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, properties, and juniper bushes dotted the tan and deep-red panorama.
Nygren mentioned 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 change and described life for the hundreds of locals with out operating water resulting from delayed authorities initiatives.
Nygren mentioned Kennedy had already finished lots, primarily saving the Indian Well being 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 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 mentioned cuts to federal well being packages 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 latest adjustments.
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 large cuts to federal well being packages.
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 information and poor communication.
The Indian Well being Service supplies free well being care at its hospitals and clinics to Native People, who, as a gaggle, face larger charges of persistent ailments and die youthful than different populations. These inequities are attributable to centuries of systemic discrimination. However many tribal members don’t stay close to an company clinic or hospital. And those that do could face restricted companies, persistent underfunding, and staffing shortages. To work round these gaps, well being organizations lean on different federally funded packages.
“There may be a misconception among some of the administration that Indian Country is only impacted by changes to the Indian Health Service,” mentioned Liz Malerba, a tribal coverage professional 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, mentioned at a Could 14 Senate committee listening to that these grants paid for neighborhood well being staff, vaccinations, information modernization, and different public well being efforts.
The federal government additionally canceled funding for packages it mentioned violated President Donald Trump’s ban on “diversity, equity, and inclusion,” together with one aimed toward Native American youth all for science and medication and one other that helps a number of tribes improve entry to wholesome meals — one thing Kennedy has mentioned 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 reduce or eradicated workers at packages associated to stopping overdoses in tribal communities, utilizing conventional meals and medication to combat persistent illness, and serving to low-income individuals afford to warmth and funky their properties by means of the Low Revenue Dwelling Power Program.
The Oglala Sioux Tribe is in South Dakota, the place Native People who wrestle to warmth their properties have died of hypothermia. By mid-Could the tribe hadn’t been capable of entry its newest funding installment from the vitality program, mentioned John Lengthy, the tribe’s chief of workers.
Abigail Echo-Hawk, director of the City Indian Well being Institute on the Seattle Indian Well being Board, mentioned the federal government has despatched her group incomplete well being information. That features statistics about Native People in danger for suicide and substance use problems, which the middle makes use of to form public well being coverage and packages.
“People are going to die because we don’t have access to the data,” Echo-Hawk mentioned.
Her group can be having hassle administering a $2.2 million federal grant, she mentioned, as a result of the company dealing with the cash fired staffers she labored with. The grant pays for public well being initiatives resembling 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 mentioned.
HHS spokesperson Emily Hilliard mentioned Kennedy goals to fight persistent ailments 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 present and proposed funding and staffing adjustments.
As Kennedy hiked alongside Navajo Nation leaders, KFF Well being Information 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 mentioned his concentrate on 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 serious Native American information outlet.
The secretary mentioned he was additionally influenced by his uncle, President John F. Kennedy, and his father, U.S. Lawyer Normal Robert F. Kennedy, who have 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 mentioned throughout his go to.
Some tribal leaders say the latest cuts, and the best way the administration made them, violate treaties wherein the U.S. promised to supply 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,” mentioned Malerba, director of coverage and legislative affairs for the United South and Japanese Tribes Sovereignty Safety Fund, which advocates for tribes from Texas to Maine.
Alkire mentioned 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 may have a big impression on tribal nations.
“This is not just a moral question of what we owe Native people,” Sen. Brian Schatz (D-Hawaii) mentioned on the listening to. “It is also a question of the law.”
Tribal leaders are frightened about further proposed adjustments, 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, mentioned 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 assets.
“Our ability to serve those who are desperately in need feels at risk,” Lucero mentioned.
Amongst essentially the most urgent considerations are congressional Republicans’ proposed cuts to Medicaid, the first authorities medical health 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 preserve 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 careworn 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 vitality help program.
“We look forward to reestablishing and protecting some of the services that your department provides,” Nygren mentioned.
As of mid-Could, the Trump administration had proposed eliminating the vitality program, which stays unstaffed.
