Indian Health Care Improvement Act Left Out of the House Republican House Repeal and Replace Health Plan

Published March 7, 2017

WASHINGTON –  The long-awaited House Republican plan to repeal and replace the Affordable Care Act, commonly referred to as Obamacare, was released Monday evening.

One problem for American Indians and Alaska Natives is the proposed plan does not mention the Indian Health Care Improvement Act that was a key component for those in Indian Country in the Affordable Care Act.

“This  plan is an urgent call for American Indians and Alaska Natives to sign up for Medicaid, children’s health insurance, or the Exchange Plans. This plan makes it clear that there is time to sign up as an act of defiance and that adds new money to the Indian health system,” writes American Indian journalist Mark Trahant in a column titled “Three Things You Need to Know about the House’s Powerball Health Care Plan” published today in Trahant Reports.

The Indian Health Care Improvement Act (IHCIA), the cornerstone legal authority for the provision of health care to American Indians and Alaska Natives, was made permanent when President Obama signed the bill on March 23, 2010.

The version of the IHCIA signed into law in 2010 includes many major changes and improvements to facilitate the delivery of health care services for American Indians and Alaska Natives, such as:

• Enhancement of the authorities of the Indian Health Service (IHS) director, including the responsibility to facilitate advocacy and promote consultation on matters relating to Indian health within the Department of Health and Human Services.

• Provides authorization for hospice, assisted living, long-term, and home- and community-based care.

• Extends the ability to recover costs from third parties to tribally operated facilities.

• Updates current law regarding collection of reimbursements from Medicare, Medicaid, and CHIP (Children’s Health Insurance Program) by Indian health facilities.

• Allows tribes and tribal organizations to purchase health benefits coverage for IHS beneficiaries.

• Authorizes IHS to enter into arrangements with the Departments of Veterans Affairs and Defense to share medical facilities and services.

• Allows a tribe or tribal organization carrying out a program under the Indian Self-Determination and Education Assistance Act and an urban Indian organization carrying out a program under Title V of IHCIA to purchase coverage for its employees from the Federal Employees Health Benefits Program.

• Authorizes the establishment of a Community Health Representative program for urban Indian organizations to train and employ Indians to provide health care services.

• Directs the IHS to establish comprehensive behavioral health, prevention, and treatment programs for Indians.





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