Letter in Support of H.R. 5549, the Indian Health Service Advance Appropriations Act

Summary

A letter to the Honorable Teresa Leger Fernandez and the Honorable Jay Obernolte of the Subcommittee for Indigenous Peoples of the United States, Committee on Natural Resources, expresses support for H.R. 5549, the Indian Health Service Advance Appropriations Act. It says the list of bi-partisan cosponsors has grown to fifteen. The letter says advance appropriations are a budget-neutral and flexible solution to funding disruptions, and that H.R. 5549 improves on the exception for IHS accounts in the FY 2022 Budget Resolution because it includes all of the accounts for the Indian Health Service. It states that the total number of coronavirus cases per week reported by IHS has been on the rise since April 2022.

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 The Honorable Teresa Leger Fernandez                 The Honorable Jay Obernolte

 Chair                                                Acting Ranking Member

 Subcommittee for Indigenous Peoples of               Subcommittee for Indigenous Peoples of

  the United States                                    the United States

 Committee on Natural Resources                       Committee on Natural Resources

 U.S. House of Representatives                        U.S. House of Representatives

 1324 Longworth House Office Building                 1329 Longworth House Office Building

 Washington, DC 20515                                 Washington, DC 20515




RE: Support for H.R. 5549, the Indian Health Service Advance Appropriations Act



Dear Chair Fernandez and Acting Ranking Member Obernolte:

We write to express support for H.R. 5549, the Indian Health Service Advance Appropriations
Act. Introduced by the late Representative Don Young and originally co-sponsored by
Representatives McCollum, Kilmer, Kind, Mullin, Cole, Johnson, and Strickland, the list of bi-
partisan cosponsors for H.R. 5549 has grown to fifteen. We urge Congress to pass this bipartisan
policy solution to end the undue suffering of our people and unnecessary drain on taxpayer
resources.

Advance appropriations for the Indian Health Service (IHS) are a bi-partisan and bi-cameral
policy initiative that increases tribal and federal government efficiency, reduces federal taxpayer
waste, and, most importantly, saves Native lives by providing more effective funding for health
care service in Indian Country. Since advance appropriations are merely advance agreements to
provide funding at a later date, they are a budget-neutral and flexible solution to the outsized
impacts of funding disruptions on Indian Country, allowing Congress to respond to changing
real-world circumstances and challenges. The result is continuity of services that reduce
bureaucratic inefficiencies and uncertainty for IHS and for Tribal Nations.

The Biden-Harris Administration supports advance appropriations and mandatory funding for
IHS–a historic shift in the paradigm of Nation-to-Nation relations that seeks to restore the
promises made between our ancestors and the United States. Advance appropriations and
mandatory funding are not mutually exclusive requests. However, once IHS obligations are
provided through mandatory direct appropriations, there is no need for advance appropriations
through the annual regular appropriations process. Until such time that mandatory appropriations
are provided, advance appropriations are a fiscally responsible solution to the outsized impacts of
disruptions and uncertainty in funding on the Indian health care system.

H.R. 5549 is an improvement on the exception for IHS accounts provided in the FY 2022 Budget
Resolution because it includes all of the accounts for the Indian Health Service and not just
certain accounts. This is an important improvement because of the nature of inherently federal
functions. Advance appropriations are not about more money in a single accounting period, they
are about advance agreements by Congress that provide certainty and continuity of services
promote efficiencies, and reduce taxpayer waste on costly duplicative tribal and federal
budgetary functions. If only certain funded accounts are provided continuity of services while
necessary and inherently federal IHS functions remain subject to the stops and starts of the
annual appropriations process, then Congress is not utilizing the policy of advance
appropriations to maximize its best fiscal features.

The coronavirus pandemic is not over, and funding certainty and stability are critical to saving
Native lives as we continue to combat the ongoing effects of COVID-19. The total number of
Coronavirus cases per week reported by IHS has been on the rise since April 2022, and experts
believe the actual infection numbers for the United States in the first week of July were about
seven times higher than the number of reported cases. Further, the seasonal cycle is a consistent
feature of respiratory viral infections, lending to the widely-held prediction that the virus will
exhibit some form of seasonality. This means that advance appropriations for IHS will provide
funding certainty and continuity of services for the fall and winter months when surges in
patients’ needs due to respiratory illness and disruptions in federal funding are most probable.
Simply, advance appropriations will provide increased efficiency during times of increased need.

Advance appropriations for IHS are a simple promise: a promise that the United States honors
and upholds its treaty and trust obligations; a promise that Congress will enact solutions that
cease the generational trauma and undue and unnecessary suffering of Native people; and a
promise of certainty and security for Native communities and our most vulnerable populations.
As Congress works to restore the promises made, all options must be on the table. Native lives
cannot wait.

Sincerely,

Richard Glenn Archambault, enrolled Citizen of the Muscogee (Creek) Nation

Edgar Alberdeen Johnson, III


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