One of the most important principles of federal Indian law is the trust responsibility that the U.S. government has toward tribal nations. Tribes gave over billions of acres of land and its resources to the United States, often under duress. In return, the federal government took on a legal obligation in perpetuity to safeguard the well-being of tribes and of Indian people.
Tribes have kept up our end of the bargain, but it has been a long and slow process to ensure that the federal government upholds theirs. One vital aspect of this is securing essential health care services for tribal citizens. Our treaties and the trust responsibility guarantee tribal citizens access to quality health care, because we have prepaid for that health care by the loss of our homelands.
Cherokee Nation has long been an Indian Country leader in both securing health care from the federal government and providing that care ourselves. Today, we run the largest tribally operated health care system in the United States, with more than 1.4 million patient visits annually. Most recently, we opened a world-class outpatient health center in Tahlequah as well as the first-ever tribally affiliated medical school on reservation lands.
As we operate these exceptional facilities and programs, we also pay close attention to policy developments on the federal level that may impact Cherokee people. Recently, I participated in a meeting of the U.S. Health and Human Services Secretary’s Tribal Advisory Committee (STAC). The STAC is a group of tribal leaders who regularly meet directly with the leaders of health and human services agencies, from Indian Health Service to the Centers for Medicare and Medicaid Services and all other agencies under HHS Secretary Xavier Becerra.
During the STAC meeting, I spoke with federal leaders on many issues, including how to ensure that American Rescue Plan funds for public health are reaching tribal nations, how to give tribal governments access to the data we need to protect the health of our people, and how to improve our working relationships with federal health agencies.
In addition to my participation in the STAC, Cherokee Nation Deputy Chief Bryan Warner has been a leader on the Center for Disease Control’s Tribal Advisory Committee (CDC TAC). He has served on this committee since 2017, previously served as co-chair, and last month was elected chair. Under Deputy Chief Warner’s leadership, the CDC TAC brings the perspectives of tribal leaders to the leaders and staff within this key federal agency. As we together battle the COVID-19 pandemic, this collaboration has become even more important.
The federal government has never fully met its trust responsibility to ensure that all citizens of tribal nations have quality health care. Indian Health Service is perpetually deeply underfunded. And for many other federal programs, tribes are not given the equal access we should have as sovereign nations that are not subordinate to any state or local government.
However, we have made a lot of progress over the years on a bipartisan basis. During the Trump administration, we held HHS to its word for initial operational funding of our joint venture outpatient facility in Tahlequah, the largest in Indian Country. During the Biden-Harris Administration, that progress continues. President Biden’s fiscal year 2022 budget includes advance appropriations for the IHS for the first time in history. Additionally, it includes plans to begin evaluating options for mandatory funding for IHS. This will ensure that government shutdowns do not impact our ability to deliver health care to our citizens, because no one should go without critical health services because of politics in Washington, D.C.
Cherokee Nation is in the rooms where this important dialogue is happening, and we continue to bring pressure on the federal government to live up to its promises. With our government relations team, led by Cherokee Nation Delegate to Congress Kim Teehee, we are also deeply engaged in persuading federal lawmakers to pass budgets and policies that do right by Indian Country.
I am proud of the work we’ve done to protect the health of Cherokee people. With a strong federal partner in the Biden-Harris Administration, I know the best is yet to come.
Chuck Hoskin Jr.