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Today, President Trump sent the Fiscal Year (FY) 2027 President’s Budget Request to Congress. After careful review, NIHB has collected our initial reaction and perspective on the most important aspects of the proposal impacting Indian health.
Overall, the Administration is requesting $9.094 billion for the Indian Health Service (IHS), a $1.1 billion increase over the FY 2026 funding levels enacted by Congress. Additional detail can be found in the congressional justification.
The Administration’s priorities include many meaningful advancements on longstanding Tribal priorities. Specifically, proposed support for Advance Appropriations would increase by $800 million. Additionally, the Request calls for substantial investment in Electronic Health Record (EHR) modernization and continued increases in funding for Health Care Facilities Construction, a major priority of the Administration, both of which are longstanding priorities for NIHB.
Additional highlights of the President’s Budget Request to Congress for IHS include:
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Would provide $5.6 billion in advance appropriations for
FY28 an increase of $327 million, continuing to provide essential protections from government shutdowns.
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Would provide $287.07 ,million for EHR modernization, a $96.44 million increase.
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Would fully fund Contract Support Costs (CSC) and 105(l) lease agreements, as required by law, providing an estimated an estimated $1.96 billion in CSC and $929 million in 105(l) leases.
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Would provide $2.84 billion for Hospitals and Health Clinics, a $202.6 million increase over FY26 enacted levels. Also includes funding for five new facilities in Alaska, Arizona, Nebraska, and Washington, across multiple line items.
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Would cut Sanitation Facilities Construction by 87%, requesting $14 million to further these efforts.
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Would cut Special Diabetes Program for Indians (SDPI) by 75%, requesting $49 million for FY27, a $150.6 million decrease.
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Would increase Purchased/Referred Care by $57.7 million, requesting $1.05 billion for PRC in FY27.
- Would provide $95 million for Urban Indian Health, a $418,000 decrease of funding.
Overall, the President proposes $111.1 billion in funding for all of Health and Human Services (HHS), a 12% decrease from enacted FY2026 levels. NIHB will release a full analysis of the President's Budget Request to Congress for HHS funding in the coming days and continue to share our perspective as dialogue continues. In the meantime, we have developed a line-by-line breakdown of proposed increases and decreases that can be found on our blog.
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