What does the do?

Refreshed annually

The Indian Health Service (IHS) is a subdivision of the Department of Health and Human Services responsible for providing comprehensive health services to American Indians and Alaska Natives. It was established in 1955.

In FY 2025,

$8.33B

was spent by the Indian Health Service
In FY 2025,

0.4%

of Dept. of Health and Human Services spending was by the Indian Health Service

How much does the Indian Health Service spend?

The Indian Health Service spent a net total of $8.33 billion in fiscal year (FY) 2025. This was 0.4% of the $1.88 trillion spent by the Department of Health and Human Services, which itself was 26.8% of all federal spending. The IHS ranked 7th among HHS subdivisions in net spending.
Net spending is the difference between agency spending and any financial accounts generating funds from the agency’s own activities, like fees or rent. When these funds offset all spending, net spending appears negative. Some agencies tend to operate with positive net spending while others will register negative net spending sometimes or often.

The Indian Health Service ranked 7th among Department of Health and Human Services divisions in net spending in 2025.

HHS net spending by division, FY 2025

Like the overall federal budget, agency spending may shift over time due to population growth, changes in policy and programs, and emerging problems to address. Adjusting for inflation, the Indian Health Service’s federal spending has increased from $2.55 billion in 1980 to $8.33 billion in 2025.

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The Indian Health Service’s federal spending in FY 2025 was higher than in FY 1980.

Yearly federal net spending by IHS, adjusted for inflation (2025 dollars), FYs 1980–2025

Since 1980, the Indian Health Service's spending has increased 227.2%, while overall spending has increased 196.9%.
As a percentage of the overall federal budget, a positive number means agency net spending made up some positive share of total federal spending; a negative number means that net generated funds offset a portion of total spending. IHS spending grew more than overall federal spending since 1980, which means that its share of the federal budget increased. In 2025, IHS accounted for 0.1% of overall federal spending.
Major legislation, internal or global economic conditions, and acute events like the COVID-19 pandemic can affect spending year to year. For example, the federal budget fluctuated during the pandemic, rising from $5.3 trillion (in 2023 dollars) in 2019 to $7.7 trillion in 2020 and $7.8 trillion in 2021.

The Indian Health Service’s share of federal spending in FY 2025 was higher than in FY 1980.

Net spending by IHS as a share of federal spending, FYs 1980–2025

Most federal spending can be categorized as direct or indirect. Direct spending refers to money the federal government spends on budget items such as federal programs, employee salaries, and debt interest. Indirect spending refers to federal transfers to state and local governments.
In FY 2025, the Indian Health Service transferred 21.4% of its total spending to states and local governments.
The chart below outlines all net IHS spending.

How did the Indian Health Service spend its budget in 2025?

Federal government net spending isolated to IHS, FY 2025

How many people work for the Indian Health Service?

Some 12,351 of the 2.03 million total civilian federal employees work for the Indian Health Service as of May 2026. This is 9.4% fewer people than the division staffed in 2012.

The number of federal employees working for the Indian Health Service has decreased 9.4% since 2012.

Number of federal employees working for IHS, May 2012–2026

The Indian Health Service accounts for 0.6% of the overall federal workforce. As the number of federal employees has changed, so too has the way the workforce is organized, with resources allocated to agencies depending on government priorities. The division constituted a similar share of the overall federal workforce in May 2026 compared to 2012 (0.6%).
While the number of employees on an agency’s payroll contributes to that agency’s expenditures, some agencies have relatively few employees compared to their budget or vice versa, giving them an outsized share of either the budget or the workforce. According to the most recent data, the Indian Health Service’s share of the workforce (0.6%) is larger than its share of the budget (0.1%).

Who leads the Indian Health Service?

IHS is led by a director, who is nominated by the president of the United States and requires Senate confirmation. The IHS director reports to the Secretary of Health and Human Services.

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Methodology

USAFacts standardizes data, in areas such as time and demographics, to make it easier to understand and compare.

Page sources

USAFacts endeavors to share the most up-to-date information available. We sourced the data on this page directly from government agencies; however, the intervals at which agencies publish updated data vary.