National Indian Health Board
On Wednesday September 25, 2019, National Indian Health Board (NIHB) Chairwoman Victoria Kitcheyan of the Winnebago Tribe of Nebraska testified before the House Natural Resources Subcommittee for Indigenous Peoples in support of advance appropriations for Indian programs. Securing advance appropriations has been a long-standing priority for Tribes and the National Indian Health Board to ensure better continuity and stability of health services for American Indians and Alaska Natives.
In her testimony, Chairwoman Kitcheyan reminded Congress of the federal government’s treaty and trust obligations to Tribes, which includes the provision of comprehensive health care services to American Indians and Alaska Natives. Chair Kitcheyan also highlighted the negative impacts of this year's 35-day government shutdown on the Indian health system. The Indian Health Service (IHS) was the only federal health care entity subject to the shutdown. By contrast, the Veterans Health Administration was able to continue its services uninterrupted during the shutdown because Congress enacted advance appropriations for that agency a decade ago.
Without that same protection during the shutdown, Indian Health Service was not able to fund existing Self-Determination and Self-Governance contracts and compacts for Tribal health care, and support and administrative staff in Indian Health Service facilities were furloughed. Some Tribes even lost physicians who were not able to continue working without pay.
Additionally, the Chairwoman highlighted to the Subcommittee that budgetary uncertainty and short term government funding — such as the upcoming Continuing Resolution — harms recruitment and retention efforts in the Indian health system and makes filling provider vacancies more challenging.
When asked by Subcommittee Chairman Ruben Gallego (D-AZ) why IHS remained the only federal health care entity without Advance Appropriations, Chairwoman Kitcheyan said, "It goes back to the disease of invisibility. Tribal nations are often left out ... [Congress] needs to be reminded that Tribes have treaty obligations and the federal government has the trust responsibility."
To ensure that Indian Country is not left out any longer, the National Indian Health Board stands in strong support of H.R. 1128 and H.R. 1135 — as well as S. 229 and S. 2541 in the Senate — to extend advance appropriations to federal Indian programs like Indian Health Service.
In his testimony to Congress, RADM Michael Weahkee, Principal Deputy Director of Indian Health Service, told the Subcommittee, "Advance appropriations could mitigate the effects of budget uncertainty on the health care programs operated across the Indian health system. The Indian Health Service could disburse funds more quickly, which could enable Indian Health Service, tribal, and urban Indian health program managers to effectively and efficiently manage budgets, coordinate care, and improve health quality outcomes for American Indians and Alaska Natives."
National Indian Health Board remains committed to working in a bipartisan fashion to advocate for enactment of advance appropriations for Indian programs.
Click here to read Chairwoman Kitcheyan's testimony.
Click here to watch a recording of the hearing, and to read testimony from other witnesses.