Mark Cruz, a member of the Klamath Tribes, was confirmed by the U.S. Senate in a 51-47 vote to become director of the Indian Health Service, filling a leadership post vacant for over a year. Cruz, nominated on June 1, previously served as Senior Advisor for Native Affairs at HHS and held roles at the Department of the Interior and on Capitol Hill. He will lead IHS as it confronts workforce shortages, aging facilities, health inequities, and budget uncertainty, and has pledged to prioritize Tribal consultation, access to care, and workforce recruitment.
Senate Confirms Mark Cruz as IHS Director, Filling Year-Long Leadership Vacancy
Mark Cruz hosted a panel at the National Indian Health Board conference at Gila River in Sept. 2025. (Photo/Levi Rickert)
The U.S. Senate on Friday confirmed Mark Cruz, a citizen of the Klamath Tribes, by a 51-47 vote to serve as director of the Indian Health Service (IHS). Cruz becomes the agency's 12th Senate-confirmed director and steps into a post that had been vacant for more than a year.
Cruz was nominated on June 1 by President Donald Trump and advanced through the Senate Committee on Indian Affairs after a confirmation hearing in June. His appointment places a Native leader at the helm of the federal agency charged with providing health care services to roughly 2.8 million American Indians and Alaska Natives via federally operated facilities, Tribal health programs, and Urban Indian Organizations.
Background and experience
Before his confirmation, Cruz served as Senior Advisor for Native Affairs to Health and Human Services Secretary Robert F. Kennedy Jr., making him one of the highest-ranking Native officials in HHS. He has also held leadership roles at the U.S. Department of the Interior and worked on Capitol Hill on Tribal policy issues. Cruz holds a bachelor’s degree in political science from Pepperdine University and a master’s degree in urban education policy from Brown University.
What Cruz Will Face as IHS Director
The Indian Health Service continues to contend with persistent workforce shortages, aging infrastructure, and stark health inequities across Tribal communities. The agency also faces uncertainty related to federal budget proposals that could affect funding for Tribal health programs and services.
During his Senate Committee on Indian Affairs hearing, Cruz highlighted priorities including stronger Tribal consultation, expanded access to quality health care, improved recruitment and retention of health professionals, and deeper collaboration with Tribal Nations to address long-standing challenges across the IHS system.
Tribal leaders and national Native organizations urged swift confirmation, arguing that stable leadership is essential as IHS navigates operational and fiscal pressures while fulfilling the federal government’s trust responsibility to provide health care to American Indians and Alaska Natives.
As director, Cruz will oversee one of the nation’s largest public health systems, responsible for hospitals, health centers, and clinics serving Tribal communities across the United States. His four-year term begins as the agency works to improve patient access, modernize facilities, and strengthen government-to-government partnerships with Tribal Nations amid an evolving federal policy landscape.
Looking ahead: Cruz’s leadership will be closely watched by Tribal leaders, advocates, and lawmakers as the IHS addresses immediate operational needs and longer-term reforms to reduce health disparities in Native communities.
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