One of the most important principles of Indian federal law is the trust responsibility the US government has in tribal nations. Tribes gave over billions of acres of land and their resources to the United States, often under duress. In return, the federal government took on the legal obligation in perpetuity to protect the welfare of tribes and Indians.
The tribes have respected our end of the bargain, but it has been a long and slow process to ensure that the federal government respects theirs. One of the essential aspects of this is to ensure essential health services for tribal citizens. Our treaties and fiduciary responsibility ensure that tribal citizens have access to quality health care, because we have prepaid for this health care through the loss of our native lands.
The Cherokee Nation has long been a leader among Indian countries both in obtaining health care from the federal government and in providing that care ourselves. Today, we run the largest tribal-operated healthcare system in the United States, with over 1.4 million patient visits per year. Most recently, we opened a world-class ambulatory health center in Tahlequah as well as the very first tribal-affiliated medical school on reserve lands.
As we operate these exceptional facilities and programs, we also pay close attention to policy developments at the federal level that may impact the Cherokee. Recently, I attended a meeting of the Tribal Advisory Committee of the Secretary of Health and Human Services. STAC is a group of tribal chiefs who regularly meet directly with the heads of health and social service agencies, from the Indian health service to Medicare and Medicaid service centers and all other agencies under the leadership of HHS Secretary Xavier Becerra .
During the STAC meeting, I discussed with federal leaders many issues including how to ensure that US public health bailout funds reach tribal nations, how to give tribal governments access to data what we need to protect the health of our people, and how to improve our working relationship with federal health agencies.
In addition to my involvement with STAC, Cherokee Nation Deputy Chief Bryan Warner was a leader of the Center for Disease Control Tribal Advisory Committee. He has served on this committee since 2017, previously as co-chair, and last month was elected chair. Under Warner’s leadership, the TAC CDC brings the perspectives of tribal chiefs to the leadership and staff of this key federal agency. As we fight the COVID-19 pandemic together, this collaboration has become even more important.
The federal government has never fully fulfilled its fiduciary responsibility to ensure that all citizens of tribal nations have quality health care. Indian Health Service is perennially profoundly underfunded. And for many other federal programs, tribes do not have the equal access that 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 bipartite basis. During the Trump administration, we kept our word at HHS for initial operational funding for our joint venture ambulatory care facility in Tahlequah, the largest in the Indian country. During the Biden-Harris administration, this progress continued. President Biden’s FY2022 budget includes cash advances for the IHS for the first time in history. In addition, it includes plans to begin evaluating IHS mandatory funding options. This will ensure that government shutdowns do not affect our ability to provide health care to our citizens, as no one should go without essential health services because of politics in Washington, DC.
The Cherokee Nation is present in the rooms where this important dialogue takes place, and we continue to press the federal government to keep its promises. Along with our government relations team, led by Cherokee Nation Delegate to Congress Kim Teehee, we are also deeply committed to persuading federal lawmakers to adopt budgets and policies that are suitable for Indian countries.
I am proud of the work we have done to protect the health of the Cherokee. With a strong federal partner in the Biden-Harris administration, I know the best is yet to come.
Chuck Hoskin Jr. is the chief leader of the Cherokee Nation.