Medicare a primary driver of growth in spending authority, appropriations  

Entitlement programs like Medicare are the main reason spending authority and permanent appropriations have grown 88 percent from 1994 to 2015 across all government agencies, according to a report from the Government Accountability Office. 

The increased spending authority and appropriations means agencies like HHS have more budget authority without waiting for congressional approval. The GAO found entitlement programs like Social Security and Medicare were a significant part of budget authority in 2015. HHS accounted for 30 percent of total spending authority and permanent appropriations, or $979 billion, the most of any agency. 

HHS surpassed the Social Security Administration in highest dollar amounts for appropriations for the first time in 2006. The GAO credits this increase to rising healthcare costs. 

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