The House and Senate have each released their annual appropriations bills for the Indian Health Service (IHS) and other HHS accounts. The outlook on spending for FY 2024 is a tightening belt, with very low chances of breakout changes, including the addition of more funding for IHS. This fall, the National Indian Health Board (NIHB) will be advocating to oppose IHS rescissions, expand advance appropriations to all IHS accounts, and reclassify CSC and 105(l) mandatory payments as mandatory spending. Outreach to Congressional members back in their district during August recess and maintaining pressure into the fall will be critical to maximizing Tribal program investment.