Stronger Engagement for Indian Health Needs Act of 2025

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Bruce Westerman, AR

Republican
“Let's pass this bill right now. We should not have a long debate. We should just vote.”
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Official Congressional Record

Mr. Speaker, I move to suspend the rules and pass the bill (H.R. 741) to elevate the position of Director of the Indian Health Service within the Department of Health and Human Services to Assistant Secretary for Indian Health, and for other purposes, as amended. The Clerk read the title of the bill. The text of the bill is as follows:

Bruce Westerman, AR

Republican
“I want this bill to pass. It changes a job title in the Department of Health. This person is in charge of health services for American Indians. This is a trust responsibility of the government. This person should be able to work with other parts of the department. The bill is simple. It does not make a new job. It does not create a new program. It does not change how services are delivered. It is a small structural change. It will help coordination across the department.”
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Mr. Speaker, I yield myself such time as I may consume. Mr. Speaker, H.R. 741 is a straightforward bill to strengthen Indian health leadership within the Department of Health and Human Services. The bill redesignates the Director of the Indian Health Service as the Assistant Secretary for Indian Health within HHS. The Federal Government has longstanding responsibilities for Indian healthcare rooted in the Federal trust responsibility. The Indian Health Service is the principal Federal entity responsible for providing health services to American Indians and Alaska Natives. Indian health issues do not begin and end at IHS. Many of these issues require coordination across HHS, including healthcare access, workforce recruitment and retention, behavioral health, public health, and health infrastructure. H.R. 741 will help that coordination by elevating IHS' senior within the Department. This bill is narrowly tailored. The IHS director is already appointed by the President and confirmed by the Senate, so H.R. 741 does not create a new Senate-confirmed appointment. It does not create a new program or change how IHS delivers healthcare. Instead, this bill makes a senior-level structural change to better coordinate health issues across the Department. This is a practical and reasonable step. When Indian health issues cut across IHS, the senior official responsible for Indian health should be positioned to work across HHS. Mr. Speaker, I support H.R. 741, and I reserve the balance of my time.

Sarah Elfreth, MD

Democrat
“I support this bill. I want this bill to pass. I agree with the last speaker. We made promises to tribes. The Indian Health Service was not given enough money for a long time. It wasn't a priority. Tribal leaders want more attention for their health. The bill changes a job title. That would give this person more power. They could speak up more. They could point out problems. There are problems like not enough buildings, not enough services, and not enough workers. The government is responsible for good health services for tribes. The bill helps with that. I want you to support the bill.”
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Mr. Speaker, I yield myself such time as I may consume. Mr. Speaker, I rise in strong support of H.R. 741, the Stronger Engagement for Indian Health Needs Act, introduced by my friend and colleague from Arizona (Mr. Stanton). The Indian Health Service, or IHS, is the primary Federal agency responsible for providing healthcare to American Indians and Alaska Natives. Yet, for decades, the agency has fallen short of meeting our trust and treaty obligations as we have left IHS underfunded and underprioritized. Tribal leaders have long called for greater Federal attention to Indian health in IHS. H.R. 741 responds to their advocacy by elevating the Director of IHS to an Assistant Secretary within the Department of Health and Human Services. This simple but meaningful change would give IHS a stronger voice within the Department, ensure the healthcare needs of Tribal patients are properly represented, and elevate health disparities, including inadequate infrastructure, limited services, and staffing shortages, facing Tribal communities. It is the Federal Government's responsibility to ensure that Indian Country has the culturally competent, robust, and accessible healthcare they deserve, and H.R. 741 will help us uphold this premise. Mr. Speaker, I strongly urge support for the bill, and I reserve the balance of my time.

Bruce Westerman, AR

Republican

Linked statement

“Thank you for working on this bill. I am done talking. Let's finish now.”
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Official Congressional Record

Mr. Speaker, I thank the gentleman from Arizona (Mr. Stanton) and the ranking member for working with us on this legislation. I have no further requests for time. I am prepared to close, and I reserve the balance of my time.

Greg Stanton, AZ

Democrat
“I support my bill. We have not met our obligations to provide healthcare to Native communities. There are health disparities. Native communities have lower life expectancies and poor health. The Indian Health Service has many job vacancies. Senator John McCain proposed something similar 20 years ago. My bill elevates the IHS Director to Assistant Secretary for Indian Health at HHS. This gives Native communities a voice at senior levels. It provides pay and hiring authorities to address workforce shortages. This means faster hiring and better retention. This is a meaningful step forward. I want my colleagues to support this bill.”
70% shorter Analysis
Official Congressional Record

Mr. Speaker, I rise in support of my bipartisan bill, H.R. 741, the Stronger Engagement for Indian Health Needs Act. Mr. Speaker, I thank my colleague from Ohio (Mr. Joyce) for co- leading on this important effort. The Federal Government has a sacred trust obligation to provide healthcare to our Native communities. For far too long, we have fallen short of that obligation. Deep disparities exist between the health of American Indian, Alaska Native, and Native Hawaiian communities and the broader American population. American Indians and Alaska Natives have lower life expectancies and some of the highest rates of poor health across racial groups. Access and quality of care are impacted by high vacancies at Indian Health Service facilities. When it comes to equality in healthcare, our Nation has a long way to go. Mr. Speaker, 20 years ago, the late Senator John McCain first tried to pass a similar measure to raise the Director of the IHS to an Assistant Secretary role within the Department of Health and Human Services. Senator McCain, who advanced this measure through the Senate time and time again, never saw it pass the House and signed into law. Today, this bill honors his legacy. This is a commonsense, bipartisan policy, and Congress should have gotten it done many years ago. H.R. 741 would finally get this across the finish line. It creates the position of Assistant Secretary for Indian Health at HHS, giving Native communities a voice at the highest levels of Department leadership. This matters. As an Assistant Secretary, the head of IHS would finally have the pay and hiring authorities needed to tackle chronic workforce shortages and disparities in access to care. It means faster hiring, better retention, and a direct line to the Secretary on every matter affecting Indian health. Congress must ensure our health systems better honor our trust obligations to Native communities. This is a meaningful step forward, and I urge my colleagues to support this bill.

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