Congress Unveils FY 2016 Omnibus Spending Agreement
December 17, 2015

On December 16, 2015, the House and Senate Appropriations Committees unveiled their final FY 2016 spending bill (H.R. 2029).  The bipartisan agreement is expected to pass Congress by the weekend in order to avoid a government shutdown.  The large spending bill will provide $1.15 trillion in discretionary  appropriations to keep the federal government funded through September 30, 2016. This legislation contains annual discretionary appropriations for the Indian Health Service (IHS), Bureau of Indian Affairs (BIA) and the Bureau of Indian Education (BIE) and other federal programs at the Department of Health and Human Services (HHS) for Indian Health.  Many of the health-related programs are unfortunately flat-funded or have nominal increases for FY 2016. 
There were several policy riders added to the final legislation including repealing a ban on oil exports, and preserving a federal ban on funding research for gun violence.  There are also provisions included to toughen visa requirements to guard against terrorism.  Importantly, separate tax legislation also released this week would postpone the "Cadillac Tax" which taxes expensive health plans (and many self-insured Tribal plans) by two years until 2020.
For FY 2016, Congress has proposed $ 4.8 billion for IHS, which is an increase of $165 million (3.5%) over the FY 2015 enacted level and $295.4 million less than requested by the President.  While important, this increase is nowhere near the $29.96 billion needed to fully fund the IHS.  According to the House Appropriations Committee's summary of the legislation, much of the increase to the Interior and Environment section of the omnibus (Division G) (where IHS and other Tribal programs are located) went to wild fire funding and the Payment in Lieu of Taxes program.  You can view the entire 2,009-page bill here.

Within the $4.8 billion allocated to IHS, the bill designates $914 million (the same amount as FY 2015) for Purchased/Referred Care and $523.2 million for Facilities funding (an increase of $63 million from FY 2015).  Table 1 below depicts individual spending allocations for individual IHS programs. The bill also contains full funding for Contract Support Costs (CSC) (estimated at $718 million) and creates a separate appropriation for CSC, meaning that "services" funds would not be used to pay the CSC obligation.
During the entire appropriations process, the National Indian Health Board (NIHB) worked closely with the House Appropriations Committee members and their staff.  As part of this work, NIHB shared the FY 2016 IHS Tribal Budget Formulation Workgroup's Recommendations with the Committee.  On March 25, 2015, NIHB Chairperson Lester Secatero testified before the House Appropriations Committee.  You can read the  written testimony here. NIHB also sent a letter at the end of the year urging the committee to increase funding for IHS and other federal health programs for American Indians and Alaska Natives (AI/ANs).  You can read that letter here.
In addition to IHS, there were several important provisions located in the Labor, HHS, and Education section of the omnibus (Division H) that will benefit the health of AI/ANs.  This includes funding Tribal Behavioral Health Grants at $15 million for FY 2015 and providing designated funding for the creation of a Tribal domestic violence hotline.  

Click here to read a detailed analysis of what is in the legislation. 

Table 1: FY 2016 Indian Health Service Funding
(Dollars in Thousands)

Mission of the National Indian Health Board

One Voice affirming and empowering American Indian and Alaska Native peoples to protect and improve health and reduce health disparities