SEC. 2. SPECIAL BEHAVIORAL HEALTH PROGRAM FOR IN-
DIANS. 
(a) IN GENERAL.—Subtitle A of title VII of the In-
dian Health Care Improvement Act (25 U.S.C. 1665 et 
seq.) is amended by adding at the end the following: 
‘‘SEC. 716. SPECIAL BEHAVIORAL HEALTH PROGRAM FOR 
INDIANS. 
‘‘(a) DEFINITION OF ELIGIBLE ENTITY.—In this sec-
tion, the term ‘eligible entity’ means— 
‘‘(1) any health program administered directly 
by the Service; 
‘‘(2) a tribal health program; and 
‘‘(3) an Urban Indian health program operated 
by an Urban Indian organization pursuant to a 
grant or contract with the Service under title V. 
‘‘(b) FORMULA GRANTS.— 
‘‘(1) IN GENERAL.—The Director of the Service 
(referred to in this section as the ‘Director’) shall 
award grants to eligible entities, in amounts deter-
mined pursuant to the formula described in para-
graph (2), to be used by the eligible entity to provide 
services for the prevention of, treatment of, and re-
covery from mental health and substance use dis-
orders. 
‘‘(2) FORMULA.—The Director, in consultation 
with Indian tribes and Urban Indian organizations, 
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shall develop a formula to determine the amount of 
a grant under paragraph (1). 
‘‘(c) TECHNICAL ASSISTANCE AND PROGRAM EVAL-
UATION.— 
‘‘(1) IN GENERAL.—The Director shall— 
‘‘(A) provide technical assistance to appli-
cants and grantees under this section; and 
‘‘(B) collect and evaluate information on 
the program carried out under this section. 
‘‘(2) CONSULTATION.—The Director shall con-
sult with eligible entities under this section for pur-
poses of developing evaluation measures and data 
submission and reporting requirements for purposes 
of the collection and evaluation of information under 
paragraph (1)(B). 
‘‘(3) DATA SUBMISSION AND REPORTING.—As a 
condition on receipt of a grant under this section, an 
applicant shall agree to submit data and reports 
consistent with the data submission and reporting 
requirements developed under paragraph (2). 
‘‘(d) FUNDING.—To carry out this section, there is 
authorized to be appropriated, and there is appropriated, 
out of any money in the Treasury not otherwise appro-
priated, $200,000,000 for each of fiscal years 2022 
through 2026.’’. 
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(b) TECHNICAL AMENDMENT.—Section 4(26) of the 
Indian Health Care Improvement Act (25 U.S.C. 
1603(26)) is amended by striking ‘‘(25 U.S.C. 450b)’’ and 
inserting ‘‘(25 U.S.C. 5304)’’. 
SEC. 3. INDIAN DEFINED IN PPACA. 
(a) INDIAN DEFINED IN PPACA.— 
(1) IN GENERAL.—Section 1304 of the Patient 
Protection and Affordable Care Act (42 U.S.C. 
18024) is amended by adding at the end the fol-
lowing new subsection: 
‘‘(f) INDIAN.— 
‘‘(1) IN GENERAL.—In this title, the term ‘In-
dian’ means any individual— 
‘‘(A) described in paragraph (13) or (28) 
of section 4 of the Indian Health Care Improve-
ment Act (25 U.S.C. 1603); 
‘‘(B) who is eligible for health services pro-
vided by the Indian Health Service under sec-
tion 809 of the Indian Health Care Improve-
ment Act (25 U.S.C. 1679); 
‘‘(C) who is of Indian descent and belongs 
to the Indian community served by the local fa-
cilities and program of the Indian Health Serv-
ice; or 
‘‘(D) who is described in paragraph (2). 
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‘‘(2) INCLUDED INDIVIDUALS.—For purposes of 
this title, the following individuals shall be consid-
ered to be an ‘Indian’: 
‘‘(A) A member of a Federally recognized 
Indian tribe. 
‘‘(B) A resident of an urban center who 
meets one or more of the following four criteria: 
‘‘(i) Membership in a Tribe, band, or 
other organized group of Indians, including 
those Tribes, bands, or groups terminated 
since 1940 and those recognized by the 
State in which they reside, or being a de-
scendant, in the first or second degree, of 
any such member. 
‘‘(ii) Is an Eskimo or Aleut or other 
Alaska Native. 
‘‘(iii) Is considered by the Secretary of 
the Interior to be an Indian for any pur-
pose. 
‘‘(iv) Is determined to be an Indian 
under regulations promulgated by the Sec-
retary. 
‘‘(C) An individual who is considered by 
the Secretary of the Interior to be an Indian for 
any purpose. 
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‘‘(D) An individual who is considered by 
the Secretary to be an Indian for purposes of 
eligibility for Indian health care services, includ-
ing as a California Indian, Eskimo, Aleut, or 
other Alaska Native.’’. 
(2) CONFORMING AMENDMENTS.— 
(A) AFFORDABLE CHOICES HEALTH BEN-
EFIT PLANS.—Section 1311(c)(6)(D) of the Pa-
tient Protection and Affordable Care Act (42 
U.S.C. 18031(c)(6)(D)) is amended by striking 
‘‘section 4 of the Indian Health Care Improve-
ment Act’’ and inserting ‘‘section 1304(f)’’. 
(B) REDUCED
COST-SHARING
FOR
INDI-
VIDUALS
ENROLLING
IN
QUALIFIED
HEALTH 
PLANS.—Section 1402(d) of the Patient Protec-
tion and Affordable Care Act (42 U.S.C. 
18071(d)) is amended— 
(i) in paragraph (1), in the matter 
preceding subparagraph (A), by striking 
‘‘section 4(d) of the Indian Self-Deter-
mination and Education Assistance Act 
(25 U.S.C. 450b(d))’’ and inserting ‘‘sec-
tion 1304(f)’’; and 
(ii) in paragraph (2), in the matter 
preceding subparagraph (A), by striking 
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‘‘(as so defined)’’ and inserting ‘‘(as de-
fined in section 1304(f))’’. 
(3) EFFECTIVE DATE.—The amendments made 
by this subsection shall apply with respect to plan 
years beginning on or after January 1, 2023. 
(b) TECHNICAL AMENDMENTS.—Section 4 of the In-
dian Health Care Improvement Act (25 U.S.C. 1603) is 
amended— 
(1) in paragraph (13), by striking ‘‘as defined 
in subsection (d) hereof’’ and inserting ‘‘as defined 
in paragraph (14)’’; and 
(2) in paragraph (28)— 
(A) by striking ‘‘as defined in subsection 
(g) hereof’’ and inserting ‘‘as defined in para-
graph (27)’’; and 
(B) by striking ‘‘subsection (c)(1) through 
(4)’’ and inserting ‘‘subparagraphs (A) through 
(D) of paragraph (13)’’. 
Æ 
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