Tribal Nations and Members of Congress continue to press for meaningful Tribal Consultation on Department of Health and Human Services (HHS) reorganization. In recent months, HHS has advanced a sweeping reorganization that would drastically affect how Tribal health programs operate and how Native communities engage with the federal government. This transformation has moved forward without the meaningful and legally required Tribal Consultation that federal agencies must conduct when Tribal interests are at stake.
Tribal Consultation is not optional – it is a legal mandate grounded in the federal trust responsibility. Federal statutes and departmental Tribal consultation policies require federal agencies to consult with Tribal Nations on policies and actions that may impact them. This obligation arises from the unique government-to-government relationship between the United States and Tribal Nations founded in the Constitution. The Administration has committed to uphold these responsibilities, and they should schedule consultation to meet that promise.
Chairwoman Murkowski and Vice-Chairman Schatz Urge HHS to Halt Cuts
The Senate Committee on Indian Affairs Chair Lisa Murkowski (R-AK) and Vice Chair Brian Schatz (D-HI) recently sent a joint letter to HHS Secretary Kennedy urging the Department to pause the reorganization. Their bipartisan message stated, “[T]he programs administered by these federal agencies support the federal government’s commitment to provide health care services to Native people grounded in treaties, statutes, executive orders, and other federal laws, and agreements.” they wrote. They also request HHS programs outside IHS be held harmless from staffing reductions to support the well-being of Tribes and the Native Hawaiian Community.
Chairwoman Janet Alkire – Great Plains Area Representative to the NIHB Provides Testimony to the Senate Committee on Indian Affairs
In a formal testimony to the Senate Committee on Indian Affairs on May 14, 2025, Chairwoman Janet Alkire of the Standing Rock Sioux Tribe, who also serves as the Great Plains Area Representative to the National Indian Health Board (NIHB), expressed deep concern about the reorganization process. The Chairwoman’s testimony discussed how the proposed HHS reorganization fundamentally alters how Tribal Nations access resources for health care, behavioral health, and public health infrastructure, and how it has occurred without formal Tribal Consultation as required by law.
Chairwoman Alkire emphasized the impact of staff terminations and funding disruptions across multiple HHS agencies to the operation of Tribal programs. Programs such as Healthy Tribes, maternal and child health services, and behavioral health services have already been cut or delayed—jeopardizing care and disrupting services in some of the most underserved regions of the country.
The Chairwoman expressed that Tribes are part of the solution; Tribal self-governance has time and time again proven one of the most successful, quality-improving, and efficient programs pursued by the United States.
On May 12, 2025, the NIHB sent a letter to Secretary Kennedy requesting Tribal Consultation on the HHS reorganization and to preserve Tribal-serving programs, set-asides, and employees serving Tribal programs.
Tribal serving programs across the Centers for Disease Control and Prevention (CDC), Health Resources and Services Administration (HRSA), Substance Abuse and Mental Health Services Administration (SAMHSA), Office of the Assistant Secretary for Health (OASH), National Institutes of Health (NIH), Centers for Medicare and Medicaid Services (CMS), and the Administration for Community Living (ACL) are being cut, downsized, or left in limbo – placing the health of Tribal citizens at risk.
The NIHB letter highlights several consequences of the reorganization:
- More than $6 million in grants to Tribes have been canceled across various HHS agencies without warning.
- Staff reductions to Tribal-serving programs like the CDC’s Healthy Tribes, CDC’s Division of Reproductive Health, CDC’s National Center for Injury Prevention and Control, SAMHSA’s Center for Mental Health Services, HRSA’s Healthy Start, OASH’s Office of Infection Disease and HIV/AIDS Policy, and CMS’s Office of Minority Health.
- Cuts and pauses to Tribal funding, including CDC’s Strengthening Public Health System and Services in Indian Country, CDC’s Healthy Tribes, National Health Service Corps, and NIH’s Native American Research Center for Health (NARCH).
- Closure of five HHS Regional Offices that has placed over 400 Tribes under the jurisdiction of just one office.
- Pause of critical data systems including the Minority HIV/AIDS Fund, Pregnancy Risk Assessment Monitoring System (PRAMS).
Call to Action
The message from Tribal Nations and Congressional leaders is clear – HHS must halt the Reorganization until full and meaningful Tribal Consultation takes place. Tribal leaders continuously request that the federal government fulfill its legal obligations and uphold the treaties and promises made to Tribal Nations.
