Native Video Series: “Don’t Get Sick after June”

While many people believe Native Americans receive free healthcare, Native Americans have said, “We would not wish Indian healthcare on anyone.” Few people realize that Congress grossly underfunds the Indian Health Service (I.H.S.) or that I.H.S. routinely runs out of funds mid-year. Indian healthcare is not a welfare program but a treaty obligation to the tribes. Yet, program partners have shared with us that when I.H.S. runs out of funds, tribal members are able to receive care only for “life and limb” emergencies. They are unable to be referred off-reservation for specialty services the I.H.S. cannot provide such as cancer treatment, and unable to be transported to or from the reservations for those and other referrals. The watchword for Indian healthcare is “Don’t Get Sick After June,” as this video accurately portrays. The video first aired on Fox News in April 2011.

The new Affordable Care Act (ACA) and the Health Insurance Marketplace is a gain for Indian healthcare. Under ACA, enrolled members of federally-recognized tribes will benefit from these changes:

  • Higher access to healthcare
  • Lower health insurance premiums
  • Removal of co-pays (and possibly other out-of-pocket costs) for services covered under their Marketplace plan, if income is less than $34,470 per year ($70,650 for a family of 4)
  • Exemption from the federal requirement to maintain minimum health insurance coverage, if eligible for I.H.S. healthcare
  • More funds available for healthcare, as health insurance will pay for health services (Formerly, Contract Health Services paid via I.H.S. Now, I.H.S. is the payer of last resort.)
  • Exemption from the open enrollment deadline in the Health Insurance Marketplace
  • Ability to change enrollment status through the Marketplace once a month

These benefits co-exist with permanent reauthorization of the Indian Health Care Improvement Act (IHCIA) under a 2012 Supreme Court decision, and the long-needed strengthening of I.H.S.  New I.H.S. programming aims at raising the health status of American Indians and Alaska Natives. Another change spawned by ACA and affecting Native Americans is the expansion of North Dakota Medicaid. Native Americans represent 18% of the states’ uninsured population.

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