The U.S. Department of Health and Human Services organization across 16 Operating and Staff Divisions, plus the proposed 2025 reorganization umbrella offices (flagged). Offices proposed in current reorganizations are flagged. Click any office for its description and Federal Register source. The budget, workforce, and spending tabs cover the Indian Health Service.
What this is. This tab recreates the federal Native American Crosscut from the spending side. Where the budget tabs show what Congress appropriated, this view follows the money that federal agencies actually obligated to tribal governments and tribal organizations, drawn from USAspending records across every federal agency, not only Health and Human Services.
Obligations are money committed, a different measure from the budget authority shown on the other tabs. The figure here is a conservative floor. It counts only accounts and awards that are exclusively tribal, so it captures the directly traceable dollars and leaves out tribal set-asides buried inside larger formula and block grants.
On that basis, directly traceable tribal obligations grew from about $11.0 billion in FY2017 to $19.2 billion in FY2024, with a pandemic-relief peak in FY2021. The clean-account obligations series shown here is a FLOOR: it counts only obligations from exclusively tribal accounts and excludes the tribal share that flows through co-mingled accounts, which is why the figures sit below the OMB Native American Crosscut control of roughly $32 billion in FY2024. (Source: tribal_obligations_account_annual_v1, clean tribal total only, current trust verdict AUDIT_PENDING.) The FY2025 bar marked with an asterisk is a PARTIAL fiscal year (USAspending period 6, not a full-year total). The Office of Management and Budget Native American Crosscut, which counts appropriated funding rather than recorded obligations and includes those embedded set-asides, reports about $32.6 billion for FY2024. The space between the two lines is mostly comingled funding that USAspending does not isolate at the account level, not missing money.
A different lens from the annual line above, on a different basis. Across roughly two decades of awards, this is how the dollars partition by recipient type.
Native-owned business contracts reflect contractor ownership rather than funding that reaches a tribe, so they are shown separately and left out of the tribal-benefit total. Assistance figures are award-lifetime totals; contract figures cover FY2025 to FY2026 only.
IHS is the one agency with award-level File C detail loaded, which is why its breakdown goes deepest. Its award-linked obligations sit at or below the account totals USAspending reports in File A every year; the gap is direct federal, non-award spending. Pandemic relief lifted FY2021 sharply: emergency, named-Act funding, mostly the American Rescue Plan, was 44.8 percent of IHS award-linked obligations that year and about 15 percent cumulatively across FY2018 to FY2024.
| Fiscal year | Award-linked obligations | Total account obligations (File A) | Award-linked share |
|---|---|---|---|
| FY2018 | $3.96B | $7.16B | 55.4% |
| FY2019 | $4.44B | $7.69B | 57.7% |
| FY2020 | $5.32B | $8.77B | 60.6% |
| FY2021 | $9.14B | $12.83B | 71.2% |
| FY2022 | $5.88B | $9.80B | 60.1% |
| FY2023 | $6.20B | $10.72B | 57.8% |
| FY2024 | $6.05B | $12.30B | 49.2% |
Sources: USAspending File A account balances and File C account-breakdown-by-award, the federal assistance tribal recipient codes and the federal contract tribal flags, and the OMB Native American Crosscut as the funding benchmark. The clean annual series counts exclusively-tribal accounts; the recipient partition uses award-level tribal recipient identification. Figures are query-derived from the project database.
Where every number comes from, how the public datasets were fit together, and what this does and does not claim.
Three views of the U.S. Department of Health and Human Services, by Operating Division and by appropriation account or activity, across fiscal years: the money appropriated (budget authority), the workforce that money supports (full-time-equivalent staff, or FTE), and, across the federal government (recreated from USAspending records, with the deepest detail for the Indian Health Service), the money actually committed to recipients (obligations). These are different measures.
Budget authority and workforce come from each Operating Division's annual Congressional Justification of Estimates for Appropriations, the detailed budget each agency sends to Congress, together with the President's Budget. Earlier years are taken from the most recent Justification that restates them, so a single, consistent structure is used per Operating Division. Actual spending comes from USAspending.gov: account-level balances and the account spending breakdown, plus the underlying grant and contract award records. Where a Justification did not publish a staffing number, workforce is estimated from the U.S. Office of Personnel Management's federal employment data.
Every figure is tied to three things: the office that administers it, the appropriation account it flows through, and the fiscal year. That shared backbone lets budget, people, and spending line up for the same office and the same year. Because budget authority, obligations, and FTE (people) measure different things and are shown side by side.
FTE, full-time-equivalent, measures funded work rather than a count of people: one full-year position is one FTE, while a part-time or partial-year position is one person but less than one FTE. Where a Justification published FTE, that number is used as printed. Where it did not, FTE is estimated from federal employment (head count) using a workforce ratio. That estimate carries some error and is not exact, but it is reliable enough to show scale and direction, and estimated values are flagged rather than presented as reported figures.
Account codes are the Treasury account symbols used in the President's Budget. Federal programs are identified by their Assistance Listing numbers (formerly the Catalog of Federal Domestic Assistance), published on SAM.gov. Spending records distinguish grants and other assistance from contracts, and carry recipient-type codes that, used only in aggregate and without naming any recipient, indicate how much funding reaches tribal entities. Agency organization and the proposed reorganizations are drawn from the official Statements of Organization published in the Federal Register.
Budget authority is the appropriated program level, not total budgetary resources. The President's Budget year is a request (proposed), not enacted law. There is not yet a House, Senate, conference, and enacted comparison, because that record is still being collected. Year coverage varies by Operating Division, as noted on each view. Actual spending detail beyond the Indian Health Service is pending additional award-level data. The proposed consolidation of the Administration for Community Living (ACL) into the Administration for Children, Families, and Communities (ACFC) is judicially enjoined (New York v. Kennedy, No. 1:25-cv-00196 (D.R.I.), preliminary injunction July 1, 2025; stay denied); ACL remains a current Operating Division and Congress continues to fund it. This is a research reconstruction built from public federal sources, not an official agency publication.