Washington, DC – Friday, December 23, 2022 – Today, Congress enacted a Fiscal Year (FY) 2023 omnibus spending package, including a historic provision providing advance appropriations for the Indian Health Service (IHS). Prior to this change, IHS was the only federal healthcare provider without basic certainty of funding from one year to the next.

The Indian health system serves approximately 2.5 million patients at IHS, Tribal facilities, and urban Indian organizations, and was created to meet the U.S. trust responsibility to raise the physical, mental, social, and spiritual health of all Native people to the highest standard. Unfortunately, Indian healthcare remains chronically underfunded – a U.S. policy exacerbated by disruptions in the discretionary appropriations process.

With advance appropriations, American Indians and Alaska Natives will no longer be uniquely at risk of death or serious harm during delays in an FY 2024 funding agreement. Inclusion of IHS advance appropriations in the spending bill means that IHS services will be protected from the harmful effects of disruptions in federal funding for FY 2024 because Congress has agreed to an amount this year that becomes available immediately on October 1, 2023.

“Including advance appropriations for Indian health in the omnibus is a historic moment for Indian Country over a decade in the making. While Indian health remains chronically underfunded, this provision will help ensure that the Indian Health Service can provide stable, uninterrupted care to our people even when there is a government shutdown. We are confident that we can build on this win and continue our work toward full and mandatory funding for the Indian Health Service, fulfilling the promises this country made to our people over two centuries ago.”

• William Smith (Valdez Native Tribe), Chairman of the National Indian Health Board

“We applaud Congress and the White House for listening to Native communities and doing what is right. For far too long, the federal government has allowed political disputes over budgets to jeopardize the lives of American Indian and Alaska Native people. Every single time there is a stopgap budget, the funding for urban Indian health clinics is deferred and reduced. This compromises the delivery of health care. We look forward to working with our leaders to help the United States make good on its responsibility to provide health care for the people who gave up the land we are on today.”

• Sonya Tetnowski (Makah), President of the National Council of Urban Indian Health

“The National Congress of American Indians (NCAI) in partnership with our invaluable allies at the National Indian Health Board (NIHB) and the National Council of Urban Indian Health (NCUIH) have fought for years to get advanced appropriations for the Indian Health Service (IHS) and commends Congress for taking this critically important step for Indian Country. This historic decision comes not a moment too soon as Indian Country continues to be plagued by an ongoing health crisis that affects all of our communities. This week's action represents a meaningful step taken by the United States towards fulfilling its trust and treaty responsibilities to Tribal Nations and we are grateful for it as we continue to call on the United States to make good on all of its promises made to our ancestors so that our communities may continue to thrive."

• Fawn Sharp (Quinault Indian Nation), President of the National Congress of American Indians

This success would not have been possible without all the advocacy from Tribes, Tribal organizations, and Urban Indian organizations. As part of this effort, the National Indian Health Board, the National Congress of American Indians, and the National Council of Urban Indian Health have been part of a broad coalition of advocates and champions for IHS advance appropriations. Our organizations would like to thank the coalition for its dedication and leadership during this endeavor.

We would like to also provide special thanks to Leader Schumer, Speaker Pelosi, and the Biden-Harris administration for championing this historic change, as well as House and Senate appropriators, the Senate Committee on Indian Affairs, the House Committee on Natural Resources, the House Native American Caucus, and all of Indian Country’s champions throughout Congress. Finally, we would like to thank Office of Management and Budget Director Shalanda Young, Department of Health and Human Services (HHS) Secretary Becerra, IHS Director Roselyn Tso, and all the OMB and HHS staff who worked tirelessly to realize this moment. Together, we made history.

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