Native Vote 2026
New Mexico Governor candidate Deb Haaland is committed to supporting ongoing tribal health care expansion.
Haaland said this Thursday after she introduced her health care policy plans that included options to expand public health services, rural hospital investments, incentives to recruit hospital staff and support for harms caused by the forced sterilization of Native women.
Her Democratic party primary opponent, Sam Bregman, shares a similar platform, a reflection of the fact that for many in the state, the public option is the option. As the state faces a potential loss of more than $8.5 billion in Medicaid funding over the next decade due to sweeping federal cuts that gut the program, both candidates see state investments as a way to cover the losses.
Around 1.2 million New Mexicans, more than half of the state’s population, receive Medicaid, Medicare, or /both options — 125,245 of whom are enrolled tribal members.
“Cuts to Medicaid are threatening the lives of New Mexicans who are just trying to get by,” Haaland said. “We have the largest share of people on Medicaid of any state in the country. Nearly half of all New Mexicans qualify.
My plan will protect New Mexico’s Medicaid coverage by expanding the state’s Medicaid trust fund to protect the more than 800,000 New Mexicans who rely on it. Supporting and expanding Medicaid, the Medicaid trust fund, will not only make healthcare more affordable, but it will make it accessible, so families can find providers without having to travel across the state.”
New Mexico Speaker of the House Javier Martinez echoed Halaand, pointing to the state’s recent move to provide universal child care, a program funded by its oil and gas royalties.
“These are resources that we leveraged in the past,” Martinez said. “… I think the time has come for us to start to think about how we leverage those permanent funds, the sovereign wealth funds, to ensure that every new Mexican has access to quality healthcare, and as the Secretary stated, a public option is always gonna be the less expensive, most efficient, best way to deliver healthcare.”
Haaland also pointed to new work requirements for Medicaid, which will roll out in January 2027 and is predicted to leave up to 10 million Americans without coverage. Enrolled members of federally recognized tribes are exempt from the requirements, but a Brookings Institution report found there is no clear process for states to verify tribal enrollment to ensure an individual qualifies for the exemption.
“I will also be sure that New Mexicans know how to apply for Medicaid,” Haaland said. “The federal government is hoping you won’t put in the work to get the coverage you need. So our state will hire a team to make sure you can navigate all of that red tape.”
Haaland’s health care policies also support greater tribal control over hospital operations. According to the New Mexico Health Care Authority, cuts to Medicaid could result in the closure of six to eight rural hospitals in the state. In response, places like Picuris and San Felipe Pueblos have worked with state and federal dollars to establish new small clinic services for patients.
“They did that by putting lots of pots of money together. The state even helped them,” she said. “When I worked at San Felipe, they had their own clinic there. It’s within walking distance of nearly every tribal member in that village.”
More and more tribes are going that route out of necessity. At a House Appropriations Committee hearing last month in Washington, D.C., Pueblo of Acoma Governor Charles Riley testified before lawmakers that the tribe was forced to take over operations of its IHS facilities in 2025. The building was in a state of deterioration and lacked hot water; the tribe spent its own funds to make the repairs.
One of the most successful examples of tribally operated health care is the Cherokee Nation Health Authority, which is funded in part by IHS. While it doesn’t receive direct state funds, it relies heavily on collaboration with the state to leverage third-party billing revenue, such as Medicaid.
Upcoming renovations to a Santa Anna Pueblo IHS facility made headlines last month as the first of 14 facilities identified in 1993 as in need of repair or renovation to finally receive construction funds. The agency, tasked with providing health care for millions of Native Americans, is underfunded by tens of billions of dollars and has long been plagued by staffing shortages that sit around 30%, and an egregious lack of resources. Nearly half of the facilities in the construction backlog are located in New Mexico.
Haaland spoke to her personal experience receiving healthcare through the IHS.
“Health care is broken,” Haaland pronounced. “I used to get my health care at the Indian hospital right here in Albuquerque. When my child was sick, we would sit in the waiting room for hours just to see a doctor. That’s untenable for most working people. I know what it’s like to worry about whether or not a doctor’s appointment is affordable. I know what it’s like to face a medical bill you can’t pay.”
She said she supports tribes that pursue legal action against the federal government for the shortcomings of the IHS, violating the U.S.’s trust and treaty obligations to provide adequate healthcare to Native people.
“We should do whatever we can to make sure that they can access healthcare, just the same as anyone,” she said. “But also, I will say that the federal government has obligations. That’s a trust and treaty obligation to Indian tribes that the federal government has, and if they’re not living up to it, then they deserve to be sued.”
