Federal Appropriations

“The President proposes, Congress disposes”

Protecting the public’s health is a shared responsibility – more than 70% of DOH’s annual federal funds directly support Tribes, local health jurisdictions, and other community partners. Washington State is facing complex public health challenges that underscore the need for smart, strategic, and sustained investments. The federal funding DOH receives supports critical programs that prevent illness and injury, promote healthy places to live and work, provide education and information to help people make healthy decisions, and ensure our state is prepared for public health emergencies.

Federal Appropriations

Federal funding can be largely divided into two major categories: discretionary and mandatory. Funding for discretionary spending is set through the annual appropriations process. Nearly 80% of state and local grant programs are discretionary. Mandatory programs (such as Medicaid, SNAP) are funded outside of the appropriations process and require an active authorization to receive funding. Mandatory programs can be reformed through a reconciliation process.

Generally speaking, the executive branch is prohibited from (1) spending more than is appropriated, (2) spending less than is appropriated, and (3) spending for purposes other than those specified.

By statute, the appropriations process should begin in February with the release of the president’s budget and end by September 30 with enactment of final appropriations for the fiscal year that begins October 1.

The House and Senate each have an appropriations committee, with 12 subcommittees that each produce an appropriations bill for the programs and agencies under their jurisdiction.

Typical Key Steps in Federal Fiscal Appropriations

Step 1. The President’s Budget Proposal (February)

The President proposes a budget to Congress (often called the "skinny budget") outlining spending priorities for the upcoming fiscal year. This initial budget includes limited details and high-level information. The President’s budget is not a law, only a suggestion. It offers insight into what the administration views as the appropriate level of spending for any discretionary program and includes legislative proposals the administration would like Congress to adopt.

Example: Federal Fiscal Year (FFY) 2026 Presidential Budget Request (PDF)

Step 2. Congressional Budget Resolution (February)

The House and the Senate Budget Committees draft a budget resolution setting total spending and revenue levels. This is often called a framework or blueprint. Importantly, a budget resolution is not a law. A budget resolution may also include reconciliation directives for committees, as it has in the 119th Congress with the concurrent budget resolution.

Step 3. Appropriations Process (Spring – Summer)

Congress passes 12 total appropriations bills that fund various parts of the federal government. These bills must be signed by the President. Appropriations bills can be signed into law as:

• Individual bills
• Part of a multi-bill package (minibus)
• Single piece of legislation containing all 12 bills (omnibus)
• Continuing resolution to extend the previous fiscal year appropriations

Step 4. Implementation

Federal agencies funded under the appropriations committees receive funding instructions written by Congress and begin distributing funding through grants, contracts, and direct spending to reflect Congressional intent.

Example: Health and Human Services FFY 2024 Division D LHHS (PDF)

DOH Appropriations Requests

As Congress moves through the appropriations process each FFY, DOH submits programmatic and fiscal priorities through the Governor's Federal and Inter-State Affairs Director to members of Washington’s congressional delegation for consideration. Federal funding of key programs awarded through the CDC and the Administration for Strategic Preparedness and Response help DOH and other state health departments sustain key programs and investments that support the state’s public health infrastructure.

DOH examples from previous years:

• FFY 2026 Appropriations Request (PDF)
• FFY 2025 Appropriations Request (PDF)
• FFY 2024 Appropriations Request (PDF)

Additional Information on Federal Budgeting

Continuing Resolution

A Continuing Resolution (CR) is a legislative measure that temporarily funds federal government operations when the annual appropriations bills have not been enacted by the beginning of the fiscal year. CRs prevent government shutdowns by maintaining funding at existing levels for a specific period of time. CRs allow federal agencies to continue to operate until appropriations are passed. The federal government is currently operating under a rare, full year CR enacting most funding at flat FFY2024 levels. This CR expires on September 30, 2025.

Mandatory Spending

Mandatory programs are funded outside of the appropriations process and require an active authorization to receive funding. The funding levels specified in the authorization are binding. In many cases, mandatory authorizations provide funding directly at a specified amount per fiscal year. In other cases, the authorization provides the funding needed to meet the cost of delivering the program to those who qualify for it.

Reconciliation

Reconciliation is a budgeting procedure established in the Budget Act of 1974 to help Congress pass mandatory spending and tax changes requiring only a simple majority to pass. Reconciliation is typically only an option when one party has control of all three chambers (the House, Senate, and the Presidency). There are specific parameters that guide how reconciliation can be used including the “Byrd Rule” which restricts reconciliation use to the following conditions:

• Every provision in a reconciliation bill must affect revenue or spending (the bill cannot include provisions that have no fiscal impact or that produce a fiscal impact incidental to a non-budgetary policy change)
• The bill does not raise the deficit outside of the time window covered by the budget resolution
• The bill does not amend Social Security

Reconciliation was generally intended to reduce budget deficits. However, a reconciliation bill is technically allowed to either decrease or increase the deficit over the period covered by the budget resolution. Congress has used reconciliation to modify taxes and make changes to Medicaid, Medicare, but also to provide pandemic relief and make changes to student loan programs. Parts of the Affordable Care Act, the 2017 Tax Cuts and Jobs Act, the 2021 American Rescue Plan Act, and the 2022 Inflation Reduction Act all passed through reconciliation. Notably, reconciliation can only be used once per FFY during a continuing resolution. For example, during the 117th Congress, it took 18 months to pass the Inflation Reduction Act, which was originally the Build Back Better Act, that failed to get a simple majority.

In April 2025, the 119th Congress concurrent budget resolution provided reconciliation directives for committees related to reconciliation instructions:

• House concurrent resolution
• Senate concurrent resolution

Table 1. Reconciliation Jurisdiction, House/Senate Committees, Washington Connection