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Tribal advocates and lawmakers back elevating IHS director to assistant secretary to boost Indian health focus
Summary
Supporters of H.R. 741 told a House subcommittee elevating the Indian Health Service director to an assistant secretary position at HHS could give tribal health issues a direct line to the HHS secretary, strengthen hiring and pay authorities, and improve interagency coordination — but proponents said Congress must also fund IHS adequately.
The House Natural Resources Subcommittee on Indian and Insular Affairs heard testimony in favor of H.R. 741, the Stronger Engagement for Indian Health Needs Act of 2025, which would elevate the director of the Indian Health Service (IHS) to an assistant secretary position within the Department of Health and Human Services.
A.C. Locklear, identified as Interim Chief Executive Officer of the National Indian Health Board, told the subcommittee that elevating the IHS director “would raise the priority and presence of Indian health matters within HHS and the federal government.” Locklear said the change would make the office a principal advisor to the HHS secretary on Indian health and provide operational authorities — such as hiring and pay flexibilities — that are typically reserved for assistant secretaries.
Locklear and members cited chronic underfunding and workforce shortages at IHS. Testimony described IHS as an agency that oversees roughly 15,000 employees and noted long‑standing health disparities: testimony referenced CDC findings that life expectancy for American Indian and Alaska Native people has declined and cited a 2018 U.S. Commission on Civil Rights finding that federal funding remains inadequate.
Members and witnesses said elevation alone would not solve funding shortfalls. Locklear urged Congress both to elevate the post and to provide appropriate funding so an assistant secretary could carry out expanded coordination and hiring authorities. Committee members noted bipartisan precedent for similar elevations when Congress raised leadership for SAMHSA in 2016.
Lawmakers questioned how an assistant secretary would affect interagency coordination; Locklear said a direct line to the HHS secretary would make it easier to coordinate across HHS divisions and with agencies such as CDC and HRSA on issues ranging from infectious diseases to behavioral health.
The subcommittee held the hearing and solicited written follow‑up but took no final vote.
