Rural tribal clinics like Stockbridge-Munsee Health and Wellness Center provide medical services to tribal and community members, but proposed spending cuts to the Indian Health Service — the federal agency that provides tribal medical services across the country — to Medicare and Medicaid would cut across all Wisconsin’s 11 federally recognized tribes.

“It's not just a budget,” says Shannon Holsey, President of the Stockbridge-Munsee Band Of Mohican Indians, “it’s a trust in treaty responsibility that the United States has entered into with tribal nations for what was taken, and what was supposed to be returned, and the loss of our land. That is the unique relationship that exists and the agreements that were entered into between the United States and tribal nations.”

While the proposed $8 billion budget for IHS is an increase, Holsey says the package lacks advanced appropriations that are needed for funding predictability.

“One of the essential threats of this Big Beautiful Bill is that they're going to strip the advanced appropriations, and we're going back into a dysfunctional cycle,” Holsey shares.

Funding the tribe's health center is complex. “It costs our nation about $16 million to operate it annually. Of that, in it, it's multifaceted in the resources that come, a mix of both private insurance and Medicare,” explains Holsey.

27 percent of the tribal clinic's funding comes from Medicare and Medicaid, according to the Congressional Budget Office. The proposed bill would reduce federal Medicaid by $793 billion.

“We have a responsibility to our citizens as a sovereign nation, so it's going to be up to our tribal government to come up with that offset to meet the basic needs and to manage,” Holsey asserts.

According to Holsey, some of the health concerns that tribal members are facing in the community include disproportionate rates of people being diagnosed with heart disease, diabetes and cancer. She describes cancer rates as, “alarming.” “And as you can imagine, that will tax your healthcare systems,” she says.

The bill also proposes adding job requirements to Medicaid. Hulsey says she's concerned that Wisconsin's rural tribal communities could disproportionately lose coverage because of additional hurdles to accessing health care. “There hasn't been a well thought out plan in terms of how that is accessed, but really what we're talking about is a human rights issue,” she cautions.

Holsey says there's room for compromise in the proposed federal spending and tax bill but, for her, access to health care for Wisconsin's 43,000 tribal population is non-negotiable.

Holsey argues, “We also have a responsibility as tribal nations to make sure the federal government upholds our trust in treaty responsibility, and robustly engage and remind the United States government and others that as sovereign nations they have a responsibility to tribal nations.”