Democratic Senators Offer Amendment to Protect Health Care for Indian Country

Published July 28, 2017

Measure would block devastating cuts to Indian health care from Republican effort to slash Medicaid, rip health care away from Native families and children

WASHINGTON — On Thursday, U.S. Senators Heidi Heitkamp (D-N.D.), Tom Udall (D-N.M.), vice chairman of the Senate Committee on Indian Affairs, and Martin Heinrich (D-N.M.) announced that they offered an amendment to protect against cuts to health care for Indian Country as a result of the Republican effort to repeal the current health reform law and slash funding for Medicaid.

As the Senate continues to debate the Republican repeal effort, Heitkamp, Udall, and Heinrich have heard from Tribal leaders and Native Americans in North Dakota, New Mexico, and across Indian Country about how the Republican health care bill would eliminate the Medicaid expansion, devastating Native Americans’ health, and undoing the progress that has been made to expand access to life-saving health care and services in Indian Country.

The amendment is also co-sponsored by U.S. Senators Maria Cantwell (D-Wash.), Catherine Cortez Masto (D-Nev.), Al Franken (D-Minn.), Patty Murray (D-Wash.), Jeff Merkley (D-Ore.), Brian Schatz (D-Hawaii), Debbie Stabenow (D-Mich.), and Jon Tester (D-Mont.). ​

Heitkamp, Udall, and Heinrich’s amendment would send the Republican health care repeal bill to committee to be amended to exempt the Indian Health Service, Tribal health care facilities, and other urban Indian health providers from any Medicaid cuts if Republicans succeed in repeal. The amendment would also make sure that American Indians and Alaska Natives are not harmed by changes to the private insurance market that create barriers to individual coverage. Nearly 287,000 American Indians and Alaska Natives from 492 tribes – almost 90 percent of all tribes – have benefited from the Medicaid expansion. Another 30,000 individual Native Americans have private insurance thanks to the individual marketplace and Native cost-sharing subsidies. Nationally, 54 percent of American Indian and Alaska Native children were enrolled in Medicaid or the Children’s Health Insurance Program for health coverage in 2015, as opposed to 39 percent of all children. Although senators are still uncertain what form the final health care legislation will look like — due to the Republicans’ chaotic effort to rip away families’ health care — the Democratic cosponsors will continue to fight to defend health care services that Indian Country depends on.

“The Republican health care bill would be devastating for Native American families, ripping away Medicaid for many and making health care unaffordable for many more. We’re working to make sure the concerns of Native Americans throughout the country and in our states are heard,” said Heitkamp.
North Dakota U.S. Senator Heidi Heitkamp

North Dakota U.S. Senator Heidi Heitkamp

“Access to health care is a treaty and trust obligation to Native communities – but under this bill, that health care is in jeopardy. I won’t stand for it. We recently led a needed discussion about how this bill would take away health care from Native populations, and last year, I brought the director of Indian Health Service to North Dakota to press her about maintaining quality care for tribal communities. It’s past time that Republicans join us and work across the aisle to find real, bipartisan solutions to improve health care instead of taking an axe to it.”

“The health and wellbeing of Indian Country should not be held hostage by this reckless, partisan repeal effort. Threats to dismantle the individual marketplace and decimate Medicaid would hit Native Americans and Alaska Natives the hardest,” Udall said. “The Affordable Care Act and Medicaid expansion have helped fulfill our federal government’s trust responsibility to Tribes, by providing badly needed resources to fill the funding gap facing Native health facilities. For years, IHS has been woefully — and shamefully – underfunded. But thanks to the Medicaid expansion, Native Americans across Indian Country are now able to access critical, life–saving services – above the ‘life and limb only’ level – that were previously unavailable. Each of the proposals offered by Republicans to this point would be utterly catastrophic for the health care of Native Americans. I will keep fighting to defeat these misguided efforts, to protect the progress we have made, and to find better, long term solutions to ensure that Native Americans can get affordable, quality health care when they need it.”

“The expansion of Medicaid, as a result of the Affordable Care Act, has made a tremendous impact in New Mexico and across Indian Country. If Republicans go forward with their back room deal, Native Americans who have some of the greatest barriers to consistent access to preventative and emergency medical care would pay the price,” Heinrich said. “I continue to hear from New Mexicans about how access to health care coverage has helped their families and even saved their lives. A reckless repeal would quickly throw our state’s health care system into chaos and strip critical funding from Indian Health Service and other Tribal health providers, which are already severely underfunded. I am proud to join Senators Heitkamp and Udall in this effort to stand up for our Tribal communities who depend on this lifesaving coverage.”

For years, the unofficial motto given to the underfunded Indian Health Service (IHS) on many reservations has been “Don’t get sick after June” — a reference to how persistent underfunding has forced IHS facilities to ration care, limiting Native families to hospitals and clinics that can only provide “life and limb” emergency medical services. But the Medicaid expansion has filled funding gaps at IHS, allowing IHS facilities to provide Native Americans with previously inaccessible, life-saving services. Thanks to Medicaid expansion and increased access to the individual insurance market, 63 percent of Indian Health Service (IHS) patients have health care coverage that allows them to receive care above and beyond the level of “life and limb.” As a result, IHS now receives almost $1 billion to supplement its health care delivery – an increase of 21 percent.

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