset. Federal investments
can help increase the promise of emerging therapies, so that
patients have access to and can benefit from these therapies.
In addition to encouraging more research broadly for
Amyotrophic Lateral Sclerosis (ALS), the Committee includes
$85,000,000, which is the same as the fiscal year 2026 enacted
level, to support expanded access grants as authorized in the
Accelerating Access to Critical Therapies for ALS Act (P.L.
117-79). The Committee continues to direct NIH to handle this
funding as separate from, not competitive with, other funding
for research on ALS. The Committee encourages NINDS and OD to
continue to strengthen the expanded access grant application
process as discussed in the joint explanatory statement which
accompanied the fiscal year 2023 consolidated appropriations
Act. The Committee commends efforts by NINDS to engage
stakeholders and grow the sustainability of this program. These
grants support treatment with investigational drugs for people
with ALS who are ineligible for clinical trials.
The Committee further urges that safety and efficacy data
generated through the Expanded Access Program be collected and
structured to produce regulatory-ready evidence, ensuring
therapies can move efficiently through approval pathways and
reach all people living with ALS as quickly as possible.
Furthermore, after the review and award of meritorious
applications under section 2, the Committee recommends NIH
apply any unused funds to programs authorized under ACT for ALS
including section 3 public-private research partnership and
section 5 Rare Neurodegenerative Disease Grant Program at FDA,
as well as the NIH ALS Strategic Priorities.
Additionally, the Committee notes the ongoing Access for
ALL in ALS natural history study that has already enrolled more
than 1,500 individuals, including individuals living with ALS
and individuals at genetic risk to develop ALS.
ALS Research and Treatments.--ALS is a rare, rapidly
progressing, and universally fatal neurological disease. While
there is no cure, recent scientific breakthroughs in gene-
targeted therapies, biomarker development, and precision
medicine offer unprecedented opportunity. Sustained and
enhanced NIH investment is critical to capitalize on this
momentum, especially given thousands of Americans are being
newly diagnosed each year. The Committee recommends an increase
of $10,000,000 above the fiscal year 2026 enacted level for ALS
research at NIH, to reduce the burden of ALS on people as
quickly as possible. It is crucial for people living with ALS
and those diagnosed with ALS in the future that NIH increases
its ALS research portfolio, which also supports the overall
research workforce. This additional funding could focus on new
drugs for ALS, as well as on ALS diagnosis protocols, enhancing
the quality of care, and studying new ALS biomarkers. It could
also accelerate work on biomarkers, earlier diagnostics,
improved standards of care, assistive technology, and gene-
targeted and disease-modifying therapies.
Additionally, the Committee notes that NIH is the primary
Federal agency conducting and supporting basic, clinical, and
translational medical research and is investigating the causes,
treatments, and cures for common and rare diseases. Expanded
research into ALS can support more clinical trials and
accelerate the discovery and development of new treatments.
NIH-funded research has facilitated the development of
diagnostic and therapeutic advances, and there has been
significant progress in understanding what causes ALS.
Alzheimer's Disease and Alzheimer's Disease-Related
Dementias (AD/ADRD).--The Committee includes an increase of
$25,000,000 above the fiscal year 2026 enacted level to
continue to support AD/ADRD research at NINDS.
Additionally, the Committee encourages NIH to consider
approaches to address the rural precision health-gap. Such
approaches could include multi-year studies into ADRD that
examine topics such as biomarker-based progression trends and
intervention approaches in at-risk rural populations.
The Committee also notes the disproportionate effect of
Alzheimer's disease on women, as women constitute two-thirds of
people with Alzheimer's disease, and sex-based differences in
risk exist beyond life expectancy alone. The Committee notes
the opportunity for the AD/ADRD program planning to incorporate
the study of sex-based differences in AD/ADRD, including
understanding the array of endocrine, genetic, and other
factors that may uniquely contribute to the risk of Alzheimer's
in women, as well as differential treatment outcomes. Such
information could inform the delivery of precision medicine-
derived interventions to individuals affected by this disease.
The Committee encourages collaboration with the Office of
Research on Women's Health in such planning. The Committee also
encourages future updates of the AD/ADRD professional
justification budget and AD/ADRD progress report to prioritize
plans and reflect accomplishments in sex-based differences and
brain health.
Angelman Syndrome.--The Committee recognizes the importance
of advancing research in Angelman syndrome, a rare neurogenetic
disorder. The Committee is aware that ongoing gene therapy and
gene-targeted approaches, including gene editing and CRISPR
technologies, require robust natural history studies with long-
term follow-up to inform clinical development and regulatory
decision making. With appropriate clinician education on data
collection during follow up, real-world evidence and
observational data collection can significantly enhance natural
history study data. Natural history databases could collect
post-market data with or in addition to sponsor data collection
to ensure that data adds to the general understanding of the
condition and the long-term impact of potential therapies. The
Committee urges NIH to prioritize and support funding for
natural history studies and real-world data collection in
Angelman syndrome to establish critical benchmarks and
facilitate the evaluation of emerging therapeutics.
Blueprint MedTech Program.--The Blueprint Medtech Program
aims to catalyze the development and creation of groundbreaking
solutions for disorders involving the nervous system. A key
aspect contributing to the success of this program is the
support of technical, regulatory, and business experts and
translational resources that are linked to innovator projects
as they progress. The Committee encourages NINDS to continue
its support for Blueprint MedTech and to maintain the program's
integrated support model that is crucial for accelerating the
transition of high-potential neurotechnologies.
Brain Aneurysms.--The Committee remains concerned that an
estimated 1 out of every 50 individuals in the United States
has a brain aneurysm, and an estimated 30,000 Americans suffer
a brain aneurysm rupture each year, often with little or no
warning. Ruptured brain aneurysms are fatal in about 50 percent
of cases. Despite the widespread prevalence of this condition
and the high societal cost it imposes on the U.S., the Federal
government spends only about $2.94 per year on brain aneurysm
research for each person afflicted with a brain aneurysm. The
Committee encourages NINDS to increase its support for research
focused on prevention and early detection of brain aneurysms.
Brain Research through Advancing Innovative
Neurotechnologies (BRAIN) Initiative.--The Committee includes
an increase of $6,000,000 to support the BRAIN initiative. The
BRAIN initiative is an ambitious program to develop and apply
new tools and technologies to answer fundamental questions
about the brain and to inspire new treatments, cures, and
prevention for brain diseases. NINDS and NIMH are leading
partners in the initiative, working with eight other NIH
Institutes, Centers, and Offices. The BRAIN Initiative has
invested more than $4,000,000,000 in more than 1,700 research
projects, engaging scientists from many areas of expertise
including mathematicians, engineers, and physicians in
individual labs and inter-disciplinary teams. It has fostered
discoveries, collaborations, and partnerships to advance
treatments and cures for brain and central nervous system
diseases, disorders, and injuries. The Committee supports the
BRAIN Initiative activities, as it promotes scientific advances
that provide opportunities to understand the structure and
function of the brain at an unprecedented level of detail,
helping bring advanced treatments for brain disorders to
clinical use.
Cerebral Palsy.--Cerebral Palsy (CP) remains the most
common lifelong motor impairment. The Committee encourages NIH
to continue to prioritize and invest in research CP to
strengthen and accelerate CP research priorities across the
lifespan. NIH is encouraged to consider a Cerebral Palsy Notice
of Special Interest. Progress has been made, but addressing
remaining gaps can improve outcomes and treatment. The
Committee further encourages NIH to assess opportunities for
additional research and increased coordination and planning
across Institutes. The Committee encourages NIH to focus on
basic and translational research. Other areas of focus could
include the mechanisms of injury, early detection,
neuroplasticity, and lifespan outcomes.
Creutzfeldt-Jakob Disease.--The Committee commends the
National Alzheimer's Project Act Advisory Council report from
2023 that acknowledges the scientific connection between prion
diseases and Alzheimer's Disease and Related Dementias (ADRDs),
and the 2024 Update mentioning Creutzfeldt-Jakob Disease (CJD).
The Committee continues to encourage NIH to fund more research
for prion diseases, such as CJD. ADRDs have benefited from
prion disease research, and further integration of the fields
could lead to new treatments and improved scientific
understanding of these devastating diseases.
Dystonia.--The Committee commends NINDS for making critical
breakthroughs for the Dystonia community including its role in
the development and clinical validation of deep brain
stimulation. The Committee encourages NINDS to continue working
with community stakeholders to explore emerging opportunities
for advancements in Dystonia treatment.
Early-Stage Neurological Disease.--The Committee recognizes
the growing public health burden posed by neurological
disorders and is concerned that current research and
therapeutic development efforts are largely focused on
symptomatic stages of disease, at which point substantial and
often irreversible brain damage has already occurred, limiting
the effectiveness of available interventions. The Committee
urges NINDS to expand research on the presymptomatic and
preclinical stages of neurological disorders, including the
biological mechanisms, biomarkers, and early pathological
changes that precede clinical presentation.
Epilepsy and Tonic-Clonic Seizures.--The Committee
recognizes that epilepsy is associated with increased
mortality, risk of injury, cognitive injury, rates of
disability, and other psychosocial impairments. Approximately
one-third of affected individuals may not be treated
effectively with existing medical therapy. Tonic-clonic
seizures, formerly known as grand mal seizures, are the type of
seizure that poses the greatest risk. Therefore, the Committee
urges NINDS to prioritize research into reducing the burden and
severity of these seizures. The Committee also urges NINDS to
explore the pathophysiology of tonic-clonic seizures using
cutting-edge imaging modalities.
Epilepsy National Plan.--The Committee is aware of the
enormous economic cost and toll in human suffering resulting
from the epilepsies and considers research and improving
outcomes in this area a high priority, as one in 26 individuals
will develop a form of epilepsy in their lifetime. Despite
epilepsy's prevalence, disproportionate gaps exist in research,
innovation, awareness and care. The Committee directs NIH to
continue to develop and update Benchmarks for Epilepsy Research
following the 2026 Curing the Epilepsies Conference to help
identify clinically meaningful research priorities to prevent,
diagnose, treat and cure epilepsy and improve the wellbeing of
people with epilepsy and their families. Not later than 270
days after enactment of this Act, NIH, together with HHS, is
directed to submit a report to the Committee describing the
steps the agency will take to enable necessary federal
coordination and engaging community stakeholders around
epilepsy and develop a national plan.
Friedreich's Ataxia.--The Committee encourages NIH to
expand its funding of Friedreich's Ataxia research and
accelerate its outreach and collaboration with other Federal
agencies including the FDA to improve neurodegenerative disease
research and treatment.
Frontotemporal Dementia Research.--The Committee recognizes
the critical role NIH funding has in advancing research on
frontotemporal dementia (FTD). NIH-funded natural history
studies, such as the ARTFL LEFFTDS Longitudinal Frontotemporal
Lobar Degeneration (ALLFTD) Research Study, have contributed to
important advances in understanding disease progression. The
Committee notes that individuals with FTD frequently experience
significant delays in obtaining an accurate diagnosis, limiting
timely access to care and participation in research and
clinical trials. The Committee supports ongoing efforts to
advance understanding of FTD and encourages NIH to support
research to develop biomarkers and clinical assessment tools
for FTD to improve diagnostic accuracy, enable earlier
intervention, and accelerate the development of effective
treatments.
Glial Cells.--The Committee recognizes that the study of
glial cells shows promise for the understanding and treatment
of diseases affecting the brain and nervous system. While most
neuroscience research and drug development have focused on
neurons, glia are central players in maintaining brain health
and driving or worsening disease progression. These include:
mylelin disorders (demyelinating diseases) such as
leukodystrophies, multiple sclerosis, and Guillain-Barre
Syndrome; neurodegenerative diseases; neurodevelopmental
conditions; neuropsychiatric conditions; gastrointestinal
diseases; and brain cancers. The potential for glia as targets
to treat and prevent these diseases is significant and still
emerging. The Committee encourages NINDS, in collaboration with
NIA, NIMH, NIDDK, and NCI, to support this emerging area of
neuroscience, to increase our understanding of glial biology
and translate findings into new therapies.
Limb-Girdle Muscular Dystrophy.--The Committee is concerned
about the additional progress needed in developing specific
treatments for over 30 forms of LGMD, a devastating and
disabling disease. Many individuals lack a definitive genetic
diagnosis despite available genetic testing. The Committee
encourages NINDS to support research to elucidate the
underlying pathophysiology for different genetic causes of
LGMD, including common biological pathways and protein
interactions to enable the development of therapies that can
target multiple LGMD subtypes. The Committee also urges
development of rigorous natural history studies to support drug
development and clinical care. Research identifying responsive,
robust, validated and noninvasive biomarkers across both
pediatric and adult populations can improve patient
stratification, endpoint selection, and treatment timing. Such
investments can support the FDA's biomarker qualification
activities, enable fit-for-purpose clinical trial endpoints,
and prevent unnecessary delays in the evaluation and delivery
of emerging therapies.
Morris K. Udall Centers of Excellence for Parkinson's
Disease Research.--Established in 1997 by P.L. 105-78, the
Udall Centers have a long tradition of conducting
interdisciplinary research to advance scientists' understanding
of the fundamental causes of Parkinson's Disease (PD) and
improve diagnosis and treatment of individuals with Parkinson's
and similar neurodegenerative disorders. The Committee is aware
that the number of centers has fluctuated over time, and
currently there are currently three funded Centers. The
Committee notes the burden of this disease, with more than one
million Americans suffering from Parkinson's Disease. The
Committee understands that following a reevaluation of the
prior Udall Centers structure, NINDS launched the Udall Centers
Without Walls via a forecasted funding opportunity. The
Committee commends NINDS for its continued support of the Udall
Centers mission.
Multiple Sclerosis.--The Committee recognizes that Multiple
Sclerosis (MS) is a chronic, disabling neurological disease and
remains a leading cause of non-traumatic disability among young
adults. While progress has been realized in treating relapsing
forms of MS, there are limited therapeutic options for
progressive MS, and the underlying causes of the disease remain
poorly understood. The Committee encourages NINDS and NIAID to
expand research on MS, including to better understand
autoimmune mechanisms, risk factors, and the role of viral
triggers. NIH is further encouraged to facilitate research into
remyelination, neurodegeneration, and biomarkers that enable
earlier diagnosis and improved disease monitoring.
Additionally, NIH is urged to continue supporting clinical
trials focused on progressive MS and to coordinate across ICs
and other Federal agencies as appropriate, to accelerate
translational research. The Committee requests an update in the
fiscal year 2028 congressional justification on current
research and opportunities to accelerate therapeutic
development.
National Parkinson's Project.--The Committee supports
NINDS' efforts to continue implementation of the National
Parkinson's Project, as created by the Dr. Emmanuel Bilirakis
and Honorable Jennifer Wexton National Plan to End Parkinson's
Act (Public Law 118-66).
Neurodegenerative Disease Research.--In recognition of
NINDS' leadership and sustained commitment to advancing
neurodegenerative disease research and leadership of the
National Plan to End Parkinson's, the Committee is aware of the
need to expand research to address the needs of other
Neurodegenerative Parkinsonian Disorders. The Committee
encourages NINDS to develop research funding opportunities that
address the needs of those living with Progressive Supranuclear
Palsy (PSP) and corticobasal degeneration/corticobasal syndrome
(CBD/CBS).
Parkinson's Disease.--The Committee commends NINDS for
taking critical steps in identifying priority research
recommendations to advance research on Parkinson's disease,
which is the second most prevalent neurodegenerative disease in
the U.S. The Committee recommendation includes a $6,000,000
increase for NINDS-supported research into Parkinson's disease.
Additionally, the Committee urges NINDS to support meritorious
research in the following areas: (1) advancement of early
detection and diagnostic capabilities, including the
development and validation of biomarkers that identify
individuals at elevated risk prior to the onset of disabling
motor symptoms; and (2) development of neuroprotective and
regenerative therapeutic strategies, including investigation of
the biological mechanisms underlying the benefits of aerobic
exercise and evaluation of emerging stem cell--based approaches
aimed at restoring lost neuronal function.
Stroke Research.--The Committee commends NINDS-supported
basic and clinical research to improve stroke prevention,
diagnosis, and treatment, and encourages continued research.
Among these efforts are support for a stroke clinical trials
network that enables discoveries of potential treatments for
people with and at risk for stroke. NINDS-supported research in
stroke has also helped increase the understanding of causes of
stroke.
Traumatic Brain Injury.--NINDS-supported research into
disorders such as traumatic brain injury (TBI) advance
scientists' understanding of this condition. Such research
findings can be translated into better diagnosis and potential
therapies for individuals with TBI. The Committee encourages
ongoing support of meritorious TBI research.
Undiagnosed Diseases Network.--The Committee recommendation
continues to include $18,000,000 for the Undiagnosed Diseases
Network, the same as the fiscal year 2026 enacted level. The
Undiagnosed Diseases Network (UDN) builds on the success of the
Undiagnosed Diseases Program at the NIH Clinical Center, a
nationwide network of clinicians and researchers who use basic
and clinical research to uncover the underlying disease
mechanisms associated with rare and undiagnosed conditions. It
is estimated that approximately 25 million Americans suffer
from a rare disorder. The UDN pioneered a new personalized
medicine model for helping patients with rare and complex
conditions that historically have been the most difficult for
the medical community to diagnose, taking advantage of cutting-
edge technologies such as genomic sequencing, metabolomics and
assessing patient variants in model organisms to give
clinicians new, powerful information to help understand the
cause of extremely rare diseases.
NATIONAL INSTITUTE OF ALLERGY AND INFECTIOUS DISEASES (NIAID)
Appropriation, fiscal year 2026....................... $6,585,279,000
Budget request, fiscal year 2027...................... 4,751,000,000
Committee Recommendation.............................. 6,603,779,000
Change from enacted level......................... +18,500,000
Change from budget request........................ +1,852,779,000
Mission.--The NIAID mission is to conduct and support basic
and applied research to better understand, treat, and
ultimately prevent infectious, immunologic, and allergic
diseases.
AIDS Research.--As part of NIH's broader AIDS Research
portfolio, the Committee notes opportunities to conduct
research in areas with a high prevalence of HIV/AIDS.
Alpha-gal Syndrome.--The Committee is concerned by the rise
in incidence of alpha-gal syndrome, an emerging allergic
condition associated with tick bites that can cause potentially
life-threatening hypersensitivity to galactose-alpha-1,3-
galactose. The Committee encourages NIH to increase efforts to
understand the immunological mechanisms and natural history of
alpha-gal syndrome, which could lead to new protocols,
therapies, and tools for managing this condition.
Antimicrobial Resistance.--The Committee continues to
include $565,000,000, the same as the fiscal year 2026 enacted
level, to support antimicrobial resistance research (AMR). This
funding supports NIAID research to combat AMR and the training
of new investigators to improve AMR research capacity as
outlined in the 2020-2025 National Action Plan for Combating
Antibiotic-Resistant Bacteria, strengthen clinical trial
infrastructure, and enhance research on mechanisms of
resistance, therapeutics, vaccines, and diagnostics. The
Committee is aware of the challenge that antimicrobial
resistance poses to public health, with more than 2.8 million
antimicrobial-resistant infections occurring in the U.S.
annually according to the CDC. The Committee remains concerned
about this increasing threat, including emerging and drug-
resistant fungal pathogens that are resistant to or
inadequately treated by currently available antifungal
therapies. The Committee encourages NIAID to incorporate
antifungal resistance and fungal pathogens into antimicrobial
resistance research initiatives, including efforts to advance
improved diagnostics, therapeutics, and prevention strategies.
The Committee encourages NIAID's continued basic,
translational, and clinical research on AMR. The Committee
requests an update in the fiscal year 2028 congressional
justification on current and planned activities to address
antifungal resistance and emerging fungal pathogens through
research, innovation, and translational programs.
Antimicrobial Stewardship.--The Committee understands the
role of antibiotic stewardship programs in preventing the
spread of antibiotic resistance in all healthcare facilities in
the U.S. and across the world. In the 2020-2025 National Action
Plan for Combating Antibiotic-Resistant Bacteria, one of the
five goals was to Accelerate Basic and Applied Research and
Development for New Antibiotics, Other Therapeutics, and
Vaccines to improve understanding of the many factors that
contribute to the emergence, spread, and persistence of
antibiotic resistance and to support new strategies for
preventing and mitigating infections. The Committee encourages
NIAID to continue to advance its broad AMR research efforts.
Antiviral Drug Discovery Centers.--Researching and
developing new antivirals is essential for combating new viral
outbreaks and preventing them from spreading into pandemics.
The Committee supports the Antiviral Drug Discovery Centers and
their mission to develop antiviral drugs to serve as our first
line of defense against forthcoming viral outbreaks and
encourages continued support to mitigate future risks.
Celiac Disease.--The Committee commends the NIH for issuing
a Notice of Special Interest to spur additional celiac disease
research. While the only currently known treatment is a gluten-
free diet, recent research confirms that this is insufficient
for many individuals with the disease. The Committee supports
focused research celiac disease and encourages NIH to support
new research on diagnosis, therapeutics, and management, as
well as on improving understanding of the mechanisms underlying
clinical manifestations of this disease. The Committee requests
an update in the fiscal year 2028 congressional justification
on celiac disease research, projects, and programs.
Consortium for Food Allergy Research.--The Committee
recognizes the serious issue of food allergies which affect
approximately 8 percent of children and 10 percent of adults in
the United States. The Committee commends the ongoing work of
NIAID in supporting a total of 25 clinical sites for this
research, including 15 sites as part of the Consortium of Food
Allergy Research (CoFAR). The Committee includes $12,100,000
for CoFAR, the same as the fiscal year 2026 enacted level, to
support clinical trials and translational research studies with
qualified collaborating institutions with demonstrated
expertise in food allergy research and patient engagement,
prioritizing projects that can rapidly advance prevention,
diagnosis, and treatment of food allergy.
HIV Vaccine Research.--The Committee notes NIH's
longstanding support for HIV vaccine research and supports the
agency in ensuring the pipeline from idea to funding does not
slow down. The Committee recognizes the value of an HIV vaccine
in preventing HIV and further notes efforts such as the HIV
Vaccine Trials Unit and its partner clinical research centers
located in 13 States.
Lyme and Other Tick-Borne Diseases.--The Committee includes
not less than $120,000,000, an increase of $10,000,000 over the
fiscal year 2026 enacted level, for NIH research into Lyme and
Other Tick-Borne disease research. The Committee understands
this increasing health concern in the U.S. and that NIH-
supported research can help advance development of reliable
diagnostics and therapies to address it and carry out NIH's
Strategic Plan for Tickborne Disease Research. The Committee
also understands Lyme Disease accounts for the majority of
reported tickborne diseases and encourages robust research in
this area.
Additionally, NIH is encouraged to increase they study of
neurologic symptoms of Lyme disease, including in children, to
expand the knowledge base and investigate novel treatments.
Research could include multiple funding mechanisms to support
areas such as basic mechanistic research on pathobiome-host
interactions in the nervous system; translational studies on
biomarker development and neuroimaging approaches to detection;
persistent neurological dysfunction following treatment of Lyme
and other tick-borne pathogens; population-based studies to
document epidemiology and long-term outcomes; and innovative
treatment approaches addressing the causes of infection-
triggered neurological disease.
National Biocontainment Laboratories.--The Committee notes
the roles of the National Biocontainment Laboratories in
developing and maintaining research resources, facilities, and
personnel to meet national biodefense and emerging infectious
diseases research needs in the event of a deliberate act of
bioterrorism or naturally occurring public health emergency.
Research on high consequence zoonotic viruses requires high-
containment BSL-4 laboratories. Such laboratories enable
researchers to safely diagnose and investigate these types of
pathogens, and develop rapid and reliable diagnostics, novel
antiviral therapeutics, and vaccines. The Committee continues
support for these institutions to maintain the research
resources for biodefense, emerging infectious disease agents,
and other infectious disease threats to U.S. public and global
health; training new researchers in biosafety level 4
practices; maintaining a workforce skilled in BSL-4 research;
and establishing best practices for the safe and efficient
conduct of research in BSL-4 facilities.
Pediatric Lyme Disease.--The Committee continues to
recognize Lyme disease as a significant public health concern
for children and notes that pediatric patients may experience
distinct clinical presentations, disease progression, and long-
term outcomes compared to adults. The Committee encourages NIH
to advance research on the prevention, diagnosis, treatment,
and long-term outcomes of Lyme disease in children. The
Committee is concerned about gaps in evidence related to early-
life exposure, infection during pregnancy, and infection
acquired during infancy and childhood, including potential
neurodevelopmental, cognitive, and behavioral impacts. The
Committee requests NIH provide an update in the fiscal year
2028 congressional justification on efforts to advance research
in pediatric Lyme disease.
Perinatal Transmission of Lyme Disease.--Additionally, the
Committee remains particularly concerned about gaps in evidence
regarding the frequency, mechanisms, and clinical consequences
of perinatal transmission of Borrelia burgdorferi, including
the potential for congenital Lyme disease and associated short-
and long-term health outcomes. The Committee encourages NIH to
support multidisciplinary research to better characterize
congenital and perinatal outcomes, including studies examining
in-utero exposure, pregnancy complications, neonatal outcomes,
and developmental trajectories in affected children.
Regional Biocontainment Laboratories.--The Committee notes
the role of the 12 regional biocontainment laboratories (RBLs)
have as part of the nation's biodefense infrastructure, helping
the U.S. prepare and respond to emerging infectious disease
agents. The Committee appreciates that NIAID competitively
awarded the RBLs' operations support. The Committee continues
to include $52,000,000 for the 12 RBLs to support core and
shared resources for BSL-3 containment. No less than $3,000,000
shall be provided to each of the 12 RBLs to support training
and maintaining a capable research workforce with broad,
relevant biomedical, technological, veterinary, and regulatory
expertise, supporting operations, facilities, and equipment
purchase costs. The remaining funding shall go to the 12 RBLs
to support: (1) research on biodefense, emerging infectious
disease agents, and other infectious disease threats to global
health; (2) training new researchers, including in biosafety
level 3 practices; (3) maintaining a workforce skilled in BSL-3
research; and (4) establishing best practices for the safe,
effective, and efficient conduct of research in BSL-3
facilities.
Tuberculosis Screening for Cadaver Tissue Donors.--The
Committee is concerned about the continued risk of donor-
derived tuberculosis (TB) transmission through human cells,
tissues, and cellular- and tissue-based products (HCT/Ps) and
the lack of a standardized testing approach suitable for
cadaveric donor matrices. The Committee encourages NIAID to
continue funding scientific research into the development of
new TB diagnostics, treatment, and prevention tools.
Universal Influenza Vaccine.--The Committee continues to
include no less than $270,000,000 for this activity, the same
as the fiscal year 2026 enacted. NIAID's influenza research
program is working to develop a universal flu vaccine, or a
vaccine that provides robust, long-lasting protection against
multiple subtypes of flu, rather than a select few. Such
vaccines would provide protection against zoonotic flu and
eliminate the need to update the seasonal flu vaccine each
year. Universal flu vaccine research includes the improvement
of current vaccines and could provide important foundational
work in outbreak responses. In February 2018, NIAID released
its Universal Influenza Vaccine Strategic Plan, which focuses
on 3 research areas to broaden knowledge around basic influenza
immunity and advance translational research efforts to drive
universal flu vaccine development. The Committee requests an
update on these efforts within 90 days of enactment of this
Act.
NATIONAL INSTITUTE OF GENERAL MEDICAL SCIENCES (NIGMS)
Appropriation, fiscal year 2026....................... $3,269,679,000
Budget request, fiscal year 2027...................... 3,248,381,000
Committee Recommendation.............................. 3,299,679,000
Change from enacted level......................... +30,000,000
Change from budget request........................ +51,298,000
The Committee recommendation includes $1,872,197,000 in
discretionary appropriations and $1,427,482,000 in PHS Act
section 241 evaluation set-aside transfers.
Mission.--NIGMS supports basic research that increases our
understanding of biological processes and lays the foundation
for advances in disease diagnosis, treatment, and prevention.
Biomedical Research Workforce Training.--Training programs
at the NIH provide a quality standard of training for graduate
students and postdoctoral fellows in biomedical research. The
training grants that support these programs at research
institutions across the country play a vital role in
establishing a biomedical research ecosystem and train the next
generation of researchers for health-related research needs.
Despite the success of training programs, the number of
students and postdoctoral scholars supported on training grants
has remained constant over the years. The Committee applauds
NIH efforts to increase funding for institutional development
awards (IDeA) States and urges the NIH to also emphasize the
importance of supporting training grants in IDeA States. The
Committee directs NIH to provide a portfolio analysis to the
Committee within 120 days of enactment of this Act on the
distribution of T32 training grants among States, including the
number of applicants and success rates per State to ensure NIH
is supporting capacity building and a diverse workforce for the
future biomedical research enterprise. In addition, in the
fiscal year 2028 congressional justification, the Committee
requests that NIH provide an update on specific actions NIH
will take to identify and remove barriers for applying for
training grants in IDeA States.
Bridge Programs.--The Committee strongly supports
opportunities for students with limited access to STEMM
(Science, Technology, Engineering, Mathematics, and Medicine)
education and research. The Committee recognizes the
effectiveness and importance of the NIGMS bridging programs
that support historically underserved students and researchers
to pursue STEMM studies and become the nation's next generation
of researchers, including programs such as the Bridges to the
Baccalaureate Research Training Program, Bridges to the
Doctorate Research Training Program, Postbaccalaureate Research
Education Program, Advancing Research Careers program, and
Maximizing Opportunities for Scientific and Academic
Independent Careers program. The Committee notes that NIH
terminated many of these programs in 2026 and strongly urges
NIH to reestablish them. The Committee urges NIH to continue
the previous training programs that bridge different
educational or career stages and maintain these programs at
institutions that have historically received low levels of
funding support from NIH. The Committee urges NIH to set clear
mentorship and support standards for students participating in
these programs. The Committee urges NIH to encourage and
provide more guidance to participating institutions to account
for sufficient staff and outreach, budget, and other training-
related expenses in grant applications. Finally, the Committee
directs NIH to provide a briefing to the Committee on this
effort within 90 days of enactment of this Act.
Institutional Development Awards
The Committee provides $480,956,000 for IDeA, an increase
of $30,000,000 from the fiscal year 2026 enacted level. The
Committee directs that of the amounts provided for IDeA,
$50,000,000 is provided for biomedical research facilities and
equipment. The Committee understands that targeting additional
resources for research facilities and associated equipment will
enable institutions to make needed improvements and modernize
their research facilities and equipment. Expanded investments
in facilities will increase institutions' research capacity,
help them attract talented investigators with promising
research ideas, and strengthen their competitiveness among
other research institutions around the country.
The IDeA program increases our nation's biomedical research
capability by improving research capacity in States that have
historically had lower levels of NIH biomedical research
funding. IDeA supports competitive basic, clinical, and
translational research, faculty development, and infrastructure
improvements. The IDeA program aims to strengthen States' and
institutions' abilities to support biomedical research, enhance
the competitiveness of investigators in securing research
funding, and enable clinical and translational research that
addresses the needs of medically underserved communities.
EUNICE KENNEDY SHRIVER NATIONAL INSTITUTE OF CHILD HEALTH AND HUMAN
DEVELOPMENT (NICHD)
Appropriation, fiscal year 2026....................... $1,769,078,000
Budget request, fiscal year 2027...................... 1,650,676,000
Committee Recommendation.............................. 1,769,078,000
Change from enacted level......................... - - -
Change from budget request........................ +118,402,000
Mission.--NICHD's mission is to lead research and training
to understand human development, improve reproductive health,
enhance the lives of children and adolescents, and optimize
abilities for all.
Adenomyosis Research.--The Committee urges NICHD to
continue expanding basic, clinical, and translational research
into the mechanics of adenomyosis, including studies on the
underlying causes, disease mechanisms, and progression of the
condition. The Committee encourages investigation into the
genetic, hormonal, and immunological factors that contribute to
adenomyosis and the development of improved diagnostic tools,
including imaging and biomarker-based approaches that enable
earlier and more accurate diagnosis. The Committee further
encourages research on innovative treatment strategies,
including fertility-preserving medical and surgical
interventions. In addition, the Committee urges NIH to
prioritize research examining the relationship between
adenomyosis, infertility--particularly unexplained
infertility--endometriosis, and adverse reproductive outcomes.
The Committee requests NIH include an update on research
activities related to adenomyosis in the fiscal year 2028
congressional justification.
Endometriosis.--Endometriosis is a chronic gynecological
condition affecting an estimated 10 percent of reproductive-age
women and often causing significant pain, infertility, and
reduced quality of life. Despite endometriosis' prevalence, it
remains poorly understood, is frequently diagnosed years after
symptom onset, and has limited treatment options beyond surgery
and hormonal therapy. The Committee encourages NICHD to expand
basic, clinical, and translational research into the mechanisms
of endometriosis, diagnostic options, and treatment methods.
Impact of Technology and Digital Media Use Among Infants,
Children, and Teens.--The Committee continues to be concerned
about the impacts of technology use and media consumption on
infant, children, and adolescent development. The Committee
appreciates NICHD's ongoing engagement on this important topic
and urges continued support for research into the cognitive,
physical, and mental health impacts of young people's use of
technologies as well as long-term developmental effects on
children's social, communication, and creative skills. The
Committee also encourages NICHD to study the repercussions of
increased use of digital media and technologies on suicidal
thoughts and ideation among children. NICHD is encouraged to
continue to consider different forms of digital media and
technologies including mobile devices, smart phones, tablets,
computers, and virtual reality tools, as well as social media
content, video games, and television programming.
Implementing a Maternal health and PRegnancy Outcomes
Vision for Everyone (IMPROVE) Initiative.--The Committee
continues to include $63,400,000 for the IMPROVE Initiative,
the same as the fiscal year 2026 enacted level. This funding
supports research to reduce preventable causes of maternal
deaths and improve the health of mothers before, during, and
after pregnancy.
Infertility.--The Committee remains concerned about the
rate of infertility suffered by couples trying to conceive.
Progress has been made in understanding the factors that
contribute to infertility but more remains to be learned. The
Committee encourages NICHD to continue to research female
reproductive conditions, which could include research into
treatments for endometriosis and polycystic ovary syndrome. The
Committee also encourages continued research on male mechanisms
of infertility.
Learning Disabilities Research Centers and Learning
Disabilities Innovation Hubs.--The Committee notes the role of
NICHD's Learning Disabilities Research Centers and Learning
Disabilities Innovation Hubs in supporting research into the
causes, origins, and development of learning disabilities.
These efforts support researchers in conducting randomized
control trials to explore the relationships between different
variables. Learning disabilities affect an individual's
education and academic achievement, but these disorders are
brain-based, making it essential that clinical research use the
latest technology and advances in neuroscience.
Maternal-Fetal Medicine Units Network.--The Maternal-Fetal
Medicine Units Network is a network of 14 centers across the
country that conduct clinical studies to improve maternal,
fetal, and neonatal health that ultimately improves the
clinical practice of obstetrics. The Committee commends the
work of the maternal fetal medicine units and encourages
continued support for this activity.
National Reading Panel.--The 2000 National Reading Panel
(NRP) report, the seminal text for the body of evidence
referred to as ``The Science of Reading,'' was established
through a fiscal year 1998 directive from this Committee. The
Committee acknowledges the role the 2000 NRP report has played
in establishing a scientific consensus around the components of
effective reading instruction. After more than a quarter of a
century, however, the Committee recognizes the need for
additional scientific insights for a contemporary context.
Specifically, the Committee is interested in the relationship
between reading books rather than passages in building reading
stamina; the relationship between writing instruction and
reading comprehension; optimal amounts of time for different
aspects of reading and writing instruction in the average
classroom; the essential components of effective reading
curricula; the relationship between teacher preparation,
professional development, and effective reading and writing
instruction; and out-of-school factors that impact reading
proficiency, including oral language development.
Accordingly, the Committee directs the director of the
NICHD, in coordination with the Department of Education's
Institute of Education Sciences (IES), to reestablish a
National Reading Panel to assess the contemporary status of
research-based knowledge, including the effectiveness of
various approaches to teaching children to read. The Committee
recommends that the panel be comprised of 15 impartial
individuals, who are not officers or employees of the Federal
Government and include leading scientists in reading research,
representatives of colleges of education, reading teachers,
educational administrators, and parents. Based on its findings,
the panel should present a report to the Secretary of Health
and Human Services, the Secretary of Education, the Committees
on Appropriations of the House of Representatives and the
Senate, the Committee on Education and Workforce of the House
of Representatives, and the Committee on Health, Education,
Labor, and Pensions of the Senate. The report should present
the panel's conclusions, an indication of the readiness for
application in the classroom of the results of this research,
and, if appropriate, a strategy for rapidly disseminating this
information to facilitate effective reading instruction in the
schools. If found warranted, the panel should also recommend a
plan for additional research regarding early reading
development and instruction.
Pediatric Trials Network.--The Committee is aware of
concerns that NIH reduced funding for the Pediatric Trials
Network (PTN). Due to the PTN's role as a national focal point
for pharmaceutical clinical trials involving pediatric
populations, the Committee encourages NIH to support the PTN to
ensure no clinical trials are disrupted. The Committee
encourages NIH to maintain PTN's role in helping advance safe
and effective therapeutics for children.
Population Research.--The Committee has commended NICHD for
supporting a robust population dynamics research portfolio that
includes the Population Dynamics Centers Research
Infrastructure Program and prospective, population
representative longitudinal studies, including the Panel Study
of Income Dynamics Child Development Supplement and Future of
Families and Child Wellbeing Study. Data from these studies are
used widely to inform research and training activities
conducted by thousands of scientists at universities
nationwide, including underserved institutions, and are heavily
used by new and early-stage investigators, facilitating
research to improve health and well-being across the lifespan.
These investments support scientists' ability to uncover how
adverse events early in an individual's life may influence the
onset and course of chronic disease. As part of the fiscal year
2028 congressional justification, the Committee requests NICHD
provide an update on how it is sustaining this area of research
and collaborations with other ICs such as NIA to advance
science on the influence of life course risk factors and how
they could be mitigated to promote better health outcomes in
infants, adolescents, and young adults.
Prenatal and Postnatal Vitamins.--The Committee encourages
NIH to support evidence-based research that generates the
criteria needed to define pregnancy-specific nutrient
requirements to support evidence-based improvements in the
formulation of prenatal and postnatal supplements to support
maternal and fetal health.
Priority Research for Pregnant and Lactating Women.--The
Committee is concerned about the lack of pregnant and lactating
women in clinical research. Women with chronic health
conditions may lack access to appropriate treatments during
pregnancy, putting them and their infants at risk. Despite 90
percent of pregnant women taking prescription medication, only
5 percent of medications have data on the impact of use during
pregnancy. The Committee commends NICHD for initiating a
prioritization process for existing medications and urges NICHD
to continue conducting priority research projects on existing
medications and therapeutics prescribed to pregnant and
lactating women, and to prioritize research applications in the
following areas: an unmet medical need or gap in treatment, and
severity and prevalence of a specific disease or condition. The
Committee requests an update in the fiscal year 2028
congressional justification on this effort.
Precision Interventions to Prevent Severe Maternal
Morbidity.--The Committee encourages NICHD and NIDDK to
consider funding for innovative trials that evaluate the
effectiveness of precision interventions to mitigate systemic
inflammation and prevent adverse pregnancy outcomes, such as
preeclampsia, particularly in overweight and obese maternal
populations.
Uterine Fibroids.--The Committee urges NICHD to continue
expanding basic, clinical, and translational research on the
causes, pathophysiology, and progression of uterine fibroids.
Possible areas of focus could include investigation of hormonal
drivers, genetic and molecular mechanisms, environmental and
endocrine-disrupting exposures, improved diagnostic tools, and
innovative treatments, including minimally invasive and
fertility-preserving surgical techniques as well as nonsurgical
therapies. Additional areas of potential study include the
effects of uterine fibroids on anemia, infertility, pregnancy
complications, and other conditions. The Committee encourages
NICHD to include an update on uterine fibroid research
activities in the fiscal year 2028 congressional justification.
NATIONAL EYE INSTITUTE (NEI)
Appropriation, fiscal year 2026....................... $896,549,000
Budget request, fiscal year 2027...................... 833,000,000
Committee Recommendation.............................. 896,549,000
Change from enacted level......................... - - -
Change from budget request........................ +63,549,000
Mission.--The mission of the National Eye Institute is to
eliminate vision loss and improve quality of life through
vision research.
Usher Syndrome.--The Committee strongly encourages NIH to
enhance and prioritize Usher syndrome research at NEI. Usher
syndrome is a rare genetic disease that causes deafness and
blindness, and there is no viable treatment or cure. The
Committee requests an update in the fiscal year 2028
congressional justification, and such update should include
efforts to stimulate the field and to accelerate viable human
treatment options for those with Usher syndrome.
NATIONAL INSTITUTE OF ENVIRONMENTAL HEALTH SCIENCES (NIEHS)
Appropriation, fiscal year 2026....................... $913,979,000
Budget request, fiscal year 2027...................... 594,086,000
Committee Recommendation.............................. 913,979,000
Change from enacted level......................... - - -
Change from budget request........................ +319,893,000
Mission.--NIEHS's mission is to discover how the
environment affects people in order to promote healthier lives.
Wildfire Smoke Health Research.--The lack of data about the
health impacts of wildland fire smoke and wildfire management
strategies is a gap in our firefighting arsenal. The Committee
encourages NIEHS to help fill this gap by pursuing research to
evaluate smoke health impacts for communities experiencing
different types of wildfire and to develop datasets linking
wildfire smoke to health impacts.
NATIONAL INSTITUTE ON AGING (NIA)
Appropriation, fiscal year 2026....................... $4,517,623,000
Budget request, fiscal year 2027...................... 4,216,770,000
Committee Recommendation.............................. 4,517,623,000
Change from enacted level......................... - - -
Change from budget request........................ +300,853,000
Mission.--NIA's mission is to understand the nature of
aging and the aging process, and diseases and conditions
associated with growing older, to extend the healthy, active
years of life.
Alzheimer's Disease and Alzheimer's Disease-Related
Dementias (AD/ADRD).--The Committee urges NIH to continue
robust funding for AD/ADRD research at the NIA at no less than
the level provided for fiscal year 2026. The Committee notes
that Alzheimer's Disease and related dementias pose challenges
to the nation's health, and AD/ADRD research at NIA is an
investment in the treatment, prevention, and eventual cure of
these diseases. NIA is encouraged to continue addressing the
research targets outlined in the fiscal year 2028 professional
judgment budget.
Extracranial Lymphatic Dysfunction.--The Committee
recognizes findings suggesting a possible role of extracranial
lymphatic dysfunction in the progression of AD/ADRD. The
Committee urges NIA to support research on this condition and
restoration strategies as potential disease-modifying
approaches, including non-pharmacologic, device-enabled, or
procedural interventions. This research could focus on
interventional or clinical trial-style studies and include
investigation of underlying mechanisms, relevant biomarkers,
and neurovascular or cognitive outcomes. The Committee requests
the NIA include information on extracranial lymphatic
dysfunction research activities in the fiscal year 2028
congressional justification.
Geographic Disparities in AD/ADRD.--The Committee is
concerned about disparities in the prevalence of Alzheimer's
Disease and Alzheimer's Disease-Related Dementias (AD/ADRD)
observed in some regions of the country, including some
counties that exhibit rates of AD/ADRD that are more than
double the national rate. To better understand the underlying
causes of these elevated incidence rates and to develop
targeted treatments and solutions, the Committee encourages
NIA, in coordination with relevant ICs, to support research on
geographic populations with an elevated incidence of AD/ADRD.
This research could include epidemiological studies;
examinations of genetic, environmental, and other factors; and
pilot intervention research designed to identify actionable
pathways toward reducing disease incidence.
Wearables and Circadian Rhythms in Aging Research.--The
Committee recognizes the value of wearable devices for research
on aging and age-related disease by enabling longitudinal
measurement of sleep, physical activity, cardiovascular
function, circadian rhythms, and other dynamic biological
processes. The Committee encourages NIA to support research on
the development, validation, and application of wearable and
continuous biodata monitoring technologies, including the
integration of such data with molecular, clinical, and
functional endpoints. The Committee further encourages NIA to
consider the role of circadian rhythm regulation in aging and
age-related disease, and to explore how wearable-derived
measures may contribute to the development of biomarkers
relevant to healthspan and aging research. The Committee
requests an update on these efforts in the fiscal year 2028
congressional justification.
NATIONAL INSTITUTE OF ARTHRITIS AND MUSCULOSKELETAL AND SKIN DISEASES
(NIAMS)
Appropriation, fiscal year 2026....................... $685,465,000
Budget request, fiscal year 2027...................... 637,819,000
Committee Recommendation.............................. 685,465,000
Change from enacted level......................... - - -
Change from budget request........................ +47,646,000
Mission.--NIAMS's mission is to support research into the
causes, treatment, and prevention of arthritis and
musculoskeletal and skin diseases; the training of basic and
clinical scientists to carry out this research; and the
dissemination of information on research progress in these
diseases.
Alopecia Areata.--The Committee notes that alopecia areata
is a common, chronic autoimmune disease with devastating
medical, psychological, and economic impacts. NIAMS research
has uncovered genetic factors that are associated with alopecia
areata, many of which have been implicated in other autoimmune
diseases. The Committee encourages NIAMS to explore
collaborative opportunities with key stakeholders to advance
critical research projects into causes and treatments.
Functional Radiation Medicine.--The Committee recognizes
emerging research suggesting targeted, low-dose radiation, also
called functional radiation medicine, may have applications
beyond oncology. The Committee notes emerging clinical interest
in using this therapy for non-malignant musculoskeletal,
neurological, and fibrotic conditions, to reduce pain,
inflammation, and functional impairment while potentially
avoiding invasive interventions. There is more to learn
regarding the mechanism of action, optimal dosing, long-term
safety, comparative effectiveness, and appropriate patient
selection. The Committee encourages NIH to support rigorous,
peer-reviewed research into functional radiation medicine,
including to evaluate basic, translational, and clinical
studies, with attention to long-term outcomes, safety
considerations, and comparisons with existing standards of
care.
Lupus.--The Committee commends NIAMS for leading key
discoveries in lupus research. The Committee encourages the
NIAMS to expand genetic, clinical, and basic research in lupus,
including prioritizing cross collaboration with other ICs. The
Committee further encourages NIAMS to continue to engage with
patient advocacy stakeholders to better understand the needs of
the lupus patient and research communities and to identify
priorities such as the use of artificial intelligence in
identifying biomarkers, developing better diagnostic tools, and
engaging in precision medicine to improve lupus outcomes.
Scleroderma.--The Committee recognizes the debilitating
effects of scleroderma on its patient population and the need
to advance treatment options for the community. The Committee
encourages NIAMS to continue collaboration with stakeholders on
reviewing the progress made in scleroderma research.
NATIONAL INSTITUTE ON DEAFNESS AND OTHER COMMUNICATION DISORDERS
(NIDCD)
Appropriation, fiscal year 2026....................... $534,333,000
Budget request, fiscal year 2027...................... 499,502,000
Committee Recommendation.............................. 534,333,000
Change from enacted level......................... - - -
Change from budget request........................ +34,831,000
Mission.--NIDCD conducts and supports biomedical and
behavioral research and research training in the normal and
disordered processes of hearing, balance, taste, smell, voice,
speech, and language. NIDCD also conducts and supports research
and research training related to disease prevention and health
promotion; addresses special biomedical and behavioral problems
associated with people who have communication impairments or
disorders; and supports efforts to create devices which
substitute for lost and impaired sensory and communication
function.
NATIONAL INSTITUTE OF NURSING RESEARCH (NINR)
Appropriation, fiscal year 2026....................... $197,693,000
Budget request, fiscal year 2027...................... 138,385,000
Committee Recommendation.............................. 197,693,000
Change from enacted level......................... - - -
Change from budget request........................ +59,308,000
Mission.--The mission of NINR is to lead nursing research
to solve pressing health challenges and inform practice and
policy for health optimization.
Artificial Intelligence.--The Committee notes ongoing areas
of NINR-supported research that leverages data science and
artificial intelligence, as outlined in the fiscal year 2027
congressional justification. The Committee encourages NINR to
support additional research opportunities that utilize these
technologies. One area of opportunity is the advancement of
telemedicine and remote monitoring capabilities, to improve
virtual care for managing chronic illnesses.
NATIONAL INSTITUTE ON ALCOHOL ABUSE AND ALCOHOLISM (NIAAA)
Appropriation, fiscal year 2026....................... $595,318,000
Budget request, fiscal year 2027...................... - - -
Committee Recommendation.............................. 595,318,000
Change from enacted level......................... - - -
Change from budget request........................ +595,318,000
Mission.--NIAAA's mission is to generate and disseminate
fundamental knowledge about the adverse effects of alcohol on
health and well-being, and apply that knowledge to improve
diagnosis, prevention, and treatment of alcohol-related
problems, including alcohol use disorder, across the lifespan.
NATIONAL INSTITUTE ON DRUG ABUSE (NIDA)
Appropriation, fiscal year 2026................... $1,662,695,000
Budget request, fiscal year 2027.................. - - -
Committee Recommendation.......................... 1,662,695,000
Change from enacted level..................... - - -
Change from budget request.................... +1,662,695,000
Mission.--NIDA's mission is to advance science on the
causes and consequences of drug use and addiction and to apply
that knowledge to improve individual and public health.
GLP-1 Receptor Agonists.--The Committee encourages NIDA and
NIAAA to consider opportunities to expand large-scale clinical
research evaluating GLP-1 receptor agonists as potential
treatments for addiction. Such research could include
randomized controlled trials and real-world studies assessing
adherence and adoption relative to existing treatments, as well
as effects on human behavior, including craving, relapse,
treatment retention, and overdose risk.
Methamphetamines and Other Stimulants.--The Committee is
concerned that, according to predicted provisional data
released by CDC, more than 19,000 overdose deaths involved
cocaine and more than 26,000 involved drugs in the category
that includes methamphetamine in the 12-month period ending in
November 2025. These elevated levels have led some to refer to
stimulant overdoses as the ``fourth wave'' of the current drug
addiction crisis in America following the rise of opioid-
related deaths involving prescription opioids, heroin, and
fentanyl-related substances. No FDA approved medications are
available for treating methamphetamine, cocaine, and other
stimulant use disorders. The Committee continues to support
NIDA's efforts to address the overdose opioid crisis, has
provided continued funding for the Helping to End Addiction
Long-term (HEAL) Initiative, and supports NIDA's efforts to
combat the growing problem of methamphetamines and other
stimulant use disorders and related deaths.
Opioid Initiative.--The Committee continues to be concerned
about the high mortality rate due to the opioid overdose
epidemic and appreciates the important role that research plays
in the various Federal initiatives aimed at this crisis.
Approximately 190 people die each day in this country from drug
overdose (more than 120 of those are directly from opioids),
making it one of the most common causes of non-disease-related
deaths for adolescents and young adults. Between 2023 and 2024,
rates declined for overdose deaths involving synthetic opioids
other than methadone, heroin, and natural and semi-synthetic
opioids. More research is needed to find new and better agents
to prevent or reverse the effects caused by this class of
chemicals and to provide improved access to treatments for
those with addiction to these drugs. To combat this crisis, the
Committee continues to include within NIDA's budget
$355,295,000, which is the same as the fiscal year 2026 enacted
level, for the Institute's management of its share of the HEAL
Initiative and in response to rising rates of stimulant use the
continued overdose burden. The Committee encourages NIDA to
support research on the development of safe and effective
medications, new formulations and combinations, and devices to
treat substance use disorders and prevent or reverse overdose,
and to support research on comprehensive care models in
communities nationwide to prevent opioid misuse, expand
treatment capacity, enhance access to overdose reversal
medications, and enhance prescriber practice; test
interventions in justice system settings to expand the uptake
of medication assisted treatment and methods to scale up these
interventions; and develop evidence based strategies to
integrate screening and treatment for opioid use disorders in
emergency department and primary care settings. Recognizing the
increasing severity of the National opioid crisis and the need
to better our options for responding to, treating, and
preventing overdoses, the Committee encourages NIDA to
prioritize research to expedite treatments for and prevention
of overdose from fentanyl and related analogs.
Raising Awareness and Engaging the Medical Community in
Drug Abuse and Addiction Prevention and Treatment.--Education
is a critical component of any effort to curb drug use and
addiction, and it must target every segment of society,
including healthcare providers (doctors, nurses, dentists,
pharmacists), patients, and families. Medical professionals
must be in the forefront of efforts to curb the opioid crisis.
The Committee continues to be pleased with the NIDAMED
initiative, targeting physicians-in-training, including medical
students and resident physicians in primary care specialties
(e.g., internal medicine, family practice, emergency medicine,
and pediatrics). The Committee encourages NIDA to continue
efforts in this area, providing physicians and other medical
professionals with the tools and skills needed to incorporate
substance abuse screening and treatment into their clinical
practices.
Wastewater Drug Testing.--The Committee supports NIDA's
research of testing wastewater to detect and understand trends
in drug substances. Wastewater-based drug testing is a
technique where wastewater samples from the sewer are tested
for specific targets. It is intended to complement more
traditional methods of monitoring drug use patterns, with the
potential to detect such patterns near real time and in hard-
to-reach populations. The Committee recognizes that such
testing can be proactive and may allow agencies and related
stakeholders to respond appropriately when spikes or new trends
are identified in certain areas or of certain drugs. The
Committee encourages NIDA to report data collection and
analysis of trends and drugs from this research so that the
field can improve and validate wastewater testing methods and
enable local governments to target support and reduce overdose
deaths.
NATIONAL INSTITUTE OF MENTAL HEALTH (NIMH)
Appropriation, fiscal year 2026................... $2,189,843,000
Budget request, fiscal year 2027.................. 2,040,397,000
Committee Recommendation.......................... 2,189,843,000
Change from enacted level..................... - - -
Change from budget request.................... +149,446,000
Mission.--NIMH's mission is to transform the understanding
and treatment of mental illnesses through basic and clinical
research, paving the way for prevention, recovery, and cures.
Autism Spectrum Disorder.--The Committee encourages NIH to
support greater investment in research on autism. NIH also is
encouraged to prioritize and expand research addressing core
statutory areas of need, specifically the development and
evaluation of interventions and services, lifespan outcomes,
the biology and prevalence of Autism Spectrum Disorder (ASD),
early identification and diagnosis, and disparities affecting
underserved populations. The Committee further encourages
implementation of the NIH-related provisions in the Autism
Collaboration, Accountability, Research, Education, and Support
Act of 2024, including releasing an annual budget estimate for
autism research, ensuring research efforts reflect the entire
population of individuals with ASD, and creating a new process
for the public to obtain information on all existing and
planned autism research activities and provide comments.
Mental Health Research.--The Committee supports NIMH's
high-quality basic research on serious mental illnesses and
requests an update in the fiscal year 2028 congressional
justification on the funding allocations at NIMH detailing the
percentage of funds spent on basic, translational, and clinical
research.
Music Therapy for Autism Research.--The Committee is aware
of developing research in the use of music as an educational,
communications, and mental and behavioral health tool for
individuals with Autism Spectrum Disorder (ASD). The Committee
encourages NIH to support additional research into the benefits
of music therapy to improve social interaction, communication,
neurological development, emotional regulation, focus, and
sensory-motor skills for individuals with ASD. Such efforts
could enhance efforts to examine outcomes and expand access to
intervention programs to increase quality of life for people
with ASD.
Psychotic Disorders.--The Committee recognizes the
substantial burden of psychotic disorders, including
Parkinson's disease psychosis and schizophrenia, and the
limitations of existing antipsychotics, which are associated
with metabolic toxicity, extrapyramidal symptoms, and high
rates of treatment discontinuation. The Committee is aware of
advances in ultra-selective D2 receptor pharmacology developed
through the NIH intramural research program that may preserve
antipsychotic efficacy while minimizing off-target side
effects. Therefore, the Committee urges NIMH to prioritize
funding for research into the continued development of
pharmacologically selective antipsychotic therapeutics,
including support for IND-enabling studies and early-phase
clinical trials for Parkinson's disease psychosis and
schizophrenia.
Suicide Prevention.--Suicide is complex, and multiple
factors--biological, psychological, social, and environmental--
play a role. The Committee encourages NIMH to provide
additional attention to suicide prevention research across
these areas, as well as the application of novel measurement
techniques, statistical analysis, digital initiatives, and
information systems. The Committee encourages NIMH to promote
greater collaboration with other institutes and centers with
expertise in research areas that can contribute to suicide
prevention.
Youth Mental Health.--The Committee remains concerned by
CDC data indicating elevated levels of depression among
adolescents and acknowledges the NIMH strategic framework for
addressing mental health among underserved and underrepresented
youth, including those in rural communities, by 2031. The
Committee recognizes ongoing work with NICHD and NIMHD to
execute this framework through research and other efforts. New
investments in research to guide recovery are key to resolving
the increase in youth mental health issues. The Committee
encourages NIMH to include an update in the fiscal year 2028
congressional justification on progress made in implementing
this strategic framework, including interagency collaborations,
research advancements, and stakeholder engagement.
NATIONAL HUMAN GENOME RESEARCH INSTITUTE (NHGRI)
Appropriation, fiscal year 2026................... $663,200,000
Budget request, fiscal year 2027.................. 619,514,000
Committee Recommendation.......................... 663,200,000
Change from enacted level..................... - - -
Change from budget request.................... +43,686,000
Mission.--NHGRI's mission is to accelerate scientific and
medical breakthroughs that improve human health by driving
cutting-edge research, developing new technologies, and
studying the impact of genomics on society.
Proteomics.--The Committee recognizes the promise of
proteomic research in the study of human biological systems.
The ability to effectively and efficiently analyze protein
patterns and their changes over time could provide valuable
insights into an individual's real-time state of health. The
Committee encourages NHGRI to continue proteomic research, in
conjunction with other ``-omic'' and multiomic research to
advance U.S. leadership in this cutting-edge field.
NATIONAL INSTITUTE OF BIOMEDICAL IMAGING AND
BIOENGINEERING (NIBIB)
Appropriation, fiscal year 2026....................... $440,627,000
Budget request, fiscal year 2027...................... 408,391,000
Committee Recommendation.............................. 440,627,000
Change from enacted level......................... - - -
Change from budget request........................ +32,236,000
Mission.--The NIBIB mission is to improve health by leading
the development and accelerating the application of biomedical
technologies.
Rapid Acceleration of Diagnostics.--The Committee notes the
contributions of the Rapid Acceleration of Diagnostics Tech
program to support infrastructure and sustain technological
capabilities that allow innovative technologies to continuously
flow to market. The Committee encourages continued support in
this area as it relates to technologies to improve maternal
health outcomes, particularly for individuals in areas with
limited access to maternity care.
NATIONAL CENTER FOR COMPLEMENTARY AND INTEGRATIVE
HEALTH (NCCIH)
Appropriation, fiscal year 2026....................... $170,384,000
Budget request, fiscal year 2027...................... - - -
Committee Recommendation.............................. 170,384,000
Change from enacted level......................... - - -
Change from budget request........................ +170,384,000
Mission.--The mission of NCCIH is to define, through
rigorous scientific investigation, the fundamental science,
usefulness, and safety of complementary and integrative health
approaches and their roles in improving health and health care.
NATIONAL INSTITUTE ON MINORITY HEALTH AND HEALTH
DISPARITIES (NIMHD)
Appropriation, fiscal year 2026....................... $538,395,000
Budget request, fiscal year 2027...................... - - -
Committee Recommendation.............................. 546,895,000
Change from enacted level......................... +8,500,000
Change from budget request........................ +546,895,000
Mission.--NIMHD's mission is to lead scientific research to
improve minority health and reduce health disparities.
Chronic Disease.--The Committee is aware of NIMHD's prior
support for research into the prevention, treatment, and
management of chronic diseases, including obesity, diabetes,
and hypertension, through regional chronic disease centers. The
Committee supports continued research into chronic disease,
consistent with the administration's priorities to support
scientific research that translates to measurable improvements
in Americans' health outcomes. Such efforts could continue to
utilize the regional chronic disease centers through a
competitive renewal of the program.
Improving Native American Cancer Outcomes.--The Committee
remains deeply concerned that Native Americans experience
overall cancer incidence and mortality rates significantly
higher than those of non-Native populations. The Committee
includes $15,000,000, an increase of $6,000,000 from the fiscal
year 2026 enacted level, to continue and expand support for
existing grantees under the Initiative for Improving Native
American Cancer Outcomes. This initiative supports research,
education, outreach, and clinical access related to cancer in
Native American communities. The Committee further directs
NIMHD to continue to work with NCI to maintain support for
current grantees.
Native Hawaiian/Pacific Islander Health Research Office.--
The Committee provides $7,500,000, which is an increase of
$2,500,000 above the fiscal year 2026 enacted level, for the
Native Hawaiian/Pacific Islander Health Research Office
(NHPIHRO) with a focus on both addressing Native Hawaiian and
Pacific Islander (NHPI) health disparities, as well as
supporting the pathway and research of NHPI investigators. The
Committee encourages NHPIHRO to develop partnerships with
academic institutions with a proven track record of working
closely with NHPI communities and NHPI-serving organizations
located in States with significant NHPI populations to support
the development of future researchers from these same
communities.
Research Endowment Program.--The Committee includes
$12,000,000 for the Research Endowment Program, which is the
same as the fiscal year 2026 enacted level. The Committee is
pleased with NIMHD's reinvigoration of this program and
supports efforts to expand this program and assist eligible
institutions receiving grants through a competitive process, to
ensure effective participation.
Research Centers at Minority Institutions (RCMI) Program.--
The Committee notes that NIMHD's investment in the RCMI program
provides opportunities for institutions with historical
missions and precedence of serving minorities and building
infrastructure to conduct minority health and health
disparities research. The Committee encourages NIMHD to
continue support of the RCMI program.
JOHN E. FOGARTY INTERNATIONAL CENTER (FIC)
Appropriation, fiscal year 2026....................... $95,162,000
Budget request, fiscal year 2027...................... - - -
Committee Recommendation.............................. 95,162,000
Change from enacted level......................... - - -
Change from budget request........................ +95,162,000
Mission.--FIC's mission is to support and facilitate global
health research conducted by U.S. and international
investigators, building partnerships between health research
institutions in the U.S. and abroad, and training the next
generation of scientists to address global health needs.
Coordination, Capacity, and Research.--The Committee notes
the Fogarty International Center's prior activities on
strengthening health research systems, training researchers
according to U.S. standards, and pandemic preparedness in low-
and middle-income countries. The Committee notes opportunities
for the FIC to continue international coordination, increase
capacity for computational modeling and outbreak analytics, and
support research to improve health outcomes in low-resource
settings, in accordance with the standards and principals for
international research partnerships that NIH announced in
August 2025.
NATIONAL LIBRARY OF MEDICINE (NLM)
Appropriation, fiscal year 2026....................... $497,548,000
Budget request, fiscal year 2027...................... 464,636,000
Committee Recommendation.............................. 497,548,000
Change from enacted level......................... - - -
Change from budget request........................ +32,912,000
Mission.--As a leader in computational health and the
world's largest medical library, NLM collects, organizes,
preserves, and disseminates data and information important to
biomedicine and health; serves as a national information
resource for medical education, research, and health service
activities; enhances access to biomedical literature through
electronic services; serves the public by providing electronic
access to reliable health information for consumers; supports
and directs the Network of the NLM; provides grants for
research in biomedical communications, medical library
development, and training health information specialists;
conducts and supports research and research training in
biomedical informatics, computational health, computational
biology, and data science; supports development, maintenance,
and dissemination of health data standards that promote
interoperability among clinical and research information
systems; and manages and maintains information resources for
genomics, molecular biology, clinical trials, medical images,
environmental health, public health, and health services
research.
NATIONAL CENTER FOR ADVANCING TRANSLATIONAL SCIENCES (NCATS)
Appropriation, fiscal year 2026....................... $942,323,000
Budget request, fiscal year 2027...................... 873,320,000
Committee Recommendation.............................. 954,323,000
Change from enacted level......................... +12,000,000
Change from budget request........................ +81,003,000
Mission.--NCATS was established to transform the
translational process so that new treatments and cures for
disease can be delivered to patients faster.
Angelman Syndrome.--As gene therapy and gene targeted
approaches continue to develop with significant potential for
changing outcomes for patients with Angelman syndrome and other
rare conditions, the Committee acknowledges the critical
leadership of NCATS, particularly through the Somatic Cell
Genome Editing (SCGE) program. The SCGE initiative has made
meaningful progress in advancing gene-editing technologies and
has demonstrated how development strategies for one disease
area can create a platform for other indications. The Committee
understands that scientific endeavors don't always follow a
pre-ordained pathway, and that manufacturing and other
challenges can arise that result in changes in project plans
and timelines. Given promising initial results in animal
models, the Committee urges NCATS to continue this initiative
and to expand this type of work to benefit all gene-targeted
modalities and to continue to apply learnings across
conditions.
Clinical and Translational Science Awards (CTSA).--The
Committee understands the role of the CTSA program in
supporting a national network of medical institutions to
advance the translation of research into improved clinical care
in communities. The Committee includes $629,560,000 for CTSA
activities, the same as the fiscal year 2026 enacted level.
Cures Acceleration Network.--The Cures Acceleration Network
is authorized to conduct and support advances in basic
research, accelerate the development of high need cures, and
reduce barriers between discoveries in the laboratory and
clinical trials for new therapies. The Committee continues to
include $75,000,000 for this activity.
National Clinical Cohort Collaborative.--The Committee
supports the National Clinical Cohort Collaborative (N3C)'s
open-science, privacy-preserved data-sharing platform to
accelerate biomedical research and discovery. N3C combines
electronic health record data with other types of data such as
imaging, mortality, and Medicare and Medicaid data from CMS to
answer key research questions on a variety of diseases. The
Committee supports the continuation of N3C.
Rare Disease Research.--The Committee notes NIH's important
role in conducting rare disease research, given that millions
of Americans are living with a rare disease. The Committee
encourages NCATS to continue leveraging its investments in rare
disease research, to accelerate the development of new
treatments for the over 95 percent of 10,000+ rare diseases
with no FDA approved treatment. Such investments have led to
investigational new drugs and approved therapies. The Committee
urges NCATS to increase its support for rare disease research
and has included an increase of $12,000,000 from the fiscal
year 2026 enacted level for rare disease research.
OFFICE OF THE DIRECTOR
Appropriation, fiscal year 2026....................... $2,475,514,000
Budget request, fiscal year 2027...................... 2,295,514,000
Committee Recommendation.............................. 2,500,514,000
Change from enacted level......................... +25,000,000
Change from budget request........................ +205,000,000
Mission.--The OD is responsible for the research, mission,
policies, and administration of the agency. The OD leads and
supports NIH-wide initiatives in partnership with NIH
Institutes and Centers and their constituents. OD guides the
development and management of intramural and extramural
research and research training policy, the review of program
quality and effectiveness, the coordination of selected NIH-
wide program activities, and the administration of centralized
support activities essential to the operations of NIH.
The items below include issues and programs specific to the
Office of the Director as well as those that involve multiple
institutes and centers.
Advancing Human Health.--Executive Order 14212,
``Establishing the President's Making America Healthy Again
Commission,'' acknowledges lagging American life expectancy
compared to other developed countries and the prevalence of
chronic disease in the U.S., including among children. This
executive order charges NIH and other federally funded health
research to prioritize gold-standard research into the causes
of diseases and sickness affecting Americans. The Committee
supports NIH's efforts to carry out the requirements of EO
14212 through research supported by the different Institutes
and Centers.
All of Us.--As NIH evaluates plans for the activities
supported by this program, the Committee encourages the agency
to consider the merits of integrating such activities into an
existing institute or center such as NCATS or NHGRI.
Alternatives to Animal Testing.--The Committee notes NIH's
recent actions related to increasing the use of new approach
methodologies (NAMs) and reducing the use of animals in
research. The Committee remains aware of concerns about the
process whereby peer review panels assess whether grant
applications sufficiently considered non-animal research
alternatives as part of their justification for animal use. The
Committee requests that NIH include an update in the fiscal
year 2028 congressional justification on actions it is taking
to strengthen enforcement of alternatives requirements and any
integration of incentives for the development and use of
scientifically robust non-animal methods, as well as actions to
include peer reviewers with expertise in non-animal methods.
Additionally, in support of the competitive evaluation of
applications that propose the use of NAMs, the Committee
encourages NIH to assess the feasibility of ensuring peer
reviewers have access to appropriate resources, which could
include reference librarians with expertise in evaluating the
adequacy of search efforts for non-animal methods.
Artificial Intelligence.--The Committee recognizes NIH's
ongoing efforts to leverage artificial intelligence to
accelerate biomedical research and the value of coordinating
these efforts across the agency to maximize impact and reduce
duplication. NIH is developing an NIH-wide AI strategy, and the
Committee notes that NIH requested public comments last summer
to inform the forthcoming strategic plan and its early one-year
action plan. In that request for information, NIH stated
interest in a unified, Office of the Director-level AI
structure to increase transparency, facilitate work across ICs
and programs, and ensure AI research discoveries translate to
improve health. The Committee requests a report within 180 days
of enactment of this Act on NIH's AI strategy efforts and
priority initiatives it plans for integrating AI into NIH
research or operations and to make such report available on the
agency's website. The Committee also urges NIH to consider the
benefits of how responsibly shared AI research tools or
platforms could accelerate biomedical research.
Artificial Intelligence Infrastructure in Biomedical
Research.--Executive Order 14363, ``Launching the Genesis
Mission,'' issued on November 24, 2025, directs a coordinated
national effort to accelerate the use of AI to lead to more
scientific discovery that can solve pressing problems. The
Committee recognizes the promise of the Genesis Mission's
American Science and Security Platform in accelerating science
and innovation and therefore encourages NIH support of the
goals and efforts outlined in the executive order, as
appropriate. Additionally, the Committee is aware NIH is
developing an AI Strategic Plan, as outlined in the Director's
unified strategy announced on August 15, 2025. The Committee
supports ongoing NIH efforts to enhance its AI and data science
capabilities and notes potential opportunities for building on
its infrastructure to link AI ready datasets, AI models, and
computing. As part of the fiscal year 2028 congressional
justification, the Committee requests that NIH include
information on ongoing or planned activities to enhance its AI
and data science capabilities, including information on
associated infrastructure such as computing, storage,
workforce, and software.
Artificial Intelligence Innovation.--The Committee notes
the Bipartisan Artificial Intelligence Task Force's December
2024 report that outlines principles and recommendations for
ensuring U.S. leadership in responsible artificial intelligence
(AI) innovation. The report underscored the role of basic
scientific research, including investments through the NIH, in
contributing scientific data that can be leveraged with AI to
find new discoveries. The Committee supports NIH's scientific
research that fosters American leadership in AI innovation,
including pursuing medical breakthroughs and groundbreaking
drug discoveries to improve Americans' health outcomes.
Artificial Intelligence and Machine Learning Biomarker
Precision Medicine.--The Committee notes the opportunity for
NIH to expand research leveraging artificial intelligence and
machine learning (AI/ML) to address infection-associated
chronic conditions. Such opportunities include clinical trials
for novel AI/ML-based mechanistic biomarkers and their
corresponding precision medicine treatments.
Cell and Gene Based Therapies.--The Committee recognizes
that cell- and gene-based therapies hold potential for a broad
range of conditions, including neurological conditions,
musculoskeletal conditions, cancer, radiation damage,
cardiovascular disease, diabetes, wound healing, and autoimmune
and immune-mediated disease. The Committee encourages NIH to
continue supporting research, development, and manufacturing of
somatic (adult) gene and cell-based therapies for patients with
serious and life-threatening conditions. Such efforts could
support large-scale, randomized, controlled clinical trials
exploring the use of somatic gene and cell-based therapies for
serious and life-threatening conditions; support for
characterization, optimization, and scaling of manufacturing of
gene- and cell-based therapies; the sharing of research
findings and best practices; and collaborative, evidence
development which could include an outcomes database.
Childhood Post Infectious Neuroimmune Disorders, Pediatric
Acute-Onset Neuropsychiatric Syndrome and Pediatric Autoimmune
Neuropsychiatric Disorders Associated with Streptococcus.--The
Committee supports efforts to advance scientific research
related to the devastating diseases of Pediatric Acute-Onset
Neuropsychiatric Syndrome (PANS) & Pediatric Autoimmune
Neuropsychiatric Disorder Associated with Streptococcus
(PANDAS). Although the NIH has undertaken research in this
area, significantly more needs to be done. Understanding the
causes, diagnosis, and treatment of these life-threatening
diseases is essential to expedite early identification and
intervention, thereby reducing the risk of chronic illness and
associated costs to families, school systems, health care
systems, and insurers. PANS/PANDAS research also would further
the understanding of the critical link between neuropsychiatric
illness and infections. The Committee urges NIH to continue to
prioritize research on PANS/PANDAS and related to autoimmune
encephalitic conditions and requests an update on such
research, in the fiscal year 2028 congressional justification.
Clinical Trials with International Partners.--The Committee
supports NIH efforts to ensure necessary transparency regarding
international research partners. These follow Federal oversight
agency reports in this area, including a June 14, 2023, report,
``Federal Research: NIH Could Take Additional Actions to Manage
Risks Involving Foreign Subrecipients,'' in which GAO
identified weaknesses and recommended process changes to
improve NIH oversight of such awards. The Committee is aware of
concerns about the disruption of low-risk clinical trials and
human subject research during implementation of NIH's new
application and award structure for awards involving
international entities. Therefore, while maintaining existing
prohibitions on high-risk pathogen research, the Committee
encourages NIH to work with trusted research partners abroad to
continue support for key areas of research.
Collaborations with the Department of Energy.--The
Committee supports collaborations between the NIH and the
Department of Energy (DOE) to strategically leverage NIH's
research needs in cancer research, brain mapping, myelin sheath
mapping, drug development that requires DOE's high frequency
imaging, supercomputing, instrumentation, materials, modeling
simulation, and data science. Increased coordination could be
instrumental to assist in the development of the nation's
health, security, biomedical technologies, and in the
development of more strategic enabling technologies. The
Committee requests an update from NIH regarding their current
and projected collaborations with DOE, including the
identification of future opportunities for continued
partnership growth as part of the fiscal year 2028
congressional justification.
Common Fund Rare Disease Research.--The Committee notes
prior NIH investments through the Common Fund have sought to
increase the scientific understanding of rare diseases, so that
new findings could be translated into improved diagnosis,
development of novel treatments, and potentially the discovery
of cures for such conditions. The Committee also notes that
findings from other Common Fund initiatives can inform rare
disease research, in addition to research on more common
diseases and conditions. The Committee encourages NIH to
continue to seek opportunities through the Common Fund that can
help advance the field of rare disease research and lead to
scientific breakthroughs.
Competitive Award Delays.--The Committee notes delays in
available competitive NIH grants. As of June in fiscal year
2026, the amount of available competitive NIH awards is down 48
percent, and the value of all competitive awards is down 40
percent in fiscal year 2026 as compared to fiscal year 2024.
These delays in disbursement of appropriated funds present
serious challenges to institutions of higher education who
depend on reliable timelines and clear communication from the
Department to allocate necessary resources and staff towards
grant applications. Additionally, the Committee is concerned
about broad-based efforts to limit access to grant funds for
some higher education institutions. The Committee urges NIH to
focus on the rigor and quality of the research and scientific
findings, while preserving access to funds for meritorious
grant applications.
Research Facilities Innovation Fund.--The Committee
recommendation includes $200,000,000 from within amounts
provided for the Office of the Director to support grants for
research facilities, to increase institutions' research
capacity. The Committee understands that modern, well-equipped
facilities are necessary for institutions to remain competitive
now and over the long term. Institutions with long-standing,
robust research portfolios have established or are better able
to invest in top-tier research facilities, equipment, and
related infrastructure. In turn, modern research facilities
mean institutions are better able to attract top research
talent, thereby remaining highly competitive among peer
institutions conducting federally funded research. The
Committee also recognizes that talented investigators with
meritorious research ideas--including new and early-stage
investigators--are at institutions around the country,
including those that have historically received lower levels of
NIH research funding or that have less established facilities.
Innovative approaches to supporting the development and
improvement of research facilities around the country have
great potential to increase the number of institutions capable
of conducting biomedical research. Such support can expand
institutional capacity for carrying out NIH-supported research
that leads to a deeper understanding of human health and
diseases, development of new or improved treatments, and cures
to save lives. As such, the Committee directs NIH to consider
geographic variance and the potential for facilities support to
increase the research capacity of institutions, as it
implements this program. The Committee directs NIH to provide a
briefing on its planned implementation of this activity,
including timelines, priorities, and staffing, within 90 days
of enactment of this Act.
Data Standardization and Governance for AI.--The Committee
understands the potential of publicly available research tools,
such as a platform, that could link federated, AI-ready
biomedical datasets and AI foundation models trained on such
data, to advance biomedical research. The Committee further
understands that such a platform would require a federated,
privacy-preserving, and AI-ready data ecosystem capable of
integrating large-scale biomedical datasets. As part of NIH's
ongoing strategic efforts related to AI and data science, the
Committee encourages NIH to consider the merits and feasibility
of such a research platform. NIH is also encouraged to consider
the data and governance standards required to enable the
integration of datasets into such a data ecosystem that
supports interoperability across data domains, AI training of
datasets, and ensures compliance with applicable laws, as well
as the governance frameworks necessary for responsible use
across any participating institutions.
Diagnostics and Precision Medicine for Chronic
Conditions.--The Committee remains concerned with the overall
economic and population health effects of chronic conditions,
including infection-associated conditions such as Lyme disease
and Long COVID. The Committee encourages NIH to consider
expanding opportunities to leverage AI and machine learning and
corresponding precision medicine treatments for chronic
conditions, including clinical trials for novel AI/ML-based
mechanistic biomarkers.
Dog and Cat Research.--The Committee is aware of concerns
regarding the use of dogs and cats in NIH-funded biomedical
research. The Committee commends NIH's recent efforts to reduce
the use of animals, including dogs and cats, in biomedical
research, by supporting increased use of new, promising human-
based models, which are also referred to as new alternative
methods (NAMs). The Committee notes the potential for NAMs to
provide researchers with better predictions of human
physiological responses in their studies. Similarly, the
Committee understands the FDA's historical use of dog models
for preclinical studies, but that the agency has launched its
``Roadmap to Reducing Animal Testing in Preclinical Safety
Studies,'' which aims to incorporate NAMs into its regulatory
review process. The Committee recognizes that some NIH-
supported research studies involve animals as companions, or
pets. Additionally, there are areas of research in which NAMs
are not yet able to replace animal models. In support of NIH's
efforts in this area, the Committee includes new bill language
prohibiting funding for NIH-supported biomedical research,
testing, or experimentation on dogs and cats that is classified
in pain category D or E, with exceptions for such activities
that involve dogs as companion animals, have no other viable
alternative, or permit post-research adoption or rehoming of
the dogs or cats.
Duchenne and Becker Muscular Dystrophy.--NIH-supported
basic and translational research in Duchenne and Becker
Muscular Dystrophy has enabled advances in these conditions.
There are multiple therapies approved to treat Duchenne, but
research data does not show that these key treatments halt or
reverse this devastating condition, and treatment varies
depending on a patient's genotype, age, and stage of disease.
Additional research is warranted. The Committee appreciates
NIH's focus on rare disease research that benefits Duchenne
patients as well as the Muscular Dystrophy Coordinating
Committee's update of its Action Plan. The Committee notes the
potential for platform technologies for targeted therapies to
be replicated across multiple rare conditions. NIH is
encouraged to consider research opportunities related to next
generation backbone chemistry for platform technologies, with a
particular focus on more challenging and rare genotypes not
addressed in gene targeted therapy development. The Committee
also encourages NIH to develop a multi-institute strategy to
accelerate discovery of platform approaches to DNA and RNA-
directed therapies.
Emerging Research Institutions.--The Committee notes NIH's
Unified Funding Strategy includes support for funding policies
that include the broad distribution and geographic balance of
funding. The Committee encourages NIH to consider approaches to
support research and the strengthening of biomedical research
capacity at emerging research institutions, which are those
lower Federal research expenditures, as well as at other
institutions and areas of the country that have historically
received lower levels of NIH research funding.
Facilities and Administrative Costs.--The Committee is
aware of the longstanding cost-sharing model for facilities and
administrative (F&A) costs, or indirect costs, between the
Federal government and research institutions, and that this
cost-sharing has an important role in supporting NIH-funded
research. The Committee is aware of concerns about high
negotiated F&A rates, and that more Federal funding would be
available to support biomedical research if these rates were
lower. The Committee is also aware of interest in making the
current model more transparent and efficient, and better
tailoring costs to different types of research, among other
possible changes. Additionally, the Committee understands that
research institutions' effective--or actual--reimbursement
rates may be quite lower than their negotiated rates.
Researchers analyzed this difference for about 350 research
institutions that account for roughly 90 percent of NIH's
extramural funding, in ``Indirect Cost Recovery in U.S.
Innovation Policy: History, Evidence, and Avenues for Reform,''
a National Bureau of Economic Research working paper issued in
March 2025. They found that most institutions' negotiated rates
were between 50 and 70 percent, averaging 58 percent, while
their effective rates tended to be between 25 and 45 percent
and averaged 42 percent. The researchers found that while
negotiated rates have increased during the past several
decades, effective rates have remained relatively constant. The
Committee recognizes recent efforts by interested stakeholders
to develop recommendations for a new F&A model, aimed at
addressing concerns with the current model. These efforts are a
valuable contribution to the ongoing dialogue about the future
of the F&A rates framework.
Food is Medicine.--The Committee understands the potential
for food is medicine interventions such as medically tailored
meals, medically tailored groceries, and produce prescriptions,
to improve health outcomes and treat diet-related chronic
diseases that contribute to health care costs and negative
health outcomes. The Committee encourages NIH to include an
update in the fiscal year 2028 congressional justification on
activities related to food is medicine research, including any
collaborations with the scientific community or consideration
of Food is Medicine Centers of Excellence.
Fragile X.--The Committee notes the importance of expanding
the base of researchers and clinicians who are familiar with
and trained in Fragile X-associated conditions and disorders
and promoting collaboration between basic scientists and
clinicians to enable researchers to better understand
phenotypes, document variations in how the disorder presents
itself, identify potential biomarkers and outcome measures, and
develop new interventions. The Committee commends the NIH for
recognizing the ethical, legal, and social issues in
premutation screening and testing and encourages the NIH to
look at existing pilot studies that are looking at innovative
ways to screen newborns, study Fragile X across the lifespan,
and coordinate such efforts and research with the CDC as they
look at screening solutions for FMR1-related conditions.
Gabriella Miller Kids First Pediatric Research Program.--
The Committee includes $12,600,000 to support pediatric
research as authorized by the Gabriella Miller Kids First
Research program, which is the same as the fiscal year 2026
enacted level.
Genomic Data.--The Committee is aware of legislative
efforts to establish a pilot program to collect new genomic
data from samples found on certain public lands to contribute
to scientific innovation.
Grant Funding and Administrative Burden.--The Committee is
aware of the significant administrative requirements required
of research as part of NIH's grant application process and the
peer-review grant funding model. The Committee encourages NIH,
within existing authorities, to consider opportunities to
reduce the administrative burden, while ensuring compliance and
stewardship of NIH-funded activities, which could enable
scientists to focus more time on their research. The Committee
requests NIH include an update on progress related to such
activities as part of the fiscal year 2028 congressional
justification.
Health Translational Outcomes.--The Committee is supportive
of NIH's efforts to ensure that federally funded biomedical
research translates into measurable improvements in patient
outcomes, life expectancy, and population health. Additionally,
the Committee supports NIH's efforts to strengthen the
biomedical workforce pipeline and expand access to NIH
resources such as clinical trial networks, data and computing
resources, research facilities, translational science programs,
and biorepositories. Additionally, the Committee supports
ongoing efforts at research institutions to combine their NIH
research portfolios, training programs for health
professionals, and partnerships with adult and pediatric
healthcare systems, to accelerate translational science and
clinical results.
Immune Thrombocytopenia.--The Committee commends NIH for
its efforts to advance research into rare blood disorders and
encourages NIH to explore opportunities to support research on
immune thrombocytopenia, including through the NIH Rare Disease
Clinical Research Network in coordination with other NIH
Institutes and Centers, with potential public health work
opportunities through the CDC. The Committee encourages NIH to
provide an update on activities and potential opportunities
related to immune thrombocytopenia research in the fiscal year
2028 congressional justification.
Interagency Coordinating Committee on the Validation of
Alternative Methods (ICCVAM).--The Committee notes NIH's recent
efforts to foster increased use of non-animal, alternative
methods in NIH-funded research, especially where such models
are more predictive of responses and outcomes in human health.
Therefore, the Committee notes the potential benefits of common
terminology among ICCVAM member agencies and encourages NIH to
facilitate efforts to standardize the ICCVAM member agencies'
public-facing definitions and terminology with the ICCVAM
glossary. The Committee further encourages ICCVAM to maintain a
consolidated, annually updated glossary. In the event a member
agency cannot adopt a definition for statutory, regulatory, or
other agency-specific reasons, such agency could provide ICCVAM
with a publicly available written definition and explanation as
to why it differs.
INCLUDE Down Syndrome Research Initiative.--The Committee
includes no less than $120,000,000, a $20,000,000 increase
above the fiscal year 2026 enacted level, within OD for the
INvestigation of Co-occurring conditions across the Lifespan to
Understand Down syndrome (INCLUDE) Initiative. With the
Committee's support, NIH launched the INCLUDE Initiative in
June 2018. The Committee remains pleased with a focus on large
cohort studies across the lifespan, novel clinical trials, and
multi-year, trans-NIH research driving important advances in
understanding immune system dysregulation, Alzheimer's disease,
and leukemia that is contributing to improvements in the health
outcomes and quality of life of individuals with Down syndrome
as well as millions of typical individuals. The Committee
directs NIH to provide an updated plan within 90 days of
enactment of this Act that includes a timeline and description
of potential grant opportunities and deadlines for all expected
funding opportunities so that young investigators and new
research institutions may be further encouraged to explore
research in this space. This plan should also incorporate and
increase pipeline research initiatives specific to Down
syndrome and be made available on the agency's website.
Infection Associated Chronic Conditions and Illnesses
(IACCIs).-- These are a related family of diseases with many
overlapping similarities and commonalities. The Committee
encourages NIH to establish a panel to review progress on
activities to address IACCIs. The Committee requests an update
on such progress related to addressing IACCIs as part of the
fiscal year 2028 congressional justification. Additionally, the
Committee notes ongoing clinical trials across 50 sites to
understand the causes, mechanisms, and potential treatment
options for post-infectious conditions.
Menopause Research.--The Committee is aware of research
gaps related to basic research into and knowledge and
understanding of menopause and perimenopause and treatments.
Addressing this gap could improve health outcomes and the
quality of life for the nation's middle aged and older women.
The Committee encourages NIH to research more into the
different stages of menopause, including the symptoms and
treatments at these different stages. As part of the fiscal
year 2028 congressional justification, the Committee requests
an update on recent NIH research into menopause and its
treatments.
Mental Health, Addiction, and Resilience Research.--The
Committee understands diseases of the mind and brain can
develop early in life and contribute to the persistent and
rising rates of deaths of despair from mental illness and
addiction. The Committee encourages NIH to support
collaborative research efforts to uncover the root causes,
risk, and resilience/protective factors of mental health and
addiction. These efforts could include leveraging existing
longitudinal research to analyze biological and other factors
and their interactions that can put people at risk for
addiction and mental illness, including patterns of
intergenerational transmission of mental illness; ways to
better prepare and respond to stress and trauma; and inform new
strategies for prevention, recovery, and resilience.
Microplastics.--The Committee notes that research has
identified microplastics and nanoplastics in water, food, and
air, and in the human body. The Committee encourages NIH to
review primary chemicals in the life cycle analysis of plastic
materials and impacts on human health. The Committee also
encourages NIH to research the presence of microplastics and
nanoplastics in the human body and the impacts on health.
Mitochondrial Disease.--The Committee recognizes the need
for the NIH to prioritize research on primary and secondary
mitochondrial disease. A constellation of rare diseases linked
to impaired mitochondrial function needs further research while
potentially promising interventions work through the FDA
approval process. At the same time, research continues to
validate the substantial connections between mitochondrial
function and major conditions such as Alzheimer's, Parkinson's,
ALS, and Muscular Dystrophy. The Committee urges the NIH to
advance mitochondrial disease research by fostering
interdisciplinary collaborations and supporting primary
mitochondrial disease research center awards.
Mucopolysaccharidoses and Mucolipidosis.--The Committee
recognizes the severity of Mucopolysaccharidoses and
Mucolipidosis (MPS/ML) diseases and the need for additional
research to improve life expectancy and quality of life for
patients.
Multi-Agency Coordination on New Alternative Models.--The
Committee understands recent NIH actions to promote greater use
of human-based research models, or new alternative models
(NAMs), which include organoids, tissue chips, and
computational models in NIH-funded research. NAMs have the
potential to provide scientists with better predictive value
for human responses in some areas of research compared to
traditional animal models. Other Federal agencies such as FDA
and EPA have announced plans to prioritize these new models,
too, thereby replacing the use of animals in research and
testing. The Committee notes the value in inter-agency
coordination on shared priorities and therefore encourages
NIH's continued coordination with other Federal scientific and
research-oriented agencies regarding policies around NAMs. The
Committee requests NIH include an update on activities related
to prioritizing human-based research models in the fiscal year
2028 congressional justification.
New Approach Methodologies.--The Committee commends NIH for
launching an initiative to expand and promote greater use of
new approach methodologies (NAMs), also sometimes referred to
as human-based models or non-animal models. NAMs include new,
promising technologies such as tissue chips, organoids, and
computational models. They hold the potential to provide better
insights into human physiological responses in research and
therefore improve our scientific understanding of human health
and disease and ultimately drive advancements in health. The
Committee understands a new Office of Research Innovation,
Validation, and Application will coordinate agency-wide
development and expansion of NAM approaches in NIH's research.
The Committee further notes that in July 2025, NIH announced
that it will no longer issue Notices of Funding Opportunities
that exclusively support animal models or limit or specify
which types of models must be used, a change that aims to
ensure researchers propose using the most scientifically
justified model. The Committee notes other NIH efforts related
to NAMs, including announcing funding in March under the
Complement Animal Research in Experimentation (Complement-AIRE)
program, to fund projects that develop, standardize, and
validate human-based NAMs. Additionally, as NIH implements its
policies surrounding NAMs, the Committee encourages NIH to
consider establishing a framework for NAMs that includes the
criteria for qualification and validation of NAMs; a process
for periodic review and updating of NAMs, and any incentives to
promote the use of NAMs where scientifically justified. The
Committee requests NIH include an update in the fiscal year
2028 congressional justification on activities related to
supporting the use of NAMs.
Neuroarts Research.--The Committee notes the contribution
of NIH to the burgeoning field of neuroarts, which shows great
promise in advancing health and wellbeing for all.
Neurofibromatosis.--The Committee supports efforts to
increase funding and resources for Neurofibromatosis (NF)
research and treatment at multiple Institutes, including NCI,
NINDS, NIDCD, NHLBI, NICHD, NIMH, NCATS, and NEI. Children and
adults with NF are at elevated risk for the development of many
forms of cancer, deafness, blindness, developmental delays, and
autism. The Committee encourages NCI to continue to support a
robust NF research portfolio in fundamental laboratory science,
patient directed research, and clinical trials focused on NF-
associated benign and malignant cancers. The Committee also
encourages NCI to support preclinical research and clinical
trials. Because NF can cause blindness, pain, and hearing loss,
the Committee urges NEI, NINDS and NIDCD to continue to support
fundamental basic science research on NF relevant to restoring
normal nerve function. Based on emerging findings from numerous
researchers worldwide demonstrating that children with NF have
a higher chance of developing autism, learning disabilities,
motor delays, and attention deficits, the Committee encourages
NINDS, NIMH, and NICHD to continue their support of research
investigations in these areas. Since NF2 accounts for some
genetic forms of deafness, the Committee encourages NIDCD to
expand its investment in NF2-related research. NF1 can cause
vision loss due to optic gliomas. The Committee encourages NIH
to expand its investment in NF1-focused research on optic
gliomas and vision restoration.
Non-Human Primates and Animal Models.--The Committee
continues to recognize the essential role of non-human primates
and other validated models in virtually all areas of biomedical
research. Research with these unique models makes irreplaceable
contributions to understanding the biological processes that
cause diseases. These models remain indispensable in the
discovery and evaluation of new therapeutics before they go to
clinical trials. As the U.S. population ages, and millions of
Americans suffer from chronic and degenerative diseases,
including Alzheimer's Disease and Related Dementias,
Parkinson's disease, cancer, and chronic pain, non-human
primate research will continue be vital to understanding both
the underlying mechanisms and potential cures for these
diseases. Non-human primate and animal model research remains
important to understanding the causes of age-related
degenerative diseases and to improve the effectiveness of new
compounds and non-pharmaceutical treatments such as deep brain
stimulation and neuromodulation. Access to all scientific
tools, including animal models, is critical to gaining control
over challenging neurological diseases that severely impact our
communities. The Committee encourages NIH to award funding to
meritorious research proposals to study these degenerative
disorders, as well as research into preventing the next
pandemic, including studies that utilize non-human primates and
other animal models.
Nutrition Research.--The Committee acknowledges NIH's prior
investments in nutrition research, including through various
institutes and centers, the Office of Nutrition Research, and
initiatives such as the Nutrition for Precision Health powered
by the All of Us Research program. The Committee also notes
that in May 2025, the NIH and FDA launched a joint Nutrition
Regulatory Science Program, to advance nutrition research to
inform policy decisions and improve health outcomes, through
research into the relationship between ultra-processed foods
and health, maternal and infant dietary exposures and health
outcomes over the lifespan, and related areas. More remains to
be learned about the role of nutrition in preventing and
addressing chronic disease. To support NIH investment in
nutrition and its relation to human health and disease, the
Committee includes an increase of $5,000,000 from the fiscal
year 2026 enacted level from amounts provided under the Office
of the Director, to support nutrition research.
Office for Research on Women's Health.--The Committee
provides $111,480,000 for the Office of Research on Women's
Health, which is $5,000,000 above the fiscal year 2026 enacted
level. The Committee recognizes that women's health includes
conditions and diseases that disproportionately or differently
affect women and that sex differences are at the cellular
level. Despite prior investments and progress made, gaps remain
in research, scientific understanding, and medical care due to
factors such as a lack of consistent sex-based data,
coordination across disciplines, and representative
participation in clinical trials. The Committee notes that
opportunities to enhance NIH efforts focused on the health of
women across the lifespan could address these gaps and urges
NIH to prioritize research that addresses the most pressing
research gaps. Expanded research into diseases that
disproportionately or differently affect women could lead to
tremendous improvements in health outcomes. NIH is encouraged
to expand basic, clinical, and translational research in this
area, to improve understanding of the mechanisms underlying
diseases and conditions including endometriosis, fibroids,
pelvic floor disorders, and other prevalent gynecological
conditions; advance early diagnostic and later prognostic
markers of these heterogeneous conditions; and develop new
preventative treatment methods. The Committee supports
expanded, integrated NIH-wide investment in women's health
research focused on accelerating innovative biomedical
discoveries and solutions and requests an update in the fiscal
year 2028 congressional justification on such research and the
number of new and early-stage investigators conducting women's
health research supported by these programs in fiscal year
2027.
Osteopathic Medical Schools.--Osteopathic medicine
represents a vibrant portion of the medical student education
and health systems ecosystem. It is well-positioned to help
address urgent health challenges, especially in primary care,
chronic disease, and rural and underserved communities. The
Committee remains concerned with the historic disparity in NIH
funding and representation for Colleges of Osteopathic Medicine
(COMs) and appreciates NIH's commitment to broaden investments
to more institutions and ideas. The Committee also appreciates
recent engagement with osteopathic leaders and urges NIH to
expand research funding opportunities and representation of
COMs across NIH Institutes and Centers, including in study
sections and national advisory councils, and to continue
encouraging osteopathic researchers to apply for funding. The
Committee requests NIH include information in the fiscal year
2028 justification on NIH's actions and goals related to
increasing osteopathic research funding opportunities and
representation.
Pain Management Improvements.--The Committee directs the
National Institutes of Health (NIH) to study pain management
improvement strategies for miscarriage.
Polyendocrine Metabolic Ovarian Syndrome.--The Committee
commends OD for incorporating Polyendocrine Metabolic Ovarian
Syndrome (PMOS) into Research, Condition, and Disease
Categories reporting. Despite progress, the Committee notes the
profound impact that PMOS has on 10 percent of women and its
disproportionate economic burden compared to research project
support. PMOS has metabolic, cardiovascular, reproductive,
maternal health, and mental health manifestations, and there
are no FDA-approved treatments specifically for PMOS. The
Committee urges increased NIH support for PMOS research,
including the metabolic, cardiovascular, psychosocial, maternal
fetal, oncologic, pediatric, dermatologic, neurologic, and
reproductive aspects of PMOS. The Committee encourages the NIH
to invest in fundamental laboratory science, patient-oriented
research, clinical trials, and longitudinal studies on the
cardiometabolic features and endocrinopathy of PMOS throughout
the lifespan. Areas of interest include closing knowledge gaps,
researching novel diagnostics and treatments, research
opportunities identified from the NHLBI report based on its
2021 NIH workshop on cardiovascular risks across the lifespan
in PMOS, and applying insights from the PMOS Externally Led
Patient-Focused Drug Development Meeting and Voice of the
Patient Report to address patients' unmet needs and treatment
priorities. Additionally, in recognition that individuals with
PMOS have a higher risk of depression or anxiety and an
elevated risk of eating disorders compared to those without the
condition, the Committee encourages NIH to consider basic
research into the mental and behavioral health burden of PMOS.
Such research could examine where elevated rates of mental
health disorders in PMOS are driven by the biological effects
of chronic hormonal and metabolic disruption, as well as other
factors and their interactions. The Committee also encourages
NIH to support research on the co-occurrence of mental health
disorders in gynecological conditions such as PMOS, and on the
effectiveness of evidence-based screening and intervention
approaches in this population, including whether PMOS-
associated mental health conditions are clinically and
mechanistically distinct from those in the general population.
Postural Orthostatic Tachycardia Syndrome and Other
Autonomic Nervous System Disorders.--The Committee urges NIH to
host a postural orthostatic tachycardia syndrome (POTS) expert
symposium with participants from NINDS, NHLBI, NIDDK, NICHD,
and leading external researchers and stakeholders to examine
the current state of POTS research and gather input on updates
in POTS research progress since the initial NIH POTS expert
symposium held in July. The Committee further encourages NIH to
expand and coordinate research on POTS and other autonomic
nervous system disorders across relevant Institutes and
Centers. This includes supporting targeted funding
opportunities, translational research, and appropriately
designed clinical studies, and ensuring stable pathways for
investigator-initiated research applications. The Committee
encourages NIH to support research addressing both infection-
associated and non-infectious forms of POTS and other autonomic
nervous system disorders, and to identify opportunities to
reduce duplication and accelerate progress across the NIH
portfolio. Additionally, the Committee requests NIH include an
update in the fiscal year 2028 congressional justification on
the state of POTS research, recent progress made on POTS
research priorities identified in NIH's January 2020 report to
Congress, ``Postural Orthostatic Tachycardia Syndrome (POTS):
State of the Science, Clinical Care, and Research;'' and
potential areas of unmet need in POTS research.
Precision Nutrition and Artificial Intelligence.--The
Committee notes that artificial intelligence and machine
learning models supporting precision nutrition research would
benefit from standardized, open-access molecular data on foods
to complement existing human multi-omic datasets. The Committee
further notes interest among the research community in such
data and is supportive of their efforts to develop such a
resource. Within existing authorities, the Committee encourages
NIH's continued collaboration with other Federal agencies, such
as the FDA, in precision nutrition research activities. The
Committee encourages NIH to include an update on activities
related to precision nutrition research in the fiscal year 2028
congressional justification.
Replication Experiments and Fraud Detection.--The Committee
is concerned that many biomedical research studies have turned
out to be irreproducible and in some instances fraudulent. The
Reproducibility Project in Cancer Biology showed that cancer
biology studies in top journals often failed to be replicable
(with replication effects that were 85 percent smaller than the
original study), and a prominent line of Alzheimer's studies
was found in recent years to be based on an allegedly
fraudulent study funded by NIH in the early 2000s. The
Committee commends NIH for setting reproducibility and rigor
among its key priorities, as this will help restore public
trust and confidence in the NIH and its mission and support
scientific advancements in pursuit of improved human health.
The Committee notes NIH's recent programs and efforts that
support replication efforts, including a replication initiative
supported by the Common Fund. The Committee continues to
support the Office of the Director in coordinating and
advancing such efforts at NIH and encourages robust support to
fund replication experiments on significant lines of research,
as well as attempts to proactively look for signs of academic
fraud. The Committee requests NIH continue to provide an update
on these efforts in the fiscal year 2028 congressional
justification.
Prioritizing Improvements in Health Outcomes.--The
Committee commends NIH for redoubling its commitment to carry
out its core mission of supporting fundamental research that
yields new knowledge, that in turn improves the health of
Americans. In recognition of the persistent health challenges
facing Americans, the Committee notes NIH's new unified funding
strategy prioritizes the promotion of research that is focused
on scientifically valid and measurable health outcomes, in
support of delivering health advancements for all Americans.
The Committee further notes that such efforts, combined with
NIH's commitment to free inquiry and a wide range of
viewpoints, have great potential for restoring trust in NIH's
mission.
Public Access Implementation.--The Committee recognizes the
importance of public access to federally funded research in
accelerating scientific discovery and maximizing taxpayer
value. The Committee encourages continued collaboration between
Federal agencies including the NIH and interested stakeholders
to implement frameworks that protect author rights while
serving the public interest, and any efforts by NIH to
encourage publication of federally funded research in journals
that support unbiased peer review and provide reliable
repository infrastructure in the public interest.
Research Involving Foreign Entities.--The Committee is
aware of the strong interest in ensuring NIH can conduct
necessary oversight over Federal research dollars that fund
research conducted by overseas, such as at foreign universities
or laboratories, given the implications for national security
and the need to guard against potential waste, fraud, and abuse
of taxpayer dollars. The Committee notes NIH's shift from using
foreign subawards to a new application and award structure for
grants that involve foreign entities, to ensure NIH can track
Federal funding and ensure recipients are complying with all
NIH grants terms and conditions. This policy change follows
congressional concerns, as well as audits by multiple Federal
agencies that found deficiencies in NIH's ability to oversee
grants to foreign recipients. Among these are the GAO reports,
``The National Institutes of Health Did Not Receive 81 of 109
Required Audit Reports for Foreign Grant Recipients,''
published December 14, 2023, and ``NIH Could Take Additional
Acts to Manage Risks Involving Foreign Subrecipients,'' issued
June 14, 2023.
Research Projects of Concern.--The Committee is aware of
concerns about certain NIH-funded research projects receiving
initial awards between November 1984 and December 2022, chiefly
that such research was wasteful or high-risk. The Committee
notes congressional investigations related to COVID-19,
including efforts focused on NIH grant oversight and
transparency. The Committee is also aware of the recent
indictment of a former NIAID employee for alleged evasion of
Freedom of Information Act requests related to COVID-19
research grant, following an investigation by the Federal
Bureau of Investigation and the HHS Office of Inspector
General. Additionally, the Committee notes NIH's implementation
of Executive Order 14292, ``Improving the Safety and Security
of Biological Research,'' issued May 5, 2025, related to ending
Federal funding of dangerous gain-of-function research
conducted in countries of concern or those with insufficient
oversight.
Sex Differences in Aging Biology.--The Committee recognizes
growing evidence that women and men age differently. Women, on
average, live longer than men but often suffer worse health--
making more doctor visits, taking more medications, losing more
time from work due to illness, and undergoing more medical
procedures. Emerging evidence from preclinical studies suggests
that interventions designed to extend lifespan or healthspan
often work in only one sex. Despite these observations, the
biological mechanisms underlying sex differences in aging and
age-related disease remain poorly understood. The Committee
encourages NIH to continue to support research on sex
differences in aging across the course of life.
Sex Differentiated Biomedical Research.--The Committee
recognizes the influence of biological sex on health, disease
susceptibility, disease progression, and responses to
treatment, but understands knowledge gaps remain in
understanding how sex-based differences affect health outcomes
across many medical conditions and treatments. The Committee
encourages NIH to continue expanding research examining sex as
a biological variable and the role of hormonal factors in
health and disease, to understand the effects of sex and
hormonal changes on disease mechanisms, symptom presentation,
and treatment response. NIH is encouraged to consider
biological sex differences in study design, enrollment, data
collection, and analysis, including through sufficient
representation of males and females to allow meaningful
evaluation of outcomes. The Committee further encourages NIH to
continue supporting the integration of sex-specific analysis
into study design, peer review, and distribution of research
findings, as appropriate. The Committee encourages the
Department to include an update in the fiscal year 2028
congressional justification on NIH-supported activities related
to sex differences and hormonal influences in biomedical
research.
Sjogren's Disease.--The Committee is aware that patients
may wait several years on average for a diagnosis of Sjogren's
disease. There is potential for promising new therapies, but
the Committee notes that Sjogren's disease is a highly
heterogeneous disease. Recognizing that research into Sjogren's
disease can lead to improved care for those living with this
disease, the Committee requests an update in the fiscal year
2028 congressional justification on NIH research and other
activities related to the diagnosis and treatment of Sjogren's
disease, including such activities related to better diagnosis,
characterization of the full spectrum of the disease, and
advancing possible new treatments.
Strategic Decisions.--The Committee encourages NIH, as part
of any future strategic decisions regarding intramural research
facilities, to take into consideration factors such as cost-
effectiveness and feasibility of leveraging collaborations with
other research partners and institutions.
Success Rates.--No later than 180 days after enactment of
this Act, the agency is directed to publicly post and maintain
on the agency's website a listing of all grant success rates by
institute or center, grant mechanism, and fiscal year. Such
website information shall be easily accessible and include
options to export into an electronic data format. Initial
information should include the last 10 years, to the extent
practicable, and be maintained on the website indefinitely.
Virus and Mental Illness.--The Committee understands the
connection between physical and mental health, including as
relates to contraction of a long-term disease or viral
infection. The Committee therefore encourages NIH to consider
research into the effects of viral infections, especially
common ones in youths and young adults, as well as effects on
the development of mental illness in adulthood.
Women's Health Research Through Engineering.--The Committee
encourages NIH-supported research on the use of engineering
techniques, such as in vitro models, computational models, and
AI, to address diseases that directly affect women. Such
efforts could also include a stakeholder workshop, which would
also allow for the sharing of best practices on the use of
specific engineered biophysical models to advance diagnostics
and aid in therapeutic development.
BUILDINGS AND FACILITIES
Appropriation, fiscal year 2026........... $350,000,000
Budget request, fiscal year 2027.......... 350,000,000
Committee Recommendation.................. 355,000,000
Change from enacted level............. +5,000,000
Change from budget request............ +5,000,000
Mission.--This account provides for the design,
construction, improvement, major repair, and demolition of
clinical, laboratory, and office buildings and supporting
facilities essential to the mission of the NIH. The funds in
this appropriation support the buildings on the main NIH campus
in Bethesda, Maryland; the Animal Center in Poolesville,
Maryland; the National Institute of Environmental Health
Sciences facility in Research Triangle Park, North Carolina;
the National Institute of Allergy and Infectious Diseases in
Hamilton, Montana; and other smaller facilities throughout the
U.S.
The Committee believes that safe, reliable, and updated
facilities are integral for supporting NIH research now and in
the future. The Committee notes that the agency's maintenance
and repairs backlog across its campuses exceeded $4.6 billion
as of the end of fiscal year 2025. The Committee also
understands that necessary emergency repairs can interrupt
operations. Therefore, the Committee appreciates NIH's
attention to its Repairs and Improvements program to ensure
facilities remain efficient and well-performing and reduce
costly or disruptive building emergencies.
ADVANCED RESEARCH PROJECTS AGENCY FOR HEALTH (ARPA-H)
Appropriation, fiscal year 2026....................... $1,500,000,000
Budget request, fiscal year 2027...................... 945,000,000
Committee Recommendation.............................. 1,500,000,000
Change from enacted level......................... - - -
Change from budget request........................ +555,000
Mission.--The Advanced Research Projects Agency for Health
fosters the development of novel, breakthrough, and broadly
applicable capabilities and technologies to accelerate
transformative innovation in biomedical science and medicine in
a manner that cannot be readily accomplished through
traditional Federal biomedical research and development
programs or commercial activity.
ALS Research.--The Committee encourages ARPA-H to support
research and development programs and projects to develop
therapies and treatments for ALS and related neurodegenerative
disorders, as well as research in other areas for which the
findings could be applied to address pressing research
questions and gaps in knowledge in the broader field of ALS
research.
Lyme and Other Tick-Borne Diseases (TBD).--The Committee
recognizes the value of and encourages ARPA-H to evaluate the
potential benefits of supporting research and development
programs and projects related to TBD. Examples of potential
research and development activities could include research
related to TBD diagnostics and a Bartonella unit. The Committee
encourages ARPA-H support in this area to build upon progress
in this area.
Mental Health Research.--The Committee encourages ARPA-H to
support mental health research, including on the diagnosis and
treatment of severe mental illness to address widespread
behavioral health issues. The Committee also encourages
research on developing treatments and cures for neurological
conditions such as schizophrenia, schizoaffective disorder, and
bipolar, as well as dementia. Such support has the potential to
spur industry developments and academic partnerships. As part
of the fiscal year 2028 congressional justification, the
Committee requests ARPA-H include information highlighting
initiatives and projects that relate to advancing research in
mental health, and whether such projects are basic,
translational, or clinical research.
Microgravity Life Sciences Research.--The Committee
recognizes the potential for ARPA-H to leverage Federal
investment in microgravity research to advance transformative
breakthroughs in human health, given that research in
microgravity environments has demonstrated unique advantages
for biotechnology development, pharmaceutical discovery, and
novel manufacturing processes that are not achievable under
terrestrial conditions. Such research has the potential to
accelerate the development of therapeutics, improve drug
delivery systems, expand access to innovative treatments in
rural communities, enhance patient outcomes, and reduce health
care costs. The Committee encourages ARPA-H to incorporate
microgravity-enabled research and development into its project
portfolio and to coordinate with relevant Federal partners to
maximize the return on prior investments. The Committee
requests ARPA-H to provide an update in the fiscal year 2028
congressional justification on potential opportunities related
to this field, and information on necessary coordination with
other agencies.
Rapid Therapeutics in Behavioral Health.--The Committee was
encouraged by ARPA-H's announcement of the Evidence-Based
Validation & Innovation for Rapid Therapeutics in Behavioral
Health (EVIDENT) program and its commitment of up to
$100,000,000 to address longstanding gaps in the evaluation,
validation, and scalable deployment of rapid-acting behavioral
health interventions. The Committee encourages ARPA-H to build
on this effort by supporting new clinical and implementation
trials focused on improving scalability and access to promising
interventions, including those related to prioritizing
populations disproportionately impacted by PTSD and other
serious mental health conditions.
Technology Commercialization.--The Committee has expressed
support for ARPA-H activities that speed the translation of
ARPA-H-funded innovative health technologies to market,
including the network of researchers, entrepreneurs, and
investors build by the agency. The Committee also notes the
potential of funding sprints to rapidly accelerate innovation
in priority areas. The Committee understands ARPA-H has
undertaken efforts to rethink the structure, scope, and
performance goals of such commercialization activities and
encourages ARPA-H to continue providing periodic updates to the
Committee regarding the status of such efforts and its
commercialization activities, including the agency's
incorporation subject matter and operational expertise to
ensure a successful commercialization network and its support
for funded performers developing transition or
commercialization strategies. ARPA-H is also encouraged to
indicate the metrics it is using to measure success in
commercialization.
Substance Abuse and Mental Health Services Administration
Appropriation, fiscal year 2026....................... $7,439,617,000
Budget request, fiscal year 2027...................... 6,685,210,000
Committee Recommendation.............................. 7,294,275,000
Change from enacted level......................... -145,342,000
Change from budget request........................ +609,065,000
The Committee recommendation for the SAMHSA program level
includes $7,148,608,000 in discretionary budget authority,
$133,667,000 in PHS Evaluation Tap Funding, and $12,000,000 in
transfers from the PPHF.
SAMHSA leads public health efforts to reduce the impact of
substance abuse and mental illness in the United States. The
Committee notes provisional CDC data indicating that U.S. drug
overdose fatalities fell by nearly 14 percent in 2025 compared
with the previous year. The U.S. suicide rate also declined by
nearly 3 percent in 2024 after reaching a 24-year high, with
deaths falling significantly among young adults ages 25 to 34.
While drug overdose and suicide deaths remain exceptionally
high, the Committee commends this incremental progress made and
recognizes SAMHSA's efforts to reduce adverse health outcomes
related to substance abuse and mental illness.
The Committee continues to include bill language that
exempts the MHBG and the SUPTRS block grants as a source of
funding for the PHS Act section 241 evaluation set aside in
fiscal year 2027.
Adolescent Mental Health.--The Committee remains concerned
about the high rates of mental health challenges and suicidal
ideation, particularly among adolescent females. Recent studies
find that adolescent females are highly susceptible to negative
health outcomes associated with extended social media use,
including higher rates of psychological distress, body image
issues, and eating disorders. The Committee continues to
instruct SAMHSA to complete the directives outlined in the
original explanatory statement accompanying Division D of P.L.
118-47 and reiterated in the explanatory statement accompanying
Division B of P.L. 119-75.
AI Chatbots and Youth Mental Health.--The Committee is
concerned that there are a growing number of minors who are
turning to AI Chatbots for companionship, including friendships
and romantic relationships, over human connections. The
Committee recognizes the need to ensure the use of AI Chatbots
is safe, appropriate, and not exploitative of youth. The
Committee is aware that nearly 64 percent of U.S. teenagers use
AI Chatbots and with 95 percent of U.S. teenagers having access
to their own smartphone, AI use will likely increase. The
Committee is aware that AI Chatbots have been involved in
disturbing instances of children committing suicide and self-
harm. Therefore, the Committee urges SAMHSA to provide an
update in the 2028 congressional justification on efforts to
address AI use among children and adolescents, including
investments made to address the rising rates of loneliness,
isolation, and other mental health issues associated with the
use of AI Chatbots.
Eligible Grantees.--Where permitted in the authorizing
statute, the Committee directs SAMHSA, when issuing new funding
opportunity announcements, to include as an eligible applicant
States, political subdivisions of States (including local
governments, communities, and municipalities), Tribes or Tribal
organizations, other public or nonprofit entities, and faith-
based organizations. The Committee encourages SAMHSA to provide
outreach and technical assistance to ensure the maximum level
of awareness and participation in new grant announcements to
ensure robust competition.
First Responders Behavioral Health.--The Committee
encourages the Secretary to establish an interagency working
group focused on peer-to-peer behavioral health programs for
first responders. The working group is encouraged to consider
best practices for peer-to-peer behavioral health programs that
are tailored to first responders and issue updated
recommendations to Congress on ways to improve mental and
behavioral health outcomes for first responders. The Committee
further encourages HHS to consult with other relevant
interagency, State, and local partners to help inform these
recommendations.
Gambling Addiction.--The Committee notes the ongoing
problem of gambling addiction. This behavioral disorder often
leads to poor financial, emotional, social, occupational, and
physical health outcomes. The Committee continues to direct
SAMHSA to include in its fiscal year 2028 congressional
justification information on how the agency is supporting
prevention and treatment efforts for individuals struggling
with gambling addiction.
Hair Testing Guidance.--The Committee recognizes that
section 5402 of the Fixing America's Surface Transportation
(FAST) Act (P.L. 114-94) required the Secretary to ``issue
scientific and technical guidelines for hair testing as a
method of detecting the use of a controlled substance for
purposes of section 31306 of title 49, U.S. Code'', which is
the drug and alcohol testing program for operators of
commercial motor vehicles. More than a decade has passed, and
HHS has only issued proposed mandatory guidelines in 2020.
Therefore, the Committee directs SAMHSA to issue final
guidance, in accordance with the FAST Act, and to provide a
briefing on the implementation of those guidelines within 120
days of enactment of this Act.
Harm Reduction.--The Committee commends the Trump
Administration's recent guidance to shift away from harm
reduction activities that facilitate illicit drug use and run
counter to Federal law, including the use of taxpayer dollars
to purchase drug testing kits. The Committee continues to
prioritize funding for evidence-based addiction treatment and
recovery, including the use of FDA-approved medications for
opioid use disorder. While the Committee provides no funding
for harm reduction activities, the Committee continues to
support the availability and provision of naloxone and other
opioid overdose reversal medications to reduce overdose deaths.
Hospital Diversion Pilot Program.--The Committee is
concerned about the emergency room boarding crisis, especially
for individuals in a mental health crisis. The Committee
encourages the Department to implement a pilot program modeled
after successful State hospital diversion programs, in which
young people experiencing a mental health crisis and at risk of
being hospitalized are instead referred to receive care at home
from trusted behavioral and mental health providers.
Opioid Settlement Funds.--The Committee acknowledges that
recipients of opioid settlement funds should maintain
transparency, accountability, and clear alignment with
evidence-based opioid use disorder prevention, treatment, and
recovery services. The Committee encourages SAMHSA, in
coordination with CDC and the Office of National Drug Control
Policy (ONDCP), to provide technical assistance to States and
localities on best practices for administering opioid
settlement funds, including models that prioritize the use of
evidence-based treatment, recovery supports, and overdose
prevention.
Right to Bear Arms.--The Committee recognizes that firearm
ownership is a constitutionally guaranteed right recognized by
the United States Supreme Court. SAMHSA should issue no
guidance, nor make a requirement of any recipient of Federal
funding, that seeks to restrict, limit, hinder, or further
diminish this fundamental right.
Rural Opioid Technical Assistance Regional Centers.--The
Committee continues to direct SAMHSA to maintain funding for
the 10 cooperative agreements under the Rural Opioid Technical
Assistance Regional Centers program at not less than the fiscal
year 2024 level without consolidation of the program.
Suicide Prevention.--The Committee recognizes that suicide
is a serious public health problem requiring strategic suicide
prevention solutions, especially among disproportionately
impacted populations. The Committee further recognizes that
suicide prevention requires a strategic public health approach
that addresses multiple risk factors at the individual,
community, and societal levels. States, Tribes, and territories
are most suited to lead a comprehensive public health approach
to suicide prevention, which demands effectively coordinating
with multisector partners to take a data-driven, evidence-based
process that addresses the broad range of risk and protective
factors associated with suicide.
MENTAL HEALTH
Appropriation, fiscal year 2026....................... $2,823,446,000
Budget request, fiscal year 2027...................... 1,489,831,000
Committee Recommendation.............................. 2,790,666,000
Change from enacted level......................... -32,780,000
Change from budget request........................ +1,300,835,000
Assisted Outpatient Treatment for Individuals with Serious
Mental Illness
The Committee provides $23,420,000 for Assisted Outpatient
Treatment for Individuals with Serious Mental Illness (AOT), an
increase of $2,000,000 above the fiscal year 2026 enacted
level, to deliver outpatient treatment under a civil court
order to adults with a serious mental illness who meet State
civil commitment AOT criteria, such as prior history of non-
adherence to treatment, repeated hospitalizations, or arrest.
The Committee notes that AOT may reduce psychiatric
hospitalizations, emergency department visits, and
incarceration rates while improving health outcomes and
treatment satisfaction and adherence. The Committee encourages
HHS to continue supporting the implementation and evaluation of
new AOT programs, including the continued support for the
technical assistance center. The Committee notes ongoing
assessment challenges of existing AOT programs and urges the
Department to identify program metrics that can be reliably
reported by grantees for the purpose of assessing the grant
program's effectiveness. The Department should also continue to
work with grantees to ensure that their programs are consistent
with the goals of the AOT program and focused on serving
participants who would not otherwise agree to participate in
treatment voluntarily.
Certified Community Behavioral Health Clinics
The Committee provides $385,500,000 for Certified Community
Behavioral Health Clinics (CCBHCs), which is the same as the
fiscal year 2026 enacted level. CCBHCs are designed to ensure
access to coordinated comprehensive behavioral health care by
providing care for mental health or substance abuse to all who
request such services regardless of their age or ability to
pay. CCBHCs provide access to crisis services around the clock,
support outpatient mental health and substance use services,
and community-based mental health care for veterans.
Integrated Care.--The Committee continues to recognize that
individuals living with serious mental illnesses and substance
use disorders face higher risks for developing chronic physical
conditions commonly associated with long-term use of
antipsychotics including diabetes, cardiovascular disease, and
medication-induced movement disorders such as tardive
dyskinesia. The Committee urges SAMHSA to expand technical
assistance to improve integrated care through the CCBHC State
Technical Assistance Center and the CCBHC Expansion Grantee
National Training and Technical Assistance Center. This
technical assistance and training would enhance routine
screening, prevention, and early intervention for physical
health conditions commonly associated with long-term use of
antipsychotic medications, particularly among high-risk
populations. The Committee further encourages SAMHSA to
coordinate with HRSA to facilitate dissemination of technical
information on screening at-risk patients in integrated care
models to Federally Qualified Health Centers and Rural Health
Clinics. The Committee requests an update in the fiscal year
2028 congressional justification on these efforts.
Children's Mental Health Services
The Committee provides $132,000,000 for Children's Mental
Health Services, which is the same as the fiscal year 2026
enacted level, to fund grants and technical assistance for
community-based services for children and adolescents with
serious emotional, behavioral, or mental disorders. The
Committee maintains a 10 percent set-aside for demonstration
grants or contracts that address the needs of individuals with
early serious mental illness, including psychotic disorders
among at-risk children and youth. These funds assist States,
local jurisdictions, and Tribes in developing integrated
systems of community care. The Committee directs SAMHSA to
continue supporting grant funding and the technical assistance
center, including efforts to increase mental health services
and supports for children and youth.
Mental Health Services Block Grant
The Committee provides $1,047,571,000 for the MHBG, an
increase of $35,000,000 above the fiscal year 2026 enacted
level. Of the funds provided, $21,039,000 shall be derived from
evaluation set aside funds available under section 241 of the
PHS Act. The MHBG provides funds to States to support mental
illness prevention, treatment, and rehabilitation services.
Funds are allocated according to a statutory formula among the
States that have submitted approved annual plans. The Committee
continues the 5 percent set aside within MHBG for crisis-based
services. The Committee notes that, consistent with State
plans, communities may choose to direct additional funding to
crises stabilization programs.
Prevention and Early Intervention.--The Committee
recognizes that early intervention is an important upstream
approach to preventing, delaying, or reducing the onset and
severity of mental illness and behavioral problems. Intervening
before symptoms progress to a diagnosable condition helps build
resilience in individuals--particularly children and youth--
while strengthening families and communities. Therefore, the
Committee urges SAMHSA to work with States, Tribes, and
territories to support evidence-based programs focused on the
prevention and early intervention of mental disorders among
high-risk populations. The Committee further requests that
SAMHSA include an update in the fiscal year 2028 congressional
justification on the agency's efforts.
National Child Traumatic Stress Initiative
The Committee provides $102,887,000 for the National Child
Traumatic Stress Initiative (NCTSI), an increase of $2,000,000
above the fiscal year 2026 enacted level, to increase access to
effective trauma and grief-focused treatment and services
systems for children, adolescents, and their families who
experience traumatic events. The Committee recognizes NCTSI's
network for building, evaluating, disseminating, and delivering
evidence-based services and best practices to prevent and
mitigate the impact of exposure to trauma among children and
families. The Committee encourages SAMHSA to continue awarding
new Category I, II, and III grants to meet core mission
activities of NCTSI, support collaboration among grantees, and
expand the capacity of current NCTSI grantees for activities
related to child trauma.
Projects for Assistance in Transition from Homelessness
The Committee provides $66,635,000 for the Projects for
Assistance in Transition from Homelessness program, which is
the same as the fiscal year 2026 enacted program level, to
provide grants to States and territories for assistance to
individuals suffering from severe mental illness and/or
substance use disorders and who are experiencing homelessness
or are at imminent risk of becoming homeless. Grants may be
used for outreach, screening and diagnostic treatment services,
rehabilitation services, community mental health services,
alcohol or drug treatment services, training, case management
services, supportive and supervisory services in residential
settings, and a limited set of housing services.
Protection and Advocacy for Individuals with Mental Illness
The Committee provides $42,000,000 for the Protection and
Advocacy for Individuals with Mental Illness program (PAIMI),
an increase of $2,000,000 above the fiscal year 2026 enacted
level, to support legal-based advocacy services to ensure the
rights of individuals with mental illness, protect and advocate
for these rights, and investigate incident of abuse and/or
neglect. The Committee notes that Federal funding continues to
supplement non-Federal funds available to States for PAIMI
activities.
Within the total provided for Mental Health Programs of
Regional and National Significance, the Committee includes the
following amounts:
------------------------------------------------------------------------
Budget Activity FY 2026 Enacted FY 2027 Committee
------------------------------------------------------------------------
Capacity:
Seclusion and Restraint $1,147,000 $1,147,000
appropriations...............
Project AWARE appropriations.. 140,001,000 151,052,000
State Grants 110,501,000 110,501,000
appropriations...........
Community Violence and 17,500,000 17,500,000
Trauma appropriations ...
School-Based Trauma 12,000,000 12,000,000
Informed Care
appropriations...........
Tribal Set-Aside - - - 11,051,000
appropriations...........
Mental Health Awareness 27,963,000 - - -
Training appropriations......
Healthy Transitions 18,451,000 18,451,000
appropriations...............
Infant and Early Childhood 15,000,000 16,000,000
Mental Health appropriations.
Children and Family Programs 7,729,000 7,729,000
appropriations...............
Consumer and Family Network 3,954,000 - - -
Grants appropriations........
Project LAUNCH appropriations. 19,605,000 19,605,000
Mental Health System 3,779,000 - - -
Transformation appropriations
Primary and Behavioral Health 55,877,000 55,877,000
Care Integration
appropriations...............
National Strategy for Suicide 30,200,000 30,200,000
Prevention appropriations....
Zero Suicide 23,800,000 23,800,000
appropriations (non-add).
American Indian and Alaska 4,400,000 4,400,000
Native appropriations
(non-add)................
Mental Health Crisis Response 20,000,000 - - -
Grants appropriations........
988 Lifeline appropriations... 534,618,000 544,618,000
Garrett Lee Smith-Youth 45,806,000 47,806,000
Suicide Prevention
appropriations...............
State Grants 33,806,000 35,806,000
appropriations...........
State Grants Transfer from 12,000,000 12,000,000
Prevention and Public
Health Fund..............
Garrett Lee Smith-Youth 10,488,000 12,488,000
Suicide Prevention Campus
Grants appropriations........
American Indian and Alaska 4,931,000 4,931,000
Native Suicide Prevention
Initiative appropriations....
Tribal Behavioral Health 26,250,000 30,000,000
Grants appropriations........
Homeless Prevention Programs 28,096,000 - - -
appropriations...............
Minority AIDS appropriations.. 9,224,000 - - -
Criminal and Juvenile Justice 11,269,000 - - -
Programs appropriations......
Assertive Community Treatment 6,000,000 7,000,000
for Individuals with Serious
Mental Illness appropriations
Interagency Task Force on 2,000,000 2,000,000
Trauma-Informed Care
appropriations...............
Science and Service:
Garrett Lee Smith-Suicide 11,000,000 11,000,000
Prevention Resource Center
appropriations...............
Practice Improvement and 7,828,000 7,828,000
Training appropriations......
Consumer and Consumer Support 1,918,000 1,918,000
Technical Assistance Centers
appropriations...............
Primary and Behavioral Health 3,991,000 3,991,000
Care Integration Technical
Assistance appropriations....
Minority Fellowship Program 11,059,000 11,059,000
appropriations...............
Disaster Response 1,953,000 1,953,000
appropriations...............
Homelessness appropriations... 2,296,000 - - -
Eating Disorder 2,000,000 4,000,000
Identification, Treatment,
and Recovery appropriations..
------------------------------------------------------------------------
Capacity:
Seclusion and Restraint.--The Committee provides
$1,147,000, which is the same as the fiscal year 2026 enacted
level, to reduce the inappropriate use of seclusion and
restraint practices through the provision of technical
assistance and the promotion of alternatives to restraint,
seclusion, and other coercive practices.
Project AWARE.--The Committee provides $151,052,000 for
Project AWARE (Advancing Wellness and Resiliency in Education),
an increase of $11,051,000 above the fiscal year 2026 enacted
level, to implement mental health related promotion, awareness,
prevention, intervention, and resilience activities to ensure
that school-aged youth have access and are connected to trauma-
informed and developmentally appropriate behavioral health
services. The Committee notes that program funding is intended
to supplement State and local investments in school mental
health services.
Within the amount provided, the Committee includes
$11,051,000 for Tribes and Tribal organizations.
Mental Health Awareness Training.--The Committee provides
no funding for the Mental Health Awareness Training to better
ensure that SAMHSA prioritizes services and programing for
individuals with severe mental illness.
Healthy Transitions.--The Committee provides $18,451,000
for the Healthy Transitions program, which is the same as the
fiscal year 2026 enacted level, to expand access to services
and supports for transition-aged youth and young adults with
serious mental illness.
Infant and Early Childhood Mental Health.--The Committee
provides $16,000,000 for the Infant and Early Childhood Mental
Health program, an increase of $1,000,000 above fiscal year
2026 enacted level, to support human service agencies and
nonprofit organizations that provide age-appropriate mental
health promotion and early intervention or treatment for
children with significant risk of developing mental illness
including through direct services, assessments, and trainings
for clinicians and education providers. Increased funding is
included to expand funding to additional communities, working
to build the infrastructure and systems needed to deliver early
childhood meant health services.
Children and Family Programs.--The Committee provides
$7,729,000 for the Children and Family program, which is the
same as the fiscal year 2026 enacted level, to provide grants
to Tribes and Tribal organizations for community-based services
and supports for children and youth, with or at risk for mental
illness.
Consumer and Family Network Grants.--Consistent with the
fiscal year 2027 budget request, the Committee provides no
funding for this program. The Committee prioritizes treatment,
prevention, and support services for individuals with serious
mental illness and does not provide funding for broad advocacy
activities that may promote bias views on mental health
treatment.
Project LAUNCH.--The Committee provides $19,605,000 for
Project LAUNCH, which is the same as the fiscal year 2026
enacted level. Project LAUNCH provides grants for screening,
prevention, and early intervention for behavioral health issues
for children.
Mental Health System Transformation.--Consistent with the
fiscal year 2027 budget request, the Committee provides no
funding for this program.
Primary and Behavioral Health Care Integration.--The
Committee provides $55,877,000 for the Primary and Behavioral
Health Care Integration program, which is the same as the
fiscal year 2026 enacted level, to promote full integration and
collaboration in clinical practice between behavioral
healthcare and primary/physical healthcare. The key goal of
this program is to improve patient access to integrated health
care services which requires bilateral cooperation between
physicians and technical assistance centers. The Committee
notes that integration of primary and behavioral health has
been found to increase access to mental health and substance
use recovery services for communities, including rural
communities, that lack access to such services and encourages
SAMHSA in making awards to prioritize such communities.
Mental Health Crisis Response Partnership Pilot Program.--
Consistent with the fiscal year 2027 budget request, the
Committee provides no funding for this program.
National Strategy for Suicide Prevention.--The Committee
provides $30,200,000 for the implementation of the National
Strategy for Suicide Prevention, which is the same as the
fiscal year 2026 enacted level.
Within the amount provided, the Committee includes
$23,800,000 for the Zero Suicide program, which is the same as
the fiscal year 2026 enacted level. Zero Suicide grants support
suicide prevention efforts in health systems, including
screening adults for suicide risks, providing referral
services, implementing evidence-based practices to provide
services to adults at-risk, and raising awareness of such
risks.
Within the amount provided, $4,400,000 is included for Zero
Suicide grants to American Indian and Alaska Native health
systems, which is the same as the fiscal year 2026 enacted
level.
988 Suicide & Crisis Lifeline.--The Committee provides
$544,618,000 for the 988 Suicide & Crisis Lifeline, an increase
of $10,000,000 above the fiscal year 2026 enacted level, to
support the national suicide hotline to continue to support
State and local suicide prevention call centers as well as a
national network of backup call centers and the national
coordination of such centers.
988 Call Center Abandonment.--The Committee is concerned by
the persistently elevated abandonment rates within the 988
Lifeline. In 2023, approximately 44 percent of calls were
abandoned before routing to a local contact center, and 11
percent of routed calls were abandoned while waiting to be
connected to a counselor. Early improvements following
implementation of a shortened integrated voice response (IVR)
system demonstrate that targeted adjustments can help reduce
abandonment. The Committee directs SAMHSA, in partnership with
the national administrator and state and local contact center
operators, to identify operational, technical, and workforce
factors contributing to abandonment, develop evidence-based
strategies to reduce abandonment, and establish clear
performance benchmarks for improvement. Within 60 days of
enactment of this Act, the Committee further directs SAMHSA to
provide a briefing with a status update on this effort.
988 Program Integrity.--The Committee recognizes the vital
work of the 988 Lifeline service and the important role of
State partners in suicide prevention and behavioral health. As
States continue to establish and develop 988 programs, the
Committee continues to direct SAMHSA to maintain State choice
in their technology platform provided these programs meet
SAMHSA's established minimum standards and minimum standards
through SAMHSA's 988 Network Administration that support
integration into the broader 988 system. States should have the
flexibility to utilize a platform that best facilitates
seamless coordination with local crisis and emergency response
teams; accommodates a connection to follow-up and community
resources; incorporates robust cybersecurity standards; and
ensures that sensitive user data is being safeguarded and
protected. The Committee instructs SAMHSA to complete the
briefing directive included under this heading in the House
Report 119-271.
988 Public Awareness and Education Activities.--The
Committee notes that suicide remains a leading cause of death
amongst adolescents and young adults, yet only 5 percent of
individuals aged 18-29 are familiar with the 988 Suicide and
Crisis Lifeline in 2024. Therefore, the Committee directs
SAMHSA to prioritize funding for 988 public awareness and
education activities targeted toward high-risk populations,
including adolescents and young adults. The Committee urges HHS
to coordinate with the relevant Departments and young adult
behavioral health stakeholders, such as stakeholders serving
secondary school and postsecondary students to increase
adolescent and young adult awareness of 988 via awareness
activities, including the publication of 988 on newly issued
student identification cards and driver's licenses, including
digital IDs, as authorized under P.L. 117-328 Sec. 1103. The
Committee requests that SAMHSA include an update in the fiscal
year 2028 congressional justification on the agency's progress
in addressing disparities in public awareness and utilization
of the 988 Lifeline, including the allocation of funds for the
purposes of carrying out public awareness and education
activities.
988 Tribal Capacity Building.--Tribal Nations continue to
face unique challenges with fully adopting 988 services,
including access to technology and crisis support services,
intergovernmental coordination, and culturally responsive
mental health services. The Committee instructs SAMHSA to
complete the briefing directive included under this heading in
the House Report 119-271.
Garrett Lee Smith Youth Suicide Prevention.--The Committee
provides $60,294,000 for GLS Youth Suicide Prevention grant
programs, an increase of $4,000,000 above the fiscal year 2026
enacted level.
Within the amount provided, the Committee includes
$47,806,000 for grants to States and Tribes to support
development and implementation efforts of youth suicide
prevention activities and services, an increase of $2,000,000
above the fiscal year 2026 enacted level. Of the funds
provided, $12,000,000 shall be transferred from the PPHF.
Within the amount provided, $12,488,000 is included for
grants to institutions of higher education to support students
with mental health or substance use disorders, an increase of
$2,000,000 above the fiscal year 2026 enacted level.
Garrett Lee Smith Campus Grants.--The Committee recognizes
that delayed mental health treatment can lead to higher acuity,
health care costs, and suicide rates. Campus programs that
provide peer training on early intervention and education on
primary prevention have shown promise in improving treatment-
seeking behaviors and mental health referrals among students.
Therefore, the Committee urges SAMHSA to require applicants to
seek input from relevant stakeholders, including student-
serving mental health groups on campus, to better reach
students in need of support. The Committee requests that SAMHSA
include an update in the fiscal year 2028 congressional
justification on the impact and effectiveness of peer-to-peer
education, awareness, peer support activities, and the agency's
efforts to improve such activities as part of the grants to
institutions of higher education program. The Committee
supports SAMHSA's waiver of matching funds for minority-serving
institutions and community colleges in the 2024 funding notice
and directs the Department to continue to waive this
requirement in future funding opportunities.
American Indian/Alaska Native Suicide Prevention
Initiative.--The Committee provides $4,931,000 for the Tribal
Training and Technical Assistance Center, which is the same as
the fiscal year 2026 enacted level, to facilitate the
development and implementation of comprehensive and
collaborative community-based prevention plans to reduce
suicide among American Indians/Alaska Natives (AI/AN), prevent
substance misuse, and reduce substance misuse among AI/AN
communities.
Tribal Behavioral Grants.--The Committee provides
$30,000,000, an increase of $3,750,000 above the fiscal year
2026 enacted level, to prevent and reduce suicidal behavior and
substance use, reduce the impact of trauma, and promote mental
health among AI/AN youth, through age 24.
Homelessness Prevention Programs.--The Committee provides
no funding for the Homelessness Prevention Programs, noting
that these programs are duplicative of the Projects for
Assistance in Transition from Homelessness program and other
federal housing assistance programs administered by the
Department of Housing and Urban Development.
Criminal and Juvenile Justice Activities.--Consistent with
the fiscal year 2027 budget request, the Committee provides no
funding for this program. The Committee notes that the Office
of Juvenile Justice and Delinquency Prevention under the
Department of Justice provides funding to States and Tribes for
the purpose of improving the juvenile justice system, including
support for mental health and substance abuse treatment.
Assertive Community Treatment for Individuals with Serious
Mental Illness.--The Committee provides $7,000,000 for
Assertive Community Treatment programs, an increase of
$1,000,000 above the fiscal year 2026 enacted level, to support
a multi-disciplinary service-delivery approach for individuals
with severe functional impairments associated with a serious
mental illness.
Interagency Task Force on Trauma Informed Care.--The
Committee provides $2,000,000, for the Interagency Task Force
on Trauma-Informed Care, which is the same as the fiscal year
2026 enacted level. The Committee supports continued operations
and implementation of the National Strategy for Trauma-Informed
Care Operation Plan. The Committee requests an update in the
fiscal year 2028 congressional justification on the
implementation of the Operating Plan, including specific
milestones achieved, cross-agency coordination efforts, and
measurable impacts on trauma-affected populations.
Science and Service:
Garrett Lee Smith Suicide Prevention Resource Center.--The
Committee provides $11,000,000 for the GLS Suicide Prevention
Resource Center, which is the same as the fiscal year 2026
enacted level, to build national capacity for preventing
suicide by providing technical assistance, training, and
resources to assist States, Tribes, private organizations, and
SAMHSA grantees to develop suicide-prevention strategies. The
Committee encourages SAMHSA to continue expanding training
opportunities and public-private collaboration on youth suicide
prevention and early intervention strategies.
Practice Improvement and Training.--The Committee provides
$7,828,000, which is the same as the fiscal year 2026 enacted
level, to support the dissemination of key information, such as
evidence-based mental health practices, to the mental health
delivery system.
Consumer and Consumer Support Technical Assistance
Centers.--The Committee provides $1,918,000, which is the same
as the fiscal year 2026 enacted level, to facilitate quality
improvement of the mental health system by the specific
promotion of consumer-directed approaches for adults with
serious mental illness.
Primary and Behavioral Health Care Integration Technical
Assistance.--The Committee provides $3,991,000, which is the
same as the fiscal year 2026 enacted level, to provide
technical assistance to Primary and Behavioral Health Care
Integration grantees. The Committee instructs SAMHSA to
continue following the directives outlined under this heading
in the House Report 119-271 and Senate Report 119-55.
Minority Fellowship Program.--The Committee provides
$11,059,000, which is the same as the fiscal year 2026 enacted
level, to increase behavioral health practitioners' knowledge
of issues related to prevention, treatment, and recovery
support for mental illness and addiction among minority
populations.
Disaster Response.--The Committee provides $1,953,000,
which is the same as the fiscal year 2026 enacted level, to
support the Disaster Technical Assistance Center to help
States, Tribes, localities, and territories deliver an
effective mental health and substance use-related response to
disasters.
Eating Disorders.--The Committee provides $4,000,000, an
increase of $2,000,000 above the fiscal year 2026 enacted
level, for the National Center of Excellence for Eating
Disorders. Funding will support increased engagement with
primary care providers, including pediatricians, to provide
specialized advice and consultation on screening and treatment
for eating disorders. The Committee supports work on pediatric
training models for prevention, early intervention, treatment,
and ongoing support protocols for youth with, or at-risk of
developing, an eating disorder. The Committee directs SAMHSA to
devote sufficient resources to a competitive grant process to
support the National Center of Excellence, as authorized in
section 1131 of Public Law 117-328. The Committee further
directs SAMHSA to provide an update in the fiscal year 2028
congressional justification detailing actions taken to support
the Center of Excellence in advancing education, training, and
awareness of eating disorders.
SUBSTANCE ABUSE TREATMENT
Appropriation, fiscal year 2026....................... $4,172,298,000
Budget request, fiscal year 2027...................... 490,202,000
Committee Recommendation.............................. 4,150,917,000
Change from enacted level......................... -21,381,000
Change from budget request........................ +3,660,715,000
State Opioid Response Grants
The Committee includes $1,600,000,000 for State Opioid
Response (SOR) grants, an increase of $5,000,000 above the
fiscal year 2026 enacted level. The Committee supports efforts
from SAMHSA through SOR grants to expand access to substance
use disorder treatments in rural and underserved communities,
including through funding and technical assistance. Within the
amount provided, the Committee includes a set-aside of not less
than 4.5 percent for Indian Tribes and Tribal organizations.
The Committee continues to support the continuum of
prevention, treatment, and recovery support services within SOR
for individuals with opioid or stimulant use disorder including
co-occurring addictions such as alcohol addiction. The
Committee encourages SAMHSA to increase awareness of grantees
regarding the availability of SOR funding to support treatment
and support for co-occurring additions, including alcohol use
disorder.
Data Collection and Sharing Information.--The Committee
instructs SAMHSA to complete the directives outlined under this
heading in the House Report 119-271.
FDA Approved Medications.--SAMHSA is directed to include as
an allowable use of funds all FDA-approved medications for
opioid use disorder, overdose reversal, and other clinically
appropriate services to treat opioid use disorder. The
Committee encourages SAMHSA to issue guidance to grantees
clarifying that funds may be used to procure long-acting
injectable formulations of buprenorphine and that no grantee
policy should exclude any FDA-approved medication or
formulation for treating opioid use disorder.
Substance Use Prevention, Treatment, and Recovery Services
Block Grant
The Committee includes $2,039,079,000 for the Substance Use
Prevention, Treatment, and Recovery Services (SUPTRS) Block
Grant, which is a $26,000,000 increase above the fiscal year
2026 enacted level. Of the funds provided, $79,200,000 shall be
derived from evaluation set aside funds available under section
241 of the PHS Act. The SUPTRS Block Grant is a critical
component of each State's publicly funded substance use
disorder system designed to address all substance use
disorders--including those related to alcohol. SUPTRS Block
Grant funds may support initiatives related to alcohol in
settings such as emergency rooms and primary care offices. In
addition, States utilize SUPTRS Block Grant funds to support
alcohol use disorder treatment services in outpatient,
intensive outpatient, and residential programs. Further, the
Committee is also aware that SUPTRS Block Grant funds may be
allocated to support medications for the treatment of alcohol
use disorders, an important tool that should be available to
those in need. The Committee also understands SUPTRS Block
Grant funds are utilized by States to support recovery
community organizations to provide recovery support for those
with alcohol use disorders.
The Committee recognizes the critical role the block grant
plays in State and Territory systems across the country, giving
States and Territories the flexibility to direct resources to
address the most pressing needs of their communities. The
Committee also recognizes that the 20 percent prevention set
aside within the SUPTRS Block Grant is a vital source of
funding for primary prevention.
Opioid Use Disorder in Rural Communities.--The Committee is
aware that responding to the opioid use disorder crisis
continues to pose unique challenges for rural America. Rural
areas can struggle with limited access to care, and there is a
shortage of health professionals needed to identify, diagnose,
and treat patients with substance use disorders, as well as to
assist individuals in recovery. As a result, addressing the
opioid crisis in rural America requires a comprehensive
approach, which may involve integrated models of care;
collaboration, when appropriate, with patients and their
families; involvement of community partners and institutions;
enhanced competency and skills development for health care
providers treating people with substance use disorders;
training to provide care in a culturally responsive manner; and
the use of technology to improve access in medically
underserved areas through telehealth and the expansion of
treatment programs where feasible. The Committee continues to
encourage SAMHSA, in coordination with relevant Federal, State,
local, and Tribal partners, to support initiatives to advance
opioid use disorder objectives in rural, medically underserved,
and Tribal communities, and other programs that emphasize a
comprehensive community-based approach involving academic
institutions, health care providers, and local criminal justice
systems.
Opioid Use Disorder Relapse and Overdose Prevention.--The
Committee is concerned that relapse following opioid
detoxification is a contributing factor to the overdose crisis.
The Committee notes SAMHSA's efforts to address this within the
Federal grant population by emphasizing that opioid
detoxification should be followed by proper treatment and long-
term recovery services. The Committee encourages SAMHSA to
continue these programs in all settings where detoxification is
offered, including opioid treatment programs, rehabilitation
centers, and criminal justice settings.
Prevention Activities.--The SUPTRS Block Grant's prevention
set aside requires States to allocate at least 20 percent of
Block Grant funds to primary prevention. States may use these
prevention set aside funds to support initiatives aimed at
addressing underage drinking. Such efforts can reduce access to
alcohol, reduce risk factors, and increase protective factors.
Preventing Prescription Drug and Opioid Overdoses.--The
Committee notes strong concerns about the increasing number of
unintentional overdose deaths attributable to prescription and
nonprescription opioids. SAMHSA is urged to take steps to
support the use of SUPTRS Block Grant funds for opioid safety
education and training, including initiatives that improve
access for licensed healthcare professionals, including
paramedics, to emergency devices used to rapidly reverse the
effects of opioid overdoses. Such initiatives should
incorporate robust evidence-based intervention training and
facilitate linkage to treatment and recovery services.
Within the total provided for Programs of Regional and
National Significance, the Committee recommends the following
amounts:
------------------------------------------------------------------------
FY 2026 FY 2027
Budget Activity Enacted Committee
------------------------------------------------------------------------
Capacity:
Opioid Treatment Programs and $10,724,000 $10,724,000
Regulatory Activities..............
Screening, Brief Intervention, 26,840,000 26,840,000
Referral to Treatment (SBIRT)......
Screening, Brief Intervention, and 2,000,000 2,000,000
Referral to Treatment (SBIRT) PHS
Evaluation Funds...................
Targeted Capacity Expansion-General. 125,416,000 129,916,000
Medication-Assisted Treatment 114,000,000 118,500,000
(non-add)......................
Tribal Set-Aside (non-add)...... 15,500,000 20,000,000
Grants to Prevent Prescription Drug/ 16,000,000 16,000,000
Opioid Overdose....................
First Responder Training............ 59,000,000 60,000,000
Rural Focus (non-add)........... 34,000,000 35,000,000
SIREN Act (non-add)............. 13,500,000 13,500,000
Pregnant and Postpartum Women....... 38,931,000 40,931,000
Recovery Community Services Program. 4,434,000 4,434,000
Children and Families............... 30,197,000 30,197,000
Treatment Systems for the Homeless.. 37,114,000 39,114,000
Minority AIDS....................... 66,881,000 - - -
Criminal Justice Activities......... 80,000,000 80,000,000
Drug Courts (non-add)........... 75,000,000 75,000,000
Improving Access to Overdose 1,500,000 1,500,000
Treatment..........................
Building Communities of Recovery.... 17,000,000 17,000,000
Peer Support Technical Assistance 2,000,000 2,000,000
Center.............................
Comprehensive Opioid Recovery 7,000,000 10,000,000
Centers............................
Emergency Department Alternatives to 8,000,000 8,000,000
Opioids............................
Treatment, Recovery, and Workforce 12,000,000 14,000,000
Support............................
Youth Prevention and Recovery 3,000,000 3,000,000
Initiative.........................
Science and Service:
Addiction Technology Transfer 9,046,000 9,046,000
Centers............................
Minority Fellowship Program......... 7,136,000 7,136,000
------------------------------------------------------------------------
Eligible Grantees.--The Committee directs the Secretary to
expand eligibility for grants under SAMHSA Prevention Programs
of Regional and National Significance and the corresponding
services provided by the Center for the Application of
Prevention Technologies to private, nonprofit, and regional
organizations, including faith-based organizations. The broad
coalitions orchestrated by these regional organizations are
uniquely positioned to supplement the work already being done
by the State, Tribal, and community organizations currently
eligible for such grants.
Capacity:
Opioid Treatment Programs and Regulatory Activities.--The
Committee provides $10,724,000, which is the same as the fiscal
year 2026 enacted level, to support access to FDA approved
medications for opioid use disorder through opioid treatment
programs and to approve organizations that accredit opioid
treatment programs.
Screening, Brief Intervention, and Referral to Treatment
(SBIRT).--The Committee provides $28,840,000 for the SBIRT
program, which is the same as the fiscal year 2026 enacted
level. The SBIRT program identifies individuals who misuse
substances and provides education, brief intervention, or
referrals to specialty treatment as necessary through grants to
States, Tribes, health departments, colleges and universities,
and other non-profit organizations.
Targeted Capacity Expansion.--The Committee provides
$129,916,000 for the Targeted Capacity Expansion program
including the Medication-Assisted Treatment for Prescription
Drug and Opioid Addiction program (MAT-PDOA), an increase of
$4,500,000 above the fiscal year 2026 enacted level. These
programs support State and local governments, Tribes, nonprofit
organizations, and health facilities respond to treatment and
capacity gaps for purposes of providing services to individuals
with opioid use disorder. MAT-PDOA provides access to FDA
approved medications for opioid use disorders to reduce opioid
use and related deaths. The Committee directs SAMHSA to support
nonprofit treatment facilities engaged in community enhancement
projects to improve the provision of services to rural
communities in surrounding regions. Better access to care
mitigates community safety risks while expanding treatment
services and recovery support programs for patients and their
families. The Committee further directs SAMHSA to include all
FDA-approved medications for opioid use disorder as an
allowable use to achieve and maintain remission and recovery.
The Committee urges SAMHSA to permit the use of funds
provided under MAT-PDOA to develop, replicate, and evaluate
state models for uninsured individuals that incorporate FDA-
approved long-acting injectable medications for serious mental
illness, alcoholism, and opioid dependence. The Committee
expects SAMHSA to emphasize continuity of care across all
clinical settings, including hospitals, corrections, post-
release, and community supervision, and to prioritize
voluntarily, clinically appropriate, and patient-centered
treatment. The Committee further encourages SAMHSA to assess
outcomes associated with these models and disseminate findings
to inform replication by States and regions.
Grants to Prevent Prescription Drug/Opioid Overdose.--The
Committee provides $16,000,000 for Grants to Prevent
Prescription Drug/Opioid Overdose Deaths (PDO), which is the
same as the fiscal year 2026 enacted level. The PDO program
trains first responders and other community providers on the
prevention of prescription drug/opioid overdose-related deaths
including through the purchase and distribution of naloxone.
The Committee notes that while fatal opioid overdose rates
among young Americans have decreased, the issue remains a
serious public health threat. Studies show that access to
opioid overdose reversal agents such as naloxone reduces
overdose deaths, therefore, the Committee encourages SAMHSA to
provide schools access to and administration training for
naloxone and other effective drug reversal agents.
First Responder Training.--The Committee provides
$60,000,000 for First Responder Training program, an overall
increase of $1,000,000 above fiscal year 2026 enacted level. Of
this amount, $35,000,000 is provided for rural communities with
high rates of substance abuse, an increase of $1,000,000 above
the fiscal year 2026 enacted level.
The Committee continues to provide a $13,500,000 set-aside
within the Rural Focus amount to make awards to rural public
and nonprofit fire and Emergency Medical Services (EMS)
agencies as authorized in the Supporting and Improving Rural
EMS Needs Reauthorization Act (P.L. 118-84) and directs SAMHSA
to follow the directives included in Senate Report 119-55.
Pregnant and Postpartum Women.--The Committee provides
$40,931,000 for the Pregnant and Postpartum Women program, an
increase of $2,000,000 above the fiscal year 2026 enacted
level. The Pregnant and Postpartum Women program supports
comprehensive residential substance use disorder treatment,
prevention, and recovery support services for pregnant and
postpartum women, their minor children, and other family
members.
Recovery Community Services Program.--The Committee
provides $4,434,000 for the Recovery Community Services
Program, which is the same as the fiscal year 2026 enacted
level. This program provides grants to develop, expand, and
enhance community and statewide recovery support services.
Children and Families Program.--The Committee provides
$30,197,000, which is the same as the fiscal year 2026 enacted
level, to support early identification and services to
children, adolescents, and young adults at risk of substance
use disorders, and treatment for such populations with co-
occurring mental illnesses.
Drug Courts.--The Committee provides $80,000,000 for
SAMSHA's Drug Court initiative, which is the same as the fiscal
year 2026 enacted level. The Committee continues to direct
SAMHSA to ensure that all funding appropriated for drug
treatment courts is allocated to serve people diagnosed with a
substance use disorder as their primary condition. The
Committee directs SAMHSA to ensure that all drug treatment
court grant recipients work directly with the corresponding
State substance use agency in the planning, implementation, and
evaluation of the grant. The Committee further directs SAMHSA
to expand training and technical assistance to drug treatment
court grant recipients to ensure evidence-based practices are
fully implemented.
Improving Access to Opioid Treatment.--The Committee
provides $1,500,000, which is the same as fiscal year 2026
enacted level, to support awards to expand access to FDA
approved drugs or devices for emergency treatment of known or
suspected opioid overdose.
Building Communities of Recovery.--The Committee provides
$17,000,000 for the Building Communities of Recovery program,
which is the same as the fiscal year 2026 enacted level. This
program enables the development, expansion, and enhancement of
recovery community organizations.
Peer Support Technical Assistance Center.--The Committee
provides $2,000,000, which is the same as the fiscal year 2026
enacted level, to provide technical assistance to recovery
community organizations and peer support networks.
Comprehensive Opioid Recovery Centers.--The Committee
provides $10,000,000 for Comprehensive Opioid Recovery Centers,
an increase of $3,000,000 above the fiscal year 2026 enacted
level. This program provides grants to entities that operate
comprehensive treatment and recovery centers for individuals
with opioid use disorder.
Emergency Department Alternatives to Opioids.--The
Committee provides $8,000,000 for the Emergency Department
Alternatives to Opioids program, which is the same as the
fiscal year 2026 enacted level. This program provides funding
to hospitals and emergency departments to develop and implement
alternative pain management protocols and treatments that limit
the prescribing of opioids in emergency departments.
Treatment, Recovery, and Workforce Support.--The Committee
provides $14,000,000 for the Treatment, Recovery, and Workforce
Support program, an increase of $2,000,000 above the fiscal
year 2026 enacted level. This program supports individuals in
substance use disorder treatment and recovery to live
independently and participate in the workforce.
Youth Prevention and Recovery Initiative.--The Committee
provides $3,000,000 for the Youth Prevention and Recovery
Initiative, which is the same as the fiscal year 2026 enacted
level, to support early identification and services to
children, adolescents, and young adults at risk of substance
use disorders, and treatment for such populations including
those with co-occurring mental illnesses.
Science and Services:
Minority Fellowship Program.--The Committee provides
$7,136,000, which is the same as the fiscal year 2026 program
level, to increase behavioral health practitioners' knowledge
of issues related to prevention, treatment, and recovery
support for mental illness and addiction among minority
populations.
Substance Use Disorder Treatment.--The Committee encourages
SAMHSA to expand the availability of treatment services
tailored to adolescents, pregnant women, and parents.
SUBSTANCE ABUSE PREVENTION
Appropriation, fiscal year 2026....................... $240,879,000
Budget request, fiscal year 2027...................... 18,704,000
Committee Recommendation.............................. 204,009,000
Change from enacted level......................... -36,870,000
Change from budget request........................ +185,305,000
Within the total provided for Programs of Regional and
National Significance, the Committee provides the following
amounts:
------------------------------------------------------------------------
Budget Activity FY 2026 Enacted FY 2027 Committee
------------------------------------------------------------------------
Capacity:
Strategic Prevention Framework $137,484,000 $137,484,000
Strategic Prevention 10,000,000 - - -
Framework Rx (non-add)...
Federal Drug-Free Workplace... 5,139,000 7,139,000
Minority AIDS................. 43,205,000 - - -
Sober Truth on Preventing 14,500,000 14,500,000
Underage Drinking (STOP Act).
National Adult-Oriented 2,500,000 2,500,000
Media Public Services
Campaign.................
Community Based Coalition 11,000,000 11,000,000
Enhancement Grants.......
Interagency Coordinating 1,000,000 1,000,000
Committee to Prevent
Underage Drinking........
Tribal Behavioral Health 25,665,000 30,000,000
Grants.......................
Science and Service:
Center for the Application of 9,493,000 9,493,000
Prevention Technologies......
Science and Service Program 4,072,000 4,072,000
Coordination.................
Minority Fellowship Program... 1,321,000 1,321,000
------------------------------------------------------------------------
Capacity:
Drug Free Communities.--The Committee notes that the
Department continues to propose to transfer the Drug-Free
Communities (DFC) from ONDCP to the Administration for a
Healthy America. DFC supports community-based coalitions that
engage multiple sectors of the community to prevent youth
substance use. The Committee again looks forward to working
with the authorizing committees of jurisdiction as they
consider this proposal.
Strategic Prevention Framework.--The Committee provides
$137,484,000 for the Strategic Prevention Framework (SPF),
which is the same as the fiscal year 2026 enacted level. SPF
provides grants to States, Tribes, and local governmental
organizations to prevent substance misuse. The Committee
provides no funding for SPF Rx in recognition of the
continually evolving nature of substance addiction and abuse.
The Committee strongly believes that investing in prevention is
essential to ending the substance abuse crisis, and supports
the core SPF program, which is designed to prevent the onset of
substance misuse, while strengthening prevention capacity and
infrastructure. The Committee intends that this program
supports comprehensive, multi-sector substance use prevention
strategies to stop or delay the age of initiation of each State
or local applicant's most pressing substance use issues, as
determined by the State and/or local epidemiological data.
Federal Drug Free Workplace.--The Committee provides
$7,139,000 for Federal Drug-Free Workplace Programs (DFWP), an
increase of $2,000,000 above the fiscal year 2026 enacted
level. The illicit drug market and patterns of drug use in the
United States, including among the American workforce, continue
to evolve with the proliferation of new psychoactive and
synthetic substances. DFWP is the gold-standard drug deterrence
program for Federal employees and regulated industries. It
ensures that employees in national security, public health, and
public safety positions are tested for illegal drug use and the
misuse of prescription drugs, and that laboratories conducting
this regulated testing are certified and inspected by the
Department. The Committee directs SAMHSA to use these funds to
remain at the forefront of forensic and toxicological science,
implement new testing modalities such as oral fluid and hair
testing, and expand the number of certified laboratories.
Sober Truth on Preventing Underage Drinking Act.--The
Committee provides $14,500,000 for the Sober Truth on
Preventing Underage Drinking (STOP) Act, which is the same as
the fiscal year 2026 enacted level. The STOP Act supports an
adult-oriented national media campaign to provide parents and
caregivers of youth under the age of 21 with information and
resources to discuss the issue of alcohol with their children
and provides grants to prevent and reduce alcohol use among
youth under the age of 21.
This program also supports the Interagency Coordinating
Committee on the Prevention of Underage Drinking (ICCPUD). The
Committee directs that ICCPUD funding be used only for the
purpose of preventing or reducing underage drinking, and not
for any other purpose outside its authorization, as specified
in Public Law 109-422.
Tribal Behavioral Grants.--The Committee provides
$30,000,000, which is a $4,335,000 increase above the fiscal
year 2026 enacted level, to address the high incidence of
substance misuse and suicide among the AI/AN population.
Despite the recent national decline in drug overdose deaths,
Tribal communities continue to experience disproportionately
higher rates of illicit drug use, opioid misuse, misuse of
prescription drugs, and fatal and non-fatal drug overdoses. The
AI/AN population is also at higher risk of dying by suicide
compared to the general U.S. population.
Fentanyl and Prescription Drug Misuse Prevention.--The
Committee supports efforts to better educate the public and
increase awareness about the potential lethality of fentanyl
and polysubstance and other prescription drug misuses.
Science and Service:
Center for the Application of Prevention Technologies.--The
Committee provides $9,493,000 for the Center for the
Application of Prevention Technologies, which is the same as
the fiscal year 2026 enacted level, to improve implementation
and delivery of effective substance use prevention
interventions and provide training and technical assistance
services to the substance use prevention field. The Committee
recognizes the Center for Substance Abuse Prevention and the
Prevention Technology Transfer Centers for their work in
implementing the Prevention Fellowship Program. This program
supports early career prevention fellows in gaining hands on
experience working in State alcohol and drug agencies. Fellows,
coached by mentors, developed leadership skills; received
training in professional development; acquired proficiency in
core competencies to prepare for certified prevention
specialist exams; and prepared for employment opportunities in
the substance use prevention field. The Committee continues its
directive under this heading in the explanatory statement that
accompanied Division B of P.L. 119-75.
Science and Service Activities.--The Committee provides
$4,072,000, which is the same as the fiscal year 2026 enacted
level, to support the adoption and use of effective substance
use disorder prevention strategies across the continuum of
care, with a special focus on health systems. The program also
supports the Tribal Training and Technical Assistance Center,
which provides specialized training and assistance to improve
Tribal behavioral health outcomes.
Minority Fellowship Program.--The Committee provides
$1,321,000, which is the same as the fiscal year 2025 enacted
level, to provide stipends to increase the number of SUD and
mental health professionals who teach, administer, conduct
services research, and provide direct mental health or
substance use disorder treatment services for minority
populations. The Committee directs SAMHSA to ensure that Center
for Substance Abuse Prevention funded fellowships focus on
substance use disorder prevention related activities.
HEALTH SURVEILLANCE AND PROGRAM SUPPORT
Appropriation, fiscal year 2026....................... $202,994,000
Budget request, fiscal year 2027...................... 65,823,000
Committee Recommendation.............................. 148,683,000
Change from enacted level......................... -54,311,000
Change from budget request........................ +82,860,000
The Committee provides the following amounts for Health
Surveillance and Program Support:
------------------------------------------------------------------------
FY 2026 FY 2027
Budget Activity Enacted Committee
------------------------------------------------------------------------
Health Surveillance..................... $50,623,000 $50,623,000
PHS Evaluation Funds (non-add)...... 30,428,000 30,428,000
Program Support......................... 63,600,000 63,600,000
Public Awareness and Support............ 13,260,000 13,260,000
Performance and Quality Information 10,200,000 10,200,000
Systems................................
Drug Abuse Warning Network.............. 10,000,000 10,000,000
Behavioral Health Workforce............. 1,000,000 1,000,000
PHS Evaluation Funds................ 1,000,000 1,000,000
------------------------------------------------------------------------
National Online Treatment Services Locator.--The Committee
instructs SAMHSA to complete the directives outlined under this
heading in the House Report 119-271.
Agency for Healthcare Research and Quality
HEALTHCARE RESEARCH AND QUALITY
Appropriation, fiscal year 2026....................... $345,380,000
Budget request, fiscal year 2027...................... - - -
Committee Recommendation.............................. - - -
Change from enacted level......................... -345,380,000
Change from budget request........................ - - -
The Committee provides no funding for the Agency for
Healthcare Research and Quality (AHRQ). Similar work is done by
several agencies funded in this bill, including the National
Institutes of Health, the Centers for Disease Control and
Prevention, the Substance Abuse and Mental Health Services
Administration, and the Office of the Assistant Secretary for
Health.
Centers for Medicare & Medicaid Services
GRANTS TO STATES FOR MEDICAID
Appropriation, fiscal year 2026................ $508,148,791,000
Budget request, fiscal year 2027............... 468,678,021,000
Committee Recommendation....................... 468,678,021,000
Change from enacted level.................. -39,470,770,000
Change from budget request................. - - -
Medicaid provides health coverage to eligible populations,
including eligible low-income adults, children, pregnant women,
elderly adults, and people with disabilities. Medicaid is
administered by States, according to Federal requirements. The
program is funded jointly by States and the Federal government.
This amount does not include $316,514,725,000, which was
provided as advance funding for the first quarter of fiscal
year 2027. In addition, the Committee recommends an advance
appropriation of $321,205,275,000 for program costs in the
first quarter of fiscal year 2028, to remain available until
expended.
The Committee continues bill language providing indefinite
budget authority for unanticipated costs in fiscal year 2027.
Federal Medicaid grants reimburse States for a portion of their
expenditures in providing health care for individuals whose
income and resources fall below specified levels. Subject to
certain minimum requirements, States are provided certain
limited authority within the law to set eligibility, coverage,
and payment levels.
PAYMENTS TO THE HEALTH CARE TRUST FUNDS
Appropriation, fiscal year 2026................ $593,817,000,000
Budget request, fiscal year 2027............... 686,855,000,000
Committee Recommendation....................... 686,855,000,000
Change from enacted level.................. +93,038,000,000
Change from budget request................. - - -
This account includes the general fund subsidy to the
Federal Supplementary Medical Insurance Trust Fund for Medicare
Part B benefits, and Medicare drug benefits and administration,
as well as other reimbursements to the Federal Hospital
Insurance Trust Fund for benefits and related administrative
costs, which have not been financed by payroll taxes or premium
contributions. The Committee continues bill language providing
indefinite authority to pay the general revenue portion of the
Medicare Part B premium match and resources for the Medicare
Part D drug benefit program if the annual appropriation is
insufficient.
PROGRAM MANAGEMENT
Appropriation, fiscal year 2026....................... $3,669,744,000
Budget request, fiscal year 2027...................... 3,700,493,000
Committee Recommendation.............................. 3,669,744,000
Change from enacted level......................... - - -
Change from budget request........................ -30,749,000
CMS program management includes funding for program
operations, survey and certification programs, and Federal
administration. Within the total provided for program
management, the Committee includes up to $4,500,000 for the
Office of Legislation. The Committee notes that HHS proposes to
administer the Office of Pharmacy Affairs within CMS rather
than HRSA. The Committee looks forward to working with the
authorizing committees of jurisdiction as they consider the
Department's proposal.
Program Operations
The Committee includes $2,479,823,000 for Program
Operations, which is equal to the fiscal year 2026 enacted
level. This account supports a broad range of activities to
administer CMS programs, fund beneficiary outreach and
education, maintain information technology infrastructure
needed to support various claims processing systems, and
support other programmatic improvements.
Access to Non-Opioid Pain Medication.--The Committee
recognizes the importance of ensuring access to safe and
effective pain management medications and remains concerned
about the continued impact of opioid misuse and dependency. As
part of the broader strategy to address the opioid crisis, the
Committee supports efforts by CMS to encourage the utilization
of non-opioid pain medications for the treatment of acute and
chronic pain, where clinically appropriate. The Committee urges
CMS to work with Medicare Part D plan sponsors and other
stakeholders to increase beneficiary education and access to
non-opioid pain medications and to ensure that benefit design
policies do not create unintended barriers to their use.
Acute Hospital Care at Home.--The Committee recognizes the
success of the Acute Hospital Care at Home Waiver
Flexibilities, which were extended to September 30, 2030, under
the Consolidated Appropriations Act, 2026 (P.L. 119-75). The
Consolidated Appropriations Act also directed the Secretary to
conduct a study to determine the types of patients that should
be eligible for hospital care at home. As part of this
evaluation, the Committee encourages the Secretary to consider
whether observation status patients would benefit from hospital
care at home.
Addressing Fraud and Abuse in Electrodiagnostic (EDX)
Medicine.--The Committee is concerned about poor, excessive,
and sometimes fraudulent EDX testing, including nerve
conduction studies and needle electromyography, particularly
due to the proliferation of mobile labs, unqualified providers,
and improper testing procedures. Despite a 2014 HHS OIG report
titled, ``Questionable Billing for Medicare Electrodiagnostic
Tests'', enforcement of existing requirements still appears
inadequate. Both the CPT code book and existing Medicare
regulations require EDX testing to be performed onsite, in real
time, and by a qualified provider; however, the Committee is
concerned by reports that these standards are not always
followed and rarely enforced. To address this, HHS and CMS are
encouraged to collaborate with professional and patient
stakeholders to ensure that ``qualified provider'' is clearly
defined to include only those with proper professional
training. Additionally, the Committee encourages HHS and CMS to
strengthen enforcement mechanisms to address poor testing and
inaccurate billing, ultimately preventing testing by
unqualified providers who cannot appropriately perform,
interpret, and guide studies onsite and in real time. Further
steps are necessary to protect patients and healthcare
resources through proper enforcement of current standards.
Addressing Post-Mastectomy Pain and Sensation Loss.--Nearly
80 percent of women experience pain or numbness after breast
cancer surgery, creating functional impairment and safety
risks. The Committee notes that modern reconstructive
techniques can restore not only appearance but also critical
functions such as breast sensation. Sensory nerve
reconstruction can reduce post-mastectomy pain syndrome,
improve safety, and enhance quality of life. The Committee
requests a report within 180 days of enactment of this Act on
insurance coverage of nerve reconstruction after mastectomy.
Application of Plasma-Derived Product Exclusion.--Congress
expressly excluded all biological products derived from human
whole blood or plasma from the Medicare Drug Price Negotiation
Program established under section 1192 of the Inflation
Reduction Act. See 42 U.S.C. 1320f-1(e)(3)(C) (the ``Plasma-
Derived Product Exclusion''). The Committee notes that plasma-
derived components of biological products originate from human
plasma and therefore are immune-compatible and can deliver
therapeutic benefits across a variety of medical treatments.
These therapies are uniquely susceptible to supply-chain
vulnerabilities caused by fluctuation in donor supply. They are
also subject to unique manufacturing challenges and strict
regulatory requirements intended to ensure safe and responsible
handling. Products with plasma-derived components are excluded
from the Drug Price Negotiation Program to avoid undermining
future research and development. These policy considerations
apply equally to all products that include a plasma-derived
component. The Committee encourages CMS to take these factors
into full consideration in carrying out the Drug Price
Negotiation Program.
Area Wage Index.--The Committee remains concerned about the
significant disparities in Medicare reimbursement created by
the current hospital wage index system. These disparities
continue to create substantial financial and operational
disadvantages for hospitals located in historically low wage
index markets, particularly rural and underserved communities
that depend on such providers for access to care. The Committee
notes that hospitals in the lowest quartile of wage indexes
often operate in close geographic proximity to substantially
higher wage index labor markets but remain unable to access
comparable reimbursement due to existing geographic
reclassification limitations and technical eligibility
requirements. The Committee believes these disparities
undermine workforce recruitment and retention, threaten access
to essential hospital services, and exacerbate inequities in
Medicare reimbursement. Accordingly, the Committee strongly
urges the Secretary to leverage existing authorities to
establish and implement a wage index reclassification mechanism
for hospitals in the lowest quartile of wage indexes that would
permit qualifying hospitals to redesignate to geographically
proximate labor markets with higher applicable wage indexes.
The Committee further urges the Secretary to provide
flexibility with respect to mileage requirements, average
hourly wage comparison requirements, and other technical
redesignation criteria that may disproportionately disadvantage
low wage index hospitals. The Committee supports allowing
qualifying low wage index hospitals to receive the higher of
the applicable pre-reclassified wage index or rural floor wage
index associated with the redesignated area while excluding
such hospitals' wage data from calculations that would
otherwise dilute the wage index or rural floor of the
redesignated market to the maximum extent permitted under
existing authorities. The Committee strongly urges the
Secretary to consider regulatory revisions consistent with
these principles in future rulemaking and directs CMS to
provide an update to the Committee not later than 180 days
after enactment of this Act regarding administrative options
available to implement such a redesignation pathway.
Artificial Intelligence to Improve Patient Care.--The
Committee notes the potential for AI to enhance the clinical
capabilities of providers and improve patient care and
outcomes. The FDA has cleared or approved AI-enabled medical
devices that operate as a decision support system to provide
meaningful clinical improvement to health care delivery. For
example, algorithm-based healthcare services (ABHS), a unique
and important subset of the AI-enabled devices the FDA has
authorized, provide otherwise unavailable clinical information.
CMS has acknowledged the importance of AI-enabled technologies,
requesting feedback on the criteria they should adopt in making
payment decisions. The Committee supports CMS' continued work
in this area, and encourages CMS to leverage the feedback it
has received over many years and consider policies in the
upcoming proposed Medicare payment rules that would provide
clear, targeted criteria to Medicare participating providers
and medical technology innovators regarding the reimbursement
pathway for FDA authorized AI/ML-enabled medical devices,
including ABHS technologies.
Autologous Breast Reconstruction Coverage.--Breast or chest
wall reconstruction has evolved significantly in the nearly 25
years since the passage of the Women's Health and Cancer Rights
Act. The Committee requests that CMS include in the fiscal year
2028 congressional justification an analysis of existing
policies regarding autologous reconstruction options, including
an examination of geographic trends in reimbursement and access
to perforator flap breast reconstruction.
Behavioral Health Efficiency and Effectiveness
Initiative.--The Committee is concerned by the disproportionate
Medicaid expenditures associated with a small subset of
beneficiaries who experience repeated emergency department
utilization and psychiatric hospitalizations, often driven by
unmet behavioral health and social needs. The Secretary is
encouraged to establish or expand demonstration initiatives
that facilitate real-time referral pathways from hospitals,
emergency departments, and Medicaid managed care organizations
to community-based stabilization teams; prioritize individuals
with three or more emergency department visits or psychiatric
admissions within a six-month period; and integrate peer
support specialists, care coordinators, and community health
workers to provide wraparound stabilization services. The
Committee encourages participating entities to track reductions
in emergency department utilization, psychiatric readmissions,
and total cost of care, while improving patient engagement,
housing stability, and continuity with primary and behavioral
health providers.
Cancer Survivorship Alternative Payment Model.--The
Oncology Care Model ended in 2022 after a five-year test, and
the successor Enhancing Oncology Model was launched in 2023.
The trigger for an episode of care in these models is the
initiation of cancer drug therapy. However, these delivery
experiments exclude a population of cancer patients who might
benefit from the patient-centered care offered in care models,
such as cancer survivors who have completed active treatment
and are entering a period of long-term survivorship. The
Committee encourages CMS to consider appropriate options for
survivors.
Certified Registered Nurse Anesthetists (CRNAs).--The
Committee is aware of challenges surrounding patient access to
anesthesia services, particularly in rural areas. Therefore,
the Committee supports CMS in its continued consideration of
the benefits of Certified Registered Nurse Anesthetists
performing services.
Chief Dental Officer.--The Committee acknowledges the
significance of oral health representation within CMS and has
supported the position of Chief Dental Officer (CDO) within the
CMS Administrator's Office. This role ensures oral health
issues remain a central focus in CMS policymaking and
operations, enhancing coordination between CMS programs and the
broader healthcare system. By embedding dental expertise at the
highest levels of CMS decision-making, the profession is
positioned to meet the evolving demands of healthcare delivery,
regulatory compliance, and patient care. The Committee commends
CMS for recognizing the essential role of oral health in
overall health and urges this commitment to continue, with the
CDO position being well-resourced and playing an integral part
in shaping policies that prioritize access to oral healthcare
and improved health outcomes.
Childhood Cancer Survivorship Transition.--The Committee
encourages CMS to collect Medicaid claims data from States on
childhood and young adult cancer beneficiaries receiving
services to transition from pediatric to adult care,
utilization of services that support transitions of care, and
receipt of an individualized transition of care plan. The
Committee requests an update on this topic in the 2028
congressional justification.
Chronic Kidney Disease (CKD).--The Committee is committed
to ensuring that patients with CKD have access to the most
clinically appropriate treatments. More effective diagnosis and
care can help reduce the rates of kidney failure and
cardiovascular complications for patients and generate savings
to the Federal government. Therefore, the Committee encourages
CMS to work to ensure the Medicare benefit guidelines reflect
the most recent clinical CKD guidelines and to increase access
to early screening utilizing both estimated glomerular
filtration rate (eGFR) and urine Albumin-to-Creatinine Ratio
(uACR) testing, diagnosis, and treatment for high-risk
populations for CKD.
Cognitive Screening and Diagnostic Tools.--The Committee
notes the importance of early cognitive screening as a critical
step in diagnosing a patient with Alzheimer's disease (AD),
which is the most common cause of dementia, and recognizes the
limited uptake among Medicare beneficiaries during the Medicare
annual wellness visit (AWV). Additionally, the Committee notes
that AD blood-based biomarker tests are a powerful, non-
invasive, and scalable tool for addressing the growing burden
of dementia compared to traditional diagnostic methods but may
not have clear and sustainable coverage pathways under
Medicare. The Committee encourages CMS to explore coverage
policies that would improve access to cognitive screening tools
and AD blood-based biomarker tests under Medicare.
Colorectal Cancer Screening Quality Measurement.--The
Committee notes that colorectal cancer is the leading cause of
cancer death among men and women under age 50 and the second
leading cause of cancer death overall. Screening significantly
reduces colorectal cancer mortality, and Medicare covers
several innovative screening technologies. The Committee
understands that quality measures developed by the National
Committee for Quality Assurance (NCQA) are widely used in
Medicare Advantage (MA), Medicaid, and the individual
marketplace. Since these measures influence clinical practice
through quality performance assessments or bonus payments,
delays in updating measures to reflect recently FDA-approved
and Medicare-covered screening technologies can limit adoption
and create access gaps--for example between Medicare fee-for-
service and MA beneficiaries. The Committee urges CMS to
leverage its existing authority and update colorectal cancer
screening quality measures in a timely manner to align with
Medicare coverage and ensure consistent access across Federal
and commercial health programs.
Competitive Bidding for Continuous Glucose Monitoring (CGM)
and Insulin Pumps.--The Committee recognizes the critical role
of advanced technology in improving patient safety and health,
particularly for people with diabetes. CGM systems and insulin
pumps help people with diabetes prevent adverse events related
to blood glucose levels, and the Committee notes that any
disruption in access to these devices could have serious health
consequences. The Committee is aware that CMS has finalized a
rule that would reclassify these devices as ``items requiring
frequent and substantial servicing'' and include them in the
durable medical equipment competitive bidding program. CMS
should ensure that Medicare coverage policies are consistent
with current clinical standards of care while protecting
against waste, fraud, and abuse. Therefore, the Committee
directs CMS to report to the Committee within 180 days of
enactment of this Act regarding the impact of the rule on
patients' ability to access medically appropriate CGMs and
insulin pumps, and recommendations for other ways to address
waste, fraud, and abuse related to diabetes technology.
Competitive Bidding for Ostomy, Tracheostomy, and
Urological Supplies.--The Committee notes concerns about CMS'
decision to include ostomy, tracheostomy, and urological
prosthetic supplies in the Medicare Competitive Bidding
Program. These supplies have not been included in the program
previously. The Committee is concerned that subjecting these
supplies to competitive bidding without sufficient analysis
could disrupt patient access, compromise clinician decision-
making, harm domestic manufacturing, and increase Medicare
costs. Accordingly, the Committee urges caution on any attempt
to impose requirements which could negatively impact the market
for these products and result in limited patient access. The
Committee requests an update on current rulemaking related to
this topic in the fiscal year 2028 congressional justification.
Connecting Caregivers to Medicare Information.--The
Committee recognizes the financial and emotional strain that
caregivers experience when caring for their elderly loved ones.
In particular, the Committee acknowledges that caregivers face
barriers to accessing health information from CMS about their
loved ones who are Medicare beneficiaries in order to
coordinate access to care on their behalf. The Committee
encourages CMS to incorporate the real-world experiences of
caregivers and to develop approaches that improve family
caregivers' access to beneficiary information and resources to
help their loved ones utilize their Medicare benefits. The
Committee encourages CMS to publish a report on the barriers
that caregivers face in obtaining essential Medicare
beneficiary information and how the agency can update both
existing and novel, technologically modern ways to deliver
resources and information to caregivers.
Consistency in Medicare Allergy Immunotherapy Coverage.--
Allergy immunotherapy is an important and effective treatment
for patients with allergies. Allergy immunotherapy has been
successfully used to help treat patients with environmental
allergies for over 100 years by gradually exposing patients to
increasingly potent amounts of allergen ``doses''' with
subcutaneous injections, starting with a buildup phase and
eventually reaching a maintenance level. The Committee notes
that Medicare recently confirmed coverage of the buildup phase
in addition to the maintenance phase of allergy immunotherapy.
The Committee encourages CMS to adopt a definition of ``dose''
that is consistent with clinical parameters and common practice
for every procedure code related to allergy immunotherapy
preparation and administration.
Convenient Access Standards.--The Committee is concerned
that existing convenient access standards for Medicare Part D
beneficiaries based on geographic distance do not take into
account all methods of access to medications, including home
delivery options. The Committee encourages CMS to consider
appropriate updates to the existing network adequacy standards
and to provide feedback, information, and technical assistance
to Congress on policies that could improve patient access to
drugs and pharmacist services, including potential changes to
Part D network adequacy standards.
Coverage Without Cost-sharing for Colorectal Cancer Bowel
Preparations.--The Committee notes that existing Federal
guidance recognizes medically appropriate bowel preparation
prescribed in connection with a preventative screening
colonoscopy as an integral part of the preventative service.
The Committee encourages CMS to review and, as appropriate,
update guidance to promote consistent implementation of
existing law, while preserving reasonable medical management to
control premium growth.
Digital Services Modernization.--The Committee supports
CMS's ongoing efforts to modernize and enhance both internal
and external digital services in alignment with the
requirements of the 21st Century Integrated Digital Experience
Act (P.L. 115-336). The Committee notes that full
implementation of 21st Century IDEA has the potential to
strengthen CMS's ability to deliver critical health care
services. The Committee supports the modernization and security
of CMS's paper-based forms, ensuring they are cloud enabled,
mobile responsive, Section 508 compliant, and expand the use of
electronic signatures.
Early-Stage Breast Cancer Testing to Inform Personalized
Treatment.--The Committee notes that ductal carcinoma in situ
(DCIS), non-invasive Stage 0 breast cancer, as well as stages I
and IIA invasive breast cancer, comprise approximately 80
percent of all breast cancer diagnoses. Among these early-stage
breast cancer patients, 70 percent can be treated successfully
with surgery alone. However, the majority of patients receive
radiation therapy when only 15 percent will benefit.
Unnecessary radiation exposure results in harmful side effects
such as radiation fibrosis, secondary cancers, skin damage, and
associated mental health risks, as well as wasted medical
expenditures. Therefore, the Committee encourages CMS to
explore coverage for breakthrough innovations approved by the
FDA that are also recommended by medical societies or included
in clinical cancer guidelines that inform clinicians on the
need for radiation therapy following surgery by analyzing
protein or RNA expression linked to breast cancer recurrence.
The Committee directs CMS to provide a report to the Committee
within 180 days of enactment of the Act on the status of
coverage for innovations that provide personalized, predictive
insights on the degree of benefit of radiation therapy, in
post-surgical early-stage breast cancer care.
Enabling Radiologist Assistant Care.--The Committee notes
that radiologist assistants are advanced-level radiographers
who are important members of the radiologist-led team.
Radiologist assistants work strictly under the supervision of a
radiologist to promote high standards of patient care by
assisting radiologists in performing diagnostic and
interventional image-guided radiology services, as permitted by
State law. The Committee remains concerned about barriers to
care provided by radiologist assistants within the Medicare
program, leading to underutilization of these providers. As
such, CMS should consider how it may remove barriers to care
rendered by radiologist assistants to promote efficiency,
improve patient outcomes, and ensure patient safety. The
Committee encourages CMS to establish effective policies to
enable patient access to radiologist assistant care under the
supervision of a radiologist, as permitted by State law. In
developing these policies, CMS should consult with
stakeholders. Within 180 days of enactment of this Act, CMS
shall provide a report to the Committee on specific actions it
may take to remove existing barriers and develop and implement
effective policies to enable radiologist assistant care under
the supervision of a radiologist, as permitted by State law.
Enforcement of Medicare's Six Protected Classes.--The
Committee is aware that several statutory and regulatory
changes to Medicare's coverage of prescription drugs are likely
to coincide this year. The Committee recognizes that Part D
redesign and direct price negotiations continue to shift
incentives that impact plan behavior, and it will take time for
Medicare Part D plans and MA plans to integrate all these
changes. According to a recent survey, independent community
oncologists are already seeing changes to utilization
management practices by insurers and PBMs resulting in delayed
cancer treatments, interference with treatment decisions
between physicians and their patients, and an increasing burden
on oncology practices and patients. CMS acknowledged in its
Part D Benefit Manual that drugs subject to prior
authorization, step therapy, or restrictive quantity limits may
function as ``non-formulary'' with respect to patient access.
The Committee supports the Administration's continued
enforcement of protected classes and requests an update within
60 days of enactment of this Act on actions the agency is
taking to ensure Medicare beneficiaries who rely on the
protected classes policy are not increasingly hindered in their
access to all or substantially all treatment options.
Enhanced Medicaid Program Integrity to Reduce Fraud, Waste,
and Abuse.--The Committee is concerned by persistent program
integrity vulnerabilities that allow erroneous, duplicative,
and improper payments within the Medicaid program. In 2025, CMS
identified approximately 2.8 million individuals simultaneously
enrolled in both Medicaid and ACA Marketplace coverage,
resulting in more than $25 billion annually in waste of
taxpayer dollars. The Committee also notes a 2024 GAO report
finding that nearly 25 percent of improper Medicaid payments
stem from State noncompliance with provider enrollment and
screening requirements. The Committee urges CMS to strengthen
program integrity efforts through enhanced data matching,
eligibility verification, and cross-program enrollment checks,
including improved use of national data tools to identify dual
enrollment and recover improper payments. CMS is further
encouraged to expand tools that detect identity fraud and
verify U.S. citizenship and State residency. Within 180 days of
enactment of this Act, CMS shall submit a report to the
Committee describing actions taken to reduce fraud, waste, and
abuse, including improvements to eligibility verification,
State compliance with enrollment safeguards, and deployment of
enhanced data analytics and program integrity tools.
Ensuring Patient Assistance Counts toward Out-of-Pocket
Limits.--The Committee notes the decision in HIV & Hepatitis
Policy Institute et al. v. U.S. Department of Health & Human
Services, No. 1:22-cv-02604 (D.D.C. Sept. 29, 2023), regarding
the treatment of manufacturer cost-sharing assistance under the
annual limitation on cost sharing. The Committee encourages CMS
to provide clear guidance to plans and issuers regarding
compliance obligations related to cost-sharing assistance
policies, including accumulator adjustment programs, consistent
with applicable law and court decisions. The Committee further
encourages CMS to engage stakeholders and coordinate with State
regulators, as appropriate, to promote transparency for
beneficiaries regarding the treatment of manufacturer cost-
sharing assistance.
Expedited Access to Breakthrough Medical Devices.--The
Committee is concerned that Medicare beneficiaries with serious
and life-threatening conditions face significant delays in
accessing FDA-designated breakthrough medical devices following
market authorization. The Committee notes that devices
receiving FDA breakthrough designation based on robust clinical
data should have a defined, expedited pathway to Medicare
coverage. The Committee urges CMS to initiate rulemaking to
establish an expedited transitional coverage pathway for
breakthrough-designated medical devices authorized for
marketing including clinical data of Medicare beneficiaries,
under which coverage would be available for a defined period
following designation while a National Coverage Determination
is completed. The Committee directs CMS to report to the
Committees on Appropriations, Energy and Commerce, and Ways and
Means of the House of Representatives, and the Committees on
Appropriations and Finance of the Senate, within 180 days of
enactment of this Act, on the timeline and status of any such
rulemaking, including any barriers to implementation.
Focused Ultrasound Reimbursement.--The Committee
understands focused ultrasound is a noninvasive, non-
pharmacological, safe, and cost-effective alternative or
complement to conventional surgery, radiation therapy, or drug-
based treatments. The FDA has cleared focused ultrasound for
ten distinct clinical indications. However, the Committee
understands that there can be a substantial lag between FDA
authorization and payment for this technology. Therefore, the
Committee directs CMS to evaluate payment policies for focused
ultrasound technologies that are FDA-cleared. The evaluation
shall assess existing coverage, coding and payment
methodologies, and barriers to appropriate beneficiary access.
Not later than 180 days after enactment of this Act, CMS shall
provide a preliminary briefing to the Committee summarizing its
findings and identifying potential administrative actions to
improve reimbursement clarity and consistency with a report to
follow.
Gene Therapy Reimbursement.--The Committee is concerned
that current pricing and reimbursement policies for gene
therapies may not adequately reflect their high development
costs, long timelines, and unique clinical value. The Committee
encourages CMS to evaluate whether existing payment policies
may discourage future innovation.
Graduate Medical Education.--The Committee notes that
Congress has provided over 1,000 additional Medicare-supported
graduate medical education (GME) positions in recent years.
Congress has specified four categories of hospitals eligible
for additional GME positions: hospitals located in rural areas,
hospitals currently training residents above their existing
caps, hospitals located in States with new medical schools, and
hospitals serving Health Professional Shortage Areas (HPSAs).
Within these categories, the Committee encourages CMS to
consider future slot distribution to teaching hospitals
associated with Historically Black Medical Schools.
Historically Black Medical Schools and their teaching hospitals
have been under-resourced, while serving in-need communities.
Health Insurance Exchange Transparency.--The Committee
continues bill language requiring CMS to continue to provide
cost information for the health insurance exchange, including
all categories described under this heading in the explanatory
statement accompanying division B of P.L. 115-245, as well as
estimated costs for fiscal year 2028.
Immediate Jeopardy Reporting.--The Committee is concerned
that CMS does not maintain consolidated national data on
immediate jeopardy (IJ) findings issued during hospital
surveys. The Committee encourages CMS to systematically track
and maintain data on IJ citations issued to hospitals
participating in the Medicare and Medicaid programs, including
the number of such IJ citations and the hospitals cited and, to
the extent practicable, make public data on such IJ citations.
Improving Behavioral Health Care Coordination for Medicare
Beneficiaries.--The Committee recognizes that behavioral health
conditions are prevalent within the Medicare population, as
older adults face unique risks, including social isolation, co-
occurring chronic disease, and elevated rates of depression,
substance use disorder, and suicide. The Committee is concerned
that Medicare beneficiaries with behavioral health conditions
do not always receive optimal care for these conditions, which
takes a significant toll on beneficiary well-being and leads to
costly episodes of care. The Committee appreciates CMS'
commitment to improving behavioral health for beneficiaries,
including those in Medicare Advantage plans, and supports
efforts to improve behavioral health care navigation in
Medicare, including through the appropriate use of technology.
The Committee requests an update in the fiscal year 2028
congressional justification detailing steps CMS is taking to
improve care navigation and outcomes for beneficiaries with
behavioral health conditions, including mental health and
substance use.
Improving Care and Access to Nurses.--The Committee
recognizes nurse practitioners play an essential role in
meeting increasing demand for high-quality health care
services. However, the Medicare program contains administrative
barriers that can stifle the way the nation's health care
delivery system is modernizing to meet increasing demand. These
barriers may create inefficiencies and lead to duplicative
visits, increased costs, delays in care for patients, and
limits in patients' ability to receive care from their provider
of choice. As such, the Committee encourages CMS to evaluate
its policies and conditions of participation across all
settings for nurse practitioners by removing any burdensome
requirements in the Medicare program that limit professionals
from practicing at the top of their profession in accordance
with State law regarding physician supervision.
Improving Veterans Enrollment into Medicare Coverage.--The
Committee is aware that information gaps exist for some
veterans related to the differences between the hospital care
and medical services available in the VA system versus coverage
provided under Medicare. The information gaps may have resulted
in some veterans receiving late-enrollment penalties under the
Medicare program. The Committee encourages HHS to work with the
Department of Veterans Affairs to ensure that veterans have
complete information regarding the differences between the VA
system and Medicare coverage, including for prescription drugs.
Integration of Direct to Patient Platforms with Insurance
Coverage.--The Committee is encouraged by the emergence of
direct-to-patient (DTP) prescription drug purchasing platforms
but is concerned that absent integration with insurance benefit
frameworks, patient purchases may not count toward deductibles
or annual out-of-pocket limits, potentially undermining
affordability and confusing consumers. The Committee directs
CMS to brief the congressional committees of jurisdiction and
submit a written update within 180 days of enactment of this
Act detailing any actions CMS is taking to facilitate the
integration of TrumpRx and similar DTP platforms with insurance
coverage so patient cost-sharing can be appropriately credited
toward deductibles and out-of-pocket maximums, and to describe
any guidance, standards, or transparency measures under
development to ensure consumers understand how such purchases
interact with insurance benefits.
Intensive Cardiac Rehabilitation.--The Committee recognizes
that Intensive Cardiac Rehabilitation (ICR) and similar
evidence-based lifestyle interventions can improve outcomes and
support prevention and chronic disease management, thus
extending the health span of Medicare beneficiaries.
Nevertheless, participation remains low. The Committee
encourages CMS, within its existing authority, to consider
opportunities to expand beneficiary access to ICR services--
including for beneficiaries with risk factors such as obesity,
diabetes, hypertension or metabolic syndrome--and to evaluate
their potential to improve health outcomes and reduce costs.
Leveraging Real-Time GME Data to Support Rural Health
Transformation.--The Committee recognizes the benefit of using
real-time information in order to assess whether GME programs
are leading to improved physician supply in medically
underserved areas. The Committee is concerned that stakeholders
lack access to timely graduate medical education pipeline data,
including residency application trends, match outcomes, and
position fulfillment rates by specialty and geography. The
Committee looks forward to receiving the professional judgment
estimate requested from HRSA under the joint explanatory
statement accompanying the Consolidated Appropriations Act,
2006, and encourages CMS and HRSA to include any related
recommendations on data standards, timelines, reporting
requirement, and any statutory or regulatory barriers.
Leveraging Virtual Care in Measuring Network Adequacy.--The
Committee strongly supports virtual care, especially in rural
and underserved areas experiencing provider shortages, but
current regulation may limit the benefits of such care,
impacting consumer choice and access. The Committee urges CMS
to explore reforms to network adequacy requirements that take
into account the benefits of virtual care providers, without
harming access to local, in-person care.
Long-Term Care Facility Metrics.--The Committee understands
that CMS is reexamining the long-stay antipsychotic medication
quality measure in the Skilled Nursing Facility (SNF) Five-Star
Quality Rating System and is taking steps to ensure that such
reporting distinguishes between appropriate and inappropriate
use of these medications. The Committee supports these
important efforts and encourages CMS to move away from an
exemptions-based measure and incorporate concordant
documentation from the prescriber and consultant pharmacist to
support determination of appropriate use and confirmation of
ongoing safety and effectiveness for the patient. To ensure the
measure update meets the needs of beneficiaries with
neuropsychiatric symptoms associated with Alzheimer's disease,
neurodegenerative disorders, and serious mental illness, the
Committee encourages CMS to bring together stakeholders to help
inform this process and address concerns about the unintended
consequences of the current measure and how it discourages
diagnosis-appropriate and guidelines-based treatment for
beneficiaries in this setting. Further, the Committee requests
CMS provide an update on these activities in the fiscal year
2028 congressional justification.
Long-term Care Pharmacies At-Home.--The Committee
recognizes the importance of long-term care (LTC) pharmacies
at-home in extending quality LTC services beyond institutional
settings to patients in a place of residence, including but not
limited to traditional long-term care facilities, assisted
living communities, other residential community settings, and
private residences. Further, the Committee notes the value of
innovative pharmacy models, such as LTC pharmacies at-home, in
delivering high-touch, specialized pharmacy services directly
to seniors and to chronically-ill Medicare beneficiaries at
home, particularly in rural and underserved areas, consistent
with the standard of care provided by traditional LTC
pharmacies. The Committee notes that LTC pharmacies at-home
serve populations that include patients who manage numerous
medications, have two or more chronic conditions, experience
impairment with activities of daily living, and who often have
limited access to brick-and-mortar pharmacies or long-term care
facilities. The Committee encourages CMS to take into
consideration the value that such pharmacy models demonstrate
towards measurable reductions in medication waste, improved
cost-savings through patient outcomes, and allowance for fewer
inpatient hospital admissions and emergency department visits.
Maintaining Access to Essential Medical Devices.--The
Committee recognizes that CMS has authority to make payment
adjustments under the inpatient prospective payment system
(IPPS) and the hospital outpatient prospective payment system
(OPPS) to support higher-quality domestically sourced medical
products. The Committee encourages CMS to consider building on
existing payment adjustments under IPPS and OPPS to promote
access to domestically made medical devices and essential
medical supplies, such as needles, syringes, and blood
collection products.
Maternal Healthcare in Rural Hospitals.--The Committee
recognizes the importance of rural hospitals in providing
maternal health care services, educating patients, and ensuring
post-partum safety. The Committee is concerned that
insufficient reimbursement and payments, increasing costs of
operation, and narrowing profit margins threaten the viability
of hospitals in rural areas. The Committee is aware that
Medicaid payment rates are often insufficient for the costs of
labor and delivery for rural hospitals, leading to the closures
of labor and delivery departments and increased maternal health
deserts. The Committee looks forward to receiving the update on
this topic requested under House Report 119-271.
Medicaid State Plan Transparency.--The Committee recognizes
that State legislatures often face difficulty obtaining timely,
complete, and comparable information regarding changes to State
Medicaid coverage, including optional benefits, waiver-based
coverage, and other State plan choices that may affect program
costs and benefit design. The Committee encourages CMS, in
consultation with the Medicaid and CHIP Payment and Access
Commission (MACPAC), to explore the development of a
centralized, publicly accessible clearinghouse that would serve
as a resource for State-by-State Medicaid benefit design and
State plan changes, including information on mandatory versus
optional benefits and waiver authorities.
Medicare Advantage Risk Adjustment.--The Committee notes
its prior report language regarding coding intensity
adjustments intended to enhance payment accuracy and protect
patient access. The Committee is further concerned that the
current risk adjustment model has become increasingly complex
and may incentivize coding practices that raise program costs
without improving patient care. The Committee encourages CMS to
examine options to streamline MA risk adjustment by relying on
demographics and a limited set of substantiated health
conditions that are supported by objective clinical evidence,
reflect meaningful differences in expected costs, and improve
payment accuracy. The Committee further encourages CMS to
evaluate options to maintain appropriate safeguards for
beneficiaries with rare and extremely high-cost conditions,
including consideration of a Federal reinsurance pool within MA
risk adjustment.
Medicare Advantage Step Therapy Protocols for Part B
Drugs.--The Committee notes that in 2019, CMS permitted
Medicare Advantage (MA) plans to apply utilization management
protocols for certain physician-administered drugs covered
under Medicare Part B. While this policy was intended to
promote value and appropriate utilization, the Committee is
concerned about the potential impact of step therapy on
Medicare beneficiaries' timely access to medically necessary
care. The Committee encourages the Secretary to review the
current regulatory framework governing step therapy for Part B
drugs in Medicare Advantage and consider reforms to help ensure
that protocols do not create inappropriate barriers to
medically necessary care. In conducting this review, the
Committee encourages the Secretary to consider whether
additional safeguards or clarifications may be appropriate to
protect beneficiary access and improve program transparency.
Medicare Clinical Laboratory Fee Schedule.--The Committee
notes that private-payer data collected under the Protecting
Access to Medicare Act (PAMA) in 2017 apparently failed to
accurately reflect prevailing commercial market payment rates
and testing volumes, particularly due to the limited
participation of large segments of the laboratory market. As a
result, Medicare payment rates established under the Clinical
Laboratory Fee Schedule (CLFS) may not reflect the broader
private market and may threaten beneficiary access to essential
diagnostic testing, particularly in underserved and rural
community settings. The Committee encourages CMS, as it
continues to administer the program and undertake regulatory
actions during ongoing policy deliberations, to educate all
applicable laboratories about their data reporting obligations
in an effort to avoid relying on incomplete or unrepresentative
data that could distort Medicare payment rates. CMS should
notify the committees of jurisdiction if commercial market data
it receives for CLFS rate-setting is over-representative or
under-representative of any segment of the laboratory market,
including independent laboratories, hospital outreach
laboratories, and physician office laboratories. CMS is
encouraged to engage stakeholders and provide transparency
regarding the data it receives and the sources of such data.
The Committee requests an update in the fiscal year 2028
congressional justification detailing any such data received
and sources of the data, including the number of labs reporting
data in each market segment and the proportional representation
of each market segment in the reported data.
Medicare Prescription Repayment Program.--The Committee
directs CMS to provide a quarterly report to Congress and post
on a public website available updates on (1) the number of
beneficiaries who have opted into the Medicare Prescription
Payment Plan, including trends and demographic breakdowns, to
ensure transparency and inform potential improvements to the
program; (2) the total number of beneficiaries categorized as
``likely to benefit'' by participation in the program; (3)
information on the methods that CMS is utilizing to encourage
participation, such as the use of Medicare.gov, the Medicare
and You handbook, 1-800-MEDICARE, and provider-focused
communications such as the Medicare Learning Network; and (4)
information on additional outreach efforts that CMS is
conducting with stakeholders, including provider associations
and societies, patient and consumer advocacy groups, and
pharmacy benefit managers. The Committee acknowledges concerns
raised by pharmacy groups regarding point-of-sale enrollment
but emphasizes the need for a streamlined and accessible
enrollment process for beneficiaries. As such, the Committee
urges CMS to explore mechanisms to facilitate point-of-sale
enrollment, ensuring that beneficiaries can easily access the
program at the time of filling their prescriptions in person or
online.
Modernizing Prior Authorization.--The Committee is
concerned that manual prior authorization processes create an
administrative burden and delay patient care. To modernize this
process, the Committee encourages CMS to establish a real-time
authorization framework for routine services. Further, the
Committee encourages CMS to publish an annual list of services
eligible for real-time adjudication, possibly including
services that: (1) have a historical approval rate of 90
percent or higher; (2) are clinically routine and low risk; or
(3) create significant administrative volume and burden for
providers.
Non-addictive Opioid Alternatives.--The Committee continues
to recognize the ongoing need to address pain management while
reducing the risk of opioid misuse, dependence, and diversion
and was pleased that the FDA approved the first non-addictive
opioid alternative in 2025. The Committee encourages CMS,
within its existing authorities, to promote beneficiary access
to these therapies, where clinically appropriate, in a manner
that supports patient safety, effective pain management, and
efforts to reduce opioid-related harms. Not later than 90 days
after enactment of this Act, the Committee directs CMS to
provide a report to the Committee on access to non-opioid acute
pain treatments, including any barriers to access identified
and actions CMS can take within its existing authorities to
address such barriers. To the extent such data are available,
the report shall include utilization rates, approval and denial
rates, common reasons for denials, and steps taken to ensure
timely, clinically appropriate access to non-addictive opioid
alternatives. Such report shall be posted on a publicly
available website.
Non-Opioid Acute Pain Access Initiative.--The Committee
encourages the Secretary to work with the Administration to
explore agreements ensuring the maximum and least costly access
to FDA-approved non-opioid acute pain therapeutics to reduce
opioid initiation and addiction risk.
No Surprises Act.--The Committee is concerned by reports
from providers and physician organizations indicating that a
significant number of Independent Dispute Resolution (IDR)
awards are not being paid within the required timeframe or are
not being paid at all. Providers have limited recourse when
health plans do not comply, particularly following the Fifth
Circuit's 2025 ruling that IDR determinations are not privately
enforceable in Federal court. The Committee believes that the
enforceability of IDR determinations is essential to the
willingness of providers and health plans to participate in the
process in good faith. The Committee directs the Departments of
HHS, Labor, and the Treasury, to submit a report to the
Committees on Appropriations of the House of Representatives
and the Senate not later than 180 days after the date of
enactment of this Act on insurer compliance with IDR payment
requirements, including data on the timeliness of payments, the
volume and nature of non-payment complaints, and enforcement
actions taken to date.
No Surprises Act Enforcement for Air Ambulance Services.--
The Committee is concerned that under the No Surprises Act
(NSA), insurers continue to fail to meet statutory payment and
independent dispute resolution (IDR) requirements for services,
including air ambulance services, such as late payments post-
IDR determinations. The Committee also has concerns about the
lack of transparent and accurate Qualified Payment Amount
calculations and the use of ghost rates and other irrelevant
contracts that depress reimbursement below market rates.
Therefore, the Committee directs the Secretary, within 180 days
of the enactment of the Act, to submit a report to the
Committee describing specific oversight and enforcement actions
taken and planned to: (1) ensure timely compliance with NSA IDR
requirements for air ambulance services; (2) improve
transparency and validation of Qualified Payment Amount
calculations and eliminate the use of ghost rates; and (3)
curtail improper medical-necessity and prior-authorization
denials for emergency transports and excessive documentation
requirements that impede payment of otherwise valid claims.
Occupational Therapy Mental Health Services.--The Committee
notes that Medicare covers occupational therapy services
furnished for the treatment of mental health and substance use
disorder diagnoses when billed under applicable HCPCS codes.
The Committee encourages CMS to review its existing guidance
and consider opportunities, within its current authority, to
improve education and outreach to stakeholders about the
Medicare Benefit Policy Manual provisions applicable to these
services.
Ongoing Responsibility for Medicals.--The Committee
continues to be supportive of modernizing the Medicare
Secondary Payer (MSP) program and interested in understanding
the impacts of the program on beneficiary access to treatment.
Since 2011, the Medicare ``User Guide'' controlling reporting
of settlements, judgments, and awards to Medicare has required
the reporting of Ongoing Responsibility for Medicals (ORM) when
an insurer or self-insured has continuing responsibility for
future medical payments as a matter of law or agreement. From
the inception of the requirement, Medicare has only allowed ORM
to be terminated if the reporting entity can secure a letter
from a treating physician that no further treatment is needed,
which is typically impossible to secure. This has created
serious problems for tens of thousands of beneficiaries, given
that many providers refuse any treatment of Medicare
beneficiaries due to an ORM flag on the file, even if the
treatment is unrelated to the accident or injury giving rise to
the MSP report. The Committee is concerned that CMS has imposed
unreasonable conditions to terminate ORM--particularly in cases
where a person went to an emergency room for a minor injury and
ORM is required by State law. The Committee urges CMS to submit
a report to the committees of jurisdiction on the impact of
modernizing the ORM termination criteria with any
recommendations for how CMS could timely do so.
Organ Procurement Organizations (OPOs) Spinal Column
Recovery.--The Committee encourages OPOs to prioritize the
recovery of the spinal column from deceased donors as a key
component of the Nation's transplantation infrastructure.
Deceased donor spinal columns contain a plentiful supply of
bone marrow that can be processed and cryopreserved as
transplantable units. Cryopreserved deceased donor bone marrow
can be rapidly deployed to support patients with life-
threatening conditions such as aggressive blood cancers, bone
marrow failure syndromes, sickle cell disease, autoimmune
disorders, and failed live donor transplants. The Committee
encourages OPOs to coordinate with HRSA, the OPTN, and
transplant hospitals to implement standardized consent,
recovery, and distribution protocols, and to report annually on
donor participation and spinal columns recovered.
PACE Quality Measurement Framework.--The Committee
recognizes the importance of the Program of All-Inclusive Care
for the Elderly (PACE), which enables medically complex older
adults with significant long-term care needs to remain living
at home safely as an alternative to nursing facility placement.
The Committee is concerned current Federal and State quality
reporting requirements are redundant, which undermines
transparency, comparability, and accountability. To improve the
effectiveness and consistency of PACE quality data reporting
and reduce administrative burden, the Committee urges CMS to
work with relevant stakeholders to establish a national,
standardized quality measurement framework.
PBM Practices in Medicare Part D Regarding Biosimilars.--
The Committee is concerned that certain payer and pharmacy
benefit manager (PBM) practices may impede patient access to
lower-cost biosimilars. The Committee notes that biosimilars
should be considered part of a cost-effective formulary and
encourages CMS to enhance oversight related to formulary
placement, utilization management, and patient cost-sharing
practices that affect biosimilars in the Part D market. CMS is
encouraged to collect and publicly report data, as appropriate,
on patient out-of-pocket costs and access barriers associated
with biosimilars compared to reference biologics, and to
identify practices that may undermine competition or increase
costs for patients.
Peripheral Artery Disease (PAD) Early Detection and
Amputation Prevention Initiative.--The Committee has previously
encouraged CMS to promote efforts to prevent amputations
associated with PAD, which effects an estimated 21 million
Americans. Each year, more than 200,000 individuals with PAD
experience avoidable amputation. The Committee has previously
encouraged the Administrator, in collaboration with leading
clinical and patient advocacy organizations, to establish a PAD
education program for patients and clinicians. To reduce the
number of Medicare and Medicaid beneficiaries undergoing
preventable amputation, the Committee encourages CMS to explore
ways to encourage the appropriate use of PAD screening for
high-risk individuals.
Pharmacist-Provided Incident to Physician Services.--The
Committee is pleased with CMS's recognition in the calendar
year 2021 physician fee schedule (PFS) final rule (FR 84583)
that ``pharmacists could be considered QHPs (qualified health
care professionals) or clinical staff, depending on their role
in a given service,'' and that ``new coding might be useful to
specifically identify these particular models of care.''
However, the Committee remains concerned with current CMS PFS
requirements restricting physicians' and nonphysician
practitioners' (NPPs) utilizing pharmacists under incident to
models to bill at the lowest-acuity E/M code (99211), with an
estimated time commitment of seven minutes. The Committee notes
this restriction has diminished providers' engagement with
pharmacists in team-based care models across the country. CMS
should consider how to ensure physicians and NPPs can optimize
the use of pharmacists. The Committee encourages CMS to
identify mechanisms to attribute, report, and sustain
pharmacists' patient care contributions to beneficiaries in the
Medicare Part B program.
Pharmacists and Patient Care Services.--The Committee is
aware that certain Medicare Part B services and care frameworks
have provisions to include pharmacists and their patient care
services. However, CMS has few mechanisms to identify and
evaluate the contributions of pharmacists to patient care and
outcomes or to identify barriers within current service
requirements that prevent the scalable involvement of
pharmacists. The Committee requests a report from CMS within 90
days of enactment of this Act describing potential regulatory
adjustments to incentivize team-based care delivery models that
include pharmacists practicing at the top of their license, in
accordance with State law and subject to any State's
requirements regarding physician supervision of collaboration
with pharmacists in furnishing services.
Postpartum Care.--The Committee recognizes postpartum care
one year after birth is critical to the health of mothers and
babies. While postpartum care in the first 84 days after birth
focuses on stabilizing and recovering, longer term care
protects future health especially for those who experience
preeclampsia, gestational diabetes, and postpartum depression
among others. Mental health conditions are the number one
underlying cause of maternal mortality, accounting for
approximately 23 percent of all pregnancy-related deaths while
blood clots and infections each account for 9 percent of
deaths. Late postpartum deaths still make up a significant
share of these deaths, making postpartum care throughout the
first year crucial. Therefore, the Committee encourages the
National Committee for Quality Assurance to consider
improvements to the Healthcare Effectiveness Data and
Information Set (HEDIS) metric for prenatal and postpartum care
to measure visits up to one year postpartum.
Private-Label or Affiliated Marketing Arrangements for
Biological Products and Biosimilars.--The Committee is aware of
the increasing use of private-label or affiliated marketing
arrangements for biological products and biosimilars by
vertically integrated entities participating in Federal health
programs. The Committee is concerned about the impact of
vertical integration and affiliated product steering on market
competition, formulary access, and long-term pricing dynamics
that could impact the increased competition for biosimilars and
value they provide to patients and the marketplace.
Program of All-Inclusive Care for the Elderly (PACE).--The
Committee continues to recognize the importance of the Program
of All-Inclusive Care for the Elderly (PACE), a capitated
coordinated care model that enables medically complex older
adults, mostly dual-eligibles, with significant long-term care
needs, to remain living at home. In its June 2025 report to
Congress, MACPAC noted that stakeholders largely agree that the
PACE program ``represents the most fully integrated form of
care available to dually eligible individuals''. The Committee
believes that all eligible participants should have the
opportunity to access these programs to meet their complex
medical and social needs. The Committee further believes that
policies should encourage access to PACE programs, and States
should provide a regulatory environment which ensures that
there are sufficient PACE entities to meet participant needs.
The Committee notes the barrier to the establishment of new
PACE programs based on the presence of existing PACE programs
in service areas even though there may be unmet need in those
service areas. Therefore, the Committee urges CMS to promulgate
regulations that address the concern of States denying new PACE
establishment applications based solely on the presence of an
existing PACE facility in a defined service area.
Protecting Essential Medicines.--The Committee recognizes
the critical importance of maintaining domestic manufacturing
capacity for essential medications. The Committee is concerned
that the statutory design of the Manufacturer Discount Program
(MDP) intended for brand products inadvertently includes
products that were approved under a New Drug Application (NDA)
rather than a generic Abbreviated New Drug Application (ANDA)
due solely to unique FDA regulatory circumstances. The
Committee requests the Department provide an update in the
fiscal year 2028 congressional justification specifying the
current impact on patients, steps that can be taken by CMS and
Congress to address this issue, and efforts to support domestic
manufacturers producing essential medicines.
Provider Directory Modernization and Infrastructure.--The
Committee appreciates the efforts of CMS to advance a National
Provider Directory for Healthcare Access and underscores the
importance of accurate, up-to-date provider data for effective
program administration and patient access to care. As this work
proceeds, the Committee encourages CMS to consider leveraging
existing integrated platforms for provider data submission
already widely used across public and private health programs,
to the maximum extent practicable, and to avoid unnecessary
duplication or fragmentation that would increase costs and
administrative and operational burdens on providers and other
stakeholders. The Committee recognizes that providers, States,
and private-sector entities routinely operate across multiple
Federal, State, and commercial health programs and rely on
shared provider data systems to meet overlapping provider
directory requirements. Accordingly, the Committee supports
current private sector platforms for data submission to avoid
disruption of existing provider data workflows.
Radiation Oncology.--The Committee remains concerned that
efforts to reform the delivery and payment of certain types of
radiation therapy may negatively affect patient access and
outcomes, particularly emerging therapies that are not widely
available. The Committee continues to encourage CMS to work
closely with all affected stakeholders to develop reforms that
will support patient access to high quality, innovative care
and best utilize Medicare trust funds.
Rapid Post-Discharge Engagement.--The Committee recognizes
the critical vulnerability of individuals in the immediate
period following discharge from hospitals, emergency
departments, and inpatient psychiatric settings. Evidence
demonstrates that the first 72 hours post-discharge present
elevated risk for relapse, avoidable readmission, overdose,
housing instability, and disengagement from care. The Committee
encourages the Secretary to support community-based
organizations, Medicaid providers, and managed care entities in
implementing rapid post-discharge engagement models that
include: community-based outreach within 72 hours of discharge;
90 days of intensive stabilization services addressing medical,
behavioral health, and social drivers of health; and 12 months
of structured peer recovery or peer support follow-up to ensure
continuity of care and long-term stabilization. Such models
should prioritize individuals with behavioral health
conditions, substance use disorders, complex chronic
conditions, and co-occurring social risk factors. The Secretary
is encouraged to promote reimbursement pathways under Medicaid,
including managed care value-based arrangements and Section
1115 demonstrations, as appropriate, to support these services.
Rare Disease Treatment.--The Committee is concerned that
the vast majority of rare diseases do not have treatments
indicated for their disease. The Committee recognizes that
these patients may rely on off-label uses of other treatments
to manage symptoms or side effects, or the disease itself.
However, for Part D patients, access to off-label treatments
within the standard of care can be particularly problematic
since Part D plans are prohibited from including off-label uses
not listed in compendia in the Part D benefit, including lack
of an appeal or reconsideration mechanism available to overcome
the fact that the prescribed use is outside of the Part D
benefit. While not similarly prohibited, coverage is also
tenuous in Medicaid, which is especially problematic given that
over half of all rare diseases affect children. The Committee
urges CMS to work with rare disease umbrella organizations that
have identified and prioritized recognition of this significant
access barrier and have undertaken efforts to serve as a
clearing house for such indications to identify possible
solutions to this access issue.
Reducing False-Positive Sepsis Blood Cultures.--The
Committee is aware that more than 40 percent of blood culture
tests used to diagnosis blood stream infections, like sepsis,
are false-positive results due to blood culture contaminations
from a patient's skin and not an actual infection. These false-
positive test results lead to serious morbidity and mortality
among misdiagnosed patients, significant spending on
unnecessary treatment, and the overuse of antibiotics. The
Committee encourages CMS to prioritize and expedite, as
appropriate, the adoption of a blood culture contamination rate
measure that relies on the one percent or less blood culture
contamination rate standard set by the CDC into the Medicare
Hospital-Acquired Condition (HAC) Reduction Program.
Removing Administrative Barriers to Accessing Pharmacist
Services in Medicare Advantage Plans.--The Committee recognizes
that Medicare Advantage (MA) plans may reimburse patient care
services provided by State-licensed pharmacists as individuals
engaged in the delivery of services as licensed or certified by
the State. However, the Committee notes that administrative
barriers may limit the ability of MA plans to successfully
contract with pharmacists. The Committee is concerned that CMS
does not currently provide a clear pathway for pharmacists to
enroll in the Medicare Provider Enrollment, Chain, and
Ownership System (PECOS). Enrolling in PECOS is required for a
pharmacist to receive a Provider Transaction Access Number
(PTAN), necessary for internal processing and communication
with MA plans. The Committee encourages CMS, within existing
statutory authority, to ensure pharmacists can enroll in PECOS
as a non-physician specialty type and provide an administrative
mechanism for pharmacists to obtain a PTAN.
Renaming of HealthCare.gov.--The Committee is concerned
that public discourse after the Affordable Care Act has
confused health care with health insurance. Therefore, the
Committee encourages CMS to rename HealthCare.gov to
HealthInsurance.gov to more accurately inform the American
people of what they are signing up to purchase.
Restriction on New Coverage Determinations for PLA/
Xinjiang-Linked Medicines.--The Committee is concerned about
the use of Federal health care dollars to support products
whose pivotal clinical trials were conducted at PLA military
hospitals or sites in Xinjiang and encourages HHS to closely
scrutinize any new reimbursement determinations or coverage
expansions involving such products.
Robotic Stereotactic Radiosurgery.--The Committee
appreciates the highly specialized and clinically important
cancer treatments of robotic stereotactic radiosurgery (SRS)
and robotic stereotactic body radiation therapy (SBRT). These
advanced technologies enable the precise, noninvasive delivery
of high-dose radiation in fewer treatment sessions, which may
improve patient compliance, reduce complications, and lower
overall system costs. The Committee urges CMS and Medicare
Administrative Contractors (MACs) administering the Medicare
program to maintain the distinct G codes that accurately
describe robotic SRS and robotic SBRT services to ensure
reimbursement appropriately reflects the complexity, resource
intensity, and clinical value of these therapies, preserving
patient access to care.
Screening For Cervical Cancer with Human Papillomavirus
Self Sampling.--The Committee recognizes that HPV self-sampling
can expand access to screening for individuals who are never or
under-screened. The Committee encourages HHS to support
implementation of screening recommendations that allow HPV
self-collection. The Committee further encourages CMS to
provide clear guidance on coverage and reimbursement for HPV
self-collection tests and encourages CDC to provide
implementation resources, particularly for rural and
underserved populations. The Committee directs HHS to provide a
report to the Committee within one year of enactment of this
Act describing implementation progress and remaining barriers
to access.
Skin Substitutes.--The Committee supports efforts to
address serious fraud regarding Medicare's coverage of and
payment for skin substitute products. In implementing changes
to the payment of skin substitutes in the Calendar Year 2026
Medicare Physician Fee Schedule Final Rule (published in the
Federal Register on November 5, 2025), the Committee strongly
encourages CMS to address the impact on Medicare patient
access, cost, and health outcomes. The Committee directs CMS to
provide an update in the fiscal year 2028 congressional
justification on the impact of the rule on preserving patient
access while ensuring program integrity.
Sole Community Hospital/Medicare Dependent Hospital
Graduate Medical Education Funding Parity.--The Committee notes
that Sole Community Hospitals (SCH) and Medicare Dependent
Hospitals (MDH) receive over $70,000 less annually per resident
in graduate medical education (GME) funding due to their
Medicare reimbursement model. A 2024 study found that PPS
hospitals received a median annual payment of $179,442 per
resident while hospital specific rates used by SCHs and MDHs
averaged $107,294 per resident per annum. The Committee
recognizes that this disparity often results from SCH and MDH
inability to access indirect medical education (IME) payments.
This situation puts SCHs and MDHs at a competitive disadvantage
for attracting a prospective healthcare workforce to rural
areas. The Committee directs CMS to report to the committees of
jurisdiction within 90 days of enactment of this Act with an
analysis of policy options to bring parity between PPS, SCH,
and MDH hospitals concerning GME payments.
State Medicaid Eligibility Innovation.--The Committee
recognizes the existing challenges faced by State Medicaid
agencies and local governments in verifying eligibility for
both new applicants and current beneficiaries. The Committee
directs HHS to coordinate with State agencies to identify the
investments needed in staffing, training, and technology to
sustainably improve the accuracy and timeliness of application
processing, eligibility verification, and the redetermination
and recertification of eligibility. No later than 180 days
after the enactment of this Act, HHS shall submit a report to
the Committee detailing its findings, including recommendations
to improve eligibility verification.
Supplier Verification.--The Committee is concerned that
durable medical equipment (DME), such as insulin delivery
systems and continuous glucose monitors (CGMs), ostomy, and
urological supplies, requires robust mechanisms to verify the
identity and legitimacy of manufacturers and distributors to
ensure patients maintain access to safe and effective
technologies and supplies. CMS and its contractors should
conduct robust monitoring, including unannounced ``secret
shopper'' calls to contract suppliers to ensure Medicare
beneficiaries are not steered into products that were not
ordered by their prescribing physicians or health care
providers.
Transparency Report on PLA Linked Pharmaceutical Clinical
Trials.--The Committee is concerned about the use of Federal
health care dollars to support products whose pivotal clinical
trials were conducted at PLA military hospitals or sites in
Xinjiang, and encourages HHS to publish a report identifying
drugs reimbursed under Medicare or Medicaid whose pivotal
clinical trials were conducted at PLA military hospitals, AMMS-
affiliated sites, or sites located in the Xinjiang Uyghur
Autonomous Region.
Treasury Referrals.--The Committee continues to be
supportive of modernizing the Medicare Secondary Payer (MSP)
program and is interested in understanding the impacts of the
program on the Federal government. The Committee understands
that CMS may refer the debt of some claims to the Treasury
Department for collection even before the appeal period has
expired and the Committee urges CMS to coordinate with Treasury
to review these timeline interactions.
Treatment in Place.--The Committee is concerned that
Medicare's current payment policy for Emergency Medical
Services (EMS), which generally reimburses only when a
beneficiary is transported by ambulance to a hospital emergency
department, can encourage unnecessary transport to one of the
most expensive sites of care. The Committee is aware that many
9-1-1 calls involve non-emergent conditions that could be
safely managed on site, including with telemedicine support or
referral to another appropriate provider, and that more than a
dozen State Medicaid programs and many commercial insurers
currently reimburse EMS for treatment in place (TIP) services.
The Committee is particularly concerned about the impact of
avoidable emergency department transport on individuals with
disabilities and mobility limitations and about the strain that
prolonged offload times place on the EMS workforce and response
capacity. The Committee notes that, when clinically
appropriate, TIP may improve patient experience, reduce costs,
and help decompress overcrowded emergency departments.
Therefore, the Committee encourages CMS to evaluate options to
recognize and reimburse appropriate TIP services furnished by
EMS agencies to Medicare beneficiaries. The Committee further
encourages HHS to: (1) review available evidence on the safety,
quality, and cost of EMS delivered TIP; (2) examine State
Medicaid and commercial payer models that reimburse TIP and
similar non-transport services; and (3) identify potential
Medicare payment pathways and corresponding standards.
Waste, Fraud, and Abuse Prevention and Program Integrity
Modernization.--The Committee supports CMS in its efforts to
move beyond traditional ``pay-and-chase'' models and adopt
proactive, technology-driven approaches to prevent waste,
fraud, and abuse before improper payments occur. The Committee
encourages CMS to leverage advanced industry solutions,
including interoperable data platforms, predictive analytics,
and artificial intelligence tools, to enhance program integrity
across Medicare, Medicaid, and marketplace programs. These
capabilities should enable real-time risk scoring, provider
identity verification, and anomaly detection to prevent bad
actors from entering the system and receiving unauthorized
payments. The Committee encourages CMS to continue these
efforts by prioritizing adoption of proven commercial
technologies that support comprehensive data integration,
secure cloud analytics, and automated compliance monitoring.
These investments should align with CMS' Program Integrity Rule
for the ACA Marketplace and other regulatory requirements,
ensuring robust governance, privacy protections, and
transparency. The Committee requests an update in the fiscal
year 2028 congressional justification from CMS on its progress
toward implementing these solutions, including measurable
outcomes such as reduced improper payments, improved provider
vetting accuracy, and enhanced consumer protections.
Wasteful and Inappropriate Services Reduction (WISeR)
Model.--The Committee notes concern with CMS' Wasteful and
Inappropriate Service Reduction (WISeR) Model, which may create
burdens and delays for patients and providers. The Committee
believes that any proposal to impose prior authorization
requirements in traditional Medicare should be subject to
robust congressional oversight and transparent evaluation of
impacts on beneficiary access to care, provider burden, and
program costs. The Committee requests CMS provide an update in
the fiscal year 2028 congressional justification on the impact
of this pilot program on patients and how States were selected
for participation.
Whole Child Health.--The Committee encourages CMS to work
with States to identify best practices and pathways to address
the root causes of poor physical and mental health in children
served by Medicaid and CHIP, including in rural areas. The
Committee looks forward to receiving the update on this topic
requested under House Report 119-271.
State Survey and Certification
The Committee provides $425,000,000 for State Survey and
Certification activities. This program supports certifications
of Medicare and Medicaid certified health care facilities to
ensure that beneficiaries receive care at facilities that meet
health, safety, and quality standards as required by CMS.
Federal Administration
The Committee provides $764,921,000 for Federal
Administration activities related to the Medicare and Medicaid
programs. Federal Administration funding supports CMS staff,
along with operating and administrative expenses for
information technology, communication, utilities, rent and
space requirements, as well as administrative contracts.
HEALTH CARE FRAUD AND ABUSE CONTROL ACCOUNT
Appropriation, fiscal year 2026....................... $941,000,000
Budget request, fiscal year 2027...................... 976,000,000
Committee Recommendation.............................. 969,000,000
Change from enacted level......................... +28,000,000
Change from budget request........................ -7,000,000
The Health Care Fraud and Abuse Control Account funds
support activities conducted by CMS, the HHS OIG, and the
Department of Justice (DOJ). This appropriation includes a base
amount of $311,000,000 and an additional $658,000,000 in budget
adjustment funding.
This funding is in addition to other mandatory funding
provided through authorizing legislation. The funding will
provide resources to continue efforts for Medicaid program
integrity activities, for safeguarding the Medicare
prescription drug benefit and the Medicare Advantage program,
and for program integrity efforts related to these programs
carried out by the DOJ.
Senior Medicare Patrol.--The Committee includes bill
language to enable the Secretary to provide a total of
$35,000,000 for the Senior Medicare Patrol program, which is
administered by the Administration for Community Living, from
either discretionary or mandatory funds provided to this
account.
Administration for Children and Families
PAYMENTS TO STATES FOR CHILD SUPPORT ENFORCEMENT AND FAMILY SUPPORT
PROGRAMS
Appropriation, fiscal year 2026....................... $4,147,000,000
Budget request, fiscal year 2027...................... 2,792,000,000
Committee Recommendation.............................. 2,792,000,000
Change from enacted level......................... -1,355,000,000
Change from budget request........................ - - -
The Committee also provides $1,700,000,000 in advance
funding, as requested, for the first quarter of fiscal year
2028 to ensure timely payments for Child Support Enforcement
programs. These formula and incentive grants to States foster
parental responsibility and promote family independence, self-
sufficiency, and child well-being through services such as
locating noncustodial parents, establishing and enforcing
support orders, and collecting and disbursing child support
payments.
LOW INCOME HOME ENERGY ASSISTANCE PROGRAM
Appropriation, fiscal year 2026....................... $4,045,000,000
Budget request, fiscal year 2027...................... - - -
Committee Recommendation.............................. 4,055,000,000
Change from enacted level......................... +10,000,000
Change from budget request........................ +4,055,000,000
The Low Income Home Energy Assistance Program provides
formula grants to States to support eligible families and
households through programs providing assistance with energy
costs. The Committee recognizes the positive impact LIHEAP has
on low-income families and encourages HHS to maintain this
program for eligible recipients.
REFUGEE AND ENTRANT ASSISTANCE
Appropriation, fiscal year 2026....................... $5,163,956,000
Budget request, fiscal year 2027...................... 3,577,234,000
Committee Recommendation.............................. 3,577,234,000
Change from enacted level......................... -1,586,722,000
Change from budget request........................ - - -
The Office of Refugee Resettlement (ORR) programs are
designed to help refugees, asylees, Cuban and Haitian entrants,
and trafficking victims become employed and self-sufficient.
These programs also provide for the care of unaccompanied alien
children in Federal custody and survivors of torture.
The Committee continues to direct ORR to provide monthly
updates of arrivals each month by category, including refugees,
asylees, Cuban and Haitian entrants, Special Immigrant Visas,
and unaccompanied alien children.
Within the total, the Committee includes the following:
------------------------------------------------------------------------
FY 2027
Budget Activity FY 2026 Enacted Committee
------------------------------------------------------------------------
Transitional and Medical Services. $564,000,000 $10,420,000
Refugee Support Services.......... 307,201,000 92,580,000
Victims of Trafficking............ 30,755,000 30,755,000
Unaccompanied Alien Children...... 4,243,000,000 3,424,479,000
Survivors of Torture.............. 19,000,000 19,000,000
------------------------------------------------------------------------
The Committee acknowledges the Trump Administration's
efforts to secure the border, reduce illegal immigration, and
limit refugee arrivals. The Committee encourages the Department
to continue processing credible refugee referrals from the
Department of State and DHS through existing refugee assistance
programs.
Transitional and Medical Services
The Transitional and Medical Services (TAMS) program
provides refugees and other eligible populations a path to
economic self-sufficiency and successful resettlement through
employment training and placement, case management services,
and English language training. TAMS also provides temporary
cash assistance, medical assistance, domestic medical
screenings for eligible individuals, and foster care services
for unaccompanied refugee children.
Refugee Support Services
The Refugee Support Services (RSS) program provides
services to address barriers to employment, focusing on
employment-based English language training, case management,
employment preparation, and job placement and retention
services.
Victims of Trafficking
The Victims of Trafficking program funds competitive grants
and contracts for services to foreign victims of trafficking
and potential victims in the United States.
Within the $30,755,000 provided for Victims of Trafficking,
the Committee includes not less than $5,000,000 for the
National Human Trafficking Hotline (Hotline), which is the same
as the fiscal year 2026 enacted level.
Education and Awareness in Health Care.--The Committee
recognizes that victims of trafficking often utilize the health
care system and medical professionals are in a unique position
to identify and respond to signs of abuse. The Committee
encourages ACF to continue funding the SOAR to Health and
Wellness Training Program (SOAR Program) to train health care
professionals to understand the risk factors of trafficking, to
recognize indicators of trafficking, to screen patients and
identify potential victims, and to work with relevant
stakeholders to deliver trauma-informed and person-centered
care. The Committee further encourages the agency to evaluate
the effectiveness of the SOAR Program, specifically its impacts
on identifying and reporting suspected trafficking cases in
health care settings. The evaluation should also include a
cost-benefit analysis of Federal spending on the SOAR Program.
The Committee requests ACF include an update in its fiscal year
2028 congressional justification detailing the agencies
efforts.
Protecting Human Trafficking Survivors.--The Committee
directs ACF to continue ensuring the Hotline complies with all
applicable laws and regulations regarding its operation,
assistance to victims of severe forms of trafficking in
persons, survivor confidentiality, and mandatory reporting. The
Hotline is authorized to assist survivors in communicating with
service providers and must maintain a person-centered approach
focused on survivors' well-being. The Committee encourages ACF
to consider mechanisms to redirect third-party callers who are
reporting tips to the appropriate law enforcement tiplines. The
Committee requests an update in the fiscal year 2028
congressional justification detailing the Hotline's compliance
with applicable laws and policies regarding the operation of
the Hotline.
Youth Prevention Education and Awareness.--The Committee
recognizes the important role of educators in preventing human
trafficking and providing a safe and supportive school
environment for survivors. The Committee strongly encourages
ACF to continue funding the Human Trafficking Youth Prevention
Education (HTYPE) Demonstration Grant program. HTYPE provides
funds to local educational agencies for the purpose of
partnering with law enforcement and non-governmental
organizations to develop and implement human trafficking
prevention education and training opportunities for students,
caregivers, teachers, and other school personnel. The Committee
notes the program's success in helping participants identify,
respond to, and support potential victims of trafficking. The
Committee urges ACF to expand education and training
opportunities to school nurses and other school-based health
care providers.
Unaccompanied Alien Children (UAC)
The UAC program supports the care and placement of
unaccompanied children under age 18 who are apprehended by DHS.
The program's core mission is to temporarily shelter, care for,
and protect vulnerable children from trafficking, forced labor,
and other forms of exploitation.
The Committee acknowledges the Trump Administration's
immigration enforcement and border protection measures that
have reduced UAC border encounters and associated costs. The
Committee proposes reduced funding consistent with the
account's historical needs and available carryover funds. The
Committee provides this funding to support standard bed
capacity, child welfare services, and continued improvements to
sponsor vetting and child safety.
Care and Placement Report.--The Committee directs ORR to
continue to submit biannual reports to the Committee that
include the number of UACs that remain in HHS care for longer
than one year and the number of UACs that HHS has released to
sponsors. The report should also include an explanation of the
methods ORR uses to follow-up with unaccompanied children after
releasing them to a sponsor, including the follow-up method
used and number of attempts made. The Department shall include
the total number of UACs that ORR has been unable to contact
successfully for follow-up for fiscal years 2021-2026 and shall
make such a report available on its website.
Facility Occupancy Rates.--The Committee notes that HHS
publishes updated data on its website on occupancy rates in
facilities, average length of care in HHS custody, UAC
demographics, and releases to sponsors by category.
Fair and Open Contracting and Grant Making.--The Committee
continues to direct the agency to conduct all public
solicitations for grants or contracts in a manner that is fair,
open, transparent, and free from ideological bias and conflict
of interest. All Federal laws, regulations, and guidelines on
communications with outside vendors should be rigorously
adhered to with appropriate internal controls in place to avoid
undue risk of favoritism or other bias in making selections.
Home Studies.--The Committee notes that the Trafficking
Victims Protection Reauthorization Act requires home studies of
potential sponsors when the child is a victim of trafficking,
special needs/disabled, a victim of physical or sexual abuse,
or if the sponsor clearly presents a risk of abuse,
maltreatment, exploitation, or trafficking. ORR additionally
mandates home studies if a potential sponsor is seeking to
sponsor two or more children and at least one of the children
is unrelated to the potential sponsor, if a potential sponsor
has previously been the sponsor of two or more children and is
now seeking to sponsor an additional child, or if a potential
sponsor is seeking to sponsor an unrelated child who is 12
years or under. The Committee acknowledges the Department's
efforts to improve ORR's sponsor vetting process and encourages
ORR to continue prioritizing the safety and well-being of UACs
by enforcing home study requirements.
Interagency Information Sharing.--The Committee instructs
ORR to complete the directives under this heading in the
explanatory statement that accompanied Division B of P.L. 119-
75.
Know Your Rights Presentations.--The Committee encourages
the Department to continue providing Know Your Rights
presentations for UACs in custody consistent with the William
Wilberforce Trafficking Victims Protection Reauthorization Act
of 2008 (P.L. 110-457). The Committee further encourages HHS to
continue providing information on resources to prevent
exploitation as part of ORR's notice of rights.
Notification of Fatalities in ORR Care.--The Committee
directs ORR to continue to report the death of any
unaccompanied alien child in its custody within 24 hours,
including relevant details regarding the circumstances of the
fatality.
ORR Employee Vetting.--The Committee encourages ORR to
continue working with influx care facilities (ICFs) and
emergency intake sites (EISs) to conduct all required
background checks for employees, volunteers, and contractors
who may have contact with children in ORR care. The Committee
further encourages ORR to maintain and enforce monitoring
requirements for ICFs and EISs, including reviewing compliance
with all background check requirements and conducting quarterly
on-site monitoring visits.
Spend Plan and Briefings.--The Committee continues to
direct ORR to complete the reporting and briefing requirements
under this heading in the explanatory statement that
accompanied Division B of P.L. 119-75.
Survivors of Torture
The program funds competitive grants to nonprofit
organizations providing services to refugees, asylees, and
asylum seekers to address the effects of torture.
Trafficking Prevention.--The Committee recognizes ORR's
efforts to establish a whole of government approach to combat
fraud, exploitation, and trafficking in the UAC program. The
Committee continues to direct ORR to submit quarterly reports
to the Committee that includes the number of referrals that ORR
has made to the DHS's Homeland Security Investigations
Division. The Committee further directs ORR to brief the
Committee within 90 days of enactment of this Act on the
implementation of the ORR Interagency Crime Coordination Cell,
including how ORR, in consultation with OTIP and law
enforcement partners, is processing potential trafficking
cases.
PROMOTING SAFE AND STABLE FAMILIES
Appropriation, fiscal year 2026....................... $482,515,000
Budget request, fiscal year 2027...................... 482,515,000
Committee Recommendation.............................. 482,515,000
Change from enacted level......................... - - -
Change from budget request........................ - - -
The Committee provides $420,000,000 in mandatory funds and
$62,515,000 in discretionary funds for the Promoting Safe and
Stable Families program. This program enables each State to
operate a coordinated program of family preservation services,
community-based family support services, time-limited
reunification services, and adoption promotion and support
services.
Within the discretionary total, the Committee provides
$2,750,000 for the Family First Clearinghouse and related
research and evaluation.
PAYMENTS TO STATES FOR THE CHILD CARE AND DEVELOPMENT BLOCK GRANT
Appropriation, fiscal year 2026....................... $8,831,387,000
Budget request, fiscal year 2027...................... 8,831,387,000
Committee Recommendation.............................. 8,841,387,000
Change from enacted level......................... +10,000,000
Change from budget request........................ +10,000,000
The Child Care and Development Block Grant (CCDBG) provides
formula grants to States, territories, and Tribes to provide
financial assistance to help low-income working families and
families engaged in training or education activities pay for
childcare.
The Committee continues to include bill language providing
a Tribal set-aside of not less than 5 percent.
Family-Based Child Care Centers.--The Committee recognizes
the essential role family childcare providers play in
supporting working families and expanding access to high
quality early childhood care and education, particularly for
children in of color, children in rural and underserved
communities, and families requiring care during nontraditional
hours. The Committee is concerned that family childcare
providers continue to experience challenges accessing funding
opportunities, workforce supports, and reimbursement rates
comparable to those available to center-based providers. The
Committee directs the Secretary of Health of Human Services and
relevant agencies to conduct a study examining the barriers to
the sustainability, expansion, and equitable treatment of
family childcare providers and opportunities to improve parity
with center-based childcare programs and to report to the
Committee on the results of such study not later than 180 days
after enactment of this Act.
Food Preparation Impacts.--The Committee is concerned that
some State food safety regulations inadvertently limit access
to fresh fruits and vegetables in childcare settings. The
Committee encourages the Secretary, in coordination with the
Secretary of Agriculture, to develop a classification for low-
risk foods, such as fresh fruits and vegetables, that reflects
the comparatively low risk of foodborne illness and other harms
associated with foods typically consumed raw or with minimal
processing. The Committee further encourages the Secretaries to
review, and as appropriate update, relevant nutrition, food
safety, and food preparation regulations and guidance that may
favor prepackaged, ultra-processed foods, and to revise them to
reflect such classification. The Committee also encourages the
Departments to work with States to align their nutrition and
food safety regulations with this approach so childcare
providers can prepare fresh fruits and vegetables for children.
Grant Administration and Oversight.--The Committee
recognizes that efficient administration of CCDBG is essential
to ensuring Federal resources reach the families who need them
most. The Committee is concerned that oversight inefficiencies
at the State level can produce administrative bottlenecks,
delayed payments, and increased risks of waste, fraud, and
abuse. The Committee encourages ACF to support States in
modernizing their oversight systems to strengthen payment
integrity and improve program outcomes. The Committee further
encourages the Department to evaluate parent-directed benefit
delivery models with built-in spending controls to improve
accountability, transparency, and program integrity. The
Committee requests a briefing within 90 days of enactment of
this Act on the Department's efforts to address improper
payments and fraud in federally funded childcare assistance
programs.
SOCIAL SERVICES BLOCK GRANT
Appropriation, fiscal year 2026....................... $1,700,000,000
Budget request, fiscal year 2027...................... 1,700,000,000
Committee Recommendation.............................. 1,700,000,000
Change from enacted level......................... - - -
Change from budget request........................ - - -
The Social Services Block Grant (SSBG) program provides
formula grants to the 50 States, the District of Columbia,
Puerto Rico, Guam, American Samoa, the U.S. Virgin Islands, and
the Commonwealth of the Northern Mariana Islands. SSBG funding
targets a broad set of goals, including reducing or eliminating
poverty, achieving, or maintaining individual self-sufficiency,
preventing or remedying neglect, abuse, or exploitation of
children and adults, preventing or reducing inappropriate
institutional care, and supporting institutional care, when
appropriate.
Family Resource Centers.--The Committee recognizes that
Family Resource Centers provide direct assistance to families
through parenting support and education, navigation of care and
social services, mental health counseling, early learning and
afterschool activities, family financial planning, and job
training. The Committee supports States' investments in Family
Resource Center services and programs at school and community-
based Family Resource Centers to strengthen families through a
localized, family-centered approach. The Committee encourages
HHS to evaluate how States are utilizing Federal funds to
support FRC activities and to measure the outcomes of such
investments.
CHILDREN AND FAMILIES SERVICES PROGRAMS
Appropriation, fiscal year 2026....................... $14,923,390,000
Budget request, fiscal year 2027...................... 13,754,443,000
Committee Recommendation.............................. 14,587,087,000
Change from enacted level......................... -336,303,000
Change from budget request........................ +832,654,000
The Children and Families Services programs fund activities
serving children, youth, families, the developmentally
disabled, Native Americans, victims of child abuse and neglect
and domestic violence, and other vulnerable populations.
The Committee provides the following amounts:
------------------------------------------------------------------------
Budget Activity FY 2026 Enacted FY 2027 Committee
------------------------------------------------------------------------
Programs for Children, Youth, and
Families:
Head Start.................... $12,356,820,000 $12,366,820,000
Preschool Development Grants.. 315,000,000 - - -
Runaway and Homeless Youth 125,283,000 125,283,000
Program......................
Prevention Grants to Reduce 21,000,000 21,000,000
Abuse of Runaway Youth.......
Child Abuse State Grants...... 105,091,000 107,091,000
Child Abuse Discretionary 36,000,000 36,000,000
Activities...................
Community Based Child Abuse 70,660,000 70,660,000
Prevention...................
Child Welfare Services........ 268,735,000 268,735,000
Child Welfare Research, 21,984,000 21,984,000
Training, and Demonstration..
Adoption Opportunities........ 53,000,000 55,000,000
Adoption and Legal 75,000,000 77,000,000
Guardianship Incentive
Payments.....................
Social Services Research and 34,512,000 30,010,000
Demonstration................
Community Project Funding/ 40,801,000 - - -
Congressionally Directed
Spending.....................
Native American Programs...... 63,500,000 65,500,000
Community Services Block Grant
Act Programs:
Community Services Block 775,000,000 778,000,000
Grant....................
Community Economic 22,383,000 23,383,000
Development..............
Rural Community Facilities 13,000,000 14,000,000
National Domestic Violence 20,500,000 20,500,000
Hotline......................
Family Violence Prevention and 245,000,000 245,000,000
Services.....................
Chafee Education and Training 44,257,000 45,257,000
Vouchers.....................
Disaster Human Services Case 1,864,000 1,864,000
Management...................
Program Direction............. 214,000,000 214,000,000
------------------------------------------------------------------------
Head Start
Head Start and Early Head Start (EHS) programs fund
competitive grants to promote school readiness of children
under 5 from low-income families through preschool services.
Early Head Start.--The Committee continues to strongly
support EHS and directs HHS to prioritize maintenance of
current slots, and then expand slots where possible, including
through Head Start to Early Head Start (HS2EHS) slot
conversion, as determined by the needs of local communities.
The Committee further directs the Department to maintain the
EHS allocation of funds to at least the current proportion of
funding within the overall Head Start appropriations, and to
include in the fiscal year 2028 congressional justification the
actual and estimated number of slots in each of Head Start,
EHS, EHS Child Care Partnerships, and slots converted from
HS2EHS.
EHS Partnerships.--The Committee recognizes the growing
interest of philanthropic organizations, individuals, and
foundations in supporting high-quality early childhood
education, including infant and toddler services delivered
through EHS. The Committee urges ACF to strengthen EHS
partnerships to enhance program integrity, expand access to
high-quality services, strengthen the infant-toddler workforce,
improve facilities, and enhance program quality. The Committee
directs ACF to ensure that contributions supplement rather than
supplant Federal funds; that donor participation does not
influence grant awards, regulatory decisions, or procurement
actions; and that funding decisions consider the extent of
philanthropic investment in communities that are aligned with
program goals. The Committee further directs the Department to
make public on the agency website a report detailing amounts
received, and purposes for which funds were used within one
year of enactment of this Act.
EHS Workforce.--The Committee requests a briefing within
180 days of enactment of this Act on the agency's efforts to
grow and strengthen the Early Head Start workforce, including
opportunities to use alternative credentialing models to
provide Head Start programs with greater hiring flexibility and
to expand access for families.
Head Start Facilities.--The Committee instructs ACF to
complete the directives included under this heading in House
Report 119-271 within 90 days of enactment of this Act.
Head Start Minimum Enrollment Requirements.--The Committee
recognizes that parents of children with disabilities often
face barriers to accessing childcare and early education. The
Committee requests a report on efforts to increase childcare
slots for children with disabilities. The report should include
current barriers, existing and proposed actions to expand
access, and the potential impacts of increasing the Head Start
minimum enrollment requirement for children with disabilities,
including effects on program capacity, cost, implementation,
and parental choice.
Native Hawaiian Head Start Programs.--The Committee
recognizes the Federal government's trust responsibility to the
Native Hawaiian community and the importance of advancing
opportunity through comprehensive early childhood education.
The Committee encourages ACF to provide technical assistance to
potential Native Hawaiian Head Start providers interested in
applying for Head Start funding opportunities. Eligible
providers should promote locally driven solutions and be
focused on serving Native Hawaiian children and families,
including programs that support Native Hawaiian language
instruction where appropriate.
Notice to Congressional Offices.--The Committee directs the
agency to notify a congressional office if a current Head Start
recipient in its congressional district will be required to re-
compete to continue its grant. The agency is directed to notify
the office when the grant forecast for the recipient's service
area and funding is published.
Tribal Colleges and Universities Head Start Partnership
Program.--The Committee includes $12,000,000 for the Tribal
Colleges and Universities Head Start Partnership program, an
increase of $2,000,000 above the fiscal year 2026 enacted
level.
Preschool Development Grants
The Committee does not provide funding for the Preschool
Development Grants (PDG) program. The Committee continues to
prioritize funding for early learning and care programs through
Head Start, Early Head Start, the Child Care and Development
Block Grant (CCDBG) and Temporary Assistance for Needy Families
(TANF).
Runaway and Homeless Youth Program
This program funds competitive grants to provide street
outreach, emergency shelters, and longer-term transitional
living programs to protect and provide supportive services to
runaway and homeless youth.
Prevention Grants to Reduce Abuse of Runaway Youth
This program funds competitive grants to nonprofit agencies
for the purpose of providing street-based services to runaway,
homeless, and street youth who have been subjected to, or are
at risk of being subjected to sexual abuse, prostitution, human
trafficking, sexual exploitation, or other forms of
victimization. The Committee encourages the agency to continue
the Runaway and Homeless Youth Prevention Demonstration
Program, which has awarded funding to community-based
organizations focused on prevention services for youth at risk
of homelessness.
Child Abuse Prevention State Grants
This program provides Child Abuse Prevention and Treatment
Act formula grants to States to improve their child protective
service systems.
Within the total, the Committee continues to provide
$60,000,000, which is the same as the fiscal year 2026 enacted
level, to help States continue to develop and implement infant
plans for safe care as directed in Senate Report 119-55.
Child Abuse Discretionary Activities
This funding supports a variety of competitive grants,
including research and demonstration projects on the causes,
prevention, identification, assessment and treatment of child
abuse and neglect, the development and implementation of
evidence-based training programs, and technical assistance to
grantees and communities through national resource centers and
the Child Welfare Information Gateway.
Child Abuse Hotline.--The Committee supports ongoing
efforts to address and support youth and families impacted by
child abuse and neglect. Within the total, the Committee
continues to provide $2,000,000, which is the same as the
fiscal year 2026 enacted level, for broad, ongoing support for
the existing national child abuse hotline in order to provide
resources and intervention through multiple modalities,
including chat, text, and call, to respond to the urgent needs
of youth and concerned adults facing these challenges.
Community Based Child Abuse Prevention
This program provides formula grants to States that then
disburse funds to local community-based organizations to
improve local child abuse prevention and treatment efforts.
Child Welfare Services
This program funds formula grants to State and Tribal child
welfare programs for research, monitoring, and special
initiatives to promote positive outcomes for children and
families involved in child welfare.
Child Welfare Research, Training, and Demonstration Projects
This program funds competitive grants to entities that
prepare personnel for work in the child welfare field and those
engaged in research around child welfare issues.
Incarcerated Parent Demonstration Project.--The Committee
recognizes that children of incarcerated parents can experience
negative health and developmental outcomes due to parental
separation. Contact with a birth parent can help mitigate these
effects for both foster youth and children of incarcerated
parents. The Committee encourages ACF to award State and Tribal
partnership demonstration grants, as authorized by P.L. 118-
679, to maintain meaningful relationships between foster youth
and their incarcerated parents when doing so is safe and in the
best interest of the child. The Committee requests the agency
provide an update in the fiscal year 2028 congressional
justification on efforts to establish this demonstration
project.
Strengthening State Indian Child Welfare Act (ICWA)
Compliance.--The Committee recognizes the important role State
child welfare agencies play in ensuring the safety of Indian
children who come into contact with the State child welfare
system. The Committee appreciates the work of the Children's
Bureau and the Tribal Engagement Team to support State
compliance with ICWA through technical assistance and through
grants to develop strong working relationships between States
and Tribes. The Committee encourages continued staffing of this
team to ensure the ability to fulfill trust obligations to
Native children and families. The Committee continues to
provide $3,000,000, which is the same as the fiscal year 2026
enacted level, for State-Tribal partnership grants to build
collaborations between States and Tribes to better address the
ongoing challenges Tribal communities face.
Adoption Opportunities
This program funds competitive grants and contracts to
public and private organizations to remove barriers to adoption
and to provide permanent homes for children who would benefit
from adoption.
Adoption Agencies.--The Committee encourages HHS to
maintain a public list of licensed adoption agencies so that
birth mothers can make decisions based on verified and
trustworthy information. The list of agencies should include
adoption agencies with current State licenses who are in good
standing with the State.
Adoption-Sensitive Care Training.--The Committee continues
to provide $1,000,000, which is the same as the fiscal year
2026 enacted level, for a competitive grant program to improve
access to adoption-sensitive care training for eligible
hospital staff as directed in the explanatory statement that
accompanied Division D of P.L. 118-47. The Committee encourages
the Department to provide grantees with resources that focus on
understanding the sensitivities regarding adoption in the
health care industry and the best practices for interacting
with prospective birth mothers and adoptive families, including
the use of non-directive education for expectant parents
considering adoption, parenting, and kinship care. Eligible
grantees should not provide or refer for abortion.
Family First Prevention Services Clearinghouse.--The
Committee continues to direct not less than $2,000,000, which
is the same as the fiscal year 2026 enacted level, for the
evaluation of programs to support adoption arrangements at risk
of a disruption or dissolution, as directed in Senate Report
118-84.
National Adoption Competency Mental Health Training
Initiative (NTI).--The Committee continues to provide
$3,000,000 for the National Adoption Competency Mental Health
Training Initiative, which is a $1,000,000 increase above the
fiscal year 2026 enacted level. The NTI provides free, web-
based training for child welfare and mental health
professionals to develop the skills needed to support foster,
adoptive, and kinship families. The Committee acknowledges
these special populations often face barriers to obtaining
quality mental health services, which adversely impacts
permanency and well-being outcomes.
National Training and Development Curriculum (NTDC).--The
Committee continues to provide $1,000,000, which is the same as
the fiscal year 2026 enacted level, for the NTDC as directed in
the explanatory statement that accompanied Division D of P.L.
118-47.
Support for Birth Parents.--The Committee recognizes that
birth parents who voluntarily place their children for adoption
often benefit from post-adoption counseling, support, and
resources. Therefore, the Committee provides $1,000,000 for a
demonstration program to provide support groups, resources, and
services to birth parents. Eligible grantees should be
adoption-focused, nonprofit organizations with experience
working with parents who have placed their children for private
domestic adoption. The Committee instructs ACF to complete the
directives under this heading in House Report 119-271.
Adoption and Legal Guardianship Incentive Payments
This program provides formula-based incentive payments to
States to encourage them to increase the number of adoptions of
children from the foster care system.
Improving Foster Youth Outcomes.--The Committee is
concerned that national data on maltreatment of children
adopted from foster care are insufficient. Although Federal
data systems collect maltreatment, foster care and adoption
information, inconsistent State identifiers and limited linkage
capacity prevent reliable longitudinal tracking and monitoring
of children who exit foster care to adoption. To improve pre-
and post-adoption supports, the Committee directs the
Department to provide technical assistance to States to build
linkage and analytic capacity, including establishing data-
quality standards and routine quality checks for linkages
between the National Child Abuse and Neglect Data System
(NCANDS) and Adoption and Foster Care Analysis and Reporting
System (AFCARS) systems. The Committee further directs the
Department to explore incentive funding mechanisms to support
States that submit high-quality, linkable data. The Committee
requests a briefing on these efforts within 180 days of
enactment of this Act.
Social Services Research and Demonstration
The Social Services Research and Demonstration funds
research, evaluation, and demonstration efforts that focus on
preventing and reducing dependency on government programs and
improving the administration and effectiveness of services for
children and families.
Diaper Distribution Demonstration and Research Pilot
(DDRP).--Within the total, the Committee continues to provide
$20,000,000, which is the same as the fiscal year 2026 enacted
level, for the DDRP. The pilot helps address diaper needs and
supports economic mobility for low-income families. The
Committee encourages ACF to continue funding grants and to
support program evaluation activities, including the release of
the final DDRP evaluation report.
Affordable Housing and Supportive Services Demonstration.--
Within the total, the Committee continues to provide
$2,500,000, which is the same as the fiscal year 2026 enacted
level, for grants to Community Action Agencies and Tribes that
own affordable housing for the purpose of connecting residents
to support services that improve housing stability, economic
mobility and well-being.
Medical Legal Partnerships.--Within the total, the
Committee continues to provide $2,000,000, which is the same as
the fiscal year 2026 enacted level, for the Medical Legal
Partnerships program.
Native American Programs
These programs fund competitive grants to assist Tribal
governments and Native American institutions and organizations
in their efforts to support and develop stable, diversified
local economies. Tribes and nonprofit organizations use funds
to develop and implement sustainable community based social and
economic programs and services to improve the wellbeing of
Native people.
Within the total, the Committee provides $16,000,000 for
Native American language preservation activities, including no
less than $7,000,000 for language immersion programs as
authorized by section 803C(b)(7)(A)-(C) of the Native American
Programs Act, as amended by the Esther Martinez Native American
Language Preservation Act of 2006.
The Committee is aware of concerns about the recent
proposal to replace the Social and Economic Development
Strategies (SEDS) and SEDS-Alaska (SEDS-AK) grants with new
programs, in particular that the proposed programs would focus
on a narrower set of priority areas and shift from the
historical model in SEDS and SEDS-AK that has allowed grantees
to tailor their project priorities and designs based on locally
identified needs. As part of future programmatic decisions, the
Committee encourages ACF to ensure engagement with interested
stakeholders, to ensure program funding continues to advance
the economic and community development goals of Tribal Nations
and other Native organizations.
Community Services Block Grant Act Programs
The Community Services Block Grant is a program that
provides formula grants to States, territories, and Tribes to
alleviate the causes and conditions of poverty in communities.
Community Economic Development.--Community Economic
Development is a competitive grant program which funds
Community Development Corporations seeking to address the
economic needs of low-income individuals and families through
the creation of sustainable business development and employment
opportunities.
Rural Community Facilities.--The Rural Community
Development competitive grant program partners with regional
and Tribal organizations to support safe water systems in rural
communities. Under the program's technical assistance
authority, grant recipients help residents in unserved and
underserved populations, including isolated unincorporated
communities, small low-income communities that cannot afford
loan or grant financing, and communities without central
systems that are therefore not covered by the Clean Water Act
of the Safe Drinking Water Act.
The Committee recognizes the critical role that access to
clean, affordable water services plays in promoting public
health. The Committee requests an update in the fiscal year
2028 congressional justification on the agency's efforts to
support and expand access to safe and affordable drinking
water, wastewater, and other water services in rural, low-
income, and underserved communities.
National Domestic Violence Hotline
The National Domestic Violence Hotline provides free and
confidential 24-hour, toll-free telephone, chat and text
services immediately connecting callers to local service
providers.
The Committee encourages ACF to continue building the
Hotline's capacity and to support investments in technology
infrastructure and staffing to ensure a timely response to
requests for help.
Religious Communities.--Individuals in religious
communities experience unique challenges in assessing
appropriate domestic violence resources and support. The
Committee provides $250,000 for the domestic violence hotline
to evaluate and expand its list of resources for contacts from
religious communities.
Family Violence Prevention and Services
The Family Violence Prevention and Services Act (FVPSA)
program provides funding to support the prevention of incidents
of family violence, domestic violence, and dating violence, and
provide immediate shelter and supportive services for adult and
youth victims.
The Committee recognizes that all forms of domestic
violence are strongly associated with poor mental health
outcomes and substance abuse. The Committee encourages ACF to
fund domestic violence prevention programs that support
individuals with co-occurring health conditions linked to
domestic violence while ensuring families remain together
through recovery and the best interests of children exposed to
violence in the home are prioritized.
Within the total, the Committee provides $9,500,000 for
supporting Native American Tribes and Tribal organizations,
which is the same as the fiscal year 2026 enacted level, to
fund immediate shelter and supportive services for survivors of
domestic violence and their dependents.
Within the total, the Committee provides $2,000,000 for the
Native Hawaiian Resource Center on Domestic Violence program,
which is the same as the fiscal year 2026 enacted level, to
continue providing technical assistance, services and supports
for Native Hawaiian adults, children and youth experiencing
domestic violence.
Addressing Domestic Violence in Religious Communities.--The
Committee recognizes the unique challenges individuals in
religious communities--particularly those underserved because
of their religious beliefs--face in accessing appropriate
domestic violence services and supports. The Committee supports
the work of FVPSA Resource Centers to improve outreach to
faith-based communities and encourages the Centers to continue
expanding efforts to reach and serve those communities,
especially underserved populations. The Committee requests an
update in the fiscal year 2028 congressional justification on
FVPSA activities serving the needs of religious communities.
Chaffee Education and Training Vouchers
This program funds formula grants to States to provide
vouchers to youth who are, or were formerly, in foster care for
expenses related to post-secondary education assistance, and
vocational training.
Disaster Human Services Case Management
This funding supports work at HHS addressing human service
preparation for, response to, and recovery from, natural
disasters.
Program Direction
This funding supports Federal administrative costs
associated with administering the agency's programs.
International Surrogacy.--The Committee understands
concerns regarding the risks that may be posed by international
surrogacy contracts, in which foreign nationals contract with
an American surrogate for the purposes of having a child with
U.S. citizenship, a passport, birth certificate, Social
Security Number, and educational benefits, even if the child
may be raised in another country with the foreign intended
parent. Such concerns include the exploitation of citizenship
processes, vulnerable women, and the children, as well as
potential national security risks. The Committee urges HHS to
coordinate with State-level health departments to report and
track, where possible, the total number of such contracts and
births, especially those where the child is born via commercial
surrogacy with the foreign national listed as the intended
parent(s). Privacy protections may remain in place as States
report on the number of contracts, country of origin, and live
births. The Committee further supports efforts by GAO to review
the legal, ethical, and public health implications of
international commercial surrogacy arrangements involving
United States citizens, including potential risks related to
exploitation of the commercial surrogate, trafficking of the
resulting children, and citizenship documentation or fraud
through green card applications or other benefits. The
Committee urges HHS, in consultation with the Departments of
State and Homeland Security, to the extent practicable, to
provide a report within 180 days of enactment of this Act,
describing the prevalence of international commercial surrogacy
arrangements involving U.S. citizens, including the countries
where such arrangements most frequently occur, the number of
contracts entered into between foreign nationals and U.S.
surrogacy agencies and/or surrogates, the number of children
born in the U.S. through these arrangements, and any associated
legal or regulatory challenges.
Temporary Assistance for Needy Families (TANF) Education
and Workforce Training.--The Committee recognizes State efforts
to use TANF funds for education and workforce training programs
that target at-risk primary and secondary students who are one
or more grades behind. Academic performance is a critical
determinant of future success and can influence whether
students continue to need Federal assistance into adulthood.
The Committee directs the Department to submit a report within
180 days of enactment of this Act detailing how States are
using TANF funds to support education and workforce preparation
initiatives focused on at-risk primary and secondary students.
The report should include an overview of TANF-supported State
programs that implement early-intervention strategies, learning
and employment outcomes associated with those programs, and the
programs' impact on long-term reliance on Federal assistance.
PAYMENTS FOR FOSTER CARE AND PERMANENCY
Appropriation, fiscal year 2026....................... $6,843,000,000
Budget request, fiscal year 2027...................... 6,617,000,000
Committee Recommendation.............................. 6,617,000,000
Change from enacted level......................... -226,000,000
Change from budget request........................ - - -
The Committee also provides an advance appropriation of
$4,000,000,000 for the first quarter of fiscal year 2028 to
ensure timely completion of first-quarter grant awards.
Within the total, the Committee provides $5,142,000,000 for
the Foster Care program. This mandatory program provides funds
to States for foster care maintenance payments for children
living in foster care. These funds also reimburse States for
administrative costs to manage the program and training for
staff and parents.
Within the total, the Committee provides $4,485,000,000 for
Adoption Assistance. This mandatory program provides funds to
States to subsidize families who adopt children with special
needs, such as older children, a member of a minority or
sibling group, or children with physical, mental, and emotional
disabilities. In addition, the program provides training for
adoptive parents and State administrative staff. This annually
appropriated entitlement provides alternatives to long,
inappropriate stays in foster care by developing permanent
placements with families.
Within the total, the Committee provides $418,000,000 for
the Kinship Guardianship Assistance program. This mandatory
program provides subsidies to a relative taking legal
guardianship of a child for whom being returned home, or
adoption, are not appropriate permanency options.
Finally, within the total, the Committee provides
$143,000,000 for the Independent Living program. This mandatory
program assists foster children age 16 or older make successful
transitions to independence. Funds support a variety of
services, including educational assistance, career exploration,
vocational training, job placement, life skills training, home
management, health services, substance abuse prevention,
preventive health activities, and room and board. Each State
receives funds based on the number of children on whose behalf
the State receives Federal Foster Care Payments.
Administration for Community Living
AGING AND DISABILITY SERVICES PROGRAMS
Appropriation, fiscal year 2026....................... $2,536,679,000
Budget request, fiscal year 2027...................... 2,454,100,000
Committee Recommendation.............................. 2,522,711,000
Change from enacted level......................... -13,968,000
Change from budget request........................ +68,611,000
The Administration for Community Living (ACL) increases
access to community support for older Americans and people with
disabilities. It is charged with administering programs
authorized under the Older Americans Act of 1965 (OAA) and the
Developmental Disabilities Assistance and Bill of Rights Act of
2000. ACL was established to create opportunities for older
adults and people with disabilities to live and engage in their
communities by removing obstacles that limit people's choices
and ability to participate in community living.
The Committee continues to fund the Senior Medicare Patrol
Program through the Health Care Fraud and Abuse Control Account
under CMS.
Home and Community-Based Supportive Services
The Committee includes $414,000,000 for Home and Community-
Based Supportive Services, which is equal to the fiscal year
2026 enacted level. This program provides formula grants to
States and territories to fund a wide range of social services
that enable seniors to remain independent in their homes for as
long as possible.
Preventive Health Services
The Committee includes $26,339,000 for Preventive Health
Services, which is equal to the fiscal year 2026 enacted level.
This program funds formula grants to States to help seniors
remain healthy and avoid chronic diseases. Funding supports a
variety of healthy aging programs designed to reduce disease
and prevent injuries, including evidence-based programs to
address the risk of falls, chronic diseases, mental health, and
medication management.
Protection of Vulnerable Older Americans
The Committee includes $28,000,000 for activities to
protect vulnerable older Americans. These programs provide
formula grants to States for protection of vulnerable older
Americans through the Long-Term Care Ombudsman and Prevention
of Elder Abuse and Neglect programs.
Long-Term Care Ombudsman.--Within the total provided for
Protection of Vulnerable Older Americans, the Committee
includes $23,000,000 for the Long-Term Care Ombudsman program.
This program works to improve the quality of life and care for
individuals who reside in long-term care facilities. Ombudsmen
work to ensure residents understand their care options and that
strong beneficiary support systems are in place in all
settings.
Family Caregivers
The Committee provides $209,000,000 for the National
Caregiver Support program, which is the same as the fiscal year
2026 enacted level. This program offers a range of support
services to family caregivers, including assistance in
accessing services such as respite care, counseling, support
groups, and caregiver training.
Native American Caregivers Support
The Committee provides $16,000,000 for the Native American
Caregivers Support program. This program provides formula
grants to Tribes for the support of American Indian, Alaskan
Native, and Native Hawaiian families caring for older relatives
with chronic illness or disabilities.
Nutrition
The Committee provides a total of $1,061,684,000 for senior
nutrition programs. This is a $3,000,000 increase over the
fiscal year 2026 enacted level. Additional funding for this
population is also available from the Department of
Agriculture. Within the total, the Committee includes
$566,342,000 for Congregate Meals, $382,342,000 for Home
Delivered Meals, and $113,000,000 for the Nutrition Services
Incentives program. These programs provide older Americans with
meals and related services in a variety of settings (including
congregate facilities such as senior centers) and via home
delivery to older adults who are homebound due to illness,
disability, or geographic isolation.
Food is Medicine.--The Committee encourages ACL to
incorporate and prioritize Food is Medicine goals in OAA
Nutrition grant recipients' programming with the goal of
integrating infrastructure capacity building and directing
service nutrition interventions to support rural-dwelling
adults age 60 and over who are in the greatest economic and
social need.
Grants for Native Americans
The Committee includes $42,264,000 for Native American
Nutrition and Supportive Services. This program provides
formula grants to Tribes to promote the delivery of nutrition
and home and community-based supportive services to Native
American, Alaskan Native, and Native Hawaiian elders.
Aging Network Support Activities
The Committee includes $33,461,000 for Aging Network
Support Activities. This program supports activities that
expand public understanding of aging and the aging process.
Holocaust Survivor Assistance Program.--Within the total
provided for Aging Network Support Activities, the Committee
includes $10,000,000 for the Holocaust Survivor Assistance
program. This program provides supportive services for aging
Holocaust survivors living in the U.S. The Committee recognizes
the program's success in serving nearly 44,000 Holocaust
survivors, more than 8,000 older adults with a history of
trauma, and over 7,000 family caregivers.
Care Corps.--Within the total provided for Aging Network
Support Activities, the Committee includes $7,000,000 for the
Care Corps volunteer program to support non-medical services
for seniors, individuals with disabilities, and family
caregivers. These include respite care, transportation, meal
preparation, minor home cleaning and modifications, education,
caring calls/visits, and training. The Committee recognizes the
success of local programs that are increasing seniors' access
to non-emergency medical services by offering transportation
with trained volunteers to serve as aides and advocates for
those with accessibility challenges. Within the total provided
for Care Corps, the Committee includes $3,000,000 for older
adult transportation and chaperone services, of which not less
than $500,000 shall be available for the purposes of developing
a national training program to increase the reach of such
volunteer services. Funds may be used for purposes including
developing training and competency frameworks, data collection
and evaluation frameworks, providing workforce development
support, and offering technical and operational assistance to
expand this volunteer model.
Direct Care Workforce Demo.--Within the total provided for
Aging Network Support Activities, the Committee continues
$2,000,000 for the Direct Care Workforce Demonstration Project.
Interagency Coordinating Committee on Healthy Aging and
Age-Friendly Communities.--Within the total provided for Aging
Network Support Activities, the Committee includes $1,000,000
for the coordination of healthy aging programs across HHS, the
Department of Housing and Urban Development, the Department of
Transportation, and other related agencies, with a focus on
falls prevention programs and safe living environments for
seniors.
Research, Demonstration, and Evaluation Center for the
Aging Network.--Within the total provided for Aging Network
Support Activities, the Committee continues $5,000,000 for the
Research, Demonstration, and Evaluation Center for the Aging
Network. The center researches best practices in the field of
falls prevention, awards competitive grants to Aging Network
entities to implement best practices, and evaluates new and
ongoing falls prevention programs.
Alzheimer's Disease Program
The Committee includes $31,500,000 for the Alzheimer's
disease program, which is the same as the fiscal year 2026
enacted level. This program provides competitive matching
grants to a limited number of States to encourage program
innovation and coordination of public and private services for
people with Alzheimer's disease and their families. Of the
funds provided, $14,700,000 shall be transferred from the PPHF.
National Alzheimer's Call Center.--Within the total
provided for the Alzheimer's Disease Program, the Committee
includes not less than $2,000,000 for the National Alzheimer's
Call Center.
Younger-Onset Dementias With Behavioral Symptoms.--The
Committee is concerned that individuals living with younger-
onset dementia with behavioral symptoms, including
frontotemporal degeneration (FTD), frequently lack access to
appropriate long-term services and supports and are at
heightened risk of involuntary discharge from long-term care
facilities due to behavioral symptoms. Inconsistent placement
practices, inadequate staff training, and limited crisis
response capacity contribute to avoidable hospitalizations,
caregiver burnout, and poor outcomes. The Committee encourages
ACL, in consultation with other relevant agencies, to develop
and publicly disseminate a best practices toolkit to support
dementia-capable systems of care for individuals with younger-
onset dementia with behavioral symptoms. The toolkit should
address facility readiness, workforce competencies, and non-
pharmacologic approaches to managing behavioral symptoms;
caregiver education, respite, and support services; and crisis
prevention, de-escalation, and response pathways designed to
reduce emergency department utilization, law enforcement
involvement, and involuntary discharges.
Lifespan Respite Care
The Committee includes $11,000,000 for Respite Care, which
is the same as the fiscal year 2026 enacted level. The program
funds competitive grants to ease the burdens of caregiving by
providing grants to eligible State organizations to improve the
quality of, and access to, respite care for family caregivers.
Chronic Disease Self-Management Program
The Committee includes $8,000,000 from the PPHF for the
Chronic Disease Self-Management program, which is the same as
the fiscal year 2026 enacted level. This program funds
competitive grants and cooperative agreements to support
evidence-based prevention models that use state of the art
techniques to help those with chronic conditions address issues
related to the management of their disease.
Elder Falls Prevention
The Committee includes $7,500,000 for the Falls Prevention
program, which is the same as the fiscal year 2026 enacted
level. Falls prevention competitive grants and cooperative
agreements support the promotion and dissemination of
prevention tools delivered in community settings. Of the funds
provided, $5,000,000 shall be transferred from the PPHF.
Elder Rights Support Activities
The Committee includes $34,005,000 for Elder Rights Support
Activities, which is a $131,000 increase above the fiscal year
2026 enacted program level. These programs support efforts that
provide information, training, and technical assistance to
legal and aging services organizations working to prevent and
detect elder abuse and neglect.
Aging and Disability Resource Centers
The Committee includes $8,619,000 for Aging and Disability
Resource Centers (ADRCs), which is the same as the fiscal year
2026 enacted level. These centers provide information,
counseling, and access for individuals to learn about the
services and support options available to seniors and the
disabled so they may retain their independence.
State Health Insurance Assistance Program
The Committee includes $55,242,000 for the State Health
Insurance Assistance Program (SHIP), which is the same as the
fiscal year 2026 enacted level. SHIP offers one-on-one
assistance, counseling, and education to Medicare
beneficiaries, their families, and caregivers to help them make
informed decisions about their care and benefits.
Paralysis Resource Center
The Committee provides $10,700,000 for the Paralysis
Resource Center, which is the same as fiscal year 2026 enacted
level. The Paralysis Resource Center offers activities and
services aimed at increasing independent living for people with
paralysis and related mobility impairments and supporting
integration into the physical and cultural communities in which
they live.
Limb Loss Resource Center
The Committee provides $5,000,000 for the Limb Loss
Resource Center, a critical national resource for individuals
living with limb loss and limb difference, as well as for the
clinicians and caregivers who support them. The Center plays a
critical role in improving rehabilitation outcomes and ensuring
access to evidence-based information, peer support, workforce
training, and provider education across the country. Given the
growing prevalence of limb loss due to diabetes, peripheral
artery disease, trauma, and cancer, the Committee encourages
ACL to continue prioritizing Center activities and expand
efforts to provide care coordination and mental health
programs, address disparities in access to limb preservation
and prosthetic care, and strengthen outreach to rural and
underserved communities. Early investment in these services
reduces long-term healthcare and social services expenditures
by supporting workforce participation, decreasing preventable
complications, and helping individuals avoid reliance on safety
net programs.
Traumatic Brain Injury
The Committee provides $13,118,000 for the Traumatic Brain
Injury program, which is the same as the fiscal year 2026
enacted level. The program provides grants to States for the
development of a comprehensive, coordinated family and person-
centered service system at the State and community level for
individuals who sustain a traumatic brain injury.
Developmental Disabilities State Councils
The Committee provides $81,000,000 for State Councils on
Developmental Disabilities, which is the same as the fiscal
year 2026 enacted level. This program provides formula grants
to States and territories to support State Councils, which work
to develop, improve, and expand the system of services and
supports for people with intellectual and developmental
disabilities.
Technical Assistance.--Within the total provided for
Developmental Disabilities State Councils, the Committee
provides not less than $800,000 for technical assistance and
training for the State Councils on Developmental Disabilities.
Developmental Disabilities Protection and Advocacy
The Committee provides $45,000,000 for Developmental
Disabilities Protection and Advocacy, which is the same as the
fiscal year 2026 enacted level. This formula grant program
provides funding to States to establish and maintain protection
and advocacy systems to protect the legal rights of persons
with developmental disabilities.
The Committee notes that the Supreme Court decision in
Olmstead v. L.C. (1999) held that the Americans with
Disabilities Act (ADA) does not require removing individuals
from institutional settings when they are unable to handle or
benefit from a community-based setting and that the ADA does
not require the imposition of community-based treatment on
individuals who do not desire it. The Committee notes that
actions to undermine and close intermediate care facilities for
individuals with intellectual disabilities may impact some
individuals who do not meet the criteria for transfer to a
community-based setting. The Committee encourages HHS to ensure
that programs properly account for the needs and desires of
individuals with disabilities, their families, legal
representatives and caregivers, and the importance of affording
individuals the proper setting for their care. The Committee
further encourages the Department to prohibit an eligible
protection and advocacy system to use funds under this heading
to institute class action litigation against an intermediate
care facility in good standing with licensure requirements.
The Committee recognizes that the ADA encourages States to
administer services for people with Intellectual and
Developmental Disabilities (IDDs) in the most integrated
setting appropriate to the needs of qualified individuals with
IDDs. Further, the Committee understands that while center-
based work is not appropriate for every individual with a
disability, center-based adult work programs chosen by
individuals with severe IDDs and their families remain a viable
choice that can provide dignity and purpose for a significant
percentage of the IDD population. These work and service
settings have been determined to be rewarding and appropriate
by the individuals and family members directly involved in the
decision-making process, and the Committee is concerned that
some organizations receiving funding under the Developmental
Disabilities Assistance and Bill of Rights Act have targeted
these settings for closure. The Committee encourages ACL to
encourage stakeholders to coordinate to ensure that individuals
with IDDs appropriately suited to participate in center-based
work programs are not deprived of the opportunity to do so.
Developmental Disabilities Voting Access for Individuals with
Disabilities
The Committee provides $10,000,000 for Voting Access for
Individuals with Disabilities program, which is the same as the
fiscal year 2026 enacted level. The Voting Access for
Individuals with Disabilities program authorized by the Help
America Vote Act provides formula grants to States to help
ensure full participation in the electoral process for
individuals with disabilities, including registering to vote,
accessing polling places, and casting a vote.
Developmental Disabilities Projects of National Significance
The Committee provides $12,250,000 for Developmental
Disabilities Projects of National Significance, which is the
same as the fiscal year 2026 enacted level. This program funds
grants and contracts that develop new technologies and
demonstrate innovative methods to support the independence,
productivity, and integration of those living with a disability
into the community.
University Centers for Excellence in Developmental Disabilities
The Committee provides $43,119,000 for University Centers
for Excellence in Developmental Disabilities (UCEDD), which is
the same as the fiscal year 2026 enacted level. UCEDDs are a
nationwide network of independent but interlinked centers,
funded via competitive grants, representing a national resource
for addressing issues, finding solutions, and advancing
research related to the needs of individuals with developmental
disabilities and their families. The funding also supports
technical assistance to strengthen and support the national
network of UCEDDs as they disseminate research, training, and
practices nationwide.
Independent Living
The Committee provides $130,183,000 for the Independent
Living program. The Independent Living program funds grants to
maximize the leadership, empowerment, independence, and
productivity of individuals with disabilities.
National Institute on Disability, Independent Living, and
Rehabilitation Research
The Committee provides $100,000,000 for the National
Institute on Disability, Independent Living, and Rehabilitation
Research (NIDILRR), which is equal to the fiscal year 2026
budget request. NIDILRR funds research and development of new
innovative technological devices, prototypes, measurement
tools, and interventions to help people with disabilities live
more independently.
Assistive Technology
The Committee provides $42,000,000 for Assistive Technology
(AT). AT supports programs providing formula grants to States
to support individuals with disabilities of all ages to obtain
devices and services that will increase, maintain, or improve
their functional capabilities. With the reauthorization of the
21st Century Assistive Technology Act, the Committee supports
implementation to meet the increased demand for access to
assistive technology for people with disabilities and older
adults. The goal is to increase awareness of and access to AT
devices and services that may help with education, employment,
daily activities, and inclusion of people with disabilities in
their communities.
Aging and Disability Technology Innovation.--The Committee
recognizes the growing demands placed on family caregivers and
the workforce shortages affecting long-term care services and
supports. The Committee strongly encourages ACL to evaluate and
promote the use of innovative technologies that reduce
caregiver burden, support independent living, and enable older
adults and individuals with disabilities to safely age in
place. The Committee urges ACL to work with public and private
partners to identify scalable technology solutions, including
assistive technologies such as assistive robotics platforms,
and digital care coordination tools that can improve care
delivery efficiency while helping address healthcare workforce
constraints. ACL is encouraged to incorporate technology
adoption and best practices into existing aging network
programs. The Committee requests an update on opportunities to
accelerate deployment of evidence-based technology solutions
that support caregivers and strengthen home-and community-based
care in the fiscal year 2028 congressional justification.
Program Administration
The Committee provides $43,727,000 for Program
Administration. This funding supports Federal administrative
costs associated with administering ACL's programs for older
Americans and people with disabilities.
Administration for Strategic Preparedness and Response
Appropriation, fiscal year 2026....................... $3,692,597,000
Budget request, fiscal year 2027...................... 3,337,069,000
Committee Recommendation.............................. 3,648,597,000
Change from enacted level......................... -44,000,000
Change from budget request........................ +311,528,000
This account supports the activities of the Administration
for Strategic Preparedness and Response (ASPR) to prevent,
prepare for, and respond to the health consequences of
chemical, biological, radiological, and nuclear (CBRN) threats
and other public health emergencies, including pandemic
influenza. ASPR is responsible for coordinating national
policies and plans for medical and public health preparedness
and for administering a variety of public health preparedness
programs.
The Committee first funded ASPR as an operating division
during the Fiscal Year 2024 budget cycle. The Committee
consolidated the Biomedical Advanced Research and Development
Authority (BARDA), Project BioShield, the associated Special
Reserve Fund, and the Strategic National Stockpile (SNS) into a
single Treasury account to better ensure a seamless transition
of medical countermeasures (MCMs) from development to
production and procurement, and provide the strongest possible
response to natural and manmade threats.
The Committee encourages HHS to continue recognizing the
significance of ASPR's work in combating CBRN threats and to
support all preparedness and response efforts to address those
threats. The Committee emphasizes the importance of maintaining
the SNS, BARDA, Project BioShield, and the Special Reserve Fund
within ASPR's independent operating structure.
ASPR is uniquely positioned to support continued investment
in biomanufacturing and the onshoring of the MCM supply chain,
which are essential to ensuring the health and security of the
American public. To that end, the Committee includes provisions
designed to support domestic manufacturing of active
pharmaceutical ingredients, antibiotics, diagnostics, essential
medicines, medical devices, personal protective equipment, and
other pharmaceutical products critical to maintaining MCM
capacity. The Committee also includes a new provision
prohibiting ASPR, and the SNS in particular, from purchasing
MCMs, goods, or services from China or China-owned companies
unless such items or services are otherwise unavailable.
ASPR Preparedness and Response Activities.--The Committee
directs ASPR, not later than 180 days after enactment of this
Act, to submit to the appropriate authorizing and
appropriations committees a report on the state of pandemic
preparedness, response, research, and development. The report
shall: (1) describe current activities across HHS agencies,
including agency-specific roles and examples of research and
development activities; (2) identify gaps and unmet needs
across the research continuum, including basic research,
diagnostics, therapeutics, vaccines, and health services
research; and (3) recommend opportunities to strengthen
coordination, reduce duplication, and address identified gaps
to enhance national readiness.
Domestic Manufacturing of Essential Medicines and Medical
Countermeasures.--The Committee appreciates ASPR taking steps
to restore capacity for domestic production of essential
pharmaceutical products, in addition to ASPR's efforts to
expand domestic manufacturing infrastructure for MCMs. The
Committee encourages ASPR to continue to prioritize the use of
existing domestic manufacturing capacity, in addition to
pursuing investments that enhance domestic medical
countermeasure manufacturing capabilities. The Committee
directs ASPR, in coordination with other relevant partners, to
assess opportunities to leverage idle or underutilized U.S.-
based manufacturing infrastructure in ways that would address
gaps in the public health supply chain, promote warm-based
surge capacity, and reduce our reliance on foreign-based
manufacturing. The assessment should also include updates on
ASPR's domestic onshoring efforts related to antibiotics,
biologic drug-delivery systems, medical devices, active
pharmaceutical ingredients (APIs), key starting materials
(KSMs), and nitrile examination gloves noted in this section of
the report. Within 270 days of enactment of this Act, the
Committee directs ASPR to issue a report on the findings of
this assessment to the Committee on Appropriations and the
Committee on Energy and Commerce.
Domestic Antibiotic Manufacturing.--The Committee
recognizes the need to strengthen the domestic pharmaceutical
industrial base and mitigate risks to the U.S. pharmaceutical
supply chain, which is heavily reliant on foreign suppliers for
critical drugs and active pharmaceutical ingredients, including
generic antibiotics. Therefore, the Committee urges the
Department, in coordination with DOD, to jointly implement a
plan to onshore the end-to-end supply chain for the
biomanufacturing of fermentation-based essential antibiotics to
ensure necessary domestic manufacturing capacity.
Domestic Manufacturing of Biologic Drug-Delivery Systems.--
The Committee recognizes the importance of expanding U.S.
capacity for high-quality biologic drug-delivery components,
including pre-fillable syringes, drug-delivery systems, self-
administered injectable therapies, wearable injectors, and
other device-drug platforms that support the shift from
infusion-based care to subcutaneous and at-home treatment. The
Committee also recognizes that strengthening domestic
production of these components will advance patient access to
critical therapies, reduce strain on healthcare facilities, and
bolster U.S. supply-chain resilience. Therefore, the Committee
encourages ASPR to work with drug-delivery manufacturers and
biopharmaceutical partners to reduce reliance on foreign
sources and support continued innovation. The Committee further
encourages ASPR to support supply-chain redundancy and surge
readiness for critical drug-delivery components to ensure
consistent availability during periods of increased demand or
public-health emergencies.
Domestic Manufacturing of Medical Devices.--The Committee
supported BARDA's investments to accelerate the expansion of
domestic manufacturing capacity for ancillary supplies like
needles and syringes during the COVID pandemic. However, to
continue to ensure Americans have access to essential medical
devices, the Committee encourages a more concerted effort to
shore up domestic production and the U.S. supply chain. The
Committee urges ASPR to advance programs and policies that
preserve and protect U.S. based manufacturing for essential
medical devices.
Domestic Medicine & Active Pharmaceutical Ingredient
Manufacturing.--The Committee is concerned with the national
security risk of our reliance on foreign-based sources of APIs,
their KSMs, and offshore drug production. The Committee
recognizes the importance of domestic drug manufacturing and
onshore production of medicine to support increased U.S.-based
manufacturing capabilities. The Committee acknowledges the
impact of weather events on U.S.-based manufacturing
capabilities and encourages intentional efforts to vary
manufacturing locations for active pharmaceutical ingredients,
including their chemical precursors. The successful work of
BARDA in addressing public health vulnerabilities and securing
a national stockpile of drugs has unique potential to consider
program expansion to include at-risk drug ingredients. The
Committee encourages ASPR to engage in public-private
partnerships for U.S.-based advanced manufacturing for active
pharmaceutical ingredients, including their chemical precursors
for the SNS.
Domestic Nitrile Examination Glove Manufacturing Capacity
and CBRN Preparedness.--The Committee is concerned that the
U.S. consumes more than 120 billion nitrile gloves annually
across healthcare, defense, manufacturing, food service, and
first responders. Domestic manufacturers produce less than one
percent of U.S. demand, with more than 99 percent of supply
imported overwhelmingly from China and Southeast Asia. The
Committee recognizes that nitrile examination gloves are
classified by the Food and Drug Administration as Class I
medical devices under 21 CFR 880.6250, constitute medical
countermeasures under 42 U.S.C. Sec. 247d-6d(i)(1)(C), and
provide essential protection against CBRN threats. The
Committee encourages ASPR, in coordination with the VA, to
develop a long-term sustainable procurement plan for nitrile
examination gloves that gives preference to, and results in
purchases directly from, domestic manufacturers to the maximum
extent practicable, consistent with the Make PPE in America Act
(section 70953 of Public Law 117-58). The Committee further
encourages ASPR to maintain warm-base surge production capacity
contracts with domestic nitrile examination glove manufacturers
to ensure large-scale production capability is available to
respond to CBRN threats, public health emergencies, and other
events that pose a significant national security risk.
Strengthening Domestic Supply Chain Resiliency.--The
Committee appreciates ASPR taking steps to strengthen our
nation's MCM enterprise, including through BioMaP and BARDA's
Pharmaceutical Countermeasures Infrastructure (PIC) Division,
and supports efforts to expand domestic manufacturing
infrastructure for MCMs. Given the global nature of certain
clinical research, development, and manufacturing activities,
it is critical for BARDA to strengthen, expand, and make
progress in onshoring these programs. Within 180 days of
enactment of this Act, ASPR is directed to brief the Committee
on ASPR's fiscal year 2027 plans to support the onshoring of
medical countermeasure development activities, including
actions taken by BioMAP and PIC.
Interagency Coordination.--The Committee encourages ASPR,
in coordination with DOD, to provide technical expertise to
FDA's Center for Biologics Evaluation and Research, as they
further the development of MCMs for combatting emerging
pathogens.
Multiyear Budget.--The Committee notes that 42 U.S.C.
300hh-10 requires annual updates to the Public Health Emergency
Medical Countermeasures Enterprise (PHEMCE) multiyear budget.
The Committee continues to direct ASPR to notify the Committee
and the Energy and Commerce Committee 14 days in advance of any
anticipated delay.
PHEMCE Advisory Committee.--The Committee recognizes
effective public-private partnerships are the best way to
support our nation's preparedness and response capabilities, as
these private sector partners are the primary developers of
critical MCMs such as diagnostics, therapeutics, and vaccines
which have no commercial market. The Committee notes with
concern that the PHEMCE, which is chaired by ASPR, has not
established an advisory committee incorporating private sector
and non-Federal partners and stakeholders despite
recommendations from Congress and NASEM. The Committee
encourages ASPR to establish this advisory committee with
urgency to ensure timely and transparent communication with the
government's private sector partners. The Committee continues
the directive included under this heading in House Report 119-
271.
PHS Act Evaluation Funding.--The Committee understands that
at the start of fiscal year 2025, the Department departed from
its prior practice and included certain biodefense programs
among the programs assessed under section 241 of the PHS Act.
The Committee has strong concerns that the Department repeated
this in fiscal year 2026, given the congressional direction
provided for in the explanatory statement that accompanied
Division B of P.L. 119-75. Therefore, the Committee has
included bill language to preserve the nation's biodefense
infrastructure from assessment under section 241 of the PHS
Act.
Rapid Detection of Bioterrorism Agents.--The Committee is
concerned that the nation is not prepared to rapidly detect
biological agents, such as anthrax, tularemia, melioidosis,
glanders, and plague, even though BARDA has successfully
supported development of diagnostic technologies that inform
care of domestic patients infected with such biothreats, in
some cases simultaneously. The Committee encourages ASPR to
coordinate with CDC and other partners responsible for
environmental test development and surveillance activities, to
ensure seamless transition from surveillance to response in the
event of a biological attack. The Committee further encourages
BARDA to prioritize partnerships with domestic manufacturers
capable of producing rapid clinical diagnostics, and to
coordinate with PHEMCE partners to develop a diagnostic testing
preparedness plan for use during public health emergencies,
disasters, and other serious public health threats.
Reporting.--The Committee directs ASPR to brief the
Committee monthly regarding activities funded by this Act and
other available appropriations. The agency is directed to
notify the Committee at least 24 hours in advance of any
obligation greater than $25,000,000 from any appropriation
available to ASPR. Such notification is directed to include the
source of funding, including the applicable legislative
citation, and a description of the obligation. In addition,
ASPR is directed to submit a monthly obligation report in
electronic format summarizing the details of these obligations
to the Committee. ASPR is further directed to provide the
report no later than 30 days after the end of each month and it
is directed to be cumulative for the fiscal year with the most
recent obligations listed at the top.
RESEARCH, DEVELOPMENT, AND PROCUREMENT
Appropriation, fiscal year 2026....................... $3,207,991,000
Budget request, fiscal year 2027...................... 2,625,591,000
Committee Recommendation.............................. 3,312,991,000
Change from enacted level......................... +105,000,000
Change from budget request........................ +687,400,000
Biomedical Advanced Research and Development Authority (BARDA)
The Committee includes $1,060,000,000 for BARDA, an
increase of $10,000,000 above fiscal year 2026 enacted level.
BARDA supports the advanced development of vaccines,
therapeutics, diagnostics, and devices for potential serious
public health threats, including chemical, biological,
radiological, and nuclear threats, pandemic influenza, and
emerging and reemerging infectious diseases.
Acceleration of Antibiotic Combination Drug Development.--
The Committee is concerned about the increasing public health
threat of antibiotic resistance (AR) and the lack of new
antibiotics entering the market. The Committee is encouraged
that BARDA has invested in combination antibiotic drug
development. Therefore, the Committee urges BARDA to continue
to prioritize the development of combination drugs,
particularly those with activity against CDC urgent threat
pathogens which can offer increased efficacy, reduced costs,
and reduce the emergence of AR infections.
Antifungal Research and Development.--The Committee is
concerned about the growing threat of drug-resistant mycotic
infections, including Coccidioidomycosis, Candida auris, and
Aspergillus fumigatus. The Committee supports the research and
development of novel antifungal therapies, particularly for
multi-drug resistant fungal pathogens, to bolster national
health security and reduce their public health impact.
Antifungal development faces challenges similar to those in
antibacterial development, and BARDA's Advanced Research and
Development program will be critical to generate additional
antifungal products, including treatments for endemic fungal
diseases. The Committee instructs ASPR to follow the directive
included under this heading in House Report 119-271.
Antimicrobial Resistance.--The Committee continues to
support advanced research and development of broad-spectrum
antimicrobials, particularly for multi-drug resistant
pathogens, and next-generation therapeutics that address the
increasing incidence of antimicrobial resistance.
Biodosimetry.--The Committee continues to support ASPR's
research and investment in biodosimetry technologies to improve
the nation's preparedness for a large-scale radiological or
nuclear incident.
Chemical, Biological, Radiological, and Nuclear Threats.--
The Committee notes with concern the elevated risk posed by
chemical, biological, radiological, and nuclear (CBRN) weapons
across the globe and provides robust funding for BARDA's core
national security mission to protect Americans against
deliberate, man-made threats. The Committee instructs ASPR to
complete the Rapid Response Partnership Vehicle (RRPV)
directive included under this heading in House Report 119-271.
The Committee continues to encourage ASPR and BARDA to engage
more frequently with private sector partners via the RRPV
process to ensure adequate prioritization, timely development
of new MCMs and stockpiling of existing MCMs against CBRN
threats.
Clostridioides difficile.--The Committee continues to
recognize that Clostridioides difficile (C. diff) infections
are an urgent problem in patient care settings, resulting in
476,000 infections which cause roughly 30,000 deaths annually
in the U.S. Currently, one in six patients diagnosed with C.
diff will be re-diagnosed in the subsequent two to eight weeks
and one in 11 people over the age of 65 diagnosed with
healthcare associated C. diff infection die within one month.
The Committee continues to encourage BARDA, in partnership with
NIH, to support research and clinical trials for the
development of novel treatments for C. diff that prevent
antibiotic resistance and recurrent infection, as seen in
existing treatments.
Diagnostic Rapid Response Initiative.--The Committee
recognizes that biological threats are a persistent and
evolving danger that require robust, proactive preparedness
measures. The Committee commends HHS and BARDA for their
leadership in developing the Diagnostic Rapid Response
Initiative (DxR2). This program strengthens public health
protection and the nation's emergency response capacity through
a long-term, affordable, sustainable, and scalable approach
that leverages or enhances existing commercial infrastructure.
Continued investment in DxR2 could enhance the nation's ability
to respond rapidly to biothreat incidents by partnering with
industry to use domestic just-in-time manufacturing, enabling
tests to be deployed within days or weeks of a public health
emergency. BARDA is encouraged to maintain this important
program as a priority within the PHEMCE portfolio.
Infectious Disease Outbreaks with Pandemic Potential.--The
Committee supports BARDA's engagement in public-private
partnerships to support advanced research and development of
innovative platform technologies and medical countermeasure
programs focused on vaccines, therapeutics, and other MCMs for
emerging infectious diseases, including novel pathogens and
viral families with pandemic potential. The Committee
encourages ASPR to prioritize the identification and
development of promising technologies that can be leveraged to
address a range of future pathogens, including virus families
with significant pandemic potential.
Multidrug Resistance.--The Committee recognizes the urgent
global health threat posed by multidrug resistant organisms and
the need for innovative, engineering-based solutions that can
be deployed across diverse clinical settings. The Committee is
aware of the early development of novel anti-microbial drug
resistance platforms and supports their ongoing research.
Next-Generation Smallpox Biodefense.--The Committee is
aware of advancements in next-generation therapeutics for
smallpox, which could address safety and efficacy issues
associated with products currently available in the stockpile.
The Committee is also aware of new breakthrough results in
manufacturing process improvement using high-expressing CHO
platforms that was jointly made by BARDA and Private Industry
has resulted in a cost-per-dose that approaches that of small
molecules. Therefore, the Committee urges ASPR to consider
procurement of next-generation drug products for the treatment
of smallpox.
Pathogen Reduction Technologies.--The Committee encourages
BARDA to continue investments in red blood cell pathogen
reduction technology to ensure the completion of urgently
needed nucleic acid targeted pathogen reduction technology to
significantly improve red blood cell transfusion safety for all
blood products in the nation's blood supply. Red blood cells
make up a majority of blood transfusions and are foundational
to emergency response, trauma care, and national health
security. The Committee urges BARDA to ensure that completion
of technology development, as defined in BARDA contracts, is
accomplished in parallel with the clinical trials to support
timely FDA review.
Point-of-Care Diagnostics.--The Committee encourages BARDA
to continue advancing next-generation, threat-agnostic point-
of-care platforms that can detect novel and drug-resistant
pathogens, guide targeted therapy, and integrate with
surveillance systems to strengthen situational awareness across
health systems. A focus on threat-agnostic diagnostics is
critical for rapid response to future outbreaks, improving
patient outcomes, and enhancing the nation's biodefense and
pandemic readiness.
Sustainable Blood Supply and National Blood Response
Capability.--The Committee remains concerned about the
continued vulnerability of the blood supply due to persistent
shortages. The Committee recognizes that next-generation, cryo-
preserved platelet (CPP) products, currently in clinical
trials, align with the objectives of BARDA. To ensure rapid
deployment of products that address capability gaps, the
Committee encourages prioritization of investments in next-
generation blood products based on clinical readiness and
directs the Department, within 180 days of enactment, to brief
the Committee on the progress of these efforts.
Project BioShield
The Committee provides $880,000,000 for Project BioShield,
an increase of $30,000,000 above fiscal year 2026 enacted
level. These funds support the acquisition of promising MCMs
developed through BARDA contracts for the most serious public
health threats.
Strategic National Stockpile
The Committee provides $1,060,000,000 for the Strategic
National Stockpile (SNS), an increase of $60,000,000 above
fiscal year 2026 enacted level.
Advanced Wound Care.--The Committee recognizes the need for
SNS capabilities that support rapid wound stabilization and
healing during mass casualty events, infectious disease
emergencies, and natural disasters in which access to
definitive surgical care may be adversely impacted. The
Committee is encouraged by the development of advanced wound
care products that are designed for rapid deployment.
Therefore, the Committee encourages ASPR to stockpile advanced
wound graft products to strengthen national readiness.
Antimicrobial Resistance.--The Committee encourages ASPR,
in coordination with FDA and CDC, to implement a review system
to regularly assess the safety, efficacy, and vulnerability to
antimicrobial resistance of existing SNS assets that could be
used to respond to CBRN and public health threats and to
support efforts to maintain an inventory of MCMs appropriate to
respond to the continued evolution of antimicrobial resistant
organisms.
Guidance to State and Local Jurisdictions.--The Committee
recognizes that SNS focuses on CBRN threats, and therefore the
Committee supports the efforts of State and local jurisdictions
to secure additional drugs, vaccines, and other biological
products, medical devices, and other medical supplies necessary
to respond to a public health emergency or a major disaster.
The Committee recognizes the importance of guidance to States
on how best to establish, expand, procure, replenish, maintain,
and manage their own State stockpile, while ensuring
appropriate collaboration with the SNS. The Committee continues
its directive under this heading in the explanatory statement
that accompanied Division B of P.L. 119-75.
Improved Access to Intravenous Saline.--The Committee
recognizes the potential for natural disasters and other supply
chain disruptions to adversely affect the ability of hospitals
and other medical providers to access saline solutions. The
Committee notes the importance of the SNS and State emergency
stockpile programs for supporting response activities during
public health emergencies. The Committee instructs ASPR to
follow the directive included under this heading in House
Report 119-271. The Committee further directs ASPR to include
in its report the extent to which State stockpile programs are
able to maintain adequate supplies of large-volume intravenous
saline and recommendations to strengthen State stockpile
readiness for saline solutions.
Influenza Medical Countermeasure Diversification.--The
Committee remains concerned about the perennial threat of
pandemic influenza, which could be exacerbated by expiring
antivirals in the SNS. The Committee encourages HHS to
diversify and replenish its stockpile of emergency influenza
antivirals to ensure the nation has multiple current treatment
options in the event of an influenza pandemic.
Made in America Strategic National Stockpile.--The
Committee is concerned about the nation's limited
infrastructure to produce essential products such as MCMs and
PPE. The Committee recognizes the COVID pandemic highlighted
both the vulnerability and necessity of maintaining a robust
domestic supply of PPE. It is critical the U.S. maintain a
robust domestic production base. Doing so is vital for both the
national security interests and protection of public health in
the face of international infectious disease threats. The
Committee directs ASPR to develop a long-term sustainable
procurement plan that gives preference to and results in
purchases directly from domestic manufacturers to the maximum
extent practicable.
Mechanical Respiratory Devices.--The Committee is aware
that current Federal requirements do not account for mechanical
ventilation needs in most respiratory-based responses such as
influenza or biological or chemical incidents. Despite their
need in every health security response, the only requirement
documenting need is against botulinum toxin, hardly comparative
to respiratory or easily communicable diseases. The Committee
acknowledges the tremendous achievements of the Administration
in 2020 to surpass past shortages and increase holdings and
distribution capabilities, capacities, and locations of
ventilators to ensure every American would have access in
emergency. Therefore, the Committee encourages an update to the
SNS Annual Review and the PHEMCE requirements to indicate
mechanical ventilation utilization across the threat spectrum
to include respiratory and other health security responses, and
to provide these update figures to Congress prior to initiating
significant modifications to the Administration's historic
success.
Medical Countermeasures Preparedness Review.--The most
recent Medical Countermeasures Preparedness Review, submitted
to Congress as part of the required annual threat-based review
of the SNS, found the Department has not met MCM stockpiling
requirements for numerous public health threats. Furthermore,
the review demonstrated how the SNS often relies on decades-old
products to fulfill other stockpiling requirements. The SNS is
a key pillar in the nation's broader strategy to protect the
American people. Gaps in the stockpile's preparedness against
these threats jeopardizes national security. The Committee
instructs ASPR to follow the directive included under this
heading in House Report 119-271.
MCM Procurements & Bioterrorism.--The Committee recognizes
the tragic anniversary of weaponized anthrax used in a terror
attack against American citizens at the highest levels of the
U.S. Government. Despite the nation's best efforts to deter and
counter the proliferation of biological weapons such as anthrax
from adversaries, global technological and scientific advances,
including in artificial intelligence and drones, make such
weaponization and utilization of anthrax and other biological
agents more likely by nefarious actors. Despite these concerns,
stockpile levels at the SNS continue to fall dangerously below
requirements, particularly for those domestically produced
therapeutic countermeasures that address Material Threat
Determinations and that lack commercial markets, such as
Anthrax antitoxin. We encourage the SNS to work with
interagency partners to bolster long-term sustainability of the
domestic industrial base through innovative approaches, such as
the use of long-term contracting that may reduce costs and
enhance overall stockpile levels through manufacturing
efficiency.
Nerve Agent Countermeasure Preparedness.--The Committee
encourages ASPR to continue evaluating and, as appropriate,
advancing the procurement of FDA-approved MCMs for nerve agent
exposure to help ensure the SNS remains prepared to respond to
chemical, biological, radiological, and other emergency
threats. The Committee further encourages ASPR to provide an
update on its plans to use available resources to support
stockpile preparedness and to identify any challenges related
to acquisition, sustainment, or modernization of these
capabilities.
Nuclear Threat Preparedness.--The Committee is concerned
that the SNS faces potential shortfalls regarding the
stockpiling of MCMs necessary in the event of a nuclear event
to counter the potential release of radioactive iodine. The
Committee encourages ASPR to prioritize investments in the MCMs
necessary for such a response and continues the directive
included under this heading in House Report 119-271.
Pathogen-Agnostic Respiratory Defense Technologies.--The
Committee recognizes the continued burden of respiratory
infections in healthcare and community settings and the
importance of pathogen-agnostic prevention strategies that can
be deployed quickly in response to emerging biological threats.
The Committee further recognizes that mucosal immunity, as an
early line of defense in the nose and upper airways, may play
an important role in helping to reduce respiratory infections.
While current vaccines for respiratory infections are primarily
designed to reduce illness severity, the Committee encourages
research and innovation into mucosal MCMs aimed at preventing
respiratory tract infections. The Committee encourages the
exploration of emerging pathogen-agnostic technologies,
including approaches that may help reduce the spread of
pathogens in exhaled breath and strengthen broader preventive
capabilities. Such technologies could complement existing
vaccine and therapeutic platforms and may contribute to a more
comprehensive response to respiratory infectious disease
threats.
Persistent Procurement Challenges.--The Committee is
concerned about the SNS's procurement process that has been
mired by successful bid protests, repeated unanswered sources
sought notices, and misuse of sole source awards under GAO
determined faulty pretexts. The Committee has invested in
efforts to bolster the nation's MCM preparedness against health
security threats, especially for those CBRN countermeasures
that lack a traditional marketplace. Therefore, the Committee
continues the directive included under this heading in House
Report 119-271.
Poxvirus Countermeasures.--The Committee is concerned by
the identified gap between established requirements and current
stockpiled levels of poxvirus vaccines for immunocompromised
individuals and poxvirus therapeutics. Given the ongoing
national security risk posed by the intentional or accidental
release of smallpox, the Committee urges ASPR to prioritize
procurement sufficiently to meet the documented requirements to
close the identified preparedness gap.
Reusable Respirators.--The Committee recognizes the
potential of reusable respirators to provide strategic long-
term value to State stockpile programs due to their longer
operational lifetime and extended shelf life when compared with
disposable masks. The Committee encourages ASPR to work with
States to consider reusable respirators when planning personal
protective equipment (PPE) investments. The Committee continues
to support warm-base surge production capacity contracts with
domestic PPE suppliers, including reusable respirators. ASPR is
encouraged to maintain domestic manufacturing surge
capabilities that can rapidly ramp up large-scale PPE
production in response to CBRN threats or other public health
crises that pose a significant national security risk. The
Committee instructs ASPR to complete the directive included
under this heading in House Report 119-271.
Shared Responsibility for Personal Protective Equipment
Preparedness.--The Committee recognizes that personal
protective equipment (PPE) is a critical component of national
preparedness, and that effective PPE readiness cannot rest
solely with the Federal government. The Committee emphasizes
that PPE procurement, stockpiling, and sustainment should be
pursued through a coordinated partnership among Federal, State,
and local governments, informed by regional risk profiles and
operational needs. While the SNS plays an important role as a
national backstop, the Committee encourages ASPR to develop a
strategy in collaboration with State and local partners to
support distributed stockpiling strategies for consumables,
including PPE. ASPR, in coordination with State and local
partners, should establish clear roles and responsibilities,
and predictable replenishment planning. The Committee directs
ASPR to provide a briefing within 180 days of enactment on
efforts to strengthen Federal, State, and local coordination on
PPE preparedness and supply chain resilience.
Shelf-Life Extension Program.--The Committee acknowledges
the benefits of the Shelf-Life Extension Program (SLEP) and
takes into consideration public skepticism of certain
countermeasures in the program. The Committee notes concerns
that efforts to achieve cost savings through SLEP may
negatively impact the distribution of, patient adherence to,
and consumer confidence in SNS products used during an
emergency. The Committee encourages ASPR to review products in
the SNS that are beyond 10 years of the date of manufacture and
develop a plan to replenish aged products.
Stockpile Readiness.--The Committee is concerned about the
sufficiency and long-term sustainment of stockpiled medical
countermeasures in the SNS intended to address material
threats. The lack of clarity regarding the division of
expenditures between MCM procurement, consumables, storage,
maintenance, lifecycle management, and other overhead expenses
may complicate long-term procurement planning and operational
readiness. The Committee notes that maintaining adequate and
reliable stockpile levels for these MCMs is essential to
national security, particularly given the limited or
nonexistent commercial markets for such products. Emerging
technologies may also enable the proliferation and
dissemination of CBRN threats, underscoring the need to
maintain effective MCMs. Therefore, the Committee strongly
encourages ASPR to continue coordinating with key industry,
governmental, and nongovernmental partners on procurement
activities to address capacity issues and support sustained
stockpile readiness for priority threats.
Synthetic Biology and Artificial Intelligence.--The
Committee is aware that rapid advances in synthetic biology and
artificial intelligence are changing the nature of biological
weapons risk by lowering barriers to the design, modification,
and recreation of dangerous pathogens. Experts have warned that
these technologies could enable state or non-state actors to
reintroduce eradicated or controlled diseases, such as
smallpox, or to enhance the lethality, transmissibility, or
resistance of other high-consequence biological agents,
including smallpox, anthrax, viral hemorrhagic fevers, and
novel or engineered pathogens, with potentially severe public
health and national security consequences. The Committee
directs ASPR, in coordination with other appropriate Federal
partners, to assess whether current MCMs stockpiling levels
adequately account for risks associated with synthetic biology-
and AI-enabled threats, and to brief the Committee within 180
days of enactment on any gaps identified and recommended
actions to address them.
U.S.-Affiliated Pacific Islands.--The Committee recognizes
that the SNS plays a vital role in ensuring the availability
and rapid deployment of MCMs and medical equipment and
supplies. The Committee notes that existing SNS distribution
models may not adequately address the logistical challenges and
response timelines associated with geographically dispersed and
remote regions such as the U.S.-Affiliated Pacific Islands.
Therefore, the Committee encourages a briefing on the
feasibility of establishing an SNS storage and distribution
facility in U.S.-Affiliated Pacific Islands.
Pandemic Influenza Preparedness
The Committee includes $312,991,000, an increase of
$5,000,000 above fiscal year 2026 enacted level, for the
pandemic influenza preparedness program. This funding supports
efforts to modernize influenza research and development of
vaccines and preparedness testing and evaluation, as well as
critical domestic vaccine manufacturing infrastructure.
The Committee encourages ASPR to support the development of
pandemic influenza therapeutics and vaccines to ensure a robust
pipeline of influenza countermeasures.
Test-To-Treat.--The Committee believes the test-to-treat
model, which was implemented for recent respiratory illness
outbreaks in retail pharmacies and health clinics, can make
other infectious disease treatments available more quickly and
reduce disease transmission and illness severity. The
availability of accurate diagnostics and the rapid prescription
of treatments is especially critical given the recent co-
circulation of multiple respiratory diseases during the winter
season. The Committee believes the test-to-treat model should
be evaluated for the confluence of influenza, COVID-19, and
RSV, given the availability of multiple diagnostic tests and
antivirals. The Committee directs HHS to provide an update in
the fiscal year 2028 congressional justification on the
findings of the NIH Home Test-to-Treat demonstration for
influenza, lessons learned from the COVID-19 Federal Retail
Pharmacy Program, and the design of a potential test-to-treat
demonstration for respiratory illnesses including, influenza
and RSV to serve vulnerable populations.
OPERATIONS AND EMERGENCY RESPONSE
Appropriation, fiscal year 2026....................... $484,606,000
Budget request, fiscal year 2027...................... 711,478,000
Committee Recommendation.............................. 335,606,000
Change from enacted level......................... -149,000,000
Change from budget request........................ -375,872,000
Office of Administration & Preparedness and Emergency Operations
The Committee includes $90,407,000 for activities within
the Assistant Secretary's Immediate Office; the Office of the
Chief Operating Officer; the Office of Acquisitions Management,
Contracts, and Grants; the Office of Financial Planning and
Analysis; and for Preparedness and Emergency Operations. The
Preparedness and Emergency Operations account also funds the
Office of Emergency Management, which supports a full spectrum
of emergency management responsibilities, including planning,
coordination, logistics, training, and responding to planned
events and unplanned incidents.
Addressing Emergency Medical Services Workforce Shortages
and Readiness.--The Committee is keenly aware of the
significant challenges the emergency medical services (EMS)
community faces, including workforce shortages in underserved,
rural, and Tribal communities. Therefore, the Committee
encourages ASPR, in consultation with SAMHSA and the National
Highway Traffic Safety Administration, to develop a national
pilot program of grants to governmental and non-governmental
EMS entities to support the recruitment and training of
emergency medical technicians and paramedics in underserved,
rural, and Tribal communities. The pilot program's objective is
to ensure a well-trained and adequate ground ambulance services
workforce that address health disparities related to accessing
prehospital ground ambulance health care services.
National Special Security Events.--The Committee provides
$15,000,000 for National Special Security Events (NSSE), an
increase of $10,000,000 above fiscal year 2026 enacted level.
This funding is included to support the increase in non-
Stafford Act response activities related to certain national
special security events.
National Disaster Medical System
The Committee provides $89,904,000 for the National
Disaster Medical System (NDMS), an increase of $13,000,000
above fiscal year 2026 enacted level. NDMS deploys trained
medical, mortuary, victim identification and veterinarian teams
to communities impacted by public health and medical
emergencies due to natural and manmade incidents.
Mission Zero.--The Committee provides $7,000,000, an
increase of $3,000,000 above fiscal year 2026 enacted level,
for civilian trauma centers to train and incorporate military
trauma care providers and teams into care centers. Civilian
trauma centers remain indispensable to sustaining a medically
ready force, yet current training pathways still do not
adequately develop proficiency in the dual- use, portable
critical care technologies required for modern combat medicine.
Providers should be prepared to deliver prolonged
resuscitation, damage control surgery, hemorrhage control, and
ICU level stabilization using life support, monitoring, oxygen
delivery, and anesthesia systems that function reliably in non-
traditional and resource constrained environments. Therefore,
the Committee encourages ASPR to expand civilian--military
trauma partnerships and modernize training infrastructure by
integrating the portable, dual-use technologies necessary to
accurately mirror real-world battlefield conditions.
Next-Generation Air Mobility Solutions.--The Committee
continues to provide no funding for next generation air
mobility solutions.
Pediatric Disaster Care.--The Committee provides
$9,000,000, an increase of $2,000,000 above fiscal year 2026
enacted level, for the pediatric disaster care program.
U.S.-Affiliated Pacific Islands.--The Committee recognizes
that NDMS plays a vital role in providing surge medical
personnel, patient evacuation, and coordinated Federal medical
response during domestic emergencies. The Committee notes that
existing NDMS structures and deployment models may not be fully
optimized for remote and geographically isolated regions such
as the U.S.-Affiliated Pacific Islands. Therefore, the
Committee encourages a briefing on the feasibility of
strengthening NDMS support for the U.S.-Affiliated Pacific
Islands.
Hospital Preparedness Program
The Committee provides $70,055,000 for the Hospital
Preparedness Program (HPP), a decrease of $237,000,000 above
fiscal year 2026 enacted level, which supports a tiered system
of care prepared to respond to a special pathogen event. HPP
supports a variety of programs to strengthen the preparedness
and response of the health care sector. Due to funding
constraints, the Committee eliminates funding for HPP formula
grants.
Cybersecurity and Infrastructure Protection (CIP).--The
Committee provides $1,774,000 for CIP, which is the same as
fiscal year 2026 enacted level.
National Emerging Special Pathogens Training and Education
Center (NETEC).--The Committee provides $8,500,000 for NETEC,
an increase of $1,000,000 above fiscal year 2026 enacted level.
NETEC serves as a national leader in readiness and response and
as a special pathogen response advisor to the Secretary and
other Federal partners. NETEC also coordinates the National
Special Pathogen System, which includes 13 Regional Emerging
Special Pathogen Treatment Centers, and partners with health
care systems across the nation. NETEC provides training and
education, consultation, technical assistance, and
recommendations on patient care and care systems improvements
for health care partners, with a focus on strengthening
national resilience against high-consequence infectious
diseases. The Committee provides funding for continued
investment and expansion of NETEC's capabilities to meet these
objectives.
Regional Disaster Health Response System.--The Committee
provides $7,000,000 for the Regional Disaster Health Response
System, which is the same as fiscal year 2026 enacted level.
Regional Emerging Special Pathogen Treatment Centers
(RESPTCs).--The Committee provides $23,000,000 for RESPTCs, an
increase of $2,000,000 above fiscal year 2026 enacted level, to
strengthen biocontainment capabilities through the RESPTCs
network and the Special Pathogen Treatment Centers.
Portable Biocontainment Units (PBCUs).--The Committee
supports ASPR's recent investment in Portable Biocontainment
Units (PBCUs). The Committee recognizes the potential value of
such units for the repatriation and domestic transfer of
American's afflicted with high-consequence infectious diseases
to facilities able to safely meet patient needs. The Committee
directs ASPR to include an estimate of the funding needed to
maintain the two existing PBCUs as well as the estimated
procurement costs of two additional PBCUs in the fiscal year
2028 congressional justification.
Trauma Care Readiness and Coordination.--The Committee
includes $2,000,000, which is the same as the fiscal year 2026
enacted level, to support States to coordinate and improve
emergency medical services and trauma care during a public
health emergency.
Medical Reserve Corps
The Committee provides $6,240,000 for the Medical Reserve
Corps (MRC), which is the same as the fiscal year 2026 enacted
level. MRC volunteers partner with public health and emergency
response organizations to prepare communities before a crisis,
strengthening coordination and readiness. The Committee
recognizes the contributions of MRC volunteers for the almost
300,000 hours of service in 2025. The Committee encourages ASPR
to continue supporting the operation and integration of the
national MRC network.
Preparedness and Response Innovation
The Committee provides $4,000,000, which is the same as the
fiscal year 2026 enacted level, for a bilateral cooperative
program with the Government of Israel for the development of
health technologies. In the fiscal year 2028 congressional
justification the Committee requests an update on the
investments this funding has produced since the program's
inception.
Industrial Base Management and Supply Chain
The Committee supports ASPR's ongoing domestic investments
to accelerate advanced development of investigational vaccines,
therapeutics, and diagnostics; emergency manufacturing of
critical MCMs and ancillary supplies; and build and validate
advanced manufacturing processes and facilities capable of
storing, producing, and deploying essential medicines and
diagnostics in the event of a national health emergency.
Diagnostics Manufacturing.--Diagnostics are critical for
the prevention, protection and surveillance of known and
unknown CBRN threat. The ability to rapidly develop and access
diagnostics is essential to ensure U.S. readiness and biohazard
preparedness. The Committee has previously encouraged ASPR to
promote policies for flexible contracting options between HHS
and diagnostic companies, which would provide incentives to
keep US manufacturing companies with warm production lines. The
Committee is aware that companies that HHS invested in during
COVID have closed or drastically reduced their domestic
footprint. Therefore, the Committee encourages ASPR to continue
to support the diagnostic domestic manufacturing
infrastructure.
Domestic Manufacturing Comprehensive Risk Assessment.--In
response to increasing risks from global disruptions, foreign
dependencies, and national security threats, the Committee
encourages ASPR to undertake a comprehensive risk assessment of
U.S. pharmaceutical supply chains to determine which medicines
are most vulnerable, with focus on reliance of foreign entities
for critical ingredients, and provide analysis on options for
mitigating risk and reducing reliance, with focus on domestic
manufacturing solutions. The Committee encourages ASPR to
assess vulnerabilities and map the full lifecycle of critical
drug supply chains from raw materials to final distribution and
requests an update on this assessment within 90 days of
enactment of this Act.
Personal Protective Equipment (PPE).--The Committee notes
the importance of increasing domestic manufacturing
capabilities for PPE in order to respond to CBRN threats and
other public health crises that pose a significant national
security risk.
Strengthening Domestic Manufacturing and Production.--The
Committee strongly supports IBMSC's efforts to increase
domestic manufacturing capacity of critical key starting
materials and active pharmaceutical ingredients. The Committee
directs ASPR to provide an update in the fiscal year 2028
congressional justification on efforts made to support domestic
capacity for essential medical products.
Supply Chain Monitoring Efforts.--The Committee recognizes
the potential value of supply chain monitoring and engagement
and appreciates ASPR's efforts to partner with industry and
provide end-to-end visibility for supply chain monitoring and
readiness. In addition to providing insights for demand and
supply forecasting, the Committee encourages ASPR to coordinate
with FDA and CDC to use available tools and platforms to
monitor the availability of a broader list of essential health
and medical products. The Committee requests a briefing on
these efforts within 180 day of enactment of this Act.
Office of the Secretary
GENERAL DEPARTMENTAL MANAGEMENT (GDM)
Appropriation, fiscal year 2026....................... $689,964,000
Budget request, fiscal year 2027...................... 419,546,000
Committee Recommendation.............................. 472,668,000
Change from enacted level......................... -217,296,000
Change from budget request........................ +53,122,000
Of the funds provided, $58,028,000 shall be derived from
evaluation set aside funds available under section 241 of the
PHS Act.
This appropriation supports activities that are associated
with the Secretary's roles as policy officer and general
manager of the Department of Health and Human Services (HHS).
The Office of the Secretary also implements Congressional
directives, and provides assistance, direction, and
coordination to the headquarters, regions, and field
organizations of the Department. In addition, this funding
supports the Office of the Surgeon General and several other
health promotion and disease prevention activities that are
centrally administered. Within the total provided for GDM, the
Committee includes up to $32,000,000 for the Assistant
Secretary for Financial Resources (ASFR). The Committee notes
that the budget request for GDM reflects a proposal to transfer
various functions within the Office of the Secretary and the
Department. The Committee looks forward to working with the
authorizing committees of jurisdiction as they consider the
Department's proposal.
Within the total provided for GDM, the Committee includes
not less than the following amounts:
------------------------------------------------------------------------
Budget Activity FY 2026 Enacted FY 2027 Committee
------------------------------------------------------------------------
Children's Interagency $3,000,000 $3,000,000
Coordinating Council.............
Embryo Adoption Awareness Campaign 2,000,000 2,000,000
Food is Medicine.................. 2,000,000 2,000,000
Interagency Coordinating Committee 2,000,000 2,000,000
on the Promotion of Optimal Birth
Outcomes.........................
KidneyX........................... 5,000,000 5,000,000
LymeX............................. 5,000,000 5,000,000
------------------------------------------------------------------------
Adoption and Utilization of Artificial Intelligence in Non-
Clinical Health Care.--The Committee recognizes the growing
importance of having a non-clinical health care workforce that
is skilled in the adoption and implementation of artificial
intelligence and machine learning (AI/ML) for usage in health
data management and information processing systems to improve
administrative efficiency. The Committee also recognizes the
impending acceleration of AI/ML utilization within health care
delivery systems and the need for safe, secure, swift, and
cost-effective non-clinical automation. Therefore, the
Committee encourages HHS to review and publicly report on the
benefits and risks of AI/ML adoption in health care for non-
clinical purposes; drivers and barriers to use, adoption, and
implementation of AI/ML for non-clinical purposes; the state of
workforce readiness, including future and current non-clinical
health care administrative staff; and policy options to enhance
benefits or address challenges associated with the use of non-
clinical AI/ML in health care. The Committee encourages HHS to
consult with relevant Federal agencies, as determined by the
Secretary, including CMS, ONC, the Department of Veterans
Affairs, FDA, DOL, the National Institute of Standards and
Technology, the White House Office of Science and Technology
Policy, and external stakeholders.
Artificial Intelligence in Health Care.--The Committee
recognizes how the innovative use of AI can improve quality
health care for patients nationwide, including by reducing
burdens, streamlining processes, helping clinicians, and
improving diagnoses. As AI applications in health care continue
to evolve and expand, the Committee supports efforts and
initiatives by HHS to promote the safe and ethical
implementation of these technologies to enhance patient
outcomes while also ensuring guardrails are in place to protect
patient safety and data privacy. The Committee notes that
utilizing AI health care accreditation processes could protect
patients and providers and yield responsible and measured
implementation by ensuring ongoing compliance with laws,
regulations, quality standards, and evidence-based practices.
Accreditation serves as a trusted indicator of high-quality
care, building both patient and provider confidence, and in
turn fostering adoption of safe and effective AI systems in
health care. To advance innovation while safeguarding patient
protections, the Committee encourages HHS to leverage
accreditation programs and standards, where appropriate, as a
supportive mechanism for ensuring that AI tools in health care
are developed, deployed, and utilized responsibly.
Automated Donor Referral for Bone Marrow.--The Committee
encourages HHS to explore, in collaboration with organ
procurement organizations and other relevant stakeholders,
whether existing electronic donor referral systems could be
adapted to facilitate identification of potential deceased
donors whose vertebral bodies may be suitable for bone marrow
recovery and processing, thereby supporting the availability of
stem cell products for transplantation.
Behavioral Health Emergency Room Boarding Diversion
Pilot.--The Committee is concerned with the emergency room
boarding crisis, especially for individuals in a mental health
crisis. The Committee encourages HHS to consider implementing a
pilot program modeled after the Massachusetts hospital
diversion program, where young people who are at risk of
hospital boarding due to mental health needs are referred
instead to receive care at home with a trusted behavioral and
mental health partner.
Bill Wide Requirements.--The Committee notes the inclusion
of a bill wide requirements section of this report. This
section contains requirements that apply to all agencies funded
by this Act.
Bone Marrow Banking.--The Committee recognizes the
potential of deceased donor bone marrow recovery and cryogenic
preservation to expand the availability of hematopoietic stem
cell products for transplantation. The Committee encourages HHS
to consider the feasibility of expanding deceased donor bone
marrow recovery, processing, and cryogenic preservation
capabilities to support the clinical availability of such
products, consistent with existing statutory authorities and in
coordination with relevant stakeholders.
Budget Requests.--The Committee instructs the Department to
follow the directive included under this heading in General
Departmental Management in Senate Report 119-55.
Cardiorespiratory Technology for Infants.--The Committee is
concerned with the rise of sudden unexpected infant death
across the country, with an increase of nearly 12 percent
between 2020 and 2022. Despite sudden unexpected infant death
claiming approximately 3,700 infant lives annually, the use of
new, home cardiorespiratory technology in relation to the
prevention of sudden unexpected infant death has yet to be
investigated on a large scale. Within one year of enactment of
this Act, the Committee directs HHS to provide a report to the
Committee regarding the use of home cardiorespiratory
technology to help prevent sudden unexpected infant death, as
defined in 42 U.S.C. 300c-11(e). The report may include
evidence on the effectiveness, performance, and accuracy of
home cardiorespiratory technology, including real world
evidence, that track the heart rate, blood oxygen levels, and
other vital signs of an infant, particularly those infants who
are high risk; new models of care to improve the home sleeping
environment of an infant; and any existing barriers to access
or opportunities to increase the use of home cardiorespiratory
monitors for infants, including recommendations for coverage by
Medicaid and commercial insurance plans.
Cell and Gene Therapies.--Newly approved cell and gene
therapies, together with the medical devices, delivery
technologies, and related innovations that enable their safe
and effective administration, provide enormous promise for
patients with conditions ranging from cancers such as lymphoma,
multiple myeloma, and chronic lymphocytic leukemia (CLL) to
inherited blood disorders including hemophilia, sickle cell
disease, and beta thalassemia. Despite the promise of new
therapies, many barriers remain for patients trying to access
them from the outset. Cell collection centers remain
concentrated in urban areas, many of them far from more rural
States where patients live. The Committee encourages the
Secretary to work with FDA, CMS, and HRSA, along with expert
stakeholders, to reduce barriers for patients who need to
travel to receive care for these diseases by bringing cell
collection and resulting therapeutic care closer to patients
and by reducing travel barriers between States where needed.
Centrally Managed Projects (formerly Joint Funding
Arrangements).--The Committee directs the agency to include all
amounts assessed from any operating or staffing division and
the methodology used to determine such amounts for each project
funded.
Children's Interagency Coordinating Council.--Within the
funds provided for GDM, the Committee includes $3,000,000 for
the Children's Interagency Coordinating Council.
Clinical Trial Methodologies for Terminal Illness
Therapies.--The Committee is concerned by reports that the FDA
has increasingly limited the use of single-arm clinical trials
in the review of therapies intended to treat terminal illnesses
with limited or no effective treatment options. The Committee
recognizes that, for decades, FDA has exercised regulatory
flexibility under the accelerated approval pathway for
therapies addressing serious or life-threatening conditions,
particularly where requiring a placebo-controlled trial may
raise ethical concerns for patients with advanced disease. The
Committee encourages the Secretary to work with FDA to continue
applying this longstanding approach, where scientifically and
medically appropriate, including consideration of single-arm
trials and alternative endpoints for therapies intended to
treat terminally ill patient populations with unmet medical
needs. The Committee further directs FDA to brief the
Committee, not later than 180 days after enactment of this Act,
on current agency policies and practices regarding the use of
single-arm trials and other flexible clinical trial designs in
accelerated approval applications for treatments targeting
serious or life-threatening diseases.
Communications With the Committee.--The Committee relies on
the budget offices of each departmental agency to provide
timely technical assistance and responsive communications
regarding Committee inquiries and directives. Prompt technical
assistance and communication are critical to enabling the
Committee to make informed decisions in allocating limited
budgetary resources and conducting effective oversight of
taxpayer funds. Accordingly, the Committee continues the
directives included under this heading in General Departmental
Management in Senate Report 119-55.
Community Academic Health Systems (CAHS).--The Committee
recognizes the important role that community hospitals, health
centers, physician offices, and other local health care
facilities play when they partner with accredited medical
schools and graduate medical education programs to provide
clinical education to medical students and residents. These
community academic health systems are a consortium of medical
schools and local health care facilities partnering to
strengthen physician workforce pipelines, particularly in rural
and underserved areas, and expand access to primary and
preventive care. The Committee directs HHS to provide a
briefing to the Committee within 180 of enactment of this Act
on the role CAHSs play in physician training and distribution,
with a report to follow, and encourages the Secretary to
develop and implement programs to support the establishment and
sustainability of CAHSs through new and existing programs.
Community Multishare Coverage Pilot Program.--The Committee
recognizes the value of innovative approaches that align health
coverage, employment stability, and upward economic mobility.
The Committee encourages the Secretary to consider pilot models
that incorporate hospital-community partnerships, shared
financing structures, individualized health improvement
supports, and measurable outcomes related to coverage
stability, employment retention, income growth, and reduced
reliance on public assistance, and to include implementation
options and any legislative recommendations in the fiscal year
2028 congressional justification.
Congressional Justifications.--The Committee instructs the
Department to follow the directive included under this heading
in General Departmental Management in House Report 119-271.
Coordination Regarding SCD Related Activities.--Sickle cell
disease (SCD) is the most common inherited blood disorder in
the U.S., affecting approximately 100,000 Americans.
Individuals living with SCD face serious health complications,
including chronic pain, stroke, and organ damage. These
complications can significantly reduce life expectancy and
contribute to high rates of emergency department utilization
and preventable hospitalizations. While federal agencies
support important SCD-related activities, current efforts
remain fragmented across programs and operating divisions. In a
constrained fiscal environment, preserving and strengthening
coordination of existing investments is essential to maximize
impact and prevent duplication. The Committee encourages HHS,
specifically NIH, CDC, HRSA, and CMS, to advance a more
cohesive federal approach to sickle cell disease. The Committee
further encourages formalized interagency consultation to align
research, surveillance, and care delivery activities; data
harmonization across surveillance, clinical research, and
reimbursement systems; improved coordination between public
health data collection and federal coverage policies; and
identification of measurable outcome metrics, including
hospitalization rates, mortality, and access to comprehensive
care. The Committee requests an update in the fiscal year 2028
congressional justification outlining steps taken to improve
coordination, eliminate redundancies, and ensure existing
federal investments in sickle cell disease infrastructure
produce measurable improvements in patient outcomes.
Countries of Concern.--The Committee is concerned about the
safety, privacy, and national security repercussions of
diabetes medical technologies imported from countries of
concern, particularly interconnected insulin delivery systems,
continuous glucose monitors, and related components. The
Committee notes recent Federal actions and warnings regarding
potential medical device failures and vulnerabilities resulting
from sensitive health data of Americans going to servers housed
in countries of concern. The Committee directs HHS to ensure
that government contracts prioritize companies that do not
house sensitive data in countries of concern. The Committee
further directs HHS to submit a report to the Committee within
180 days of enactment of this Act on its activities to monitor,
evaluate, and mitigate safety, quality, and cybersecurity risks
associated with diabetes medical technologies imported from
countries of concern.
Diagnostic and Supplemental Breast Imaging Coverage.--The
Committee recognizes the importance of screening and diagnostic
tests for breast cancer, which can be treated successfully if
caught early. The Committee encourages HHS to provide a report
on utilization, access, and cost-sharing trends associated with
breast cancer screening and follow-on diagnostic imaging,
including the potential premium impact of policies that
increase coverage.
Digital Identity Solutions.--The Committee notes the
growing need to modernize online identity verification
solutions across government to protect against fraud,
strengthen digital identity nationwide, and support American
users. Agencies should replace legacy checks with multi-
layered, high assurance verification to deliver a more secure,
seamless experience while saving taxpayer funds. The Committee
encourages HHS to work with agencies to utilize commercially
available, user-consented and reusable digital identity
solutions that support high-assurance identity proofing and
authentication independently certified to meet or exceed
National Institute of Standards and Technology (NIST) Identity
Assurance Level 2 (IAL2) guidelines to achieve the highest
possible pass rates, fraud prevention, and cost reduction.
Digital Mammography Coverage Analysis.--The Committee
recognizes the importance of access to mammography screening
for early detection of breast cancer. Digital Breast
Tomosynthesis, or 3D mammography, offers clinical benefits to
women with dense breasts, detects more invasive cancers,
improves accuracy, reduces patient recalls for additional
testing, and provides rapid and reliable results and storage of
images. The Committee directs GAO to study any coverage and
copay gaps across States and different forms of private and
public health insurance, as well as trends in usage for 3D
mammography screening, and to provide a preliminary briefing to
the Committee within 180 days of enactment of this Act with a
report to follow.
Disclosure of Reimbursements for People's Liberation Army
(PLA) and Xinjiang-Developed Medicines.--The Committee is
concerned that manufacturers may seek reimbursement under
Medicare or Medicaid without clearly disclosing whether pivotal
clinical trials were conducted at PLA military hospitals or
locations in Xinjiang. The Committee encourages the Department
to promote robust disclosure practices so policymakers and
program administrators can better assess related risks.
Drug Resistant Tuberculosis.--Drug resistant tuberculosis
(TB) is identified as a serious threat level pathogen to the
U.S. by CARB-X. As drug resistant TB cases are on the rise
globally, the threat to the U.S. also grows and HHS's
investment in new TB diagnostics, drugs, and vaccines is
critical. The Committee directs HHS to provide a briefing to
the Committee within 180 days of enactment of this Act on
cross-cutting Departmental investments in drug resistant
diseases.
Embryo Adoption Awareness Campaign.--The Committee
continues funding for the Embryo Adoption Awareness Campaign to
educate Americans about the existence of frozen human embryos
(resulting from in-vitro fertilization), which may be available
for donation/adoption to help other couples build their
families. The Committee includes bill language permitting these
funds to be used to provide medical and administrative services
to individuals adopting embryos, deemed necessary for such
adoptions, consistent with the Code of Federal Regulations.
Ensuring Access to Colorectal Cancer Screening Continuum of
Care.--The Committee remains concerned about increases in
colorectal cancer incidence and death rates. According to new
data, colorectal cancer is now the leading cause of cancer
deaths for Americans under 50 years old, which was not
initially projected to occur until 2030. The Committee
encourages HHS to summarize and report on current Federal
guidance regarding colorectal cancer preventive screening
coverage, including the treatment of follow-up colonoscopy
after a positive stool-based test, and to identify any areas of
implementation confusion affecting patient access to preventive
screening. Such report should distinguish between preventive
screening services and diagnostic or surveillance services and
include any estimated premium effects of broader first-dollar
coverage requirements.
Farmers and Ranchers Mental Health.--The Committee is
concerned by the drastic increase in suicide and the mental
health crisis affecting farmers, ranchers, and other
agricultural workers. The Committee directs HHS to brief the
Committee within 180 days of enactment of this Act, with a
report to follow, providing an analysis of mental health care
utilization, including counseling usage among farmers,
ranchers, and other agricultural workers, as well as barriers
to care. The Committee notes that tele-mental health offers an
opportunity to improve care access. Therefore, the Committee
requests that the analysis also assesses tele-mental health
uptake and access, including insurance coverage and provider
availability. The Committee requests that such an analysis also
contain suggestions to improve access to and uptake of both
traditional mental health care and tele-mental health care in
rural and remote locations, especially as it pertains to
Federal programs like Medicare and the individual marketplace.
Global Health Research.--The Committee requests an update
in the fiscal year 2028 congressional budget justification on
how CDC, FDA, ASPR/BARDA, NIH (including the Fogarty
International Center), and other agencies jointly coordinate
global health research activities with specific metrics to
track progress and collaboration toward agreed upon health
goals.
Graduate Psychiatry Education.--The Committee supports
efforts to expand Graduate Medical Education (GME) programs in
underserved areas and recognizes the critical role that public
universities and teaching hospitals play in meeting the
healthcare needs of rural communities, veterans, and other
high-need populations. Within the various GME programs
supported by HHS, the Committee encourages the Department to
expand opportunities for applications for residency positions
from academic institutions that demonstrate established and
sustained partnerships with community-based providers,
including Rural Health Centers, Community Health Centers,
Veterans clinics, VA hospitals, Women and Children's units, and
other community-based outpatient clinics.
Health Savings Account Utilization and Stability.--The
Committee recognizes the importance of health savings accounts
to increase Americans' control over their medical spending and
the potential to reduce costs by increasing competition among
providers. The Committee encourages HHS, in coordination with
the Department of Treasury, to conduct an analysis on the
utilization of health savings accounts, including common
procedures, services, prescription drugs, devices, or other
medical expenses paid for using such accounts.
HHS Open Data.--The Committee encourages HHS, in
coordination with NIH, to assess and pilot the integration of
privacy-preserving health data discovery and search tools,
including systems similar to Trusted Research Environments
(TREs), into the Department's Living Open Data Plan and
evidence-building activities, noting that such tools enable
secure discovery of large-scale health datasets while
maintaining strong patient privacy protections. The Committee
requests an update on this topic in the fiscal year 2028
congressional justifications.
Immune Stratification and Early Detection Study.--The
Committee recognizes the need for innovative, scalable
approaches to improve early detection, risk stratification, and
prevention of respiratory and immune-mediated illnesses. The
Committee is aware of emerging diagnostic approaches that
leverage innate immune biomarkers to assess variability in
individual immune response through non-invasive, low-cost
methodologies. The Committee further recognizes ongoing State-
level pilot programs evaluating the feasibility and public
health impact of such approaches. Accordingly, the Committee
encourages HHS to conduct a study evaluating the feasibility,
clinical utility, and cost-effectiveness of implementing
population-level immune stratification tools within Federal
healthcare programs and public health initiatives. The study
should assess impacts on healthcare utilization, infection
rates, and overall cost of care, and include consideration of
existing State-level pilot programs as case studies. The
Committee requests an update on this topic in the fiscal year
2028 congressional justification.
Innovative Diagnostics and Connected Healthcare.--The
Committee notes the important emerging role that point of care
testing, self-testing, and self-collection can play in
successful efforts across HHS to respond to sexually
transmitted diseases like HCV, HIV, HPV, chlamydia, gonorrhea,
and syphilis. The Committee encourages HHS to further adopt
diagnostic testing strategies that appropriately incorporate
point-of-care, self-testing, and self-collection components.
Kidney Preservation and Utilization Technology.--The
Committee notes that more than 90,000 Americans are awaiting a
kidney transplant and that nearly a third of recovered kidneys
are discarded each year. While there is no precise accounting
of how many of these organs could be translated with improved
organ assessment, preservation, allocation, and distribution
practices, conservative metrics suggest that at least 20
percent of discarded kidneys may represent potentially
avoidable nonuse. Existing standard-of-care approaches provide
limited real-time assessment of kidney viability, reducing
transplant surgeons' confidence in accepting higher-risk
organs. Emerging technologies have shown promise in extending
preservation windows and enabling additional real-time metrics
which could meaningfully increase donated kidney utilization
and reduce Medicare dialysis expenditures. The Committee
requests an update in the fiscal year 2028 congressional
justification detailing: (1) Federal initiatives across ARPA-H,
NIH, HRSA, and CMS to understand potential opportunities and
regulatory questions presented by novel kidney preservation and
viability assessment technologies; (2) the current kidney
discard rate and utilization trends; (3) actions HHS is taking
to support the development, validation, and deployment of
technologies designed to increase kidney utilization; and (4)
the estimated impact of improved utilization on transplant wait
times, patient outcomes, and Medicare expenditures.
Lyme and Other Tick-Borne Diseases Network.--The Committee
encourages the Secretary and the Director of NIH, in
consultation with CDC and FDA, to enter into discussions on the
potential benefits of establishing a National Network of
Academic Research and Clinical Centers of Excellence for Tick-
Borne Diseases.
LymeX.--The Committee provides funding to continue the
LymeX Innovation Accelerator to advance public-private
partnerships and innovation in Lyme disease prevention
diagnosis. The Committee encourages the LymeX Innovation
Accelerator focus to expand beyond diagnostic innovation, to
accelerate therapeutic innovation and fulfill the original
vision statement of the program calling for effective
treatments that all Americans can afford.
Maternal Health Navigator Programs.--The Committee notes
the potential for State maternal health navigator programs to
improve maternal and infant health outcomes while optimizing
Medicaid expenditure efficiency. Such models illustrate the
efficacy of targeted care coordination interventions in
addressing the drivers of maternal morbidity and mortality. The
Committee urges HHS to evaluate the scalability of successful
State models. As part of the fiscal year 2028 congressional
justification, the Committee requests an update on departmental
efforts to expand demonstrations related to maternal and infant
health outcomes.
Medically Tailored Meals and Produce Prescriptions.--The
Committee recognizes the importance of Medically Tailored Meals
(MTMs), Medically Tailored Groceries (MTGs), and Produce
Prescriptions and notes recent progress to expand access. MTMs
are customized for patients with severe, complex, or chronic
conditions based on therapeutic, evidence-based dietary
specifications. MTGs consist of nutrient-dense groceries--such
as fruits, vegetables, whole grains, and lean proteins--
provided to individuals based on an assessment of their
nutritional needs and tailored using disease-specific,
evidence-based guidance as part of a therapeutic diet plan. A
Produce Prescription is a medical treatment or preventive
service for eligible patients due to diet-related health risks
or conditions, food insecurity, or other documented challenges
in access to nutritious foods. The Committee encourages the
Secretary to identify programs and collaborations that could
facilitate coverage for MTMs, MTGs, and Produce Prescriptions
and further encourages HHS to work with Congress regarding
access and coverage of MTMs, MTGs, and Produce Prescriptions.
Menopause Education for Doctors.--The Committee is aware
that about 1.3 million women in the U.S. reach menopause each
year, yet fewer than half report that a healthcare provider has
advised them about what to expect during this transition,
including how to manage symptoms. Moreover, menopausal hormone
therapy (MHT or HRT), the primary treatment for menopause
symptoms, has declined among postmenopausal women in the U.S.
from 1999 to 2020 from 26.9 percent to 4.7 percent over two
decades. The Committee notes that nearly every woman will go
through menopause and the majority of women report experiencing
menopause symptoms, which can cause serious impacts on their
broader health and daily life. Despite the prevalence of
menopause and the need for associated care, only 31.3 percent
of OB-GYN residents report having menopause curriculum in their
residency program. Therefore, the Committee encourages HHS to
support medical accrediting and education bodies, such as the
Accreditation Council for Graduate Medical Education, the
Association of American Medical Colleges, the American
Association of Continuing Medical Education (CME), and State
CME organizations, in their efforts to enhance and strengthen
evidence-based content on menopause. The Committee requests an
update on this topic in the fiscal year 2028 congressional
justification.
National Plan for Epilepsy.--The Committee is aware of the
enormous economic cost and human suffering resulting from
epilepsy. Despite epilepsy's prevalence, disproportionate gaps
exist in research, innovation, awareness, and care. Therefore,
the Committee encourages HHS to develop the framework for a
national plan for epilepsy research to facilitate clinically
meaningful research progress to prevent, diagnose, treat, and
cure epilepsy and improve the wellbeing of people with epilepsy
and their families. The Committee requests an update on this
topic in the fiscal year 2028 congressional justification.
National Risk Pool for Cell and Gene Therapies.--The
Committee recognizes that cell and gene therapies offer
transformative potential for patients with rare, debilitating
and life-threatening conditions but is concerned that their
exceptionally high upfront costs and expanding pipeline present
significant access and affordability challenges within the
current health insurance framework. The Committee encourages
the Secretary to conduct a study on the feasibility and impact
of establishing a national risk pool to finance select high-
cost cell and gene therapies. The study should evaluate how
such a framework could spread financial risk broadly, promote
patient access to clinically appropriate therapies, and support
long-term affordability. In conducting this study, the
Secretary is encouraged to examine options for mandatory payer
participation, financing mechanisms such as per-beneficiary
per-month assessments, the use of outcomes-based contracting
arrangements to promote value and accountability, criteria to
limit eligible therapies to those treating the rarest
conditions or carrying exceptionally high costs and appropriate
Federal governance structures, and to report findings and any
legislative recommendations to Congress.
Neonatal Abstinence Syndrome (NAS) Study.--The Committee
recognizes the ongoing impact of neonatal abstinence syndrome
(NAS) on infants, families, and State Medicaid programs,
particularly in communities affected by substance use
disorders. The Committee encourages the Secretary to conduct a
comprehensive study on the prevalence of NAS and its impact on
infant and maternal health outcomes associated with pediatric
transitional care facilities, defined as residential pediatric
recovery centers that provide inpatient or outpatient treatment
for infants with NAS. In carrying out this study, the Secretary
should assess barriers to obtaining valid, accurate, and timely
data on NAS prevalence among Medicaid beneficiaries, including
under State plans and waivers authorized under title XIX of the
Social Security Act. Such a study should further evaluate the
scope of services and supports available to infants diagnosed
with NAS under such plans and waivers, including the
availability and utilization of pediatric transitional care
facilities. The Committee requests an update on this topic in
the fiscal year 2028 congressional justification, including any
recommendations to improve data collection, service delivery,
and health outcomes for infants with NAS and their mothers.
Nonrecurring Expenses Fund.--The Committee directs HHS to
provide quarterly reports for all ongoing projects. The report
shall include the following for each project: the agency each
project is funded under; a detailed description for each
project; the date the project was notified to the Committee;
total obligations to date; obligations for the prior fiscal
year; anticipated obligations for the current fiscal year; and
any expected future obligations. For any project ongoing for
more than three years, the report should include a narrative
describing the cause of delay and steps being taken by the
agency to ensure prompt completion. In addition, the Committee
requests biannual reports on expired balances that are eligible
for transfer to the Nonrecurring Expenses Fund (NEF). Such
report shall include the Treasury Account Fund Symbol, program
name, unobligated balance, and unexpended balance. Such report
shall be transmitted 30 days after the close of the second
quarter and within 45 days after the close of the fourth
quarter of the fiscal year.
Obstetric Fistula Training.--The Committee notes that an
estimated 500,000 women and girls worldwide live with obstetric
fistula with thousands of additional cases occurring annually.
Obstetric fistula occurs disproportionately among impoverished,
vulnerable, and marginalized women and girls. It can be
prevented by skilled health personnel at birth and emergency
obstetric and newborn care. The Committee is concerned that
fistula repairs were widely halted or slowed down due to COVID,
as they were deemed non-urgent and unsafe during the pandemic.
This may have resulted in an increased backlog of fistula
cases. The Committee requests additional information on the
funding levels provided across HHS to support training for
health care providers on the subject of obstetric fistula. The
Committee requests an update in the fiscal year 2028
congressional justification on the annual funding level for
training on obstetric fistula over the preceding five fiscal
years, including the types of grants supported during this
period.
Optimization of Federal Resources to Prevent
Neurodegenerative Disease.--The Committee notes the need to
strengthen coordination of Federal resources, strengthen our
nation's public health infrastructure, and prioritize turning
risk reduction into clinical practice with respect to research,
training, and health information dissemination related to
Parkinson's and other neurodegenerative diseases. To accomplish
these results, the Committee encourages HHS to enhance
coordination within the Department and consult with the
Department of Veterans Affairs, Department of Defense, and the
Environmental Protection Agency to include in research programs
a focus on environmental toxicants and the interactions of such
toxicants with neurodegenerative diseases. This coordination
and consultation should include a focus on advancing the
development of effective actions that address such stressors to
help prevent, manage, treat, or slow the progression of
neurodegenerative diseases.
Oral Health and Preventive Care.--The Committee recognizes
the importance of evidence-based, topical preventive oral
health interventions, particularly for children and underserved
populations. The Committee encourages HHS to continue
supporting rigorous, transparent, and replicable research,
education, and best practices related to topical fluoride
applications, including toothpaste, varnishes, and sealants,
which act locally on tooth enamel and do not require ingestion.
The Committee further emphasizes the importance of
transparency, parental choice, and clear communication
regarding the appropriate use of such products, and encourages
HHS to prioritize age-appropriate, indication-based use
consistent with current clinical guidance to improve oral
health outcomes.
Organizational Integrity of the National Center for
Toxicological Research (NCTR).--The Committee recognizes the
critical role of the National Center for Toxicological Research
in conducting toxicological research that supports the missions
of the Food and Drug Administration (FDA) and the Department of
Health and Human Services to protect and promote public health
and the support it provides to FDA product centers to fulfill
their regulatory roles. The Committee commends the research
contributions of NCTR, especially in its work to improve the
nutrition of school lunches, NanoCore research to ensure the
safety of FDA-regulated products containing nanomaterials, and
advancements in new approach methods.
Out of Pocket Hearing Aid Costs.--The Committee is
concerned with the significant out-of-pocket costs patients may
face when purchasing prescribed hearing aids. The Committee
requests a report within 180 days of enactment of this Act
assessing the coverage of hearing aids in the private
marketplace, including information on patient cost-sharing and
average out-of-pocket expenses for individuals with private
insurance.
Patient Safety.--The Committee recognizes the importance of
ensuring that patients are protected during sensitive medical
examinations and that future physicians are appropriately
trained on professional conduct and patient safety. The
Committee encourages the Secretary, in coordination with
relevant agencies and accreditation bodies, to promote
education and training for medical students, residents, and
trainees across medical specialties on the risk factors for
sexual misconduct in clinical settings and appropriate
procedures for reporting suspected misconduct.
Performance Reporting.--As part of the congressional
justification for fiscal year 2028, the Committee directs the
Department to include, for the past five fiscal years, the
percentage of the Senior Executive Service (SES) for each
performance level rating (5--outstanding, 4--exceeds fully
successful, 3--fully successful, 2--minimally satisfactory, or
1--unsatisfactory), broken down by operating division. Such
information shall include the number of SES for each
performance level and the average performance bonus paid for
each performance level listed by operating division. In
addition, the Department shall include in such justification
the total amount spent on performance awards for the Senior
Executive Service and the total number of SES in the Department
both broken down by operating division.
PHS Act Evaluation Funding.--The Committee recommendation
includes amounts made available under section 241 of the PHS
Act, as specified in the bill. The Committee continues the
assessment of 2.5 percent. The Committee includes new bill
language to preserve the nation's biodefense infrastructure
from assessment. In addition, the Committee no longer includes
bill language exempting administrative expenses from
assessment.
Additionally, as part of the President's Budget Request,
HHS is directed to provide the Committee, in electronic format,
tables providing PHS evaluation funding exclusions,
assessments, and uses for the budget request year. Such tables
shall also include a column for the most recently executed full
fiscal year and most recently enacted appropriation. HHS is
also directed to provide the Committees an updated version of
this table on a quarterly basis.
Protective Operations.--The Committee includes not less
than $20,000,000,000 for protective operations within the funds
provided under this heading.
Rare Diseases.--The Committee recognizes that multiple
Federal departments, agencies, and programs exist to address
the needs of people impacted by rare diseases and improve the
lives of members of the rare disease community. The Committee
encourages enhanced coordination and collaboration across the
Federal government and encourages the Secretary to develop a
framework to strengthen interagency coordination for rare
diseases. Such a framework would focus on optimizing rare
disease activities across the Federal government and may
include annual updates assessing all Federal agency activities
concerning rare diseases, including but not limited to
regulatory flexibilities in rare disease therapy reviews,
current and emerging biomedical research opportunities, current
and future rare disease surveillance and epidemiological
activities, and analysis and outcomes using Federal program
data, as well as programs to support rare disease patients and
caregivers, and overall programmatic funding.
Restorative Reproductive Medicine General Education.--
Restorative reproductive medicine (RRM) seeks to identify and
correct underlying causes and factors contributing to
infertility and reproductive dysfunction. RRM does not employ
methods that are inherently suppressive, circumventive, or
destructive and respects the integrity of the human person. RRM
can employ surgical and nonsurgical responses to reproductive
dysfunction and infertility, including cycle tracking, targeted
lab testing, lifestyle interventions, medical and hormonal
therapies, and corrective surgeries to restore natural
fertility for both men and women. In the last 50 years, RRM
approaches have been developed, including addressing underlying
endocrine, autoimmune, and reproductive health conditions such
as endometriosis. Endometriosis may affect as many as 10
percent of women in the U.S. or 7 million women, yet on
average, it takes 10 years to receive a diagnosis. Further, in
2022, the NIH allotted only $2 per affected patient for
research on this condition. The Committee notes that for women
diagnosed with endometriosis, 30 to 50 percent of these women
are also diagnosed with infertility and their fecundity rate
drops from 15 to 20 percent (normal fertility) to 2 to 10
percent with this disease. For infertility care, doctors must
be trained or knowledgeable about fertility-preserving
laparoscopic surgery and specialized in the form of minimally
invasive gynecologic surgery. One of the aims of laparoscopic
surgery is to reconstruct the uterus, fallopian tubes, ovaries,
and other organ structures so that endometriosis can be
eliminated. The excision of endometriosis can alleviate pain
and improve fertility preservation. Medical training in this
type of surgery requires at least one to two additional
fellowship years for surgeons. Addressing this gap in care is
crucial, given the rising number of endometriosis diagnoses and
its relationship with infertility. The Committee notes that
this education is not currently part of standard medical
education and often medical professionals are not versed in
this type of reproductive health care. There is a need for
further educational opportunities, especially fellowships and
residency electives. The Committee encourages HHS to explore
scholarship and loan opportunities for medical students and
professionals interested in pursuing this specialty. The
Committee requests an update in the fiscal year 2028
congressional justification on ongoing and planned research
activities related to RRM education and training.
Rural Defense Community Hospitals GAO Study.--The Committee
recognizes that rural hospitals located near military
installations provide critical emergency services and health
care access to civilian workforces, National Guard and Reserve
families, and communities supporting installation operations.
The Committee is concerned that hospital closures in rural
defense communities may adversely impact installation readiness
and resilience, surge capacity, and local workforce stability.
The Committee directs GAO to conduct a study to identify rural
hospitals located within 50 miles of military installations
that are financially distressed or at risk of closure and
evaluate options for providing targeted stabilization grants or
other support under existing authorities. For the purposes of
this study, rural hospitals shall include Critical Access
Hospitals, Sole Community Hospitals, Rural PPS hospitals, REH,
or other rural facilities designated by the Secretary of HHS.
The Committee directs GAO to provide a preliminary briefing to
the Committees on Appropriations of the House of
Representatives and the Senate no later than 12 months after
enactment of this Act, with a report to follow. The Committee
directs HHS, including CMS, the Department of Defense, and the
Department of Agriculture to provide data, analysis, and
consultation as requested to facilitate the study.
Rural Health Care Access.--The Committee is concerned with
Americans' ability to access quality health care in rural or
remote regions of the country. The Committee encourages HHS to
provide an analysis of rural health care resources available
and their utilization. Specifically, the Committee is
interested in the utilization of primary care, common specialty
care, surgical care, substance use disorder treatment, and
mental health. Further, the Committee encourages HHS to include
in such analysis an assessment of barriers to health care, the
cost of health care, and morbidity and mortality from a lack of
access to health care; and recommendations to improve access to
care in rural and remote locations, especially as it pertains
to Medicare, Medicaid, CHIP, and plans offered under State and
Federal health insurance marketplaces.
Rural Hospital Closures and Financial Stability.--The
Committee is concerned about the ongoing crisis of rural
hospital closures, which jeopardize health care access in
medically underserved regions. Rural communities often face
compounding challenges, including older and sicker populations
and a higher reliance on public insurance or uncompensated
care. While the Committee supports continued investments in key
rural hospital designations--such as Critical Access Hospitals,
Rural Emergency Hospitals, and Medicare-Dependent Hospitals--
the Committee encourages HHS to evaluate and address the needs
of rural hospitals that do not fall within these existing
categories but still face persistent operational and financial
challenges.
Rural News Media and Advertising Campaigns.--The Committee
continues to recognize the critical role that local media plays
in delivering lifesaving messages to small and rural
communities. Therefore, the Committee urges the Secretary to
ensure that local media in small and rural markets are a key
component in the Department's public health advertising
campaigns, which is critical to improving the delivery of
public health messages to these small and rural communities. To
further this goal, the Committee urges the Secretary, in
coordination with the Assistant Secretary for Public Affairs
and the Department's buyer contractors, to utilize local news
media in small and rural areas for public health advertising
campaigns for HHS and its related agencies to reach citizens
with key health messages. Local media includes newspapers,
specifically non-daily newspapers, television, and radio.
Within 90 days of enactment of this Act, the Committee directs
the Office of the Secretary to provide an update to the
Committee on the efforts of the Department in its utilization
of local media in small and rural areas as part of the
Department's public health advertising campaigns for fiscal
year 2027 and plans for subsequent fiscal years. The Committee
also directs the Assistant Secretary for Public Affairs, in
consultation with the CDC's Office of Rural Health, to
undertake a review of the use of local media in small and rural
communities in several States in an HHS public health
advertising campaign for fiscal year 2027 and plans for
subsequent fiscal years, to better understand their role as a
key delivery system to reach small and rural communities with
critically important health messages. The Committee requests an
update from the Assistant Secretary for Public Affairs within
180 days of enactment of the Act on the status of this review
and directs HHS to provide a final report by the end of fiscal
year 2027.
Rural Residencies Nonhospital Partnerships.--The Committee
recognizes the important role residency training in rural, non-
hospital settings can have on the recruitment and retention of
physicians to care for rural and underserved communities. The
Committee is encouraged that accredited teaching hospitals may
have residents participate in training rotations at independent
or rural facilities and non-hospital settings but is concerned
that the details of such arrangements are largely unknown.
Therefore, the Committee directs the Assistant Secretary for
Planning and Evaluation (ASPE), in consultation with MedPAC and
MACPAC, to provide a report to the Committee that explores the
current curriculum and financial arrangements between
accredited teaching hospitals, rotations at independent or
rural facilities, and non-hospital settings. Additionally, the
report shall include recommendations on opportunities to
enhance teaching hospital and non-hospital training
partnerships through streamlined financial support and
technical assistance programs. In addition, the Committee
encourages CMS and HRSA to take steps to expand rural residency
partnerships between hospitals and non-hospital settings. The
Committee requests an update on this topic in the fiscal year
2028 congressional justification.
Staffing Reports.--The Department is directed to provide
staffing reports to the Committee consistent with the
requirements specified under this heading in General
Departmental Management in Senate Report 119-55.
Strengthening Nursing Workforce Pipelines.--The Committee
encourages the Secretary and the Secretary of Labor, jointly,
to conduct a review of all grant programs carried out by HHS or
DOL that support the nurse workforce and submit a report to the
Committee that includes recommendations for changes to such
grant programs to improve upon the goals of increasing nurse
faculty, particularly in underserved areas; providing pathways
for nurses who have more than 10 years of clinical experience
to become faculty at schools of nursing; and encouraging and
increasing the nursing pipeline through pathways for licensed
practical nurses to become registered nurses.
Support for Rural Hospitals.--The Committee is concerned
that access to health care services in rural communities
remains under severe strain, with patients often forced to
travel long distances to obtain even basic care. Reports
indicate that more than 30 percent of rural hospitals are at
risk of closure. Since 2010, 167 rural hospitals have closed
nationwide, with an additional 418 considered vulnerable to
closure. The Committee recognizes that many rural health
facilities lack the resources necessary to modernize aging
infrastructure and integrate advanced medical technologies.
Accordingly, the Committee supports efforts to strengthen rural
health systems, improve access to care, and prevent further
hospital closures. The Committee urges the Secretary to
prioritize the needs of rural health facilities when
implementing Department-administered programs and grants.
Use of Advanced Monitoring Technologies in Obstetric and
Clinical Care.--The Committee encourages the Department to
support, as appropriate, the evaluation, implementation, and
adoption of artificial intelligence (AI) enabled continuous
patient monitoring technologies in obstetric and surgical care
settings. These systems can provide clinicians with ongoing,
real-time insights supported by predictive analytics that help
identify early signs of patient hemodynamic instability and
guide timely intervention. The Committee encourages HHS to
collaborate with clinical leaders, professional societies, and
research institutions to develop implementation guidance,
support workforce training, and drive the clinical behavior
change needed to fully integrate appropriate continuous, AI-
enabled monitoring into routine care for individuals undergoing
cesarean delivery and other surgical procedures.
Veterans' Opioid Prescribing Practices.--The Committee is
concerned about the continued risks associated with opioid
prescribing among veterans, particularly given high rates of
chronic pain, post-traumatic stress disorder, traumatic brain
injury, and co-occurring substance use disorders. The Committee
notes the need for improved understanding of prescribing
practices, acute exposure risks, and pathways to long-term use
within the veteran population. Therefore, the Committee urges
HHS, in cooperation with the Department of Veterans Affairs, to
submit a report to the Committees on Appropriations of the
House of Representatives and the Senate detailing: (1) current
opioid prescribing policies and adherence to clinical
guidelines across VA facilities; (2) trends over the past five
fiscal years, including initial prescribing for acute pain,
dosage, and duration; (3) rates of transition from acute to
chronic opioid use; (4) data on adverse outcomes, including
overdose, dependency, and interactions with other medications;
(5) oversight and enforcement mechanisms to identify and
address inappropriate prescribing; (6) use of non-opioid and
non-pharmacologic pain management options; and (7) coordination
with SAMHSA, NIDA, and other relevant agencies to advance
research on veteran-specific opioid risks and improve
prescribing practices.
Workforce Preparedness for Neuroplastogens.--The Committee
notes recent developments related to novel neuroplastogens and
rapid-acting treatments for complex neuropsychiatric and
neurocognitive conditions. The Committee requests an update in
the fiscal year 2028 congressional justification on any
associated interagency work between HHS and the Department of
Veterans Affairs related to workforce readiness, including any
training and credentialing programs, and any associated
concerns that emerge.
Office of the Assistant Secretary for Health
Lyme and Other Tick-Borne Diseases.--The Committee
encourages the Secretary to work with the Director of NIH to
evaluate the potential benefits of expanding the Tick-Borne
Diseases (TBD) portfolio to other Institutes and Centers in
addition to NIAID. Due to the profound neurologic involvement
of TBD, such as Lyme disease, NINDS and NIMH may make major
contributions to the study of TBD, such as developing novel
treatments for neurologic symptoms, including severe neurologic
symptoms in children. Due to the severe impacts of TBD on
children, NICHD may also greatly enhance NIH accomplishments in
developing tools to manage pediatric cases of TBD. The
Committee strongly encourages the Secretary to establish within
OASH a Tick-Borne disease coordinating office to track, monitor
and provide technical assistance on TBD activities throughout
HHS, including its operating divisions, and to serve as an HHS-
wide facilitator for TBD activities. The coordinating office
should monitor and report to the Secretary on implementing
``The National Public Health Strategy to Prevent and Control
Vector-Borne Diseases in People.'' The Committee further
encourages the OASH TBD Coordinating Office to establish a
program for temporary agency/stakeholder panels or commissions
to address a need or gap related to TBD goals and objectives in
an HHS agency or across agencies. Such panels should consist of
a range of stakeholders, similar to the TBD Working Group
(TBDWG), except on a smaller scale, to operate for a short
period of time to address a particular need or gap in the TBD
knowledge base or TBD activity. The overarching purpose is to
facilitate transitioning products to patients, health care
practitioners, researchers, academia (including VBD Centers of
Excellence), industry, and State and local governments. The
Committee commends OASH and CDC for building on the six years
of dedication of numerous TBDWG participants. Although the
TBDWG is now sunset, the Committee commends its participants
and other stakeholders, including patients, patient advocates,
researchers, clinicians, and Federal staff, who made sacrifices
from their professional and personal lives in the hope of
helping patients and their care providers.
Nutrition Continuing Medical Education.--The Committee
recognizes the Administration's emphasis on strengthening
nutrition education across the medical education continuum and
notes that accredited continuing medical education (CME) has
the potential to serve as an effective and scalable mechanism
to improve clinicians' ability to deliver evidence-based
nutrition counseling and related practice change. The Committee
is concerned, however, that expanded expectations for
clinicians and accredited CME providers to advance this
priority without dedicated support would limit participation
and reduce impact. Therefore, the Committee encourages the
Secretary, acting through the Assistant Secretary for Health,
and in coordination with the Office of Disease Prevention and
Health Promotion, the CDC, HRSA, and other relevant agencies,
to support accredited CME providers to develop, disseminate,
and evaluate independent, evidence-based nutrition CME for
physicians and other health professionals. The Committee
requests an update on this topic in the fiscal year 2028
congressional justification.
Office of Minority Health
The Committee includes $45,000,000 for the Office of
Minority Health (OMH), which is equal to the fiscal year 2027
budget request.
OMH works with public health service agencies and other
agencies of the Department to address the health status and
quality of life for minority populations in the United States.
OMH develops and implements new policies; partners with States,
Tribes, and communities through cooperative agreements;
supports research, demonstration, and evaluation projects; and
disseminates information.
Within the total provided for OMH, the Committee provides
not less than the following amounts:
------------------------------------------------------------------------
Budget Activity FY 2026 Enacted FY 2027 Committee
------------------------------------------------------------------------
Center for Indigenous Innovation $6,000,000 $6,000,000
and Health.......................
Improving Maternal Health Outcomes 10,000,000 10,000,000
National Lupus Training, Outreach, 3,000,000 3,000,000
and Clinical Trial Education.....
Promoting Language Access Services 4,000,000 4,000,000
------------------------------------------------------------------------
Center for Indigenous Innovation and Health.--The Committee
continues to recognize the importance of advancing Indigenous
solutions to achieve health excellence. The Committee includes
funding to support the work of the Center for Indigenous
Innovation and Health. The Committee supports HHS in its
partnerships with universities with a focus on Indigenous
health research and policy among Native Americans and Alaska
Natives, as well as universities with a focus on Indigenous
health policy and innovation among Native Hawaiians/Pacific
Islanders.
National Lupus Training, Outreach, and Clinical Trial
Education.--The Committee continues to support the National
Lupus Outreach and Clinical Trial Education program and its
goal of increasing participation in lupus clinical trials while
ensuring that study populations are representative of the
broader lupus population. While approximately 140 lupus
clinical trials are currently underway in the U.S. and progress
has been made in raising awareness of research opportunities,
challenges persist. These challenges include identifying
individuals who are representative of the lupus population who
meet trial eligibility criteria but may be unaware of available
studies. Additionally, evidence indicates that many eligible
patients are not informed about clinical trial opportunities by
their healthcare providers. Therefore, the Committee encourages
OMH to support efforts such as patient registries, peer-to-peer
education and training programs, and targeted provider
outreach, which improve awareness of research and clinical
trial opportunities. Importantly, these strategies can
facilitate increased participation among those living with
lupus, especially among those who most commonly develop lupus,
but who are underrepresented in lupus research and clinical
trials.
Office on Women's Health
The Committee includes $30,000,000 for the Office on
Women's Health (OWH), which is equal to the fiscal year 2027
budget request.
OWH provides consultation to the Secretary on women's
health and establishes short and long-range goals and
objectives for women's health within the Department. OWH
monitors activities regarding women's health and coordinates
across the Department on disease prevention, health promotion,
service delivery, research, public and health care professional
education, and other women's health concerns throughout their
lifespan. OWH leads the coordination of activities to promote
women's health programs and policies with the private sector
and to share information with the public. OWH also leads the
Coordinating Committee on Women's Health and the National
Women's Health Information Center.
Within the total provided for OWH, the Committee provides
not less than the following amounts:
------------------------------------------------------------------------
Budget Activity FY 2026 Enacted FY 2027 Committee
------------------------------------------------------------------------
Combatting Violence Against Women. $10,100,000 $10,100,000
Eating Disorders Research......... 1,000,000 1,000,000
Pregnant and Lactating Women's 200,000 200,000
Advisory Committee...............
Reporting on Access to Medical 5,000,000 5,000,000
Forensic Exams...................
Stillbirth Working Group.......... 2,000,000 2,000,000
------------------------------------------------------------------------
Eating Disorders Research.--The Committee includes funding
for OWH to continue prioritizing projects to support early
detection and treatment protocols for women and girls with or
at-risk of developing an eating disorder. The Committee urges
OWH to coordinate with SAMHSA's Center of Excellence for Eating
Disorders, outside organizations, eating disorders specialists,
and other groups as necessary to identify research needs of
eating disorders among women and girls.
Pregnant and Lactating Women's Advisory Committee.--The
Committee includes funding for the advisory committee to
continue activities within the 2020 Task Force on Research
Specific to Pregnant and Lactating Women (PRGLAC)
Implementation Plan. The Committee requests an update in the
fiscal year 2028 congressional justification on progress and
Federal activities undertaken to implement the PRGLAC
recommendations and suggestions for further implementation.
Stillbirth Working Group.--The Committee includes funding
for the Secretary to prioritize implementation of the
Stillbirth Working Group's recommendations across the
Department and to continue to engage in efforts to promote
evidence-based stillbirth awareness and prevention activities.
The Committee looks forward to reviewing the Department's
report on its progress, as requested in House Report 119-271
and Senate Report 119-55. The Committee directs the Secretary
to continue to prioritize the Department-wide implementation of
the Stillbirth Working Group's recommendations and engage in
efforts to promote evidence-based stillbirth awareness and
prevention activities. The Committee further directs the
Department to prioritize (1) improved data collection and
surveillance systems including the modernization of fetal death
reporting and interstate data harmonization, (2) identification
of evidence-based risk reduction strategies, especially in
disproportionately affected populations, and (3) initiatives to
support maternal mental health and bereavement care. The
Committee directs the Department to provide a report to the
Committees on Appropriations of the House of Representatives
and the Senate on the progress made toward these directives and
the implementation of the Working Group's recommendations and
to make such report available on the agency's website within
180 days of enactment of this Act.
Minority HIV/AIDS Fund
The Committee includes $20,000,000 for the Secretary's
Minority HIV/AIDS Fund (MHAF).
Tribal Set-Aside.--The Committee notes that according to
the CDC, HIV-positive status among Native Americans is
increasing and nearly one-in-five HIV-positive Native Americans
is unaware of their status. In addition, only three-in-five
receive care and less than half are virally suppressed. To
increase access to HIV/AIDS testing, prevention, and treatment,
the Committee reserves not less than $6,000,000 as a Tribal
set-aside within the total provided for MHAF.
Office of the Assistant Secretary for Administration
Cybersecurity
The Committee provides $100,000,000 for information
technology cybersecurity to strengthen the Department's
cybersecurity posture. The Committee recognizes the growing
cybersecurity risks facing the health sector. The Committee
supports the Department's ongoing efforts to modernize the ATO
process through the deployment of AI and automated
cybersecurity compliance and risk management tools, which
reduce administrative burden, improve continuous visibility
into security controls, and strengthen oversight of third-party
vendors. Not later than 180 days after the enactment of this
Act, the Department shall brief the Committee on the status of
deployment, an assessment of the efficiency and cybersecurity
posture impacts, and plans to further deploy automated
compliance tools across the Department.
Office of National Security
The Committee provides $8,983,000 for the Office of
National Security to maintain the security of the Department's
personnel, systems, and critical infrastructure.
Office of Global Affairs
The Committee provides $7,009,000 for the Office of Global
Affairs to coordinate HHS policy to strengthen U.S. health
security.
MEDICARE HEARINGS AND APPEALS
Appropriation, fiscal year 2026....................... $186,155,000
Budget request, fiscal year 2027...................... 185,000,000
Committee Recommendation.............................. 185,000,000
Change from enacted level......................... -1,155,000
Change from budget request........................ - - -
This appropriation supports activities carried out by two
Office of the Secretary Staff Divisions. The Office of Medicare
Hearings and Appeals supports Medicare appeals at the
administrative law judge level, the third level of Medicare
claims appeals. The Departmental Appeals Board represents the
fourth level of the Medicare appeals process and provides
impartial, independent hearings and appellate reviews.
OFFICE OF THE NATIONAL COORDINATOR FOR HEALTH
INFORMATION TECHNOLOGY
Appropriation, fiscal year 2026....................... $69,238,000
Budget request, fiscal year 2027...................... 50,000,000
Committee Recommendation.............................. 60,000,000
Change from enacted level......................... -9,238,000
Change from budget request........................ +10,000,000
The Office of the National Coordinator for Health
Information Technology (ONC) is the principal Federal entity
charged with coordinating efforts to implement and use health
information technology and exchange electronic health
information.
Of the funds provided, $35,863,000 shall be derived from
evaluation set aside funds available under section 241 of the
PHS Act.
In addition to the funds provided, the Committee notes that
ONC plans to obligate $18,000,000 of available recoveries to
advance interoperability standards, scale and accelerate
trusted health information exchange, and develop advanced
testing tools.
Patient Matching.--The Committee is concerned there is no
consistent and accurate way to link patients to their health
information as they seek care across the continuum. Health
information must be accurate, timely, and robust to inform
clinical care decisions for every patient. The recommendation
includes not less than $3,000,000 for ONC to work with industry
to develop matching standards that prioritize interoperability,
patient safety, and patient privacy.
Vetting Participants in the Trusted Exchange Framework and
Common Agreement (TEFCA).--The Committee supports ONC
allocating sufficient resources to vet organizations seeking to
join TEFCA, including Qualified Health Information Networks
(QHINs), participants, and subparticipants. The Committee
recognizes the importance of ensuring that entities
participating in TEFCA meet rigorous standards for security,
privacy, and operational integrity. As TEFCA scales nationally,
appropriate safeguards are necessary to maintain trust in
nationwide health information exchange. This vetting should
include, but is not limited to, strengthening eligibility
verification procedures for applicants, reviewing publicly
available business descriptions, implementing ongoing
compliance monitoring and auditing mechanisms, and coordinating
with other Federal agencies, as appropriate, to assess security
and fraud risks. The Committee requests that ONC include the
following information in the fiscal year 2028 congressional
justification: (1) current participant vetting procedures; (2)
identified gaps in oversight or risk management; and (3)
planned enhancements supported by funds provided in this Act.
OFFICE OF INSPECTOR GENERAL
Appropriation, fiscal year 2026....................... $87,000,000
Budget request, fiscal year 2027...................... 77,650,000
Committee Recommendation.............................. 87,000,000
Change from enacted level......................... - - -
Change from budget request........................ +9,350,000
The Committee recommends $87,00,000 for the Office of
Inspector General, which is equal to the fiscal year 2026
enacted level.
In addition, within the Health Care Fraud and Abuse Control
program discretionary appropriations for fiscal year 2027, the
Committee provides the OIG with $109,735,000, which is
$1,000,000 above the fiscal year 2026 enacted level. Mandatory
appropriations for this office are also contained in the HCFAC
program and the Health Insurance Portability and Accountability
Act of 1996.
The Committee supports the OIG as an independent and
objective entity charged with conducting oversight, preventing
waste, fraud and abuse, and promoting economy, efficiency, and
effectiveness in the Department's programs and operations.
OFFICE FOR CIVIL RIGHTS
Appropriation, fiscal year 2026....................... $39,798,000
Budget request, fiscal year 2027...................... 42,780,000
Committee Recommendation.............................. 39,798,000
Change from enacted level......................... - - -
Change from budget request........................ -2,982,000
The Office for Civil Rights (OCR) is responsible for
enforcing civil rights statutes that prohibit discrimination in
health and human services programs. OCR implements the civil
rights laws through a compliance program designed to generate
voluntary compliance among all HHS recipients.
Patient Health Information Regulation.--The Committee
recognizes that OCR has been working on matters pertaining to
regulatory barriers that impede the delivery of coordinated,
value-based care. The Notice of Proposed Rulemaking (NPRM)
published on January 21, 2021 (HHS-OCR-0945-AA00) was intended
to modify existing patient privacy regulations to support
coordinated care, case management, and value-based care while
protecting the privacy and security of electronic protected
health information (ePHI). However, the Committee remains
concerned that this draft NPRM could have unintended
consequences, such as granting unprecedented access to valuable
health information by commercial entities as well as eroding
patient privacy protections through disclosure of more
information than necessary to third-party interests, most of
whom operate outside the bounds of HIPAA. The Committee also
remains concerned that the NPRM, as drafted, could shift the
growing economic burden of fulfilling requests for ePHI
securely and lawfully from commercial requestors to the
healthcare system. Therefore, the Committee urges the Secretary
to withdraw and rescind the proposed ``HIPAA Privacy Rule:
Changes to Support the Use of Telecommunications Relay Services
and Improve Information Sharing for Uniformed Services
Personnel.''
Protection of Conscience Rights.--The Committee maintains
the Weldon Amendment, which protects the conscience rights of
Americans by prohibiting Federal, State, or local government
discrimination against health care entities that decline to pay
for, or provide coverage of, abortion. The Committee commends
OCR for taking comprehensive action to enforce conscience
rights and protect human life.
Report on Antisemitism in Health Care.--The Committee looks
forward to receiving the report required under this heading in
House Report 119-271.
RETIREMENT PAY AND MEDICAL BENEFITS FOR
COMMISSIONED OFFICERS
Appropriation, fiscal year 2026....................... $947,182,000
Budget request, fiscal year 2027...................... 967,192,000
Committee Recommendation.............................. 967,192,000
Change from enacted level......................... +20,010,000
Change from budget request........................ - - -
The Committee provides for retirement pay and medical
benefits of Public Health Service Commissioned Officers, for
payments under the Retired Serviceman's Family Protection Plan,
and for medical care of dependents and retired personnel.
General Provisions
Sec. 201. The Committee continues a provision to limit the
amount available for official reception and representation
expenses.
Sec. 202. The Committee continues a provision to limit the
salary of an individual through an HHS grant or other
extramural mechanism to not more than the rate of Executive
Level II.
Sec. 203. The Committee continues a provision to prohibit
the Secretary from using evaluation set aside funds until the
Committees on Appropriations receive a report detailing the
planned use of such funds.
Sec. 204. The Committee modifies a provision regarding the
use of PHS evaluation set aside.
(TRANSFER OF FUNDS)
Sec. 205. The Committee continues a provision permitting
the Secretary of HHS to transfer up to one percent of any
discretionary funds between appropriations, provided that no
appropriation is increased by more than three percent by any
such transfer to meet emergency needs. Notification must be
provided to the Committees on Appropriations at the program,
project, and activity level in advance of any such transfer.
Sec. 206. The Committee modifies a provision providing 60-
day flexibility for National Health Service Corps contract
terminations.
Sec. 207. The Committee continues a provision to prohibit
the use of Title X funds 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. 208. The Committee continues a provision stating that
no provider of services under Title X shall be exempt from any
law requiring notification or the reporting of child abuse,
child molestation, sexual abuse, rape, or incest.
Sec. 209. The Committee continues a provision related to
the Medicare Advantage program.
Sec. 210. The Committee continues a provision prohibiting
funds from being used to advocate or promote gun control.
Sec. 211. The Committee modifies a provision to allow
funding for HHS international HIV/AIDS and other infectious
diseases, chronic and environmental disease, and other health
activities abroad to be spent under the State Department Basic
Authorities Act of 1956.
(TRANSFER OF FUNDS)
Sec. 212. The Committee continues a provision to provide
the Director of NIH, jointly with the Director of the Office of
AIDS Research, the authority to transfer up to three percent of
human immunodeficiency virus funds.
(TRANSFER OF FUNDS)
Sec. 213. The Committee continues a provision that makes
NIH funds for human immunodeficiency virus research available
to the Office of AIDS Research.
Sec. 214. The Committee continues a provision granting
authority to the Office of the Director of the NIH to enter
directly into transactions in order to implement the NIH Common
Fund for medical research and permitting the Director to
utilize peer review procedures, as appropriate, to obtain
assessments of scientific and technical merit.
Sec. 215. The Committee continues a provision clarifying
that funds appropriated to NIH institutes and centers may be
used for minor repairs or improvements to their buildings, up
to $5,000,000 per project with a total limit for NIH of
$100,000,000.
(TRANSFER OF FUNDS)
Sec. 216. The Committee continues a provision transferring
one percent of the funding made available for National
Institutes of Health National Research Service Awards to the
Health Resources and Services Administration.
Sec. 217. The Committee continues the Biomedical Advanced
Research and Development Authority ten-year contract authority.
Sec. 218. The Committee modifies a provision requiring HHS
to include information regarding full-time Federal employees
and contractors working on the Affordable Care Act in the
fiscal year 2028 budget request.
Sec. 219. The Committee modifies a provision for a report
on CMS's Health Insurance Exchange activities in the fiscal
year 2028 budget request.
Sec. 220. The Committee continues a provision prohibiting
the CMS Program Management account from being used to support
risk corridor payments.
(TRANSFER OF FUNDS)
Sec. 221. The Committee modifies a provision directing the
spending of the Prevention and Public Health Fund.
PREVENTION AND PUBLIC HEALTH FUND
In fiscal year 2027, the level appropriated for the fund is
$1,438,075,000 after accounting for sequestration. The
Committee includes bill language in section 221 of this Act
that requires that funds be transferred within 45 days of
enactment of this Act to the following accounts, for the
following activities, and in the following amounts:
----------------------------------------------------------------------------------------------------------------
Agency Budget Activity FY 2026 Enacted FY 2027 Committee
----------------------------------------------------------------------------------------------------------------
ACL........................................ Alzheimer's Disease Program.. $14,700,000 $14,700,000
ACL........................................ Chronic Disease Self- 8,000,000 8,000,000
Management.
ACL........................................ Falls Prevention............. 5,000,000 5,000,000
CDC........................................ Section 317 Immunization 596,390,000 696,933,000
Grants.
CDC........................................ Epidemiology and Laboratory 40,000,000 55,000,000
Capacity.
CDC........................................ Healthcare-Associated 12,000,000 12,000,000
Infections.
CDC........................................ Tobacco...................... 200,000,000 200,000,000
CDC........................................ Heart Disease and Stroke..... 111,105,000 115,312,000
CDC........................................ Diabetes..................... 118,130,000 118,130,000
CDC........................................ Million Hearts Program....... 5,000,000 - - -
CDC........................................ National Early Child Care 5,000,000 5,000,000
Collaboratives.
CDC........................................ Hospitals Promoting 9,750,000 - - -
Breastfeeding.
CDC........................................ Public Health Data - - - 45,000,000
Modernization.
CDC........................................ Childhood Lead Poisoning..... 51,000,000 51,000,000
CDC........................................ Preventative Health and 160,000,000 - - -
Health Services Block Grants.
CDC........................................ Public Health Infrastructure 90,000,000 100,000,000
and Capacity.
SAMHSA..................................... Garrett Lee Smith--Youth 12,000,000 12,000,000
Suicide Prevention.
----------------------------------------------------------------------------------------------------------------
Sec. 222. The Committee modifies a provision related to
breast cancer screening.
Sec. 223. The Committee includes a new provision related to
NIH facilities and administration costs.
(TRANSFER OF FUNDS)
Sec. 224. The Committee continues a provision permitting
transfer of funds within NIH, if such funds are related to
opioid and pain management research.
Sec. 225. The Committee continues a provision related to
certain Congressional notification requirements.
Sec. 226. The Committee continues a provision related to
funding for the Medicare program.
Sec. 227. The Committee modifies a provision related to a
biannual reporting requirement.
Sec. 228. The Committee continues a provision allowing HHS
to cover travel expenses when necessary for employees to obtain
medical care when they are assigned to duty in a location with
a public health emergency.
Sec. 229. The Committee includes a new provision related to
donations for Early Head Start programs.
Sec. 230. The Committee continues a provision related to
donations for unaccompanied alien children.
Sec. 231. The Committee continues a provision related to
the notification requirements regarding the use of facilities
that are not State licensed for the care of unaccompanied alien
children.
Sec. 232. The Committee continues a provision related to
Members of Congress and oversight of facilities responsible for
the care of unaccompanied alien children.
Sec. 233. The Committee continues a provision requiring
monthly reporting on unaccompanied alien children who were
separated from their parents or legal guardians and transferred
to the care of the Office of Refugee Resettlement.
Sec. 234. The Committee continues a provision related to
primary and secondary school costs for eligible dependents of
personnel stationed in a U.S. territory.
Sec. 235. The Committee modifies a provision related to CDC
funding.
Sec. 236. The Committee includes a new provision related to
research, testing, or experimentation on dogs or cats.
(RESCISSION)
Sec. 237. The Committee modifies a provision related to
unobligated balances in the Nonrecurring Expenses Fund.
Sec. 238. The Committee includes a new provision related to
fetal tissue.
Sec. 239. The Committee includes a new provision related to
physician training for abortions.
Sec. 240. The Committee includes a new provision
restricting funding to certain health care entities.
Sec. 241. The Committee includes a new provision related to
providing information on abortion.
Sec. 242. The Committee includes a new provision related to
referral for abortions.
Sec. 243. The Committee includes a new provision limiting
funding for certain elective services.
Sec. 244. The Committee includes a new provision related to
placement of unaccompanied alien children.
Sec. 245. The Committee includes a new provision related to
a public health emergency and a citizen's Second Amendment
rights.
Sec. 246. The Committee includes a new provision related to
civil actions for certain designated violations of law.
Sec. 247. The Committee includes a new provision related to
placements of unaccompanied alien children.
Sec. 248. The Committee includes a new provision related to
research on firearm-related restrictions or policies.
Sec. 249. The Committee includes a new provision related to
research on vertebrate animals.
Sec. 250. The Committee includes a new provision related to
the activities of the Interagency Coordinating Committee on the
Prevention of Underage Drinking.
TITLE III--DEPARTMENT OF EDUCATION
Appropriation, fiscal year 2026....................... $78,793,603,000
Budget request, fiscal year 2027...................... 77,192,582,000
Committee Recommendation.............................. 70,655,376,000
Change from enacted level......................... -8,138,227,000
Change from budget request........................ -6,537,206,000
The Committee commends the Department for its budget
proposals aimed at improving educational outcomes for students,
from K-12 education through education and training
opportunities beyond high school. The Committee commends the
Department's emphasis on literacy, which is critical for
students' academic success throughout their schooling and
necessary in life. The Committee also commends the Department's
empowerment of States, in recognition that education is
fundamentally a local and State responsibility. Similarly, the
Committee appreciates the Department's consideration of ways to
create efficiencies in Federal programs. Additionally, the
Committee notes the Department's efforts to assist millions of
borrowers with federally held student loans in returning to
repayment, including assisting struggling borrowers and
safeguard Federal funds.
Office of Elementary and Secondary Education
EDUCATION FOR THE DISADVANTAGED
Appropriation, fiscal year 2026....................... $19,127,790,00
Budget request, fiscal year 2027...................... 20,426,802,000
Committee Recommendation.............................. 16,790,647,000
Change from enacted level......................... -2,337,143,000
Change from budget request........................ -3,636,155,000
This appropriation account includes compensatory education
programs authorized under title I and subpart 2 of part B of
title II of the Elementary and Secondary Education Act of 1965
(ESEA) and section 418A of the Higher Education Act (HEA).
Of the total amount available, $5,949,470 is appropriated
for fiscal year 2027 for obligation on or after July 1, 2027,
and $10,841,177,000 is appropriated for fiscal year 2028 for
obligation on or after October 1, 2027.
Grants to Local Educational Agencies
For fiscal year 2027, the Committee provides
$16,531,647,000 for Title I grants to Local Educational
Agencies (LEAs or school districts).
High-Quality Tutoring.--The Committee encourages the
Department to promote and provide technical assistance to LEAs
and support partnerships between LEAs and education-related
community-based organizations to implement evidence-based
tutoring models.
Basic Grants
Of the amounts provided for Title I programs, the Committee
provides $5,036,746,000 for Basic Grants to LEAs, which is
$1,422,655,000 below the fiscal year 2026 enacted level. Of
this amount, $763,776,000 is available for fiscal year 2028.
Basic grants are awarded to school districts with at least
10 low-income children who make up more than 2 percent of the
school-age population.
Concentration Grants
The Committee provides $1,362,301,000, the same as the
fiscal year 2027 budget request and fiscal year 2026 enacted
level for Title I Concentration Grants.
These grants target funds to school districts in which the
number of low-income children exceeds 6,500 or 15 percent of
the total school-age population.
Targeted Grants
The Committee provides $5,066,300,000, which is
$236,250,000 below the fiscal year 2027 budget request and the
fiscal year 2026 enacted level for Title I Targeted Grants.
Within this amount, $4,357,550,000 is available for fiscal year
2028.
Targeted Grants provide higher payments to school districts
with high numbers or percentages of low-income students.
Education Finance Incentive Grants
The Committee provides $5,066,300,000, which is
$236,250,000 below the fiscal year 2027 budget request and the
fiscal year 2026 enacted level for Title I Education Finance
Incentive Grants. Within this amount, $4,357,550,000 is
available for fiscal year 2028.
These funds are allocated according to one of the four
allocation formulas authorized under ESEA Title I, Part A for
providing Federal education funding to the States for the
education of disadvantaged students.
Innovative Approaches to Literacy
The Committee provides $40,000,000 for the Innovative
Approaches to Literacy program, which is $10,000,000 above the
fiscal year 2026 enacted level. This program provides
competitive grants to support school libraries.
Innovative Approaches to Literacy.--The Committee
encourages the Department to use a portion of the funds under
this program for grants to pediatric literacy programs that are
provided during well-child visits by medical providers trained
in evidence-based methods of early language and literacy.
Literacy Coaches.--The Committee is concerned with the
decline in literacy rates across the majority of U.S. and
recognizes the need to equip educators with the resources to
address this literacy crisis. The Committee supports literacy
coaches in schools to improve high-quality reading curriculum,
educator preparation, and institutional literacy support.
Science of Reading.--The Committee commends the success of
States such as Louisiana, California, and Mississippi, for
providing a roadmap to nationwide success in raising reading
scores through implementing methods aligned with the Science of
Reading. The Committee encourages the Department to ensure
federal funds support only the highest quality professional
development and curricula based on well-established, evidence-
based instructional methods. Federally funded programs should
be required to demonstrate efficacy and impact through high-
quality, independently validated research, and statistically
significant improvements in student outcomes.
Restriction on Funds from the People's Republic of China.--
The Committee is concerned that local education agencies
receiving support from the Government of the People's Republic
of China for cultural or language institutes, including
Confucius Classrooms and similar programs, may create
vulnerabilities in the educational environment.
Comprehensive Literacy Development Grants
The Committee provides $219,000,000 for the Comprehensive
Literacy Development Grants, which is $219,000,000 above the
fiscal year 2027 budget request and 25,000,000 above the fiscal
year 2026 enacted level. This program supports competitive
grants to States to subgrant to school districts and/or early
education programs to improve literacy instruction for
disadvantaged students.
The Committee is encouraged by the effective implementation
of Science of Reading-based programs, including high-quality
curriculum, educator preparation, and early childhood reading
interventions. The Committee encourages the Department to
support programs aligned with the Science of Reading and
supported by strong or moderate evidence. Further, the
Committee directs the Department to brief the Committee, within
90 days of enactment of this Act, on its plan to expend fiscal
year 2027 funds.
State Agency Programs: Migrant The Committee does not
provide funding for the State Agency Program for Migrant
Education, which is consistent with the fiscal year 2027 budget
request.
This formula grant program supports special educational and
related services for children of migrant agricultural workers
and fishermen, including: (1) supplementary academic education;
(2) remedial or compensatory instruction; (3) English for
limited English proficient students; (4) testing; (5) guidance
counseling; and (6) other activities to promote coordination of
services across States for migrant children whose education is
interrupted by frequent moves.
The Committee has chosen to prioritize funding for local
school districts to improve student outcomes in the core
curriculum of writing, reading comprehension, and math.
State Agency Programs: Neglected and Delinquent/High Risk Youth
The Committee does not provide funding for the State Agency
Program for Neglected and Delinquent Children, which is the
same as the fiscal year 2027 budget request and $49,239,000
below the fiscal year 2026 enacted level.
This formula grant program supports educational services
for children and youth under age 21 in State-run institutions,
attending community day programs, and in correctional
facilities. A portion of these funds are provided for projects
that support the successful reentry of youth from the criminal
justice system into postsecondary and vocational programs.
The Committee has chosen to prioritize funding for local
school districts to improve student outcomes in the core
curriculum of writing, reading comprehension, and math.
Special Programs for Migrant Students
The Committee does not provide funding for the Special
Programs for Migrant Students, which is the same as the fiscal
year 2027 budget request and $52,123,000 below the fiscal year
2026 enacted level.
These programs make competitive grants to colleges,
universities, and nonprofit organizations to support
educational programs designed for students who are engaged in
migrant and other seasonal farm work. The High School
Equivalency Program recruits migrant students aged 16 and over
and provides academic and support services to help those
students obtain a high school equivalency certificate and
subsequently to gain employment or admission to a postsecondary
institution or training program. The College Assistance Migrant
Program provides tutoring and counseling services to first-
year, undergraduate migrant students and assists those students
in obtaining student financial aid for their remaining
undergraduate years.
The Committee has chosen to prioritize funding for local
school districts to improve student outcomes in the core
curriculum of writing, reading comprehension, and math.
IMPACT AID
Appropriation, fiscal year 2026....................... $1,630,151,000
Budget request, fiscal year 2027...................... 1,630,151,000
Committee Recommendation.............................. 1,635,151,000
Change from enacted level......................... +5,000,000
Change from budget request........................ +5,000,000
This account supports payments to school districts affected
by Federal activities, such as those that educate children
whose families are connected with the military or who live on
Indian land.
Basic Support Payments
The Committee provides $1,480,000,000 for Basic Support
Payments to LEAs, which is an increase of $3,000,000 from the
fiscal year 2027 budget request and the fiscal year 2026
enacted level.
Basic Support Payments compensate school districts for lost
tax revenue and are made on behalf of Federally connected
children, such as children of members of the uniformed services
who live on Federal property.
Compact Migrant Populations.--The Committee notes
disproportionate impact and financial costs associated with
providing resources to compact migrant populations, as
identified in a June 2020 Government Accountability Office
(GAO) report (GAO-20-491). In fiscal years 2004-2018, Hawaii,
Guam, and the Commonwealth of Northern Mariana Islands reported
estimated costs totaling $3.2 billion. While these States and
territories receive Federal assistance on food, housing, and
healthcare to support these populations, the Committee notes
the increased financial burden on other public systems,
including education.
Payments for Children with Disabilities
The Committee provides $50,316,000 for Payments for
Children with Disabilities, which is an increase of $1,000,000
from the fiscal year 2027 budget request and the fiscal year
2026 enacted level.
These payments compensate school districts for the
increased costs of serving Federally connected children with
disabilities.
Facilities Maintenance
The Committee provides $4,835,000 for Facilities
Maintenance, which is the same as the fiscal year 2027 budget
request and the fiscal year 2026 enacted level.
Capital payments are authorized for maintenance of certain
facilities owned by the Department.
Construction
The Committee provides $19,000,000 for the Construction
program, which is the same as the fiscal year 2027 budget
request and the fiscal year 2026 enacted level.
This program provides formula grants for building and
renovating school facilities to school districts that educate
Federally connected students or have Federally owned land.
Payments for Federal Property
The Committee provides $81,000,000 for payments for Federal
property, which is a $1,000,000 increase from the fiscal year
2027 budget and the and the fiscal year 2026 enacted level.
Funds are awarded to school districts to compensate for
lost tax revenue as the result of Federal acquisition of real
property since 1938.
SCHOOL IMPROVEMENT PROGRAMS
Appropriation, fiscal year 2026....................... $5,781,178,000
Budget request, fiscal year 2027...................... - - -
Committee Recommendation.............................. 3,164,523,000
Change from enacted level......................... -2,616,655,000
Change from budget request........................ +3,164,523,000
The School Improvement account includes programs authorized
under Titles I, II, IV, VI, and VII of the ESEA; the McKinney-
Vento Homeless Assistance Act; Title IV-A of the Civil Rights
Act; and section 203 of the Educational Technical Assistance
Act of 2002.
Supporting Effective Instruction State Grants
The Committee does not provide fiscal year 2027 funding for
these formula grants to States, which is consistent with the
fiscal year 2027 budget request. This funding has not shown
significant evidence that funding improves teacher quality or
advances student achievement.
State Assessments
The Committee does not provide funding for this program.
The Committee believes that other sources of educational
funding can cover these activities.
Education for Homeless Children and Youth
The Committee provides $129,000,000 for the Education for
Homeless Children and Youth program, which is $129,000,000
above the fiscal year 2027 budget request and the same as the
fiscal year 2026 enacted level.
Formula grants are allocated to States in proportion to the
total each State receives under the Title I program.
Training and Advisory Services
The Committee does not provide funding for this program.
The Committee is concerned that this funding is used to push
divisive training and ideologies on public school teachers and
other officials by training them how to address racial and
sexual bias in teaching materials, school discipline policies,
and school climates.
Nita M. Lowey 21st Century Community Learning Centers
The Committee provides $1,329,673,000 for the Nita M. Lowey
21st Century Community Learning Centers program, which is
$1,329,673,000 above the fiscal year 2027 budget request and
the same as the fiscal year 2026 enacted level. This program
awards formula grants to States, which in turn distribute funds
on a competitive basis to local school districts, nonprofit
organizations, and other public entities. Funds may be used to
provide activities that complement and reinforce the regular
school-day program for participating students and may also fund
local activities that are included as part of an expanded
learning time program.
Summer Reading Programs.--The Committee urges the
Department to support States in efforts to establish summer
reading programs for K-6 students, particularly for students in
underserved areas.
The Committee is aware of the unique barriers students with
disabilities face in accessing after-school programs, which
include identifying an appropriate program and experiencing
higher-than-average costs. These barriers prevent students from
experiencing the many benefits of afterschool programs, such as
improved academic performance, social competence, and improved
motor skills. The Committee encourages the Department of
Education to prioritize funds awarded under the Nita M. Lowey
21st Century Community Learning Centers program to applicants
that increase accessibility to high-quality and inclusive
after-school programs for students with disabilities.
Student Support and Academic Enrichment Grants
The Committee provides $1,385,000,000 for Student Support
and Academic Enrichment State Grants, which is an increase of
$5,000,000 from the fiscal year 2026 enacted level.
The Every Student Succeeds Act eliminated several narrowly
focused competitive grant programs and replaced them with this
formula grant program. States and school districts have
flexibility to focus these resources on locally determined
priorities to provide students with access to a well-rounded
education, including rigorous coursework, and to improve school
conditions and the use of technology.
Rural Education
The Committee provides $230,000,000 for Rural Education
programs, which is an increase of $5,000,000 from the fiscal
year 2026 enacted level.
There are two dedicated programs to assist rural school
districts with improving teaching and learning in their
schools: the Small, Rural Schools Achievement program, which
provides funds to rural districts that serve a small number of
students; and the Rural and Low-Income Schools program, which
provides funds to rural districts that serve concentrations of
poor students, regardless of the number of students served by
the district. Funds appropriated for Rural Education shall be
divided equally between these two programs.
Native Hawaiian Education
The Committee provides $45,897,000 for the Education for
Native Hawaiian program, which is $45,897,000 more than the
fiscal year 2027 budget request and the same as the fiscal year
2026 enacted level. These funds are used to provide competitive
grants for supplemental education services to the Native
Hawaiian population.
Education for Native Hawaiians Program.--The Committee
continues to support the usage of Education for Native
Hawaiians program funds for construction, renovation, and
modernization of any public elementary school, secondary
school, or structure related to a public elementary school or
secondary school, that serves a predominantly Native Hawaiian
student body. The Committee encourages the Department to
prioritize funding to organizations with construction needs
that have experience providing supplemental education services
to Native Hawaiian children and youth.
Native Hawaiian Education Council.--The Committee
recommendation provides $650,000 for the Native Hawaiian
Education Council to fulfill the statutory requirement for data
collection.
Alaska Native Education
The Committee provides $44,953,000 for the Alaska Native
Education program, which is $44,953,000 more than the fiscal
year 2027 budget request and the same as the fiscal year 2026
level. These funds are used to provide competitive grants for
supplemental education services to the Alaska Native
population.
Comprehensive Centers
The Committee does not provide funding for this program.
The Committee has chosen to prioritize funding for local school
districts to improve student outcomes in the core curriculum of
writing, reading comprehension, and math.
SAFE SCHOOLS AND CITIZENSHIP EDUCATION
Appropriation, fiscal year 2026....................... $431,000,000
Budget request, fiscal year 2027...................... - - -
Committee Recommendation.............................. 243,643,000
Change from enacted level......................... -187,357,000
Change from budget request........................ +243,643,000
This appropriation account includes programs authorized
under parts of Title IV of the ESEA.
Promise Neighborhoods
The Committee does not provide funding for these
competitive grants, which is the same as the fiscal year 2027
budget request and $91,000,000 below the fiscal year 2026
enacted level.
School Safety National Activities
The Committee provides $243,643,000 for the School Safety
National Activities program, which is $243,643,000 above the
fiscal year 2027 budget request and $53,643,000 above the
fiscal year 2026 enacted level.
Within the total for School Safety National Activities, the
Committee provides the following amounts:
------------------------------------------------------------------------
Budget Activity FY 2026 Enacted FY 2027 Committee
------------------------------------------------------------------------
Mental Health Services $82,000,000 $82,000,000
Professional Grants..............
Project SERV...................... 6,000,000 6,000,000
School-based Mental Health 82,000,000 82,000,000
Services Grants..................
School Safety Enhancement Grants.. 20,000,000 73,643,000
------------------------------------------------------------------------
The Committee's recommendation provides up to $6,000,000
for the Project School Emergency Response to Violence (Project
SERV) program, which is the same as the fiscal year 2026
enacted level. The Project SERV program provides counseling and
referral to mental health services as well as other education-
related services to LEAs and Institutions of Higher Education
(IHEs) in which the learning environment has been disrupted by
a natural disaster or violent crisis.
The Committee notes that funds made available through the
Bipartisan Safer Communities Act (P.L. 117-159), for the
Stronger Connections Grant program may be used for information
technology to improve the safety of the school environment in
high need LEAs. Guidance documentation published by the
Department also includes information regarding other related
eligible uses of funds including equipment and minor
remodeling.
School Enhancement Grants.--The Committee provides
$73,643,000 for a competitive grant program to help schools
implement best practices to improve school safety. This
includes several things that were recommended in the Department
of Justice's January 18, 2024, report, ``Critical Incident
Review: Active Shooter at Robb Elementary School,'' such as
updated doors and locks that can be locked from the inside,
metal detectors, or other deterrent measures; wi-fi to ensure
emergency alerts are received in a timely manner; universal
master key access boxes; school resource officers and security
personnel; and training and preparedness exercises coordinated
between students, school personnel, local law enforcement and
first responders, and local government agencies. The Committee
directs the Department to provide a briefing within 90 days of
enactment of this Act to the Committee on its plans for
carrying out these competitive grants. In addition, the
Committee directs the Department to provide notice to the
Committee at least seven days before any notice of funding
opportunity is published or any grantees for a new competition
are announced.
School Classroom Emergency Door Security.--The Committee
recognizes the importance of ensuring that educators and school
personnel have the ability to quickly secure classrooms during
an emergency or active threat. In many emergency scenarios,
including active shooter incidents, the ability to rapidly
secure a classroom door can significantly improve the safety of
students and staff.
School Safety Grant Application Feedback.--The Committee
acknowledges the challenges that urban and rural school
districts encounter when applying for federal funding for
school safety-related grants. The Committee recommends that the
Department provide applicants with a detailed explanation of
any grant denials and explicit feedback on grant applications
within 30 days of the announcement of awardees.
Full-Service Community Schools
The Committee does not provide funding for Full-Service
Community Schools program, which is the same as the fiscal year
2027 budget request and a decrease of $150,000,000 from the
fiscal year 2026 enacted level. This program makes competitive
grants to support comprehensive school-based services for
students, families, and communities, such as mental health and
nutrition services.
INDIAN EDUCATION
Appropriation, fiscal year 2026....................... $196,746,000
Budget request, fiscal year 2027...................... 196,746,000
Committee Recommendation.............................. 200,746,000
Change from enacted level......................... +4,000,000
Change from budget request........................ +4,000,000
This account supports programs authorized by part A of
title VI of the ESEA.
The Office of Elementary and Secondary Education has
recognized that the Federal government has a unique political
and legal relationship with Federally recognized Indian Tribes
and has committed to continuing to deliver on all statutory
grant programs that support American Indian, Alaska Native, and
Native Hawaiian students. Over 90 percent of AI/AN students
attend public schools, and the dedicated funds to serve this
population are an essential part of meeting our Federal trust
and treaty obligations to tribal nations.
Grants to Local Educational Agencies
The Committee provides $110,381,000 for Grants to Local
Educational Agencies, which is the same as the fiscal year 2027
budget request and the fiscal year 2026 enacted level. This
program provides formula grants to school districts and schools
supported or operated by the Bureau of Indian Education. The
purpose of this program is to improve elementary and secondary
school programs that serve American Indian students, including
preschool children. Grantees must develop a comprehensive plan
and ensure that the programs they carry out will help American
Indian students reach the same challenging standards that apply
to all students. This program supplements the regular school
program to help American Indian children sharpen their academic
skills, bolster their self-confidence, and participate in
enrichment activities that would otherwise be unavailable.
Special Programs for Indian Children
The Committee provides $72,000,000 for Special Programs for
Indian Children, which is the same as the fiscal year 2027
budget request and the fiscal year 2026 enacted level. These
programs make competitive grants to improve the quality of
education for American Indian students.
National Activities
The Committee provides $18,365,000 for National Activities,
which is an increase of $4,000,000 above the fiscal year 2027
budget request and the fiscal year 2026 enacted level.
Funds under this authority support: (1) research,
evaluation, and data collection to provide information about
the educational status of Indian students and the effectiveness
of Indian education programs; (2) grants to support Native
language immersion schools and programs; and (3) grants to
Tribes for education administrative planning, development, and
coordination.
Within the total National Activities, the Committee
includes the following amounts:
------------------------------------------------------------------------
Budget Activity FY 2026 Enacted FY 2027 Committee
------------------------------------------------------------------------
Native American Language Immersion $4,750,000 $6,000,000
Native American Language Resource 3,000,000 4,000,000
Centers..........................
State-Tribal Education 4,000,000 5,000,000
Partnerships.....................
Other National Activities......... 2,615,000 3,365,000
------------------------------------------------------------------------
INNOVATION AND IMPROVEMENT
Appropriation, fiscal year 2026....................... $1,191,147,000
Budget request, fiscal year 2027...................... 500,000,000
Committee Recommendation.............................. 907,000,000
Change from enacted level......................... -284,147,000
Change from budget request........................ +407,000,000
This appropriation account includes programs authorized
under portions of Titles II and IV of the ESEA.
Student-Facing Educational Support Staff.--The Committee
recognizes that student-facing education staff are some of the
most consequential figures in a student's development and are
critical for student success. In school districts facing budget
shortfalls, the Committee is concerned that some districts opt
to disproportionately layoff student-facing educational support
staff, compared to administrative staff. In these situations,
the Committee encourages schools to retain student-facing
educational support staff to the extent possible in order to
support student development and set students up for long-term
success.
American History and Civics Academies
The Committee provides $3,000,000 for this program, which
is the same as the fiscal year 2026 enacted level.
This program supports academies for teachers and high
school students to strengthen their knowledge on American
history, civic, and government education.
American History and Civics National Activities
The Committee provides $30,000,000 for this program, which
is a $10,000,000 increase above the fiscal year 2026 enacted
level.
National Activities grants promote evidence-based
instructional methods and professional development programs in
American history, civics and government, and geography,
particularly those methods and programs that benefit students
from low-income backgrounds and underserved students. Grant
projects may include civic engagement activities and
educational programs on the history and principles of the
Constitution and Bill of Rights. The Department makes
competitive grants to institutions of higher education and
other nonprofit or for-profit organizations with demonstrated
expertise.
Teacher and School Leader Incentive Grants
Due to funding constraints, the Committee does not provide
funding for these competitive grants.
Supporting Effective Educator Development
The Committee does not provide funding for these
competitive grants. The Committee is unaware of research
demonstrating that these grants have improved teacher quality
or student achievement.
Charter Schools Grants
The Committee provides $500,000,000 for Charter School
Program (CSP) Grants, which is the same as the fiscal year 2027
budget request and an increase of $60,000,000 from the fiscal
year 2026 enacted level.
The Charter Schools Grants program awards competitive
grants to State Educational Agencies (SEAs) or, if a State's
SEA chooses not to participate, to charter school developers to
support the development and initial implementation of public
charter schools. State Facilities Incentive Grants and Credit
Enhancement for Charter School Facilities awards help charter
schools obtain adequate school facilities. These programs work
in tandem to support the development and operation of charter
schools.
Facilities Grants.--The Committee is supportive of
construction and renovation of charter school facilities,
including storm shelters, safe rooms, and other infrastructure
improvements such as fortified roof and wall construction to
improve windstorm, tornado, and hurricane resilience, and to
ensure that a school building is equipped to support the
provision of a high-quality education.
Magnet Schools Assistance
The Committee provides $139,000,000 for this program, which
is $139,000,000 above the fiscal year 2027 budget request and
the same as the fiscal year 2026 enacted level. This program
makes competitive grants to support the establishment and
operation of magnet schools that are a part of a court-ordered
or Federally approved voluntary desegregation plan.
Ready to Learn Television Programming
The Committee does not provide funding for these
competitive grants, which is the same as the fiscal year 2027
budget request and $31,000,000 below the fiscal year 2026
enacted level. This program supports the development and
distribution of educational video programming for preschool and
elementary school children and their parents, caregivers, and
teachers. The Committee has chosen to prioritize funding for
local school districts to improve student outcomes in the core
curriculum of writing, reading comprehension, and math.
Arts in Education
The Committee does not provide funding for these
competitive grants, which is the same as the fiscal year 2027
budget request and $36,500,000 below the fiscal year 2026
enacted level. The Committee believes that considering the
continued decline of public-school performance and student
achievement across the country, funding provided by the
Department should be focused on core education such as reading,
writing, and math.
Javits Gifted and Talented Education
The Committee does not provide funding for these
competitive grants, consistent with the fiscal year 2027 budget
request and $16,500,000 below the fiscal year 2026 enacted
level. The Committee is concerned that the Department's focus
on equity within the gifted and talented program further
divides American students and leaves them less prepared to
compete in a challenging global economy. The Committee believes
this program should be merit based.
Statewide Family Engagement Centers
The Committee does not provide funding for these
competitive grants, which is the same as the fiscal year 2027
budget request. The Committee is concerned that despite the
millions of dollars appropriated for these grants in recent
years, there is no evidence that the grants have fostered
trusting relationships between families and schools.
Education Innovation and Research
The Committee provides $235,000,000 for the Education
Innovation and Research (EIR) program, which is $235,000,000
above the fiscal year 2027 budget request and the same as the
fiscal year 2026 enacted level. This program makes competitive
grants to support the replication and scaling-up of evidence-
based education innovations.
Social and Emotional Learning.--Within the total for EIR,
the Committee provides $87,000,000 to provide grants for Social
and Emotional Learning (SEL). To fulfill the set-aside, the
Committee supports the prioritization of high-quality SEL
proposals for both the early- and mid-phase evidence tiers. No
later than 60 days after enactment of this Act, the Department
is directed to have an initial consultation briefing with the
Committees on plans to expend the fiscal year 2027 EIR funding.
Not less than two weeks before the publication of a notice of
proposed priorities or a notice inviting applications, the
Department is directed to brief the Committees on plans for
carrying out an EIR competition. In addition, the Department
shall provide a briefing and notice of grant awards to the
Committees at least seven days before grantees are announced.
STEM.--Within the total of EIR, the agreement includes
$87,000,000 for Science, Technology, Education, and Math and
computer science education activities.
Office of English Language Acquisition
ENGLISH LANGUAGE ACQUISITION
Appropriation, fiscal year 2026....................... $890,000,000
Budget request, fiscal year 2027...................... - - -
Committee Recommendation.............................. - - -
Change from enacted level......................... -890,000,000
Change from budget request........................ - - -
The Committee does not provide funding for these formula
and competitive grants.
Office of Special Education and Rehabilitative Services
SPECIAL EDUCATION
Appropriation, fiscal year 2026....................... $15,490,264,000
Budget request, fiscal year 2027...................... 16,028,819,000
Committee Recommendation.............................. 15,536,264,000
Change from enacted level......................... +46,000,000
Change from budget request........................ -492,555,000
These grants help States and localities pay for a free,
appropriate education for students with disabilities aged 3
through 21.
Individuals with Disabilities Education Act.--The Committee
recognizes the central importance of the Individuals with
Disabilities Education Act for the well-being of American
schools and youth. The Committee recommends robust funding for
this critical program in order to ensure necessary
opportunities and support for all students.
Self-Contained Classrooms.--The Committee is concerned
about reported high level of abuse occurring to students with
significant disabilities or intensive needs occurring in self-
contained classrooms. Using existing school safety and security
grants, the Committee urges the Department of Education to
address reports of abuse occurring in these classroom settings.
Special Education in Guam.--The Committee is aware that
special education services provided in Guam may not be fully
meeting the needs of students with special needs in the
Territory of Guam. The Committee is concerned that special
education program gaps in Guam may negatively impact access and
quality of educational services provided to students with
special needs. The Committee directs the Office of Special
Education and Rehabilitative Services to provide a briefing to
Congress on special education service gaps in Guam no later
than 180 days after the enactment of this Act.
Grants to States
The Committee provides $14,268,704,000 for Part B Grants to
States, which is $1,132,115,000 below the fiscal year 2027
budget request and an increase of $35,000,000 from the fiscal
year 2026 enacted level.
The Committee includes a $25,000,000 increase for Part B
Grants to States. In addition, the Committee accepts and
includes the budget request for funding of $10,000,000 and
legislative language to allow the Department to provide
technical assistance to States related to paperwork reduction
challenges and opportunities, including support for States
interested in pursuing the Paperwork Reduction Pilot waiver
authority.
This program provides formula grants to assist States in
meeting the costs of providing special education and related
services to children with disabilities. States generally
transfer most of the funds to LEAs; however, they can reserve
some funds for program monitoring, technical assistance, and
other related activities. To be eligible for funds, States must
make free appropriate public education available to all
children with disabilities.
The Committee recognizes the central importance of the
Individuals with Disabilities Education Act programs for the
well-being of American schools and youth. This program supports
the most vulnerable students, families, teachers, and schools.
The Committee continues to fund this critical program to ensure
necessary opportunities and support for students.
Preschool Grants
The Committee provides $420,000,000 for Preschool Grants,
which is $420,000,000 above the fiscal year 2027 budget request
and the same as the fiscal year 2026 enacted level.
These funds provide additional assistance to States to help
them make free, appropriate public education available to
children with disabilities aged 3 through 5.
Grants for Infants and Toddlers with Disabilities (Part C)
The Committee provides $550,000,000 for Grants for Infants
and Toddlers with Disabilities, which is $10,000,000 above the
fiscal year 2026 enacted level.
These funds provide additional assistance to States to help
them make free, appropriate public education available to
children with disabilities from birth through age 2. The
Committee continues bill language to promote the continuity of
services for eligible infants and their families.
IDEA National Activities
The Committee provides $258,560,000 for IDEA National
Activities, which is $258,560,000 more than the fiscal year
2027 budget request and consistent with the fiscal year 2026
enacted level.
The IDEA National Activities programs support State efforts
to improve early intervention and education results for
children with disabilities.
State Personnel Development.--The Committee provides
$38,630,000 for State Personnel Development, which is
$38,630,000 above the fiscal year 2027 budget request and the
same as the fiscal year 2026 enacted level. This program
supports grants to States to assist with improving personnel
preparation and professional development related to early
intervention and educational and transition services that
improve outcomes for students with disabilities.
Technical Assistance and Dissemination.--The Committee
provides $39,345,000 for Technical Assistance and
Dissemination, which is $39,345,000 above the fiscal year 2027
budget request and the same as the fiscal year 2026 enacted
level. Funding supports technical assistance, demonstration
projects, and information dissemination.
This program is essential to sustaining the specialized,
low-incidence infrastructure needed to effectively serve
children who are deafblind. As such, the Committee recognizes
that continued, dedicated investment in IDEA National
Activities programs is critical to the delivery of highly
specialized expertise to improve education results for children
with disabilities.
Personnel Preparation.--The Committee provides $115,000,000
for Personnel Preparation, which is $115,000,000 above the
fiscal year 2027 budget request and the same as the fiscal year
2026 enacted level. This program supports competitive grants to
help address State-identified needs for qualified personnel to
work with children with disabilities, and to ensure that those
personnel have the necessary skills and knowledge to serve
children with special needs. Awards focus on addressing the
need for leadership and personnel to serve low-incidence
populations.
Parent Information Centers.--The Committee provides
$33,152,000 for Parent Information Centers, which is
$33,152,000 above the fiscal year 2027 budget request and the
same as the fiscal year 2026 enacted level. This program makes
awards for parent organizations to support Parent Training and
Information Centers, including community parent resource
centers. These centers provide training and information to meet
the needs of parents of children with disabilities living in
the areas served by the centers, particularly underserved
parents and parents of children who may be inappropriately
identified. Technical assistance is also provided under this
program for developing, assisting, and coordinating centers
receiving assistance under this program.
Educational Technology, Media, and Materials.--The
Committee recommends $32,433,000, which is $32,433,000 above
the fiscal year 2027 budget request and the same as the fiscal
year 2026 enacted level, for the Educational Technology, Media
and Materials program. This program makes competitive awards to
support the development, demonstration, and use of technology
and educational media activities of value to children with
disabilities.
Special Olympics Education Programs
The Committee provides $39,000,000 for Special Olympics
Education Programs, which is an increase of $1,000,000 from the
fiscal year 2027 budget request and fiscal year 2026 enacted
level, to support activities authorized by the Special Olympics
Sport and Empowerment Act.
This funding supports efforts to expand Special Olympics
programs and the design and implementation of Special Olympics
education programs that can be integrated into classroom
instruction and are consistent with academic content standards.
REHABILITATION SERVICES
Appropriation, fiscal year 2026....................... $4,648,295,000
Budget request, fiscal year 2027...................... 4,679,024,000
Committee Recommendation.............................. 4,772,906,000
Change from enacted level......................... +124,611,000
Change from budget request........................ +93,882,000
The programs in this account are authorized by the
Rehabilitation Act of 1973 and the Helen Keller National Center
Act.
Vocational Rehabilitation State Grants
This program supports vocational rehabilitation services
through formula grants to States. These grants support a wide
range of services designed to help persons with physical and
mental disabilities prepare for and engage in gainful
employment to the extent of their capabilities. Emphasis is
placed on providing vocational rehabilitation services to
persons with the most significant disabilities.
Randolph-Sheppard Program.--The Committee encourages the
Department to provide participants in the Randolph-Sheppard
program with technical assistance and support in applying for
funding opportunities available under the Office of Special
Education and Rehabilitative Services. In the fiscal year 2028
congressional justification, the Committee requests an update
on such efforts from fiscal year 2026 and planned efforts in
fiscal years 2027 and 2028.
Client Assistance State Grants
The Committee provides $13,000,000 for Client Assistance
State Grants, which is $13,000,000 above the fiscal year 2027
budget request and the same as the fiscal year 2026 enacted
level.
Client Assistance State Grants support services for
eligible individuals and applicants of the vocational
rehabilitation State Grants program, and other programs,
projects, and services funded under the Rehabilitation Act.
These formula grants are used to help persons with disabilities
overcome problems with the service delivery system and improve
their understanding of services available to them under the
Rehabilitation Act.
Training
The Committee provides $29,388,000 for the Training
program, which is $29,388,000 above the fiscal year 2027 budget
request and the same as the fiscal year 2026 enacted level.
The program supports long-term and short-term training, in-
service personnel training, and training of interpreters for
deaf persons. Projects in a broad array of disciplines are
funded to ensure that skilled personnel are available to serve
the vocational needs of persons with disabilities.
Demonstration and Training Programs
The Committee provides $5,796,000 for Demonstration and
Training Programs, which is $5,796,000 above the fiscal year
2027 budget request and the same as the fiscal year 2026
enacted level.
These programs authorize competitive grants to public and
private organizations to support demonstrations, direct
services, and related activities for persons with disabilities.
Protection and Advocacy of Individual Rights
The Committee provides $21,150,000 for Protection and
Advocacy of Individual Rights, which is $21,150,000 above the
fiscal year 2027 budget request and $1,000,000 above the same
as the fiscal year 2026 enacted level.
Grants are awarded to entities that have the authority to
pursue legal, administrative, and other appropriate remedies to
protect and advocate for the rights of persons with
disabilities.
Supported Employment State Grants
The Committee provides $22,548,000 for Supported Employment
State Grants, which is $22,548,000 above the fiscal year 2027
budget request and the same as the fiscal year 2026 enacted
level.
These formula grants assist States in developing
collaborative programs with public agencies and nonprofit
agencies for training and post-employment services leading to
supported employment. In supported employment programs, persons
with the most significant disabilities are given special
supervision and assistance to enable them to work in integrated
settings.
Services for Older Blind Individuals
The Committee provides $33,317,000 for Services for Older
Blind Individuals, which is consistent with the fiscal year
2027 budget request and the same as the fiscal year 2026
enacted level.
Funds are distributed to States according to a formula
based on the population of individuals who are 55 or older and
provide support for services to persons 55 years old or over
whose severe visual impairment makes gainful employment
extremely difficult to obtain, but for whom independent living
goals are feasible.
Helen Keller National Center
The Committee provides $22,000,000 for the Helen Keller
National Center for DeafBlind Youth and Adults, which is
$2,000,000 above the fiscal year 2027 budget request and the
fiscal year 2026 enacted level. These funds will be used to
further expand technical assistance for professionals serving
deafblind youth and support state vocational rehabilitation
agencies and rehabilitation providers.
The Committee recognizes the need to ensure delivery of
high-quality special education and related services to children
and youth who are blind or visually impaired, deaf, hard of
hearing, deaf disabled, or deafblind through specialized
instructional services and methodologies designed to meet their
unique language and learning needs. The Committee also
recognizes the need to support the development of personnel
serving children and youth who are blind or visually impaired,
deaf, hard of hearing, deaf disabled, or deafblind. The
Committee includes $1,000,000 for grants to provide support to
eligible deafblind schools, or other applicable entities, to
expand the capacity to work with medically complex students.
SPECIAL INSTITUTIONS FOR PERSONS WITH DISABILITIES
Appropriation, fiscal year 2026....................... $303,292,000
Budget request, fiscal year 2027...................... 303,292,000
Committee Recommendation.............................. 312,292,000
Change from enacted level......................... +9,000,000
Change from budget request........................ +9,000,000
AMERICAN PRINTING HOUSE FOR THE BLIND
Appropriation, fiscal year 2026....................... $43,431,000
Budget request, fiscal year 2027...................... 43,431,000
Committee Recommendation.............................. 46,431,000
Change from enacted level......................... +3,000,000
Change from budget request........................ +3,000,000
This funding supports the production of educational
materials for legally blind persons enrolled in pre-college
programs. The American Printing House for the Blind (APH),
which is chartered by the Commonwealth of Kentucky,
manufactures and maintains an inventory of educational
materials in accessible formats that are distributed free of
charge to schools and States based on the number of blind
students in each State. The APH also conducts research and
field activities to inform educators about the availability of
materials and how to use them.
The Committee provides $46,431,000 for continued support
and development of assistive technology products and
educational materials for students who are blind or visually
impaired. Within amounts provided for APH, the Committee
includes up to $10,000,000 to support production and
distribution of an innovative braille and tactile display
product developed by the Printing House and its partners.
Center for Assistive Technology Training.--Within the
amounts provided for APH, the Committee includes up to
$8,000,000 for the Center for Assistive Technology Training,
including regional partnerships to provide instruction and
technical assistance throughout the United States. The
Committee believes training on a national level is essential to
ensure teachers and families have the resources necessary to
fully utilize APH products and technologies. Of the amounts
provided, the Committee recommendation includes no less than
$4,000,000 for regional partnerships, of which the Committee
believes funding should be based on the proportion of States
served by the regional partner.
Monarch.--Within amounts provided for APH, the Committee
includes up to $7,000,000, an increase of $1,000,000 over
fiscal year 2026 enacted, to support production and
distribution of an innovative braille and tactile display
product developed by APH and its partners.
NATIONAL TECHNICAL INSTITUTE FOR THE DEAF
Appropriation, fiscal year 2026....................... $92,500,000
Budget request, fiscal year 2027...................... 92,500,000
Committee Recommendation.............................. 95,500,000
Change from enacted level......................... +3,000,000
Change from budget request........................ +3,000,000
Congress established the National Technical Institute for
the Deaf (Institute) in 1965 to provide a residential facility
for postsecondary technical training and education for deaf
persons with the purpose of promoting the employment of these
individuals. The Institute also conducts applied research and
provides training related to various aspects of deafness. The
Secretary of Education administers these activities through a
contract with the Rochester Institute of Technology in
Rochester, New York. The Committee provides $95,500,000 for the
Institute, an increase of $3,000,000 from fiscal year 2026
enacted.
Regional STEM Center.--The Committee includes up to
$9,500,000, which is equal to the fiscal year 2026 enacted
level, to continue NTID's current Regional STEM Center
partnership. The STEM Center program expands NTID's
geographical reach and improves access to postsecondary STEM
education and employment for students who are deaf or hard of
hearing in underserved areas. This has included professional
development for teachers, developing relationships with
business and industry to promote employment opportunities, and
preparing students to be successful in STEM fields.
GALLAUDET UNIVERSITY
Appropriation, fiscal year 2026....................... $167,361,000
Budget request, fiscal year 2027...................... 167,361,000
Committee Recommendation.............................. 170,361,000
Change from enacted level......................... +3,000,000
Change from budget request........................ +3,000,000
Gallaudet University is a private, nonprofit educational
institution Federally chartered in 1864 providing elementary,
secondary, undergraduate, and continuing education for deaf
persons. In addition, the University offers graduate programs
in fields related to deafness for deaf and hearing students,
conducts research on deafness, and provides public service
programs for deaf persons.
Early Learning Acquisition Project (ELAP).--The Committee
includes $8,500,000, which is equal to the fiscal year 2026
enacted level, to continue the national expansion of ELAP
through the Gallaudet University regional centers, of which the
current partner is a regional center. ELAP supports early
language acquisition for children from birth through age three
who are deaf or hard of hearing. This program also supports
activities to improve early language acquisition training for
early educators, caretakers, and other professionals and allows
Gallaudet to expand and build on its current research in this
area, and test and evaluate interventions in diverse geographic
areas.
Office of Career, Technical, and Adult Education
CAREER, TECHNICAL, AND ADULT EDUCATION
Appropriation, fiscal year 2026....................... $2,181,436,000
Budget request, fiscal year 2027...................... 1,450,000,000
Committee Recommendation.............................. 1,460,000,000
Change from enacted level......................... -721,436,000
Change from budget request........................ +10,000,000
This account includes vocational education programs
authorized by the Carl D. Perkins Career and Technical
Education Act of 2006, as recently reauthorized by the
Strengthening Career and Technical Education for the 21st
Century Act, and the Adult Education and Family Literacy Act.
The Committee supports skilled workforce education in
schools and recognizes what it brings to America's skilled
professions through educating a new generation of pride,
progress, and professionals.
The Committee notes Congress' intent for Perkins funding to
provide career and technical education for the ``middle
grades,'' which may include 5th and 6th graders in some States.
Where applicable, the Committee supports efforts to limit
barriers of Federal support not reaching all eligible
populations.
Career and Technical Education and Workforce Demands.--The
Committee recognizes the potential of career and technical
education in preparing children and adults for a wide range of
high-wage, high-skill, and high-demand careers. However,
current CTE curriculum has left gaps in adequately preparing
students for high-skill and high-wage employment, as well as
sufficiently addressing the needs of the workforce. Therefore,
the Committee directs the Department, in conjunction with the
Department of Labor, to conduct a review of existing CTE
programs funded by the Department of Education and issue a
report on the gaps these programs and the needs of the
workforce. The report shall be submitted no more than one year
after the enactment of this Act and made available on the
agency's website.
Dual Enrollment Pathways.--The Committee continues to urge
the Department, in coordination with local education agencies
and institutions of higher education, to expand dual enrollment
pathways for technical work, such as welding and shop class,
and encourages the Secretary to offer additional technical
assistance to schools to support this use.
Energy Workforce Pathways.--The Committee recognizes that a
highly skilled domestic energy workforce is essential to
supporting America's energy reliability, economic
competitiveness, and critical infrastructure resilience.
Accordingly, the Committee supports efforts to strengthen
workforce pathways that prepare students and workers for
careers in the energy sector, including through career and
technical education (CTE) programs aligned with industry
workforce needs. The Committee encourages the Department to
support the adoption and implementation of the energy and
natural resources (ENR) career cluster within state and local
CTE frameworks in order to expand awareness of, and access to,
high-skill, high-wage career opportunities in the energy
sector. The Committee further recognizes the importance of
developing a skilled workforce pipeline to address current and
emerging workforce shortages across critical energy industries.
Accordingly, no later than 180 days after enactment of this
Act, the Department is directed to brief the Committees on
Appropriations on efforts to support the ENR career cluster
within State and local CTE frameworks.
Skill-Aligned Instruction.--The Committee recognizes that
excellence in high school level career and technical programs
is predicated on middle school career and technical programs
that are flexible and achievable in all schools and for all
skill levels, and that foundational career and technical
programs can be achieved with programs such as cardboard model
building with high quality instructors.
Career and Technical Education: State Grants
The Committee provides $1,449,848,000 for Career and
Technical Education (CTE) State Grants, which is an increase of
$10,000,000 from the fiscal year 2026 enacted level.
State Grants support a variety of career and technical
education programs developed in accordance with a State's
submitted plan. This program focuses Federal resources on
institutions with high concentrations of low-income students.
The populations assisted by State Grants range from secondary
students in prevocational courses to adults who need retraining
to adapt to changing technological and labor markets.
Career and Technical Education: National Programs
The Committee provides $10,152,000 for National Programs,
which is the same as the fiscal year 2027 budget request and a
decrease of $2,269,000 from the fiscal year 2026 enacted level.
This program supports the conduct and dissemination of research
in career and technical education.
Adult Education State Grants
The Committee does not provide funding for Adult Basic and
Literacy Education State Grants, which is the same as the
fiscal year 2027 budget request and $715,455,000 below the
fiscal year 2026 enacted level.
Adult Education National Leadership Activities
The Committee does not provide funding for National
Leadership Activities, which is the same as the fiscal year
2027 budget request and $13,712,000 below the fiscal year 2026
enacted level. This program supports applied research,
development, dissemination, evaluation, and program improvement
efforts to strengthen the quality of adult education services.
Office of Federal Student Aid (FSA)
90/10 Rule.--The 90/10 rule under the HEA requires
proprietary institutions of higher education to derive at least
10 percent of their tuition and fee revenue from non-Title IV
sources. An October 2022 rule included other Federal education
assistance funds from other Federal agencies, not just Title IV
funds, as required by P.L. 117-2. The rule was effective July
1, 2023, for institutional fiscal years that begin on or after
January 1, 2023. The Committee is aware of concerns regarding
the timing of compliance, as well as that the rule penalizes
institutions for utilizing distance learning, given the rule's
requirement in the preamble that institutions cannot count as
non-Federal revenue the funds they receive from distance
learning programs that are ineligible for Title IV funds, for
purposes of calculating 90/10 compliance. The Committee notes
that on July 7, 2025, the Department issued an interpretive
rule, ``Classification of Revenue Under Title IV,'' published
in the Federal Register on July 7, 2025, stating that this
preamble language is non-binding, because the Department did
not incorporate it through changes to the regulatory text. The
Committee continues to encourage the Department to provide
clear communication and information on these regulations, given
the rule's complexities and impact on students and proprietary
institutions.
Certificate Programs.--The Committee understands that
certificate programs are a valuable way that students can gain
skills to advance in the workforce or launch into a career. The
Committee understands the Department, following a negotiated
rulemaking process, has proposed regulations to implement an
updated accountability framework that includes a new earnings
premium measure. The Committee is aware of concerns about the
proposed rule's potential impacts on certain certificate
programs, given the career and earnings trajectory of students
who enroll in such programs. Such concerns include that the
regulations' earnings standard does not include occupation-
specific earnings adjustments or allow for additional earnings
evidence.
College Scorecard.--The Committee applauds efforts by the
Administration to help consumers better understand the short-
and long-term financial outcomes of attaining higher education
degrees. Enhanced transparency is essential for making both
sound economic and policy decisions, and while the Department's
College Scorecard is a positive step towards this aim, this
resource needs further refinement before it can serve as
intended. The Committee encourages the Department to engage
with stakeholders, including health care education
organizations, to ensure cost data is comprehensive and
collected from institutions in a manner that minimizes
administrative burden to the extent possible.
Federal Financial Aid Fraud.--The Committee remains
concerned about fraud occurring within Federal financial aid
programs, including identify fraud. The Committee notes that
such exploitation of taxpayer-funded education programs may
disproportionately affect low-income students' ability to
enroll, due to fraudsters taking limited class spots, as well
as divert resources that would otherwise be available to
students with demonstrated financial need. The Committee
commends the Department's efforts to address this problem and
protect Federal investments in student financial aid, given
that the Department oversees $131 billion in financial aid
through grants and loans annually. In December 2025, the
Department announced it had successfully prevented $1 billion
in Federal financial aid fraud, including attempted fraud by
artificial intelligence bots posing as students and
international fraud rings, following implementation of
additional fraud control measures such as identity verification
for certain first-time student applicants. The Committee
requests an update in the fiscal year 2028 congressional
justification on the Department's efforts to identify, prevent,
and dismantle coordinated financial aid fraud rings. The
Department of Education's Office of Inspector General reported
in December 2024 that fraud rings accounted for a substantial
share of the identify theft and ineligible student cases it
closed between 2019 and 2024. Additionally, the Committee urges
the Department to continue developing and implementing
solutions, in coordination with institutions of higher
education, that enhance the ability of the Department and IHEs
to identify and prevent financial aid fraud. The Committee
requests the Department provide an update on these efforts in
the fiscal year 2028 congressional justification. The Committee
also notes opportunities to provide periodic updates to the
Committees as part of any regularly scheduled briefings.
Gainful Employment.--The Committee notes that the prior
approach to higher education accountability treated
institutions of higher education differently based on their tax
status, as opposed to equal treatment of different types of
institutions. Additionally, the Committee notes strong concerns
with a 2023 gainful employment rule titled, ``Financial Value
Transparency and Gainful Employment'' (88 Fed. Reg. 70004),
particularly due its targeting of proprietary institutions and
the overly burdensome requirements it imposed on institutions.
The Committee notes the Department's ongoing regulatory
activities to implement the accountability provisions in the
Working Families Tax Cut Act (P.L. 119-21). Due to this
regulatory work, the Committee did not include a general
provision blocking funding for implementing or enforcing the
2023 rule that the Committee included in the in prior years.
Limited Distance Education for Foreign Institutions.--The
Committee is aware that the HEA does not allow programs of
study offered at foreign institutions of higher education to
participate in Title IV loans if they are taught in whole or in
part using telecommunications. The Committee notes that
international education opportunities provide students with
global awareness and diplomatic skillsets they can bring back
to the U.S. after their studies. Due to recent innovations in
blended learning, domestic and foreign institutions have been
increasingly incorporating online components into their
programs. The Committee is aware of interest in permitting a
limited share of a program at a foreign institution to be
taught online, if students are present in the country where the
school is located.
Nursing and Other Health Care Professionals.--The Committee
understands the role of health care professionals, including
nurses, with postbaccalaureate degrees in the health care
system. Advanced practice registered nurses help foster and
expand health care access, particularly in rural and
underserved communities where healthcare worker shortages are
acute. Post-baccalaureate nurses, including nursing faculty,
help educate future nurses. The Committee is aware of concerns
about potential effects of some parts of the final rule issued
May 1, 2026, ``Reimagining and Improving Student Education''
(91 FR 23768) on the pipeline of certain health care
professionals, including nurses, whose roles require advanced
degrees. Certain health care programs do not meet the rule's
definition of a professional degree program, for purposes of
determining borrowing limits under title IV of the HEA. They
will be considered graduate programs and subject to borrowing
limits of $20,500 annually and $100,000 in the aggregate,
compared to annual and aggregate limits of $50,000 and
$200,000, respectively, for professional programs. The
Department convened a negotiated rulemaking committee in fall
2025 that reached consensus on this and the other parts of the
rule, before issuing a proposed rule and seeking public
comment. The final rule includes discussion of public comments
urging the Department to include certain health care programs
including graduate level nursing within the professional degree
definition. Commenters explained that some of these programs
are at the doctoral level, require substantial clinical
preparation, contain the academic requirements necessary for an
individual to begin practice in a distinct profession, and
require licensure, among other factors.
Professional Fields.--The Committee recognizes the
importance of maintaining strong, affordable pathways for
students preparing to enter a wide range of careers, including
professional fields. The Committee is interested in
understanding the effects of the Department's Reimagining and
Improving Student Education regulation on such pathways and
program costs. The Committee directs the Department to provide
a report to the Committees within 12 months following the
completion of the 2027-2028 academic year, on the
implementation of the regulation and effects on programs and
professions not designated as ``professional.'' The report
should include an analysis of recent trends in enrollment,
prices, and borrowing among programs most affected by changes
in loan limits. The Department may include, as appropriate, any
observations or considerations regarding the designation of
professional programs based on the nature of the training,
regulatory requirements, costs, and workforce needs.
Theology and Religious Vocations.--The Committee
understands concerns that part of the proposed rule,
``Accountability in Higher Education and Access through Demand-
Driven Workforce Pell: Student Tuition and Transparency System
(STATS) and Earnings Accountability'' (91 FR 21088), issued on
April 20, 2026, could impact future eligibility of Federal
financial assistance for students pursuing theological and
religious vocation programs. Theology and related religious
vocations program risk becoming ineligible for Federal loans
under the proposed rule if their graduates' earnings do not
meet the proposed rule's earnings standard, and concerns
include that institutions might have to discontinue such
programs as a result. The Committee understands the importance
of promoting accountability in higher education and a good
return on investment for students and taxpayers. The Committee
still emphasizes the concerns about the potential impact to
students in theology and other religious vocation program, with
the knowledge that some such programs require individuals to
engage in extensive education to be able to serve in their
chosen profession, even if the profession have more modest
income potential. The Department's assessment in the proposed
rule also indicates that religiously affiliated institutions
are among those that are likely to be most negatively affected.
The Committee urges the Department to consider public comments
related to these issues to inform this rulemaking process.
STUDENT FINANCIAL ASSISTANCE
Appropriation, fiscal year 2026....................... $24,615,352,000
Budget request, fiscal year 2027...................... 33,146,352,000
Committee Recommendation.............................. 24,179,352,000
Change from enacted level......................... -436,000,000
Change from budget request........................ -8,967,000,000
Pell Grants
The Committee provides $22,725,352,000 in discretionary
funding for the Pell Grant program, which is an increase of
$250,000,000 from the fiscal year 2026 enacted level. These
funds will support Pell Grants to students for the 2027-2028
award year.
The Committee recommendation includes $6,385 for the
discretionary portion of the maximum Pell Grant award, which is
an increase of $50 from the fiscal year 2026 enacted level.
Combined with mandatory funding under current law, this would
support a total maximum award of $7,445 for the 2027-2028 award
year.
The Pell Grant program forms the foundation of Federal
postsecondary student aid programs, providing need-based
financial assistance for lower-income students and increasing
their access to educational and economic opportunities. The
program is funded by discretionary appropriations and mandatory
funding and affords benefits to all students who meet
eligibility requirements. As a result, program costs vary year
to year, driven by the statutory maximum award; the volume of
students applying; eligibility criteria; and the size of
students' grants determined by statutory formula that considers
factors such as income, assets, household size, cost of
attendance, and full-time or part-time enrollment status.
The Committee is aware that college enrollment has been
recovering from declines during the pandemic, especially at
community colleges. The fiscal year 2027 budget request's
Analytical Perspectives notes that due to factors such as
enrollment increases and statutory changes in Pell eligibility
that took effect in recent years, there are approximately
300,000 more Pell recipients as of the 2025-2026 award year
than the year prior. Pell program costs have increased
substantially, and the Committee understands the program is
projected to have a budgetary shortfall in fiscal year 2027
under current law. To ensure the Pell Grant program can
continue to support students' access to higher education, the
Committee has included a provision to end authority to make
Federal subsidized loans, consistent with provisions in H.R. 1
as passed by the House of Representatives in May 2025. The
provision includes an exception for students who have already
enrolled in a program of study and taken out a loan for the
program, during the time they are expected to earn a
credential. Unsubsidized loans remain available for borrowers
to utilize to help finance their education, within existing
statutory borrowing limits. Additionally, the Committee
includes bill language to reinvest the budgetary savings from
this provision into the Pell Grant program. In incorporating
these provisions, the Committee is prioritizing the
preservation of the Pell Grant program, which afford grants to
students that do not have to be repaid, and which constitutes
the very foundation of Federal financial aid to students.
Combined with the increase in the discretionary maximum award,
these policies aim to sustain and strengthen Pell Grant program
support for students in the 2027-2028 award year.
Federal Supplemental Educational Opportunity Grants
The Federal Supplemental Educational Opportunity Grant
(FSEOG) program provides need-based grant aid to eligible
undergraduate students to help reduce financial barriers to
postsecondary education. Federal funding allocations are
awarded to qualifying postsecondary institutions under a
statutory formula. The Committee recommendation includes
$546,000,000 for FSEOG, which is a $364,000,000 decrease from
the fiscal year 2026 enacted level. Given limited Federal
resources, the Committee prioritizes funding for other
assistance to students, primarily through the Pell Grant
program which is the foundation of Federal student aid and
directly supports students by following them to the institution
of their choosing. The Committee is aware of concerns that the
SEOG program's statutory formula allocates funding in part
based on an institution's historical participation in the
program and therefore does not ensure grant aid goes to
institutions with the largest shares of students with financial
need.
Federal Work-Study
The Federal Work-Study (FWS) program provides funds for
part-time employment to help low-income students to finance the
costs of postsecondary education. Students can receive FWS
funds at approximately 3,400 participating postsecondary
institutions. The Committee recommendation includes
$908,000,000 for this program, which is $322,000,000 below the
fiscal year 2026 enacted level.
The Committee encourages the Department to continue support
in fiscal year 2026 for the Work Colleges program authorized
under section 448 of the HEA.
The Committee notes concerns that the formula governing the
FWS program has become outdated, and therefore the program has
not been able to keep pace with the changing higher education
landscape. As such, the formula does not ensure program funding
is targeted to institutions that serve the greatest share of
students with financial need, such as those with higher shares
of students who receive Pell Grants. The Committee is aware of
prior legislative efforts to modernize the program.
Additionally, the Committee encourages timely responsiveness by
the Department to future requests regarding potential options
related to this program.
STUDENT AID ADMINISTRATION
Appropriation, fiscal year 2026....................... $2,058,943,000
Budget request, fiscal year 2027...................... 2,058,943,000
Committee Recommendation.............................. 2,058,943,000
Change from enacted level......................... - - -
Change from budget request........................ - - -
Programs administered under the Student Aid Administration
(SAA) include Pell Grants, campus-based aid programs, Teacher
Education Assistance for College and Higher Education grants,
and Federal student loan programs.
Salaries and Expenses
Within the total provided for SAA, the Committee provides
$1,058,943,000 for salaries and expenses, which is the same as
the fiscal year 2026 enacted level.
Servicing Activities
Within the total provided for SAA, the Committee provides
$1,000,000,000 for Loan Servicing Activities, which is the same
as the fiscal year 2026 enacted level.
Free Application for Federal Student Aid (FAFSA).--The
Committee commends the Department for efforts to ensure the
2026-2027 FAFSA process launched successfully and was fully
functioning and on time. The Committee appreciates the
Department's regular communication with the Committee on
administration of the current FAFSA cycle as well as the
upcoming cycle, as relevant, and encourages the Department to
continue providing quarterly briefings on its administration of
the FAFSA.
Reprogramming of Funds.--Any reallocation of funds between
administrative costs and servicing activities within this
account should be treated as a reprogramming of funds, and the
Department is directed to notify the Committee in advance of
any such changes, pursuant to section 514 of this Act.
Return to Repayment.--The Committee commends the Department
for its efforts to support individuals with Federally held
student loans in returning to repayment status and its
commitment to responsibly steward the Federal loan portfolio.
The Committee is aware that many borrowers have begun to make
payments for the first time in several years. As the Department
undertakes this important work the Committee directs the
Department to continue providing monthly briefings to the
Committees and to the Committees on Education and Workforce of
the House of Representatives and Health, Education, Labor, and
Pensions of the Senate, on progress related to Federal student
loan servicing and repayment. In such briefings, the Department
is encouraged to continue providing information that includes
but is not limited to the repayment status of the Federal loan
portfolio and communications with borrowers.
Spend Plans.--The Committee directs the Department to
provide a detailed spend plan of the planned uses of funds in
this account for fiscal year 2027, within 45 days of enactment
of this Act, and to provide quarterly updates on this plan no
later than 10 days prior to the start of such quarter. This
shall include contracts awarded, change orders, bonuses paid to
staff, reorganization costs, and any other activity carried out
using amounts provided under this heading for fiscal year 2027.
The Department is urged to provide a comparison to the prior
fiscal year in such spend plan, as well as include a narrative
description of planned activities and any notable comparisons
to the prior fiscal year. Such spend plan should include
details of major activities, including the Unified Servicing
and Data Solution and initiatives related to implementation of
recently enacted legislation, as applicable.
Office of Postsecondary Education
HIGHER EDUCATION
Appropriation, fiscal year 2026....................... $3,265,598,000
Budget request, fiscal year 2027...................... 610,116,000
Committee Recommendation.............................. 2,855,010,000
Change from enacted level......................... -410,588,000
Change from budget request........................ +2,244,894,000
Critical Minerals Education.--The Committee notes that
research and workforce training in the critical minerals sector
is important for ensuring a stable, secure, and resilient
supply chain that underpins modern technologies and national
defense systems. The Committee supports efforts among
institutions of higher education and private sector employers
to expand research, workforce development, and applied
technology development opportunities related to critical
minerals, including mineral processing, refining,
hydrometallurgy, and pyrometallurgy. The Committee supports an
increase of degrees and related workforce training in this
area.
State Authorization Reciprocity Agreements.--The Committee
notes that State Authorization Reciprocity Agreements (SARAs)
have served as efficient, effective, and uniform requirements
for postsecondary distance education. SARAs can expand
educational choice for students to adapt to a changing
professional landscape, enable institutions to provide
efficient and consistent distance education more broadly, and
reduce institutional costs and bureaucracy. The Committee
encourages the Department to continue supporting SARAs and
encourage their continued use and expansion.
Aid for Institutional Development
Strengthening Institutions
The Strengthening Institutions program under Part A of
title III of the HEA supports competitive grants for general
operating subsidies to institutions with below average
educational and general expenditures per student and
significant percentages of low-income students. Funds may be
used for faculty and academic program development, management,
joint use of libraries and laboratories, acquisition of
equipment, and student services.
The Committee provides $112,070,000 for the Strengthening
Institutions program, which is an increase of $10,000,000 from
the fiscal year 2026 enacted level.
The Committee commends the Department for its recognition
of this program's historical importance in building
institutional capacity at lower-resourced schools that serve a
disproportionate share of minority students. The Committee
further appreciates the Department's decision to include the
suite of authorized activities in the HEA as an absolute
priority in the fiscal year 2026 competition. This is
especially important given the enduring purpose of the
Strengthening Institutions Program, which is to improve the
academic quality, institutional management, and fiscal
stability of eligible institutions of higher education so that
they can become more self-sufficient and expand their
institutional capacity.
The Committee understands ongoing interest in advancing
specific policies such as artificial intelligence and career-
focused pathways and therefore has included funding under the
Fund for the Improvement of Postsecondary Education dedicated
to bolstering these targeted, priority areas.
Developing Hispanic-Serving Institutions
The Committee provides $231,637,000 for the Developing
Hispanic-Serving Institutions (HSI) program.
The Developing HSIs program provides operating subsidies to
schools that serve at least 25 percent Hispanic students. Funds
may be used for faculty and academic program development,
management, joint use of libraries and laboratories,
acquisition of equipment, and student services.
Hispanic-Serving Institutions.--The Committee recognizes
the important role that Hispanic-Serving Institutions (HSIs)
play in expanding access to higher education and supporting the
success of the nation's growing Hispanic student population,
including many who are first-generation, low-income, and from
rural communities. These institutions strengthen the nation's
workforce and the economic development of the communities they
serve. On December 2, 2025, the Department of Justice's Office
of Legal Counsel released a legal opinion analyzing the
constitutionality of the Department of Education's Minority
Serving Institution programs, including HSIs. The Committee
urges the Department to continue to evaluate the impact of this
legal opinion on affected programs. The Committee is concerned
that eligible institutions may not be fully aware of other
Federal funding opportunities to support their missions,
including the Strengthening Institutions Program. Therefore,
within 90 days of enactment of this Act, the Committee directs
the Department to produce a report identifying all Federal
funding opportunities available to HSIs across the Department,
including eligibility requirements and participation rates, as
well as recommendations to improve awareness and access. Such
report shall be made publicly available on the Department's
website.
Further, the Committee urges the Department to establish,
to the extent legally feasible, a targeted set-aside or
priority within the Strengthening Institutions Program for
institutions that typically serve communities with high
populations of Hispanic individuals. The Department is further
encouraged to focus on institutions that serve low-income,
rural, and high agricultural-producing counties with a proven
track-record of return on investment for low-income students.
Promoting Postbaccalaureate Opportunities for Hispanic Americans
The Committee provides $27,780,000 for the Promoting
Postbaccalaureate Opportunities for Hispanic Americans program,
the same as the fiscal year 2025 enacted level. This program
provides expanded postbaccalaureate educational opportunities
for the academic attainment of Hispanic and low-income
students. In addition, it expands academic offerings and
enhances program quality at IHEs educating the majority of
Hispanic college students.
The Committee encourages the Department to support awards
for projects that support consortiums of HSIs that award PhDs
to develop and test new models of cross-institutional
partnerships that facilitate mutually reinforcing activities,
such as resource-sharing learning communities, mentorship
programs for PhD students, graduate research experiences,
faculty mentor capacity-building, and other uses associated
with the pursuit and completion of PhDs by Hispanic students.
Strengthening Historically Black Colleges and Universities
The Committee provides $406,778,000 for Strengthening
Historically Black Colleges and Universities (HBCUs), which is
$1,000,000 more than the fiscal year 2026 enacted level. This
program provides operating subsidies to accredited HBCUs that
were established prior to 1964, with the principal mission of
educating Black Americans. Funds are distributed through a
formula grant based on the enrollment of Pell Grant recipients,
number of graduates, and the number of graduates entering
graduate or professional schools in which Black students are
underrepresented.
The Committee is aware that many students choose to pursue
their academic and career goals by enrolling in programs at
two-year HBCUs. These students may attain an associate's degree
or other certification and enter the workforce directly or
choose to transfer to complete a bachelor's degree at a four-
year IHE. The Committee recognizes the important role of two-
year HBCUs, given that community colleges can provide students
with opportunities to more quickly and affordably obtain the
learning and skills required for their chosen field. In support
of educational opportunities for students at these schools, the
Committee continues language providing supplemental awards to
junior or community colleges that are eligible under the
Historically Black Colleges and Universities program.
Reducing Recidivism.--The Committee supports the
Department's coordination and collaboration with institutions
of higher education, including Historically Black Colleges and
Universities, to provide educational programs for recently
released and soon to be released criminal offenders to assist
them in obtaining skills that will help them successfully
transition back into their communities and reduce recidivism
rates.
Strengthening Historically Black Graduate Institutions
The Committee provides $102,501,000 for the Strengthening
Historically Black Graduate Institutions program, which is the
same as the fiscal year 2025 enacted level. The program
provides five-year grants to postsecondary institutions that
are specified in section 326(e)(1) of the HEA. Institutions may
use funds to build endowments, provide scholarships and
fellowships, and to assist students with the enrollment and
completion of postbaccalaureate and professional degrees.
Strengthening Predominantly Black Institutions
The Committee provides $22,681,000 for the Strengthening
Predominantly Black Institutions (PBIs) program, which is the
same as the fiscal year 2025 enacted level. This program
provides grants to PBIs to increase their capacity to serve the
academic needs of students.
Strengthening Asian American and Native American
Pacific-Islander-Serving Institutions
The Committee provides $18,906,000 for the Strengthening
Asian American and Native American Pacific-Islander-Serving
Institutions program. This program provides grants to
undergraduate institutions that have an undergraduate student
enrollment of at least 10 percent Asian American or Native
American Pacific Islander.
Strengthening Alaska Native and Native Hawaiian-Serving
Institutions
The Committee provides $24,850,000 for the Strengthening
Alaska Native and Native Hawaiian-Serving Institutions program.
Through the Strengthening Alaska Native and Native Hawaiian-
Serving Institutions program, the Department provides grants to
assist institutions of higher education in serving Alaska
Native and Native Hawaiian students.
Strengthening Native American Serving Non-Tribal Institutions
The Committee provides $12,600,000 for the Native American
Serving Non-Tribal Institutions program, which is $1,000,000
more than the fiscal year 2026 enacted level. This program
makes grants to IHEs at which enrollment is at least 10 percent
Native American students and that are not Tribally Controlled
Colleges or Universities.
Strengthening Tribally Controlled Colleges and Universities
The Committee provides $57,807,000 for the Strengthening
Tribally Controlled Colleges and Universities (TCCUs) program,
which is $4,000,000 more than the fiscal year 2026 enacted
level. This program makes grants to TCCUs to increase their
capacity to serve the academic needs of students.
Strengthening HBCU Masters Program
The Committee provides $20,277,000 for the Strengthening
HBCU Masters Programs, which is the same as the fiscal year
2026 enacted level. This program provides grants to specified
colleges and universities making a substantial contribution to
graduate education opportunities at the Master's level in
mathematics, engineering, the physical or natural sciences,
computer science, information technology, nursing, allied
health, or other scientific disciplines.
International Education and Foreign Language Studies
Authorized by Title VI of the HEA, these programs include
National Resource Centers, foreign language and area studies
fellowships, undergraduate international studies and foreign
language programs, international research and studies projects,
business and international education projects, international
business education centers, language resource centers, American
overseas research centers, and technological innovation and
cooperation for foreign information access.
Domestic Programs
The Committee does not include funding for the Domestic
Programs of the International Education and Foreign Languages
Studies program. The Committee prioritizes limited resources
for other programs providing financial aid to students and aid
to institutions and supports efforts by States, localities, and
institutions of higher education to conduct the activities
supported by the Domestic Programs according to their policy
priorities.
Overseas Programs
The Committee does not include funding for the Overseas
Programs. The Committee prioritizes limited resources for other
programs providing financial aid to students and aid to
institutions and supports efforts by States, localities, and
institutions of higher education to conduct the activities
supported by the Overseas Programs according to their policy
priorities.
Model Comprehensive Transition and Postsecondary Programs for Students
with Intellectual Disabilities
The Committee provides $13,800,000 for the Model
Comprehensive Transition and Postsecondary Programs for
Students with Intellectual Disabilities (TPSID) program, which
is the same as the fiscal year 2026 enacted level. TPSID
supports grants to create model transition programs into
postsecondary education for students with intellectual
disabilities.
Minority Science and Engineering Improvement
The Committee provides $16,370,000 for the Minority Science
and Engineering Improvement Program. This program awards grants
to improve mathematics, science, and engineering programs at
institutions serving primarily minority students and to
increase the number of minority students who pursue advanced
degrees and careers in those fields.
Tribally Controlled Postsecondary Career and Technical
Institutions
The Committee provides $16,953,000 for the Tribally
Controlled Postsecondary Career and Technical Institutions
program, which is $3,000,000 more than the fiscal year 2026
enacted level. This program awards competitive grants to
Tribally controlled postsecondary career and technical
institutions to provide career and technical education to
Native American students.
Federal TRIO Programs
The Committee provides $1,197,000,000 for the Federal TRIO
programs, an increase of $6,000,000 above the fiscal year 2026
enacted level. TRIO provides a variety of outreach and support
services to encourage low-income, first-generation college
students and individuals with disabilities to enter and
complete college. Discretionary grants of up to four or five
years are awarded competitively to IHEs and other nonprofit
organizations. At least two thirds of the eligible participants
in TRIO must be low-income, first-generation college students.
The Department is directed to provide no less than the
fiscal year 2026 enacted levels for each TRIO Program: Talent
Search; Upward Bound, Upward Bound-Math-Science; Veterans
Upward Bound; Educational Opportunity Centers; Student Support
Services, the Ronald E. McNair Postbaccalaureate Achievement
Program and TRIO Training Grants. The Department is further
directed to take steps necessary to issue grant award
notifications for all TRIO programs (both new and non-competing
continuation award notices) no later than May 1, 2027.
The Committee underscores the longstanding, bipartisan
congressional support for the Federal TRIO programs and notes
there are concerns with the applications for the fiscal year
2026 Talent Search and Educational Opportunity programs,
released in March 2026. Particularly, such concerns are that
the applications' shift emphasis on apprenticeships and other
workforce development activities risks coming at the expense of
TRIO's core mission of fostering college access and success.
The Committee appreciates the Department's support for
workforce development and supports expanding such opportunities
for students and encourages the Department to examine other
programs through which to advance this goal. The applications
also indicate that fewer grants will be awarded in fiscal year
2026 than in the past, due to a new prioritization of State-
level applicants which are eligible for additional priority
points and a higher award amount. The Committee understands
State applicants may subgrant to other entities but is aware of
concerns about the potential impact on current grantees,
particularly smaller programs operating in rural areas. The
Committee urges the Department to account for such longstanding
programs and bipartisan congressional priorities when
implementing the TRIO programs.
Gaining Early Awareness and Readiness for Undergraduate
Programs
The Committee provides $394,000,000 for Gaining Early
Awareness and Readiness for Undergraduate Programs (GEAR UP),
an increase of $6,000,000 from the fiscal year 2026 enacted
level. GEAR UP provides grants to States and partnerships of
low-income middle and high schools, IHEs, and community
organizations to target entire grades of students and give them
the skills, encouragement, and scholarships to pursue
successfully postsecondary education.
The Committee continues bill language allowing the
Department to maintain the GEAR UP evaluation set aside at 1.5
percent to work with the GEAR UP community and grantees to
standardize data collection, including using third-party data
systems. The Committee urges the Department to carry out new
competitions for Partnership Grants and State Grants in fiscal
year 2027 and to announce Notices Inviting Applications for
such grant competitions in the Federal Register in a timely
manner.
Additionally, the Committee continues to direct the
Department to ensure that no request from a State Grant
applicant to receive an exception to the GEAR UP scholarship
(as described in section 404E(b)(2) of the HEA) shall be denied
based on 34 CFR 694.14(c)(3).
Graduate Assistance in Areas of National Need
The Committee does not provide funding for the Graduate
Assistance in Areas of National Need program. This program
funds fellowships for students pursuing a doctoral degree or
the highest degree in the field available at their institution,
and who are studying in areas considered to be of national
need. The Committee recommendation prioritizes other programs
providing support to students and recognizes that institutions
of higher education or non-Federal sources of postsecondary
funding are alternative sources of support for such graduate
fellowships. The Committee is concerned that the program
performance is not meeting its targets. The target completion
rate for fellows to finish their degree is only 65 percent, but
the actual completion rate in 2024 was 40 percent, down from 56
percent in 2023. Additionally, the program's cost per PhDs and
for students who pass preliminary exams far exceeded the target
of $68,0000 in 2023 and 2024, for which data is most recently
available.
Teacher Quality Partnership Grants
The Committee does not provide funding for the Teacher
Quality Partnerships program. The Committee notes this
program's purpose duplicates those of other Federal programs
related to teacher preparation and development. The Committee
recognizes that K-12 education is inherently local in nature.
States and districts are most knowledgeable regarding needs
related to teacher recruitment and development in local schools
and are therefore best positioned to make funding decisions for
such activities.
Child Care Access Means Parents in School
The Committee recommendation includes $75,000,000 for the
Child Care Access Means Parents in School (CCAMPIS) program,
which is the same as the fiscal year 2026 enacted level. This
program makes competitive grants to institutions of higher
education to support or establish a campus-based childcare
program primarily serving the needs of low-income students
enrolled at the institution.
Fund for the Improvement of Postsecondary Education
The Committee recommendation includes $89,000,000 for the
Fund for the Improvement of Postsecondary Education.
------------------------------------------------------------------------
Budget Activity FY 2026 Enacted FY 2027 Committee
------------------------------------------------------------------------
Basic Needs Grants................ $10,000,0000 $5,000,0000
Centers of Excellence for Veteran 9,000,0000 7,000,0000
Student Success Program..........
HBCU, TCU, and MSI Research and 15,000,0000 15,000,0000
Development Infrastructure Grants
Open Textbook Pilot............... 7,000,0000 - - -
Postsecondary Student Success 45,000,0000 45,000,0000
Grants...........................
Rural Postsecondary and Economic 45,000,0000 - - -
Development Grants...............
Transitioning Gang-Involved Youth 5,000,0000 2,000,0000
to Higher Education..............
Workforce Development and - - - 15,000,0000
Artificial Intelligence
Innovation Grants................
------------------------------------------------------------------------
Basic Needs Grants.--The Committee directs the Department
to continue to carry out this program as described in the
explanatory statement accompanying Division B of P.L. 119-75.
Postsecondary Student Success Grants.--The Committee
directs the Department to continue to carry out this program as
described in the explanatory statement accompanying Division B
of P.L. 119-75.
Transfer of Funds.--Any reallocation of funds within the
programs listed under Fund for the Improvement of Postsecondary
Education is a transfer of funds, and the Department is
directed to notify the Committee in advance of any such
changes, pursuant to section 302 of this Act.
Workforce Readiness and Artificial Intelligence Innovation
Grants.--The Committee includes $15,000,000 for grants to
support projects that advance the Department's priority areas
of supporting career pathways and workforce readiness and
advancing artificial intelligence in education. These
priorities are outlined in ``Final Priority and Definitions--
Secretary's Supplemental Priority and Definitions on Career
Pathways and Workforce Readiness,'' published in the Federal
Register on April 13, 2026 (91 FR 18780) and in ``Final
Priority and Definitions--Secretary's Supplemental Priority and
Definitions on Advancing Artificial Intelligence in
Education,'' published on April 13, 2026 (91 FR 18774). The
Committee notes the benefits to individuals and the economy of
supporting innovative education and training pathways that
prepare students for careers in high-demand areas and connect
them to jobs upon completion. Given the increasing prevalence
of AI and related technologies across sectors of the U.S.
economy, the Committee also notes the importance of supporting
student literacy in, and knowledge of, AI and computer science
concepts and skills.
Augustus F. Hawkins Centers of Excellence
The Committee continues to include $15,000,000 for the
Hawkins Centers of Excellence program. The Hawkins program is
intended to support teacher education programs at Minority
Serving Institutions, Historically Black Colleges or
Universities, Historically Black Graduate Institutions,
Hispanic-Serving Institutions, Tribally Controlled Colleges,
Alaska Native-Serving Institutions, Native Hawaiian-Serving
Institutions, Predominantly Black Institutions, Asian American
and Native American Pacific Islander-Serving Institutions, and
Native American-Serving Nontribal Institutions. The program
provides competitive grants for up to five years for IHEs to
improve or expand their teacher education programs through the
establishment of centers of excellence.
HOWARD UNIVERSITY
Appropriation, fiscal year 2026....................... $254,018,000
Budget request, fiscal year 2027...................... 254,018,000
Committee Recommendation.............................. 254,018,000
Change from enacted level......................... - - -
Change from budget request........................ - - -
The Committee provides $254,018,000 for Howard University.
Howard University is a leading research university located in
the District of Columbia and provides undergraduate liberal
arts, graduate, and professional instruction to students. Of
the amounts provided, the Committee recommendation includes no
less than $3,405,000 for the matching endowment grant, which is
the same as the fiscal year 2026 enacted level. The Committee
recommendation also includes $27,325,000 for Howard University
Hospital for ongoing hospital operations, the same as the
fiscal year 2026 enacted level.
COLLEGE HOUSING AND ACADEMIC FACILITIES LOANS PROGRAM
Appropriation, fiscal year 2026....................... $298,000
Budget request, fiscal year 2027...................... 298,000
Committee Recommendation.............................. 298,000
Change from enacted level......................... - - -
Change from budget request........................ - - -
Previously, these programs helped to ensure that
postsecondary institutions were able to make necessary capital
improvements to maintain and increase their ability to provide
a high-quality education. Since 1994, no new loans have been
made, and the Department's role has been to manage the
outstanding loans.
HISTORICALLY BLACK COLLEGE AND UNIVERSITY CAPITAL FINANCING PROGRAM
ACCOUNT
Appropriation, fiscal year 2026....................... $20,678,000
Budget request, fiscal year 2027...................... 20,678,000
Committee Recommendation.............................. 20,678,000
Change from enacted level......................... - - -
Change from budget request........................ - - -
The Committee provides $20,678,000 for the HBCU Capital
Financing program, which is the same as the fiscal year 2026
enacted level. This program is authorized under part D of Title
III of the HEA and makes capital available for repair and
renovation of facilities at HBCUs.
Within the total provided for this program, the Committee
recommendation includes $528,000 for administrative expenses to
carry out the program and $20,150,000 for loan subsidy costs,
which will support an estimated $389,319,673 in new loan volume
in fiscal year 2027.
HBCU Infrastructure.--The Committee encourages the
Administration to continue to prioritize funding that supports
infrastructure repair, modernization, and related improvements
at HBCUs, in support of their long-term competitiveness and
ability to serve students.
Institute of Education Sciences
INSTITUTE OF EDUCATION SCIENCES
Appropriation, fiscal year 2026....................... $789,606,000
Budget request, fiscal year 2027...................... 261,300,000
Committee Recommendation.............................. 493,455,000
Change from enacted level......................... -296,151,000
Change from budget request........................ +232,155,000
This account supports education research, statistics,
dissemination, evaluation, and assessment activities.
The Committee notes the extensive fiscal year 2025
carryover funding available to the agency, in addition to the
funding appropriated in fiscal year 2026. Absent the
elimination of current funding resources, the Committee
recommends $493,455,000 for fiscal year 2027.
National Reading Panel.--The Committee includes language
under NICHD directing NICHD, incoordination with IES, to
reestablish a National Reading Panel to assess the contemporary
status of research-based knowledge, including the effectiveness
of various approaches to teaching children to read.
Research, Development, and Dissemination
The Committee provides $200,000,000 for Research,
Development, and Dissemination, which is $160,250,000 above the
fiscal year 2027 budget request and $45,000,000 below the
fiscal year 2026 enacted level.
This account supports research, development, and national
dissemination activities that are aimed at expanding
fundamental knowledge of education and promoting the use of
research and development findings in the design of efforts to
improve education.
Rapid-Cycle Development.--A portion of funds should be
provided to continue efforts started under the Accelerate,
Transform, and Scale (ATS) initiative to develop rapid-cycle,
high-reward scalable education solutions intended to
significantly improve outcomes for all students. ATS seeks to
pilot efforts modeled on the advanced research projects
agencies (ARPAs) found throughout the Federal government. To
successfully advance ARPA-style efforts in education, the
Committee directs IES to continue to support: (1) phases two
and three of the Seedlings to Scale Grant Program and (2) the
new funding opportunity to develop innovative learning models
as directed in House Report 119-271. The Committee requests
quarterly updates on progress on these initiatives. The IES is
further directed to report on its intention to make new awards
not less than two weeks before the publication of a funding
opportunity notice.
What Works Clearinghouse.--The Committee understands the
importance of the Department of Education's What Works
Clearinghouse in providing rigorously researched evidence for
educational practices, such as science of reading
implementation best practices. However, the Committee is aware
of the bottlenecks in the What Works Clearinghouse's review
process and need for the research to focus more heavily on
outcomes and teaching applications. The Committee directs the
Department of Education to review the What Works Clearinghouse
review process and research focus and provide recommendations
to streamline these processes to produce practical instruction
guidance for teachers and administrators, especially in early
childhood reading models like the Science of Reading approach.
Statistics
The Committee provides $61,000,000 for the activities of
the National Center for Education Statistics (NCES), which is
$18,780,000 above the fiscal year 2027 budget request.
Statistics activities are authorized under Title I of the
Education Sciences Reform Act of 2002. NCES collects, analyzes,
and reports statistics on all levels of education in the U.S.
Activities are carried out directly and through grants and
contracts and include projections of enrollments, teacher
supply and demand, and educational expenditures. NCES also
provides technical assistance to State and local educational
agencies and postsecondary institutions.
Regional Educational Laboratories
The Committee does not provide funding for this program.
Research in Special Education
The Committee provides $64,255,000 for Research in Special
Education, which is same as the fiscal year 2026 enacted level.
This program supports competitive grants to produce and
advance the use of knowledge to improve services and results
for children with disabilities. The program focuses on
producing new knowledge, integrating research and practice, and
improving the use of knowledge.
Special Education Studies and Evaluations
The Committee provides no funding for Special Education
Studies and Evaluations, which is the same as the fiscal year
2026 enacted level.
Statewide Longitudinal Data Systems
The Committee provides no funding this program, which is
the same as the fiscal year 2027 budget request and the fiscal
year 2026 enacted level. These competitive grants are awarded
to States to design and maintain longitudinal data systems.
Assessment
The Committee provides $138,200,000 for Assessment, which
is $55,100,000 below the fiscal year 2026 enacted level. This
amount includes $8,300,000 for the National Assessment
Governing Board (NAGB), which is $870,000 above the fiscal year
2027 budget request and the same as the fiscal year 2026
enacted level.
The National Assessment of Educational Progress (NAEP) is
the only nationally representative and continuing survey of
educational ability and achievement of students in the U.S. The
primary goal of the assessment is to determine and report the
status and trends of the knowledge and skills of students,
subject by subject. Subject areas assessed in the past have
included reading, writing, mathematics, science, history,
citizenship, literature, art, and music. The NAEP is operated
by contractors through competitive grants made by the NCES. The
NAGB formulates the policy guidelines for the program.
Program Administration
The Committee provides $30,000,000 for Program
Administration, which is $40,000,000 below the fiscal year 2026
enacted level.
DEPARTMENTAL MANAGEMENT
Appropriation, fiscal year 2026....................... $606,907,000
Budget request, fiscal year 2027...................... 251,750,000
Committee Recommendation.............................. 575,157,000
Change from enacted level......................... -31,750,000
Change from budget request........................ +323,407,000
PROGRAM ADMINISTRATION
Appropriation, fiscal year 2026....................... $399,407,000
Budget request, fiscal year 2027...................... 100,000,000
Committee Recommendation.............................. 374,407,000
Change from enacted level......................... -25,000,000
Change from budget request........................ +274,407,000
The Committee recommendation includes $374,407,000 for
Program Administration, which is $25,000,000 less than the
fiscal year 2026 enacted level. These funds are used for
expenses related to staff and other costs of administering
programs and activities at the Department. Such expenses
include personnel compensation, health, retirement, and other
benefits, as well as travel, rent, telephones, utilities,
postage fees, data processing, printing, equipment, supplies,
technology training, consultants, and other contractual
services.
After School STEM.--The Committee recognizes the importance
of a strong domestic STEM workforce to U.S. economic
competitiveness, national security, and technological
leadership. The Committee appreciates the benefits of educators
trained in emerging technologies and the impact that informal
STEM learning environments, such as afterschool and summer STEM
programs, play in strengthening student engagement, improving
academic outcomes, and expanding pathways into high-demand STEM
fields, such as artificial intelligence, machine learning,
cybersecurity, robotics, advanced manufacturing, and quantum
mechanics. The Committee encourages the Department to support
evidence-based STEM educator development initiatives that
strengthen instructional quality in out-of-school settings,
including initiatives that promote partnerships among schools,
community organizations, and local STEM-focused industry
leaders. The Committee urges the Department to prioritize
underserved, rural, and low-income communities, where access to
robust STEM learning opportunities remain the most limited.
Bill Wide Requirements.--The Committee notes the inclusion
of a bill-wide requirements section of this report. This
section contains requirements which apply to all agencies
funded by this Act.
Credit Mobility for Service Members and Veterans.--The
Committee is aware of concerns that there is no consistent,
transparent framework for evaluating prior learning, which
creates inefficiencies for student veterans transferring
between institutions. The Committee encourages the Department
to work with IHEs, States, and relevant Federal partners to
support the development of consistent approaches to prior
learning assessment and to improve the portability of academic
credit across institutions. The Committee requests an update in
the fiscal year 2028 congressional justification on actions
taken and additional options to improve credit mobility for
service members and veterans.
Foreign Influence in Higher Education.--The Committee
remains concerned about the risks associated with malign
foreign influence in American postsecondary education. The
Committee is encouraged by the Department's renewed focus on
enforcement of Section 117 of the HEA, which requires
institutions of higher education receiving Federal funding to
disclose foreign-sourced gifts and contracts if the value is
$250,000 or more, as well as to disclose ownership or control
by a foreign source. The Committee encourages the Department's
continued support for efforts related to improving
institutional reporting under Section 117, to prevent malign
foreign influence, and increase compliance and transparency.
The Committee understands the Department began a new, updated
reporting portal at the beginning in January 2026 and
encourages the Department to continue providing technical
assistance to IHEs on using new system, to promote accuracy,
full participation, and increased transparency.
Additionally, the Committee is aware of concerns that some
associations on IHE campuses may operate in ways that
facilitate foreign influence or undue pressure on IHEs and
therefore encourages the Department to consider ways to promote
greater transparency and safeguards regarding such
relationships.
Janus Rights.--The Committee notes that in 2018, the U.S.
Supreme Court ruled in Janus v. AFSCME that no public employee
may be forced to pay money to a union as a condition of
employment, even if they benefit from union representation.
Despite the ruling, the Committee is aware of concerns
regarding efforts to deter initiatives that raise awareness
among teachers, faculty, and other public personnel of their
First Amendment rights to free speech and free association. The
Committee is supportive of good faith efforts that inform and
provide awareness for public workers regarding their rights.
The Committee urges the Department to use available means to
increase awareness among Federal aid recipients of Janus
rights.
Hands-On STEM and Computer Science Education.--The
Committee recognizes that shortages in computer science,
engineering, and artificial intelligence fields are
accelerating and that K-12 schools represent a critical
pipeline for developing the next generation of technical
talent. The Committee also recognizes that hands-on, project-
based learning experiences--including physical computing,
programmable robotics, and structured AI literacy curricula--
improve STEM outcomes and equip students with foundational
skills for high-demand fields. The Committee encourages the
Department to prioritize grants that support evidence-based,
hands-on STEM and computer science programs, with particular
attention to schools serving underserved and economically
disadvantaged communities.
Military Student Identifier.--The Committee recognizes the
unique challenges faced by children of members of the National
Guard and Reserve who are not currently identified under the
Military Student Identifier (MSI) established in the Every
Student Succeeds Act. The Committee encourages the Department
to explore options for expanding the MSI to include all
military-connected students, including those whose parents
serve in the Reserve Components but are not on full-time active
duty. The Committee further urges the Department to provide
guidance to States and local educational agencies on how to
support these students through targeted programs, data
collection, and educator training, to ensure equitable
recognition and support for all military-connected children.
Nonrecurring Expenses Fund.--The Committee directs the
Department to provide quarterly reports for all ongoing
projects. The report shall include the following for each
project: agency project is funded under; a description for each
project; the date the project was notified to the Committees;
total obligations to date; obligations for the prior fiscal
year; anticipated obligations for current fiscal year; and any
expected future obligations. For any project ongoing for more
than 3 years, the report should include a narrative describing
the cause for delay and steps being taken by the agency to
ensure prompt completion. In addition, the Committee requests
biannual reports on expired balances that are eligible for
transfer to the Nonrecurring Expenses Fund. Such report shall
include the Treasury Account Fund Symbol, program name,
unobligated balance, and unexpended balance. Such report shall
be transmitted 30 days after the close of the second quarter
and within 45 days after the close of the fourth quarter of the
fiscal year.
Performance Reporting.--As part of the congressional
justification for fiscal year 2028, the Department is directed
to include, for the past five fiscal years, the percentage of
the Senior Executive Service (SES) for each performance level
rating (5--outstanding, 4--exceeds fully successful, 3--fully
successful, 2--minimally satisfactory, or 1--unsatisfactory).
Such information shall include the number of SES for each
performance level and the average performance bonus paid for
each performance level. In addition, the Department shall
include in such justification the total amount spent on
performance awards for the SES and the total number of SES in
the Department.
Promise Neighborhoods Extensions.--The Committee directs
the Department to use any available fiscal year 2026 funds, not
being used for continuation awards, only for 2-year extension
grants to high quality Promise Neighborhood grantees that have
demonstrated improvements in program performance indicators or
for new 5-year implementation awards. If the Departments runs a
grant competition for new 5-year awards, it is directed to
allow previously awarded grantees with programs that may have
recently expired to compete for additional funding for the same
neighborhood, provided they have at least 5 years of
successfully submitting performance data, demonstrated
improvements in Promise Neighborhoods indicators, and justify
the need for additional funding for their continued
implementation of high quality plans and evidence-based
activities.
Recess in Schools.--The Committee recognizes the critical
role of recess in K-12 schools in providing protected,
unstructured time for children and adolescents, strengthening
cognitive function and memory retention, and building problem-
solving and communication skills. The Committee requests an
update in the fiscal year 2028 congressional justification on
the benefits of recess on the academic, social, and physical
development of children and adolescents and recommendations on
how to preserve recess time and remove unnecessary regulatory
and administrative barriers, such as those limiting the use of
wood chips on playgrounds.
Reports to Congress.--The Department is directed to provide
5 business days' notice to the Committees before release of any
congressionally directed report.
Staffing Report.--The Committee requests, no later than 30
days after enactment of this Act, an operating plan identifying
the total full time equivalent (FTE) and non-personnel
allocations supported by the program administration
appropriation in total for the Department, and FTE and non-
personnel allocations for each program office supported by the
program administration appropriation provided by this Act. In
addition, the Department is directed to provide biannually the
number of on-board staff, attrition, approved hires not yet on-
board and projected full-year FTE usage, including approved
hires, and actual non-personnel expenses, for each program
office supported by, and in total for, the program
administration appropriation provided by this Act. The biannual
reports should be detailed by career and non-career staff. In
addition, the Department shall separately identify in such
plans and reports total FTE allocations supported by other
funding sources.
Strategic Staffing.--The Committee supports efforts by
State and local educational agencies, and other stakeholders,
to address teacher workforce shortages through innovative
strategic staffing models, including research into new
innovations in strategic staffing models, program development
and implementation, and the dissemination of findings and best
practices. The Committee encourages the Department, within
existing means and authorities, to support such efforts.
Technical Assistance and Transparency in the Grant
Application Review Process.--The Committee recognizes that the
complexity of the Federal grant application process can present
difficulties for institutions with limited administrative
resources. To ensure fair review and transparency in the
application process, the Committee urges the Department to
communicate and provide clear, accessible, comprehensive
technical assistance, including webinars with department staff
outlining application requirements and training that is
explicitly aligned with program scoring criteria.
Workforce Readiness.--The Committee notes the importance of
addressing future workforce needs in high-need economic
sectors. The Committee further notes the potential for mobile
laboratories to advance professional development, technical
training, technology awareness, outreach, and workforce up-
skilling in mobility, automotive, manufacturing, energy,
artificial intelligence, and infrastructure technologies. The
Committee encourages ongoing support of activities at
educational institutions.
OFFICE FOR CIVIL RIGHTS
Appropriation, fiscal year 2026....................... $140,000,000
Budget request, fiscal year 2027...................... 91,000,000
Committee Recommendation.............................. 140,000,000
Change from enacted level......................... - - -
Change from budget request........................ +49,000,000
The Office for Civil Rights (OCR) is responsible for
enforcing laws that prohibit discrimination based on race,
color, national origin, sex, disability, and age in all
programs and institutions that receive funds from the
Department. These laws extend to SEAs, LEAs, and IHEs,
including proprietary schools. They also extend to State
rehabilitation agencies, libraries, museums, and other
institutions receiving Federal funds.
The Committee supports efforts by OCR to continue to
provide technical assistance regarding antisemitism on
campuses, including regarding student and faculty civil rights,
and to complete pending investigations of complaints relating
to antisemitism under Title VI of the Civil Rights Act of 1964.
Antisemitism Investigations.--The Committee remains
concerned by instances of antisemitism on campuses of
educational institutions, including reports of vandalism and
incitement of violence. The Committee is also aware of concerns
regarding the existing backlog of reported violations and urges
OCR to continue to resolve active cases to reduce such backlog.
The Committee requests the Department include information in
the fiscal year 2028 congressional justification on progress
made toward resolving the case backlog relating to shared
ancestry investigations, including a summary of the number of
cases that opened, closed, or remained unresolved during the
previous year.
Clery Act.--The Committee supports the Department in
continuing to collect and report data related to hate crimes
from IHEs as authorized by the Jeanne Clery Disclosure of
Campus Security Policy and Campus Crime Statistics Act (P.L.
101-542). The Committee encourages the Department to collect
and report this data in coordination with the Federal Bureau of
Investigation Uniform Crime Report Program.
Reporting.--The Committee urges OCR to continue efforts to
complete investigations of outstanding complaints.
Additionally, the Committee urges OCR to complete publication
of the 2023-2024 Civil Rights Data Collection and to publish
the 2025 annual report in as timely a manner as practicable.
Statutory Responsibilities.--The Committee recognizes the
statutory responsibilities of OCR to enforce Federal civil
rights laws and ensure that all students have equal access to
educational opportunities. The Committee is concerned that
prolonged delays deny students the right to a timely and fair
investigation process and therefore urges the Department to
support staffing and capacity in support of carrying out these
statutory functions and responsibilities. Additionally, within
90 days of enactment of this Act and 180 days thereafter, the
Committee directs the Department to provide a briefing to the
Committees summarizing the total number of open cases; the
number of open, dismissed, and resolved cases in each category
and subcategory; and staffing levels by each regional office.
The Committee also urges the Department to maintain its
publicly available information on investigations.
OFFICE OF INSPECTOR GENERAL
Appropriation, fiscal year 2026....................... $67,500,000
Budget request, fiscal year 2027...................... 60,750,000
Committee Recommendation.............................. 60,750,000
Change from enacted level......................... -6,750,000
Change from budget request........................ - - -
The Office of Inspector General has authority to inquire
into all program and administrative activities of the
Department, as well as related activities of grant and contract
recipients. It conducts audits and investigations to determine
compliance with applicable laws and regulations, to check
alleged fraud and abuse, efficiency of operations, and
effectiveness of results.
General Provisions
Sec. 301. The Committee continues a provision related to
the implementation of programs of voluntary prayer and
meditation in public schools.
(TRANSFER OF FUNDS)
Sec. 302. The Committee continues a provision regarding
transfer authority.
Sec. 303. The Committee modifies a provision allowing ESEA
funds consolidated for evaluation purposes to be available from
July 1, 2027 through September 30, 2028.
Sec. 304. The Committee modifies a provision allowing
certain institutions to continue to use endowment income for
student scholarships.
Sec. 305. The Committee modifies a provision extending the
authorization of the National Advisory Committee on
Institutional Quality and Integrity.
Sec. 306. The Committee modifies a provision extending the
authority to provide account maintenance fees to guaranty
agencies for Federal student loans.
Sec. 307. The Committee continues a provision allowing
administrative funds to cover outstanding Perkins loans
servicing costs.
Sec. 308. The Committee modifies a provision allowing up to
0.5 percent of funds appropriated in this Act for programs
authorized under the HEA, except for the Pell Grant program, to
be used for evaluation of any HEA program.
(INCLUDING TRANSFER OF FUNDS)
Sec. 309. The Committee modifies a provision regarding
centralized support costs for the Institute of Education
Sciences.
(RESCISSION)
Sec. 310. The Committee modifies a provision rescinding
amounts from the Nonrecurring Expenses Fund.
Sec. 311. The Committee continues a provision on formula
grants.
Sec. 312. The Committee includes a new provision regarding
institutions of higher education.
Sec. 313. The Committee includes a new provision regarding
participation in athletic programs.
Sec. 314. The Committee includes a new provision on
parental notification.
Sec. 315. The Committee includes a new provision regarding
protection for religious student groups at institutions of
higher education.
Sec. 316. The Committee includes a new provision
prohibiting certain rules related to borrower defense to
repayment and 90/10.
Sec. 317. The Committee includes a new provision related to
local educational agencies.
(RESCISSION)
Sec. 318. The Committee includes a new provision rescinding
certain mandatory funding.
Sec. 319. The Committee includes a new provision related to
student loans.
Sec. 320. The Committee includes a new provision on
mandatory funding under the Higher Education Act.
Sec. 321. The Committee includes a new provision on
budgetary effects.
TITLE IV--RELATED AGENCIES
Appropriation, fiscal year 2026....................... $17,079,804,000
Budget request, fiscal year 2027...................... 15,516,381,000
Committee Recommendation.............................. 16,966,419,000
Change from enacted level......................... -113,385,000
Change from budget request........................ +1,450,038,000
Committee for Purchase From People Who are Blind or Severely Disabled
SALARIES AND EXPENSES
Appropriation, fiscal year 2026....................... $13,124,000
Budget request, fiscal year 2027...................... 13,124,000
Committee Recommendation.............................. 13,124,000
Change from enacted level......................... - - -
Change from budget request........................ - - -
The Committee for Purchase from People Who Are Blind or
Severely Disabled, an independent Federal agency, oversees and
manages the AbilityOne Program, which uses the purchasing power
of the Federal government to buy products and services from
participating, community-based nonprofit agencies nationwide.
These organizations are dedicated to training and employing
individuals with disabilities.
Office of Inspector General.--The Committee provides not
less than $3,150,000 for the Office of Inspector General, the
same as the fiscal year 2026 enacted level.
Corporation for National and Community Service
OPERATING EXPENSES
Appropriation, fiscal year 2026....................... $975,525,000
Budget request, fiscal year 2027...................... 32,430,000
Committee Recommendation.............................. 970,525,000
Change from enacted level......................... -5,000,000
Change from budget request........................ +938,095,000
The Corporation for National and Community Service (CNCS)
funds various service and volunteer programs.
The Committee provides $970,525,000 for service and
volunteer programs, a $5,000,000 decrease below the fiscal year
2026 enacted program level. The Committee notes that ongoing
audit findings confirm CNCS has not fully resolved long-
standing issues or conducted proper oversight of its grant
programs.
Within the total for CNCS, the Committee provides the
following amounts:
------------------------------------------------------------------------
Budget Activity FY 2026 Enacted FY 2027 Committee
------------------------------------------------------------------------
Operating Expenses................ $975,525,000 $970,525,000
Domestic Volunteer Service 340,202,000 344,202,000
Programs.....................
Volunteers in Service to 103,285,000 103,285,000
America..................
National Senior Volunteer 236,917,000 241,917,000
Corps....................
Foster Grandparents 125,363,000 125,363,000
Program..............
Senior Companion 56,449,000 56,449,000
Program..............
Retired Senior 55,105,000 59,105,000
Volunteer Program....
National and Community Service 635,323,000 626,323,000
Programs.....................
AmeriCorps State and 557,094,000 557,094,000
National Grants..........
Innovation, Assistance, 14,706,000 15,706,000
and Other Activities.....
Research and Evaluation... 6,250,000 6,250,000
National Civilian 37,735,000 27,735,000
Community Corps..........
State Service Commission 19,538,000 19,538,000
Grants...................
------------------------------------------------------------------------
National Senior Volunteer Corps
The Retired Senior Volunteer Program (RSVP) provides grants
to organizations that engage Americans aged 55 years and older
in volunteer service. RSVP volunteers participate in community
service activities including serving veterans and military
families, supporting workforce development and training in job
readiness skills, assisting in disaster preparedness and
mitigation efforts, and mentoring and tutoring opportunities.
Demographic Distribution.--The Committee supports the
equitable distribution of CNCS resources to engage seniors and
improve their lives across the country. The Committee commends
the agency for providing detailed information on their website
regarding the geographic distribution of RSVP grants and where
AmeriCorps volunteers serve. Therefore, the Committee
encourages CNCS to continue their efforts to promote
transparency through publicly available information.
Innovation, Assistance, and Other Activities
National Days of Service.--The Committee provides an
increase of $1,000,000 to the September 11 National Day of
Service and Remembrance. The Committee encourages CNCS to
prioritize eligible organizations with expertise in
representing families of victims of the September 11, 2001,
terrorist attacks and other impacted constituencies when
planning for the September 11 National Day of Service and
Remembrance.
Payment to the National Service Trust
Appropriation, fiscal year 2026....................... $180,000,000
Budget request, fiscal year 2027...................... - - -
Committee Recommendation.............................. 160,000,000
Change from enacted level......................... -20,000,000
Change from budget request........................ +160,000,000
The National Service Trust makes payments for Segal
education awards, pays interest that accrues on qualified
student loans for participants during terms of service in
approved national service positions, and makes other payments
entitled to members who serve in CNCS programs.
SALARIES AND EXPENSES
Appropriation, fiscal year 2026....................... $89,686,000
Budget request, fiscal year 2027...................... 69,627,000
Committee Recommendation.............................. 79,686,000
Change from enacted level......................... -10,000,000
Change from budget request........................ +10,059,000
OFFICE OF INSPECTOR GENERAL
Appropriation, fiscal year 2026....................... $8,595,000
Budget request, fiscal year 2027...................... 5,624,000
Committee Recommendation.............................. 10,095,000
Change from enacted level......................... +1,500,000
Change from budget request........................ +4,471,000
The Office of Inspector General provides oversight of CNCS
programs, operations and grantees with the goal of preventing
and detecting fraud, waste, and abuse.
The Committee directs the OIG to continue focusing on (1)
improving agency compliance with applicable laws and
regulations; (2) ensuring robust financial reporting processes
and internal controls; and (3) strengthening the grant
processes to ensure grantees are prioritizing Americans seeking
volunteer opportunities.
ADMINISTRATIVE PROVISIONS
Sec. 401. The Committee continues a provision requiring the
agency to make any significant changes to program requirements,
service delivery or policy through rulemaking.
Sec. 402. The Committee continues a provision related to
National Service Trust minimum share requirements.
Sec. 403. The Committee continues a provision related to
donations.
Sec. 404. The Committee continues a provision related to
veterans.
Sec. 405. The Committee continues a provision related to
criminal history background checks.
Sec. 406. The Committee continues a provision related to
1,200 hours of service positions.
Sec. 407. The Committee includes a provision related to
approved national service positions.
Sec. 408. The Committee continues a provision related to
Volunteers in Service to America members' education awards.
Federal Mediation and Conciliation Service
SALARIES AND EXPENSES
Appropriation, fiscal year 2026....................... $48,705,000
Budget request, fiscal year 2027...................... 7,400,000
Committee Recommendation.............................. 38,705,000
Change from enacted level......................... -10,000,000
Change from budget request........................ +31,305,000
The Federal Mediation and Conciliation Service provides
mediation and conflict resolution services to industry,
government agencies, and communities.
The Committee provides $38,705,000 for the Federal
Mediation and Conciliation Service.
Federal Mine Safety and Health Review Commission
SALARIES AND EXPENSES
Appropriation, fiscal year 2026....................... $18,012,000
Budget request, fiscal year 2027...................... 16,909,000
Committee Recommendation.............................. 16,909,000
Change from enacted level......................... -1,103,000
Change from budget request........................ - - -
The Federal Mine Safety and Health Review Commission is an
independent adjudicative agency that provides administrative
trial and appellate review of legal disputes arising under the
Federal Mine Safety and Health Act of 1977. The Committee
provides $16,909,000 for Commission activities.
Institute of Museum and Library Services
OFFICE OF MUSEUM AND LIBRARY SERVICES: GRANTS AND ADMINISTRATION
Appropriation, fiscal year 2026....................... $291,800,000
Budget request, fiscal year 2027...................... 6,000,000
Committee Recommendation.............................. 291,800,000
Change from enacted level......................... - - -
Change from budget request........................ +285,800,000
Within the total for the Institute of Museum and Library
Services (IMLS), the Committee provides the following amounts:
------------------------------------------------------------------------
FY 2026 FY 2027
Budget Activity Enacted Committee
------------------------------------------------------------------------
Library Services Technology Act:
Grants to States.............. $181,400,000 $180,400,000
Native American Library 5,763,000 5,763,000
Services.....................
National Leadership: Libraries 15,287,000 15,287,000
Laura Bush 21st Century 10,000,000 10,000,000
Librarian....................
Museum Services Act:
Museums for America........... 28,730,000 28,730,000
Native American/Hawaiian 3,772,000 3,772,000
Museum Service...............
National Leadership: Museums.. 9,348,000 9,348,000
African American History and
Culture Act:
Museum Grants for African 6,000,000 6,000,000
American History and Culture.
National Museum of the American
Latino Act:
Museum Grants for American 6,000,000 6,000,000
Latino History and Culture...
Museum and Library Services Act
General Provisions:
Research, Analysis and Data 5,500,000 5,500,000
Collection...................
Program Administration............ 19,000,000 21,000,000
------------------------------------------------------------------------
Office of Museum Services.--The Committee directs the
Institute of Museum and Library Services to ensure transparency
in the selection and award of competitive grants administered
through the Office of Museum Services. The Committee further
notes funds provided under this Act shall be obligated and
expended in a manner consistent with the Institute's statutory
authorities and the intent of Congress.
Medicaid and CHIP Payment and Access Commission
SALARIES AND EXPENSES
Appropriation, fiscal year 2026....................... $9,405,000
Budget request, fiscal year 2027...................... 10,698,000
Committee Recommendation.............................. 10,698,000
Change from enacted level......................... +1,293,000
Change from budget request........................ - - -
The Medicaid and the Children's Health Insurance Program
(CHIP) Payment and Access Commission (MACPAC) is an independent
Agency tasked with advising Congress on issues affecting
Medicaid and CHIP. MACPAC conducts policy and data analysis on
Medicaid and CHIP to support policymakers and promote program
accountability.
The Committee supports the role played by MACPAC in
providing nonpartisan policy recommendations and data analysis
on a wide array of issues affecting Medicaid and CHIP. The
Committee encourages MACPAC to include with their policy
recommendations additional specific recommended policy changes
to the programs that can result in savings designed to help
improve access to care for beneficiaries and offset proposed
increases in spending. Additionally, the Committee encourages
MACPAC to provide more detailed cost estimates and actuarial
analyses for costs that would be incurred by the Federal
government and the States to better understand the implications
of the Commission's recommendations.
Congressional Outreach.--The Committee encourages MACPAC to
increase proactive outreach to all congressional offices to
better inform Members and staff about its role in providing
information, technical assistance, and recommendations on
legislative efforts.
Medicare Payment Advisory Commission
SALARIES AND EXPENSES
Appropriation, fiscal year 2026....................... $14,673,000
Budget request, fiscal year 2027...................... 15,048,000
Committee Recommendation.............................. 15,048,000
Change from enacted level......................... +375,000
Change from budget request........................ - - -
The Medicare Payment Advisory Commission (MedPAC) is an
independent agency tasked with advising Congress on issues
affecting the Medicare program. In addition to advising on
payments to private health plans participating in Medicare and
providers in Medicare's traditional fee-for-service (FFS)
program, MedPAC is also responsible for providing analysis on
access to care, quality of care, and other issues affecting
Medicare.
Congressional Outreach.--The Committee encourages MedPAC to
increase proactive outreach to all congressional offices to
better inform Members and staff about its role in providing
information, technical assistance, and recommendations on
legislative efforts.
National Council on Disability
SALARIES AND EXPENSES
Appropriation, fiscal year 2026....................... $3,850,000
Budget request, fiscal year 2027...................... 3,850,000
Committee Recommendation.............................. 3,850,000
Change from enacted level......................... - - -
Change from budget request........................ - - -
The National Council Disability (NCD) is an independent
Federal agency charged with advising the President, Congress,
and other Federal agencies regarding policies, programs,
practices, and procedures that affect people with disabilities.
NCD is comprised of a team of Presidential and Congressional
appointees, an Executive Director appointed by the Chair, and a
fulltime professional staff.
National Labor Relations Board
SALARIES AND EXPENSES
Appropriation, fiscal year 2026....................... $294,224,000
Budget request, fiscal year 2027...................... 285,499,000
Committee Recommendation.............................. 200,000,000
Change from enacted level......................... -94,224,000
Change from budget request........................ -85,499,000
The National Labor Relations Board (NLRB) is responsible
for enforcing U.S. labor law related to collective bargaining
and unfair labor practices, including the National Labor
Relations Act of 1935.
ADMINISTRATIVE PROVISIONS
Sec. 409. The Committee continues language restricting the
use of electronic voting.
National Mediation Board
SALARIES AND EXPENSES
Appropriation, fiscal year 2026....................... $15,113,000
Budget request, fiscal year 2027...................... 14,306,000
Committee Recommendation.............................. 15,113,000
Change from enacted level......................... - - -
Change from budget request........................ +807,000
The National Mediation Board coordinates labor-management
relations within the U.S. railroads and airlines industries.
The Committee notes an increase in recent years of a case
backlog at the Office of Arbitration due to the Board
decreasing the budget line item allocated to arbitrator
salaries and expenses. The Committee further notes the negative
effect the case backlog has on the prompt and orderly handling
of disputes under the Railway Labor Act. The Committee urges
the Board to reduce the case backlog by restoring funding for
arbitrator salaries and expenses. The Committee also recognizes
the Board's declining mediation capacity which has led to
reduced grievance mediation and dispute resolution and further
urges the Board to support overall mediation capacity.
Occupational Safety and Health Review Commission
SALARIES AND EXPENSES
Appropriation, fiscal year 2026....................... $14,449,000
Budget request, fiscal year 2027...................... 14,223,000
Committee Recommendation.............................. 14,223,000
Change from enacted level......................... -226,000
Change from budget request........................ - - -
The Occupational Safety and Health Review Commission
provides administrative trial and appellate review related to
contests of citations or penalties resulting from Occupational
Safety and Health Administration (OSHA) inspections of American
workplaces.
Railroad Retirement Board
DUAL BENEFITS PAYMENTS ACCOUNT
Appropriation, fiscal year 2026....................... $5,000,000
Budget request, fiscal year 2027...................... 4,000,000
Committee Recommendation.............................. 4,000,000
Change from enacted level......................... -1,000,000
Change from budget request........................ - - -
This appropriation is authorized by the Railroad Retirement
Act of 1974 to fund vested dual benefits received by railroad
retirees who, under prior law, would have become covered by
both the railroad retirement system and the Social Security
system because railroad retirement was not fully coordinated
with Social Security from 1937 to 1974.
FEDERAL PAYMENT TO THE RAILROAD RETIREMENT ACCOUNTS
Appropriation, fiscal year 2026....................... $150,000
Budget request, fiscal year 2027...................... 75,000
Committee Recommendation.............................. 75,000
Change from enacted level......................... -75,000
Change from budget request........................ - - -
LIMITATION ON ADMINISTRATION
Appropriation, fiscal year 2026....................... $127,000,000
Budget request, fiscal year 2027...................... 127,000,000
Committee Recommendation.............................. 126,000,000
Change from enacted level......................... -1,000,000
Change from budget request........................ -1,000,000
LIMITATION ON THE OFFICE OF INSPECTOR GENERAL
Appropriation, fiscal year 2026....................... $14,000,000
Budget request, fiscal year 2027...................... 14,000,000
Committee Recommendation.............................. 14,000,000
Change from enacted level......................... - - -
Change from budget request........................ - - -
Social Security Administration
In fiscal year 2027, the Social Security Administration
(SSA) anticipates exceeding $1.83 trillion in total spending on
social security retirement, disability insurance, and
supplemental security income (SSI) payments. SSA's total
outlays have grown 195 percent since 2007 as mandatory
entitlement programs continue to grow. The SSA Old-Age and
Survivors Insurance Trust Fund, which funds retirement and
survivor benefit payments, is projected to be depleted in 2033,
at which time, Americans will see a 23 percent cut to their
benefits. By comparison, SSA's discretionary budget request for
fiscal year 2027, which funds the agency's administrative
expenses, totals $14.87 billion, an increase of 60 percent
since 2007. The escalating pace of mandatory entitlement-driven
spending remains the primary cost driver within SSA.
PAYMENTS TO SOCIAL SECURITY TRUST FUNDS
Appropriation, fiscal year 2026....................... $15,000,000
Budget request, fiscal year 2027...................... 15,000,000
Committee Recommendation.............................. 15,000,000
Change from enacted level......................... - - -
Change from budget request........................ - - -
The Committee provides this mandatory funding to reimburse
the Old Age and Survivors Insurance (OASI) and Disability
Insurance (DI) trust funds for non-trust fund activities. This
appropriation restores the trust funds to the same financial
position they would have been in had they not borne these
costs.
SUPPLEMENTAL SECURITY INCOME PROGRAM
Appropriation, fiscal year 2026....................... $49,452,282,000
Budget request, fiscal year 2027...................... 51,588,254,000
Committee Recommendation.............................. 51,588,254,000
Change from enacted level......................... +2,135,972,000
Change from budget request........................ - - -
The Committee provides $51,588,254,000 in fiscal year 2027
mandatory funds for the SSI program. This is in addition to the
$23,500,000,000 provided in the fiscal year 2026 appropriations
act for the first quarter of fiscal year 2027. In addition, the
Committee provides $24,000,000,000 in advance funding for the
first quarter of fiscal year 2028, as requested.
Federal Benefit Payments
The Committee provides a fiscal year 2027 program level of
$70,389,000,000 for Federal benefit payments.
Beneficiary Services
The Committee provides $75,000,000 in new mandatory budget
authority for beneficiary services. These funds reimburse
vocational rehabilitation (VR) agencies for successfully
rehabilitating disabled SSI recipients by helping them achieve
and sustain productive, self-supporting work activity. Funds
also support the Ticket to Work program that provides SSI
recipients with a ticket to offer employment networks (ENs),
including VR agencies, in exchange for employment and support
services. The Ticket to Work program pays ENs based on
recipients achieving certain milestones and outcomes.
Research and Demonstration
Sections 1110, 1115, and 1144 of the Social Security Act
provide authority to the Social Security Administration to
conduct research and demonstration projects related to SSA's
programs. Within the appropriation for Supplemental Security
Income, the Committee provides $70,000,000 in mandatory funds
for research and demonstration activities, as requested. These
funds support a variety of research and demonstration projects
designed to improve the disability process, promote self-
sufficiency and assist individuals in returning to work,
encourage savings and retirement planning through financial
literacy, and generally provide analytical and data resources
for use in preparing and reviewing policy proposals.
Administration
Within the appropriation for SSI, the Committee provides
$4,554,254,000 for payment to the Social Security trust funds
for SSI's share of the administrative expenses of SSA.
LIMITATION ON ADMINISTRATIVE EXPENSES
Appropriation, fiscal year 2026....................... $14,841,978,000
Budget request, fiscal year 2027...................... 14,867,978,000
Committee Recommendation.............................. 14,867,978,000
Change from enacted level......................... +26,000,000
Change from budget request........................ - - -
The Limitation on Administrative Expenses (LAE) account
funds the administrative and operational costs for
administering the OASI, DI, and SSI programs, and associated
costs to support CMS in administering the Medicare program. The
LAE account is funded by the Social Security and Medicare trust
funds for their share of administrative expenses, the general
fund for the SSI program's share of administrative expenses,
and applicable user fees. These funds support core
administrative activities including processing retirement and
disability claims, conducting hearings to review disability
determination appeals, issuing Social Security numbers and
cards, processing individuals' annual earnings information, and
ensuring the integrity of Social Security programs through
continuing disability reviews (CDR) and SSI redeterminations of
non-medical eligibility.
Bill Wide Requirements.--The Committee notes the inclusion
of a bill wide requirements section of this report. This
section contains requirements which apply to all agencies
funded by this Act.
Hiring and Retention.--The Committee continues to direct
SSA to provide a quarterly staffing report to the Committee
detailing full-time permanent staff and new hires by component
and the attrition percentage by component.
Improved Delivery of Social Security Survivor Benefits.--
The Committee urges SSA to improve the accuracy and timeliness
of processing survivor benefit claims of eligible children and
requests an update in the fiscal year 2028 congressional
justification on steps the agency has taken to reduce errors
and processing delays.
Occupational Information System (OIS).--The Committee
continues to direct SSA to include information in its
congressional justifications detailing efforts to fully
implement the OIS project, including the status of
implementation and timeline for transitioning entirely to OIS,
an action plan to accomplish such timeline, and the costs
associated with the project.
Report on LAE Expenditures.--The Committee continues to
request that the data referenced under this heading in House
Report 114-699 be included in future congressional
justifications. In addition, the Committee requests the fiscal
year 2028 congressional justification include a historical
table of costs and fiscal year 2028 requests for personnel and
benefits, by major SSA component.
Social Security Administration Service Delivery.--The
Committee notes that millions of Americans count on consistent
and reliable delivery of critical services from SSA and is
concerned by any reductions in direct-service operations,
including staff at field offices and processing and teleservice
centers. Performance related to disability claim processing
times, timely processing of retirement claims, administration
of SSA's field offices and 1-800 number, and overall customer
service are all integral to the public's interaction with SSA.
As such, the Committee directs SSA to take steps to avoid field
office closures, reduced office hours, and increased delays to
appointments for beneficiaries seeking in-person support. The
Committee also directs SSA to provide a monthly report of
performance metrics that measure SSA's progress on addressing
key service delivery functions, including staff levels and
appointment waiting times by field office, as well as the
average time that 1-800 number callers wait to receive a
callback. Additionally, the Committee urges SSA to seek public
and stakeholder input in advance of policy and operations
changes when appropriate.
SSA Administrative or Applicant Errors.--The Committee
notes that the maintenance of accurate records is critical for
SSA to deliver timely and accurate benefits to those who
qualify. The Committee is concerned about the prolonged
timeline associated with an administrative or applicant error,
which oftentimes results in delayed benefits. The Committee
requests an update in the fiscal year 2028 congressional
justification detailing the steps the agency is taking to
improve the timeliness and efficiency of its error correction
processes. The update should describe the agency's internal
review systems, how the agency informs an applicant of an
error, relevant staffing and training initiatives, and what
improvements the agency has taken or plans to take to avoid
prolonged delays in resolving such errors.
Ticket to Work Program.--The Committee encourages SSA to
inform all SSDI and SSI beneficiaries of the Ticket to Work
program.
Updating Organizational Representative Payee Guidance.--The
Committee notes findings by the SSA OIG and GAO identifying
vulnerabilities in the organizational representative payee
program, including risks related to fraud, misuse of
beneficiary funds, and deficiencies in financial recordkeeping
and oversight. The Committee is concerned that reliance on
outdated or fragmented accounting practices may contribute to
these risks and limit effective oversight of beneficiary funds.
Accordingly, the Committee encourages SSA to consider any
updates and clarifying guidance that may be needed regarding
the types of systems organizational representative payees are
expected to use to manage, track, and report their activities
to ensure they are meeting the fiduciary standard required to
direct and control beneficiary funds. In so doing, SSA should
consider encouraging the use of systems for representative
payee operations that provide individualized beneficiary-level
fund accounting, enforce compliance with applicable SSA rules
and regulations governing the use of beneficiary funds, and
that are scalable, automated, and centralized with complete
audit trails, standardized reporting, secure record retention,
and strong internal controls. Such guidance should support the
timely identification of irregular transactions, potential
fraud, misuse, or noncompliance to improve accountability and
transparency in the management of beneficiary funds.
Work Incentives Planning and Assistance (WIPA) and
Protection and Advocacy for Beneficiaries of Social Security
(PABSS).--The recommendation includes $23,000,000 for WIPA and
$10,000,000 for PABSS. These programs provide services to help
Social Security disability beneficiaries return to work.
Continuing Disability Reviews, Redeterminations, and Program
Integrity Activities
As requested in the fiscal year 2027 budget request, the
Committee provides $2,397,000,000 for program integrity
activities, the same as the fiscal year 2026 enacted level.
This includes $273,000,000 in base funding and $2,124,000,000
in budget adjustment funding.
The bill also includes language transferring up to
$25,100,000 to the OIG for the cost of jointly operating
cooperative disability investigation units.
Social Security Advisory Board
The Committee provides $2,700,000 for the Social Security
Advisory Board, which is the same as the fiscal year 2026
enacted level.
User Fees
In addition to the other amounts provided, the Committee
provides $175,000,000 for administrative activities funded from
user fees. Of this amount, $174,000,000 is derived from fees
collected from States that request SSA administer State SSI
supplementary payments. The remaining $1,000,000 is derived
from fees charged to non-attorneys who apply for certification
to represent claimants under titles II and XVI of the Social
Security Act.
OFFICE OF THE INSPECTOR GENERAL
Appropriation, fiscal year 2026....................... $114,665,000
Budget request, fiscal year 2027...................... 114,665,000
Committee Recommendation.............................. 114,665,000
Change from enacted level......................... - - -
Change from budget request........................ - - -
The Office of the Inspector General is responsible for
meeting the statutory mission of promoting economy, efficiency,
and effectiveness in the administration of SSA programs and
operations and to prevent and detect fraud, waste, abuse, and
mismanagement in such programs and operations. To accomplish
this mission, the OIG directs, conducts, and supervises audits,
evaluations, and investigations. In addition, the OIG searches
for and reports on systemic weaknesses in SSA programs and
operations and makes recommendations for needed improvements
and corrective actions.
TITLE V--GENERAL PROVISIONS
(TRANSFER OF FUNDS)
Sec. 501. The Committee continues a provision allowing the
Secretaries of Labor, Health and Human Services, and Education
to transfer unexpended balances of prior appropriations to
accounts corresponding to current appropriations to be used for
the same purposes and for the same periods of time for which
they were originally appropriated.
Sec. 502. The Committee continues a provision prohibiting
the obligation of funds beyond the current fiscal year unless
expressly so provided.
Sec. 503. The Committee continues a provision prohibiting
funds from being used to support or defeat legislation.
Sec. 504. The Committee continues a provision limiting the
amount available for official reception and representation
expenses for the Secretaries of Labor and Education, the
Director of the Federal Mediation and Conciliation Service, and
the Chairman of the National Mediation Board.
Sec. 505. The Committee continues a provision requiring
grantees receiving Federal funds to clearly state the
percentage of the total cost of the program or project that
will be financed with Federal money.
Sec. 506. The Committee continues a provision prohibiting
the use of funds for any abortion.
Sec. 507. The Committee continues a provision providing
exceptions to section 506 and a provision prohibiting funds
from being made available to a Federal agency or program, or to
a State or local government, if such agency, program, or
government discriminates against institutional or individual
health care entities because they do not provide, pay for,
provide coverage of, or refer for abortions.
Sec. 508. The Committee continues a provision prohibiting
use of funds for certain research involving human embryos.
Sec. 509. The Committee continues a provision prohibiting
use of funds for any activity that promotes the legalization of
any drug or substance included in schedule I of the schedules
of controlled substances.
Sec. 510. The Committee continues a provision prohibiting
use of funds to promulgate or adopt any final standard
providing for a unique health identifier until legislation is
enacted specifically approving the standard.
Sec. 511. The Committee continues a provision related to
annual reports to the Secretary of Labor.
Sec. 512. The Committee continues a provision prohibiting
transfer of funds made available in this Act except by
authority provided in this Act or another appropriations Act.
Sec. 513. The Committee continues a provision to limit
funds in the bill for public libraries to those that comply
with the requirements of the Children's Internet Protection
Act.
Sec. 514. The Committee modifies a provision regarding
procedures for reprogramming of funds.
Sec. 515. The Committee continues a provision pertaining to
appointments to scientific advisory committees.
Sec. 516. The Committee modifies a provision requiring each
department and related agency funded through this Act to submit
an operating plan within 45 days of enactment, detailing any
funding allocations that are different than those specified in
this Act, the accompanying detailed table, or budget request.
Sec. 517. The Committee modifies a provision requiring the
Secretaries of Labor, Health and Human Services, and Education
to submit a quarterly report to the Committees on
Appropriations containing certain information on noncompetitive
contracts, grants, and cooperative agreements exceeding
$500,000 in value.
Sec. 518. The Committee continues a provision prohibiting
the use of funds to process claims for credit for quarters of
coverage based on work performed under a Social Security number
that was not the claimant's number, where the performance of
such work under such number has formed the basis for a
conviction of the claimant of a violation of section 208(a)(6)
or (7) of the Social Security Act.
Sec. 519. The Committee continues a provision prohibiting
the use of funds to implement a Social Security totalization
agreement with Mexico.
Sec. 520. The Committee continues a provision prohibiting
the use of funds for the downloading or exchanging of
pornography.
Sec. 521. The Committee continues a provision related to
reporting requirements for conference expenditures.
Sec. 522. The Committee continues a provision related to
disclosure of U.S. taxpayer funding for programs used in
advertising.
Sec. 523. The Committee modifies a provision requesting
quarterly reports on the status of balances of appropriations
from the departments of Labor, Health and Human Services and
Education.
Sec. 524. The Committee continues a provision related to
grant notifications.
Sec. 525. The Committee modifies a provision related to
needle exchange.
Sec. 526. The Committee continues a provision related to
questions for the record.
Sec. 527. The Committee modifies a provision related to
research and evaluation funding flexibility.
Sec. 528. The Committee modifies a provision related to the
obligation of funds from the Child Enrollment Contingency Fund.
(RESCISSION)
Sec. 529. The Committee includes a new provision rescinding
unobligated balances from the American Rescue Plan Act.
(RESCISSION)
Sec. 530. The Committee includes a new provision rescinding
unobligated balances from the Patient Centered Outcomes
Research Trust Fund.
(RESCISSION)
Sec. 531. The Committee includes a new provision rescinding
offsetting collections derived from fees collected from certain
qualified health plans.
Sec. 532. The Committee includes a new provision related to
compensable medical treatments or benefits under Federal
workers' compensation programs.
Sec. 533. The Committee includes a new provision
prohibiting certain actions related to a sincerely held
religious belief.
Sec. 534. The Committee includes a new provision related to
the display of flags over Federal facilities.
Sec. 535. The Committee includes a new provision related to
diversity, equity, and inclusion and critical race theory
activities.
Sec. 536. The Committee includes a new provision related to
discriminatory activities.
Sec. 537. The Committee includes a new provision related to
antisemitism.
Sec. 538. The Committee includes a new provision related to
gain of function research in certain countries.
Sec. 539. The Committee includes a new provision related to
COVID mask and vaccine mandates.
Sec. 540. The Committee includes a new provision related to
the provision related to partnerships with entities operated or
controlled by the Chinese Communist Party or the Government of
the People's Republic of China.
Sec. 541. The Committee includes a new provision related to
entities in which the People's Republic of China has any
ownership stake.
SPENDING REDUCTION ACCOUNT
Sec. 542. The Committee includes a Spending Reduction
Account.
House of Representatives Report Requirements
The following materials are submitted in accordance with
various requirements of the Rules of the House of
Representatives:
Minority Views
Pursuant to the provisions of clause 3(a)(1) of House rule
XIII and sec. 6(i) of the Committee Rules, the dissenting views
of the minority party of the House of Representatives, are
printed below:
MINORITY VIEWS
This bill is a continuation of the Republican Party's
multi-year effort to eliminate public education and jeopardize
health care for millions of Americans. It would cut funding for
health care, education, and labor programs by $19 billion--9
percent below the 2026 level.
This bill would hurt the middle class, the working class,
and the most vulnerable.
Americans are struggling to afford everything from gasoline
to groceries; from utilities to health insurance; from mortgage
payments to medical bills. But instead of doing anything to
address the affordability crisis, this bill makes the problem
even worse.
Due to the president's signature piece of legislation--the
One Big Beautiful Bill--healthcare costs are going up and
hospitals are shutting down. Fifteen million Americans will
lose their health insurance, while the very wealthy and large
corporations enjoy the benefits of a $4.5 trillion tax cut.
The president wants to increase the Defense budget by half
a trillion dollars. He claims we do not have money for child
care, Medicare, or Medicaid, because ``we are fighting wars.''
Meanwhile, this bills cuts funding for education, public
health, reproductive health, and job training.
This bill cuts $8 billion--10 percent--from the Department
of Education. That includes a cut of $2 billion to Title I
grants, which will push 30,000 teachers out of their classrooms
and leave countless children with a worse education.
It is a step down the path toward eliminating public
education.
This bill eviscerates funding for employment and training
by $3.3 billion--one-third below the 2026 level. It eliminates
funding for adult and youth job training entirely, while
cutting funding for Job Corps in half.
As inflation outpaces wage growth, and new technology
upends the workforce, we should be investing in programs that
support workers--not cutting funding and leaving them out to
dry.
This bill cuts funding for Health and Human Services
programs by $4.5 billion, including a $1 billion cut to the
Centers for Disease Control and Prevention (CDC). The majority
of these cuts target programs that combat the HIV/AIDS
epidemic, jeopardizing the extraordinary progress we have made
toward defeating this disease.
The ongoing Ebola outbreak threatens to become the
deadliest in history. Tragically, the outbreak has had a
significant head start on efforts to contain it, due to the
Trump Administration's decisions to dismantle USAID, withdraw
from the World Health Organization, and drastically scale back
our global health footprint.
Further compounding the risk to our public health security,
this bill leaves funding for CDC global health activities
stagnant, which will not be nearly enough to sustain our global
presence after the State Department's decision to restructure
the PEPFAR program.
This bill eliminates funding for Title X Family Planning,
leaving 2.6 million women and men without access to preventive
care services and contraception. It eliminates the Teen
Pregnancy Prevention Program. And it includes new partisan
provisions that target reproductive health care access.
This bill cuts $2 billion in operations funding from the
Affordable Care Act health insurance marketplace, threatening
health care coverage for millions of Americans. Even if you
qualify for an affordable ACA health care plan, you will have a
harder time accessing it.
This Administration and House Republicans are squeezing
working families from both ends--increasing costs for daily
necessities while hollowing out health, education, nutrition,
and employment programs that support the middle class, the
working class, and vulnerable Americans.
And in keeping with the majority's other partisan bills,
this bill includes a litany of poison pill riders, including
multiple provisions that target abortion rights and
reproductive health care services, multiple provisions that
would allow discrimination against LGBTQI+ individuals,
prohibitions on programs to promote diversity in the federal
government, and prohibitions on research to reduce firearm
injury and mortality prevention research.
In addition, this bill does not protect nonpartisan
scientific research from the political influence of the
president and his political allies. Since taking office, this
Administration has repeatedly tried to condition grant funding
on political preference.
On May 29, the Administration published a proposed
regulation, which would subject all federal grant-making to
political influence. Not peer review, not objective merit, not
empirical evidence--just personal political preference. This
cannot be allowed to happen. Congress must exercise its power
of the purse.
I have strong objections to this bill, as written, and as
it moves through the legislative process, I will continue
working to improve it. That being said, there are some bright
spots that I believe are worth recognizing.
First, I am glad to see the overall funding level for the
National Institutes of Health is increased under this bill,
especially targeted increase for research on cancer,
Alzheimer's disease, ALS, diabetes, women's health, and rare
diseases.
Second, during our subcommittee hearing on the Science of
Reading earlier this year, I called for this committee to
reestablish a National Reading Panel to explore ways to improve
how we teach our children to read. I am pleased that this
committee has answered that call.
However, I remain overwhelmingly opposed to the legislation
as a whole.
Full Committee Markup
During full committee markup, House Democrats proposed an
amendment to block a rescission of $2 billion from user fees
necessary to operate the ACA health insurance marketplace,
which would jeopardize health insurance for millions of
Americans who are covered by ACA health plans, but it was
rejected by the Republican majority.
House Democrats proposed an amendment to block the
termination of subsidized loans to undergraduate students,
which would increase interest rates for four million college
student borrowers, but it was rejected by the Republican
majority.
House Democrats proposed an amendment to prevent the
dismantling of the Department of Education through interagency
agreements to move education programs to other federal
departments, but it was rejected by the Republican majority.
House Democrats proposed an amendment to block OMB's
proposed rule to politicize grant-making across the federal
government, as well as an amendment to block an effort to
politicize the federal civil service workforce, but both
amendments were rejected by the Republican majority.
House Democrats proposed amendments to restore funding for
WIOA Adult and Youth job training grants, Preschool Development
Grants, Full-Service Community Schools, Teacher Quality
Partnerships, English Language Acquisition, Federal Work Study
and the Supplemental Educational Opportunity Grant, and the
Institute of Education Sciences, but each of the amendments
were rejected by the Republican majority.
House Democrats proposed amendments to restore funding for
the National Labor Relations Board, the Office of Federal
Contract Compliance Programs, and the Bureau of International
Labor Affairs (ILAB), but each of the amendments were rejected
by the Republican majority.
House Democrats proposed amendments to restore funding for
the Reintegration of Ex-Offenders program, the CDC's Racial and
Ethnic Approaches to Community Health program, SAMHSA's
Criminal and Juvenile Justice programs, and SAMHSA's
homelessness programs, but each of the amendments were rejected
by the Republican majority.
House Democrats proposed an amendment to restore funding
for firearm injury and mortality prevention research, but it
was rejected by the Republican majority.
House Democrats proposed an amendment to prohibit the
Administration from temporarily or permanently withholding
SAMHSA funds from grantees that have been approved for their
grant awards, as well as an amendment to remove a prohibition
on OSHA from finalizing a health regulation on heat injury and
illness prevention, but both amendments were rejected by the
Republican majority.
Finally, House Democrats proposed amendments to strike
harmful policy riders that do not belong in the Labor-HHS-
Education appropriations bill, including the Hyde and Weldon
amendments, the prohibition on funding for Planned Parenthood
clinics, and multiple poison pill riders that target abortion
rights and reproductive health care services, but each of the
amendments were rejected by the Republican majority.
Conclusion
Instead of addressing the cost-of-living crisis, this bill
continues the Republican Party's multi-year effort to dismantle
the nation's public education systems and the Affordable Care
Act--so I cannot support it.
This bill, like the 11 other appropriations bills, will
need support from Republicans and Democrats in the House and
Senate in order to become law.
Despite my opposition to the current bill, I look forward
to working with Chairman Cole and Chairman Aderholt through
this year's appropriations process to produce a responsible
bill that both parties can support.
Rosa L. DeLauro.
Full Committee Votes
Pursuant to the provisions of clause 3(b) of rule XIII of
the House of Representatives, the results of each roll call
vote on an amendment or on the motion to report, together with
the names of those voting for and those against, are printed
below:
FULL COMMITTEE VOTES
[GRAPHIC(S) NOT AVAILABLE IN TIFF FORMAT]
Comparative Statement of Budget Authority
Pursuant to clause 3(c)(2) of rule XIII of the Rules of the
House of Representatives and section 308(a)(1)(A) of the
Congressional Budget Act of 1974, the following table compares
the levels of new budget authority provided in the bill with
the appropriate allocation under section 302(b) of the Budget
Act.
Some funding amounts displayed under the FY 2027 Request
column are displayed in accordance with the programs and
accounts under current law and may not be directly comparable
to the display in the FY 2027 budget request submitted by the
Office and Management and Budget.
[GRAPHIC(S) NOT AVAILABLE IN TIFF FORMAT]
BUDGETARY IMPACT OF THE DEPARTMENTS OF LABOR, HEALTH AND HUMAN
SERVICES, AND EDUCATION, AND RELATED AGENCIES APPROPRIATIONS BILL,
2027, PREPARED IN CONSULTATION WITH THE CONGRESSIONAL BUDGET OFFICE
PURSUANT TO SECTION 308(A) OF THE CONGRESSIONAL BUDGET ACT OF 1974
[IN MILLIONS OF DOLLARS]
COMPARISON WITH BUDGET RESOLUTION
Pursuant to clause 3(c)(2) of rule XIII of the Rules of the
House of Representatives and section 308(a)(1)(A) of the
Congressional Budget Act of 1974, the following table compares
the levels of new budget authority provided in the bill with
the appropriate allocation under section 302(b) of the Budget
Act:
[In millions of dollars]
----------------------------------------------------------------------------------------------------------------
302(b) Allocation This Bill
---------------------------------------------------------------
Budget Budget
Authority Outlays Authority Outlays
----------------------------------------------------------------------------------------------------------------
Comparison of amounts in the bill with Committee
allocations to its subcommittees: Subcommittee
on Labor, Health and Human Services, and
Education, and Related Agencies:
Discretionary............................... .............. .............. $192,461 1$221,037
Mandatory................................... .............. .............. 1,503,574 11,495,392
----------------------------------------------------------------------------------------------------------------
1Includes outlays from prior-year budget authority.
FIVE-YEAR OUTLAY PROJECTIONS
Pursuant to clause 3(c)(2) of rule XIII and section
308(a)(1)(A) of the Congressional Budget Act of 1974, the
following table contains five-year projections associated with
the budget authority provided in the accompanying bill as
provided to the Committee by the Congressional Budget Office:
[In millions of dollars]
------------------------------------------------------------------------
Outlays
------------------------------------------------------------------------
Projection of outlays associated with the
recommendation:
2027............................................. 1$1,556,506
2028............................................. 109,992
2029............................................. 26,283
2030............................................. 6,223
2031 and future years............................ 1,464
------------------------------------------------------------------------
1Excludes outlays from prior-year budget authority.
FINANCIAL ASSISTANCE TO STATE AND LOCAL GOVERNMENTS
Pursuant to clause 3(c)(2) of rule XIII and section
308(a)(1)(A) of the Congressional Budget Act of 1974, the
Congressional Budget Office has provided the following
estimates of new budget authority and outlays provided by the
accompanying bill for financial assistance to State and local
governments:
[In millions of dollars]
------------------------------------------------------------------------
Budget Authority Outlays
------------------------------------------------------------------------
Financial Assistance to State and $545,261 1$763,608
local governments for 2027.......
------------------------------------------------------------------------
1Excludes outlays from prior-year budget authority.
Statement of General Performance Goals and Objectives
Pursuant to clause 3(c)(4) of rule XIII of the Rules of the
House of Representatives, the following is a statement of
general performance goals and objectives for which this measure
authorizes funding:
The Committee on Appropriations considers program
performance, including a program's success in
developing and attaining outcome-related goals and
objectives, in developing funding recommendations.
Program Duplication
No provision of this bill establishes or reauthorizes a
program of the Federal Government known to be duplicative of
another Federal program, a program that was included in any
report from the Government Accountability Office to Congress
pursuant to section 21 of Public Law 111-139, or a program
related to a program identified in the most recent Catalog of
Federal Domestic Assistance.
Committee Hearings
Pursuant to clause 3(c)(6) of rule XIII of the Rules of the
House of Representatives, the following hearings were used to
develop or consider the Labor, Health and Human Services, and
Education, and Related Agencies Appropriations Bill, 2027:
The Subcommittee on Labor, Health and Human Services,
Education, and Related Agencies held a hearing on February 10,
2026, entitled ``The Science of Reading.'' The Subcommittee
received testimony from:
Holly Lane, Ph.D., Director, Univ. of Florida
Literacy Institute & Professor,
Bonnie Short, Director, Alabama Reading Initiative,
and
Larry Saulsberry, Director of Teaching and Learning
for Literacy, Huntsville City Schools.
The Subcommittee on Labor, Health and Human Services,
Education, and Related Agencies held a hearing on March 4,
2026, entitled ``Preparing for the Future: America's Community
Colleges.'' The Subcommittee received testimony from:
Patricia G. Sims, EdD, President of Drake State
Community & Technical College,
Brad Hall, EdD, President of Blackfeet Community
College,
Mr. Shalin Jyotishi, Founder and Managing Director of
Future of Work and Innovation Economy Initiative, New
America
Mr. Shawn M. Morgan, Vice President of Workforce and
Strategic Initiatives at Bevill State Community
College.
The Subcommittee on Labor, Health and Human Services, and
Education, and Related Agencies held a hearing on March 5,
2026, entitled ``Member Day.'' The Subcommittee received
testimony from:
The Honorable Morgan Luttrell,
The Honorable Laura Gillen,
The Honorable Chris Smith,
The Honorable Debbie Wasserman Schultz,
The Honorable Chuck Edwards, and
The Honorable Sylvia Garcia.
The Subcommittee on Labor, Health and Human Services, and
Education, and Related Agencies held a hearing on March 17,
2026, entitled ``National Institutes of Health.'' The
Subcommittee received testimony from:
Dr. Jay Bhattacharya, M.D., Ph.D., Director of the
National Institutes of Health.
The Subcommittee on Labor, Health and Human Services, and
Education, and Related Agencies held a hearing on March 26,
2026, entitled ``Advancing Permanency in Child Welfare:
Leveraging Federal Funding for Adoption Programs.'' The
Subcommittee received testimony from:
Kate McLean, Executive Director of Congressional
Coalition on Adoption Institute,
Sarah Font, Ph.D., Professor at the Brown School at
Washington University in St. Louis,
Debbie Riley, CEO of Center for Adoption Support and
Education,
Aurene Martin, Board Secretary of the National Indian
Child Welfare Association, and
Lee Marshall, Founder and CEO of Kids to Love.
The Subcommittee on Labor, Health and Human Services, and
Education, and Related Agencies held a budget hearing on April
16, 2026, entitled ``Department of Health and Human Services
Fiscal Year 2027 Budget Hearing.'' The Subcommittee received
testimony from:
The Honorable Robert F. Kennedy, Jr., Secretary of
the Department of Health and Human Services.
Compliance With Rule XIII, Cl. 3(d) (Ramseyer Rule)
In compliance with clause 3(e) of rule XIII of the Rules of
the House of Representatives, changes in existing law made by
the bill, as reported, are shown as follows (existing law
proposed to be omitted is enclosed in black brackets, new
matter is printed in italics, and existing law in which no
change is proposed is shown in roman):
Compliance With Rule XIII, Cl. 3(e) (Ramseyer Rule)
In compliance with clause 3(e) of rule XIII of the Rules of
the House of Representatives, changes in existing law made by
the bill, as reported, are shown as follows (existing law
proposed to be omitted is enclosed in black brackets, new
matter is printed in italics, and existing law in which no
change is proposed is shown in roman):
PUBLIC HEALTH SERVICE ACT
* * * * * * *
TITLE II--ADMINISTRATION AND MISCELLANEOUS PROVISIONS
* * * * * * *
Part B--Miscellaneous Provisions
* * * * * * *
SEC. 245A. CIVIL ACTION FOR CERTAIN VIOLATIONS.
(a) In General.--A qualified party may, in a civil action,
obtain appropriate relief with regard to a designated
violation.
(b) Definitions.--For purposes of this section:
(1) Designated violation.--The term ``designated
violation'' means an actual or threatened violation
of--
(A) section 507(d) of division B of the
Consolidated Appropriations Act, 2026 (or any
subsequent substantially similar provision); or
(B) any funding condition imposed by the
Federal Government pursuant to such section
507(d) (or such substantially similar
provision).
(2) Qualified party.--The term ``qualified party''
means--
(A) the Attorney General of the United
States;
(B) any attorney general of a State; or
(C) any person or entity adversely affected
by the designated violation without regard to
whether such person or entity is a health care
provider.
(3) State governmental entity.--The term ``State
governmental entity'' means a State, a local government
within a State, and any agency or other governmental
unit or subdivision of a State, or of such a local
government.
(c) Administrative Remedies Not Required.--An action under
this section may be commenced, and relief may be granted,
without regard to whether the party commencing the action has
sought or exhausted any available administrative remedies.
(d) Defendants.--An action under this section may be
maintained against a Federal agency committing a designated
violation described in subsection (b)(1)(A) or any recipient or
subrecipient of Federal assistance committing a designated
violation described in subsection (b)(1)(B), including a State
governmental entity.
(e) Nature of Relief.--In an action under this section, the
court shall grant--
(1) all appropriate relief, including injunctive
relief, declaratory relief, and compensatory damages,
to prevent the occurrence, continuance, or repetition
of the designated violation and to compensate for
losses resulting from the designated violation; and
(2) to a prevailing plaintiff, reasonable attorneys'
fees and litigation costs.
Relief in an action under this section may include money
damages even if the defendant is a governmental entity.
(f) Abrogation of State Immunity.--No State or governmental
official that commits a designated violation shall be immune
under the Tenth Amendment to the Constitution of the United
States, the Eleventh Amendment to the Constitution of the
United States, or any other source of law, from an action under
subsection (a).
* * * * * * *
----------
HIGHER EDUCATION ACT OF 1965
* * * * * * *
TITLE IV--STUDENT ASSISTANCE
Part A--Grants to Students in Attendance at Institutions of Higher
Education
* * * * * * *
Subpart 1--Federal Pell Grants
SEC. 401. FEDERAL PELL GRANTS: AMOUNT AND DETERMINATIONS; APPLICATIONS.
(a) Purpose; Definitions.--
(1) Purpose.--The purpose of this subpart is to
provide a Federal Pell Grant to low-income students.
(2) Definitions.--In this section--
(A) the term ``adjusted gross income''
means--
(i) in the case of a dependent
student, for the second tax year
preceding the academic year--
(I) the adjusted gross income
(as defined in section 62 of
the Internal Revenue Code of
1986) of the student's parents;
plus
(II) for Federal Pell Grant
determinations made for
academic years beginning on or
after July 1, 2026, the foreign
income (as described in section
480(b)(5)) of the student's
parents; and
(ii) in the case of an independent
student, for the second tax year
preceding the academic year--
(I) the adjusted gross income
(as defined in section 62 of
the Internal Revenue Code of
1986) of the student (and the
student's spouse, if
applicable); plus
(II) for Federal Pell Grant
determinations made for
academic years beginning on or
after July 1, 2026, the foreign
income (as described in section
480(b)(5)) of the student (and
the student's spouse, if
applicable);
(B) the term ``family size'' has the meaning
given the term in section 480(k);
(C) the term ``poverty line'' means the
poverty line (as determined under the poverty
guidelines updated periodically in the Federal
Register by the Department of Health and Human
Services under the authority of section 673(2)
of the Community Services Block Grant Act (42
U.S.C. 9902(2))) applicable to the student's
family size and applicable to the second tax
year preceding the academic year;
(D) the term ``single parent'' means--
(i) a parent of a dependent student
who was a head of household (as defined
in section 2(b) of the Internal Revenue
Code of 1986) or a surviving spouse (as
defined in section 2(a) of the Internal
Revenue Code of 1986) or was an
eligible individual for purposes of the
credit under section 32 of such Code,
in the second tax year preceding the
academic year; or
(ii) an independent student who is a
parent and was a head of household (as
defined in section 2(b) of the Internal
Revenue Code of 1986) or a surviving
spouse (as defined in section 2(a) of
the Internal Revenue Code of 1986) or
was an eligible individual for purposes
of the credit under section 32 of such
Code, in the second tax year preceding
the academic year;
(E) the term ``total maximum Federal Pell
Grant'' means the total maximum Federal Pell
Grant award per student for any academic year
described under subsection (b)(5); and
(F) the term ``minimum Federal Pell Grant''
means the minimum amount of a Federal Pell
Grant that shall be awarded to a student for
any academic year in which that student is
attending full time, which shall be equal to 10
percent of the total maximum Federal Pell Grant
for such academic year.
(b) Amount and Distribution of Grants.--
(1) Determination of amount of a federal pell
grant.--Subject to paragraphs (2) and (3), the amount
of a Federal Pell Grant for a student shall be
determined in accordance with the following:
(A) A student shall be eligible for a total
maximum Federal Pell Grant for an academic year
in which the student is enrolled in an eligible
program full time--
(i) if the student (and the student's
spouse, if applicable), or, in the case
of a dependent student, the dependent
student's parents (or single parent),
is not required to file a Federal
income tax return in the second year
preceding the academic year;
(ii) if the student or, in the case
of a dependent student, the dependent
student's parent, is a single parent,
and the adjusted gross income is
greater than zero and equal to or less
than 225 percent of the poverty line;
or
(iii) if the student or, in the case
of a dependent student, the dependent
student's parent, is not a single
parent, and the adjusted gross income
is greater than zero and equal to or
less than 175 percent of the poverty
line.
(B) A student who is not eligible for a total
maximum Federal Pell Grant under subparagraph
(A) for an academic year, shall be eligible for
a Federal Pell Grant for an academic year in
which the student is enrolled in an eligible
program full time if such student's student aid
index in such award year is less than the total
maximum Federal Pell Grant for that award year.
The amount of the Federal Pell Grant for a
student eligible under this subparagraph shall
be--
(i) the total maximum Federal Pell
Grant as calculated under paragraph
(5)(A) for that year, less
(ii) an amount equal to the amount
determined to be the student aid index
with respect to that student for that
year, except that a student aid index
of less than zero shall be considered
to be zero for the purposes of this
clause,
rounded to the nearest $5, except that a
student eligible for less than the minimum
Federal Pell Grant as defined in section
(a)(2)(F) shall not be eligible for an award.
(C) A student who is not eligible for a
Federal Pell Grant under subparagraph (A) or
(B) shall be eligible for the minimum Federal
Pell Grant for an academic year in which the
student is enrolled in an eligible program full
time--
(i) in the case of a dependent
student--
(I) if the student's parent
is a single parent, and the
adjusted gross income is equal
to or less than 325 percent of
the poverty line; or
(II) if the student's parent
is not a single parent, and the
adjusted gross income is equal
to or less than 275 percent of
the poverty line; or
(ii) in the case of an independent
student--
(I) if the student is a
single parent, and the adjusted
gross income is equal to or
less than 400 percent of the
poverty line;
(II) if the student is a
parent and is not a single
parent, and the adjusted gross
income is equal to or less than
350 percent of the poverty
line; or
(III) if the student is not a
parent, and the adjusted gross
income is equal to or less than
275 percent of the poverty
line.
(D) For each academic year beginning before
July 1, 2026, a student eligible for the total
maximum Federal Pell Grant under subparagraph
(A) who has (or whose spouse or parent, as
applicable based on whose information is used
under such subparagraph, has) foreign income
that would, if added to adjusted gross income,
result in the student no longer being eligible
for such total maximum Federal Pell Grant,
shall not be provided a Federal Pell Grant
until the student aid administrator evaluates
the student's FAFSA and makes a determination
regarding whether it is appropriate to make an
adjustment under section 479A(b)(1)(B)(v), as
in effect for such academic year, to account
for such foreign income when determining the
student's eligibility for such total maximum
Federal Pell Grant.
(E) With respect to a student who is not
eligible for the total maximum Federal Pell
Grant under subparagraph (A) or a minimum
Federal Pell Grant under subparagraph (C), the
Secretary shall subtract from the student or
parents' adjusted gross income, as applicable
based on whose income is used for the Federal
Pell Grant calculation, the sum of the
following for the individual whose income is so
used, and consider such difference the adjusted
gross income for purposes of determining the
student's eligibility for such Federal Pell
Grant award under such subparagraph:
(i) If the applicant, or, if
applicable, the parents or spouse of
the applicant, elects to report
receiving college grant and scholarship
aid included in gross income on a
Federal tax return described in section
480(e)(2), the amount of such aid.
(ii) Income earned from work under
part C of this title.
(2) Less than full-time enrollment.--In any case
where a student is enrolled in an eligible program of
an institution of higher education on less than a full-
time basis (including a student who attends an
institution of higher education on less than a half-
time basis) during any academic year, the amount of the
Federal Pell Grant to which that student is entitled
shall be reduced in direct proportion to the degree to
which that student is not so enrolled on a full-time
basis, rounded to the nearest whole percentage point,
as provided in a schedule of reductions published by
the Secretary computed in accordance with this subpart.
Such schedule of reductions shall be published in the
Federal Register in accordance with section 482. Such
reduced Federal Pell Grant for a student enrolled on a
less than full-time basis shall also apply
proportionally to students who are otherwise eligible
to receive the minimum Federal Pell Grant, if enrolled
full-time.
(3) Award may not exceed cost of attendance.--No
Federal Pell Grant under this subpart shall exceed the
cost of attendance (as defined in section 472) at the
institution at which that student is in attendance. If,
with respect to any student, it is determined that the
amount of a Federal Pell Grant for that student exceeds
the cost of attendance for that year, the amount of the
Federal Pell Grant shall be reduced until the Federal
Pell Grant does not exceed the cost of attendance at
such institution.
(4) Study abroad.--Notwithstanding any other
provision of this subpart, the Secretary shall allow
the amount of the Federal Pell Grant to be exceeded for
students participating in a program of study abroad
approved for credit by the institution at which the
student is enrolled when the reasonable costs of such
program are greater than the cost of attendance at the
student's home institution, except that the amount of
such Federal Pell Grant in any fiscal year shall not
exceed the maximum amount of a Federal Pell Grant for
which a student is eligible under paragraph (1) or (2)
during such award year. If the preceding sentence
applies, the financial aid administrator at the home
institution may use the cost of the study abroad
program, rather than the home institution's cost, to
determine the cost of attendance of the student.
(5) Total maximum federal pell grant.--
(A) In general.--For award year 2024-2025,
and each subsequent award year, the total
maximum Federal Pell Grant award per student
shall be equal to the sum of--
(i) $1,060; and
(ii) the amount specified as the
maximum Federal Pell Grant in the last
enacted appropriation Act applicable to
that award year.
(B) Rounding.--The total maximum Federal Pell
Grant for any award year shall be rounded to
the nearest $5.
(6) Funds by fiscal year.--
(A) In general.--To carry out this section--
(i) there are authorized to be
appropriated and are appropriated (in
addition to any other amounts
appropriated to carry out this section
and out of any money in the Treasury
not otherwise appropriated) such sums
as are necessary to carry out paragraph
(5)(A)(i) for fiscal year 2024 and each
subsequent fiscal year; and
(ii) such sums as may be necessary
are authorized to be appropriated to
carry out paragraph (5)(A)(ii) for each
of the fiscal years 2024 through 2034.
(B) Availability of funds.--The amounts made
available by subparagraph (A) for any fiscal
year shall be available beginning on October 1
of that fiscal year, and shall remain available
through September 30 of the succeeding fiscal
year.
(7) Appropriation.--
(A) In general.--In addition to any funds
appropriated under paragraph (6) and any funds
made available for this section under any
appropriations Act, there are authorized to be
appropriated, and there are appropriated (out
of any money in the Treasury not otherwise
appropriated) to carry out this section--
(i) $1,170,000,000 for fiscal year
2024;
(ii) $3,170,000,000 for fiscal year
2025;
(iii) $12,670,000,000 for fiscal year
2026; [and]
[(iv) $1,236,000,000 for fiscal year
2027 and each succeeding fiscal year.]
(iv) $16,270,000,000 for fiscal year
2027; and
(v) $1,236,000,000 for fiscal year
2028 and each succeeding fiscal year.
(B) No effect on previous appropriations.--
The amendments made to this section by the
FAFSA Simplification Act shall not--
(i) increase or decrease the amounts
that have been appropriated or are
available to carry out this section for
fiscal year 2017, 2018, 2019, 2020,
2021, 2022, 2023, or 2024 as of the day
before the effective date of such Act;
or
(ii) extend the period of
availability for obligation that
applied to any such amount, as of the
day before such effective date.
(C) Availability of funds.--The amounts made
available by this paragraph for any fiscal year
shall be available beginning on October 1 of
that fiscal year, and shall remain available
through September 30 of the succeeding fiscal
year.
(8) Method of distribution.--
(A) In general.--For each fiscal year through
fiscal year 2034, the Secretary shall pay to
each eligible institution such sums as may be
necessary to pay each eligible student for each
academic year during which that student is in
attendance at an institution of higher
education as an undergraduate, a Federal Pell
Grant in the amount for which that student is
eligible.
(B) Alternative disbursement.--Nothing in
this section shall be interpreted to prohibit
the Secretary from paying directly to students,
in advance of the beginning of the academic
term, an amount for which they are eligible, in
the cases where an eligible institution does
not participate in the disbursement system
under subparagraph (A).
(9) Additional payment periods in same award year.--
(A) Effective in the 2017-2018 award year and
thereafter, the Secretary shall award an
eligible student not more than one and one-half
Federal Pell Grants during a single award year
to permit such student to work toward
completion of an eligible program if, during
that single award year, the student has
received a Federal Pell Grant for an award year
and is enrolled in an eligible program for one
or more additional payment periods during the
same award year that are not otherwise fully
covered by the student's Federal Pell Grant.
(B) In the case of a student receiving more
than one Federal Pell Grant in a single award
year under subparagraph (A), the total amount
of Federal Pell Grants awarded to such student
for the award year may exceed the total maximum
Federal Pell Grant available for an award year.
(C) Any period of study covered by a Federal
Pell Grant awarded under subparagraph (A) shall
be included in determining a student's duration
limit under subsection (d)(5).
(D) In any case where an eligible student is
receiving a Federal Pell Grant for a payment
period that spans 2 award years, the Secretary
shall allow the eligible institution in which
the student is enrolled to determine the award
year to which the additional period shall be
assigned, as it determines is most beneficial
to students.
(c) Special Rule.--
(1) In general.--A student described in paragraph (2)
shall be eligible for the total maximum Federal Pell
Grant.
(2) Applicability.--Paragraph (1) shall apply to any
dependent or independent student--
(A) whose parent or guardian was--
(i) an individual who, on or after
September 11, 2001, died in the line of
duty while serving on active duty as a
member of the Armed Forces; or
(ii) actively serving as a public
safety officer and died in the line of
duty while performing as a public
safety officer; and
(B) who is less than 33 years of age.
(3) Information.--Notwithstanding any other provision
of law--
(A) the Secretary shall establish the
necessary data-sharing agreements with the
Secretary of Veterans Affairs and the Secretary
of Defense, as applicable, to provide the
information necessary to determine which
students meet the requirements of paragraph
(2)(A)(i); and
(B) the financial aid administrator shall
verify with the student that the student is
eligible for the adjustment and notify the
Secretary of the adjustment of the student's
eligibility.
(4) Treatment of pell amount.--Notwithstanding
section 1212 of the Omnibus Crime Control and Safe
Streets Act of 1968 (34 U.S.C. 10302), in the case of a
student who receives an increased Federal Pell Grant
amount under this section, the total amount of such
Federal Pell Grant, including the increase under this
subsection, shall not be considered in calculating that
student's educational assistance benefits under the
Public Safety Officers' Benefits program under subpart
2 of part L of title I of such Act.
(5) Prevention of double benefits.--No eligible
student described in paragraph (2) may concurrently
receive a grant under both this subsection and
subsection (b).
(6) Terms and conditions.--The Secretary shall award
grants under this subsection in the same manner and
with the same terms and conditions, including the
length of the period of eligibility, as the Secretary
awards Federal Pell Grants under subsection (b), except
that--
(A) the award rules and determination of need
applicable to the calculation of Federal Pell
Grants under subsection (b)(1) shall not apply
to grants made under this subsection; and
(B) the maximum period determined under
subsection (d)(5) shall be determined by
including all grants made under this section
received by the eligible student and all grants
so received under subpart 10 before the
effective date of this subsection.
(7) Definition of public safety officer.--For
purposes of this subsection, the term ``public safety
officer'' means--
(A) a public safety officer, as defined in
section 1204 of title I of the Omnibus Crime
Control and Safe Streets Act of 1968 (34 U.S.C.
10284); or
(B) a fire police officer, defined as an
individual who--
(i) is serving in accordance with
State or local law as an officially
recognized or designated member of a
legally organized public safety agency;
(ii) is not a law enforcement
officer, a firefighter, a chaplain, or
a member of a rescue squad or ambulance
crew; and
(iii) provides scene security or
directs traffic--
(I) in response to any fire
drill, fire call, or other
fire, rescue, or police
emergency; or
(II) at a planned special
event.
(d) Period of Eligibility for Grants.--
(1) In general.--The period during which a student
may receive Federal Pell Grants shall be the period
required for the completion of the first undergraduate
baccalaureate course of study being pursued by that
student at the institution at which the student is in
attendance, except that any period during which the
student is enrolled in a noncredit or remedial course
of study, as described in paragraph (2), shall not be
counted for the purpose of this paragraph.
(2) Noncredit or remedial courses; study abroad.--
Nothing in this section shall exclude from eligibility
courses of study which are noncredit or remedial in
nature (including courses in English language
instruction) which are determined by the institution to
be necessary to help the student be prepared for the
pursuit of a first undergraduate baccalaureate degree
or certificate or, in the case of courses in English
language instruction, to be necessary to enable the
student to use already existing knowledge, training, or
skills. Nothing in this section shall exclude from
eligibility programs of study abroad that are approved
for credit by the home institution at which the student
is enrolled.
(3) No concurrent payments.--No student is entitled
to receive Pell Grant payments concurrently from more
than one institution or from both the Secretary and an
institution.
(4) Postbaccalaureate program.--Notwithstanding
paragraph (1), the Secretary may allow, on a case-by-
case basis, a student to receive a Federal Pell Grant
if the student--
(A) is carrying at least one-half the normal
full-time work load for the course of study the
student is pursuing, as determined by the
institution of higher education; and
(B) is enrolled or accepted for enrollment in
a postbaccalaureate program that does not lead
to a graduate degree, and in courses required
by a State in order for the student to receive
a professional certification or licensing
credential that is required for employment as a
teacher in an elementary school or secondary
school in that State,
except that this paragraph shall not apply to a student
who is enrolled in an institution of higher education
that offers a baccalaureate degree in education.
(5) Maximum period.--
(A) In general.--Except as provided in
subparagraph (B), the period during which a
student may receive Federal Pell Grants shall
not exceed 12 semesters, or the equivalent of
12 semesters, as determined by the Secretary by
regulation. Such regulations shall provide,
with respect to a student who received a
Federal Pell Grant for a term but was enrolled
at a fraction of full time, that only that same
fraction of such semester or equivalent shall
count towards such duration limits.
(B) Exception.--
(i) In general.--Any Federal Pell
Grant that a student received during a
period described in subclause (I) or
(II) of clause (ii) shall not count
towards the student's duration limits
under this paragraph.
(ii) Applicable periods.--Clause (i)
shall apply with respect to any Federal
Pell Grant awarded to a student to
enroll in an eligible program at an
institution--
(I) during a period of a
student's attendance at an
institution--
(aa) at which the
student was unable to
complete a course of
study due to the
closing of the
institution; or
(bb) for which the
student was falsely
certified as eligible
for Federal aid under
this title; or
(II) during a period--
(aa) for which the
student received a loan
under this title; and
(bb) for which the
loan described in item
(aa) is discharged
under--
(AA) section
437(c)(1) or
section
464(g)(1);
(BB) section
432(a)(6); or
(CC) section
455(h) due to
the student's
successful
assertion of a
defense to
repayment of
the loan,
including
defenses
provided to any
applicable
groups of
students.
(6) Exclusion.--Beginning on July 1, 2026, and
notwithstanding this subsection or subsection (b), a
student shall not be eligible for a Federal Pell Grant
under subsection (b) during any period for which the
student receives grant aid from non-Federal sources,
including States, institutions of higher education, or
private sources, in an amount that equals or exceeds
the student's cost of attendance for such period.
(e) Applications for Grants.--
(1) Deadlines.--The Secretary shall from time to time
set dates by which students shall file the Free
Application for Federal Student Aid under section 483.
(2) Application.--Each student desiring a Federal
Pell Grant for any year shall file the Free Application
for Federal Student Aid containing the information
necessary to enable the Secretary to carry out the
functions and responsibilities of this subpart.
(f) Distribution of Grants to Students.--Payments under this
section shall be made in accordance with regulations
promulgated by the Secretary for such purpose, in such manner
as will best accomplish the purpose of this section. Any
disbursement allowed to be made by crediting the student's
account shall be limited to tuition and fees, and food and
housing if that food and housing is institutionally owned or
operated. The student may elect to have the institution provide
other such goods and services by crediting the student's
account.
(g) Insufficient Appropriations.--If, for any fiscal year,
the funds appropriated for payments under this subpart are
insufficient to satisfy fully all entitlements, as calculated
under subsections (b) and (c) (but at the maximum grant level
specified in such appropriation), the Secretary shall promptly
transmit a notice of such insufficiency to each House of the
Congress, and identify in such notice the additional amount
that would be required to be appropriated to satisfy fully all
entitlements (as so calculated at such maximum grant level).
(h) Use of Excess Funds.--
(1) 15 percent or less.--If, at the end of a fiscal
year, the funds available for making payments under
this subpart exceed the amount necessary to make the
payments required under this subpart to eligible
students by 15 percent or less, then all of the excess
funds shall remain available for making payments under
this subpart during the next succeeding fiscal year.
(2) More than 15 percent.--If, at the end of a fiscal
year, the funds available for making payments under
this subpart exceed the amount necessary to make the
payments required under this subpart to eligible
students by more than 15 percent, then all of such
funds shall remain available for making such payments
but payments may be made under this paragraph only with
respect to entitlements for that fiscal year.
(i) Treatment of Institutions and Students Under Other
Laws.--Any institution of higher education which enters into an
agreement with the Secretary to disburse to students attending
that institution the amounts those students are eligible to
receive under this subpart shall not be deemed, by virtue of
such agreement, a contractor maintaining a system of records to
accomplish a function of the Secretary. Recipients of Pell
Grants shall not be considered to be individual grantees for
purposes of chapter 81 of title 41, United States Code.
(j) Institutional Ineligibility Based on Default Rates.--
(1) In general.--No institution of higher education
shall be an eligible institution for purposes of this
subpart if such institution of higher education is
ineligible to participate in a loan program under part
B or D as a result of a final default rate
determination made by the Secretary under part B or D
after the final publication of cohort default rates for
fiscal year 1996 or a succeeding fiscal year.
(2) Sanctions subject to appeal opportunity.--No
institution may be subject to the terms of this
subsection unless the institution has had the
opportunity to appeal the institution's default rate
determination under regulations issued by the Secretary
for the loan program authorized under part B or D, as
applicable. This subsection shall not apply to an
institution that was not participating in the loan
program authorized under part B or D on October 7,
1998, unless the institution subsequently participates
in the loan programs.
(k) Workforce Pell Grant Program.--
(1) In general.--For the award year beginning on July
1, 2026, and each subsequent award year, the Secretary
shall award grants (to be known as ``Workforce Pell
Grants'') to eligible students under paragraph (2) in
accordance with this subsection.
(2) Eligible students.--To be eligible to receive a
Workforce Pell Grant under this subsection for any
period of enrollment, a student shall meet the
eligibility requirements for a Federal Pell Grant under
this section, except that the student--
(A) shall be enrolled, or accepted for
enrollment, in an eligible program under
section 481(b)(3) (hereinafter referred to as
an ``eligible workforce program''); and
(B) may not--
(i) be enrolled, or accepted for
enrollment, in a program of study that
leads to a graduate credential; or
(ii) have attained such a credential.
(3) Terms and conditions of awards.--The Secretary
shall award Workforce Pell Grants under this subsection
in the same manner and with the same terms and
conditions as the Secretary awards Federal Pell Grants
under this section, except that--
(A) each use of the term ``eligible program''
(except in subsection (b)(9)(A)) shall be
substituted by ``eligible workforce program
under section 481(b)(3)'';
(B) the provisions of subsection (d)(2) shall
not be applicable to eligible workforce
programs; and
(C) a student who is eligible for a grant
equal to less than the amount of the minimum
Federal Pell Grant because the eligible
workforce program in which the student is
enrolled or accepted for enrollment is less
than an academic year (in hours of instruction
or weeks of duration) may still be eligible for
a Workforce Pell Grant in an amount that is
prorated based on the length of the program.
(4) Prevention of double benefits.--No eligible
student described in paragraph (2) may concurrently
receive a grant under both this subsection and--
(A) subsection (b); or
(B) subsection (c).
(5) Duration limit.--Any period of study covered by a
Workforce Pell Grant awarded under this subsection
shall be included in determining a student's duration
limit under subsection (d)(5).
* * * * * * *
PART D--WILLIAM D. FORD FEDERAL DIRECT LOAN PROGRAM
* * * * * * *
SEC. 455. TERMS AND CONDITIONS OF LOANS.
(a) In General.--
(1) Parallel terms, conditions, benefits, and
amounts.--Unless otherwise specified in this part,
loans made to borrowers under this part shall have the
same terms, conditions, and benefits, and be available
in the same amounts, as loans made to borrowers, and
first disbursed on June 30, 2010, under sections 428,
428B, 428C, and 428H of this title.
(2) Designation of loans.--Loans made to borrowers
under this part that, except as otherwise specified in
this part, have the same terms, conditions, and
benefits as loans made to borrowers under--
(A) section 428 shall be known as ``Federal
Direct Stafford Loans'';
(B) section 428B shall be known as ``Federal
Direct PLUS Loans'';
(C) section 428C shall be known as ``Federal
Direct Consolidation Loans''; and
(D) section 428H shall be known as ``Federal
Direct Unsubsidized Stafford Loans''.
(3) Termination of authority to make interest
subsidized loans and federal direct plus loans to
graduate and professional students.--
(A) Termination of authority to make interest
subsidized loans to graduate and professional
students.--Subject to subparagraph (B), and
notwithstanding any provision of this part or
part B--
(i) for any period of instruction
beginning on or after July 1, 2012, a
graduate or professional student shall
not be eligible to receive a Federal
Direct Stafford loan under this part;
and
(ii) for any period of instruction
beginning on July 1, 2012, and ending
on June 30, 2026, the maximum annual
amount of Federal Direct Unsubsidized
Stafford loans such a student may
borrow in any academic year (as defined
in section 481(a)(2)) or its equivalent
shall be the maximum annual amount for
such student determined under section
428H, plus an amount equal to the
amount of Federal Direct Stafford loans
the student would have received in the
absence of this subparagraph.
(B) Exception.--Subparagraph (A) shall not
apply to an individual enrolled in course work
specified in paragraph (3)(B) or (4)(B) of
section 484(b).
(C) Termination of authority to make federal
direct plus loans to graduate and professional
students.--Subject to paragraph (8) and
notwithstanding any provision of this part or
part B, for any period of instruction beginning
on or after July 1, 2026, a graduate or
professional student shall not be eligible to
receive a Federal Direct PLUS Loan under this
part.
(D) Termination of authority to make
subsidized loans to undergraduate students.--
Subject to paragraph (8) and notwithstanding
any provision of this part or part B, for any
period of instruction beginning on or after
July 1, 2027--
(i) an undergraduate student shall
not be eligible to receive a Federal
Direct Stafford loan under this part;
and
(ii) the maximum annual amount of
Federal Direct Unsubsidized Stafford
loans such a student may borrow in any
academic year (as defined in section
481(a)(2)) or its equivalent shall be
the maximum annual amount for such
student determined under section 428H,
plus an amount equal to the amount of
Federal Direct Stafford loans the
student would have received in the
absence of this subparagraph.
(4) Graduate and professional annual and aggregate
limits for federal direct unsubsidized stafford loans
beginning july 1, 2026.--
(A) Annual limits beginning july 1, 2026.--
Subject to paragraphs (7)(A) and (8), beginning
on July 1, 2026, the maximum annual amount of
Federal Direct Unsubsidized Stafford loans--
(i) a graduate student, who is not a
professional student, may borrow in any
academic year or its equivalent shall
be $20,500; and
(ii) a professional student may
borrow in any academic year or its
equivalent shall be $50,000.
(B) Aggregate limits.--Subject to paragraphs
(6), (7)(A), and (8), beginning on July 1,
2026, the maximum aggregate amount of Federal
Direct Unsubsidized Stafford loans, in addition
to the amount borrowed for undergraduate
education, that--
(i) a graduate student--
(I) who is not (and has not
been) a professional student,
may borrow for programs of
study described in subparagraph
(C)(i) shall be $100,000; or
(II) who is (or has been) a
professional student, may
borrow for programs of study
described in subparagraph
(C)(i) shall be an amount equal
to--
(aa) $200,000; minus
(bb) the amount such
student borrowed for
programs of study
described in
subparagraph (C)(ii);
and
(ii) a professional student--
(I) who is not (and has not
been) a graduate student, may
borrow for programs of study
described in subparagraph
(C)(ii) shall be $200,000; or
(II) who is (or has been) a
graduate student, may borrow
for programs of study described
in subparagraph (C)(ii) shall
be an amount equal to--
(aa) $200,000; minus
(bb) the amount such
student borrowed for
programs of study
described in
subparagraph (C)(i).
(C) Definitions.--
(i) Graduate student.--The term
``graduate student'' means a student
enrolled in a program of study that
awards a graduate credential (other
than a professional degree) upon
completion of the program.
(ii) Professional student.--In this
paragraph, the term ``professional
student'' means a student enrolled in a
program of study that awards a
professional degree, as defined under
section 668.2 of title 34, Code of
Federal Regulations (as in effect on
the date of enactment of this
paragraph), upon completion of the
program.
(5) Parent borrower annual and aggregate limits for
federal direct plus loans beginning july 1, 2026.--
(A) Annual limits.--Subject to paragraph (8)
and notwithstanding any provision of this part
or part B, beginning on July 1, 2026, for each
dependent student, the total maximum annual
amount of Federal Direct PLUS loans that may be
borrowed on behalf of that dependent student by
all parents of that dependent student shall be
$20,000.
(B) Aggregate limits.--Subject to paragraph
(8) and notwithstanding any provision of this
part or part B, beginning on July 1, 2026, for
each dependent student, the total maximum
aggregate amount of Federal Direct PLUS loans
that may be borrowed on behalf of that
dependent student by all parents of that
dependent student shall be $65,000, without
regard to any amounts repaid, forgiven,
canceled, or otherwise discharged on any such
loan.
(6) Lifetime maximum aggregate amount for all
students.--Subject to paragraph (8) and notwithstanding
any provision of this part or part B, beginning on July
1, 2026, the maximum aggregate amount of loans made,
insured, or guaranteed under this title that a student
may borrow (other than a Federal Direct PLUS loan, or
loan under section 428B, made to the student as a
parent borrower on behalf of a dependent student) shall
be $257,500, without regard to any amounts repaid,
forgiven, canceled, or otherwise discharged on any such
loan.
(7) Additional rules regarding annual loan limits.--
(A) Less than full-time enrollment.--
Notwithstanding any provision of this part or
part B, in any case in which a student is
enrolled in a program of study of an
institution of higher education on less than a
full-time basis during any academic year, the
amount of a loan that student may borrow for an
academic year or its equivalent shall be
reduced in direct proportion to the degree to
which that student is not so enrolled on a
full-time basis, rounded to the nearest whole
percentage point, as provided in a schedule of
reductions published by the Secretary computed
for purposes of this subparagraph.
(B) Institutionally determined limits.--
Notwithstanding the annual loan limits
established under this section and, for
undergraduate students, under this part and
part B, beginning on July 1, 2026, an
institution of higher education (at the
discretion of a financial aid administrator at
the institution) may limit the total amount of
loans made under this part for a program of
study for an academic year that a student may
borrow, and that a parent may borrow on behalf
of such student, as long as any such limit is
applied consistently to all students enrolled
in such program of study.
(8) Interim exception for certain students.--
(A) Application of prior limits.--Paragraphs
(3)(C), (4), (5), and (6) shall not apply, and
paragraph (3)(A)(ii) shall apply as such
paragraph was in effect for periods of
instruction ending before June 30, 2026, during
the expected time to credential described in
subparagraph (B), with respect to an individual
who, as of June 30, 2026--
(i) is enrolled in a program of study
at an institution of higher education;
and
(ii) has received a loan (or on whose
behalf a loan was made) under this part
for such program of study.
(B) Expected time to credential.--For
purposes of this paragraph, the expected time
to credential of an individual shall be equal
to the lesser of--
(i) three academic years; or
(ii) the period determined by
calculating the difference between--
(I) the program length for
the program of study in which
the individual is enrolled; and
(II) the period of such
program of study that such
individual has completed as of
the date of the determination
under this subparagraph.
(C) Definition of program length.--In this
paragraph, the term ``program length'' means
the minimum amount of time in weeks, months, or
years that is specified in the catalog,
marketing materials, or other official
publications of an institution of higher
education for a full-time student to complete
the requirements for a specific program of
study.
(D) Application of prior undergraduate
limits.--Paragraph (3)(D) shall not apply
during the expected time to credential
described in subparagraph (B), with respect to
an individual who, as of June 30, 2027, meets
the requirements of clauses (i) and (ii) of
subparagraph (A).
(b) Interest Rate.--
(1) Rates for fdsl and fdusl.--For Federal Direct
Stafford Loans and Federal Direct Unsubsidized Stafford
Loans for which the first disbursement is made on or
after July 1, 1994, the applicable rate of interest
shall, during any 12-month period beginning on July 1
and ending on June 30, be determined on the preceding
June 1 and be equal to--
(A) the bond equivalent rate of 91-day
Treasury bills auctioned at the final auction
held prior to such June 1; plus
(B) 3.1 percent,
except that such rate shall not exceed 8.25 percent.
(2) In school and grace period rules.--(A)
Notwithstanding the provisions of paragraph (1), but
subject to paragraph (3), with respect to any Federal
Direct Stafford Loan or Federal Direct Unsubsidized
Stafford Loan for which the first disbursement is made
on or after July 1, 1995, the applicable rate of
interest for interest which accrues--
(i) prior to the beginning of the repayment
period of the loan; or
(ii) during the period in which principal
need not be paid (whether or not such principal
is in fact paid) by reason of a provision
described in section 428(b)(1)(M) or
427(a)(2)(C),
shall not exceed the rate determined under subparagraph
(B).
(B) For the purpose of subparagraph (A), the rate
determined under this subparagraph shall, during any
12-month period beginning on July 1 and ending on June
30, be determined on the preceding June 1 and be equal
to--
(i) the bond equivalent rate of 91-day
Treasury bills auctioned at the final auction
prior to such June 1; plus
(ii) 2.5 percent,
except that such rate shall not exceed 8.25 percent.
(3) Out-year rule.--Notwithstanding paragraphs (1)
and (2), for Federal Direct Stafford Loans and Federal
Direct Unsubsidized Stafford Loans made on or after
July 1, 1998, the applicable rate of interest shall,
during any 12-month period beginning on July 1 and
ending on June 30, be determined on the preceding June
1 and be equal to--
(A) the bond equivalent rate of the security
with a comparable maturity as established by
the Secretary; plus
(B) 1.0 percent,
except that such rate shall not exceed 8.25 percent.
(4) Rates for fdplus.--
(A)(i) For Federal Direct PLUS Loans for
which the first disbursement is made on or
after July 1, 1994, the applicable rate of
interest shall, during any 12-month period
beginning on July 1 and ending on or before
June 30, 2001, be determined on the preceding
June 1 and be equal to--
(I) the bond equivalent rate of 52-
week Treasury bills auctioned at final
auction held prior to such June 1; plus
(II) 3.1 percent,
except that such rate shall not exceed 9
percent.
(ii) For any 12-month period beginning on
July 1 of 2001 or any succeeding year, the
applicable rate of interest determined under
this subparagraph shall be determined on the
preceding June 26 and be equal to--
(I) the weekly average 1-year
constant maturity Treasury yield, as
published by the Board of Governors of
the Federal Reserve System, for the
last calendar week ending on or before
such June 26; plus
(II) 3.1 percent,
except that such rate shall not exceed 9
percent.
(B) For Federal Direct PLUS loans made on or after
July 1, 1998, the applicable rate of interest shall,
during any 12-month period beginning on July 1 and
ending on June 30, be determined on the preceding June
1 and be equal to--
(i) the bond equivalent rate of the security
with a comparable maturity as established by
the Secretary; plus
(ii) 2.1 percent,
except that such rate shall not exceed 9 percent.
(5) Temporary interest rate provision.--
(A) Rates for fdsl and fdusl.--
Notwithstanding the preceding paragraphs of
this subsection, for Federal Direct Stafford
Loans and Federal Direct Unsubsidized Stafford
Loans for which the first disbursement is made
on or after July 1, 1998, and before October 1,
1998, the applicable rate of interest shall,
during any 12-month period beginning on July 1
and ending on June 30, be determined on the
preceding June 1 and be equal to--
(i) the bond equivalent rate of 91-
day Treasury bills auctioned at the
final auction held prior to such June
1; plus
(ii) 2.3 percent,
except that such rate shall not exceed 8.25
percent.
(B) In school and grace period rules.--
Notwithstanding the preceding paragraphs of
this subsection, with respect to any Federal
Direct Stafford Loan or Federal Direct
Unsubsidized Stafford Loan for which the first
disbursement is made on or after July 1, 1998,
and before October 1, 1998, the applicable rate
of interest for interest which accrues--
(i) prior to the beginning of the
repayment period of the loan; or
(ii) during the period in which
principal need not be paid (whether or
not such principal is in fact paid) by
reason of a provision described in
section 428(b)(1)(M) or 427(a)(2)(C),
shall be determined under subparagraph (A) by
substituting ``1.7 percent'' for ``2.3
percent''.
(C) PLUS loans.--Notwithstanding the
preceding paragraphs of this subsection, with
respect to Federal Direct PLUS Loan for which
the first disbursement is made on or after July
1, 1998, and before October 1, 1998, the
applicable rate of interest shall be determined
under subparagraph (A)--
(i) by substituting ``3.1 percent''
for ``2.3 percent''; and
(ii) by substituting ``9.0 percent''
for ``8.25 percent''.
(6) Interest rate provision for new loans on or after
october 1, 1998, and before july 1, 2006.--
(A) Rates for fdsl and fdusl.--
Notwithstanding the preceding paragraphs of
this subsection, for Federal Direct Stafford
Loans and Federal Direct Unsubsidized Stafford
Loans for which the first disbursement is made
on or after October 1, 1998, and before July 1,
2006, the applicable rate of interest shall,
during any 12-month period beginning on July 1
and ending on June 30, be determined on the
preceding June 1 and be equal to--
(i) the bond equivalent rate of 91-
day Treasury bills auctioned at the
final auction held prior to such June
1; plus
(ii) 2.3 percent,
except that such rate shall not exceed 8.25
percent.
(B) In school and grace period rules.--
Notwithstanding the preceding paragraphs of
this subsection, with respect to any Federal
Direct Stafford Loan or Federal Direct
Unsubsidized Stafford Loan for which the first
disbursement is made on or after October 1,
1998, and before July 1, 2006, the applicable
rate of interest for interest which accrues--
(i) prior to the beginning of the
repayment period of the loan; or
(ii) during the period in which
principal need not be paid (whether or
not such principal is in fact paid) by
reason of a provision described in
section 428(b)(1)(M) or 427(a)(2)(C),
shall be determined under subparagraph (A) by
substituting ``1.7 percent'' for ``2.3
percent''.
(C) PLUS loans.--Notwithstanding the
preceding paragraphs of this subsection, with
respect to Federal Direct PLUS Loan for which
the first disbursement is made on or after
October 1, 1998, and before July 1, 2006, the
applicable rate of interest shall be determined
under subparagraph (A)--
(i) by substituting ``3.1 percent''
for ``2.3 percent''; and
(ii) by substituting ``9.0 percent''
for ``8.25 percent''.
(D) Consolidation loans.--Notwithstanding the
preceding paragraphs of this subsection, any
Federal Direct Consolidation loan for which the
application is received on or after February 1,
1999, and before July 1, 2006, shall bear
interest at an annual rate on the unpaid
principal balance of the loan that is equal to
the lesser of--
(i) the weighted average of the
interest rates on the loans
consolidated, rounded to the nearest
higher one-eighth of one percent; or
(ii) 8.25 percent.
(E) Temporary rules for consolidation
loans.--Notwithstanding the preceding
paragraphs of this subsection, any Federal
Direct Consolidation loan for which the
application is received on or after October 1,
1998, and before February 1, 1999, shall bear
interest at an annual rate on the unpaid
principal balance of the loan that is equal
to--
(i) the bond equivalent rate of 91-
day Treasury bills auctioned at the
final auction held prior to such June
1; plus
(ii) 2.3 percent,
except that such rate shall not exceed 8.25
percent.
(7) Interest rate provision for new loans on or after
july 1, 2006 and before july 1, 2013.--
(A) Rates for fdsl and fdusl.--
Notwithstanding the preceding paragraphs of
this subsection, for Federal Direct Stafford
Loans and Federal Direct Unsubsidized Stafford
Loans for which the first disbursement is made
on or after July 1, 2006, and before July 1,
2013, the applicable rate of interest shall be
6.8 percent on the unpaid principal balance of
the loan.
(B) PLUS loans.--Notwithstanding the
preceding paragraphs of this subsection, with
respect to any Federal Direct PLUS loan for
which the first disbursement is made on or
after July 1, 2006, and before July 1, 2013,
the applicable rate of interest shall be 7.9
percent on the unpaid principal balance of the
loan.
(C) Consolidation loans.--Notwithstanding the
preceding paragraphs of this subsection, any
Federal Direct Consolidation loan for which the
application is received on or after July 1,
2006, and before July 1, 2013, shall bear
interest at an annual rate on the unpaid
principal balance of the loan that is equal to
the lesser of--
(i) the weighted average of the
interest rates on the loans
consolidated, rounded to the nearest
higher one-eighth of one percent; or
(ii) 8.25 percent.
(D) Reduced rates for undergraduate fdsl.--
Notwithstanding the preceding paragraphs of
this subsection and subparagraph (A) of this
paragraph, for Federal Direct Stafford Loans
made to undergraduate students for which the
first disbursement is made on or after July 1,
2006, and before July 1, 2013, the applicable
rate of interest shall be as follows:
(i) For a loan for which the first
disbursement is made on or after July
1, 2006, and before July 1, 2008, 6.8
percent on the unpaid principal balance
of the loan.
(ii) For a loan for which the first
disbursement is made on or after July
1, 2008, and before July 1, 2009, 6.0
percent on the unpaid principal balance
of the loan.
(iii) For a loan for which the first
disbursement is made on or after July
1, 2009, and before July 1, 2010, 5.6
percent on the unpaid principal balance
of the loan.
(iv) For a loan for which the first
disbursement is made on or after July
1, 2010, and before July 1, 2011, 4.5
percent on the unpaid principal balance
of the loan.
(v) For a loan for which the first
disbursement is made on or after July
1, 2011, and before July 1, 2013, 3.4
percent on the unpaid principal balance
of the loan.
(8) Interest rate provisions for new loans on or
after july 1, 2013.--
(A) Rates for undergraduate fdsl and fdusl.--
Notwithstanding the preceding paragraphs of
this subsection, for Federal Direct Stafford
Loans and Federal Direct Unsubsidized Stafford
Loans issued to undergraduate students, for
which the first disbursement is made on or
after July 1, 2013, the applicable rate of
interest shall, for loans disbursed during any
12-month period beginning on July 1 and ending
on June 30, be determined on the preceding June
1 and be equal to the lesser of--
(i) a rate equal to the high yield of
the 10-year Treasury note auctioned at
the final auction held prior to such
June 1 plus 2.05 percent; or
(ii) 8.25 percent.
(B) Rates for graduate and professional
fdusl.--Notwithstanding the preceding
paragraphs of this subsection, for Federal
Direct Unsubsidized Stafford Loans issued to
graduate or professional students, for which
the first disbursement is made on or after July
1, 2013, the applicable rate of interest shall,
for loans disbursed during any 12-month period
beginning on July 1 and ending on June 30, be
determined on the preceding June 1 and be equal
to the lesser of--
(i) a rate equal to the high yield of
the 10-year Treasury note auctioned at
the final auction held prior to such
June 1 plus 3.6 percent; or
(ii) 9.5 percent.
(C) PLUS loans.--Notwithstanding the
preceding paragraphs of this subsection, for
Federal Direct PLUS Loans, for which the first
disbursement is made on or after July 1, 2013,
the applicable rate of interest shall, for
loans disbursed during any 12-month period
beginning on July 1 and ending on June 30, be
determined on the preceding June 1 and be equal
to the lesser of--
(i) a rate equal to the high yield of
the 10-year Treasury note auctioned at
the final auction held prior to such
June 1 plus 4.6 percent; or
(ii) 10.5 percent.
(D) Consolidation loans.--Notwithstanding the
preceding paragraphs of this subsection, any
Federal Direct Consolidation Loan for which the
application is received on or after July 1,
2013, shall bear interest at an annual rate on
the unpaid principal balance of the loan that
is equal to the weighted average of the
interest rates on the loans consolidated,
rounded to the nearest higher one-eighth of one
percent.
(E) Consultation.--The Secretary shall
determine the applicable rate of interest under
this paragraph after consultation with the
Secretary of the Treasury and shall publish
such rate in the Federal Register as soon as
practicable after the date of determination.
(F) Rate.--The applicable rate of interest
determined under this paragraph for a Federal
Direct Stafford Loan, a Federal Direct
Unsubsidized Stafford Loan, or a Federal Direct
PLUS Loan shall be fixed for the period of the
loan.
(9) Repayment incentives.--
(A)(A) Incentives for loans disbursed before
july 1, 2012.--Notwithstanding any other
provision of this part with respect to loans
for which the first disbursement of principal
is made before July 1, 2012,, the Secretary is
authorized to prescribe by regulation such
reductions in the interest or origination fee
rate paid by a borrower of a loan made under
this part as the Secretary determines
appropriate to encourage on-time repayment of
the loan. Such reductions may be offered only
if the Secretary determines the reductions are
cost neutral and in the best financial interest
of the Federal Government. Any increase in
subsidy costs resulting from such reductions
shall be completely offset by corresponding
savings in funds available for the William D.
Ford Federal Direct Loan Program in that fiscal
year from section 458 and other administrative
accounts.
(B) Accountability.--Prior to publishing
regulations proposing repayment incentives with
respect to loans for which the first
disbursement of principal is made before July
1, 2012, the Secretary shall ensure the cost
neutrality of such reductions. The Secretary
shall not prescribe such regulations in final
form unless an official report from the
Director of the Office of Management and Budget
to the Secretary and a comparable report from
the Director of the Congressional Budget Office
to the Congress each certify that any such
reductions will be completely cost neutral.
Such reports shall be transmitted to the
authorizing committees not less than 60 days
prior to the publication of regulations
proposing such reductions.
(C) No repayment incentives for new loans
disbursed on or after july 1, 2012.--
Notwithstanding any other provision of this
part, the Secretary is prohibited from
authorizing or providing any repayment
incentive not otherwise authorized under this
part to encourage on-time repayment of a loan
under this part for which the first
disbursement of principal is made on or after
July 1, 2012, including any reduction in the
interest or origination fee rate paid by a
borrower of such a loan, except that the
Secretary may provide for an interest rate
reduction for a borrower who agrees to have
payments on such a loan automatically
electronically debited from a bank account.
(10) Publication.--The Secretary shall determine the
applicable rates of interest under this subsection
after consultation with the Secretary of the Treasury
and shall publish such rate in the Federal Register as
soon as practicable after the date of determination.
(c) Loan Fee.--
(1) In general.--The Secretary shall charge the
borrower of a loan made under this part an origination
fee of 4.0 percent of the principal amount of loan.
(2) Subsequent reduction.--Paragraph (1) shall be
applied to loans made under this part, other than
Federal Direct Consolidation loans and Federal Direct
PLUS loans--
(A) by substituting ``3.0 percent'' for ``4.0
percent'' with respect to loans for which the
first disbursement of principal is made on or
after the date of enactment of the Higher
Education Reconciliation Act of 2005, and
before July 1, 2007;
(B) by substituting ``2.5 percent'' for ``4.0
percent'' with respect to loans for which the
first disbursement of principal is made on or
after July 1, 2007, and before July 1, 2008;
(C) by substituting ``2.0 percent'' for ``4.0
percent'' with respect to loans for which the
first disbursement of principal is made on or
after July 1, 2008, and before July 1, 2009;
(D) by substituting ``1.5 percent'' for ``4.0
percent'' with respect to loans for which the
first disbursement of principal is made on or
after July 1, 2009, and before July 1, 2010;
and
(E) by substituting ``1.0 percent'' for ``4.0
percent'' with respect to loans for which the
first disbursement of principal is made on or
after July 1, 2010.
(d) Repayment Plans.--
(1) Design and selection.--Consistent with criteria
established by the Secretary, the Secretary shall offer
a borrower of a loan made under this part before July
1, 2026, who has not received a loan made under this
part on or after July 1, 2026, a variety of plans for
repayment of such loan, including principal and
interest on the loan. The borrower shall be entitled to
accelerate, without penalty, repayment on the
borrower's loans under this part. The borrower may
choose--
(A) a standard repayment plan, consistent
with subsection (a)(1) of this section and with
section 428(b)(9)(A)(i);
(B) a graduated repayment plan, consistent
with section 428(b)(9)(A)(ii);
(C) an extended repayment plan, consistent
with section 428(b)(9)(A)(iv), except that the
borrower shall annually repay a minimum amount
determined by the Secretary in accordance with
section 428(b)(1)(L);
(D) before June 30, 2028, an income
contingent repayment plan, with varying annual
repayment amounts based on the income of the
borrower, paid over an extended period of time
prescribed by the Secretary, not to exceed 25
years, except that the plan described in this
subparagraph shall not be available to the
borrower of a Federal Direct PLUS loan made on
behalf of a dependent student;
(E) beginning on July 1, 2009, an income-
based repayment plan in accordance with section
493C, except that the plan described in this
subparagraph shall not be available to the
borrower of a Federal Direct PLUS Loan made on
behalf of a dependent student or an excepted
Consolidation Loan (as defined in section
493C(a)(2)); and
(F) beginning on July 1, 2026, the income-
based Repayment Assistance Plan under
subsection (q), provided that--
(i) such Plan shall not be available
for the repayment of excepted loans (as
defined in paragraph (7)(E)); and
(ii) the borrower is required to pay
each outstanding loan of the borrower
made under this part under such
Repayment Assistance Plan, except that
a borrower of an excepted loan (as
defined in paragraph (7)(E)) may repay
the excepted loan separately from other
loans under this part obtained by the
borrower.
(2) Selection by secretary.--If a borrower of a loan
made under this part does not select a repayment plan
described in paragraph (1), the Secretary may provide
the borrower with a repayment plan described in
subparagraph (A), (B), or (C) of paragraph (1).
(3) Changes in selections.--The borrower of a loan
made under this part may change the borrower's
selection of a repayment plan under paragraph (1), or
the Secretary's selection of a plan for the borrower
under paragraph (2), as the case may be, under such
terms and conditions as may be established by the
Secretary.
(4) Alternative repayment plans.--The Secretary may
provide, on a case by case basis, an alternative
repayment plan to a borrower of a loan made under this
part who demonstrates to the satisfaction of the
Secretary that the terms and conditions of the
repayment plans available under paragraph (1) are not
adequate to accommodate the borrower's exceptional
circumstances. In designing such alternative repayment
plans, the Secretary shall ensure that such plans do
not exceed the cost to the Federal Government, as
determined on the basis of the present value of future
payments by such borrowers, of loans made using the
plans available under paragraph (1).
(5) Repayment after default.--The Secretary may
require any borrower who has defaulted on a loan made
under this part to--
(A) pay all reasonable collection costs
associated with such loan; and
(B) repay the loan pursuant to an income-
based repayment plan under subsection (q) or
section 493C, as applicable.
(6) Termination and limitation of repayment
authority.--
(A) Sunset of repayment plans available
before july 1, 2026.--Paragraphs (1) through
(4) of this subsection shall only apply to
loans made under this part before July 1, 2026.
(B) Prohibitions.--The Secretary may not, for
any loan made under this part on or after July
1, 2026--
(i) authorize a borrower of such a
loan to repay such loan pursuant to a
repayment plan that is not described in
paragraph (7)(A); or
(ii) carry out or modify a repayment
plan that is not described in such
paragraph.
(7) Repayment plans for loans made on or after july
1, 2026.--
(A) Design and selection.--Beginning on July
1, 2026, the Secretary shall offer a borrower
of a loan made under this part on or after such
date (including such a borrower who also has a
loan made under this part before such date) two
plans for repayment of the borrower's loans
under this part, including principal and
interest on such loans. The borrower shall be
entitled to accelerate, without penalty,
repayment on such loans. The borrower may
choose--
(i) a standard repayment plan--
(I) with a fixed monthly
repayment amount paid over a
fixed period of time equal to
the applicable period
determined under subclause
(II); and
(II) with the applicable
period of time for repayment
determined based on the total
outstanding principal of all
loans of the borrower made
under this part before, on, or
after July 1, 2026, at the time
the borrower is entering
repayment under such plan, as
follows--
(aa) for a borrower
with total outstanding
principal of less than
$25,000, a period of 10
years;
(bb) for a borrower
with total outstanding
principal of not less
than $25,000 and less
than $50,000, a period
of 15 years;
(cc) for a borrower
with total outstanding
principal of not less
than $50,000 and less
than $100,000, a period
of 20 years; and
(dd) for a borrower
with total outstanding
principal of $100,000
or more, a period of 25
years; or
(ii) the income-based Repayment
Assistance Plan under subsection (q).
(B) Selection by secretary.--If a borrower of
a loan made under this part on or after July 1,
2026, does not select a repayment plan
described in subparagraph (A), the Secretary
shall provide the borrower with the standard
repayment plan described in subparagraph
(A)(i).
(C) Selection applies to all outstanding
loans.--A borrower is required to pay each
outstanding loan of the borrower made under
this part under the same selected repayment
plan, except that a borrower who selects the
Repayment Assistance Plan and also has an
excepted loan that is not eligible for
repayment under such Repayment Assistance Plan
shall repay the excepted loan separately from
other loans under this part obtained by the
borrower.
(D) Changes of repayment plan.--A borrower
may change the borrower's selection of--
(i) the standard repayment plan under
subparagraph (A)(i), or the Secretary's
selection of such plan for the borrower
under subparagraph (B), as the case may
be, to the Repayment Assistance Plan
under subparagraph (A)(ii) at any time;
and
(ii) the Repayment Assistance Plan
under subparagraph (A)(ii) to the
standard repayment plan under
subparagraph (A)(i) at any time.
(E) Repayment for borrowers with excepted
loans made on or after july 1, 2026.--
(i) Standard repayment plan
required.--Notwithstanding
subparagraphs (A) through (D),
beginning on July 1, 2026, the
Secretary shall require a borrower who
has received an excepted loan made on
or after such date (including such a
borrower who also has an excepted loan
made before such date) to repay each
excepted loan, including principal and
interest on those excepted loans, under
the standard repayment plan under
subparagraph (A)(i). The borrower shall
be entitled to accelerate, without
penalty, repayment on such loans.
(ii) Excepted loan defined.--For the
purposes of this paragraph, the term
``excepted loan'' means a loan with an
outstanding balance that is--
(I) a Federal Direct PLUS
Loan that is made on behalf of
a dependent student; or
(II) a Federal Direct
Consolidation Loan, if the
proceeds of such loan were used
to discharge the liability on--
(aa) an excepted PLUS
loan, as defined in
section 493C(a)(1); or
(bb) an excepted
consolidation loan (as
such term is defined in
section 493C(a)(2)(A),
notwithstanding
subparagraph (B) of
such section).
(e) Income Contingent Repayment.--
(1) Information and procedures.--The Secretary may
obtain such information as is reasonably necessary
regarding the income of a borrower (and the borrower's
spouse, if applicable) of a loan made under this part
that is, or may be, repaid pursuant to income
contingent repayment, for the purpose of determining
the annual repayment obligation of the borrower.
Returns and return information (as defined in section
6103 of the Internal Revenue Code of 1986) may be
obtained under the preceding sentence only to the
extent authorized by section 6103(l)(13) of such Code.
The Secretary shall establish procedures for
determining the borrower's repayment obligation on that
loan for such year, and such other procedures as are
necessary to implement effectively income contingent
repayment.
(2) Repayment based on adjusted gross income.--A
repayment schedule for a loan made under this part and
repaid pursuant to income contingent repayment shall be
based on the adjusted gross income (as defined in
section 62 of the Internal Revenue Code of 1986) of the
borrower or, if the borrower is married and files a
Federal income tax return jointly with the borrower's
spouse, on the adjusted gross income of the borrower
and the borrower's spouse.
(3) Additional documents.--A borrower who chooses, or
is required, to repay a loan made under this part
pursuant to income contingent repayment, and for whom
adjusted gross income is unavailable or does not
reasonably reflect the borrower's current income, shall
provide to the Secretary other documentation of income
satisfactory to the Secretary, which documentation the
Secretary may use to determine an appropriate repayment
schedule.
(4) Repayment schedules.--Income contingent repayment
schedules shall be established by regulations
promulgated by the Secretary and shall require payments
that vary in relation to the appropriate portion of the
annual income of the borrower (and the borrower's
spouse, if applicable) as determined by the Secretary.
(5) Calculation of balance due.--The balance due on a
loan made under this part that is repaid pursuant to
income contingent repayment shall equal the unpaid
principal amount of the loan, any accrued interest, and
any fees, such as late charges, assessed on such loan.
The Secretary may promulgate regulations limiting the
amount of interest that may be capitalized on such
loan, and the timing of any such capitalization.
(6) Notification to borrowers.--The Secretary shall
establish procedures under which a borrower of a loan
made under this part who chooses or is required to
repay such loan pursuant to income contingent repayment
is notified of the terms and conditions of such plan,
considers that special circumstances, such as a loss of
employment by the borrower or the borrower's spouse,
warrant an adjustment in the borrower's loan repayment,
the borrower may contact the Secretary, who shall
determine whether such adjustment is appropriate, in
accordance with criteria established by the Secretary.
(7) Maximum repayment period.--In calculating the
extended period of time for which an income contingent
repayment plan under this subsection may be in effect
for a borrower, the Secretary shall include all time
periods during which a borrower of loans under part B,
part D, or part E--
(A) is not in default on any loan that is
included in the income contingent repayment
plan; and
(B)(i) is in deferment due to an economic
hardship described in section 435(o);
(ii) makes monthly payments under paragraph
(1) or (6) of section 493C(b);
(iii) makes monthly payments of not less than
the monthly amount calculated under section
428(b)(9)(A)(i) or subsection (d)(1)(A), based
on a 10-year repayment period, when the
borrower first made the election described in
section 493C(b)(1);
(iv) makes payments of not less than the
payments required under a standard repayment
plan under section 428(b)(9)(A)(i) or
subsection (d)(1)(A) with a repayment period of
10 years; or
(v) makes payments under an income contingent
repayment plan under subsection (d)(1)(D).
(8) Automatic recertification.--
(A) In general.--The Secretary shall
establish and implement, with respect to any
borrower described in subparagraph (B),
procedures to--
(i) use return information disclosed
under section 6103(l)(13) of the
Internal Revenue Code of 1986, pursuant
to approval provided under section 494,
to determine the repayment obligation
of the borrower without further action
by the borrower;
(ii) allow the borrower (or the
spouse of the borrower), at any time,
to opt out of disclosure under such
section 6103(l)(13) and instead provide
such information as the Secretary may
require to determine the repayment
obligation of the borrower (or withdraw
from the repayment plan under this
subsection); and
(iii) provide the borrower with an
opportunity to update the return
information so disclosed before the
determination of the repayment
obligation of the borrower.
(B) Applicability.--Subparagraph (A) shall
apply to each borrower of a loan made under
this part who, on or after the date on which
the Secretary establishes procedures under such
subparagraph--
(i) selects, or is required to repay
such loan pursuant to, an income-
contingent repayment plan; or
(ii) recertifies income or family
size under such plan.
(f) Deferment; Forbearance.--
(1) Effect on principal and interest.--A borrower of
a loan made under this part who meets the requirements
described in paragraph (2) shall be eligible for a
deferment, during which periodic installments of
principal need not be paid, and interest--
(A) shall not accrue, in the case of a--
(i) Federal Direct Stafford Loan; or
(ii) a Federal Direct Consolidation
Loan that consolidated only Federal
Direct Stafford Loans, or a combination
of such loans and Federal Stafford
Loans for which the student borrower
received an interest subsidy under
section 428; or
(B) shall accrue and be capitalized or paid
by the borrower, in the case of a Federal
Direct PLUS Loan, a Federal Direct Unsubsidized
Stafford Loan, or a Federal Direct
Consolidation Loan not described in
subparagraph (A)(ii).
(2) Eligibility.--A borrower of a loan made under
this part shall be eligible for a deferment during any
period--
(A) during which the borrower--
(i) is carrying at least one-half the
normal full-time work load for the
course of study that the borrower is
pursuing, as determined by the eligible
institution (as such term is defined in
section 435(a)) the borrower is
attending; or
(ii) is pursuing a course of study
pursuant to a graduate fellowship
program approved by the Secretary, or
pursuant to a rehabilitation training
program for individuals with
disabilities approved by the Secretary,
except that no borrower shall be eligible for a
deferment under this subparagraph, or a loan
made under this part (other than a Federal
Direct PLUS Loan or a Federal Direct
Consolidation Loan), while serving in a medical
internship or residency program;
(B) subject to paragraph (7), not in excess
of 3 years during which the borrower is seeking
and unable to find full-time employment;
(C) during which the borrower--
(i) is serving on active duty during
a war or other military operation or
national emergency; or
(ii) is performing qualifying
National Guard duty during a war or
other military operation or national
emergency,
and for the 180-day period following the
demobilization date for the service described
in clause (i) or (ii); or
(D) subject to paragraph (7), not in excess
of 3 years during which the Secretary
determines, in accordance with regulations
prescribed under section 435(o), that the
borrower has experienced or will experience an
economic hardship.
(3) Deferment for borrowers receiving cancer
treatment.--
(A) Effect on principal and interest.--A
borrower of a loan made under this part who
meets the requirements of subparagraph (B)
shall be eligible for a deferment, during which
periodic installments of principal need not be
paid, and interest shall not accrue.
(B) Eligibility.--A borrower of a loan made
under this part shall be eligible for a
deferment during--
(i) any period in which such borrower
is receiving treatment for cancer; and
(ii) the 6 months after such period.
(C) Applicability.--This paragraph shall
apply with respect to loans--
(i) made on or after the date of the
enactment of this paragraph; or
(ii) in repayment on the date of the
enactment of this paragraph.
(4) Deferment for dislocated military spouses.--
(A) Duration and effect on principal and
interest.--A borrower of a loan made under this
part who meets the requirements of subparagraph
(B) shall be eligible for a deferment for an
aggregate period of 180 days, during which
periodic installments of principal need not be
paid, and interest--
(i) shall not accrue, in the case of
a--
(I) Federal Direct Stafford
Loan; or
(II) a Federal Direct
Consolidation Loan that
consolidated only Federal
Direct Stafford Loans, or a
combination of such loans and
Federal Stafford Loans for
which the student borrower
received an interest subsidy
under section 428; or
(ii) shall accrue and be capitalized
or paid by the borrower, in the case of
a Federal Direct PLUS Loan, a Federal
Direct Unsubsidized Stafford Loan, or a
Federal Direct Consolidation Loan not
described in clause (i)(II).
(B) Eligibility.--A borrower of a loan made
under this part shall be eligible for a
deferment under subparagraph (A) if the
borrower--
(i) is the spouse of a member of the
Armed Forces serving on active duty;
and
(ii) has experienced a loss of
employment as a result of relocation to
accommodate a permanent change in duty
station of such member.
(C) Documentation and approval.--
(i) In general.--A borrower may
establish eligibility for a deferment
under subparagraph (A) by providing to
the Secretary--
(I) the documentation
described in clause (ii); or
(II) such other documentation
as the Secretary determines
appropriate.
(ii) Documentation.--The
documentation described in this clause
is--
(I) evidence that the
borrower is the spouse of a
member of the Armed Forces
serving on active duty;
(II) evidence that a military
permanent change of station
order was issued to such
member; and
(III)(aa) evidence that the
borrower is eligible for
unemployment benefits due to a
loss of employment resulting
from relocation to accommodate
such permanent change in duty
station; or
(bb) a written certification,
or an equivalent as approved by
the Secretary, that the
borrower is registered with a
public or private employment
agency due to a loss of
employment resulting from
relocation to accommodate such
permanent change in duty
station.
(5) Definition of borrower.--For the purpose of this
subsection, the term ``borrower'' means an individual
who is a new borrower on the date such individual
applies for a loan under this part for which the first
disbursement is made on or after July 1, 1993.
(6) Deferments for previous part b loan borrowers.--A
borrower of a loan made under this part, who at the
time such individual applies for such loan, has an
outstanding balance of principal or interest owing on
any loan made, insured, or guaranteed under part B of
title IV prior to July 1, 1993, shall be eligible for a
deferment under section 427(a)(2)(C) or section
428(b)(1)(M) as such sections were in effect on July
22, 1992.
(7) Sunset of unemployment and economic hardship
deferments.--A borrower who receives a loan made under
this part on or after July 1, 2027, shall not be
eligible to defer such loan under subparagraph (B) or
(D) of paragraph (2).
(8) Forbearance on loans made under this part on or
after july 1, 2027.--A borrower who receives a loan
made under this part on or after July 1, 2027, may only
be eligible for a forbearance on such loan pursuant to
section 428(c)(3)(B) that does not exceed 9 months
during any 24-month period.
(g) Federal Direct Consolidation Loans.--
(1) In general.--A borrower of a loan made under this
part may consolidate such loan with the loans described
in section 428C(a)(4), including any loan made under
part B and first disbursed before July 1, 2010. To be
eligible for a consolidation loan under this part, a
borrower shall meet the eligibility criteria set forth
in section 428C(a)(3).
(2) Separating joint consolidation loans.--
(A) In general.--
(i) Authorization.--A married couple,
or 2 individuals who were previously a
married couple, and who received a
joint consolidation loan as such
married couple under subparagraph (C)
of section 428C(a)(3) (as such
subparagraph was in effect on June 30,
2006), may apply to the Secretary, in
accordance with subparagraph (C) of
this paragraph, for each individual
borrower in the married couple (or
previously married couple) to receive a
separate Federal Direct Consolidation
Loan under this part.
(ii) Eligibility for borrowers in
default.--Notwithstanding any other
provision of this Act, a married
couple, or 2 individuals who were
previously a married couple, who are in
default on a joint consolidation loan
may be eligible to receive a separate
Federal Direct Consolidation Loan under
this part in accordance with this
paragraph.
(B) Secretarial requirements.--
Notwithstanding section 428C(a)(3)(A) or any
other provision of law, for each individual
borrower who applies under subparagraph (A),
the Secretary shall--
(i) make a separate Federal Direct
Consolidation Loan under this part
that--
(I) shall be for an amount
equal to the product of--
(aa) the unpaid
principal and accrued
unpaid interest of the
joint consolidation
loan (as of the date
that is the day before
such separate
consolidation loan is
made) and any
outstanding charges and
fees with respect to
such loan; and
(bb) the percentage
of the joint
consolidation loan
attributable to the
loans of the individual
borrower for whom such
separate consolidation
loan is being made, as
determined--
(AA) on the
basis of the
loan
obligations of
such borrower
with respect to
such joint
consolidation
loan (as of the
date such joint
consolidation
loan was made);
or
(BB) in the
case in which
both borrowers
request, on the
basis of
proportions
outlined in a
divorce decree,
court order, or
settlement
agreement; and
(II) has the same rate of
interest as the joint
consolidation loan (as of the
date that is the day before
such separate consolidation
loan is made); and
(ii) in a timely manner, notify each
individual borrower that the joint
consolidation loan had been repaid and
of the terms and conditions of their
new loans.
(C) Application for separate direct
consolidation loan.--
(i) Joint application.--Except as
provided in clause (ii), to receive
separate consolidation loans under this
part, both individual borrowers in a
married couple (or previously married
couple) shall jointly apply under
subparagraph (A).
(ii) Separate application.--An
individual borrower in a married couple
(or previously married couple) may
apply for a separate consolidation loan
under subparagraph (A) separately and
without regard to whether or when the
other individual borrower in the
married couple (or previously married
couple) applies under subparagraph (A),
in a case in which--
(I) the individual borrower
certifies to the Secretary that
such borrower--
(aa) has experienced
an act of domestic
violence (as defined in
section 40002 of the
Violence Against Women
Act of 1994 (34 U.S.C.
12291) from the other
individual borrower;
(bb) has experienced
economic abuse (as
defined in section
40002 of the Violence
Against Women Act of
1994 (34 U.S.C. 12291)
from the other
individual borrower; or
(cc) is unable to
reasonably reach or
access the loan
information of the
other individual
borrower; or
(II) the Secretary determines
that authorizing each
individual borrower to apply
separately under subparagraph
(A) would be in the best fiscal
interests of the Federal
Government.
(iii) Remaining obligation from
separate application.--In the case of
an individual borrower who receives a
separate consolidation loan due to the
circumstances described in clause (ii),
the other non-applying individual
borrower shall become solely liable for
the remaining balance of the joint
consolidation loan.
(3) Consolidation loans made on or after july 1,
2026.--A Federal Direct Consolidation Loan offered to a
borrower under this part on or after July 1, 2026, may
only be repaid pursuant to a repayment plan described
in clause (i) or (ii) of subsection (d)(7)(A) of this
section, as applicable, and the repayment schedule of
such a Consolidation Loan shall be determined in
accordance with such repayment plan.
(h) Borrower Defenses.--Notwithstanding any other provision
of State or Federal law, the Secretary shall specify in
regulations which acts or omissions of an institution of higher
education a borrower may assert as a defense to repayment of a
loan made under this part, except that in no event may a
borrower recover from the Secretary, in any action arising from
or relating to a loan made under this part, an amount in excess
of the amount such borrower has repaid on such loan.
(i) Loan Application and Promissory Note.--The common
financial reporting form required in section 483(a)(1) shall
constitute the application for loans made under this part
(other than a Federal Direct PLUS loan). The Secretary shall
develop, print, and distribute to participating institutions a
standard promissory note and loan disclosure form.
(j) Loan Disbursement.--
(1) In general.--Proceeds of loans to students under
this part shall be applied to the student's account for
tuition and fees, and, in the case of institutionally
owned housing, to room and board. Loan proceeds that
remain after the application of the previous sentence
shall be delivered to the borrower by check or other
means that is payable to and requires the endorsement
or other certification by such borrower.
(2) Payment periods.--The Secretary shall establish
periods for the payments described in paragraph (1) in
a manner consistent with payment of Federal Pell Grants
under subpart 1 of part A of this title.
(k) Fiscal Control and Fund Accountability.--
(1) In general.--(A) An institution shall maintain
financial records in a manner consistent with records
maintained for other programs under this title.
(B) Except as otherwise required by regulations of
the Secretary an institution may maintain loan funds
under this part in the same account as other Federal
student financial assistance.
(2) Payments and refunds.--Payments and refunds shall
be reconciled in a manner consistent with the manner
set forth for the submission of a payment summary
report required of institutions participating in the
program under subpart 1 of part A, except that nothing
in this paragraph shall prevent such reconciliations on
a monthly basis.
(3) Transaction histories.--All transaction histories
under this part shall be maintained using the same
system designated by the Secretary for the provision of
Federal Pell Grants under subpart 1 of part A of this
title.
(l) Armed Forces and NOAA Commissioned Officer Corps Student
Loan Interest Payment Programs.--
(1) Authority.--Using funds received by transfer to
the Secretary under section 2174 of title 10, United
States Code, or section 268 of the National Oceanic and
Atmospheric Administration Commissioned Officer Corps
Act of 2002 for the payment of interest on a loan made
under this part to a member of the Armed Forces or an
officer in the commissioned officer corps of the
National Oceanic and Atmospheric Administration,
respectively, the Secretary shall pay the interest on
the loan as due for a period not in excess of 36
consecutive months. The Secretary may not pay interest
on such a loan out of any funds other than funds that
have been so transferred.
(2) Forbearance.--During the period in which the
Secretary is making payments on a loan under paragraph
(1), the Secretary shall grant the borrower
forbearance, in the form of a temporary cessation of
all payments on the loan other than the payments of
interest on the loan that are made under that
paragraph.
(m) Repayment Plan for Public Service Employees.--
(1) In general.--The Secretary shall cancel the
balance of interest and principal due, in accordance
with paragraph (2), on any eligible Federal Direct Loan
not in default for a borrower who--
(A) has made 120 monthly payments on the
eligible Federal Direct Loan after October 1,
2007, pursuant to any one or a combination of
the following--
(i) payments under an income-based
repayment plan under section 493C;
(ii) payments under a standard
repayment plan under subsection
(d)(1)(A), based on a 10-year repayment
period;
(iii) monthly payments under a
repayment plan under subsection (d)(1)
or (g) of not less than the monthly
amount calculated under subsection
(d)(1)(A), based on a 10-year repayment
period;
(iv) payments under an income
contingent repayment plan under
subsection (d)(1)(D) (as in effect on
the day before the date of the repeal
of subsection (e) of this section); or
(v) on-time payments under the
Repayment Assistance Plan under
subsection (q); and
(B)(i) is employed in a public service job at
the time of such forgiveness; and
(ii) has been employed in a public service
job during the period in which the borrower
makes each of the 120 payments described in
subparagraph (A).
(2) Loan cancellation amount.--After the conclusion
of the employment period described in paragraph (1),
the Secretary shall cancel the obligation to repay the
balance of principal and interest due as of the time of
such cancellation, on the eligible Federal Direct Loans
made to the borrower under this part.
(3) Definitions.--In this subsection:
(A) Eligible federal direct loan.--The term
``eligible Federal Direct Loan'' means a
Federal Direct Stafford Loan, Federal Direct
PLUS Loan, or Federal Direct Unsubsidized
Stafford Loan, or a Federal Direct
Consolidation Loan.
(B) Public service job.--The term ``public
service job'' means--
(i) a full-time job in emergency
management, government (excluding time
served as a member of Congress),
military service, public safety, law
enforcement, public health (including
nurses, nurse practitioners, nurses in
a clinical setting, and full-time
professionals engaged in health care
practitioner occupations and health
care support occupations, as such terms
are defined by the Bureau of Labor
Statistics), public education, social
work in a public child or family
service agency, public interest law
services (including prosecution or
public defense or legal advocacy on
behalf of low-income communities at a
nonprofit organization), early
childhood education (including licensed
or regulated childcare, Head Start, and
State funded prekindergarten), public
service for individuals with
disabilities, public service for the
elderly, public library sciences,
school-based library sciences and other
school-based services, or at an
organization that is described in
section 501(c)(3) of the Internal
Revenue Code of 1986 and exempt from
taxation under section 501(a) of such
Code; or
(ii) teaching as a full-time faculty
member at a Tribal College or
University as defined in section 316(b)
and other faculty teaching in high-
needs subject areas or areas of
shortage (including nurse faculty,
foreign language faculty, and part-time
faculty at community colleges), as
determined by the Secretary.
(4) Ineligibility for double benefits.--No borrower
may, for the same service, receive a reduction of loan
obligations under both this subsection and section
428J, 428K, 428L, or 460.
(n) Identity Fraud Protection.--The Secretary shall take such
steps as may be necessary to ensure that monthly Federal Direct
Loan statements and other publications of the Department do not
contain more than four digits of the Social Security number of
any individual.
(o) No Accrual of Interest for Active Duty Service Members.--
(1) In general.--Notwithstanding any other provision
of this part and in accordance with paragraphs (2) and
(4), interest shall not accrue for an eligible military
borrower on a loan made under this part for which the
first disbursement is made on or after October 1, 2008.
(2) Consolidation loans.--In the case of any
consolidation loan made under this part that is
disbursed on or after October 1, 2008, interest shall
not accrue pursuant to this subsection only on such
portion of such loan as was used to repay a loan made
under this part for which the first disbursement is
made on or after October 1, 2008.
(3) Eligible military borrower.--In this subsection,
the term ``eligible military borrower'' means an
individual who--
(A)(i) is serving on active duty during a war
or other military operation or national
emergency; or
(ii) is performing qualifying National Guard
duty during a war or other military operation
or national emergency; and
(B) is serving in an area of hostilities in
which service qualifies for special pay under
section 310, or paragraph (1) or (3) of section
351(a), of title 37, United States Code.
(4) Limitation.--An individual who qualifies as an
eligible military borrower under this subsection may
receive the benefit of this subsection for not more
than 60 months.
(p) Disclosures.--Each institution of higher education with
which the Secretary has an agreement under section 453, and
each contractor with which the Secretary has a contract under
section 456, shall, with respect to loans under this part and
in accordance with such regulations as the Secretary shall
prescribe, comply with each of the requirements under section
433 that apply to a lender with respect to a loan under part B.
(q) Repayment Assistance Plan.--
(1) In general.--Notwithstanding any other provision
of this Act, beginning on July 1, 2026, the Secretary
shall carry out an income-based repayment plan (to be
known as the ``Repayment Assistance Plan''), that shall
have the following terms and conditions:
(A) The total monthly repayment amount owed
by a borrower for all of the loans of the
borrower that are repaid pursuant to the
Repayment Assistance Plan shall be equal to the
applicable monthly payment of a borrower
calculated under paragraph (4)(B), except that
the borrower may not be precluded from repaying
an amount that exceeds such amount for any
month.
(B) The Secretary shall apply the borrower's
applicable monthly payment under this paragraph
first toward interest due on each such loan,
next toward any fees due on each loan, and then
toward the principal of each loan.
(C) Any principal due and not paid under
subparagraph (B) or paragraph (2)(B) shall be
deferred.
(D) A borrower who is not in a period of
deferment or forbearance shall make an
applicable monthly payment for each month until
the earlier of--
(i) the date on which the outstanding
balance of principal and interest due
on all of the loans of the borrower
that are repaid pursuant to the
Repayment Assistance Plan is $0; or
(ii) the date on which the borrower
has made 360 qualifying monthly
payments.
(E) The Secretary shall cancel any
outstanding balance of principal and interest
due on a loan made under this part to a
borrower--
(i) who, for any period of time,
participated in the Repayment
Assistance Plan under this subsection;
(ii) whose most recent payment for
such loan prior to the loan
cancellation under this subparagraph
was made under such Repayment
Assistance Plan; and
(iii) who has made 360 qualifying
monthly payments on such loan.
(F) For the purposes of this subsection, the
term ``qualifying monthly payment'' means any
of the following:
(i) An on-time applicable monthly
payment under this subsection.
(ii) An on-time monthly payment under
the standard repayment plan under
subsection (d)(7)(A)(i) of not less
than the monthly payment required under
such plan.
(iii) A monthly payment under any
repayment plan (excluding the Repayment
Assistance Plan under this subsection)
of not less than the monthly payment
that would be required under a standard
repayment plan under section
455(d)(1)(A) with a repayment period of
10 years.
(iv) A monthly payment under section
493C of not less than the monthly
payment required under such section,
including a monthly payment equal to
the minimum payment amount permitted
under such section.
(v) A monthly payment made before
July 1, 2028, under an income
contingent repayment plan carried out
under section 455(d)(1)(D) (or under an
alternative repayment plan in lieu of
repayment under such an income
contingent repayment plan, if placed in
such an alternative repayment plan by
the Secretary) of not less than the
monthly payment required under such a
plan, including a monthly payment equal
to the minimum payment amount permitted
under such a plan.
(vi) A month when the borrower did
not make a payment because the borrower
was in deferment under subsection
(f)(2)(B) or due to an economic
hardship described in subsection
(f)(2)(D).
(vii) A month that ended before the
date of enactment of this subsection
when the borrower did not make a
payment because the borrower was in a
period of deferment or forbearance
described in section 685.209(k)(4)(iv)
of title 34, Code of Federal
Regulations (as in effect on the date
of enactment of this subsection).
(G) The procedures established by the
Secretary under section 493C(c) shall apply for
annually determining the borrower's eligibility
for the Repayment Assistance Plan, including
verification of a borrower's annual income and
the annual amount due on the total amount of
loans eligible to be repaid under this
subsection, and such other procedures as are
necessary to effectively implement income-based
repayment under this subsection. With respect
to carrying out section 494(a)(2) for the
Repayment Assistance Plan, an individual may
elect to opt out of the disclosures required
under section 494(a)(2)(A)(ii) in accordance
with the procedures established under section
493C(c)(2).
(2) Balance assistance for distressed borrowers.--
(A) Interest subsidy.--With respect to a
borrower of a loan made under this part, for
each month for which such a borrower makes an
on-time applicable monthly payment required
under paragraph (1)(A) and such monthly payment
is insufficient to pay the total amount of
interest that accrues for the month on all
loans of the borrower repaid pursuant to the
Repayment Assistance Plan under this
subsection, the amount of interest accrued and
not paid for the month shall not be charged to
the borrower.
(B) Matching principal payment.--With respect
to a borrower of a loan made under this part
and not in a period of deferment or
forbearance, for each month for which a
borrower makes an on-time applicable monthly
payment required under paragraph (1)(A) and
such monthly payment reduces the total
outstanding principal balance of all loans of
the borrower repaid pursuant to the Repayment
Assistance Plan under this subsection by less
than $50, the Secretary shall reduce such total
outstanding principal balance of the borrower
by an amount that is equal to--
(i) the amount that is the lesser
of--
(I) $50; or
(II) the total amount paid by
the borrower for such month
pursuant to paragraph (1)(A);
minus
(ii) the total amount paid by the
borrower for such month pursuant to
paragraph (1)(A) that is applied to
such total outstanding principal
balance.
(3) Additional documents.--A borrower who chooses, or
is required, to repay a loan under this subsection, and
for whom adjusted gross income is unavailable or does
not reasonably reflect the borrower's current income,
shall provide to the Secretary other documentation of
income satisfactory to the Secretary, which
documentation the Secretary may use to determine
repayment under this subsection.
(4) Definitions.--In this subsection:
(A) Adjusted gross income.--The term
``adjusted gross income'', when used with
respect to a borrower, means the adjusted gross
income (as such term is defined in section 62
of the Internal Revenue Code of 1986) of the
borrower (and the borrower's spouse, as
applicable) for the most recent taxable year,
except that, in the case of a married borrower
who files a separate Federal income tax return,
the term does not include the adjusted gross
income of the borrower's spouse.
(B) Applicable monthly payment.--
(i) In general.--Except as provided
in clause (ii), (iii), or (vi), the
term ``applicable monthly payment''
means, when used with respect to a
borrower, the amount equal to--
(I) the applicable base
payment of the borrower,
divided by 12; minus
(II) $50 for each dependent
of the borrower (which, in the
case of a married borrower
filing a separate Federal
income tax return, shall
include only each dependent
that the borrower claims on
that return).
(ii) Minimum amount.--In the case of
a borrower with an applicable monthly
payment amount calculated under clause
(i) that is less than $10, the
applicable monthly payment of the
borrower shall be $10.
(iii) Final payment.--In the case of
a borrower whose total outstanding
balance of principal and interest on
all of the loans of the borrower that
are repaid pursuant to the Repayment
Assistance Plan is less than the
applicable monthly payment calculated
pursuant to clause (i) or (ii), as
applicable, then the applicable monthly
payment of the borrower shall be the
total outstanding balance of principal
and interest on all such loans.
(iv) Base payment.--The amount of the
applicable base payment for a borrower
with an adjusted gross income of--
(I) not more than $10,000, is
$120;
(II) more than $10,000 and
not more than $20,000, is 1
percent of such adjusted gross
income;
(III) more than $20,000 and
not more than $30,000, is 2
percent of such adjusted gross
income;
(IV) more than $30,000 and
not more than $40,000, is 3
percent of such adjusted gross
income;
(V) more than $40,000 and not
more than $50,000, is 4 percent
of such adjusted gross income;
(VI) more than $50,000 and
not more than $60,000, is 5
percent of such adjusted gross
income;
(VII) more than $60,000 and
not more than $70,000, is 6
percent of such adjusted gross
income;
(VIII) more than $70,000 and
not more than $80,000, is 7
percent of such adjusted gross
income;
(IX) more than $80,000 and
not more than $90,000, is 8
percent of such adjusted gross
income;
(X) more than $90,000 and not
more than $100,000, is 9
percent of such adjusted gross
income; and
(XI) more than $100,000, is
10 percent of such adjusted
gross income.
(v) Dependent.--For the purposes of
this paragraph, the term ``dependent''
means an individual who is a dependent
under section 152 of the Internal
Revenue Code of 1986.
(vi) Special rule.--In the case of a
borrower who is required by the
Secretary to provide information to the
Secretary to determine the applicable
monthly payment of the borrower under
this subparagraph, and who does not
comply with such requirement, the
applicable monthly payment of the
borrower shall be--
(I) the sum of the monthly
payment amounts the borrower
would have paid for each of the
borrower's loans made under
this part under a standard
repayment plan with a fixed
monthly repayment amount, paid
over a period of 10 years,
based on the outstanding
principal due on such loan when
such loan entered repayment;
and
(II) determined pursuant to
this clause until the date on
which the borrower provides
such information to the
Secretary.
* * * * * * *
Changes in the Application of Existing Law
Pursuant to clause 3(f)(1)(A) of rule XIII of the Rules of
the House of Representatives, the following statements are
submitted describing the effect of provisions in the
accompanying bill that directly or indirectly change the
application of existing law.
The bill includes a number of provisions which place
limitations on the use of funds in the bill or change existing
limitations and that might, under some circumstances, be
construed as changing the application of existing law:
TITLE I--DEPARTMENT OF LABOR
Language is included under ``Employment and Training
Administration'' providing that allotments to outlying areas
are not required to be made through the Pacific Region
Educational Laboratory as provided by section 127 of the
Workforce Innovation and Opportunity Act (WIOA).
Language is included under ``Employment and Training
Administration'' providing that outlying areas may submit a
single application for consolidated grant awards and may use
the funds for any of the programs and activities authorized
under subtitle B of title I of WIOA.
Language is included under ``Employment and Training
Administration'' providing amounts made available for
dislocated workers may be used for State activities or across
multiple local areas where workers remain dislocated.
Language is included under ``Employment and Training
Administration'' providing that technical assistance and
demonstration projects may provide assistance to new entrants
in the workforce and incumbent workers.
Language is included under ``Employment and Training
Administration'' providing that the Secretary may reserve a
higher percentage of funds for technical assistance than what
is provided in section 168(b) of the WIOA.
Language is included under ``State Unemployment Insurance
and Employment Service Operations'' providing funds to States
to improve operations and modernize State Unemployment
Insurance systems.
Language is included under ``State Unemployment Insurance
and Employment Service Operations'' providing authority for
States to use funds to assist other States to carry out
authorized activities in cases of a major disaster declared by
the President under the Robert T. Stafford Disaster Relief and
Emergency Assistance Act.
Language is included under ``State Unemployment Insurance
and Employment Service Operations'' providing that the
Department of Labor may make payments on behalf of States for
the use of the National Directory of New Hires.
Language is included under ``State Unemployment Insurance
and Employment Service Operations'' providing that the
Department of Labor may make payments from funds appropriated
for States' grants on behalf of States to the entity operating
the State Information Data Exchange System.
Language is included under ``State Unemployment Insurance
and Employment Service Operations'' providing that
appropriations for establishing a national one-stop career
system may be obligated in contracts, grants or agreements with
States or non-State entities.
Language is included under ``State Unemployment Insurance
and Employment Service Operations'' providing that funds
available for integrated Unemployment Insurance and Employment
Service automation may be used by States notwithstanding cost
allocation principles prescribed under the Office of Management
and Budget ``Uniform Administrative Requirements, Cost
Principles, and Audit Requirements for Federal Awards.''
Language is included under ``State Unemployment Insurance
and Employment Service Operations'' providing that the
Department of Labor may reallot funds among States
participating in a consortium.
Language is included under ``State Unemployment Insurance
and Employment Service Operations'' allowing the Secretary to
collect fees for the costs associated with additional data
collection, analyses, and reporting services related to the
National Agricultural Workers Survey.
Language is included under ``Veterans' Employment and
Training'' providing that funds may be used for support
specialists providing intensive services to wounded service
members, spouses or other family caregivers of the service
member, and to Gold Star Spouses.
Language is included under ``Veterans' Employment and
Training'' providing that the Department may award grants under
section 2023 of Title 38, United States Code.
Language is included under ``Veterans' Employment and
Training'' providing that services may be provided to certain
homeless or recently incarcerated veterans under section 2021,
2021A, and 2023 of Title 38, United States Code.
Language is included under ``Veterans' Employment and
Training'' providing that the fees assessed pursuant to the
HIRE Vets Medallion Award Fund shall be available to the
Secretary for expenses of the HIRE Vets Medallion Award Program
and that the start date prescribed in the Act shall not apply.
Language is included under ``Special Benefits'' providing
that the Department of Labor may use authority to reimburse an
employer who is not the employer at the time of injury for
portions of the salary of a re-employed, disabled beneficiary.
Language is included under ``Special Benefits'' providing
that funds shall be transferred to the appropriation from
entities required under 5 U.S.C. 8147(c) as determined by the
Department of Labor.
Language is included under ``Special Benefits'' providing
that of funds transferred from entities under 5 U.S.C 8147(c),
specified amounts may be used by the Department of Labor for
maintenance and data and communications systems, workload
processing, roll disability management and medical review, and
program integrity with remaining amounts paid into the
Treasury.
Language is included under ``Special Benefits'' providing
that the Secretary may prescribe regulations requiring
identification for the filing of benefit claims.
Language is included under ``Administrative Expenses,
Energy Employees Occupational Illness Compensation Fund''
providing that the Secretary may prescribe regulations for
requiring identification for the filing of benefit claims.
Language is included under ``Occupational Safety and Health
Administration'' providing that up to a certain amount of fees
collected from the training institute may be retained and used
for related training and education.
Language is included under ``Occupational Safety and Health
Administration'' providing that fees collected from Nationally
Recognized Testing Laboratories may be used to administer
laboratory recognition programs that ensure safety of equipment
used in the workplace.
Language is included under ``Mine Safety and Health
Administration'' providing that a specific amount may be
collected by the National Mine Health and Safety Academy and
made available for mine safety and health education and
training.
Language is included under ``Mine Safety and Health
Administration'' providing that a specific amount may be
collected from the approval and certification of equipment and
materials and made available for other such activities.
Language is included under ``Mine Safety and Health
Administration'' providing that the Department of Labor may
accept lands, buildings, equipment, and other contributions
from public and private sources for cooperative projects.
Language is included under ``Mine Safety and Health
Administration'' providing that the Department of Labor may
promote health and safety education and training through
cooperative agreements with States, industry, and safety
associations.
Language is included under ``Mine Safety and Health
Administration'' providing that the Department of Labor may
recognize the Joseph A. Holmes Safety Association as the
principal safety association and may provide funds or personnel
as officers in local chapters or the national organization.
Language is included under ``General Provisions''
prohibiting the use of any funds appropriated for grants under
section 414(c) of the American Competitiveness and Workforce
Improvement Act of 1998, for purposes other than competitive
grants for training individuals over the age of 16 who are not
currently enrolled in school in the occupations and industries
for which employers are using H-1B visa to hire foreign
workers.
Language is included under ``General Provisions'' allowing
the Secretary to furnish a certain amount of excess personal
property to apprenticeship programs through grants, contracts,
and other arrangements.
Language is included under ``General Provisions'' providing
that the Secretary may dispose or divest of certain Job Corps
center property and use the proceeds to carry out the program
in the same geographic location.
Language is included under ``General Provisions''
establishing the effective Adverse Effect Wage rate for the
fiscal year.
Language is included under ``General Provisions'' to
prohibit funding for the proposed ``Heat Injury and Illness
Prevention in Outdoor and Indoor Work Settings'' rule.
TITLE II--DEPARTMENT OF HEALTH AND HUMAN SERVICES
Language is included under ``Health Resources and Services
Administration--Health Workforce'' overriding the proportional
funding requirements in the Public Health Service Act for
sections 751 and 756.
Language is included under ``Health Resources and Services
Administration--Health Workforce'' providing permissive
authority to the Secretary to waive requirements for entities
awarded funds from sections 751(d)(2)(A) and 751 (d)(2)(B).
Language is included under ``Health Resources and Services
Administration--Health Workforce'' providing 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 the operation program and shall remain
available until expended to carry out that Act.
Language is included under ``Health Resources and Services
Administration--Health Workforce'' allowing funds for the Nurse
Corps and National Health Service Corps Scholarship and Loan
programs to be used to make prior year adjustments.
Language is included under ``Health Resources and Services
Administration--Health Workforce'' providing funding under the
National Health Service Corps Loan Repayment Program for
substance use disorder counselors and placement in Indian
Health Service facilities.
Language is included under ``Health Resources and Services
Administration--Health Workforce'' to provide funds for the
purpose of establishing or expanding optional community-based
nurse practitioner fellowship programs.
Language is included under ``Health Resources and Services
Administration--Health Workforce'' to provide funds for grants
to public institutions of higher education meeting certain
requirements for graduate education for physicians.
Language is included under ``Health Resources and Services
Administration--Rural Health'' to provide funding for State
Offices of Rural Health notwithstanding section 338J(k), which
terminates the program after an aggregate funding amount.
Language is included under ``Centers for Disease Control
and Prevention--Buildings and Facilities'' providing the use of
funds to support acquisition, renovation, or replacement, of
the National Institute Occupational Safety and Health's
underground and surface coal mining research capacity.
Language is included under ``Centers for Disease Control
and Prevention--CDC-Wide'' related to the implementation of the
Epidemiology-Laboratory Capacity Grant program.
Language is included under ``Substance Abuse and Mental
Health Services Administration--Mental Health'' related to data
infrastructure development.
Language is included under ``Substance Abuse and Mental
Health Services Administration--Mental Health'' requiring that
5 percent of the Mental Health Block Grant funding be available
to support evidence-based crisis systems.
Language is included under ``Substance Abuse and Mental
Health Services Administration--Mental Health'' allowing up to
10 percent of the amounts made available to carry out the
Children's Mental Health Services program may be used to carry
out demonstration grants or contracts for early interventions
for people 25 years and younger at high risk of developing a
first episode of psychosis.
Language is included under ``Substance Abuse and Mental
Health Services Administration--Mental Health'' exempting the
Mental Health Block Grant from the evaluation set-aside in
section 241 of the Public Health Service Act.
Language is included under ``Substance Abuse and Mental
Health Services Administration--Substance Abuse Treatment''
requiring that 4.25 percent of State Opioid Response grant
funding be made available for Indian Tribes or tribal
organizations.
Language is included under ``Administration for Children
and Families--Low Income Home Energy Assistance'' modifying the
formula distribution of funds.
Language is included under ``Administration for Children
and Families--Refugee and Entrant Assistance'' to exempt the
matching requirements of certain funds as required in section
235(c)(6)(C)(iii) of the William Wilberforce Trafficking
Victims Protection Reauthorization Act of 2008.
Language is included under ``Administration for Children
and Families--Payments to States for the Child Care and
Development Block Grant'' reserving 5 percent of available
funds for payments to Indian Tribes and Tribal organizations.
Language is included under ``Administration for Children
and Families--Payments to States for the Child Care and
Development Block Grant'' to make amounts available for Federal
administrative expenses.
Language is included under ``Administration for Children
and Families--Children and Families Services Programs'' related
to the calculation of base grants, the Tribal Colleges and
Universities Head Start Partnership program, and selection
criteria for Head Start programs operated by Indian tribes.
Language is included under ``Administration for Children
and Families--Children and Families Services Programs'' related
to the allocation of funding in the Family Violence Prevention
and Services Act.
Language is included under ``Administration for Community
Living--Aging and Disability Services Programs'' to allow
funding provided for adult protective services grants under
section 2042 of title XX of the Social Security Act to be set-
aside for Tribes and Tribal organizations.
Language is included making 2.5 percent of amounts
appropriated for programs authorized under the PHS Act
available for the purposes and in the amounts provided in this
Act, or for the evaluation of such programs.
Language is included modifying the timeframe when a NHSC
contract may be terminated.
Language is included requiring that providers of Title X
services adhere to state laws requiring notification or the
reporting of child abuse, child molestation, sexual abuse,
rape, or incest.
Language is included prohibiting the Secretary from denying
participation in the Medicare Advantage program to entities who
do not provide coverage or referrals for abortion services.
Language is included permitting funding for HHS
international HIV/AIDS and other infectious disease, chronic
and environmental disease, and other health activities abroad
to be spent under the State Department Basic Authorities Act of
1956.
Language is included granting authority to the Office of
the Director of the NIH to enter directly into transactions in
order to implement the NIH Common Fund for medical research and
permitting the Director to utilize peer review procedures as
the Director deems appropriate.
Language is included providing the Biomedical Advanced
Research and Development Authority ten-year contract authority.
Language is included directing the Secretary to consider
current recommendations of the United State Preventive Services
Task Force with respect to breast cancer screening,
mammography, and prevention as if such recommendations were a
reference to such recommendations issued before 2009.
Language is included limiting the availability of funds
made available to the NIH for use for facilities and
administration costs by certain specified institutions.
Language is included allowing HHS to cover travel expenses
when necessary for employees to obtain medical care when they
are assigned to duty in a location in response to a public
health emergency.
Language is included permitting the Secretary to accept
gifts to support Early Head Start programs under specified
circumstances.
Language is included related to the circumstances when the
Secretary may accept donations related to the care of
unaccompanied alien children.
Language is included limiting the availability of funds to
conduct or support biomedical research, testing, or
experimentation on dogs or cats under specified circumstances.
Language is included prohibiting funding to conduct or
support research using human fetal tissue if such tissue is
obtained pursuant to an induced abortion.
Language is included prohibiting funding under specified
circumstances available to a hospital or any other entity that
administers any postgraduate physician training program, or any
other program of training in the health professions, that
provides training in the performance of, or assisting in the
performance of, induced abortions, or in counseling or
referrals for such abortions.
Language is included prohibiting funding from being made
available to Planned Parenthood Federation of America or its
affiliates.
Language is included prohibiting funding be used to
establish, support, administer, oversee, or issue a grant,
contract, or cooperative agreement for the purposes of
providing information on, promoting access to, or facilitating
an abortion.
Language is included prohibiting funding from being used
for social, psychological, behavioral, or medical intervention
performed for the purposes of intentionally changing the body
of an individual (including by disrupting the body's
development, inhibiting its natural functions, or modifying its
appearance) to no longer correspond to the individual's
biological sex.
Language is included limiting the placement of an
unaccompanied alien child who has been convicted of a crime
related to gang affiliation or activity.
Language is included limiting the circumstances under which
the Secretary of HHS may determine a public health emergency
exists.
Language is included allowing for civil actions for certain
violations.
Language is included limiting the placement of an
unaccompanied alien child with an alien sponsor who has not
been admitted.
Language is included limiting certain research activities
by CDC, NIH, and SAMHSA.
Language is included limiting certain research activities
on vertebrate animals.
Language is included limiting certain activities by ICCPUD.
TITLE III--DEPARTMENT OF EDUCATION
Language is included under ``Impact Aid'' allowing
continued eligibility for students affected by the deployment
or death of their military parent so long as the children
attend school in the same local education agency they attended
prior to the parent's death or deployment.
Language is included under ``School Improvement Programs''
related to the funding limitation for administrative purposes.
Language is included under ``School Improvement Programs''
related to the funding limitation for administrative purposes.
Language is included under ``Innovation and Improvement''
related to the provision of awards under the Charter School
Program.
Language is included under ``Innovation and Improvement''
related to the provision of awards under the Per-Pupil
Facilities Aid Program.
Language is included under ``Innovation and Improvement''
related to the period of availability of funding awarded under
such section.
Language is included under ``Special Education'' regarding
the factors to be considered by the Secretary when making
formula awards to states.
Language is included under ``Special Education'' outlining
procedures for reducing a State award because of a failure to
meet the maintenance of State financial support requirements of
the Individuals with Disabilities Education Act.
Language is included under ``Special Education'' permitting
States to subgrant funds that they reserve for ``Other State-
Level Activities'' under the Grants to States, Preschool Grants
to States, and Grants for Infants and Families programs.
Language is included under ``Special Education'' to promote
continuity of services for eligible infants and their families.
Language is included under ``Rehabilitation Services''
expanding state allowed uses of funding for funding received
under the Rehabilitation Act.
Language is included under ``Higher Education'' allowing
funds to carry out Title VI of the Higher Education Act to be
used to support visits and study in foreign countries for
participants in advanced foreign countries by individuals who
are participating in advanced foreign language training and
international studies in areas that are vital to United States
national security and who plan to apply their language skills
and knowledge of these countries in the fields of government,
the professions, or international development.
Language is included under ``Higher Education'' stating the
section 313(d) of the Higher Education Act does not apply to an
institution of higher education that is eligible to receive
funding under section 318 of such Act.
Language is included under ``Higher Education'' related to
the provision of awards to institutions of higher education to
assist the institutions in providing campus-based child care
services.
Language is included under ``Higher Education'' stating
that the activities authorized under sections 317 and 320 of
the Higher Education Act may include construction and
maintenance in classrooms, libraries, laboratories, and other
instructional facilities.
Language is included under ``General Provisions'' allowing
certain institutions to continue to use endowment income for
student scholarships.
Language is included under ``General Provisions'' regarding
the National Advisory Committee on Institutional Quality and
Integrity.
Language is included under ``General Provisions'' regarding
account maintenance fees.
Language is included under ``General Provisions'' regarding
the authority to make subsidized loans under section 455 of the
Higher Education Act.
Language is included under ``General Provisions'' regarding
statutory funding made available under section 401 of the
Higher Education Act.
TITLE IV--RELATED AGENCIES
Language is included under ``The Committee for Purchase
from People Who are Blind or Severely Disabled'' requiring that
written agreements, with certain oversight provisions, be in
place in order for authorized fees to be charged by certified
nonprofit agencies.
Language is included under ``Corporation for National and
Community Service'' related to the provision of awards.
Language is included under ``Corporation for National and
Community Service'' allowing the requirements of section
112(c)(1)(D) to be met through a determination of need by the
local community.
Language is included under ``Corporation for National and
Community Service'' related to the grantee minimum share
requirement.
Language is included under ``Corporation for National and
Community Service'' limiting the use of an educational award
under section 148(a)(4) to individuals who are veterans.
Language is included under ``Corporation for National and
Community Service'' related to criminal background checks.
Language is included under ``Corporation for National and
Community Service'' related to education awards.
Language is included under ``National Labor Relations
Board'' related to electronic voting.
Language is included under ``Railroad Retirement Board--
Limitation on Administration'' related to the hiring of
attorneys.
TITLE V--GENERAL PROVISIONS
Language is included related to the use of funds
transferred pursuant to Section 4002 of Public Law 111-148.
Language is included related to public posting requirements
for programs, projects, or activities funded with Federal
funds.
Language is included limiting ability for trust funds
receiving funding appropriated by this act to fund health
benefits coverage that includes abortion.
Language is included related to compensable medical
treatments or benefits under Federal workers' compensation
programs.
Language is included prohibiting certain actions related to
a sincerely held religious belief.
Language is included related to the display of flags over
Federal facilities.
Language is included related to diversity, equity, and
inclusion and critical race theory activities.
Language is included to discriminatory activities.
Language is included related to antisemitism.
Language is included related to gain of function research
in certain countries.
Language is included related to COVID mask and vaccine
mandates.
Language is included related to the provision related to
partnerships with entities operated or controlled by the
Chinese Communist Party or the Government of the People's
Republic of China.
Language is included in which the People's Republic of
China has any ownership stake.
Appropriations Not Authorized by Law
Pursuant to clause 3(f)(1)(B) of rule XIII of the Rules of
the House of Representatives, the following table lists the
appropriations in the accompanying bill which are not
authorized by law for the period concerned:
----------------------------------------------------------------------------------------------------------------
Appropriations in
Agency Program Last Year of Authorization Last Year of Appropriations in
Authorization Level Authorization this Bill
----------------------------------------------------------------------------------------------------------------
DEPARTMENT OF LABOR ETA
Dislocated Worker Employment FY 2020........... 1,436,137,000..... 1,052,053,000..... 1,095,553,000
and Training Activities.
Native Americans............ FY 2020........... 54,137,000........ 55,000,000........ 65,000,000
Apprenticeship Programs..... N/A............... N/A............... N/A............... 290,000,000
Job Corps................... FY 2020........... 1,983,236,000..... 1,743,655,000..... 880,078,000
One-Stop Career Centers/ N/A............... N/A............... N/A............... 42,893,000
Labor Market Information.
DEPARTMENT OF HEALTH AND HUMAN
SERVICES HRSA
School-Based Health Centers. FY 2026........... Such Sums......... 55,000,000........ 55,000,000
Medical Student Education... N/A............... N/A............... N/A............... 80,000,000
Early Hearing Detection and FY 2022........... 19,522,758........ 17,818,000........ 18,818,000
Intervention.
Heritable Disorders......... FY 2019........... 11,900,000........ 20,883,000........ 24,883,000
Pediatric Mental Health FY 2022........... 9,000,000......... 10,000,000........ 13,000,000
Access.
Screening and Treatment for FY 2022........... 5,000,000......... 5,000,000......... 14,500,000
Maternal Depression.
Emergency Relief--Part A.... FY 2013........... 789,471,000....... 649,373,000....... 680,752,000
Comprehensive Care--Part B.. FY 2013........... 1,562,169,000..... 1,314,446,000..... 1,364,878,000
Organ Transplantation....... FY 1993........... Such Sums......... 2,767,000......... 59,049,000
Rural Hospital Flexibility FY 2012........... Such Sums......... 41,040,000........ 75,00,000
Grants.
Nursing Programs............ FY 2025........... 254,972,000....... 305,472,000....... 92,635,000
Oral Health Training........ FY 2025........... 28,531,000........ 42,050,000........ 46,673,000
Primary Care Training and FY 2025........... 48,924,000........ 49,924,000........ 54,924,000
Enhancement.
Workforce Information and FY 2025........... 5,663,000......... 5,663,000......... 5,663,000
Analysis.
Area Health Education FY 2025........... 41,250,000........ 47,000,000........ 47,000,000
Centers.
Behavioral Health Workforce FY 2025........... 5,000,000......... 153,000,000....... 159,053,000
Education.
Geriatrics.................. FY 2025........... 40,737,000........ 48,245,000........ 48,245,000
Telehealth.................. FY 2025........... 29,000,000........ 42,050,000........ 45,550,000
Rural Health Outreach....... FY 2025........... 79,500,000........ 100,975,000....... 120,000,000
CDC
Sexually Transmitted FY 1998........... Such Sums......... 112,117,000....... N/A
Infections.
National Center for Health FY 2003........... Such Sums......... 125,899,000....... 187,397,000
Statistics.
WISEWOMAN................... FY 2003........... Such Sums......... 12,419,000........ 34,620,000
National Cancer Registries.. FY 2003........... Such Sums......... N/A............... 53,440,000
Asthma Surveillance & Grants FY 2005........... Such Sums......... 32,422,000........ 34,500,000
Injury Prevention and FY 2005........... Such Sums......... 138,237,000....... 705,829,000
Control.
Oral Health Promotion....... FY 2005........... Such Sums......... 11,204,000........ 22,250,000
Screening, Referrals, and FY 2005........... Such Sums......... 36,474,000........ 51,000,000
Education Regarding Lead
Poisoning.
Birth Defects, Developmental FY 2007........... Such Sums......... 122,242,000....... 199,460,000
Disability, Disability and
Health.
Breast and Cervical Cancer.. FY 2012........... 275,000,000....... 204,779,000....... 238,500,000
Public Health Workforce..... FY 2013........... 39,500,000........ 64,000,000........ 71,000,000
National Diabetes Prevention FY 2014........... Such Sums......... 10,000,000........ 39,300,000
Program.
Johanna's Law............... FY 2014........... 18,000,000........ 4,972,000......... 13,000,000
Section 317 Immunization.... FY 2014........... Such Sums......... 610,847,000....... 696,933,000
Young Women's Breast Health FY 2019........... 4,900,000......... 4,960,000......... 6,960,000
Awareness and Support of
Young Women Diagnosed with
Breast Cancer (PHSA 399NN).
Preventive Health Measures FY 2004........... Such Sums......... 14,091,000........ 17,205,000
with regard to Prostate
Cancer.
Combating Antimicrobial FY 2006........... Such Sums......... 17,443,000........ 207,000,000
Resistance.
Newborn Screening Quality FY 2019........... 8,000,000......... 17,250,000........ 21,000,000
Assurance.
Early Hearing Detection and FY 2022........... 11,852,000........ 10,760,000........ 6,760,000
Intervention.
Breast Cancer Awareness for FY 2019........... 9,000,000......... 6,960,000......... 6,960,000
Young Women.
Vector-Borne Diseases and FY 2025........... 130,000,000....... 90,603,000........ 93,603,000
Lyme Disease.
NIH
National Institutes of FY 2020........... 36,472,442,775.... 40,954,400,000.... 48,816,000,000
Health.
SAMHSA
Protection and Advocacy for FY 2003........... Such Sums......... 36,146,000........ 42,000,000
Individuals with Mental
Illness.
ACF
Low Income Home Energy FY 2007........... 5,100,000,000..... 2,161,170,000..... 4,055,000,000
Assistance Program.
Child Care and Development FY 2020........... 2,748,591,018..... 5,826,000,000..... 8,841,387,000
Block Grant.
Children and Families FY 2021........... 43,000,000........ 75,000,000........ 77,000,000
Services Programs Adoption
and Legal Guardianship
Incentive Payments.
Native American Programs.... FY 2025........... 34,000,000........ 60,500,000........ 65,500,000
Community Services Block FY 2003........... Such Sums......... 645,762,000....... 778,000,000
Grant.
Economic Development........ FY 2003........... Such Sums......... 27,082,000........ 23,383,000
Rural Community Development. FY 2003........... Such Sums......... 7,203,000......... 14,000,000
Head Start.................. FY 2012........... Such Sums......... 7,968,544,000..... 12,366,820,000
Runaway and Homeless Youth FY 2020........... 127,421,000....... 126,980,000....... 125,283,000
Programs.
CAPTA programs.............. FY 2015........... Such Sums......... 143,981,000....... 107,091,000
Family Violence Programs.... FY 2015........... 178,500,000....... 139,500,000....... 245,000,000
National Domestic Violence FY 2015........... Such Sums......... 4,500,000......... 20,500,000
Hotline.
Child Welfare Services...... FY 2016........... 325,000,000....... 268,735,000....... 268,735,000
Refugee and Entrant FY 2002...........
Assistance Programs.
Survivors of Torture........ FY 2007........... 25,000,000........ 9,817,000......... 19,000,000
Anti-Trafficking in Persons FY2021............ 19,500,000........ 28,755,000........ 30,755,000
Programs.
ACL
Lifespan Respite Care....... FY 2011........... 94,810,000........ 2,495,000......... 11,000,000
State Health Insurance FY 1996........... 10,000,000........ N/A............... 55,242,000
Assistance Program.
Developmental Disabilities.. FY 2007........... Such Sums......... 155,115,000....... 191,369,000
Voting Access for People FY 2005........... 17,410,000........ 13,879,000........ 10,000,000
with Disabilities.
Traumatic Brain Injury...... FY 2019........... 7,321,000......... 11,321,000........ 13,118,000
Paralysis Resource Center... FY 2011........... 25,000,000........ 6,352,000......... 10,700,000
Limb Loss................... N/A............... N/A............... N/A............... 5,000,000
Independent Living and the FY 2020........... 214,135,000....... 228,153,000....... 272,183,000
National Institute on
Disability, Independent
Living and Rehabilitation
Research.
Aging and Disability FY2024............ 10,967,554........ 8,619,000......... 8,619,000
Resource Center.
Preventative Health Services FY2024............ 33,565,929........ 26,339,000........ 26,339,000
ASPR
BARDA....................... FY 2024........... 611,700,000....... 1,015,000......... 1,060,000,000
Strategic National Stockpile FY 2024........... 750,000,00........ 980,000,000....... 1,060,000,000
Pandemic Influenza.......... FY 2024........... 250,000,000....... 315,000,000....... 312,991,000
National Disaster Medical FY 2024........... 57,404,000........ 78,904,000........ 89,904,000
System.
Hospital Preparedness FY 2024........... 385,000,000....... 305,055,000....... 70,055,000
Program.
Medical Reserve Corps....... FY 2024........... 11,200,000........ 6,240,000......... 6,240,000
DEPARTMENT OF EDUCATION
Title I Grants to LEAs...... FY 2020........... 16,182,345,000.... 16,309,802,000.... 16,531,647,000
Innovative Approaches to FY 2020........... 180,014,000....... 27,000,000........ 40,000,000
Literacy.
Comprehensive Literacy FY 2020........... (include in 192,000,000....... 219,000,000
Development. program above).
Impact Aid.................. FY 2020........... 1,388,603,000..... 1,486,112,000..... 1,635,151,000
Supporting Effective FY 2020........... 2,295,830,000..... 2,131,830,000..... 1,681,441,000
Instruction State Grants.
Indian Education............ FY 2020........... N/A............... 196,746,000....... 200,746,000
Nita M. Lowey 21st Century FY 2020........... 1,100,000,000..... 1,249,673,000..... 1,329,673,000
Community Learning Centers.
Education for Native FY 2020........... 32,397,000........ 36,897,000........ 45,897,000
Hawaiians.
Alaska Native Education..... FY 2020........... 31,453,000........ 35,953,000........ 44,953,000
Rural Education............. FY 2020........... 169,840,000....... 185,840,000....... 230,000,000
Student Support and Academic FY 2020........... 1,600,000,000..... 1,210,000,000..... 1,385,000,000
Enrichment Grants.
Education Innovation and FY 2020........... 90,611,000........ 190,000,000....... 235,000,000
Research.
Education for Homeless FY 2020........... 85,000,000........ 101,500,000....... 129,000,000
Children and Youth.
American History and Civics. FY 2020........... 19,567,000........ 4,815,000......... 33,000,000
Charter Schools Grants...... FY 2020........... 300,000,000....... 440,000,000....... 500,000,000
Magnet Schools.............. FY 2020........... 108,530,00........ 107,000,000....... 139,000,000
School Safety National FY 2020........... 5,000,000......... 105,000,000....... 243,643,000
Activities.
Vocational Rehabilitation FY 2021........... 3,610,040,000..... 4,504,096,000..... 4,625,707,000
State Grants.
Client Assistance State FY 2021........... 14,098,000........ 13,000,000........ 13,000,000
Grants.
Supported Employment State FY 2021........... 32,363,000........ 22,548,000........ 22,548,000
Grants.
Training.................... FY 2021........... 39,540,000........ 29,388,000........ 29,388,000
Demonstration and Training FY 2021........... 6,809,000......... 5,796,000......... 5,796,000
Programs.
Services for Older Blind FY 2021........... 39,141,000........ 33,317,000........ 33,317,000
Individuals.
Protection and Advocacy of FY 2021........... 20,735,000........ 17,650,000........ 21,150,000
Individual Rights.
Helen Keller National Center FY 2004........... Such Sums......... 8,666,000......... 22,000,000
for Deaf-Blind Youths and
Adults.
National Technical Institute FY 2015........... Such Sums......... 66,291,000........ 95,500,000
for the Deaf.
Gallaudet University........ FY 2015........... Such Sums......... 119,000,000....... 170,361,000
Aid for Institutional FY 2015........... N/A............... N/A............... 1,037,887,000
Development.
Aid for Hispanic-Serving FY 2015........... N/A............... N/A............... 261,637,000
Institutions.
Institute of Education FY 2008........... N/A............... 559,603,000....... 493,455,000
Sciences.
Federal TRIO Programs....... FY 2015........... Such Sums......... 109,223,000....... 1,037,877,000
IDEA National Activities.... FY 2010........... Such Sums......... 838,252,000....... 258,560,000
IDEA Grants for Infants and FY 2010........... Such Sums......... 439,973,000....... 550,000,000
Families.
RELATED AGENCIES
Corporation for National and FY 2014........... Such Sums......... 1,049,954,000..... 1,220,306,000
Community Service.
----------------------------------------------------------------------------------------------------------------
Transfers of Funds
Pursuant to clause 3(f)(2) of rule XIII of the Rules of the
House of Representatives, the following list includes the
transfers included in the accompanying bill:
TITLE I--DEPARTMENT OF LABOR
JOB CORPS
Language is included under ``Job Corps'' allowing the
transfer of funds from the construction, rehabilitation, and
acquisition account to the operations account.
STATE UNEMPLOYMENT INSURANCE AND EMPLOYMENT SERVICE OPERATIONS
Language is included under ``State Unemployment Insurance
and Employment Service Operations'' allowing the transfer of
funds made available for research and demonstration projects to
the ``Office of Disability Employment Policy'' account.
SPECIAL BENEFITS
Language is included under ``Special Benefits'' requiring
the transfer of funds from the Postal Service and other
required entities to pay the cost of administration of the
Federal Employees' Compensation Act.
BLACK LUNG DISABILITY TRUST FUND
Language is included under ``Black Lung Disability Trust
Fund'' allowing the transfer of funds from the Black Lung
Disability Trust Fund to the Office of Workers' Compensation
Programs for ``Salaries and Expenses''; to Departmental
Management for ``Salaries and Expenses''; to Departmental
Management for the ``Office of Inspector General''; and for
payments into miscellaneous receipts for the expenses of the
Department of the Treasury.
OFFICE OF DISABILITY EMPLOYMENT POLICY
Language is included under ``Office of Disability
Employment Policy'' which provides for the transfer of funds to
``State Unemployment Insurance and Employment Service
Operations.''
DEPARTMENTAL MANAGEMENT
Language is included under ``Departmental Management,
Salaries and Expenses'' allowing the transfer of program
evaluation funds to the appropriate account in the Department
for such purpose.
GENERAL PROVISIONS
A general provision is included permitting up to one
percent of any discretionary appropriation to be transferred
between an existing program, project, or activity of the
Department of Labor, provided that no program, project, or
activity is increased by more than three percent by any such
transfer.
A general provision is included permitting the transfer of
``Employment and Training Administration'' funds for technical
assistance to ``Program Administration'' when such activities
would be more effectively performed by Federal employees. The
provision also authorizes the transfer of 0.5 percent of
``Employment and Training Administration'' discretionary grants
to ``Program Administration'' for purposes of program integrity
activities.
A general provision is included that allows for the
transfer of up to 0.75 of funds under the ``Training and
Employment Services,'' ``Job Corps,'' ``Community Service
Employment for Older Americans,'' State Unemployment Insurance
and Employment Service Operations,'' Employee Benefits Security
Administration,'' ``Office of Workers Compensation Services,''
Wage and Hour Division,'' Office of Federal Contract Compliance
Programs,'' ``Office of Labor Management Standards,''
Occupational Safety and Health Administration,'' ``Mine Safety
and Health Administration,'' Office of Disability Employment
Policy,'' funds made available for the ``Bureau of
International Labor Affairs'' and ``Women's Bureau'' within the
``Departmental Management, Salaries, and Expenses'' account and
``Veterans'' Employment and Training'' accounts to
``Departmental Management'' for purposes of evaluating programs
or activities funded under such accounts.
TITLE II--DEPARTMENT OF HEALTH AND HUMAN SERVICES
CENTERS FOR DISEASE CONTROL AND PREVENTION
Language is included under ``Buildings and Facilitates''
that directs that prior-year unobligated balances from
individual learning accounts for former employees be credited
and merged with the amounts made available for the replacement
of the mine safety and research facility.
Language is included under ``CDC Wide Activities and
Program Support'' for funds to be transferred to and merged
with the Infectious Diseases Rapid Response Reserve Fund.
NATIONAL INSTITUTES OF HEALTH
Language is included under ``Office of the Director''
requiring the transfer of funds to the ``Office of Inspector
General'' for oversight of grant programs and operations of the
NIH.
ADMINISTRATION FOR CHILDREN AND FAMILIES
Language is included under ``Refugee and Entrant
Assistance'' allowing additional transfers to this account
notwithstanding the limitations in section 205.
ADMINISTRATION FOR COMMUNITY LIVING
Language is included under the ``Aging and Disability
Services Programs'' for the transfer to the Secretary of
Agriculture to carry out section 311 of the Older Americans Act
of 1965.
GENERAL PROVISIONS
A general provision that allows up to one percent of any
discretionary funds to be transferred between existing
appropriations accounts of the ``Department of Health and Human
Services,'' provided that no appropriation account is increased
by more than three percent by such transfer.
A general provision is included that allows for the
transfer of funding determined to be related to the human
immunodeficiency virus to the ``Office of AIDS Research.''
A general provision is included that allows the transfer of
funds among the institutes and centers of the ``National
Institutes of Health'' from amounts identified as funding
research pertaining to the human immunodeficiency virus to the
``Office of AIDS Research'' account.
A general provision is included that transfers 1 percent of
the amounts made available for the ``National Research Service
Awards'' and the ``National Institutes of Health'' to the
``Health Resources and Services Administration.''
A general provision is included to direct the transfer of
the ``Prevention and Public Health Fund'' as specified in the
committee report accompanying the Act.
A general provision is included that allows the transfer of
funds related to research on opioid addiction, opioid
alternatives, stimulant misuse and addiction, pain management,
and addiction treatment between the institutes and centers of
the ``National Institute of Health.''
TITLE III--DEPARTMENT OF EDUCATION
GENERAL PROVISIONS
A general provision is included that allows not to exceed
one percent of any discretionary funds to be transferred
between existing appropriations accounts of the Department of
Educations, provided that not appropriation accounts is
increased by more than three percent by such transfer.
A general provision is included that allows the transfer of
funds available for ``Institute of Education Sciences'' for
support services to ``Departmental Management, Program
Administration''.
TITLE IV--RELATED AGENCIES
CORPORATION FOR NATIONAL AND COMMUNITY SERVICE
Language is included under ``Payment to the National
Service Trust'' allowing for the transfer of funds from amounts
provided in ``Operating Expenses'' to ``Payment to the National
Service Trust'' to support the activities of national service
participants.
SOCIAL SECURITY ADMINISTRATION
Language is included under ``Limitation on Administrative
Expenses'' allowing the transfer of funds to the ``Office of
the Inspector General''.
Language is included under ``Office of the Inspector
General'' allowing the transfer of funds from ``Limitation on
Administrative Expenses'' to the ``Office of the Inspector
General.''
TITLE V--BILL WIDE GENERAL PROVISIONS
A general provision is included that allows the Secretaries
of Labor, Health and Human Services, and Education to transfer
balances of prior appropriations to accounts corresponding to
current appropriations.
RESCISSIONS OF FUNDS
Pursuant to clause 3(f)(2) of rule XIII of the Rules of the
House of Representatives, the following table lists the
rescissions included in the accompanying bill:
------------------------------------------------------------------------
Program or Activity Amount
------------------------------------------------------------------------
Title I--Department of Labor
Employment and Training Administration
Adult Training FY 2026 Advance................ $712,000,000
General Provisions
H-1B Fees (Sec. 115).......................... 213,000,000
Title II--Department of Health and Human Services
Nonrecurring Expenses Fund (sec. 237)............. 2,000,000,000
Title III--Department of Education
School Improvement Programs
Supporting Effective Instruction State Grants 1,681,441,000
FY 2027 Advance..............................
General Provisions
Nonrecurring Expenses Fund (sec. 310)......... 250,000,000
Section 401 of the Higher Education Act (sec. 20,000,000
318).........................................
Title V--General Provisions
American Rescue Plan Act (sec. 529)............... 162,000,000
Patient Centered Outcomes Research Trust Fund 859,000,000
(sec. 530).......................................
Affordable Care Act (sec. 531).................... 1,900,000,000
------------------------------------------------------------------------
Disclosure of Earmarks and Congressionally Directed Spending Items
Pursuant to clause 9 of rule XXI of the Rules of the House
of Representatives, neither the bill nor this report contains
any congressional earmarks, limited tax benefits, or limited
tariff benefits as defined in clause 9 of rule XXI of the Rules
of the House of Representatives.
DEPARTMENTS OF LABOR, HEALTH AND HUMAN SERVICES, AND EDUCATION, AND RELATED AGENCIES
[Community Project Funding]
----------------------------------------------------------------------------------------------------------------
House
Agency Account Project House Amount Requestor(s)
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Access Community Health Network, $2,000,000 Davis (IL)
Human Services Services Chicago, IL for facilities and
Administration equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Access Community Health Network, 750,000 Jackson (IL)
Human Services Services Chicago, IL for facilities and
Administration equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Access Community Health Network, 500,000 Ramirez
Human Services Services Chicago, IL for facilities and
Administration equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Adult & Child Health, 750,000 Carson
Human Services Services Indianapolis, IN for facilities
Administration and equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Advance Community Health, 1,000,000 Ross (NC)
Human Services Services Raleigh, NC for facilities and
Administration equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and AdventHealth Polk, Columbus, NC 1,000,000 Moore (NC)
Human Services Services for facilities and equipment
Administration
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Adventist Health Mendocino Coast, 250,000 Huffman
Human Services Services Fort Bragg, CA for facilities
Administration and equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Adventist Health System Georgia, 400,000 Loudermilk
Human Services Services Inc., Calhoun, GA for equipment
Administration
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Adventist Health Tillamook, 480,000 Bonamici
Human Services Services Tillamook, OR for facilities and
Administration equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Affinia Healthcare, Ferguson, MO 1,500,000 Bell
Human Services Services for facilities and equipment
Administration
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Agape Community Health Center, 325,000 Rutherford
Human Services Services Inc., Jacksonville, FL for
Administration equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Alabama Regional Medical 716,000 Sewell
Human Services Services Services, Birmingham, AL for
Administration facilities and equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Albany Area Primary Health Care, 745,000 Bishop
Human Services Services Inc., Albany, GA for facilities
Administration and equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Alivio Medical Center, Chicago, 1,500,000 Garcia (IL)
Human Services Services IL for facilities and equipment
Administration
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Allegheny County, PA for 1,000,000 Lee (PA)
Human Services Services facilities and equipment
Administration
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Allegheny County, PA for 250,000 Deluzio
Human Services Services facilities and equipment
Administration
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and AltaPointe Health System, Inc., 250,000 Figures
Human Services Services Mobile, AL for facilities and
Administration equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Altura Centers for Health, 250,000 Fong
Human Services Services Tulare, CA for equipment
Administration
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and American Indian Health & 250,000 Carbajal
Human Services Services Services, Santa Barbara, CA for
Administration facilities and equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Appalachian Center for 1,250,000 Griffith
Human Services Services Excellence, Coeburn, VA for
Administration equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Aria Community Health Center, 1,749,171 Valadao
Human Services Services Lemoore, CA for equipment
Administration
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Arlington County, VA for 1,000,000 Beyer
Human Services Services facilities and equipment
Administration
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Armstrong County Memorial 2,358,755 Thompson (PA)
Human Services Services Hospital, Kittanning, PA for
Administration equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Ashtabula County Medical Center 2,000,000 Joyce (OH)
Human Services Services dba Ashtabula Regional Medical
Administration Center, Ashtabula, OH for
facilities and equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Asian American Health Coalition 1,500,000 Garcia (TX)
Human Services Services of the Greater Houston Area--
Administration HOPE Clinic, Houston, TX for
facilities and equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Athol Memorial Hospital, Athol, 1,600,000 McGovern
Human Services Services MA for facilities and equipment
Administration
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Auburn Community Hospital, 950,000 Mannion
Human Services Services Auburn, NY for facilities and
Administration equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Austintown Township, OH for 1,000,000 Rulli
Human Services Services facilities and equipment
Administration
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and AxessPointe Community Health 750,000 Sykes
Human Services Services Centers, Inc., Ravenna, OH for
Administration facilities and equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Baptist Health Deaconess 2,500,000 Comer
Human Services Services Madisonville, Inc.,
Administration Madisonville, KY for facilities
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Bates County Memorial Hospital, 100,000 Alford
Human Services Services Butler, MO for facilities and
Administration equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Bay Area Community Health, 750,000 Khanna
Human Services Services Fremont, CA for facilities and
Administration equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Bay Area Hospital, Coos Bay, OR 2,000,000 Hoyle (OR)
Human Services Services for facilities and equipment
Administration
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Benson Hospital Corporation, 2,000,000 Ciscomani
Human Services Services Benson, AZ for facilities and
Administration equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Berks Community Health Center, 675,000 Houlahan
Human Services Services Reading, PA for facilities and
Administration equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Bernalillo County, NM for 750,000 Vasquez
Human Services Services facilities and equipment
Administration
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Bighorn Valley Health Center, 1,000,000 Downing
Human Services Services Inc., dba One Health, Hardin, MT
Administration for facilities and equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Blanchard Valley Health System, 350,000 Latta
Human Services Services Findlay, OH for equipment
Administration
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Blue Ridge Community Health 1,000,000 Edwards
Human Services Services Services, Inc., dba Blue Ridge
Administration Health, Hendersonville, NC for
facilities and equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Bon Secours Mercy Health-- 500,000 Kaptur
Human Services Services Defiance Hospital, Defiance, OH
Administration for facilities and equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Bond Community Health Center, 450,000 Dunn (FL)
Human Services Services Inc., Tallahassee, FL for
Administration facilities and equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Boone Memorial Hospital, Madison, 1,000,000 Miller (WV)
Human Services Services WV for equipment
Administration
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Borinquen Health Care Center, 576,356 Diaz-Balart
Human Services Services Inc., dba Borinquen Medical
Administration Centers, Miami, FL for equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Borinquen Health Care Center, 264,790 Diaz-Balart
Human Services Services Inc., dba Borinquen Medical
Administration Centers, Miami, FL for equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Bowling Green-Warren County 740,125 Comer
Human Services Services Community Hospital Corporations
Administration dba Med Center Health
Russellville, Bowling Green, KY
for equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Bowling Green-Warren County 497,500 Comer
Human Services Services Community Hospital Corporations
Administration dba Med Center Health
Scottsville, Bowling Green, KY
for facilities and equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Box Elder County, Brigham City, 475,000 Moore (UT)
Human Services Services UT for equipment
Administration
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Broward Community and Family 500,000 Wilson (FL)
Human Services Services Health Centers, Hollywood, FL
Administration for facilities and equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Bucktail Medical Center, Renovo, 182,000 Thompson (PA)
Human Services Services PA for facilities and equipment
Administration
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Butler Memorial Hospital, Butler, 1,250,000 Kelly (PA)
Human Services Services PA for equipment
Administration
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Calhoun Liberty Hospital 450,000 Dunn (FL)
Human Services Services Association Inc., Blountstown,
Administration FL for facilities and equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Capital Area Health Network, 400,000 McClellan
Human Services Services Richmond, VA for facilities and
Administration equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Cares Community Health dba One 250,000 Bera
Human Services Services Community Health, Sacramento, CA
Administration for facilities and equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Caring Health Center, Inc., 1,000,000 Neal
Human Services Services Springfield, MA for facilities
Administration and equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Carroll Hospital Center, Inc., 250,000 Olszewski
Human Services Services Westminster, MD for facilities
Administration and equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Central Florida Family Health 1,100,000 Mills
Human Services Services Center, Inc., Sanford, FL for
Administration equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Centro San Vicente, El Paso, TX 750,000 Escobar
Human Services Services for facilities and equipment
Administration
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Charles County, MD for facilities 750,000 Hoyer
Human Services Services and equipment
Administration
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Charles Drew Health Center, Inc., 750,000 Bacon
Human Services Services Omaha, NE for facilities
Administration
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Charles River Community Health 2,000,000 Clark (MA)
Human Services Services Center, Waltham, MA for
Administration facilities and equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Charlotte Community Health Clinic 1,000,000 Adams
Human Services Services Inc., Charlotte, NC for
Administration equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Chemung County, Elmira, NY for 500,000 Langworthy
Human Services Services facilities and equipment
Administration
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and ChesPenn Health Services, 180,000 Scanlon
Human Services Services Eddystone, PA for a health
Administration technology initiative
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Chestnut Health Systems, 750,000 Budzinski
Human Services Services Bloomington, IN for facilities
Administration and equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Chicago Family Health Center, 208,000 Jackson (IL)
Human Services Services Inc., Chicago, IL for a health
Administration information technology
initiative
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Chickasaw Nation, Ada, OK for 4,000,000 Cole
Human Services Services facilities and equipment
Administration
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Chinatown Service Center, Los 750,000 Gomez
Human Services Services Angeles, CA for facilities and
Administration equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Chiricahua Community Health 204,000 Grijalva
Human Services Services Centers, Inc., Douglas, AZ for
Administration equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Circle Health Services dba The 1,000,000 Brown
Human Services Services Centers, Cleveland, OH for
Administration facilities and equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Citizens Memorial Hospital, 1,000,000 Alford
Human Services Services Bolivar, MO for equipment
Administration
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and City of Albuquerque, NM for 1,000,000 Stansbury
Human Services Services facilities and equipment
Administration
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and City of Alexandria, VA for 95,000 Beyer
Human Services Services equipment
Administration
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and City of Anaheim, CA for 500,000 Correa
Human Services Services facilities and equipment
Administration
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and City of Brockton, MA for 568,000 Lynch
Human Services Services facilities and equipment
Administration
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and City of Burlington, VT for 750,000 Balint
Human Services Services equipment
Administration
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and City of Cincinnati, OH for 750,000 Landsman
Human Services Services facilities and equipment
Administration
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and City of Clovis, NM for facilities 1,500,000 Leger
Human Services Services and equipment Fernandez
Administration
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and City of El Paso, TX for 500,000 Escobar
Human Services Services facilities and equipment
Administration
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and City of Fort Worth, TX for 750,000 Veasey
Human Services Services equipment
Administration
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and City of Frederick, MD for 1,100,000 McClain
Human Services Services equipment Delaney
Administration
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and City of Gulfport, MS for 1,500,000 Ezell
Human Services Services facilities and equipment
Administration
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and City of Hampton, VA for equipment 250,000 Scott (VA)
Human Services Services
Administration
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and City of Indianapolis, IN for 750,000 Carson
Human Services Services equipment, including an
Administration electronic health records
initiative
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and City of Laurel, MT for facilities 500,000 Downing
Human Services Services and equipment
Administration
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and City of Long Beach, CA for 500,000 Garcia (CA)
Human Services Services facilities and equipment
Administration
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and City of Los Angeles, CA for 1,500,000 Sherman
Human Services Services equipment
Administration
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and City of Marianna, FL for 200,000 Dunn (FL)
Human Services Services facilities and equipment
Administration
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and City of Philadelphia, PA for 500,000 Boyle (PA)
Human Services Services equipment
Administration
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and City of Phoenix, AZ for 750,000 Ansari
Human Services Services facilities and equipment
Administration
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and City of Providence, RI for 230,000 Amo
Human Services Services equipment
Administration
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and City of Redondo Beach, CA for 250,000 Lieu
Human Services Services equipment
Administration
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and City of San Diego, CA for 1,000,000 Jacobs
Human Services Services equipment
Administration
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and City of Springfield, IL for 461,000 Budzinski
Human Services Services equipment
Administration
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and City of St. Joseph, MO for 500,000 Graves
Human Services Services facilities and equipment
Administration
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and City of Stockton, CA for 2,000,000 Harder
Human Services Services equipment
Administration
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and City of Sunland Park, NM for 1,500,000 Vasquez
Human Services Services facilities and equipment
Administration
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and City of Tuscaloosa, AL for 1,000,000 Sewell
Human Services Services facilities and equipment
Administration
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and City of Union, OH for facilities 1,000,000 Turner
Human Services Services and equipment
Administration
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and City of Wooster, OH for 1,500,000 Miller (OH)
Human Services Services facilities and equipment
Administration
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Clarion Healthcare System, Inc., 1,500,000 Thompson (PA)
Human Services Services Clarion, PA for facilities and
Administration equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Clark County, NV for facilities 821,000 Lee (NV)
Human Services Services and equipment
Administration
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Clay County Hospital, Ashland, AL 1,000,000 Rogers (AL)
Human Services Services for equipment
Administration
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Cleveland County, NC for 500,000 Moore (NC)
Human Services Services equipment
Administration
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Clinica Sierra Vista, 1,500,000 Valadao
Human Services Services Bakersfield, CA for facilities
Administration and equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Clinicas de Salud del Pueblo, 1,500,000 Ruiz
Human Services Services Inc., El Centro, CA for
Administration facilities and equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Clinton Hospital Authority dba 250,000 Lucas
Human Services Services Clinton Regional Hospital,
Administration Clinton, OK for facilities and
equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Codman Square Health Center, 140,000 Pressley
Human Services Services Boston, MA for equipment
Administration
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Commonwealth Healthcare 1,000,000 King-Hinds
Human Services Services Corporation, Saipan, MP for
Administration equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Community Action Partnership of 298,000 Smith (NE)
Human Services Services Western Nebraska, Gering, NE for
Administration facilities and equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Community Health and Dental Care, 119,000 Houlahan
Human Services Services Pottstown, PA for facilities and
Administration equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Community Health Care, Inc., 500,000 Miller-Meeks
Human Services Services Davenport, IA for facilities and
Administration equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Community Health Center of Branch 3,000,000 Walberg
Human Services Services County, Coldwater, MI for
Administration facilities and equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Community Health Center of Cape 500,000 Keating
Human Services Services Cod, Inc., Mashpee, MA for
Administration facilities and equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Community Health Centers, Inc., 1,500,000 Webster (FL)
Human Services Services Winter Garden, FL for facilities
Administration
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Community Health Centers, Inc., 700,000 Frost
Human Services Services Winter Garden, FL for facilities
Administration and equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Community Health Centers of 834,000 Castor (FL)
Human Services Services Pinellas dba Evara Health,
Administration Clearwater, FL for facilities
and equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Community Health Centers of the 750,000 Balint
Human Services Services Rutland Region, Inc., Rutland,
Administration VT for facilities and equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Community Health Connections 500,000 McGovern
Human Services Services Inc., Fitchburg, MA for
Administration facilities and equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Community Health Partnership of 250,000 Kelly (IL)
Human Services Services Illinois, Kankakee, IL for
Administration facilities and equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Community Health Systems, Inc., 1,000,000 Aguilar
Human Services Services Riverside, CA for facilities and
Administration equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Compass Health, Inc., Clinton, MO 500,000 Alford
Human Services Services for facilities and equipment
Administration
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Concho County Hospital District, 500,000 Pfluger
Human Services Services Eden, TX for equipment
Administration
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Cookeville Regional Medical 300,000 Rose (TN)
Human Services Services Center, Cookeville, TN for
Administration equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Coosa Valley Medical Center, 2,500,000 Rogers (AL)
Human Services Services Sylacauga, AL for equipment
Administration
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Cottage Hospital, Woodsville, NH 250,000 Goodlander
Human Services Services for facilities and equipment
Administration
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and County of Atlantic, NJ for 1,000,000 Van Drew
Human Services Services facilities and equipment
Administration
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and County of Franklin, VA for 500,000 Griffith
Human Services Services equipment
Administration
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and County of Humboldt, CA for 750,000 Huffman
Human Services Services facilities and equipment
Administration
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and County of Lee--Office of County 400,000 Donalds
Human Services Services Commissioners, Fort Myers, FL
Administration for equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and County of Riverside, CA for 750,000 Ruiz
Human Services Services facilities and equipment
Administration
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and County of Saginaw, MI for 1,500,000 McDonald Rivet
Human Services Services facilities and equipment
Administration
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and County of Saginaw, MI for 750,000 McDonald Rivet
Human Services Services facilities and equipment
Administration
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and County of Santa Barbara, CA for 500,000 Carbajal
Human Services Services facilities and equipment
Administration
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and County of Saratoga, NY for 300,000 Stefanik
Human Services Services equipment
Administration
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and County of Schenectady, NY for 437,000 Tonko
Human Services Services equipment
Administration
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and County of Taylor dba Taylor 485,000 Nunn (IA)
Human Services Services County Public Health, Bedford,
Administration IA for facilities and equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Crawford Hospital District dba 2,000,000 Bost
Human Services Services Crawford Memorial Hospital,
Administration Robinson, IL for equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Crenshaw County Health Care 750,000 Figures
Human Services Services Authority dba Crenshaw Community
Administration Hospital, Luverne, AL for
facilities and equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Crescent Community Health Center, 850,000 Hinson
Human Services Services Dubuque, IA for facilities and
Administration equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Cuba Memorial Hospital, Cuba, NY 300,000 Langworthy
Human Services Services for facilities
Administration
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Cumberland County, NC for 750,000 Rouzer
Human Services Services equipment
Administration
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Dallas County, TX for facilities 1,000,000 Johnson (TX)
Human Services Services and equipment
Administration
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Damian Family Care Centers Inc., 45,000 Meeks
Human Services Services Jamaica, NY for facilities and
Administration equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Deborah Heart and Lung Center, 750,000 Conaway
Human Services Services Browns Mills, NJ for facilities
Administration and equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Delta County Memorial Hospital 1,245,404 Hurd
Human Services Services District, Delta, CO for
Administration facilities and equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Delta Health Center, Mound Bayou, 500,000 Thompson (MS)
Human Services Services MS for facilities and equipment
Administration
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Delta Memorial Hospital, Dumas, 750,000 Crawford
Human Services Services AR for facilities and equipment
Administration
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Department of Public Health and 500,000 Moylan
Human Services Services Social Services, Dededo, GU for
Administration facilities and equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Donalsonville Hospital, Inc., 348,000 Bishop
Human Services Services Donalsonville, GA for facilities
Administration and equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Douglas, Grant, Lincoln, and 1,750,000 Newhouse
Human Services Services Okanogan Counties Public
Administration Hospital District #6, Grand
Coulee, WA for facilities
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Duplin General Hospital Inc., 1,000,000 Murphy
Human Services Services Kenansville, NC for facilities
Administration and equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and East Alabama Medical Center, 1,500,000 Rogers (AL)
Human Services Services Opelika, AL for facilities and
Administration equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and East Grand Health Center, LLC, 500,000 Golden (ME)
Human Services Services Danforth, ME for facilities and
Administration equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and East Hill Family Medical, Inc. 1,000,000 Mannion
Human Services Services dba East Hill Medical Center,
Administration Auburn, NY for facilities and
equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Edward M. Kennedy Community 1,095,000 Clark (MA)
Human Services Services Health Center, Framingham, MA
Administration for facilities and equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Eisner Health, Los Angeles, CA 250,000 Rivas
Human Services Services for facilities and equipment
Administration
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and El Centro de Corazon, Houston, TX 2,000,000 Garcia (TX)
Human Services Services for facilities and equipment
Administration
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and El Centro del Barrio dba 509,000 Castro (TX)
Human Services Services CentroMed, San Antonio, TX for
Administration facilities and equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and El Paso County, TX for facilities 1,000,000 Escobar
Human Services Services and equipment
Administration
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and El Paso County, TX for facilities 500,000 Escobar
Human Services Services and equipment
Administration
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and El Proyecto del Barrio, Inc., 1,000,000 Sherman
Human Services Services Arleta, CA for facilities and
Administration equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Electra Hospital District, 500,000 Jackson (TX)
Human Services Services Electra, TX for facilities and
Administration equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Erlanger Health, Dunlap, TN for 750,000 DesJarlais
Human Services Services facilities
Administration
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Fairview Hospital, Great 975,000 Neal
Human Services Services Barrington, MA for facilities
Administration and equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Families Together of Orange 500,000 Min
Human Services Services County, Tustin, CA for
Administration facilities and equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Family Care Health Centers, St. 500,000 Bell
Human Services Services Louis, MO for facilities and
Administration equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Family Health Centers, Inc., 1,000,000 McGarvey
Human Services Services Louisville, KY for facilities
Administration and equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Family Health Centers of San 1,000,000 Jacobs
Human Services Services Diego, Inc., San Diego, CA for
Administration facilities and equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Family Practice & Counseling 990,000 Scanlon
Human Services Services Services Network, Philadelphia,
Administration PA for facilities and equipment,
including an electronic health
records initiative
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Farmers Union Hospital 500,000 Lucas
Human Services Services Association dba Great Plains
Administration Regional Medical Center, Elk
City, OK for facilities and
equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Fisher-Titus Medical Center, 350,000 Latta
Human Services Services Norwalk, OH for equipment
Administration
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Foremost Family Health Centers, 1,880,000 Crockett
Human Services Services Dallas, TX for facilities and
Administration equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Fort Bend Family Health Center, 500,000 Green
Human Services Services Inc., TX for facilities and
Administration equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and FoundCare, Inc., West Palm Beach, 1,000,000 Frankel
Human Services Services FL for facilities and equipment
Administration
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and FoundCare, Inc., West Palm Beach, 1,000,000 Frankel
Human Services Services FL for facilities and equipment
Administration
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Franklin County Medical Center, 750,000 Simpson
Human Services Services Preston, ID for facilities and
Administration equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Franklin Parish Hospital Service 2,500,000 Letlow
Human Services Services Dist 1 dba Franklin Medical
Administration Center, Winnsboro, LA for
facilities and equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Frederiksted Health Care, Inc., 1,000,000 Plaskett
Human Services Services St. Croix, VI for facilities and
Administration equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Frick Hospital and Community 500,000 Reschenthaler
Human Services Services Health Center, Mount Pleasant,
Administration PA for equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Friend Family Health Center, 250,000 Jackson (IL)
Human Services Services Inc., Chicago, IL for facilities
Administration and equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Frontera Healthcare Network, 1,000,000 Pfluger
Human Services Services Menard, TX for equipment
Administration
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Ft. Bend Family Health Center, 1,000,000 Nehls
Human Services Services Inc., Richmond, TX for
Administration facilities and equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Fulton County Medical Center, 200,000 Joyce (PA)
Human Services Services McConnellsburg, PA for equipment
Administration
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and G.A. Carmichael Family Center, 500,000 Thompson (MS)
Human Services Services Inc., Canton, MS for facilities
Administration and equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Garfield County Hospital 750,000 Baumgartner
Human Services Services District, Pomeroy, WA for
Administration facilities and equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Garfield Health Center, Monterey 1,500,000 Cisneros
Human Services Services Park, CA for facilities and
Administration equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Gateway Community Health Center, 1,000,000 Cuellar
Human Services Services Inc., Laredo, TX for facilities
Administration and equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Genesis Community Health Inc., 500,000 Frankel
Human Services Services Boynton Beach, FL for facilities
Administration and equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Gibson Area Hospital, Rantoul, IL 250,000 Kelly (IL)
Human Services Services for facilities and equipment
Administration
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Gila Regional Medical Center, 500,000 Vasquez
Human Services Services Silver City, NM for facilities
Administration and equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Government of the Virgin Islands, 1,300,000 Plaskett
Human Services Services St. Croix, VI for facilities and
Administration equipment, including information
technology
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Governor Juan F. Luis Hospital 750,000 Plaskett
Human Services Services and Medical Center, St. Croix,
Administration VI for facilities and equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Grafton City Hospital, Inc., 1,500,000 Moore (WV)
Human Services Services Grafton, WV for equipment
Administration
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Grant Memorial Hospital, Inc., 1,500,000 Moore (WV)
Human Services Services Petersburg, WV for facilities
Administration and equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Grant Regional Health Center, 750,000 Van Orden
Human Services Services Inc., Lancaster, WI for
Administration equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Great Salt Plains Health Center, 250,000 Lucas
Human Services Services Enid, OK for facilities
Administration
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Greater New Bedford Community 1,500,000 Keating
Human Services Services Health Center, Inc., New
Administration Bedford, MA for facilities and
equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Greater Philadelphia Health 1,380,000 Evans (PA)
Human Services Services Action, Inc., Philadelphia, PA
Administration for facilities and equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Greater Regional Medical Center, 275,000 Nunn (IA)
Human Services Services Creston, IA for equipment
Administration
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Greene County, AL for equipment 400,000 Sewell
Human Services Services
Administration
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Guadalupe Regional Medical 3,000,000 De La Cruz
Human Services Services Center, Seguin, TX for
Administration facilities and equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Guam Memorial Hospital Authority, 500,000 Moylan
Human Services Services Tamuning, GU for equipment
Administration
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Gulf Health Hospitals, Inc. dba 1,000,000 Moore (AL)
Human Services Services North Baldwin Infirmary, Bay
Administration Minette, AL for facilities and
equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Guthrie Robert Packer Hospital, 1,000,000 Meuser
Human Services Services Sayre, PA for facilities
Administration
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Gwinnett County, GA for equipment 496,000 Scott (GA)
Human Services Services
Administration
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Hamdard Health Alliance, Chicago, 1,000,000 Schakowsky
Human Services Services IL for facilities and equipment
Administration
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Harmony Health Care Long Island, 1,000,000 Gillen
Human Services Services Garden City, NY for facilities
Administration and equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Harris County, TX for equipment 425,000 Fletcher
Human Services Services
Administration
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Harris County, TX for facilities 1,000,000 Menefee
Human Services Services and equipment
Administration
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Harris County, TX for facilities 1,000,000 Garcia (TX)
Human Services Services and equipment
Administration
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Harris County, TX for facilities 1,000,000 Fletcher
Human Services Services and equipment
Administration
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Harris County, TX for facilities 500,000 Green
Human Services Services and equipment
Administration
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Harris County, TX for facilities 250,000 Menefee
Human Services Services and equipment
Administration
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Harvard Street Neighborhood 2,000,000 Pressley
Human Services Services Health Center, Inc., Boston, MA
Administration for facilities and equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Health Care District of Palm 1,000,000 Frankel
Human Services Services Beach County, West Palm Beach,
Administration FL for facilities and equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and HealthFirst Family Care Center, 500,000 Pappas
Human Services Services Inc., Laconia, NH for facilities
Administration and equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and HealthLinc INC, South Bend, IN 1,500,000 Yakym
Human Services Services for facilities and equipment
Administration
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Heart of Ohio Family Health 750,000 Beatty
Human Services Services Centers, Columbus, OH for
Administration facilities and equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Heartland Health Center, Inc., 700,000 Smith (NE)
Human Services Services Grand Island, NE for facilities
Administration and equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Henry J. Austin Health Center, 1,500,000 Watson Coleman
Human Services Services Inc., Trenton, NJ for facilities
Administration and equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and HH Health System--DeKalb LLC., 4,245,159 Aderholt
Human Services Services Huntsville, AL for facilities
Administration and equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and HH Health System--Lincoln Inc., 250,000 DesJarlais
Human Services Services Huntsville, AL for facilities
Administration and equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Hillsborough County, FL for 1,500,000 Lee (FL)
Human Services Services equipment
Administration
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Hillsdale Community Health Center 952,368 Walberg
Human Services Services dba Hillsdale Hospital,
Administration Hillsdale, MI for equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Hilltown Community Health 250,000 McGovern
Human Services Services Centers, Worthington, MA for a
Administration telehealth and health
information technology
initiative
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Hilltown Community Health 350,000 Neal
Human Services Services Centers, Worthington, MA for
Administration facilities and equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Hilltown Community Health 250,000 Neal
Human Services Services Centers, Worthington, MA for
Administration facilities and equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and HOPE Clinic, Houston, TX for 250,000 Green
Human Services Services facilities and equipment
Administration
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Hospital General de Castaner, 750,000 Hernandez
Human Services Services Inc., Castaner, PR for
Administration facilities and equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Houston Area Community Services 250,000 Green
Human Services Services dba Avenue 360 Health and
Administration Wellness, Houston, TX for
facilities and equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Hurtt Family Health Clinic, Inc., 1,000,000 Kim
Human Services Services Tustin, CA for facilities and
Administration equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Hurtt Family Health Clinic, Inc., 250,000 Correa
Human Services Services Tustin, CA for facilities and
Administration equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Ibis Healthcare, Tampa, FL for 750,000 Castor (FL)
Human Services Services facilities and equipment
Administration
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Indian Health Center of Santa 950,000 Lofgren
Human Services Services Clara Valley, San Jose, CA for
Administration facilities and equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Indiana Regional Medical Center, 1,750,000 Reschenthaler
Human Services Services Indiana, PA for equipment
Administration
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Infinity Health, Leon, IA for 750,000 Nunn (IA)
Human Services Services facilities and equipment
Administration
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Iroquois Memorial Hospital and 250,000 Kelly (IL)
Human Services Services Resident Home, Watseka, IL for
Administration facilities and equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Islands Community Medical 635,000 Pingree
Human Services Services Services, Inc., Vinalhaven, ME
Administration for facilities and equipment,
including information technology
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Jericho Road Ministries, Inc., 500,000 Kennedy (NY)
Human Services Services Buffalo, NY for an electronic
Administration health records initiative
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Jessie Trice Community Health 750,000 Wilson (FL)
Human Services Services System, Inc., Miami, FL for
Administration facilities and equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Johnson County, KS for equipment 2,000,000 Davids (KS)
Human Services Services
Administration
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Jordan Valley Community Health, 1,000,000 Alford
Human Services Services Lebanon, MO for facilities and
Administration equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Kahuku Medical Center, Kahuku, HI 1,500,000 Tokuda
Human Services Services for facilities and equipment
Administration
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Kalihi Palama Health Center, 1,000,000 Case
Human Services Services Honolulu, HI for facilities and
Administration equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Kane County Human Resource 2,000,000 Maloy
Human Services Services Special Service District dba
Administration Kane County Hospital, Kanab, UT
for facilities and equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Kedren Community Care Clinic, Los 472,000 Kamlager-Dove
Human Services Services Angeles, CA for facilities and
Administration equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Kedren Community Health Center, 1,500,000 Waters
Human Services Services Inc., Los Angeles, CA for
Administration facilities and equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Kleberg County, TX for facilities 950,000 Gonzalez
Human Services Services and equipment
Administration
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Klickitat County Public Hospital 1,000,000 Newhouse
Human Services Services District No. 1, Goldendale, WA
Administration for facilities
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Kokua Kalihi Valley Comprehensive 250,000 Case
Human Services Services Family Services, Honolulu, HI
Administration for facilities and equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and La Casa de Buena Salud, Inc., 750,000 Leger
Human Services Services Portales, NM for facilities and Fernandez
Administration equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Lackawanna County, Scranton, PA 2,000,000 Bresnahan
Human Services Services for facilities and equipment
Administration
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Lakeland Community Hospital, 11,900,000 Aderholt
Human Services Services Inc., Haleyville, AL for
Administration facilities and equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and LaSalle Parish Hospital Service 750,000 Letlow
Human Services Services District No. 1 (Hardtner Medical
Administration Center), Olla, LA for facilities
and equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Lawrence Township, NJ for 600,000 Van Drew
Human Services Services equipment
Administration
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and LCH Health and Community 188,000 Houlahan
Human Services Services Services, Kennett Square, PA for
Administration facilities and equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Little Rivers Health Care, Inc., 750,000 Balint
Human Services Services Newbury, VT for facilities and
Administration equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Lodi Memorial Hospital 1,000,000 Matsui
Human Services Services Association, Inc. dba Adventist
Administration Health Lodi Memorial, Lodi, CA
for facilities and equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Lone Star Circle of Care, 904,500 Carter (TX)
Human Services Services Georgetown, TX for facilities
Administration and equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Lone Star Family Health Center 250,000 Luttrell
Human Services Services Inc. dba Lone Star Family Health
Administration Center, Conroe, TX for
facilities and equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Lorain County Health & Dentistry, 250,000 Latta
Human Services Services Lorain, OH for facilities and
Administration equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Los Barrios Unidos Community 609,000 Veasey
Human Services Services Clinic, Inc., Dallas, TX for
Administration facilities and equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Los Barrios Unidos Community 750,000 Veasey
Human Services Services Clinic, Inc., Dallas, TX for
Administration facilities and equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Loudoun Community Health Center, 143,000 Subramanyam
Human Services Services Leesburg, VA for facilities and
Administration equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Louisville-Jefferson County Metro 500,000 McGarvey
Human Services Services Government, Louisville, KY for
Administration equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Louisville-Jefferson County Metro 1,500,000 McGarvey
Human Services Services Government, Louisville, KY for
Administration facilities and equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Love County Health Center, 12,000,000 Cole
Human Services Services Marietta, OK for facilities and
Administration equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Lower Lights Christian Health 540,000 Beatty
Human Services Services Center Inc., Columbus, OH for
Administration facilities and equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Lower Umpqua Hospital District, 250,000 Hoyle (OR)
Human Services Services Reedsport, OR for facilities and
Administration equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Lutheran Hospital Association of 504,596 Hurd
Human Services Services the San Luis Valley dba San Luis
Administration Valley Health, Alamosa, CO for
facilities and equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Lynn Community Health, Inc., 500,000 Moulton
Human Services Services Lynn, MA for facilities and
Administration equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Madison Memorial Hospital, 750,000 Simpson
Human Services Services Rexburg, ID for facilities and
Administration equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Marana Health Care, Inc., Marana, 737,000 Grijalva
Human Services Services AZ for facilities and equipment
Administration
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Marietta Memorial Hospital, 500,000 Rulli
Human Services Services Marietta, OH for equipment
Administration
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Marillac Community Health Centers 500,000 Crawford
Human Services Services dba DePaul Community Health
Administration Center, Dumas, AR for facilities
and equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Marin City Health and Wellness 750,000 Huffman
Human Services Services Center, Marin City, CA for
Administration facilities and equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Marion Regional Medical Center, 3,000,000 Aderholt
Human Services Services Inc. dba North Mississippi
Administration Medical Center-Hamilton,
Hamilton, AL for facilities and
equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Mark Twain Medical Center, San 1,500,000 Harder
Human Services Services Andreas, CA for equipment
Administration
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Martin Luther King Jr. Family 280,000 Johnson (TX)
Human Services Services Clinic dba Foremost Family
Administration Health Centers, Dallas, TX for
facilities and equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Maui Health System, Kula, HI for 500,000 Tokuda
Human Services Services facilities and equipment
Administration
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Mecklenburg County, North 250,000 Adams
Human Services Services Carolina for equipment
Administration
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and MedStar Ambulatory Services, 1,000,000 Hoyer
Human Services Services Columbia, MD for facilities and
Administration equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Memorial Healthcare, Owosso, MI 1,500,000 Barrett
Human Services Services for facilities and equipment
Administration
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Mercy Hospital Kingfisher, Inc., 250,000 Lucas
Human Services Services Kingfisher, OK for facilities
Administration and equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Mercy Hospital Lebanon, Lebanon, 100,000 Alford
Human Services Services MO for equipment
Administration
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Mercy Hospital Logan County, 2,000,000 Bice
Human Services Services Inc., Guthrie, OK for facilities
Administration and equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Metro Denver Provider Network dba 250,000 Pettersen
Human Services Services STRIDE Community Health Center,
Administration Wheat Ridge, CO for facilities
and equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Minidoka Memorial Hospital, 495,000 Simpson
Human Services Services Rupert, ID for equipment
Administration
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Monroe County Hospital, 750,000 Figures
Human Services Services Monroeville, AL for facilities
Administration and equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Monroe County, NY for facilities 1,000,000 Morelle
Human Services Services and equipment
Administration
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Montgomery County, MD for 1,000,000 Raskin
Human Services Services facilities and equipment
Administration
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Montgomery County, MD for 250,000 Raskin
Human Services Services facilities and equipment
Administration
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Montgomery General Hospital, 250,000 Miller (WV)
Human Services Services Montgomery, WV for facilities
Administration and equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Mount Vernon Neighborhood Health 635,000 Latimer
Human Services Services Center, Inc., dba Westchester
Administration Community Health Center, Mount
Vernon, NY for facilities and
equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Mountain Community Health 1,000,000 Edwards
Human Services Services Partnership, Bakersville, NC for
Administration facilities and equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Mountain Park Health Center, 2,000,000 Ansari
Human Services Services Phoenix, AZ for facilities and
Administration equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Mt. Enterprise Community Health 750,000 Moran
Human Services Services Clinic, Mt. Enterprise, TX for
Administration facilities and equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Mt. Graham Regional Medical 650,000 Ciscomani
Human Services Services Center Inc., Safford, AZ for
Administration equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Municipality of Guayama, PR for 1,000,000 Hernandez
Human Services Services facilities and equipment
Administration
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Muskegon County, MI for 1,500,000 Scholten
Human Services Services facilities and equipment
Administration
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Native American Health Center, 1,000,000 Simon
Human Services Services Inc., Oakland, CA for facilities
Administration and equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Navarro County Ambulatory Care 350,000 Ellzey
Human Services Services Association, Corsicana, TX for
Administration facilities and equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Neighborhood Health Centers of 350,000 Mackenzie
Human Services Services the Lehigh Valley, Bethlehem, PA
Administration for facilities and equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and NeoMed Center, Inc., Gurabo, PR 1,500,000 Hernandez
Human Services Services for facilities and equipment
Administration
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Neosho Memorial Regional Medical 500,000 Schmidt
Human Services Services Center, Chanute, KS for
Administration equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Newman Memorial Hospital, 250,000 Lucas
Human Services Services Shattuck, OK for facilities and
Administration equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Newton County, GA for equipment 500,000 Scott (GA)
Human Services Services
Administration
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and North Adams Regional Hospital, 1,705,000 Neal
Human Services Services North Adams, MA for facilities
Administration and equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and North Arkansas Regional Medical 150,000 Crawford
Human Services Services Center, Harrison, AR for
Administration facilities and equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and North Hudson Community Action 500,000 Menendez
Human Services Services Corporation, Union City, NJ for
Administration facilities and equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and North Shore Community Health, 500,000 Moulton
Human Services Services Salem, MA for facilities and
Administration equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and North Texas Area Community Health 300,000 Veasey
Human Services Services Centers, Inc., Forth Worth, TX
Administration for facilities and equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and North Texas Area Community Health 200,000 Veasey
Human Services Services Centers, Inc., Forth Worth, TX
Administration for facilities and equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Northeast Community Clinic, 500,000 Lieu
Human Services Services Harbor City, CA for facilities
Administration and equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Nye County, NV for equipment 1,000,000 Horsford
Human Services Services
Administration
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Oak Orchard Community Health 700,000 Tenney
Human Services Services Center, Inc., Brockport, NY for
Administration facilities
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Oak Orchard Community Health 500,000 Morelle
Human Services Services Center, Inc., Brockport, NY for
Administration facilities and equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Ochiltree Hospital District, 1,000,000 Jackson (TX)
Human Services Services Perryton, TX for facilities and
Administration equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Ohio County Hospital Corporation, 2,500,000 Guthrie
Human Services Services Hartford, KY for facilities and
Administration equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Olean General Hospital, Olean, NY 500,000 Langworthy
Human Services Services for facilities and equipment
Administration
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Omni Family Health, Bakersfield, 1,250,000 Valadao
Human Services Services CA for facilities and equipment
Administration
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and OSF HealthCare, Danville, IL for 500,000 Kelly (IL)
Human Services Services facilities and equipment
Administration
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Our Lady of the Lake Regional 1,000,000 Carter (LA)
Human Services Services Medical Center, Baton Rouge, LA
Administration for facilities and equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Palm Beach County, FL for 1,390,000 Frankel
Human Services Services equipment
Administration
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Palmer Lutheran Health Center, 350,000 Hinson
Human Services Services Inc., West Union, IA for
Administration facilities and equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and PanCare of Florida Inc., Panama 450,000 Dunn (FL)
Human Services Services City, FL for facilities and
Administration equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Park DuValle Community Health 1,092,000 McGarvey
Human Services Services Center, Inc., Louisville, KY for
Administration facilities and equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Pawhuska Hospital, Inc., 250,000 Lucas
Human Services Services Pawhuska, OK for facilities and
Administration equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Peak Vista Community Health 1,300,000 Crank
Human Services Services Centers, Colorado Springs, CO
Administration for facilities and equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Pender Memorial Hospital dba 750,000 Rouzer
Human Services Services Novant Health Pender Medical
Administration Center, Burgaw, NC for
facilities and equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and People's Community Clinic Inc., 750,000 Casar
Human Services Services Austin, TX for facilities and
Administration equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Peoples Community Health Clinic, 275,000 Hinson
Human Services Services Inc., Waterloo, IA for
Administration facilities and equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Petaluma Health Center, Petaluma, 1,000,000 Thompson (CA)
Human Services Services CA for facilities and equipment
Administration
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Petersburg Medical Center, 2,000,000 Begich
Human Services Services Petersburg, AK for facilities
Administration
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Phoebe Sumter Medical Center, 549,000 Bishop
Human Services Services West Americus, GA for equipment
Administration
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Pikeville Medical Center, Inc., 4,000,000 Rogers (KY)
Human Services Services Pikeville, KY for facilities and
Administration equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Plymouth County, MA for equipment 709,000 Keating
Human Services Services
Administration
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Pocahontas Memorial Hospital, 250,000 Miller (WV)
Human Services Services Buckeye, WV for equipment
Administration
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Ponca Tribe of Nebraska, NE for 750,000 Bacon
Human Services Services facilities and equipment
Administration
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Preferred Family Healthcare dba 100,000 Alford
Human Services Services Clarity Healthcare, Kirksville,
Administration MO for facilities and equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Premier Community HealthCare 1,500,000 Bilirakis
Human Services Services Group, Inc., Dade City, FL for
Administration facilities and equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Primary Care Medical Services of 500,000 Soto
Human Services Services Poinciana, Inc., dba Osceola
Administration Community Health Services,
Kissimmee, FL for facilities and
equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Prince George's County, MD for 500,000 Hoyer
Human Services Services equipment
Administration
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Progressive Community Health 257,000 Moore (WI)
Human Services Services Centers, Inc., Milwaukee, WI for
Administration facilities and equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Public Hospital District 1-A of 750,000 Baumgartner
Human Services Services Whitman County, Pullman, WA for
Administration facilities and equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Raphael Health Center, Inc., 140,000 Carson
Human Services Services Indianapolis, IN for facilities
Administration and equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Reedsburg Area Medical Center, 200,000 Van Orden
Human Services Services Inc., Reedsburg, WI for
Administration equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Regional Health Services of 1,480,424 Hinson
Human Services Services Howard County, Cresco, IA for
Administration facilities and equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Rhea County Hospital dba Rhea 250,000 DesJarlais
Human Services Services Medical Center, Dayton, TN for
Administration equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Ridgecrest Regional Hospital, 1,321,904 Fong
Human Services Services Ridgecrest, CA for facilities
Administration and equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Riverview Healthcare Association, 549,000 Fischbach
Human Services Services Crookston, MN for facilities and
Administration equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Roane County Medical Center, 4,300,000 Fleischmann
Human Services Services Harriman, TN for facilities and
Administration equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Rochelle Community Hospital 1,500,000 LaHood
Human Services Services Association, Rochelle, IL for
Administration facilities and equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Russellville Hospital Inc., 3,000,000 Aderholt
Human Services Services Russellville, AL for facilities
Administration and equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and SAC Health, San Bernardino, CA 1,500,000 Obernolte
Human Services Services for facilities and equipment
Administration
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and SAC Health, San Bernardino, CA 2,000,000 Aguilar
Human Services Services for equipment
Administration
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Saint Luke's Hospital of Trenton, 500,000 Graves
Human Services Services Trenton, MO for equipment
Administration
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Saint Luke's Hospital of Allen 500,000 Schmidt
Human Services Services County, Inc. dba Allen County
Administration Regional Hospital, Iola, KS for
equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Saint Thomas Regional Hospitals, 250,000 DesJarlais
Human Services Services McMinnville, TN for facilities
Administration and equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Salud Integral en la Montana, 500,000 Hernandez
Human Services Services Inc., Naranjito, PR for
Administration facilities and equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and San Benito Health Foundation, 1,250,000 Lofgren
Human Services Services Hollister, CA for facilities and
Administration equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and San Fernando Community Hospital 500,000 Rivas
Human Services Services dba San Fernando Community
Administration Health Center, San Fernando, CA
for facilities and equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Santa Fe County, NM for 750,000 Leger
Human Services Services facilities and equipment Fernandez
Administration
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Santo Nino Health Center, 217,000 Rivas
Human Services Services Panorama City, CA for equipment
Administration
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Schneider Regional Medical 750,000 Plaskett
Human Services Services Center, St. Thomas, VI for
Administration facilities and equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Schneider Regional Medical 750,000 Plaskett
Human Services Services Center, St. Thomas, VI for
Administration facilities and equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Schneider Regional Medical 500,000 Plaskett
Human Services Services Center, St. Thomas, VI for
Administration facilities and equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Scott & White Hospital--Marble 3,000,000 Carter (TX)
Human Services Services Falls dba Baylor Scott & White
Administration Medical Center--Marble Falls,
Dallas, TX for facilities and
equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Sharon Regional Medical Center, 250,000 Kelly (PA)
Human Services Services Sharon, PA for equipment
Administration
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Sheridan Community Hospital, 4,000,000 Moolenaar
Human Services Services Sheridan, MI for facilities and
Administration equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and South Central Family Health 750,000 Sanchez
Human Services Services Center, Los Angeles, CA for
Administration facilities and equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Southern California Medical 250,000 Cisneros
Human Services Services Center Inc., Van Nuys, CA for
Administration facilities and equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Southern Humboldt Community 250,000 Huffman
Human Services Services Healthcare District,
Administration Garberville, CA for facilities
and equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Spring Branch Community Health 1,300,000 Menefee,
Human Services Services Center, Houston, TX for Garcia (TX)
Administration facilities and equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and St. Francis House NWA, Inc. dba 1,026,948 Womack
Human Services Services Community Clinic, Springdale, AR
Administration for facilities and equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and St. John's Bread and Life 400,000 Jeffries
Human Services Services Program, Inc., Brooklyn, NY for
Administration facilities and equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and St. Louis County, MO for 250,000 Bell
Human Services Services equipment
Administration
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and St. Mary's Healthcare, Amsterdam, 750,000 Tonko
Human Services Services NY for facilities and equipment
Administration
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and St. Thomas East End Medical 1,000,000 Plaskett
Human Services Services Center Corporation, St. Thomas,
Administration VI for facilities and equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and St. Vincent Randolph Hospital, 150,000 Stutzman
Human Services Services Inc., Winchester, IN for
Administration equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and State of Delaware for facilities 250,000 McBride
Human Services Services and equipment
Administration
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and State of Louisiana for facilities 250,000 Carter (LA)
Human Services Services and equipment
Administration
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and State of Louisiana for facilities 250,000 Carter (LA)
Human Services Services and equipment
Administration
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and State of New Mexico for equipment 500,000 Stansbury
Human Services Services
Administration
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and State of Rhode Island, 250,000 Amo
Human Services Services Providence, RI for facilities
Administration and equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Steele Memorial Medical Center, 2,000,000 Simpson
Human Services Services Salmon, ID for facilities and
Administration equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Stephen F. Austin Community 500,000 Nehls
Human Services Services Health Center Inc., Pearland, TX
Administration for equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Stillwater Medical Center 250,000 Lucas
Human Services Services Authority, Stillwater, OK for
Administration facilities
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and STRIDE Community Health Center, 365,000 Crow
Human Services Services Aurora, CO for equipment
Administration
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and STRIDE Community Health Center, 814,000 DeGette
Human Services Services Wheat Ridge, CO for facilities
Administration and equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Su Clinica Familiar, Harlingen, 580,000 Gonzalez
Human Services Services TX for facilities and equipment
Administration
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Sullivan County Memorial 2,500,000 Graves
Human Services Services Hospital, Milan, MO for
Administration facilities and equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Sun Life Family Health Center 500,000 Ciscomani
Human Services Services Inc., Casa Grande, AZ for
Administration facilities and equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Sweetwater Hospital Association, 1,800,000 Fleischmann
Human Services Services Sweetwater, TN for facilities
Administration and equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Swope Health Services, Kansas 500,000 Schmidt
Human Services Services City, MO for facilities and
Administration equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and T.H.E. Clinic, Inc. dba To Help 750,000 Kamlager-Dove
Human Services Services Everyone Health and Wellness,
Administration Los Angeles, CA for facilities
and equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Tampa Family Health Centers, 2,000,000 Castor (FL)
Human Services Services Inc., Tampa, FL for facilities
Administration and equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and TCC Family Health, Long Beach, CA 750,000 Barragan
Human Services Services for facilities and equipment
Administration
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Texas Health Harris Methodist 1,500,000 Williams (TX)
Human Services Services Hospital Stephenville,
Administration Stephenville, TX for facilities
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and The Asian Americans for Community 500,000 Liccardo
Human Services Services Involvement of Santa Clara
Administration County, Inc., San Jose, CA for
facilities and equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and The Brevard Health Alliance, 1,500,000 Haridopolos
Human Services Services Inc., West Melbourne, FL for
Administration facilities
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and The C.W. Williams Community 910,000 Adams
Human Services Services Health Center, Inc., Charlotte,
Administration NC for facilities and equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and The C.W. Williams Community 15,000 Adams
Human Services Services Health Center, Inc., Charlotte,
Administration NC for facilities and equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and The Center for Health Education, 2,500,000 Smith (NJ)
Human Services Services Medicine, & Dentistry, Lakewood,
Administration NJ for facilities and equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and The City of Buffalo, NY for 750,000 Kennedy (NY)
Human Services Services equipment
Administration
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and The City of Mobile, AL for 250,000 Figures
Human Services Services facilities and equipment
Administration
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and The City of New York, NY for 750,000 Ocasio-Cortez
Human Services Services facilities and equipment
Administration
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and The HealthCare Connection, Inc, 750,000 Landsman
Human Services Services Cincinnati, OH for facilities
Administration and equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and The Joseph P. Addabbo Family 500,000 Meeks
Human Services Services Health Center, Inc., Arverne, NY
Administration for facilities and equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and The Troy Hospital Healthcare 2,000,000 Figures
Human Services Services Authority dba Troy Regional
Administration Medical Center, Troy, AL for
facilities and equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and The University of Houston Family 1,000,000 Menefee
Human Services Services Care Center, Houston, TX for
Administration facilities and equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and The Washington County Healthcare 750,000 Figures
Human Services Services Authority, Inc., Chatom, AL for
Administration facilities and equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and The West Oakland Health Council 750,000 Simon
Human Services Services dba Baywell Health, Oakland, CA
Administration for facilities and equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Thunder Bay Community Health 500,000 Bergman
Human Services Services Service, Inc., Alpena, MI for
Administration facilities and equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Town of Alstead, NH for equipment 500,000 Goodlander
Human Services Services
Administration
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Town of Glocester, RI for 250,000 Magaziner
Human Services Services equipment
Administration
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Town of Greenwich, CT for 500,000 Himes
Human Services Services facilities and equipment
Administration
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Town of Jackman, ME for 500,000 Golden (ME)
Human Services Services facilities and equipment
Administration
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Town of Ramapo, NY for equipment 3,000,000 Lawler
Human Services Services
Administration
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Township of Berwyn, IL for 1,000,000 Garcia (IL)
Human Services Services facilities and equipment
Administration
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Township of Hainesport, NJ for 382,000 Conaway
Human Services Services equipment
Administration
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Tristate Community Health Center, 250,000 Cohen
Human Services Services Memphis, TN for facilities and
Administration equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Unified Government of Wyandotte 1,000,000 Davids (KS)
Human Services Services County/Kansas City, Kansas, KS
Administration for equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and United Neighborhood Health 1,000,000 Rose (TN)
Human Services Services Services, Inc., Nashville, TN
Administration for facilities and equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Unity Healthcare dba Trinity 2,000,000 Miller-Meeks
Human Services Services Muscatine, Muscatine, IA for
Administration facilities and equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and University Muslim Medical 170,000 Waters
Human Services Services Association, Inc., Los Angeles,
Administration CA for facilities and equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and University Muslim Medical 1,000,000 Kamlager-Dove
Human Services Services Association, Inc., Los Angeles,
Administration CA for facilities and equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and University of Maryland Charles 650,000 Hoyer
Human Services Services Regional Medical Center, La
Administration Plata, MD for facilities and
equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and UPMC Bedford, Everette, PA for 223,000 Joyce (PA)
Human Services Services facilities and equipment
Administration
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and UPMC Chautauqua, Jamestown, NY 300,000 Langworthy
Human Services Services for facilities and equipment
Administration
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and UPMC Greene, Waynesburg, PA for 500,000 Reschenthaler
Human Services Services facilities and equipment
Administration
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and UPMC Muncy, Williamsport, PA for 500,000 Meuser
Human Services Services facilities and equipment
Administration
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and UPMC Somerset, Somerset, PA for 500,000 Reschenthaler
Human Services Services equipment
Administration
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Upper Great Lakes Family Health 1,250,000 Bergman
Human Services Services Care, Gwinn, MI for facilities
Administration and equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and UT Medical Center dba University 200,000 Rose (TN)
Human Services Services Health System, Inc., Knoxville,
Administration TN for facilities and equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Valle del Sol, Phoenix, AZ for 1,000,000 Ansari
Human Services Services facilities and equipment
Administration
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Valle del Sol, Phoenix, AZ for 500,000 Ansari
Human Services Services facilities and equipment
Administration
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Valle del Sol, Phoenix, AZ for 500,000 Ansari
Human Services Services facilities and equipment
Administration
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Valle del Sol, Phoenix, AZ for 250,000 Stanton
Human Services Services facilities and equipment
Administration
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Valley Health Partners, 650,000 Mackenzie
Human Services Services Allentown, PA for facilities
Administration
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Valley Health Systems Inc., 250,000 Miller (WV)
Human Services Services Huntington, WV for facilities
Administration and equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Van Buren County Hospital, 2,000,000 Miller-Meeks
Human Services Services Keosauqua, IA for facilities and
Administration equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Venice Family Clinic, Venice, CA 500,000 Waters
Human Services Services for facilities and equipment
Administration
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Via Care Community Health Center, 750,000 Gomez
Human Services Services Inc., Los Angeles, CA for
Administration facilities and equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Village of La Grange, IL for 450,000 Garcia (IL)
Human Services Services equipment
Administration
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Village of North Baltimore-- 250,000 Latta
Human Services Services Westhaven Community Health
Administration Clinic, North Baltimore, OH for
facilities and equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and VIP Community Services, Bronx, NY 500,000 Torres (NY)
Human Services Services for facilities and equipment
Administration
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Wai'anae Coast Comprehensive 1,859,000 Case
Human Services Services Health Center, Waianae, HI for
Administration facilities and equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Waikiki Health, Honolulu, HI for 395,000 Case
Human Services Services facilities and equipment
Administration
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Watts Healthcare Corporation, Los 2,000,000 Waters
Human Services Services Angeles, CA for facilities and
Administration equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Watts Healthcare Corporation, Los 750,000 Kamlager-Dove
Human Services Services Angeles, CA for facilities and
Administration equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Wayne Community Health Centers 1,000,000 Maloy
Human Services Services Inc., Bicknell, UT for
Administration facilities and equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Wayne County Hospital, Corydon, 1,500,000 Nunn (IA)
Human Services Services IA for facilities
Administration
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Wayne Memorial Hospital, 1,000,000 Bresnahan
Human Services Services Honesdale, PA for facilities and
Administration equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and WellSpace Health, Sacramento, CA 750,000 Matsui
Human Services Services for facilities and equipment
Administration
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Wesley Community Centers Inc., 750,000 Ansari
Human Services Services Phoenix, AZ for facilities and
Administration equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and West Hawaii Region of Hawaii 500,000 Tokuda
Human Services Services Health Systems Corporation,
Administration Kealakekua, HI for facilities
and equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Westchester-Ellenville Hospital, 250,000 Riley
Human Services Services Inc., Ellenville, NY for
Administration facilities and equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Wilmington Community Clinic, 250,000 Barragan
Human Services Services Wilmington, CA for facilities
Administration and equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Wood County Community Health 500,000 Kaptur
Human Services Services Center, Bowling Green, OH for
Administration facilities and equipment
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Wood County Hospital, Green, OH 500,000 Latta
Human Services Services for equipment
Administration
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Wyoming County, PA for equipment 250,000 Meuser
Human Services Services
Administration
----------------------------------------------------------------------------------------------------------------
Department of Health and Health Resources and Zapata County, TX for facilities 1,000,000 Cuellar
Human Services Services and equipment
Administration
----------------------------------------------------------------------------------------------------------------
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