[Congressional Record Volume 172, Number 144 (Monday, September 14, 2026)]
[House]
[Pages H5568-H5570]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]
STRONGER ENGAGEMENT FOR INDIAN HEALTH NEEDS ACT OF 2025
Mr. WESTERMAN. Mr. Speaker, I move to suspend the rules and pass the
bill (H.R. 741) to elevate the position of Director of the Indian
Health Service within the Department of Health and Human Services to
Assistant Secretary for Indian Health, and for other purposes, as
amended.
The Clerk read the title of the bill.
The text of the bill is as follows:
H.R. 741
Be it enacted by the Senate and House of Representatives of
the United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ``Stronger Engagement for
Indian Health Needs Act of 2025''.
SEC. 2. ASSISTANT SECRETARY FOR INDIAN HEALTH.
(a) Establishment.--Section 601(a) of the Indian Health
Care Improvement Act (25 U.S.C. 1661(a)) is amended--
(1) in paragraph (1), by striking ``tribes'' and inserting
``Tribes'';
(2) in paragraph (2)--
(A) by striking ``a Director'' and inserting ``an Assistant
Secretary for Indian Health (in this section referred to as
the `Assistant Secretary')'';
(B) by striking ``The Director shall report'' and inserting
``The Assistant Secretary shall report directly'';
(C) by striking ``the Director'' and inserting ``the
Assistant Secretary''; and
(D) by striking ``A Director'' and inserting ``An Assistant
Secretary'';
(3) in paragraph (3), by striking ``date of enactment of
the Indian Health Care Improvement Reauthorization and
Extension Act of 2009 shall serve as Director'' and inserting
``date of enactment of the Stronger Engagement for Indian
Health Needs Act of 2025 shall serve as Assistant
Secretary'';
(4) in paragraph (4), in the matter before subparagraph
(A), by striking ``Director'' and inserting ``Assistant
Secretary''; and
(5) by adding at the end the following new paragraph:
``(5) Deputy assistant secretary.--The Assistant Secretary
may--
``(A) with the approval of the Secretary, appoint a Deputy
Assistant Secretary; and
``(B) consistent with applicable law, utilize officers and
employees of the Department as necessary to administer the
activities of the Service.''.
(b) Duties.--Section 601(c) of the Indian Health Care
Improvement Act (25 U.S.C. 1661(c)) is amended--
(1) in the matter before paragraph (1), by striking
``Director'' and inserting ``Assistant Secretary''; and
(2) in paragraph (1), by striking ``date of enactment of
the Indian Health Care Improvement Reauthorization and
Extension Act of 2009'' and inserting ``date of enactment of
the Stronger Engagement for Indian Health Needs Act of
2025''.
(c) Authority.--Section 601(d)(1) of the Indian Health Care
Improvement Act (25 U.S.C. 1661(d)(1)) is amended in the
matter before subparagraph (A), by striking ``Director'' and
inserting ``Assistant Secretary''.
(d) References.--Section 601 of the Indian Health Care
Improvement Act (25 U.S.C. 1661) is amended by adding at the
end the following new subsection:
``(e) References.--Any reference to the Director of the
Indian Health Service in any Federal law, Executive order,
rule, regulation, or delegation of authority, or in any
document of or relating to the Director of the Indian Health
Service, shall be deemed to refer to the Assistant
Secretary.''.
(e) Rate of Basic Pay.--
(1) Positions at level iv.--Section 5315 of title 5, United
States Code, is amended by striking ``Assistant Secretaries
of Health and Human Services (6)'' and inserting ``Assistant
Secretaries of Health and Human Services (7)''.
(2) Positions at level v.--Section 5316 of title 5, United
States Code, is amended by striking ``Director, Indian Health
Service, Department of Health and Human Services.''.
The SPEAKER pro tempore. Pursuant to the rule, the gentleman from
Arkansas (Mr. Westerman) and the gentlewoman from Maryland (Ms.
Elfreth) each will control 20 minutes.
[[Page H5569]]
The Chair recognizes the gentleman from Arkansas.
General Leave
Mr. WESTERMAN. Mr. Speaker, I ask unanimous consent that all Members
may have 5 legislative days to revise and extend their remarks and to
include extraneous material on H.R. 741, the bill now under
consideration.
The SPEAKER pro tempore. Is there objection to the request of the
gentleman from Arkansas?
There was no objection.
Mr. WESTERMAN. Mr. Speaker, I yield myself such time as I may
consume.
Mr. Speaker, H.R. 741 is a straightforward bill to strengthen Indian
health leadership within the Department of Health and Human Services.
The bill redesignates the Director of the Indian Health Service as
the Assistant Secretary for Indian Health within HHS.
The Federal Government has longstanding responsibilities for Indian
healthcare rooted in the Federal trust responsibility. The Indian
Health Service is the principal Federal entity responsible for
providing health services to American Indians and Alaska Natives.
Indian health issues do not begin and end at IHS. Many of these
issues require coordination across HHS, including healthcare access,
workforce recruitment and retention, behavioral health, public health,
and health infrastructure.
H.R. 741 will help that coordination by elevating IHS' senior within
the Department.
This bill is narrowly tailored. The IHS director is already appointed
by the President and confirmed by the Senate, so H.R. 741 does not
create a new Senate-confirmed appointment. It does not create a new
program or change how IHS delivers healthcare.
Instead, this bill makes a senior-level structural change to better
coordinate health issues across the Department. This is a practical and
reasonable step. When Indian health issues cut across IHS, the senior
official responsible for Indian health should be positioned to work
across HHS.
Mr. Speaker, I support H.R. 741, and I reserve the balance of my
time.
House of Representatives,
Committee on Natural Resources,
Washington, DC, August 24, 2026.
Hon. Brett Guthrie,
Chairman, Committee on Energy and Commerce,
Washington, DC.
Dear Chairman Guthrie: I write regarding H.R. 741, the
``Stronger Engagement for Indian Health Needs Act of 2025,''
which was ordered reported by the Committee on Natural
Resources on May 14, 2026.
I recognize that the bill contains provisions that fall
within the jurisdiction of the Committee on Energy and
Commerce and appreciate your willingness to forgo further
consideration of the bill. I acknowledge that the Committee
on Energy and Commerce will not formally consider H.R. 741
and agree that the inaction of your Committee with respect to
the bill does not waive any jurisdiction over the subject
matter contained therein.
I am pleased to support your request to name members of the
Committee on Energy and Commerce to any conference committee
to consider such provisions. I will ensure that our exchange
of letters is included in the Congressional Record during
floor consideration of the bill and will include such letters
in the committee report on H.R. 741. I appreciate your
cooperation regarding this legislation.
Sincerely,
Bruce Westerman,
Chairman, Committee on Natural Resources.
____
House of Representatives,
Committee on Energy and Commerce,
Washington, DC, August 24, 2026.
Hon. Bruce Westerman,
Chairman, Committee on Natural Resources,
Washington, DC.
Dear Chairman Westerman: I write regarding H.R. 741, the
``Stronger Engagement for Indiana Health Needs Act of 2025.''
While there are provisions of the legislation that fall
within the Rule X jurisdiction of the Committee on Energy and
Commerce, I wanted to notify you that the Committee will
forgo action on the bill so that it may proceed expeditiously
to the House floor for consideration.
This is done with the understanding that the Committee's
jurisdictional interests over this and similar legislation
are in no way diminished or altered. In addition, the
Committee reserves the right to seek conferees on H.R. 741
and requests your support when such a request is made.
I would appreciate your response confirming this
understanding with respect to H.R. 741 and ask that a copy of
our exchange of letters on this matter be included in the
committee report on the bill or in the Congressional Record
during consideration of the bill on the House floor.
Thank you again for your assistance on this matter.
Sincerely,
Brett Guthrie,
Chairman.
{time} 1630
Ms. ELFRETH. Mr. Speaker, I yield myself such time as I may consume.
Mr. Speaker, I rise in strong support of H.R. 741, the Stronger
Engagement for Indian Health Needs Act, introduced by my friend and
colleague from Arizona (Mr. Stanton).
The Indian Health Service, or IHS, is the primary Federal agency
responsible for providing healthcare to American Indians and Alaska
Natives. Yet, for decades, the agency has fallen short of meeting our
trust and treaty obligations as we have left IHS underfunded and
underprioritized.
Tribal leaders have long called for greater Federal attention to
Indian health in IHS. H.R. 741 responds to their advocacy by elevating
the Director of IHS to an Assistant Secretary within the Department of
Health and Human Services.
This simple but meaningful change would give IHS a stronger voice
within the Department, ensure the healthcare needs of Tribal patients
are properly represented, and elevate health disparities, including
inadequate infrastructure, limited services, and staffing shortages,
facing Tribal communities.
It is the Federal Government's responsibility to ensure that Indian
Country has the culturally competent, robust, and accessible healthcare
they deserve, and H.R. 741 will help us uphold this premise.
Mr. Speaker, I strongly urge support for the bill, and I reserve the
balance of my time.
Mr. WESTERMAN. Mr. Speaker, I thank the gentleman from Arizona (Mr.
Stanton) and the ranking member for working with us on this
legislation.
I have no further requests for time. I am prepared to close, and I
reserve the balance of my time.
Ms. ELFRETH. Mr. Speaker, I yield such time as he may consume to the
gentleman from Arizona (Mr. Stanton), the sponsor of the bill.
Mr. STANTON. Mr. Speaker, I rise in support of my bipartisan bill,
H.R. 741, the Stronger Engagement for Indian Health Needs Act.
Mr. Speaker, I thank my colleague from Ohio (Mr. Joyce) for co-
leading on this important effort.
The Federal Government has a sacred trust obligation to provide
healthcare to our Native communities. For far too long, we have fallen
short of that obligation.
Deep disparities exist between the health of American Indian, Alaska
Native, and Native Hawaiian communities and the broader American
population. American Indians and Alaska Natives have lower life
expectancies and some of the highest rates of poor health across racial
groups. Access and quality of care are impacted by high vacancies at
Indian Health Service facilities. When it comes to equality in
healthcare, our Nation has a long way to go.
Mr. Speaker, 20 years ago, the late Senator John McCain first tried
to pass a similar measure to raise the Director of the IHS to an
Assistant Secretary role within the Department of Health and Human
Services. Senator McCain, who advanced this measure through the Senate
time and time again, never saw it pass the House and signed into law.
Today, this bill honors his legacy.
This is a commonsense, bipartisan policy, and Congress should have
gotten it done many years ago.
H.R. 741 would finally get this across the finish line. It creates
the position of Assistant Secretary for Indian Health at HHS, giving
Native communities a voice at the highest levels of Department
leadership.
This matters. As an Assistant Secretary, the head of IHS would
finally have the pay and hiring authorities needed to tackle chronic
workforce shortages and disparities in access to care. It means faster
hiring, better retention, and a direct line to the Secretary on every
matter affecting Indian health.
Congress must ensure our health systems better honor our trust
obligations to Native communities. This is a meaningful step forward,
and I urge my colleagues to support this bill.
Ms. ELFRETH. Mr. Speaker, I urge my colleagues to support this
critical
[[Page H5570]]
legislation, and I yield back the balance of my time.
Mr. WESTERMAN. Mr. Speaker, I support H.R. 741, and I yield back the
balance of my time.
The SPEAKER pro tempore. The question is on the motion offered by the
gentleman from Arkansas (Mr. Westerman) that the House suspend the
rules and pass the bill, H.R. 741, as amended.
The question was taken; and (two-thirds being in the affirmative) the
rules were suspended and the bill, as amended, was passed.
The title of the bill was amended so as to read: ``A bill to
redesignate the position of Director of the Indian Health Service
within the Department of Health and Human Services as Assistant
Secretary for Indian Health, and for other purposes.''.
A motion to reconsider was laid on the table.
____________________