Congressional Research Service R47232.2 (COVID-19 Supplemental Appropriations for the Department of Health and Human Services (HHS), 2022: In Brief)
Summary
A Congressional Research Service report, R47232 (version 2), updated October 7, 2022, on FY2022 COVID-19 supplemental appropriations for the Department of Health and Human Services (HHS). It summarizes the President's requests for additional funding, selected congressional proposals in response and policy considerations. It states that on March 2, 2022 the White House submitted an FY2022 supplemental request of $22.5 billion for HHS and other agencies, with the HHS portion at $18.3 billion, much of it for oral antivirals, monoclonal antibodies, vaccines and tests. It notes that COVID-19 supplemental funding for HHS was not included in the FY2023 continuing resolution package enacted in late September 2022 (H.R. 6833).
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COVID-19 Supplemental Appropriations for
the Department of Health and Human
Services (HHS), 2022: In Brief
Updated October 7, 2022
Congressional Research Service
https://crsreports.congress.gov
R47232
FY2022 COVID-19 Supplemental Appropriations for HHS
Contents
President’s March 2022 Request, Subsequent Proposals, and Related Developments ................... 1
March Request .......................................................................................................................... 1
Selected Congressional Proposals and Related Developments ................................................. 2
September Request Update ....................................................................................................... 3
Selected Considerations................................................................................................................... 7
Public Availability of Data on COVID-19 Public Health Spending ......................................... 7
Policy Considerations................................................................................................................ 8
Tables
Table 1. Selected Proposals for HHS Emergency Supplemental Appropriations for
COVID-19 Response.................................................................................................................... 4
Table 2. HHS Emergency Supplemental Appropriations for COVID-19 Response:
Summary and Comparison of Provisions ..................................................................................... 5
Contacts
Author Information.......................................................................................................................... 9
FY2022 COVID-19 Supplemental Appropriations for HHS
ince March 2020, more than $400 billion has been appropriated for the domestic
S Coronavirus Disease 2019 (COVID-19) public health response to Department of Health
and Human Services (HHS) agencies, mostly as emergency-designated supplemental
discretionary appropriations.1 Much of this funding is available for multiple years or until
expended. HHS has allocated funding for vaccines, therapeutics, tests, and health care supports,
among other activities.2 In 2022, Congress has considered additional supplemental appropriations
for HHS to support continued COVID-19 response activities. In addition, with the recent public
health emergency declared for the monkeypox outbreak, more recent legislative and Biden
Administration proposals would provide supplemental appropriations for other emerging diseases
in addition to COVID-19.3 This report summarizes the President’s requests for additional
funding, selected congressional proposals in response, and selected policy considerations.
COVID-19 supplemental funding for HHS was not included with the FY2023 continuing
resolution package enacted in late September 2022 (H.R. 6833).
President’s March 2022 Request, Subsequent
Proposals, and Related Developments
March Request
On March 2, 2022, the White House submitted an FY2022 supplemental appropriations request
of $22.5 billion for HHS and other agencies to support ongoing COVID-19 response efforts.4 The
HHS portion of the request would provide $18.3 billion, as summarized in Table 1. According to
the request, much of the funding would support procurement of oral antivirals, monoclonal
antibodies, booster and pediatric vaccines, and rapid and lab-based tests. The funding would also
support preparedness for new variants, including research and development for “pan-COVID”
next-generation vaccines and surveillance of new variants.5 In addition, the Centers for Disease
Control and Prevention (CDC) would allocate $750 million for global COVID-19 vaccine
assistance (in addition to Department of State, Foreign Operations, and Related Programs
appropriations for global assistance).
1 CRS Report R46711, U.S. Public Health Service: COVID-19 Supplemental Appropriations in the 116th Congress,
coordinated by Kavya Sekar, and CRS Report R46834, American Rescue Plan Act of 2021 (P.L. 117-2): Public Health,
Medical Supply Chain, Health Services, and Related Provisions, coordinated by Johnathan H. Duff and Kavya Sekar.
2 See U.S. Government Accountability Office, Appendix 4: COVID-19: Current and Future Federal Preparedness
Requires Fixes to Improve Health Data and Address Improper Payments, GAO-22-105397, April 27, 2022, at
https://files.gao.gov/reports/GAO-22-105397/index.html#appendix4; CRS In Focus IF11951, Domestic Funding for
COVID-19 Vaccines: An Overview, by Kavya Sekar; CRS In Focus IF12050, Federal Support for Domestic COVID-19
Test Availability, by Kavya Sekar, Taylor R. Wyatt, and Erica A. Lee; and CRS Report R46897, The Provider Relief
Fund: Frequently Asked Questions, by Elayne J. Heisler.
3 See CRS In Focus IF12186, U.S. Domestic Response to the 2022 Monkeypox Outbreak, by Taylor R. Wyatt, Kavya
Sekar, and Hassan Z. Sheikh.
4 Letter from Shalanda D. Young, Acting Director of OMB, to Nancy Pelosi, March 2, 2022, at
https://www.whitehouse.gov/wp-content/uploads/2022/03/COVID-and-Ukraine-Supplemental-Funding-Request-
Pelosi.pdf.
5 Pan-covid vaccines are vaccines designed to target multiple coronavirus types and variants. See, for example,
National Institutes of Health, “NIAID Issues New Awards to Fund ‘Pan-Coronavirus’ Vaccines,” press release,
September 28, 2021, at https://www.nih.gov/news-events/news-releases/niaid-issues-new-awards-fund-pan-
coronavirus-vaccines, and CRS In Focus IF11789, COVID-19 Variants: Vaccines, Diagnostics, and Therapeutics, by
Amanda K. Sarata, Agata Bodie, and Kavya Sekar.
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FY2022 COVID-19 Supplemental Appropriations for HHS
Selected Congressional Proposals and Related Developments
COVID-19 supplemental appropriations were included in an early version of the FY2022
omnibus appropriations package (see Rules Committee print in Table 1).6 However, these
appropriations were ultimately excluded from the enacted Consolidated Appropriations Act, 2022
(H.R. 2471; P.L. 117-103, March 15, 2022), reportedly after some Members objected to
rescinding certain previously appropriated funding in the American Rescue Plan Act (P.L. 117-2)
to offset the proposed supplemental COVID-19 appropriations.7
On April 4, 2022, a group of Senators announced a bipartisan agreement on COVID-19
supplemental funding.8 However, on April 5, 2022, the Senate voted not to invoke cloture on the
motion to proceed to consider the proposal (using H.R. 4373 as the legislative vehicle).9 No
subsequent action has occurred as of the date of this report. Several Senators reportedly voted
against cloture because they sought an agreement on amendments that would be considered to the
bill.10
On June 8, 2022, the Administration reportedly repurposed $10 billion in existing funding,
originally allocated for testing and other purposes, to purchase vaccines and therapeutics.11
As the FY2023 appropriations cycle has progressed, congressional debate has continued over
potential supplemental COVID-19 funding. COVID-19 supplemental appropriations were not
included in the bill reported on July 5, 2022 by the House Labor, HHS, Education and Related
Agencies (LHHS) Appropriations Subcommittee.12 The Senate Appropriations Committee Chair
released draft FY2023 appropriations bills on July 28, 2022.13 The LHHS draft bill includes a title
with $16 billion in HHS FY2022 emergency-designated supplemental appropriations for COVID-
6 See Division M of U.S. Congress, House Committee on Rules, Rules Committee Print 117-35: Consolidated
Appropriations Act, 2022, committee print, 117th Cong., March 8, 2022, at https://rules.house.gov/sites/
democrats.rules.house.gov/files/BILLS-117HR2471SA-RCP-117-35.pdf.
7 Laura Weiss, David Lerman, Lindsey McPherson, and Paul M. Krawzak, “Pandemic Aid Bill Pulled as House Aims
to Wrap Up Omnibus,” Roll Call, March 9, 2016, at https://rollcall.com/2022/03/09/covid-19-aid-to-be-stripped-from-
omnibus-package/. See legislative history for H.Res. 972 and H.Res. 973.
8 Senate Democrats, “Schumer Statement on $10 Billion COVID Preparedness Funding Agreement,” press release,
April 4, 2022, at https://www.democrats.senate.gov/newsroom/press-releases/schumer-statement-on-10-billion-covid-
preparedness-funding-agreement.
9 Lindsey McPherson, Laura W., and Caroline Simon, “Odds Dimming for Quick Passage of $10B Virus Aid
Package,” Roll Call, April 5, 2022, at https://rollcall.com/2022/04/05/immigration-timing-issues-slow-pandemic-relief-
bill-in-senate/. See also H.Res. 972, H.Res. 973, and Senate Roll Call vote number 129 at https://www.senate.gov/
legislative/LIS/roll_call_votes/vote1172/vote_117_2_00129.htm. For discussion of the cloture process, see CRS Report
98-425, Invoking Cloture in the Senate, by Christopher M. Davis.
10 Lindsey McPherson and Laura Weiss, “Vote on COVID-19 Spending Bill Indefinitely Delayed,” April 6, 2022, at
https://rollcall.com/2022/04/06/vote-on-covid-19-spending-bill-indefinitely-delayed/.
11 Tony Rumm, “White House Shifts Pandemic Money to Vaccines, Cutting Other Programs,” Washington Post, June
8, 2022, at https://www.washingtonpost.com/us-policy/2022/06/08/coronavirus-aid-white-house-vaccines/. CRS could
not identify an official announcement for the repurposed funding in June, but the Biden Administration has mentioned
the repurposed funds in official press releases; see, for example, HHS, “Biden-Harris Administration Secures 66
Million Doses of Moderna’s Variant-Specific COVID-19 Vaccine Booster for Potential Use in Fall and Winter 2022,”
press release, July 29, 2022, at https://www.hhs.gov/about/news/2022/07/29/biden-harris-administration-secures-66-
million-doses-modernas-variant-specific-covid-19-vaccine-booster-for-potential-use-in-fall-winter-2022.html.
12 H.R. 8295.
13 U.S. Senate Committee on Appropriations, “Chairman Leahy Releases Fiscal Year 2023 Senate Appropriations
Bills,” press release, July 28, 2022, at https://www.appropriations.senate.gov/news/majority/breaking-chairman-leahy-
releases-fiscal-year-2023-senate-appropriations-bills.
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FY2022 COVID-19 Supplemental Appropriations for HHS
19 or “any disease with potential for creating a pandemic.”14 According to a press release from
Senate Appropriations Committee leaders, proposed funding is for the “the next phase of the
COVID-19 pandemic and to address other emerging diseases that pose a significant threat to
public health.”15
Table 1 compares appropriations amounts across the proposals, and Table 2 summarizes and
compares key provisions.
September Request Update
On September 2, 2022, the Biden Administration announced an updated proposal for COVID-19
supplemental funding packaged with its FY2023 continuing resolution request.16 COVID-19
supplemental funding for HHS was not included with the FY2023 continuing resolution package
enacted in late September 2022 (H.R. 6833).
The request would provide $18.4 billion for HHS, all provided to the Public Health and Social
Services Emergency Fund (PHSSEF) account and available until September 30, 2026. The
requested statutory text for the appropriation includes no set-asides; funding would be available
for a broad set of purposes, including for research, development, manufacturing, production,
purchase, distribution, promotion, monitoring, tracking, and administration of vaccines,
therapeutics, diagnostics, and other medical supplies, as shown in Table 1. Additionally,
provisions accompanying the appropriation would further allow funds to be used for myriad
purposes, such as payments for testing, purchases for the Strategic National Stockpile, grants to
federal community health centers, and grants to state, local, territorial, and tribal governments and
other community organizations, as shown in Table 2. (The request would also provide a separate
$3.9 billion appropriation to HHS for the monkeypox public health emergency. This aspect of the
proposal is not included in the tables below because this report focuses on COVID-19 funding.)
An additional funding summary provided by the Biden Administration broke down the $18.4
billion in COVID-19 supplemental funding requested for HHS as follows:17
$7.1 billion to procure additional vaccines and therapeutics, purchase equipment
for the Strategic National Stockpile, cover vaccination costs for the uninsured
and underinsured, and improve access to treatment for people with Long COVID;
$2 billion to continue testing programs, including by supporting free community
testing at pharmacies, sustaining testing capacity, and distributing free tests to
households;
$8 billion for R&D for new vaccines and therapeutics; and
14 U.S. Congress, Senate Committee on Appropriations, Subcommittee on Labor, Health and Human Services, and
Education, and Related Agencies, FY2023 LHHS Appropriations, committee print, 117th Cong., 2nd sess., July 2022, at
https://www.appropriations.senate.gov/imo/media/doc/LHHSFY2023.PDF.
15 U.S. Senate Committee on Appropriations, press release, July 28, 2022, “Leahy, Murray, Coons Introduce $21
Billion Emergency Supplemental To Address The Ongoing COVID Crisis And Other Emerging Diseases,” at
https://www.appropriations.senate.gov/news/leahy-murray-coons-introduce-21-billion-emergency-supplemental-to-
address-the-ongoing-covid-crisis-and-other-emerging-diseases.
16 White House, “FY2023 Continuing Resolution (CR) Appropriations Issues,” September 2, 2022, at
https://www.whitehouse.gov/wp-content/uploads/2022/09/CR_Package_9-2-22.pdf.
17 These amounts were not proposed as part of the statutory appropriations text. White House, “Summary of Funding
Request to Meet Critical Needs,” September, 2022, at https://www.whitehouse.gov/wp-
content/uploads/2022/09/Summary-of-Funding-Request-to-Meet-Critical-Needs.pdf.
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FY2022 COVID-19 Supplemental Appropriations for HHS
$1.3 billion to support ongoing Phase 3 clinical trials for adult and pediatric vaccines, and
for variant surveillance.
Table 1. Selected Proposals for HHS Emergency Supplemental Appropriations for
COVID-19 Response
Dollars in Millions
July 28
Rules Senate
Admin. Committee April 4 Approp. Admin.
March 2 Print 117-35 Senate Cmte. Maj. Sept. 2
HHS Appropriations Account Request (Division M) Draft Drafta Request
HRSA Program Management- 1,500 — — — —
Uninsured Fund
CDC Wide Activities and 1,050 — — — —
Program Support
PHSSEF: R&D, manufacturing, 15,700 10,600 10,000 16,000 —
purchase, distribution of vaccines,
therapeutics, diagnostics, and
other medical supplies.
NMT for BARDA (13,700) (9,850) (9,250) (9,000) —
NLT for therapeutics — (5,000) (5,000) — —
NLT for vaccines for — (750) (750) (750)
emerging variants and vaccine
manufacturing
NMT for testing (2,000) — — — —
PHSSEF: R&D, manufacturing, — — — — 18,400
purchase, distribution, promotion,
monitoring, tracking, and
administration of vaccines,
therapeutics, diagnostics, and
other medical supplies.
$ Total $18,250 $10,600 $10,000 $16,000 $18,400
Source: The amounts for March 2 request are from Letter from Shalanda D. Young, Acting Director of OMB,
to Nancy Pelosi, March 2, 2022 at https://www.whitehouse.gov/wp-content/uploads/2022/03/COVID-and-
Ukraine-Supplemental-Funding-Request-Pelosi.pdf; the amounts for Rules Committee Print 117-35 are from U.S.
Congress, House Committee on Rules, Rules Committee Print 117-35, Consolidated Appropriations Act 2022,
committee print, 117th Cong., 2nd sess., March 8, 2022; the amounts for April 4 Senate draft are from Senate
Democrats, “Schumer Statement On $10 Billion COVID Preparedness Funding Agreement,” press release, April
4, 2022, at https://www.democrats.senate.gov/newsroom/press-releases/schumer-statement-on-10-billion-covid-
preparedness-funding-agreement; the amounts for July 28 Senate Appropriations Committee majority draft are
from the draft FY2023 LHHS text linked at https://www.appropriations.senate.gov/news/majority/breaking-
chairman-leahy-releases-fiscal-year-2023-senate-appropriations-bills; the amounts for the September 2 request
from White House, “FY2023 Continuing Resolution (CR) Appropriations Issues,” September 2, 2022, at
https://www.whitehouse.gov/wp-content/uploads/2022/09/CR_Package_9-2-22.pdf.
Notes: Non-adds shown in italics and parentheses. Abbreviations: HRSA: Health Resources and Services
Administration; CDC: Centers for Disease Control and Prevention; PHSSEF: Public Health and Social Services
Emergency Fund Account; R&D: Research and Development; BARDA: Biomedical Advanced Research and
Development Authority; NMT: not more than; NLT: not less than; LHHS: Departments of Labor, Health and
Human Services, Education, and Related Agencies.
a. Proposed funding is for COVID-19 or “any disease with potential for creating a pandemic.”
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FY2022 COVID-19 Supplemental Appropriations for HHS
Table 2. HHS Emergency Supplemental Appropriations for COVID-19 Response:
Summary and Comparison of Provisions
July 28
Rules Senate
Admin. Committee April 4 Approp. Admin.
March 2 Print 117-35 Senate Cmte. Maj. Sept 2
Provision Request (Division M) Draft Draft Request
Provisions tied to PHSSEF appropriation
Funds may be used to — — — — √
reimburse test
administration costs, as
specified.
Funds may be used for — — — — √
Health Center program
grants, with certain funding
allocation requirements
waived.
Products purchased with √ √ √ √ √
funds may be deposited in
the SNS.
Funds may be used for √ √ √ √ √
construction, alteration, or
renovation of nonfederally
owned facilities for vaccine,
therapeutic, and diagnostic
production.
Funds may be used for — — — — √
grants to SLTT
governments and other
community organizations.
Funds may be transferred √ √ √ √ √
to and merged with the
Covered Countermeasure
Process Fund.a
HHS Secretary may √ — — — —
reallocate or transfer funds
to other HHS
appropriations for the
purposes specified.
Secretary must notify ACs — √ √ √ —
of any obligation in excess
of $50,000,000 at least two
days in advance.
Report to ACs every 30 — √ √ √ —
days detailing obligations in
excess of $20,000,000 and
current inventory and
distribution of COVID-19
vaccines, therapeutics, and
diagnostics.
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FY2022 COVID-19 Supplemental Appropriations for HHS
July 28
Rules Senate
Admin. Committee April 4 Approp. Admin.
March 2 Print 117-35 Senate Cmte. Maj. Sept 2
Provision Request (Division M) Draft Draft Request
Other provisions: transfer and reporting
Funds may be transferred √ — — — —
between PHSSEF, CDC,
HRSA, and NIH for
specified purposes with
prior notification to ACs.
Funds may be transferred — — — — √
from PHSSEF to CDC,
NIH, FDA, HHS OIG,
HRSA, and General
Departmental Management
for specified purposes with
prior notification to ACs.
Funds may be transferred — √ √ √ —
from PHSSEF to NIH for
specified purposes with
prior notification to ACs.
Funds may restore √ — — — √b
obligations incurred prior
to enactment.
HHS Secretary must — √ √ √ —
provide a detailed spend
plan, which must be
updated and submitted to
the ACs every 60 days.
HHS Secretary must — √ √ √ —
provide biweekly obligation
reports to the ACs not
later than 60 days after
enactment.
HHS Secretary must — √ √ √ —
provide monthly reports on
obligations for research,
advanced development,
procurement, and
administration activities,
and supply needs
projections to designated
committees.
Source: The amounts for March 2 request are from Letter from Shalanda D. Young, Acting Director of OMB,
to Nancy Pelosi, March 2, 2022, at https://www.whitehouse.gov/wp-content/uploads/2022/03/COVID-and-
Ukraine-Supplemental-Funding-Request-Pelosi.pdf; the amounts for Rules Committee Print 117-35 are from U.S.
Congress, House Committee on Rules, Rules Committee Print 117-35, Consolidated Appropriations Act 2022,
committee print, 117th Cong., 2nd sess., March 8, 2022; the amounts for April 4 Senate draft are linked at Senate
Democrats, “Schumer Statement On $10 Billion COVID Preparedness Funding Agreement,” press release, April
4, 2022, https://www.democrats.senate.gov/newsroom/press-releases/schumer-statement-on-10-billion-covid-
preparedness-funding-agreement; the amounts for July 28 Senate Appropriations Committee majority draft are
from the draft FY2023 LHHS text linked at https://www.appropriations.senate.gov/news/majority/breaking-
chairman-leahy-releases-fiscal-year-2023-senate-appropriations-bills; and the amounts for the September 2
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FY2022 COVID-19 Supplemental Appropriations for HHS
request from White House, “FY2023 Continuing Resolution (CR) Appropriations Issues,” September 2, 2022, at
https://www.whitehouse.gov/wp-content/uploads/2022/09/CR_Package_9-2-22.pdf.
Notes: Acronyms (in addition to those noted in Table 1): SNS = Strategic National Stockpile; SLTT= State,
local, territorial, and tribal; HHS = Health and Human Services; NIH = National Institutes of Health; ACs =
Appropriations Committees; OIG= Office of the Inspector General; LHHS: Departments of Labor, Health and
Human Services, Education, and Related Agencies.
a. The Covered Countermeasures Process Fund is the account that funds claims under the Countermeasures
Injury Compensation Program (CICP).
b. In the September 2022 request, this provision is tied to the PHSSEF appropriation.
Selected Considerations
Public Availability of Data on COVID-19 Public Health Spending
Throughout the pandemic, real-time publicly available information on COVID-19 public health
spending by appropriated purpose has been limited—due in part to how Congress and the
President appropriated the funding. Much of the COVID-19 relief public health appropriations
were made available for broad and flexible purposes.18 Further, a large portion of COVID-19
relief funding was appropriated to the PHSSEF account, including funding for the Provider Relief
Fund, testing, vaccines, and therapeutics, among other purposes.19 The laws that provided
COVID-19 relief funding also included transfer authorities that have allowed HHS to shift funds
between accounts.20 Providing emergency appropriations to the PHSSEF account under the Office
of the Secretary, in addition to transfer authorities, has allowed HHS some flexibility to allocate
funds to meet emerging needs. At the same time, this practice has diminished public transparency
regarding how much funding has been spent for what purpose. Official federal spending trackers
such as USASpending.gov track spending by agency and account. When several different
appropriations are provided to an account, or when funds are shifted between accounts, it is
challenging for observers to assess what amount of the appropriations have been spent for
specific purposes as appropriated.
The Government Accountability Office has separately published detailed tables on HHS COVID-
19 funding by agency and activity (e.g., vaccines, testing) in its quarterly CARES Act reports, but
these tables are not current—they reflect data from several months earlier.21 Though not official,
media organizations have published what are reportedly more detailed White House documents
on COVID-19 spending transmitted to Congress.22
It is unclear whether current congressional proposals would improve publicly available
information. Such proposals would continue the practice of providing all of the supplemental
18 See CRS Report R46711, U.S. Public Health Service: COVID-19 Supplemental Appropriations in the 116th
Congress, coordinated by Kavya Sekar, and CRS Report R46834, American Rescue Plan Act of 2021 (P.L. 117-2):
Public Health, Medical Supply Chain, Health Services, and Related Provisions, coordinated by Johnathan H. Duff and
Kavya Sekar.
19 See section on PHSSEF account in CRS Report R46711, U.S. Public Health Service: COVID-19 Supplemental
Appropriations in the 116th Congress, and table on American Rescue Plan Act appropriations assigned to the PHSSEF
account at HHS Budget in Brief: FY2022, p. 22, at https://www.hhs.gov/sites/default/files/fy-2022-budget-in-brief.pdf.
20 See “Understanding PHS COVID-19 Supplemental Appropriations” in CRS Report R46711, U.S. Public Health
Service: COVID-19 Supplemental Appropriations in the 116th Congress, coordinated by Kavya Sekar.
21 See Coronavirus Oversight Reports at https://www.gao.gov/coronavirus.
22 Rachel Cohrs, “White House Documents Detail a Looming Squeeze on Covid-19 Boosters,” STAT, May 6, 2022, at
https://www.statnews.com/2022/05/06/white-house-documents-detail-a-looming-squeeze-on-covid-19-boosters/.
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FY2022 COVID-19 Supplemental Appropriations for HHS
appropriations to the PHSSEF account. Although the proposals would require regular reports to
congressional committees, it is unclear if the reports would be made publicly available. Congress
could also propose long-term solutions to better track HHS public health emergency spending and
require that spending data be made publicly available in useful categories and formats for
analysis.
Policy Considerations
In determining whether and how much funding to appropriate toward the public health response
to COVID-19 and other threats, Congress may consider the following issues:
Supply availability and demand: Data regarding ordered and administered
COVID-19 therapeutics and vaccines do not indicate a supply shortage relative to
demand, but this situation may not continue.23 For the current bivalent COVID-
19 vaccine booster campaign, program operational guidance notes that the
Administration has purchased enough doses “to ensure a robust and complete
national booster vaccination campaign through the fall and early winter.”24 One
survey shows that, as of September 2022, about one-third of adults have already
received or intend to get the booster as soon as possible. The rest are waiting, do
not intend to get a booster, or are ineligible.25 Public education and awareness,
however, could affect demand.26 Separately, several COVID-19 therapeutic
products are in late-stage clinical trials and may become available for purchase
later this year.27 Further, the Biden Administration specifically highlighted a goal
to maintain testing capacity for future surges in a blog post on the September
2022 request for additional funding.28
Variants: The evolution of SARS-CoV-2 is unknown, which adds uncertainty to
any supply needs projection. Some currently available vaccines, therapeutics and
tests might be ineffective against future variants.29 Some of the proposed funding
in the FY2022 supplemental appropriations proposals would fund pan-COVID
23 For data on therapeutics, see Administration for Strategic Preparedness and Response (ASPR), Cumulative COVID-
19 Therapeutics Ordered and Administered Amounts by Jurisdiction, September 25, 2022, at https://aspr.hhs.gov/
COVID-19/Therapeutics/Orders/Documents/state-data.pdf. For current data on vaccination, see CDC, COVID Data
Tracker, COVID-19 Vaccinations in the United States, at https://covid.cdc.gov/covid-data-tracker/#vaccinations_vacc-
total-admin-rate-total.
24 CDC, CDC Fall Vaccination Operational Planning Guide - Information for the Fall Vaccine Campaign, Including
Upcoming Bivalent COVID-19 Vaccine Booster Doses, updated September 30, 2022, at https://www.cdc.gov/vaccines/
covid-19/downloads/CDC-Fall-Vaccination-Operational-Planning-Guide.pdf.
25 Kaiser Family Foundation, KFF COVID-19 Vaccine Monitor, September 2022, at https://www.kff.org/coronavirus-
covid-19/dashboard/kff-covid-19-vaccine-monitor-dashboard/#vaccines.
26 For information about HHS’s public education campaign, see HHS, “COVID-19 Public Education Campaign: About
the Campaign,” at https://wecandothis.hhs.gov/about.
27 Heidi Ledford, “Hundreds of COVID Trials Could Provide a Deluge of New Drugs,” Science, March 1, 2022, and
BIO, “BIO COVID-19 Therapeutic Development Tracker,” last updated September 19, 2022, at https://www.bio.org/
policy/human-health/vaccines-biodefense/coronavirus/pipeline-tracker.
28 White House, “Meeting Critical Needs for the American People in the New Fiscal Year,” September 2, 2022, at
https://www.whitehouse.gov/omb/briefing-room/2022/09/02/meeting-critical-needs-for-the-american-people-in-the-
new-fiscal-year/.
29 CRS In Focus IF11789, COVID-19 Variants: Vaccines, Diagnostics, and Therapeutics, by Amanda K. Sarata, Agata
Bodie, and Kavya Sekar.
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FY2022 COVID-19 Supplemental Appropriations for HHS
vaccine research, which is already supported by the Department of Defense and
NIH.30
Commercialization: To date, the federal government has purchased much of the
U.S. COVID-19 vaccine and therapeutics supply. Congress could consider
whether and when to stop appropriating specific funds for federal purchase and
distribution, and therefore transition COVID-19 products to routine health care
financing systems. On August 30, 2022, the Administration for Strategic
Preparedness and Response (ASPR) announced plans to commercialize COVID-
19 products, with vaccines and therapeutics transitioning to the commercial
market by early 2023. According to the announcement, the commercialization
plans were “accelerated” given the lack of additional funding from Congress. The
announcement also states that additional funding would assist with winding down
federal procurement and distribution programs.31
Monkeypox outbreak: The public health emergency for monkeypox raises new
questions as supplemental appropriations are considered. As noted, the July 28
proposal from the Senate Appropriations Committee Chair would provide
funding that would be available for both COVID-19 and other emerging threats.
In contrast, in September 2022, the Biden Administration has requested separate
funding for COVID-19 and monkeypox response respectively. As another
consideration, many states and other jurisdictions have remaining funding
balances on COVID-19-specific public health grants that they received from the
prior relief laws.32 Congress could consider legislative changes to expand the
possible uses of existing grant funds to other threats.
Author Information
Kavya Sekar
Analyst in Health Policy
Acknowledgments
CRS Analyst in Public Health Emergency Management Taylor Wyatt and CRS Research Assistant Sylvia
Bryan assisted with aspects of this report.
30 Walter Reed Army Institutes of Research, “Preclinical Studies Support Army’s Pan-coronavirus Vaccine
Development Strategy,” press release, December 16, 2021, at https://www.army.mil/article/252890/
preclinical_studies_support_armys_pan_coronavirus_vaccine_development_strategy, and NIH, “NIAID Issues New
Awards to Fund ‘Pan-Coronavirus’ Vaccines,” press release, September 28, 2021, at https://www.nih.gov/news-events/
news-releases/niaid-issues-new-awards-fund-pan-coronavirus-vaccines.
31 ASPR, “COVID-19 Medical Countermeasures and the Commercial Marketplace,” August 30, 2022, at
https://aspr.hhs.gov/ASPRBlog/Pages/BlogDetailView.aspx?ItemID=440.
32 Data on state and local award spending available at Pandemic Oversight, “All Pandemic Awards,” at
https://www.pandemicoversight.gov/data-interactive-tools/interactive-dashboards/all-pandemic-awards.
Congressional Research Service 9
FY2022 COVID-19 Supplemental Appropriations for HHS
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