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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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Bipartisan Legislation to Permit Half-Time Health Care Providers to Receive Loan Repayments Through IHS

On October 4th, Senators Cortez Masto (D-Nev.) and Mullin (R-Okla.) introduced the Indian Health Services (IHS) Workforce Parity Act of 2023 with the goal of making it easier for IHS to retain current providers while also recruiting new doctors. The proposed bipartisan legislation would allow part-time health care providers to access IHS scholarships and loan repayment programs as they serve the more than 2 million American Indian and Alaska Natives (AI/ANs). “I am confident this legislation will address the current difficulty IHS is facing in recruiting and retaining healthcare professionals,” said Senator Mullin in a press release.

Both Senators Cortez Masto and Mullin noted the bill would bring IHS in line with the National Health Service Corps (NHSC) loan and scholarship programs. The IHS Workforce Parity Act of 2023 is another piece of legislation aimed at leveling the playing field between the IHS and NHSC programs to make the rounds on Capitol Hill. Another difference between the two programs is that the NHSC Loan Repayment Program (LRP) is tax exempt while the IHS LRP is not tax exempt. According to IHS, tax-exempt status would allow the agency to award 190 more scholarships, thereby increasing the number of providers in Indian Country[1]. In the 117th Congress, Representative Moore (D-Wis.) sponsored the Indian Health Service Health Professions Tax Fairness Act of 2022 that would have amended the Internal Revenue Code to make the IHS LRP tax exempt. The Indian Health Service Health Professions Tax Fairness Act of 2022 was last referred to the House Ways and Means committee in April of 2022. The National Indian Health Board passed a resolution supporting this in 2023. You can view that resolution here.

IHS has a 28% vacancy rate for health care providers with the Government Accountability Office reporting that IHS needs over 1,300 clinical providers[2,3]. “Too many Tribal members can’t access the health care they need because of a dire doctor shortage in Indian County,” said Senator Cortez Masto in her press release. The current requirement for providers to work in a full-time capacity discourages other providers from serving Tribal communities. The proposed legislation would bring more doctors, nurses, and other providers, to AI/AN communities throughout Indian Country.


[1] House Natural Resources Hearing on "Examining the President's FY 2024 Budget Request for the Indian Health Service"

[2] IHS FY 2024 Congressional Justification, p. CJ 291

[3] Id.

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