Katheryn Houghton and Jazmin Orozco Rodriguez and Arielle Zionts
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 scorching.
Buu Nygren, president of the Navajo Nation, paused on the edge with Health and Human Services Secretary Robert F. Kennedy Jr. Below them, tribal authorities buildings, houses, and juniper timber dotted the tan and deep-red panorama.
Nygren stated he wished Kennedy to have a look at the capital for the nation of about 400,000 enrolled members. The tribal president pointed towards an antiquated well being heart that he hoped federal funding would assist substitute and described life for the hundreds of locals with out working water on account of delayed authorities tasks.
Nygren stated Kennedy had already carried out rather a lot, primarily saving the Indian Health Service from a spherical of staffing cuts rippling by means of 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 informed Kennedy, of his transfer to spare the federal company charged with offering well being care to Native Americans and Alaska Natives.
But Nygren and different Navajo leaders stated cuts to federal well being applications exterior the Indian Health Service are hurting Native Americans.
“You’re disrupting real lives,” Cherilyn Yazzie, a Navajo council delegate, informed KFF Health News as she described latest adjustments.
Kennedy has repeatedly promised to prioritize Native Americans’ well being care. But Native Americans 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 Americans. Staffing cuts, tribal well being leaders say, have led to lacking knowledge and poor communication.
The Indian Health Service supplies free well being care at its hospitals and clinics to Native Americans, who, as a gaggle, face larger charges of continual ailments and die younger than different populations. Those inequities are attributable to centuries of systemic discrimination. But many tribal members don’t dwell close to an company clinic or hospital. And those that do might face limited services, continual underfunding, and staffing shortages. To work around those 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 knowledgeable 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 National Indian Health Board wrote in a May letter to Kennedy.
Janet Alkire, chairperson of the Standing Rock Sioux Tribe within the Dakotas, said at a May 14 Senate committee hearing that these grants paid for group well being employees, vaccinations, knowledge modernization, and different public well being efforts.
The authorities additionally canceled funding for applications it stated violated President Donald Trump’s ban on “diversity, equity, and inclusion,” together with one geared toward Native American youth all in favour of science and drugs and one other that helps a number of tribes increase access to healthy food — one thing Kennedy has stated he needs to prioritize.
Tribal well being officers say slashed federal staffing has made it tougher to get technical help and cash for federally funded well being tasks they run.
The firings have minimize or eradicated workers at applications associated to preventing overdoses in tribal communities, using traditional food and medicine to combat continual illness, and serving to low-income folks afford to heat and cool their homes by means of the Low Income Home Energy Program.
The Oglala Sioux Tribe is in South Dakota, the place Native Americans who wrestle to warmth their houses have died of hypothermia. Through mid-May the tribe hadn’t been in a position to entry its newest funding installment from the vitality program, stated John Long, the tribe’s chief of workers.
Abigail Echo-Hawk, director of the Urban Indian Health Institute on the Seattle Indian Health Board, stated the federal government has despatched her group incomplete well being knowledge. That consists of statistics about Native Americans 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 hassle 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 continual ailments and enhance well-being amongst Native Americans “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 present and proposed funding and staffing adjustments.
As Kennedy hiked alongside Navajo Nation leaders, KFF Health News requested how he would enhance and defend 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 lawyer, 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. Attorney General Robert F. Kennedy, who had been each assassinated when Robert F. Kennedy Jr. was a toddler.
“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 latest cuts, and the way in which the administration made them, violate treaties during which 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 Eastern Tribes Sovereignty Protection 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 adjustments that might have a major 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 further proposed adjustments, together with funding cuts to the Indian Health Service and a reorganization of the federal well being division.
Esther Lucero, president and CEO of the Seattle Indian Health Board, stated the maneuvers remind her of the extent of day by day uncertainty she felt working by means of the covid-19 pandemic — solely with fewer sources.
“Our ability to serve those who are desperately in need feels at risk,” Lucero stated.
Among the most pressing concerns are congressional Republicans’ proposed cuts to Medicaid, the first authorities medical insurance program for folks with low incomes or disabilities.
About 30% of Native American and Alaska Native folks youthful than 65 are enrolled in Medicaid, and this system helps preserve Indian Health Service and different tribal well being services afloat.
Native American adults would be exempt from Medicaid work necessities accepted by House Republicans final month.
After Kennedy summited Window Rock with Navajo Nation leaders, the tribe held a prayer ceremony during which they blessed him in Diné Bizaad, the Navajo language. President Nygren pressured how significant it was for the nation’s well being secretary to stroll alongside them. He additionally reminded Kennedy of the checklist of priorities they’d mentioned. That included sustaining the federal low-income vitality help program.
“We look forward to reestablishing and protecting some of the services that your department provides,” Nygren stated.
As of mid-May, the Trump administration had proposed eliminating the vitality program, which stays unstaffed.
KFF Health News is a nationwide newsroom that produces in-depth journalism about well being points and is among the core working applications at KFF—an impartial supply of well being coverage analysis, polling, and journalism. Learn extra about KFF.
USE OUR CONTENT
This story may be republished without spending a dime (details).
