On March 27, 2025, the Department of Health and Human Services (HHS) announced plans for a “dramatic restructuring”. HHS will implement a restructuring plan that will combine operating divisions, such as the Health Resources and Services Administration (HRSA) and the Substance Abuse and Mental Health Services Administration (SAMHSA), into a new entity: the Administration for a Healthy America (AHA). According to the announcement, HHS will reduce its staff by an additional 10,000 staff, for a total HHS staffing reduction of 20,000 staff since the start of the Administration.

The announcement does not mention the Indian Health Service or any potential impacts this restructuring may have on IHS or the Indian health care system generally. Therefore, it’s not possible to know how this restructuring may impact Urban Indian Organizations, including those funded through HRSA and SAMHSA. However, the statement indicates the changes will “serve multiple goals without impacting critical services.”

NCUIH is committed to working with the Administration to ensure that the trust responsibility is fulfilled and that UIOs have the resources needed to effectively support their patients and communities. We will continue to closely monitor the restructuring and any impacts it may have on HHS operating divisions and programs affecting the Indian Health system.

About NCUIH

The National Council of Urban Indian Health (NCUIH) is a national representative for the 41 Urban Indian Organizations contracting with the Indian Health Service under the Indian Health Care Improvement Act. NCUIH is devoted to the support and development of high quality and accessible health and public health services for American Indian and Alaska Native people living in urban areas.

NCUIH respects and supports Tribal sovereignty and the unique government-to-government relationship between our Tribal Nations and the United States. NCUIH works to support those federal laws, policies, and procedures that respect and uplift Tribal sovereignty and the government-to-government relationship. NCUIH does not support any federal law, policy, or procedure that infringes upon or in any way diminishes Tribal sovereignty or the government-to-government relationship.

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NCUIH Contact: Meredith Raimondi, Vice President of Policy and Communications, mraimondi@ncuih.org