Tribes question Kennedy's promise to protect them from health care cuts

Tribes question Kennedy's promise to protect them from health care cuts

Health and Human Services Secretary Robert F. Kennedy Jr. has repeatedly pledged to protect and improve health services for Native Americans - whether during his late January Senate confirmation hearing or an April trip to Arizona where he met with tribal leaders.

In a way he has.

When the layoffs were about to reach the Indian Health Service - the federal agency responsible for providing health care to Native Americans and Alaska Natives - Kennedy's department reversed the actions hours later.

While visiting Arizona's Navajo Nation in April, Kennedy told KFF Health News he made sure broader budget cuts and layoffs at HHS would not impact Native Americans.

But tribal leaders expressed skepticism. They said they had already seen consequences of the major restructuring in the federal health agencies. Public health data is incomplete and the agency's communications have become less reliable. Tribes have also lost at least $6 million in grants from other HHS agencies, according to the National Indian Health Board's letter sent to Kennedy in May.

“There may be a misconception among some in the administration that Indian Country is only affected by changes to the Indian Health Service,” said Liz Malerba, a tribal policy expert and citizen of the Mohegan Tribe. “That’s just not true.”

Native Americans face higher rates of chronic disease and die younger than other populations. These inequalities stem from centuries of systemic discrimination. The Indian Health Service has been chronically underfunded and understaffed, resulting in gaps in care.

Janet Alkire, chair of the Standing Rock Sioux Tribe in the Dakotas, said during a hearing in May that the canceled grants would have paid for health worker grants, vaccinations, data modernization and other public health efforts.

Other programs — including those aimed at youth interested in science and medicine and increasing access to healthy foods — were dismantled after the administration said it violated the Trump administration's ban on "diversity, equity and inclusion."

Native leaders and organizations have requested tribal consultation, a legal process required when federal authorities consider changes that would affect tribal nations. Alkire and other tribal leaders at the Senate committee hearing said federal officials had not responded.

“This is not just a moral question about what we owe to Native people,” Sen. Brian Schatz (D-Hawaii) said at the hearing. “It is also a question of law.”

The Indian Health Service was largely spared in the federal government's widespread staffing cuts, but tribal governments and organizations have lost funding elsewhere in the melee of federal health agency cuts.

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