Seneca Nation of Indians: Support for H.R. 5549, the Indian Health Service Advance Appropriations Act

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A letter from the Seneca Nation of Indians President's Office, on letterhead listing Matthew B. Pagels as President, to the Chair and Acting Ranking Member of the Subcommittee for Indigenous Peoples of the United States, with the subject line Support for H.R. 5549, the Indian Health Service Advance Appropriations Act. The letter states that H.R. 5549 was introduced by the late Representative Don Young and that its list of bipartisan cosponsors has grown to fifteen. It urges Congress to pass the bill to end what it calls undue suffering of the nation's people and an unnecessary drain on taxpayer resources. It states that advance appropriations are budget-neutral and flexible and would provide continuity of services for the Indian Health Service and for Tribal Nations.

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Seneca Nation of Indians

President - Matthew B. Pagels
Clerk - Marta L. Kettle

12837 ROUTE 438 90 OHI: YO' WAY
CATTARAUGUS TERRITORY ALLEGANY TERRITORY
SENECA NATION SENECA NATION

IRVING, NY 14081 SALAMANCA, NY 14779

Tel. (716) 532-4900 Tel. (716) 945-1790

FAX (716) 532-6272 FAX (716) 945-1565
PRESIDENT'S OFFICE
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:

Thank you for the great work you do on behalf of Indian Country. I 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. I 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.

Treasurer - Rickey L. Armstrong Sr.
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,

4

Matthew B. Pagels
Seneca Nation President

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