The IHS per capita expenditure of $3,688 in 2016 was significantly lower than the general population’s expenditure of $9,990 per capita. In 2019, the IHS’ per capita rose to $4,078 but was still under funded in comparison to Medicaid ($8,109), the Veterans Health Administration ($10,692) and Medicare ($13,185).

This lack of funding despite stark health disparities amongst AI/AN is compounded by lack of a Federal Insurance plan to cover the gaps the IHS cannot fill.