Bay Mills Indian Community, Keweenaw Bay Indian Community — Support for H.R. 5549

Summary

Written in the first person plural on letterhead naming Michigan tribes and the Council of Michigan, Inc. (ITC), this letter urges the House Natural Resources subcommittee to pass H.R. 5549, the Indian Health Service Advance Appropriations Act. It says the bill covers all Indian Health Service accounts rather than certain accounts, and that IHS-reported coronavirus cases per week have risen since April 2022, with experts believing actual U.S. infections in early July were about seven times the reported number. The signature block reads Director, and the name is not legible. No date is printed.

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Bay Mills Indian Community Keweenaw Bay Indian Community
Brimley, Michigan 49715 Baraga, Michigan 49908
Grand Traverse Band Lac Vieux Desert Band
of Ottawa & Chippewa Indians of Lake Superior Chippewa
Suttons Bay, Michigan 49682 Watersmeet, Michigan 49969
Hannahville indian Community Sault Ste. Marie
Wilson, Michigan 49896 Tribe of Chippewa Indians
Saginaw Chippewa Sautt Ste. Marie, Michigan 49783
indian Tribe Pokagon Band of Potawatomi Indians
Mt. Pleasant, Michigan 48858 Dowagiac, Michigan 49047
Little Traverse Bay Match-E-Be-Nash-She-Wish
Bands of Odawa Indians (Gun Lake Tribe)
Harbor Springs, Michigan 49740 COUNCIL OF MICHIGAN, INC. Shelbyville, Michigan 49323
Nottawaseppi Huron Litile River Band
Band of The Potawatomi ITC is an equal opportunity provider, and employer. of Ottawa Indians
Fulton, Michigan 49502 Manistee, Michigan 49660

2956 Ashmun Street, Suite A, Sault Ste. Marie, Michigan 49783
Phone: (906) 632-6896 Main Fax: 906-632-1810

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 !HS—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,

—

_

i

an Director

b

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