Nez Perce Tribe Letter in Support of H.R. 5549 — July 27, 2022

Summary

A letter dated July 27, 2022 from the Nez Perce Tribe 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 15. The letter says advance appropriations will increase tribal and federal government efficiency, reduce federal taxpayer waste, and save Native lives by providing more effective funding for health care service in Indian Country. It describes advance appropriations as a budget-neutral and flexible solution to the impacts of funding disruptions.

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TRIBAL EXECUTIVE COMMITTEE

PO, BOX 305 + LAPWAI, IDAHO 83540 + (208) 843-2253

July 27, 2022

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, D.C. 20515 Washington, D.C. 20515

Re: Support for H.R. 5549, the Indian Health Service Advance Appropriations Act
Dear Chair Fernandez and Acting Ranking Member Obernolte:

The Nez Perce Tribe (“Tribe”) writes 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 15. Advance
appropriations will increase tribal and federal government efficiency, reduce federal taxpayer
waste, and, most importantly, save Native lives by providing more effective funding for health
care service in Indian Country. The Tribe urges Congress to pass this bipartisan policy solution
to address the inequity caused by the current funding process for the Indian Health Service

» (“THS”).

Whereas, advance appropriations are advance agreements to provide funding at a later date, they
are a budget-neutral and flexible solution to the outsized impacts on health services in Indian
Country caused by funding disruptions. 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
The Honorable Teresa Leger Fernandez
The Honorable Jay Obernolte

July 27, 2022

Page 2

are provided, advance appropriations are a fiscally responsible solution to the uncertainty in
funding on the Indian healthcare system.

It is important to note that 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.

Overall, advance appropriations for IHS are a simple promise: a promise that the United States
honor and uphold 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 and H.R. 5549
is the best option now. Thank you

Sincerely,

Samuel N. Penney
Chairman

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