PRESS RELEASE: House FY21 Interior Appropriations Bill includes $66 Million for Urban Indian Health, $8.4 Million above FY20


Contact: Meredith Raimondi, 202-932-6615,

The bill includes $6.5 Billion for Indian Health Service.

Washington, DC (July 9, 2020) – Today, the House Appropriations Committee released the bill report for the Fiscal Year (FY) 2021 Interior, Environment, and Related Agencies funding bill. The bill includes $6.5 billion for the Indian Health Service (IHS), an increase of $445 million above the FY 2020 enacted level and $199 million above the President’s budget request for FY 2021. The full Appropriations Committee will mark up the bill on Friday at 9:00 a.m.

The bill includes $66.1 million for Urban Indian Health line item in the IHS budget. The National Council of Urban Indian Health (NCUIH) requested $106 million Urban Indian Health as recommended by the Tribal Budget Formulation Workgroup (TBFWG) for FY 2021. The bill also includes $83.9 million in Direct Operations for IHS and directs IHS to confer with UIOs to conduct a study on infrastructure needs. Additionally, Alzheimer’s Disease and the Hepatitis C & HIV/AIDS Initiative would receive $5 million respectively with provisions to work with UIOs.

“We are grateful for Chair McCollum, Ranking Member Joyce and the Committee for their tireless efforts in ensuring all of Indian Country has the resources needed to protect and care for our relatives. We are encouraged by the inclusion of $66.1 million for urban Indian health and the long-needed infrastructure study for urban Indian health facilities who require new resources to safely operate amid this pandemic,” said Francys Crevier, Executive Director of NCUIH.

In June, NCUIH testified before the House Committee on Appropriations Subcommittee on Interior, Environment and Related Agencies for a hearing on the Indian Health Service (IHS) COVID-19 Response. NCUIH highlighted the dire need for facilities and infrastructure funding, which is currently unfunded, in the wake of the COVID-19 crisis. In February, NCUIH testified as part of American Indian and Alaska Native Public Witness Day.

Indian Health Service

Note: Additional analysis is forthcoming.

Indian Health Service – $6.5 billion, an increase of $445 million above the FY 2020 enacted level and $199 million above the President’s budget request.

  • Urban Indian Health – $66.1 million, $8,443,000 above the FY20 enacted level and $16,491,000 above the President’s budget request
  • Health Services – $4.5 billion, an increase of $225 million above the FY 2020 enacted level and $33 million above the President’s budget request. This reflects the move of Payment for Tribal Leases (Indian Self-Determination and Education Assistance Act section 105(l) lease cost agreements, commonly referred to as “section 105(l)” leases) to a separate, indefinite appropriation account.
    • Note: UIOs are ineligible for the 105(l) leases. Over the past few years, IHS has diverted over $1.5 million of UIO funds to cover the cost of these leases, so a separate appropriation to cover 105(l) lease costs will ensure future UIO funding is not diverted again for this reason.
  • Health Facilities – $935 million, an increase of $23 million above the FY 2020 enacted level and $166 million above the President’s budget request.
    • Note: Even though the bill language does not exclude UIOs, there is still the limitation found in 25 U.S.C. § 1659 that limits UIO facility renovation or construction to “minor” activities for the sole purpose of meeting Joint Commission on Accreditation of Healthcare Organizations (JCAHO) accreditation standards.
  • Alzheimer’s Disease – $5 million
    • The Committee directs IHS, in consultation with Indian Tribes and Urban Indian Organizations (UIOs), to develop a plan to assist those with Alzheimer’s, the additional services required, and the costs associated with increasing Alzheimer’s patients and submit this information to Congress within 270 days of enactment of this Act.
  • Hepatitis C & HIV/AIDS Initiative- $5 million
    • The Committee encourages IHS to confer with UIOs to determine how they may participate in this Initiative.

Next Steps

On Tuesday, the House Interior Appropriations Subcommittee approved the bill with funding for the Indian Health Service. On Friday, the full House Appropriations Committee will markup the Interior bill. While the House is expected to move swiftly, the Senate is in recess until July 20 and has yet to begin their COVID-19 emergency response package. Majority Leader Mitch McConnell has signaled the Senate will still recess for August meaning that the Senate Appropriations process may not be underway until September. As it is an election year, the chances of a passage for an Interior Appropriations Bill in both chambers is dwindling and it’s looking like a Continuing Resolution will be needed.



The National Council of Urban Indian Health (NCUIH) is the national non-profit organization devoted to the support and development of quality, accessible, and culturally-competent health and public health services for American Indians and Alaska Natives (AI/ANs) living in urban areas. NCUIH is the only national representative of the 41 Title V Urban Indian Organizations (UIOs) under the Indian Health Service (IHS) in the Indian Health Care Improvement Act (IHCIA). NCUIH strives to improve the health of the over 70% of the AI/AN population that lives in urban areas, supported by quality, accessible health care centers.

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