{"id":43039,"date":"2026-07-31T15:36:54","date_gmt":"2026-07-31T10:06:54","guid":{"rendered":"https:\/\/banitoday.com\/the-newest-federally-recognized-tribe-wants-better-healthcare-it-may-be-on-its-own\/"},"modified":"2026-07-31T15:36:54","modified_gmt":"2026-07-31T10:06:54","slug":"the-newest-federally-recognized-tribe-wants-better-healthcare-it-may-be-on-its-own","status":"publish","type":"post","link":"https:\/\/banitoday.com\/hi\/the-newest-federally-recognized-tribe-wants-better-healthcare-it-may-be-on-its-own\/","title":{"rendered":"The Newest Federally Recognized Tribe Wants Better Healthcare. It May Be On Its Own."},"content":{"rendered":"


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LUMBERTON, N.C. \u2014 Soybean fields surround Angie Lowery\u2019s home in Robeson County, on a plot of rural land in southeastern North Carolina. Dozens of antique gas station signs, 20 feet tall, dominate her front yard. A framed re-creation of The Last Supper<\/em>, Lone Ranger posters, and a 3-foot-wide tobacco harvesting basket adorn the walls of her home. A collector, Lowery over the years has amassed remnants of her region\u2019s past.<\/p>\n

But behind the house, the 44-year-old\u2019s backyard garden showcases her goals for the future, one that involves a long, healthy life with her kids: collard greens, bell peppers, onions, tomatoes, red and white potatoes, kale.<\/p>\n

Like Lowery, many in the small towns of Lumberton and nearby Pembroke are citizens of the Lumbee Tribe who have dealt with heart conditions. The mother of four struggled with obesity and had to take insulin pills and shots daily. By when her first grandchild was born, in 2024, Lowery imagined her own life ending the way her biological father\u2019s did: Daily insulin shots for diabetes. Kidney dialysis treatments at home. Dead of a heart attack at 63. She wanted her grandkids to remember her.<\/p>\n

\u201cIf I don\u2019t get this weight off me, if I don\u2019t change my eating habits, it\u2019s going to take me over,\u201d she recalled thinking.<\/p>\n

So, she expanded her garden. She cut fatty foods and sugary drinks out of her diet, stopped eating fried and fast food, and started moving more. She lost 120 pounds in two years and weaned herself off the daily insulin pills.<\/p>\n

The Lumbee Tribe of North Carolina late last year became the 575th tribe to secure federal recognition as a sovereign nation, a milestone that leaders and citizens celebrated in tears. The designation provides federal funding for an array of services, including for healthcare. John Lowery<\/a>, chairman of the tribe and a state representative, declared that<\/a> \u201cthe biggest benefit\u201d would be access to the Indian Health Service \u2014 its clinics and hospitals, as well as funding that it could provide for the tribe to create its own health system<\/a>.<\/p>\n

But Lumbee researchers and healthcare providers say that money won\u2019t be enough. For decades, IHS has been chronically underfunded<\/a>, with the agency\u2019s budget workgroup estimating that it\u2019s nearly $55 billion short<\/a> of what it needs this year. And that was before the Trump administration\u2019s cuts to other federal agencies further pinched IHS. Slashes to the Centers for Disease Control and Prevention last year initially included laying off nearly 1,000 IHS employees<\/a>, and President Donald Trump\u2019s proposed 2027 budget cuts more than $150 million for a program to address diabetes<\/a> in Native American tribes.<\/p>\n

The nearest IHS facility is more than a two-hour drive to another state for most of the 55,000 Lumbee citizens in Robeson County. The county is one of the poorest in the U.S.<\/a> and has some of the worst health outcomes<\/a>.<\/p>\n

\"A
Robeson County is mostly rural, agricultural land. Most of the members of the Lumbee Tribe live in the small towns of Lumberton and Pembroke, both about a half-hour drive from the South Carolina border. (Andrew Jones\/KFF Health News)<\/figcaption><\/figure>\n

The Congressional Budget Office in 2022 estimated that the tribe could increase IHS spending by $247 million over four years<\/a>.<\/p>\n

The tribe will have to rely on other revenue sources that are now allowed through recognition, such as a casino, to reverse the health disparities their people have faced for decades, Lumbee researchers said.<\/p>\n

\u201cNone of us can depend on IHS alone, because we just don\u2019t have the resources within that system,\u201d said Donald Warne<\/a>, a physician, a researcher at the Johns Hopkins Center for Indigenous Health, and a member of the Oglala Lakota tribe. \u201cBut it\u2019s a great starting point.\u201d<\/p>\n

The IHS did not respond to questions about plans for the tribe\u2019s health system. John Lowery did not respond to requests for an interview or a list of questions, but he said on a June podcast that he expected healthcare to be the largest portion of the tribe\u2019s budget<\/a>.<\/p>\n

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\n\t\t\t\t\t\t\tLowery makes beaded earrings, teaches culture classes, owns a gravestone business, and makes engravings in her Pembroke, North Carolina, shop.\t\t\t\t\t\t (Andrew Jones\/KFF Health News)<\/figcaption>
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\n\t\t\t\t\t\t\tAntiques hang on Lowery\u2019s walls at her home. She and her husband, Grant Hunt, are avid collectors.\t\t\t\t\t\t (Andrew Jones\/KFF Health News)<\/figcaption>
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\u2018Not Just Statistics\u2019<\/strong><\/p>\n

Eighteen years ago, Andrea Blackburn<\/a>, a doctor in Lumberton and a citizen of the tribe, was working at a nearby medical center. There, she said, she was taught that patients with certain last names \u201care often referred directly to cardiac catheterization,\u201d a procedure to diagnose heart conditions.<\/p>\n

Blackburn said she realized that common Lumbee surnames carried an expectation of disease.<\/p>\n

\u201cNearly two decades later, I can tell you that reality has not changed,\u201d she told assembled tribal leadership and citizens at a public hearing.<\/p>\n

Robeson County\u2019s rates of heart disease, diabetes, and risky substance use<\/a> continue to rank among the highest in the state, Blackburn noted. In 2025, more than half of the county\u2019s residents<\/a> were Medicaid enrollees, the highest percentage of all counties in the state.<\/p>\n

\u201cBut these are not just statistics to me,\u201d she said. \u201cThese are my patients. These are our families.\u201d<\/p>\n

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Andrea Blackburn, a citizen of the Lumbee Tribe, is a physician in Robeson County. (Andrew Jones\/KFF Health News)<\/figcaption><\/figure>\n

For Angie Lowery, breaking free from those statistics meant taking her health into her own hands.<\/p>\n

She hopes a healthy diet is the answer to breaking her family\u2019s cycle and living long enough to form relationships with her grandkids. And she brought the rest of the family with her. Her teenage daughter lost about 35 pounds. Two of her other children are now \u201chealth fanatics,\u201d Lowery said.<\/p>\n

Her granddaughter will be 2 in November. One Sunday morning in March, Lowery served up macaroni, cauliflower, and chickpeas for her as they spent the day together.<\/p>\n

Lowery had supported building a casino, believing it would provide better education, infrastructure, and healthcare for her family.<\/p>\n

\u201cThat vote, I\u2019m thinking of my children\u2019s future,\u201d she said.<\/p>\n

\"Angie
Lowery grows squash, onions, potatoes, and other produce in her backyard garden. Later this year, she\u2019ll can some of the harvest for her family. (Andrew Jones\/KFF Health News)<\/figcaption><\/figure>\n
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Casino Dreams in Limbo<\/strong><\/p>\n

Tribal citizens are deeply divided over how to reverse decades of economic decline that have led to poor living conditions, unaffordable health services, and chronic disease.<\/p>\n

Four months after Trump signed the Lumbee Fairness Act \u2014 declaring<\/a> \u201cI love the Lumbee Tribe\u201d \u2014 tribal leaders gathered at a business meeting to take the first steps toward building a casino and establishing gaming as a new revenue source. Hundreds of federally recognized tribes across 29 states have used gaming as a source of revenue, bringing in $43.9 billion<\/a> in fiscal 2024, according to the latest report from the National Indian Gaming Commission.<\/p>\n

The approach has been popular among tribal nations looking for more dollars to build up healthcare. The Choctaw Nation of Oklahoma in 1999 became the first tribe<\/a> to build its own hospital, using roughly $25 million in gaming money, and the Eastern Band of Cherokee Indians in western North Carolina funded its own hospital in 2015 mostly with $82 million in gaming funds<\/a>.<\/p>\n

But the Lumbee Tribe\u2019s effort to establish a casino collapsed in June.<\/p>\n

More than 60% of voters<\/a> rejected a Lumbee constitutional amendment that would have allowed tribal leaders to create infrastructure needed for a gaming business. John Lowery said on Facebook<\/a> that he doesn\u2019t plan on bringing back the initiative now that it was rejected \u201cby the majority of Lumbee voters.\u201d His term as chairman ends in two years.<\/p>\n

\"An
A portrait of Lumbee Tribe Chairman John Lowery hangs beside a rendering of a proposed casino and resort meant to help bring in revenue for the newly federally recognized tribe. Citizens voted against the project. (Andrew Jones\/KFF Health News)<\/figcaption><\/figure>\n

Other funding sources to provide health services for the tribe could include gas stations or hotels, he said in a call with citizens before the vote.<\/p>\n

Lumbee and other Native health researchers said they believe a twofold system \u2014 using IHS money and additional revenue \u2014 is necessary. Funds from gaming could compensate for what IHS can\u2019t support.<\/p>\n

Casinos\u2019 impact on tribal health has been debated in research for decades. Studies show<\/a> that the money from gaming helps tribes build more facilities, hire more doctors, and improve social services, but unhealthy substance use and smoking increase.<\/p>\n

\u201cThere\u2019s going to be negative impacts,\u201d Brittany Locklear<\/a>, a social work professor at the University of North Carolina and citizen of the Lumbee Tribe, said at a June panel discussion on gaming.<\/p>\n

Ronny Bell<\/a>, 62, a Lumbee citizen and a researcher studying Native health at UNC, said the community has felt ripple effects from systemic racism, having not been acknowledged as a tribal nation for so long, and the economic downturn following the loss of Robeson County\u2019s manufacturing and tobacco jobs.<\/p>\n

That history plays a part in the health statistics in Robeson today, Bell said. But with federal recognition, he said, the Lumbee people have achieved a victory they\u2019ve fought for since 1888.<\/p>\n

\u201cI think about the resilience of the Lumbee people and how they\u2019ve gone through this 100-plus-year fight for federal recognition,\u201d Bell said. \u201cI sort of see that as a continuation of this resilience, and how now we have this opportunity with federal recognition to bring in resources to help address those issues.\u201d<\/p>\n

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The Lumbee Tribe government offices and citizen housing in Pembroke, North Carolina, stand amid long stretches of agricultural countryside. (Andrew Jones\/KFF Health News)<\/figcaption><\/figure>\n

Resolution and Uncertainty<\/strong><\/p>\n

Jada Brooks, a Lumbee citizen and UNC researcher who studies Indigenous health and lives in Robeson County, is conducting a study about heart health among Lumbee women. The initiative includes classes in which Lumbee women ages 18 to 50 signed up to discuss their health. That\u2019s where she met Angie Lowery, who talked about her lifestyle changes with the group.<\/p>\n

\u201cI was just floored by, like, just the extent to which she went,\u201d Brooks said.<\/p>\n

She and other Lumbee researchers said federal recognition allows Lumbee citizens to be set apart in census data, paving a way to get clear information on heart health, cancer rates, diabetes diagnoses, and mental health risks.<\/p>\n

\u201cThere\u2019s challenges in even understanding the nuances of these complex health disparities, because a lot of data isn\u2019t out there,\u201d said Ryan Dial, a public health researcher at UNC and a member of the Lumbee Tribe.<\/p>\n

But access and confidence may be the biggest barriers Lumbee people will have to overcome, Brooks said.<\/p>\n

\u201cI think what really matters is people feeling like they can trust the healthcare system.\u201d<\/p>\n

Brooks said she worried that a casino would encourage bad health habits, such as smoking and drinking.<\/p>\n

\u201cLet\u2019s not create more problems for ourselves than we already have,\u201d she said. She voted against the casino.<\/p>\n

Like others in the tribe, Angie Lowery believes in her people\u2019s power to help themselves, regardless of whether government steps in to help.<\/p>\n

\u201cJust because we\u2019re federally recognized don\u2019t mean that the doors are going to open up and money\u2019s going to fall through the door like dirt,\u201d she said.<\/p>\n

\"A
Angie Lowery sits in her Ford F-250 reading the Lumbee Constitution on a hot June day. The tribe secured federal recognition in December 2025. (Andrew Jones\/KFF Health News)<\/figcaption><\/figure>\n<\/div>\n


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LUMBERTON, N.C. \u2014 Soybean fields surround Angie Lowery\u2019s home in Robeson County, on a plot of rural land in southeastern North Carolina. Dozens of antique gas station signs, 20 feet tall, dominate her front yard. A framed re-creation of The Last Supper, Lone Ranger posters, and a 3-foot-wide tobacco harvesting basket adorn the walls of […]<\/p>\n","protected":false},"author":1,"featured_media":43040,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[270],"tags":[],"class_list":["post-43039","post","type-post","status-publish","format-standard","has-post-thumbnail","category-health-2"],"aioseo_notices":[],"aioseo_head":"\n\t\t\n\t\n\t\n\t\n\t\n\t\n\t\t\n\t\t\n\t\t\n\t\t\n\t\t\n\t\t\n\t\t\n\t\t\n\t\t\n\t\t\n\t\t\n\t\t