The act opens the Indian Health Service (IHS) to be managed by tribal communities and not by the U.S. government.
However, adequate funding continues to be a significant barrier to the IHS being able to provide adequate assistance to this day. In 2014, the Indian Health Service per capita expenditures for patient health services were only $3,107, compared to $8,097 per person for healthcare spending nationally. Furthermore, when examining medical spending only, IHS per capita was approximately $1,904.