Big Changes Are Coming to Our Health Systems

We are always the first to feel the effects of change, and healthcare is no different. From federal funding to public trust, Native health systems need to pay attention right now.

OBBBA is Restructuring Healthcare Funding

The One Big Beautiful Bill Act, signed in July 2025, is cutting federal healthcare spending over the next decade through reductions to Medicaid, ACA subsidies, and Medicare payments. Medicaid provider taxes are now capped, 340B drug discount programs are curtailed, and supplemental payments many hospitals depended on are restricted. The law does allocate $50 billion for rural hospitals, eliminates copays for substance use disorder services, and permanently covers pre-deductible telehealth. But for Native populations relying on Medicaid-funded care outside the Indian Health Service, these structural changes directly impact all of us.

Trust and Ethics has Collapsed

A 2024 JAMA Network Open study found that public trust in physicians and hospitals dropped from 71.5% in April 2020 to just 40.1% by January 2024. That erosion hits Native health even harder, where cultural awareness and culturally competent care have long been underfunded. Native communities must be at the table when it comes to whole-health, long-term solutions.

Working ethics committees bring credibility and trust to an institution by widening clinical and administrative perspectives. Yet as of a 2010 HEC Forum study, only 60% of rural hospitals had ethics committees, and many still lag behind today. For tribal health facilities serving Native communities, that gap matters deeply.

The Workforce Gap is Real

Research in Health Affairs confirms that most family physicians practice near their residency training programs, leaving underserved regions stuck in a cycle of shortage. We need more programs like WSU Native American Health Sciences, Mayo Clinic’s Native American Pathway, Salish Kootenai College Nursing, Diné College CONVOY Project, and the University of Arizona’s INCATS Program to help build the onramp our communities need.

Ellsworth is Here

As a Native-owned small business and certified ISBEE, Ellsworth Medical Staffing places culturally competent Native practitioners in IHS facilities, tribal health programs, and rural hospitals where the need is greatest. We also maintain one of the strongest databases of culturally competent physicians, providers, and medical professionals experienced in working with our communities and ready to serve at your facility. The healthcare landscape is shifting fast—contact Ellsworth today to strengthen your Native health workforce before these changes reshape your community’s future.