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Indian Health Care Improvement Act

Public Law 94-437 · S. 522 · 94th Congress · began in the Senate

Signed by Gerald Ford (R) on Sep 30, 1976 · Native Americans

Sponsor: Sen. Scoop Jackson (D-WA)

Cosponsors (25): Sen. Paul Fannin,

Passage votesYeaNay

  • HouseMethod not stated
  • SenateRecorded vote: 78 yea, 0 nay78–0
Data notes

The final version of the law, as each chamber passed it. A chamber that passed it by voice vote or unanimous consent has no count. “Method not stated” means the record does not say how the chamber voted. Where the record has a member-by-member vote, the “Who voted for it” section shows who voted yea.

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Summary

The Congressional Research Service’s plain-language summary of what the law does.

Indian Health Care Improvement Act - =Title I: Indian Health Manpower= - Directs the Secretary of Health, Education, and Welfare, acting through the Indian Health Service, to make grants to public or nonprofit private health or educational entities of Indian tribes or tribal organizations to assist such entities in meeting the costs of, among other items, identifying Indians with a potential for education or training in the health professions and encouraging and assisting them to enroll in health professions schools, or to undertake postsecondary education or training to qualify them to so enroll. Authorizes appropriations from fiscal year 1978 through fiscal year 1984 for such grants.

Authorizes two-year scholarship grants to Indians who completed high school and have demonstrated the capability of completing a course of study in a health professions school. Authorizes appropriations from fiscal year 1978 through fiscal year 1984 for such grants.

Authorizes appropriations through fiscal year 1984 for the Health Professions Scholarship Program. Gives priority to Indians for such scholarships. Permits the service requirement of such scholarships to be met by service in the Indian Health Service in an urban Indian health program under this Act or by private practice in an area of physician shortage which will serve Indians.

Authorizes appropriations through fiscal year 1984 for the Service extern programs.

=Title II: Health Services= - Authorizes expenditures through the Service over a seven-year period for patient care, field health, dental care, mental health, inpatient mental health services, model dormitory mental health services, therapeutic and residential treatment centers, treatment and control of alcoholism among Indians, and maintenance and repair.

=Title III: Health Facilities= - Authorizes expenditures through the Service over a seven-year period for the construction and renovation of hospitals, health centers, health stations, and other facilities of the Service. Authorizes the equipping and staffing of such facilities. Requires consultation with affected Indian tribes before such funds are expended.

Authorizes expenditures over a seven-year period to supply unmet needs for safe water and sanitary waste disposal facilities in existing and new Indian homes and communities. Gives preference to Indian firms (including those owned by federally recognized tribes in the State of New York) in construction or renovation of facilities and safe water and sanitary waste disposal facilities authorized by this Act.

=Title IV: Access to Health Services= - Makes hospitals and skilled nursing facilities of the Indian Health Service, whether operated by the Service or a tribal organization, eligible for Medicare reimbursement payments. Makes such hospitals and facilities eligible, if not in compliance with Federal standards, for 12 months after submitting a plan for achieving compliance. Requires the Secretary to use such payments for making improvements in such hospitals and facilities to bring them into compliance.

Authorizes Medicaid reimbursement payments to the States for health services to Indians. Sets the Medicaid assistance at 100 percent for services received through a Service facility.

=Title V: Health Services for Urban Indians= - Authorizes contracts with urban Indian organizations to assist them in establishing and administering programs to meet urban Indian health needs. Sets forth requirements of eligibility for such organizations to enter into such contracts, including that such organizations provide assistance to public and private health service resources in serving Indians, aid in familarization of Indians with available services, determine the size of the Indian populations served by such organizations, determine the extent of unmet health care needs of such populations, and determine the feasibility of providing services through such organizations to meet the purposes of this Act.

Permits Indian organizations to utilize existing Federal facilities in connection with such contracts.

Authorizes appropriation for purposes of this title of $5,000,000 in fiscal year 1978, $10,000,000 in fiscal year 1979, and $15,000,000 in fiscal year 1980.

=Title VI: American Indian School of Medicine= - Directs the Secretary to study the need for and feasibility of establishing a school of medicine to train Indians to provide health services to Indians. Requires a report within one year on such study to the Congress.

=Title VII:= - Requires specific reviews and reports on programs under this Act to be submitted to the Congress.

Prescribes procedures for implementation of regulations and a plan to effectuate the provisions of this Act.

Who voted for it

Every senator of the 94th Congress on the ideology compass. Highlighted: the 79 who voted yea on final passage. Faded: everyone else, including those who voted nay, did not vote, or had not yet taken office.

79 yea0 nay21 present or did not vote

Dimension 2
Economic left–right
More liberalMore conservative

Democrats who voted yea(47)

  • Sen. James AbourezkD-SD
  • Sen. William ProxmireD-WI
  • Sen. Dick ClarkD-IA
  • Sen. Gaylord NelsonD-WI
  • Sen. Mike MansfieldD-MT
  • Sen. George McGovernD-SD
  • Sen. Joseph BidenD-DE
  • Sen. Floyd HaskellD-CO
  • Sen. Lee MetcalfD-MT
  • Sen. John CulverD-IA
  • Sen. William HathawayD-ME
  • Sen. John DurkinD-NH
  • Sen. Patrick LeahyD-VT
  • Sen. Thomas EagletonD-MO
  • Sen. Edmund MuskieD-ME
  • Sen. Alan CranstonD-CA
  • Sen. Frank ChurchD-ID
  • Sen. Fritz HollingsD-SC
  • Sen. Hubert HumphreyD-MN
  • Sen. Stuart SymingtonD-MO
  • Sen. Dale BumpersD-AR
  • Sen. Quentin BurdickD-ND
  • Sen. Claiborne PellD-RI
  • Sen. Dee HuddlestonD-KY
  • Sen. Robert ByrdD-WV
  • Sen. Scoop JacksonD-WA
  • Sen. Warren MagnusonD-WA
  • Sen. Abraham RibicoffD-CT
  • Sen. Wendell FordD-KY
  • Sen. John PastoreD-RI
  • Sen. Howard CannonD-NV
  • Sen. Daniel InouyeD-HI
  • Sen. Robert MorganD-NC
  • Sen. Jennings RandolphD-WV
  • Sen. Lawton ChilesD-FL
  • Sen. Dick StoneD-FL
  • Sen. Mike GravelD-AK
  • Sen. John JohnstonD-LA
  • Sen. Samuel NunnD-GA
  • Sen. John SparkmanD-AL
  • Sen. Lloyd BentsenD-TX
  • Sen. Russell LongD-LA
  • Sen. John StennisD-MS
  • Sen. John McClellanD-AR
  • Sen. James EastlandD-MS
  • Sen. Harry ByrdD-VA
  • Sen. James AllenD-AL

Republicans who voted yea(32)

  • Sen. Clifford CaseR-NJ
  • Sen. Edward BrookeR-MA
  • Sen. Richard SchweikerR-PA
  • Sen. Jacob JavitsR-NY
  • Sen. Charles MathiasR-MD
  • Sen. Robert StaffordR-VT
  • Sen. Charles PercyR-IL
  • Sen. Mark HatfieldR-OR
  • Sen. Hugh ScottR-PA
  • Sen. James PearsonR-KS
  • Sen. Robert PackwoodR-OR
  • Sen. Hiram FongR-HI
  • Sen. Ted StevensR-AK
  • Sen. Milton YoungR-ND
  • Sen. Pete DomeniciR-NM
  • Sen. Robert DoleR-KS
  • Sen. Robert TaftR-OH
  • Sen. Howard BakerR-TN
  • Sen. William BrockR-TN
  • Sen. Henry BellmonR-OK
  • Sen. Strom ThurmondR-SC
  • Sen. Dewey BartlettR-OK
  • Sen. Roman HruskaR-NE
  • Sen. Jake GarnR-UT
  • Sen. Paul LaxaltR-NV
  • Sen. William ScottR-VA
  • Sen. Clifford HansenR-WY
  • Sen. John TowerR-TX
  • Sen. Carl CurtisR-NE
  • Sen. James McClureR-ID
  • Sen. Paul FanninR-AZ
  • Sen. Jesse HelmsR-NC
Data notes

The Senate’s recorded vote on the final version of the law (roll call 1188 in Voteview), matched to the vote the record cites and checked against its totals. Positions are each member’s DW-NOMINATE score for that Congress, as on the Ideology page; left to right is more liberal to more conservative. Paired and announced yea votes count as yea. Lists follow the compass, most liberal first. A name links to a profile only for members of the current Congress. A law passed by voice vote or unanimous consent has no member list, and neither does a vote Voteview has not yet recorded.

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Committees

The committees the bill was sent to, and what each did with it.

Data notes

A committee links to its page only where it exists in the current Congress; older and renamed committees are named without a link.

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Timeline

From introduction to signing, newest first: the committees, the floor and the president. 14 actions.

  1. Sep 30, 1976Became lawBecame law · Signed by President.
  2. PresidentPresident · Public law 94-437.
  3. Sep 20, 1976PresidentPresident · Measure presented to President.
  4. PresidentPresident · Measure enrolled in Senate.
  5. PresidentPresident · Measure enrolled in House.
  6. Sep 16, 1976Resolving differencesResolving differences · House agreed to Senate amendment.
  7. Sep 9, 1976Resolving differencesResolving differences · Senate agreed to House amendment with an amendment, roll call #577 (78-0).Senate roll call 577
  8. OtherOther · Resolving differences -- Senate actions: Senate agreed to House amendment with an amendment, roll call #577 (78-0).Senate roll call 577
  9. Jul 30, 1976FloorFloor · Measure passed House, amended, in lieu of H.R. 2525.
  10. May 22, 1975CommitteeCommittee · Referred to House Natural Resources Committee
  11. May 16, 1975FloorFloor · Measure passed Senate, amended.
  12. May 13, 1975CommitteeCommittee · Reported by Senate Energy and Natural Resources Committee
  13. Feb 3, 1975CommitteeCommittee · Referred to Senate Energy and Natural Resources Committee
  14. IntroducedIntroduced · Introduced in the Senate
Data notes

Shows the introduction, each committee and subcommittee step the source dates (referral, hearings, markup, report, discharge), and the floor, conference, presidential and became-law steps. Calendar placements, messages between the chambers, amendments and committee report numbers are not shown for laws before the 108th Congress. Two entries the source lists twice are shown once.

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Official record

The bill’s full text and every action, including introduction and committee steps, are on Congress.gov. Data through Oct 7, 2026.