House of Representatives passes major budget bill



The House of Representatives passed the Build Back Better bill, H.R. 5376 (as amended) by a vote of 220-213. This bill is the Budget Reconciliation measure to carry out portions of the President’s domestic agenda for social programs including child care, early education, and access to health care. A summary of the Indian health-related provisions in the bill (with the relevant amendments) is provided here.


In brief, for the specific Indian Health Service (IHS) programs, this bill includes the following in direct funding, for FY 2022, to remain available until September, 30, 2031:


  • $945 M for maintenance and improvement for IHS and tribal facilities;
  • $123.716 M for mental health and substance use prevention and treatment services, including facility renovation, construction, expansion;
  • $1 B for the health care facility priority system established in 25 U.S.C. §1631(c)(1)(A);
  • $40 M for small ambulatory construction;
  • $100 M urban Indian health care facility renovation, construction, expansion, equipping, improvement;
  • $25 M epicenters pursuant to 25 U.S.C. §1621m(a)(1)-(2); and
  • $113.284 M environmental health facilities support.


Originally, the Senate Committee on Indian Affairs had been allocated $20.5 Billion for Native American programs, including Indian health care. Based on objections to the top line dollar figure for the entire Budget Reconciliation of $3.5 Trillion, that amount was trimmed to roughly $1.75 Trillion. As a result, Indian programs took a hit and were reduced significantly.


Most likely, in December, the bill will be amended in the Senate and a chance that the top line dollar may get reduced again. Tribes and friends of Indian health need to once again reach out to Senators to protect the Indian health funding from any further cuts.


For questions, please contact Rhonda Harjo, at

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