Nominations are submitted to the National Council on the Arts, the advisory committee of the National Endowment for the Arts (NEA), who then submits its recommendations to the White House for the President of the United States to award.

The ceremony was not held in 2021 or 2022 due to the COVID-19 pandemic therefore the 2021 recipients were given the award in 2023.

[3] In 1989, composer and conductor Leonard Bernstein refused his award, allegedly due to how a federal grant to an art show on AIDS had been revoked.

[10] In 1992, composer and lyricist Stephen Sondheim refused his award, claiming that the NEA had "become a victim of its own and others' political infighting and is rapidly being transformed into a conduit and a symbol of censorship and repression rather than encouragement and support".

[11] In 1997, poet Adrienne Rich refused her award as a protest against "inconsistencies" between art and "the cynical politics" of the Clinton administration.