Tribes warn of deep health care crisis as Federal budget cuts advance

Native health leaders are raising urgent concerns about sweeping federal budget cuts they say could destabilize tribal health systems already stretched thin. The warnings came during an April 8 episode of Native America Calling, which examined the impact of President Donald Trump’s 2026 budget proposal on Native communities.

The proposal includes a 75% cut to a diabetes prevention and treatment program serving Native Americans, along with up to $65 million in reductions to Indian Health Service (IHS) facility improvements. Tribal leaders say these cuts strike at the core of essential services.

Acoma Pueblo’s clinic at the breaking point

Acoma Pueblo in New Mexico is among the communities most immediately affected. Its aging tribal health clinic requires costly repairs, repairs that could be delayed indefinitely if federal support is slashed. Gov. Charles Riley, chairman of the Acoma Pueblo Health Board and former governor, has testified before Congress about the urgent need for upgrades, and the episode highlights how his community is already contending with the strain of an aging facility.

The episode brought together four leaders from across Indian Country, each offering a different vantage point on how the proposed cuts and the looming drop off in Medicaid reimbursements threaten Native health care.

Liz Malerba (Mohegan), director of policy and legislative affairs for the United South and Eastern Tribes Sovereignty Protection Fund, helped frame the cuts within the broader policy landscape. Her perspective underscored how the diabetes program reduction fits into a long running pattern of federal underinvestment in Native health care, and how shifts in federal priorities continue to place tribes in a defensive posture.

A.C. Locklear (Lumbee), CEO of the National Indian Health Board, spoke to the national implications of the Medicaid reimbursement crisis. The episode notes that hundreds of rural hospitals across the country, many serving Native patients, are at risk as reimbursements decline. Locklear’s contribution emphasized that the financial shock is not confined to one region but threatens the stability of Native health systems nationwide.

Jerilyn Church (Cheyenne River Lakota), president and CEO of the Great Plains Tribal Leader’s Health Board, brought the conversation directly to the realities facing tribal communities in the Great Plains. Representing a region with some of the highest diabetes rates in the country, Church underscored how devastating the 75% cut to diabetes programs would be for prevention, early detection, and long-term disease management. She also highlighted how the Medicaid reimbursement drop compounds the danger, since rural hospitals and tribal clinics in her region already operate on razor-thin margins. Her perspective tied the two crises together, illustrating how cuts to both diabetes funding and Medicaid revenue would hit Native communities simultaneously and severely.

Kurt Riley (Acoma Pueblo), chairman of the Acoma Pueblo Health Board and former governor, grounded the discussion in the lived experience of a tribal nation struggling to maintain essential health infrastructure. His community’s aging clinic, already in need of costly repairs, stands as a clear example of how facility needs become nearly impossible to meet when federal support shrinks.

What’s next?

With Congress divided on whether to support the proposed cuts, tribal leaders are mobilizing to defend programs they say are essential to Native health and sovereignty. The episode frames the moment as a critical juncture for tribal health systems nationwide.

The post Tribes warn of deep health care crisis as Federal budget cuts advance first appeared on Native Sun News Today.

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