thanks to the aca, the puyallup tribal health authority in washington state created the country's firsttribal family medicine residency program. patients are cared for in a culturally sensitive way, often by native american staff. and we're seeing results --- a young physician caring for a revered tribal elder; a doctor who has delivered babies in the community for years, and now his son is also doing the same. and that's creating more quality health care, but also sustaining bonds between generations. that's progress that we need to build on. and then the fourth area that we've got to work on is, let's keep our covenant strong by being good stewards of native homelands, which are sacred to you and your families. i saw the beauty of crow agency, montana, when i was a candidate for this office. next year, i'll make my first trip to indian country as president. [applause] the health of tribal nations depends on the health of tribal lands. so it falls on all of us to protect the extraordinary beauty of those lands for future generations. and already, many of your lands have felt the impact