Window Rock, Arizona. - Navajo national leaders took turns talking to top health officials in the U.S. government, who hiked along sandstone ridges overlooking the small towns of the countryside, high towns, and then the morning sun was too hot.

Navajo Nation President Buu Nygren stops on the edge Secretary of Health and Human Services Robert F. Kennedy Jr. Below them, tribal government buildings, houses and juniper trees are scattered with tan and crimson views.

Nygren said he wanted Kennedy to view the capital of the country with about 400,000 members. The tribal president pointed to an outdated health center and he hopes federal funding will help replace the lives of thousands of locals without running water due to delays in government projects.

Nygren said Kennedy has done a lot, mainly to save Indian health services and stand out from a round of staff layoffs.

"You are the first person to stand in the Indian country when we start hearing about layoffs and freezing," he told Kennedy.

But Nygren and other Navajo leaders say cuts in federal health plans outside India’s Health Service are harming Native Americans.

"You are destroying real life," Navajo Commission Representative Cherilyn Yazzie told KFF Health News, who described the recent changes.

Kennedy has repeatedly promised to prioritize Native American health care. But Native American and health officials in tribal countries say the proposals are overshadowed by the collateral harms of massive cuts to federal health plans.

The massive reductions have resulted in funding cuts targeted or disproportionately relying on Native Americans. Tribal Health leaders say staff cuts lead to data loss and poor communication.

The Indian Health Service provides free health care to Native Americans in its hospitals and clinics, and as a group, they face higher rates of chronic illness than chronic illnesses, and deaths are younger than others. These inequality is attributed to centuries of systematic discrimination. But many tribal members do not live near agency clinics or hospitals. Those who do so may face limited services, long-term underfunding and staffing shortages. To address these gaps, WHO relies on other federally funded programs.

"In some governments, there may be misunderstandings that Indian countries are only affected by changes from the Indian Health Service," said Liz Malerba, a tribal policy expert and a tribal citizen of the Mohgen tribe. "This is not true at all."

The National Health Commission of India wrote in a letter to Kennedy that the tribe lost more than $6 million in grants from other HHS institutions.

The grants are paid to community health workers, vaccinations, data modernization and other public health efforts, Janet Alkire, the president of the Dakota resident Rock Tribe, said during a May 14 Senate Committee hearing.

The administration also lifted funding for the program, saying it violated President Trump's ban on "diversity, equity and inclusion," which included one targeting Native American youth interested in science and medicine, and another helping multiple tribes increase opportunities for healthy food -- Kennedy said he wanted to prioritize.

Tribal health officials say cutting federal staff makes it difficult for them to get technical support and funding for federally funded health programs they operate.

Shooting has cut or eliminated plans to prevent overdoses from tribal communities, use traditional food and medicine to fight chronic diseases, and help low-income people afford to heat and cool homes through low-income household energy programs.

The Oglala Sioux tribe is in South Dakota, where Native Americans who work to heat their homes die of hypothermia. Tribe Chief of Staff John Long said the tribe was unable to obtain the latest installments of funds from the energy program through mid-May.

Abigail Echo-Hawk, director of the Indian Health School of Urban India, Seattle, said the government has sent incomplete health data to her organization. These include statistics on risk of suicide and substance use disorders, which the center uses to shape public health policies and programs.

"People will die because we can't access the data," Echo-Hawk said.

She said her organization also has difficulty managing a $2.2 million federal grant because the agency handles currency employees she works with. The grant pays for public health programs such as smoking cessation and vaccination.

"It is confusing to say that preventing chronic diseases is the first priority and then eliminating the support needed to address chronic diseases in India's country," Echo-Hawk said.

HHS spokesman Emily Hilliard said Kennedy’s goal is to combat chronic disease and improve Native American happiness “through culturally relevant, community-driven solutions.”

Hilliard did not answer questions about Kennedy’s specific plans for Native American health, or concerns about existing and proposed changes in funding and personnel.

When Kennedy hiked with the Navajo National Leader, KFF Health News asked him how he would improve and protect the tribal communities within the department to access care.

"That's exactly what I'm doing," Kennedy replied. "Make sure all the cuts don't affect these communities."

Kennedy said his focus on Native American health stems from personal and family experiences, which he repeated to the Navajo leadership. As a lawyer, he worked with the tribe in an environmental health lawsuit. He also served as editor of the Native American news media ICT.

The secretary said his uncle, President John F. Kennedy, and his father, U.S. Attorney General Robert F. Kennedy, were also affected when Robert F. Kennedy Jr. was a kid.

"If we don't look back first, remedy or mitigate the original sins experienced by the United States, it's a genocide of the natives who will never live up to their moral authority and their role as a model nation around the world," Kennedy said during his visit.

Some tribal leaders say recent cuts and the way governments have made them violate the treaty, and the United States promises to provide a basis for the health and welfare of the tribe in exchange for land.

"We have not yet consulted meaningfully on these actions," said Maleba, director of policy and legislative affairs for the United Southern and Eastern Tribal Sovereignty Protection Fund.

Argil said at a congressional hearing that many Native American health organizations sent letters to the health department asking for consultations, but no one received a response.

Tribal consultation is legally required when federal agencies pursue changes that have a significant impact on tribal states.

"It's not just a moral issue that we owe indigenous peoples," Senator Brian Schatz (D-Hawaii) said at the hearing. "It's also a matter of law."

Tribal leaders are concerned about other proposed changes, including cutting funding for Indian health services and a restructuring of the federal health sector.

Esther Lucero, president and CEO of the Seattle India Health Commission, said the exercise reminded her of the level of daily uncertainty she worked in the Covid-19-19 pandemic, but with fewer resources.

"Our ability to serve those who are desperately in need is dangerous," Lucerro said.

One of the most pressing concerns is the proposal of Congressional Republicans to cut Medicaid, a major government health insurance program for people with low income or disabilities.

About 30% of Native Americans and Alaska Natives under the age of 65 participate in Medicaid, a program that helps keep Indian health services and other tribal sanitation facilities alive.

Native American adults will be exempt from Medicaid job requirements It was approved by House Republicans on May 21.

After Kennedy reached the top of the window rock with the leaders of the Navajo Nation, the tribe held a prayer ceremony, and they blessed him at the Diné Bizaad in Navajo. President Nygren stressed how meaningful it is for the country’s health minister to go with them. He also reminded Kennedy of the list of priorities they discussed. This includes maintaining the federal low-income energy assistance program.

"We look forward to rebuilding and protecting some of the services that your department provides," Nygren said.

As of mid-May, the Trump administration proposed to cancel the energy program, which has not been supported.

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