Methodology & source manifest
Everything on the Department of Health & Human Services monitor derives from public records — the HHS Budget-in-Brief, the CMS Congressional Justification, OMB's Historical Tables, the USAspending API, and reachable HHS Agency Financial Report / GAO oversight documents. This page is the audit trail: method, sources, validation, and every flag.
Method
Mandatory vs. discretionary
The cardinal rule for HHS. Almost all HHS spending is MANDATORY — the federal share of Medicaid (Grants to States) and the General-Fund transfer to the Medicare trust funds (Payments to the Health Care Trust Funds) — set by law, not annual appropriations, and an order of magnitude larger than everything else. DISCRETIONARY (NIH, CDC, FDA, IHS, and the other appropriated divisions) is what Congress sets each year. This monitor reports the mandatory accounts (from the CMS Congressional Justification) in their own frame and the discretionary divisions (from the HHS Budget-in-Brief) in another, and never sums them into a single “HHS budget” figure. The Medicare line is the General Fund's share of Medicare, not total Medicare spending.
The discretionary reconciliation
The discretionary spine is the FY2027 Budget-in-Brief reorganization-structure composition table (p. 8). Every operating/staff division's Budget Authority sums, to the dollar per fiscal year, to the published Total Discretionary Budget Authority ($128,167M FY25 / $128,737M FY26 / $112,238M FY27) — asserted at build time. Program Level (which adds user fees and collections) is carried as a separate, larger frame and never folded into the BA spine. On the mandatory side, the CMS appropriated-accounts components reconcile to the published CMS Total All Appropriated Accounts within the published $1K rounding — flagged, not absorbed.
Source documents & validation ledger
The history layer is shown in nominal dollars only — OMB Historical Table 5.2 publishes no constant-dollar basis, and no deflator is synthesized. HHS was created from HEW in 1980, so the budget-authority series begins there; pre-1980 HEW years are not comparable and are excluded, not fabricated. The audit layer carries the standing Statement-of-Social-Insurance disclaimer explicitly alongside the 26-year clean streak on the basic statements.