By Mordecai Specktor
Defunding Indian health care
In my April column, I wrote about the chaos created by Trump 2.0 administration and MAGA congressional policies: a proposal to delist the gray wolf from the Endangered Species Act and reorienting the Environmental Protection Agency (EPA) to further the president’s call to “drill, baby, drill.” I also updated the threat by the government to invade and take control of Greenland, a territory with a 90 percent Indigenous population.
The press lately has been focusing on the cruel Trump regime’s first 100 days, which have seen a variety of repressive actions. ICE cops have snatched a number of international students off the streets and sent them to detention centers. And there is the high-profile case of Kilmar Armando Abrego Garcia, a Salvadoran citizen residing in Maryland, who was mistakenly deported to the new U.S. gulag in El Salvador. Deportations of other undocumented residents, in Minnesota and around the country, is proceeding apace.
Tourists have been detained at the Mexican border and at airports, and some U.S. citizens have been caught up in the deportation fervor. Two U.S. citizen children were packed off on their mother’s deportation flight to Honduras, “without the opportunity to speak with attorneys, leaving a 4-year-old boy with Stage 4 cancer without access to his medication, according to the National Immigration Project,” NBC News reported in late April.
The Trump/Musk wrecking ball is taking apart entire government departments, and Indian country is bracing for the decimation of the Indian Health Service (IHS).
On April 18, the National Council of Urban Indian Health (NCUIH), along with 41 urban Indian organizations, sent a letter to Robert F. Kennedy, the secretary of Health and Human Services, expressing “deep concern regarding proposed sweeping budget cuts” to IHS and tribal health care programs.
The letter warned that the Office of Management and Budget’s (OMB) 2026 Discretionary Budget Passback funding cuts —slashing $900 million from the IHS — “will have a direct impact on the health care delivery for American Indian and Alaska Native people all over the United States.”
The letter, which was signed by Francys Crevier, NCUIH’s chief executive officer, stated: “This appeal is necessary to ensure the United States upholds its trust obligations to American Indian and Alaska Native people and communities. Notably, the Indian Health Care Improvement Act (IHCIA) affirms this obligation, establishing that ‘Federal health services to maintain and improve the health of the Indians are consonant with and required by the Federal Government’s historical and unique legal relationship with, and resulting responsibility to, the American Indian people.’”
A Native News Online story in late April noted that the IHS “and other federal entities supporting healthcare in Indian Country have been subject to a flurry of budget cuts, layoffs and grant freezes. … IHS has long been underfunded and understaffed, with a historic vacancy rate of nearly 30 percent and a budget that falls tens of billions short of its projected need. Native Americans experience the most negative health outcomes across the board, with some of the highest rates of cancer, heart disease, respiratory illness, diabetes, overdose, and suicide. In 2022, the life expectancy for Native Americans was 67.8 years, the lowest of any racial group in the United States and nearly 10 years below the national average of 77.4 years.”
RFK, Jr., who has a sorry track record of propounding quack medical theories, had promised to address the federal government’s dereliction of its obligations in Indian country.
It appears that the federal government’s treaty and trust responsibilities to Native nations have been confused with Trump’s executive order, from Jan. 20, 2025, to stop funding “radical and wasteful DEI programs and preferencing.” In February, Trump unleashed the Department of Government Efficiency (DOGE) to “reduce the size of the Federal Government’s workforce through efficiency improvements and attrition.”
The Native News Online story explained that these orders “created chaos as thousands of federal grants froze, employees were terminated and initiatives operating under Diversity, Equity and Inclusion (DEI) shuttered. While the United States’ legal obligation to provide healthcare to tribal nations falls outside of DEI, Native healthcare was swept up in the flurry.”
In an April 17 letter to Robert F. Kennedy Jr., William Smith (Valdez Native Tribe), the chairman of the National Indian Health Board, said that the proposed IHS funding cuts “will lead to deaths in our communities from preventable medical incidents, such as precipitous births, cardiac events, untreated diabetes complications, and preventable suicides. We know these impacts because we have lived these outcomes. Before IHS had advance appropriations, during previous government shutdowns, members of our families died from these exact types of preventable emergencies.”
It’s unclear at this point how the Trump regime’s push for repression and authoritarian rule can be stopped.
