WINDOW ROCK, Ariz. — Navajo Nation leaders took turns speaking with the U.S. authorities’s prime well being official as they hiked alongside a sandstone ridge overlooking their rural, high-desert city earlier than the morning solar grew too sizzling.
Buu Nygren, president of the Navajo Nation, paused on the edge with Well being and Human Companies Secretary Robert F. Kennedy Jr. Under them, tribal authorities buildings, houses, and juniper bushes dotted the tan and deep-red panorama.
Nygren stated he wished Kennedy to take a look at the capital for the nation of about 400,000 enrolled members. The tribal president pointed towards an antiquated well being middle that he hoped federal funding would assist change and described life for the 1000’s of locals with out working water because of delayed authorities initiatives.
Katheryn Houghton/KFF Well being Information
Nygren stated Kennedy had already completed so much, primarily saving the Indian Well being Service from a spherical of staffing cuts rippling via the federal authorities.
“When we started hearing about the layoffs and the freezes, you were the first one to stand up for Indian Country,” he instructed Kennedy, of his transfer to spare the federal company charged with offering well being care to Native People and Alaska Natives.
However Nygren and different Navajo leaders stated cuts to federal well being applications outdoors the Indian Well being Service are hurting Native People.
“You’re disrupting real lives,” Cherilyn Yazzie, a Navajo council delegate, instructed KFF Well being Information as she described current modifications.
Kennedy has repeatedly promised to prioritize Native People’ well being care. However Native People and well being officers throughout tribal nations say these overtures are overshadowed by the collateral hurt from huge cuts to federal well being applications.
The sweeping reductions have resulted in cuts to funding directed towards or disproportionately relied on by Native People. Staffing cuts, tribal well being leaders say, have led to lacking knowledge and poor communication.
The Indian Well being Service supplies free well being care at its hospitals and clinics to Native People, who, as a bunch, face increased charges of power illnesses and die youthful than different populations. These inequities are attributable to centuries of systemic discrimination. However many tribal members don’t dwell close to an company clinic or hospital. And people who do could face restricted providers, power underfunding, and staffing shortages. To work round these gaps, well being organizations lean on different federally funded applications.
“There may be a misconception among some of the administration that Indian Country is only impacted by changes to the Indian Health Service,” stated Liz Malerba, a tribal coverage skilled and citizen of the Mohegan Tribe. “That’s simply not true.”
Tribes have misplaced greater than $6 million in grants from different HHS companies, the Nationwide Indian Well being Board wrote in a Could letter to Kennedy.
Janet Alkire, chairperson of the Standing Rock Sioux Tribe within the Dakotas, stated at a Could 14 Senate committee listening to that these grants paid for group well being employees, vaccinations, knowledge modernization, and different public well being efforts.
The federal government additionally canceled funding for applications it stated violated President Trump’s ban on “diversity, equity, and inclusion,” together with one aimed toward Native American youth thinking about science and medication and one other that helps a number of tribes enhance entry to wholesome meals — one thing Kennedy has stated he desires to prioritize.
Tribal well being officers say slashed federal staffing has made it more durable to get technical help and cash for federally funded well being initiatives they run.
The firings have lower or eradicated employees at applications associated to stopping overdoses in tribal communities, utilizing conventional meals and medication to battle power illness, and serving to low-income individuals afford to warmth and funky their houses via the Low Earnings Residence Power Program.
The Oglala Sioux Tribe is in South Dakota, the place Native People who wrestle to warmth their houses have died of hypothermia. By means of mid-Could the tribe hadn’t been in a position to entry its newest funding installment from the power program, stated John Lengthy, the tribe’s chief of employees.
Abigail Echo-Hawk, director of the City Indian Well being Institute on the Seattle Indian Well being Board, stated the federal government has despatched her group incomplete well being knowledge. That features statistics about Native People in danger for suicide and substance use issues, which the middle makes use of to form public well being coverage and applications.
“People are going to die because we don’t have access to the data,” Echo-Hawk stated.
Her group can be having bother administering a $2.2 million federal grant, she stated, as a result of the company dealing with the cash fired staffers she labored with. The grant pays for public well being initiatives akin to smoking cessation and vaccinations.
“It is very confusing to say chronic disease prevention is the No. 1 priority and then to eradicate the support needed to address chronic disease prevention in Indian Country,” Echo-Hawk stated.
HHS spokesperson Emily Hilliard stated Kennedy goals to fight power illnesses and enhance well-being amongst Native People “through culturally relevant, community-driven solutions.”
Hilliard didn’t reply to questions on Kennedy’s particular plans for Native American well being or considerations about current and proposed funding and staffing modifications.
As Kennedy hiked alongside Navajo Nation leaders, KFF Well being Information requested how he would enhance and shield entry to look after tribal communities amid rollbacks inside his division.
“That’s exactly what I’m doing,” Kennedy responded. “Making sure that all the cuts do not affect these communities.”
Kennedy has stated his give attention to Native American well being stems from private and household expertise, one thing he repeated to Navajo management. As an legal professional, he labored with tribes on environmental well being lawsuits. He additionally served as an editor at ICT, a significant Native American information outlet.
The secretary stated he was additionally influenced by his uncle, President John F. Kennedy, and his father, U.S. Lawyer Normal Robert F. Kennedy, who had been each assassinated when Robert F. Kennedy Jr. was a baby.
“They thought that America would never live up to its moral authority and its role as an exemplary nation around the world if we didn’t first look back and remediate or mitigate the original sin of the American experience — the genocide of the Native people,” Kennedy stated throughout his go to.
Some tribal leaders say the current cuts, and the best way the administration made them, violate treaties wherein the U.S. promised to offer for the well being and welfare of tribes in return for taking their land.
“We have not been consulted with meaningfully on any of these actions,” stated Malerba, director of coverage and legislative affairs for the United South and Jap Tribes Sovereignty Safety Fund, which advocates for tribes from Texas to Maine.
Alkire stated on the congressional listening to that many Native American well being organizations despatched letters to the well being division asking for consultations however none has acquired a response.
Tribal session is legally required when federal companies pursue modifications that may have a big influence on tribal nations.
“This is not just a moral question of what we owe Native people,” Sen. Brian Schatz (D-Hawaii) stated on the listening to. “It is also a question of the law.”
Tribal leaders are nervous about extra proposed modifications, together with funding cuts to the Indian Well being Service and a reorganization of the federal well being division.
Esther Lucero, president and CEO of the Seattle Indian Well being Board, stated the maneuvers remind her of the extent of day by day uncertainty she felt working via the COVID-19 pandemic — solely with fewer assets.
“Our ability to serve those who are desperately in need feels at risk,” Lucero stated.
Amongst probably the most urgent considerations are congressional Republicans’ proposed cuts to Medicaid, the first authorities medical insurance program for individuals with low incomes or disabilities.
About 30% of Native American and Alaska Native individuals youthful than 65 are enrolled in Medicaid, and this system helps hold Indian Well being Service and different tribal well being amenities afloat.
Native American adults can be exempt from Medicaid work necessities authorized by Home Republicans on Could 21.
After Kennedy summited Window Rock with Navajo Nation leaders, the tribe held a prayer ceremony wherein they blessed him in Diné Bizaad, the Navajo language. President Nygren burdened how significant it was for the nation’s well being secretary to stroll alongside them. He additionally reminded Kennedy of the listing of priorities they’d mentioned. That included sustaining the federal low-income power help program.
“We look forward to reestablishing and protecting some of the services that your department provides,” Nygren stated.
As of mid-Could, the Trump administration had proposed eliminating the power program, which stays unstaffed.
KFF Well being Information is a nationwide newsroom that produces in-depth journalism about well being points and is without doubt one of the core working applications at KFF — the impartial supply for well being coverage analysis, polling, and journalism.
