Congressional Leaders Release Three Bill Minibus for FY 2027 with Increases for Urban Indian Health and Advance Appropriations for Indian Health Service

On January 5, 2026, the House and Senate Appropriations Full Committee released a three bill appropriations minibus for fiscal year (FY) 2026 entitled the Commerce, Justice, Science; Energy and Water Development; and Interior and Environment Appropriations Act, 2026. The bill provides a total of $8.05 billion for the Indian Health Service (IHS), and $5.31 billion in advance appropriations for the agency for FY 2027. The bill also authorizes $95.42 million for urban Indian health– an increase of $5 million over the FY 2025 enacted amount. The bill also reaffirms the Senate report language directing IHS to explore the formation of an interagency working group aimed at supporting urban Indian organizations (UIOs).

Other key provisions include:

$5 million for generators at IHS/Tribal Health Programs/UIOs
$7 million, a $4 million increase, for the Produce Prescription Pilot Program for Tribes and UIOs to increase access to produce and other traditional foods
$39.43 million, a $5 million increase, for Tribal Epidemiology Centers (TECs).

Next Steps

The minibus is expected to receive a vote by the House on January 8, 2026. Once it passes, the bill will head to the Senate for a vote. The bill is expected to pass both chambers.

Background

The National Council of Urban Indian Health (NCUIH) is a longstanding advocate for full funding for IHS and urban Indian health and supports the recommendations of the Tribal Budget Formation Workgroup. On February 27, 2025, NCUIH board president-elect and Oklahoma City Indian Clinic CEO Robyn Sunday-Allen (Cherokee) testified before the House Appropriations Subcommittee on Interior, Environment, and Related Agencies, urging full funding for urban Indian health and the Indian Health System.

NCUIH is also grateful for the support of the Senators and Representatives working to support the health of Indian Country. On May 15, 2025, 60 Congressional leaders joined Representative Leger Fernandez in a bipartisan letter to Chairman Simpson and Ranking Member Pingree of the House Interior Appropriations Committee requesting support for Urban Indian Health, maintaining advance appropriations for IHS, and protecting IHS from sequestration. The letter emphasized that the federal government has a trust responsibility to provide federal health services to maintain and improve the health of American Indian and Alaska Native people. On May 21, 2025, 19 Senators joined Senator Tina Smith in a similar letter to Chair Lisa Murkowski (R-AK) and Ranking Member Jeff Merkley (D-OR) of the Senate Interior Appropriations Committee.

Bill Highlights

Line Item	FY 25 Enacted	FY 26 Tribal Request	FY 26 Senate Proposed	FY 26 House Proposed	FY 26 Enacted
Urban Indian Health	$90.42 million	$770.5 million	$90.4 million	$105.99 million	$95.42 million
Indian Health Service	$8.22 billion	$63 billion	$8.1 billion	$8.41 billion	$8.05 billion
Advance Appropriations	$5.19 billion	______________	$5.3 billion	$6.05 billion	$5.3 billion
Hospital and Clinics	$2.5 billion	$13.8 billion	$2.65 billion	$2.85 billion	$2.63 billion
Tribal Epidemiology Centers	$34.4 million	______________	______________	$44.43 million	$39.4 million
Mental Health	$127.1 million	$4.76 billion	$131.3 million	$144.95 million	$133.69 million

Additional Key Provisions:

Produce Prescription Pilot Program: $7 million

Bill Report, Pg. 60: The recommendation includes $7,000,000 for IHS to expand, in coordination with Tribes and Urban Indian Organizations (UIOs), the Produce Prescription Pilot to implement a produce prescription model to increase access to produce and other traditional foods among its service population.

This represents a $4 million increase.

Contract Support Costs – $ 1,819 billion and Tribal 105(l) leases – $366 million

Bill Report, Pg. 60: The bill provides an indefinite appropriation to fully fund contract support costs, which are estimated to be $ 1,819,000,000 in fiscal year 2026.

This represents a $217 million decrease.

Bill Report, Pg. 60: The bill provides an indefinite appropriation to fully fund payments for Tribal leases. which are estimated to be $366,000,000 in fiscal year 2026.

This represents a $34 million decrease.

Purchased and Referred Care – $997 million

This is level funding for the line item.

Indian Health Professions: $84.57 million

This represents a $4 million increase.

Sanitation Facilities Construction: $107.94 million

Bill Report, Pg. 62: The agreement provides $107,943,000 for Sanitation Facilities Construction.

This represents a $1.3 million increase.

Health Care Facilities Construction: $184.68 million

Bill Report, Pg. 62: The agreement includes $184,679,000. including $13,000,000 for staff quarters for staff housing across the IHS health care delivery to support the recruitment and retention of quality healthcare professionals across Indian country.

This represents a $2 million increase.

Equipment – Generators: $5 million

Dental Health: $260.36 million

Bill Report, Pg. 60: The recommendation includes $260,360,000 for Dental Health, including $6,500,000 for Dental Support Centers and continues funding for Electronic Dental Health Records.

This Represents a $6.24 million increase.

Alzheimer’s Disease: $6 million

Bill Report, Pg. 60: The agreement provides $6,000,000 to continue Alzheimer’s and related dementia activities.

Maternal Health: $8 million

Bill Report, Pg. 60: The agreement provides $8,000,000 for Improving Maternal Health.

Alcohol and Substance Abuse: $267.08 million

This represents a $309,000 increase.

Bureau of Indian Affairs, Missing and Murdered Indigenous Women Initiative: $18. 5 million

Bill Report, Pg. 32: The recommendation includes $27.094,000 for Law Enforcement Special Initiatives, including $ 18,500,000 for the Missing and Murdered Indigenous Women Initiative.

This represents a $2 million increase.

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