The Indian Health Service (IHS) remains underfunded in a newly passed spending minibus that allocates $8.05 billion to the historically strapped agency for the 2026 Fiscal Year, plus an additional $5.31 billion in advance appropriations for the 2027 Fiscal Year.
The budget is a slight decrease from last year and tens of billions of dollars short of the $63.04 billion recommended by the National Tribal Budget Formulation Working Group to fully fund the agency tasked with providing health care to more than 2.5 million American Indians and Alaska Natives.
Line items in the budget include:
$4.55 Billion in Services
- Hospitals and Health Clinics: $2.63 billion ($46.6 million increase)
- Indian Health Care Improvement Fund: $74.14 million (flat funding)
- Electronic Health Records: $190.56 (flat funding)
- Dental Health: $260.36 million ($6.24 million increase)
- Mental Health: $133.69 million ($3.58 million increase)
- Alcohol and Substance Abuse: $267 million ($309,000 increase)
- Purchased and Referred Care: $996.76 million (flat funding)
- Contract Support Costs: $1.82 billion ($217 million decrease)
- 105(l) Lease: $366 million ($34 million decrease)?
- Self-Governance: $6.17 million (flat funding)
- Urban Indian Health: $95.42 million ($5 million increase)
- Indian Health Professions: $84.57 million ($4 million increase)
- Direct Operations: $2.99 million (flat funding)
- Self-Governance: $6.17 (flat funding)
$809.22 Million in Facilities
- Sanitation Facilities Construction: $107.94 million ($1.32 million increase)
- Health Care Facilities Construction: $184.68 ($2 million increase)
- Maintenance and Improvement: $170.6 million (flat funding)
- Facilities and Environmental Health Support: $311.41 million ($3.83 million increase)
This marks the fourth consecutive year the IHS budget includes advance appropriations, which were critical for the agency, its hospitals, and clinics remaining in operations during October 2025’s historic government shutdown that shuttered other essential services.
For decades, the agency has operated with an average staffing shortage of 25%; in some areas, it has been as high as 46%.
Native people suffer from chronic diseases — such as diabetes, heart disease, and cancer — and have the shortest lifespan of any demographic.
