The largest federal agency's money — mandatory and discretionary, never conflated.

Office of the Assistant Secretary for Financial Resources · HHS

HHS spends more than any other federal department — but almost all of it is mandatory: Medicare and the federal share of Medicaid. The appropriated, discretionary budget that Congress sets each year — NIH, CDC, FDA, the Indian Health Service, and the rest — is a small fraction of the total. This monitor keeps the two strictly apart. FY2025 actuals, FY2026, and the FY2027 request; every number recomputes against its own source.

Mandatory · FY2027

Set by law, not annual appropriations — the bulk of HHS

Federal share of MedicaidGrants to States—

Medicare — General-Fund sharePayments to the Health Care Trust Funds—

CMS appropriated accounts, totalMedicaid + Medicare transfer + CMS admin—

Discretionary · FY2027

The appropriated budget Congress sets each year

Total discretionary budget authorityall operating & staff divisions—

Discretionary outlayscash out in-year (incl. prior-year balances)—

Request vs. FY2026discretionary budget authority—

Mandatory figures are from the CMS Congressional Justification; discretionary figures from the HHS Budget-in-Brief. The Medicare line is the General Fund's shareof Medicare (chiefly Parts B and D) — most of Medicare is financed by payroll taxes and premiums inside the trust funds and never appears as an HHS appropriation. The two frames are never summed into a single “HHS budget” number.

The discretionary budget, by operating & staff division — FY2027 budget authority

$ in millions · mandatory Medicare/Medicaid excluded