IHS Director Provides COVID-19 Funding Update: Rescissions Impact $419 Million, $900 Million Remaining for IHS COVID Activities

On Thursday, June 30, 2023, Indian Health Service (IHS) Director Roselyn Tso released a Dear Tribal Leader and Dear Urban Indian Organization Leader Letter to provide an update on the status of COVID-19 supplemental appropriations provided to the IHS in Fiscal Year (FY) 2020 and FY 2021. In June 2023, President Biden signed the Fiscal Responsibility Act of 2023 (FRA) (Public Law 118-5) into law, which rescinds certain unobligated COVID-19 supplemental funding balances. Approximately $419 million of COVID-19 funding that was transferred to the IHS from COVID-19 appropriations is impacted by the enacted rescissions. IHS has nearly $900 million in remaining COVID-19 funding. These remaining resources are predominately for the uses of ongoing COVID-19 testing, treatment, and vaccination of patients at IHS-operated hospitals and health clinics, and other mitigation activities; and purchasing and distributing personal protective equipment, along with COVID-19 tests, therapeutics, and vaccines, at no cost to IHS, Tribal, and Urban Indian health programs through the IHS National Supply Service Center.

Background

In FY 2020 and FY 2021, over $9 billion was appropriated or made available to the IHS from six emergency supplemental bills to combat the novel coronavirus. On June 3, 2023, President Biden signed the Fiscal Responsibility Act of 2023 (FRA) (Public Law 118-5) into law. The FRA suspends the public debt limit through January 1, 2025, establishes new discretionary spending limits, and rescinds certain unobligated COVID-19 supplemental funding balances, among other items.

Prior to the enactment of the FRA, IHS continued to obligate COVID-19 funding and the Agency obligated approximately $600 million during the month of May. The FRA protects IHS funds, particularly those that were directly appropriated to the Agency in the American Rescue Plan Act (ARPA) and the Coronavirus Aid, Relief, and Economic Security (CARES) Act. However, approximately $419 million of COVID-19 funding that was transferred to the IHS from COVID-19 appropriations is impacted by the enacted recissions.

The rescinded funds were intended to support a variety of ongoing COVID-19 mitigation and recovery activities. For example:

• COVID-19 testing, treatment, and vaccination activities at IHS-operated hospitals and health clinics, and other mitigation activities;
• The purchase and distribution of PPE, COVID-19 tests, therapeutics, and vaccines at no cost to IHS, Tribal, and urban Indian health programs over the next several years by the IHS NSSC; and
• The establishment, expansion, and sustainment of a public health workforce.

 Resources:

• Status of IHS COVID-19 Supplemental Funding After the Fiscal Responsibility Act of 2023
• Estimated COVID-19 Supplemental Rescission Impacts Under the Fiscal Responsibility Act of 2023