This report compares selected Indian Health Service budget categories for fiscal years 2021–2025: Facilities, Contract Support Costs (CSC), Purchased/Referred Care (PRC) and the Catastrophic Health Emergency Fund (CHEF), and Section 105(l) Tribal leases. It includes a five-year budget-share analysis, an additional analysis excluding Facilities, and a research section on why Section 105(l) estimates and later-reported costs differ.
Important limitations: The figures are nominal and are not adjusted for inflation. The report does not separately identify or analyze temporary COVID-19 emergency appropriations or supplemental funding. The analysis excluding Facilities is explicitly provisional and calls for reconciliation of FY2021 figures before publication as a definitive series.
An accompanying Excel workbook of the report’s tables has been prepared and will be added to the site’s Data Tables resource once the workbook is uploaded to the WordPress media library.