Last week, Congress passed the Commerce, Justice, Science; Energy and Water Development; and Interior and Environment Appropriations Act, funding three key appropriations accounts for Fiscal Year 2026, including the Indian Health Service.
Once signed into law by the President, the minibus provides full-year funding through September 30, 2026, for the Indian Health Service, Bureau of Indian Affairs, and Bureau of Indian Education. This legislation provides $8.05 billion for the Indian Health Service overall, including $5.05 billion for IHS Services and $809.22 million for IHS Facilities, a 1.3% increase over FY 2025. Additionally, the legislation includes $5.31 billion in advance appropriations for Fiscal Year 2027, a historic and critical inclusion for the future.
Key Line-Item Funding:
- $5.05 Billion in IHS Services
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- Self-Governance: $6.17 million (flat funding)
- Urban Indian Health: $95.42 million ($5 million increase)
- Indian Health Professions: $84.57 million ($4 million increase)
- Direct Operations: $103.8 million (flat funding)
- Tribal Management: $2.99 million (flat funding)
- Preventative Health: $206.12 million (1.3 million increase)
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- $4.55 Billion in Clinical Services
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- Hospitals and Health Clinics: $2.63 billion ($46.6 million increase)
- Indian Health Care Improvement Fund: $74.14 million (flat funding)
- Electronic Health Records: $190.56 (flat funding)
- Dental Health: $260.36 million ($6.24 million increase)
- Mental Health: $133.69 million ($3.58 million increase)
- Alcohol and Substance Abuse: $267 million ($309,000 increase)
- Purchased and Referred Care: $996.76 million (flat funding)
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- Contract Support Costs: $1.82 billion ($217 million estimated decrease)
- 105(l) Lease: $366 million ($34 million estimated decrease)
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- $809.22 Million in IHS Facilities
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- Sanitation Facilities Construction: $107.94 million ($1.32 million increase)
- Health Care Facilities Construction: $184.68 ($2 million increase)
- Maintenance and Improvement: $170.6 million (flat funding)
- Facilities and Environmental Health Support: $311.41 million ($3.83 million increase)
- Equipment: $34.6 million ($2 million increase)
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The National Indian Health Board applauds Congressional leaders and appropriators for including advance appropriations for FY27. During the historic government shutdown in October 2025, the Indian Health Service was able to remain 100 percent open, not missing a single payment and maintained life-saving and essential direct care services without disruption. Advance Appropriations at the Indian Health Service is lifesaving and NIHB thanks Congress for maintaining this advance funding in FY27.
What’s Next?
While Congress has passed full year funding for the Indian Health Service for Fiscal Year 2026, there are still six appropriations accounts that must be passed before January 31, 2026, to avoid another partial shutdown.
This includes the Labor, Health, and Human Services bill, which provides funding for all Department of Health and Human Services accounts outside of the Indian Health Service. Congressional leaders continue to conference on these critical funding accounts and are expected to release further agreement details in the coming days. Additionally, there are several critical public health programs set to expire on January 31, 2026. Most notably, Congress must extend funding for the Special Diabetes Program for Indians as well as extend Medicare telehealth flexibilities, Community Health Center funding, National Health Service Corps funding, and the Medicare Hospital-at-Home program. NIHB continues to advocate for increased health funding and resources across Indian Country.
Previously, NIHB and IHS reported that the Interior, Environment, and Related Agencies Appropriations Act included a small decrease in funding for FY 2026 for the IHS. This was reported in error, due to the IHS’ estimations for FY 2026 105(l) Lease Payments and Contract Support Costs (CSCs) being lower than the IHS’ estimations for FY 2025. However, 105(l) Lease Payments and CSC will continue to be provided for at the level necessary (such sums which may be necessary), regardless of the IHS or Congress’ estimations. Additionally, Congress provided a total of $5.05 billion for IHS services, representing a 1.3% increase over FY 2025 and $809.22 million for IHS facilities, representing a 1.1% increase over FY 2025. The IHS is funded at a full total of $5.86 billion for services and facilities, an increase of 1.3% over FY 2025.
