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- By Elyse Wild
A bipartisan group of senators with oversight on tribal and appropriations matters is calling on Health and Human Services Secretary Robert F. Kennedy Jr. to immediately halt staffing reductions and resource cuts to the Indian Health Service (IHS).
In a letter sent Tuesday, Sens. Jeff Merkley (D-Ore.), Brian Schatz (D-Hawaii) and Lisa Murkowski (R-Alaska) stressed that efforts to reduce federal spending and hiring strain the agency’s already understaffed and underresourced facilities and impede the federal government’s obligation to provide healthcare to federally recognized tribes.
American Indians and Alaska Natives face staggering health disparities, with higher mortality rates from cardiac disease, respiratory illness, liver disease, diabetes, injuries, assault and suicide. Their life expectancy of 65.2 years falls more than a decade below the national average.
The IHS provides healthcare to 2.8 million Native Americans, despite a chronic 30% staffing shortage and an annual budget shortfall of $50 billion.
The letter notes that “IHS cannot deliver quality health care without sufficient personnel – not just physicians, nurses, dentists, and mental health professionals, but also laboratory technicians who perform tests and process and collect specimens, and administrative personnel who perform essential tasks, including billing, appointment scheduling, and ensuring IHS facilities maintain their accreditation.”
The lawmakers warn that losing accreditation would further limit healthcare access in Indian Country and jeopardize Medicare and Medicaid reimbursements, which provide 30-60% of funding at many IHS locations.
The letter urged Kennedy to engage in meaningful tribal consultation before taking any further action that could affect IHS’s capacity to provide healthcare to Native communities. It also addresses reports of senior officials from HHS agencies being reassigned to IHS positions in Alaska, Montana, and Oklahoma without consideration of tribal needs, Indian Preference requirements, or IHS service priorities.
“This foundational tenet of the federal government’s trust relationship empowers Tribes to be a part of policymaking on a government-to-government basis,” the letter read. It appears that HHS has failed to meaningfully consult with Tribes on recent actions, which have negatively impacted the federal-Tribal relationship, and we urge you to seek Tribal input and consult on any future federal action impacting their interests.”
In an email to Native News Online, Merkley said the administration should be filling open positions at IHS.
“Trump and his unelected billionaire sidekick Elon Musk are wreaking havoc on Tribal communities by forcing people out of the workforce at HHS and IHS and putting a hiring freeze in place,” Merkley wrote. “This administration should be doing everything it can to shore up vacancies, not create new ones.”
Merkley also addressed sweeping cuts made to other agencies operating under HHS that serve tribal nations.
According to the Department of Government Efficiency (DOGE) website tracking federal spending and staffing reductions, more cuts have been made to HHS since January than to any other federal agency.
“I hope that HHS and Secretary Kennedy will heed our call to reverse these dangerous decisions to arbitrarily cut programs not only at IHS but also at the NIH, SAMHSA, CMS, and the CDC, all of which impact care for Tribes,” Merkley wrote. “They must also engage in meaningful Tribal consultation, as is required by law.”
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