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Oregon’s U.S. Senator Jeff Merkley and Congresswoman Chellie Pingree (ME-01), the top Democrats on the subcommittees that oversee funding for the Indian Health Service (IHS), demanded urgent action from the U.S. Department of Health and Human Services (HHS) to stop dangerous cuts to the IHS workforce, which is already facing huge challenges and staffing vacancies.

As Ranking Members of the Senate and House Interior Appropriations Subcommittees, Merkley and Pingree wrote to HHS Acting Secretary Dorothy Fink after President Donald Trump issued a hiring freeze, proposed buyouts for federal workers, and illegal executive orders that will amount to cutting the federal health care workforce. Together, these dangerous actions jeopardize Indigenous communities’ access to the health care they need and deserve while undermining the federal government’s ability to meet its trust and treaty obligations to Tribes.

“Freezing the hiring of critical staff positions and attempts to diminish the workforce at the IHS poses a grave threat to the vital medical services provided to American Indians and Alaska Natives – including emergency services, maternity care, and cancer treatments. The IHS is already plagued by chronic underfunding and significant staffing shortages, and this hiring freeze and attacks on the federal workforce impacts its ability to fill vacancies for the medical professionals and staff needed to keep critical facilities and programs operating,” Ranking Members Merkley and Pingree stated.

“These actions are exacerbating the current difficulties IHS is confronting to meet the health care needs of Native American communities,” the senior Appropriators pointed out. “For example, IHS medical facilities regularly face significant vacancy rates for physicians, nurses, and other key clinical providers. Last year, IHS experienced nearly 2,000 vacancies, and a 2018 Government Accountability Office (GAO) report found that IHS had an overall health care provider vacancy rate of 25 percent across service areas. These vacancies negatively impact the receipt of quality and timely health care, employee morale, and force facilities in many Tribal communities to reduce access to critical medical care, including behavioral and mental health care, that is needed to address the substance use and suicide crises plaguing Indian Country and Alaska Native villages. Further disruption in staffing could push IHS beyond its breaking point, potentially leaving thousands without access to critical care.”

The lawmakers demanded, “The federal government must honor its trust responsibility to Tribal Nations. We urge you to advocate for the revocation of this hiring freeze and stop the onslaught on health care professionals. The health care of millions of Native Americans and Alaska Natives hangs in the balance.”

Full text of the letter can be found by clicking here and follows below:

Dear Acting Secretary Fink:

The hiring freeze imposed on January 20, 2025, the deferred resignation and early retirement offers, and efforts to cut the federal health workforce violate Congressional direction to implement programs and activities funded through appropriations. We strongly oppose these efforts to denigrate the federal health care workforce and are concerned that it will negatively impact the Indian Health Service’s (IHS) ability to deliver health care. We urge you to lift the hiring freeze, officially rescind the deferred resignation and early retirement offers, and instead work to strengthen and grow the Indian Health Service to best meet the health and wellness needs of American Indians and Alaska Natives in accordance with our trust and treaty responsibilities.

Freezing the hiring of critical staff positions and attempts to diminish the workforce at the IHS poses a grave threat to the vital medical services provided to American Indians and Alaska Natives – including emergency services, maternity care, and cancer treatments. The IHS is already plagued by chronic underfunding and significant staffing shortages, and this hiring freeze and attacks on the federal workforce impacts its ability to fill vacancies for the medical professionals and staff needed to keep critical facilities and programs operating.

These actions are exacerbating the current difficulties IHS is confronting to meet the health care needs of Native American communities. For example, IHS medical facilities regularly face significant vacancy rates for physicians, nurses, and other key clinical providers. Last year, IHS experienced nearly 2,000 vacancies, and a 2018 Government Accountability Office (GAO) report found that IHS had an overall health care provider vacancy rate of 25 percent across service areas. These vacancies negatively impact the receipt of quality and timely health care, employee morale, and force facilities in many Tribal communities to reduce access to critical medical care, including behavioral and mental health care, that is needed to address the substance use and suicide crises plaguing Indian Country and Alaska Native villages. Further disruption in staffing could push IHS beyond its breaking point, potentially leaving thousands without access to critical care.

We also remind you of the critical and unique relationship the federal government has with American Indians and Alaska Natives. This relationship, grounded in a federal trust responsibility rooted in the United States Constitution, treaties, and countless federal laws and policies, has resulted in a protected legal status of Tribal Nations as political entities rather than a racial class. As such, the federal government acts as a trustee and has charged itself with moral obligations of the highest responsibility and trust towards Indian Tribes, and in doing so, has established programs and services necessary to fulfill its trust and treaty obligations. Federal courts have consistently recognized this and upheld this distinct and legal political status, particularly regarding the provision of health care to American Indians and Alaska Natives.

Central to this trust responsibility is the health care provided through the IHS, which serves as the primary health care provider for 2.8 million American Indians and Alaska Natives. The IHS has long been foundational in ensuring the well-being of Indigenous communities across the nation.

The federal government must honor its trust responsibility to Tribal Nations. We urge you to advocate for the revocation of this hiring freeze and stop the onslaught on health care professionals. The health care of millions of Native Americans and Alaska Natives hangs in the balance.

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