President’s Budget Proposes Increase for Indian Health Service, Advance Appropriations for FY 2028

On April 3, 2026, the President released the full Fiscal Year (FY) 2027 Department of Health and Human Services Budget In Brief and the Indian Health Service (IHS) Congressional Justification. The budget prioritizes funding for IHS by proposing $9.1 billion for the Indian Health Service — an increase of more than $1 billion above FY 2026 enacted levels. Notably, the budget also requests $5.6 billion in advance appropriations for FY 2028, ensuring continuity of care for IHS, Tribal, and urban Indian health programs regardless of disruptions in the annual appropriations process.

The budget states that advance appropriations provide IHS with “predictable, stable funding that allows facilities to maintain operations, retain staff, and plan effectively across fiscal years.” Importantly, the budget also reflects direct Tribal input, stating that it “incorporates top tribal budget recommendations and invests in systems that enable Tribes to manage their own health programs effectively.” This commitment reflects the Administration’s recognition that funding stability and Indian Country partnership are essential to the success of the Indian health system.

Advance appropriations for IHS proved critical during the 2025 government shutdown, when IHS and urban Indian health programs were able to maintain operations and protect services for patients. Maintaining advance appropriations will help ensure the Indian health system continues to be protected from future funding disruptions.

Next Steps

The FY 2027 proposal serves as a statement of the Administration’s policy and funding priorities. The budget acts primarily as a symbolic blueprint of the President’s vision for the size and scope of the federal government. The final appropriations will be determined through the Congressional budget process. The House and Senate Appropriations Committees are currently crafting their respective FY 2027 funding bills.

NCUIH has stood alongside Tribes, Urban Indian Organizations, and the community to advocate for stable and secure resources for the Indian health system. NCUIH will continue to engage with lawmakers to ensure the Indian health system and all Tribal programs receive the resources they need. NCUIH encourages Tribal leaders and Urban Indian Organizations to share their priorities as the Congressional process moves forward.

A more detailed NCUIH analysis of the budget will be released next week.

About NCUIH

The National Council of Urban Indian Health (NCUIH) is a national representative for the 41 Urban Indian Organizations contracting with the Indian Health Service under the Indian Health Care Improvement Act. NCUIH is devoted to the support and development of high quality and accessible health and public health services for American Indian and Alaska Native people living in urban areas.

NCUIH respects and supports Tribal sovereignty and the unique government-to-government relationship between our Tribal Nations and the United States. NCUIH works to support those federal laws, policies, and procedures that respect and uplift Tribal sovereignty and the government-to-government relationship. NCUIH does not support any federal law, policy, or procedure that infringes upon or in any way diminishes Tribal sovereignty or the government-to-government relationship.

NCUIH Contact: Meredith Raimondi, Vice President of Policy and Communications, mraimondi@ncuih.org