VA Exempts Over 5,000 Native Veterans from Copayments, Reimburses $3 Million: VA Secretary McDonough Highlights Progress at NCUIH Conference

On April 17, 2024, the Department of Veterans Affairs (VA) announced that more than 4,000 Native Veterans have been approved for the VA’s copayment exemption and has exempted and/or reimbursed over 168,000 copayments totaling more than $3 million for Native Veterans. During NCUIH’s Annual Conference on April 30, 2024, VA Secretary Denis McDonough highlighted these new numbers and noted an update – that over 6000 Native Veterans have applied and over 5000 had been approved.


American Indians and Alaska Natives serve in the military at some of the highest rates in the country, and many Native veterans receive healthcare from the Veterans Health Administration (VHA), alongside IHS, Tribal, and urban Indian organization (UIO) facilities. Unfortunately, American Indian and Alaska Native Veterans generally face a higher rate of mental health disorders compared to White veterans.

On April 4, 2023, VA published a final rule in the Federal Register establishing the waiver process for Veterans to submit documentation to have their VA copays waived. This rule implements Section 3002 of the Johnny Isakson and David P. Roe, M.D. Veterans Health Care and Benefits Improvement Act of 2020 Public Law 116-315, signed into law on January 5, 2021, which prohibits collection of a health care copayment by the Secretary of Veterans Affairs from an American Indian and Alaska Native Veteran who meets the definitions of “Indian” or “urban Indian” under the Indian Health Care Improvement Act (IHCIA).

The copayment exemption is a crucial step in honoring the federal government’s trust responsibility to “maintain and improve the health of the Indians” and NCUIH has been a strong advocate for this policy. NCUIH continues to stress that Native Veterans are entitled to this copayment exemption due to the federal government’s responsibility to provide and support services for Native Veterans, fulfilling the trust responsibility for healthcare provisions for all American Indians and Alaska Natives. We remain committed to engaging with the VA on issues affecting American Indian and Alaska Native Veterans in urban areas.

See NCUIH resources on the VA Copayment Exemption for Native Veterans: