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

Legislative Action Alerts are only sent to your inbox when legislation relevant to Indian health is introduced, debated, or voted upon. These timely alerts will provide background information and a pathway for you to get involved in the issue at hand.

Advance Appropriations

The National Indian Health Board, along with the National Congress of American Indians, and the National Council on Urban Indian Health are working with Congress to achieve advance appropriations for the Indian Health Service (IHS). 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 Fiscal Year (FY) 2020 advance appropriations for the IHS were included in the FY 2019 appropriations bills, those advance appropriations would not be counted against the FY 2019 funding allocation but rather, against the FY 2020 allocation. If IHS were to receive advance appropriations, it would not be subject to government shutdowns or automatic sequestration cuts as its funding for the next year would already be in place.

On January 25, 2019, Senator Tom Udall (D-NM), Ranking Member of the Senate Committee on Indian Affairs, introduced the “Indian Programs Advanced Appropriations Act” (S. 229). This legislation would allow the Bureau of Indian Affairs, the Bureau of Indian Education, and the Indian Health Service to receive advanced appropriations starting in Fiscal Year (FY) 2020. Congresswoman Betty McCollum (D-MN), the Chair of the appropriations subcommittee on Interior, Environment, and Related Agencies, introduced an identical bill in the House (H.R. 1128). Congressman Don Young (R-AK) a senior member of the House Natural Resources Committee, also introduce H.R. 1135, the Indian Health Service Advance Appropriations Act, which provides advance appropriations to the IHS.

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. Since FY 1998, there has been only one year (FY 2006) when the Interior, Environment, and Related Agencies budget, which contains the funding for IHS, has been enacted by the beginning of the fiscal year. The lateness in enacting a final budget during that time ranges from 5 days (FY 2002) to 197 days (FY 2011). These delays make it very difficult for Tribal health providers and IHS to adequately address the health needs of American Indians and Alaska Natives. When the Veterans’ Administration health programs achieved advance appropriations in 2009, the Congressional Budget Office ruled that it would not affect spending or revenue. Advance appropriations will allow IHS and Tribal health professionals time to plan and tackle many other administrative hurdles, thereby enriching access to care.

We need your help! Please contact your Members of Congress to urge them to co-sponsor the “Indian Health Service Advance Appropriations Act” (H.R. 1135), and the “Indian Programs Advanced Appropriations Act” (H.R. 1128 and S.229). NIHB and its partners are also 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.

  • NIHB’s resolution supporting advance appropriations:
    Click Here
  • Fact sheet on advance appropriations that you can share with Congress:
    Click Here
  • FAQ’S on advance appropriations for the Indian Health Service:
    Click Here
  • Government Accountability Office Report on Advance Appropriations for IHS:
    Click Here
  • Congressional Research Service report on Advance Appropriations:
    Click Here
  • H.R. 1135 “Indian Health Service Advance Appropriations Act of 2019”:
    Click Here
  • H.R. 1128 “Indian Programs Advance Appropriations Act”:
    Click Here
  • S.229 “Indian Programs Advance Appropriations Act”:
    Click Here
  • Sample letter to Congress on advance appropriations:
    House and Senate


Legislative Inquiries:

Stacy A. Bohlen
CEO of NIHB

910 Pennsylvania Ave, SE
Washington, DC 20003
Phone: 202-507-4073
Email: [email protected]