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 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, a small decrease from Fiscal Year 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:
- $4.55 Billion in Services
- 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)
- Contract Support Costs: $1.82 billion ($217 million decrease)
- 105(l) Lease: $366 million ($34 million decrease)
- 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: $2.99 million (flat funding)
- Self-Governance: $6.17 (flat funding)
- $809.22 Million in Facilities
- 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)
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.
