The White House announced on Monday, June 1, that Mark Cruz, a citizen of the Klamath Tribes, has been nominated to serve a four-year term as director of the Indian Health Service (IHS).The IHS director position has been vacant since the start of the second Trump administration, following the resignation of former Director Roselyn Tso (Navajo) at the end of the Biden administration.
Cruz currently serves as Senior Advisor to Secretary of Health and Human Services (HHS) Robert F. Kennedy Jr. He was sworn into the newly created senior advisor position in June 2025, becoming one of the highest-ranking Native officials within HHS. The role was established to ensure Native health priorities are represented at the highest levels of the department and to strengthen communication between HHS and tribal nations.
Since joining HHS, Cruz has become a key liaison between the department and Indian Country. Native health organizations have credited him with helping elevate tribal health priorities within the administration, including support for advance appropriations for the IHS and major investments in IHS facility construction.
The IHS is the federal agency responsible for providing health care to American Indians and Alaska Natives and operates within HHS. Established in 1955, the agency was created to fulfill the federal government’s trust and treaty obligations to Native nations by delivering health care services to eligible tribal citizens.
Today, the IHS serves approximately 2.8 million American Indians and Alaska Natives from 575 federally recognized tribes across 37 states. The agency oversees a nationwide network of hospitals, clinics, health centers, and community health programs that provide primary care, behavioral health services, dental care, emergency treatment, and preventive health programs.
Much of the IHS system is now operated by tribes under self-determination contracts and self-governance compacts authorized by federal law. This arrangement allows tribes to manage their own health care programs while receiving federal funding, giving tribal nations greater control over services delivered to their citizens.
Despite its critical role in Indian Country, the Indian Health Service has long faced funding and staffing challenges. Tribal leaders and health advocates have frequently called for increased federal investment to modernize facilities, expand specialty care, address workforce shortages, and improve health outcomes in Native communities. For many tribal nations, particularly those in rural and remote areas, IHS-funded facilities remain the primary source of health care.
