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.

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Advance Appropriations

After more than a decade of tireless advocacy by Tribes, Tribal organizations, and Champions for Indian Country, on Friday, December 23, 2022, Congress enacted a Fiscal Year (FY) 2023 omnibus spending package, including FY 2024 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.

This enactment marks a historic paradigm shift in the nation-to-nation relationship between Tribal nations and the United States. With advance appropriations, American Indians and Alaska Natives will no longer be uniquely at risk of death or serious harm caused by delays in the annual appropriations process. However, inclusion of advance appropriations each year is not guaranteed.

The treaty and trust obligations of the United States to provide for Indian health care are duties that should be mandatory direct appropriations; but until such time, advance appropriations are an interim step that will save lives. NIHB is working to promote smooth implementation of this policy and ensure that IHS advance appropriations are included each year, as we continue to collaborate with Tribal leadership for the advancement of mandatory direct appropriations for the Indian Health Service.

A Special Thank You

This success would not have been possible without all the advocacy from Tribes, Tribal organizations, and Urban Indian organizations. 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.


Legislative Inquiries:

Caitrin McCarron Shuy, MSc
Government Relations Director
50 F St NW, Suite 600
Washington, DC 20001
Email: [email protected]

National Indian Health Board
50 F St NW, Suite 600 | Washington, DC 20001 | Phone: 202-507-4070 | Email: [email protected]