Direct Expenditures in the Health Sector
Grants in the Health Sector
The federal government spent approximately $555.7 billion in fiscal year 2010 on grant programs that may provide a subsidy to the Health sector.1 This funding, administered by seven agencies2 across more than 270 active programs (Table 1), accounted for almost 68 percent of all government grants made that year ($822.6 billion).3 This makes grants in the Health sector the largest of all the sectors analyzed by Subsidyscope. This is due to the fact that Medicare and Medicaid make up 60 percent of all grants payments reported in USASpending.gov in fiscal year 2010; the same programs make up 89 percent of all health grants in the same year.4
Subsidyscope reports the total amount spent on grants and contracts that are most likely to contain any subsidy. Since not all the spending in these programs would properly be counted as a subsidy, the spending estimates presented here constitute the upper bound of government subsidies in a sector. For example, there is a distinction between spending on grants and contracts and the subsidies conveyed through that spending. Not all of the money obligated to a grant or contract ends up subsidizing the sector. Some funds are devoted to administering the grants or other activities that do not affect supply or prices. However, little data are available that would help estimate just the subsidy portion of spending on grants and contracts.
Figure 1: Expenditures on Grant Programs in the Health Sector, Fiscal Years 2000-2010 ($ billions)
Source: Subsidyscope analysis of data from USASpending.gov. Estimates are in nominal dollars and reflect the data as they appear in USASpending.gov at the time of this analysis.
Note: Data presented are obligations to programs that Subsidyscope deems likely to contain a subsidy. All grant programs in Subsidyscope's definition of the Health sector are included, despite the fact that some programs may not have reported dollar amounts. Changes in government reporting methods during fiscal year 2007 make the estimates for that year highly unreliable. Moreover, the dip in FY2007 for our Health sector grants data is primarily attributable to the fact that totals for Medicare Parts A, B, and D were not reported to USASpending.gov. Of the $373.6 billion drop in reporting between FY2006 and FY2007, $360.2 billion, or 96 percent, is attributable to non-reporting by these three programs. For more information about the quality of these data sources, visit Clearspending.org.
The direct expenditure totals presented on this Web page are compiled using government data from USASpending.gov and the Catalog of Federal Domestic Assistance (CFDA).5 As previously noted, these data may not include some types of subsidies and may contain gaps that prevent allocating some published subsidy data to the Health sector. All of these limitations can result in omissions of federal support that may, nonetheless, influence markets. However, they are the best data available and they provide a baseline for comparing subsidies across economic sectors. By publishing these estimates, Subsidyscope makes these data more accessible and their shortcomings can be more easily identified and, ultimately, improved.
Contracts in the Health Sector
In addition to awarding grants, the government directly contracts with organizations to provide health-related goods and services. During fiscal year 2010, all reported health-related contracts totaled $32.6 billion, 6 percent of all government contracts ($537.8 billion).6 Of the $32.6 billion in total health-related contracts, $5.3 billion, or 16 percent, were not competed.7 While not all contracts contain a subsidy, non-competed contracts are more likely to contain a subsidy than competed contracts.
Subsidyscope's focus on non-competed contracts reflects that the federal government generally prefers agencies to compete contracts because competition is expected to result in lower costs and/or better quality goods and services. In contrast, non-competed contracts generally are assumed to be more likely to cost the government more than the fair market value.8
Subsidyscope presents spending on programs deemed likely to contain a subsidy, rather than the subsidy amount itself. Under a contract, a subsidy occurs when the government pays more than fair market value for a good or service. It is difficult to determine when and how much of a subsidy is included, as the fair market value may be open to interpretation. Subsidyscope does not differentiate between specific contracts that may or may not include a subsidy or measure the amount of the subsidy. However, competed contracts—contracts that are subject to an open bidding process—generally are less likely to have a subsidy component, even though the bidding process may include certain preferences. Therefore, Subsidyscope does not analyze competed contracts. This does not mean non-competed contracts contain a significant subsidy, only that they are more likely to do so. There may be various reasons why the government uses non-competed contracts, for example, there may be only one provider of the service, there may be unique experience required, or it may be more expedient or convenient. For more information on contracts, see Subsidyscope’s Contracts page.
Figure 2: Expenditures on Non-competed Contracts in the Health Sector, Fiscal Years 2000-2010 ($ billions)
Source: Subsidyscope analysis of data from USASpending.gov. Estimates are in nominal dollars and reflect the data as they appear in USASpending.gov at the time of this analysis.
Note: Government spending on non-competed contracts is likely more consistent during this time period than the figure represents. Any increases or decreases may reflect poor data resulting from reporting variation, in addition to actual spending increases or decreases in health-related contracts.
To search Subsidyscope's direct expenditures data from the federal government’s USASpending.gov Web site, click here for grants and here for non-competed contracts. The table below provides an aggregate summary of the grants made by each program in the Health sector in fiscal years 2009 and 2010, retrieved from Subsidyscope's searchable database of grants.
Table 1: Health Sector Direct Expenditure Programs, Fiscal Years 2009 and 2010 ($ thousands)
| CFDA # | CFDA Program Title | FY 2009 | FY 2010 |
|---|---|---|---|
| 93.778 | Medical Assistance Program [Medicaid] | $245,777,290 | $253,675,134 |
| 93.773 | Medicare_Hospital Insurance [Part A] | $235,645,664 | $119,268,719i |
| 93.774 | Medicare_Supplementary Medical Insurance [Part B] | $200,113,170 | $99,705,378ii |
| 93.770 | Medicare_Prescription Drug Coverage [Part D] | $29,095,026 | $20,847,928 |
| 93.767 | Children's Health Insurance Program [CHIP] | $12,643,951 | $10,730,095 |
| 93.701 | Trans-NIH Recovery Act Research Support | $4,317,183 | $3,868,364 |
| 93.855 | Allergy, Immunology and Transplantation Research | $2,567,902 | $2,635,775 |
| 93.224 | Consolidated Health Centers (Community Health Centers, Migrant Health Centers, Health Care for the Homeless, Public Housing Primary Care, and School Based Health Centers) | $1,942,319 | $1,968,579 |
| 93.859 | Biomedical Research and Research Training | $1,871,831 | $1,896,054 |
| 93.959 | Block Grants for Prevention and Treatment of Substance Abuse | $1,689,661 | $1,708,661 |
| 93.837 | Cardiovascular Diseases Research | $1,473,757 | $1,582,819 |
| 93.847 | Diabetes, Digestive, and Kidney Diseases Extramural Research | $1,426,269 | $1,524,873 |
| 93.210 | Tribal Self-Governance Program: IHS Compacts/Funding Agreements | $1,194,163 | $1,417,334 |
| 93.853 | Extramural Research Programs in the Neurosciences and Neurological Disorders | $1,320,806 | $1,354,189 |
| 64.012 | Veterans Prescription Service | not reported | $1,264,591 |
| 93.917 | HIV Care Formula Grants | $1,177,560 | $1,228,221 |
| 93.389 | National Center for Research Resources | $1,199,814 | $1,216,431 |
| 93.242 | Mental Health Research Grants | $1,098,803 | $1,130,568 |
| 93.865 | Child Health and Human Development Extramural Research | $790,420 | $921,244 |
| 93.283 | Centers for Disease Control and Prevention_Investigations and Technical Assistance | $883,068 | $911,026 |
| 93.866 | Aging Research | $890,543 | $901,418 |
| 93.067 | Global AIDS | $719,057 | $818,667 |
| 93.279 | Drug Abuse and Addiction Research Programs | $779,687 | $818,040 |
| 93.069 | Public Health Emergency Preparedness | $2,037,006 | $778,040 |
| 93.702 | National Center for Research Resources, Recovery Act Construction Support | $31,025 | $762,690 |
| 93.395 | Cancer Treatment Research | $736,267 | $757,889 |
| 64.029 | Purchase Care Program | not reported | $754,874 |
| 93.393 | Cancer Cause and Prevention Research | $689,278 | $733,258 |
| 93.718 | Health Information Technology Regional Extension Centers Program | not reported | $676,637 |
| 93.914 | HIV Emergency Relief Project Grants | $633,029 | $648,295 |
| 93.243 | Substance Abuse and Mental Health Services_Projects of Regional and National Significance | $565,169 | $630,176 |
| 93.703 | ARRA Grants to Health Center Programs [The American Recovery and Reinvestment Act of 2009] | $1,384,494 | $608,182 |
| 93.867 | Vision Research | $574,451 | $581,258 |
| 93.994 | Maternal and Child Health Services Block Grant to the States | $555,491 | $551,838 |
| 93.719 | ARRA - State Grants to Promote Health Information Technology | not reported | $547,703 |
| 93.397 | Cancer Centers Support Grants | $458,162 | $534,612 |
| 93.777 | State Survey and Certification of Health Care Providers and Suppliers (Title XVIII) Medicare | $478,766 | $511,575 |
| 93.396 | Cancer Biology Research | $500,294 | $507,314 |
| 93.846 | Arthritis, Musculoskeletal and Skin Diseases Research | $439,901 | $443,444 |
| 93.838 | Lung Diseases Research | $480,040 | $440,992 |
| 93.889 | National Bioterrorism Hospital Preparedness Program | $428,890 | $420,584 |
| 93.724 | ARRA - Prevention and Wellness Communities Putting Prevention to Work Funding Opportunities Announcement (FOA) | not reported | $402,111 |
| 93.958 | Block Grants for Community Mental Health Services | $399,735 | $399,735 |
| 93.172 | Human Genome Research | $379,353 | $388,952 |
| 93.310 | Trans-NIH Research Support | $354,289 | $381,934 |
| 93.113 | Environmental Health | $335,226 | $358,020 |
| 93.173 | Research Related to Deafness and Communication Disorders | $323,083 | $332,641 |
| 93.839 | Blood Diseases and Resources Research | $363,299 | $327,976 |
| 93.273 | Alcohol Research Programs | $313,947 | $327,063 |
| 93.394 | Cancer Detection and Diagnosis Research | $279,095 | $318,607 |
| 93.940 | HIV Prevention Activities_Health Department Based | $335,393 | $312,796 |
| 93.121 | Oral Diseases and Disorders Research | $299,396 | $311,392 |
| 93.715 | Recovery Act Comparative Effectiveness Research - AHRQ | $297 | $311,210 |
| 93.255 | Children's Hospitals Graduate Medical Education Payment | $136,010 | $301,458 |
| 93.217 | Family Planning_Services | $282,964 | $292,486 |
| 93.441 | Indian Self-Determination | $146,851 | $290,350 |
| 93.268 | Immunization Grants | $289,825 | $287,142 |
| 93.941 | HIV Demonstration, Research, Public and Professional Education Projects | $390,491 | $285,250 |
| 93.286 | Discovery and Applied Research for Technological Innovations to Improve Human Health | $275,430 | $280,836 |
| 93.887 | Health Care and Other Facilities | $257,680 | $267,693 |
| 93.727 | ARRA - Health Information Technology - Beacon Communities | not reported | $250,000 |
| 93.262 | Occupational Safety and Health Program | $215,516 | $205,432 |
| 93.918 | Grants to Provide Outpatient Early Intervention Services with Respect to HIV Disease | $187,926 | $192,600 |
| 93.398 | Cancer Research Manpower | $195,470 | $188,537 |
| 64.015 | Veterans State Nursing Home Care | not reported | $176,226 |
| 93.510 | Affordable Care Act (ACA) Primary Care Residency Expansion Program | not reported | $167,356 |
| 93.307 | Minority Health and Health Disparities Research | $148,720 | $156,220 |
| 93.399 | Cancer Control | $236,839 | $152,529 |
| 93.110 | Maternal and Child Health Federal Consolidated Programs | $144,108 | $150,492 |
| 93.266 | Rapid Expansion of Antiretroviral Therapy Programs for HIV-Infected Persons in Selected Countries in Africa and the Caribbean Under the President's Emergency Plan for AIDS Relief | $176,279 | $148,050 |
| 93.185 | Immunization Research, Demonstration, Public Information and Education_Training and Clinical Skills Improvement Projects | $133,530 | $143,751 |
| 93.226 | Research on Healthcare Costs, Quality and Outcomes | $89,822 | $135,573 |
| 93.237 | Special Diabetes Program for Indians_Diabetes Prevention and Treatment Projects | $135,205 | $134,342 |
| 93.145 | AIDS Education and Training Centers | $116,057 | $131,081 |
| 93.361 | Nursing Research | $123,663 | $120,330 |
| 93.723 | ARRA - Prevention and Wellness-State, Territories and Pacific Islands | not reported | $120,160 |
| 93.791 | Money Follows the Person Rebalancing Demonstration | $246,593 | $107,832 |
| 93.228 | Indian Health Service_Health Management Development Program | $118,955 | $107,274 |
| 93.977 | Preventive Health Services_Sexually Transmitted Diseases Control Grants | $106,542 | $103,199 |
| 93.297 | Teenage Pregnancy Prevention Program | not reported | $100,000 |
| 93.926 | Healthy Start Initiative | $95,434 | $99,196 |
| 93.213 | Research and Training in Complementary and Alternative Medicine | $101,834 | $98,870 |
| 93.116 | Project Grants and Cooperative Agreements for Tuberculosis Control Programs | $92,681 | $97,708 |
| 93.136 | Injury Prevention and Control Research and State and Community Based Programs | $99,299 | $95,815 |
| 93.275 | Substance Abuse and Mental Health Services-Access to Recovery | $97,550 | $94,788 |
| 93.943 | Epidemiologic Research Studies of Acquired Immunodeficiency Syndrome (AIDS) and Human Immunodeficiency Virus (HIV) Infection in Selected Population Groups | $69,848 | $93,595 |
| 93.991 | Preventive Health and Health Services Block Grant | $95,635 | $93,028 |
| 93.505 | Affordable Care Act (ACA) Maternal, Infant, and Early Childhood Home Visiting Program | not reported | $91,813 |
| 93.104 | Comprehensive Community Mental Health Services for Children with Serious Emotional Disturbances (SED) | $84,230 | $87,744 |
| 93.989 | International Research and Research Training | $70,101 | $80,502 |
| 93.768 | Medicaid Infrastructure Grants To Support the Competitive Employment of People with Disabilities | $64,566 | $79,934 |
| 93.153 | Coordinated Services and Access to Research for Women, Infants, Children, and Youth | $72,075 | $73,159 |
| 93.888 | Specially Selected Health Projects | $48,513 | $73,005 |
| 93.256 | State Health Access Program | $70,945 | $70,661 |
| 93.779 | Centers for Medicare and Medicaid Services (CMS) Research, Demonstrations and Evaluations | $64,235 | $64,023 |
| 93.150 | Projects for Assistance in Transition from Homelessness (PATH) | $52,978 | $62,121 |
| 93.939 | HIV Prevention Activities_Non-Governmental Organization Based | $61,525 | $61,967 |
| 93.728 | ARRA - Strategic Health IT Advanced Research Projects (SHARP) | not reported | $60,000 |
| 93.241 | State Rural Hospital Flexibility Program | $62,080 | $59,427 |
| 64.024 | VA Homeless Providers Grant and Per Diem Program | not reported | $59,277 |
| 93.780 | Grants to States for Operation of Qualified High-Risk Pools | $75,000 | $55,000 |
| 93.092 | Affordable Care Act (ACA) Personal Responsibility Education Program | not reported | $54,877 |
| 93.103 | Food and Drug Administration_Research | $47,976 | $52,133 |
| 93.411 | ARRA Equipment to Enhance Training for Health Professionals | not reported | $50,572 |
| 93.135 | Centers for Research and Demonstration for Health Promotion and Disease Prevention | $63,514 | $50,307 |
| 93.884 | Grants for Training in Primary Care Medicine and Dentistry | $44,371 | $50,249 |
| 93.525 | State Planning and Establishment Grants for the Affordable Care Act (ACA)s Exchanges | not reported | $48,788 |
| 93.944 | Human Immunodeficiency Virus (HIV)/Acquired Immunodeficiency Virus Syndrome (AIDS) Surveillance | $44,046 | $48,423 |
| 93.879 | Medical Library Assistance | $54,271 | $48,216 |
| 93.403 | ARRA Grants for Training in Primary Care Medicine and Dentistry Training and Enhancement | not reported | $47,267 |
| 93.143 | NIEHS Superfund Hazardous Substances_Basic Research and Education | $46,340 | $47,041 |
| 93.511 | Affordable Care Act (ACA) Grants to States for Health Insurance Premium Review | not reported | $46,000 |
| 93.925 | Scholarships for Health Professions Students from Disadvantaged Backgrounds | $41,989 | $45,588 |
| 93.938 | Cooperative Agreements to Support Comprehensive School Health Programs to Prevent the Spread of HIV and Other Important Health Problems | $40,014 | $44,892 |
| 93.233 | National Center on Sleep Disorders Research | $36,601 | $44,323 |
| 64.005 | Grants to States for Construction of State Home Facilities | $141,307 | $44,139 |
| 93.912 | Rural Health Care Services Outreach, Rural Health Network Development and Small Health Care Provider Quality Improvement Program | $44,898 | $43,780 |
| 93.281 | Mental Health Research Career/Scientist Development Awards | $43,507 | $43,744 |
| 93.507 | Strengthening Public Health Infrastructure for Improved Health Outcomes | not reported | $42,500 |
| 93.247 | Advanced Nursing Education Grant Program | $43,369 | $42,138 |
| 17.503 | Occupational Safety and Health_State Program | $54,968 | $38,839 |
| 93.129 | Technical and Non-Financial Assistance to Health Centers | $58,562 | $37,943 |
| 93.142 | NIEHS Hazardous Waste Worker Health and Safety Training | $36,416 | $36,910 |
| 93.138 | Protection and Advocacy for Individuals with Mental Illness | $35,930 | $36,291 |
| 93.721 | ARRA - Health Information Technology Professionals in Health Care | not reported | $35,726 |
| 93.520 | Centers for Disease Control and Prevention Affordable Care Act (ACA) Communities Putting Prevention to Work | not reported | $34,232 |
| 93.359 | Nurse Education, Practice and Retention Grants | $34,476 | $33,395 |
| 93.282 | Mental Health National Research Service Awards for Research Training | $31,234 | $31,663 |
| 93.513 | Affordable Care Act (ACA) Advanced Nursing Education Expansion Initiative | not reported | $31,044 |
| 93.070 | Environmental Public Health and Emergency Response | $25,561 | $30,346 |
| 93.514 | Affordable Care Act (ACA) Expansion of Physician Assistant Training Program | not reported | $30,118 |
| 93.789 | Alternatives to Psychiatric Residential Treatment Facilities for Children | $5,889 | $28,901 |
| 93.065 | Laboratory Leadership, Workforce Training and Management Development, Improving Public Health Laboratory Infrastructure | $3,521 | $28,618 |
| 93.184 | Disabilities Prevention | $25,900 | $27,462 |
| 93.061 | Innovations in Applied Public Health Research | $35,091 | $27,047 |
| 93.725 | ARRA - Communities Putting Prevention to Work: Chronic Disease Self-Management Program | not reported | $27,000 |
| 93.521 | The Affordable Care Act: Building Epidemiology, Laboratory, and Health Information Systems Capacity in the Epidemiology and Laboratory Capacity for Infectious Disease (ELC) and Emerging Infections Program (EIP) Cooperative Agreements | not reported | $26,740 |
| 17.502 | Occupational Safety and Health_Susan Harwood Training Grants | $9,877 | $26,659 |
| 93.253 | Poison Center Support and Enhancement Grant Program | $25,438 | $26,509 |
| 93.197 | Childhood Lead Poisoning Prevention Projects_State and Local Childhood Lead Poisoning Prevention and Surveillance of Blood Lead Levels in Children | $26,218 | $25,995 |
| 93.500 | Pregnancy Assistance Fund Program | not reported | $24,000 |
| 93.157 | Centers of Excellence | $19,218 | $23,640 |
| 93.264 | Nurse Faculty Loan Program (NFLP)iii | $10,680 | $23,481 |
| 93.928 | Special Projects of National Significance | $23,730 | $23,269 |
| 93.822 | Health Careers Opportunity Program | $18,329 | $21,130 |
| 93.945 | Assistance Programs for Chronic Disease Prevention and Control | $28,673 | $20,940 |
| 93.407 | ARRA - Scholarships for Disadvantaged Students | $19,342 | $20,458 |
| 93.933 | Demonstration Projects for Indian Health | $6,264 | $20,336 |
| 93.107 | Area Health Education Centers Point of Service Maintenance and Enhancement Awards | $18,128 | $20,032 |
| 93.127 | Emergency Medical Services for Children | $18,341 | $19,400 |
| 93.249 | Public Health Training Centers Grant Program | $5,199 | $19,124 |
| 93.729 | ARRA Health Information Technology and Public Health | not reported | $19,066 |
| 93.301 | Small Rural Hospital Improvement Grant Program | $17,530 | $17,972 |
| 93.004 | Cooperative Agreements to Improve the Health Status of Minority Populations | $20,751 | $17,641 |
| 93.236 | Grants for Dental Public Health Residency Training | $10,192 | $17,622 |
| 93.969 | Geriatric Education Centers | $16,471 | $17,227 |
| 93.523 | The Affordable Care Act: Human Immunodeficiency Virus (HIV) Prevention and Public Health Fund Activities | not reported | $17,200 |
| 93.936 | National Institutes of Health Acquired Immunodeficiency Syndrome Research Loan Repayment Program | $23,206 | $16,770 |
| 93.358 | Advanced Nursing Education Traineeships | $16,001 | $16,000 |
| 93.137 | Community Programs to Improve Minority Health Grant Program | $10,933 | $15,162 |
| 93.251 | Universal Newborn Hearing Screening | $14,371 | $15,009 |
| 93.515 | Affordable Care Act (ACA) Nurse-Managed Health Clinics | not reported | $14,848 |
| 93.722 | ARRA - IHS Tribal Agreements | $49,731 | $14,649 |
| 93.178 | Nursing Workforce Diversity | $14,851 | $14,520 |
| 93.712 | ARRA - Immunization | $99,971 | $14,487 |
| 93.506 | ACA Nationwide Program for National and State Background Checks for Direct Patient Access Employees of Long Term Care Facilities and Providers | not reported | $13,752 |
| 93.932 | Native Hawaiian Health Systems | $15,190 | $13,200 |
| 93.924 | Ryan White HIV/AIDS Dental Reimbursements Community Based Dental Partnership | $12,828 | $12,938 |
| 93.240 | State Capacity Building | $12,339 | $12,433 |
| 64.014 | Veterans State Domiciliary Care | not reported | $12,080 |
| 93.995 | Adolescent Family Life_Demonstration Projects | $24,101 | $12,058 |
| 93.946 | Cooperative Agreements to Support State-Based Safe Motherhood and Infant Health Initiative Programs | $16,323 | $11,367 |
| 93.824 | Area Health Education Centers Infrastructure Development Awards | $12,480 | $10,787 |
| 93.604 | Assistance for Torture Victims | $10,260 | $10,628 |
| 93.260 | Family Planning_Personnel Training | $10,944 | $10,598 |
| 93.225 | National Research Service Awards_Health Services Research Training | $9,209 | $10,328 |
| 93.360 | Biomedical Advanced Research and Development Authority (BARDA), Biodefense Medical Countermeasure Development | not reported | $10,218 |
| 93.051 | Alzheimer's Disease Demonstration Grants to States | $10,225 | $10,140 |
| 93.731 | ARRA - Prevention and Wellness - Leveraging National Organizations | not reported | $10,000 |
| 93.730 | ARRA Prevention Research Centers Comparative Effectiveness Research Program | not reported | $9,997 |
| 93.193 | Urban Indian Health Services | $11,325 | $9,987 |
| 93.420 | ARRA - Community Health Applied Research Network | not reported | $9,953 |
| 93.272 | Alcohol National Research Service Awards for Research Training | $10,472 | $9,864 |
| 17.600 | Mine Health and Safety Grants | $8,226 | $9,851 |
| 93.913 | Grants to States for Operation of Offices of Rural Health | $9,239 | $9,840 |
| 93.211 | Telehealth Programs | $7,248 | $9,794 |
| 17.276 | Health Coverage Tax Credit (HCTC) | not reported | $9,783 |
| 93.720 | ARRA - Survey and Certification Ambulatory Surgical Center Healthcare-Associated Infection (ASC-HAI) Prevention Initiative | $734 | $9,265 |
| 93.130 | Cooperative Agreements to States/Territories for the Coordination and Development of Primary Care Offices | $9,458 | $9,078 |
| 93.155 | Rural Health Research Centers | $7,564 | $8,721 |
| 93.165 | Grants to States for Loan Repayment Program | $9,029 | $8,357 |
| 93.978 | Preventive Health Services_Sexually Transmitted Diseases Research, Demonstrations, and Public Information and Education Grants | $7,982 | $8,275 |
| 93.156 | Geriatric Training for Physicians, Dentists and Behavioral/Mental Health Professionals | $5,614 | $8,055 |
| 12.350 | Department of Defense HIV/AIDS Prevention Program | $24,609 | $7,996 |
| 93.134 | Grants to Increase Organ Donations | $7,353 | $7,800 |
| 93.910 | Family and Community Violence Prevention Program | $6,075 | $7,766 |
| 93.186 | National Research Service Award in Primary Care Medicine | $7,507 | $7,511 |
| 93.965 | Coal Miners Respiratory Impairment Treatment Clinics and Services | $7,399 | $7,338 |
| 93.008 | Medical Reserve Corps Small Grant Program | $7,350 | $6,880 |
| 93.524 | The Affordable Care Act (ACA): Capacity Building Assistance to Strengthen Public Health Infrastructure and Performance | not reported | $6,782 |
| 93.448 | Food Safety and Security Monitoring Project | $6,399 | $6,682 |
| 93.392 | Cancer Construction | $6,688 | $6,661 |
| 93.412 | ARRA - Preventive Medicine Residency Program | not reported | $6,652 |
| 93.408 | ARRA - Nurse Faculty Loan Programiii | $5,328 | $6,544 |
| 93.982 | Mental Health Disaster Assistance and Emergency Mental Health | $29,754 | $6,525 |
| 93.191 | Patient Navigator and Chronic Disease Prevention Program | $4,952 | $6,513 |
| 93.988 | Cooperative Agreements for State-Based Diabetes Control Programs and Evaluation of Surveillance Systems | $5,143 | $6,489 |
| 93.068 | Chronic Diseases: Research, Control, and Prevention | $3,387 | $6,439 |
| 93.235 | Affordable Care Act (ACA) Abstinence Education Program | $22,949 | $6,420 |
| 93.974 | Family Planning_Service Delivery Improvement Research Grants | $5,512 | $6,261 |
| 93.015 | HIV Prevention Programs for Women | $5,500 | $5,975 |
| 93.856 | Microbiology and Infectious Diseases Research | $15,563 | $5,959 |
| 93.271 | Alcohol Research Career Development Awards for Scientists and Clinicians | $7,287 | $5,943 |
| 93.161 | Health Program for Toxic Substances and Disease Registry | $2,670 | $5,729 |
| 93.231 | Epidemiology Cooperative Agreements | $12,830 | $5,605 |
| 93.296 | State Partnership Grant Program to Improve Minority Health | not reported | $5,370 |
| 93.234 | Traumatic Brain Injury State Demonstration Grant Program | $5,087 | $5,204 |
| 93.250 | Geriatric Academic Career Awards | not reported | $5,032 |
| 93.522 | Affordable Care Act (ACA) Prevention Center for Healthy Weight | not reported | $4,984 |
| 93.088 | Advancing System Improvements to Support Targets for Healthy People 2010 | $4,447 | $4,976 |
| 93.016 | Postal Model for Medical Countermeasures Delivery and Distribution | $9,987 | $4,952 |
| 93.402 | ARRA - State Loan Repayment Program | $5,814 | $4,566 |
| 93.891 | Alcohol Research Center Grants | $6,342 | $4,410 |
| 93.265 | Comprehensive Geriatric Education Program(CGEP) | $4,163 | $4,357 |
| 93.512 | Affordable Care Act (ACA) Personal and Home Care Aide State Training Program (PHCAST) | not reported | $4,213 |
| 93.704 | Trans-NIH Recovery Act Loan Repayment Support | not reported | $3,967 |
| 93.089 | Emergency System for Advance Registration of Volunteer Health Professionals | not reported | $3,795 |
| 93.007 | Public Awareness Campaigns on Embryo Adoption | $3,725 | $3,693 |
| 93.970 | Health Professions Recruitment Program for Indians | $2,709 | $3,507 |
| 93.365 | Sickle Cell Treatment Demonstration Program | $2,658 | $3,501 |
| 93.419 | ARRA - Maternal and Child Health (MCH) Pediatric Research Network Program | not reported | $3,500 |
| 93.418 | ARRA - Emergency Medical Services for Children | not reported | $3,498 |
| 93.006 | State and Territorial and Technical Assistance Capacity Development Minority HIV/AIDS Demonstration Program | $8,778 | $3,464 |
| 93.267 | State Grants for Protection and Advocacy Services | $3,274 | $3,272 |
| 93.063 | Centers for Genomics and Public Health | $500 | $3,225 |
| 93.118 | Acquired Immunodeficiency Syndrome (AIDS) Activity | $3,174 | $3,206 |
| 93.269 | Complex Humanitarian Emergency and War-Related Injury Public Health Activities | $2,790 | $3,060 |
| 93.508 | Affordable Care Act (ACA) Tribal Maternal, Infant, and Early Childhood Home Visiting Program | not reported | $3,000 |
| 93.117 | Preventive Medicine Residency Program | $1,261 | $2,831 |
| 93.449 | Ruminant Feed Ban Support Project | $2,267 | $2,645 |
| 93.284 | Injury Prevention Program for American Indians and Alaskan Natives_Cooperative Agreements | $1,623 | $2,490 |
| 93.503 | Affordable Care Act (ACA) Nursing and Home Health Aides Training Program | not reported | $2,412 |
| 93.942 | Research, Treatment and Education Programs on Lyme Disease in the United States | $1,632 | $2,321 |
| 93.259 | Rural Access to Emergency Devices Grant | $1,278 | $2,264 |
| 93.990 | National Health Promotion | $2,485 | $2,169 |
| 93.338 | Foreign Public Health Construction | not reported | $2,000 |
| 93.975 | National All Schedules Prescription Electronic Reporting Grant | $2,000 | $2,000 |
| 93.064 | Laboratory Training, Evaluation, and Quality Assurance Programs | $2,785 | $1,990 |
| 93.212 | Chiropractic Demonstration Project Grants | $1,814 | $1,945 |
| 93.290 | National Community Centers of Excellence in Women's Health | not reported | $1,900 |
| 93.414 | ARRA - State Primary Care Offices | $1,830 | $1,773 |
| 93.204 | Surveillance of Hazardous Substance Emergency Events | $1,634 | $1,733 |
| 93.257 | Grants for Education, Prevention, and Early Detection of Radiogenic Cancers and Diseases | $1,642 | $1,714 |
| 93.018 | Strengthening Public Health Services at the Outreach Offices of the U.S.-Mexico Border Health Commission | not reported | $1,465 |
| 93.964 | Public Health Traineeships | $1,436 | $1,437 |
| 93.223 | Development and Coordination of Rural Health Services | $776 | $1,325 |
| 93.124 | Nurse Anesthetist Traineeships | $1,250 | $1,252 |
| 93.100 | Health Disparities in Minority Health | $334 | $1,200 |
| 93.443 | Health Promotion/Disease Prevention Program for American Indians and Alaska Natives | $835 | $1,067 |
| 93.440 | National Project Management of the Healthcare Communities Knowledge Gateway | not reported | $999 |
| 93.410 | ARRA Licensure Portability Grant Program | not reported | $998 |
| 93.066 | State Vital Statistics Improvement Program | $732 | $889 |
| 93.300 | National Center for Health Workforce Analysis | $750 | $750 |
| 93.208 | Great Lakes Human Health Effects Research | $798 | $598 |
| 17.603 | Brookwood-Sago Grant | $410 | $500 |
| 93.206 | Human Health Studies_Applied Research and Development | $600 | $500 |
| 93.238 | Cooperative Agreements for State Treatment Outcomes and Performance Pilot Studies Enhancement | $1,374 | $500 |
| 93.003 | Public Health and Social Services Emergency Fund | $50 | $450 |
| 17.505 | OSHA Data Initiative | $721 | $419 |
| 93.239 | Policy Research and Evaluation Grants | not reported | $400 |
| 64.026 | Veterans State Adult Day Health Care | not reported | $318 |
| 93.444 | Tribal Self-Governance Program: Planning and Negotiation Cooperative Agreement | not reported | $285 |
| 93.923 | Disadvantaged Health Professions Faculty Loan Repayment (FLRP) and Minority Faculty Fellowship Program (MFFP) | $68 | $257 |
| 93.073 | Birth Defects and Developmental Disabilities - Prevention and Surveillance | not reported | $185 |
| 93.760 | Rural PACE (Program of All-Inclusive Care for the Elderly) Provider Grant Program | not reported | $174 |
| 93.285 | National Institutes of Health Pediatric Research Loan Repayment Program | not reported | $68 |
| 93.252 | Healthy Communities Access Program | $iv | $29 |
| 17.504 | Consultation Agreements | $31,172 | -$300 |
| 10.029 | Avian Influenza Indemnity Program | not reported | not reported |
| 10.475 | Cooperative Agreements with States for Intrastate Meat and Poultry Inspection | $135,543 | not reported |
| 10.477 | Meat, Poultry, and Egg Products Inspection | not reported | not reported |
| 10.479 | Food Safety Cooperative Agreements | not reported | not reported |
| 10.874 | Delta Health Care Services Grant Program | not reported | not reported |
| 14.128 | Mortgage Insurance_Hospitals | not reported | not reported |
| 17.601 | Mine Health and Safety Counseling and Technical Assistance | not reported | not reported |
| 17.602 | Mine Health and Safety Education and Training | not reported | not reported |
| 17.604 | Safety and Health Grants | not reported | not reported |
| 21.013 | Qualifying Therapeutic Discovery Project Credit | not reported | not reported |
| 64.007 | Blind Rehabilitation Centers | not reported | not reported |
| 64.008 | Veterans Domiciliary Care | not reported | not reported |
| 64.009 | Veterans Medical Care Benefits | not reported | not reported |
| 64.010 | Veterans Nursing Home Care | not reported | not reported |
| 64.011 | Veterans Dental Care | not reported | not reported |
| 64.013 | Veterans Prosthetic Appliances | not reported | not reported |
| 64.016 | Veterans State Hospital Care | not reported | not reported |
| 64.018 | Sharing Specialized Medical Resources | not reported | not reported |
| 64.019 | Veterans Rehabilitation_Alcohol and Drug Dependence | not reported | not reported |
| 64.022 | Veterans Home Based Primary Care | not reported | not reported |
| 64.127 | Monthly Allowance for Children of Vietnam Veterans Born with Spina Bifida | not reported | not reported |
| 64.128 | Vocational Training and Rehabilitation for Vietnam Veterans' Children with Spina Bifida or Other Covered Birth Defects | not reported | not reported |
| 93.010 | Community-Based Abstinence Education (CBAE) | $87,255 | not reported |
| 93.011 | National Organizations of State and Local Officials | not reported | not reported |
| 93.012 | Improving, Enhancing, and Evaluating Outcomes of Comprehensive Heart Health Care Programs for High-Risk Women | not reported | not reported |
| 93.013 | Ambassadors for Change Program | not reported | not reported |
| 93.014 | Steps to Healthier Girls Program | not reported | not reported |
| 93.017 | Strengthening the Management and Services of the Women's and Children's Hospitals in Kabul | not reported | not reported |
| 93.019 | Technical Assistance and Provision for Foreign Hospitals and Health Organizations | $11,647 | not reported |
| 93.043 | Special Programs for the Aging_Title III, Part D_Disease Prevention and Health Promotion Services | not reported | not reported |
| 93.055 | Applied Leadership for Community Health Improvement | not reported | not reported |
| 93.056 | Initiative to Educate State and Territorial Officials about Maintaining and Strengthening Public Health in a Changing Environment | not reported | not reported |
| 93.062 | Biomonitoring Programs for State Public Health Laboratories | not reported | not reported |
| 93.071 | Medicare Enrollment Assistance Program | $17,500 | not reported |
| 93.105 | Bilingual/Bicultural Service Demonstration Grants | $2,249 | not reported |
| 93.111 | Adolescent Family Life Research Grants | $507 | not reported |
| 93.123 | Health Professions Pregraduate Scholarship Program for Indians | not reported | not reported |
| 93.140 | Intramural Research Training Award | not reported | not reported |
| 93.162 | National Health Service Corps Loan Repayment Program | not reported | not reported |
| 93.164 | Indian Health Service Educational Loan Repayment | not reported | not reported |
| 93.181 | Podiatric Residency Training in Primary Care | not reported | not reported |
| 93.187 | Undergraduate Scholarship Program for Individuals from Disadvantaged Backgrounds | not reported | not reported |
| 93.189 | Health Education Training Centers Continuing Educational Support for Health Professionals Serving in Underserved Communities | not reported | not reported |
| 93.192 | Quentin N. Burdick Program for Rural Interdisciplinary Training | not reported | not reported |
| 93.202 | Capacity Building Among American Indian Tribes | not reported | not reported |
| 93.209 | Contraception and Infertility Research Loan Repayment Program | not reported | not reported |
| 93.220 | Clinical Research Loan Repayment Program for Individuals from Disadvantaged Backgrounds | not reported | not reported |
| 93.229 | Demonstration Cooperative Agreements for Development and Implementation of Criminal Justice Treatment Networks | not reported | not reported |
| 93.230 | Consolidated Knowledge Development and Application (KD&A;) Program | not reported | not reported |
| 93.232 | Loan Repayment Program for General Research | not reported | not reported |
| 93.244 | Mental Health Clinical and AIDS Service-Related Training Grants | not reported | not reported |
| 93.270 | Adult Viral Hepatitis Prevention and Control | not reported | not reported |
| 93.280 | National Institutes of Health Loan Repayment Program for Clinical Researchers | not reported | not reported |
| 93.288 | National Health Service Corps Scholarship Program | not reported | not reported |
| 93.289 | President's Council on Fitness, Sports, and Nutrition | not reported | not reported |
| 93.291 | Surplus Property Utilization | not reported | not reported |
| 93.294 | Mentoring Partnership Program - Protege | not reported | not reported |
| 93.295 | Intergenerational Approaches to HIV/AIDS Prevention Education with Women across The Lifespan Pilot Program | $1,300 | not reported |
| 93.303 | Nursing Scholarship Program | not reported | not reported |
| 93.308 | Extramural Loan Repayment for Individuals from Disadvantaged Backgrounds Conducting Clinical Research | not reported | not reported |
| 93.339 | Public Health Conference Support | not reported | not reported |
| 93.400 | National Health Service Corps Scholarship Program | not reported | not reported |
| 93.401 | ARRA - National Health Service Corps Loan Repayment | not reported | not reported |
| 93.404 | ARRA Dental Public Health Residency Training Grants | $811 | not reported |
| 93.405 | ARRA - Public Health Traineeship Program | $2,985 | not reported |
| 93.406 | Nursing Education Loan Repayment Program (NELRP) | not reported | not reported |
| 93.409 | Faculty Loan Repayment Programs | not reported | not reported |
| 93.415 | ARRA - Centers of Excellence | $5,029 | not reported |
| 93.416 | ARRA - Health Careers Opportunity Program | $2,504 | not reported |
| 93.417 | ARRA - Nursing Workforce Diversity | $2,618 | not reported |
| 93.442 | Special Diabetes Program for Indians (SDPI) Competitive Grant Program | not reported | not reported |
| 93.445 | Indian Health Service Sanitation Facilities Construction Program | not reported | not reported |
| 93.451 | The Linkage to Life Program: Rebuilding Broken Bridges for Minority Families Impacted by HIV/AIDS. | not reported | not reported |
| 93.452 | Health Improvement for Re-entering Ex-offenders Initiative (HIRE) HIV/AIDS | not reported | not reported |
| 93.453 | Coalition for a Healthier Community | not reported | not reported |
| 93.501 | Affordable Care Act (ACA) Grants for School-Based Health Center Capital Expenditures | not reported | not reported |
| 93.502 | Affordable Care Act (ACA) Infrastructure to Expand Access to Care | not reported | not reported |
| 93.504 | Affordable Care Act (ACA) Family to Family Health Information Centers | not reported | not reported |
| 93.516 | Affordable Care Act (ACA) Public Health Training Centers Program | not reported | not reported |
| 93.519 | Affordable Care Act (ACA) Consumer Assistance Program Grants | not reported | not reported |
| 93.526 | Affordable Care Act (ACA) Grants for Capital Development in Health Centers | not reported | not reported |
| 93.527 | Affordable Care Act (ACA) Grants for New and Expanded Services under the Health Center Program | not reported | not reported |
| 93.528 | National Forum for State and Territorial Chief Executives | not reported | not reported |
| 93.529 | Pre-existing Condition Insurance Program (PCIP) | not reported | not reported |
| 93.530 | Affordable Care Act - Teaching Health Center Graduate Medical Education Payments Program | not reported | not reported |
| 93.531 | The Patient Protection and Affordable Care Act of 2010 (Affordable Care Act) authorizes Community Transformation Grants and National Dissemination and Support for Community Transformation Grants | not reported | not reported |
| 93.533 | Prevention and Public Health Fund (Affordable Care Act): Enhanced Surveillance for New Vaccine Preventable Disease | not reported | not reported |
| 93.534 | Affordable Care Act Program for Early Detection of Certain Medical Conditions Related to Environmental Health Hazards | not reported | not reported |
| 93.535 | Affordable Care Act (ACA) Childhood Obesity Research Demonstration | not reported | not reported |
| 93.536 | The Affordable Care Act Medicaid Incentives for Prevention of Chronic Disease Demonstration Project | not reported | not reported |
| 93.537 | Affordable Care Act Medicaid Emergency Psychiatric Demonstration | not reported | not reported |
| 93.538 | Affordable Care Act - National Environmental Public Health Tracking Program-Network Implementation | not reported | not reported |
| 93.539 | Prevention and Public Health Fund (Affordable Care Act) - Capacity Building Assistance to Strengthen Public Health Immunization Infrastructure and Performance | not reported | not reported |
| 93.540 | Affordable Care Act Streamlined surveillance for ventilator-associated pneumonia: Reducing burden and demonstrating preventability | not reported | not reported |
| 93.541 | The Patient Protection and Affordable Care Act of 2010 (ACA) | not reported | not reported |
| 93.542 | Health Promotion and Disease Prevention Research Centers: Affordable Care Act (ACA) Special Interest Project Competitive Supplements (SIPS) | not reported | not reported |
| 93.544 | The Patient Protection and Affordable Care Act of 2010 (Affordable Care Act) authorizes Coordinated Chronic Disease prevention and Health Promotion Program | not reported | not reported |
| 93.717 | ARRA - Preventing Healthcare-Associated Infections | $39,800 | not reported |
| 93.726 | ARRA Accelerating Adoption of Comparative Effectiveness Research (CER) | not reported | not reported |
| 93.769 | Demonstration to Maintain Independence and Employment | not reported | not reported |
| 93.775 | State Medicaid Fraud Control Units | not reported | not reported |
| 93.776 | Hurricane Katrina Relief | not reported | not reported |
| 93.781 | Seed Grants to States for Qualified High-risk Pools | $334 | not reported |
| 93.783 | Medicare Transitional Drug Assistance Program for States | not reported | not reported |
| 93.784 | Federal Reimbursement of Emergency Health Services Furnished to Undocumented Aliens | not reported | not reported |
| 93.785 | Pilot Program for National and State Background Checks--Direct Patient Access for Long-term Care | not reported | not reported |
| 93.786 | State Pharmaceutical Assistance Programs | not reported | not reported |
| 93.790 | Alternate Non-Emergency Service Providers or Networks | $24,021 | not reported |
| 93.793 | Medicaid Transformation Grants | not reported | not reported |
| 93.794 | Reimbursement of State Costs for Provision of Part D Drugs | not reported | not reported |
| 93.796 | State Survey Certification of Health Care Providers and Suppliers (Title XIX) Medicaid | not reported | not reported |
| 93.890 | Healthy Communities Access Program (HCAP) Demonstration Authority | not reported | not reported |
| 93.908 | Nursing Education Loan Repayment Program | not reported | not reported |
| 93.919 | Cooperative Agreements for State-Based Comprehensive Breast and Cervical Cancer Early Detection Programs | not reported | not reported |
| 93.947 | Tuberculosis Demonstration, Research, Public and Professional Education | $855 | not reported |
| 93.952 | Trauma Care Systems Planning and Development | not reported | not reported |
| 93.954 | Tribal Recruitment and Retention of Health Professionals into Indian Health Programs | not reported | not reported |
| 93.962 | Health Administration Traineeships Program | not reported | not reported |
| 93.971 | Health Professions Preparatory Scholarship Program for Indians | not reported | not reported |
| 93.972 | Health Professions Scholarship Program | not reported | not reported |
| 93.993 | Public Health Research Accreditation Project | not reported | not reported |
| 93.996 | Bioterrorism Training and Curriculum Development Program | not reported | not reported |
| Grand Total | $769,966,530 | $555,662,655 | |
i. The Medicare Part A spending reported in USASpending.gov for FY2010 is significantly less than what is reported in the Catalog of Federal Domestic Assistance, which shows Medicare Part A obligations for FY2010 to be $245.3 billion. Additionally, the Historical Tables in the President’s Budget for FY2013 display outlays for Medicare spending, in which Medicare Part A (Hospital Insurance) totaled $250.2 billion in FY2010 (Table 11.3).
ii. The Medicare Part B spending reported in USASpending.gov for FY2010 is significantly less than what is reported in the Catalog of Federal Domestic Assistance, which shows Medicare Part B obligations for FY2010 to be $209.8 billion. Additionally, the Historical Tables in the President’s Budget for FY2013 display outlays for Medicare spending, in which Medicare Part B (Supplementary Medical Insurance) totaled $268.9 billion in FY2010 (Table 11.3).
iii. The Nurse Faculty Loan Program (NFLP) is a direct loan program not captured in the Federal Credit Supplement (FCS) portion of the President's Budget. NFLP refers to loan programs set up by nursing schools with direct grants from the Department of Health and Human Services (HHS). HHS gives nursing schools grants with which to establish loan programs for nurses pursuing advanced degrees, up to 85 percent of which students can cancel after graduation. Therefore, Subsidyscope treats NFLP as a grant program.
iv. This program reported a dollar amount of -$1 for FY2009 in USASpending.gov.
Source: Subsidyscope analysis of data from USASpending.gov. Program names are copied directly from USASpending.gov. For more information about the quality of these data sources, visit Clearspending.org.
Notes: Individual estimates may not sum to the reported total due to rounding. Some programs report negative totals for FY2010. This reflects a downward adjustment to obligations made in previous years. Table excludes loans and loan guarantees.
- Subsidyscope analysis of USASpending.gov.
- The seven agencies are the Department of Health and Human Services (CFDA # 93.***), Department of Agriculture (10.***), the Department of Defense (12.***), the Department of Housing and Urban Development (14.***), the Department of Labor (17.***), the Department of the Treasury (21.***), and the Department of Veterans Affairs (64.***). For the purpose of counting the number of agencies that administer funding in a sector, Subsidyscope relies on the CFDA’s designation of what constitutes a federal agency.
- Subsidyscope analysis of USASpending.gov. This total is the aggregate of grant spending in Subsidyscope’s Agriculture, Education, Energy, Health, Housing, National Defense, Natural Resources and Environment, Science, Space, and Technology, and Transportation sectors. The Nonprofit sector is not included in this total, as it is not mutually exclusive in scope and cuts across all other sectors.
- Subsidyscope analysis of USASpending.gov. See table footnotes i and ii above for more on Medicare Part A and B.
- The Catalog of Federal Domestic Assistance (CFDA) captures domestic grant programs and thus does not include grants administered in a foreign capacity.
- Subsidyscope analysis of USASpending.gov. This total is the aggregate of total contract spending (competed and non-competed) in Subsidyscope’s Agriculture, Education, Energy, Health, Housing, National Defense, Natural Resources and Environment, Science, Space, and Technology, and Transportation sectors. The Nonprofit sector is not included in this total, as it is not mutually exclusive in scope and cuts across all other sectors.
- Subsidyscope analysis of USASpending.gov. Subsidyscope has previously determined that there can be problems with the quality of the contracts data that are reported by agencies to USASpending.gov. In order to sort government contracts by economic sector, Subsidyscope uses North American Industry Classification System (NAICS) codes to match contracts to the appropriate economic sector, or Product Service Codes if NAICS codes are not available. (See Section C of Subsidyscope's methodology for more on how contracts are organized by sector.) Specifically, Subsidyscope found that there is significant variation in agencies' use of NAICS codes when reporting contracts to USASpending.gov over the 10-year period from fiscal year 2000 to 2010. For instance, despite there being a requirement that contracting officers identify NAICS codes for each contract, for fiscal year 2000, approximately 88 percent of all contract records are missing NAICS codes while in fiscal year 2010, only 3 percent of records are missing NAICS codes. This inconsistent application of NAICS codes as well as other reporting variations may be responsible for some of the increase in health-related contracts spending in fiscal years 2000 to 2010, as presented in Figure 2 above.
- U.S. Department of Energy (DOE). “Competition in Contracting Guide.” p. 1.