Health care services for Native Americans and Alaska Natives will be bolstered by a provision included in the government spending bill approved by Congress in the final hours of the 2022 session.
The measure provides more certainty for a federal agency that delivers health care to more than 2.5 million people.
A coalition of lawmakers from Kansas, Arizona, New Mexico, California, Alaska and elsewhere fought to include advance appropriations for the Indian Health Service in the bill, marking a first for the chronically underfunded agency as a way to ensure that services continue in case of potential funding disruptions.
In addition to authorizing spending for the current federal fiscal year, the bill sets the funding amount for the fiscal year that starts Oct. 1, 2023.
With the legislation, IHS joins other federal health care programs that receive advance funding, including Medicare, Medicaid and the Veterans Health Administration.
“This consistent funding will assist SEARHC in its continued mission to provide the best health care in our communities, as well as offer opportunities for strategic growth in services and facilities,” SEARHC communications director Lyndsey Schaefer said in an email last week.
The SouthEast Alaska Regional Health Consortium is among several Alaska providers that receive funding through the program. SEARHC provides services in 19 Southeast communities and operates the Wrangell Medical Center.
Advance appropriations are intended to “prevent the interruption of health care services in the event of a government shutdown,” Alaska Sen. Lisa Murkowski said of the provision.
Before December’s budget bill, “IHS was the sole federal health care provider without basic certainty of funding from year to year,” Schaefer noted. “This package will support significantly needed planning and budgeting stability for the Alaska tribal health system, while meeting the federal trust responsibility. Advance appropriations for the IHS have been a longstanding priority for tribal health.”
IHS, which runs two dozen hospitals and nearly 100 other clinics around the country, repeatedly has been the focus of congressional hearings and scathing government reports that seek reform.
The House Native American Caucus has urged the Biden administration, IHS and tribal nations to work toward authorizing the shift away from discretionary funding.
The lawmakers pointed to a 2017 report by the Government Accountability Office that showed per-capita spending for IHS trailed by more than two-thirds the $13,185 spent by Medicare. They said insufficient funding has led to persistent staffing shortages, limited equipment availability, extended wait times and other problems at IHS facilities.
More recently, a GAO report issued in March noted that outdated facilities, few inpatient beds and health care provider shortages made the agency’s response to the Coronavirus pandemic even more challenging.
IHS received more than $9 billion in COVID-19 relief funding — which it used to address both immediate and longstanding needs — but some members of Congress have argued that the agency’s overall budget needs to catch up with the actual needs in tribal communities.
Advocates have argued that every time Congress passes a temporary continuing budget resolution to avert a government shutdown, IHS has to modify hundreds of contracts to adjust for the available funding. There have been five shutdowns since 1995 amid budget fights in Congress.
During the last government shutdown, a 35-day closure in 2018-2019, the National Council of Urban Indian Health noted that urban Indian organizations reported at least five patient deaths and significant disruptions in patient services as some IHS clinics were forced to shut their doors.
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