A Federal Indian Health Insurance Plan: Fulfilling a solemn obligation to American Indians and Alaska Natives in the United States

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Authors: Vishal Kheptal et al.

Publication Year: 2022

Last Updated:

Journal: Preventive Medicine Reports

Keywords: Appropriations; Budget Proposals; Federal Health Care; Health Disparities; Health Care Reform; IHS; Public Health Insurance

 

Short Abstract: The Indian Health Service (IHS) is but the latest effort to honor the constitutional and treaty commitment made to deliver health care to American Indians and Alaska Natives in the United States. The agency currently serves over 2.5 million American Indians and Alaska Natives through IHS-operated health facilities, as well provides funding support for contractual delivery of health services by Tribes to their constituents. Not unlike its predecessors, however, the IHS is struggling to fulfill its stated mission.

 

Abstract: The Indian Health Service (IHS) is but the latest effort to honor the constitutional and treaty commitment made to deliver health care to American Indians and Alaska Natives in the United States. The agency currently serves over 2.5 million American Indians and Alaska Natives through IHS-operated health facilities, as well provides funding support for contractual delivery of health services by Tribes to their constituents. Not unlike its predecessors, however, the IHS is struggling to fulfill its stated mission. Access to specialty care remains limited through the agency, particularly for Urban Indians, due to limited fiscal support of the Purchase-Referred Care Program. As a result of chronic underfunding stemming from Congressional inaction, the agency faces perennial understaffing and leadership turnover. In addition, the IHS is structurally unprepared to address the progressive urbanization of Alaska Natives and American Indians, more of whom now live in New York City than in North Dakota. Given these challenges, a renewed approach is warranted. In this essay, we review the history of the IHS, examine its current fiscal challenges, outline the ongoing demographic shift of AI/AN toward urban centers, and call for the creation of a Federal Indian Health Insurance Plan. Offered as a benefit to all American Indians and Alaska Natives without cost-sharing, the plan would be applicable both on and off tribal lands. Funded through mandatory appropriations, the plan would significantly increase fiscal support for AI/AN health programs and work to reduce health disparities affecting AI/ANs in the United States.

 

Source: Link to Original Article.

Funding:

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Source: https://www.sciencedirect.com/science/article/pii/S2211335521003600

Type of Resource: Best Practices Newsletter

Making Amends: Recommended Strategies and Actions to Improve the Health and Safety of American Indian and Alaska Native Mothers and Infants

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Authors: U.S. Secretary of Health and Human Services Advisory Committee on Infant and Maternal Mortality (ACIMM)

Publication Year: 2022

Last Updated: December 2022

Journal:

Keywords: Awareness; Ethnicity; Federal Health Care; Health Care Access; Health Disparities; IHS; Infant Mortality; Medicare; Medicaid; Minority Groups; Misclassification of AI/AN; Pregnancy; Women's Health; Social Determinants of Health

 

Short Abstract: Report submitted in to US HHS Secretary with recommendations for the federal government to reconcile past actions and step up to the obligations to American Indians and Alaska Natives (AI/AN). Recommendations are based on the findings of previous reports on the health of AI/AN people, populations, and communities, ACIMM’s analysis of maternal health and birth outcome-related data, presentations by representatives of federal health programs, and the testimony and input of over 88 individuals with relevant lived and professional experience.

 

Abstract: Report submitted in to US HHS Secretary with recommendations for the federal government to reconcile past actions and step up to the obligations to American Indians and Alaska Natives (AI/AN). Recommendations are based on the findings of previous reports on the health of AI/AN people, populations, and communities, ACIMM’s analysis of maternal health and birth outcome-related data, presentations by representatives of federal health programs, and the testimony and input of over 88 individuals with relevant lived and professional experience. 59 strategies are offered to support three overarching recommendations: I. Make the health and safety of AI/AN mothers and infants a priority for action. II. Improve the living conditions of AI/AN mothers and infants and assure universal access to high quality healthcare III. Address urgent and immediate challenges that disproportionately affect AI/AN women before, during, and after pregnancy.

 

Source: Link to Original Article.

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Source: https://www.hrsa.gov/sites/default/files/hrsa/advisory-committees/infant-mortality/birth-outcomes-AI-AN-mothers-infants.pdf

Type of Resource: Report

American Indian Health Policy: Historical Trends and Contemporary Issues

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Authors: Donald Warne and Linda Bane Frizzell

Publication Year: 2014

Keywords: Federal Health Care; Health Care Access; Health Care Reform; IHS; Medicare; Medicaid; Affordable Care Act

 

Short Abstract: The United States has a trust responsibility to provide services to American Indians and Alaska Native (AI/AN) persons. However, a long-standing history of underfunding of the Indian Health Service (IHS) has led to significant challenges in providing services. Twentieth-century laws, including the Snyder Act, Transfer Act, Indian Self Determination and Education Assistance Act, and Indian Health Care Improvement Act (IHCIA) have had an effect on the way health services are provided. IHCIA was reauthorized as part of the Patient Protection and Affordable Care Act (ACA). Several provisions in ACA allow for potential improvements in access to services for AI/AN populations and are described herein. Although policy developments have been promising, IHS underfunding must be resolved to ensure improved AI/AN health.

 

Source: Link to Original Article.

Funding:

Type of Resource: Peer-reviewed scientific article

National Indian Heath Board 51 State Health Insurance Status Report

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Authors: National Indian Health Board

Publication Year: 2022

Last Updated: October 2022

Keywords: General Materials; Health Care Access; Health Disparities; Health Care Reform; Medicare; Medicaid; Insurance; Affordable Care Act; Social Determinants of Health

 

Short Abstract: This report from the National Indian Health Board details the enrollment of the AI/AN population in Medicare and Medicaid, as well as the AI/AN population that was uninsured between 2012-2020. This also offers a breakdown of this by each state and DC and the percent changes in enrollment over the 2012-2020 period. This report provides a view into the percent change in insurance enrollment of the AI/AN population before implementing the Affordable Care Act in 2013 and after.

 

Source: Link to Original Article.

Source: https://www.nihb.org/tribalhealthreform/wp-content/uploads/2022/11/NIHB-2022-State-Enrollment-Report-_FINAL.pdf

Type of Resource: NCUIH data products

Medicaid’s Role in Health Care for American Indians and Alaska Natives

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Authors: Medicaid and CHIP Payment and Access Commission

Publication Year: 2021

Last Updated: February 2021

Journal: MACPAC IssueBrief

Keywords: Health Care Access; Medicaid

 

Short Abstract: This brief provides an overview of the relationship between the federal government and AIAN people in the United States and provides a snapshot of the AIAN people in terms of demographics, economic and health disparities, and access to health coverage and care. It then describes the structure of the IHS, including eligibility criteria, delivery system, and financing sources. It goes on to detail the special Medicaid rules and protections that apply to AIAN beneficiaries and Indian health providers. Finally, it discusses some of the key policy issues affecting Medicaid’s relationship with the IHS and in serving the AIAN population.

 

Source: Link to Original Article.

Source: https://www.macpac.gov/wp-content/uploads/2021/02/Medicaids-Role-in-Health-Care-for-American-Indians-and-Alaska-Natives.pdf