HealthCare for Native Americans

Published June 9, 2015    By Partnership

There is a prevalent misunderstanding regarding the nature of federal healthcare for American Indians. The Indian Health Service (I.H.S.) under the Department of Health and Human Services provides health services to federally recognized tribes based on the special government-to-government relationship between the federal government and tribes dating as far back as 1787. This obligation arises out of treaties and other legal mandates.

Yet, while the federal government is obligated to provide healthcare for these tribes, I.H.S. is not immune to the cuts facing many federal programs. As Montana Senator and member of the Indian Affairs Committee, Jon Tester, highlighted in a 2014 NPR interview, I.H.S. is struggling to fulfill its obligation.

Of late, I.H.S. has found itself unable to make it through a fiscal year without running out of funds. Combined with the challenge of recruiting healthcare professionals to rural and remote I.H.S. facilities, this makes for a real crisis in providing quality healthcare to American Indian communities.

In response, the I.H.S. is limiting treatment to only the most sensitive cases such as those involving loss of life or limb. Fewer resources are available for preventative care that can address health issues before they become a serious condition. The I.H.S. simply cannot prioritize non-life threatening needs or pay for patient referrals outside of the I.H.S. system, and however minor, well-being and quality of life for tribal members reliant on I.H.S. care is directly affected by untreated medical needs. This is why we support health screenings, health education and other initiatives by tribally-operated health and wellness programs and our partners who work for them. Our Health Services benefited 287,209 Native Americans in 2014.

Another response to the I.H.S. situation is the Affordable Care Act (aka ObamaCare), through which efforts are underway to enroll American Indians in affordable private insurance plans. Private plans offer American Indians more healthcare providers and services than available through I.H.S.  In addition, private plan holders may still access I.H.S. healthcare covered by private insurance, which redirects funds back into I.H.S.

There are, however, legitimate concerns with private insurance enrollment too. In 2013, less than half a percent of individuals who enrolled in private insurance under ObamaCare are American Indians. To increase Native enrollment in Obamacare, significant community outreach, education and assurance of affordability will be required.