Crushing Colonialism Treasurer Speaks at National Medicaid Vigil in Washington, D.C.

Crushing Colonialism is an Indigenous-led 501(c3) nonprofit in the so-called United States that uplifts Indigenous people through arts, media, and traditional storytelling while supporting those doing the work. We were founded in 2016 and are operated by Indigenous people working in a variety of storytelling fields across the world. We work to increase the pay and employment of Indigenous storytellers while also promoting their work, providing funding for media and arts projects, and increasing access to professional representation.

We operate with a decolonial disability justice framework which is the impetus in our participation in the 60 hour Medicaid Vigil. 

Who better to share the healthcare experiences and needs of American Indian and Alaska Native (AI/AN) people than a storytelling organization run by a team of several chronically ill and disabled people? 

AI/AN people have the highest rates per capita of disability in the so-called US. 38.7% of AI/AN people are disabled. That’s 2 in 5 AI/AN people. In 2022, AI/AN life expectancy was lower than the life expectancy for the general population in 1950. These figures are due to social determinants of health that are a result of over five hundred years of genocide that has never ended. 

In 2025, the poverty rates for AI/AN people are estimated between 22-24%, according to the International Work Group for Indigenous Affairs (IWGIA). AI/AN people are impoverished at a rate of more than double that of non-Hispanic white people. However, AI/AN people and tribes aren’t a monolith and some tribal nations have significantly higher rates of poverty than others leading to even more desperate situations for some of our community. 

Approximately 2.7 million AI/AN people are enrolled in Medicaid, with 24% of AI/AN adults aged 18-64 and 23% of those over 64, enrolled. Almost 49% of AI/AN children are enrolled in Medicaid. These stark cuts to Medicaid are compounded for the Indigenous people and tribal nations of the so-called US due to the already existing lack of resources and generations of underfunding. 

Indian Health Service

The federal government has a trust and treaty obligation to provide healthcare to the enrolled citizens of federally recognized tribal nations. Indian Health Service (IHS) is the federal agency tasked with this obligation. Tribal leaders estimate that significantly more funding is needed for IHS to operate properly and meet the healthcare needs of citizens. IHS currently operates with a budget that addresses only an estimated 48.6% of the healthcare needs for AI/ANs. 

The chronic underfunding has led to high staff vacancy rates, rationing of healthcare services, and outdated facilities and equipment. Many of the IHS facilities are old and in poor condition. The state of medical equipment is unknown because “IHS does not have complete or reliable data.”

The National Tribal Budget Formulation Workgroup (NTBFW), who represents the 574 federally recognized tribes, recommended $73 billion for IHS in their Fiscal Year 2027 Tribal Budget Recommendations. For comparison and an understanding of the horrific chronic underfunding of IHS, the current administration’s proposed budget for Fiscal Year 2026 is only $8.1 billion. This has been an issue across administrations, but the recent severe cuts to Medicaid only worsen an already dire situation. 

Much of the healthcare paid for by IHS includes the Purchased/Referred Care (PRC) program. PRC covers essential health care services from non-IHS providers when said services aren’t available within IHS. According to the Workgroup, “much of the secondary care and nearly all the tertiary care provided in Indian Country is purchased from non-IHS facilities.” 

The severed lifeline that is Medicaid will only exacerbate the lack of overall healthcare facilities as well, especially in more rural areas. Clinics and hospitals that depend on Medicaid dollars will close making the opportunity of PRC or Medicaid covered care impossible for AI/AN people. Leaving our most vulnerable without care. 

The Workgroup recommended $12.6 billion for PRCs fiscal year 2027 IHS line item versus the little more than $1 billion appropriated in the 2025 budget.

Urban Indian Organizations & Healthcare 

Our tribes have citizens across the so-called US in rural and highly remote areas as well as those that are densely populated. In 1940 only 8 percent of AI/AN lived in urban areas. Today, 71% of AI/AN live in urban areas. The US Termination and Relocation Program of the 1950s and 60s was a continuation of the theft of tribal lands and attempted to destroy tribes entirely. Further, by removing many Native people from our lands to urban areas, we were cut off from access to many IHS and tribal health facilities, making Medicaid crucial to our survival. 

Native people were promised jobs, education, housing, and healthcare if we left our tribal lands for the cities. As the colonizer has always done, they broke their promises. 

Currently, the federal government contracts with 41 Urban Indian Organizations (UIO), which operate over 80 facilities in 38 urban areas nationwide. UIOs were created in the 1950s by urban AI/AN people and tribal leaders, to address the many dire consequences of the federal government’s Termination and Relocation policies, including health, education, and housing. 

UIOs are fundamental to the well-being of Native people and tribes. They provide a wide range of health care and social services, including primary care, oral care, HIV treatment, substance abuse treatment, behavioral health, diet and nutrition classes, cultural and educational programming, and traditional medicine. Patients from over 500 federally recognized tribes are served by the 41 UIOs

Tribal leaders recommended $1.09 billion to fund the IHS Urban Indian Health line item in the fiscal year 2027 tribal budget recommendations. UIOs only receive direct funding through a single line item–Urban Indian Health. UIOs typically don’t receive direct funds from other IHS budget line items further limiting the services provided. In the past, the Urban Indian Health line item has received only one percent of IHS’ budget. 

In the 2025 IHS budget only a little more than $219 million ($219,035,000.00) was given to UIOs. 

Importance of Medicaid to small non-profit organizations & small businesses

There are special work related circumstances that necessitate a higher need for Medicaid. The exorbitantly high price of private insurance to both employers and employees means that many people working for smaller organizations and businesses or who are self-employed rely on Medicaid for health insurance. One-third of Medicaid enrollees work for small businesses or are family members of small business employees. Even 20% of small business owners are enrolled in Medicaid. 

Per capita, AI/AN people face the highest unemployment rates and are the least likely to hold managerial positions in the so-called US, meaning access to employer sponsored health insurance is considerably lower for AI/AN people. However, we have higher rates of self-employment at 10%. These realities make Medicaid even more crucial to AI/AN people and tribal nations. 

We at Crushing Colonialism are worried about our own ability to recruit and retain team mates that we can support in the ways needed to live a joyful and healthy life while also contributing to the collective work and community that we strive to achieve. As a very small non-profit with an annual budget of less than $.5 million, we aren’t in the financial position to offer our team health insurance or other benefits. We already struggle to find and retain team members due to the absurdly tight income restrictions for adult Medicaid enrollees. The so-called US needs a fully funded, upgraded, and free healthcare system for all. Instead, the opposite is occurring. 

Fascism, State Violence & Medicaid

There are countless factors that impact AI/AN’s access to healthcare including safety in medical facilities. We have a long history of being forced and coerced into medical experimentation, sterilization, and a host of other racist and violent actions by those in the medical field. This administration has added another fear to the list. 

A recent policy has given Immigration and Customs Enforcement (ICE) access to every Medicaid recipients’ personal information, including date of birth, social security number, and ethnicity and race. The government claims this is to find “illegal” immigrants, but they’re not eligible for Medicaid benefits. This is particularly alarming for all oppressed peoples. ICE has arrested tribal citizens and the government has even claimed that AI/AN people aren’t American citizens. Not only is this patently untrue and racist beyond measure, ICE could use Medicaid data to target, hunt, kidnap, deport, and even kill AI/AN people, as well as others that the government wants gone. ICE and government actors have repeatedly demonstrated that they won’t abide by their own laws nor do they have any sense of humanity. People are even being kidnaped during medical appointments and  procedures. 

Cuts to Education and impacts to future healthcare workers

The Big Beautiful Bill has impacted healthcare for generations in numerous ways. All of the 37 Tribal Colleges and Universities (TCUs) are at risk of closing or making very severe cuts to staff and programming due to potential budget cuts of 90% by the Trump administration. Seventy-five percent of TCUs funding comes from the federal government. This impacts our tribal nations in a number of ways, including the education and professional support of future healthcare workers. How does a 19-year-old with no car or money, but a dream of becoming a doctor start their education if the tribal college on their reservation has closed? How does a single working parent further their education and become a mental healthcare therapist to treat Native people for the centuries of trauma if their local tribal college has closed? What happens to the Native people who want to work directly with patients as social workers or health aides? 

The answer is that they don’t receive an education and our nations suffer further genocide. The so-called US and IHS are already facing a massive shortage of healthcare workers across all sectors and specialities that will only worsen as the US destroys the educational system for all, but the wealthiest of people.  

We are indeed in dark times in the so-called US and globally, but where we are now is rooted in our past. Until we confront the legacy of white supremacy, racism, sexism, ableism, xenophobia, classism, and anti-queer discrimination and institutional oppression we cannot solve the healthcare crisis as it’s not a crisis by accident, but rather by nefarious design. Despite the conditions we are under, we must dream of and strategize and fight for the world we deserve that is rooted in justice, decolonization, liberation, and love. This vigil is one piece of this puzzle. There is power in our collective organizing and ways of being. We can learn, unlearn, grow, and heal together as communities, tribal nations, and beyond. We must immediately make space for our most attacked community members to lead the way they see appropriate and affirming. As a piece of this work, we offer personal testimonials on the importance of Medicaid directly from our AI/AN people and organizations.

1. Medicaid has been, and still is keeping my family alive. As a disabled autistic homeless community organizer, I am traveling the country helping orgs and groups produce covid-safer events. With the few spoons I have left, I am focusing on surviving so I am overwhelmed by the process. I can’t currently access Medicaid or any healthcare. Even as I am trying to get help, it is hard to find. But with the funding cuts and attacks on autistic, disabled, queer, homeless, and Native/Indigenous people (all of which I am part of), I am not sure that there will be a system or funding by the time I apply.  Medicaid helped my mom avoid metastasizing thyroid cancer, it helped save my brother from losing their foot (from living in an area of food apartheid and no public transportation), and helped my sister survive both her pregnancies with the complications of EDS that we all have. We are natural born citizens to the US, but because we are brown, we are in danger. Danger from our own government and the people who keep “just following orders” to ignore and dismantle public health systems.  In the US, one covid infection can disabled you, kill you, or have you drowning in medical debt. And although we are citizens, we can at any moment be kidnapped by this government, with no due process, and sent to concentration camps profiting from the modern day slavery system of private prisons, just for being Native. Defunding Medicaid is one domino in the many being knocked down right now in order to destabilize our social care networks and make it harder for us to live. That is their goal. We reject the notion that anyone has to be “productive” to have value. That is a colonizer’s mindset and we will not stand for it.  We have value by existing and we all share in the community care needed to keep society functional for us all. Any act to support your community is one more drop that powers the strength of the ocean.  From wearing a mask, to feeding your neighbors, it all counts.  For us all to have access to healthcare it is vital for everyone to act!  

-Jesenia
One Free Community

2. Medicaid is how so many of us survive. For disabled Native people, it’s often the only way we can access the care, equipment, and support we need to live, since more than 80% of all Native people do not live on the reservation and do not always have access to Indian Health Services. 

Native communities already face some of the highest rates of disability, chronic illness, and poverty in the U.S. as the result of centuries of broken treaties, stolen lands, and underfunded healthcare systems. And yet, every time the budget is discussed, Medicaid and Indian Health Services are on the chopping block. It makes the statement that Disabled and Native lives are expendable and unworthy of the unalienable and constitutional rights of life, liberty, and the pursuit of happiness. 

Protecting and expanding Medicaid is fulfilling the promise of those rights by keeping our relatives out of institutions, keeping families intact, and preserving our communities. It’s about ensuring that disabled Natives can live with dignity, autonomy, and connection. But make no mistake in believing it is THE SOLUTION. Protecting Medicaid is the bare minimum, expanding Medicaid is the bare minimum, but it is a step forward to a future where healthcare is accessible for ALL. 

-Johnnie Jae (Otoe-Missouria & Choctaw)
Webmaster & Board member, Crushing Colonialism

3. To say that the very real threat to our community with the loss of Medicaid is terrifying is an understatement. I recall the days before the passage of the Affordable Care Act (ACA), when relatives in the Baltimore American Indian community had to make the difficult choice to neglect their health – often very real disabling conditions – and keep a roof over their head, or leave the employment that paid their rent so that they could pursue disability. You see, in Maryland prior to the ACA, you needed to prove that you had a physical or mental health disability in order to access Medicaid, and to be disabled meant that you could not work. We were so gratified that Maryland decided to expand Medicaid under the ACA, meaning that people could do work that was meaningful but still treat their chronic and disabling conditions so that they enjoyed a better and more dignified quality of life. 

Medicaid expansion was especially important for our tribal citizens. Because there are no full-ambulatory Indian Health Service clinics in the DMV, services provided by our outreach and referral were often suboptimal. While we are fortunate to receive funding to pay for medical, behavioral health, and dental services, prior to ACA and Medicaid expansion, these funds were never enough for the real needs of the uninsured and those with complex medical needs.

But with Medicaid expansion, the Indian Health Service encouraged all tribal citizens and Urban Indian beneficiaries to apply for coverage. Doing so allowed relatives to receive the comprehensive services they need and allowed our organization to do more with our limited funding, including pay for prescriptions, eye exams and glasses, durable medical equipment like wheelchairs and scooters, and much needed preventive and restorative dental care.

Loss of Medicaid will truly imperil the lives of our relatives, especially those with disabilities. It will mean that Urban Indian Health Programs will need to limit care at a time when the demand for care increases. It means watching the quality of life for our relatives decline and watching the house of cards that are social determinants of health collapse among themselves. It means that those who may be fluent or proficient Indigenous language speakers or our culture bearers and medicine keepers become too ill to share their knowledge. The outcomes are truly too dire to overstate.

During the height of the COVID pandemic, our communities spoke of “being a good relative” by taking care of ourselves and of each other. The prospect of scores of relatives losing coverage and suffering declines in wellness and social stability will greatly hamper our ability to be the relatives we want to be and know we can be. The loss of Medicaid is yet another blow we can NOT afford.

-Kerry Hawk Lessard
Executive Director, Native American LifeLines

4. ‘Siyo, greetings. My name is Tony Enos. I am a Two-Spirit Cherokee artist and musician, and HIV has been living with ME!!! For the past 19 years. I’m the Boss! I’ll always BE the Boss!

Sounds like the words of an empowered person right? But that person wouldn’t be alive today without the city of Philadelphia and the Medicaid programs that sustain and treat so many people like myself living with HIV today in the so-called “United States of America.”

Some genocides are more blatant like those happening in Palestine, and some are more subtle and insidious like the alleged “leaders” who enact them. Make no mistake about it, the attack on Medicaid is an enactment of genocide. 

When Donald Trump told Dr. Anthony Fauci to just let COVID-19 wash over the country, his allegiance to the blessed dollar and not the citizens who he serves became evidently clear. 

On all U.S. currency is printed the words “In God We Trust.” They’re talking about money. That’s their God. That’s what they worship. But the opportunity has come for us to prove that the value of human life and sustainable holistic health cannot be measured in God Damn dollars. 

Universal Healthcare is a basic human right. The right to health, and a THRIVING quality of life is universally inherent. And we will not stop fighting until the United States of America makes good on the ideology that has never come to fruition in almost 300 years: “Liberty and Justice for All.” That includes health.

-Tony Enos (Cherokee)

5. Dear Relatives,

On behalf of the Two-Spirit & Native LGBTQ+ Center for Equity, I write to express our deep support for the preservation and expansion of Medicaid services. Medicaid is not just a public health program; it is a lifeline for many in our communities. For Native people, particularly Two Spirit and LGBTQ+ relatives, elders, and those living with HIV, Medicaid is essential to accessing equitable, culturally-affirming, and life-saving care.

Two-Spirit people have always held sacred and vital roles in our tribal nations, but today we face disproportionate health disparities rooted in colonization, discrimination, and underfunded health systems. Medicaid helps bridge the gap by providing access to mental health care, gender affirming treatment, substance use services, HIV medication and treatment, and care for chronic conditions that affect our community at higher rates.

Our Native elders and HIV-positive community members rely on Medicaid for continuity of care, medications, home-based services, and dignity in aging. LGBTQ+ Native people, especially in rural and tribal areas, often lack alternative options for health coverage and face unique barriers due to stigma and systemic neglect. Without Medicaid, many of our relatives would go without basic health care – this is not acceptable.

For our organization, which exists to uplift and serve Two-Spirit and Native LGBTQ+ people, Medicaid is not just a policy issue, it is personal. It affects our families, our future, and our tribal sovereignty to care for our people in ways aligned with our cultural values and teachings.

We urge you to protect Medicaid and to ensure that its programs continue to be inclusive, accessible, and adequately funded for Native communities. This includes honoring the government-to-government relationship between tribes and the federal government and recognizing that health equity cannot be achieved without justice for our Two-Spirit and LGBTQ+ Relatives.

In strength and solidarity,
Elton Naswod, Executive Director
Two-Spirit & Native LGBTQ+ Center for Equity

6. I’m multiply-disabled, chronically ill, bisexual, Two-Spirit woman and citizen of the Cherokee Nation of Oklahoma. I’m also a Medicare and Medicaid enrollee and I receive IHS and Urban Indian Healthcare benefits. My life is literally in the hands of the federal government, and given who I am, that is truly terrifying. Losing my healthcare would be a death sentence. I’m already struggling without necessary care as too few doctors with the level of expertise and facilities I require accept Medicaid where I live. I don’t have the home health and personal care attendant services that I need either. My survival in the death cult that is the so-called US is a weight too heavy to bear and it’s killing me.

I did everything I was supposed to do. I left my rural community on my nation’s reservation for urban life. I worked and fought my way through fancy private universities, obtained the degrees and built an extensive resume, but it wasn’t enough. In order to maintain some of the healthcare services I need as a severely disabled person, I must remain impoverished and dependent on the government for my survival. The government and every day ableists claim I’m a burden while they literally left me the choices of working to the best of my current abilities and pursuing my passions, but having zero healthcare leaving me unable to live the life of my choosing. Or I can have subpar, and often dangerous healthcare, but have to settle for an ambitionless and poverty-stricken life. 

Currently, Medicaid pays for my monthly Medicare and prescription plan premiums, covers the 20% of my medical bills that Medicare doesn’t, covers the co-pays for all doctor and health visits, and as a federally enrolled tribal citizen it also covers all of my prescription co-pays. If I lost Medicaid, it would cost me thousands of dollars annually and would cause me to further ration the care I need. I live in fear of further cuts to IHS as some of my medical expenses that aren’t covered by Medicare and Medicaid have been paid for through the Urban Indian Health Purchase/Referral Care system. 

I see our Native healthcare professionals scrambling every day to care for our people, but the government refuses to honor its own treaties which are the “supreme law of the land.” But we also can’t expect a government that wants much of its populace enslaved through the prison industrial complex or dead, to provide basic human needs, such as healthcare. I exist everyday knowing that someone wants me dead. In country where the president demands traumatic racial slurs and Native people demeaned as mascots for commerce, political pundits claim “We should have killed more Indians,” and the foundational document for the creation of the so-called US, the Declaration of Independence, refers to Native people as “merciless Indian savages,” I’ve never had the luxury of good health, liberty, or the pursuit of happiness. 

I’m not with you today as I’m having yet another medical procedure. I’m able to have this procedure because I have Medicare and Medicaid. To say Medicaid is a lifeline for myself and others is an understatement. It’s no surprise that our government hasn’t properly funded Medicaid and is now hell bent on destroying it. Controlling a populace is much easier when they’re destitute, in horrible health, without education, housing, parks, arts, and a clean natural environment. The intersecting forms of oppressions that communities will suffer as a result of this administration’s eugenicist actions are too many to name in the time I have. 

Hope is in limited supply these days. My health is worsening with little hope of it slowing down. My quality of life continues to decline. The options available to me are few and far between. Health and medical research for my lifetime and generations to come have been demonstrably impacted due to the fascist government. The racist, sexist, anti-queer, and ableist restrictions on federal funding, as well as attacks on scientists and physicians, have ensured that I don’t stand a chance at better care in the future due to advanced research. This builds upon the already existing lack of vital medical research due to government restrictions, such as those on stem cell research. 

Each cut runs deep and I’m tired of bleeding out because our fascist, colonial government privileges a few and wants to create the world’s first trillionaires off the backs of the populace who they aim to control. It’s catastrophic to individuals, families, communities, and the country for millions of people losing the only healthcare coverage they have so that the President can turn a profit off of his Secret Service coverage by renting his properties back to the federal government. I am enraged. Super yachts, multiple mansions, and private jets don’t deserve precedent over my life or yours. Healthcare is a human right, it shouldn’t be a for-profit venture nor should our government limit access. There is no reason for anyone in the so-called US to go without high quality, culturally relevant, integrated healthcare, homecare, and holistic care. 

I try to think and organize for the future we could have and deserve. I’m tired of fighting for the bare minimum. I’m tired of the few crumbs that the colonizer deigns to throw my way. I am a survivor of generations of genocide. My ancestors suffered the horrors of multiple colonial wars. We were tossed around among European nations until the US became our overlord. We fought and lost many. My ancestors survived so that I may be here today. I too will fight for my people, for my tribal nation, for myself. My testimony today is, but one action of this warfare. Even if I lose Medicaid, even if they kill me, my words will live on. 

In solidarity!

-Jen Deerinwater (Cherokee Nation of Oklahoma)
Founding Executive Director, Crushing Colonialism