Reports & Testimonies

Serious mental illnesses affected 14.6 million adults in 2023. Left untreated, such illnesses can lead to issues like poor health and higher medical costs. Assisted outpatient treatment can help adults with serious mental illnesses who can't live safely on their own. It can include medication and referrals for social services. But it is controversial because it's court-ordered and involuntary. HHS awards grants to organizations to...

Satellites are used for GPS, weather forecasts, and more. Generally, satellites have to be small and tough enough to withstand launch. Repairing or upgrading them involves sending people to space—so they usually aren't made to be serviced. In-space robotic servicing could change this and open the door to other advances, like in-space assembly and manufacturing. But the technology is mostly unproven in space. Companies and...

Organized groups of individuals working together have defrauded public programs, as was evident during the COVID-19 pandemic. Such groups comprised almost half of those convicted of COVID-19 fraud. These groups include organized criminal enterprises, groups organized around particular programs, and clusters of individuals exploiting new opportunities. These groups have used technology, program knowledge, and other means to commit fraud on a large scale against government...

The Federal Aviation Administration conducts research to support its mission to run the world's safest, most efficient aerospace system. In fiscal year 2019, Congress directed FAA to spend 70% of its research and development funding on safety projects, including projects researching aircraft fuels, fire safety, and how to prevent ice from forming on aircraft. Although FAA reports annually on its research and development programs, it...

The Department of Defense's space operations and other activities, including exercises, are aimed at deterring and preparing for potential conflict. DOD emphasizes that collaborating with the nation's allies and other partners is critical to achieving its goals. DOD collaborates closely with allies and partners but has trouble carrying out the work. For example, the U.S. Space Force doesn't have enough people in some units to...

The State Department's National Passport Information Center is a call center that provides information to the public about passport services. In 2023, the center experienced periods of extremely high call volumes, and customers experienced longer-than-usual wait times to speak to call agents. In response, the center took steps to address staffing, infrastructure, and technology factors that affected wait times. For instance, it increased its call...

The Department of Energy is required to annually submit to Congress a forward-looking energy program that includes estimates of funding needed for the current year and the next 4 years of its activities. This can help ensure greater transparency for DOE's nearly $50 billion budget. DOE hasn't fully complied with the requirement; reporting has been incomplete and inconsistent. For example, DOE: Didn't explain how proposed...

"Automatic stabilizers" adjust federal spending and taxes when there is an economic downturn. These adjustments can help keep the economy afloat and mitigate harmful effects. An example of an automatic stabilizer is when unemployment is high and incomes fall, and more people become eligible for a government benefit like Medicaid. Automatic stabilizers are more effective when they're timely, temporary, targeted, and predictable. We used these...

In fiscal year 2025, NASA planned to invest about $74 billion in its major projects to continue exploring Earth, the moon, and beyond. This is our 17th annual assessment of these projects. In the last year, four of 18 major projects had cost overruns—when costs incurred are more than NASA planned for. And three had schedule delays. Since 2009, most major projects that completed the...

The 5 permanently-inhabited U.S. territories borrow through financial markets to fund priorities like infrastructure projects. Every 2 years, we examine the territories' public debt and review their economic conditions. The territories face challenges to economic growth, which can make it harder for them to secure or repay debt. These include the high cost of importing goods and energy, population loss, and extreme weather events that...

Health care spending per capita is higher in the U.S. than in any other high-income country. Yet, people living in the U.S. don't live as long in comparison and are more likely to die of conditions that can be prevented or treated. To find ways to help address this disparity, we convened a forum in October 2024. Experts from government, academia, and industry identified changes...

The Department of Veterans Affairs and Department of Defense provide health care to over 18 million veterans and servicemembers. The two departments may share health care resources, like surgery services, through sharing agreements, which help improve access to health care and lower costs. There were 185 such agreements as of April 2025 in areas like mental health and orthopedics. However, we found that the departments...

Building commercial ships in U.S. shipyards supports the maritime industry, which plays a vital role in national security. However, U.S. commercial shipbuilding has been in decline for decades. The Maritime Administration has four financial assistance programs to help change that. It's not clear if these programs are meeting the needs of the industry or national security. The agency hasn't established measurable goals, such as the...

The Department of Defense expects to spend billions of dollars over the next 5 years to launch hundreds of satellites into space. Private companies conduct these launches at federal launch sites, called ranges. Companies also use the ranges to launch commercial satellites. As government and commercial launches have increased, so too has the strain on range infrastructure. DOD can bill companies for their use of...

Improper payments are payments that shouldn't have been made, were made in the wrong amount, or lacked sufficient supporting documentation. This Q&A looks at the improper payment estimate for Medicaid managed care. About three-quarters of Medicaid beneficiaries are in managed care, under which states pay private health plans a set fee per person to cover care. Recently, Medicaid managed care's improper payment estimate has been...