The Lumbee Tribe of North Carolina is seeking to improve healthcare after gaining federal recognition, which opens access to the Indian Health Service, but the funding and planning needed to deliver services remain uncertain. A proposed casino had been presented as a major source of independent revenue for healthcare and other tribal priorities, yet members voted it down, leaving the tribe without that potential income stream.

More than 62% of voters opposed the gaming amendment in June, with over 9,200 ballots cast. Supporters had said the planned development near Interstate 95 could create about 3,000 jobs and fund healthcare, housing, education and public safety; the tribe had already spent more than $6 million on nearby land. The federal government’s proposed 2027 budget retains $6 million to prepare initial healthcare services for the Lumbee, whose membership is about 60,000.