Indian Health Service director post vacant since late 2025
The vote ends an extended vacancy at the top of the Indian Health Service, which had been operating without a permanent director since late 2025.
Cruz, a citizen of the Klamath Tribes, takes charge of the federal agency responsible for healthcare delivered to some 2.8 million Native American and Alaska Native patients. His confirmation places a tribal citizen atop the system that serves Indian Country’s communities.
At his confirmation hearing in July, Cruz told the Senate Indian Affairs Committee he would advocate “ferociously” to improve health outcomes, drawing on the stake he holds in the agency’s work. “My family, my friends and my tribal community will live with the consequences of the work I do for decades to come,” he said at the hearing.
The Senate approved him by a 51-47 margin, with the vote counted among the chamber’s last actions before the August recess. Cruz was confirmed alongside more than 70 other nominees of President Donald Trump, part of a wave of confirmations lawmakers cleared before leaving Washington.