Amelia Schafer
ICT
Two senators introduce a bill elevating the Indian Health Services director to assistant secretary for Indian health within the Department of Health and Human Services Tuesday morning.
U.S. Sens. Catherine Cortez Masto, D-Nevada, and Mike Rounds, R-South Dakota, introduced the Stronger Engagement for Indian Health Needs Act with the goal of improving health outcomes in tribal communities. To do this, they proposed an upgrade of IHS’s top position.
Currently, the IHS director position lacks certain authorities critical for the recruitment and retention of doctors, nurses and other essential IHS employees, the press release states.
If those decisions need to be made at present, then the IHS director would need to relay that information to and receive approval from the assistant secretary of health, who does not fall under IHS and doesn’t have the background and training to make those choices, said Sen. Cortez Masto’s office. It can create delays and worse situations.
Senators said that by elevating the position to assistant secretary in HHS would give IHS more authority, especially when it comes to new hires and advocating for health disparities in Indian Country as a whole without going through someone else.
If passed, the assistant secretary for Indian health would report directly to Secretary of Health and Human Services Robert F. Kennedy Jr.
IHS has recently struggled with employee retention, especially following the “Fork in the Road” memo allowing for early retirements among government employees.
More than 1,000 IHS employees left the department in 2025 through early retirement offers or voluntary termination, said National Indian Health Board Chief Executive Officer A.C. Locklear, Lumbee during a Senate Committee on Indian Affairs hearing in October.
On Jan. 29, IHS announced its largest hiring effort in agency history, aiming to hire more doctors, dentists, administrators, mental health providers and more. The initiative’s immediate focus will be on filling vacancies, a news release said.
Nevada has five IHS clinics and South Dakota has over 10 facilities (including 638 contract facilities).
“The shockingly unequal health outcomes in Indian Country paint a clear picture: our country has failed to live up to our obligation to provide quality health care for Tribal communities,” said Sen. Cortez Masto in a statement. “This bipartisan legislation would be an important step toward giving IHS the tools and authority it needs to ensure everyone has access to excellent, affordable health care.”
The bill is endorsed by the National Congress of American Indians, the National Indian Health Board, the National Council of Urban Indians and the Reno-Sparks Indian Colony, the senators said.
Companion legislation has been introduced in the House of Representatives by Reps. Greg Stanton, D-Arizona, and David Joyce, R-Ohio.