Update on Reauthorization of the Indian Health Care Improvement Act

11/4/2009

Below is an update on recent federal activities relating to funding for the Indian Health Service (IHS) as well as reauthorization of the Indian Health Care Improvement Act (IHCIA).

Update on FY 2010 Funding for the Indian Health Service

On October 30, 2009 President Obama signed into law the FY 2010 Interior and Environment Appropriations bill, which provides funding for the Indian Health Service (IHS). The bill provides IHS with a budget of $4.051 billion, which is $471 million or 13 percent more than the FY 2009 level and $17 million more than the amount requested by the President. Within this amount, the appropriation includes $40.7 million for Indian health professions programs, which is $3.2 million or 8.5 percent above current funding.

Below is a breakdown of funding within IHS, including mental health, alcohol and substance abuse, and urban health programs. Passage of this bill completes the FY 2010 funding process for the Indian Health Service. Funding for other federal agencies and programs, such as the National Institutes of Health (NIH) and the rest of the Department of Health and Human Services (HHS), is still pending in Congress.

Breakdown of IHS Funding

  FY 2009 Enacted FY 2010 Budget Request FY 2010 House FY 2010 Senate FY 2010 Enacted
Indian Health Services $3.190 billion $3.639 billion $3.642 billion $3.639 billion $3.658 billion
Mental Health Programs $67.7 million $72.7 million $72.7 million $72.7 million $72.7 million
Alcohol and Substance Abuse Programs $183.7 million $194.4 million $194.4 million $194.4 million $194.4 million
Urban Health Programs $36.2 million $38.1 million $43.1 million $38.1 million $43.1 million
Health Professions $37.5 million $40.7 million $40.7 million $40.7 million $40.7 million
Indian Health Facilities $390 million $394 million $410 million $394 million $395 million
IHS Total* $3.581 billion $4.034 billion $4.052 billion $4.034 billion $4.051 billion
*Totals may not add due to rounding.

Status of Indian Health Care Improvement Act (IHCIA) Reauthorization

On October 20, the House Energy and Commerce Subcommittee on Health held a hearing to discuss the Indian Health Care Improvement Act (IHCIA) Amendments of 2009 (H.R. 2708). The purpose of the hearing was to receive testimony from experts about specific provisions that should be included or excluded in reauthorization of the law that governs the Indian health care system. Subcommittee Chairman Frank Pallone, Jr. (D-NJ) stated his strong desire to incorporate IHCIA reauthorization into current health care reform efforts, but also stated the possibility of passing independent Indian health care legislation in order to ensure that all of the necessary changes and improvements are enacted. This is particularly important considering reauthorization of the IndianHealth Care Improvement Act has been pending since 1999.

Behavioral health was addressed in great detail at the hearing. Specifically, the bill would authorize the Secretary of the Department of Health and Human Services to “develop a comprehensive behavioral health prevention and treatment program which emphasizes collaboration among alcohol and substance abuse, social services, and mental health programs,” including providing information and identifying opportunities to collaborate with community-based programs.

On October 29, the text of H.R. 2708 was incorporated into the House’s version of health care reform legislation, known as the Affordable Health Care for America Act (H.R. 3962). If passed, this would provide IHCIA with a permanent authorization (past authorizations contain sunset clauses, or dates for which the act would expire, requiring reauthorization every few years).

In the Senate, Senator Byron Dorgan (D-ND) recently introduced the Indian Health Care Improvement Reauthorization and Extension Act of 2009 (S. 1790), the Senate counterpart to H.R. 2708. This bill includes almost identical provisions for the behavioral health section mentioned above. However, the Senate IHCIA bill has not been incorporated into the Senate’s health care reform proposal. It is unclear at this time whether efforts will be made to do so.

Attached is a side-by-side comparison of the House and Senate bills. Lewis-Burke will continue to provide updates on the status of IHCIA reauthorization.

If you have any questions about this or any other CSWE Public Policy activity, please do not hesitate to contact Wendy Naus at wendy@lewis-burke.com.

Contact: Wendy Naus