Luján, Colleagues to President Trump: Don’t Turn Your Back on Tribal Communities

Recent Reporting Indicates Musk-Trump Layoffs at Indian Health Service Will Cut Off Access to Health Care for Tribal Communities

Washington, D.C. – Today, U.S. Senator Ben Ray Luján (D-N.M.), a member of the Senate Indian Affairs Committee, led nine other Senators in a letter to President Trump expressing concern regarding reporting that layoffs at the Indian Health Service (IHS) will dramatically impact access to health care for Tribal communities and demanding that President Trump stop from these firings at IHS. Recent reporting indicates that over 850 IHS employees who deliver critical medical care for Tribal communities are at risk of being laid off immediately. At a time when IHS faces a significant health care workforce shortage, any further reductions in IHS’ workforce will severely impact the health and wellbeing of our Tribal communities.

“We write to express our concern regarding recent reporting that layoffs at the Indian Health Service (IHS) resulting from Executive Order 14210 and OPM guidance will dramatically impact American Indians and Alaska Native (Native) communities’ access to health care. Tribal Nations have a legal and political relationship with the United States, and the federal government has a fundamental obligation to fulfill its treaty and trust responsibilities to Tribal Nations – an obligation that includes providing services such as health care to Native communities,” wrote the senators.

“Not only will this lead to worse health outcomes, but overall costs will also rise. With less health care services at existing IHS facilities, there will be increased Purchased Referred Care referrals. This will increase costs for the Federal government and require increased travel, accommodations, and expenses, creating increased hardships and barriers for patients and families seeking care far from where they live on Tribal lands. The federal government is already failing to meet its trust and treaty obligations to Tribal Nations, and further reductions in IHS’ workforce will severely impact the health and wellbeing of Tribal communities across the country,” the senators continued.

In addition to Senator Luján, the letter is signed by U.S. Senators Alex Padilla (D-Calif.), Tina Smith (D-Minn.), Ron Wyden (D-Ore.), Kirsten Gillibrand (D-N.Y.), Martin Heinrich (D-N.M.), Ruben Gallego (D-Ariz.), Elizabeth Warren (D-Mass.), Mark Kelly (D-Ariz.), and Catherine Cortez Masto (D-Nev.).

The full text of the letter is available here or below.

Dear President Trump:

We write to express our concern regarding recent reporting that layoffs at the Indian Health Service (IHS) resulting from Executive Order 14210 and OPM guidance will dramatically impact American Indians and Alaska Native (Native) communities’ access to health care. Tribal Nations have a legal and political relationship with the United States, and the federal government has a fundamental obligation to fulfill its treaty and trust responsibilities to Tribal Nations – an obligation that includes providing services such as health care to Native communities. Abruptly terminating any IHS employees undermines this responsibility, and we urge you to halt the mass firing of any essential health care workers at IHS to preserve the Federal obligations to Tribes.

Reporting indicates that more than 850 IHS employees, including 90 physicians, 350 nurses, at least 25 nurse practitioners, nearly 20 dentists, 43 dental assistants, more than 85 pharmacists, 45 lab technicians and more than 15 service area chief executives or their deputies are at risk of being laid off immediately. This is particularly concerning because IHS has long struggled with chronic health care workforce shortages. Last year, IHS experienced nearly 2,000 vacancies, and a 2018 GAO report found that IHS had an overall health care provider vacancy rate of 25 percent across service areas. These shortages, which are attributed to limited recruitment incentives, lower salaries, lengthy hiring processes, and geographic isolation, result in longer wait times for appointments, over worked providers who cannot spend enough time with patients, inadequate follow-up care, and provider burnout – leading to lower patient satisfaction and worse health outcomes. It is not uncommon for recently hired clinicians to be the only primary care provider or specialist in their IHS Service Area. AI/ANs already face significantly lower life expectancies compared to the general U.S. population and higher rates of disease including diabetes and hypertension.

Not only will this lead to worse health outcomes, but overall costs will also rise. With less health care services at existing IHS facilities, there will be increased Purchased Referred Care referrals. This will increase costs for the Federal government and require increased travel, accommodations, and expenses, creating increased hardships and barriers for patients and families seeking care far from where they live on Tribal lands.

The federal government is already failing to meet its trust and treaty obligations to Tribal Nations, and further reductions in IHS’ workforce will severely impact the health and wellbeing of Tribal communities across the country. Therefore, we strongly urge you to stop these firings and retain IHS probationary staff.

Sincerely,

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