An empty lot between a fire station and a soccer field just outside Albuquerque will soon become a new federal medical center for Native American patients, U.S. officials and tribal leaders said, as the Indian Health Service tries to work through a backlog of long-delayed construction projects.
Earlier this month, Santa Ana Pueblo Gov. Myron Armijo led officials from the Indian Health Service and the U.S. Department of Health and Human Services on a tour of the location where officials say patients will eventually receive services ranging from dialysis and diabetes care to optometry and other care. Armijo said the project would “definitely change the game for health care in our area,” linking the planned facility to pressure on an aging federal clinic in Albuquerque, where some patients and tribal leaders describe waits that can stretch for months.
The planned center is scheduled to break ground in 2027 and will cover 235,000 square feet, according to officials described in the report. The facility will be run by the Indian Health Service, the U.S. agency that provides health care to Native Americans. Tribal leaders said the new building is expected to relieve strain on the Albuquerque Indian Health Center, which was originally built about 90 years ago and which some patients say has become overextended as demand has grown and shifted.
Federal officials and tribal advocates have framed the construction effort as part of a broader problem: funding to update Native American health facilities, they said, has not kept pace with community needs. The Albuquerque facility was among more than 60 clinics and hospitals the agency identified for replacement in 1993 due to age, condition, and inability to serve a growing population, and the project at Santa Ana Pueblo is one of the 1993-era priorities still underway. IHS officials said the Albuquerque area would eventually be served by two new facilities, including the one planned at Santa Ana Pueblo.
The scale of the funding gap is central to officials’ warnings about timelines. In February, HHS Secretary Robert F. Kennedy Jr. pledged $1 billion toward the delayed projects, including $22 million for the Santa Ana Pueblo center. The report said the agency estimates $8 billion is needed to tackle remaining projects on the 1993 list that, under federal law, must be completed before the IHS can address other major construction needs.
A.C. Locklear, CEO of the nonprofit National Indian Health Board, said the $1 billion pledged by the administration is the single largest investment by any administration in addressing aging facilities. But Locklear said the money also shows the federal government has neglected its legal duty to provide adequate health care to tribal nations, adding that it is “a drop in the bucket in terms of what’s needed to modernize these facilities.”
The report also described how aging infrastructure can affect care in day-to-day ways. It said the IHS serves 2.8 million Native American and Alaska Native patients through 21 hospitals and 78 smaller health centers nationwide, and that the average age of those facilities is around 40 years, with one-third in “poor” physical condition, citing a 2023 U.S. Government Accountability Office report. Theresa Nelson, a 62-year-old Navajo Nation citizen, said she relied on the Albuquerque Indian Health Center after retiring and losing health insurance and described the facility as feeling like “going back in time,” including examples of outdated X-ray machines, exam rooms, and waiting room furniture.
Nelson said the center depends on outside referrals for treatments and tests that are easier to access in private health care and described waiting eight weeks for IHS to approve a referral for a 3D mammogram. The Indian Health Service told the report that appointment wait times at the Albuquerque center are less than 14 days for patients established with a primary care provider, while Nelson and other patients report years without being assigned a doctor and months-long waits for preventive care.
Other parts of Indian Country face similar pressures, the report said. Farther west, it described the Gallup Indian Medical Center as operating out of modular buildings and piecemeal renovations and said the hospital was on the 1993 list when opened more than six decades ago. Tribal lawmaker Vince James said constant construction and a disjointed layout make it difficult for elderly and disabled patients to navigate the hospital and for providers to do their jobs, describing the improvements as “Band-Aid fixes,” and warning, “Eventually the GIMC campus will become unsafe.”
Against that backdrop, the report said senior HHS adviser Mark Cruz urged Congress to make a special appropriation to complete the remaining projects on the 1993 priority list in various stages of planning and design. Cruz said it could take another 40 years to get through the list without funding, and he told officials during the Santa Ana Pueblo tour, “It’s really unacceptable that we’re still working off of that 33-year-old construction list.” Federal law, the report said, requires the Indian Health Service to complete the 1993 list before it can replace clinics and hospitals that have fallen into disrepair since then, including two nearly 90-year-old hospitals in Montana and Minnesota.
The report also said the IHS is constrained from moving quickly to meet changing demand. Cruz said he cannot get to additional projects with merit across Indian Country or Alaska because of a statutory obligation to get through the 1993 list first. The report cited the IHS’s completion of a project in Rapid City, South Dakota in 2023, where the replacement of the aging and troubled Sioux San Hospital was described as “transformational.” Jerilyn Church, CEO of the Great Plains Tribal Leaders’ Health Board, said the renamed Oyate Health Center is three times larger than the former hospital and equipped with more modern medical equipment, but she also warned that demand is already outstripping available space. Church said, “That’s what happens when you work from a backlog,” explaining, “In the time between identifying the need and the money finally becoming available, the population grows.”