January 22, 2025
Letter from the Coalition of Large Tribes
Dear Chairmen Crapo and Cassidy and Ranking Members Wyden and Sanders,
I write as Chairman of the Coalition of Large Tribes (COLT)—an intertribal organization representing the interests of the more than 50 tribes with reservations of 100,000 acres or more, encompassing more than 95% of the Indian Country lands and more than half the Native American population—to deliver COLT’s highest endorsement of Robert F. Kennedy, Jr.’s nomination to serve as the Secretary for Health and Human Services.
The HHS Secretary is the chief steward of the United States’ Treaty and trust obligations to provide healthcare services to Indian tribes, encompassing both the Indian Health Service and the Administration for Native Americans within the Office of Children and Families. From our perspective, Mr. Kennedy is the most qualified nominee there has ever been, from any Administration, to carry that mantle of responsibility. He has been a stalwart advocate for tribes, clearly understanding and respecting tribal sovereignty. We know he cares deeply about the health and wellness of Native American people.
In March 2024, Mr. Kennedy came to a COLT membership meeting and spent a half a day with tribal leaders. For some, it was a reunion—Mr. Kennedy has broad and deep relationships with COLT-member tribes, including Lakota tribes his father and uncles championed in their public service careers. Mr. Kennedy was himself ceremonially named as a child and so too, had each of children ceremonially named. Throughout his life, he has been a respectful student of tribal cultures and a champion for tribal governments working to improve the health, environmental conditions, and food sovereignty for our citizens.
For some COLT tribes, Mr. Kennedy’s visit was an introduction—and a breath of fresh air. He extemporaneously shared his substantial track record with leaders over the course of several hours including discussion of his work on tribal Treaty resources, water and fisheries—spanning advocacy for indigenous rights across North and South America in dozens of cases. He also shared—and we read—more than a dozen of his thought-provoking books on vaccines and public health. Our observation is that, when you take the time to listen to him and probe and understand his positions, they are always intelligent, insightful and entirely rationale. He answered every question tribal leaders posed to him. The media’s frequent quotes out of context and mischaracterizations of his scholarship are just completely discordant with the thoughtful, brilliant, dedicated Bobby Kennedy that we know and have embraced in our communities for many years.
In March, we honored him with several ceremonial robings and honor songs at our COLT meeting. To have someone we consider a relative nominated to the Secretary’s Office is incredible. He understands Indian Country better than anyone ever nominated to the HHS Secretary’s Office before.
We also appreciate his deep appreciation for food sovereignty, and particularly for bison as a pivotal food resource supporting national security. He knows that if the United States went to war with a foreign power, we would struggle to feed ourselves. Bison are far more resilient than cattle and require no vaccines, antibiotics, pesticide-laden grains, or human calving assistance. Bison are central to the healthy diets of many COLT member tribes and we look forward to Mr. Kennedy’s help restoring and growing tribal food systems and supporting local control of the food supply.
COLT also lauds his deep understanding of behavioral health and trauma healing. Indian Country needs both, and more resources and inclusion in the historic silos of HHS that have never served tribal governments well—CDC, CMS, SAMSHA, etc. Bobby is the person who can build connections and transcend outmoded ways of thinking, respecting traditional, cultural medicine and tribal lifeways. He is a doer. He is exactly the leader tribes need at HHS.
Mr. Kennedy has COLT’s highest recommendation and endorsement to serve as Secretary of the Department of Health and Human Services.
J. Garret Renville,
COLT Chairman
Chairman of the Sisseton-Wahpeton Oyate of the Lake Traverse Reservation, South Dakota
Additional Coverage
RFK Jr. Pledges Commitment to Native Healthcare in Senate Hearing
Media share from Native Americans for Sovereignty and Preservation
During his recent nomination hearing, Robert F. Kennedy Jr. responded to key questions from Senator Ben Ray Luján of New Mexico, highlighting his deep commitment to improving healthcare for American Indian, Alaska Native, and Indigenous communities. His remarks reinforced the need for inclusion in medical research, greater accountability for the Indian Health Service (IHS), and the elevation of a Native health leader within his administration.
Kennedy acknowledged the longstanding healthcare inequities Native communities face, emphasizing his family’s history of advocating for tribal health reform. He affirmed that under his leadership, Native American representation would be prioritized at the highest levels, ensuring meaningful influence over major policy decisions.
When pressed on the exclusion of Native Americans from clinical trials, Kennedy pledged to do everything possible to ensure their inclusion, recognizing the direct impact on the effectiveness of life-saving medicine. Additionally, he committed to finalizing the congressionally mandated FDA guidance on clinical trial diversity, a crucial step toward ensuring Native participation in medical research.
Kennedy expressed openness to reviewing staffing concerns and working to ensure key roles are properly filled. His responses reflect an understanding of the challenges in Native healthcare and a willingness to engage in solutions.
NASP is also encouraged by Kennedy’s “Make America Healthy Again” platform, which addresses obesity, diabetes, processed foods, and over-medication–issues that disproportionately impact Native American populations. This national conversation resonates deeply with Native communities, where health disparities remain an urgent concern. According to the Indian Health Service (IHS), 2.8 million American Indians and Alaska Natives from 574 federally recognized tribes in 37 states rely on IHS services (IHS Profile | Fact Sheets).
AIAN adults report significantly worse health outcomes compared to the general U.S. population, with 19.1% experiencing frequent poor mental health days compared to 13.3% of U.S. adults and 19.3% reporting poor physical health compared to 11.6%. Additionally, AIAN adults face a higher prevalence of obesity, diabetes, physical inactivity, smoking, and heavy drinking than the national average. (Social Determinants of Health Among American Indians and Alaska Natives and Tribal Communities: 1990–2022) These disparities highlight the urgent need for reform and more decisive healthcare leadership in Native communities.
Of particular interest to NASP is Kennedy’s commitment to appointing a Native healthcare professional to oversee tribal health matters. As Kennedy stated (2:49 timestamp Senate Committee on Finance Hearing to consider the nomination of RFK Jr):
“I spent 20% of my career working on Native issues… My father and uncle were big critics of the Indian Health Service (IHS)–a failure to deliver good health results or healthcare on the reservations. I’m going to bring a Native in for the first time in history into my central office that all the major decisions in my office will… An interviewed candidate, a very, very good candidate… will have a direct impact on all the major offices. One of my priorities…,” interrupted by Senator Lujan.
Ensuring that a Native leader has direct influence over federal healthcare decisions is a significant and promising step forward. NASP recognizes the importance of this dialogue and will continue to advocate for strong Native leadership in federal health policy decisions. Our communities deserve an administration prioritizing tribal sovereignty, healthcare equity, and meaningful consultation.