Gallup Indian Medical Center limits care because of Trump executive order on contract review

A Trump administration policy that calls for heavier oversight of federal contract approval has led to staffing shortages at a medical facility in Gallup for Native American patients, leading to drastic cuts in surgical services.
The Gallup Indian Medical Center, operated by the federal Indian Health Service, has limited general surgeries to patients in immediate need of care, halved the beds available in its surgical units and restricted birth services in its Women’s Health Unit due to “shortages in nursing and provider staffing,” according to an internal email obtained byThe New Mexican.
The center is the only place to give birth in the city after Rehoboth McKinley Christian Hospitalshutteredits maternity ward in 2022. This means many patients giving birth in Gallup must be transported to hospitals hours away.
The policy change stems from an executive order signed Feb. 26 by President Donald Trump. The measure, part of an initiative by the Department of Government Efficiency, imposed an extra layer of oversight on contracts, including those for contracted clinical staff, which many Indian Health Service hospitals rely on for patient care.
The Gallup Indian Medical Center is one of more than a dozen facilities under the Navajo Area Indian Health Service, which provides care to nearly 250,000 people.
The internal email announcing cuts at the Gallup facility, sent three weeks ago by a hospital administrator, noted contracts for most of the understaffed positions were in place, but “the approval of the purchase requisitions were delayed” by the new policy.
Dr. Connie Liu, who worked as a generalist OB/GYN at the Gallup hospital until a few weeks ago, called the new policy a “moral injury.”
It’s an increasingly common phrase in the medical world, used to describe the distress providers feel when they know what a patient needs but don’t have the resources to provide it.
Liu argued the policy change was bad for patients — and bad for staff.
“You are there to do the best job that you can, but you aren’t being given the resources for what feels like pretty arbitrary reasons,” she said.
U.S. Sen. Martin Heinrich has called on the Trump administration to immediately repeal the contract policy, arguing it is “crushing” the rural hospital.
“I am appalled at Gallup Indian Medical Center’s dismal state,” Heinrich said in a recent statement. “Despite the truly heroic work being done by providers there, burdensome and unnecessary red tape inflicted by the Trump Administration has caused this already overburdened hospital to cut down on essential services.”
Representatives from the Indian Health Service did not respond toThe New Mexican’s requests for comment on the disruptions at the Gallup center; nor did they answer questions about whether the issue extends to other Indian Health Service facilities in New Mexico.
Supervisors at Indian Health Service facilities in Albuquerque and Santa Fe were not immediately available for comment.
Trump framed the Feb. 26 order as a “transformation in Federal spending on contracts, grants and loans.” It requires each federal agency’s highest-ranking official to review and OK contracts and requisitions.
The policy created a contracting bottleneck at the Gallup Indian Medical Center because it required final approval from a top official at the Indian Health Service’s parent agency, the U.S. Department of Health and Human Services, an investigation by health publicationSTATfound.
The hospital has limited its general surgery services to patients arriving at the emergency room and requiring “urgent and emergent intervention,” the internal email said, while the beds in its surgical unit would be reduced from 40 to 20.
The email also outlines extensive reductions in services at the Women’s Health Unit. Under the new policy, scheduled cesarean sections are “limited,” the email said, while births involving induction or attempted vaginal delivery following a cesarean section are referred to other facilities.
However, the email added, “All patients presenting in labor or with concerns of maternal or fetal status who cannot be safely transferred will be evaluated and managed at GIMC.”
“Patients deserve to deliver close to their homes, close to their support systems, close to their families,” Liu said. “They deserve not to need to be burdened with a ... several hour drive to another hospital in order to have their baby.”
She added, “To me, it’s not government efficiency to centralize decision-making like this because the hospital knows best what the hospital needs.”
Administrators at the Gallup Indian Medical Center plan to reopen beds and reinstitute services “as soon as staff are cleared to start,” the internal email stated.
But when that will happen remains unclear.
Heinrich framed the resulting cuts at the Indian Health Service as failing to meet treaty obligations and undermining tribal sovereignty.
The Indian Health Service and the health care it provides to members of federally recognized tribes stem from the unique government-to-government relationship between tribes and the federal government, delineated first in the U.S. Constitution and since reiterated in treaties, laws and court decisions.
Heinrich argued treaty obligations require the U.S. government to appropriately fund and staff Indian Health Service hospitals.
“The Trump Administration’s actions are a blatant and unacceptable violation of treaty obligations and must end now,” Heinrich said.