In Fiscal Years 2020 and 2021, over $9 billion was appropriated or made available to the Indian Health Service from six emergency supplemental bills to combat the novel coronavirus.
On June 3, 2023, President Biden signed the Fiscal Responsibility Act of 2023 (FRA) into law. The FRA suspends the public debt limit through January 1, 2025, establishes new discretionary spending limits, and rescinds certain unobligated COVID-19 supplemental funding balances, among other items.
Prior to the enactment of the FRA, the IHS continued to obligate COVID-19 funding and the agency obligated approximately $600 million during the month of May. The FRA protects IHS funds, particularly those which were directly appropriated to the agency in the American Rescue Plan Act and the Coronavirus Aid, Relief, and Economic Security Act. However, COVID 19 funding that was transferred to the IHS from COVID-19 appropriations, approximately $419 million, is impacted by the enacted rescissions. Funds obligated to tribal health programs and urban Indian organizations prior to the FRA’s enactment are not affected by these rescissions.
The rescinded funds were intended to support a variety of ongoing COVID-19 mitigation and recovery activities, including:
- COVID-19 testing, treatment, and vaccination activities at IHS-operated hospitals and health clinics.
- The purchase and distribution of PPE, COVID-19 tests, therapeutics, and vaccines at no cost to IHS, tribal, and urban Indian health programs.
- The establishment, expansion, and sustainment of a public health workforce.
Following the enactment of the FRA, the IHS has nearly $900 million in remaining COVID-19 funding. These remaining resources are predominately for the uses that follow and could be used for many of the activities previously supported by rescinded funds:
- Ongoing COVID-19 testing, treatment, and vaccination of patients at IHS-operated hospitals and health clinics, and other mitigation activities.
- Purchasing and distributing personal protective equipment, along with COVID-19 tests, therapeutics, and vaccines at no cost to IHS, tribal, and urban Indian health programs through the IHS National Supply Service Center.
The IHS will continue to appropriately obligate its COVID-19 balances. Additional information can be found in a Dear Tribal and Urban Indian Organization Leader Letter, as well as in tables showing the status of IHS COVID-19 funds at the IHS after enactment of the FRA.
