Despite democratic fears about the secondary consequences to the agency from cuts to Medicaid, general support remains high.
WASHINGTON, D.C. – There was rare bipartisan support to increase funding for the Indian Health Service’s (IHS) proposed budget for Fiscal Year 2027 on Thursday in the House Appropriation Committee’s Subcommittee on the Interior, Environment, and Related Agencies.
President Trump’s 2027 Proposed Budget would give the agency around $9 billion in discretionary funding to maintain and enhance the agency’s work. This is an increase of nearly $1.1 billion compared to the budget for 2026. It would also include a proposal for $5.6 billion in advance appropriations for 2028.
Both Democratic and Republican Representatives of the House asked staff from the agency questions about the use of the new budget, including Clayton Fulton, the Chief of Staff, and Jillian Curtis, the Director of the Office of Finance and Accounting.
“I know this funding does not begin to meet the full need, but I am encouraged by the commitment to continuity of funding that this budget represents, and believe it signals a deeper understanding of our responsibility to uphold our trust and treaty obligations,” Chairman Mike Simpson, R-Utah, said.
Ranking member Chellie Pingree, D-ME, raised some lingering concerns she has despite the increased funding due to the Trump Administration’s cuts to Medicaid and the budget’s partial reliance on Medicaid funds.
“The nearly $1 trillion cut to Medicaid in the ‘Big Ugly Bill’ would have a devastating impact on tribal healthcare. 2.7 million American Indians and Alaska Natives are enrolled in Medicaid, including 49% of children,” Pingree said, referencing what Trump calls the “Big, Beautiful Bill.” “[The IHS] fiscal year 2027 budget request assumes collections of $1.4 billion from Medicaid, so I’m greatly concerned about the impacts of Medicaid reductions in what they will have on the delivery of vital healthcare to tribal members.”
Another concern that Pingree voiced was how the budget decreases funding in one specific area, sanitation facilities construction, by 87%.
“This budget is guided by three key priorities: strengthening the future of the Indian Health Service, improving health outcomes, and supporting tribal self-governance,” Fulton said in his opening statement. The agency plans to accomplish these goals by modernizing its structure, prioritizing direct healthcare services, and fully funding contract support costs and 105 L’s, which are leases that allow tribes to receive federal funding for using tribally-owned facilities.
Fulton fielded many questions from representatives about the agency’s efforts in Electronic Health Records modernization. The proposed budget would raise the funding specifically for these efforts by $96.44 million.
“So far, we’re seeing success. We’re working forward, and we’re pretty much on pace to finish our initial pilot site,” Fulton said. “We have not run into any significant delays with that so far. Things continue to march on, and I think… that is because of our deep partnership with the VA (Veterans’ Affairs).”
Multiple representatives also asked questions regarding the “Missing, Murdered Indigenous People” movement, which attempts to bring awareness to the disproportionate amounts of violence that Indigenous people, notably women and girls, endure.
Rep. Jake Ellzey, R-Texas, reflected the importance of the movement by sharing some facts about the violence against Native women. According to Ellzey, 40% of women involved in sex trafficking are identified as American Indian and Alaskan Native, one in three Native American women report being raped in their lifetime, and American Indian women are 10 times more likely to be murdered than any other group.
Fulton responded that they are focusing on addressing the movement through education and public safety initiatives. Examples include partnering with universities such as Texas A&M University to improve these initiatives.
“This committee is committed to addressing this issue of Murdered, Missing, Indigenous (people). It is stunning to most of us. And it’s unfortunate that, generally, the public doesn’t know how big of a problem this is,” Simpson said.
The hearing concluded on a positive note, with all involved parties optimistic about the future continuation of collaboration between the committee and the Indian Health Service.
“We greatly appreciate what this committee has done. You’ve been making investments over the last decade, and we’re seeing the fruits of those,” Fulton concluded.