U.S. Senator Lisa Murkowski (R-Alaska), Chair of the Senate Committee on Indian Affairs, led a nomination hearing to consider Mr. Mark Cruz, of Oregon, to be Director of the Indian Health Service within the U.S. Department of Health and Human Services and expressed her intent to support his nomination.
Representative Tom Cole (R-Okla.), a citizen of the Chickasaw Nation and chairman of the House Appropriations Committee, introduced Mr. Cruz to the committee. Cole noted that he first met Mr. Cruz while he was teaching on the Rosebud Indian Reservation and later hired him as a legislative fellow. Cole praised Mr. Cruz’s commitment to Tribal communities, saying he stood out early for his “knowledge, work ethic, and genuine care for Tribal communities.”
During her opening statement, Chairman Murkowski highlighted Mr. Cruz’s commitment to meaningful Tribal engagement and improving Native health outcomes. The Chairman also emphasized the importance of the Indian Health Service Director position, and Mr. Cruz’s qualifications to serve in the role.
“While you do not come from the career ranks of IHS, your experience gives you a strong foundation for this position,” Murkowski said. “Your lived experience in Native communities, your service as the first Tribal Senior Advisor to Secretary Kennedy, and your previous work at the Department of the Interior as Deputy Assistant Secretary for Indian Affairs have provided you with valuable perspective and experience.
“I am looking forward to supporting your nomination and working with the Vice Chairman and our colleagues to move your nomination through the committee,” continued Murkowski.
Dual Role as IHS Director and Senior Advisor for Indian Health (click for video)
Chairman Murkowski asked Mr. Cruz how he will balance leading the Indian Health Service while continuing to serve as the Tribal Senior Advisor to Secretary of Health and Human Services (HHS), particularly as the department undergoes reorganization. Senator Murkowski also asked for assurance that future changes will include meaningful Tribal consultation and protect programs that serve Native communities.
“I would continue to do those things and advocate even more ferociously for the equities of our Tribal partners and our urban Indian partners,” said Mr. Cruz.
Contract Support Costs and 105(l) Lease Payments (click for video)
Chairman Murkowski raised concerns about funding pressures from 105(l) lease payments and contract support costs while emphasizing the need to continue supporting Tribal self-determination. The Chairman acknowledged the complexity of resolving these issues and requested a commitment from Mr. Cruz to work with the Committee, appropriators, and Tribal leaders to address them.
“It’s one of those really powerful authorities that does a lot of good, but can go sideways very quickly if misapplied or, you know, mismanaged,” said Mr. Cruz, regarding the 105(l) program. “I do eagerly look forward to working with you and your team on this matter.”
Sanitation Funding and Long-Term Sustainability (click for video)
Chairman Murkowski applauded Secretary Kennedy and IHS for the recent FY 2026 IIJA sanitation funding allocations under the Bipartisan Infrastructure Law, highlighting its impact on long-neglected Alaska Native communities lacking basic sanitation. The Chairman emphasized that while these investments are significant, they are not a substitute for sustained annual funding to operate and maintain systems over time.
“I am concerned though, because we know that the infrastructure funds are winding down and in fairness, these funds were designed to address the unmet needs. It wasn’t intended to replace the need for sustained annual investments,” said Murkowski. “When I think about the role of just basic sanitation in meeting healthcare needs, of Native people, regardless of where they are. To me, this is pretty basic. Clean water to drink, to wash your hands, keep your family clean. It’s pretty basic and it goes to healthcare.”
The Chairman asked Mr. Cruz to speak to how IHS will ensure long-term upkeep and what role ongoing base and maintenance funding should play.
Mr. Cruz expressed support for sanitation and Indian Health Service efforts, noting the completion of recent funding distribution and over 2,000 active infrastructure projects while committing to help ensure their completion and strengthen coordination. He also emphasized continued collaboration and advocacy to identify community needs and secure resources for ongoing work.
“If confirmed, I look forward to ensuring those come to completion. I also look forward to working with the team on lessons learned and identifying and advocating for robust resources to continue that work,” said Mr. Cruz.
An archived video and witness testimony from the hearing are available on the Committee website.
