Four Arizona House Democrats pressed the Trump administration Friday to urgently provide $120 million in emergency aid to the Indian Health Service after delays in sending money to combat the new coronavirus that is sweeping across tribal communities.

Reps. Ruben Gallego, Raúl Grijalva, Tom O'Halleran and Greg Stanton wrote a letter to Alex Azar, the Health and Human Services secretary, arguing that Native Americans have higher incidence of the kind of conditions that make the outbreak more severe.

"Paired with an already severely under-resourced Indian health system, which spends less than half the amount on health care per patient than the national average, this vulnerability could lead to catastrophic outcomes in the current pandemic," the letter said.

In response to the lack of federal funding, the Navajo Nation signed a resolution Friday approving a $4 million appropriation that will be directed to the Navajo Department of Health to fight COVID-19.

This funding will be be used to provide resources and equipment to health care experts and emergency response personnel, provide food and water supplies and increase public outreach, the press release states.

“The federal government is not expediting the release of funds that have already been approved by Congress, so our Navajo government is stepping up to help the people most in need of resources and assistance,” Navajo Nation President Jonathan Nez said. 

"The $4 million appropriation will help our first responders, health care experts, and emergency officials to protect our communities, while we continue to seek assistance from federal and state agencies and others," he said.

The Navajo Nation announced 11 coronavirus cases late Thursday night. Nez also issued a "shelter-in-place" order for the community of Chilchinbeto. A total of 14 Navajo cases have been reported.

The congressional letter, joined by 20 other House members, asks the Department of Health and Human Services to triple the minimum amount of money already approved for IHS, $40 million. That money is part of the emergency funds President Donald Trump signed into law on March 6.

“As Congress and the Administration is working hard to address COVID-19, we are gravely concerned about the timeline for funds and resources to Indian Country," said Francys Crevier, the executive director for the National Council of Urban Indian Health, in a press release.

"Lives are at stake and time is of the essence for action as our programs are already tackling this crisis without the resources they need,” she added.

Despite passage of the emergency funds, "Tribes, tribal organizations, and urban Indian organizations have yet to be able to access the resources within it set aside for them. (U.S. Centers for Disease Control and Prevention) lacks the expertise, relationships and mechanisms that IHS possesses to quickly and effectively disseminate these resources ... to combat this health crisis," the letter said.  

Indigenous communities are disproportionately impacted by health conditions that the CDC identified as an increased risk for a more serious COVID-19 illness, according to the National Indian Health Board.

According to Politico, CDC hasn't released money to IHS "because it doesn’t have the necessary funding relationship with the IHS hospitals, tribal-run health facilities and urban American Indian organizations that are supposed to receive it." 

Sen. Martha McSally, R-Ariz., and Sen. Steve Daines, R-Mt., said in a separate letter to Senate Majority Leader Mitch McConnell, R-Ky., they were "disappointed" that tribal health issues were left out of initial plans for more stimulus.

"Native American stakeholders have provided clear and concise funding and policy proposals for Congress to consider that would help address the specific needs of Indian Country during this pandemic," they wrote. "We are disappointed to see that none of these proposals were included" in McConnell's proposal unveiled Thursday.

Sen. Kyrsten Sinema, D-Ariz., has made similar requests for the next round of stimulus.

Most of the Arizona contingent have deep ties to Native American oversight in Congress.

McSally is a member of the Senate Indian Affairs Committee.

Grijalva chairs the House Natural Resources Committee that has oversight of Native Americans. Gallego chairs the subcommittee for indigenous peoples. O'Halleran's district that spans northeastern Arizona has the largest Native American population in Congress.