Federal Programs Serving Native Americans

thumbnail environmentMore than 560 federally recognized tribes in the United States receive approximately $19 billion in annual funding from the federal government for certain protections, services, and benefits. These federal programs cover areas ranging from education to health care to cultural preservation. Let’s take a look at some of our recent work to help improve federal programs that serve Native American communities.


Bureau of Indian Education (BIE) schools receive almost $1 billion in federal funds annually. However, Native American students attending these schools have lower graduation rates and consistently perform below public school students on national assessments. In 2013, we examined BIE students’ poor academic performance and the myriad management challenges that hinder BIE’s ability to provide students with a quality education. We made several recommendations to improve BIE’s management of its schools and enhance collaboration with the Department of Education to improve student performance.

More recently, we reported on BIE schools’ funding and expenditures as compared to public schools nationwide (expenditures are shown in the figure). We identified significant weaknesses in the Bureau’s oversight of school spending, resulting in millions of dollars in misspent funds. We made several recommendations to strengthen BIE’s oversight of school expenditures to ensure that funds are being used for their intended purposes.

chart1(Excerpted from GAO-15-121)

Health Care

The Department of Health and Human Services’ Indian Health Service (IHS) provides health care to Native Americans, but access to that care has been a long-standing concern. We have examined various IHS programs, such as the contract health services program. This program enables IHS to purchase health services on the market when they are not available at IHS facilities. We found delays and other problems with payments from this program, and made several recommendations to strengthen it. These include capping payment rates for physician and nonhospital services, and using a more equitable method for allocating funds.

We’ve also reported on the effects of the Patient Protection and Affordable Care Act on Native Americans, and found that most could be eligible for either new or expanded coverage under the Patient Protection and Affordable Care Act.

Cultural Preservation

Several agencies are involved with federal efforts to preserve Native American cultural artifacts by returning them to their original tribal owners. We’ve examined several issues related to the repatriation of Native American human remains and objects.

In 2010, we reviewed the implementation of the Native American Graves Protection and Repatriation Act, and found that data on repatriations were not centrally tracked and reported, and were not readily available to the affected tribes.

We also reviewed the Smithsonian Institution’s implementation of repatriation provisions in the National Museum of the American Indian Act, and found opportunities for the Smithsonian to improve transparency for both tribes and policymakers when handling culturally unidentifiable items.

As a result of our work, the agencies and museums involved have improved their repatriation policies and procedures.

chart2(Excerpted from GAO-11-515)

To learn more about these and other Native American issues, check out our Key Issue page.

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