The Supreme Court’s decision to pass the Affordable Care Act will affect all Native Americans and Tribal Nations served by the Indian Health Care Service. It makes permanent the reauthorization of the Indian Health Care Improvement Act (IHCIA), the key legal authority for the provision of health care for tribal people. The Act was originally passed in 1976 and last authorized in 2000. Each year since that time, tribes have had to lobby for the reauthorization of the IHCIA. The Supreme Court’s decision affirmed and made permanent the Act; it also extends current law and authorizes new programs and services.
The Affordable Care Act law provides American Indians and tribes more choices. We can use the Indian Health Service if eligible or we can purchase affordable health coverage, and/or access coverage through other sources such as Medicaid, Medicare, and Children’s Health Insurance Program if eligible.
Some of the new programs and authorities include:
- Authorities for new and expanded programs for mental and behavioral health treatment and prevention;
- Expanded authorities for long-term care services, including home health care, assisted living and community-based care;
- New authorities for development of health professional shortage demonstration programs’
- Expanded authorities for funding of patient travel costs;
- New authorities for demonstration projects for innovative health care facility construction;
- New authorities for the provision of dialysis services;
- Improvements in the Contract Health Services program, which pays for referrals ;
- New authorities for facilitation of care for Indian Veterans; and
- New authorities for urban Indian health programs.
These authorities presuppose consultation with tribal sovereign nations and this nation’s Government-to-Government relationship with tribal nations. It is now up to tribes to hold the federal government to this key law upheld by the U.S. Supreme Court, a law that our ancestors gave up so much for.