FLAGSTAFF, Ariz. — When it comes to the automatic spending cuts that began taking effect this month, federal lawmakers spared programs that serve the nation’s most vulnerable — such as food stamps, Medicare, Medicaid and veterans’ assistance — from hard hits.

That wasn’t the case with programs for American Indian reservations, where unemployment is far above the national average, women suffer disproportionately from sexual assaults, and school districts largely lack a tax base to make up for the cuts.

The federal Indian Health Service, which serves 2.1 million tribal members, says it would be forced to slash its number of patient visits by more than 800,000 per year. Tribal programs under the U.S. Department of Interior and the U.S. Bureau of Indian Affairs that fund human services, law enforcement, schools, economic development and natural resources stand to lose almost $130 million under the cuts, according to the National Congress of American Indians.

“We will see significant impacts almost immediately,” Interior Secretary Ken Salazar told The Associated Press, referring to the BIA. “We will have to furlough some employees. It will mean that there’s going to be a slowing down of the processing of applications and so there will be an impact on the work that the BIA does on behalf of Indian Country.”

The timing and magnitude of most of the cuts are uncertain as Congress looks for a way to keep the government operating beyond March 27 with no budget in place. In the meantime, tribes across the country are preparing for the worst.

Some are better-positioned than others.

In northwestern New Mexico’s McKinley County, where about a third of the population lives below the federal poverty level, the Gallup-McKinley County School District is facing a $2 million hit. The cuts could result in job losses and more crowded classrooms. The district that draws mostly Navajo students from reservation land not subject to state property taxes relies heavily on federal funding to pay its teachers and provide textbooks to students.

“To me, it seems very unfair that one of the poorest counties with one of highest Native enrollment in the country has to be impacted the most by sequestration,” said district superintendent Ray Arsenault. “We are very poor, we’re very rural, and it’s going to hurt us much more.”

The district faced enormous public pressure when it wanted to close schools on the Navajo Nation due to budget shortfalls, so it won’t go that route under looming cuts, Arsenault said. Instead, he would look to reduce his 1,800 employees by 200 — mostly teachers — and add a handful of students to each classroom.

The Red Lake Band Of Chippewa Indians in northern Minnesota expects 22 jobs, mostly in law enforcement, will be lost immediately. Tribal Chairman Floyd Jourdain Jr. said police already operate at a level considered unsafe by the BIA. Deeper cuts forecast for later this year will increase job losses to 39, and “public safety operations at Red Lake will collapse,” he said.

On the Rosebud Indian Reservation in south-central South Dakota, a new $25 million, 67,500-square foot jail that was to provide cultural and spiritual wellness programs for tribal members charged with crimes sits empty. The annual operating budget of $5 million would be reduced to around $840,000 because of the automatic budget cuts, said jail administrator Melissa Eagle Bear.

“I don’t think this is intentional, but I do feel like it’s the government’s way of controlling things,” she said. “They definitely have control, and we’re going to keep going. … I know Indian people. We tend to survive off what resources we have.”

The National Indian Education Association said the cuts to federal impact aid will affect the operation of 710 schools that serve about 115,000 American Indian students. Those cuts would be immediate because the money is allocated in the same school year it is spent.

In Oklahoma, the Cherokee Nation said it is well-poised to handle cuts to its diabetes, housing rehabilitation, Head Start and health care programs. The tribe put a freeze on nonessential hires and halted most travel and training for tribal employees. The tribe’s $600 million budget for services and programs comes largely from federal funds, but tribal businesses also post annual revenues in the same amount that have been used to fill in gaps, said Principal Chief Bill John Baker.

“What this really is going to boil down to mean is that there won’t be any new purchases, new equipment, and probably we’ll hold our programs but not be in a position to add new programs,” Baker said. “Luckily, we’re in pretty good shape.”

Baker and other tribal leaders have argued against the cuts, saying the federal government has a responsibility that dates back to the signing of treaties to protect American Indian people, their land and tribal sovereignty.

While food distribution, welfare programs and health care services that serve the needy are exempt from the cuts, similar services on reservations aren’t, said Amber Ebarb, a budget and policy analyst for the National Congress of American Indians.

“Tribes have too little political clout, too small numbers for those same protections to be applied,” she said. “I don’t think it’s the intent of any member of Congress. The ones we hear from, Republicans and Democrats who understand trust and treaty rights, think it’s outrageous that tribes are subject to these across-the-board cuts.”

Democratic Rep. Raul Grijalva of Arizona said he doesn’t believe Congress as a whole understands the potential impact to tribes and the duty that federal agencies have to meaningfully consult with them on major actions. He and Republican Rep. Don Young of Alaska are urging their colleagues to spare those populations from automatic budget cuts, particularly when it comes to health care.

“It’s not about creating a niche for American Indians. It’s about addressing areas in which need is great,” Grijalva said.

Clara Pratte, director of the Navajo Nation’s Washington, D.C., office, said regardless of the outcome of the budget talks, tribal leaders should press Congress to make funding for Indian programs mandatory, not discretionary.

Nearly two-thirds of the Navajo Nation’s $456 million budget comes from federal sources that go to public safety, education, health and human services, roads and infrastructure. The tribe is facing up to $30 million in automatic budget cuts.

“A lot of these programs go to people that cannot lift themselves up by their bootstraps,” Pratte said. “I’m talking about grandmas, grandpas, kids under the age of 10. We can’t very well expect them to go to work.”