Indian Health Service Proposes Three-Region Realignment Affecting Local Tribes

The Indian Health Service (IHS) announced a proposed reorganization on Jan. 8, 2026, that would reduce its 12 regional offices to three, a change officials tied to planning for a new Gallup Indian Medical Center and a drive to modernize agency operations and strengthen coordination. The agency expanded tribal consultation sessions, adding both in-person and virtual meetings after tribes requested additional opportunities to weigh in.

Tribal leaders and attendees who participated in the consultation sessions said the consolidation raises concrete worries for communities that depend on IHS and tribal health programs. Participants expressed concern that consolidating regional offices could result in fewer direct services locally and diminish tribal influence over how health care is delivered and governed. Several attendees said the consultations felt like a formality because key decisions appeared already advanced when meetings began.

For residents of San Juan County, where many families rely on tribal and IHS-funded clinics, the proposed restructuring could affect access to services and the lines of communication between tribes and the federal agency. Local tribal health authorities play a central role in coordinating care and managing programs tailored to community needs; any realignment that centralizes administrative functions risks distancing decisionmakers from on-the-ground realities in communities across the region.

IHS framed the plan as a modernization intended to improve coordination and efficiency while supporting capital projects such as the planned Gallup Indian Medical Center. Agency officials said consolidating regions would align oversight with updated operational priorities, but they did not present detailed modeling of how service delivery would be maintained or expanded at the community level during and after the transition.

Tribal governments successfully pushed for more opportunities to participate, prompting the additional consultation sessions. Those expanded sessions included both in-person and virtual options to reach more stakeholders, a procedural change that allowed more local voices to raise concerns about service continuity, oversight, and tribal self-determination in health decisions.

Next steps include continued consultations as IHS develops its implementation plan and timelines. For San Juan County residents and tribal health administrators, the coming weeks will be important for tracking how proposed administrative changes might translate into shifts in clinic operations, staffing, and patient access. Local tribal offices and IHS regional contacts are the primary points for updates as the agency moves from proposal to potential implementation.