I 
117TH CONGRESS 
1ST SESSION H. R. 5549 
To amend the Indian Health Care Improvement Act to authorize advance 
appropriations for the Indian Health Service by providing 2-fiscal-year 
budget authority, and for other purposes. 
IN THE HOUSE OF REPRESENTATIVES 
OCTOBER 8, 2021 
Mr. YOUNG (for himself, Ms. MCCOLLUM, Mr. KILMER, Mr. KIND, Mr. 
MULLIN, Mr. COLE, Mr. JOHNSON of South Dakota, and Ms. STRICK-
LAND) introduced the following bill; which was referred to the Committee 
on Natural Resources, and in addition to the Committees on Energy and 
Commerce, and the Budget, for a period to be subsequently determined 
by the Speaker, in each case for consideration of such provisions as fall 
within the jurisdiction of the committee concerned 
A BILL 
To amend the Indian Health Care Improvement Act to au-
thorize advance appropriations for the Indian Health 
Service by providing 2-fiscal-year budget authority, and 
for other purposes. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Indian Health Service 
Advance Appropriations Act’’. 
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SEC. 2. ADVANCE APPROPRIATIONS FOR CERTAIN INDIAN 
HEALTH SERVICE ACCOUNTS. 
(a) IN GENERAL.—Section 825 of the Indian Health 
Care Improvement Act (25 U.S.C. 1680o) is amended— 
(1) by inserting ‘‘(a)’’ before ‘‘There are au-
thorized’’; and 
(2) by adding at the end the following: 
‘‘(b) For each fiscal year, beginning with the first fis-
cal year that starts during the year after the year in which 
this subsection is enacted, discretionary new budget au-
thority provided for the Indian Health Services and Indian 
Health Facilities accounts of the Indian Health Service 
shall include advance discretionary new budget authority 
that first becomes available for the first fiscal year after 
the budget year. 
‘‘(c) The Secretary shall include in documents sub-
mitted to Congress in support of the President’s budget 
submitted pursuant to section 1105 of title 31, United 
States Code, for each fiscal year to which subsection (b) 
applies detailed estimates of the funds necessary for the 
Indian Health Services and Indian Health Facilities ac-
counts of the Indian Health Service for the fiscal year fol-
lowing the fiscal year for which the budget is submitted.’’. 
(b) SUBMISSION
OF BUDGET REQUEST.—Section 
1105(a) of title 31, United States Code, is amended by 
adding at the end the following new paragraph: 
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‘‘(40) information on estimates of appropria-
tions for the fiscal year following the fiscal year for 
which the budget is submitted for the following ac-
counts of the Indian Health Service: 
‘‘(A) Indian Health Services. 
‘‘(B) Indian Health Facilities. 
‘‘(C) Contract Support Costs. 
‘‘(D) Payments For Tribal Leases.’’. 
Æ 
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