Press Releases

WASHINGTON, D.C. –Following recent reporting that new, internal policies in the Trump Administration — implemented via presidential executive orders and the President’s so-called “Department of Government Efficiency” (DOGE) — are delaying and reducing patient care at Gallup Indian Medical Center, U.S. Representative Teresa Leger Fernández (D-N.M.) and U.S. Senator Martin Heinrich (D-N.M.) formally invited Mark Cruz, a Tribal citizen of the Klamath Tribes and Senior Advisor to Department of Health and Human Services (HHS) Secretary Robert F. Kennedy, Jr., to visit Gallup Indian Medical Center and witness firsthand how the Administration's bureaucratic red tape is limiting access to basic and essential health care services like ultrasounds and emergency care.

Leger Fernández and Heinrich's invitation comes as an immediate follow-up to an earlier letter sent by members of the New Mexico Congressional Delegation, where the lawmakers praised the hard working health professionals at Gallup and demanded answers from Department of Health and Human Services (HHS) Secretary Robert F. Kennedy, Jr. and Indian Health Service (IHS) Acting Director Benjamin Smith upon learning that medical services at the hospital had been significantly suspended or reduced.

The New Mexico lawmakers continue to cite a new “Presidential Appointee Approver and Departmental Efficiency Review” (PAA-DER) policy that is causing delays in standard contract renewals for essential personnel, equipment, and services at Gallup Indian Medical Center. The burdensome process restricts the ability of health care workers to immediately diagnose and treat urgent conditions, including maternal and emergency care.

“We remain extremely concerned by the devastating impacts of the Department of Government Efficiency’s (DOGE) policies on primary and emergency care services at Gallup Indian Medical Center (GIMC) in Gallup, New Mexico,” Leger Fernández and  Heinrich wrote.

Leger Fernández and Heinrich continued, “President Trump’s February 26th Executive Order, entitled “Implementing the President’s ‘Department of Government Efficiency’s Cost Efficiency Initiative,” instituted the Presidential Appointee Approver and Departmental Efficiency Review (PAA DER) process. It requires all Indian Health Service (IHS) facilities to have all contracts and related expenses approved by the Acting Director of IHS. And it was implemented without necessary technical assistance or guidance to health facilities. As you know, IHS relies heavily on contracts for everything, from lab work to paying travel doctors and nurses. Prior to the implementation of this new policy, approvals for contracts were largely done locally at the hospital.

“The new policy has dramatically and dangerously slowed down care at GIMC and brought some essential services to a halt entirely. While you have publicly stated that it ‘has not interrupted the IHS's ability to fulfill any responsibilities,’ our offices have received numerous reports to the contrary. Specifically, we understand that GIMC has slashed the number of beds available and scaled back maternal and emergency care,” the lawmakers stated, underscoring the worsening conditions at the hospital due to the Administration’s new burdensome red tape.

Additionally, Leger Fernández and Heinrich emphasized how the new DOGE policy violates Tribal trust and treaty obligations, writing, “Trust and treaty obligations require the federal government to adequately fund and staff IHS hospitals, including GIMC.”

The lawmakers concluded their letter by inviting HHS Senior Advisor Cruz to visit GIMC to observe these worsening conditions at the hospital firsthand, “While in Gallup, you can hear firsthand from local leaders, patients, health care providers, Tribal officials, and community members about the situation at the hospital. And you can see how bureaucratic red tape is limiting access to essential health care services in this community.”

Read the full letter here and below:

Dear Mr. Cruz,

We remain extremely concerned by the devastating impacts of the Department of Government Efficiency’s (DOGE) policies on primary and emergency care services at Gallup Indian Medical Center (GIMC) in Gallup, New Mexico.

President Trump’s February 26th Executive Order, entitled “Implementing the President’s ‘Department of Government Efficiency’s Cost Efficiency Initiative,” instituted the Presidential Appointee Approver and Departmental Efficiency Review (PAA DER) process. It requires all Indian Health Service (IHS) facilities to have all contracts and related expenses approved by the Acting Director of IHS. And it was implemented without necessary technical assistance or guidance to health facilities.

As you know, IHS relies heavily on contracts for everything, from lab work to paying travel doctors and nurses. Prior to the implementation of this new policy, approvals for contracts were largely done locally at the hospital.

The new policy has dramatically and dangerously slowed down care at GIMC and brought some essential services to a halt entirely. While you have publicly stated that it “has not interrupted the IHS's ability to fulfill any responsibilities,” our offices have received numerous reports to the contrary. Specifically, we understand that GIMC has slashed the number of beds available and scaled back maternal and emergency care.

The inherent sovereignty of Tribes is recognized in the U.S. Constitution, in treaties, and across many federal laws and policies, and it has been consistently upheld by the U.S. Supreme Court. These trust and treaty obligations require the federal government to adequately fund and staff IHS hospitals, including GIMC.

We extend an invitation to you to visit GIMC. While in Gallup, you can hear firsthand from local leaders, patients, health care providers, Tribal officials, and community members about the situation at the hospital. And you can see how bureaucratic red tape is limiting access to essential health care services in this community.

We look forward to hearing back from you and joining you at GIMC.

Sincerely,

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