Sen. Udall on Repeal of ACA & Medicaid expansion: ‘Indian Country Would be Hit the Hardest’

Democratic Members of the U.S. Senate Committee on Indian Affairs at roundtable with tribal leaders.


Published July 19, 2017

WASHINGTON — On Tuesday, U.S. Senator Tom Udall, vice chairman of the Senate Committee on Indian Affairs, led a day of action to highlight the devastating consequences for Indian Country if Senate Republicans follow through on their threats to repeal the Affordable Care Act (ACA) and decimate Medicaid. Udall has heard from Tribal leaders and Native Americans in New Mexico and across Indian Country that repealing the ACA and the Medicaid expansion would devastate Native Americans’ health, and would undo the progress that has been made to expand access to life-saving health care and services in Indian Country. This morning, Udall hosted a roundtable discussion to hear directly from Tribal leaders. Later in the day, Udall led Democratic members of the Indian Affairs Committee in speaking on the Senate floor to showcase how the ACA has benefitted Native communities. 
Udall opened the roundtable saying that he agreed with numerous Tribal leaders who are troubled that while Republicans’ plans to repeal the ACA would have sweeping implications for Indian Country, GOP leaders have not made any attempt to consult with Tribes. “It has significant impact for Tribes, and we haven’t really done the consultation – government-to-government — that we should be doing. And so, that’s what this roundtable is all about – listening to you, opening it up, and hearing what you have to say,” Udall said. 
The roundtable was attended by U.S. Senators Maria Cantwell (D-Wash.), Catherine Cortez Masto (D-Nev.), Al Franken (D-Minn.), Heidi Heitkamp (D-N.D.), and Jon Tester (D-Mont.).
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 Wayne Keplin, chairman of the Turtle Mountain Band of Chippewa Indians, told the senators that “Don’t get sick after June” is no longer true on his reservation, because of the ACA and Medicaid expansion — which have decreased uninsurance rates on his reservation from 53 percent to 39 percent.  Several Tribal leaders said that the Medicaid expansion – which has insured an additional 287,000 Native Americans across the country and 45,600 Native Americans in New Mexico specifically – has helped fill badly needed funding gaps at IHS, drastically expanding the availability of life-saving services for Native Americans.

Watch the roundtable here:

Daryl Candelaria, administrator of the Pueblo of San Felipe in New Mexico, said Medicaid has helped fulfill the U.S. government’s trust responsibility to provide health care to Native Americans. “I don’t see Indian health care as an entitlement. We have prepaid for this service,” Candelaria said. “We’re the only population here in the United States that has done that with our natural resources, our water, our land … the Medicaid expansion is much needed, and critical within our communities.” Tribes like the Pueblo of San Felipe have “stepped up” to provide critical mental health services in New Mexico, Candelaria said, in part because they have been able to rely on Medicaid to reimburse the cost of providing care.
After the roundtable, Udall was joined on the Senate floor by fellow Indian Affairs Committee members Heitkamp and Franken and Senate Minority Whip Richard Durbin (D-Ill.).
Udall said that nearly 287,000 American Indians and Alaska Natives from 492 tribes – almost 90 percent — have benefited from the ACA’s Medicaid expansion, while another 30,000 individual Native Americans have private insurance thanks to the ACA’s individual marketplace and Native cost-sharing subsidies. In New Mexico alone, Medicaid expansion has insured an additional 45,600 Native Americans. Thanks to Medicaid expansion and increased access to the individual insurance market, 63 percent of IHS patients have health care coverage that allows them to receive care above and beyond the level of “life and limb.”
“These aren’t just numbers and statistics. We are talking about people’s lives,” Udall said, telling the story of Rachael, Justin, and their two young children, Adalie and Jude – a Native family from the Pueblo of Laguna near Albuquerque, whose “lives have been changed for the better under the ACA and Medicaid expansion.” Medicaid expansion gave Rachael access to preventive services like prenatal care and maternity care, helped ensure she could get health care after complications during her pregnancy with her second child, Jude, and later ensured Rachael could get her master’s degree and get a job in her chosen field without worrying about her family’s health care. 
“But now, the Republican Leader and the president are moving in a … dangerous direction. They are pushing to repeal the ACA with no replacement, which would strip health care from over 30 million Americans,” Udall continued. “It would devastate anyone who is sick today, anyone who relies on the insurance they get through Medicaid expansion or the ACA. And it sets up disaster for anyone who might get sick after repeal — because it would destabilize insurance markets — and it would throw our economy into turmoil, killing up to 50,000 jobs in New Mexico alone. 
“And, as often happens with policies that hurt the most vulnerable, Indian Country would be hit the hardest,” Udall said. “Traditionally, the Senate has worked on a bipartisan basis to address Native American issues. That tradition must continue now. We must work together to find a sustainable solution so Native Americans can get affordable, quality health care when they need it.”

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