Senate confirms Mark Cruz as new head of Indian Health Service amid chronic staffing and facility woes

The U.S. Senate voted 51-47 to confirm Mark Cruz, a citizen of the Klamath Tribes, as director of the Indian Health Service, a post that has been empty since late 2025. Cruz, who currently advises Health Secretary Robert F. Kennedy Jr. on tribal health, said he will advocate ferociously for improved outcomes in Indian Country, emphasizing the personal stakes for his family and community. The IHS, responsible for the health care of about 2.8 million Native American and Alaska Native individuals, operates 21 hospitals and 78 health centers, many of which are around four decades old and one-third are classified as being in poor condition.

The agency also struggles with high provider vacancy rates and a three-decade backlog of facility replacements. Cruz intends to address these challenges, protect tribal health programs from federal budget impasses, and fund the overhead costs tribes bear when managing their own care. The National Congress of American Indians and the National Indian Health Board praised the confirmation, noting the agency’s estimated $73 billion need versus the $8 billion appropriated for fiscal year 2026.