Lawmakers Grill Indian Health Service Leader on Failing Care

The Indian Health Service’s top official dodged frustrated lawmakers’ questions about unsafe care at the federal agency and whether proposed budget cuts would worsen the situation during a tense Senate committee hearing Wednesday.

Members of the Senate Indian Affairs and Senate Appropriations committees repeatedly cited two articles published last week in The Wall Street Journal on the agency, which provides health care to 2.2 million tribal members. The articles examined agency-run hospitals that failed to meet basic U.S. standards and employed doctors who are now accused of crimes, while the IHS’s political leaders focused on other priorities.

The Journal identified 11 patients who U.S. regulators asserted had died in connection with insufficient treatment by the agency.

“You say that the goal here is to improve the patient experience,” Sen. Lisa Murkowski (R., Alaska) told the newly appointed acting IHS director, Rear Adm. Michael Weahkee. “Well, the experience is people are dying in these facilities.”

Before reading aloud details of The Journal articles, she said: “I was horrified. I was sickened. I was mad.”

Adm. Weahkee responded that he had visited the agency’s Pine Ridge hospital, one of several troubled facilities examined in The Journal’s reporting, shortly after his June appointment to the post. He said he “saw a committed caring workforce that is working hard” to address problems federal hospital regulators identified there.

Ms. Murkowski repeatedly pushed Adm. Weahkee, an officer in the U.S. Public Health Service Commissioned Corps and a career IHS official, to acknowledge whether proposed budget cuts for next year would affect the agency’s ability to resolve problems at its hospitals. Since 2015 U.S. regulators have sanctioned several IHS hospitals for dangerous care.

President Donald Trump’s budget would cut about $300 million in agency funding, including supplemental funding added to the 2017 budget by Congress earlier this year. That is a 6% cut from the $5.1 billion lawmakers appropriated for this year.

Adm. Weahkee responded that the IHS had focused “a lot of efforts” on the hospitals identified in The Journal article, and said, “We appreciate the resources” Congress had made available.

Ms. Murkowski chided him for having “not directly answered the question.” She said: “I can’t stand down knowing our system is failing so many of our Native people around the country.”

The IHS directly runs 26 hospitals and provides funding for more that are run by tribes. Its facilities in the Dakotas and Nebraska have faced mounting scrutiny in recent years and were the focus of The Journal stories. However, tribes around the country are raising alarm about care at the agency’s other facilities.

On Thursday, the Navajo Nation will host a hearing in Tuba City, Ariz., on concerns about IHS facilities there. The Navajo Nation is the largest U.S. Indian reservation and makes up the IHS’s largest service area.

The pressure at Wednesday’s Senate hearing came from both parties. Sen. Jon Tester, a Montana Democrat, repeatedly pressed Adm. Weahkee to acknowledge whether, after years serving as an official at the IHS, he was aware of the agency’s challenges with maintaining facilities, recruiting staff and providing adequate care.

Mr. Tester also pressed Adm. Weahkee to say whether budget cuts proposed in Mr. Trump’s 2018 budget would reduce the agency’s resources available to hire staff, but the admiral demurred, saying the agency’s “priority has been to ensure we can continue to provide direct health services.”

That appeared to agitate Mr. Tester, who said: “All I want is some damn answers. This is an unbelievable hearing.”

Several members in both parties also pressed Adm. Weahkee to provide data showing how a Medicaid expansion under the 2010 Affordable Care Act had affected revenue at IHS hospitals, which can also bill federal health programs for services they provide. About a fifth of the agency’s budget comes from such billing, and a Republican effort to repeal or replace that law could strip a portion of that.

Adm. Weahkee said he didn’t have any information available, but pledged to provide it later.

Sen. Tom Udall (D., N.M.) asked whether IHS had discussed the possible impact that action on the health law could have on the agency with the White House or Congressional Republican leadership. Adm. Weahkee responded that IHS hadn’t been consulted on proposed plans.

Adm. Weahkee’s posting is temporary. The Trump administration hasn’t appointed a permanent agency head.

After the hearing, Adm. Weahkee said in a statement to The Journal, “We welcome the opportunity to work with the Committee and will continue our communication with the members to include responding with the information requested during today’s hearing.”

In a display of the bipartisan frustration with the agency at Wednesday’s hearing, Sen. Steve Daines (R., Mont.) suggested renaming it, “Indian Health Suffering.”