Tribal health leaders urge full IHS funding, maternal‑infant care investments
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Summary
Witnesses at the Senate Indian Affairs priorities hearing urged Congress to move toward full Indian Health Service funding, expand behavioral health resources, and prioritize maternal and infant health improvements after reports of elevated mortality rates and chronic underfunding.
At a Senate Committee on Indian Affairs hearing focused on tribal priorities, William “Chief Bill” Smith, chair of the National Indian Health Board, told senators that the Indian Health System is “dramatically underfunded” and urged Congress to provide full and mandatory funding to honor federal trust and treaty responsibilities.
Why it matters: Witnesses said current funding shortfalls limit services for behavioral health, maternal and infant care, and workforce recruitment and retention. Chief Smith cited an Indian Health Service National Tribal Budget Formulation estimate that “full funding for 2026 would be $63,000,000,000.” He warned that workforce shortages and recent federal workforce directives risk cutting frontline providers.
Health officials and tribal leaders recommended several steps: preserve IHS advance appropriations; support HR 741 (the Stronger Engagement for Indian Health Needs Act of 2025, referenced in testimony); protect Medicare, Medicaid, and CHIP arrangements that tribes rely on; make Indian health scholarships and loan repayment programs tax-exempt to strengthen recruitment; and expand support for tribal traditional healing within behavioral health programs.
Committee members pressed for actionable items. Chief Smith highlighted the need to “address trauma and strengthen connections to culture” as part of behavioral health responses and urged investments in prenatal-to-age-3 services. When asked about maternal mortality by Chair Murkowski, Chief Smith listed five priorities including protecting tribal sovereignty, investing in equity funding, enhancing access to quality health services, addressing intergenerational trauma, and strengthening the maternal health workforce.
Ending: Witnesses asked the committee to translate existing commission reports and recommendations into implementable legislation and funding lines; senators said they will seek to incorporate those recommendations into the committee’s work for the 119th Congress.
