NIHB Testifies on Indian Health Service Advance Appropriations Act

WASHINGTON, D.C. – Jonathan Nez, President of the Navajo Nation and a National Indian Health Board (NIHB) Board Member, recently testified before the U.S. House of Representatives Natural Resources Committee Hearing on the HR 5549 Indian Health Services Advance Appropriations Act, introduced by the late Congressman Don Young (AK).

The HR 5549 Indian Health Services Advance Appropriations Act is a continuation of bipartisan Congressional efforts that increases tribal and federal government efficiency, reduces federal taxpayer waste, and saves American Indian/Alaska Native (AI/AN) lives by providing stable funding for health care services in Indian Country. NIHB recognized advance appropriations included in President Biden’s Fiscal Year (FY) 2023 funding request and urges Congress to include advance appropriations for the Indian Health Service (IHS) in this FY appropriations bill, which sets overall spending limits by agency.

During the most recent 35-day government shutdown in 2019, IHS was the only federal health care program directly harmed.

“The Navajo Nation’s 27,000 sq. mi. of land and more than 400,000 tribal citizens were especially hard hit during the worldwide COVID-19 pandemic,” said President Nez. “While there is no good time for government shutdowns to occur, it will take years following the COVID-19 pandemic before tribal nations are resilient enough to withstand another government shutdown.”

IHS faces chronic challenges made worse by endless use of continuing resolutions (CRs) and the persistent threat of government shutdowns. IHS is the only one of four federal health delivery programs not protected from government shutdowns and CRs. Medicare/Medicaid receive mandatory appropriations. The Veterans Health Administration receive advance appropriations starting a decade ago.

In September 2018, the Government Accountability Office issued a report that noted “uncertainty resulting from recurring CRs and from government shutdowns has led to adverse financial effects on tribes and their health care programs.” If the uncertainly of CR’s continue, so too does the threat to an interruption of the treaty and trust obligation for the only class of Americans with a federal treaty right to health care.

“Advance Appropriations for IHS is a step towards fully honoring the treaty and trust obligation for health,” said President Nez. “It would constitute a demonstrated commitment that Congress will enact solutions that address the health inequities and ensure the health and wellness of tribal communities.”