or service produced by a Chinese-owned company, unless 
such equipment, good, or service is otherwise unavailable. 
OPERATIONS, PREPAREDNESS, AND EMERGENCY 
RESPONSE 
For carrying out titles III, XII, and subtitles A and 
B of title XXVIII of the PHS Act, operations and emer-
gency response activities related to countering potential 
chemical, biological, radiological, and nuclear threats and 
other public health emergencies, $244,606,000: Provided, 
That of the amounts made available under this heading, 
$5,000,000 shall remain available through September 30, 
2028, to support emergency operations: Provided further, 
That of the amounts made available under this heading, 
$10,000,000 shall remain available until September 30, 
2027, for advanced research and development, manufac-
turing, production, procurement, distribution, and the ac-
quisition, construction, alteration, or renovation of non- 
federally owned facilities for the production and purchase 
of medical countermeasures, which may include the devel-
opment, translation, and demonstration at scale of innova-
tions in manufacturing platform. 
OFFICE OF THE SECRETARY 
GENERAL DEPARTMENTAL MANAGEMENT 
For necessary expenses, not otherwise provided, for 
general departmental management, including hire of six 
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passenger motor vehicles, and for carrying out titles III, 
XVII, XXI, and section 229 of the PHS Act, the United 
States-Mexico Border Health Commission Act, research 
studies under section 1110 of the Social Security Act, and 
for protection services for the Secretary, $333,169,000, 
together with $58,028,000 from the amounts available 
under section 241 of the PHS Act to carry out national 
health or human services research and evaluation activi-
ties: Provided, That of this amount, $20,000,000 shall be 
for minority AIDS prevention and treatment activities: 
Provided further, That of the funds made available under 
this heading, $40,000,000 shall be for making competitive 
grants which exclusively implement education in sexual 
risk avoidance (defined as voluntarily refraining from non- 
marital sexual activity): Provided further, That funding for 
such competitive grants for sexual risk avoidance shall use 
medically accurate information referenced to peer-re-
viewed publications by educational, scientific, govern-
mental, or health organizations; implement an evidence- 
based approach integrating research findings with prac-
tical implementation that aligns with the needs and de-
sired outcomes for the intended audience; and teach the 
benefits associated with self-regulation, success sequenc-
ing for poverty prevention, healthy relationships, goal set-
ting, and resisting sexual coercion, dating violence, and 
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other youth risk behaviors such as underage drinking or 
illicit drug use without normalizing teen sexual activity: 
Provided further, That no more than 10 percent of the 
funding for such competitive grants for sexual risk avoid-
ance shall be available for technical assistance and admin-
istrative costs of such programs: Provided further, That 
funds provided in this Act for embryo adoption activities 
may be used to provide to individuals adopting embryos, 
through grants and other mechanisms, medical and ad-
ministrative services deemed necessary for such adoptions: 
Provided further, That such services shall be provided con-
sistent with 42 CFR 59.5(a)(4): Provided further, That 
of the funds made available under this heading, 
$5,000,000 shall be for carrying out prize competitions 
sponsored by the Office of the Secretary to accelerate in-
novation in the prevention, diagnosis, and treatment of 
kidney diseases (as authorized by section 24 of the Steven-
son-Wydler Technology Innovation Act of 1980 (15 U.S.C. 
3719)). 
In addition, for expenses necessary to carry out title 
II of the PHS Act to support, except as otherwise pro-
vided, activities related to safeguarding classified national 
security information and providing intelligence and na-
tional security support across the Department and to 
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counter cybersecurity threats to civilian populations, 
$108,983,000. 
In addition, for expenses necessary to prevent, pre-
pare for, or respond to an influenza pandemic, 
$7,009,000. 
In 
addition 
to 
amounts 
otherwise 
available, 
$100,000,000, to remain available until expended, for car-
rying out activities to Make America Healthy Again 
(MAHA). 
MEDICARE HEARINGS AND APPEALS 
For expenses necessary for Medicare hearings and 
appeals in the Office of the Secretary, $180,000,000 shall 
remain available until September 30, 2027, to be trans-
ferred in appropriate part from the Federal Hospital In-
surance Trust Fund and the Federal Supplementary Med-
ical Insurance Trust Fund. 
OFFICE OF THE NATIONAL COORDINATOR FOR HEALTH 
INFORMATION TECHNOLOGY 
For expenses necessary for the Office of the National 
Coordinator for Health Information Technology, including 
grants, contracts, and cooperative agreements for the de-
velopment and advancement of interoperable health infor-
mation technology, $59,238,000 shall be from amounts 
made available under section 241 of the PHS Act. 
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OFFICE OF INSPECTOR GENERAL 
For expenses necessary for the Office of Inspector 
General, including the hire of passenger motor vehicles for 
investigations, in carrying out the provisions of the Inspec-
tor General Act of 1978, $87,000,000: Provided, That of 
such amount, necessary sums shall be available for inves-
tigating non-payment of child support cases for which non- 
payment is a Federal offense under 18 U.S.C. 228: Pro-
vided further, That of the amount appropriated under this 
heading, necessary sums shall be available for carrying out 
activities authorized under section 3022 of the PHS Act 
(42 U.S.C. 300jj–52). 
OFFICE FOR CIVIL RIGHTS 
For expenses necessary for the Office for Civil 
Rights, $39,798,000. 
RETIREMENT PAY AND MEDICAL BENEFITS FOR 
COMMISSIONED OFFICERS 
For retirement pay and medical benefits of Public 
Health Service Commissioned Officers as authorized by 
law, for payments under the Retired Serviceman’s Family 
Protection Plan and Survivor Benefit Plan, and for med-
ical care of dependents and retired personnel under the 
Dependents’ Medical Care Act, such amounts as may be 
required during the current fiscal year. 
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100 
GENERAL PROVISIONS 
SEC. 201. Funds appropriated in this title shall be 
available for not to exceed $50,000 for official reception 
and representation expenses when specifically approved by 
the Secretary. 
SEC. 202. None of the funds appropriated in this title 
shall be used to pay the salary of an individual, through 
a grant or other extramural mechanism, at a rate in excess 
of Executive Level II: Provided, That none of the funds 
appropriated in this title shall be used to prevent the NIH 
from paying up to 100 percent of the salary of an indi-
vidual at this rate. 
SEC. 203. None of the funds appropriated in this or 
any other Act may be expended pursuant to section 241 
of the PHS Act, except for funds specifically provided for 
in this Act, or for other taps and assessments made by 
any office located in HHS, prior to the preparation and 
submission of a report by the Secretary to the Committees 
on Appropriations of the House of Representatives and the 
Senate detailing the planned uses of such funds. 
SEC. 204. Notwithstanding section 241(a) of the 
PHS Act, such portion as the Secretary shall determine, 
but not more than 2.5 percent, of any amounts appro-
priated for programs authorized under such Act shall be 
made available for the evaluation (directly, or by grants 
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101 
or contracts) and the implementation and effectiveness of 
programs funded in this title. 
(TRANSFER OF FUNDS) 
SEC. 205. Not to exceed 1 percent of any discre-
tionary funds (pursuant to the Balanced Budget and 
Emergency Deficit Control Act of 1985) which are appro-
priated for the current fiscal year for HHS in this Act 
may be transferred between appropriations, but no such 
appropriation shall be increased by more than 3 percent 
by any such transfer: Provided, That the transfer author-
ity granted by this section shall not be used to create any 
new program or to fund any project or activity for which 
no funds are provided in this Act: Provided further, That 
the Committees on Appropriations of the House of Rep-
resentatives and the Senate are notified at least 15 days 
in advance of any transfer. 
SEC. 206. In lieu of the timeframe specified in section 
338E(c)(2) of the PHS Act, terminations described in 
such section may occur up to 60 days after the effective 
date of a contract awarded in fiscal year 2026 under sec-
tion 338B of such Act, or at any time if the individual 
who has been awarded such contract has not received 
funds due under the contract. 
SEC. 207. None of the funds appropriated in this Act 
may be made available to any entity under title X of the 
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102 
PHS Act unless the applicant for the award certifies to 
the Secretary that it encourages family participation in 
the decision of minors to seek family planning services and 
that it provides counseling to minors on how to resist at-
tempts to coerce minors into engaging in sexual activities. 
SEC. 208. Notwithstanding any other provision of 
law, no provider of services under title X of the PHS Act 
shall be exempt from any State law requiring notification 
or the reporting of child abuse, child molestation, sexual 
abuse, rape, or incest. 
SEC. 209. None of the funds appropriated by this Act 
(including funds appropriated to any trust fund) may be 
used to carry out the Medicare Advantage program if the 
Secretary denies participation in such program to an oth-
erwise eligible entity (including a Provider Sponsored Or-
ganization) because the entity informs the Secretary that 
it will not provide, pay for, provide coverage of, or provide 
referrals for abortions: Provided, That the Secretary shall 
make appropriate prospective adjustments to the capita-
tion payment to such an entity (based on an actuarially 
sound estimate of the expected costs of providing the serv-
ice to such entity’s enrollees): Provided further, That noth-
ing in this section shall be construed to change the Medi-
care program’s coverage for such services and a Medicare 
Advantage organization described in this section shall be 
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103 
responsible for informing enrollees where to obtain infor-
mation about all Medicare covered services. 
SEC. 210. None of the funds made available in this 
title may be used, in whole or in part, to advocate or pro-
mote gun control. 
SEC. 211. The Secretary shall make available through 
assignment not more than 60 employees of the Public 
Health Service to assist in child survival activities and to 
work in AIDS programs through and with funds provided 
by the Agency for International Development, the United 
Nations International Children’s Emergency Fund or the 
World Health Organization. 
SEC. 212. In order for HHS to carry out inter-
national health activities, including HIV/AIDS and other 
infectious disease, chronic and environmental disease, and 
other health activities abroad during fiscal year 2026: 
(1) The Secretary may exercise authority equiv-
alent to that available to the Secretary of State in 
section 2(c) of the State Department Basic Authori-
ties Act of 1956. The Secretary shall consult with 
the Secretary of State and relevant Chief of Mission 
to ensure that the authority provided in this section 
is exercised in a manner consistent with section 207 
of the Foreign Service Act of 1980 and other appli-
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104 
cable statutes administered by the Department of 
State. 
(2) The Secretary is authorized to provide such 
funds by advance or reimbursement to the Secretary 
of State as may be necessary to pay the costs of ac-
quisition, lease, alteration, renovation, and manage-
ment of facilities outside of the United States for 
the use of HHS. The Department of State shall co-
operate fully with the Secretary to ensure that HHS 
has secure, safe, functional facilities that comply 
with applicable regulation governing location, set-
back, and other facilities requirements and serve the 
purposes established by this Act. The Secretary is 
authorized, in consultation with the Secretary of 
State, through grant or cooperative agreement, to 
make available to public or nonprofit private institu-
tions or agencies in participating foreign countries, 
funds to acquire, lease, alter, or renovate facilities in 
those countries as necessary to conduct programs of 
assistance for international health activities, includ-
ing activities relating to HIV/AIDS and other infec-
tious diseases, chronic and environmental diseases, 
and other health activities abroad. 
(3) The Secretary is authorized to provide to 
personnel appointed or assigned by the Secretary to 
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105 
serve abroad, allowances and benefits similar to 
those provided under chapter 9 of title I of the For-
eign Service Act of 1980, and 22 U.S.C. 4081 
through 4086 and subject to such regulations pre-
scribed by the Secretary. The Secretary is further 
authorized to provide locality-based comparability 
payments (stated as a percentage) up to the amount 
of the locality-based comparability payment (stated 
as a percentage) that would be payable to such per-
sonnel under section 5304 of title 5, United States 
Code if such personnel’s official duty station were in 
the District of Columbia. Leaves of absence for per-
sonnel under this subsection shall be on the same 
basis as that provided under subchapter I of chapter 
63 of title 5, United States Code, or section 903 of 
the Foreign Service Act of 1980, to individuals serv-
ing in the Foreign Service. 
(TRANSFER OF FUNDS) 
SEC. 213. The Director of the NIH, jointly with the 
Director of the Office of AIDS Research, may transfer up 
to 3 percent among institutes and centers from the total 
amounts identified by these two Directors as funding for 
research pertaining to the human immunodeficiency virus: 
Provided, That the Committees on Appropriations of the 
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106 
House of Representatives and the Senate are notified at 
least 15 days in advance of any transfer. 
(TRANSFER OF FUNDS) 
SEC. 214. Of the amounts made available in this Act 
for NIH, the amount for research related to the human 
immunodeficiency virus, as jointly determined by the Di-
rector of NIH and the Director of the Office of AIDS Re-
search, shall be made available to the ‘‘Office of AIDS 
Research’’ account. The Director of the Office of AIDS 
Research shall transfer from such account amounts nec-
essary to carry out section 2353(d)(3) of the PHS Act. 
SEC. 215. (a) AUTHORITY.—Notwithstanding any 
other provision of law, the Director of NIH (‘‘Director’’) 
may use funds authorized under section 402(b)(12) of the 
PHS Act to enter into transactions (other than contracts, 
cooperative agreements, or grants) to carry out research 
identified pursuant to or research and activities described 
in such section 402(b)(12). 
(b) PEER REVIEW.—In entering into transactions 
under subsection (a), the Director may utilize such peer 
review procedures (including consultation with appropriate 
scientific experts) as the Director determines to be appro-
priate to obtain assessments of scientific and technical 
merit. Such procedures shall apply to such transactions 
in lieu of the peer review and advisory council review pro-
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107 
cedures that would otherwise be required under sections 
301(a)(3), 405(b)(1)(B), 405(b)(2), 406(a)(3)(A), 492, 
and 494 of the PHS Act. 
SEC. 216. Not to exceed $100,000,000 of funds ap-
propriated by this Act to the institutes and centers of the 
National Institutes of Health may be used for alteration, 
repair, or improvement of facilities, as necessary for the 
proper and efficient conduct of the activities authorized 
herein, at not to exceed $5,000,000 per project. 
(TRANSFER OF FUNDS) 
SEC. 217. Of the amounts made available for NIH, 
1 percent of the amount made available for National Re-
search Service Awards (‘‘NRSA’’) shall be made available 
to the Administrator of the Health Resources and Services 
Administration to make NRSA awards for research in pri-
mary medical care to individuals affiliated with entities 
who have received grants or contracts under sections 736, 
739, or 747 of the PHS Act, and 1 percent of the amount 
made available for NRSA shall be made available to the 
Director of the Agency for Healthcare Research and Qual-
ity to make NRSA awards for health service research. 
SEC. 218. (a) The Biomedical Advanced Research 
and Development Authority (‘‘BARDA’’) may enter into 
a contract, for more than one but no more than 10 pro-
gram years, for purchase of research services or of security 
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108 
countermeasures, as that term is defined in section 319F– 
2(c)(1)(B) of the PHS Act (42 U.S.C. 247d–6b(c)(1)(B)), 
if— 
(1) funds are available and obligated— 
(A) for the full period of the contract or 
for the first fiscal year in which the contract is 
in effect; and 
(B) for the estimated costs associated with 
a necessary termination of the contract; and 
(2) the Secretary determines that a multi-year 
contract will serve the best interests of the Federal 
Government by encouraging full and open competi-
tion or promoting economy in administration, per-
formance, and operation of BARDA’s programs. 
(b) A contract entered into under this section— 
(1) shall include a termination clause as de-
scribed by subsection (c) of section 3903 of title 41, 
United States Code; and 
(2) shall be subject to the congressional notice 
requirement stated in subsection (d) of such section. 
SEC. 219. (a) The Secretary shall publish in the fiscal 
year 2027 budget justification and on Departmental Web 
sites information concerning the employment of full-time 
equivalent Federal employees or contractors for the pur-
poses of implementing, administering, enforcing, or other-
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109 
wise carrying out the provisions of the ACA, and the 
amendments made by that Act, in the proposed fiscal year 
and each fiscal year since the enactment of the ACA. 
(b) With respect to employees or contractors sup-
ported by all funds appropriated for purposes of carrying 
out the ACA (and the amendments made by that Act), 
the Secretary shall include, at a minimum, the following 
information: 
(1) For each such fiscal year, the section of 
such Act under which such funds were appropriated, 
a statement indicating the program, project, or ac-
tivity receiving such funds, the Federal operating di-
vision or office that administers such program, and 
the amount of funding received in discretionary or 
mandatory appropriations. 
(2) For each such fiscal year, the number of 
full-time equivalent employees or contracted employ-
ees assigned to each authorized and funded provision 
detailed in accordance with paragraph (1). 
(c) In carrying out this section, the Secretary may 
exclude from the report employees or contractors who— 
(1) are supported through appropriations en-
acted in laws other than the ACA and work on pro-
grams that existed prior to the passage of the ACA; 
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