FLAGSTAFF - 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 draws mostly Navajo students from reservation land not subject to state property taxes and 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.

Rep. Raul Grijalva, D- Ariz., 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.