Congress has taken a key step toward restoring financial stability for Tribal healthcare systems. The House Appropriations Committee has passed the FY26 funding bill for the Indian Health Service (IHS), approving $8.41 billion for the agency. Included in that total is $6.05 billion in advance appropriations for FY27, a crucial tool for avoiding service interruptions due to delayed federal budgets.
This move represents a course correction from the Administration’s FY26 request, which proposed zero advance funding for IHS. That decision drew sharp concern from Tribal leaders, who rely on advance appropriations to ensure continuous care in Indian Country. The House’s bill reflects bipartisan support voiced in recent hearings and delivers about $500 million more than the President’s proposal of $8.1 billion.
Still, the funding remains far below the $63 billion requested by the National Tribal Budget Formulation Workgroup, a reminder that IHS continues to operate under significant financial constraints while serving 3.6 million Native people.
Here’s the Breakdown
Urban Indian Health: $105.99 million
A $15 million increase from FY25. With over 70% of Native citizens now living in cities, these funds help expand access to care beyond reservation boundaries.
Purchased and Referred Care (PRC): $1.05 billion
PRC provides Tribes with the ability to purchase services that are not available at their Tribal Clinic or regional IHS hospitals. This funding is extremely vital for those areas with limited or no access to IHS Service Units and hospitals
Dental Health: $287 million
Includes $8 million to bring Dental Support Centers to all 12 IHS regions and $6.5 million to roll out an electronic dental records system.
Alcohol and Substance Abuse: $286 million
Continues support for treatment and recovery programs across Tribal and urban health settings.
Health Facilities & Infrastructure
Healthcare Facilities Construction: $188.7 million
Includes $14 million for new staff housing — a strategic investment to attract and retain healthcare professionals in underserved regions.
Sanitation Facilities Construction: $131 million
Dedicated to expanding critical water, waste, and sanitation infrastructure.
Emergency Generators: $8 million
Will fund the installation of backup power systems across IHS, Tribal, and Urban Indian health programs to safeguard care during outages.
Operational Support for Tribal Self-Governance
Contract Support Costs: $1.819 billion (indefinite appropriation)
Covers the administrative and overhead costs of Tribally run health programs.
Tribal Leases: $366 million (indefinite appropriation)
Supports facility leases under 105(l) agreements, ensuring Tribes are reimbursed for delivering healthcare from Tribal-owned properties.
Workforce Development
Indian Health Professions: $95.3 million
Funds scholarships, loan repayment, and training to build a pipeline of Indigenous healthcare providers and administrators.
Special Initiatives
Produce Prescription Pilot: $7 million
Supports programs that increase access to fresh produce and traditional foods as part of holistic nutrition and chronic disease prevention.
Alzheimer’s Disease Programs: $6 million
Invests in culturally appropriate dementia care services tailored to Native elders.
Maternal Health: $3 million
Focused on improving prenatal and maternal health outcomes across Tribal communities.
Missing and Murdered Indigenous Women Initiative: $31 million
Supports investigative personnel and evidence collection tools to strengthen responses to MMIW cases.
What It Means for Tribal Nations
The restoration of advance appropriations is more than a technical fix, it’s a foundational step toward reliability in care delivery. Tribes and Tribal health organizations depend on early budget certainty to plan staffing, purchase supplies, and run programs without disruption.
While the funding still falls short of the level required to fully meet trust obligations, this bill offers a window of opportunity to strengthen infrastructure, expand services, and prepare for future investments. Whether your priorities include workforce development, dental expansion, or behavioral health services, the groundwork can begin now.