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Coalition requests additional funding for IHS in 2020

May 22, 2019

By Jennifer Garvin

Washington — The ADA is part of a coalition of health care stakeholders asking Congress to increase funding for the Indian Health Service by $72 million for 2020 in order to improve access to health care for American Indians and Alaska Natives.

In testimony submitted May 21 to the Senate Indian Affairs Committee, the American Indian/Alaska Native Health Partners reminded lawmakers of the "substantial health disparities and higher mortality and morbidity rates" that AI/ANs face and said being able to access health care when needed is "key to erasing the disparity of care."

The coalition said while it recognizes the budget constraints the committee faces, "for too many years federal funding for tribal health programs has fallen woefully short" compared to other government programs such as Medicare, Medicaid and Veterans Affairs. Citing the December 2018 Government Accountability Office report, the groups noted that in 2018 IHS spent $4,078 per capita compared to $8,109 for Medicaid, $10,692 for Veterans Affairs and $13,185 for Medicare. 

The coalition said three things would help improve timely access for health care:

  • increasing the number of primary care providers.
  • improving infrastructure.
  • replacing and updating medical and diagnostic equipment.

To address these concerns, the AI/AN Health Partners recommended Congress:

  • Increase the funding for loan repayment and scholarships by $32 million. They noted in 2018, 1,325 health professionals received IHS loan repayment, but 844 providers sought and were denied loan repayment and 399 of those applicants did not take an assignment with any IHS or tribe facility. 
  • Increase funding for staff housing by $30 million. "Providing decent housing, especially in remote areas, is essential for attracting and keeping health care providers in Indian country," the coalition said.
  • Increase funding for modern medical equipment by $10 million. "Accurate clinical diagnosis and effective medical treatment depends in part on health care providers using modern equipment/systems to assure the best possible outcomes."

On May 15, the House Interior Appropriations Subcommittee approved much of the American Indian/Alaska Native Health Partners' request for the additional funding.

The coalition also endorsed the Trump administration's request to make Indian Health Service loan repayment and scholarship programs tax free.

"While the IHS currently has funding for scholarships and loan repayment for health care providers, these programs are not tax exempt like the National Health Service Corps and Armed Forces Health Professions loan repayment programs," the coalition said. "As a result, the IHS provides tax payments for health care providers and students from the Health Professions account. According to the Service's FY 2020 budget justification, making these programs tax free would free up an additional $9,187,927 that could be used to bring more providers to Indian country."    

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