NCUIH Urges HHS to Reconsider Proposed Budget Cuts to Indian Health Service and HHS

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FOR IMMEDIATE RELEASE

Washington, D.C. (April 18, 2025)– The National Council of Urban Indian Health (NCUIH) sent a letter to Robert F. Kennedy, Jr., Secretary of the U.S. Department of Health and Human Services (HHS), expressing deep concern over the proposed budget cuts to the Indian Health Service (IHS)  and HHS as outlined in the Office of Management and Budget’s (OMB) Fiscal Year 2026 Discretionary Budget Passback. The proposed reductions include nearly $900 million in cuts to the IHS budget and the elimination of IHS advance appropriations, which are crucial for protecting IHS funding from interruptions such as government shutdowns.The proposed changes would have detrimental effects on the health care delivery for American Indian and Alaska Native people across the United States including for Urban Indian Organizations and Tribal programs.  A recent report showed that 50% of Urban Indian Organizations could be forced to discontinue services within six months of funding disruptions.

“The proposed budget cuts are a direct threat to the health and well-being of American Indian and Alaska Native communities. We call on Secretary Kennedy to honor his commitment to prioritizing Indian Country and appeal these proposed reductions. Lives are at stake and this could have catastrophic consequences,” said NCUIH CEO Francys Crevier, JD (Algonquin).

Impact of HHS Cuts on American Indian and Alaska Native Communities

In addition to the specific cuts to the IHS, NCUIH is concerned about the broader reductions in funding to several HHS programs impacting Native health. UIOs and tribal health facilities rely on HHS grants (e.g., SAMHSA, HRSA, CDC, and HIV/AIDS initiatives) to address disparities. For example, Tribal Behavioral Health Grants (Native Connections) are eliminated in the proposal. Tribes and Urban Indian Organizations receiving Native Connections funding will lose funding that addresses suicide, substance use, and trauma impacting American Indian and Alaska Native youth.

Secretary’s Commitment to Indian Country

NCUIH appreciates Secretary Kennedy’s recent visit to Native Health, an Urban Indian Organization located in Arizona that contracts with the Indian Health Service to provide critical services to Native people. Following this visit, Secretary Kennedy praised Native Health as a model of care that should be replicated and become the standard across Indian Country. He also expressed his commitment to prioritizing Indian Country in his efforts to improve health outcomes.

Call to Action

NCUIH urges Secretary Kennedy to appeal the proposed budget cuts and uphold the federal government’s trust obligations to American Indian and Alaska Native people.  NCUIH remains committed to working alongside HHS and the current administration to ensure that the IHS and other critical programs receive the necessary funding to effectively serve American Indian and Alaska Native communities. We call for immediate action to prevent the devastating impact of the proposed budget cuts and to support the health and well-being of Indian Country.

Read the Letter
Related News
Resources

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

Secretary Kennedy Visits Arizona Urban Indian Organization NATIVE HEALTH

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FOR IMMEDIATE RELEASE

MESA, AZ (April 8, 2025)– Today, Health and Human Services (HHS) Secretary Robert F. Kennedy Jr. visited NATIVE HEALTH’S Mesa clinic to learn more about the vital work of Urban Indian Organizations as part of the Indian Health System. Secretary Kennedy is on a tour that includes a focus on “Tribal Health & Self-Governance” and a discussion with Navajo Nation leadership on food sovereignty initiatives.

“NATIVE HEALTH is a shining example of innovative health care in Arizona, demonstrating the success of services developed by Native people for Native people. Secretary Kennedy’s commitment to protecting the Indian Health Service, including Urban Indian Organizations, reflects a shared dedication to better health outcomes for all Native people. We are especially encouraged by his willingness to engage directly with the community, witnessing firsthand the innovation and success of programs like NATIVE HEALTH and listening to Native leaders. Together, we aim to build on this foundation, fostering collaboration and sustainable progress for future generations,” said NCUIH CEO Francys Crevier (Algonquin).


HHS Secretary Kennedy speaks with NCUIH President and NATIVE HEALTH CEO Walter Murillo (Choctaw) at NATIVE HEALTH Mesa.

Native Leaders Urge Secretary Kennedy to Honor Trust and Treaty Obligations

Recently, Secretary Kennedy met with the HHS Tribal Advisory Committee and promised to protect IHS from any administrative changes. On February 25, HHS also issued an Advisory Opinion reiterating the “legal obligation to provide health care for Indian Tribes and their citizens.” The advisory opinion affirms that during his first administration, President Trump sought to enhance federal programs addressing the concerns of American Indian and Alaska Native communities.

Administrative changes have recently been announced at HHS, and NCUIH has called upon the administration to honor the advisory opinion so that programs for Tribes and their citizens do not become collateral damage during reform efforts. NCUIH is hopeful that the administration will continue to engage in opportunities to hear from Native leaders as we work together to uplift the health care of all Native people.


L to R:
Francys Crevier (Algonquin), JD, CEO of NCUIH
Kyu Rhee, President and CEO of the National Association of Community Health Centers (NACHC)
Secretary Kennedy
Jessica Yanow, President and CEO of the Arizona Alliance for Community Health Centers
Walter Murillo (Choctaw), CEO of NATIVE HEALTH

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

NCUIH Statement on the Passing of Congressman Raúl M. Grijalva

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Congressman Raúl Grijalva

NCUIH is deeply saddened by the passing of Congressman Raúl Grijalva, a fearless champion for Native communities whose impact will be felt for generations. His dedication to Native health and honoring trust and treaty obligations was more than just policy work—it was a reflection of his deep respect for Native people and communities.

Congressman Grijalva was a true ally in protecting and serving Native people, including the millions living in urban areas. His leadership was instrumental in securing the permanent reauthorization of the Indian Health Care Improvement Act (IHCIA), which strengthened and expanded health care access for all Native communities. He was a dedicated champion for secure and stable funding for the Indian Health Service (IHS) and Urban Indian Health programs. He played an important role in achieving advance appropriations for the IHS and led an annual letter to appropriators requesting full funding for both IHS and Urban Indian Health. He believed in Native-led solutions and never hesitated to stand alongside us as an ally.

“His legacy is not one of loss, but of progress—of doors opened, voices amplified, and a future where Native people continue to thrive. His work lives on in every policy he championed, and in the communities he uplifted,” said NCUIH CEO Francys Crevier (Algonquin).

We extend our gratitude for his unwavering commitment to Native health care and send our thoughts to his family, friends, and all those who walked alongside him on this journey.

May his path forward be as powerful as the one he carved here.

Congressman Raúl Grijalva

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

Congress Extends Government Funding Through September

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Maintains Advance Appropriations for Indian Health Service and Extends Funding for the Special Diabetes Program for Indians

FOR IMMEDIATE RELEASE

WASHINGTON, D.C. (March 14, 2025) – The House and Senate passed a Continuing Resolution (CR) to extend government funding set to expire on March 14, 2025, until September 30, 2025. The CR maintains advance appropriations for the Indian Health Service (IHS) and extends the Special Diabetes Program for Indians (SDPI), Medicare Telehealth Flexibilities, Community Health Center Funding, and the National Health Service Corps (NHSC) funding. A more detailed analysis of the Continuing Resolution is below.

Read the Bill Text
Key Provisions

Indian Health Service:

  • Maintains advance appropriations for FY26 for the Indian Health Service (IHS).
  • Provides $38,709,000 anomaly for the IHS Services line item.
    • Includes $38,709,000 IHS Services anomaly as advance appropriations to “become available on October 1, 2025, and remain available through September 30, 2027.”
  •  Provides $3,920,000 anomaly for the IHS Facilities line item.
    • Includes $38,709,000 IHS Services anomaly as advance appropriations to “become available on October 1, 2025, and remain available until expended.”
  • Rescinds $17,023,000 earmarked for Sanitation Facilities Construction projects.

Special Diabetes Programs for Indians (SDPI)

  • Extends SDPI at “$79,832,215 for the period beginning on April 1, 2025, and ending on September 30, 2025, to remain available until expended.’’
    • This brings the total FY25 funding for SDPI to $159,422,727.00.

Community Health Centers (CHC)

  • Extends CHC at “$2,135,835,616 for the period beginning on April 1, 2025, and ending on September 30, 2025.”

Telehealth

  •  Extend flexibilities allowing for greater Medicare coverage of virtual health services until Sept. 30. The provisions, which stem from the Covid-19 pandemic, are set to expire March 31.
  • This provision allows federally qualified health centers (FQHCs), rural health clinics, and Medicare to pay for mental health telehealth services, without any in-person requirements. Without continuation of this provision, physicians would be required to provide an in-person service within the six months prior to beginning telehealth services.

Health Resources and Services Administration (HRSA)

  • Rescinds $890,788,000 in earmarked funds provided in FY24 for construction and renovation of health-care facilities and for training grants through HRSA.
  • Rescinds $72,090,000 in earmarked funds provided in FY24 for substance abuse and mental health projects.

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

PRESS RELEASE: NCUIH Applauds the Invitation of Native Health Leaders at Joint Session of Congress

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FOR IMMEDIATE RELEASE

WASHINGTON, D.C. (March 4, 2025) – The National Council of Urban Indian Health (NCUIH) proudly recognizes the invitation of two esteemed Native health leaders to attend the upcoming Joint Session of Congress in Washington, D.C. Dr. Linda Son-Stone, CEO of First Nations Community HealthSource, has been invited as a guest of Congresswoman Melanie Stansbury (NM-01), while Walter Murillo, CEO of Native Health Phoenix and NCUIH Board President, will attend as a guest of Congressman Greg Stanton (AZ-04). Both Stansbury and Stanton are members of the Native American Caucus. The Joint Session of Congress presents an opportunity to emphasize the importance of honoring the federal trust responsibility to provide adequate healthcare to Native people.Both leaders have dedicated their careers to advocating for the health and well-being of urban Native populations. Their invitations are a recognition of the key role of Urban Indian Organizations (UIOs) in providing healthcare to Native communities.

UIOs are nonprofit organizations funded by the Indian Health Service (IHS) to provide quality health care to Native Americans living in urban areas. Native Health, based in Phoenix, Arizona, delivers primary medical, behavioral health, and community wellness services to the urban Native population. First Nations Community HealthSource (FNCH), located in Albuquerque, New Mexico, is the state’s only Urban Indian Organization and serves as a critical healthcare provider for Native and other underserved communities.

Stanton Emphasizes Importance of Native Health in Serving People on Medicaid

Stanton Emphasizes Importance of Native Health in Serving People on Medicaid

Congressman Stanton emphasized the importance of Murillo’s attendance in light of proposed Medicaid cuts that would disproportionately impact Native communities.

“Walter and the team at Native Health work every day to provide quality, affordable health care to Arizona’s urban Native population, and as many as half of their patients rely on AHCCCS (Arizona Health Care Cost Containment System). I’m proud that Walter will be my guest at the President’s address to highlight why Congress should reject any budget that cuts Medicaid and takes away health care for Arizona families,” said Rep. Stanton.

Medicaid is the biggest source of funding for Urban Indian Organizations outside of the Indian Health Service (IHS). 37.4% of Native Arizonans are enrolled in Medicaid—including more than 53,000 Native Medicaid beneficiaries in Arizona’s Fourth Congressional District.

First Nations Community HealthSource: A Shining Light

First Nations Community HealthSource: A Shining Light

Similarly, Congresswoman Stansbury highlighted the innovative work of First Nations Community HealthSource as “the shining light of health care in New Mexico.” Stansbury, stated, “this clinic is a cornerstone of our community, providing holistic and wrap-around services that address the deep health disparities facing our Native populations. I am honored to have Dr. Linda Son-Stone, an extraordinary leader in urban Indian health, as my guest at the Joint Session of Congress” said Rep. Stansbury.

On February 27, Rep. Stansbury led 111 members of Congress in a letter urging the administration to reverse executive actions that are negatively impacting Tribal programs. Their support is particularly critical as proposed Medicaid cuts threaten the health care coverage of the 2.7 million Native Americans who rely on Medicaid.

The joint session airs tonight, March 4 at 9:00 pm ET, live on C-SPAN.

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

NCUIH Board President-Elect Robyn Sunday-Allen Testifies on Importance of Native Health Care

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FOR IMMEDIATE RELEASE

Robyn Sunday-Allen Testimony
WASHINGTON, D.C. (February 28, 2025)– On Thursday, National Council of Urban Indian Health (NCUIH) board president-elect and Oklahoma City Indian Clinic CEO Robyn Sunday-Allen (Cherokee) testified before the House Appropriations Subcommittee on Interior, Environment, and Related Agencies, urging full funding for urban Indian health and the Indian Health System.

Read Written Testimony

What They’re Saying: Congressional Support for Strengthening Indian Health Services

Chair Mike Simpson (ID-02-R) reaffirmed the committee’s commitment to advancing progress in Indian health care, acknowledging the long-standing failures in meeting treaty obligations.

“You have this committee standing behind you, doing everything we can to ensure we move forward—not backward—on our treaty obligations. The progress we’ve made so far is inadequate, but we are working to change how things are done,” Chair Simpson stated.

Chair Mike Simpson

Representative Jake Ellzey (TX-06-R) raised concerns about the rising cancer rates in Native communities including in urban areas of Texas, asking Ms. Sunday Allen for insights into potential causes. Ms. Sunday Allen discussed the complex interplay of social determinants, environmental exposure, and structural barriers limiting access to quality health care.

Why It Matters: The Urgency of Action

Protecting the Entire Indian Health System

  • Chronic Underfunding
    Urban Indian Organizations (UIOs) are integral parts of the Indian Health System, which has been “chronically underfunded,” according to Ms. Sunday-Allen. Any disruptions in federal funding—including cuts, sequestrations, or hiring freezes—jeopardize lives and can force UIOs to consider staff furloughs or even suspending services.
  • “Our Care Is Too Critical to Be Paused”
    As Ms. Sunday-Allen testified: “Historically, disruptions in funding to the Indian health system have resulted in loss of life… Our care is too critical to be paused or reduced.” Ensuring mandatory and full funding for the entire Indian Health System—tribal facilities, the Indian Health Service (IHS), and UIOs—is essential for saving lives.
  • Cancer: The “New Diabetes” in Indian Country
    Ms. Sunday-Allen highlighted the alarming rise in cancer rates at the Oklahoma City Indian Clinic, noting that they now diagnose 15–20 new cancer cases each month. She emphasized that “cancer has become what I refer to as the new diabetes in Indian Country. It is ravaging our community like diabetes has done.” Increased resources and support are imperative to address this growing public health crisis.
Next Steps

NCUIH will continue to advocate for protecting and fully funding the Indian Health System–including UIOs, Tribes, and IHS—so that no Native person goes without life-saving care. NCUIH stands ready to work with Congress and federal agencies to ensure that all Native people have consistent, high-quality health care.

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

STATEMENT: NCUIH Responds to HHS Advisory Opinion: Safeguarding Native Healthcare Amid Policy Shifts

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FOR IMMEDIATE RELEASE

WASHINGTON, D.C. (February 26, 2025) – The National Council of Urban Indian Health (NCUIH) welcomes the Advisory Opinion issued by the Department of Health and Human Services (HHS) Office of General Counsel on February 25, 2025. This opinion reaffirms that recent Executive Orders do not alter the federal government’s trust responsibility to provide healthcare for American Indian and Alaska Native (AI/AN) people. This opinion clarifies that recent Executive Orders do not alter the federal government’s distinct legal obligations to Indian Tribes and their citizens, as established by treaties, statutes, and the U.S. Constitution. It also notes that certain policies at Indian Health Service (IHS) facilities must comply with these Executive Orders.

This action reflects responsiveness to calls from Tribal leaders and Native organizations urging the administration to uphold its trust obligations. NCUIH has consistently advocated for the protection of the Indian health system, including Urban Indian Organizations (UIOs), which provide health services for AI/AN people.

Read Advisory Opinion

Francys Crevier (Algonquin), CEO of NCUIH, stated:

“We appreciate the Administration’s affirmation of the federal trust responsibility to provide healthcare for American Indian and Alaska Native people. Native-led Urban Indian Organizations play a critical role in delivering essential services to Native populations, and any policy changes must prioritize the health and well-being of our people.”

NCUIH calls on policymakers to continue listening to Tribal voices and Native organizations and uphold the federal trust responsibility without compromise. NCUIH remains steadfast in advocating for health care access for all Native communities.

Recent news:

PRESS RELEASE: Tribal Organizations Urge Administration to Respect Tribal Sovereignty and Uphold Trust and Treaty Obligations Amid Executive Actions (Feb. 3, 2025)

NCUIH Joins NIHB, NCAI and Self-Governance Communication and Education Tribal Consortium in Requesting the Indian Health System be Exempt from Federal Hiring Freezes (Feb 4, 2025)

IHS Employee Layoffs Halted After Urgent Advocacy Efforts (Feb. 19, 2025)

NCUIH Joins NIHB in Letter to Congressional Leadership Advocating for Protecting the Indian Health System from Funding Freezes (Feb. 25, 2025)

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

PRESS RELEASE: Tribal Organizations Urge Administration to Respect Tribal Sovereignty and Uphold Trust and Treaty Obligations Amid Executive Actions

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FOR IMMEDIATE RELEASE

WASHINGTON, D.C. (February 3, 2025) – A coalition of Tribal organizations, representing Tribal Nations and their citizens and communities, is calling on the Administration to ensure that recent executive actions do not undermine the unique sovereign political status of Tribal Nations as sovereign nations with which the federal government has trust and treaty obligations, or disrupt federal funding that flows from those relationships for essential Tribal programs.

Following the issuance of multiple executive orders and Office of Management and Budget (OMB) directives, concerns arose over freezes on federal funding that Tribal Nations and Tribal organizations, including urban Indian organizations, rely on to provide critical healthcare, economic development, education, and social services to Tribal communities. While OMB has since rescinded the initial memorandum, questions remain about how federal agencies will interpret and implement the Administration’s executive orders and policies moving forward.

Tribal Nations are not special interest groups—they are sovereign governments with a unique legal and political relationship with the United States and with their own Tribal communities. The trust and treaty obligations of the federal government are political and debt-based in nature.  Tribal Nations’ sovereignty and the federal government’s delivery on its trust and treaty obligations must not become collateral damage in broader policy shifts.

The coalition emphasizes that federal funding for Tribal programs is not discretionary, but rather a legal mandate owed under the United States’ trust and treaty obligations and the many statutes that carry them out. The organizations urge the Administration to explicitly recognize Tribal sovereignty and trust and treaty obligations in the implementation of all executive orders and priorities and to ensure that federal agencies provide clear guidance that protects Tribal programs from unnecessary disruption.

As the Administration advances its priorities, it must do so in a way that respects Tribal sovereignty, strengthens self-determination, and delivers on trust and treaty obligations. We stand ready to work with federal partners to ensure that all policies and decisions uphold the government-to-government relationship beteen the U.S. and Tribal Nations.

The coalition will continue to advocate for Tribal sovereignty and fulfillment of the trust and treaty obligations and ensure that the voices of Indian Country are heard in Washington. A full copy of the sign-on letter can be found here: https://qrco.de/letter2225.

List of National Tribal Organizations

American Indian Higher Education Consortium
Association on American Indian Affairs
Affiliated Tribes of Northwest Indians
California Tribal Chairpersons Association
Great Lakes Inter-Tribal Council
Great Plains Tribal Chairmans Association
Indian Gaming Association
Inter-Tribal Association of Arizona
Midwest Alliance of Sovereign Tribes
Native American Finance Officers Association
National American Indian Court Judges Association
Native American Rights Fund
National Association of Tribal Historic Preservation Officers
Native Forward Scholars Fund
National Congress of American Indians
National Council of Urban Indian Health
National Indian Child Welfare Association
National Indian Education Association
National Indian Health Board
Northern California Tribal Chairperson’s Association
Rocky Mountain Tribal Leaders Council
Self-Governance Communication & Education Tribal Consortium
Southern California Tribal Chairmen’s Association
United South and Eastern Tribes

January 31, 2025 – National Council of Urban Indian Health Calls for Protection of Indian Health System Funding

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

PRESS RELEASE: National Council of Urban Indian Health Calls for Protection of Indian Health System Funding

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FOR IMMEDIATE RELEASE

WASHINGTON, D.C. (January 31, 2025) – The National Council of Urban Indian Health (NCUIH) today urged Congress, the Office of Management and Budget (OMB), and the Department of Health and Human Services (HHS) to exempt the Indian Health System from any future funding restrictions or pauses. This call to action comes in response to recent events that temporarily froze resources critical to the operation of Tribal health care and Urban Indian Organization (UIO) facilities. While the recent OMB memorandum (M-25-13) has been rescinded, NCUIH remains concerned about potential future impacts on the Indian health system. The organization emphasizes that any disruption to funding could have severe consequences for American Indian and Alaska Native communities.

Key points from NCUIH’s communications include:

  1. Federal Trust Responsibility: NCUIH stresses the U.S. Government’s legal obligation to provide health services to Native people, as established by the Indian Health Care Improvement Act.
  2. Preventing Service Disruptions: Recent funding uncertainties forced UIOs to consider staffing cuts, service suspensions, and even facility closures.
  3. Historical Context: Past experience shows any disruption in funding can have grave consequences on the Indian health system. During the 2019 government shutdown, funding disruptions led to reduced services and facility closures, resulting in tragic consequences including fatal opioid overdoses in some communities.
  4. Specific Exemption Request: NCUIH is calling for a specific exemption for the entire Indian Health System, including the Tribal organizations, and UIOs, from any future funding restrictions.

Walter Murillo (Choctaw), Board President of NCUIH stated, “Even a temporary halt in funding could immediately deprive Native communities of necessary health services. As leaders of Urban Indian Organizations, we’re on the front lines of providing essential healthcare to Tribal citizens. We’re calling for a specific exemption for the entire Indian Health System from any future funding restrictions or pauses. This isn’t just about honoring agreements; it’s about fulfilling the federal government’s trust responsibility to provide healthcare for Tribal citizens, regardless of where they live.”

NCUIH is actively engaging with Congress, the OMB, and HHS to secure this specific exemption and prevent any future disruptions to critical health care services for Tribal citizens. The organization has sent letters to both Congress and HHS detailing the critical need for uninterrupted funding to 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

OMB Announces Temporary Pause on Federal Financial Assistance Programs: Implications for Urban Indian Organizations

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FOR IMMEDIATE RELEASE

Washington, D.C. (January 28, 2025)– On January 27, 2025, Matthew J. Vaeth, Acting Director of the Office of Management and Budget (OMB) at the Executive Office of the President released a memorandum addressed to all heads of Executive Departments and Agencies with the subject line “Temporary Pause of Agency Grant, Loan, and Other Financial Assistance Programs.” The memorandum requires that Agency leadership “to the extent permissible under applicable law…temporarily pause all activities related to obligation or disbursement of all Federal financial assistance.”

Each Agency must “identify and review all Federal financial assistance programs and supporting activities consistent with the President’s policies and requirements.” To determine whether such programs and supporting activities are “consistent with the President’s policies and requirements” Department and Agency heads should refer to the series of thirty-four (34) executive orders released by the President since he took office on January 20, 2025. Relevant topics “includ[e], but are not limited to, foreign aid, nongovernmental organizations, DEI, woke gender ideology, and the green new deal.” The temporary pause becomes effective today, January 28, 2025, at 5:00 p.m. There is presently no scheduled end date for the pause. All activities related to open Notice of Funding Opportunities are subject to the pause. OMB may “grant exceptions allowing Federal agencies to issue new awards or take other actions case-by-case basis.”

Application to Urban Indian Organizations and Next Steps

Urban Indian Organizations (UIOs) receive federal funding from various sources, some, if not all, of which will be affected by the pause. Urban Indian Organizations (UIOs) are advised to discuss the potential implications of this memorandum with their finance and legal departments. Please note that federal agencies may be unable to respond to inquiries or questions. The Department of Health and Human Services has issued a pause on issuing documents and public communications until February 1, 2025.

Additional Information

The memorandum requires Federal Agencies to:

  1. Immediately identify and notify OMB of any legally mandated actions or deadlines for assistance programs that will arise during the pause.
  2. Submit detailed information of any programs, projects, or activities subject to this pause no later than February 10,
  3. Carry out the following activities for each Federal financial assistance program:
    1. Assign responsibility and oversight to a senior political appointee to ensure Federal financial assistance conforms to Administration priorities;
    2. Review currently pending Federal financial assistance announcements to ensure Administration priorities are addressed, and, subject to program statutory authority, modify unpublished Federal financial assistance announcements, withdraw any announcement already published, and, to the extent permissible by law, cancel awards already awarded conflict with Administration priorities; and
    3. Ensure adequate oversight of Federal financial assistance programs and initiate investigations when warranted to identify underperforming recipients, and address identified issues up to and including cancellation of awards.

The memorandum defines “financial assistance program” as the term is defined in 2 CFR 200.1 meaning “assistance that recipients or subrecipients receive or administer in the form of:(i) Grants;(ii) Cooperative agreements;(iii) Non-cash contributions or donations of property (including donated surplus property);(iv) Direct appropriations; (v) Food commodities; and (vi) Other financial assistance,” but clarifies that the memorandum does not apply to Social Security benefits or Medicare.

Follow-up instructions provided by OMB on Federal Financial Assistance program analysis require all Federal agencies that provide Federal financial assistance complete a spreadsheet with information on any program that has funding or activities planned through March 15th. Agency heads must submit the completed spreadsheet to OMB no later than February 7th, 2025.

About NCUIH

The National Council of Urban Indian Health (NCUIH) is a national representative advocating 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 quality, accessible health and public health services for American Indians and Alaska Natives 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.