PRESS RELEASE: Report Finds States Again Shoulder the Cost of an Unmet Federal Trust Responsibility

Congress Must Reauthorize 100% FMAP for Urban Indian Health Care


NCUIH Contact: Meredith Raimondi, Vice President of Policy and Communications,

WASHINGTON, D.C. (September 15, 2023) – Today, the National Council of Urban Indian Health (NCUIH) announced the release of a policy report on the importance of setting the federal medical assistance percentage (FMAP) at 100% for services provided to Medicaid beneficiaries at urban Indian organizations (100% FMAP for UIOs).  With Medicaid beneficiaries making up 46% of the UIO Native patient population, 100% FMAP for UIOs is critical to expanding community health programming and youth services, ultimately leading to improved long-term health outcomes.

“This report showcases what we already knew: when the federal government faithfully honors its Trust responsibility to Native people, health access in our communities improves,” said Francys Crevier, CEO of NCUIH. “This provision has broad support across Indian Country because it directly impacts our people. Congress must act now to permanently reauthorize 100% FMAP for UIOs.”

The report reflects the findings from case studies of two states, Washington and Montana, that successfully utilized the American Rescue Plan Act’s (ARPA) temporary authorization of 100% FMAP for UIOs to increase funding support for their UIOs. The reports’ findings demonstrate that 100% FMAP for UIOs results in:

  • Increased services at UIOs;
  • Significant cost savings for states; and,
  • Flexibility for states to support UIOs in their health care delivery.

The report also provides an extensive history of 100% FMAP in the Indian health care system. The Indian Health Service and Tribal facilities have been extended 100% FMAP for decades, and UIOs have advocated for parity through legislation since 1999. Parity for UIOs allows patients to seek care closer to their homes and access community-focused and culturally competent care.

The full report is available at this link.


About NCUIH 

The National Council of Urban Indian Health (NCUIH) is the national non-profit organization devoted to the support and development of quality, accessible, and culturally competent health and public health services for American Indians and Alaska Natives (AI/ANs) living in urban areas. NCUIH is the only national representative of the 41 Title V Urban Indian Organizations (UIOs) under the Indian Health Service (IHS) in the Indian Health Care Improvement Act (IHCIA). NCUIH strives to improve the health of the over 70% of the AI/AN population that lives in urban areas, supported by quality, accessible health care centers.