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Mary Smith and Mary Wakefield: Obamacare repeal is bad for Indian Country






Indian Health Service staff at a powwow on the Rosebud Sioux Reservation in South Dakota. Photo: IHS

Republican lawmakers are moving to replace the Affordable Care Act, popularly known as Obamacare, with the American Health Care Act. But while the Indian Health Care Improvement Act, won't be affected by the effort, two former Obama administration officials -- Mary Smith, the former director of the Indian Health Service, and Mary Wakefield, the former deputy secretary at the Department of Health and Human Services -- warn of negative impacts in Indian Country if Obamacare goes away:
By almost any measure, the health status of American Indians and Alaska Natives has consistently lagged behind other U.S. populations. This situation makes every effective health policy and program critically important to Indian country. Funding for health programs and policy strategies designed to prevent illness and keep families healthy as well as improving access for American Indian and Alaska Native populations are vital. The Affordable Care Act (ACA) has advanced these goals, and Indian country has been able to benefit from a number of provisions of the ACA. This includes the important reauthorization of the Indian Health Care Improvement Act (IHCIA). IHCIA allows for the Indian Health Service (IHS) to be reimbursed by Medicare, Medicaid and third-party insurers, which is crucial to providing supplemental funding to keep the system running. Third party reimbursements, especially Medicaid reimbursements are vital in the provision of direct health care services to American Indians and Alaska Natives.

Additionally, to help prevent serious illnesses, the Affordable Care Act has and continues to strengthen public health across American Indian and other communities. It provides more options and supports better access to health care services. ACA-supported insurance coverage, available through private plans on the Health Insurance Marketplace (or Exchange) and through Medicaid expansion, add an essential complementary tool to the programs provided through IHS. For example, through the health insurance options available through the ACA, many tribal members benefit by having expanded choices in where and when they obtain health care services. Additionally, for tribal members that reside in states that expanded Medicaid, more American Indian families are now filling some of the longstanding gaps in accessing health care services. These provisions were so important to the health of Indian communities that in 2016, IHS implemented efforts across Indian country to get more individuals enrolled in Medicaid expansion.

Read More on the Story:
Mary Smith and Mary Wakefield: The Affordable Care Act Repeal: A Road Natives Should Not Be Forced to Go Down (Indian Country Media Network 3/20)

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