Helena Independent Record: Federal budget contains historic funding for Indian Health Service

by Nora Mabie

Congress earlier this month passed a roughly $1.7 trillion spending package. The bill, which awaits President Joe Biden’s signature, contains historic funding for Indian Health Service and support for other programs across Indian Country.

The federal budget for 2023, also known as the Fiscal Year 2023 Omnibus Appropriations Package, funds the government through September. Sen. Jon Tester voted in favor of the legislation. Sen. Steve Daines opposed the package, and in a statement said it is “packed with wasteful spending and fails to address the crises facing Montana families.”

The package includes nearly $7 billion for Indian Health Service — a $297 million increase from 2022. And for the first time, the budget will provide Indian Health Service (IHS) with advance appropriations, or future funding.  

IHS Director Roselyn Tso said the advance appropriations “will provide critically needed protection from budgetary uncertainty.” She said predictable funding will ensure access to health care services and enable IHS to effectively manage budgets and improve health outcomes for Indigenous people.

IHS is the federal agency responsible for providing health care for all federally recognized tribes. The agency has long been criticized for being chronically underfunded. In Montana, IHS served 80,468 people, and a recent report estimated that the federal agency addressed about 48% of the health care needs for the population it serves.

That same report estimated that IHS would need $49.9 billion in 2023 to be adequately funded. While the appropriated $7 billion falls short of IHS’ needs, the report also argued that advance appropriations were critical, as unpredictable funding creates “long-term uncertainty … and makes it challenging to maintain and modernize needed health care infrastructure.”

The report stated that predictable funding could help IHS recruit and retain staff. IHS employs more than 15,000 people. In the Billings area, which includes facilities in Montana and Wyoming, IHS has a 51% medical officers vacancy rate, 51% nurse vacancy rate, 48% advance practice nurse vacancy rate and 44% physician assistant vacancy rate.

Funding in Indian Country

The federal budget includes $3.8 billion for the Bureau of Indian Affairs, Bureau of Indian Education and office of the Special Trustee. It allocates $1.02 billion for Native housing programs, $22.7 million for tribal mental health behavioral grants, $23.6 million for tribal substance abuse prevention and $3.4 million for tribal suicide prevention grants.

The package also includes several investments in public safety in Indian Country, including $129 million to the Department of Justice to support tribal programs. The budget appropriates $25 million for tribal law enforcement special initiatives, $72 million for tribal courts and $34.8 million for tribal justice support. It also allocates $1 million for research on violence against Native women.

While Native Americans account for 6.7% of Montana’s population, they comprise, on average, 26% of the state’s active missing persons population. 

Federal budget contains historic funding for Indian Health Service (helenair.com)