Fulfilling the Promise of a Healthier Tomorrow in Indian Country

Dr. Nadine Gracia

Dr. Nadine Gracia

Guest Commentary

By Dr. Nadine Gracia

Tucked away in central Wyoming you will find the Wind River Indian Reservation—home to the Eastern Shoshone and the Northern Arapaho tribes, and home to a spirit of perseverance and self-determination that permeates America. While we celebrate the rich traditions of our nation’s indigenous people during National American Indian and Alaska Native Heritage Month, we cannot forget the fateful history that is imprinted on Indian Country. With this history in mind, we can work to create a brighter and healthier future for American Indians and Alaska Natives.

Earlier this year, I had the privilege to visit the Wind River Indian Reservation to meet with tribal leaders and community members about the challenges faced by American Indians. We know that this community frequently contends with issues that prevent them from receiving quality health care including cultural differences, geographic isolation, environmental threats, and low income—all factors that impact health. But what resonated with me most during my visit was the enduring hope that sprung forth from the community—a hope that with sound resources and opportunities, these barriers can be broken down.

One barrier that we are striking down is access to affordable, quality health care for American Indians/Alaska Natives. And since the passage of the Affordable Care Act five years ago, America’s Native population has greater coverage from a variety of providers including their local Indian health service units. This increased access provides a certain level of security that is a bright light amidst challenging life circumstances.

At the U.S. Department of Health and Human Services (HHS) Office of Minority Health (OMH), we are working to ensure that American Indians/Alaska Natives—who face significant health disparities including higher rates of uninsurance, higher rates of chronic conditions such as diabetes and chronic liver disease, higher rates of suicide, and lower life expectancy—have access to coverage through the Health Insurance Marketplace.  To increase awareness of the opportunities and benefits for American Indians/Alaska Natives made possible by the Affordable Care Act, we have created a new infographic that answers common questions, including information on the Indian health coverage exemption.

More than 500,000 uninsured American Indians/Alaska Natives have the opportunity for coverage through the Marketplace, and it is our goal to see as many members as possible of the American Indian/Alaska Native community gain coverage—and the peace of mind that comes with being covered. While members of federally recognized tribes and Alaska Native Claims Settlement Act (ANCSA) shareholders can enroll in Marketplace coverage any time of year, we encourage consumers in these communities to visit HealthCare.gov to sign up for coverage during the current open enrollment period, which runs through January 31, 2016. Anyone who signs up for coverage by December 15, 2015 can have coverage beginning January 1 for a healthier start to the New Year.

American Indians/Alaska Natives gaining health insurance coverage is beneficial not only to the individual, but to their tribe as a whole. The more American Indians/Alaska Natives who have health insurance, the more tribal health providers can obtain reimbursements from insurance companies, allowing the reinvestment of those dollars back into their communities. This means additional services and greater capacity to provide care to American Indians/Alaska Native people.

OMH not only works to maximize access to care for American Indians/Alaska Natives, but also supports efforts to strengthen the capacity of the community to address health disparities. Through OMH initiatives such as the American Indian/Alaska Native Health Disparities Program, the American Indian/Alaska Native Health Research Advisory Council (HRAC), and the Higher Education Technical Assistance Project (HE-TAP), OMH is helping create programs to encourage Native youth to  pursue health professions careers, strengthen disease surveillance of Tribal Epidemiology Centers and Urban Indian Health Programs, address tribal health research priorities, and enhance the capacity of Tribal Colleges and Universities.

With access and opportunity, the future for Indian Country is one filled with the hope to overcome the odds and to fully realize the promise a healthier tomorrow.

To learn more about your health insurance options, visit HealthCare.gov or call 1-800-318-2596 (TTY: 1-855-889-4325) 24/7. Find free, confidential in-person assistance in your local area by visiting localhelp.healthcare.gov.

To learn more about the HHS Office of Minority Health visit www.minorityhealth.hhs.gov.

Dr. J. Nadine Gracia is the Deputy Assistant Secretary for Minority Health and the Director of the Office of Minority Health at the U.S. Department of Health and Human Services (HHS). The Office of Minority Health is dedicated to improving the health of racial and ethnic minority populations through the development of health policies and programs that will help eliminate health disparities. A pediatrician with epidemiology training, Dr. Gracia joined the Federal government as a White House Fellow, assigned to HHS and later to the Office of the First Lady. She most recently served as Chief Medical Officer in the HHS Office of the Assistant Secretary for Health, where she focused child and adolescent health, disaster preparedness, environmental health, global health, Haiti recovery, and the White House Council on Women and Girls. She also led the development of the 2012 HHS environmental justice strategy.

A first-generation Haitian-American, Dr. Gracia holds a Bachelor of Arts in French from Stanford University, a medical degree from the University of Pittsburgh School of Medicine, and a Master of Science in Clinical Epidemiology from the University of Pennsylvania.

UPDATED: Wednesday, November 18, 2015.


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  1. Lena Toledo 4 years ago
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