Health organizations press Congress to boost Indian Health Service funding

The AI/AN Health Partners, which includes the ADA and several national health organizations, sent letters to House and Senate appropriators April 15 urging increased funding for the Indian Health Service, or IHS, in fiscal year 2027.

Directed to leadership of the Appropriations Subcommittees on Interior, Environment and Related Agencies, the coalition emphasized that American Indians and Alaska Natives, or AI/ANs, continue to experience disproportionately poor health outcomes, including higher mortality and morbidity rates than the general U.S. population. It described the IHS as “critical” to delivering care in these communities, while stressing that the agency requires additional resources to meet its mission.

“The IHS must have sufficient resources to meet its mission to raise the physical, mental, social, and spiritual health of American Indians and Alaska Natives to the highest level,” the letters read.

The coalition acknowledged congressional support in recent years, noting that appropriations have reflected testimony from tribes and tribal organizations. Still, it said funding levels remain insufficient to meet ongoing and growing needs. The letters outline three primary funding priorities: workforce recruitment through loan repayment, staff housing and updated medical equipment.

On workforce, the coalition pointed to an IHS health care provider vacancy rate of about 30%. It identified the IHS Health Professions loan repayment program as a key recruitment and retention tool, but noted that demand exceeds available funding. According to the IHS fiscal year 2027 budget request, there were 483 “unmatched unfunded” health professionals in 2025.

The coalition cited estimates that an additional $18 million would allow IHS to hire at least 400 more providers. While the House had proposed that level of funding for fiscal year 2026, the final appropriation included only a $4 million increase. The coalition is urging lawmakers to provide an additional $14 million in Fiscal Year 2027 to meet that target.

The letters also highlighted the condition and availability of staff housing. Of approximately 2,700 staff quarters in the IHS system, many are more than 40 years old and require major renovation or replacement. In some locations, housing shortages further complicate recruitment, particularly in rural and remote areas. Testimony from tribal leaders cited in the letters links inadequate housing to staffing shortages, long commutes and reliance on contract workers.

Medical and diagnostic equipment is identified as another critical need. The coalition noted that IHS and affiliated programs manage about 90,000 devices, many of which are outdated or no longer manufactured. Modern equipment is essential not only for accurate diagnosis and treatment but also for attracting and retaining providers.

“Failure to sustain modern functioning medical devices and systems is also key to recruiting and retaining health care staff. The lack of both can shut down care,” the coalition said.

The coalition noted that equipment funding has remained largely flat in recent years and called on Congress to increase the Indian Health Facilities equipment account to at least $42.9 million for fiscal year 2027.

“Thank you for considering our IHS funding requests for Fiscal Year 2027. We look forward to working with you to ensure the best possible health care for American Indians and Alaska Natives,” the letters concluded.