President fails to request life-saving advance appropriations for IHS in FY 2026

On May 30, 2025, the Trump Administration released the Fiscal Year 2026 (FY 2026) President’s Budget, which includes $7.909 billion for the Indian Health Service and does not include a request for advance appropriations for FY 2027. While the budget reflects a small increase for the Indian Health Service, the increase mainly comes from mandatory Contract Support Costs and Tribal leases, leaving the majority of line items largely flat funded.

The IHS budget proposal prioritizes IHS Services by shifting $84 million from IHS Facilities to Services. These increases are largely to fund newly opened facilities. Other line-items with increases include Dental ($5 million), Mental Health ($1 million), and PRC ($6 million). Within the Facilities account, Sanitation Facilities Construction received an 87% reduction in funding. Other Facilities line-items remained flat funded except Facilities and Environmental Health which see a small $8 million increase. The entire $921 million increase for the IHS budget comes from increased Contract Support Cost and section 105(l) Lease Payments. The budget proposes a small decrease to the Special Diabetes Program for Indians.

The Department of Health and Human Services Budget in Brief emphasizes Tribal self-governance, stating “HHS strongly supports the sovereignty and self-governance rights of the nation’s 574 federally recognized tribes.”

Throughout the rest of the HHS FY 2026 Budget Proposal, a number of Tribal programs are cut or moved to new agencies. Among the programs proposed for termination or relocation include the CDC Healthy Tribes Program and SAMHSA’s Tribal Behavioral Health Grants and Tribal Opioid Response Grants. It also proposes relocating critical ACL’s Title VI programs for Native Elders Services and Nutritional Supports to ACF. Nearly all other HHS agencies sustained significant cuts, including the Administration for a Healthy American ($6 billion), National Institutes of Health ($17 billion), and Administration for Children, Families, and Communities ($7 billion).

Importantly, some critical programs for Tribes were called out in the HHS Budget in Brief, including recognition of Tribal health data and jurisdiction, Tribal needs for Public Health Infrastructure, and preservation of Tribal outreach and education activities at CMS. Although several SAMHSA programs for Tribes are proposed for being cut, the Administration does propose to finally fund the Native American Behavioral Health and Substance Use Disorder Program, originally authorized in 2022 and set to expire in FY 2027.

Why It Matters

The President’s Proposed Budget will now be sent to Congress to continue the FY 2026 appropriations process. The House and Senate Appropriations Committees will be holding markups of their funding bills over the summer and will have the final say on the FY 2026 appropriations. NIHB will continue advocacy and outreach to Congressional appropriators, ensuring they understand the importance of advance appropriations and increased funding across the Indian Health Service.

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