Master of Jurisprudence in Indian Law - University of Tulsa College of Law
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Health | Opinion
Mark Trahant: Send Medicaid funds right to IHS


"Health care reform will be high on the list of topics for President Barack Obama’s meeting next Thursday with representatives of the nation’s 564 federally recognized tribes. The president said he looks forward to talks with tribal leaders about ways to “improve their lives and the lives of their peoples.”

The president will be looking for political support from Indian Country for his broader reform proposals, while tribal leaders will be seeking improvements in the health care system for American Indians and Alaskan Natives.

The U.S. Indian Health Service is the closest thing this country has to a single-payer system, serving nearly two million American Indians and Alaskan Natives in 36 states. The agency represents the promise of health care for American Indians made through treaties and other laws and is a full health care delivery system. The IHS operates hospitals and clinics, funds tribal and urban facilities and manages programs ranging from sanitation to diabetes care.

But virtually everyone recognizes the IHS is seriously under-funded.

“Putting all the legal aspects aside, I think the trust responsibility can be summed up by saying that something is owed to American Indians for the lands that were both voluntarily given to the United States and forcefully taken, as well as the atrocities that were committed against their peoples,” said Democratic Rep. Frank Pallone Jr. of New Jersey at an Oct. 20 hearing about Indian health care. “But the federal government has consistently failed to live up to this responsibility in almost every respect.”

The Indian Health Service, in fact, doesn't even count as an acceptable insurance plan under any reform bill. This is ironic because those same health proposals exempt American Indians from the individual mandate to purchase health insurance because of that IHS promise. But unless funding improves, health care reform will guarantee a permanent disparity in just about every Native American health statistic."

Get the Story:
Mark Trahant: A Practical Reform: Indian Country As The 51st State (Kaiser Health News 10/29)

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