Despite treaties, agreements and federal laws, most American Indians and Alaska Natives live without adequate health care.

The Indian Health Service budget only meets about half of the need and is forced to ration care. The agency has a 18 percent vacancy rate for doctors but in some areas, like Great Plains, the rate jumps to 38 percent.

The lack of services often leads to misdiagnosed cases or worse, no treatment, at all. The family of Ta'Shon Rain Little Light, a five-year-old from the Crow Tribe of Montana, was told she had depressed but it was later discovered she had terminal cancer.

"It is heartbreaking to imagine that our leaders in Washington do not care, so I must believe that they do not know," Joe Garcia, the president of the National Congress of American Indians, said in the State of Indian Nations address in February.

The IHS budget includes money for outside health care providers. But contract health care support funds run out only a few months into the year, leaving some patients without options and, in some cases, large medical bills.

Get the Story:
PROMISES, PROMISES: Indian health care needs unmet (AP 6/15)

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