‘These are our lives’: Indian Health Service slated for budget hearing amid new setbacks

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House Committee on Appropriations: Budget Hearing – Indian Health Service

Wednesday, June 4, 2025

By Acee Agoyo

Indianz.Com

Representatives of the Indian Health Service (IHS) are testifying about a budget that tribes say represents a setback for their communities.

Last Friday, the Department of Health and Human Services (HHS) released details of its proposed budget for fiscal year 2026 (FY 2026). The 55-page document calls for $7.909 billion to be spent on the IHS, the federal agency charged with providing health care to more than 2.8 million American Indians and Alaska Natives.

“The budget prioritizes funding for IHS, providing $7.9 billion to fulfill our promises to tribal nations,” the HHS document reads. “In particular, the budget prioritizes funding for direct health services as well as funding for staffing and operational costs of new facilities opening in FY 2026.”

“This investment will ensure access to care in remote and underserved communities,” the budget-in-brief continues.

But while the IHS is one of the few places where massive cuts aren’t being made by President Donald Trump, Indian Country is not celebrating. According to the National Indian Health Board, most of the additional funds being proposed won’t bolster the care promised to tribes as part of the U.S. government’s trust and treaty obligations.

And in a major setback, the Trump administration is eliminating advance appropriations from the IHS budget. The policy, which tribes fought hard to secure through years of lobbying and advocacy, puts the agency at risk of government shutdowns and other political whims — including changes in funding priorities.

“These are not just budget numbers — these are our lives,” NIHB Chairman William “Chief Bill” Smith, a leader from the Valdez Native Tribe in Alaska, said when explaining the need to fund the IHS, especially with advance appropriations.

Earlier this month, HHS announced a major reorganization that would reshape Tribal programs without the legally required Tribal Consultation. This process is not optional. HHS must honor its trust responsibility. Learn more and get involved at https://t.co/qdeqt0C8fD. pic.twitter.com/Pd2gXBgRBv
— NIHB (@NIHB1) May 30, 2025

The National Council of Urban Indian Health (NCUIH) also has raised alarms about the budget, whose full details became public as part of a 1,225-page document released by the White House last Friday. The organization notes that funding for urban Indian providers won’t be increasing at all if the new administration gets its way.

“Lives are at stake and this could have catastrophic consequences,” NCUIH CEO Francys Crevier, a citizen of the Algonquin First Nation from Canada, said when word of the setbacks surfaced in Washington, D.C.

The IHS-specific budget is getting its first hearing in the nation’s capital on Thursday afternoon. But, once again, the leader of the so-called “Make America Healthy Again” movement — Secretary Robert F. Kennedy Jr. — won’t be present to discuss his vision for Indian Country.

Instead, the Trump administration is sending two career employees to present and defend a proposal that does not reflect tribal wishes. Benjamin Smith, the acting director of the IHS, and Jillian Curtis, the director of the Office of Finance and Accounting at the IHS, are the only witnesses scheduled to appear at the hearing.

“To ensure clinical health care services continue uninterrupted at IHS, Tribal, and urban Indian health programs, the FY 2026 Budget maintains health care service funding flat with FY 2025,” Smith’s written statement reads, confirming the analyses from NIHB and NCUIH about no new dollars going into their communities.

“This approach prioritizes investments that advance high quality health care and prevention- focused services, core principles of the Make America Healthy Again (MAHA) initiative, Smith continues. “The budget reflects the Administration’s strong commitment to the health and well-being of American Indian and Alaska Native communities by protecting critical clinical health care investments.”

NCUIH Analysis: The FY 2026 Budget Proposal includes increased funding for the Indian Health Service and stable funding for Urban Indian Health.
Read our full analysis → https://t.co/uCJRLwUh1M pic.twitter.com/LtT3k84Cio
— National Council of Urban Indian Health (@NCUIH_Official) June 3, 2025

Even so, MAHA is not making a direct mark on IHS. Instead, HHS is proposing to spend $80 million for a Native American Behavioral Health and Substance Use Disorder program that will be housed within an entirely new entity called the Administration for a Healthy America, or AHA.

According to the HHS budget-in-brief, the AHA will be created by combining other agencies that tribes have relied on for funding, effectively hindering Indian Country’s access to those funds. They include the Health Resources and Services Administration (HRSA), the Substance Abuse and Mental Health Services Administration (SAMHSA), the Office of the Assistant Secretary for Health (OASH) and the National Institute for Environmental Health Sciences (NIEHS), along with some programs from the Centers for Disease Control and Prevention (CDC).

Indian Country also was ignored in the MAHA children’s assessment released by the White House last month. Despite American Indian and Alaska Native youth dealing with numerous health disparities and challenges, the MAHA Commission — which is led by Kennedy — did not directly address any of them.

In April, Kennedy met with tribal leaders and visited Indian health facilities in Arizona and New Mexico as a MAHA tour. In May, he hosted tribal leaders in D.C. for a consultation about the HHS budget.

Also in May, Kennedy testified about the overall HHS budget request at three hearings in May. “HHS has a unique trust responsibility to provide healthcare for Tribes, including on remote reservations and other vulnerable communities in Indian Country,” the Secretary said in a nearly identical written statement to three different legislative committees. [May 14 AM | May 14 PM | May 20]

Young dancers perform during a visit by Secretary of Health and Human Services Robert F. Kennedy Jr., to Window Rock, Arizona, the capital of the Navajo Nation, on April 9, 2025. Photo: Navajo Nation Office of President and Vice President

Though Kennedy answered questions about tribal health at all of the hearings, he has not testified specifically about Indian Country so far. He appeared before the Senate Committee on Health, Education, Labor and Pensions (HELP) on May 14 that started shortly before the Senate Committee on Indian Affairs began hearing from Native witnesses about program and budget cuts at HHS.

“I was in a hearing that began at 1:30, before the HELP committee, and Secretary Kennedy was there,” said Sen. Lisa Murkowski (R-Alaska), the chair of Indian Affairs. “I had alerted him that we were having this oversight, and he said if he wasn’t in that hearing, he would be here as well, which I appreciate.”

“And I think perhaps some of his team, if they’re not here in the room, they might be watching, or listening,” said Murkowski.

Indianz.Com Audio: Examining Federal Programs serving Native Americans at the Department of Health and Human Services

The IHS budget hearing takes place at 1:30pm Eastern on Thursday in Room 2008 of the Rayburn House Office Building. A livestream is available at youtu.be/vVyvsSibJx0.

The hearing is before the House Committee on Appropriations, which is led by Rep. Tom Cole (R-Oklahoma), a citizen of the Chickasaw Nation. During the week of June 23, he plans to advance the appropriations bill that funds the IHS.

Although the IHS is part of HHS, the agency is included in the same bill that funds the the Bureau of Indian Affairs, the Bureau of Indian Education and other Indian Country programs at the Department of the Interior. The BIA is set to lose at least $1 billion in Trump’s budget proposal.

House Committee on Appropriations Notice

Budget Hearing – Indian Health Service (June 5, 2025)