Solomon Center Hosts Conversation with U.S. Indian Health Service Director

On Oct. 2, the Solomon Center for Health Law and Policy hosted “A Conversation with the Director of the U.S. Indian Health Service: Health Care in Indian Country — Disparities, Challenges, and Opportunities,” a discussion with Roselyn Tso, a citizen of the Navajo Nation currently serving as the 11th Director of the Indian Health Service (IHS).

Housed within the U.S. Department of Health and Human Services, the IHS operates as the 17th largest health care system in the nation. It serves as the principal federal health care advocate and provider of health care services for approximately 2.8 million American Indians and Alaska Natives.

The discussion, which drew a crowd from the Law School and the broader Yale community, was moderated by Yale Health Law and Policy Society board member Hannah Terrapin ’26 and Professor Elizabeth Reese of Stanford Law School. Reese is a nationally recognized expert on tribal law and federal Indian law and served as the Senior Policy Advisor for Native Affairs in the Biden administration.

Tso began by noting that the uniqueness of the IHS, in comparison to other large health care systems, is that it also provides public health services like utilities, food distribution, and housing support. According to Tso, it is crucial that the IHS addresses social determinants of health while also holding itself accountable for longstanding inequities in care delivery and lost trust. She shared a story of visiting a food distribution center, where she was taken aback by the quality of the food being provided — what she termed a “box of preservatives” — while conditions like heart disease skyrocket within the communities that IHS serves. 

Reese discussed how colonialism “fundamentally decimated” the governmental institutions that tribal nations had in place previously. As with the food distribution program, tribal communities receive services directly from the government, such as food boxes, in lieu of federal programs like food stamps and Medicaid. 

Reese described the health care system as a “separate and not very equal system of social service safety net,” and said that Tso had a nearly impossible task of navigating a complicated legacy and rebuilding trust. 

In response to Reese asking how she sees her role, Tso said that she asks how she can help each person and demands more accountability from different departments to provide help and services, as she knows that if problems continue to be shoved under the carpet, trust will never be rebuilt.

“I believe wholeheartedly that we are seeing change across Indian Country and that we have to keep pushing this,” Tso said. “I hope that today you hear from me that we are doing everything we can to ensure that our children, and our children that are yet to come, will have better health care than we have today.”