What GAO Found The Federal Aviation Administration (FAA) Reauthorization Act of 2024 (the Act) communicates congressional direction for how FAA should carry out aspects of its mission and helps ensure the safety and efficiency of the U.S. airspace system. The Act is broad and contains provisions on areas including FAA's organizational structure, controller staffing and aviation workforce, modernizing the national airspace system (NAS), and supporting safety and efficiency for both conventional users and new entrants such as drones. The Act contains 36 provisions for GAO to study various issues related to FAA and the NAS. In addition, the Act requires FAA to implement various GAO recommendations. GAO has 50 open recommendations to FAA that address, for example: Air traffic control modernization delays and challenges and urgent actions needed to address aging legacy IT systems. Certifying small aircraft and aviation products, better preventing and detecting fraud and abuse in aircraft registration, and sharing information with law enforcement on persons who intentionally point lasers at aircraft. Challenges related to skill gaps and assessing training in critical competencies to ensure FAA's aviation workforce can help it prepare for changes in technology. Integrating new operations—such as drones and commercial space vehicles—into the NAS, while ensuring safety and efficiency. GAO maintains that implementing these recommendations will better position FAA to address the widespread challenges it faces in modernizing the NAS and fulfilling its commitment to ensuring that the U.S. has the safest, most efficient airspace system in the world. Why GAO Did This Study With over 45,000 flights daily, the U.S. national airspace system is the busiest and most complex in the world. FAA is responsible for regulating and overseeing civil aviation within the U.S. Its primary mission is to ensure the safety and efficiency of air transportation, including air traffic control, aircraft certification, and certain airport operations. The FAA Reauthorization Act of 2024 was signed into law on May 16, 2024, and authorizes FAA activities through fiscal year 2028. Congress directed FAA to take various actions to maintain and improve the safety and efficiency of air transportation while accommodating new entrants such as drones and commercial space vehicles. This testimony provides an overview of key areas of the Act, GAO's open recommendations to FAA in these areas, and the work GAO is doing in response to several provisions in the Act. This statement draws from several GAO reports completed since fiscal year 2020.

What GAO Found Since 2022, the President, with special authority from Congress, has greatly expanded the use of Presidential Drawdown authority (PDA). This authority is used to provide defense items from Department of Defense (DOD) inventories, such as ammunition and missiles, and services to foreign partners—especially Ukraine. From fiscal year 2022 to 2024, Congress used its authority to add billions of dollars to the $100 million yearly ceiling for PDA. From October 2021 through January 2025, the President authorized the drawdown of $31.7 billion of defense articles and services to Ukraine, and also used PDA to authorize more than a billion dollars in assistance to Taiwan and Haiti. In doing so, DOD and State have generally followed Defense Security Cooperation Agency (DSCA) steps for developing these PDA packages for Ukraine, Taiwan, and Haiti; however, GAO identified some gaps in guidance. Specifically, GAO found that DOD has not conducted Operations and Maintenance (O&M) budget impact assessments for the 21 packages GAO reviewed. These assessments have previously identified the adverse impact of diverting funds from other activities to support PDA packages. DOD guidance did not identify the purpose or specific elements of these assessments. In a 2016 report, GAO made a recommendation directing the Secretaries of the military departments to develop guidance that assigns responsibility for the preparation of O&M budget impact assessments and includes direction on how such assessments should be conducted as part of drawdown planning. However, the military services have not yet implemented this recommendation. Absence of this guidance may prevent DOD officials from making fully informed decisions, potentially depriving decision-makers of information about impacts of PDA packages on the services’ O&M budgets. While replacement funding is not traditionally provided to replace defense articles and services provided to partners through PDA, Congress occasionally appropriates funding for this purpose. DOD officials said they consider replacement needs when choosing equipment to provide to Ukraine. Since the start of Russia’s invasion into Ukraine, DOD has received $45.8 billion to replace equipment provided to Ukraine using PDA. Status of Obligations of Funds by Year of Supplemental Appropriation for Replacement of Defense Articles Sent to Ukraine as of November 2024 (dollars in billions) According to DOD officials, as of February 2025, DOD had planned to obligate all the remaining $45.8 billion of replacement funding and would require an additional appropriation to replace some defense articles and services previously included in drawdown packages for Ukraine. The replacement funding was a part of the five Ukraine supplemental appropriation acts, which provided $174.2 billion to help combat Russian aggression and to preserve Ukraine’s territorial integrity. DOD has not developed guidance that accounts for the potential that the services will need to replace defense articles provided through PDA, but DOD officials told us a draft instruction may do so. Adjusting or developing new guidance on using funds available to replace DOD equipment provided to partners through PDA would help ensure U.S. military services do not face greater than anticipated readiness impact. Why GAO Did This Study While presidents have used PDA numerous times since 1961, the way PDA has been used for Ukraine since Russia’s invasion in 2022 is unprecedented. This report is one of several engagements we initiated in response to a provision included in the Consolidated Appropriations Act for Fiscal Year 2023, which provided resources for us to exercise oversight of the funding provided in the Ukraine supplemental appropriations acts. Further, a House Report accompanying the Department of Defense Appropriations Bill, 2024, included a provision asking GAO to review DOD’s execution of PDA and related funding and notifications since February 24, 2022.

Standards for Internal Control in the Federal Government (commonly known as the “Green Book”), sets the standards for an effective internal control system for federal agencies and provides the overall framework for designing, implementing, and operating an effective internal control system. An entity uses the Green Book to help achieve its objectives related to operations, reporting, and compliance. GAO updated the Green Book in 2025 to provide requirements, guidance, and resources to help managers better address risk areas related to fraud; improper payments; information security; and the implementation of new or substantially changed programs, including emergency assistance programs The 2025 revision of Standards for Internal Control in the Federal Government contains changes from, and supersedes, Standards for Internal Control in the Federal Government (GAO-14-704G) issued in September 2014. Key changes in this 2025 revision include the following: The need to consider risks related to improper payments and information security when identifying, analyzing, and responding to risks. Documentation of the results of risk assessments, including the identification, analysis, and response to risks. Documentation of a change assessment process for identifying, analyzing, and responding to risk related to significant changes so that the internal control system can be quickly adapted as needed to respond to changes once they occur. Two new appendixes that provide additional information related to control activities, examples of sources of data, and references to additional resources that management may leverage in designing, implementing, and operating effective internal control systems to address risks, including areas related to fraud, improper payments, and information security. Updates include an emphasis on prioritizing preventive control activities and highlighting management’s responsibility for internal control at all levels within the entity’s organizational structure, such as program and financial managers. Other updates were made to clarify the intent of the standards and to continue harmonization with the Committee of Sponsoring Organizations of the Treadway Commission’s (COSO) Internal Control – Integrated Framework. The 2025 revision of Standards for Internal Control in the Federal Government is also available in a digital format. Effective Date The 2025 revision of Standards for Internal Control in the Federal Government revision is effective beginning with fiscal year 2026 and the Federal Managers’ Financial Integrity Act of 1982 reports covering that year. Early implementation is permitted. Revision Process Revisions of Standards for Internal Control in the Federal Government undergo an extensive, deliberative process, including public comments and input from the Comptroller General's Advisory Council on Standards for Internal Control in the Federal Government. GAO considered all comments and input in finalizing revisions to the standards. Why GAO Revised the Green Book Section 3512 (c) and (d) of Title 31 of the United States Code, commonly known as the Federal Managers’ Financial Integrity Act of 1982, requires the Comptroller General to issue standards for internal control in the federal government. This update is intended to help managers design and strengthen their entities’ internal control systems to address risks, including risks related to fraud, improper payments, and information security, and the implementation of new or substantially changed programs, including emergency assistance programs. For more information or for technical assistance regarding the Green Book, please e-mail greenbook@gao.gov. Visit GAO’s Green Book website for more information on applicable updates and alerts.

What GAO Found The Senate, in its capacity to give advice and consent to the President on appointing officers of the United States, must vote to confirm all nominations for senior military leaders, known as general and flag officers (GFO), that the President has approved. During the confirmation process, a Senator can object to approving nominations through Senate procedures, thereby placing a “hold” on them. When a Senator objects to a category of nominations, such as all GFOs, this is known as a “blanket hold.” Since 2014, GAO identified two occasions—in 2020 and 2023—where GFO nominations were on a blanket hold from Senate confirmation. GAO found that for 14 days in July 2020, a Senator placed a blanket hold affecting 42 GFO nominees; and for 10 months in 2023, a Senator placed a blanket hold affecting 447 GFO nominees. Due to the relatively short duration of the 2020 hold, this report largely focuses on the 2023 hold. Number of Individual General and Flag Officer Nominees on Blanket Hold During February to December 2023 In response to the 2023 blanket hold on GFO nominations, various former and then-current senior leaders within the Department of Defense (DOD) issued statements mentioning risks to national security. For example, a group of former Secretaries of Defense who served in bipartisan administrations wrote that the hold sent the wrong message to adversaries. Further, senior DOD leaders expressed concerns about potential impacts to service members and their families as a result of the hold. GAO did not find challenges to unit-level readiness—that is, individual military units’ ability to meet missions—from the 2023 hold, based on analysis of key DOD reports and meeting with a DOD official involved in readiness oversight. Specifically, upon reviewing 2023 and 2024 readiness reports that DOD submitted to Congress, GAO did not find that DOD had identified the 2023 hold as a readiness challenge. GAO found that the 2023 hold disrupted the standard flow of leadership across the department, as well as the military promotion cycle and pay for some of the nominated officers. For example, the hold affected some of the officers’ ability to accrue time-in-grade requirements—specified amounts of time that GFOs must spend in a grade before they are eligible for promotion. The 2023 hold also affected some military families. According to DOD officials, some families were not able to move to planned duty stations, enroll children at their next schools on time, or start new spousal employment opportunities. In some instances, GFOs also sold their homes, lived in temporary housing, and paid for storage out of their own pocket. In contrast, some families experienced limited impact, such as National Guard GFO nominees who did not require moves to new duty stations. GAO found that DOD mitigated effects of the 2023 hold through proceeding with planned assignments for some officers, deferring retirements, and having senior civilian executives or other GFOs serve in acting capacities. Specifically, in some instances, incumbent heads of organizations were asked to remain in place until their successor had been confirmed. In other instances, individuals who were in the normal line of succession, such as deputies, stepped into the head role in an acting capacity. Why GAO Did This Study GFOs are the senior military leaders within DOD who plan and implement U.S. military operations across the domains of land, sea, air, space, and cyberspace. They also have high-level interagency, intergovernmental, and multinational responsibilities. According to the Secretary of Defense, prompt transitions of confirmed military leaders are necessary for the United States’ security. GAO was asked to review issues surrounding past Senate holds on GFO nominations. This report describes effects on military readiness, leadership continuity, nominated officers, and military families as a result of past Senate blanket holds on GFO nominations, and the steps DOD took to mitigate the effects of the holds. To conduct this work, GAO reviewed DOD guidance and related laws and regulations. GAO also reviewed congressional documents to identify the universe of blanket holds that occurred within the last 10 years and analyzed data on Congress.gov to identify and derive summary characteristics of the GFOs affected by holds. In addition, GAO reviewed or assessed relevant DOD reports, documents, and public statements of senior DOD leaders, and interviewed DOD officials. Further, GAO reached out to 12 senior DOD civilian and military leaders to offer them an opportunity to provide additional information. They declined or did not respond to GAO’s offer. For more information, contact Diana Maurer at maurerd@gao.gov.

What GAO Found For most of the last 20 years, regulations issued by federal agencies have been subject to some version of administrative pay-as-you-go (PAYGO) requirements. Agencies were required to propose potential offsets to certain estimated increases in direct spending (also called mandatory spending) resulting from regulatory actions. In January 2021, President Biden revoked these requirements. In June 2023, the Fiscal Responsibility Act of 2023 reinstated similar administrative PAYGO requirements. GAO found that four rules published during the time frame when no requirements were in place could have been subject to offset reporting requirements had they been in place at the time. Most rules estimated increased federal costs of less than $1 billion in the first 10 years and therefore would have been exempt. GAO's Analysis of Rules That Could Have Been Subject to 2023 Administrative Pay-As-You-Go Provisions GAO reviewed the 28 major rules published in the first 5 months following enactment of the Fiscal Responsibility Act of 2023. GAO found the range of federal costs agencies estimated to be $0 to $156 billion, with half of the 28 rules estimating no federal cost. According to Office of Management and Budget (OMB) staff, none of the 28 rules were ultimately subject to administrative PAYGO requirements because they did not increase direct spending above the law's thresholds or they received a waiver. OMB issued guidance and reviewed agency compliance with administrative PAYGO requirements through its established regulatory review process. OMB was responsible for assisting agencies in determining how the act applied to a rule, if a rule might be exempt or eligible for a waiver, and the required reporting. Why GAO Did This Study The Fiscal Responsibility Act of 2023, enacted on June 3, 2023, reinstated certain administrative PAYGO requirements, which then expired on December 31, 2024. January 2021 to June 2023 was the only period between 2005 and 2024 when administrative PAYGO requirements did not exist in any form. GAO was asked to review the effects of the administrative PAYGO provisions of the 2023 act. This report reviews (1) how many rules published between January 20, 2021, and June 3, 2023, could have been subject to the requirements of the act; (2) the estimated costs of the 28 major rules published in the first 5 months of the act; and (3) OMB's process for monitoring agencies' compliance with administrative PAYGO requirements under the act. For the first objective, GAO analyzed rules and related documentation to determine whether they would have been subject to the act. When additional information was needed, GAO contacted the relevant agency to request that information. For the second objective, GAO reviewed economic analyses and summarized the federal cost estimates for each of the 28 major rules. For the third objective, GAO reviewed relevant laws, executive orders, and OMB guidance. GAO also interviewed OMB staff about their process for ensuring compliance with administrative PAYGO requirements. For more information, contact Yvonne D. Jones at jonesy@gao.gov.

What GAO Found Pilots and flight attendants (crewmembers) who are lactating may work long shifts and, as a result, may need to express breast milk while on duty. In 2024, 10 percent of U.S. commercial pilots, and 79 percent of U.S. commercial flight attendants, were female. In accordance with Federal Aviation Administration (FAA) regulations, pilots at large U.S.-based airlines may be scheduled for flight time of up to 8 hours between rest periods, while flight attendants may be on duty for as long as 14 hours. Representatives of selected airlines identified the use of wearable, battery-operated breast pumps as one option available to lactating crewmembers while in flight. Other options available to lactating crewmembers include pumping in airport lactation facilities between flights and taking extended leave to delay the return to work after childbirth, according to the representatives. According to labor unions representing airline crewmembers, crewmembers may face several barriers to expressing breast milk upon returning to work. For example, crewmembers are only allowed to pump during noncritical phases of flight or between flights, neither of which may provide sufficient time to do so. Barriers to Expressing Breast Milk That Airline Crewmembers May Face FAA and selected airlines have leveraged existing processes to address safety implications of crewmembers' use of breast pumps on aircraft. In January 2025, FAA issued an informational document to airlines that identifies FAA regulations, procedures, and guidance applicable to crewmembers' onboard pumping, including how airlines can determine the safety of wearable breast pumps. This document advises airlines to consider and assess potential safety risks, such as effects on crewmembers' ability to carry out their safety duties, and whether pumps that use wireless technology could interfere with aircraft navigation and communications systems. GAO found that three of the eight largest airlines have used existing risk management processes to assess safety risks associated with crewmembers' use of breast pumps and establish policies to address identified risks. These airlines require, for example, that breast pumps be wearable and hands-free, and that crewmembers not use the pumps during certain flight times, such as takeoff and landing. Representatives of one airline told GAO they had used the FAA informational document to update their internal practices, while three other airlines told GAO they were planning to do so. The eighth airline did not allow crewmembers to express breast milk while on flight duty. Why GAO Did This Study Leading health organizations recommend that women breastfeed for at least 12 months. Yet many women find that returning to work can be a significant barrier to breastfeeding. Although U.S. workers generally have federal protections for breastfeeding in the workplace, the PUMP for Nursing Mothers Act expressly excludes airline crewmembers from its protections. Crewmembers are therefore largely dependent on the lactation accommodations, if any, their employer chooses to provide. The Senate report accompanying the fiscal year 2024 Transportation, Housing and Urban Development, and Related Agencies Appropriations Bill includes a provision for GAO to examine barriers to women in the airline industry, such as lactation accommodations for crewmembers. This report examines (1) options for crewmembers to express breast milk that airlines have identified, (2) barriers to expressing breast milk that labor unions representing airline crewmembers have identified, and (3) how FAA and selected airlines have addressed potential safety implications of airlines' lactation accommodations for crewmembers. GAO reviewed FAA documents, including requirements on airline safety management and guidance; interviewed FAA officials; and conducted semi-structured interviews with representatives of the eight largest U.S. commercial airlines, based on operating revenues and total employment, and seven labor union associations representing crewmembers of these airlines. For more information, contact Danielle Giese at GieseD@gao.gov.

This report was submitted to the Comptroller General in accordance with Section 5 of the Government Accountability Office (GAO) Act of 2008. The report summarizes the activities of GAO's Office of Inspector General (OIG) for the 6-month reporting period ending March 31, 2025. During this reporting period, the OIG issued one audit report, closed 13 GAO related investigations, opened 12 new GAO related investigations, and processed 58 substantive hotline complaints. The OIG also initiated two performance audits, continued work on another performance audit, and worked on developing a manual to conduct inspections and evaluations. In addition, in November 2024, Congress passed the GAO Inspector General Parity Act. This law provides greater budget independence, ensures prior congressional notification of changes in the Inspector General's employment status, improves our ability to recruit and retain staff, and codifies changes to align with other Inspectors General. For more information, contact the OIG at oig@gao.gov.

What GAO Found In May 2024, GAO identified 13 priority recommendations for the Department of Labor (DOL). Since then, DOL implemented five recommendations by (1) publishing a final rule to improve oversight of coal miner operator insurance under the Black Lung Benefits Program, addressing two recommendations, (2) collaborating with USDA's Food Safety and Inspection Service to improve the safety and health of meat and poultry workers and issuing new inspection guidance focused on multiple hazards, addressing two recommendations, and (3) using survey data to better approximate the veteran population protected under the Vietnam Era Veterans' Readjustment Assistance Act of 1974. In May 2025, GAO identified four additional priority recommendations for DOL, bringing the total number to 12. These priority recommendations involve the following areas: enhancing unemployment insurance, strengthening worker safety and health protections, and protecting sensitive information. DOL's attention to these issues could lead to significant improvements in government operations. Why GAO Did This Study Priority open recommendations are the GAO recommendations that warrant priority attention from heads of key departments or agencies because their implementation could save large amounts of money; improve congressional and/or executive branch decision-making on major issues; eliminate mismanagement, fraud, and abuse; or ensure that programs comply with laws and funds are legally spent, among other benefits. Since 2015 GAO has sent letters to selected agencies to highlight the importance of implementing such recommendations. For more information, contact Cindy Brown Barnes at brownbarnesc@gao.gov.

What GAO Found Coast Guard data shows that the service lost more enlisted service members than it recruited from fiscal years 2019 through 2023. For example, in fiscal year 2023, the Coast Guard lost more than 3,800 enlisted service members and recruited 3,126. This trend changed in fiscal year 2024, when the Coast Guard recruited over 1,000 more enlisted service members than it lost. However, even with this gain, it remained approximately 2,600 enlisted service members short of its enlisted workforce target. Coast Guard enlisted and officer service members identified retention issues that GAO grouped into four categories: (1) rotations and support services, (2) work environment and culture, (3) compensation and career advancement, and (4) incentives and benefits (see figure). These results were based on GAO discussions with service members and the Coast Guard's Career Intention Survey (2021-2023). Retention Issues Cited in GAO Discussion Groups with Coast Guard Service Members and Coast Guard Career Intention Survey Responses (2021-2023) The Coast Guard has taken steps to address retention challenges by offering monetary and nonmonetary incentives. As of 2022, it also began to require service members to complete its Career Intention Survey to help identify key issues affecting retention. However, despite this requirement, response rates remained consistently low—at 39 percent in 2023—and the Coast Guard has not taken steps to analyze and improve response rates. By implementing additional mechanisms to increase survey response rates and completing a nonresponse bias analysis, the Coast Guard could better assess retention issues and enhance its ability to develop relevant initiatives. In 2024, the Coast Guard established its Talent Management Transformation Program Integration Office to enable, accelerate, and track human capital initiatives, including those focused on retention. However, this office has not developed a clear plan that aligns initiatives with strategic objectives and includes time frames and key milestones. With a clear plan, the office can more effectively support its initiatives and gauge program performance, which can help improve retention and enhance the Coast Guard's ability to carry out its missions. Why GAO Did This Study The Coast Guard is a multi-mission maritime military service within the Department of Homeland Security. In fiscal year 2024, it employed about 55,500 personnel across the service, about 30,600 of which were active duty enlisted service members. However, in recent years, the Coast Guard has reported operating below the workforce level it deems necessary to meet operational demands. GAO was asked to review how the Coast Guard addresses service member retention issues. This report examines (1) trends in retention data for enlisted service members, (2) issues that may influence service member retention, and (3) how the Coast Guard addresses retention challenges. GAO analyzed Coast Guard data on enlisted service member losses and reviewed documentation of Coast Guard efforts to address retention issues. This included its survey analyses, strategic plans, and implementation guidance on retention incentives and related initiatives. GAO also conducted discussion groups with service members in three Coast Guard districts about retention.

What GAO Found In May 2024, GAO identified 35 priority recommendations for the Department of Health and Human Services (HHS). Since then, HHS has implemented four of those recommendations, including sharing data that helps ensure the reproducibility of Centers for Disease Control and Prevention (CDC) research, and increasing agencies' awareness of limitations related to cybersecurity. In May 2025, GAO identified four additional priority recommendations for HHS, bringing the total number of open priority recommendations to 35. These 35 recommendations involve the following seven areas: Leadership of public health emergency preparedness and response;  Food and Drug Administration oversight; Prevention and reduction of improper payments in Medicaid and Medicare; Public health and human services program oversight; Medicaid program oversight; Medicare payment accuracy and appropriateness; and Health care infrastructure, information technology, and cybersecurity improvements. Implementing these priority recommendations could help improve the efficiency and effectiveness of key federal health care programs and funding. Why GAO Did This Study Priority recommendations are the GAO recommendations that have not been implemented and warrant attention from heads of key departments or agencies because their implementation could save large amounts of money; improve congressional or executive branch decision-making on major issues; eliminate mismanagement, fraud, and abuse; or ensure that programs comply with laws and funds are legally spent, among other benefits. Since 2015, GAO has sent letters to selected agencies to highlight the importance of implementing such recommendations. For more information, contact Jessica Farb at farbj@gao.gov.

What GAO Found The Department of Homeland Security's Federal Emergency Management Agency (FEMA) revised its Individual Assistance (IA) declaration factors in 2019, which included incorporating a factor on state fiscal capacity. In fiscal years 2015 through 2023, the percentage of IA requests that were approved by the President increased. Specifically, 55 percent of requests (56 of 102) for IA were approved in fiscal years 2015 through 2018. This increased to 62 percent of requests (78 of 126) approved for IA in fiscal years 2020 through 2023. FEMA provides training and other resources to help states understand the IA declaration process but uses outdated information to convey the likelihood of approval. When evaluating an IA declaration request, FEMA considers a state's cost-to-capacity ratio, which measures the estimated cost of assistance relative to the state's capacity to respond to a disaster. The higher the ratio, the more likely FEMA will approve an IA request. FEMA's IA guidance discusses how this ratio helps states understand the likelihood of IA approval and includes a table with historical approval rates of IA declarations for each range of ratios. However, the approval rates are based on data from 2008 through 2016. GAO found that using data from 2020 through 2023 would increase the IA approval rates across all ratio ranges. By updating this table regularly, FEMA could communicate a more accurate likelihood of approval to states. This could better inform states' decisions on whether to request IA and help communities receive needed assistance after a disaster. Percentages of Individual Assistance Approved by Cost-to-Capacity Ratios and Time Periods FEMA uses information on vulnerable populations, such as poverty rates, in its declaration process and is taking steps to better support small states and rural areas. For example, this information is used in developing Preliminary Damage Assessments that help determine whether federal assistance is needed. Since being appointed in 2023, FEMA's Small State and Rural Advocate has conducted listening sessions with stakeholders in small states and rural communities to understand their needs for the declaration process. Why GAO Did This Study FEMA's IA program provides help to individuals to meet their immediate needs after a disaster, such as shelter. When a state, territorial, or tribal government requests IA through a major disaster declaration, FEMA evaluates the request against IA declaration factors such as uninsured home losses and makes a recommendation to the President. The President declares the disaster or denies the request. The James M. Inhofe National Defense Authorization Act for Fiscal Year 2023 includes a provision for GAO to review the IA declaration factors. This report addresses (1) trends in IA disaster declarations; (2) the resources FEMA uses to help states understand the IA declaration process and the extent to which this information is updated; and (3) the extent to which FEMA uses information on vulnerable populations when making recommendations for IA declarations. GAO analyzed data from FEMA's disaster declaration system from fiscal years 2015 through 2018 and fiscal years 2020 through 2023—the time periods before and after 2019 when FEMA revised its IA declaration factors. GAO also reviewed agency documentation, and interviewed officials from FEMA and a non-generalizable selection of 11 states.

What GAO Found National data on individuals who care for family members can provide insights into the population of caregivers, but the surveys GAO identified do not allow for accurate estimates of minors who provide informal, often unpaid care to family members (caregiving youth). However, three state-level surveys GAO identified that collected data on caregiving youth showed that middle school students and racial and ethnic minorities played a larger role providing care for a family member compared to other students. According to selected studies, a GAO survey of 43 former caregiving youth and interviews with five of those youth, caregiving youth experience some positive effects from caregiving, but also face several challenges. For example, some respondents to a GAO survey reported experiencing stress and anxiety because of concerns about their family member's health condition. Examples of Effects Youth Experience While Caring for Family Members Key federal programs that support family caregivers focus on adults and not on caregiving youth. Under the three federal caregiver support programs administered by the Departments of Health and Human Services (HHS) and Veterans Affairs (VA), officials told GAO that family caregivers must be adults to receive supports such as counseling, referrals, and respite care. However, according to a 2024 federal register notice issued by HHS, states and service providers may determine when family caregivers younger than age 18 could be eligible to receive supports under at least one federal caregiver support program. States and service providers may be unaware of any flexibilities because the HHS website does not include this information. One of HHS's objectives in its 2022–2026 Strategic Plan is to support high-quality services for older adults and people with disabilities, and their caregivers. The plan states that to achieve this objective, HHS leverages resources to better address the needs of all caregivers across the age spectrum. Without complete information from HHS on eligible caregivers, states and service providers may not be aware that they have flexibility to provide services to certain family caregivers under 18. England established a national policy in 2014 that calls for local governments to take reasonable steps to identify and assess the needs of caregiving youth in their area, according to stakeholders GAO interviewed. Local governments implement this policy by coordinating with municipal agencies, charities, and schools. Some English schools, for example, provide lunchtime groups for caregiving youth and use school bulletins to raise awareness about the population. Why GAO Did This Study Family caregivers provide informal, often unpaid, care to family members in their homes and communities. Research estimates that 3 to 5 million minors may be caregivers. Yet little is known about these children, referred to as caregiving youth, who care for family members with functional limitations, a health condition, or a disability. GAO was asked to examine issues related to caregiving youth. This report addresses (1) information on caregiving youth in the U.S.; (2) how federal caregiver support programs address caregiving youth needs; and (3) how England, a recognized leader in supporting caregiving youth, supports those youth through policy and programs. GAO reviewed relevant federal laws, federal regulations, and documents. GAO surveyed a non-generalizable sample of former caregiving youth ages 18 to 25 and obtained useable responses from 43 respondents. GAO analyzed or reviewed the results of school-based surveys of caregiving youth in three states where data were collected—Rhode Island, Colorado, and Florida. GAO reviewed scholarly, peer-reviewed literature on caregiving youth. GAO interviewed officials from HHS, VA, and the Department of Education; stakeholders in England; and representatives from 16 organizations selected for their work on caregiving topics or certain health conditions.

What GAO Found The Department of Defense Education Activity (DODEA) educated more than 65,000 military-connected pre-K-12 students in 160 schools worldwide in school year 2023–24. GAO found that, like U.S. public school students, DODEA students have experienced increasing mental health concerns in recent years. Per GAO analysis, DODEA schools assessed one in 50 students for suicide risk in each of school years 2022–23 and 2023–24 in response to an identified mental health concern. In all 27 DODEA schools GAO visited worldwide, school leaders described more frequent and acute concerns (see figure). Student Mental Health Concerns Shared by Leaders in Select DOD Schools School psychologists and school counselors told GAO they rarely had time to work with students to prevent crises due to competing responsibilities and heavy administrative workloads, such as testing coordination duties. Such staff are key to successfully implementing DODEA's Multi-Tiered System of Supports (MTSS) framework—an evidence-based approach to help schools identify and proactively address student needs and build resilience. However, DODEA has not assessed its workforce capacity to implement MTSS with fidelity. Federal workforce planning principles include identifying and addressing human capital needs. Without a workforce plan, DODEA may be unaware of resource gaps that could hinder its success—particularly in light of DOD's recent directives to optimize its civilian workforce. DOD has not assured that the three mental health programs it operates in DODEA schools meet student needs. First, none of the programs have been evaluated, contrary to DOD policy. The largest—Military and Family Life Counseling (MFLC)—places nonclinical counselors in nearly every DODEA school. However, school leaders raised concerns about the program, including poor collaboration with school staff and high turnover among counselors. Second, DOD has not assured that these programs provide the right mix of services to meet student needs. School leaders, parents, and military treatment facility staff all told GAO that DODEA students need additional clinical mental health care. Two programs provide clinical services in some DODEA schools. However, these programs are small—embedding one clinician in DODEA schools for every four non-clinical MFLC counselors. Further, DOD has not facilitated collaboration among these programs to assure that they provide the right mix of services to meet DODEA student needs. GAO has reported that collaboration can help agency components address cross-cutting challenges—such as responding to student mental health needs. Collaboration could help DOD better assure that these programs provide the right mix of services to meet DODEA student needs, in line with leading practices and its own goals. Why GAO Did This Study DOD research has found that military families and children face severe barriers to accessing mental health care, harming family well-being and military readiness. Without proper treatment, children with mental health concerns are at risk of school failure, substance misuse, and suicide. Senate Report 118-58 includes a provision for GAO to examine mental health services in DODEA schools. This review examines (1) mental health concerns of DODEA students, (2) DODEA's capacity to implement its new MTSS framework, and (3) the extent to which DOD has assessed how well mental health programs in DODEA schools meet student needs and their collaboration in doing so. GAO analyzed suicide-related incident data collected by DODEA for school years 2022–23 and 2023–24, the most recent data available. GAO also conducted site visits to 27 schools and eight military treatment facilities on 11 military installations across DODEA's three regions. GAO interviewed DOD and DODEA officials, reviewed relevant federal laws, policies, and procedures, and assessed DOD actions against policy and relevant federal standards.

What GAO Found In 2024, the Coast Guard took additional actions to reach potential recruits by expanding the number of recruiting office locations, initiating new outreach efforts, offering bonuses to eligible recruits, and increasing marketing efforts. In recent years, it also revised enlistment eligibility standards and began to address challenges with the medical waiver review process, such as hiring additional medical staff to review waiver requests. Collectively, these efforts contributed to the Coast Guard exceeding its recruiting target of 4200 enlisted personnel by more than 200 in fiscal year 2024, but additional opportunities and challenges remain. For example, the Coast Guard has not fully assessed how its initiatives contribute to recruiting results. Additional data collection or analyses, such as determining the cost effectiveness of certain efforts, could help the Coast Guard make evidence-based decisions regarding any further changes needed. Example of Coast Guard Recruiting Outreach The Coast Guard also took steps in fiscal year 2024 to enhance recruiter effectiveness. This entailed initiating a recruiter incentive pay program, offering a new career track for recruiting specialists, and increasing recruiter support resources. However, recruiter training has been conducted virtually since the COVID-19 pandemic. Recruiters stated that the virtual format was not as effective as in-person training, especially for practicing key skills such as public speaking. Returning to an in-person or hybrid format would help recruiters model real-world interactions and would better align with other military services. In addition, recruiters stated that their offices faced a variety of IT challenges, including issues with computers, equipment, and system outages, but the Coast Guard does not have a mechanism to monitor or fully address them. Further, the recruiting website had persistent technical challenges, and the service does not routinely monitor the site to ensure it is properly functioning. As a primary access point for potential recruits, maintaining a fully operational website and addressing any technical issues in a timely manner is critical. By monitoring data on technology issues and downtime, the Coast Guard would be better positioned to identify and resolve IT-related challenges and help prevent extended service delays that may impact recruiter effectiveness. Why GAO Did This Study The Coast Guard is a multi-mission maritime military service within the Department of Homeland Security. In fiscal year 2024, it employed over 39,000 active-duty service members; about 30,600 were enlisted personnel. The service's ability to recruit qualified enlisted personnel is critical to maintaining its readiness and morale. However, the Coast Guard missed its military recruiting targets from fiscal years 2019 through 2023. GAO was asked to examine the Coast Guard's recruitment efforts. This report examines Coast Guard actions taken to (1) meet recruitment goals for enlisted personnel, and (2) enhance recruiter effectiveness. GAO identified Coast Guard recruiting office locations and reviewed recent outreach efforts and initiatives. GAO also reviewed recruitment-related documentation. This included policies and guidance on enlistment eligibility, medical standards, and eligibility waivers. In addition, GAO interviewed officials at headquarters and at five selected recruiting offices about recruitment processes and challenges.

What GAO Found In May 2024, GAO identified five priority recommendations for the Department of Education. Since then, Education implemented one recommendation by taking steps to provide more accurate information on the frequency and prevalence of restraint (restricting a student's movement) and seclusion (confining a student to a space alone) incidents in schools. In May 2025, GAO identified four additional priority recommendations for Education, bringing the total number to eight. These priority recommendations involve the following areas: improving the federal student aid system, managing financial risks associated with charter school management organizations, and protecting sensitive information. Education's attention to these issues could lead to significant improvements in government operations. Why GAO Did This Study Priority open recommendations are the GAO recommendations that warrant priority attention from heads of key departments or agencies because their implementation could save large amounts of money; improve congressional and/or executive branch decision-making on major issues; eliminate mismanagement, fraud, and abuse; or ensure that programs comply with laws and funds are legally spent, among other benefits. Since 2015 GAO has sent letters to selected agencies to highlight the importance of implementing such recommendations. For more information, contact Cindy Brown Barnes at brownbarnesc@gao.gov.

What GAO Found The Department of Defense's (DOD) two managed care support contractors generally processed TRICARE claims for care provided between 2018 and 2023 within required timeliness standards. The claims process involves determining payment amounts to civilian health care providers, including behavioral health providers. DOD's timeliness standards require contractors to process 98 percent of TRICARE claims within 30 days, and 100 percent of claims within 90 days. Although DOD does not apply these standards to specific provider types, GAO separately analyzed the nearly 28 million claims from behavioral health providers over the 6-year period. GAO found that almost 90 percent were processed in 30 days. In addition, the percentage of claims processed within 30 and 90 days generally increased each year (see figure for the 3 most recent years). Time to Process TRICARE Claims Submitted by Behavioral Health Providers for Care Provided in Calendar Years 2021-2023, by Managed Care Support Contractor To oversee TRICARE payment accuracy, DOD monitored internal and external audit reports of randomly sampled claims from all types of providers, including behavioral health providers. DOD assessed contractor performance on all audited claims against the payment accuracy standards—which require payment error rates to not exceed between 2 and 1.75 percent, depending on the year of the contract—and took action when necessary. Across the audit reports from 2018 through 2023, claims from behavioral health providers made up between 1 and 8 percent of audited claims. DOD's oversight actions were consistent with its oversight goal for early identification and resolution of performance issues, and with a recommended practice from the Office of Management and Budget and prior GAO work that federal agencies use multiple sources of evidence to support decision-making. Why GAO Did This Study To support military deployments and provide health care, including behavioral health care, DOD operates a health system known as TRICARE. This system offers behavioral health and other services to over nine million eligible beneficiaries in military hospitals and clinics, or through authorized civilian providers in the private sector. The Conference Report 118-301 accompanying the National Defense Authorization Act for Fiscal Year 2024 includes a provision for GAO to report on TRICARE's payments to civilian network behavioral health providers. This report examines (1) the timeliness of TRICARE claims processing and (2) DOD's oversight of payment accuracy to all civilian providers, including behavioral health providers. GAO reviewed relevant documents, such as DOD and contractor reports for timeliness and accuracy, and DOD's oversight plans for the TRICARE contracts. GAO also analyzed time frames for processing claims from behavioral health providers from 2018 through 2023 and audit findings on payment accuracy. Finally, GAO interviewed DOD officials with oversight responsibilities of TRICARE's contractors, contractor staff, and four selected behavioral health provider groups who participate in TRICARE. GAO compared DOD's oversight activities to a DOD goal and a recommended practice. For more information, contact Sharon Silas at silass@gao.gov.

What GAO Found GAO identified 148 new matters and recommendations in 43 new topic areas for Congress or federal agencies to improve efficiency and effectiveness of government. For example: The Office of Management and Budget (OMB) and 24 federal agencies should implement statutory requirements for annual IT portfolio reviews and high-risk IT investment reviews, which could result in one hundred million dollars or more in cost savings by reducing duplicative IT investments and halting or terminating investments, when appropriate. The Space Development Agency should fully demonstrate its space-based laser communications technology in each iterative development phase before progressing, potentially saving hundreds of millions of dollars over 10 years. The Department of Defense should take steps to incorporate data analytics into its fraud risk management strategy and improve the usability of fraud investigative information to support fraud risk management and potentially save one hundred million dollars or more. OMB and General Services Administration should join Congress in taking steps to help ensure the Federal Audit Clearinghouse contains quality single audit information, which could reduce risk and resolve deficiencies in federal award spending by hundreds of millions of dollars per year. The Director of the Administrative Office of the U.S. Courts should better manage fragmentation by collaborating with relevant stakeholders when updating design standards for constructing federal courthouses, and reassess changes made to those standards to potentially avoid cost increases of tens of millions of dollars. Congress should clarify the Department of Energy's waste management authority at the Hanford site. Energy should also pause work at a waste treatment facility at the site—as it previously did with other types of waste—until it takes several actions, potentially saving billions of dollars. The Department of Interior could prevent continued productivity losses and cost overruns from a failed data system development and improve its compliance activities to verify federal oil and gas royalties, potentially increasing collections by tens of millions of dollars per year. As of March 2025, Congress and agencies had fully addressed 1,460 (71 percent) of the 2,049 matters and recommendations GAO identified from 2011-2025 and partially addressed 130 (about 6 percent). This has resulted in financial and other benefits such as improved interagency coordination and reduced mismanagement, fraud, waste, and abuse. As shown in the figure below, these efforts have cumulatively resulted in about $725 billion in financial benefits, an increase of about $57 billion from GAO's last report on this topic. These are rough estimates based on a variety of sources that considered different time periods and used different data sources, assumptions, and methodologies. Total Financial Benefits of $725 Billion Identified in GAO's 2011-2025 Duplication and Cost Savings Annual Reports Further steps are needed to fully address the matters and recommendations GAO identified from 2011 to 2025. Of the 589 open matters and recommendations, 170 (about 29 percent) have the potential for financial benefits. Legislation was introduced in the 118th or 119th Congress to address 27 (about 33 percent) of the 83 open matters. As of February 2025, the legislation had not been enacted. GAO estimates that fully addressing the remaining open matters and recommendations could yield financial benefits of one hundred billion dollars or more and improved governmental services, among other benefits. Examples of Open Topic Areas with Potential Financial Benefits Topic area and description (GAO report number linked) Mission Potential financial benefits (source of estimate) *Medicare Payments by Place of Service: Congress could realize additional financial benefits if it took steps to direct the Secretary of Health and Human Services to equalize payment rates between settings for evaluation and management office visits and other services that the Secretary deems appropriate. (GAO-16-189) Health $156.9 billion over 10 years (Congressional Budget Office) *Public-Safety Broadband Network: Congress should consider reauthorizing FirstNet, including different options for its placement, and ensure key statutory and contract responsibilities are addressed before current authorities sunset in 2027. (GAO-22-104915) Information Technology $15 billion over 15 yearsa (GAO analysis of the FirstNet Contract) *Individual Retirement Accounts: Congress should consider revisiting the use of Individual Retirement Accounts (IRA) to accumulate large balances and consider ways to improve the equity of the existing tax expenditure on IRAs. (GAO-15-16) General Government Ten billion dollars or more (Joint Committee on Taxation and the Department of the Treasury) *Disability and Unemployment Benefits: Congress should consider passing legislation to require the Social Security Administration to offset Disability Insurance benefits for any Unemployment Insurance benefits received in the same period. (GAO-14-343SP) Income Security $2.2 billion over 10 years (Office of Management and Budget) Legend: * = Legislation is likely to be necessary to fully address all matters or recommendations in this topic area. Source: GAO. | GAO-25-107604 Note: The potential financial benefits shown in this table represent estimates of amounts GAO or others believe could accrue if steps are taken to implement the actions described. The estimates are dependent on various factors, such as whether action is taken and how it is taken. Realized financial benefits may be less, depending on costs associated with implementing the action, unintended consequences, and the effect of controlling for other factors. The individual estimates in this table should be compared with caution, as they come from a variety of sources, which consider different time periods and use different data sources, assumptions, and methodologies. aIf FirstNet sunsets, it is unclear what will happen to the remaining $15 billion in scheduled annual payments, which FirstNet currently has authority to collect and reinvest. Why GAO Did This Study GAO annually reports on federal programs, agencies, offices, and initiatives—either within departments or government-wide—that have potentially duplicative goals or activities. As part of this work, GAO also identifies additional opportunities for greater efficiency and effectiveness that result in cost savings or enhanced revenue collection. This report discusses new opportunities for achieving billions of dollars in potential financial benefits and improving the efficiency and effectiveness of a wide range of federal programs. It also evaluates the status of prior matters for congressional consideration and recommendations for federal agencies related to the Duplication and Cost Savings body of work. In addition, this report provides examples of other, still open matters and recommendations where further implementation steps could yield significant financial and other benefits. For more information, contact Jessica Lucas-Judy at lucasjudyj@gao.gov or Michelle Sager at sagerm@gao.gov.

What GAO Found Across demographic groups, labor market outcomes for older workers were generally resilient in the COVID-19 pandemic's wake, with older workers' employment outcomes returning to pre-pandemic levels after an initial spike in unemployment. The unemployment rate for workers aged 55–64 peaked at 12.6 percent in April 2020 and had returned to its pre-pandemic level of 2.2 percent by April 2023, according to GAO's analysis of Current Population Survey data from 2017 to 2023. Further, older workers were more likely to report that they were unemployed because they had lost their job or been laid off, and they were also more likely to have exited the labor force by retiring. Younger workers (aged 25–54) were more likely to report that they were unemployed because a temporary job had ended or because they left a job. GAO found that existing differences by demographic group generally persisted, such as more highly educated older workers having higher labor force participation. During the pandemic, older workers' personal finances generally remained relatively steady. The rate of Social Security retirement benefit claims by workers who were near the full retirement age decreased during the first 3 months of the pandemic, according to GAO's analysis of Social Security Administration data. In late 2020, the rate of benefit claiming for those near full retirement age increased, eventually exceeding pre-pandemic levels, according to GAO's analysis. The prevalence of households aged 55 or over that had retirement accounts, and the value of those accounts, held relatively steady between 2019 and 2022, according to GAO's analysis of Survey of Consumer Finances data. However, differences persisted in the value of assets held by income quartile (see figure), as well as by some demographic groups, including differences by education, race, and gender. Estimated Median Total Value of Assets Held by Older Households (Aged 55–64), by Income Group The 25 experts who responded to GAO's written questionnaire generally favored policy options that could most effectively boost older workers' employability. Among the options favored by 12 or more experts was a policy option suggesting that the Department of Labor identify and report on the legal, regulatory, logistical, or other barriers to the employment of older workers. Experts also favored a policy option that the Department of Labor offer targeted support, such as improving the agency's existing job-search assistance programs for older job seekers. Why GAO Did This Study The COVID-19 pandemic caused significant nationwide economic disruptions. Older adults, particularly those close to or already in retirement, may have faced a greater financial burden because they did not have sufficient time to rebuild retirement savings. The CARES Act includes a provision for GAO to monitor federal efforts in response to the pandemic. This report describes: (1) how trends in older workers' employment status and duration varied from 2017-2023 and demographic differences among worker subpopulations; (2) how older workers' personal finances, including Social Security benefit claiming rates, changed; and (3) what policy options experts identified that could enhance the outcomes of discouraged or unemployed older workers. GAO used Current Population Survey monthly data from 2017 to 2023 to analyze labor force participation rates and employment trends for older and younger workers. Using the most recent data available, GAO examined retirement account balances and total assets held by older households using Survey of Consumer Finances data and analyzed claims for retirement benefits using Social Security Administration administrative data. GAO also sent a written questionnaire to 32 experts, asking them to identify policies likely to help discouraged or unemployed older workers. For more information, contact Kris Nguyen at nguyentt@gao.gov.

What GAO Found In June 2024, GAO identified 28 priority recommendations for the Department of Veterans Affairs (VA). Since then, VA has implemented four of those recommendations, including taking steps to improve efficiency, such as reducing underutilized clinic space, and ensuring consistency in measuring health care appointment availability to improve the reliability of wait time measures. In May 2025, GAO identified five additional priority recommendations for VA, bringing the total number of open priority recommendations to 29. These 29 recommendations involve the following areas: improving timely access to the Veterans Community Care Program, enhancing acquisition management, modernizing electronic health records, improving strategic human capital management, improving quality of care and patient safety, modernizing VA's health care system, improving disability benefits management, assessing software licenses, enhancing Equal Employment Opportunity and harassment prevention programs, and improving veteran education program management. VA's continued attention to these issues could lead to significant improvements in government operations. Why GAO Did This Study Priority recommendations are the GAO recommendations that have not been implemented and warrant attention from heads of key departments or agencies because their implementation could save large amounts of money; improve congressional or executive branch decision-making on major issues; eliminate mismanagement, fraud, and abuse; or ensure that programs comply with laws and funds are legally spent, among other benefits. Since 2015, GAO has sent letters to selected agencies to highlight the importance of implementing such recommendations. For more information, contact Jessica Farb at farbj@gao.gov.

What GAO Found In May 2024, GAO identified eight priority recommendations for the Nuclear Regulatory Commission (NRC) that if implemented, would address the security of radiological sources and improve the reliability of NRC's cost estimates. All eight priority recommendations remain open. In May 2025, GAO identified one additional priority recommendation that if implemented, would improve risk-informed decision-making. This brings our total NRC priority recommendations to nine. The recommendations are in the following areas: Addressing the security of radiological sources, Improving the reliability of cost estimates, and Improving risk-informed decision-making. NRC's continued attention to these issues could lead to significant improvements in government operations. Why GAO Did This Study Priority open recommendations are the GAO recommendations that warrant priority attention from heads of key departments or agencies because (1) their implementation could save large amounts of money; (2) improve congressional or executive branch decision-making on major issues; (3) eliminate mismanagement, fraud, and abuse; or (4) ensure that programs comply with laws and that funds are legally spent, among other benefits. Since 2015, GAO has sent letters to selected agencies to highlight the importance of implementing such recommendations. For more information, contact Mark Gaffigan at gaffiganM@gao.gov.