A Voice from the Eastern Door
A Voice from the Eastern Door
On March 9, 2023, the President released the annual budget proposal for Fiscal Year (FY) 2024. The “HHS Budget in Brief” has been released but the Congressional Justification for the Indian Health Service has not been released.
The bottom line: Mandatory Funding for IHS Remains a Priority; Advance Funding Still Needed
What they’re saying: “The Administration is committed to upholding the United States’ trust responsibility to tribal nations by addressing the historical underfunding of IHS. The enactment of an advance appropriation for 2024 for IHS was a historic and welcome step toward the goal of securing adequate and stable funding to improve the overall health status of American Indians and Alaska Natives.”
The budget proposal includes the Administration’s commitment that by 2025, the IHS budget would shift from mostly discretionary to all mandatory funding.
The President also reaffirmed that “until [mandatory funding] is enacted, it is critical that Congress continue to prioritize advance appropriations for IHS through the discretionary appropriations process to ensure funding for healthcare services and critical facilities activities are not disrupted.”
In Context: This proposal falls short of the Tribal Budget Formulation Workgroup (TBFWG)’s request of $51.4 billion for IHS for FY24.
The big picture: NCUIH will continue to advocate for the Tribal Budget Formulation Workgroup requests for urban Indian health and the Indian Health Service.
What’s next: Congress will hold hearings to review the President’s request. House Republicans are calling for reduced spending levels, while Senate appropriators are having bipartisan talks on top-line totals, with a goal of starting spending bill markups as soon as May.
Overall Budget for Department of Health and Human Services (HHS)
The Budget requests $144 billion in discretionary budget authority for FY24, a $14.8 billion or 11.5% increase from the FY23 enacted level.
Indian Health Service Budget Highlights
Indian Health Service Overall: $9.7 billion, an increase of $2.5 billion or 36% above FY23 enacted and $41.7 billion less than requested by TBFWG.
Urban Indian Health: $115 Million for an increase of $25 million or 27% above FY23 enacted and $858.6 million less than requested by the TBFWG.
Reauthorizes and Increases Funding for the Special Diabetes Program for Indians: The budget proposes to reauthorize the Special Diabetes Program for Indians and provide $250 million in FY24, $260 million in FY25, and $270 million in FY26 in new mandatory funding.
Proposes New Program to Increase Public Health Capacity and Infrastructure: The budget also proposes new funding of $150 million in FY25 to address public health capacity and infrastructure needs in Indian Country. This funding would support an innovative hub-and-spoke model to address local public health needs in partnership with tribes and urban Indian organizations.
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