The National Indian Health Board (NIHB) Board of Directors set forth the 2025 NIHB Legislative and Policy Agenda to advance the organization’s mission. This agenda guides the work of NIHB as we work to advance national Tribal health priorities and provides a blueprint for ensuring that all American Indian and Alaska Native (AI/AN) people can achieve the highest level of health and well-being. Tribal Nations are distinct domestic sovereign governments. The United States Constitution, Supreme Court decisions, and numerous laws and treaties recognize this status and distinction. The United States has executed hundreds of treaties with Tribal Nations in which millions of acres of Tribal lands and natural resources were ceded, often involuntarily, in exchange for the resulting federal trust obligations and responsibilities that exist in perpetuity, including, but not limited to, health care for American Indians and Alaska Natives (AI/AN). These obligations and responsibilities are part of a nation-to-nation agreement. The federal government has committed to honoring and advancing Tribal sovereignty, fulfilling treaty promises, and upholding the trust responsibility to Tribes. This relationship requires that the federal government acts transparently, respectfully, and consistently on a government-to-government basis with Tribes across Indian Country.

Throughout this agenda, all policy priorities adhere to these overarching principles: upholding the federal trust responsibility, promoting the highest health status possible for Tribal citizens, full funding for health services, advancing Tribal sovereignty and self-determination, and incorporating traditional healing practices.