Note: This article is part of the project: "Indigenous Impacts: How Native American communities are responding to COVID-19." We invite you to view the entire project here.


SIOUX FALLS, S.D. — The COVID-19 pandemic has slammed Indian Country, and the end is not yet in sight.

The coronavirus has disproportionately hit indigenous Americans, native-owned businesses have been slow to recover if they’ve survived at all, and tribal governments and health care systems are running out of federal stop-gap pandemic relief funds.

What’s next for Indian Country amid the pandemic? All eyes on are Washington, D.C. Additional federal pandemic relief measures are stalled in Congress, leading a broad swath of tribes, non-profit groups and lobby organizations to sound the alarm and plead for action as the pandemic continues to cut a deadly path across indigenous peoples.

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The Democrat-controlled House has approved the $3 trillion Health and Economic Recovery Omnibus Emergency Solutions Act (HEROES) Act, which contains $20 billion in fiscal relief for tribal governments and $2.1 billion for the Indian Health Service, but the legislation is stalled in the Republican-led Senate as of this article's deadline.

In early September, the National Indian Health Board, National Congress of American Indians and the National Council of Urban Indian Health wrote Congressional leaders from both sides of the aisle, insisting that without swift and sizable financial assistance, the worst could be yet to come.

“Without sufficient additional congressional relief … these shocking upward trends will more than likely continue as COVID-19 restrictions are eased, schools and businesses reopen, and the potential threat of a more severe flu season coincides with this pandemic,” they wrote.

“In short, that is a recipe for even more disaster, death, and despair.”

Businesses, casinos seek relief, recovery

Like many businesses across the nation, the pandemic has rained down catastrophe on businesses in Indian Country, both those privately owned and those owned by tribes. Those businesses are seeking to recover, even as the pandemic has yet to loosen its grip, but progress has been slow.

Tribal-owned enterprises and the tribe themselves slashed jobs as revenue cratered, according to the April survey, conducted by the Center for Indian Country Development at the Federal Reserve Bank of Minneapolis.

Gaming enterprises, a crucial economic backbone in some tribal economies, have greatly suffered. A full quarter of tribally owned enterprises reported zero revenue, according to the Federal Reserve Bank survey.

"Given the number of employees tied to tribal governments as employers, tribes must remain viable for the return of the American economy this year and next," said Ernest L. Stevens Jr., chairman of the National Indian Gaming Association and retired U.S. Senator Ben Nighthorse Campbell, in an August op-ed published by Indian Country Today.

Things remain equally grim for small businesses in tribal communities according to a July survey conducted by the Center for Indian Country Development, conducted in partnership with the National Center for American Indian Enterprise Development, and published in early September.

Small businesses were experiencing dramatic declines in their revenue and didn’t foresee those declines reversing in the next six months, with 68 percent seeing at least a 20% reduction in revenue and one in six businesses reporting a loss of all revenue due to the pandemic. Particularly hard hit were industries like arts, entertainment and recreation.

“With many business owners in Indian Country anticipating that conditions will never return to normal, and cash reserves rapidly being depleted, employees and the tribal small business community face stiff headwinds,” the CICD researchers concluded.

Health service grasps for funding lifeline

It's no secret the federal Indian Health Service is chronically underfunded. So the pandemic is something of a rolling emergency for a belabored health system focused on providing health care for a population that, according to the CDC, is being disproportionately hit by COVID-19.

Federally provided health care is provided to Native Americans under right of treaties and trust obligations of the federal government to the tribes.

Federal coronavirus relief measures approved earlier this year bolstered the IHS, allowing it to expand its services and COVID-19 testing. But indigenous health organizations are united in insisting the funding was stop-gap at best.

"While we appreciate the roughly $1 billion to IHS under the CARES Act and the $750 million testing set-aside under the Paycheck Protection Program and Health Care Enhancement Act; these investments have been necessary but woefully insufficient to stem the tide of the pandemic," wrote the National Indian Health Board, National Congress of American Indians and the National Council of Urban Indian Health to congressional leaders in early September.

The COVID-19 pandemic has highlighted the stark needs of the IHS, wrote Dr. Donald Warne, the associate dean of diversity, equity and inclusion, director of the Indians into Medicine and the public health programs at the University of North Dakota and an enrolled member of the Oglala Lakota Tribe, in an Forum News Service opinion piece.

"It is going to require a generation of good policy to make up for generations of bad policy, but among the most important things is for Congress to fully fund IHS," he wrote. "As tribal nations, we are not asking for anything unusual; all we are asking for is the federal government to live up to its treaty obligations."