The appropriations committees allocate funding based on the guidance they receive from the policies set by the authorizing committees. The House and Senate Appropriations Committees each have several subcommittees. The number of these has varied over the years, but stabilized at 13 during the 1970s and stayed that way until 2004. Each of the 13 subcommittees in the House then had a counterpart in the Senate, and each pair generated one discretionary spending bill. In 2004, however, the structure changed in preparation for the 109th Congress, and the House now has 10 appropriations subcommittees, while the Senate has 12. While this structure no longer offers the simplicity of 13 pairs and 13 bills, the jurisdictions of the subcommittees relating to health spending have remained largely unchanged, and two of the annual appropriations bills still cover the vast majority of discretionary health spending.
These two bills are generated by four appropriations subcommittees. The two in the House of Representatives are the House Appropriations Subcommittee on Labor, Health & Human Services and Education (L-HHS) and the House Appropriations Subcommittee on Foreign Operations and Export Financing, which both have their counterparts in the Senate. L-HHS has jurisdiction over the Department of Health and Human Services and all its agencies (such as the Centers for Disease Control [CDC] and the National Institutes of Health [NIH]), the National Commission on AIDS, the National Commission to Prevent Infant Mortality, and the Occupational Safety and Health Review Commission (OSHRC). The Subcommittee on Foreign Operations and Export Financing has jurisdiction over the U.S. Agency for International Development (USAID), the State Department (international health-related programs), the Millennium Challenge Account (MCA), and U.S. contributions to multilateral institutions such as the World Bank, the Peace Corps, the African Development Bank Group (AFDB), and the Asian Development Bank (ADB).
The groupings of federal agencies and programs funded by each bill are largely a product of political history, with various members of Congress vying to control the budget process for their own areas of interest. As a result, each subcommittee must make funding decisions for a group of agencies and programs that often have missions that are unrelated to each other.
For more information on committee members and jurisdiction, visit the following sites:
appropriations.senate.gov
appropriations.house.gov