Reps. Greg Stanton, D-Ariz., and David Joyce, R-Ohio, today introduced the Stronger Engagement for Indian Health Needs Act, which would elevate the current role of the Indian Health Service Director to Assistant Secretary for Indian Health within the Department of Health and Human Services (HHS) with the goal of improving Native American health outcomes.
Specifically, the Senate-confirmed position will provide greater leadership on Indian health issues within the Administration and bring greater attention to addressing the health care status and needs of American Indians and Alaska Natives.
The Assistant Secretary would work to enhance the government-to-government relationship between Indian tribes and the United States, increase access and collaboration among agencies within HHS as Indian health policy and budgets are developed, bring much needed parity to Indian health care needs, and ensure these issues are a priority in current and future administrations.
The late Sen. John McCain first championed the proposal, introducing legislation in the mid-1990s. It passed the Senate four times, but died in the House. The issue has not been revisited since 2010, when efforts were made to include it as part of the Affordable Care Act.
“The federal government has an obligation to provide for the health care of Tribal members. Doing all we can to honor that obligation is vital, particularly as Tribal communities are once again seeing an explosion of COVID-19 cases,” Stanton said. “Our bill does what should’ve been done years ago—elevates native voices when it comes to making federal policy that affects American Indians and Alaska Natives.”
“I’m proud to join Congressman Stanton in introducing the Stronger Engagement for Indian Health Needs Act,” said Joyce. “We know that federal American Indian and Alaska Native health programs continue to be plagued by challenges, and that many who rely on these services continue to experience health disparities and face barriers accessing care. By elevating the Indian Health Service Director position to Assistant Secretary for Indian Health within the U.S. Department of Health and Human Services, this bipartisan bill represents an important step as we seek to fulfill the federal government’s sacred trust and treaty obligations to American Indians and Alaska Natives.”
Leading Native American advocacy groups—including the National Congress of American Indians, National Indian Health Board, and National Council of Urban Indian Health—already support the bipartisan effort.
“The health of our people has suffered due to the failure of the government to uphold the trust responsibility of providing health care to all American Indians and Alaska Natives. The pandemic, which continues to devastate Indian Country, has made it clear that it’s time for the Administration to recognize the importance of Indian health by elevating the position of the Director of the IHS to Assistant Secretary,” said Walter Murillo, president of the National Council of Urban Indian Health and chief executive officer of Native Health, which is based in Phoenix. Murillo is a member of the Choctaw Nation. “We applaud Representatives Greg Stanton and David Joyce for their longstanding leadership to improve health outcomes for Native people and hope this change will usher in a new era where Indian health is a priority and not an afterthought.”
“NCAI applauds this bipartisan effort to reaffirm tribal treaty rights and uphold the federal trust responsibility for Indian health care as a core mission of the Department of Health and Human Services. Elevating the Director of the Indian Health Service to an Assistant Secretary of HHS acknowledges this responsibility and ensures the health of Indian Country is continually advocated for at the highest levels of leadership at HHS,” said Dante Desiderio, the group’s chief executive officer. “We thank Representatives Stanton and Joyce for working to ensure Indian health has the support necessary to provide better health outcomes across our communities.”
William Smith, the chairman of the National Indian Health Board, praised the bill’s introduction as “a clear statement prioritizing Indian health care.” Smith said that “elevating the Indian Health Service leadership and authority will amplify the voice and credibility needed to ensure Indian health care receives appropriate attention and support. It is a necessary step in fulfilling the United States trust responsibility and treaty obligations to Tribal nations for health care. The NIHB stands ready to help support and advance this important legislation.” His words were echoed by Stacy Bohlen, chief executive officer of the NIHB, who remarked that “the elevation of the IHS Director to an Assistant Secretary has been a long-standing priority for the NIHB and Tribal nations.”
American Indians and Alaska Natives (AI/ANs) have 1.6 times the infant mortality rate of non-Hispanic whites and the life expectancy is 5.5 years less than the national average. AI/ANs continue to die at higher rates than other Americans from chronic liver disease and cirrhosis, diabetes mellitus, unintentional injuries, assault/homicide, intentional self-harm/suicide, and chronic lower respiratory diseases. The COVID-19 pandemic, which disproportionately impacts tribal communities, only further highlights these disparities.
In 2018, the U.S. Commission on Civil Rights released its report, Broken Promises: Continuing Federal Funding Shortfall for Native Americans, chronicling the continued failure of the federal government to honor its sacred commitments. Among its findings, the Commission noted that the programs supporting the social and economic wellbeing of AI/ANs “remain chronically underfunded and sometimes inefficiently structured, which leaves many basic needs in the Native American community unmet and contributes to the inequities….” In 2019, Indian Health Service (IHS) health care expenditures per person were $4,078 compared to $9,726 for health care spending nationwide.