NCUIH April Policy Update: 2026-27 Policy Priorities, FY 2027 President’s Budget Update, Medicaid and 340B, and IHS Policy Developments
In this Edition:
- 📋 NCUIH Released 2026-2027 Policy Priorities
- 📊 FY 2027 President’s Budget: Proposes Increase for Indian Health Service, Advance Appropriations for FY 2028
- 🤝 60 Bipartisan Representatives Sign Letter Supporting IHS and Urban Indian Health Funding
- 💰 HRSA 340B Rebate Pilot Program: NCUIH and TTAG Support for IHCP Exemption
- 📋 FMAP Updates for Urban Indian Organizations
- 💻 NCUIH Comments on IHS Health IT Modernization PATH Activities
- 🌾 Rural Health Transformation Fund: NCUIH Requests UIO Input
- 📅 Upcoming Policy Events, Deadlines, and Opportunities
- 🎉 Join Us April 27–30 for the 2026 NCUIH Annual Conference
NCUIH Released 2026-2027 Policy Priorities
NCUIH has released its 2026-2027 Policy Priorities, which outlines a summary of urban Indian organization (UIO) federal priorities:
- Increasing Funding for IHS and the Urban Indian Health Line Item
- Establishing Permanent Full (100%) Federal Medical Assistance Percentage (FMAP) for Medicaid Services at UIOs
- Increasing Behavioral Health Funding
- Stability in Federal Grants
- Health Information Technology and Electronic Health Record Improvement
Read the full priorities.
President Releases FY 2027 Budget with Proposed Increase for IHS, Congress Requests Protection of IHS Funding
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. It also includes:
- Advance Appropriations for IHS for FY 2028: $5.6B
- Read more on NCUIH’s blog.
60 Bipartisan Representatives Sign Letter Supporting IHS and Urban Indian Health Funding
In a significant show of bipartisan support, 60 Members of Congress signed a dear-colleague letter urging the protection of IHS funding and increased resources for Urban Indian Health. NCUIH supporting this effort which included requests for $106 million for Urban Indian Health, maintaining Advance Appropriations for IHS, and protecting IHS from sequestration.
Read more on NCUIH’s blog.
Health Resources and Services Administration 340B Rebate Pilot Program Updates – NCUIH Support for Indian Health Care Provider Exemption
The Health Resources & Services Administration (HRSA) is seeking information on potential implementation of a 340B Rebate Model Pilot Program rebate pilot program, which poses administrative and financial burdens for Indian Health Care Providers (IHCPs), including Urban Indian Organizations.
- NCUIH and the Centers for Medicare and Medicaid Services (CMS) Tribal Technical Advisory Group (TTAG) are supporting an exemption for IHCPs from the 340B rebate pilot program and requesting tribal consultation and urban confer.
Comments to HRSA are due April 20, 2026. Submission information can be found here.
HRSA Visit to NATIVE HEALTH in Arizona
NCUIH’s CEO participated in a HRSA visit to NATIVE HEALTH on April 9, providing an opportunity to highlight the impact of 340B on Urban Indian clinics directly to HRSA leadership. The visit included Tom Engels, HRSA Administrator; Mark Cruz, Senior Advisor to U.S. Department of Health and Human Services Secretary Kennedy; Francys Crevier, NCUIH CEO, as well as Jack Ganter, HRSA Director of Legislation and Devin Delrow, Principal Advisor for Tribal Affairs, U.S. Department of Health and Human Services.
Federal Updates: 100% FMAP for UIOs and Traditional Healing Reimbursement
FMAP Support at CMS TTAG Meeting
Federal Medical Assistance Percentage (FMAP) policy continues to be a critical issue for UIOs. Updates include:
- NCUIH Board President Walter Murillo, who serves as the NCUIH representative on the CMS TTAG, raised the need of 100% Federal Medical Assistance Percentage for UIOs, specifically for Traditional Healing services reimbursement, to CMS leadership during the the March 24-25 CMS TTAG quarterly meeting.
Read more on NCUIH’s Policy Resource Center.
NCUIH Submitted Comments on IHS Health IT Modernization PATH Activities
On April 4, 2026, NCUIH submitted written comments to IHS in response to the March 5 Health IT Modernization Tribal Consultation/Urban Confer on Patients at the Heart (PATH) Electronic Health Record (EHR) activities.
- NCUIH recommended that IHS ensure cohort selection equally prioritizes all facility types and provide UIOs with clear guidance on PATH EHR implementation.
NCUIH is Requesting UIO Input on Rural Health Transformation Fund Awards
On December 29, 2025, the Centers for Medicare & Medicaid Services (CMS) awarded all 50 states funding through the Rural Health Transformation Fund (RHTF). Read more about this funding on NCUIH’s blog.
Request for UIOs:
- Let NCUIH know if your UIO receives RHTF funding. Contact: policy@ncuih.org
2026 NCUIH Annual Conference
April 27–30, 2026, in Washington, D.C., as NCUIH marks the 50th anniversary of the Indian Health Care Improvement Act (IHCIA)—a landmark commitment to the health and well-being of American Indians and Alaska Natives—and reflects on five decades of progress, collaboration, and continued commitment to Native health.
- Registration has closed.
Notable sessions include:
- IHS Listening Session — An opportunity for UIOs to engage directly with IHS leadership on policy priorities.
Upcoming Events and Policy Dates
April 21-22 — HHS Annual Tribal Budget Consultation (Washington, DC)
April 27–30, 2026 — 2026 NCUIH Annual Conference (Washington, D.C.)
May 20 — NCUIH Monthly Policy Workgroup (virtual)
Recent NCUIH Policy Blogs
- President’s Budget Proposes Increase for Indian Health Service, Advance Appropriations for FY 2028
April 3, 2026/in Policy Blog/by NCUIH - NCUIH Recognized at IHS 70th Anniversary Tribal Summit for Exceptional Partnership
March 28, 2026/in Policy Blog/by River Carroll - Tribal Leaders Recommend Increased Urban Indian Health Funding for Fiscal Year 2028
March 25, 2026/in Policy Blog/by Alex Sampson
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.
