Department of Health and Human Services
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Mission Statement –
The mission of the U.S. Department of Health and Human Services (HHS) is to enhance the health and well-being of all Americans, by providing for effective health and human services and by fostering sound, sustained advances in the sciences underlying medicine, public health, and social services.
Discussion –
As a nation, we have decided to provide certain safety nets for our citizens. One of those in Medicare. We considered whether or not it would make sense to distribute responsibility for this important program back to the States. It is our opinion that it does not – people move regularly throughout their lives and where they pay taxes as workers may not be where they spend their retirement years. A good example is Florida – many people move there specifically to retire. Because of this, we believe that Medicare must remain a Federal responsibility. However, Medicare should be removed from Health & Human Services and placed in an independent agency similar to the Social Security Administration.
Medicaid, on the other hand, is an example of the Federal Government acting as a middleman, taking from the people to give back to the States. This program should simply be returned to the States to manage as they see fit.
There are a number of important agencies at HHS that are legitimate Federal responsibilities, but that should be moved elsewhere. The Centers for Disease Control should be made an independent agency to insulate it from political manipulation. The Food and Drug Administration should be moved to the Department of Interstate Commerce. The Indian Health Service should be moved to the new Department of Indigenous Peoples. The National Institutes for Health should be moved to the National Science Foundation.
Most other functions should be closed and returned to the States.
Budget
| Current Budget | $1,213,798,000,000.00 |
| Proposed Budget | $707,631,000,000.00 * |
| Savings | $506,167,000,000.00 |
* Remaining functions transferred to other departments.
| Bureau Name | Account Name | Subfunction Title | 2019 Budget | Proposed |
|---|---|---|---|---|
| Administration for Children and Families | Child Care Entitlement to States | Other income security | $3,244,000,000.00 | $0.00 |
| Administration for Children and Families | Children and Families Services Programs | Social services | $367,000,000.00 | $0.00 |
| Administration for Children and Families | Children and Families Services Programs | Social services | $11,240,000,000.00 | $0.00 |
| Administration for Children and Families | Children's Research and Technical Assistance | Other income security | $36,000,000.00 | $0.00 |
| Administration for Children and Families | Contingency Fund | Other income security | $600,000,000.00 | $0.00 |
| Administration for Children and Families | Low Income Home Energy Assistance | Other income security | $3,695,000,000.00 | $0.00 |
| Administration for Children and Families | Payments for Foster Care and Permanency | Other income security | $8,599,000,000.00 | $0.00 |
| Administration for Children and Families | Payments to States for Child Support Enforcement and Family Support Programs | Other income security | $4,117,000,000.00 | $0.00 |
| Administration for Children and Families | Payments to States for the Child Care and Development Block Grant | Other income security | $12,000,000.00 | $0.00 |
| Administration for Children and Families | Payments to States for the Child Care and Development Block Grant | Other income security | $3,906,000,000.00 | $0.00 |
| Administration for Children and Families | Promoting Safe and Stable Families | Social services | $61,000,000.00 | $0.00 |
| Administration for Children and Families | Promoting Safe and Stable Families | Social services | $421,000,000.00 | $0.00 |
| Administration for Children and Families | Refugee and Entrant Assistance | Other income security | $515,000,000.00 | $0.00 |
| Administration for Children and Families | Refugee and Entrant Assistance | Other income security | $2,014,000,000.00 | $0.00 |
| Administration for Children and Families | Social Services Block Grant | Social services | $1,646,000,000.00 | $0.00 |
| Administration for Children and Families | Temporary Assistance for Needy Families | Other income security | $3,000,000.00 | $0.00 |
| Administration for Children and Families | Temporary Assistance for Needy Families | Other income security | $15,493,000,000.00 | $0.00 |
| Administration for Community Living | Aging and Disability Services Programs | Social services | $30,000,000.00 | $0.00 |
| Administration for Community Living | Aging and Disability Services Programs | Social services | $76,000,000.00 | $0.00 |
| Administration for Community Living | Aging and Disability Services Programs | Social services | $1,917,000,000.00 | $0.00 |
| Agency for Healthcare Research and Quality | Healthcare Research and Quality | Health research and training | -$2,000,000.00 | -$2,000,000.00 |
| Agency for Healthcare Research and Quality | Healthcare Research and Quality | Health research and training | $324,000,000.00 | $0.00 |
| Centers for Disease Control and Prevention | Agency for Toxic Substances and Disease Registry, Toxic Substances and Environmental Public Health | Health care services | $2,000,000.00 | $2,000,000.00 |
| Centers for Disease Control and Prevention | Agency for Toxic Substances and Disease Registry, Toxic Substances and Environmental Public Health | Health care services | $73,000,000.00 | $73,000,000.00 |
| Centers for Disease Control and Prevention | Buildings and Facilities | Health care services | $35,000,000.00 | $35,000,000.00 |
| Centers for Disease Control and Prevention | CDC Working Capital Fund | Health care services | -$6,000,000.00 | -$6,000,000.00 |
| Centers for Disease Control and Prevention | CDC-wide Activities and Program Support | Atomic energy defense activities | $47,000,000.00 | $47,000,000.00 |
| Centers for Disease Control and Prevention | CDC-wide Activities and Program Support | Health care services | $2,000,000.00 | $2,000,000.00 |
| Centers for Disease Control and Prevention | CDC-wide Activities and Program Support | Health care services | $1,015,000,000.00 | $1,015,000,000.00 |
| Centers for Disease Control and Prevention | CDC-wide Activities and Program Support | Health care services | $5,046,000,000.00 | $5,046,000,000.00 |
| Centers for Disease Control and Prevention | CDC-wide Activities and Program Support | Health research and training | $147,000,000.00 | $147,000,000.00 |
| Centers for Disease Control and Prevention | CDC-wide Activities and Program Support | Health research and training | $188,000,000.00 | $188,000,000.00 |
| Centers for Disease Control and Prevention | CDC-wide Activities and Program Support | Health research and training | $767,000,000.00 | $767,000,000.00 |
| Centers for Disease Control and Prevention | World Trade Center Health Program Fund | Health care services | $420,000,000.00 | $420,000,000.00 |
| Centers for Medicare and Medicaid Services | Affordable Insurance Exchange Grants | Health care services | $4,000,000.00 | $0.00 |
| Centers for Medicare and Medicaid Services | Center for Medicare and Medicaid Innovation | Health care services | $978,000,000.00 | $500,000,000.00 |
| Centers for Medicare and Medicaid Services | Child Enrollment Contingency Fund | Health care services | $3,000,000.00 | $0.00 |
| Centers for Medicare and Medicaid Services | Children's Health Insurance Fund | Health care services | $17,689,000,000.00 | $0.00 |
| Centers for Medicare and Medicaid Services | Consumer Operated and Oriented Plan Program Account | Health care services | $259,000,000.00 | $0.00 |
| Centers for Medicare and Medicaid Services | Consumer Operated and Oriented Plan Program Contingency Fund | Health care services | $5,000,000.00 | $0.00 |
| Centers for Medicare and Medicaid Services | Federal Contribution for Admin. Contribution for Admin. Costs, Prescription Drug Account, FSMI | Medicare | -$1,196,000,000.00 | -$1,196,000,000.00 |
| Centers for Medicare and Medicaid Services | Federal Contributions for Benefits, Prescription Drug Account, SMI | Medicare | -$66,687,000,000.00 | -$66,687,000,000.00 |
| Centers for Medicare and Medicaid Services | Federal Contributions, FSMI Fund | Medicare | -$265,819,000,000.00 | -$265,819,000,000.00 |
| Centers for Medicare and Medicaid Services | Federal Hospital Insurance Trust Fund | Medicare | $2,945,000,000.00 | $2,945,000,000.00 |
| Centers for Medicare and Medicaid Services | Federal Hospital Insurance Trust Fund | Medicare | $324,910,000,000.00 | $324,910,000,000.00 |
| Centers for Medicare and Medicaid Services | Federal Supplementary Medical Insurance Trust Fund | Medicare | $3,008,000,000.00 | $3,008,000,000.00 |
| Centers for Medicare and Medicaid Services | Federal Supplementary Medical Insurance Trust Fund | Medicare | $364,579,000,000.00 | $364,579,000,000.00 |
| Centers for Medicare and Medicaid Services | FHI Trust Fund, Payment from the General Fund for Health Care Fraud and Abuse Control Account | Medicare | -$138,000,000.00 | -$138,000,000.00 |
| Centers for Medicare and Medicaid Services | FHI Trust Fund, Payments from the General Fund (uninsured and Program Management) | Medicare | -$1,177,000,000.00 | -$1,177,000,000.00 |
| Centers for Medicare and Medicaid Services | FHI Trust Fund, Taxation on OASDI Benefits | Medicare | -$23,781,000,000.00 | -$23,781,000,000.00 |
| Centers for Medicare and Medicaid Services | FHI Trust Fund, Transfers from General Fund (asset Forfeitures) | Medicare | -$37,000,000.00 | -$37,000,000.00 |
| Centers for Medicare and Medicaid Services | FHI Trust Fund, Transfers from General Fund (civil Monetary Penalties) | Medicare | -$64,000,000.00 | -$64,000,000.00 |
| Centers for Medicare and Medicaid Services | FHI Trust Fund, Transfers from General Fund (criminal Fines) | Medicare | -$15,000,000.00 | -$15,000,000.00 |
| Centers for Medicare and Medicaid Services | Grants to States for Medicaid | Health care services | $409,421,000,000.00 | $0.00 |
| Centers for Medicare and Medicaid Services | Health Care Fraud and Abuse Control Account | Medicare | $708,000,000.00 | $708,000,000.00 |
| Centers for Medicare and Medicaid Services | Health Care Fraud and Abuse Control Account | Medicare | $1,257,000,000.00 | $1,257,000,000.00 |
| Centers for Medicare and Medicaid Services | Medicare Health Information Technology Incentive Payments, Recovery Act | Health care services | -$10,000,000.00 | -$10,000,000.00 |
| Centers for Medicare and Medicaid Services | Medicare Prescription Drug Account, Federal Supplementary Insurance Trust Fund | Medicare | $460,000,000.00 | $460,000,000.00 |
| Centers for Medicare and Medicaid Services | Medicare Prescription Drug Account, Federal Supplementary Insurance Trust Fund | Medicare | $84,680,000,000.00 | $84,680,000,000.00 |
| Centers for Medicare and Medicaid Services | Miscellaneous Federal Payments, Federal Supplementary Medical Insurance Trust Fund | Medicare | -$1,000,000.00 | -$1,000,000.00 |
| Centers for Medicare and Medicaid Services | Payments to Health Care Trust Funds | Medicare | $358,880,000,000.00 | $358,880,000,000.00 |
| Centers for Medicare and Medicaid Services | Pre-Existing Condition Insurance Plan Program | Health care services | $52,000,000.00 | $0.00 |
| Centers for Medicare and Medicaid Services | Program Management | Health care services | -$619,000,000.00 | -$619,000,000.00 |
| Centers for Medicare and Medicaid Services | Program Management | Health care services | -$54,000,000.00 | -$54,000,000.00 |
| Centers for Medicare and Medicaid Services | Quality Improvement Organizations | Medicare | -$22,000,000.00 | -$22,000,000.00 |
| Centers for Medicare and Medicaid Services | Rate Review Grants | Health care services | $17,000,000.00 | $17,000,000.00 |
| Centers for Medicare and Medicaid Services | Risk Adjustment Program Payments | Health care services | $6,911,000,000.00 | $6,911,000,000.00 |
| Centers for Medicare and Medicaid Services | State Grants and Demonstrations | Health care services | $378,000,000.00 | $0.00 |
| Centers for Medicare and Medicaid Services | Transitional Reinsurance Program | Health care services | $35,000,000.00 | $35,000,000.00 |
| Department of Health and Human Services | Affordable Care Act Medicare Shared Savings Models (HI) | Medicare | -$79,000,000.00 | -$79,000,000.00 |
| Department of Health and Human Services | Affordable Care Act Medicare Shared Savings Models, SMI | Medicare | -$72,000,000.00 | -$72,000,000.00 |
| Department of Health and Human Services | All Other General Fund Proprietary Receipts Including Budget Clearing Accounts | Deductions for offsetting receipts | -$511,000,000.00 | -$511,000,000.00 |
| Department of Health and Human Services | Basic Premium, Medicare Advantage, FSMI Trust Fund | Medicare | -$486,000,000.00 | -$486,000,000.00 |
| Department of Health and Human Services | Centers for Disease Control, Gifts and Donations | Health research and training | -$26,000,000.00 | -$26,000,000.00 |
| Department of Health and Human Services | Contributions, Indian Health Facilities | Health care services | -$3,000,000.00 | -$3,000,000.00 |
| Department of Health and Human Services | Contributions, N.I.H., Conditional Gift Fund | Health research and training | -$40,000,000.00 | -$40,000,000.00 |
| Department of Health and Human Services | Contributions, N.I.H., Unconditional Gift Fund | Health research and training | -$2,000,000.00 | -$2,000,000.00 |
| Department of Health and Human Services | Cooperative Research and Development Agreements, Centers for Disease Control | Health research and training | -$1,000,000.00 | -$1,000,000.00 |
| Department of Health and Human Services | Cooperative Research and Development Agreements, FDA | Consumer and occupational health and safety | -$1,000,000.00 | -$1,000,000.00 |
| Department of Health and Human Services | Cooperative Research and Development Agreements, NIH | Health research and training | -$51,000,000.00 | -$51,000,000.00 |
| Department of Health and Human Services | Downward Reestimates of Subsidies, Health Centers | Health care services | -$1,000,000.00 | -$1,000,000.00 |
| Department of Health and Human Services | Federal Share of Child Support Collections | Other income security | -$526,000,000.00 | -$526,000,000.00 |
| Department of Health and Human Services | FHI Trust Fund, Basic Premium, Medicare Advantage | Medicare | -$387,000,000.00 | -$387,000,000.00 |
| Department of Health and Human Services | FHI Trust Fund, Medicare Refunds | Medicare | -$6,231,000,000.00 | -$6,231,000,000.00 |
| Department of Health and Human Services | FHI Trust Fund, Premiums Collected for Uninsured Individuals not Otherwise Eligible | Medicare | -$3,823,000,000.00 | -$3,823,000,000.00 |
| Department of Health and Human Services | General Fund Payment, FDA Innovation, CURES Act | Consumer and occupational health and safety | -$70,000,000.00 | -$70,000,000.00 |
| Department of Health and Human Services | General Fund Payment, NIH Innovation, CURES Act | Health research and training | -$711,000,000.00 | -$711,000,000.00 |
| Department of Health and Human Services | General Fund Proprietary Interest Receipts, not Otherwise Classified | Other interest | -$120,000,000.00 | -$120,000,000.00 |
| Department of Health and Human Services | Interest, Child Enrollment Contingency Fund | Other interest | -$254,000,000.00 | -$254,000,000.00 |
| Department of Health and Human Services | Medicare Refunds, SMI | Medicare | -$4,961,000,000.00 | -$4,961,000,000.00 |
| Department of Health and Human Services | Payments from States, Medicare Prescription Drug Account, FSMI | Medicare | -$12,154,000,000.00 | -$12,154,000,000.00 |
| Department of Health and Human Services | Premiums Collected for Medicare Prescription Drug Account, FSMI | Medicare | -$5,542,000,000.00 | -$5,542,000,000.00 |
| Department of Health and Human Services | Premiums Collected for the Aged, FSMI Fund | Medicare | -$84,468,000,000.00 | -$84,468,000,000.00 |
| Department of Health and Human Services | Premiums Collected for the Disabled, FSMI Fund | Medicare | -$13,290,000,000.00 | -$13,290,000,000.00 |
| Department of Health and Human Services | Rent and Charges for Quarters, Indian Health Service | Health care services | -$8,000,000.00 | -$8,000,000.00 |
| Department of Health and Human Services | Transfers from Presidential Election Campaign Fund | Health research and training | -$41,000,000.00 | -$41,000,000.00 |
| Departmental Management | General Departmental Management | Health care services | -$2,000,000.00 | -$2,000,000.00 |
| Departmental Management | General Departmental Management | Health care services | $373,000,000.00 | $0.00 |
| Departmental Management | Health Insurance Reform Implementation Fund | Health care services | $5,000,000.00 | $0.00 |
| Departmental Management | Medicare Hearings and Appeals | Health care services | $28,000,000.00 | $0.00 |
| Departmental Management | Nonrecurring Expenses Fund | Health care services | $235,000,000.00 | $0.00 |
| Departmental Management | Office for Civil Rights | Federal law enforcement activities | -$12,000,000.00 | $0.00 |
| Departmental Management | Office for Civil Rights | Federal law enforcement activities | $40,000,000.00 | $0.00 |
| Departmental Management | Office of the National Coordinator for Health Information Technology | Health care services | $55,000,000.00 | $0.00 |
| Departmental Management | Pregnancy Assistance Fund | Health care services | $21,000,000.00 | $0.00 |
| Departmental Management | Public Health and Social Services Emergency Fund | Health care services | $254,000,000.00 | $0.00 |
| Departmental Management | Public Health and Social Services Emergency Fund | Health care services | $2,317,000,000.00 | $0.00 |
| Departmental Management | Section 241 Evaluation Transactions Account | Health research and training | $1,000,000.00 | $0.00 |
| Departmental Management | Transfers from the Patient-Centered Outcomes Research Trust Fund | Health research and training | -$66,000,000.00 | -$66,000,000.00 |
| Food and Drug Administration | FDA Innovation, Cures Act | Consumer and occupational health and safety | $43,000,000.00 | $43,000,000.00 |
| Food and Drug Administration | FDA Working Capital Fund | Consumer and occupational health and safety | -$233,000,000.00 | -$233,000,000.00 |
| Food and Drug Administration | Payment to the FDA Innovation Account, CURES Act | Consumer and occupational health and safety | $70,000,000.00 | $70,000,000.00 |
| Food and Drug Administration | Revolving Fund for Certification and Other Services | Consumer and occupational health and safety | -$1,000,000.00 | -$1,000,000.00 |
| Food and Drug Administration | Salaries and Expenses | Consumer and occupational health and safety | $7,000,000.00 | $7,000,000.00 |
| Food and Drug Administration | Salaries and Expenses | Consumer and occupational health and safety | $3,015,000,000.00 | $3,015,000,000.00 |
| Health Resources and Services Administration | Covered Countermeasure Process Fund | Health care services | $2,000,000.00 | $0.00 |
| Health Resources and Services Administration | Health Resources and Services | Health care services | $2,726,000,000.00 | $0.00 |
| Health Resources and Services Administration | Health Resources and Services | Health care services | $3,009,000,000.00 | $0.00 |
| Health Resources and Services Administration | Health Resources and Services | Health care services | $4,205,000,000.00 | $0.00 |
| Health Resources and Services Administration | Health Resources and Services | Health research and training | $135,000,000.00 | $0.00 |
| Health Resources and Services Administration | Health Resources and Services | Health research and training | $865,000,000.00 | $0.00 |
| Health Resources and Services Administration | Maternal, Infant, and Early Childhood Home Visiting Programs | Health care services | $384,000,000.00 | $0.00 |
| Health Resources and Services Administration | Vaccine Injury Compensation | Health care services | -$2,000,000.00 | -$2,000,000.00 |
| Health Resources and Services Administration | Vaccine Injury Compensation Program Trust Fund | Health care services | $34,000,000.00 | $34,000,000.00 |
| Health Resources and Services Administration | Vaccine Injury Compensation Program Trust Fund | Health care services | $217,000,000.00 | $217,000,000.00 |
| Indian Health Service | Contract Support Costs | Health care services | $830,000,000.00 | $830,000,000.00 |
| Indian Health Service | Indian Health Facilities | Health care services | $6,000,000.00 | $6,000,000.00 |
| Indian Health Service | Indian Health Facilities | Health care services | $688,000,000.00 | $688,000,000.00 |
| Indian Health Service | Indian Health Services | Health care services | $148,000,000.00 | $148,000,000.00 |
| Indian Health Service | Indian Health Services | Health care services | $3,783,000,000.00 | $3,783,000,000.00 |
| National Institutes of Health | National Institutes of Health | Health research and training | $201,000,000.00 | $201,000,000.00 |
| National Institutes of Health | National Institutes of Health | Health research and training | $34,661,000,000.00 | $34,661,000,000.00 |
| National Institutes of Health | NIH Innovation, Cures Act | Health research and training | $52,000,000.00 | $52,000,000.00 |
| National Institutes of Health | Payment to the NIH Innovation Account, CURES Act | Health research and training | $711,000,000.00 | $711,000,000.00 |
| Office of the Inspector General | Office of Inspector General | Health care services | $15,000,000.00 | $0.00 |
| Office of the Inspector General | Office of Inspector General | Health care services | $77,000,000.00 | $0.00 |
| Program Support Center | HHS Accrual Contribution to the Uniformed Services Retiree Health Care Fund | Health care services | $29,000,000.00 | $0.00 |
| Program Support Center | HHS Service and Supply Fund | Health care services | $99,000,000.00 | $0.00 |
| Program Support Center | Miscellaneous Trust Funds | Health care services | $78,000,000.00 | $0.00 |
| Program Support Center | Retirement Pay and Medical Benefits for Commissioned Officers | Health care services | $617,000,000.00 | $0.00 |
| Substance Abuse and Mental Health Services Administration | Substance Abuse and Mental Health Services Administration | Health care services | $11,000,000.00 | $0.00 |
| Substance Abuse and Mental Health Services Administration | Substance Abuse and Mental Health Services Administration | Health care services | $638,000,000.00 | $0.00 |
| Substance Abuse and Mental Health Services Administration | Substance Abuse and Mental Health Services Administration | Health care services | $3,679,000,000.00 | $0.00 |