Health Care Funding: Federal Obligations to and Expenditures by Selected Entities Involved in Health-Related Activities, 2010-2012

What GAO Found

From fiscal year 2010 through 2012, the Department of Health and Human Services (HHS) and the U.S. Agency for International Development (USAID) reported obligating about $236 million to six organizations and their affiliates and member associations: Advocates for Youth, Guttmacher Institute, International Planned Parenthood Federation, Planned Parenthood Federation of America, Population Council, and the Sexuality Information and Education Council of the United States. While HHS obligated funding to each of these six organizations, USAID obligated funding to two of the six organizations. In addition, the six organizations reported expending funding they received directly and indirectly from federal agencies, including HHS and USAID, as well as the Departments of Agriculture, Defense, Housing and Urban Development, and Justice. The six organizations reported expending over $482 million of federal funding during the same time frame.

Federal agencies reported obligating over $19 billion to federally qualified health centers (FQHCs), which provide primary health care services, from fiscal year 2010 through 2012. Of this amount, HHS obligated over $15 billion. FQHCs reported expending almost $10 billion in federal funding from HHS in calendar years 2010 through 2012. In 2012, FQHCs provided services during approximately 84 million visits to over 21 million individuals. The majority--about 60 million--of the visits provided were medical visits. Other types of visits included dental and mental health. GAO is not making any recommendations. HHS and USAID reviewed a draft of this report and provided comments, which GAO incorporated as appropriate.

Why GAO Did This Study

In order to achieve their programmatic goals, federal government agencies, including HHS and USAID, provide funding to various entities through programs such as the Title X Family Planning Program and the Health Center Program. Federal agencies obligate funding to entities, which the entities then expend for a range of activities, including providing health services. Among these entities are FQHCs, which provide health services to low-income individuals as part of the nation's safety net, and six organizations engaged in health-related activities.

GAO was asked to update its 2010 work on the federal funding obligated to and expended by these six organizations from 2010 through 2012. GAO was also asked to expand upon its prior work by including information about FQHCs. This report describes (1) federal obligations to the six organizations; (2) these organizations' expenditures of federal funding; (3) federal obligations to FQHCs; and (4) FQHCs' expenditures of federal funding.