National Tribal Budget Formulation Workgroup Releases Recommendations for Fiscal Year 2027, Recommends Full Funding for Indian Health Service and Urban Indian Health
In April 2025, the National Tribal Budget Formulation Workgroup (NTBFW) released their fiscal year (FY) 2027 Tribal Budget Recommendations, The Federal Trust Responsibility to Tribal Nations: A Strategy to Advance Indian Health Care, as part of the Indian Health Service (IHS) Budget Formulation process. The NTBFW recommends $1.09 billion for the Urban Indian Health line item and $73 billion for IHS. The NTBFW also recommends that IHS retain and expand eligibility for Urban Indian Organizations (UIOs) to participate in grant programs and ensure that UIOs are included in exemptions for Medicaid reform, including work requirements.
Read the full recommendations here.
Background on IHS Budget Formulation
As part of the trust responsibility to provide health care to all American Indian and Alaska Native people, Tribal leaders present their funding needs each year to the Secretary of the U.S. Department of Health and Human Services (HHS) and the Director of the Office of Management and Budget (OMB). The recommendations are formed through the Tribal Budget Formulation Workgroup and serve as a framework for the Administration in setting budget amounts for their annual requests to Congress. This process ensures the federal government has the resources to provide health care to all American Indian and Alaska Native people in fulfillment of the trust responsibility.
The National Council of Urban Indian Health (NCUIH) assists UIOs in advocating for their needs during the IHS Area level consultation sessions and presents information on UIOs’ priorities and needs during the February Area Report Webinar. NCUIH supports full funding for the IHS, Tribal, and UIOs (I/T/U) system. NCUIH endorses a budget in which IHS, Tribal Facilities, and UIOs are all fully funded to improve health outcomes for all Native people no matter where they live.
