Washington Report

An NIHB Publication

The Washington Report is an e-newsletter produced by the National Indian Health Board. Each issue contains a listing of current events on Capitol Hill, information on passed and upcoming legislation, Indian health policy analysis and action items.

Read More

Advance Appropriations

The National Indian Health Board, along with the National Congress of American Indians, the National Council on Urban Indian Health and the Maniilaq Association are working with Congress to achieve advance appropriations for the Indian Health Service. On January 15, 2015, Congressman Don Young (R-AK), Chairman of the House Natural Resources Subcommittee for Indian and Alaska Native Affairs, along with Rep. Ben Ray Lujan (D-NM), introduced the “Indian Health Service Advance Appropriations Act of 2015” (H.R. 395). This legislation would allow for the Indian Health Service (IHS) to receive advance appropriations. An advance appropriation is funding that becomes available one year or more after the year of the appropriations act in which it is contained. For example, if the FY 2017 advance appropriations for the IHS were included in the FY 2016 appropriations bills, those advance appropriations would not be counted against the FY 2016 funding allocation but rather, against the FY 2017 allocation.

Adopting advance appropriations for IHS would result in the ability for health administrators to continue treating patients without wondering if –or when– they would have the necessary funding. Additionally, IHS administrators would not waste valuable resources, time and energy re-allocating their budget each time Congress passed a continuing resolution. Indian health providers would know in advance how many physicians and nurses they could hire without wondering if funding would be available when Congressional decisions funnel down to the local level. When the Veterans’ Administration health programs achieved advance appropriations in 2009, the Congressional Budget Office ruled that it would not affect spending or revenue.

We need your help! NIHB and its partners are encouraging Tribes to pass resolutions and send letters to Congress in support of this important issue in order to demonstrate widespread support in Indian Country. We are also encouraging you to share your story on how funding delays have impacted health care delivery at your Tribe.

  • NIHB’s resolution supporting advance appropriations CLICK HERE (PDF).
  • Advance Appropriations Outreach Toolkit CLICK HERE (PDF).
  • Former NIHB Chair Cathy Abramson wrote an op-ed in support of Advance Appropriations for IHS which appeared in The Hill newspaper on September 22. You can read it here.
  • Fact sheet on advance appropriations that you can share with Congress CLICK HERE (PDF).
  • Congressional Research Service report on Advance Appropriations CLICK HERE (PDF).
  • NIHB delivered testimony to Congress on Advance Appropriations twice in 2014.
  • Sample letter to Congress on advance appropriations CLICK HERE (DOC).
  • To view a sample resolution CLICK HERE (DOC).
  • Help us Achieve Advance Appropriations by sharing your story. CLICK HERE (PDF) to learn more.


Legislative Inquiries:

Caitrin Shuy
Director, Congressional Relations

910 Pennsylvania Ave, SE
Washington, DC 20003
Phone: 202-507-4085
Email: [email protected]