The National Indian Health Board is a dedicated advocate in Congress on behalf of all Tribal Governments and American Indians/Alaska Natives. Each weekly issue contains a listing of current events on Capitol Hill, information on passed and upcoming legislation, Indian health policy analysis, and action items. To view all of our legislative resources, please visit www.nihb.org/legislative/washington_report.php.
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This Week: Articles and Action Items
- NIHB, Tribes, Organizations, and Friends of Indian Health Join to Push for Advance Appropriations
- President Seeks Additional COVID-19 Relief Funding
- Meet the Members: Alaska
- Advance Appropriations: What Happens When Government Funding Expires
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NIHB, Tribes, Organizations, and Friends of Indian Health Join to Push for Advance Appropriations
The National Indian Health Board (NIHB) along with 72 Tribes, Organizations, and friends of Indian health that represent well over 1 million American Indian, Alaska Natives, and friends of Indian health joined to urge Congress to include advance appropriations and no less than the House of Representatives passed level of $8.114 billion for FY 2022 funding for Indian health care. The letters were sent to the following House of Representatives and Senate Committees:
If passed, that level of funding would be an increase of $1.884 billion over the FY2021 enacted level. In addition, if advance appropriations are secured, Indian health programs would be protected against the harmful impacts of continuing resolutions (temporary funding measures) and government shutdowns.
The current continuing resolution expires on this Friday, March 11, 2022. Congress is negotiating and finalizing an omnibus appropriations bill to fund the federal government through the end of FY2022 which ends on September 30, 2022. The omnibus bill may be released for review as early as Wednesday, March 9, 2022.
WHY THIS MATTERS AND WHAT YOU CAN DO
To see more information on advance appropriations and what you can do to help secure and advocate for better funding and advance appropriations for Indian health care, please review the information available in the 'Congressional Spotlight' section of this week's The Washington Report.
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President Seeks Additional COVID-19 Funding
This week, Congress is finalizing the Omnibus Appropriations bill to fund the federal government through the end of the Fiscal Year 2022. Additional COVID-19 relief funding of up to $15 billion is being proposed to be included in this bill - this is a new development the President stressed in his State of the Union Address on March 1, 2022. Tribes have still been addressing COVID-19 challenges for the past two years. Past COVID-19 relief packages have been welcomed, but have not addressed the underlying conditions which contributed to more tragic COVID-19 outcomes throughout Tribal communities. Additional COVID-19 funding is still required to continue fighting this pandemic in Tribal communities, in addition to advance appropriations and no less-than the House-passed levels for Indian health care of $8.114 billion. This is another important development that National Indian Health Board will be tracking and updating as the omnibus appropriations bill will be released in the upcoming days.
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Senator Lisa Murkowski (R-AK)
Senator Murkowski was elected to the U.S Senate in 2002 and is currently serving her third term. She is seeking a fourth term in the November 2022 Congressional elections. Senator Murkowski advocates for Alaska Native issues, including health care, and other issues related to clean, renewable energy and public land.
Committees
Indian Health-Related Legislative Actions
The National Indian Health Board (NIHB) of Directors passed Resolution no. 22-01 on February 24, 2022 that encourages the U.S government to accept responsibility for the boarding school policy, provide direct non-competitive funding to Tribes, assist with healing from historical and intergenerational trauma from the boarding school policies, and provide resources for programmatic services that encourages reclamation of American Indian/Alaska Native (AI/AN) languages. Read the resolution here.
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Senator Dan Sullivan (R-AK)
Senator Dan Sullivan was re-elected to the U.S Senate in 2020 and currently serving his second term. Senator Sullivan's top issue priorities relating to Indian health care are veterans' affairs and supporting and protecting survivors of sexual assault, domestic violence, and addiction.
Committees
Indian Health-Related Legislative Actions
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Representative Don Young (R-AK-At-Large)
Representative Don Young is currently serving his 25th term in the U.S House of Representatives when first elected in 1973 and is the longest serving member of the current 117th Congress. He is up for re-election in the November 2022 Congressional elections. Representative Young advocates for promoting and defending native economic development and health care and improving Alaska's transportation and infrastructure development.
Committees
Indian Health-Related Legislative Actions
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Advance Appropriations: What Happens When Government Funding Expires
Each year Congress must pass appropriations bills to fund the government by the end of the fiscal year which is September 30, 2022. Individuals and Tribes have been fighting for advance appropriations in the final Omnibus Appropriations for FY 2022. You can download the National Indian Health Board's (NIHB) Toolkit here. This omnibus bill may be finalized early this week and released for review as early as Wednesday, March 9, 2022. It must be passed by Congress by Friday, March 11, 2022, or another short-term continuing resolution must be passed again to give Congress more time to pass the final bill.
If those bills, either individually or wrapped up in an “omnibus”, are not passed, then congress must pass a continuing resolution until the final appropriations bills are enacted or else the government “shuts down”. The last time congress passed all appropriations bill by the September 30 deadline was in 1996.
During a shutdown, no new funding is provided. For the Indian Health Service (IHS), the Department of Health and Human Services develops a shutdown contingency plan which identifies the IHS employees who are identified as essential and the number of employees that may be covered by other carryover or third party funding (such as Medicare, Medicaid, or private insurance), or may be subject to furlough. However, when no funding is provided for the Tribes, they must then rely on either remaining carryover, available third party funding, or Tribal funding not otherwise obligated or designated.
A continuing resolution is a temporary funding measure to provide a portion of the fiscal year funding until congress passes a full appropriations bill. Both IHS and Tribal health programs may only receive a portion of their full year of funding. In both instances, other available funds, if any, for both the Tribes and IHS are limited and are then no longer available for other expenses, such as purchasing new medical equipment or hiring additional health professionals. In past shutdowns, patients have experienced delays in health care services and appointments and IHS employees have experienced income hardships during furloughs.
Advance appropriations are intended to avoid this type of uncertainty for patients and employees of the Indian health care system. In simple terms, advance appropriations is authority for funding a year in advance. If a continuing resolution or shutdown occurs, the funding is already authorized and the IHS and Tribes would not be subject to the budget instability of the continuing resolution or shutdown.
The request for advance appropriations has been a top priority for Tribal nations so that their health care systems, programs, and patients would not get impacted. It is just a first step in securing budget stability for the Indian health care delivery system. If advance appropriations are not included in the omnibus appropriations for FY 2022, then the process for authorizing it, will have to start all over again. That is, first, by including it in the President’s Budget Request for FY 2023 (which currently does not have a specific release day yet, but could be released in late March or early April, 2022) and again the Congressional Budget Resolution for FY 2023.
It will help limit the negative impacts as the Tribal nations continue to work on additional means of budget stability. Those additional steps include examining and evaluating mandatory funding for the entire Indian health care delivery system. In January, 2022, the National IHS-Tribal Budget Formulation Workgroup has established a subgroup to begin reviewing and evaluating mandatory funding for Indian health care. To review past work of this Workgroup for FY 2023, please review the Workgroup’s Recommendations here.
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Register for the National Tribal Public Health Summit 2022
This year’s summit theme is Tribal Health is Public Health and will feature dynamic national speakers, interactive workshops and roundtable discussions, a welcome reception, a fitness event, as well as the presentation of the Native Public Health Innovation Awards.
Plan now and take advantage of the Early Bird registration rates! Register here.
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