On Thursday, July 28, 2022, the Senate Committee on Appropriations released the Interior and Related Agencies appropriations bill. The appropriations package provides advance appropriations for the Indian Health Service and Indian Health Facilities account. The National Indian Health Board (NIHB) Chairman William Smith (Valdez Native Tribe) highlighted “the historic nature of the possibility of enacting advance appropriations for the Indian Health Service to stabilize health care in Indian Country.”

The Interior and Related Agencies bill provides $11.52 billion for Tribal programs. For Fiscal Year (FY) 2023, the bill provides $7.38 billion for the Indian Health Service (IHS), an increase of $762 million above the FY 2022 enacted level. This provides $2.7 billion for hospitals, clinics, doctors, nurses, and health services; $260 million for dental health; and $127 million for mental health programs such as suicide prevention initiatives for American Indian and Alaska Native (AI/AN) youth, and tele-behavioral health programs.

The bill also provides an advance appropriation of $5.577 billion for the IHS for FY 2024. Therefore, the vast majority of Indian Health Service funding will be provided by an advance appropriation. The Committee noted in the Appropriations Bill Summary that “budget uncertainty due to temporary lapses of appropriations and continuing resolutions affect the orderly operations of critical healthcare programs for AI/AN communities.” Advance appropriations will enable IHS to continue to provide health services without interruption or uncertainty, improving the quality of care and providing peace of mind for patients and medical providers.

This funding also increases Indian Health facilities investments by 15 percent for a total of $1.08 billion for new hospital construction, new and replacement equipment, and water and solid waste infrastructure improvements for AI/AN communities, which are critically important for public health. 

For nearly a decade, NIHB has worked alongside Tribal Nations and other Tribal and urban Indian health advocates to secure advance appropriations for IHS. Following the devastating impact in 2013 of the 16-day government shutdown, NIHB moved quickly to pass Resolution 14-03 in Support of Advance Appropriations for IHS. Since that time, there have been numerous bi-partisan bills introduced in support of advance appropriations for IHS by champions such as Senator Lisa Murkowski (AK), Congresswoman Betty McCollum (MN), and the late Don Young (AK), to name just a few. 

Just today, Jonathan Nez, President of the Navajo Nation and an NIHB Board Member, testified in support of advance appropriations as the first and vital step toward truly honoring the treaty and trust obligation as an entitlement. “This first step in elevating Indian Health Care to advance appropriations is significant and welcomed”, said NIHB Chairman William Smith. 

See below for more information on the Senate Interior and Related Agencies Appropriation Bill:

What can Tribes do? Tribes can contact their member of Congress and ask them to support this legislation.

For questions, please contact NIHB Director of Government Relations Aaron Payment, EdD, at apayment@nihb.org.