Washington, D.C. - March 10, 2023 - William Smith, Chairman of the National Indian Health Board (NIHB), testified before the House Appropriations Subcommittee on Interior, Environment, and Related Agencies, March 9, 2023. Smith highlighted the disparities in life expectancy, diabetes rates, and infant and maternal death rates as a direct result of funding shortfalls for the Indian Health Service (IHS). Smith also testified on the importance of Congress keeping its promises to the Tribes during budget discussions. 

“The IHS need-based cost estimate for [FY] 2024 is about $51.4 billion, and the cost estimate for 2025 is about [FY] $53.8 billion,” Smith said.

IHS is currently funded at just under $7 billion. NIHB supports the recommendations of the IHS Tribal Budget Formulation Workgroup. Smith's testimony also supported enacting full, mandatory appropriations for IHS, and continuing IHS advance appropriations until mandatory funding is achieved.  Smith also said that as Congress considers budget cuts in FY 2024, it must hold IHS harmless to any reductions in funding.

In direct response to Smith’s testimony, Congressman Mike Simpson (R-ID), chairman of the subcommittee, identified a spending disparity for healthcare costs between the general population and American Indians and Alaskan Natives (AI/AN) and said the subcommittee would not cut Indian Healthcare in the budget.

“We are going to have to prioritize Indian Healthcare in these budgets,” said Simpson. “I spoke to my staff and said, ‘what are we going to do when we get a budget that requires 25% cuts?’ There are some areas we are going to have to protect. Indian Healthcare is going to be one of them.”

It is critical that Tribal health advocates continue to meet with Members of Congress to ensure that the House Appropriations Committee follows through on that commitment.

After the morning hearing, NIHB Board members also visited Congressional offices to advocate for increased funding for Indian Health, continued and expanded advance appropriations for the IHS, and long-term renewal of Special Diabetes Program for Indians, which expires on September 30, 2023. The Members of Congress and staff that the NIHB Board members met with expressed their support for these priorities but noted the need to continue to work on these issues during the 118th Congress. 

Watch NIHB Chairman Smith's full testimony here. (His statement begins at the 1:02:14 mark)

Read NIHB's written testimony here.