Indian Health Service (IHS)

BACKGROUND

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The Indian Health Service (IHS) is the most important source of health care for Indian Country.

  1. IHS provides care at no cost to American Indians and Alaskan Natives (AI/AN).
  2. IHS provides health care directly on reservations, subsidizes tribes which provide their own health care, and subsidizes the urban Indian health providers (UIHPs) which were established by Congress.
  3. IHS is significantly under-resourced, usually funded at between 50% and 60% of need; sometimes, the agency runs out of money in the middle of the fiscal year, which can force patients to forego serious care and delay basic care.
  4. While health care spending per capita across the nation was more than $8,500 in 2015, IHS spending on health care per user was just $3,136.
  5. The life expectancy for AI/AN is more than four years below the national rate, and AI/AN die at higher rates than other Americans from diabetes, alcoholism, unintentional injuries, suicide, and homicide; AI/AN also have higher mortality rates from cervical cancer, pneumonia / influenza, and child-birth.
  6. Although more than two-thirds of AI/AN live off reservations, IHS spends less than 1% of its budget on the provision of health care to urban Indians. Funding increases don’t keep up with health care inflation. Financially hard-pressed cities and towns are unable to make up the difference.

The National Tribal Budget Formulation Workgroup's Recommendations on IHS FY19 Budget

Tribal Budget Formulation Working Documents

NCUIH Presentation at the National Budget Formulation Meeting (February 16-17, 2017)