Window Rock, Ariz.-Navajo Nation leaders talked in turn with the best health officer of the American government while walking past a sandstone ridge with a view of their rural, high-desert city before the morning sun became too hot.
Buu Nygren, chairman of the Navajo Nation, paused on the outskirts with health and human service secretary Robert F. Kennedy Jr. Among them, tribal government buildings, houses and jeniper trees were littered and deep red landscape.
Nygren said he wanted Kennedy to look at the capital for the nation of around 400,000 registered members. The tribal president pointed to an outdated health center that he hoped that federal financing would help replace and describe life for the thousands of locals without running water due to delayed government projects.
Nygren said Kennedy had already done a lot, Mainly save The Indian Health Service of a round of staff savings ripples by the federal government.
“When we started to hear about the dismissal and the freezes, you were the first to stand up for the Indian country,” he told Kennedy, from his switch to save the federal agency that they offer health care to Indians and residents of Alaska.
But Nygren and other Navajo leaders said that cuts on federal health programs outside the Indian Health Service Ineemse Americans hurt.
“You disrupt real life,” Cherilyn Yazzie, a representative of the Navajo Council, told KFF Health News as she described recent changes.
Kennedy has repeatedly promised to give priority to the health care of Indians. But Indians and health officials in the tribal countries say that those overtures are overshadowed by the collateral damage of mass cutbacks on federal health programs.
The radical reductions have resulted in cuts on financing aimed or disproportionate dependent on Indians. Staffing cuts, say the leaders of the Stamen Health, have led to missing data and poor communication.
The Indian Health Service offers free health care in its hospitals and clinics to Indians, who are dealing with higher percentages of chronic diseases and younger than other populations. Those inequalities can be attributed to centuries of systemic discrimination. But many tribal members do not live near a clinic or hospital. And those who do that can be confronted with limited services, chronic under -financing and staff shortages. To bypass those gaps, health organizations tend to be on other federally funded programs.
“There may be a misconception in part of the administration that the Indian country is only affected by changes in the Indian Health Service,” said Liz Malerba, a tribal policy expert and citizen of the Mohegan -stem. “That’s just not true.”
Tribes have lost more than $ 6 million on subsidies from other HHS agencies, the National Indian Health Board wrote in a letter from May To Kennedy.
Janet Alkire, chairman of the Standing Rock Sioux -Stame in the Dakotas, said on a hearing of May 14 Senate Committee That these subsidies paid for health workers in the community, vaccinations, data killing and other efforts for public health.
The government has also canceled the financing for programs that, according to President Donald Trump, violated ‘diversity, equity and inclusion’, including a targeted Native American Youth Interested in science and medicine and another that helps different tribes Increase access to healthy food – Something Kennedy has said he wants to give priority.
Tribal health officials say that cut federal staff has made it more difficult to get technical support and money for federally financed health projects they run.
The dismissals have cut or eliminated the staff with programs related to prevent overdoses In tribal communities, Use traditional food and medicines To combat chronic diseases and to help people with a low income afford to heat and cool their houses Via the Low Income Home Energy Program.
The Oglala Sioux -Stame is located in South Dakota, where Indians who have difficulty heating their houses have died of hypothermia. Until mid -May the tribe had not been able to access its latest financing episode of the Energy Program, said John Long, the Staff Chef of the tribe.
Abigail Echo-HaWK, director of the Urban Indian Health Institute of the Seattle Indian Health Board, said that the government has sent its organization incomplete health data. This includes statistics about Indians who are at risk of suicide and substance use disorders that the center uses to shape public health policy and programs.
“People die because we don’t have access to the data,” said Echo-Hawk.
Her organization also has problems managing a federal subsidy of $ 2.2 million, she said, because the agency that handles the staff of the money with whom she worked. The subsidy pays for public health initiatives such as quitting smoking and vaccinations.
“It is very confusing to say that chronic disease prevention is no. 1 priority and then to eradicate the support that is needed to tackle chronic pathogen in the Indian country,” said Echo-Hawk.
HHS spokesperson Emily Hilliard said that Kennedy strives to combat chronic diseases and improve well-being among Indians “through culturally relevant, community-driven solutions.”
Hilliard did not respond to questions about the specific plans of Kennedy for Indian health or concerns about existing and proposed changes in financing and staff.
While Kennedy walked together with Navajo Nation leaders, KFF Health News asked how he would improve and protect access to tribal communities in the midst of his department.
“That’s exactly what I do,” Kennedy replied. “Ensure that all cutbacks do not influence these communities.”
Kennedy said that his focus on Indian health comes from personal and family experience, something that he repeated to the leadership of Navajo. As a lawyer he worked with tribes on lawsuits for environmental health. He also served as an editor at ICT, a large native American News Outlet.
The secretary said he was also influenced by his uncle, President John F. Kennedy, and his father, American attorney -general Robert F. Kennedy, who were both murdered when Robert F. Kennedy Jr. was a child.
“They thought that America would never realize its moral authority and its role as an exemplary nation around the world if we did not first look back and the original sin of American experience – the genocide of the indigenous population,” Kennedy said during his visit.
Some tribal leaders say that the recent cuts, and the way in which the administration has made them, violates in which the US promised to take care of the health and well -being of tribes in exchange for taking their country.
“We are not useful about one of these actions,” says Malerba, director of policy and legislative matters for the Sovereiny Protection Fund of United South and Eastern Tribes, which argues for tribes from Texas to Maine.
Alkire said during the hearing with the congress that many Indian health organizations sent letters to the health department to ask for consultation, but none has received a response.
Tribal Consultation is legally required when federal agencies through changes that would have a significant impact on tribal countries.
“This is not just a moral question of what we owe indigenous people,” said Senator Brian Schatz (D-Hawaii) during the hearing. “It’s also a matter of the law.”
Tribal leaders are concerned about extra proposed changes, including Financing cuts on the Indian Health Service And a reorganization of the federal health department.
Esther Lucero, president and CEO of the Seattle Indian Health Board, said that the maneuvers remind her of the level of daily uncertainty she felt to work through the COVID-19 Pandemie with fewer resources.
“Our ability to serve those who are desperate in need feels risk,” said Lucero.
One of the most urgent concerns is the proposed cuts of congress republicans for Medicaid, the primary health insurance program for people with low incomes or a disability.
About 30% From Indian and Alaska -resident people younger than 65 are registered in Medicaid, and the program helps to maintain the Indian health service and other tribal health facilities.
Indian adults would be exempt From Medicaid -Work Requirements approved by Huis Republicans last month.
After Kennedy Window Rock had beaten Navajo Nation leaders, the tribe held a prayer ceremony in which they bless him in Diné Bizaad, the Navajo language. President Nygren emphasized how useful it was for the country’s health secretary to walk next to them. He also reminded Kennedy of the list of priorities they had discussed. This included maintaining the federal energy tool with low incomes.
“We look forward to recovering and protecting some of the services that your department offers,” said Nygren.
From mid-May had the Trump administration Proposed to eliminate The energy program, which is not stimulated.
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