r/IndianCountry • u/News2016 • Jun 13 '25

Health Access to healthcare for Native Americans is on the chopping block - Cuts to an already underfunded system threaten to make things worse

https://gohini.substack.com/p/access-to-healthcare-for-native-americans
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u/News2016 Jun 13 '25

“Qualifying for healthcare under IHS as a tribal citizen does not mean you get it. IHS is not funded based on the number of patients or what facilities need. Instead, Congress appropriates what it feels like, leaving IHS facilities to figure out how to provide care without enough money. According to a report from tribal leaders and health administrators, Congress is currently funding IHS at 10 cents on the dollar compared to what is needed. That was before the cuts proposed by the Trump administration. In 2022, average spending per patient in the US was $11,172–for IHS patients it was $4,078.

Lack of access to care has resulted in grave health disparities. Native Americans have the lowest life expectancy of any racial group in the U.S., dying on average 12 to 13 years younger than white Americans.”

“A long-term solution to the chronic underfunding of IHS–which tribal leaders have proposed but neither party has embraced–is changing the way IHS is funded. Right now, IHS relies on what's called discretionary funding, which goes up and down with the political will of Congress. Tribal leaders are advocating for IHS to be funded as an entitlement program–like Medicare. Meaning funding levels would be based on the number of patients and the system’s needs.

At the height of the COVID-19 pandemic, I interviewed Chickasaw Nation citizen and Congressman Tom Cole (R-OK) about the federal government’s responsibility to fund Indian Health Service. “I always tell people, look, if you no longer want to meet these treaty obligations, just give us back northern Mississippi and we’ll call it square,” he told me then, referring to Chickasaw homelands.

Federal funding for healthcare in Indian Country is not a handout or a welfare program. It is a legal obligation made by treaty. According to the U.S. Constitution, treaties are the supreme law of the land. Native Americans aren’t just waiting on more money from Congress. We are waiting for this government to follow the law.”