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The grim prospects of the Indian Health Service under Trump

Fan Fei / Modern Healthcare

The Indian Health Service has battled mismanagement and underfunding for several years, and it's unlikely President Trump's administration will lend a helping hand soon.

The bottom line: The IHS network of hospitals and clinics exclusively treats Native Americans who are in federally protected tribes, and many tribal leaders have traveled to D.C. to beg Congress for help to improve a system they say is riddled with substandard care. Congress is attempting to pass legislation to help employee recruitment and retention within IHS. But don't expect larger meaningful changes to the system, considering Trump's 2018 budget would cut IHS funding by $56 million.

What's happening in Congress: The Senate is again proposing a bill that would help remove problematic IHS employees and improve employee recruitment by allowing IHS to boost pay scales and repay student loans. The Senate will hold a hearing on the bill June 13.

The first iteration of this bill popped up a year ago. A spokesperson for the Senate Indian Affairs Committee said the Trump administration is looking over the legislation, and so far "feedback has been generally positive." This comes several months after a Senate staffer said the committee had to "make sure the Trump administration also supports a reform-focused bill."

Reality check: Even if the Senate bill passes, the Trump administration has made it clear it would cut financial support for IHS. The budget, for instance, would eliminate a grant program that helps tribes take over their IHS facilities. And in areas where IHS would gain additional funding, the increased rate would fall short of inflation. Frustration within Native American communities is real.