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Upon appointment to Guatemalan Health Minister, Lucrecia Hernández Mack implemented the Inclusive Model of Health (IMH), requiring doctors to treat patients who use non-medical vocabulary to describe ailments. Considering the importance of community-based knowledges in developing policy, Mack’s IMH instructs medical professionals to trust patients with diverse, non-traditional knowledges. I identify a shift from necropolitical policy that discriminates against indigenous and poor people toward policy derived from campesino epistemologies. Engaging María Lugones, I argue that the IMH shows how decolonial epistemology brought to bear on policy can fundamentally alter who is allowed to live and die in the state’s care.