It's no secret: when Congressional Republicans were pushing through Trump’s Big Disaster Budget Bill, many key services ended up on the chopping block. One key program did not get nearly enough attention at the time: the Indian Health Services.
A Brief History of the Indian Health Services (IHS):
During the 1800s, many treaties signed between tribal nations and the U.S. government required the federal government to provide healthcare services in exchange for land. However, the IHS did not become a formal federal agency until 1955.
In the years that followed, federal policies designed to undermine tribal sovereignty resulted in many Native communities losing federal recognition and access to the Indian Health Services. Moreover, no mandatory spending was put aside for IHS, leaving the agency chronically underfunded.
Decades later, the Affordable Care Act expanded funding for IHS, but those additional funds did little to meet the needs of populations who have been chronically underserved for decades.
This brings us to 2025.
Where IHS Stood Before Trump’s Cuts
Before the 2025 cuts, IHS already faced systemic shortfalls, all of which found their root in chronic underfunding. Case in point: IHS spends less per patient than any other federal healthcare program (also less than half the national average for per-patient spending).
This has resulted in:
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Staffing Shortages: Nationwide, 1 in 4 IHS provider positions were unfilled.
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Aging Infrastructure: Many hospitals and clinics on reservations were decades old, with outdated equipment and unsafe facilities. Nearly half of IHS facilities were past their useful life.
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Geographic Barriers: Because Native communities are often rural and isolated, IHS facilities face unique barriers recruiting specialists. When in need of specialty care, many patients have to travel hundreds of miles to reach it. For example, if someone on the Navajo Nation needs a neurologist, they may need to travel as far as Phoenix in order to receive timely care.
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High Wait Times: All three problems listed above have resulted in significantly longer waits to access even basic, preventative care.
The result of these pitfalls is disproportionately higher incidences of chronic illness among Native patients, heart disease, maternal/infant mortality, and more. Already, we are seeing these problems worsen, and health outcomes are worsening in lockstep.
Where IHS Stands Now:
The Big Disaster Bill cut $900 million in base funding from the IHS. In addition to this, Trump entirely eliminated the CDC’s Healthy Tribes Program, which allocated $32.5 million annually to support traditional medicine, community gardens, and overall culturally grounded wellness practices. He also eliminated $102 million in public and mental health grant programs which are specifically geared to serve tribal communities.
Women gathered in Bacavi for AND’s Hopi Listening Tour, Aug. 20, 2025
Through our work on sovereign lands, Arizona Native Democrats are seeing the impacts firsthand. For example, physicians on the Navajo Nation are raising alarms that the funding cuts are compounding existing problems so much that IHS on the Navajo Nation is poised to entirely collapse. IHS doctors in the Navajo Nation are reporting worsening staffing shortages; lower morale and higher burnout among existing staff; worsening ability to access funds, updated medical equipment, or facilities improvements; and rapidly increasing delays in delivering life-saving care for patients. All of this breeds mistrust of health services in Native communities across Arizona.
What was already a systemically flawed system is now at a breaking point because of callous decisions made by a President to whom Native communities don’t even rate a second thought. During a listening tour event on Hopi, one woman said she wanted Trump to go through Native lands to, “See how remote we live, how difficult access can become, so he’s not only talking but sees firsthand for himself.”
Listening Tours are events for voters to air their concerns and organize around issues that matter to them. Bacavi, Aug. 20, 2025
This is why the Arizona Native Democrats was founded.
The issues Native communities presently face in accessing quality healthcare were made worse by Trump and Congressional Republicans, but they didn’t start there. They are born from hundreds of years of chronic abuse and genocide, followed by decades more of representation that at best is ignorant of those problems, or at worst willfully ignores them.
We started our program in part to hold elected officials accountable for both by building a powerful, informed electorate that can change the course of elections. And Native voters in Arizona can indeed change the course of our elections. In short, we force electeds to listen. Moreover, we have a track record of bringing in officials directly to voters. Our Cafe 6 series, listening tours, and crowd canvasses have been attended by candidates ranging from Corporation Commissioner Candidate Clara Pratte to sitting Attorney General Kris Mayes.
Because of our work, our elected officials (and candidates) in Arizona really do see the challenges their constituents face firsthand.
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