The mentality of Congress is that it has never considered a single proposal to fully-fund Indian health.

Source: Indianz.Com Mark Trahant: A Republican plan to terminate the Indian Health Service

MARK TRANHANT: Instead of promising adequate funding Ryan’s plan gives the IHS “the ability to set up a system for eligible American Indians to access to care outside of the Indian Health Service facilities. Not only will this give American Indians more choice in where they receive care, it will challenge Indian health facilities to provide the best care possible to American Indians.”
Less money. That’s sure to result in better care for those who remain, right? There is also a provision to create individual Native Americans to have Health Savings Accounts. Come again. What about treaty rights? Not. So. Much.
Damn. This is a play right out of the 1940s. The Republican complaints then were that the Bureau of Indian Affairs was responsible for poverty, horrible living conditions, and general mismanagement. The solution over the next decade was the idea of “freeing the Indians”by terminating the federal responsibility. A hundred and nine tribes were terminated, representing some 12,500 tribal members, and the end result was conditions that were far worse.
That’s exactly what will happen if the Ryan’s “choice” approach to Indian health becomes law. The word “termination” used to be toxic in Indian Country. But legislation that would destroy the Indian health system is beyond appalling.