What GAO Found As of July 2026, U.S. Immigration and Customs Enforcement (ICE) has pursued an approach to expand detention capacity that has resulted in millions of dollars of waste. Since January 2025, ICE invested billions of dollars in six new initiatives without conducting necessary analysis and planning. For example, ICE purchased 11 warehouses to renovate for detention purposes at a reported cost of about $1.07 billion. In June 2026, ICE officials told GAO they were working to sell seven of the warehouses. ICE reported spending over $20 million on nonrecoverable costs, such as zoning assessments and security, on the warehouses it intends to sell. Waste, which occurs when agencies spend government resources carelessly or extravagantly, is also evident in other initiatives. U.S. Immigration and Customs Enforcement’s (ICE) New Detention Expansion Initiatives, January 2025–July 2026 ICE pursued these detention expansion initiatives without developing a comprehensive strategic plan to guide its efforts. For example, ICE has not developed consistent goals or objectives for the size and characteristics of its detention bed space. ICE also has not assessed the risks and benefits of using facilities with high operating costs compared to other less costly options in ICE's traditional detention portfolio. Developing a comprehensive strategic plan—which includes goals, activities, and resource needs—is a critical element of successful program management. Such a plan could help ICE better manage its multibillion-dollar detention expansion efforts and reduce waste associated with scaling back inefficient detention initiatives. These planning efforts would also better position ICE to select the approaches most likely to achieve its goals while making more efficient and effective use of taxpayer dollars. Why GAO Did This Study A January 2025 Executive Order directed the Department of Homeland Security (DHS) to detain individuals apprehended for violations of immigration law to the extent permitted by law and to allocate all available resources for ICE detention purposes. GAO was asked to review ICE’s expansion of immigration detention and operations. This report examines ICE’s efforts to expand detention capacity since January 2025. GAO reviewed agency documentation on detention expansion efforts and interviewed headquarters and field officials at eight detention facilities in Texas and Florida. GAO selected these locations because, among other factors, they were the sites of new ICE detention expansion initiatives. GAO reviewed data on operating costs of expansion initiatives and compared ICE detention expansion efforts to program management and DHS guidance.

What GAO Found As of March 2025, the Department of Homeland Security’s (DHS) Federal Emergency Management Agency (FEMA) awarded 1,245 Building Resilient Infrastructure and Communities (BRIC) subgrants to communities over its first four grant cycles in fiscal years 2020 through 2023. These subgrants were for mitigation activities to address hazards, such as floods. FEMA allocated about $2.5 billion for these subgrants, half the $4.8 billion available. FEMA reimbursed $62 million, and 37 subgrants had completed work and initiated the closeout process. From April 2025 to March 2026, FEMA did not award subgrants nor obligate funds. GAO found the median time for FEMA to finalize its review of subapplications and award BRIC subgrants was 7 to 9 months. As of March 2025, FEMA had not made award decisions for 700 subapplications because it had not completed the second of its two review stages. These subapplications were associated with about $2.2 billion of the $4.8 billion. Communities said these review timeframes could extend project timelines and increase costs. Identifying efficiencies to shorten FEMA’s review may enable communities to begin hazard mitigation activities sooner and minimize additional costs. Number of BRIC Subapplications Pending FEMA’s Award Decision and BRIC Funds Associated with These Subapplications, Across Four Grant Cycles and as of March 2025 FEMA announced it was ending BRIC in April 2025, but it did not communicate key information internally and externally until March 2026 when it announced it was restarting BRIC. For example, FEMA did not clarify which subgrants would be terminated. Officials and stakeholders said the lack of actionable information from FEMA headquarters created challenges and delayed mitigation efforts. State officials told GAO that some subrecipients stopped work due to funding uncertainty, which may increase project costs. Moving forward, identifying and applying lessons learned from this period will help ensure FEMA communicates relevant, timely program information internally and externally. FEMA established performance goals, but it did not consistently establish methods and targets to measure results. For example, one of FEMA’s goals in fiscal year 2023 included a goal to spread grants across the U.S. but FEMA did not set a target to determine if it had achieved its goal. FEMA officials also told GAO it did not use performance information to inform its announcement ending BRIC. By establishing results-oriented performance goals and generating annual performance information, FEMA could use this information to determine BRIC’s effectiveness and inform agency decision-making. Why GAO Did This Study Disasters caused by natural hazards have become costlier and more frequent in recent years. Independent research has found that investing in disaster resilience can reduce costs of future disasters. FEMA launched its BRIC grant program in 2020 to fund activities that enhance resilience and lower disaster costs. In April 2025, FEMA announced it was ending BRIC. In March 2026, FEMA announced it was restarting BRIC. GAO was asked to review FEMA’s implementation of BRIC, and explanatory statement language includes a provision for GAO to conduct oversight of the Infrastructure Investment and Jobs Act, which made appropriations for BRIC. This report examines (1) communities that applied for and received grants and activities funded, (2) challenges that communities identified and the extent to which FEMA addressed them, (3) the extent to which FEMA communicated BRIC’s status and the impact of announcing its end, and (4) the extent to which FEMA measured the program’s performance and used this information to inform agency decisions. GAO reviewed FEMA documentation, analyzed BRIC data from four grant cycles as of March 2025, interviewed a nongeneralizable selection of 6 states and 6 communities, and interviewed FEMA officials.

What GAO Found The federal judiciary’s administrative space, such as the district clerks’ and probation offices that support the judiciary’s mission, made up 40 percent of the judiciary’s total space in fiscal years 2021 through 2025. In fiscal year 2025, the judiciary’s administrative space totaled 12.2 million usable square feet across 716 of the 772 facilities the judiciary occupied nationwide, a decrease of 1 percent from fiscal year 2021. GAO found that administrative space was the sole type of space in over a third of judiciary occupied facilities in fiscal year 2025. Most of these facilities (234 of 272) were commercially owned. Ninety-six percent of the 234 commercially owned facilities were occupied by federal public defender organizations and probation offices. The proportion of the judiciary’s annual rent payments spent on administrative space, in both nominal and inflation adjusted dollars, remained steady—between 39 and 40 percent from fiscal year 2021 through fiscal year 2025. The Federal Judiciary’s Fiscal Year 2025 Administrative Space Distribution, in Usable Square Feet Note: The remaining court units include the courts of appeals clerks’ offices (including bankruptcy appellate panels); courts of appeals central legal staff; circuit executives’, bankruptcy administrators’, and pretrial services offices; and the Administrative Office of the U.S. Courts. For more details, see fig. 2 in GAO-26-108603. While the judiciary has data on the amount of administrative space it occupies and the associated rent costs, it does not collect or review occupancy data. Without occupancy data, the judiciary is unable to measure the extent to which its administrative space is utilized, as utilization is the ratio of the average daily occupancy of a space compared to the usable square feet of the space. Judiciary policies and guidance identify the importance of maximizing the use of its space and taking a data-based approach when doing so. For example, part of the judiciary’s Asset Management Planning process includes a physical assessment of how well court units’ space functions and meets the judiciary’s space standards. But, according to judiciary officials, measuring utilization is not part of the judiciary’s practices because it has not identified a business need to do so. Measuring the utilization of its administrative space and identifying utilization benchmarks would enhance the judiciary’s decision-making, bolster its efforts to meet its stated goals to efficiently manage and maximize the use of its space, and help ensure it is not wasting resources by leasing more space than it needs. Why GAO Did This Study Chronic underutilization of federal buildings is one of the main reasons that federal real property management has been on GAO’s High Risk List for more than 20 years. In fiscal year 2025, the judiciary paid over $1 billion in rent, making rent one of its largest expenses. GAO was asked to examine the judiciary’s utilization of its administrative space. This report (1) describes the characteristics of the judiciary’s administrative space and how it has changed from fiscal years 2021 through 2025 and (2) assesses the extent to which the judiciary is measuring the utilization of its administrative space. GAO selected a nongeneralizable sample of nine judiciary facilities and interviewed officials about the utilization of their administrative space. GAO observed the use of administrative space at four of these facilities. GAO surveyed the 13 judiciary circuit executives who represent all court units nationwide about using occupancy data to measure utilization. GAO also reviewed and analyzed judiciary data and documents and interviewed officials from the Administrative Office of the U.S. Courts (AOUSC) and General Services Administration.

What GAO Found The Infrastructure Investment and Jobs Act (IIJA) and Inflation Reduction Act (IRA) provided federal funding to agencies, including the Department of Agriculture (USDA) and Department of Energy (DOE), for a wide range of efforts. These efforts included projects to reduce wildfire risk, improve rural power production, and develop clean energy technologies. Of the $37 billion provided to USDA that was not later rescinded by Public Law 119-21, commonly known as the One Big Beautiful Bill Act, USDA obligated $32.2 billion for fiscal years 2022 through 2025. Of the $78 billion provided to DOE that was not later rescinded, DOE obligated $51 billion for fiscal years 2022 through 2025. Infrastructure Investment and Jobs Act (IIJA) and Inflation Reduction Act (IRA) Funding for USDA and DOE as of September 30, 2025 Note: This figure does not include budget authority for which the entire period of availability occurs after September 30, 2025, or obligations, disbursements, or rescissions of that budget authority. USDA. In response to the President’s directive in 2025 to review IIJA and IRA funding for alignment with executive orders, USDA reported that it reviewed awards for the use of racial, ethnic, and gender preferences and for promoting climate change or environmental justice initiatives. Senior leadership ultimately made final decisions on whether to approve to continue, modify, or cancel awards, according to USDA officials and documentation. According to agency officials, USDA completed its review of IIJA- and IRA-funded awards by June 30, 2025. The agency terminated 34 contracts, totaling $67 million, according to its data. However, GAO concluded that USDA data were not sufficiently reliable to determine the status of all awards reviewed. Specifically, USDA officials could not specify which awards the agency approved to continue or modified as a result of its review or if the agency canceled additional awards. DOE. In May 2025, DOE created the advisory portfolio review process (PRP) committee to evaluate awards for consistency with executive orders. According to DOE officials, the relevant program office head made the final decision for each award under review, with the PRP committee serving in an advisory role. According to agency officials, DOE completed its review of IIJA and IRA awards in April 2026. According to agency data, DOE reported approving to continue 381 awards ($19.6 billion) and canceling 155 awards ($9.1 billion). Why GAO Did This Study The IIJA and IRA provided billions in federal funding to agencies to distribute through mechanisms like grants and loans. Beginning in January 2025, executive orders directed agencies to pause this funding to review it for consistency with administration priorities. Grant recipients have raised concerns that delays in distributing these funds affect their ability to implement their projects. GAO was asked to review the status of IIJA and IRA funding. This report describes USDA’s and DOE’s (1) IIJA and IRA budget authority, rescissions, obligations, and disbursements for fiscal years 2022 to 2025; (2) processes for reviewing IIJA and IRA funding in response to executive orders; and (3) IIJA and IRA funding review status. GAO analyzed the IIJA and IRA and financial data from USDA’s and DOE’s accounting systems and the agencies’ policies and guidance for reviewing IIJA and IRA funding. GAO also analyzed and summarized agency review data. GAO also interviewed selected agency officials. GAO found USDA’s and DOE’s data to be sufficiently reliable for reporting aspects of the agencies’ funding review status, with some limitations, as discussed in the report. For more information, contact Anne Sit-Williams at sitwilliamsa@gao.gov.

What GAO Found In 2024, about 82 percent of women of reproductive age reported using some form of contraception in the past 12 months, according to research from KFF. Most private health plans are generally required to cover the full range of contraceptives for women. The Department of Labor (DOL), the Centers for Medicare & Medicaid Services (CMS)—an agency within the Department of Health and Human Services—and states each have responsibilities for overseeing private health plans, including plans' coverage of contraception. See table for descriptions of their general oversight responsibilities and activities. DOL, CMS, and States’ General Responsibilities for Overseeing Private Health Plans   Oversight authority Oversight activities DOL Private employer-sponsored group health plans Responding to enrollee complaints Conducting investigations in response to systemic concerns identified from various sources, such as complaints CMS Non-federal governmental plans Qualified health plans offered through the federally-facilitated exchanges Group and individual plans in certain states that do not have authority to enforce federal requirements or are not otherwise enforcing requirements Conducting annual plan reviews and certification Conducting individual complaint investigations Conducting market conduct examinations of potential systemic compliance issues States Individual health plans and some group health plans sold in their state Conducting premarket health plan reviews Collecting individual complaints Carrying out market conduct examinations Source: GAO review of information from CMS, DOL, selected state officials and prior GAO work. | GAO-26-108446 Note: The Department of Treasury oversees certain aspects of PPACA compliance for church plans, which were outside the scope of our report. Of the plans for which they have oversight responsibility, DOL and CMS identified instances of noncompliance within the last 6 years. For example, DOL identified noncompliance with federal contraceptive coverage requirements in three investigations DOL conducted in the last 6 years, according to DOL officials. For example, DOL found that a pharmacy benefit manager required enrollees to try other types of contraception before covering the medically necessary, preferred method at no cost-sharing. According to DOL officials, this pharmacy benefit manager revised its practices and reprocessed the associated claims. CMS identified instances of health plan noncompliance with federal contraceptive coverage requirements in three out of five market conduct examinations conducted in the last 6 years. For example, CMS found that one health plan failed to provide coverage of contraceptive coverage services without cost-sharing. Officials say this health plan revised its practices and reprocessed the associated claims. Why GAO Did This Study Two-thirds of Americans receive their health coverage through private health plans. Private health plans must generally cover a range of contraceptives without cost-sharing including oral contraceptives, intrauterine devices, and female sterilization services, among others. Concerns have been raised by stakeholders and researchers that health plan enrollees have been denied coverage for certain contraceptive products or services. GAO was asked to review oversight by federal and state agencies of group and individual health plans’ compliance with federal contraceptive coverage requirements. This report provides information on payments enrollees made for contraceptives, including cost-sharing; perspectives from stakeholder organizations and health plans about contraceptive coverage requirements; and federal and state oversight of federal contraceptive coverage requirements. To conduct this review, GAO analyzed available data from the Agency for Healthcare Research and Quality on contraceptive prescription purchases; reviewed literature to identify information about when enrollees had cost-sharing for contraceptives; reviewed federal guidance issued by CMS and DOL; and interviewed officials from DOL, CMS, six selected states, selected health plans, and selected stakeholder organizations, including those representing enrollees and providers. GAO selected these states to capture variation in rurality and state laws, among other criteria. GAO provided a draft of this report to the Department of Health and Human Services and DOL. The agencies provided technical comments that we incorporated as appropriate. For more information, contact John E. Dicken at dickenj@gao.gov.

What GAO Found Remote and isolated military installations are often away from population centers or located in austere environments, making the delivery of critical support services, such as health care or housing, challenging. GAO found that while remote and isolated installations consistently faced challenges in areas such as recruiting and retaining civilian personnel, the causes and severity of those challenges differed by location. For example, in Alaska, Eielson Air Force Base had the most vacant positions (428) while Fort Greely and Clear Space Force Station had no vacant critical support services positions. In 2024, the Department of Defense (DOD) issued guidance for designating installations as remote and isolated. As of May 2026, the Departments of the Army and Navy compiled lists of remote and isolated installations in accordance with this guidance. The Department of the Air Force has opted not to make a formal designation at this time. A DOD official stated that efforts to fully develop the risk assessment process outlined in the same guidance will begin once the initial designations of remote and isolated installations are complete. However, this guidance does not establish a clear definition for what a remote and isolated installation is. Moreover, other guidance varies in how these installations are defined. A consistent definition of remote and isolated installations would enhance DOD’s ability to produce an accurate picture of what is considered remote and isolated across the enterprise for purposes of identifying and assessing risks among these installations. Photos of Remote and Isolated Military Installations DOD implemented multiple efforts to reduce its civilian workforce since January 2025 that had significant impacts on the ability to staff or hire civilian positions in critical support services at remote and isolated installations. However, DOD has not assessed the effect of these reductions on remote and isolated locations where recruiting and retaining civilian personnel can be difficult. Collecting specific lessons learned at remote and isolated installations from the civilian workforce reduction efforts could assist DOD in understanding the effect of such reductions. Why GAO Did This Study DOD has established policies and programs intended to enhance quality of life and well-being of service members and their families. Installations that could be considered remote and isolated often have reduced support services for service members and their families. The Joint Explanatory Statement accompanying the James M. Inhofe National Defense Authorization Act for Fiscal Year 2023 included a provision for GAO to assess civilian positions supporting critical services at remote installations. This report (1) describes the ability to fill civilian personnel positions in critical support services at remote and isolated installations and challenges providing critical support services at these locations; and assesses the extent to which DOD has (2) designated installations as remote and isolated and assessed risks at these locations; and (3) developed lessons learned from civilian workforce reductions on critical support service positions at remote and isolated installations. GAO reviewed documentation and interviewed officials from a non-generalizable sample of nine remote and isolated installations to discuss the provision of critical support services at those installations. GAO also collected data from these installations for fiscal years 2023 through 2025 on vacancy rates and time to hire for civilian positions in the critical support services.

What GAO Found The U.S. faces a maternal mortality crisis, with mortality rates that exceed every other high-income country. More than 600 women die during pregnancy or from causes aggravated by pregnancy each year in the U.S.; over 80 percent of these deaths are preventable, according to the Centers for Disease Control and Prevention (CDC). To help prevent these kinds of deaths, CDC provides funding for Maternal Mortality Review Committees (MMRCs). These committees, typically supported and maintained by state and local health agencies, identify factors contributing to pregnancy-related deaths and make recommendations to patients and their families, providers, hospitals, or state policymakers to help prevent similar deaths. They convene at the state or local level and comprise clinical and non-clinical representatives. GAO found all 10 selected MMRCs consider federal and state laws and policies as potential factors that affect maternal mortality. For example, representatives GAO interviewed from five MMRCs said their states changed state laws to extend Medicaid coverage for certain women to 12 months postpartum, due to MMRC recommendations. Such health care coverage could save lives by treating and reducing chronic disease, such as severe hypertension, that can underlie maternal mortality, according to these representatives. GAO found the 10 selected MMRCs commonly made recommendations in the areas of care coordination, mental health and substance use, health equity, reproductive health, and health care workers. For example: Mental health and substance use. Unintentional drug overdose and suicide were among the leading causes of death among pregnant and postpartum women, according to a recent study. Nine of the selected MMRCs made recommendations in this area, including for screening and referrals for treatment, and to increase funding for access to care. Health equity. There are persistent racial and ethnic disparities in deaths of pregnant women, with both Black and American Indian/Alaska Native women experiencing deaths at a rate of 2.5 or more times higher than White women, according to GAO’s previous work and CDC. Nine of the selected MMRCs made recommendations to address these disparities. For example, one MMRC recommended ensuring American Indian/Alaska Native representation in the planning and implementation of improvements in maternity care. Over the 5-year funding cycle from 2024 through 2029, CDC plans to provide about $134 million to 52 states and territories. To monitor MMRCs that receive this CDC funding, the agency holds regular meetings, reviews required reports, and conducts site visits. GAO found that to assess MMRC performance, CDC has incorporated key performance management practices identified in prior GAO work. For example, CDC set a goal of eliminating preventable deaths and collects information on the number of MMRC recommendations being implemented. Why GAO Did This Study GAO was asked to provide information on MMRCs and federal oversight of them. This report provides information on whether MMRCs consider laws and policies when reviewing factors that contribute to maternal mortality, recommendations by MMRCs to reduce mortality, and CDC’s efforts to evaluate the MMRCs. GAO reviewed the most recently available MMRC reports as of December 2025 and interviewed officials representing a nongeneralizable sample of 10 MMRCs, selected to obtain a mix of geographic locations and rate of maternal mortality, among other characteristics. GAO also reviewed CDC documentation and interviewed CDC officials. Additionally, GAO assessed the extent to which CDC is following key performance management practices. For more information, contact Mary Denigan-Macauley at DeniganMacauleyM@gao.gov.

What GAO Found All states that receive funding under Title I of the Elementary and Secondary Education Act of 1965, as amended (ESEA) are required to develop statewide accountability systems. Thirty-six states have chosen to include indicators related to chronic absenteeism in their statewide accountability systems. ESEA also has certain chronic absenteeism reporting requirements for all states, regardless of whether a state includes chronic absenteeism in its accountability system. In 2026, the Department of Education discontinued its most comprehensive monitoring of ESEA’s programmatic and fiscal requirements. The ESEA provision intended to improve oversight of funds does not explicitly direct Education to monitor grantees, nor does it include specific requirements regarding the method or frequency of monitoring and oversight activities. Suspending its most comprehensive monitoring has broad oversight implications that extend beyond chronic absenteeism. Given that Education is not currently assessing ESEA compliance with Title I fiscal requirements, there is higher risk that these federal funds—comprising about two-thirds of the nearly $27 billion in ESEA funding in 2025—could be subject to undetected fraud, waste, or abuse. While Education requires states to report data on chronically absent students using a standard method, the way Education uses those data to calculate chronic absenteeism rates can be unreliable. For example, Education directs states to report the number of chronically absent students over a school year, but to report total enrollment based on a single date. Calculating rates using mismatched timeframes has resulted in unreliable and implausible chronic absenteeism rates (e.g., rates over 100 percent), according to GAO’s analysis. GAO calculated rates at the school level and found this was especially true in low-performing schools where enrollment fluctuates more often, and shared-time schools which students attend for partial days, such as those housing career and technical education programs. Specifically, over 30 percent of these schools had implausible rates compared to under 2 percent for other schools. Methods of Calculating the Chronic Absenteeism Rates Missing school means missing valuable instructional time and poses serious implications for students' overall academic success and wellbeing. Absent quality chronic absenteeism data, this nationwide data source cannot be used to reliably track trends or evaluate the effectiveness of accountability efforts and interventions to address chronic absenteeism. Why GAO Did This Study Chronic absenteeism, which Education defines as missing 10 percent or more school days, is associated with decreased academic performance. As recently as February 2026, Education cited chronic absenteeism as a key challenge. Education has also noted that chronic absenteeism remains elevated following the COVID-19 pandemic. At least one-quarter of K-12 students were estimated to be chronically absent in recent years. GAO was asked to examine federal oversight related to chronic absenteeism. This report examines (1) how states have incorporated chronic absenteeism into their statewide accountability systems and the extent to which Education’s monitoring addresses relevant federal requirements and (2) the extent to which Education has leveraged its data to help address chronic absenteeism. GAO reviewed relevant federal laws and analyzed Education’s guidance and relevant monitoring reports since 2019, when Education fully implemented its main ESEA monitoring strategy. GAO also analyzed Education’s school year 2022–2023 chronic absenteeism data (the most recent available).

What GAO Found Under the Controlled Substances Act, substances that pose a risk of abuse and dependence are placed in categories—referred to as schedules. To carry out certain scheduling actions, the Drug Enforcement Administration (DEA) is required to obtain a scheduling recommendation from the Department of Health and Human Services (HHS) based on a scientific and medical evaluation from the Food and Drug Administration (FDA). Evaluations and recommendations from HHS or DEA are not required for substances scheduled through legislation. Of the 208 substances for which DEA took scheduling actions from 2020 through 2025, DEA considered HHS evaluations and recommendations for all 95 substances for which they were required. Of those 95 substances, DEA’s final scheduling decision aligned with HHS’s recommendation for all 84 substances for which DEA had published a final rule as of December 31, 2025. The remaining 11 substances were still under extended temporary scheduling orders. We selected this timeframe to assess DEA scheduling actions during the most recent 6 calendar years. DEA and FDA have policies that address aspects of the scheduling process, including a memorandum of understanding (MOU) for sharing information; however, these policies have gaps. For example, DEA does not have policies that identify roles, responsibilities, and procedures related to scheduling. FDA does not have policies or procedures specifying how its staff are to conduct evaluations or develop recommendations. Developing such policies and procedures could help ensure operational consistency, especially if key personnel with longstanding subject matter expertise depart. The below figure shows DEA and FDA methods for coordinating regarding evaluations and recommendations for substances. Figure: DEA and FDA Methods for Coordinating Regarding Evaluations and Recommendations for Substances FDA has another MOU with the National Institutes of Health’s (NIH) National Institute on Drug Abuse (NIDA) that describes procedures for FDA to consult NIDA when developing recommendations, but the MOU is over 40 years old and does not reflect the current entities involved or procedures. Without updating and regularly reviewing the MOU, FDA and NIDA staff may not know the entities and procedures to follow to ensure that NIDA’s expertise about drug abuse informs scheduling recommendations. According to DEA and FDA officials, differences of scientific opinion between the two agencies about a substance’s schedule have occurred rule but are rare. In such cases, they usually discuss their differences, share information, and resolve differences prior to soliciting public comments. Why GAO Did This Study The use of illicit drugs and misuse of prescription drugs has been a long-standing public health issue in the U.S. DEA, in consultation with HHS, may schedule such substances. Scheduling and quantity of a controlled substance control the extent to which criminal penalties under the Controlled Substances Act may be levied. Members of Congress have raised questions about how DEA considers HHS evaluations and recommendations. This report identifies when DEA is required to request and consider HHS evaluations and recommendations, the extent to which DEA requested and considered HHS evaluations and recommendations for scheduling actions from 2020 through 2025, and the extent to which the agencies have related policies. GAO analyzed relevant statutes and regulations, available agency policies, and DEA and FDA data on substances for which DEA took scheduling actions. GAO analyzed regulatory dockets to validate and supplement data. GAO also interviewed officials from DEA and HHS, including FDA and NIH.

What GAO Found The Vocational Rehabilitation (VR) and Medicaid home- and community-based services (HCBS) programs are the primary sources of federal funds supporting employment services for individuals with intellectual or developmental disabilities (I/DD), according to officials. The VR and I/DD agencies that administer these programs within three selected states—Georgia, Pennsylvania, and Washington—generally compensated employment service providers based on either units of services rendered, such as billed time, or when supported individuals achieved milestones, such as job placement. These compensation models can present different drawbacks. For example, according to one employment service provider, compensation based on units of services rendered does not incentivize providers to reduce the services they provide as an individual develops job skills. In contrast, milestone-based compensation may not cover a provider’s actual costs, which can vary in unforeseen ways, according to employment service providers that GAO interviewed. The VR and I/DD agencies within the selected states established procedures for funding employment services and collaborating with service providers to jointly support individuals with I/DD. In these states, VR and I/DD agencies generally funded employment services sequentially with the VR agency funding them before the I/DD agency followed through Medicaid HCBS. According to state VR and I/DD officials, such sequencing of services was more common than braiding, which uses multiple funding streams separately and simultaneously to provide services to an individual. Strategies for Using Different Funds to Increase Employment for Individuals with Disabilities Employment service providers that GAO interviewed in these states identified challenges in using funds from the VR and Medicaid HCBS programs in combination to support individuals. They described the administrative burden of navigating two state agencies as a challenge that contributed to service gaps. For instance, according to a service provider in Pennsylvania, I/DD service coordinators experienced confusion about whether a closure letter from the state’s VR agency was necessary before employment services through Medicaid HCBS were allowed, creating unnecessary service gaps for some individuals. The federal Departments of Education, Health and Human Services, and Labor have issued guidance and provided some technical assistance on using different program funds to increase employment for individuals with disabilities that could address these challenges. For example, a letter issued jointly in 2022 encouraged state agencies and others to coordinate different funding streams to support individuals with disabilities seeking employment. The guidance cited specific strategies for using different funds in combination, such as sequencing and braiding, to increase such employment. Why GAO Did This Study An estimated 2 million adults in the United States have I/DD, such as Down syndrome and cerebral palsy. Although many want to and can work, they are less likely to be employed than those without disabilities. Given concerns that employment service providers for individuals with I/DD often struggle to secure funding, GAO was asked to review how the federal government supports individuals with I/DD in employment and the degree to which separate federally funded programs could lead to inefficiencies. This report provides information about how VR and I/DD agencies in selected states compensated employment service providers and coordinated funding from VR and Medicaid HCBS programs, challenges the employment service providers experienced in using these program funds, and related federal guidance. GAO examined how the state VR and Medicaid HCBS programs operated in a nongeneralizable sample of three states selected based on variation in programmatic factors and geography. In each state, GAO reviewed VR and I/DD agency documents and interviewed state officials and employment service providers. GAO also reviewed relevant federal guidance and spoke with representatives of professional associations supporting individuals with I/DD. For more information, contact Elizabeth H. Curda at CurdaE@gao.gov.

What GAO Found More than 9 million enrolled veterans are eligible to receive health care services through the Department of Veterans Affairs’ (VA) Veterans Health Administration (VHA) each year. Veterans who meet certain requirements (such as having a 100 percent service-connected disability or being former prisoners of war) are also eligible to receive VA dental benefits. According to VA, about 26 percent of VHA-enrolled veterans were eligible to receive dental benefits as of February 2026. According to VHA data, the number of veterans eligible for VA dental benefits increased from fiscal years 2020 through 2025, resulting in an overall increase of approximately 70 percent from fiscal year 2020 through fiscal year 2025. Number of VHA-Enrolled Veterans Eligible for VA Dental Benefits, Fiscal Years 2020–2025 The increase in the number of veterans eligible for dental benefits was largely driven by increases in veterans eligible because of a 100 percent service-connected disability rating or a 100 percent service-connection compensation rate due to the inability to work, according to VHA data. GAO’s review of VHA data regarding demographic characteristics of veterans eligible for VA dental benefits (age, sex, race and ethnicity, and rurality of residence) from 2020 through 2025 found that the largest increase in veterans eligible for VA dental benefits occurred among younger veterans (under age 50). Specifically, younger veterans composed 21 percent of eligible veterans in 2020 compared to 36 percent in 2025. Other demographic characteristics of veterans remained relatively constant. Using VHA data for 2025, GAO estimated that if all veterans with heart disease were eligible for dental benefits, the number of veterans eligible for VA dental benefits could increase by 25 percent from about 2.45 million to about 3.07 million. VHA officials and dental providers from selected facilities reported that if such an expansion were to occur, VA may need to consider hiring additional dental providers and increasing dental clinic space to accommodate it. Why GAO Did This Study According to VA, poor oral health can affect veterans’ overall health. Additionally, the American Heart Association and others have reported a link between poor oral health and other serious health conditions, such as heart disease. Congress has considered expanding eligibility for VA dental benefits to veterans with a diagnosis of heart disease. For example, the Senator Elizabeth Dole 21st Century Veterans Healthcare and Benefits Improvement Act required VA to begin a pilot program in 2026 in which VA provides dental benefits to certain veterans with heart disease. The act also includes a provision for GAO to examine VA dental services and benefits. This report describes (1) the population of veterans eligible for VA dental benefits and (2) the potential effect of including all veterans with heart disease in the population eligible for VA dental benefits. GAO interviewed VHA officials and reviewed VHA documentation and data for calendar and fiscal years 2020 through 2025, the most recent full years of data available. GAO interviewed dental providers and staff from three VHA facilities, selected because they participated in a pilot program through which veterans without VA dental benefits could receive free or reduced-cost dental care. GAO also collected information from VA lead dentists and interviewed representatives from four relevant national organizations and three veterans service organizations, selected because they represent dental providers or could provide information about veterans’ dental care experiences. For more information, contact Sharon M. Silas at silass@gao.gov.

What GAO Found The U.S. Agency for International Development (USAID) allocated $624 million in Economic Support Fund (ESF) assistance for the West Bank and Gaza for fiscal years (FY) 2022-2024. This assistance funded 37 prime awards for sectors including water infrastructure and education, as well as debt relief payments to a Palestinian Authority creditor. With a few exceptions, USAID complied with its anti-terrorism policies and procedures. State took over administration of this ESF funding from USAID in July 2025. All 37 awards have ended except for support to the East Jerusalem Hospital Network. U.S.-Funded Neonatal Intensive Care Training for East Jerusalem Hospital Network State’s Bureau of Near Eastern Affairs (NEA) is managing the remaining USAID activities in the West Bank and Gaza. Congress appropriated ESF funding in FY 2025 and National Security Investment Programs (NSIP) funding in FY 2026 that State can use for the West Bank and Gaza if oversight requirements are met. Officials told GAO that State’s planning had identified potential early recovery and economic development programming for West Bank and Gaza, but State has not yet determined responsibility for managing such programs. According to State officials, ongoing regional conflict has delayed NEA’s initial efforts to replace USAID’s anti-terrorism policies and procedures for West Bank and Gaza. Once developed, these policies and procedures would not necessarily apply to State components other than NEA, such as the U.S. Embassy in Jerusalem, if they become responsible for future programming. State guidance says that risks should be identified, evaluated, and mitigated. Determining and documenting how relevant components will mitigate terrorism risk could help State ensure that such assistance is not diverted to terrorist ends. As State determines its risk mitigation measures, it could incorporate leading practices and lessons learned. GAO has identified mandatory provisions in award agreements as a leading oversight practice. This practice, formerly used by USAID, could help State ensure awardees understand their anti-terrorism obligations and associated penalties. Additionally, State could directly leverage USAID lessons learned by adopting timelines for any future compliance audits. As GAO has previously reported, these timelines could help ensure that appropriate corrective actions can be taken to address any noncompliance before awards expire. Incorporating these leading practices and lessons learned would strengthen State’s oversight of future funding to the West Bank and Gaza. Why GAO Did This Study Since 1993, the U.S. has provided more than $7.8 billion in assistance to Palestinians in the West Bank and Gaza primarily through ESF assistance. Appropriations acts for FY 2022-2024 include provisions for GAO to review the treatment, handling, and uses of ESF funds provided for assistance to the West Bank and Gaza. This report examines (1) the status of USAID’s West Bank and Gaza program supported by FY 2022-2024 ESF assistance, (2) the extent to which USAID complied with its anti-terrorism policies and procedures, and (3) U.S. plans for oversight of future ESF or NSIP assistance in the West Bank and Gaza. GAO reviewed relevant policies and data from USAID and State, as well as compliance reports and financial audits conducted by third parties. GAO also analyzed prime awards and a random generalizable sample of subaward actions for compliance with USAID’s anti-terrorism policies and procedures. Finally, GAO conducted fieldwork in Israel and the West Bank and interviewed USAID and State officials.

What GAO Found The National Nuclear Security Administration (NNSA) has traditionally used a single, all-encompassing management and operating (M&O) contract at each of its sites to acquire work performed, including to subcontract for construction services. Beginning in 2014, NNSA introduced individual contract line item numbers (line items) to some contracts to increase the visibility of specific efforts. Line items capture information about separately identifiable goods and services that the government seeks to acquire within the scope of the overall contract. Since introducing individual contract line items in 2014, NNSA has minimally used line items to separate contract deliverables, especially for construction projects. Specifically, five of NNSA’s 21 capital asset projects that had approved performance baselines as of June 2026 are covered by separate line items in the M&O contracts (see table). One smaller project and two projects under a former contract were completed as separate contract line items. NNSA officials told GAO they are considering adding at least two other construction projects at one site as separate line items. Ongoing Construction Projects with Separate Contract Line Items in the National Nuclear Security Administration’s Management and Operating Contracts Line item Contract Uranium Processing Facility (2 projects) Y-12 National Security Complex Savannah River Plutonium Processing Facility (2 projects) Savannah River Site Power Sources Capability Sandia National Laboratories Source: GAO analysis of National Nuclear Security Administration data. | GAO-26-108409 According to NNSA officials and M&O contractor representatives GAO interviewed, contract line items can enhance transparency of procurement data and allow NNSA to develop separate contractor fee plans and performance evaluations for high-risk, high-value projects. However, officials said these separate fee plans and performance evaluations require additional administrative resources to implement. Because line items can have both benefits and drawbacks, NNSA officials stated that they decide which deliverables are most appropriate to oversee through contract line items based on several considerations, such as the total project cost, complexity, and whether there are dedicated appropriations. However, NNSA has not documented the criteria for determining how and when officials should decide to use separate line items. Without doing so, NNSA lacks reasonable assurance that contracting officers are using consistent and appropriate criteria when determining separate line items. This could result in missed opportunities to improve accountability and contractor performance. NNSA also has not fully assessed and documented lessons learned from its use of line items, which could be used to inform its future use of line items. By documenting lessons learned, NNSA can ensure it retains information that could help it to most effectively and appropriately use line items and avoid expending administrative resources on ineffective acquisition approaches. Why GAO Did This Study Over the next decade, NNSA plans to spend almost $200 billion modernizing the nation’s nuclear weapons production and research infrastructure. In fiscal year 2025, NNSA spent close to $24 billion on multi-year, multi-billion-dollar M&O contracts to run the government-owned, contractor-operated sites of the nuclear security enterprise. Senate Report 118-188, accompanying S. 4638, the National Defense Authorization Act for Fiscal Year 2025, includes a provision for GAO to review NNSA’s use of line items in its M&O contracts and how line items can improve contract oversight. This report examines (1) the extent to which NNSA has used line items in its M&O contracts; (2) the benefits and drawbacks of using line items, according to officials and contractors; and (3) how NNSA determines when to use line items in M&O contracts. GAO reviewed NNSA’s M&O contracts and compared NNSA’s use of line items to Department of Energy (DOE) acquisition policy and relevant standards for internal control. GAO also interviewed DOE and NNSA headquarters and field office officials and M&O contractor representatives.

What GAO Found As part of the federal government’s efforts to support Tribes and tribal members’ health and to help prevent disease, an Indian Health Service (IHS) program provides Tribes with technical and financial assistance to build drinking water and wastewater infrastructure in tribal communities. Through this program, IHS staff work closely with Tribes to identify their needs and design and build water projects. Several U.S. Environmental Protection Agency (EPA) and U.S. Department of Agriculture (USDA) programs also provide assistance for tribal water projects, and the three agencies often work together and with Tribes. Selected Agencies’ Funding for Tribal Water Projects, Fiscal Year 2025 IHS has determined that only certain homes are eligible for funding as part of a community tribal water project based on its interpretation of its statutory authority to build water infrastructure for “Indian homes, communities, and lands.” This excludes various homes that tribal members live in, such as those owned by a spouse or grandparent who is not a tribal member—something tribal officials said is common in tribal communities. It also excludes homes owned by Tribes or tribal members that are rented to other tribal members with fewer than 5 years on the lease or to community service providers (e.g., teachers or law enforcement) who are not tribal members. Examples of Water Infrastructure in Underserved Tribal Communities When an IHS-funded project includes ineligible properties, such as nontribal homes or community buildings, Tribes and the IHS staff helping them must provide or obtain other funding for these properties’ costs. This can lead to high administrative costs, such as to help Tribes navigate other federal agencies’ differing application processes. This can be expensive and inefficient for IHS when such activities cost as much or more than the project costs of these properties. For example, IHS officials reported spending over 80 hours helping one Tribe obtain a $8,000 grant, plus more hours helping the Tribe report on how it spent the grant. Congress could help IHS more efficiently fund projects and expedite delivering safe water to more tribal members by (1) defining in law “Indian homes, communities, and lands” to clarify which homes and buildings in a tribal community should be eligible for IHS funding, and (2) authorizing IHS to create an exception to allow it to fund ineligible properties when administrative costs would exceed the costs to serve them. These changes would enable IHS to focus more of its limited resources on projects when Tribes do not need to pursue other funding for IHS-ineligible properties. EPA, USDA, and IHS have opportunities to streamline processes and requirements to reduce administrative burdens for Tribes and IHS staff, help Tribes more easily access funding, and make agency collaboration efforts more cost effective. For example: USDA requires additional financial information from Tribes for underwriting to help ensure project sustainability, which can be burdensome for Tribes. IHS and EPA do not require such information or underwriting for their programs. Further streamlining the standard interagency agreements that EPA and IHS use in part to facilitate joint funding of water projects, changing how IHS can distribute EPA funding for projects to Tribes, and streamlining EPA’s application process for certain projects in IHS’s project database could minimize the additional time IHS staff spend helping Tribes pursue EPA funding and administering that funding, which can be significant. Maintenance of a Tribal Water Tank After water infrastructure construction is complete, Tribes’ limited financial capacity can contribute to challenges with operating and maintaining their infrastructure, which can lead to it deteriorating and failing early. For example, Tribes face difficulties with hiring and retaining certified water operators who keep systems in working order, according to an agency study. This can create risks to tribal health and increase costs to the federal government from needing to repair or replace infrastructure. IHS generally does not provide funding to Tribes for routine operations and maintenance (O&M). While IHS has assessed tribal capacity to fund O&M, it has not assessed whether funding O&M could result in federal cost savings and better tribal health. Since Tribes’ needs can vary, more information on the effects of funding O&M on federal costs could help Congress make decisions on how to cost effectively meet those needs. However, IHS officials have said IHS does not have the authority or funding to pay O&M costs. By establishing an IHS pilot program for routine O&M assistance for tribal water infrastructure, Congress would enable IHS to provide direct, on-the-ground assistance to participating Tribes while collecting data that could inform decision-making on whether it is cost-effective to provide that assistance to Tribes on a broader scale. Why GAO Did This Study Safe drinking water and wastewater disposal are critical to public health, but many Tribes have limited resources to build, operate, and maintain water infrastructure. Tribes often do not have access to the same financing options and traditional tax bases as other communities. Tribal water systems have been underdeveloped, and many have fallen into disrepair because of chronic underfunding, according to the U.S. Commission on Civil Rights. IHS estimated that as of November 2025, $6 billion was needed to ensure all tribal communities have access to safe water. GAO has previously reported that Tribes face systemic barriers to accessing federal assistance, including for tribal water infrastructure. IHS, within the Department of Health and Human Services, EPA, and USDA have taken steps to better collaborate with each other, including through a tribal infrastructure task force, but Tribes may continue to experience barriers. Many Tribes also have limited capacity to operate and maintain their water infrastructure, according to agency studies. GAO was asked to review federal tribal water infrastructure assistance. This report examines the extent to which (1) IHS can fund water infrastructure for various properties in a tribal community, (2) opportunities exist to address differing agency processes and requirements when IHS collaborates with other agencies, and (3) IHS funds the operations and maintenance of tribal water infrastructure. GAO reviewed agency data and program documents, including interagency and task force documents; conducted site visits to Alaska and Arizona; and interviewed Tribes, tribal organizations, and headquarters and regional agency officials.

What GAO Found Section 889 of the John S. McCain National Defense Authorization Act for Fiscal Year 2019 prohibits federal agencies from procuring covered telecommunications and surveillance equipment and services from five specific Chinese companies (and their affiliates or subsidiaries) or awarding contracts to companies that use such equipment and services. Following implementation in fiscal year 2019, agencies reduced spending with the five companies through fiscal year 2025 with no spending in three of those fiscal years. As of March 2026, GAO found that nearly 90 percent of companies with active government contracts in fiscal year 2025 represented publicly that they do not use equipment from these companies. Federal Obligations to Five Identified Companies in Section 889 Prohibitions, Fiscal Years 2016-2025   Note: Agencies could have used a waiver to make awards after 2019, which the statute permitted for a certain time. The General Services Administration (GSA) and Department of Defense (DOD) have processes to help ensure they do not buy the prohibited equipment and services or contract with vendors that use such equipment and services. For example, GSA has automated processes to remove prohibited equipment and services on its Multiple Award Schedule contracts used by other agencies. DOD and GSA have search tools that contracting officers and purchase cardholders can use to determine how contractors represent their compliance with the prohibitions in the System for Award Management. However, GSA and DOD do not broadly share their insights from implementing Section 889 prohibitions with other government agencies. This would include information about the five companies’ subsidiaries and affiliates and methods the two agencies have used to enhance insight into the supply chain. For example, based on its experience with Section 889 prohibitions, GSA has plans to expand its use of customs data to identify the origin of goods, which GAO previously reported is difficult to do. By sharing information about their experience with current prohibitions, GSA and DOD could help other agencies address additional upcoming statutory prohibitions, such as on semiconductors. Sharing information could also help improve compliance. Why GAO Did This Study Concerns about the U.S. government’s reliance on Chinese companies for telecommunications and information technology have existed for more than a decade. Government agencies have reported concerns that government procurement of certain foreign-made items could facilitate cyberattacks, espionage, and threats to U.S. national security. A House report asked GAO to report on implementation of Section 889 prohibitions. GAO’s report assesses, among other objectives, how selected agencies have taken actions to ensure compliance with the prohibitions and the extent to which these agencies are sharing information to improve their ability to implement prohibition efforts. GAO identified GSA and DOD processes for ensuring compliance with prohibitions and analyzed federal procurement and System for Award Management data. GAO focused on DOD and GSA as they together account for nearly two-thirds of fiscal year 2025 contract obligations and GSA supports procurements across government agencies. GAO also interviewed GSA and DOD officials to obtain their perspectives on government efforts to comply with prohibitions.

What GAO Found The General Services Administration (GSA) owns and leases thousands of office buildings, which are used by federal employees and the public. The Architectural Barriers Act of 1968 (ABA) requires that certain GSA office buildings be accessible to individuals with physical disabilities. According to GSA officials and documentation, GSA reviews alteration, leasing, and construction projects throughout the design process for compliance with its ABA Accessibility Standard. The U.S. Access Board (Board), an independent federal agency, enforces the ABA by addressing complaints of potential violations of applicable ABA standards. The Board generally relies on complaints rather than inspections due to resource constraints, according to Board officials. Anyone may file complaints with the Board alleging ABA noncompliance of GSA buildings. From October 2022 to June 2026, the Board received 41 ABA complaints about GSA’s office buildings and closed 25; 16 are still in process. Some stakeholders who were aware of the process said it was effective in addressing ABA complaints. However, the public is generally unaware that it can file complaints on accessibility barriers in GSA office buildings, according to almost all the industry stakeholders, federal employee unions, and disability advocates GAO interviewed. Moreover, GSA has not publicized the ABA complaint process. The Board relies on complaints it receives through its complaint process to learn about potential ABA violations and enforce the ABA. Without public information from GSA on this process, such as in its buildings, people with disabilities may be unaware that they are able to file ABA complaints and barriers to the accessibility of GSA office buildings may go unremedied. Accessible Parking Spaces at the Eaglecrest Building in Memphis, TN, Leased by the General Services Administration Why GAO Did This Study Tens of millions of Americans live with disabilities. Those individuals may need to access federal office buildings to work or to obtain government services. GSA’s national accessibility program helps ensure that these individuals can access the more than 6,000 office buildings owned or leased by GSA. The Thomas R. Carper Water Resources Development Act of 2024 includes a provision for GAO related to GSA office buildings and the ABA. This report (1) describes GSA’s practices for ensuring compliance with the ABA during construction, alteration, and leasing of office buildings and recent changes to its ABA program; and (2) examines the extent to which ABA complaints about GSA office buildings are received and addressed, and the extent to which GSA makes individuals aware they can file complaints. GAO reviewed relevant statutes, regulations, and agency documents. GAO conducted site visits to six GSA office buildings with open and closed ABA complaints and with recent construction, alteration, and leasing projects. GAO analyzed October 2022 to June 2026 complaint data from the Access Board. GAO also interviewed nine stakeholders including from industry organizations, federal employee unions, and disability advocates, as well as GSA and Access Board officials.

What GAO Found Many countries, including the U.S., are experiencing an increase in both the number and the proportion of older adults in their populations. According to the World Health Organization, the share of the global population aged 60 and over is expected to more than double from one billion in 2020 to 2.1 billion by 2050. As countries experiencing population aging take steps to address the domestic effects, experts told GAO that global population aging may also affect the U.S. GAO identified three broad U.S. foreign policy interests that may be affected by aging abroad: national security, economic competitiveness, and global health and humanitarian assistance (see figure). Effects of Global Aging on U.S. Foreign Policy Interests GAO identified several key implications of global aging populations for the U.S. by interviewing experts and conducting a literature review. For example, U.S. national security interests may be affected as allies spend more on healthcare for their aging populations, likely resulting in fewer available resources for defense spending. U.S. economic interests may also be affected by shrinking labor pools abroad, which could affect labor force competition and worldwide migration patterns. Lastly, global health interests may be influenced by the prevalence of chronic disease in aging populations. As a result, U.S. global health priorities may have to be adapted to the health-related risks and vulnerabilities faced by aging populations. The Departments of Defense (DOD), Health and Human Services (HHS), and State have some efforts that indirectly address the implications of global aging. These agencies produce research and data, engage with partner nations, and provide health and humanitarian assistance. State’s regional bureaus train younger populations in other countries to replace skills lost when older individuals leave the workforce. Additionally, HHS researches the effects of aging and age-related conditions on populations both domestically and abroad. However, U.S. agencies do not provide foreign assistance that specifically addresses the needs of older populations, according to agency officials. Why GAO Did This Study According to the United Nations, population aging is occurring at an unprecedented pace and is poised to become one of the most significant social transformations of the twenty-first century. As the populations of partners and adversaries age, the U.S. may be affected by this trend. Stakeholders have increasingly identified global aging abroad as a potential strategic challenge for the U.S. Understanding the changes associated with global aging and their potential effects, including consequences for U.S. fiscal policy, may help inform U.S. strategic priorities and goals. GAO was asked to examine the U.S. foreign policy implications of global aging and how U.S. agencies are considering these implications in their programming. This report examines (1) the implications of aging populations worldwide on U.S. foreign policy interests; and (2) U.S. agencies’ efforts to identify and address the implications of aging populations worldwide on U.S. interests. To address these objectives, GAO interviewed experts and conducted a literature review to identify the implications of aging populations worldwide on U.S. foreign policy interests. GAO selected experts from academia and nongovernmental organizations to represent a balance of views. To identify agency efforts to address global aging, GAO reviewed relevant agency documents, policy guidance, and program documentation. GAO also spoke with officials at DOD, HHS, and State. GAO selected these agencies based on their roles in foreign assistance programming and policy development relevant to demographic change. For more information, contact Chelsa Kenney at kenneyc@gao.gov.

What GAO Found The Federal Assets Sale and Transfer Act of 2016 (FASTA) established a temporary process to reduce the inventory of federal civilian real property and the time it takes to dispose of such property. FASTA created the Public Buildings Reform Board (Board) to recommend properties for disposal for approval in each of several rounds. Once approved, the General Services Administration (GSA) takes a primary role in implementation. FASTA also established a fund to help with disposal costs. The last year of FASTA implementation is underway, with two approved rounds—2019 and 2025—and a final round expected to be released before the Board ceases operations in December 2026. As of August 2026, 14 properties (of 23 recommended and approved) have been disposed of for a total of about $576 million in sales proceeds. Most of these disposals were from the 2019 round. Timeframes for completing disposal on many 2025 round properties are not clear due to shifting cost and schedule estimates. Stakeholders said that FASTA’s main benefit is the potential for funding to offset disposal costs, but the uncertainty of accessing this funding has been a significant challenge. Proceeds from initial FASTA disposals are deposited into a fund—the Asset Proceeds and Space Management Fund—that can be accessed to cover the costs of future disposals, subject to congressional appropriation. While Congress appropriated $90 million from 2016 to 2022 for the fund, it did not provide additional FASTA appropriations from 2023 to 2025. Without this appropriation, GSA could not access the full amount of sales proceeds. Timeline of Cumulative Amounts Deposited into and Appropriated from the Asset Proceeds and Space Management Fund In 2026, Congress appropriated an additional about $143 million in FASTA proceeds. However, other longstanding disposal challenges remain. For example, stakeholders said relocating tenants is a challenge, particularly for the 2025 round, as most of these properties remain occupied by federal tenants. GSA and the Board suggested improvements to FASTA if it were extended beyond 2026, including greater access to FASTA sales proceeds. Why GAO Did This Study The federal government owns hundreds of thousands of buildings that cost billions of dollars annually to occupy, operate, and maintain. Disposing of real property that federal agencies no longer need—but continue to pay for—has been a longstanding challenge. The process for disposing of unneeded property may take years, with the federal government bearing the property costs until the disposal is completed. FASTA includes provisions for GAO to review the Board’s recommendations and selection process and annually review agencies’ efforts to implement the FASTA recommendations. This report describes (1) the status of the FASTA disposal process and (2) insights from FASTA implementation as of the Second Round (2025). GAO reviewed published reports, relevant federal laws and regulations. GAO interviewed officials from the Board, GSA, and four selected tenant agencies occupying properties recommended under FASTA. GAO also conducted site visits to four selected FASTA properties included in the 2025 round recommendations. In addition, GAO analyzed GSA real property disposal data from January 1, 2020, through August 5, 2025, to review the amount of time it takes to dispose of federal properties.

What GAO Found The Food and Drug Administration’s (FDA) Center for Devices and Radiological Health (CDRH) administers the Third Party Review Program, a voluntary alternative review process for selected low-to-moderate risk medical devices, such as diagnostic ultrasound systems and surgical lasers. Under this program, which is intended to facilitate faster reviews, device sponsors can contract with FDA-accredited entities. These entities, known as Third Party Review Organizations (third parties), conduct the initial review of certain premarket applications, known as 510(k) submissions. These third party reviews occur prior to agency officials making the final decision about whether the device can be marketed. According to FDA officials, the agency received approximately $8 million for Third Party Review Program operations in fiscal years 2023 through 2027. FDA’s administration of the program includes overseeing third parties’ accreditation and reaccreditation applications to ensure participation standards are met, and reviewing third parties’ recommendations on 510(k) submissions and making final decisions. From fiscal years 2018 through 2025, third parties provided FDA with 617 510(k) submission reviews and recommendations, which accounted for about 2 percent of CDRH’s 510(k) submission reviews annually. Center for Devices and Radiological Health (CDRH) and Third Party 510(k) Medical Device Submission Reviews, Fiscal Years 2018–2025, as of November 2025     Fiscal Year 2018 2019 2020 2021 2022 2023 2024 2025 Number of 510(k) submissions reviewed by CDRH only 3,276 3,464 3,504 3,731 3,554 3,684 3,461 3,476 Number of 510(k) submissions reviewed by Third Party Review Organizations and CDRH 75 78 85 90 77 77 68 67 Source: GAO analysis of Food and Drug Administration data. | GAO-26-108499 FDA is required to audit third parties periodically to ensure they remain in compliance with the standards for program participation. The agency conducted 25 periodic audits of third parties from 2000 to 2026, according to FDA officials. These audits were conducted in four phases: 13 audits from 2000 through 2003, five audits from 2011 through 2013, two audits in 2022, and five audits from 2025 to 2026. Results of these audits varied in terms of the deficiencies identified. GAO found that FDA’s audit policies have gaps and are missing key details. For example, FDA has not established time frames specifying how long it should take the agency to complete an audit and communicate results to third parties. As a result, GAO identified several recent audits with findings of deficiencies, such as language in standard operating procedures being too vague, that took FDA more than 6 months to close. Ensuring the agency has detailed policies, such as time frames for completing audits and communicating results, would strengthen FDA’s efforts to ensure third parties meet program requirements and are therefore eligible to continue reviewing 510(k) submissions, which provide recommendations to FDA as to whether devices should be allowed on the market and thus available for patient use. Why GAO Did This Study FDA, within the Department of Health and Human Services (HHS), is responsible for ensuring that medical devices sold in the U.S. are regulated to provide reasonable assurance of safety and effectiveness. The review process FDA uses to make this determination represents a substantial investment of time and resources for both the agency and the device sponsor. The Food and Drug Administration Modernization Act of 1997 created the Third Party Review Program, which FDA oversees. Since program inception, FDA said it accredited 32 third parties to participate in the program; as of May 2026, there were nine third parties with active accreditations. The Consolidated Appropriations Act, 2023, includes a provision for GAO to report on the Third Party Review Program. This report (1) describes FDA’s roles and responsibilities in administering the Third Party Review Program; and (2) examines the extent to which FDA audits third parties’ performance. GAO reviewed the statute authorizing the Third Party Review Program and FDA’s related policy and guidance documents. GAO analyzed FDA third party performance metrics from fiscal years 2018 through 2025. GAO also reviewed documentation and internal communications from completed third party audits. GAO interviewed FDA officials and representatives from six third parties.

What GAO Found The Federal Aviation Administration (FAA) has identified electromagnetic spectrum-related threats, including spoofing and jamming, to the National Airspace System (NAS) and international flight routes. However, FAA has not completed risk and mitigation assessments, and updated security documentation needed to address these threats. Additionally, FAA did not have a defined, real-time monitoring and detection capability for all spectrum-related threats. Without comprehensive risk and mitigation assessments, complete security documentation, and real-time monitoring capabilities, FAA may not have sufficient information to identify, prioritize, and respond to evolving spectrum-related threats. As a result, spoofing, jamming, and other attacks could disrupt aviation communications, degrade situational awareness, and increase the risk of operational disruptions. Potential Cyberattacks Impacting Aircraft Communications FAA participates in multiple collaborative efforts with other federal agencies as well as non-federal aviation industry stakeholders regarding cybersecurity. FAA's collaborative efforts fully addressed two of the eight leading practices and partially addressed six. While FAA has defined roles and responsibilities within interagency groups, it has not established policies or procedures for information sharing, reporting, and coordination with non-federal partners outside those groups. Fully implementing leading collaboration practices could strengthen FAA's ability to effectively coordinate with key partners to mitigate cybersecurity threats affecting the aviation sector and thereby avoid fragmented and inefficient responses to incidents. The communication applications that FAA, pilots, and aviation stakeholders use to exchange text-based information are vulnerable to cyber threats, including interception and spoofing, due to limitations related to authentication, encryption, and protocol design. For example, a malicious actor could transmit fraudulent clearance cancellations, possibly leading to flight delays or safety issues. Until FAA develops and implements a plan to strengthen authentication and data protection for these applications, malicious actors could exploit weaknesses and increase the risk of disrupted flight operations, aviation accidents, or safety incidents. Why GAO Did This Study Commercial flight operations rely on interconnected systems that reside onboard an aircraft and on the ground in the NAS. These systems use radio frequency signals transmitted through the electromagnetic spectrum to communicate. The Servicemember Quality of Life Improvement and National Defense Authorization Act for Fiscal Year 2025 includes a provision for GAO to review the vulnerability of the NAS to spectrum attacks and to assess efforts to prevent and prepare for such attacks. This report examines, among other objectives, the extent to which FAA has identified and mitigated spectrum-related cybersecurity threats; the extent to which FAA has collaborated with federal partners to defend against cybersecurity threats; and what specific cybersecurity vulnerabilities exist in key communication applications. To address these objectives, GAO analyzed FAA vulnerability assessments to identify spectrum-related threats to the NAS. GAO selected eight spectrum-dependent systems and assessed them against National Institute of Standards and Technology guidance. GAO also assessed key FAA collaboration mechanisms against leading practices. In addition, GAO reviewed FAA documentation to identify vulnerabilities with communication applications. GAO interviewed FAA officials and federal and non-federal stakeholders.